JP5161250B2 - Spacer fixing thread and spacer with spacer fixing thread - Google Patents

Description

  The present invention relates to a spacer fixing thread used when fixing a spacer to a bone, and a spacer provided with such a spacer fixing thread.

  As a treatment for cervical spondylotic myelopathy, posterior longitudinal ligament ossification, yellow ligament ossification, intervertebral disc herniation and the like, a median longitudinal split cervical vertebral laminoplasty is performed.

  In midline longitudinal split laminoplasty, the midline (center) of the vertebral arch or spinous process is cut, and the vertebral arches on both sides are opened like hinges with the midline as the boundary. To enlarge. At this time, a spacer is inserted into a gap opened by cutting a vertebral arch or spinous process.

  For example, a spacer having a substantially trapezoidal shape in plan view is used by being inserted into the gap such that the narrow portion is on the spinal canal (vertebral foramen) side.

  In order to prevent the spacer from detaching from the vertebral arch or spinous process, a suture thread is inserted into the through-hole formed in the vertebral arch or spinous process and the through-hole formed in the spacer, and the spacer is tightened. (See, for example, JP 2007-082826 (Patent Document 1)). The spacer is usually fixed using a plurality of sutures, but the operation of inserting the plurality of sutures through the through holes is extremely complicated, and improvement is desired.

  Japanese Patent Application Laid-Open No. 2010-11929 (Patent Document 2) includes a suture made of a plurality of biocompatible materials, and two needle-like hard portions arranged at intervals in the longitudinal direction of the suture. A bone graft suturing tool is disclosed, and the hard portion describes a configuration in which a part of the suture is cured by a surgical needle or an adhesive. By using a bone graft suturing tool, when inserting a suture through a through hole formed in a vertebral arch or spinous process and a through hole formed in a spacer, the suture is used instead of a surgical needle. Since the surgical needle is unnecessary, there is no inconvenience that the suture thread comes out of the surgical needle.

  However, the bone graft suturing device described in Japanese Patent Application Laid-Open No. 2010-11929 cannot easily separate a plurality of sutures because the suture is hardened with an adhesive to form a hard portion. Therefore, when the spacer is tied and fixed with the suture thread inserted into the through-hole, it is necessary to cut the hard portion with scissors or the like to separate a plurality of suture threads. It is very complicated to perform such work during the operation, and when the cut hard part is lost, it is difficult to find this part and there is a risk of leaving it in the patient's body.

JP 2007-082826 JP 2010-11929

  An object of the present invention is to provide a spacer fixing thread capable of easily and reliably performing an operation of fixing a spacer to a bone, and a spacer with a spacer fixing thread capable of easily performing an operation of securing a gap between bones. It is to provide.

  As a result of diligent research in view of the above object, the present inventors joined the ends of a plurality of sutures to form a waisted joint, and easily separated the suture from the joint By adjusting the joint strength so that it is possible, the bone and the through hole provided in the spacer can be easily inserted, and the operation of securing the gap between the bones by fixing the spacer after the insertion is easily performed. The inventors have found that a suture that can be obtained is obtained, and have arrived at the present invention.

That is, the spacer fixing thread of the present invention used to fix the spacer to the bone with the spacer inserted in the gap between the bones,
Multiple threads,
It has an easily separable joining part formed by joining at least one end of the plurality of yarns so as to be separable when necessary.

  It is preferable that the easily separable joint portion is formed at both ends of each yarn.

The easily separable joint may be further formed in the middle of the spacer fixing yarn in the longitudinal direction.

  The bending strength of the easily separable joint is preferably higher than the bending strength of the portion where the easily separable joint is not formed.

  The bending strength in the longitudinal direction of the easily separable joint is preferably 0.5 to 3.5 N.

  The bending strength in the longitudinal direction of the portion where the easily separable joint portion of each yarn is not formed is preferably 0.02 to 0.1 N.

  The force required to separate the plurality of yarns of the easily separable joint from each other is preferably 1 to 5 N in terms of tensile strength.

