JP5893332B2 - Spacer - Google Patents

Description

  The present invention relates to a spacer, and in particular, to a spinous process, a spinous process and a vertebral spacer that are installed in a cutting portion formed by cutting a vertebral arch.

  For example, as treatment for cervical spondylotic myelopathy, posterior longitudinal ligament ossification, yellow ligament ossification, intervertebral disc herniation, etc. Has been done.

  In the case of the midline longitudinal split laminoplasty, the spinal canal is cut by cutting the midline (central part) of the spinous process and opening the vertebral arches on both sides like a hinge at the midline. To enlarge. At this time, a spacer is inserted into a gap (bone defect) formed by cutting the spinous process (see, for example, Patent Document 1).

  The spacer is inserted into the gap so that the cut end of the vertebral arch or spinous process and a pair of contact surfaces of the spacer are in contact with each other, and the pair of through holes provided in the cut end It is fixed in the gap portion by ligation fixing in which a thread is inserted and tied into a through hole provided through the contact surface.

  However, this ligation fixation is complicated in operation, and the yarn may swell with body fluid, which may make it difficult to pass the yarn through the through hole. Furthermore, there is a possibility that it is difficult to insert the thread by blocking the through hole with bone powder generated when cutting the bone.

  Furthermore, a method for fixing the spacer in the gap by fixing the spacer and the cut end with a screw using a metal plate has been proposed (for example, Patent Document 2).

  However, in the method using this plate, in order to fix with a screw, it is necessary to form a hole in the spacer, and there is a problem that a crack or a crack occurs in the spacer when the hole is formed.

JP-A-8-638 Japanese Patent No. 4482445

  An object of the present invention is to provide a spacer that can be firmly fixed without causing cracks or cracks in the spacer installed in the gap.

Such an object is achieved by the present invention described in the following (1) to ( 5 ).
(1) A spacer installed and fixed in a gap between bones,
A block body installed in the gap portion, and a plate-like body for fixing the block body to the gap portion,
The plate-like body includes a holding unit that is integrated with the plate-like body and holds the block body,
The holding portion includes a pair of arm portions protruding from a surface of the plate-like body that supports the holding portion and arranged to face each other, and a locking portion provided on the arm portion. When the portion locks the block body, the block body is held by the plate-shaped body,
The block body is composed of a ceramic material as a main material, and includes a rear surface in contact with the plate-shaped body, a front surface facing the rear surface, two side surfaces in contact with the two bones, an upper surface disposed opposite to each other, and Having a lower surface,
The pair of arm portions are set to have a separation distance so as to hold the block body on the upper surface and the lower surface, and the locking portion is an end opposite to the end portion on the supporting surface side. At the corner formed by the front surface and the upper surface of the block body, and the locking portion of the other arm portion. At the corner formed by the front surface and the lower surface of the block body, the block body is locked,
Further, the plate-like body has two end portions protruding from the block body, and the two protruding end portions constitute an engaging portion that engages with the bone. .
(2) Each of the two end portions includes a through-hole penetrating in the thickness direction, and a screw is inserted into the through-hole so that the block body is screwed into the bone. The spacer according to (1), which is fixed to the spacer.

  Thereby, a spacer can be firmly fixed to a gap part, without producing a crack, a crack, etc. in the spacer (block body) installed in the gap part.

( 3 ) The spacer according to (1) or (2) , wherein the locking portion is a claw protruding in a direction in which the arm portion is opposed.

  Accordingly, the block body can be hooked and fixed, and as a result, the block body is fixed to the plate-like body.

( 4 ) The spacer according to any one of (1) to ( 3 ), wherein the plate-like body includes a metal material or a polymer material as a main material.

  Since the metal material or the polymer material has excellent strength and elasticity, the block body can be more firmly fixed to the gap portion.

( 5 ) The spacer according to any one of the above (1) to ( 4 ), which is a spinous process spacer or a vertebral spacer that is installed in a cut portion formed by cutting / vertical splitting of a spinous process or cutting of a vertebral arch.

  The spacer of the present invention is particularly preferably applied as a spinous process spacer or a larch spacer.

  According to the present invention, the spacer can be fixed to the gap portion without using a thread, and further, the spacer can be fixed to the spacer without forming a screw insertion hole. As a result, the spacer is firmly fixed without causing cracks or cracks in the spacer installed in the gap.

