JP6076912B2 - 横方向脊椎すべり症整復ケージ - Google Patents
横方向脊椎すべり症整復ケージ Download PDFInfo
- Publication number
- JP6076912B2 JP6076912B2 JP2013542047A JP2013542047A JP6076912B2 JP 6076912 B2 JP6076912 B2 JP 6076912B2 JP 2013542047 A JP2013542047 A JP 2013542047A JP 2013542047 A JP2013542047 A JP 2013542047A JP 6076912 B2 JP6076912 B2 JP 6076912B2
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- Prior art keywords
- wall
- cage
- proximal
- height
- front wall
- Prior art date
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- A61F2/442—Intervertebral or spinal discs, e.g. resilient
- A61F2/4425—Intervertebral or spinal discs, e.g. resilient made of articulated components
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- A61F2/447—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 substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section
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- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30576—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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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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-
- A—HUMAN NECESSITIES
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- A61F2002/30879—Ribs
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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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- A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
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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
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2002/465—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using heating means
-
- 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
- A61F2310/00017—Iron- or Fe-based alloys, e.g. stainless steel
-
- 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
-
- 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
- A61F2310/00029—Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
-
- 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
- A61F2310/00185—Ceramics or ceramic-like structures based on metal oxides
- A61F2310/00239—Ceramics or ceramic-like structures based on metal oxides containing zirconia or zirconium oxide ZrO2
-
- 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
- A61F2310/00179—Ceramics or ceramic-like structures
- A61F2310/00299—Ceramics or ceramic-like structures based on metal nitrides
- A61F2310/00317—Ceramics or ceramic-like structures based on metal nitrides containing silicon nitride
-
- 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
- A61F2310/00389—The prosthesis being coated or covered with a particular material
- A61F2310/00592—Coating or prosthesis-covering structure made of ceramics or of ceramic-like compounds
- A61F2310/00796—Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite
Description
a)前壁と、後壁と、前壁及び後壁を連結する近位壁及び遠位壁と、上部椎体と接触するための上面と、下面とを有する上部ケージと、
b)前壁と、後壁と、前壁及び後壁を連結する近位壁及び遠位壁と、下部椎体と接触するための下面と、上面とを有する下部ケージと、を備え、
上部ケージの下面は、下部ケージの上面と摺動的に嵌合する、装置が提供される。
a)上部ケージ及び下部ケージを備える融合装置を選択する工程と、
b)上部ケージを患者の上部椎体に、かつ下部ケージを患者の下部椎体に固定する工程と、
c)脊椎すべり症を矯正するために、下部ケージに対して上部ケージを移動させる工程と、を含む、方法が提供される。
a)前壁と、後壁と、前壁及び後壁を連結する近位壁及び遠位壁と、上部椎体と接触するための上面と、内部に第1の溝を有する下面とを有する上部ケージと、
b)前壁と、後壁と、前壁及び後壁を連結する近位壁及び遠位壁と、下部椎体と接触するための下面と、内部に第2の溝を有する上面とを有する下部ケージと、
c)係止プレートと、を備え、
第1及び第2の溝が近位壁から遠位壁の辺りに及ぶ第1の貫通孔を形成するように、上部ケージの下面は、下部ケージの上面と接触し、
係止プレートは、第1の貫通孔の中に配設される、装置が提供される。
a)前壁と、後壁と、前壁及び後壁を連結する近位壁及び遠位壁と、上部椎体と接触するための上面と、下面とを有する上部ケージと、
b)前壁と、後壁と、前壁及び後壁を連結する近位壁及び遠位壁と、下部椎体と接触するための下面と、上面とを有する下部ケージと、を備え、
前壁は、第1の二重結合部によって近位壁に、かつ第2の二重結合部によって遠位壁に連結され、
後壁は、第3の二重結合部によって近位壁に、かつ第4の二重結合部によって遠位壁に連結され、
結合部は、上部プレートを近位壁の平面で下部プレートに対して旋回させることを可能にする、装置が提供される。
a)上部椎体と接触するように適合された上面と、内表面とを有する上壁と、
b)下部椎体と接触するように適合された下面と、内表面とを有する下壁と、
c)上壁と下壁との間に延在する近位壁及び遠位壁と、
d)上壁と下壁との間に延在する前壁及び後壁と、
e)上壁及び下壁の内表面間に位置するラックアンドピニオン機構と、を備え、
ピニオンは、遠位壁から近位壁に実質的に延在し、
ラックは、前壁から後壁に実質的に延在し、
そのため、ピニオンの回転は、前後方向における上壁及び下壁の相対運動をもたらす、装置が提供される。
a)前壁3と、後壁5と、前壁及び後壁を連結する近位壁7及び遠位壁9と、上部椎体と接触するための上面11と、下面13とを有する上部ケージ1と、
b)前壁17と、後壁19と、前壁及び後壁を連結する近位壁21及び遠位壁23と、下部椎体と接触するための下面25と、上面27とを有する下部ケージ15と、を備え、
上部ケージの下面は、下部ケージの上面と摺動的に嵌合する、装置が提供される(請求項1)。
c)第1及び第2の貫通孔53を有する係止プレート51と、
d)第1及び第2の骨締結具(ねじ等)55と、を更に備え、
係止プレートは、係止プレートの第1の貫通孔を通じて上部ケージの下部貫通孔の中に第1の骨締結具を通すことによって、かつ係止プレートの第2の貫通孔を通じて下部ケージの上部貫通孔の中に第2の骨締結具を通すことによって、上部及び下部ケージの近位壁に固定される。
前壁は、それを貫通する貫通孔61を更に備える。これらの貫通孔は、融合を促進するように適合された寸法である。
a)上部ケージ及び下部ケージを備える融合装置を選択する工程と、
