JP5647264B2 - 固定装置、椎間インプラント、および移植器具 - Google Patents
固定装置、椎間インプラント、および移植器具 Download PDFInfo
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- JP5647264B2 JP5647264B2 JP2012546508A JP2012546508A JP5647264B2 JP 5647264 B2 JP5647264 B2 JP 5647264B2 JP 2012546508 A JP2012546508 A JP 2012546508A JP 2012546508 A JP2012546508 A JP 2012546508A JP 5647264 B2 JP5647264 B2 JP 5647264B2
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- implant
- pawl
- passage
- plate
- vertebra
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
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- 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
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- 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
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- A61F2/4637—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for connecting or disconnecting two parts of a prosthesis
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- 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
- A61F2220/0008—Fixation appliances for connecting prostheses to the body
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- 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
- A61F2220/0041—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting screws
Description
固定装置(1)(または「固定具」)、および/または同一の、異なる、または補完的であってもよい複数の固定装置(1)を含む固定システム;
このような固定装置(1)またはシステムのうちの1つ以上を受容するように構成された椎間インプラント(2);および
椎骨の間にインプラント(2)を埋め込み、1つ以上の固定装置(1)または固定システムでインプラントを固着させるための器具(3、4)。
本願において説明される実施形態による固定装置(1)を提供するステップと;
本願において説明される実施形態による椎骨インプラント(2)を提供するステップと;
本願において説明される実施形態による移植器具(3、4)を提供するステップと;
移植器具(3、4)を用いて椎骨インプラント(2)を把持するステップと、を含んでもよい。
脊椎の隣り合う椎骨の間の椎間腔内に(または骨接合プレートの場合には脊椎の隣り合う椎骨上に)脊椎インプラント(2)を挿入するステップと;
(隣り合う椎骨のレベルにおいて)脊柱の軸に対して実質的に直交する進入路軸に沿って、固定装置(1)を提供するステップと;
移植器具(3、4)の嵌入具(4)を用いて、固定装置(1)がインプラント(2)の少なくとも一部を横断している状態で、移植器具(3、4)のガイドヘッド(30)を通じて、およびインプラント(2)内の通路(21)を通じて、固定装置(1)を挿入するステップと;