It is a figure which shows 1st Embodiment of the spacer of this invention. It is a figure for explaining step by step about the midline longitudinal split type laminoplasty. It is a figure for explaining step by step about the midline longitudinal split type laminoplasty. It is a figure for explaining step by step about the midline longitudinal split type laminoplasty. It is a figure for explaining step by step about the midline longitudinal split type laminoplasty. It is a figure which shows the manufacturing method for manufacturing 1st Embodiment of the spacer of this invention. It is a figure which shows 2nd Embodiment of the spacer of this invention. It is a figure which shows 3rd Embodiment of the spacer of this invention. It is a figure which shows 4th Embodiment of the spacer of this invention. It is a figure which shows 5th Embodiment of the spacer of this invention. It is a figure which shows 6th Embodiment of the spacer of this invention. It is a figure which shows 7th Embodiment of the spacer of this invention. It is a figure which shows 8th Embodiment of the spacer of this invention.

Hereinafter, the spacer of the present invention will be described in detail based on preferred embodiments shown in the accompanying drawings.
In the following, a case where the spacer of the present invention is applied to a vertebral arch spacer used in a median longitudinal split type laminoplasty will be described as an example.

<First Embodiment>
FIG. 1 is a view showing a first embodiment of a spacer of the present invention ((a) front view, (b) plan view, (c) side view), and FIGS. It is a figure for explaining step by step about laminoplasty.

<< Medium longitudinal split-type laminoplasty >>
First, prior to describing the first embodiment of the spacer of the present invention, a median longitudinal split-type laminoplasty will be described with reference to FIGS. 2 to 5, the upper side is the dorsal 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.

  [1] First, as shown in FIG. 2, the spinous process 130 in the vertebra 100 is separated (cut) from the vertebral arch 120 at a cutting line 131.

  [2] Next, as shown in FIG. 3, the central portion (midline portion) of the vertebral arch 120 is cut using, for example, an air drill.

  Further, grooves 121a and 121b are formed on the outer side of the root portion of the vertebral arch 120 with the median plane 200 as a boundary, for example, using an air drill or the like.

  The depths of the grooves 121a and 121b are set such that only the outer plate is cut and the inner plate is not cut. The portions where the grooves 121a and 121b are formed are hinge portions (hinges) 122a and 122b.

  [3] Next, as shown in FIG. 4, the vertebral arch 120 is rotated around the hinges 122a and 122b, and the cut portion of the vertebral arch 120 is expanded. As a result, a gap 150 is formed between the cut ends (bones) 120a and 120b.

  If necessary, the cut ends 120a and 120b facing the gap 150 of the vertebral arch 120 are shaped.

  [4] Next, as shown in FIG. 5, after inserting the spacer 1 of the present invention into the gap portion 150, the cutting end portion with the screw (screw) 4 inserted into the through hole 32 provided in the spacer 1. The spacer 1 is fixed in the gap 150 by screwing it to the rear surfaces 124a and 124b of 120a and 120b. Thus, an enlarged vertebral arch 160 is formed by the patient's vertebral arch 120 and the spacer 1.

  The spacer 1 is screwed to the cut end portions 120a and 120b with screws 4 and the spacer 1 is fixed in the gap 150, so that the spacer 1 is positioned relative to the vertebral arch 120 early after the operation. Misalignment can be prevented, and bone union between the cut ends 120a and 120b and the side surface 12 can be reliably caused.

  Further, as compared to the case where the thread is inserted and tied into the through hole formed in the spacer as in the ligation fixing described above, the screw is simply fixed to the rear surfaces 124a and 124b with the screw 4 inserted into the through hole 32. The spacer 1 can be firmly fixed in the gap 150 with a simple operation.

  Further, as will be described in detail later, since the block body 2 is held (fixed) in advance on the plate-like body 3 by the holding portion 5, it is not necessary to form a hole in the block body 2 with a screw. 2 can be reliably prevented from being cracked or broken.

  The spinous process 130 separated in the step [1] may be returned to the center (midline) of the rear surface 13 of the spacer 1 and fixed to the spacer 1 with a thread or the like.

  Further, the spinous process 130 may be cut along the median plane 200 in the step [2] without separating the spinous process 130 from the vertebral arch 120.

