JP5769217B2 - 椎体間固定外科手術システム - Google Patents
椎体間固定外科手術システム Download PDFInfo
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- JP5769217B2 JP5769217B2 JP2014078022A JP2014078022A JP5769217B2 JP 5769217 B2 JP5769217 B2 JP 5769217B2 JP 2014078022 A JP2014078022 A JP 2014078022A JP 2014078022 A JP2014078022 A JP 2014078022A JP 5769217 B2 JP5769217 B2 JP 5769217B2
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- vertebral bodies
- pair
- interbody
- main body
- interbody fusion
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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
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
- A61F2/446—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages having a circular or elliptical cross-section substantially parallel to the axis of the spine, e.g. cylinders or frustocones
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- A—HUMAN NECESSITIES
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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
- 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
- A61F2/4611—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 of spinal prostheses
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- A—HUMAN NECESSITIES
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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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- A—HUMAN NECESSITIES
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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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- A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
- A61F2002/30004—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis
- A61F2002/30014—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis differing in elasticity, stiffness or compressibility
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- A—HUMAN NECESSITIES
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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
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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
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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
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- A61F2310/00035—Other metals or alloys
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Description
に雄ねじ258、259を介して螺入された後に、1対の骨ねじ280、280が椎体L4、L5内に斜めに螺入する構成である。(特許文献2参照)。
これに加えて、第1のシャフト部に外嵌されたクランプアーム開閉管の前進又は後退により弾性支持部を有する各1対のクランプアームを縮径方向に閉じ又は拡径方向に開くことから、隣接する椎体の左右両側面をそれぞれ挟持し固定する椎体間スペース保持装置の構造及び操作が簡易化される効果がある。
み固定工程)。このとき、本体嵌入ドライバー80の把持部82を回転しないうに別途いずれも図示しない人手又は機械的回転拘束手段により十分押圧して保持しながら、押圧ねじ40をキャップ42連設面が本体11の後端面13に当接する所定トロークまで雌ねじ16内に螺入する。
11、11b、11c、11d、11e、11g、11h、11i 本体
12 前端面
13 後端面
14 外面係合部((部分)雄ねじ)
