JP6416304B2 - 展開式椎体間インプラント - Google Patents
展開式椎体間インプラント Download PDFInfo
- Publication number
- JP6416304B2 JP6416304B2 JP2017047419A JP2017047419A JP6416304B2 JP 6416304 B2 JP6416304 B2 JP 6416304B2 JP 2017047419 A JP2017047419 A JP 2017047419A JP 2017047419 A JP2017047419 A JP 2017047419A JP 6416304 B2 JP6416304 B2 JP 6416304B2
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- JP
- Japan
- Prior art keywords
- component
- intervertebral implant
- wedge
- configuration
- slope
- 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.)
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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
- A61F2/447—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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- 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
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- 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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- A61F2/00—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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- A61F2/3094—Designing or manufacturing processes
- A61F2/30965—Reinforcing the prosthesis by embedding particles or fibres during moulding or dipping
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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
- A61F2/28—Bones
- A61F2002/2817—Bone stimulation by chemical reactions or by osteogenic or biological products for enhancing ossification, e.g. by bone morphogenetic or morphogenic proteins [BMP] or by transforming growth factors [TGF]
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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
- A61F2/28—Bones
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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
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
- A61F2002/3006—Properties of materials and coating materials
- A61F2002/30062—(bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
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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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- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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- A61F2002/3008—Properties of materials and coating materials radio-opaque, e.g. radio-opaque markers
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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
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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- A61F2002/3006—Properties of materials and coating materials
- A61F2002/30092—Properties of materials and coating materials using shape memory or superelastic materials, e.g. nitinol
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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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- A61F2002/30108—Shapes
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A—HUMAN NECESSITIES
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- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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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
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- 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
- A61F2002/30891—Plurality of protrusions
- A61F2002/30892—Plurality of protrusions parallel
-
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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
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- A61F2002/30904—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves serrated profile, i.e. saw-toothed
-
- 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