  In the spacer fixing yarn, it is preferable that one easily separable joining portion has a length of 1 to 3.5 cm.

  The easily separable joint is preferably formed by fusing the plurality of yarns to each other.

  It is preferable that the fusion part between adjacent yarns has a length of (diameter of yarn before fusion × 0.1) or more and (diameter of yarn before fusion × 0.7) or less in a cross-sectional view.

  The plurality of yarns are preferably made of a polymer material.

  The plurality of yarns preferably include at least one monofilament yarn and at least one multifilament yarn.

  The plurality of yarns preferably have different colors from each other.

  The plurality of yarns may include yarns having different lengths.

  The spacer fixing yarn is preferably formed by joining the plurality of yarns such that at least one of the yarns protrudes from the easily separable joining portion without matching the end surfaces thereof.

  A spacer with a thread for fixing a spacer according to the present invention is a spacer having a through hole inserted into a gap between bones, wherein the spacer fixing thread is inserted into the through hole.

  Preferably, the spacer is for cutting the vertebral arch or the vertebral arch and spinous process and inserting it into the open gap.

  Since the spacer fixing thread according to the present invention is provided with an easily separable joining portion formed by joining a plurality of threads so as to be separable when necessary, the plurality of threads can be easily inserted into the through holes provided in the bone and the spacer. In addition, the plurality of threads can be easily separated after being inserted, and the operation of securing the spacer and securing the gap between the bones can be easily and reliably performed.

It is a top view which shows an example of the thread | yarn for spacer fixation of this invention. It is a schematic diagram for demonstrating a median longitudinal split-type expansion laminoplasty. It is another schematic diagram for demonstrating a median longitudinal split-type expansion laminoplasty. FIG. 10 is still another schematic diagram for explaining a median longitudinal split-type laminoplasty. FIG. 10 is still another schematic diagram for explaining a median longitudinal split-type laminoplasty. It is a perspective view for demonstrating the method to fix a spacer. It is a top view which shows the other example of the thread | yarn for spacer fixation of this invention. It is an enlarged view of the edge part which shows the other example of the thread | yarn for spacer fixation of this invention. It is a perspective view which shows an example of the spacer with the thread | yarn for spacer fixation of this invention. It is a schematic diagram for demonstrating the measuring method of tensile strength. It is a schematic diagram which shows the easily separable junction part of the spacer fixing thread | yarn of this invention. It is a schematic diagram which shows the junction part formed of the adhesive agent. It is a schematic diagram explaining the method for forming the easily separable junction part of the thread for spacer fixation of this invention.

[1] Median longitudinal split-type laminoplasty The spacer fixing thread or spacer fixing thread-attached spacer of the present invention is used, for example, in a midline vertical split-type laminoplasty. The median longitudinal split laminoplasty will be described with reference to FIGS. 2 to 5, the upper side is the back side, and the lower side is the ventral side.

  As shown in FIG. 2, the vertebra 100 includes a vertebral body 110, a vertebral arch 120 that extends behind the vertebral body 110 (upper side in FIG. 2) and forms a spinal canal (vertebral foramen) 140, And a spinous process 130 protruding backward from the central portion.

  First, as shown in FIG. 3, the spinous process 130 is cut along the midline 200 using an air drill or the like, and the vertebral arch 120 is divided into two to form the cut portions 130a and 130b. Further, grooves 121a and 121b are formed on the outer side of the root portion of the vertebral arch 120 using an air drill or the like. The grooves 121a and 121b have a depth enough to cut only the outer plate and not the inner plate. The portions where the grooves 121a and 121b are formed are hinge portions (hinges) 122a and 122b.

  Next, as shown in FIG. 4, the cut portions 130a and 130b are rotated about the hinge portions 122a and 122b, so that the cut portion of the spinous process 130 is expanded and a gap 150 is formed. Here, the inner side surface facing the gap 150 between the cutting portions 130a and 130b is shaped as necessary.