移植器具(3、4)の嵌入具(4)を用いて、隣り合う椎骨のうちの1つに固定装置(1)の少なくとも一部を埋め込み、インプラント(2)内に固定装置(1)を完全に挿入するステップと、をさらに含んでもよい。
技術的特徴および要素:
− リブ(11):椎骨内で固定具を安定化するように構成されてもよいが、さらに(インプラントの溝(211)を含む)インプラント内で固定具を安定化するように構成されてもよく、これはさらにインプラントを安定化するだろう。
− 直線通路内の湾曲固定具の場合の肥厚部および/または平坦面(20、110;110aおよび/または110b、111):インプラント内に固定具を安定化するのを支援するためにインプラント内に固定具の滑合を提供してもよく、したがって椎骨内で固定具を安定化してもよく、したがってインプラントをさらに安定化するだろう。
− 「垂直配向された」、すなわちプレート(10)の幅の方向に湾曲した固定具:椎骨内で固定具を安定化するように構成されてもよく、こうしてインプラントをさらに安定化するだろう。
技術的特徴および要素:
− 保持歯止め(14):椎骨内に埋め込まれた固定具によって、椎骨に対して押しつけられたままインプラントを保持してもよい。これは、椎骨上でインプラントを安定化するが、加えてインプラントおよび/または椎骨内で固定具をさらに安定化してもよい。
− 抜去歯止め(12):インプラント内で固定具を保持/維持してもよい。これは、インプラントおよび/または椎骨内で固定具を安定化し、椎骨間のインプラントをさらに安定化してもよい。
− 協働歯止め(18、19):インプラント内で2つの固定具の連結を可能にする。これはインプラントおよび/または椎骨内で固定具を安定化し、椎骨間でインプラントをさらに安定化してもよい。これらの協働歯止め(18、19)はさらに、必要な係止構造(およびそのサイズ)を最小化できるようにする。
技術的特徴および要素:
− 意図的な抜去のためにアクセス可能な保持歯止め(14):
インプラント内の補完的歯止め(214)は、固定具の保持歯止め(14)上を引っ張るために配置されてもよい
インプラント内の筐体(240)は、保持歯止め(14)へのアクセスを提供するために配置されてもよい
− 意図的な抜去のためにアクセス可能な協働歯止め(18、19):
固定具内の筐体(40)は、協働歯止め(18、19)のうちの少なくとも1つへのアクセスを提供するように構成されてもよい、
インプラント内の筐体(240)は、協働歯止め(18、19)のうちの少なくとも1つへのアクセスを提供するように構成されてもよい、
− 意図的な抜去のためにアクセス可能な抜去歯止め(12):
固定具内の筐体(40)は、抜去歯止め(12)へのアクセスを提供するように構成されてもよい、
インプラント内の筐体(240)は、抜去歯止め(12)へのアクセスを提供するように構成されてもよい、
固定具内の筐体(40)は、協働歯止め(18、19)および/または抜去歯止め(12)のうちの少なくとも1つへのアクセスを提供するように構成されてもよい、
インプラント内の筐体(240)は、協働歯止め(18、19)および/または抜去歯止め(12)のうちの少なくとも1つへのアクセスを提供するように構成されてもよい
技術的特徴および要素:
− 湾曲した剛性固定具のための湾曲通路は、通路を通じて固定具を案内するのに役立ち、固定具の最小クリアランスのために構成されてもよく、これは良好な安定性を保証するのに役立てるためのインプラント内の固定具の滑合を提供するだろう。
− 直線的剛性固定具のための直線通路は、通路を通じて固定具を案内するのに役立つように、および固定具の最小クリアランスを有するように構成されることが可能であり、これは良好な安定性を保証するのに役立てるためのインプラント内の固定具の滑合を提供するだろう。
− 湾曲した剛性固定具のための直接通路は、通路を通じて固定具を案内するのに役立ち、固定具の最小クリアランスのために構成されてもよく、これは良好な安定性を保証するのに役立てるためのインプラント内の固定具の滑合を提供するだろう。
− 直線的剛性固定具または相互間に角度を形成する複数の直線部分を備える固定具のための湾曲通路曲線:通路を通じて固定具を案内するのに役立ち、固定具の最小クリアランスのために構成されてもよく、これは良好な安定性を保証するのに役立てるためのインプラント内の固定具の滑合を提供するだろう。