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2002/3092—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth having an open-celled or open-pored structure
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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
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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
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- 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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- 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
- A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2210/0004—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof bioabsorbable
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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
- A61F2220/0016—Fixation appliances for connecting prostheses to the body with sharp anchoring protrusions, e.g. barbs, pins, spikes
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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
- A61F2310/00011—Metals or alloys
- A61F2310/00017—Iron- or Fe-based alloys, e.g. stainless steel
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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
- 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
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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
- A61F2310/00011—Metals or alloys
- A61F2310/00029—Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
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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
-
- 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
- A61F2310/00221—Ceramics or ceramic-like structures based on metal oxides containing calcia or calcium oxide
-
- 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
- A61F2310/00341—Coral, e.g. aragonite, porite
-
- 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
-
- 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
- A61F2310/00976—Coating or prosthesis-covering structure made of proteins or of polypeptides, e.g. of bone morphogenic proteins BMP or of transforming growth factors TGF
Landscapes
- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Neurology (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
Description
またここに使用されている用語は、特定の実施形態を単に一例として説明するのが目的であって、請求されている開示について限定を課すことを意図するものではないことを理解されたい。更に、付随の特許請求の範囲を含め明細書での使用に際し、原文の単数形「a」、「an」、及び「the」の対訳である「一」、「或る」、及び「当該」は、複数形を含み、特定の数値への言及は、文脈により別途明白に指示されていない限り、少なくとも当該の特定の値を含む。範囲は、ここでは、「約」又は「大凡」と付く1つの特定値から、及び/又は「約」又は「大凡」と付く別の特定値まで、として表されていよう。その様な範囲が表されているとき、別の実施形態は、当該一方の特定値からを、及び/又は当該他方の特定値までを、含んでいる。同様に、値が、先行詞「約」の使用によって近似として表されているとき、当該特定の値は別の実施形態を成すものと理解しておきたい。更に、例えば、水平、垂直、上、上側、下側、下、外、内、末端(位置又は場所を表示)、左及び右、後、前、などの様な全ての空間参照は、例示のみが目的であり、本開示の範囲内で変わり得るものと理解している。例えば、「上位」及び「下位」という参照は、相対であり、他方に対しての文脈でしか使用されず、必ずしも「上側」及び「下側」であるとは限らない。
SO4ポリマーゴム、ポリエチレンテレフタレート(PET)、布、シリコン、ポリウレタン、シリコンポリウレタンコポリマー、ポリマーゴム、ポリオレフィンゴム、ヒドロゲル、半剛性及び剛性材料、エラストマー、ゴム、熱可塑性エラストマー、熱硬化性エラストマー、エラストマー複合材、ポリフェニレン、ポリアミド、ポリイミド、ポリエーテルイミド、ポリエチレン、エポキシ、を含む剛性ポリマー、自家移植片、同種移植片、異種移植片、又は遺伝子組み換え皮質骨及び/又は皮質海綿骨、を含む骨材料、及び組織成長又は分化因子、即ち、一部分解吸収性材料として、例えば、金属とカルシウムを基材とするセラミックスとの複合材、PEEKとカルシウムを基材とするセラミックスとの複合材、PEEKと分解吸収性ポリマーとの複合材、など、全分解吸収性材料として、例えば、リン酸カルシウム、リン酸三カルシウム(TCP)、ヒドロキシアパタイト(HA)‐TCP、硫酸カルシウム、の様なカルシウムを基材とするセラミックス、など、又は他の分解吸収性ポリマーとして、ポリラクチド、ポリグリコリド、ポリチロシンカーボネート、ポリカプロラクトン、など、及びそれらの組合せ、の様な材料から製作することができる。システムの様々な構成要素は、強度、剛性、弾性、可撓性、伸展性、生体力学的性能、耐久性、及びX線透過性、又は画像化選好、の様な様々な所望の特性を実現するように、上記材料を含む材料複合物から製作されていてもよい。システムの構成要素は、個別的に又は集合的に、更に、上述の材料の2つ又はそれ以上から成る組合せの様な混成材料から製作されていてもよい。
固定を強化する代わりの表面構成、例えば、特定の用途の要件に従って、粗面、弓形、波状、メッシュ、有孔、半有孔、窪み付き、及び/又は肌理付きの様な面構成を有していてもよいと構想している。更に、要素54は、軸aに対して、例えば、直角に及び/又は鋭角又は鈍角の様な他の角度向きに配置されていてよいし、同軸に配置されていてもよいし、及び/又は、オフセットしているか又は千鳥状であってもよいと構想している。
り、楔58の表面に係合するように構成されている。内側の面82は、楔58を構成要素46、48に対して動かすことができるように楔58の表面に係合する。
