JP5508182B2 - 骨の回復のための方法および装置 - Google Patents
骨の回復のための方法および装置 Download PDFInfo
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- JP5508182B2 JP5508182B2 JP2010174886A JP2010174886A JP5508182B2 JP 5508182 B2 JP5508182 B2 JP 5508182B2 JP 2010174886 A JP2010174886 A JP 2010174886A JP 2010174886 A JP2010174886 A JP 2010174886A JP 5508182 B2 JP5508182 B2 JP 5508182B2
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- implant
- tube
- bone
- expansion
- rod
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2002/4629—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof connected to the endoprosthesis or implant via a threaded connection
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2002/4635—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/0091—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements connected by a hinged linkage mechanism, e.g. of the single-bar or multi-bar linkage type
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0063—Three-dimensional shapes
- A61F2230/0069—Three-dimensional shapes cylindrical
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0004—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof adjustable
- A61F2250/0009—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof adjustable for adjusting thickness
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00005—The prosthesis being constructed from a particular material
- A61F2310/00011—Metals or alloys
- A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Transplantation (AREA)
- Animal Behavior & Ethology (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- Heart & Thoracic Surgery (AREA)
- General Health & Medical Sciences (AREA)
- Neurology (AREA)
- Vascular Medicine (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Cardiology (AREA)
- Surgery (AREA)
- Physical Education & Sports Medicine (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Prostheses (AREA)
- Surgical Instruments (AREA)
- Materials For Medical Uses (AREA)
Description
本願は、2004年9月29日に出願された、米国特許出願番号10/951,766、および2004年6月9日に出願された、仏国特許出願番号0406211の利益を主張する。これらの両方の開示は、その全体が、本明細書中に参考として援用される。
本発明は、外科手術および医療用移植物の分野に関し、そしてより特定すると、医療用骨移植物を使用して、ヒトまたは動物の骨の解剖学的構造を回復させるための、デバイスおよび方法に関する。
種々の原因が、骨の圧縮の本質であり得る。この原因とは、特に、骨粗鬆症(これは例えば、個体の体重の下での自然な椎骨の圧縮を引き起こす)および外傷であり、これらの2つの原因は、時々、組み合わせられる。このような骨の圧縮は、椎骨に影響を与え得、さらに、他の骨(例えば、橈骨および大腿骨)にもまた関係する。
本発明の実施形態は、上で注目した欠点を減少させ、そして骨の回復のための先行技術のデバイスより優れたさらなる利点を提供する。より具体的には、本発明のいくつかの実施形態は、ヒトまたは動物の骨の解剖学的構造を回復させるための方法を包含し、この方法は、以下の工程のうちの1つ以上を包含する:
・拡張可能な移植物を、1つの規定された拡張面(この拡張面は、好ましくは、この移植物に固有である)に沿って骨に導入する工程、
・拡張面を骨の回復面と対応させるために、この拡張可能な移植物を、この骨の内部で位置決めする工程、
・この拡張可能な移植物を、骨の回復面内で展開する工程、ならびに
・この移植物の内部および/または周囲に充填材料を注入する工程。