<< Spacer >>
Next, a first embodiment of the spacer of the present invention will be described with reference to FIG. 1 and FIG.

  In the following description, unless otherwise specified, the direction is specified based on the state in which the spacer 1 is inserted (installed) in the treatment site (gap portion 150) of the patient. That is, the patient's ventral side (vertebral canal 140 side) is called “front”, the dorsal side (opposite to the spinal canal 140) is called “rear”, the patient's head side is “up”, and the patient's leg side is “down”. "

  As shown in FIGS. 1 and 5, the spacer 1 includes a block body (spacer main body) 2 installed (inserted) in the gap portion (defect portion) 150 and a plate shape that fixes the block body 2 to the gap portion 150. And a body 3.

  The block body 2 is inserted into the gap 150 to form an enlarged vertebral arch 160.

  In the present embodiment, as shown in FIG. 5, the block body 2 has a substantially trapezoidal shape with a concave portion on the front surface 11 side in a top view or a bottom view, and has a plurality of corners.

  In this block body 2, the front surface 11 is configured by a curved concave surface, and the rear surface 13 facing the front surface 11 is configured by a plane. By configuring the front surface 11 with a curved concave surface, the spinal canal 140 can be enlarged larger (wider), and compression of the spinal nerve can be reliably prevented.

  In addition, the pair of side surfaces 12 of the block body 2 constitute contact surfaces with which the cut end portions 120a and 120b of the vertebral arch 120 abut in a state of being inserted into the gap portion 150, respectively.

  In addition, in such a block body 2, the dimension of each part is set as follows, respectively.

  The length in the front-rear direction of the block body 2 (L in FIG. 1) is preferably about 5 to 12 mm, and more preferably about 5 to 7 mm.

  Moreover, it is preferable that the length (H in FIG. 1) of the up-down direction of the block body 2 is about 5-12 mm, and it is more preferable that it is about 5-7 mm.

Moreover, it is preferable that the length (W1 in FIG. ₁ ) of the left-right direction of the block body 2 is about 6-23 mm, and it is more preferable that it is about 10-21 mm.

Also, the left-right direction of the length of the block body 2 (in FIG. 1 _{W 2)} is preferably about 4～21Mm, more preferably about 6～18Mm.

  The average radius of curvature of the curved concave surface of the front surface 11 is preferably about 20 to 120 mm, and more preferably about 23 to 53 mm.

  By setting the dimension of each part in the spacer 1 within the above-described range, it is possible to more reliably impart excellent mechanical strength to the block body 2.

  Such a block body 2 is preferably composed of a ceramic material as a main material. Since ceramic materials are stable and inorganic materials, there is no burden on the living body of elution of organic substances.

  Examples of the ceramic material include various materials, and bioceramics such as alumina, zirconia, and calcium phosphate compounds are particularly preferable. Among these, a calcium phosphate compound is particularly preferable as a constituent material of the block body 2 because it has excellent biocompatibility.

  Examples of the calcium phosphate compound include apatites such as hydroxyapatite, fluorapatite, and carbonate apatite, dicalcium phosphate, tricalcium phosphate, tetracalcium phosphate, octacalcium phosphate, and the like. Species or a combination of two or more can be used. Of these calcium phosphate compounds, those having a Ca / P ratio of 1.0 to 2.0 are preferably used.

  Of such calcium phosphate compounds, hydroxyapatite is more preferable. Hydroxyapatite has an excellent biocompatibility because it has the same structure as the mineral main component of bone. Further, it is possible to expect the fusion between the block body 2 itself and the cut ends 120a and 120b.

  The block body 2 may be a dense body or a porous body, but is preferably a porous body. By constituting the block body 2 with a porous body, it is possible to invade osteoblasts into the block body 2 and to perform osteogenesis in the block body 2. In particular, the block body 2 is made of hydroxyapatite. When constituted as a main material, reliable fusion between the block body 2 itself and the cut ends 120a and 120b can be expected.

  Moreover, it is preferable that the porosity of a porous body is about 0 to 90%, and it is more preferable that it is about 15 to 60%. Thereby, while preventing the mechanical strength of the block body 2 from being lowered, it is possible to allow the osteoblasts to enter the block body 2 more smoothly and to promote osteogenesis in the block body 2. . As a result, the bone fusion between the cut ends 120a and 120b and the side surface 12 can be caused more reliably and early.

