JP5952198B2 - 手術用具 - Google Patents
手術用具 Download PDFInfo
- Publication number
- JP5952198B2 JP5952198B2 JP2012555954A JP2012555954A JP5952198B2 JP 5952198 B2 JP5952198 B2 JP 5952198B2 JP 2012555954 A JP2012555954 A JP 2012555954A JP 2012555954 A JP2012555954 A JP 2012555954A JP 5952198 B2 JP5952198 B2 JP 5952198B2
- Authority
- JP
- Japan
- Prior art keywords
- bone
- bioabsorbable
- filler
- surgical instrument
- bag
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Active
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Images
Classifications
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- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
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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
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- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30581—Special structural features of bone or joint prostheses not otherwise provided for having a pocket filled with fluid, e.g. liquid
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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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- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
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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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- A—HUMAN NECESSITIES
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- 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
- A61F2310/00179—Ceramics or ceramic-like structures
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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
- 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
- A61F2310/00179—Ceramics or ceramic-like structures
- A61F2310/00293—Ceramics or ceramic-like structures containing a phosphorus-containing compound, e.g. apatite
-
- 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
- A61F2310/00359—Bone or bony tissue
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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
- 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
- A61F2310/00365—Proteins; Polypeptides; Degradation products thereof
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Description
(1) 可撓性を有する袋体を備え、該袋体を骨欠損部あるいは骨と接する部位に挿入し、その挿入状態で前記袋体の内部に充填材を充填して使用される手術用具であって、
前記袋体は、その少なくとも一部に生体吸収性を有する生体吸収部と、生体への吸収が抑止または防止された生体非吸収部とを備え、
前記袋体は、メッシュ状をなし、その目開きが大であり、前記生体吸収部を兼ねる大目開き部と、該大目開き部よりも目開きが小であり、前記生体非吸収部を兼ねる小目開き部とを備え、
当該手術用具を椎体に使用する際、前記生体吸収部を兼ねる前記大目開き部は、前記椎体の終板骨に宛がわれ、前記生体非吸収部を兼ねる前記小目開き部は、骨折線が生じた前記椎体の側壁を構成する骨に宛がわれることを特徴とする手術用具。