b)上部ケージを患者の上部椎体に、かつ下部ケージを患者の下部椎体に固定する工程と、
c)脊椎すべり症を矯正するために、下部ケージに対して上部ケージを移動させる工程と、を含む、方法が提供される(請求項16)。
a)前壁77と、後壁79と、前壁及び後壁を連結する近位壁81及び遠位壁83と、上部椎体と接触するための上面85と、内部に第1の溝89を有する下面87とを有する、上部ケージ75と、
b)前壁93と、後壁95と、前壁及び後壁を連結する近位壁97及び遠位壁99と、下部椎体と接触するための下面101と、内部に第2の溝104を有する上面103とを有する、下部ケージ91と、
c)一対の係止プレート105と、を備え、
第1及び第2の溝が近位壁から遠位壁の辺りに及ぶ第1の貫通孔107を形成するように、上部ケージの下面は、下部ケージの上面と接触し、
係止プレートは、第1の貫通孔の中に配設される、装置が提供される(請求項21)。
a)前壁117と、後壁119と、前壁及び後壁を連結する第1側壁としての近位壁121及び第2側壁としての遠位壁123と、上部椎体と接触するための上面125と、下面127とを有する、上部端板としての上部ケージ115と、
b)前壁133と、後壁135と、前壁及び後壁を連結する第1側壁としての近位壁137及び第2側壁としての遠位壁139と、下部椎体と接触するための下面141と、上面143とを有する、下部端板としての下部ケージ131と、を備え、
前壁は、第1の二重結合部145によって近位壁に、かつ第2の二重結合部(図示せず)によって遠位壁に連結され、
後壁は、第3の二重結合部149によって近位壁に、かつ第4の二重結合部(図示せず)によって遠位壁に連結され、
芯部材としての結合部は、上部プレートを近位壁の平面内で下部プレートに対して旋回させることを可能にする、装置が提供される(請求項31)。
a)上部椎体と接触するように適合された上面173と、内表面175とを有する上壁171と、
b)下部椎体と接触するように適合された下面179と、内表面181とを有する下壁177と、
c)上壁と下壁との間に延在する近位壁183及び遠位壁185と、
d)上壁と下壁との間に延在する前壁187及び後壁189と、
e)上壁及び下壁の内表面間に位置するラックアンドピニオン機構と、を備え、
ピニオン191は、遠位壁から該近位壁に実質的に延在し、
ラック193は、前壁から後壁に実質的に延在し、
そのため、ピニオンの回転は、前後方向における上壁及び下壁の相対的動作をもたらす、装置が提供される(請求項41)。
i)椎間装置を選択する工程であって、その椎間装置が、
a.前壁と、後壁と、前壁及び後壁を連結する2つの側壁とを有する上半分の構成要素と、
b.前壁と、後壁と、前壁及び後壁を連結する2つの側壁とを有する下半分の構成要素と、を備える、工程と、
ii)装置を対向した椎体間に挿入することによって、前壁が一直線にならない工程と、
iii)前壁が実質的に一直線になるように、構成要素のうちの1つをもう一方の構成要素に対して(好ましくは旋回させることによって)移動させる工程と、
iv)装置を対向した椎体に固定する工程と、を含む、方法が提供される。
a)前壁と、後壁と、前壁及び後壁を連結する一対の側壁とを有する椎間装置を選択する工程であって、側壁のうちの少なくとも1つは、前壁及び後壁を超えて軸方向に延在するフランジを有し、フランジは、貫通孔を有する、工程と、
b)装置を対向した椎体間に挿入する工程と、
c)貫通孔を通じて固定装置を挿入し、対向した椎体のうちの1つの面に装置を固定する工程と、を含む、方法が提供される。
a)前壁と、後壁と、前壁及び後壁を連結する近位壁及び遠位壁と、骨固定装置を受容するための近位壁の上縁部に存在する貫通孔とを有する上部ケージと、
b)前壁と、後壁と、前壁及び後壁を連結する近位壁及び遠位壁と、下部椎体と接触するための下面と、上面と、骨固定装置を受容するための近位壁の下縁部に存在する貫通孔とを有する下部ケージと、を備え、
上部ケージの下面は、下部ケージの上面と摺動的に嵌合する、装置が提供される。
a)上部ケージ及び下部ケージを備える器具を選択する工程であって、それぞれのケージは、ハンドルに取り付けられる、工程と、
b)上部ケージを患者の上部椎体に、かつ下部ケージを患者の下部椎体に(好ましくはカスパーピン(caspar pin)で)取り付ける工程と、
c)脊椎すべり症を矯正するために、下部ケージに対して上部ケージを(好ましくはカスパーピンを係合するディストラクタ(distractor)で)移動させる工程と、
d)患者から器具を取り除く工程と、を含む、方法が提供される。
a)近位ハンドル部と、
b)第1及び第2の椎体係合ビームであって、長手方向軸と、近位端部と、遠位端部とを有し、それぞれのビームの遠位端部は、骨係合特徴を形成する、第1及び第2の椎体係合ビームと、を備え、
第1のビームの近位端部は、ハンドル部に固定的に取り付けられ、
第2のビームの近位端部は、ハンドル部に枢動可能に取り付けられ、
そのため、第2のビームは、第1のビームの長手方向軸に対して横方向に移動することができる、工具が提供される。
(1) 患者の脊椎すべり症を矯正するための椎間融合装置であって、
