JP4047112B2 - 椎骨連結部材のロッド部固定構造 - Google Patents

椎骨連結部材のロッド部固定構造 Download PDF

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JP4047112B2
JP4047112B2 JP2002267298A JP2002267298A JP4047112B2 JP 4047112 B2 JP4047112 B2 JP 4047112B2 JP 2002267298 A JP2002267298 A JP 2002267298A JP 2002267298 A JP2002267298 A JP 2002267298A JP 4047112 B2 JP4047112 B2 JP 4047112B2
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rod
rod portion
screw
vertebra
connecting member
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JP2004097705A (ja
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信正 鈴木
裕 野原
進之介 中原
栄修 佐藤
和正 植山
和宏 長谷川
一弥 織部
洋 高御堂
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昭和医科工業株式会社
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Priority to JP2002267298A priority Critical patent/JP4047112B2/ja
Priority to KR1020030062793A priority patent/KR100614143B1/ko
Priority to US10/659,302 priority patent/US8048112B2/en
Priority to EP08016285A priority patent/EP2011445B1/en
Priority to EP03020808A priority patent/EP1402828B1/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7004—Longitudinal elements, e.g. rods with a cross-section which varies along its length
    • A61B17/7005—Parts of the longitudinal elements, e.g. their ends, being specially adapted to fit in the screw or hook heads
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7032—Screws or hooks with U-shaped head or back through which longitudinal rods pass
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7035—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • A61B17/7037—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other wherein pivoting is blocked when the rod is clamped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7011—Longitudinal element being non-straight, e.g. curved, angled or branched
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7047—Clamps comprising opposed elements which grasp one vertebra between them
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7056—Hooks with specially-designed bone-contacting part
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A61B2017/00858—Material properties high friction or non-slip

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  • Health & Medical Sciences (AREA)
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  • Surgical Instruments (AREA)
  • Prostheses (AREA)
  • Table Equipment (AREA)
  • Mutual Connection Of Rods And Tubes (AREA)
  • Clamps And Clips (AREA)