  As a constituent material of the block body 2, in addition to the ceramic material, a composite material of the ceramic material and a metal material with low biological harm such as titanium can be used.

  The plate-like body 3 is disposed so as to be in contact with the rear surface 13 of the block body 2, and is for fixing the block body 2 to the gap portion 150.

  The plate-like body 3 includes a main body portion 34 and a holding portion 5 that is integrated with the main body portion 34 and holds the block body 2.

  The main body 34 has a flat plate shape that is long in the left-right direction, and protrudes from both ends of the block body 2 on the rear surface 13 side of the block body 2.

  The protruding portion functions as the engaging portion 31 that engages the rear surfaces 124a and 124b of the cut ends 120a and 120b of the vertebral arch 120 when the block body 2 is inserted into the gap 150. As a result, the block body 2 (spacer 1) is prevented from moving toward the spinal canal 140, and the compression of the spinal nerve by the block body 2 can be surely prevented, so that safety is high.

  Moreover, the engaging part 31 has the through-hole 32 penetrated in the thickness direction. The block body 2 is fixed in the gap 150 by screwing the screws 4 to the rear surfaces 124a and 124b of the cut ends 120a and 120b in a state where the screws 4 are inserted into the through holes 32.

  Further, as in the present embodiment, the rear surface 33 of the main body 34 is configured as a flat surface. For example, when the separated spinous process 130 is returned to the original position as a surgical procedure, The positional displacement of the spinous process 130 can be suitably prevented.

  The holding portion 5 includes a pair of arm portions 51 that protrude from the front surface 35 of the main body portion 34, that is, a surface that supports the holding portion 5, and an end portion (base end) on the side opposite to the front surface 35 side of these arm portions 51. And an engaging portion 52 provided at the end (tip).

  In the present embodiment, the pair of arm portions 51 has a quadrangular prism shape as a whole, and is provided at each edge portion near the center of the front surface 35 in the longitudinal direction so as to face each other.

  Further, the locking portion 52 has a quadrangular prism shape like the arm portion 51, and is provided so as to protrude in a direction in which the pair of arm portions 51 face each other (short direction of the front surface 35). The locking portion 52 having such a configuration functions as a claw that is fixed by hooking the block body 2.

  In the present embodiment, the engaging portion 52 is located near the center of the corner formed by the front surface 11 and the upper surface 14 of the block body 2 and at the center of the corner portion formed by the front surface 11 and the lower surface 15 of the block body 2. In the vicinity, the block body 2 is locked, whereby the block body 2 is held (fixed) by the plate-like body 3.

  Therefore, since the block body 2 can be fixed to the plate-like body 3 without forming a hole in the block body 2 with a screw, it is possible to reliably prevent the block body 2 from being cracked or cracked. .

  In the present embodiment, the distance between the arm portions 51 is set so that the block body 2 is held by the pair of arm portions 51. As a result, the block body 2 can be held (fixed) more firmly by the plate-like body 3.

  Further, when the block body 2 is held by the pair of arm portions 51, a plate in which the main body portion 34, the arm portion 51 and the locking portion 52 are integrated is prepared, and this plate is transferred from the main body portion 34 to the arm portion 51. By using the elasticity of the arm portion 51 (holding portion 5), it is also possible to obtain the plate-like body 3 by bending at the transition portion and the transition portion from the arm portion 51 to the locking portion 52. The block body 2 can be sandwiched.

  Such a plate-like body 3 is preferably composed of a metal material or a polymer material as a main material. Since the metal material and the polymer material have excellent strength and elasticity, the block body 2 can be fixed in the gap 150 more firmly.

  Examples of the metal material include various materials, and titanium or a titanium alloy is particularly preferable. Titanium or a titanium alloy is preferably used as a constituent material of the plate-like body 3 because of high biocompatibility and excellent strength. In addition, although it does not specifically limit as a titanium alloy, For example, Ti, such as Ti-6Al-4V and Ti-29Nb-13Ta-4.6Zr, has Al as a main component, Sn, Cr, Zr, Mo, Ni , Pd, Ta, Nb, V, Pt and the like are added. The metal material may be a shape memory alloy. The plate-like body 3 is made of a shape memory alloy and designed to have a shape capable of holding the block body near the body temperature (around 35 degrees). Even if etc. deform | transformed, the plate-shaped body 3 returns to the original shape which can hold | maintain the block body 2. FIG.