Claims (47)
- 椎骨内に椎間インプラント(2)を固定するための装置(1)にして、前部末端と後部末端との間を伸びる長手軸(L)に沿って延伸する少なくとも1つの湾曲プレート(10)を含む本体を含み、前記湾曲プレート(10)は、その後部末端がインプラント(2)の通路(21)内に残留している間にその前部末端がインプラント(2)を通じて椎骨内に貫通するように、インプラント(2)の少なくとも一部を横断する通路(21)を通じて挿入されるように設計されており、インプラント(2)の補完的歯止め(214)に対して停止されることが可能な固定装置(1)の少なくとも1つの保持歯止め(14)は、前記湾曲プレート(10)が前記通路(21)を通じてインプラント(2)の外側から椎骨を貫通するときに、椎骨に対して前記インプラント(2)を押さえる、装置であって、
本体は、その面のうちの少なくとも1つの少なくとも一部に少なくとも1つの長手方向リブ(11)を含むことを特徴とする、装置(1)。 - 前記リブ(11)のレベルが本体の長手軸に沿って変化することを特徴とする、請求項1に記載の固定装置(1)。
- 前記リブ(11)の幅が本体の長手軸に沿って変化することを特徴とする、請求項1および2に記載の固定装置(1)。
- 本体の湾曲プレート(10)が、本質的に椎間腔の平面内に長手軸(L)を有する一方で、脊柱の垂直軸に対しておよそ90°を形成する進入路の軸に沿って前記椎骨の椎体終板内に固定装置(1)が埋め込まれるように作られた寸法および少なくとも1つの曲率半径を有する、円または楕円の少なくとも1つの弧を描くことを特徴とする、請求項1から3のいずれか一項に記載の固定装置(1)。
- 前部末端が、椎骨内への装置(1)の貫通を容易にする、少なくとも1つの面取り(15)または少なくとも1つの角取りを含むことを特徴とする、請求項1から4のいずれか一項に記載の固定装置(1)。
- 前部末端が、椎骨内への装置(1)の貫通を容易にする、少なくとも1つの刻み目(13)を含むことを特徴とする、請求項1から5のいずれか一項に記載の固定装置(1)。
- 本体には、一旦椎骨内に埋め込まれたら装置(1)の抜去に対抗するように配向された刻み目(16)が設けられていることを特徴とする、請求項1から6のいずれか一項に記載の固定装置(1)。
- 前記保持歯止め(14)が、装置(1)が固定されるように設計された椎骨に対してインプラント(2)を保持するために、前記前部末端と本質的に対向して配向され、前記後部末端と本質的に対向して配向されたインプラント(2)の少なくとも1つの歯止め面(214)と協働するように設計された、少なくとも1つの歯止め面を含むことを特徴とする、請求項1から7に記載の固定装置(1)。
- 保持歯止め(14)が、固定装置(1)の本体の少なくとも1面上に、少なくとも1つの突起ラグを含むことを特徴とする、請求項8に記載の固定装置(1)。
- 保持歯止め(14)が、固定装置(1)の本体の側面上に少なくとも2つの突起ラグを含むことを特徴とする、請求項8に記載の固定装置(1)。
- 保持歯止め(14)が、後部末端のレベルで、リブ(11)に対して直角に突起する2つのラグを含むことを特徴とする、請求項8に記載の固定装置(1)。
- 本体が、後部末端に向かって配向され、固定装置(1)の抜去に対抗する抜去歯止めを形成するためにインプラント(2)の補完的歯止め(212)上で停止されることが可能な、少なくとも1つの可撓性ラグ(12)を含むことを特徴とする、請求項1から11に記載の固定装置(1)。
- 前記プレート(10)が、前記長手軸(L)に沿った長さ、幅、およびレベルを有し、プレート(10)の曲率はプレート(10)のレベルにおいて配向され、それによって前記プレート(10)の凹面および凸面を定義することを特徴とする、請求項1から12に記載の固定装置(1)。
- 前記プレート(10)が、前記長手軸(L)に沿った長さ、幅、およびレベルを有し、プレート(10)の曲率はプレート(10)の幅の方向に配向され、それによって前記プレート(10)の凹辺および凸辺を定義することを特徴とする、請求項1から12に記載の固定装置(1)。