Description

【０００１】
【発明の属する技術分野】
本発明は、脊椎における椎骨を一体的に連結するためのロッド部材等のロッド部を固定する固定構造に係り、さらに詳細には、前記ロッド部材等の軸方向の位置ずれ及び軸心回りの回転方向への位置ずれを防止することのできるロッド部固定構造に関する。
【０００２】
【従来の技術】
従来、椎骨における椎体に螺入埋設するネジ部を備えたスクリューの頭部に、離隔した椎体を連結するためのロッド部材等の連結部材におけるロッド部を係合可能の溝、長穴等のロッド係合部を備え、このロッド係合部に、ロッド係合部に係合したロッド部を押圧固定自在の止めネジ等のごとき押圧固定具を備えた構成が採用されている。
【０００３】
上記構成においては、スクリューの頭部に対してロッド部の位置ずれを生じることがあるので、上記位置ずれを防止することが望まれている。
【０００４】
そこで、図５に示すように、椎体に螺入埋設するネジ部１０１を備えたスクリュー１０３の頭部１０５に形成した溝状のロッド係合部１０７に拡大係合凹部１０９を形成し、この拡大係合凹部１０９に、連結部材１１１のロッド部に形成した拡大係合凸部１１３を係合した後、前記ロッド係合部１０７に、止めネジ等のごとき押圧固定具１１５を係合する構成がある（例えば特許文献１）。
【０００５】
【特許文献１】
特表平１１−５０９４５３号公報
【０００６】
【発明が解決しようとする課題】
前述のごとき従来の構成においては、スクリュー１０３における頭部１０５のロッド係合部１０７から連結部材１１１が軸方向に位置ずれを生じることが防止できるものの、スクリュー１０３の設置位置と連結部材１１１に形成した拡大係合凸部１１３との位置とを一致せしめる必要があり、汎用性に欠けるきらいがある。また連結部材１１１の製造が厄介であると共に、従来の一般的なロッド等に適用することができない等の問題がある。
【０００７】
【課題を解決するための手段】
本発明は、前述のごとき従来の問題に鑑みてなされたもので、請求項１に係る発明は、離隔した椎骨を連結するための椎骨連結部材のロッド部を固定するための構造であって、前記ロッド部と係合自在の円弧状のロッド係合部に対して前記ロッド部を押圧固定自在の押圧固定具を備え、この押圧固定具よりも外側の前記ロッド係合部の両端側に、前記ロッド部を銜え込み可能の鋭角をなす微小突出部を備え、前記押圧固定具による押圧固定時に前記ロッド部は、前記両微小突出部の間で微小量曲げられる構成であり、前記ロッド係合部に備えた前記微小突出部の間のロッド係合部の凹面を、前記ロッド部が接触したときの摩擦を大きくするために荒面に形成してある。
【０００９】
【発明の実施の形態】
図１を参照するに、図１には、椎骨連結部材の固定を行うためのインプラントの１例として、椎骨に螺入埋設するスクリューの場合について例示するが、上記インプラントとしてはスクリューに限ることなく、椎骨の椎弓や棘突起に係止する係止部を備えたフックにも適用可能なものである。
【００１０】
本実施の形態に係るスクリュー１は、椎骨（図示省略）における椎体に螺入埋設するネジ部３を備えると共に、このスクリュー１に備えた頭部５には、椎骨連結部材７におけるロッド部７Ｒを係合自在の円弧状のロッド係合部９を備えた係合孔又は係合溝１１が形成してある。より詳細には、前記ロッド係合部９は前記係合溝１１の底部に形成してあり、かつ固定すべき椎骨連結部材７のロッド部７Ｒの径に対応した半円弧に形成してある。
【００１１】
そして、前記係合溝１１には、当該係合溝１１に係合した椎骨連結部材７のロッド部７Ｒを前記ロッド係合部９に対して押圧固定する押圧固定具の一例としての固定ネジ１３が着脱可能に螺合してある。前記固定ネジ１３によって前記ロッド部７Ｒを強固に押圧固定したときに、前記ロッド部７Ｒを銜え込み可能な鋭角の微小突出部１５が前記固定ネジ１３の外側で前記ロッド係合部９の両端部側に形成してある。そして、前記両側の微小突出部１５の間の前記ロッド係合部９の凹面は、前記ロッド部７Ｒが接触したときの摩擦が大きくなるように、例えば、サンドブラスト等による荒面に形成してある。
【００１２】
上記構成により、スクリュー１におけるネジ部３を椎骨における椎体に螺入埋設し、当該スクリュー１の頭部５に備えた係合溝１１に椎骨連結部材７のロッド部７Ｒを係合し、固定ネジ１３によって前記ロッド部７Ｒを、係合溝１１の底部のロッド係合部９に強固に押圧固定すると、ロッド係合部９の両端側に備えた微小突出部１５と固定ネジ１３の三点が前記ロッド部７Ｒに作用することとなり、前記微小突出部１５が前記ロッド部７Ｒを強固に銜え込むと、ロッド部７Ｒの表面に擦り傷を生じる程度に微少量食込む態様になると共に、前記ロッド部７Ｒは前記両微小突出部１５の間で微少量曲げられる態様となり、ロッド部７Ｒはロッド係合部９の荒面に接触することになる。
【００１３】
したがって、スクリュー１における頭部５に対して椎骨連結部材７の前記ロッド部７Ｒが軸方向に位置ずれを生じることが防止されると共に、前記ロッド部７Ｒが軸心回りに回動することによる位置ずれが防止されるものである。また、前記ロッド部７Ｒは単なる丸棒状で良いものであり、ロッド部７Ｒの所望位置を係合固定することが可能であって、前述したごとき従来の問題を解消し得るものである。
【００１４】
図２は第２実施形態を示すもので、この第２の実施の形態において、前記実施形態と同一機構を奏する構成部分には同一符号を付することとして重複した説明は省略する。
【００１５】
この第２の実施形態においては、ネジ部３を備えたスクリュー１７の頭部１７Ｈを球体部に形成し、この球体部に、前記係合溝１１に相当する係合溝１９を備えた係合頭部２１を揺動可能に係合し、かつ前記係合溝１９の底部に、ロッド部との接触面を荒面に形成したロッド係合部２３を備えた底部材２５を備えた構成である。
【００１６】
上記底部材２５は前記スクリュー１７の頭部１７Ｈと係合可能な空孔２７Ｈを備えた筒状の係合突出部２７の上部に樋状の前記ロッド係合部２３を備えた構成であって、このロッド係合部２３の両端部に、前記微小突出部１５と同様の微小突出部２９が形成してある。
【００１７】
上記構成により、スクリュー１７に対して係合頭部２１を任意、所望方向に揺動することができ、支持固定すべき椎骨連結部材７のロッド部７Ｒの傾斜等に容易に対応できるものである。
【００１８】
前記構成において、係合溝１９に前記椎骨連結部材７のロッド部７Ｒを係合し、固定ネジ１３を締付けることにより、底部材２５のロッド係合部２３に備えた微小突出部２９でもって前記ロッド部７Ｒを強固に銜え込むことができ、前述同様の効果を奏し得るものである。また、前記固定ネジ１３を強固に締付けると、前記底部材２５の前記空孔２７Ｈの部分がスクリュー１７の頭部１７Ｈに強固に押圧固定されるものであって、椎骨連結部材７を所定位置に固定支持することができるものである。
【００１９】
図４は第３の実施形態を示すものである。この第３の実施の形態においては、椎骨における椎弓へ引掛け自在のフック３１を備えたブロック３３に、前記係合溝１１に相当する係合溝３５を備えると共に固定ネジ３６Ａを螺合自在の雌ネジ部３６Ｂを備え、かつ前記係合溝３５の荒面の底部の両端側に、前記微小突出部１５に相当する微小突出部３７を備えた構成である。そして、椎骨連結部材３９としては、椎骨における棘突起に引掛け自在のフック４１をロッド部４３の先端部に備えた構成である。
【００２０】
上記構成によれば、フック４１を椎骨の棘突起に引掛けた椎骨連結部材３９のロッド部４３をブロック３３の係合溝３５に係合し、当該ブロック３３の雌ネジ部３６Ｂに固定ネジ３６Ａを締付け、前記ロッド部４３を係合溝３５の底部へ強固に押圧固定することにより、前述した実施形態と同様の効果を奏し得るものである。
【００２１】
【発明の効果】
以上のごとき説明より理解されるように、本発明によれば、椎骨連結部材のロッド部を係合自在のロッド係合部の両端側に、上記ロッド部を銜え込み可能の微小突出部を備えたことにより、押圧固定具によって前記ロッド部を前記ロッド部係合部に押圧固定すると、前記微小突出部がロッド部を強固に銜え込む態様となり、前記ロッド部の位置ずれ発生を防止して固定することができるものであり、前述したごとき従来の問題を解消し得るものである。
【図面の簡単な説明】
【図１】本発明の第１実施形態としてスクリューに適用した場合を示す説明図である。
【図２】本発明の第２実施形態としてスクリューに適用した場合を示す説明図である。
【図３】同上の実施部分の説明図である。
【図４】フックに実施した場合を示す説明図である。
【図５】従来の構成を示す説明図である。
【符号の説明】
１…スクリュー
３…ネジ部
５…頭部
７…椎骨連結部材
７Ｒ…ロッド部
９…ロッド係合部
１１…係合溝
１３…固定ネジ
１５…微小突出部
１９…係合溝
２３…ロッド係合部
２５…底部材
２９…微小突出部
３３…ブロック
３５…係合溝
３７…微小突出部
３９…椎骨連結部材
４３…ロッド部