  Examples of the polymer material include various materials, and polyether ether ketone is particularly preferable. In addition to these, those used in clinical practice such as polyethylene, polyethylene terephthalate, polymethyl methacrylate, polylactic acid and the like can be mentioned.

  Moreover, each part which comprises the spacer 1 may comprise the shape where the corner | angular part was rounded over the whole (R attachment is made | formed). With such a configuration, there is an advantage that it is possible to prevent the surrounding tissue from being damaged when the spacer 1 is inserted into the gap 150.

  In the present specification, the above-mentioned “gap portion” refers to a space formed by harvesting autologous bone such as the iliac in addition to a space formed for widening the vertebral arch as in the present embodiment. It also includes spaces where bones have been lost due to accidents or illness.

  Further, the through-hole 32 is formed, for example, in the form of a perfect circle when viewed from the rear surface 13 side as in the present embodiment, for example, an outer square shape such as a triangle or a quadrangle, or an ellipse such as an ellipse. It may be an eggplant. In the case of an ellipse, there is an advantage that the selection range of the positions of the rear surfaces 124a and 124b to be screwed by the screw 4 is widened.

The spacer 1 as described above can be manufactured, for example, as follows.
In the following description, an example of manufacturing the spacer 1 in which the block body 2 is made of a ceramic material and the plate-like body 3 is made of a metal material will be described.

  6A and 6B are diagrams showing a manufacturing method for manufacturing the first embodiment of the spacer of the present invention. FIG. 6A is a perspective view showing the configuration of the block body and the plate-like body, and FIG. It is a perspective view for demonstrating the method fixed with a shape body.

  In the following description, unless otherwise specified, the direction is specified on the basis of the state in which the spacer 1 shown in FIG. 6 is inserted (mounted) into the treatment site (gap portion 150) of the patient. That is, the patient's ventral side (vertebral canal 140 side) is called “front”, the dorsal side (opposite to the spinal canal 140) is called “rear”, the patient's head side is “up”, and the patient's leg side is “down”. "

  [A] First, a block body 2 and a plate-like body 3 as shown in FIG.

  [A-1] The block body 2 can be obtained by firing the molded body after obtaining the molded body corresponding to the shape.

  For example, the molded body may be, for example, I: a method of filling a slurry containing ceramic raw material powder into a predetermined mold and molding, II: a method of unevenly distributing solid content to the slurry by precipitation or centrifugation, III : A method in which the slurry is put in a predetermined mold and dehydrated to leave a solid content in the mold. IV: Compression molding method (in the case of powder, compacting) V: Ceramic raw material powder and water-like paste Can be produced by various methods such as mixing and drying in a mold.

  The slurry may contain secondary particles granulated in advance by a spray drying method or the like as a ceramic raw material powder.

  Moreover, you may make it adjust the shape, a magnitude | size, etc. of a molded object by cutting using a lathe, a drill, etc. as needed.

  For example, when the ceramic material is a calcium phosphate compound, the firing temperature when firing the formed body is preferably about 700 to 1300 ° C.

  [A-2] The plate-like body 3 can be easily obtained by preparing a metal dense body having a block shape and molding the dense body into the shape, size, etc. of the plate-like body 3. .

  For forming the dense body, for example, a thin piece cutting method such as laser cutting, water jet, discharge wire processing, or ultrasonic cutting can be used.

  In the present embodiment, as shown in FIG. 6A, the locking portion 52 is integrally formed with the arm portion 51 in the longitudinal direction of the arm portion 51 without protruding in the direction in which the arm portion 51 faces. Form it.

  Further, the plate-like body 3 is prepared as a metal dense body having a flat plate shape, and the plate-like dense body is cut into a desired shape, and the arm portion 51 is bent as shown in FIG. You may make it obtain by doing.

[B] Next, as shown in FIG. 6 (b), the pair of arm portions 51 are arranged so that the rear surface 13 of the block body 2 and the front surface 35 of the plate-like body 3 (main body portion 34) are in contact with each other. Then, the block body 2 is disposed, and then the hook 52 is bent in a direction in which the pair of arms 51 face each other to form a claw. Thereby, the block body 2 is locked by the locking portion 52.
As described above, the spacer 1 in which the block body 2 is held by the plate-like body 3 is obtained.