  Next, through holes 131a and 131b are formed in the cutting portions 130a and 130b. Thereafter, as shown in FIG. 5, a substantially trapezoidal spacer S is inserted into the gap 150 in plan view. Thus, an enlarged vertebral arch 160 is formed by the spinous process 130 of the patient and the spacer S.

  During or after this operation, the spacer fixing thread 1 of the present invention is inserted into the through holes 131a and 131b of the spinous process 130 and the through hole S1 of the spacer S. Then, as will be described later, the spacer S is fixed to the cutting portions 130a and 130b by using the first yarn 10a and the second yarn 10b of the spacer fixing yarn 1.

  As the spacer S, those composed of bioceramics such as alumina, zirconia, calcium phosphate compound, etc. are preferably used. A porosity of 70% or less (particularly 30 to 50%) is suitable.

[2] Spacer fixing thread
(1) First Embodiment As shown in FIG. 1, the spacer fixing yarn 1 is composed of a plurality of yarns 10 each having a diameter D (in this embodiment, the first yarn 10a and the second yarn 10b 2) and a joint formed by joining both ends of these yarns 10a, 10b to each other with a length L. This joint has a strength that can separate the yarns 10a, 10b from each other when necessary. This is an easily separable joint 11 joined by The spacer fixing thread 1 of the present embodiment has easy-separable joints 11 at both ends thereof.

  The shape of the easily separable joint 11 is preferably formed into a shape as shown in FIG. 11 (a) or FIG. 11 (b), for example. When formed into the shape shown in FIG. 11 (a), the diameter of the easily separable joint 11 is substantially uniform, so the easily separable joint 11 of the thread 10a and the thread 10b with respect to the joint surface direction x The bending strength and the bending strength of the easily separable joint 11 with respect to the vertical direction y perpendicular to the bending strength can be made to be approximately the same. When molded into the shape shown in FIG. 11 (b), it is easy to adjust the later-described tensile strength to an appropriate level.

  In the above-described median longitudinal split type laminoplasty, as shown in FIG. 6, (a) the spacer fixing thread 1 is inserted into the through holes 131a, 131b, and S1, and (b) the spacer S is inserted into the spinous process 130. After matching with the cutting portions 130a, 130b, (c) separating the first yarn 10a and the second yarn 10b joined by the easily separable joining portion 11, and (d) separating each yarn 10a. 10b, the spacer S and the cut portions 130a, 130b of the spinous process 130 are tied together so that the spacer S can be firmly fixed to the cut portions 130a, 130b of the spinous process 130. The method of using the spacer fixing thread 1 will be described in detail later.

  The easily separable joining portion (joining portion) 11 formed by joining the first yarn 10a and the second yarn 10b formed at the end of the spacer fixing yarn 1 when not in use is composed of two yarns 10a. 10b are joined to each other, the rigidity (bending strength) of the yarns 10a and 10b is higher than that of the portion where the easily separable joining portion 11 is not formed. Therefore, it is easy to insert the spacer fixing thread 1 through the through holes 131a, 131b, and S1.

  Furthermore, since the easily separable joints 11 are provided at both ends of the spacer fixing yarn 1, when inserting the spacer fixing yarn 1 into the through holes 131a, 131b and S1, the end can be seen from any end side. , Can be inserted.

<Bending strength>
The bending strength in the longitudinal direction of the easily separable joint 11 is sufficient if it has a strength that allows the spacer fixing thread 1 to be inserted into the through holes 131a and 131b and the through hole S1 of the spacer S. The strength of is preferably about 0.5 to 3.5 N, more preferably about 1 to 2.5 N, and most preferably about 1 to 2 N. If the bending strength of the easily separable joint portion 11 is set within the above range, the easily separable joint portion 11 has sufficiently high rigidity. For this reason, the said insertion operation can be performed more reliably and easily.

  Bending strength is measured by cutting the easy-to-separate joint 11 to a predetermined length and setting it on a strength measuring machine (Shimadzu Corporation "EZ-Test") so that a part (approximately 10 mm) protrudes. Then, this protrusion is pressed by pushing it almost perpendicularly to the base at 5 mm / min, and the maximum strength until bending is evaluated.

