JP5124739B2 - 自在継手を有する骨コネクタ - Google Patents
自在継手を有する骨コネクタ Download PDFInfo
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- JP5124739B2 JP5124739B2 JP2008511334A JP2008511334A JP5124739B2 JP 5124739 B2 JP5124739 B2 JP 5124739B2 JP 2008511334 A JP2008511334 A JP 2008511334A JP 2008511334 A JP2008511334 A JP 2008511334A JP 5124739 B2 JP5124739 B2 JP 5124739B2
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- bone
- screw
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- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
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Landscapes
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Description
本出願は、2005年5月10日に出願された米国仮特許出願第60/679,710号明細書;2005年6月21日に出願された米国仮特許出願第60/701,891号明細書;及び“自在継手を有する骨コネクタ”という発明の名称でMatthew C. Sucec及びThomas C. Tullerを発明者として2006年5月9日に出願された米国特許出願第11/431,740号明細書に基づいた優先権を主張するものである。これら明細書は、参照により本明細書に組み込まれる。
本発明の接続される骨コネクタは、互いに対して相対的に移動可能であり、且つ任意の適切な構造を有する2つ又は複数の構成要素を含むことができる。その構成要素は、各アンカー要素の除去に抵抗するために骨を係合することができる2つ又は複数の別個のアンカー構成要素を含んでもよい。各アンカー要素は、単一の部品(1つの部品)でもよく、互いに固定される2つ又は複数の部品のような、2つ又は複数の部品で形成されてもよい。接続される骨コネクタは、アンカー要素及び/又は骨コネクタの一方又は両方の端部に近接してアンカー要素を側面に位置している1つ又は複数の端部構成要素の間に配置された1つ又は複数の別個のスペーサー構成要素のような、1つ又は複数の別個の構成要素を含むこともできる。
各アンカー要素は、任意の適切な保持機構を有することができる。アンカー要素は、骨内に配置することによって及び/又は骨に配置した後で作動される保持機構を含むことができる。接続される骨コネクタのアンカー要素は、(例えば、雄ねじ部を有する各保持機構のような)同型の保持機構を有することができ、又は(例えば、雄ねじ部を有する一の保持機構及び骨と非螺合で係合する他の保持機構のような)異なる型の保持機構を有することができる。
接続される骨コネクタのアンカー要素は、任意の適切な接続部によって接続されることができる。接続部は、アンカー要素の間で移動可能な接続部であってもよく、併設された接続部構成要素の相対的な滑り運動(回動運動及び/又は並進運動)によって操作している。接続部は、アンカー要素の相対的な回動運動及び/又は並進運動を可能にする一方、骨を無い場合アンカー要素の完全な分離を制限するように操作することができる。接続部は、アンカー要素の間の単一の連結部であってもよく、又は2つ又は複数の別個の移動可能な接続部によって集団的に形成された複合の連結部であってもよい。
接続された骨コネクタは、骨内にコネクタを容易に駆動するために、ドライバーと係合するための1つ又は複数の構造を有することができる。例えば、アンカー要素の1つのアンカー要素だけが(例えば、例5に示すように)ドライバー係合構造を有することができ、又はコネクタの各アンカー要素は(例えば、例1−3に示すように)ドライバー係合構造を有することができる。コネクタのドライバー係合構造の断面は、(例えば、例2及び3に示すように)同一の大きさ及び形状を有することができ、又は(例えば、例1に示すように)異なる大きさ及び形状を有することができる。それに応じて、ドライバー係合構造は、一緒にアンカー要素を回転するように、同一のドライバーで同時に係合されることができ、又は、少なくとも1つのドライバー係合構造は、(例えば、より大きな空隙又はより少ない空隙のために骨部材の間の空隙を調整するために)アンカー要素の選択的な回転のために、選択的に係合されることができる。