a)前壁と、後壁と、前記前壁及び後壁を連結する近位壁及び遠位壁と、上部椎体と接触するための上面と、下面とを有する上部ケージと、
b)前壁と、後壁と、前記前壁及び後壁を連結する近位壁及び遠位壁と、下部椎体と接触するための下面と、上面とを有する下部ケージと、を備え、
前記上部ケージの前記下面が、前記下部ケージの上面と摺動的に嵌合する、装置。
(2) 前記上部プレートの前記下面及び前記下部ケージの前記上面が、さねはぎ特徴を含む、実施態様1に記載の装置。
(3) 前記さねはぎ特徴が、前記前壁の辺りから前記後壁の辺りに及ぶ、実施態様2に記載の装置。
(4) 前記前壁の合わせた高さが、前記後壁の前記合わせた高さを超える、実施態様3に記載の装置。
(5) 前記上部ケージの前記下面及び前記下部ケージの前記上面が、近位遠位方向に及ぶ隆起及び陥凹特徴を含む、実施態様1に記載の装置。
(7) 前記上部ケージの前記近位壁が、前記前壁の上に位置し、かつ骨ねじを受容するように適合された上部貫通孔を有する上部を有する、実施態様6に記載の装置。
(8) 前記下部ケージの前記近位壁が、高さを有し、前記下部ケージの前記前壁が、高さを有し、前記下部ケージの前記近位壁の前記高さが、前記下部ケージの前記前壁の前記高さを超える、実施態様7に記載の装置。
(9) 前記下部ケージの前記近位壁が、前記前壁の下に位置し、かつ骨締結具を受容するように適合された下部貫通孔を有する下部を有する、実施態様8に記載の装置。
(10) 前記上部ケージの前記近位壁が、前記上部ケージの前記前壁の下に位置し、かつ骨締結具を受容するように適合された下部貫通孔を有する下部を有する、実施態様1に記載の装置。
(12) c)第1及び第2の貫通孔を有する係止プレートと、
d)第1及び第2の骨締結具と、を更に備え、
前記係止プレートが、前記係止プレートの前記第1の貫通孔を通じて前記上部ケージの前記下部貫通孔の中に前記第1の骨締結具を通すことによって、かつ前記係止プレートの前記第2の貫通孔を通じて前記下部ケージの前記上部貫通孔の中に前記第2の骨締結具を通すことによって、前記上部及び下部ケージの前記近位壁に固定される、実施態様11に記載の装置。
(13) 前記上部ケージが、下面と、前記上面から前記下面に及ぶ貫通孔とを更に備える、実施態様1に記載の装置。
(14) 前記前壁が、それを貫通する貫通孔を更に備える、実施態様1に記載の装置。
(15) 前記上部及び下部ケージのそれぞれの前記遠位端壁が、挿入を容易にするためのテーパを有する、実施態様1に記載の装置。
a)上部ケージ及び下部ケージを備える融合装置を選択する工程と、
b)前記上部ケージを前記患者の上部椎体に、かつ前記下部ケージを前記患者の下部椎体に固定する工程と、
c)前記脊椎すべり症を矯正するために、前記下部ケージに対して前記上部ケージを移動させる工程と、を含む、方法。
(17) d)前記上部ケージを前記下部ケージに係止する工程を更に含む、実施態様16に記載の方法。
(18) 前記係止する工程が、係止プレートによって達成される、実施態様17に記載の方法。
(19) 前記移動させる工程が、圧縮を目的としたはめ込み器で達成される、実施態様16に記載の方法。
(20) 前記移動させる工程が、回転スプレッダで達成される、実施態様16に記載の方法。
a)前壁と、後壁と、前記前壁及び後壁を連結する近位壁及び遠位壁と、上部椎体と接触するための上面と、内部に第1の溝を有する下面とを有する上部ケージと、
b)前壁と、後壁と、前記前壁及び後壁を連結する近位壁及び遠位壁と、下部椎体と接触するための下面と、内部に第2の溝を有する上面とを有する下部ケージと、
c)係止プレートと、を備え、
前記第1及び第2の溝が前記近位壁から前記遠位壁の辺りに及ぶ第1の貫通孔を形成するように、前記上部ケージの前記下面が、前記下部ケージの前記上面と接触し、
前記係止プレートが、前記第1の貫通孔の中に配設される、装置。
(22) 前記第1の溝が、前記上部ケージの前記前壁の前記下面上に存在し、前記第2の溝が、前記下部ケージの前記前壁の前記上面上に存在する、実施態様21に記載の装置。
(23) 前記第1の溝が、前記上部ケージの前記後壁の前記下面上に存在し、前記第2の溝が、前記下部ケージの前記後壁の前記上面上に存在する、実施態様21に記載の装置。
(24) 前記前壁と前記後壁との間の前記上部ケージの前記下面上に存在する第3の溝と、前記前壁と前記後壁との間の前記下部ケージの前記上面上に存在する第4の溝とを更に備え、前記第3及び第4の溝が、前記近位壁から前記遠位壁の辺りに及ぶ、内部にスプレッダを挿入するよう適合された第2の貫通孔を形成するように、前記上部ケージの前記下面が、前記下部プレートの前記上面と接触する、実施態様21に記載の装置。
(25) 患者の脊椎すべり症を矯正するための椎間融合装置であって、
a)前壁と、後壁と、前記前壁及び後壁を連結する近位壁及び遠位壁と、上部椎体と接触するための上面と、下面とを有する上部ケージと、
b)前壁と、後壁と、前記前壁及び後壁を連結する近位壁及び遠位壁と、下部椎体と接触するための下面と、上面とを有する下部ケージと、を備え、