Second Embodiment
Next, a second embodiment of the spacer of the present invention will be described.

  FIG. 7 is a diagram ((a) front view, (b) plan view, (c) side view) showing a second embodiment of the spacer of the present invention.

  Hereinafter, the spacer 1 of the second embodiment will be described focusing on the differences from the spacer 1 of the first embodiment, and the description of the same matters will be omitted.

  The spacer 1 shown in FIG. 7 is the same as the spacer 1 shown in FIG. 1 except that the structures of the block body 2 and the holding portion 5 are different.

  That is, in the spacer 1 of the second embodiment, the locking portion 52 is provided not in the end portion of the arm portion 51 but substantially in the center thereof. Further, holes 21 are respectively provided at positions corresponding to the locking portions 52 of the upper surface 14 and the lower surface 15 of the block body 2.

  Then, by inserting the locking portions 52 into these holes 21, the locking portions 52 are locked to the inner peripheral surface of the holes 21, whereby the block body 2 is held (fixed) by the plate-like body 3. The

The effect similar to the said 1st Embodiment is acquired also by the spacer 1 of such 2nd Embodiment.
In addition, the dimension of each part is the same as that of the spacer 1 of the said 1st Embodiment.

<Third Embodiment>
Next, a third embodiment of the spacer of the present invention will be described.

  FIG. 8 is a view ((a) front view, (b) plan view, (c) side view) showing a third embodiment of the spacer of the present invention.

  Hereinafter, the spacer 1 of the third embodiment will be described focusing on the differences from the spacer 1 of the first embodiment, and the description of the same matters will be omitted.

  The spacer 1 shown in FIG. 8 is the same as the spacer 1 shown in FIG. 1 except that the structures of the block body 2 and the holding portion 5 are different.

  That is, in the spacer 1 of the third embodiment, the pair of arm portions 51 are provided in the vicinity of the center of the front surface 35 so as to face each other along the short direction of the main body portion 34. The locking portion 52 is provided so as to protrude in the opposite direction (longitudinal direction of the front surface 35) of the direction in which the pair of arm portions 51 face each other. Furthermore, a through hole 22 that penetrates the rear surface 13 and the front surface 11 is provided at a position corresponding to the arm portion 51 of the block body 2.

  And the arm part 51 is inserted in the through-hole 22, and the block part 2 is hold | maintained (fixed) by the plate-shaped body 3 because the latching | locking part 52 latches to the edge of the through-hole 22. FIG.

The effect similar to the said 1st Embodiment is acquired also by the spacer 1 of such 3rd Embodiment.
In addition, the dimension of each part is the same as that of the spacer 1 of the said 1st Embodiment.

<Fourth embodiment>
Next, a fourth embodiment of the spacer of the present invention will be described.

  FIG. 9 is a view ((a) front view, (b) plan view, (c) side view) showing a fourth embodiment of the spacer of the present invention.

  Hereinafter, the spacer 1 of the fourth embodiment will be described focusing on the differences from the spacer 1 of the first embodiment, and the description of the same matters will be omitted.

  The spacer 1 shown in FIG. 9 is the same as the spacer 1 shown in FIG. 1 except that the number of holding portions 5 provided in the plate-like body 3 is different.

  That is, in the spacer 1 of 4th Embodiment, as shown in FIG. 9, the plate-shaped body 3 is equipped with two (plural) holding | maintenance parts 5 along the left-right direction, ie, the longitudinal direction.

The effect similar to the said 1st Embodiment is acquired also by the spacer 1 of such 4th Embodiment.
In addition, the dimension of each part is the same as that of the spacer 1 of the said 1st Embodiment.

<Fifth Embodiment>
Next, a fifth embodiment of the spacer of the present invention will be described.

  FIG. 10 is a view ((a) front view, (b) plan view, (c) side view) showing a fifth embodiment of the spacer of the present invention.

  Hereinafter, the spacer 1 of the fifth embodiment will be described focusing on the differences from the spacer 1 of the first embodiment, and the description of the same matters will be omitted.

  The spacer 1 shown in FIG. 10 is the same as the spacer 1 shown in FIG. 1 except that the structures of the block body 2 and the holding portion 5 are different.