- プレート(10)の後部末端付近に、インプラント(2)の通路(21)内の装置の遊びを制限するために、前記通路(21)の壁に接触してそこにプレートを押さえることができるように配置された、プレート(10)の残部の厚みよりも大きい厚みの少なくとも1つの部分(20)を含むことを特徴とする、請求項1から14のいずれか一項に記載の固定装置(1)。
- 本体が、後部末端付近に、インプラントの外側からアクセス可能であり、装置を抽出して固定装置の抜去を可能にするツールを受容するために形成された、少なくとも1つの陥凹(40)を含むことを特徴とする、請求項1から15のいずれか一項に記載の固定装置(1)。
- 陥凹(40)が、ツールが前記陥凹内に直接貫通できるように、本体の後部末端上で開放していることを特徴とする、請求項1から16に記載の固定装置(1)。
- 一旦埋め込まれたら装置(1)を通じて骨成長を可能にするために、プレート(10)を横断する少なくとも1つの開口部(17)を含むことを特徴とする、請求項1から17のいずれか一項に記載の固定装置(1)。
- リブ(11)が、この刻み目がインプラント(2)の通路(21)の末端の歯止め面(220)で停止するように決定された距離だけ後部末端から離れて位置する刻み目(112)を含むことを特徴とする、請求項1から18のいずれか一項に記載の固定装置(1)。
- 椎骨内に椎間インプラント(2)を固定するための装置(1)にして、前部末端と後部末端との間を伸びる長手軸(L)に沿って延伸する少なくとも1つの直線プレート(10)を含む本体を含み、前記直線プレート(10)は、その後部末端がインプラント(2)の通路(21)内に残留している間にその前部末端がインプラント(2)を通じて椎骨内に貫通するように、インプラント(2)の少なくとも一部を横断する通路(21)を通じて挿入されるように設計されており、インプラント(2)の補完的歯止め(214)に対して停止されることが可能な固定装置(1)の少なくとも1つの保持歯止め(14)は、前記直線プレート(10)が前記通路(21)を通じてインプラント(2)の外側から椎骨を貫通するときに、椎骨に対して前記インプラント(2)を押さえる、装置であって、
本体は、その面のうちの少なくとも1つの少なくとも一部に少なくとも1つの長手方向リブ(11)を含むことを特徴とする、装置(1)。 - 少なくとも1つの周囲壁(28)を含む椎間インプラント(2)にして、後部と称されるその少なくとも一部は、変形することなくこの剛性の固定装置(1)の通過を許容するように、プレート(10)を含む少なくとも1つの固定装置(1)を受容することが可能な少なくとも1つの通路(21)を含み、この通路(21)は、前記インプラント(2)がインプラントの前記固定装置(1)によってこの椎骨に対して保持されるように、固定装置(1)の少なくとも1つの保持歯止め(14)を補完し、前記プレート(10)の後部末端が前記通路(21)内に残留する間に前記プレート(10)の前部末端が前記通路(21)を通じてインプラント(2)の外側から椎骨を貫通するときにこの保持歯止め(14)を停止することが可能な、少なくとも1つの歯止め(214)も含む、前記インプラント(2)の少なくとも一部を横断する、椎間インプラントであって、
通路(21)は、請求項1から20のいずれか一項に記載の固定装置(1)の少なくとも1つのリブ(11)を受容することができるように設計された少なくとも1つの溝(211)を含むことを特徴とする、椎間インプラント(2)。 - インプラント(2)の前記歯止め(214)が、前記通路(21)の近傍に位置しており、インプラント(2)の外側の方向に配向された少なくとも1つの歯止め面を含むことを特徴とする、請求項21に記載の椎間インプラント(2)。
- 通路(21)内に挿入された固定装置の前部末端と本質的に対向して配向された少なくとも1つの歯止め面を含む少なくとも1つの抜去歯止め(212)を含んでおり、この抜去歯止め(212)は、インプラント(2)からの固定装置(1)の抜去に対抗するために、固定装置(1)の少なくとも1つの可撓性ラグ(12)の歯止め末端を受容することが可能であることを特徴とする、請求項1から22のいずれか一項に記載の椎間インプラント(2)。
- 周囲壁(28)が、その間にインプラント(2)が埋め込まれるように設計された椎骨の各々に1つの固定装置(1)を固定することができるように、インプラント(2)の上面および下面のうちの1つに向かって各々配向された2つの通路(21)を含むことを特徴とする、請求項1から23のいずれか一項に記載の椎間インプラント(2)。
