JP4456607B2 - 骨固定アセンブリおよび取り付けの方法 - Google Patents
骨固定アセンブリおよび取り付けの方法 Download PDFInfo
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- JP4456607B2 JP4456607B2 JP2006541150A JP2006541150A JP4456607B2 JP 4456607 B2 JP4456607 B2 JP 4456607B2 JP 2006541150 A JP2006541150 A JP 2006541150A JP 2006541150 A JP2006541150 A JP 2006541150A JP 4456607 B2 JP4456607 B2 JP 4456607B2
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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
- A61B17/7059—Cortical plates
-
- 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
-
- 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
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/8023—Variable length plates adjustable in both directions
-
- 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
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/8033—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers
- A61B17/8047—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers wherein the additional element surrounds the screw head in the plate hole
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
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- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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- Surgical Instruments (AREA)
- Prostheses (AREA)
Description
本発明は、一般に、脊椎固定システムに関する。より詳細には、本発明は、所望の角度でプレートに骨固定ねじを固定して取り付け、そしてロックするため、および、そうでなければ、このプレートの調節可能な部分を同時にロックするための機構を含む脊椎プレートアセンブリに関する。
腰椎および胸椎に対する脊椎手術は、古典的には開放手術であり、用いられる器具が、機器が配置される脊椎のすべて、および適正な可視化の必要性に起因して装置が配置されるべき領域の上または下の部分を剥き出す切開を通じて配置されることを意味する。この広範囲に剥き出すことは、相当な量の組織、特に、腰部傍脊椎筋肉組織を破壊し、これは、剥き出すために椎骨から剥ぎ取られる必要がある。この剥ぎ取ることは、電気的焼灼または手動切断のいずれかにより直接に、または血管の凝固または切断に起因する筋肉への血管供給の中断により間接的に引き起こされる筋肉損傷に至り、そしてまた、剥き出しを維持するために必要である筋肉に対する開創器による圧縮に起因する手術の経過の間の血管供給の困惑によってまた引き起こされる。さらに、脊椎インプラントは、脊椎の椎間関節、特に椎弓根ねじの最上部のペアに衝撃を与え得、これは、関与する関節の痛みまたは機能障害を引き起こし得る。これは、椎弓根ねじシステムが個々の通常の解剖学になされることなく安定性を与えるように設計されているという事実に一部起因する。換言すれば、金属が脊椎に適合する代わりに、脊椎が金属に適合されている。
本発明の骨固定アセンブリは、プレートを下にある骨に取り付けるための固定ねじのねじ山のあるシャフトを挿入するための貫通通路を有する骨プレートを含む。このねじ山のあるねじシャフトは、この骨プレートの貫通通路中に位置するブッシングを通じて挿入され、下にある骨中に通されて取り付けられる。このブッシングは、このプレートの貫通通路中のブッシングを回転することにより作動されるカムでねじのヘッドに対して圧縮されるような形態および寸法であり、それによって、このねじは、上記骨プレートに対してロックされる。このブッシングはまた、その他の調節可能な骨プレートの別個の要素を一緒にクランプ留めしてそれらを固定してロックするために、同時にシート中に下方に圧縮され得る。
図1および2をまず参照して、本発明の骨固定アセンブリ10は、脊椎の安定化のために提供され、そして脊椎の固定のためにプレートアセンブリの最小侵襲性外科的移植のためにその中の発明的手順における使用についての本発明者らの前述の同時係属中の出願に示され、かつ記載されるインプラントプレートアセンブリの改良された改変物である。このアセンブリ10は、2つの別個の部分、第1の部分11および第2の部分12からなり、これらは、一緒に調節可能に組み立てられる。この第1の部分11は、アセンブリ10の遠位端14に第1の受容ソケット要素13を含む。この第1の受容ソケット要素13は、図2に見られるように、骨固定ねじ23の支援で椎骨への要素13の取り付けのために、通路15を通る、ねじシャンクを備えた形態である。図1の平面図は、要素12および13のねじシャンク貫通通路の内部の剥き出た図を提供するために、図2に含まれる骨固定ねじ、およびその他の内部部分を含まない。