14a 外面係合部(スプライン歯)
14b 先端部(尖鋭刃)
14c 外面係合部(鋸歯)
15 外面係合部((完全)雄ねじ)
16 雌ねじ
16a 中空内面
17、17a、17c、17d、18、18a、18c、18d ガイド孔
19 カット側面
21、22、23 側面開口
24、25、26 上下面開口
27 後端開口
28 小穴
29、44、54 後端係合部
30、30A、30B、30C、30D、30E、30F、30a、30b、30c、30d、30j、30k ピン
30An、30Dn 薄板材
30Bn、30En、30Cn、30Fn 線材
31、31a、31b、31c、31d、31j、31k (ピンの)後端
32、32a、32b、32c、32d、32j、32k (ピンの)先端
33、33k 基端部
34、34k 雌ねじ穴
40、40a、40j、40k、50 押圧ねじ
41、41j、41k、51、95a、96a 雄ねじ部
42、42j、42k、52 キャップ
43、53 先端面
43a 先端部
43b 傾斜面
44、45 挿通孔
55 摩擦板
55a ピン固定溝
60 固定補強具
61 ボス
62 アーム
62a フランジ
62b ウエブ
70、70´、70´´ (椎体間固定外科手術用)椎体間スペース保持装置
70a、70´a 保持装置本体
70b、70´b クランプアーム開閉管
71、71´ 第1のシャフト部
71a、71´a、76a 先端部
71b ガイド筒
71c 針状突起
72、77、82、92 把持部
72a、77a、82a、92a ボス部
73、73´ スペーサー
74、74´ クランプアーム
74a 弾性支持部
74´a 支持部
74b 固定爪
74c 尖鋭突起
75 補強板
75a 後部支持部材
75b 前部支持部材
75c 挿通孔
76 第2のシャフト部
76´ 椎体固定機構
76´a ねじ部
76´b 長尺固定ねじ部材
76´c 頭部
78 ブラケット
79 リンク部材
80 本体嵌入ドライバー
81、91 シャフト部
83、93 先端係合部
90 押圧ねじドライバー
95、96 引抜きドライバー
Bd 脊柱手術台
C1 (本体の)主軸
C2、C3 (ガイド孔の)傾斜軸(中心軸)
K カニューレ
L 脊柱(脊椎)
L1、L2 椎体(椎骨)
L1a、L2a 対向面
L1b、L2b 係合溝
M 椎間板(椎間板スペース)
Ma、Mb、Mc、Md、Me (内視鏡用)ポート
Mf 切開創
MN 生体(人体)
MN1 腹(部)
MN2 背(部)
P1 第1の支持軸
P2 第2の支持軸
P3 第3の支持軸
X1、X1´ 全閉位置
X2 椎体把持/固定位置
X3、X3´ 全開位置
Θ1、Θ2 傾斜角
Claims (4)
- 椎体間固定装置を用いる生体の椎体間固定外科手術の際に、2つの隣接する椎体(椎骨)間の適正な間隔を修正して椎間板スペースを保持するための椎体間スペース保持装置であって、
後端に把持部が設けられ、生体腹部側に設けられた内視鏡用腹腔部内のカニューレを介して前記椎体の前面近傍まで挿入される中空長尺の第1のシャフト部と、
該第1のシャフト部の先端部に軸方向に沿って延設され、前記隣接する椎体の左右両側面をそれぞれ挟持し固定する固定爪が先端に連接されて前記椎体の直交面内で開閉可能な少なくとも各1対のクランプアームと、を有する椎体クランプ機構を備えた椎体間スペース保持装置を有し、
前記椎体クランプ機構は、
先端に前記各固定爪が連設され、後端部が前記第1のシャフト部の先端部に連設され、フリー状態では前記固定爪をそれぞれ前記椎体の直交面内で拡径して開くように屈曲されて弾支する弾性支持部を有する前記各1対のクランプアームと、
前記第1のシャフト部に前進/後退自在に外嵌され、後端に把持部が設けられた中空長尺の第2のシャフト部の先端部が前進して前記弾性支持部を外側から押圧することにより前記各1対のクランプアームを縮径方向に閉じ、その先端部が前記弾性支持部から後退することにより前記各1対のクランプアームを拡径方向に開くクランプアーム開閉管と、を備えることを特徴とする椎体間固定外科手術システム。 - 椎体間固定装置を用いる生体の椎体間固定外科手術の際に、2つの隣接する椎体(椎骨)間の適正な間隔を修正して椎間板スペースを保持するための椎体間スペース保持装置であって、
後端に把持部が設けられ、生体腹部側に設けられた内視鏡用腹腔部内のカニューレを介して前記椎体の前面近傍まで挿入される中空長尺の第1のシャフト部と、
該第1のシャフト部の先端部に軸方向に沿って延設され、前記隣接する椎体の左右両側面をそれぞれ挟持し固定する固定爪が先端に連接されて前記椎体の直交面内で開閉可能な少なくとも各1対のクランプアームと、を有する椎体クランプ機構を備えた椎体間スペース保持装置を有し、
前記椎体クランプ機構は、
先端に前記各固定爪が連設され、後端部が前記第1のシャフト部の先端部に第1の支持軸を介して前記椎体の直交面内で揺動自在に枢着された前記各1対のクランプアームと、
前記第1のシャフト部に前進/後退自在に外嵌され、後端に把持部が設けられた中空長尺の第2のシャフト部と、
前記各1対のクランプアームの中間部に第2の支持軸を介してそれぞれ一端部が揺動自在に枢着されるとともに、その各他端部が前記第2のシャフト部の先端部に第3の支持軸を介して揺動自在に枢着された各1対のリンク部材と、からなり、
前記第2のシャフト部が前進又は後退することにより前記各1対のリンク部材を前記第3の支持軸を支点として反時計回り又は時計回りに揺動させて前記各1対のクランプアームを前記椎体の直交面内で前記第1の支持軸を支点として縮径方向に閉じ又は拡径方向に開くトグル機構を構成することを特徴とする椎体間固定外科手術システム。 - 前記固定爪の椎体挟持面に前記椎体の側面に突刺可能な複数の尖鋭突起を有することを特徴とする請求項1又は請求項2に記載の椎体間固定外科手術システム。
- 前記第1のシャフト部の先端部に前記椎体の外径より僅かに狭い間隔で前記椎体間スペースに向かい軸方向に沿って対向状態で延設され、先端部から前記椎間板スペース内に挿入されることにより前記隣接する椎体を適正な間隔に修正して保持するような外形形状に形成された少なくとも1対のスペーサーをさらに備えることを特徴とする請求項1又は請求項2に記載の椎体間固定外科手術システム。
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