- 周囲壁(28)が、通路(21)を含むものの反対側の、いわゆる前部分に、椎骨間のインプラント(2)の挿入を容易にするように、少なくとも1つの角取り部分(27)を含むことを特徴とする、請求項1から24のいずれか一項に記載の椎間インプラント(2)。
- 固定装置(1)によって少なくとも1つの椎骨内に固定される椎間インプラント(2)のシステムであって、請求項1から20のいずれか一項に記載の少なくとも1つの固定装置と、請求項21から25のいずれか一項に記載の少なくとも1つのインプラント(2)を含むことを特徴とする、システム。
- その曲率に関わらず変形を伴わずに固定装置(1)のこの剛性の湾曲プレート(10)の通過を許容するように、インプラント(2)の通路(21)はまっすぐでありながら、固定装置(1)のプレート(10)は湾曲しており、プレート(10)の厚みよりも大きい通路(21)のレベルを有することを特徴とする、請求項26に記載のシステム。
- その曲率に関わらず変形を伴わずに固定装置(1)のこの剛性の湾曲プレート(10)の通過を許容するように、固定装置(1)のプレート(10)は湾曲しており、インプラント(2)の通路(21)も湾曲していることを特徴とする、請求項26に記載のシステム。
- 椎骨間に椎間インプラント(2)を埋め込み、これら椎骨のうちの少なくとも1つに少なくとも1つの固定装置(1)を埋め込むための器具(3、4)にして、器具は、一方で、インプラントの把持と称される第一末端と、押さえと称される第二末端との間を伸びる長手軸に沿って延伸する形状の少なくとも1つのガイド(3)であって、把持末端はインプラント(2)の少なくとも1つの締結手段(22)と協働することが可能な少なくとも1つの把持手段(321)を含む、ガイド(3)を、他方では、椎骨に対して前記インプラントを押さえるように、インプラント(2)を横断する通路(21)内に前記固定装置(1)を押し込むのに適した形状およびサイズのヘッド(40)を含む少なくとも1つの嵌入具(4)を含む器具であって、
ガイド(3)は、椎骨内に固定装置(1)を嵌入するために、請求項21から25のいずれか一項に記載のインプラント(2)の前記通路(21)を通じてこの固定装置(1)を案内するように、少なくとも部分的に嵌入具のヘッド(40)を受容するのに適した形状およびサイズであって、請求項1から19に記載の固定装置(1)の少なくとも1つの曲率半径と本質的に同一の少なくとも1つの曲率半径を有する少なくとも1つの案内面(31)を含む、ヘッド(30)を含み、ヘッド(30)は、固定装置(1)のリブ(11)の通過および/または案内を許容するように作られていることを特徴とする、器具(3、4)。 - ヘッド(30)が、固定装置(1)のリブ(11)の通路のために作られた少なくとも1つの溝(3011)を含むことを特徴とする、請求項29に記載の器具(3、4)。
- ガイド(3)のヘッド(30)は、固定装置(1)を受容し、少なくとも部分的に嵌入具(4)のヘッド(40)を受容するのに適した形状およびサイズの空洞(300)を含み、案内面(31)は、本体(10)の両側で固定装置(1)の側面を案内するためにこの空洞(300)の片側に各々位置する少なくとも2つの湾曲溝(31)を含み、嵌入具(4)のヘッド(40)は、末端からこれら溝(31)の他方まで、空洞(300)内に貫通していることを特徴とする、請求項29および30のいずれか一項に記載の器具(3、4)。
- 把持手段(321)が、把持手段がハンドル(33)によって作動されたときにインプラント(2)を固着させるために、前記締結手段(22、22a)の補完的なネジ切りと協働するネジ切り末端を含むことを特徴とする、請求項29から31のいずれか一項に記載の器具(3、4)。
- 把持手段(321)が、インプラント(2)の締結手段の一部を形成する陥凹(22、22a)に出入りするためにハンドル(33)によって作動されたときにガイド(3)の本体(32)内を摺動するシャフトの末端を含むことを特徴とする、請求項29から32のいずれか一項に記載の器具(3、4)。