前記前壁が、第1の二重結合部によって前記近位壁に、かつ第2の二重結合部によって前記遠位壁に連結され、
前記後壁が、第3の二重結合部によって前記近位壁に、かつ第4の二重結合部によって前記遠位壁に連結され、
前記結合部が、前記上部プレートを前記近位壁の前記平面内で前記下部プレートに対して旋回させることを可能にする、装置。
(27) 前記上部ケージの前記近位壁が、前記前壁の上に位置し、かつ骨ねじを受容するように適合された上部貫通孔を有する上部を有する、実施態様26に記載の装置。
(28) 前記下部ケージの前記近位壁が、高さを有し、前記下部ケージの前記前壁が、高さを有し、前記下部ケージの前記近位壁の前記高さが、前記下部ケージの前記前壁の前記高さを超える、実施態様27に記載の装置。
(29) 前記下部ケージの前記近位壁が、前記前壁の下に位置し、かつ骨ねじを受容するように適合された下部貫通孔を有する下部を有する、実施態様28に記載の装置。
(30) 前記上部ケージが、前記上面から前記下面に及ぶ貫通孔を有する、実施態様25に記載の装置。
a)前壁と、後壁と、前記前壁及び後壁を連結する一対の側壁とを有する椎間装置を選択する工程であって、前記側壁のうちの少なくとも1つが、前記前壁を超えて軸方向に延在するフランジを有し、前記フランジが、貫通孔を有する、工程と、
b)前記装置を前記対向した椎体間に挿入する工程と、
c)前記貫通孔を通じて固定装置を挿入し、前記対向した椎体のうちの1つの面に前記装置を固定する工程と、を含む、方法。
(32) 前記装置が、融合装置である、実施態様31に記載の方法。
(33) 前記装置が、上半分の構成要素及び下半分の構成要素を有する、実施態様31に記載の方法。
(34) 前記装置が、実質的に横方向手法によって挿入される、実施態様31に記載の方法。
(35) 患者の脊椎すべり症を矯正するための椎間融合装置であって、
a)上部椎体と接触するように適合された上面と、内表面とを有する上壁と、
b)下部椎体と接触するように適合された下面と、内表面とを有する下壁と、
c)前記上壁と前記下壁との間に延在する近位壁及び遠位壁と、
d)前記上壁と前記下壁との間に延在する前壁及び後壁と、
e)前記上壁及び下壁の前記内表面間に位置するラックアンドピニオン機構と、を備え、
前記ピニオンが、前記遠位壁から前記近位壁に実質的に延在し、
前記ラックが、前記前壁から前記後壁に実質的に延在し、
そのため、前記ピニオンの回転が、前後方向における前記上壁及び下壁の相対的動作をもたらす、装置。
(37) 前記上壁及び下壁がそれぞれ、その中を通る少なくとも1つの孔を有し、前記装置を介した融合を容易にする、実施態様35に記載の装置。
(38) 前記前壁及び後壁がそれぞれ、その中を通る少なくとも1つの孔を有し、前記装置を介した融合を容易にする、実施態様35に記載の装置。
(39) 前記ラックが、前記上壁の前記内表面から延在する、実施態様35に記載の装置。
(40) 前記ラックが、前記下壁の前記内表面から延在する、実施態様35に記載の装置。
(42) 前記前壁及び後壁のうちの少なくとも1つが、前記上壁及び下壁のうちの少なくとも1つと一体である、実施態様35に記載の装置。
(43) 前記前壁及び後壁のうちの少なくとも1つが、取り外し可能である、実施態様35に記載の装置。
(44) 患者の脊椎すべり症を矯正するための方法であって、
a)上部ケージ及び下部ケージを備える器具を選択する工程であって、それぞれのケージが、ハンドルに取り付けられる、工程と、
b)前記上部ケージを前記患者の上部椎体に、かつ前記下部ケージを前記患者の下部椎体に取り付ける工程と、
c)前記脊椎すべり症を矯正するために、前記下部ケージに対して前記上部ケージを移動させる工程と、
d)前記患者から前記器具を取り除く工程と、を含む、方法。
(45) 椎間装置を対向した椎体間に移植する方法であって、
i)椎間装置を選択する工程であって、前記椎間装置が、
a.前壁と、後壁と、前記前壁及び後壁を連結する2つの側壁とを有する上半分の構成要素と、
b.前壁と、後壁と、前記前壁及び後壁を連結する2つの側壁とを有する下半分の構成要素と、を備える、工程と、
ii)前記装置を対向した椎体間に挿入することによって、前記前壁が一直線にならない工程と、
iii)前記前壁が実質的に一直線になるように、前記構成要素のうちの1つをもう一方の構成要素に対して移動させる工程と、
iv)前記装置を前記対向した椎体に固定する工程と、を含む、方法。
(47) 患者の脊椎すべり症を矯正するための椎間融合装置であって、
a)前壁と、後壁と、前記前壁及び後壁を連結する近位壁及び遠位壁と、骨固定装置を受容するための前記近位壁の前記上縁部に存在する貫通孔とを有する上部ケージと、
b)前壁と、後壁と、前記前壁及び後壁を連結する近位壁及び遠位壁と、下部椎体と接触するための下面と、上面と、骨固定装置を受容するための前記近位壁の前記下縁部に存在する貫通孔とを有する、下部ケージと、を備え、
前記上部ケージの前記下面が、前記下部ケージの上面と摺動的に嵌合する、装置。
(48) 脊椎すべり症整復工具であって、
a)近位ハンドル部と、