コネクタは、任意の適切な生態適合(biocompatible)材料及び/又は生態再吸収(bioresorbable)材料から形成されることができる。典型的な生態適合材料は、(1)金属(例えば、チタニウム又はチタニウム合金;コバルトとクロムの合金(コバルトクロム合金);ステンレス鋼;等);(2)プラスチック(例えば、超高分子ポリエチレン(UHMWPE)、メタクリル樹脂(PMMA)、フッ素樹脂(PTFE)、ポリエーテルエーテルケトン(PEEK)、及び/又はポリメタクリル酸ヒドロキシエチル(PHEMA));(3)セラミックス(例えば、特にアルミナ、ベリリア(beryllia)、リン酸カルシウム(calcium phosphate)、及び/又は、ジルコニア(zirconia));(4)複合材料;(5)生態再吸収(生態吸収(bioabsorbable))材料又は高分子化合物(例えば、((ポリL乳酸(PLLA)、ポリDL乳酸(PDLLA)、及び/又はポリD乳酸(PDLA)のような)ポリ乳酸、ポリグリコール酸、ラクチド/グリコール酸共重合体(lactide/glycolide copolymers)等)α―ヒドロキシカルボン酸(α-hydroxy carboxylic acids)、ポリジオキサノン(polydioxanones)、ポリカプロラクトン(polycaprolactone)、ポリトリメチレン・カーボネート(polytrimethylene carbonate)、ポリエチレングリコール、ポリ―β―ヒドロキシ酪酸(poly-β-hydroxybutyrate)、ポリ―β―ヒドロキシプロピオン酸(poly-β- hydroxypropionate)、ポリ―δ―バレロラクトン(poly-δ-valerolactone)、PHB−PHVクラスのポリ(ヒドロキシ酪酸(hydroxyalkanoate))、別の生態再吸収ポリエステル、及び/又は(コラーゲン及び/又は他のポリペプチド、(例えば、スターチ、セルロース、及び/又はキトサン)多糖類などの)天然高分子、その任意の共重合体等);(6)骨組織(例えば、骨の粉及び/又は骨の破片);及び/又は同様のものを含む。いくつかの例において、それらの材料は、アンカー要素の本体を形成することができ、及び/又はアンカー要素上に被膜を形成すること
ができる。コネクタのアンカー要素は、同一の材料又は異なる材料から形成されることができる。異なる材料を備える典型的な構成は、特に、チタニウム合金から形成されたトレーリングアンカー要素及びコバルトクロム(又は、逆にクロムコバルト)から形成されたリーディングアンカー要素を備える金属から形成されたコネクタを含み、又は金属から形成されたトレーリングアンカー要素及びプラスチックの生態再吸収材料から形成されたリーディングアンカー要素を備える(又は、逆に金属から形成されたリーディングアンカー要素及びプラスチックの生態再吸収材料から形成されたトレーリングアンカー要素を備える)コネクタを含む。
本発明の接続された骨コネクタは、任意の適切なプロセスによって組み立てられることができる。例えば、各接続された骨コネクタのアンカー要素は、別々に形成されることができ、その後互いに接続されることができる。その代わりに、アンカー要素は、アンカー要素が接続された後に少なくとも部分的に形成されることができる。
本発明の接続される骨コネクタは、任意の適切な方法によって挿入されることができる。実行可能な典型的なステップは、以下に記載される。それらのステップは、任意の適切な順序、任意の適切な組み合わせ、及び任意の適切な回数で実行されることができる。
本発明の接続された骨コネクタは、キットで提供されることができる。キットは、(1)同一の大きさ及び/又は異なる大きさの複数の接続される骨コネクタ、(2)接続される骨コネクタを受容するための孔を形成するためのドリル及び/又は別の工具、(3)骨から接続された骨コネクタを挿入及び/又は除去するためのドライバー及び/又は(把持工具のような)別の工具、(4)必要に応じて、接続された骨コネクタ、ドリル、及び/又はドライバーを受容し、及び/又は案内するためのワイヤー、及び/又は、(5)キットの別の構成要素を保持又は整理するためのケース、を含むことができる。キットの構成要素は、消毒及び/又は殺菌可能(例えば、加圧殺菌可能)であることができる。いくつかの例において、接続された骨コネクタ及び/又はワイヤーのようなキットの構成要素は、一回の使用を意図されることができる。いくつかの例において、ドリル及び/又はドライバーのようなキットの構成要素は、繰り返しの使用を意図されることができ、又は繰り返しの使用に適している。
以下の例は、自在継手を備える骨コネクタを使用して、骨及び/又は骨の破片を接続するために選択されたシステムの態様及び実施形態を記載する。それらの例は、図面のために含まれ、本発明の全技術範囲を制限又は画定するものでない。
この例は、図4〜8に示すように、接続された骨ねじ116の選択された態様を記載する。さらに、骨ねじ116の追加の態様は、図3に関連して上記に記載される。
この例は、図9〜11に示すように、自在継手を有する別の典型的な骨ねじを記載する。
この例は、図12に示すように回転可能な接続部と共にさら別の典型的な骨ねじ240を記載する。
この例は、図13に示すように、ねじ要素の並進運動の役割を可能にする自在継手を備える典型的な骨ねじ260を記載する。
この例は、図14〜15に示すように、骨内に配置されたコネクタと共に独立的且つ選択可能に作動されることができる変形をベースにした保持機構を備える典型的な接続された骨コネクタ290を記載する。
この例は、図16−18に記載されるように、接続される骨コネクタの導入のために適切である典型的なドライバーを記載する。
この例は、一連のインデックス付きの項目として提示された、本発明の選択された態様及び実施形態を記載する。
18.長軸に関する回動運動は、遠位のアンカー要素が完全な回転を介して回転されることができるように、制限されないことを特徴とする項目17に記載の骨ねじ。
22 近位の列
24 遠位の列
26 橈骨
28 尺骨
30 中手骨
32 舟状骨
34 月状骨
36 舟状骨―月状骨の接続部
40 ハーバードスクリュー
60 システム
62 骨部材
64 骨部材