に相補し得る。追従カム面41そしてまた要素12の半径方向に面するカム面49には、相補的リッジが提供され得、ブッシング30がその場にロックされた後、その回転戻りを防ぐ。
Claims (12)
- 骨固定アセンブリであって:
(a)貫通通路を有する固定デバイス;
(b)該貫通通路を通る挿入、および骨中へのねじによる挿入のための、ねじ山のあるシャフト、ならびに球切頭形状の側面を有するねじヘッドを有する固定ねじ;
(c)(i)上面および下面;(ii)該固定デバイスの貫通通路内で軸方向の回転のための形態および寸法の外面、および該上面および下面を通って延びるソケットボアを規定し、およびその中で該ねじヘッドの多軸方向回転のための形態および寸法である内面を備えた側壁;(iii)該ねじヘッドに対する該ソケットボアの内方圧縮を可能にするために該側壁上に位置する少なくとも1つのスロット;および(iv)該ソケットボアへの接近のための該ねじヘッドをそれを通って受容するための寸法である、該上面中の接近通路;を有するブッシング;
(d)該貫通通路と該ブッシングとの間に配置され、そして該貫通通路中のその軸方向回転に際し、該ブッシングを内方に圧縮するための形態および寸法であるカム手段であって、それによって、該ソケットボアが、該固定ねじを該固定デバイスに対して所望の姿勢でロックするために該ねじヘッドに対して圧縮され、該ブッシングが該貫通通路中で軸方向に回転されるとき、該ソケットボアを内方に圧縮するための寸法および形態である該ブッシングの外面上で半径方向に延びるランプカムを含むカム手段、を備える、骨固定アセンブリ。 - 前記ブッシングソケットボアが、中心長軸方向軸を備えた球切頭形状を有する、請求項1に記載の骨固定アセンブリ。
- 前記ソケットボアが、前記ブッシングの中心軸を通って延び、そして前記上面および下面に垂直である、請求項2に記載の骨固定アセンブリ。
- 前記少なくとも1つのスロットの1つが、前記上面から前記下面を通って前記側壁を完全に通って延びるスロットであり、前記接近通路が、該接近通路を拡大することによりスナップ係合で、前記ねじヘッドをそれを通って受容するための寸法である、請求項3に記載の骨固定アセンブリ。
- 前記貫通通路の底部分が、逆円錐台形状のシートを有し、そして前記ブッシングの外面が、該シート中に静止するための形態および寸法である嵌合逆円錐台形状のベースを有し、該シートおよび該ベースが前記中心軸と同軸であり、前記カム手段が、該ブッシングの上面上で環状方向に間隔を置かれて上方に延びるランプカムからなり、そして前記接近通路が、該上面上に位置決めされた該貫通通路上の内方に延びるオーバーハングを含み、かつ該ブッシングが該貫通通路中で軸方向に回転されるとき該ランプカムを係合するための形態および寸法である下方に面するカム追従面を有し、それによって、該ブッシングが、該ランプカムによって該シート中に下方に駆動され、それによって、前記ブッシングボアを前記ねじヘッドに対して内方に圧縮する、請求項4に記載の骨固定アセンブリ。
- 前記カム手段が、前記カムの少なくとも1つの上にリッジを含む、請求項5に記載の骨固定アセンブリ。
- 前記貫通通路の底部分が、逆円錐台形状のシートを有し、そして前記ブッシングの外面が、該シート中に静止するための形態および寸法である嵌合逆円錐台形状のベースを有し、該シートおよび該ベースが前記中心軸と同軸であり、前記カム手段が、該貫通通路の底部分と、該ブッシングのベースとの間のねじによる係合からなり、それによって、該ブッシングが、該貫通通路のシート中で回転するとき、該ブッシングが該シート中に引かれ、そしてそれによって、前記ねじヘッドに対して内方に圧縮される、請求項4に記載の骨固定アセンブリ。
- 前記ねじによる係合が、左巻きねじの形態である、請求項7に記載の骨固定アセンブリ。
- 請求項1に記載の骨固定アセンブリであって、前記固定デバイスが、該アセンブリの遠位端に、そして骨固定ねじの支援で骨への取り付けのためにねじシャンク通路およびねじヘッドシートを備えた形態である第1のねじ受容ソケット要素、該第1のソケット要素から近位方向に延び、そしてそれに沿って細長い貫通スロットを有する細長いアーム、前記ブッシングおよび前記カム手段を含む貫通通路を含み、そして骨への取り付けのためにそれを通る固定ねじのシャンクを受容するための前記ソケットボアを該細長い貫通スロット上で整列させて該アーム上にスライド可能に受容される第2のねじ受容ソケット要素を有する骨プレートであり、該ブッシングのシートが、該細長い貫通スロットの部分を含み、それによって、該第2のソケット要素が、該ブッシングが該カム手段によって該シート中に下方に押されるとき、該アームに押しつけられる、骨固定アセンブリ。
- 貫通通路を有する骨プレートを骨に固定するためのシステムであって:
貫通通路中に挿入するように構成されたブッシング;
ねじヘッドおよびねじ山のあるシャフトを有する固定ねじであって、該シャフトは、該骨プレートの貫通通路中に位置する該ブッシングを通って挿入されるように構成されている、固定ねじ;
を備え、
該固定ねじは、骨に通されると、該ねじヘッドが該ブッシング中の内部ソケットボア中に引かれるように構成されており;そして
該ブッシングは、半径方向に延びるランプカムをさらに備え、該ランプカムは、該貫通通路中で該ブッシングを回転することによって作動され、該カム手段の作動は、該ブッシングを、該ねじヘッドに対して内方に圧縮し、それによって、該ねじが該骨プレートに対してロックされる、システム。 - 前記カム手段がまた、前記ブッシングをシート中に下方に圧縮して、前記骨プレートの別個の要素を一緒に押しつける、請求項10に記載のシステム。