  The bending strength in the longitudinal direction of each of the yarns 10a and 10b measured by the same method, that is, the bending strength of the portion where the easily separable joint portion 11 is not formed is preferably about 0.02 to 0.1 N, 0.025 More preferably, it is about 0.09 N. Since the yarns 10a and 10b having such bending strength have relatively high flexibility, it is easy to perform an operation of fixing the spacer S to the cut portions (bones) 130a and 130b of the spinous process 130.

<Separation strength>
The easily separable joining portion 11 can be separated into the yarns 10a and 10b with a relatively small force when necessary (in this embodiment, when the spacer S is fixed to the cutting portions 130a and 130b). It is preferable to join with strength. The force required for separating the easily separable joint 11 is preferably about 1 to 5 N, and more preferably about 1.5 to 3.5 N in terms of tensile strength measured by the following method. If the tensile strength of the easily separable joint 11 is set within the above range, the threads 10a and 10b can be easily separated at the easily separable joint 11, and the impact during transfer of the suture, etc. Do not separate. Therefore, the operation of fixing the spacer S to the cut portions 130a and 130b can be performed in a shorter time, and the problem that the easily separable joint portion is separated before use can be prevented.

  The separation strength is measured by cutting a predetermined length portion including the easily separable joint portion 11 of the spacer fixing thread 1 and each of the ends of the yarns 10a and 10b opposite to the easily separable joint portion 11 respectively. Set to a strength measuring machine (Shimadzu Corp., `` EZ-Test ''), as shown in FIG. 10, the thread 10a and the thread 10b are 5 mm in length so that the ends are separated from each other in the longitudinal direction. The easily separable joint 11 is separated by pulling at a speed of / min, and the maximum tensile strength at that time is evaluated.

<Length L of easily separable joint 11>
The length L of each easily separable joint 11 is not particularly limited, but is preferably about 1 to 3.5 cm, and more preferably about 1.5 to 2.5 cm. By setting the length of the easily separable joint portion 11 within the above range, the easily separable joint portion 11 can be reliably held with a finger or the like. Further, within the above range, the length of the easily separable joint portion 11 is not too long, and the insertion operation of the spacer fixing thread 1 to the through holes 131a and 131b and the through hole S1 can be easily performed. .

<Thread material>
The yarns 10a and 10b are not particularly limited, but are preferably mainly made of a polymer material. The yarn is preferably made of a material having biocompatibility.

  Polymer materials include polyethylene, polypropylene, ethylene-propylene copolymer, ethylene-vinyl acetate copolymer (EVA) and other polyolefins, cyclic polyolefins, modified polyolefins, polyvinyl chloride, polyvinylidene chloride, polystyrene, polyamide, polyimide Polyamideimide, polycarbonate, poly- (4-methylpentene-1), ionomer, acrylic resin, polymethyl methacrylate, acrylonitrile-butadiene-styrene copolymer (ABS resin), acrylonitrile-styrene copolymer (AS resin) , Butadiene-styrene copolymer, polyoxymethylene, polyvinyl alcohol (PVA), ethylene-vinyl alcohol copolymer (EVOH), polyethylene terephthalate (PET), polybutylene terephthalate (PBT), polycyclohexane terephthalate (PCT), etc. Polyester, polyether, polyetherketone (PEK), polyetheretherketone (PEEK), polyetherimide, polyacetal (POM), polyphenylene oxide, modified polyphenylene oxide, polysulfone, polyethersulfone, polyphenylene sulfide, polyarylate, fragrance Group polyester (liquid crystal polymer), polytetrafluoroethylene, polyvinylidene fluoride, fluororesin, and the like, and these may be used in combination.

  Among these, polyester is preferable. By using polyester, relatively high flexibility can be imparted to each of the yarns 10a and 10b, and the operation of fixing the spacer S is facilitated.

<Thread shape>
The surface of each thread 10a, 10b may be subjected to a surface treatment for making it difficult to slip when the spacer fixing thread 1 is gripped with a finger or the like. Examples of the surface treatment include coating with a silicone resin.