Claims (1)

  1. 離隔した椎骨を連結するための椎骨連結部材のロッド部を固定するための構造であって、前記ロッド部と係合自在の円弧状のロッド係合部に対して前記ロッド部を押圧固定自在の押圧固定具を備え、この押圧固定具よりも外側の前記ロッド係合部の両端側に、前記ロッド部を銜え込み可能の鋭角をなす微小突出部を備え、前記押圧固定具による押圧固定時に前記ロッド部は、前記両微小突出部の間で微小量曲げられる構成であり、前記ロッド係合部に備えた前記微小突出部の間のロッド係合部の凹面を、前記ロッド部が接触したときの摩擦を大きくするために荒面に形成してあることを特徴とする椎骨連結部材のロッド部固定構造。
JP2002267298A 2002-09-12 2002-09-12 椎骨連結部材のロッド部固定構造 Expired - Lifetime JP4047112B2 (ja)

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JP2002267298A JP4047112B2 (ja) 2002-09-12 2002-09-12 椎骨連結部材のロッド部固定構造
KR1020030062793A KR100614143B1 (ko) 2002-09-12 2003-09-08 척추뼈연결부재의 로드부 고정기구
US10/659,302 US8048112B2 (en) 2002-09-12 2003-09-11 Rod fixing apparatus for vertebra connecting member
EP08016285A EP2011445B1 (en) 2002-09-12 2003-09-12 Rod fixing apparatus for vertebra connecting member
EP03020808A EP1402828B1 (en) 2002-09-12 2003-09-12 Rod fixing apparatus for vertrebra connecting member

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JP2002267298A JP4047112B2 (ja) 2002-09-12 2002-09-12 椎骨連結部材のロッド部固定構造

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KR20040024492A (ko) 2004-03-20
EP1402828A2 (en) 2004-03-31
EP1402828B1 (en) 2012-07-18
KR100614143B1 (ko) 2006-08-18
US20040122425A1 (en) 2004-06-24
EP2011445A3 (en) 2009-01-14
US8048112B2 (en) 2011-11-01
EP2011445A2 (en) 2009-01-07
EP1402828A3 (en) 2005-12-07
EP2011445B1 (en) 2012-01-25
JP2004097705A (ja) 2004-04-02

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