- 把持手段(321)が、インプラント(2)の陥凹(22、22a)を出入りするためにハンドル(33)によって作動されたときにガイド(3)の本体(32)内を摺動するシャフトの1つの末端と、インプラント(2)の周囲壁(28)の側面の溝(22b)内に嵌合されるように作られ、椎骨間でインプラント(2)を位置決めするためのレバーアームの役割を果たすラグ(3210)と、を含み、前記陥凹(22a)および溝(22b)はインプラント(2)の締結手段(22)の一部であることを特徴とする、請求項29から33のいずれか一項に記載の器具(3、4)。
- 溝(22b)が、器具によるインプラント(2)の把持を改善するように、ラグ(3210)のスタッド(3210b)を受容するように設計された陥凹(22c)を含むことを特徴とする、請求項34に記載の器具(3、4)。
- 固定装置(1)のリブ(11)の通路のために形成された前記溝(3011)は、ガイド(3)のヘッド(30)の空洞(300)の上部壁および/または下部壁の少なくとも一部に形成されることを特徴とする、請求項29から35のいずれか一項に記載の器具(3、4)。
- 椎骨内に椎間インプラント(2)を固定するための装置(1)にして、前部末端と後部末端との間を伸びる長手軸(L)に沿って延伸する少なくとも1つのプレート(10)を含む本体を含み、前記プレート(10)は、その後部末端がインプラント(2)の通路(21)内に残留している間にその前部末端がインプラント(2)を通じて椎骨内に貫通するように、インプラント(2)の少なくとも一部を横断する通路(21)を通じて挿入されるように設計されており、インプラント(2)の補完的歯止め(214)に対して停止されることが可能な固定装置(1)の少なくとも1つの保持歯止め(14)は、前記プレート(10)が前記通路(21)を通じてインプラント(2)の外側から椎骨を貫通するときに、椎骨に対して前記インプラント(2)を押さえる、装置であって、
本体は、前記通路(21)内に固定装置(1)を押し込んでインプラント(2)内で固定装置(1)を安定化するように、前記通路(21)の内壁との接触を提供するサイズおよび形状の、少なくとも1つの肥厚部(20)および/または少なくとも1つの平坦面(110a、110b、111)を含むことを特徴とする、装置(1)。 - 椎骨内に椎間インプラント(2)を固定するための装置(1)にして、プレート(10)の幅および長さを定義する長手軸(L)に沿って延伸する少なくとも1つの湾曲プレート(10)を含む本体を含み、長さは前部末端と後部末端との間に延在し、前記湾曲プレート(10)は、その後部末端がインプラント(2)の通路(21)内に残留している間にその前部末端がインプラント(2)を通じて椎骨内に貫通するように、インプラント(2)の少なくとも一部を横断する通路(21)を通じて挿入されるように設計されており、インプラント(2)の補完的歯止め(214)に対して停止されることが可能な固定装置(1)の少なくとも1つの保持歯止め(14)は、前記湾曲プレート(10)が前記通路(21)を通じてインプラント(2)の外側から椎骨を貫通するときに、椎骨に対して前記インプラント(2)を押さえる、装置であって、
プレート(10)の曲率は、プレート(10)の前記幅の方向に配向されており、それによって前記プレート(10)の凹辺および凸辺を定義することを特徴とする、装置(1)。 - 椎骨内に椎間インプラント(2)を固定するための装置(1)にして、前部末端と後部末端との間を伸びる長手軸(L)に沿って延伸する少なくとも1つのプレート(10)を含む本体を含み、前記プレート(10)は、その後部末端がインプラント(2)の通路(21)内に残留している間にその前部末端がインプラント(2)を通じて椎骨内に貫通するように、インプラント(2)の少なくとも一部を横断する通路(21)を通じて挿入されるように設計されており、インプラント(2)の補完的歯止め(214)に対して停止されることが可能な固定装置(1)の少なくとも1つの保持歯止め(14)は、前記プレート(10)が前記通路(21)を通じてインプラント(2)の外側から椎骨を貫通するときに、椎骨に対して前記インプラント(2)を押さえる、装置であって、