より特定すれば、本願発明は以下の項目に関し得る。
(項目1)
骨の回復のための拡張可能な移植物であって、以下:
上記移植物に固有の、1つの拡張面であって、上記1つの拡張面は、骨の回復面に対応する、拡張面;
上記骨のための、第一の負担表面および第二の負担表面をそれぞれ形成する、対向する第一のプレートおよび第二のプレートであって、上記第一のプレートおよび第二のプレートは、上記移植物の拡張の際に、上記1つの拡張面に沿って互いから離れて移動するために適している、第一のプレートおよび第二のプレート;
上記第一の負担表面および第二の負担表面の各々のための、第一の支持体および第二の支持体であって、それぞれ、第一のプレートおよび第二のプレートの下方に位置する、第一の支持体および第二の支持体;ならびに
上記移植物の拡張を制御するための手段であって、上記手段は、各支持体と対応するプレートとの間に提供される材料ウェブを備え、上記移植物の拡張を制御する所定の厚さを有する、手段、
を備える、拡張可能な移植物。
(項目2)
各材料ウェブに隣接して位置する溝をさらに備え、上記溝は、各支持体とそれぞれのプレートとの間のクリアランスを可能にするための所定の幅を有する、項目1に記載の拡張可能な移植物。
(項目3)
各支持体の長さが互いに実質的に等しい、項目1に記載の拡張可能な移植物。
(項目4)
上記プレートのうちの少なくとも一方の、少なくとも1つの第一の支持体の長さが、対応する第二の支持体より短く、その結果、上記移植物の拡張の際に、上記第一のプレートおよび第二のプレートが、互いに対してある角度で移動する、項目1に記載の拡張可能な移植物。
(項目5)
上記第一の支持体および第二の支持体が、1対の第一の支持体および第二の支持体を備える、項目1に記載の拡張可能な移植物。
(項目6)
拡張可能な移植物を患者に挿入するための、医療用挿入デバイスであって、以下:
中心ボアを有する把持部分;
上記中心ボアに収容される第一の管;
上記第一の管に収容されるねじ切りされた棒であって、上記患者への挿入のために、移植物を受容するための遠位端を有する、ねじ切りされた棒;
上記把持部分および/または上記移植物キャリアに取り付けられた、ハンドル;ならびに
上記移植物の拡張を決定するためのゲージ、
を備える、デバイス。
(項目7)
上記把持部分の近位端と上記第一の管の近位端とが、同一面にある、項目6に記載のデバイス。
(項目8)
上記ハンドルが、上記把持部分と上記第一の管との、いずれかまたは両方の近位端に取り付けられている、項目6に記載のデバイス。
(項目9)
上記ハンドルが、上記把持部分および/または上記第一の管に対して自由に回転する、項目8に記載のデバイス。
(項目10)
上記ハンドルが、ねじ山を有する開口部を備え、上記ねじ山のねじ山ピッチが、上記ねじ切りされた棒のねじ山ピッチに対応する、項目6に記載のデバイス。
(項目11)
上記ゲージが、上記把持部分内の、上記ねじ切りされた棒の一部を受容するための開口部を備える、項目6に記載のデバイス。
(項目12)
上記窓に隣接して位置する第一のマークをさらに備え、上記第一のマークは、上記窓内に表示される、上記ねじ切りされた棒の一部に提供された第二のマークに関連し、上記ねじ切りされた棒の回転が、上記第一のマークと第二のマークとの間の相対的な移動を引き起こす、項目11に記載のデバイス。
(項目13)
上記ねじ切りされた棒が回転することを実質的に止めるロックデバイスをさらに備える、項目6に記載のデバイス。
(項目14)
骨の回復のためのシステムであって、以下:
少なくとも1つの拡張可能な移植物であって、骨の回復面に対応する1つの拡張面を有する、拡張可能な移植物;
回復させる骨の外側表面に隣接して位置するための、第一の管;
上記骨の内部の遠位端に固定するためにねじ切りされた端部を有する第一の棒であって、上記第一の棒は、上記第一の管に受容される、第一の棒;
上記第一の管を内部に受容するための第二の管;
上記第二の管を受容するための第三の管であって、上記第三の管は、上記第三の管を上記骨の外側表面に係留するための1つ以上の係合部材を備える、第三の管;
上記骨の側面に細長開口部を作製するためのドリルであって、上記ドリルは、上記第一の棒によって案内される、ドリル;および
拡張可能な移植物を患者に挿入するための、医療用挿入デバイス、
を備える、システム。
(項目15)
上記医療用挿入デバイスが、以下:
中心ボアを有する把持部分;
上記中心ボアに収容される第四の管;
上記第一の管に収容される第二の棒であって、上記第二の棒は、上記患者への挿入のために移植物を受容するための遠位端を有し、そしてねじ切りされている、第二の棒;
上記把持部分および/または上記移植物キャリアに取り付けられた、ハンドル;ならびに
上記移植物の拡張を決定するためのゲージ、
を備える、項目14に記載のシステム。
(項目16)
ヒトまたは動物の骨の解剖学的構造を回復させるための方法であって、以下:
1つの拡張面を有する拡張可能な移植物を、骨に導入する工程;
上記1つの所定の面を骨の回復面と一致させるように、上記拡張可能な移植物を、上記骨の内部で位置決めする工程;
上記骨の回復面内で上記移植物を拡張させる工程であって、第一の支持表面および第二の支持表面が、上記骨の内部の組織を広げる、工程;ならびに
上記移植物の周囲に充填材料を注入する工程、
を包含する、方法。
(項目17)
上記注入する工程が、イオン性セメントを注入する工程を包含する、項目16に記載の方法。
図1A〜図7に示される拡張可能な移植物1(および他の実施形態)は、以下のうちの1つ以上を備え得る:
・その移植物に固有であり得る、1つの所定の拡張面2、
・拡張可能な移植物を位置決めして、拡張面を骨の回復面に対応させるための手段3、・1つの拡張面2において、拡張可能な移植物を展開するための手段4、
・移植物のあらゆる拡張の前の移植物の最小の厚さAと、移植物の最大の拡張後の移植物の最大の厚さBとの間で、所定の拡張値を制御するための手段5、ならびに
・骨においてそれぞれ第一の支持表面8および第二の支持表面9を形成し得る、対向する第一のプレート6および第二のプレート7であって、これらのプレートは、移植物1の拡張の間、1つの拡張面2に沿って互いから離れて移動するように適合されている、プレート。