  That is, in the spacer 1 of the fifth embodiment, the pair of arm portions 51 has a flat plate shape as a whole and is provided so as to face each other along the short direction of the main body portion 34. . The locking portion 52 is provided so as to protrude in the opposite direction (longitudinal direction of the front surface 35) of the direction in which the pair of arm portions 51 face each other. Furthermore, two through holes 22 that penetrate the rear surface 13 and the front surface 11 are provided at positions corresponding to the arm portions 51 of the block body 2 so as to correspond to the respective arm portions 51.

  And the arm part 51 is inserted in the through-hole 22, and the block part 2 is hold | maintained (fixed) by the plate-shaped body 3 because the latching | locking part 52 latches to the edge of the through-hole 22. FIG.

The effect similar to the said 1st Embodiment is acquired also by the spacer 1 of such 5th Embodiment.
In addition, the dimension of each part is the same as that of the spacer 1 of the said 1st Embodiment.

<Sixth Embodiment>
Next, a sixth embodiment of the spacer of the present invention will be described.

  FIG. 11 is a diagram ((a) front view, (b) plan view, (c) side view) showing a sixth embodiment of the spacer of the present invention.

  Hereinafter, the spacer 1 of the sixth embodiment will be described with a focus on differences from the spacer 1 of the fifth embodiment, and description of the same matters will be omitted.

  The spacer 1 shown in FIG. 11 is the same as the spacer 1 shown in FIG. 10 except that the configuration of the plate-like body 3, particularly the main body 34 is different.

  That is, in the spacer 1 of the sixth embodiment, the main body portion 34 is omitted in the region inside (the side opposite to the engaging portion 31) from the position where the pair of arm portions 51 are formed. .

  Thus, even if the formation of a part of the main body 34 is omitted, the block body 2 is held (fixed) by the plate-like body 3 by the locking portion 52 being locked to the edge of the through hole 22. Can do.

The effect similar to the said 5th Embodiment is acquired also by the spacer 1 of such 6th Embodiment.
In addition, the dimension of each part is the same as that of the spacer 1 of the said 1st Embodiment.

<Seventh embodiment>
Next, a seventh embodiment of the spacer of the present invention will be described.

  FIG. 12 is a diagram ((a) front view, (b) plan view, (c) side view) showing a seventh embodiment of the spacer of the present invention.

  Hereinafter, the spacer 1 of the seventh embodiment will be described focusing on the differences from the spacer 1 of the sixth embodiment, and the description of the same matters will be omitted.

  The spacer 1 shown in FIG. 12 is the same as the spacer 1 shown in FIG. 11 except that the configuration of the holding portion 5, particularly the locking portion 52, is different.

  That is, in the spacer 1 of 7th Embodiment, a pair of latching | locking part 52 is provided so that it may protrude from the edge part of the block body 2 over each side surface 12 together. The protruding portion functions as an engaging portion that engages with the cut ends 120 a and 120 b of the vertebral arch 120 when the block body 2 is inserted into the gap portion 150. It can be firmly fixed.

The effect similar to the said 6th Embodiment is acquired also by the spacer 1 of such 7th Embodiment.
In addition, the dimension of each part is the same as that of the spacer 1 of the said 1st Embodiment.

<Eighth Embodiment>
Next, an eighth embodiment of the spacer of the present invention will be described.

  FIG. 13 is a view ((a) front view, (b) plan view, (c) side view) showing an eighth embodiment of the spacer of the present invention.

  Hereinafter, the spacer 1 of the eighth embodiment will be described focusing on the differences from the spacer 1 of the first embodiment, and description of the same matters will be omitted.

  The spacer 1 shown in FIG. 13 is the same as the spacer 1 shown in FIG. 1 except that the structures of the block body 2 and the main body 34 are different.

  That is, in the spacer 1 of the eighth embodiment, a through hole 36 that penetrates the front surface 35 and the rear surface 33 is provided near the center of the main body 34. Further, a protrusion 23 protruding from the rear surface 13 is provided at a position corresponding to the through hole 36 of the block body 2.