  Each yarn 10a, 10b may be composed of a monofilament yarn or a multifilament yarn. Here, the monofilament yarn refers to a single fiber that does not have a long continuous connection portion, and the multifilament yarn refers to a single fiber that is formed by twisting a plurality of monofilaments together. Say that.

  When monofilament yarn is used, there is an advantage that the stiffness of each yarn 10a, 10b becomes strong and the spacer S can be tightened (fixed) more firmly. On the other hand, when the multifilament yarn is used, there is an advantage that the flexibility of the yarns 10a and 10b is increased and the spacer S can be tightened more easily and accurately. The effect of the present invention is exhibited when a multifilament yarn is used.

  Further, for example, the first yarn 10a can be a monofilament yarn, and the second yarn 10b can be a multifilament yarn. In this case, first, the spacer S can be temporarily fixed with the second multifilament yarn (yarn 10b) and then firmly tightened with the first monofilament yarn (yarn 10a) and tied (mainly fixed). . In this way, the spacer S can be more securely and firmly fixed to the cutting parts 130a and 130b.

<Thread length>
In the present embodiment, the first yarn 10a and the second yarn 10b have substantially the same length. The length of each yarn 10a, 10b is not particularly limited, but is preferably about 30-100 cm, and more preferably about 50-80 cm.

<Thread thickness>
It is preferable that the first yarn 10a and the second yarn 10b have substantially the same diameter. The diameter D of each yarn 10a, 10b is not particularly limited, but is preferably about 0.05 to 1.0 mm, and more preferably 0.2 to 0.8 mm. The diameters of the yarns 10a and 10b may be different depending on the purpose.

<Thread color>
In order to prevent the ends of different yarns 10a and 10b from being tied together when the spacer is fixed after separating the easily separable joint 11, the first yarn 10a and the second yarn 10b are These are preferably colored in different colors.

<Method of forming easily separable joint>
The easily separable joining portion 11 is formed by joining the yarns 10a and 10b. This joining uses a method by fusion. By using the fusion method, the bending strength and separation strength of the easily separable joint 11 can be easily adjusted within a preferable range.

  Examples of the method by fusion (fusion) include thermal fusion, ultrasonic fusion, and high-frequency fusion, and thermal fusion is most preferred. The heat fusion does not require expensive equipment, and the yarns 10a and 10b can be easily and reliably joined to form the easily separable joining portion 11. In addition, when the method by heat fusion is used, since the component constituting the suture is substantially only the component of the yarn, the possibility of foreign matter entering the body can be reduced.

  The bonding strength of the easily separable bonding portion 11 (the force necessary for separation) can be easily adjusted by changing the heat sealing conditions. For example, the bonding strength is adjusted by adjusting the fusing temperature, adjusting the fusing time, and adjusting the fusing area between adjacent yarns.

  The fusing temperature is preferably not less than the softening temperature of the yarn used and lower than the fusing temperature. When fused at a temperature lower than the softening temperature, sufficient strength cannot be obtained. When fused at a temperature higher than the melting temperature, the yarns are completely integrated with each other and cannot be easily separated. In particular, (softening temperature + 5 ° C.) to (melting temperature−5 ° C.) is preferable. For example, when the yarn material is polyester, the treatment temperature is preferably about 245 ° C to 255 ° C. The fusing time can be determined in a timely manner in order to obtain a desired bonding strength, but is preferably about 0.1 to 1 second, more preferably about 0.2 to 0.5 second, 0.2 Most preferably, it is about 2 to 0.4 seconds.

  The heat fusion between the yarns can be performed using a film sealer or the like, for example, by adhering the yarns together using a jig as shown in FIG. The fusion area can be adjusted to be constant. The fusion area that has sufficient bonding strength and can be easily separated is expressed by the contact length s between adjacent yarns in the cross-sectional view of the fusion portion, and s is the yarn of the yarn before fusion. It is preferably 10% to 140% of the diameter D, more preferably 10% to 70%, still more preferably 20% to 60%, and most preferably 30% to 50%. By adjusting the width w and depth d of the jig mold, the fusion area can be set freely.