インプラントの補完的歯止め(212)と接触可能であることによって、インプラント(2)からのその抜去に対抗するために固定装置(1)の後部末端に向かって配向された、少なくとも1つのラグまたはタブ(12)を含み、前記ラグ(12)は、可撓性であって、インプラント内への固定装置(1)の挿入の間に折り畳まれて、固定装置(1)がインプラント内に完全に挿入されているときに前記補完的歯止め(212)と嵌合するために展開されるように配置されており、前記固定装置(1)は、インプラントの外側から、固定装置(1)の可撓性ラグまたはタブ(12)をその補完的歯止め(212)から解放するために配置されたリソース(40)をさらに含むことを特徴とする、装置(1)。 - 椎間インプラント(2)にして、後部と称されるその少なくとも一部が、少なくとも1つのプレートを含む少なくとも1つの固定装置(1)を受容するのに適した寸法の少なくとも1つの通路(21)を含む、少なくとも1つの周囲壁(28)を含み、この通路(21)は、インプラントの外側から、その間またはそこにインプラント(2)が埋め込まれるように設計された椎骨のうちの1つの方向に、固定装置(1)を配向するように、固定装置(1)に適合した軌道に沿って、インプラント(2)を横断している、椎間インプラントであって、
インプラントは、インプラント(2)からのその抜去に対抗するために固定装置(1)の後部末端に向かって配向された、固定装置(1)のラグまたはタブ(12)を補完して受容可能な少なくとも1つの歯止め(212)を含み、前記ラグ(12)は、可撓性であって、インプラント内への固定装置(1)の挿入の間に折り畳まれて、固定装置(1)がインプラント内に完全に挿入されているときに前記補完的歯止め(212)と嵌合するために展開されるように配置されており、前記インプラント(2)は、インプラント(2)の外側からツールを受容するように構成され、インプラント(2)内の補完的歯止め(212)からこれを解放するために固定装置(1)の可撓性ラグまたはタブ(12)の折り畳みを可能にする、リソース(240)をさらに含むことを特徴とする、椎間インプラント(2)。 - 椎間インプラント(2)にして、後部と称されるその少なくとも一部が、少なくとも1つのプレートを含む少なくとも1つの固定装置(1)を受容するのに適した寸法の少なくとも1つの通路(21)を含む、少なくとも1つの周囲壁(28)を含み、この通路(21)は、インプラントの外側から椎骨の方向に固定装置(1)を配向するように、固定装置(1)に適合した軌道に沿って、インプラント(2)を横断しており、前記インプラント(2)は、前記固定装置(1)の後部末端のレベルに位置する保持歯止め(14)を補完する歯止め(214)の表面を含み、前記歯止め面(214)は、インプラント内の前記通路(21)への入り口に、またはその付近に位置する陥凹内に形成されており、前記保持歯止め(14)によってこの椎骨に対して前記インプラント(2)を押さえるために、前記通路(21)を通じて、固定装置(1)が完全に内部に挿入されてインプラント(2)の外側から椎骨を貫通するときに、インプラント(2)から突出することなく、保持歯止め(14)の隣接のために配置されている、椎間インプラントであって、
インプラント(2)は、インプラント(2)の外側からツールを受容し、前記保持歯止め(14)上を引っ張ることによって固定装置(1)の抜去を可能にするように保持歯止めへのアクセスを提供するように構成された、少なくとも1つの陥凹(214、240)をさらに含むことを特徴とする、椎間インプラント(2)。 - 椎骨内に椎間インプラント(2)を固定するための装置(1)にして、前部末端と後部末端との間を伸びる長手軸(L)に沿って延伸する少なくとも1つのプレート(10)を含む本体を含み、前記プレート(10)は、その後部末端がインプラント(2)の通路(21)内に残留している間にその前部末端がインプラントを通じて椎骨内に貫通するように、インプラント(2)の少なくとも一部を横断する通路(21)を通じて挿入されるように設計されており、インプラント(2)の補完的歯止め面(214)に対して停止されることが可能な、前記通路(21)の入り口に、またはその付近に位置する陥凹内に形成された、固定装置(1)の少なくとも1つの保持歯止め(14)は、前記プレート(10)が前記通路(21)を通じてインプラント(2)の外側から椎骨を貫通するときに、椎骨に対して前記インプラント(2)を押さえ、前記保持歯止め(14)は、固定装置(1)が完全に内部に挿入されたときにインプラント(2)から突出することなく前記補完的歯止め面(214)に隣接するように、前記固定装置(1)の後部末端のレベルに位置決めされている、装置であって、