66 コネクタ
68 自在継手
70 トレーリングアンカー要素
72 リーディングアンカー要素
73 孔
74 本体
76 本体
78 保持機構
80 保持機構
82 ドライバー係合構造
84 ドライバー係合構造
86 ねじる動き
88 長軸
92 交差軸
112 舟状骨
114 月状骨
116 骨ねじ
118 自在継手
120 ねじ要素
122 ねじ要素
124 雄ねじ部
126 リーディングねじ要素
128 トレーリングねじ要素
130 本体
132 本体
134 先細の先端部
136 先細の先端部
138 タップ領域
140 ヘッド部
142 ソケット
144 壁部
146 開口部
147 ネック
148 ドライバー係合構造
150 ドライバー係合構造
152 円筒状のボア
154 空洞
156 ショルダー
180 骨ねじ
182 自在継手
184 ねじ要素
186 ねじ要素
188 突出部
190 空洞
192 ネック
194 ねじ部領域
196 リーディングねじ部
198 中央軸
200 トレーリング領域
202 リーディング領域
208 中空部
210 受容構造
212 開口部領域
214 リップ
216 ショルダー
222 ショルダー
240 骨ねじ
242 ねじ要素
244 ねじ要素
246 玉継手
248 ソケット
250 ボール
252 ドライバー係合構造
260 骨ねじ
262 自在継手
264 ねじ要素
266 ねじ要素
268 ソケット
270 ヘッド部
274 中央領域
290 骨コネクタ
292 トレーリングアンカー要素
294 リーディングアンカー要素
296 自在継手
302 本体部材
310 延在領域
312 壁部
316 軸方向のボア
320 トレーリング保持機構
322 トレーリング本体部材
324 トレーリング作動要素
332 凹所
360 ドライバー
362 シャフト
364 ハンドル
366 延在領域
368 六角形状の先端領域
370 ショルダー
380 ドライバー
382 六角形状の先端領域
384 係合領域
386 係合領域
Claims (17)
- 少なくとも2つの骨部材を接続するための装置であって、自身が各前記骨部材内に螺入し、これにより前記骨部材に固着されるように構成された一対のアンカー要素を備えている前記装置において、
一対の前記アンカー要素は、一対の前記アンカー要素が前記骨部材のそれぞれに導入された場合に前記アンカー要素のうち一のアンカー要素が他のアンカー要素に従うように構成されており、少なくとも2つの非平行な軸を中心とした前記アンカー要素の相対的な回動運動を可能とし、且つ、前記アンカー要素が骨と係合されているか否かに関わらず前記アンカー要素同士が互いに近接した状態を保持する球継手によって結合されており、
各アンカー要素がドライバー係合構造部を形成し、前記ドライバー係合構造部は共に前記装置の同一の端部からアクセス可能とされることを特徴とする装置。 - 前記アンカー要素が前記球継手を形成していることを特徴とする請求項1に記載の装置。
- 前記アンカー要素のうちの一の前記アンカー要素が空洞を形成し、他の前記アンカー要素の突起が前記球継手を形成するために前記空洞内に捕捉されていることを特徴とする請求項2に記載の装置。
- 前記アンカー要素が互いに対して並進的に移動可能であることを特徴とする請求項1に記載の装置。
- 前記装置がツーピース構造とされることを特徴とする請求項1に記載の装置。
- 前記アンカー要素のうち少なくとも1つの前記アンカー要素が骨に係合するために雄ねじ部を含んでいることを特徴とする請求項1に記載の装置。
- 前記アンカー要素がリーディングアンカー要素及びトレーリングアンカー要素として構成され、前記リーディングアンカー要素が前記トレーリングアンカー要素を骨内に導入するために構成され、前記リーディングアンカー要素が前記トレーリングアンカー要素を通じてアクセス可能なように構成されたドライバー係合構造部を形成していることを特徴とする請求項1に記載の装置。
- 各前記アンカー要素がドライバー係合構造部を形成し、前記ドライバー係合構造部の断面が同一の大きさ及び形状とされることを特徴とする請求項1に記載の装置。
- 前記アンカー要素のうち少なくとも1つの前記アンカー要素は、少なくとも1つの前記アンカー要素が骨内に配置された後で選択可能な時間に少なくとも1つの前記アンカー要素を骨内に固着するように動作可能な保持機構を含んでいることを特徴とする請求項1に記載の装置。
- それぞれが骨と螺合するために雄ねじ部を有しており、予め組立てられたユニットとして骨内に挿入されるように構成された一対のねじ要素を備え、
一対の前記ねじ要素は、少なくとも2つの非平行な軸を中心とした前記ねじ要素の相対的な回動運動を可能とし、且つ、前記ねじ要素が骨に係合されているか否かに関わらず一対の前記ねじ要素同士が互いに近接した状態を保持する球継手によって結合されており、
各ねじ要素がドライバー係合構造部を形成し、前記ドライバー係合構造部は共に骨ねじの同一の端部からアクセス可能とされることを特徴とする骨ねじ。 - 前記ねじ要素のうち一のねじ要素が空洞を形成し、且つ他のねじ要素が突起を含み、
前記空洞内に受容された前記突起が前記球継手を形成することを特徴とする請求項10に記載の骨ねじ。 - 前記骨ねじは、ツーピース構造とされることを特徴とする請求項10に記載の骨ねじ。
- 前記ねじ要素がリーディングねじ要素及びトレーリングねじ要素として構成され、前記リーディングねじ要素が前記トレーリングねじ要素を骨内に導入するように構成され、前記リーディングねじ要素の直径が前記トレーリングねじ要素の直径よりも小さいことを特徴とする請求項10に記載の骨ねじ。