b)第1及び第2の椎体係合ビームであって、長手方向軸と、近位端部と、遠位端部とを有し、それぞれのビームの前記遠位端部が、骨係合特徴を形成する、第1及び第2の椎体係合ビームと、を備え、
前記第1のビームの前記近位端部が、前記ハンドル部に固定的に取り付けられ、
前記第2のビームの前記近位端部が、前記ハンドル部に枢動可能に取り付けられ、
そのため、前記第2のビームが、前記第1のビームの前記長手方向軸に対して横方向に移動することができる、工具。
(49) 前記ハンドル部が、前記第2のビームを枢動可能に移動させるように適合されたトリガを備える、実施態様48に記載の工具。
Claims (12)
- 患者の脊椎すべり症を矯正するための椎間融合装置であって、
a)前壁と、後壁と、前記前壁及び後壁を連結する近位壁及び遠位壁と、上部椎体と接触するための上面と、下面とを有する上部ケージと、
b)前壁と、後壁と、前記前壁及び後壁を連結する近位壁及び遠位壁と、下部椎体と接触するための下面と、上面とを有する下部ケージと、を備え、
前記上部ケージの前記下面が、前記下部ケージの上面と摺動的に嵌合し、
前記上部ケージの前記近位壁が、前記上部ケージの前記前壁の下に位置し、かつ骨締結具を受容するように適合された下部貫通孔を有する下部を有し、
前記下部ケージの前記近位壁が、前記下部ケージの前記前壁の上に位置し、かつ骨締結具を受容するように適合された上部貫通孔を有する上部を有し、
前記椎間融合装置は、
c)第1及び第2の貫通孔を有する係止プレートと、
d)第1及び第2の骨締結具と、
を更に備え、
前記係止プレートが、前記係止プレートの前記第1の貫通孔を通じて前記上部ケージの前記下部貫通孔の中に前記第1の骨締結具を通すことによって、かつ前記係止プレートの前記第2の貫通孔を通じて前記下部ケージの前記上部貫通孔の中に前記第2の骨締結具を通すことによって、前記上部及び下部ケージの前記近位壁に固定される、装置。 - 前記上部ケージの前記下面及び前記下部ケージの前記上面が、さねはぎ特徴を含む、請求項1に記載の装置。
- 前記さねはぎ特徴が、前記前壁の辺りから前記後壁の辺りに及ぶ、請求項2に記載の装置。
- 前記前壁の合わせた高さが、前記後壁の前記合わせた高さを超える、請求項3に記載の装置。
- 前記上部ケージの前記下面及び前記下部ケージの前記上面が、近位遠位方向に及ぶ隆起及び陥凹特徴を含む、請求項1に記載の装置。
- 前記上部ケージの前記近位壁が、高さを有し、前記上部ケージの前記前壁が、高さを有し、前記上部ケージの前記近位壁の前記高さが、前記上部ケージの前記前壁の前記高さを超える、請求項1に記載の装置。
- 前記上部ケージの前記近位壁が、前記前壁の上に位置し、かつ骨ねじを受容するように適合された上部貫通孔を有する上部を有する、請求項6に記載の装置。
- 前記下部ケージの前記近位壁が、高さを有し、前記下部ケージの前記前壁が、高さを有し、前記下部ケージの前記近位壁の前記高さが、前記下部ケージの前記前壁の前記高さを超える、請求項7に記載の装置。
- 前記下部ケージの前記近位壁が、前記前壁の下に位置し、かつ骨締結具を受容するように適合された下部貫通孔を有する下部を有する、請求項8に記載の装置。
- 前記上部ケージが、下面と、前記上面から前記下面に及ぶ貫通孔とを更に備える、請求項1に記載の装置。
- 前記前壁が、当該前壁を貫通する貫通孔を更に備える、請求項1に記載の装置。
- 前記上部及び下部ケージのそれぞれの前記遠位端壁が、挿入を容易にするためのテーパを有する、請求項1に記載の装置。
Applications Claiming Priority (5)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US39771610P | 2010-11-30 | 2010-11-30 | |
US61/397,716 | 2010-11-30 | ||
US13/163,427 | 2011-06-17 | ||
US13/163,427 US8845733B2 (en) | 2010-06-24 | 2011-06-17 | Lateral spondylolisthesis reduction cage |
PCT/US2011/061611 WO2012074809A1 (en) | 2010-11-30 | 2011-11-21 | Lateral spondylolisthesis reduction cage |
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JP2016135826A Division JP6309574B2 (ja) | 2010-11-30 | 2016-07-08 | 横方向脊椎すべり症整復ケージ |
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JP2014502867A5 JP2014502867A5 (ja) | 2016-02-25 |