  And the convex part 23 is arrange | positioned in the through-hole 36, and when the through-hole 36 and the convex part 23 engage, the position shift of the block body 2 with respect to the plate-shaped body 3, especially with respect to the left-right direction of the block body 2 Misalignment can be prevented or suppressed more accurately. A plurality of through holes 36 and convex portions 23 may be provided.

The effect similar to the said 1st Embodiment is acquired also by the spacer 1 of such 8th Embodiment.
In addition, the dimension of each part is the same as that of the spacer 1 of the said 1st Embodiment.

  As mentioned above, although the spacer of this invention was demonstrated based on embodiment of illustration, this invention is not limited to this.

  For example, in the spacer of the present invention, each component can be replaced with any component that can exhibit the same function, or any component can be added.

  For example, in the present invention, any two or more configurations shown in the first to eighth embodiments may be combined.

  Furthermore, in the spacers of the above-described embodiment, the block body 2 has a substantially trapezoidal shape when viewed from the top. However, in the spacer of the present invention, the entire shape of the insertion portion is a columnar shape or a quadrangular prism shape. It may be a columnar shape.

  In addition, as the block body 2, when the rear surface 13 is not a flat surface as in the above-described embodiment, but is configured by a curved convex surface corresponding to the front surface 11 forming a curved concave surface, the shape of the curved convex surface is followed. The upper and lower surfaces of the plate-like body 3 (main body part 34) may be curved (arc-shaped) instead of linear.

  In the above-described embodiment, the spacer 1 is used for the mid-vertical split-type enlarged laminoplasty. However, in the present invention, the spacer is cut on one side (one side) of the vertebra and the other side is hinged. As described above, the spinal canal may be expanded by expanding the spinal canal by opening the vertebral arch.

  Furthermore, the spacer 1 can be placed and fixed in gaps formed in various bones such as the iliac bones, femurs, and skulls, in addition to being installed and fixed in gaps formed in the vertebral arches.

DESCRIPTION OF SYMBOLS 1 Spacer 11 Front surface 12 Side surface 13 Rear surface 14 Upper surface 15 Lower surface 2 Block body 21 Hole 22 Through-hole 23 Convex part 3 Plate body 31 Engagement part 32 Through-hole 33 Rear surface 34 Main-body part 35 Front surface 36 Through-hole 4 Screw 5 Holding part 51 Arm part 52 Locking part 100 Vertebrum 110 Vertebral body 120 Ling arch 120a, 120b Cutting end part 121a, 121b Groove 122a, 122b Hinge part 124a, 124b Rear surface 130 Spinous process 131 Cutting line 140 Spinal canal 150 Gap part 160 Expanded vertebra Bow 200 Midline

Claims (5)

A spacer that is installed and fixed in a gap between bones,
A block body installed in the gap portion, and a plate-like body for fixing the block body to the gap portion,
The plate-like body includes a holding unit that is integrated with the plate-like body and holds the block body,
The holding portion includes a pair of arm portions protruding from a surface of the plate-like body that supports the holding portion and arranged to face each other, and a locking portion provided on the arm portion. When the portion locks the block body, the block body is held by the plate-shaped body,
The block body is composed of a ceramic material as a main material, and includes a rear surface in contact with the plate-shaped body, a front surface facing the rear surface, two side surfaces in contact with the two bones, an upper surface disposed opposite to each other, and Having a lower surface,
The pair of arm portions are set to have a separation distance so as to hold the block body on the upper surface and the lower surface, and the locking portion is an end opposite to the end portion on the supporting surface side. At the corner formed by the front surface and the upper surface of the block body, and the locking portion of the other arm portion. At the corner formed by the front surface and the lower surface of the block body, the block body is locked,
Further, the plate-like body has two end portions protruding from the block body, and the two protruding end portions constitute an engaging portion that engages with the bone. .   Each of the two end portions has a through hole penetrating in the thickness direction, and the block body is fixed in the gap by screwing the bone into the through hole with a screw inserted therethrough. The spacer according to claim 1.   The spacer according to claim 1, wherein the locking portion is a claw protruding in a direction in which the arm portion is opposed. The spacer according to any one of claims 1 to 3 , wherein the plate-like body is configured using a metal material or a polymer material as a main material. The spacer according to any one of claims 1 to 4 , which is a spinous process spacer or a vertebral spacer that is installed in a cutting portion formed by cutting / vertical splitting of a spinous process and cutting of a vertebral arch.

Images