- リーディング端部及びトレーリング端部を有し、各前記アンカー要素がドライバー係合構造部を有し、前記ドライバー係合構造部が共に前記装置の前記トレーリング端部からアクセス可能であることを特徴とする請求項1に記載の装置。
- 各前記アンカー要素が前記ドライバー係合構造部を形成し、前記ドライバー係合構造部が同一のドライバーによって同時に係合されるように構成されていることを特徴とする請求項1に記載の装置。
- 各前記アンカー要素は、前記ドライバー係合構造部を形成し、前記ドライバー係合構造部は一体にアンカー要素を骨内に移動させるように構成されていることを特徴とする請求項1に記載の装置。
- アンカー要素が互いに結合されている状態で、前記アンカー要素が骨部材に固着されるように各前記骨部材に挿入及び固定されるように構成されている一対の前記アンカー要素を備えている、少なくとも2つの前記骨部材を接続するための装置であって、
一対の前記アンカー要素は、少なくとも2つの非平行な軸を中心とした前記アンカー要素の相対的な回動運動を可能とし、且つ、前記アンカー要素が骨と係合されているか否かに関わらず前記アンカー要素同士が互いに近接した状態を保持する球継手によって結合されており、
各ねじ要素がドライバー係合構造部を形成し、前記ドライバー係合構造部は共に前記装置の同一の端部からアクセス可能とされることを特徴とする装置。
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US60/701,891 | 2005-07-21 | ||
US11/431,740 | 2006-05-09 | ||
US11/431,740 US7951198B2 (en) | 2005-05-10 | 2006-05-09 | Bone connector with pivotable joint |
PCT/US2006/018157 WO2006122218A2 (en) | 2005-05-10 | 2006-05-10 | Bone connector with pivotable joint |
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US9161793B2 (en) | 1993-01-21 | 2015-10-20 | Acumed Llc | Axial tension screw |
US8070786B2 (en) * | 1993-01-21 | 2011-12-06 | Acumed Llc | System for fusing joints |
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-
2006
- 2006-05-09 US US11/431,740 patent/US7951198B2/en active Active
- 2006-05-10 EP EP06759524.9A patent/EP1885262B1/en active Active
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- 2006-05-10 JP JP2008511334A patent/JP5124739B2/ja active Active
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- 2006-05-10 KR KR1020077028849A patent/KR20080027250A/ko not_active Application Discontinuation
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US20060271054A1 (en) | 2006-11-30 |
US20110224738A1 (en) | 2011-09-15 |
GB2441690B (en) | 2010-08-11 |
JP2009505683A (ja) | 2009-02-12 |
GB2441690A (en) | 2008-03-12 |
WO2006122218A3 (en) | 2007-05-24 |
AU2006244045A1 (en) | 2006-11-16 |
BRPI0608966A2 (pt) | 2010-02-17 |
US7951198B2 (en) | 2011-05-31 |
AU2006244045B2 (en) | 2011-10-06 |
EP1885262A2 (en) | 2008-02-13 |
US20140114365A1 (en) | 2014-04-24 |
GB0723843D0 (en) | 2008-01-23 |
WO2006122218A9 (en) | 2007-03-01 |
US8617227B2 (en) | 2013-12-31 |
EP1885262B1 (en) | 2015-08-05 |
WO2006122218A8 (en) | 2007-01-04 |
EP1885262A4 (en) | 2012-06-06 |
WO2006122218A2 (en) | 2006-11-16 |
KR20080027250A (ko) | 2008-03-26 |
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