固定装置(1)は、インプラント(2)の外側からツールを受容し、その上を引っ張ることによって固定装置(1)の抜去のために配置された後部末端を支持する止め具面を含むように構成された、陥凹(40)を含むことを特徴とする、装置(1)。 - 椎骨内に固定される椎間インプラント(2)のシステムであって、
インプラント(2)、および椎骨内に前記インプラントを固定するための2つの固定装置(1)を含み、
各固定装置(1)は、前部と称される第一末端と、後部と称される第二末端との間を延びる長手軸(L)に沿って延伸する少なくとも1つのプレート(1)を含む、前記プレートの少なくとも一方の表面の少なくとも一部に、少なくとも1つの長手方向リブ(11)が設けられた本体を有し、固定装置(1)は、前記湾曲プレート(10)が前記通路(21)を通じてインプラント(2)の外側から椎骨を貫通するときに、前記固定装置(1)がインプラント(2)を保持する歯止めによってこの椎骨に対してインプラント(2)を保持するように各々配置された、前記固定装置(1)を受容するために配置された位置および寸法の少なくとも2つの通路(21)を、後部と称されるその少なくとも一部が含む、少なくとも1つの周囲壁(28)を含む前記インプラント(2)を通じて椎骨内に貫通するために、インプラント(2)の少なくとも一部を横断する通路(21)を通じて各々挿入されるように設計されており、前記通路(21)は、1つの椎骨の方向に固定装置(1)を配向するように、各々固定装置(1)に適合された軌道に沿って、インプラントの外側から椎骨に向かってインプラント(2)を各々横断することを特徴とし、第一固定装置(1)は、前部末端と本質的に対向して配向された少なくとも1つの歯止め面を含む、第一協働歯止め(18)を含み、第二固定装置(1)は、本質的に後部末端に対向する方向に配向された少なくとも1つの歯止め面を含む、第二協働歯止め(19)を含み、これら2つの協働歯止め(18、19)は、前記第一協働歯止め(18)が前記第二協働歯止め(19)に隣接して、前記第二固定装置(1)の抜去を防止する抜去歯止めを形成するように、互いの近くに位置する前記通路(21)内に挿入されたときに、互いに協働するように作られていることを特徴とする、システム。 - 第二固定装置(1)の前記第二協働歯止め(19)が、本質的に前部末端に対向して配向された、第二歯止め面(190)を含み、第一固定装置(1)は、その後部歯止め末端が前記第二協働歯止め(19)の第二歯止め面(190)と接触して、前記抜去歯止め(12)を支持するのに役立つように位置決めされた、抜去歯止め(12)を含み、こうして一旦インプラント(2)内に収まったら、第二装置(1)を保持する第一固定装置(1)の抜去を妨害することを特徴とする、請求項43に記載のシステム。
- 第一固定装置(1)の抜去歯止め(12)の歯止め末端が、これらの固定装置(1)のうちの少なくとも1つに作られてインプラント(2)の外側に現れるチャネルを通じて、第二固定装置(1)の第二歯止め面(190)から解放可能なように配置されていることを特徴とする、請求項44に記載のシステム。
- インプラント(2)が、インプラント(2)の外側からアクセス可能であり、協働歯止め(18、19)を経由する固定装置(1)の抜去のために配置された、リソース(214、240)を含むことを特徴とする、請求項43から45のいずれか一項に記載のシステム。
- インプラント(2)が、インプラント(2)の外側からツールを受容するように構成され、固定装置(1)の抜去歯止め(12)を解放するために配置された、少なくとも1つの陥凹(240)を含むことを特徴とする、請求項43から45のいずれか一項に記載のシステム。
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Publication number | Priority date | Publication date | Assignee | Title |
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JP2015507989A (ja) * | 2012-02-24 | 2015-03-16 | エル・デ・エール・メデイカル | 椎間インプラント用のアンカー装置およびシステム、椎間インプラント、および移植器具 |
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