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US8845733B2 (en) | 2010-06-24 | 2014-09-30 | DePuy Synthes Products, LLC | Lateral spondylolisthesis reduction cage |
TW201215379A (en) | 2010-06-29 | 2012-04-16 | Synthes Gmbh | Distractible intervertebral implant |
US9474625B2 (en) * | 2010-09-03 | 2016-10-25 | Globus Medical, Inc | Expandable fusion device and method of installation thereof |
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WO2012074809A1 (en) * | 2010-11-30 | 2012-06-07 | Depuy Spine Inc. | Lateral spondylolisthesis reduction cage |
US9522070B2 (en) | 2013-03-07 | 2016-12-20 | Interventional Spine, Inc. | Intervertebral implant |
JP6514697B2 (ja) * | 2013-08-07 | 2019-05-15 | グローバス メディカル インコーポレイティッド | 拡張可能な固定デバイス及びその設置方法 |
US11426290B2 (en) | 2015-03-06 | 2022-08-30 | DePuy Synthes Products, Inc. | Expandable intervertebral implant, system, kit and method |
JP7023877B2 (ja) | 2016-06-28 | 2022-02-22 | イーアイティー・エマージング・インプラント・テクノロジーズ・ゲーエムベーハー | 拡張可能かつ角度調節可能な関節運動式の椎間ケージ |
CN109688981A (zh) | 2016-06-28 | 2019-04-26 | Eit 新兴移植技术股份有限公司 | 可扩张的、角度可调整的椎间笼 |
US10398563B2 (en) | 2017-05-08 | 2019-09-03 | Medos International Sarl | Expandable cage |
US11344424B2 (en) | 2017-06-14 | 2022-05-31 | Medos International Sarl | Expandable intervertebral implant and related methods |
US11446156B2 (en) | 2018-10-25 | 2022-09-20 | Medos International Sarl | Expandable intervertebral implant, inserter instrument, and related methods |
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-
2011
- 2011-11-21 WO PCT/US2011/061611 patent/WO2012074809A1/en active Application Filing
- 2011-11-21 JP JP2013542047A patent/JP6076912B2/ja not_active Expired - Fee Related
- 2011-11-21 EP EP11845811.6A patent/EP2645965B1/en not_active Not-in-force
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2016
- 2016-07-08 JP JP2016135826A patent/JP6309574B2/ja not_active Expired - Fee Related
Also Published As
Publication number | Publication date |
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EP2645965B1 (en) | 2016-08-10 |
JP6309574B2 (ja) | 2018-04-11 |
WO2012074809A1 (en) | 2012-06-07 |
EP2645965A1 (en) | 2013-10-09 |
EP2645965A4 (en) | 2014-07-09 |
JP2016190074A (ja) | 2016-11-10 |
JP2014502867A (ja) | 2014-02-06 |
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