  When fusing yarns together using a jig as shown in FIG. 13 (a), the two yarns are held by the jig and held at the fusing temperature for a certain period of time. It is preferable to leave it fixed and take it out until it becomes a temperature sufficiently lower than the softening temperature. If the yarn is taken out at a temperature higher than the softening temperature of the yarn, it may be peeled off or deformed such as warping.

  Adhesion between adjacent yarns does not necessarily have to hold the round shape of the yarn, for example, it may be a square shape using a jig as shown in FIG. As shown in a), the cross section of the easily separable joint 11 can be formed into a substantially circular shape. Also, when forming an easily separable joint with three or more yarns, the width w of the jig mold shown in FIG. 13 (a) or FIG. 13 (b) is expanded, and three or more yarns are attached at once. By making it possible to fuse, it is possible to form an easily separable joint having a shape in which a plurality of yarns having a circular cross section are arranged.

  The bonding strength of the easily separable bonding portion 11 can also be adjusted by applying a release agent such as silicon powder or oil to the fusion bonded portion by appropriately setting the type and amount thereof.

  For example, when a method using an adhesive is used as opposed to the method using fusion, the yarn 10a and the yarn 10b are bonded with the adhesive 111 as shown in FIG. A strong force is required to separate the two yarns 10a and the yarn 10b. Therefore, in order to be able to easily separate the joint portion 11a, it is necessary to reduce the amount of adhesive used as shown in FIG.12 (b), but such a small amount of adhesive is used. Thus, it is difficult to form the joint portion 11a.

<Example of using spacer fixing thread 1>
A method of fixing the spacer S to the cut portions 130a and 130b of the spinous process 130 using the spacer fixing thread 1 will be described with reference to FIG. FIG. 6 shows a stage between FIG. 4 and FIG. 5 for explaining the median longitudinal split-type laminoplasty.

(1) Hold one separable joint 11 of the spacer fixing thread 1 with a finger or the like and insert it into the through hole S1 of the spacer S (not shown). With the spacer fixing thread 1 inserted into the through hole S1 of the spacer S, one easily separable joint 11 of the spacer fixing thread 1 is inserted into the through hole 131a formed in the cutting part 130a and the other easily separable joint. The portion 11 is inserted into a through hole 131b formed in the cutting portion 130b (see FIG. 6 (a)).

  At this time, since the easily separable joint portion 11 has the high bending strength as described above, it can be securely gripped and is not easily bent when inserted into the through holes 131a, 131b and S1, and this operation is ensured. Can be done.

(2) Pull both ends of the spacer fixing thread 1 in the direction of separating, and insert the spacer S into the gap 150 (see FIG. 6 (b)).

(3) The first yarn 10a and the second yarn 10b joined at each easily separable joining portion 11 are separated (see FIG. 6 (c)). At this time, since the easily separable joint 11 has the low tensile strength as described above, it can be easily and reliably separated into the first yarn 10a and the second yarn 10b. Note that the order of (2) and (3) may be reversed.

(4) The first yarn 10a and the second yarn 10b are tied with the spacer S being tightened. Thereby, the spacer S can be fixed to the cutting parts 130a and 130b.

(5) Unnecessary portions of the first thread 10a and the second thread 10b are cut to complete the median longitudinal split-type laminoplasty (see FIG. 6 (d)).

  Unlike the present invention, for example, when using a thread for fixing a spacer in which a thread is firmly joined (integrated) to form a joint having high strength, each thread cannot be easily separated. It is necessary to cut and remove the joint from the spacer fixing yarn. Also, if the cut joint is lost, it is difficult to find this part and there is a risk of leaving it in the patient's body.

  On the other hand, when the spacer fixing thread 1 of the present invention is used, the two threads can be easily separated without cutting the thread, so that the operation is easy and the operation is safe. Will increase.