Claims (10)
- 拡張可能な移植物(1)を患者に挿入するための医療用挿入デバイス(3310)であって:
中心ボアを有する把持部分(3312);
該中心ボアに収容される第一の管(71);
該患者への挿入のために移植物を受容するための遠位端を有する該第一の管に収容される棒(3316);および
該把持部分および該第一の管(71)のいずれか、または両方の近位端に取り付けられるハンドル(3314)であって、前記把持部分(3312)および/または前記第一の管(71)に対して自由に回転するハンドル(3314)、
を備える医療用挿入デバイス。 - 前記把持部分(3312)の近位端および前記第一の管(71)の近位端が同一平面上にある、請求項1に記載の医療用挿入デバイス。
- 拡張可能な移植物(1)を患者に挿入するための医療用挿入デバイス(3310)であって:
中心ボアを有する把持部分(3312);
該中心ボアに収容される第一の管(71);
該患者への挿入のために移植物を受容するための遠位端を有する該第一の管に収容される棒(3316);および
該把持部分に取り付けられるハンドル(3314)、
を備え、前記棒(3316)がねじ切りされた棒を備え、そして前記ハンドル(3314)が、ねじ山を有する開口部を備え、該ねじ山のねじ山ピッチが、該ねじ切りされた棒のねじ山ピッチに対応する、デバイス。 - 拡張可能な移植物(1)を患者に挿入するための医療用挿入デバイス(3310)であって:
中心ボアを有する把持部分(3312);
該中心ボアに収容される第一の管(71);
該患者への挿入のために移植物を受容するための遠位端を有する該第一の管に収容される棒(3316);
該把持部分に取り付けられるハンドル(3314);および
前記移植物(1)の拡張を決定するためのゲージ(3320)、
を備え、前記ゲージ(3320)が、前記把持部分(3312)に、前記棒(3316)の部分を見るための開口部を備える、デバイス。 - 前記ゲージが、前記窓(3324)に隣接して位置する第一のマークをさらに備え、該第一のマークは、該窓内に表示される、前記棒(3316)の一部に提供された第二のマーク(3322)に関連し、該棒(3316)の回転が、該第一のマークと第二のマークとの間の相対的な移動を引き起こす、請求項4に記載のデバイス。
- 前記棒(3316)が回転することを実質的に止めるロックデバイス(3321)をさらに備える、請求項1に記載のデバイス。
- 前記棒(3316)の遠位端が、前記移植物(1)の遠位端との係合のための係合手段を含む、請求項1に記載のデバイス。
- 前記係合手段が螺合係合を含む、請求項7に記載のデバイス。
- 前記棒(3316)が前記ハンドル(3314)を通って横切る、請求項1に記載のデバイス。
- 前記棒の近位端が、該棒が前記移植物(1)からはずれるか、または前記第一の管(71)からはずれることを可能にする脱係合手段(3318)を含む、請求項1に記載のデバイス。
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
FR0406211A FR2871366A1 (fr) | 2004-06-09 | 2004-06-09 | Implant expansible prothetique osseux |
FR0406211 | 2004-06-09 | ||
US10/951,766 | 2004-09-29 | ||
US10/951,766 US20050278036A1 (en) | 2004-06-09 | 2004-09-29 | Method for restoration of human or animal bone anatomy, and expansible prosthetic implant allowing implementation of this method |
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US (6) | US20050278036A1 (ja) |
EP (2) | EP2572680B1 (ja) |
JP (3) | JP4620120B2 (ja) |
KR (1) | KR101206552B1 (ja) |
CN (2) | CN101031259A (ja) |
AU (1) | AU2005251536B2 (ja) |
CA (1) | CA2567274C (ja) |
ES (2) | ES2442454T3 (ja) |
FR (2) | FR2871366A1 (ja) |
HK (1) | HK1102712A1 (ja) |
MX (2) | MXPA06014196A (ja) |
PL (1) | PL1778136T4 (ja) |
WO (1) | WO2005120400A2 (ja) |
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US8864833B2 (en) | 2011-09-30 | 2014-10-21 | Globus Medical, Inc. | Expandable fusion device and method of installation thereof |
TWI503097B (zh) | 2012-10-23 | 2015-10-11 | Spirit Spine Holdings Corp Inc | Bone fixation device |
TWI495458B (zh) | 2012-11-13 | 2015-08-11 | Univ Chang Gung | A device that supports bone strength |
US9913727B2 (en) | 2015-07-02 | 2018-03-13 | Medos International Sarl | Expandable implant |
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