前記複数の素線のうちの少なくとも1本は、生体吸収性材料で構成され、前記生体吸収部として機能する上記(2)または(3)に記載の手術用具。
これにより、生体吸収部が確実に生体吸収性を有するものとなる。
前記接触可能部には、前記生体吸収部が宛がわれ、前記接触抑止部には、前記生体非吸収部が宛がわれる上記(1)ないし(6)のいずれかに記載の手術用具。
これにより、骨欠損部での袋体の設置状態をX線透視下で把握することができる。
<第1実施形態>
図1は、本発明の手術用具の自然状態(未使用時)での第1実施形態を示す斜視図、図2は、図1に示す手術用具の使用状態の一例を示す斜視図、図3は、図2中のA−A線断面図(図1に示す手術用具の使用状態での経時的な変化を示す断面図)、図8〜図13は、それぞれ、図1に示す手術用具の使用方法を順に説明するための図である。なお、図2、図8〜図13中、紙面手前側が「頭側」、紙面奥側が「脚側」、上側が「腹側」、下側が「背側」となっている。
充填材8Aは、手術用具1に充填されるまでは粘性(流動性)を有するペースト状のものである。これにより、充填材8Aを手術用具1に容易にかつ確実に充填することができる。なお、充填材8Aの充填には、例えば図13に示すように、シリンジ10を用いることができる。また、充填材8Aとしては、特に限定されず、例えば、以下の物性(稠度)を有するものが好ましい。25℃の環境下で1[g]のペースト状の充填材8Aをガラス板上に載置し、その上から120[g]のガラス板を静かに重ねる。そして、このときに広がった充填材8Aの最大幅を有する部分の長さと最小幅を有する部分の長さとを測定し、これらの平均値を算出する。その平均値は、10〜40[mm]が好ましく、15〜30[mm]がより好ましい。
手術用具1は、袋体2と管状部3とで構成されている。
[1] まず、X線透視下で、図8に示すように、椎体圧迫骨折整復術を施す椎骨9の椎弓92、92から、椎体91に向けて穿孔器20を穿刺する。これにより、椎骨9の図8中の左右両側には、各椎弓92から椎体91内にかけて、細径の孔93、93が形成される。次に、リーマ30を用いて、各孔93の内径をそれぞれ拡径する。
図4は、本発明の手術用具(第2実施形態)の使用状態での経時的な変化を示す断面図、図5は、図4に示す手術用具に充填される充填材の粒度分布を示すグラフである。
本実施形態は、充填材の態様が異なること以外は前記第1実施形態と同様である。
図6は、本発明の手術用具(第3実施形態)を構成する線状体の使用状態での経時的な変化を示す図である。
本実施形態は、線状体の構成が異なること以外は前記第1実施形態と同様である。
図7は、本発明の手術用具の自然状態(未使用時)での第4実施形態を示す斜視図である。
また、袋体には、ハイドロキシアパタイトや、BMP、TGF等の骨癒合を促進する物質が含まれていてもよい。
Claims (10)
- 可撓性を有する袋体を備え、該袋体を骨欠損部あるいは骨と接する部位に挿入し、その挿入状態で前記袋体の内部に充填材を充填して使用される手術用具であって、
前記袋体は、その少なくとも一部に生体吸収性を有する生体吸収部と、生体への吸収が抑止または防止された生体非吸収部とを備え、
前記袋体は、メッシュ状をなし、その目開きが大であり、前記生体吸収部を兼ねる大目開き部と、該大目開き部よりも目開きが小であり、前記生体非吸収部を兼ねる小目開き部とを備え、
当該手術用具を椎体に使用する際、前記生体吸収部を兼ねる前記大目開き部は、前記椎体の終板骨に宛がわれ、前記生体非吸収部を兼ねる前記小目開き部は、骨折線が生じた前記椎体の側壁を構成する骨に宛がわれることを特徴とする手術用具。 - 前記袋体は、複数本の線状体を交差させて前記メッシュ状に形成した編組体で構成されたものである請求項1に記載の手術用具。
- 前記袋体は、使用状態で経時的に前記生体吸収部での目開きが増大する請求項2に記載の手術用具。
- 互いに交差する2本の前記線状体のうちの少なくとも一方は、生体吸収性材料で構成され、前記生体吸収部として機能する請求項2または3に記載の手術用具。
- 前記各線状体は、それぞれ、複数の素線を撚り合わせてなる撚り線もしくは合糸で構成されており、
前記複数の素線のうちの少なくとも1本は、生体吸収性材料で構成され、前記生体吸収部として機能する請求項2または3に記載の手術用具。 - 前記生体吸収性材料は、ポリジオキサノン、ポリ−L−ラクチド(PLLA)、ポリ−D,L−ラクチド(P−D,L−LA)、ポリグリコール酸、ポリカプロラクトンからなる群から選択された少なくとも1種である請求項4または5に記載の手術用具。
- 前記骨欠損部が形成された骨または骨と接する前記部位には、前記充填材とできるだけ接触させたい接触可能部と、前記充填材との接触をできるだけ抑止したい接触抑止部とがあり、
前記接触可能部には、前記生体吸収部が宛がわれ、前記接触抑止部には、前記生体非吸収部が宛がわれる請求項1ないし6のいずれかに記載の手術用具。 - 前記袋体は、扁平形状をなし、その両面側にそれぞれ前記生体吸収部が配置され、側面側に前記生体非吸収部が配置されている請求項1ないし7のいずれかに記載の手術用具。
- 前記袋体は、X線透視下で視認可能なマーカ部を備える請求項1ないし8のいずれかに記載の手術用具。
- 前記マーカ部は、前記生体吸収部と前記生体非吸収部との境界部に配置されている請求項9に記載の手術用具。
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JP2007534375A (ja) * | 2004-04-15 | 2007-11-29 | ソテイラ, インコーポレイテッド | セメント誘導整形外科用インプラント |
US20050288797A1 (en) * | 2004-06-23 | 2005-12-29 | Warwick Mills, Inc. | Controlled absorption biograft material for autologous tissue support |
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