  In the present embodiment, the easily separable joints 11 are provided at both ends of the spacer fixing thread 1. However, the operation for inserting the spacer fixing thread 1 into the through holes 131a, 131b and S1 is easy. In consideration of only this point, the easily separable joining portion 11 may be provided only at one end portion of the spacer fixing yarn 1.

(2) Second embodimentThe spacer fixing thread 1 shown in FIG. 7 is provided with the easily separable joint portions 11 not only at both end portions but also at a plurality of locations in the longitudinal direction (5 locations in this embodiment). Except for the above, it is the same as the spacer fixing thread 1 of the first embodiment.

  Even when the spacer fixing thread 1 having such a configuration is used, the same operations and effects as those of the first embodiment can be obtained.

  Further, for example, if the spacer fixing thread 1 is cut at the position indicated by the dotted line A in FIG. 7, the easily separable joint portions 11 are provided at both ends even after the cutting. That is, the spacer fixing thread 1 can be cut and used to a length that is easy for the operator to use, which is highly convenient.

  Further, as shown in FIG. 7, when the spacer fixing yarn 1 is taken out from the package by providing an easily separable joint 11 in the middle of the longitudinal direction of the spacer fixing yarn 1, the first yarn 10a and the first yarn 10a It is possible to prevent the second yarn 10b from being entangled.

  The number of easily separable joints 11 provided in the middle of the spacer fixing yarn 1 in the longitudinal direction is not limited to five, but may be one to four or six or more. Furthermore, the first yarn 10a and the second yarn 10b may be joined in the entire longitudinal direction thereof to provide the easily separable joining portion 11 over the entire length of the spacer fixing yarn 1.

(3) Third embodiment The third embodiment of the spacer fixing thread 1 according to the present invention, as shown in an enlarged view of its end in FIG. 8, is the end face of the first thread 10a and the second thread. The end face of 10b is not aligned, the second thread 10b protrudes from the easily separable joint 11, and a portion of the length L1 of only the second thread 10b exists at one end thereof, This is the same as the spacer fixing thread 1 of the first and second embodiments.

  Even when the spacer fixing thread 1 having such a configuration is used, the same operations and effects as those of the first and second embodiments can be obtained.

  Since this spacer fixing thread 1 has a portion (second thread 10b) that protrudes from the easily separable joint 11 and is thinner than the diameter of the easily separable joint 11, the spacer fixing thread 1 is connected to the through hole 131a, The operation of inserting through 131b and S1 becomes easier.

  The length L1 of the portion protruding from the easily separable joint 11 is not particularly limited, but is preferably about 0.5 to 1 cm.

  In this embodiment, in order not to align the end surface of the first yarn 10a and the end surface of the second yarn 10b, the first yarn 10a and the second yarn 10b having different lengths are used. The easily separable joint portion 11 may be formed, or the easily separable joint portion 11 may be formed by shifting the first thread 10a and the second thread 10b having the same length.

[3] Spacer with spacer fixing thread As shown in FIG. 9, the spacer fixing thread 1S has a spacer fixing thread as described in the first to third embodiments. 1 is inserted through the through hole.

  The spacer fixing thread 1 is provided to the operator in a state of being inserted through the through hole S1 of the spacer S, for example. The spacer fixing thread 1 may be fixed to the spacer S using a biocompatible material or the like.

  By using a spacer with a spacer fixing thread, the operation of inserting the spacer fixing thread 1 into the through hole S1 of the spacer S can be omitted at the operation site, so that the operation time can be shortened and the patient Can be reduced.

  As mentioned above, although the spacer fixing thread and the spacer with spacer fixing thread according to the present invention have been described based on the illustrated embodiments, the present invention is not limited to these embodiments, and each configuration is the same. It can be replaced with any one that can function, or can be added with any configuration.

  For example, the spacer fixing yarn of each embodiment is composed of two yarns, but may be composed of three or more yarns. In this case, for example, when the spacer is fixed to the bone with two threads, and the remaining thread is used to fix the separated spinous process in its original position when the spinous process is separated from the vertebral arch. When the ligament is separated from the spinous process, the separated ligament can be used for fixing to the spinous process.