- 前記ねじが、時計方向に回転することによって該骨内に入るように構成されており、そして前記ブッシングが、該ブッシングを反時計方向に回転することによって該カム手段を作動させるように構成されている、請求項10に記載のシステム。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/731,625 US6945975B2 (en) | 2003-07-07 | 2003-12-09 | Bone fixation assembly and method of securement |
US10/815,160 US6979334B2 (en) | 2003-07-07 | 2004-03-31 | Bone fixation assembly and method of securement |
PCT/US2004/032798 WO2005060845A1 (en) | 2003-12-09 | 2004-10-06 | Bone fixation assembly and method of securement |
Publications (2)
Publication Number | Publication Date |
---|---|
JP2007512085A JP2007512085A (ja) | 2007-05-17 |
JP4456607B2 true JP4456607B2 (ja) | 2010-04-28 |
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Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
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JP2006541150A Expired - Fee Related JP4456607B2 (ja) | 2003-12-09 | 2004-10-06 | 骨固定アセンブリおよび取り付けの方法 |
Country Status (10)
Country | Link |
---|---|
US (4) | US6945975B2 (ja) |
EP (1) | EP1691699B1 (ja) |
JP (1) | JP4456607B2 (ja) |
CN (1) | CN100435743C (ja) |
AU (1) | AU2004305481B2 (ja) |
BR (1) | BRPI0417500B1 (ja) |
CA (1) | CA2548504C (ja) |
ES (1) | ES2404031T3 (ja) |
HK (1) | HK1099504A1 (ja) |
WO (1) | WO2005060845A1 (ja) |
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-
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- 2003-12-09 US US10/731,625 patent/US6945975B2/en not_active Expired - Lifetime
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2004
- 2004-03-31 US US10/815,160 patent/US6979334B2/en not_active Expired - Lifetime
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- 2004-10-06 EP EP04785377A patent/EP1691699B1/en not_active Not-in-force
- 2004-10-06 BR BRPI0417500A patent/BRPI0417500B1/pt not_active IP Right Cessation
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- 2004-10-06 JP JP2006541150A patent/JP4456607B2/ja not_active Expired - Fee Related
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US6945975B2 (en) | 2005-09-20 |
US6979334B2 (en) | 2005-12-27 |
AU2004305481A1 (en) | 2005-07-07 |
WO2005060845A1 (en) | 2005-07-07 |
WO2005060845A8 (en) | 2005-11-03 |
EP1691699A4 (en) | 2010-07-07 |
JP2007512085A (ja) | 2007-05-17 |
CA2548504A1 (en) | 2005-07-07 |
BRPI0417500B1 (pt) | 2015-12-22 |
US20050010218A1 (en) | 2005-01-13 |
US20060015104A1 (en) | 2006-01-19 |
BRPI0417500A (pt) | 2007-06-05 |
US20050010219A1 (en) | 2005-01-13 |
CN100435743C (zh) | 2008-11-26 |
CN1889891A (zh) | 2007-01-03 |
ES2404031T3 (es) | 2013-05-23 |
HK1099504A1 (en) | 2007-08-17 |
US20050267474A1 (en) | 2005-12-01 |
EP1691699A1 (en) | 2006-08-23 |
CA2548504C (en) | 2012-07-03 |
EP1691699B1 (en) | 2012-12-26 |
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