  The spacer shown in each embodiment is a spacer used for a gap between bones formed by cutting a vertebral arch and a spinous process, that is, a spinous process spacer. It may be a spacer used for the gap between the formed bones, that is, a larch spacer. Furthermore, the spacer may be an intervertebral spacer used between vertebral bodies.

1 ... Spacer fixing thread
10 ... Thread
10a ... first thread
10b Second thread
11 ・ ・ ・ Easily separable joint
111 ・ ・ ・ Adhesive
1S ・ ・ ・ Spacer with spacer fixing thread
S ・ ・ ・ Spacer
S1 ... through hole
100 ... vertebra
110 ... vertebral body
120 ...
121a, 121b ... groove
122a, 122b ・ ・ ・ Hinges
130 ・ ・ ・ Spinous process
130a, 130b ... cutting part
131a, 131b ... through hole
140 ... spinal canal
150 ... Gap
160 ... enlarged arch
200: Midline

Claims (17)

A spacer fixing thread used to fix the spacer to the bone with the spacer inserted in the gap between the bones,
Multiple threads,
A spacer fixing yarn, comprising: an easily separable joining portion formed by joining at least one end of the plurality of yarns so as to be separable when necessary.   2. The spacer fixing yarn according to claim 1, wherein the easily separable joint portions are formed at both ends of each yarn. 3. The spacer fixing yarn according to claim 1, wherein the easily separable joining portion is further formed midway in the longitudinal direction of the spacer fixing yarn. The spacer fixing yarn according to any one of claims 1 to 3, wherein a bending strength of the easily separable joint portion is higher than a bending strength of a portion where the easily separable joint portion is not formed. Spacer fixing thread to be used. 5. The spacer fixing yarn according to claim 4, wherein a bending strength in a longitudinal direction of the easily separable joint portion is 0.5 to 3.5 N. 6. The spacer fixing yarn according to claim 4 or 5, wherein a bending strength in a longitudinal direction of a portion of each yarn where the easily separable joint portion is not formed is 0.02 to 0.1 N. Yarn. The spacer fixing yarn according to any one of claims 1 to 6, wherein a force required to separate the plurality of yarns of the easily separable joint portion from each other is 1 to 5 N in terms of tensile strength. Characteristic spacer fixing thread. The spacer fixing yarn according to any one of claims 1 to 7, wherein one easily separable joining portion has a length of 1 to 3.5 cm. The spacer fixing yarn according to any one of claims 1 to 8, wherein the easily separable joining portion is formed by fusing the plurality of yarns to each other.   10. The spacer fixing yarn according to claim 9, wherein a fusion portion between adjacent yarns is (diameter of yarn before fusion × 0.1) or more and (diameter of yarn before fusion × 0.7) or less in a cross-sectional view. A spacer fixing thread characterized by having a length of.   The spacer fixing yarn according to any one of claims 1 to 10, wherein the plurality of yarns are made of a polymer material.   The spacer fixing yarn according to any one of claims 1 to 11, wherein the plurality of yarns include at least one monofilament yarn and at least one multifilament yarn. .   The spacer fixing yarn according to any one of claims 1 to 12, wherein the plurality of yarns have different colors from each other.   The spacer fixing yarn according to any one of claims 1 to 13, wherein the plurality of yarns include yarns having different lengths.   The spacer fixing yarn according to any one of claims 1 to 14, wherein at least one of the plurality of yarns protrudes from the easily separable joint portion without matching end surfaces thereof. A thread for fixing a spacer characterized by being joined. A spacer having a through-hole inserted into a gap between bones,
16. A spacer fixing thread-attached spacer, wherein the spacer fixing thread according to any one of claims 1 to 15 is inserted through the through hole.   17. The spacer with a thread for fixing a spacer according to claim 16, wherein the spacer is for cutting a vertebral arch or a vertebral arch and a spinous process and inserting it into an open gap. Spacer with thread.

Images