ト202の様な受け器を含んでいる。楔58は、少なくとも1つの薬剤、例えば骨移植片、を配置させるように構成されている例えばバスケット204の様な受け器を含んでいる。第1の折り畳み構成では、バスケット202、204は、直列に隣り合う構成に配置されている。椎間インプラント40が第2の展開構成へ展開されてゆくと、バスケット202、204は、垂直に積み重ねられた構成へと並進し、骨移植片が接続されたバスケット202、204を通って成長できるようにする。バスケット202、204の各々は、骨がバスケット202と204間で成長するのを許容する複数の開口部を含んでいる。1つの実施形態では、バスケット202は一定した体積を有する上側のバスケットであり、バスケット204は一定した体積を有する下側のバスケットである。バスケット202、204は、手術部位への送達に先立って骨移植片を詰められ、直列に隣り合う構成に配置される。バスケット202、204は、椎間インプラント40が第1の折り畳み構成から第2の展開構成へ展開してゆく際にバスケット202と204がそれらの間の接触を維持できるようにする勾配の付けられた接合面を有しており、バスケット202、204は、隣り合う構成から積重構成及び/又は上下構成へと移行する。このバスケット202と204間の接合面は、バスケット202と204の一方の骨移植片がバスケット202と204の他方の骨移植片と接合することができるように開口部を有している。この構成は、骨移植片を第1の椎骨終板からバスケット202を通し次にバスケット204を通して又はバスケット204を通し次にバスケット202を通して第2の椎骨終板へ融合させられるようにする。
素46、48が第1の折り畳み構成と第2の展開構成の間で展開するように上述の様に滑動可能に係合する。
か、又は置換されてもよい。椎体間インプラントシステムの構成要素の1つ又は全ては、用手操作及び/又はフリーハンド技法により手術部位へ送達させることができるものと考えている。更に、椎間インプラント40は、後方挿入され、次いで前方及び/又は側方及び/又は正中に操作されてもよいものと考えている。
いるか、離間されているか、及び/又は千鳥状になっていてもよい。
0、562は、長手方向軸aaに対して実質的に平行な向きに配置されている。
58は構成要素546に係合する第1面607と構成要素548に係合する第2面608とを含んでいる。楔558は、椎間インプラント540を第1構成と第2構成の間で展開し及び折り畳むために構成要素546、548に可動式に係合する、長手方向軸aaに沿って配置された第1レール部分610及び第2レール部分612を含んでいる。
レール部分610、612の各々は、第1面607の少なくとも一部分であって椎間インプラント540を第1構成と第2構成の間で展開し及び折り畳むべく構成要素546の内側の面556の少なくとも一部分に係合する部分を含んでいる。面607の、レール部分610に沿って配置されている楔部分614、616を含む部分は、延在部560に沿って配置されている部分570、576に滑動可能に係合する。面607の、レール部分612に沿って配置されている楔部分620、622を含む部分は、延在部562に沿って配置されている部分570、576に滑動可能に係合する。
うに構成されている例えばバスケット702の様な受け器を含んでいる。楔558は、少なくとも1つの薬剤、例えば骨移植片、を配置させるように構成されている例えばバスケット704の様な受け器を含んでいる。第1の折り畳み構成では、バスケット702、704は、直列に隣り合う構成に配置されている。椎間インプラント540が第2の展開構成へ展開されてゆくと、バスケット702、704は、垂直に積み重ねられた構成へと並進し、骨移植片が接続されたバスケット702、704を通って成長できるようにする。バスケット702、704の各々は、骨がバスケット702と704の間で成長するのを許容する複数の開口部を含んでいる。
42 前端
44 後端
46 ピストン構成要素
48 基部構成要素
50 蝶番
52 終板面
53 開口部
54 隆起要素
56 内側の面
58 楔
60 第1延在部
62 第2延在部
64 前端
66 後端
68 平板状部分
70 第1傾斜部分
72 陥凹部分
74 移行部
76 第2傾斜部分
78 終板面
80 隆起要素
82 内側の面
84 前端
86 後端
88 壁
90 ねじ山の切られた開口部
92 ねじ山の切られたねじ
94 遠位端
96 フランジ
98 壁
100 縮径部
102 隣接面
104 ピン
106 スロット
107 楔の第1面
108 楔の第2面
110 第1レール部分
112 第2レール部分
114 前楔部分
116 後楔部分
118 突起
120 前楔部分
122 後楔部分
124 突起
202、204 バスケット
206 開口部
292 引締ねじ
294 時計回りのねじ部
296 近位端
298 反時計回りのねじ部
300 遠位端
302 ねじ山の切られた開口部
402 楔部分の第1面
404 楔部分の第2面
540 椎間インプラント
542 前端
544 後端
546 ピストン構成要素
548 基部構成要素
550 蝶番
552 終板面
553 開口部
554 隆起要素
556 内側の面
558 楔
560 第1延在部
562 第2延在部
564 前端
566 後端
568 基部構成要素に係合する部分
570 傾斜部分
576 直線部分
578 終板面
580 隆起要素
582 壁
584 前端
586 後端
588 壁部分
590 ねじ山の切られたスロット
591 壁
592 ねじ山の切られたねじ
604 ピン
606 細長いスロット
607 楔の第1面
608 楔の第2面
610 第1レール部分
612 第2レール部分
614 前楔部分
616 後楔部分
618 楔部分間に配置され楔部分同士を接続している部材
620 前楔部分
622 後楔部分
702、704 バスケット
840 椎間インプラント
842 前端
846 ピストン構成要素
848 基部構成要素
858 楔
860、862 延在部
884 楔形状の前端
886 後端
892 ねじ
902 リンク仕掛け構成要素
904 第1端
906 スロット
908 ピン
910 第2端
912 ピン
948 ピン
950 チャネル
952 側壁
a、aa 長手方向軸
h1 前楔部分の第1高さ
h2 後楔部分の第2高さ
L1 開口部の長さ
L2 開口部の減少した長さ
α1 前楔部分の長手方向軸に対する第1傾斜角度
α2 後楔部分の長手方向軸に対する第2傾斜角度
β1 楔部分の第1面の傾斜角度
β2 楔部分の第2面の傾斜角度
v 骨移植片の体積
V 椎骨
V1 第1椎骨
V2 第2椎骨
I 椎間円板空間
S スリーブ又はカニューレ
P 手術経路
Claims (20)
- 椎間インプラントにおいて、
外側の組織係合面及び内側の面を備えており、長手軸線に沿って延びる第1構成要素と、
前記第1構成要素へ接続された第2構成要素であって、前記第1構成要素と第2構成要素の開口を通って延びる長手軸線を横断して延びるピンの周りで、前記第1構成要素が前記第2構成要素に対して回動可能であり、外側の組織係合面及び内側の面を備え、作動器を含んでいる、第2構成要素と、
前記第1構成要素及び前記第2構成要素に係合するように配置されていて、前記第1構成要素及び前記第2構成要素に対して動かすことのできる第3構成要素であって、少なくとも、第1斜面及び前記第1斜面から長手軸線方向に離間されている第2斜面を備えている、第3構成要素と、を備えており、
前記作動器は、前記斜面が前記第1構成要素と前記第2構成要素の一方の前記内側の面に係合して前記構成要素同士を第1の折り畳み構成と第2の展開構成の間で動かすような前記第3構成要素の長手軸線方向並進をもたらすように前記第3構成要素と係合可能であり、
前記第2の展開構成は、前記第1構成要素の前端および後端が同等に展開するような初期展開と、前記前端が前記後端よりも大きく展開する二次展開とを含む、
椎間インプラント。 - 前記第3構成要素は、前記第1斜面及び前記第2斜面を含む第1レールと、第3斜面及び第4斜面を含む第2レールと、を備えており、前記第4斜面は前記第3斜面から長手軸線方向に離間されている、請求項1に記載の椎間インプラント。
- 前記第1斜面は、第1傾斜角度を有し、前記第2斜面は、第2傾斜角度を有する、請求項1に記載の椎間インプラント。
- 椎間インプラントにおいて、
ピストン構成要素であって、終板面及び前記終板面に対して反対の向きに配置されている内側の面を備え、前端と後端の間を長手軸線に沿って延びている、ピストン構成要素と、
基部構成要素であって、終板面及び前記基部構成要素の前記終板面に対して反対の向きに配置されている内側の面を備え、前端と後端の間を延び、前記ピストン構成要素へそれぞれの前記後端付近でヒンジによって枢動可能に接続されていて、前記ピストン構成要素は少なくとも1つの面を通る長手軸線を横断する回転軸線の周囲で前記基部構成要素に対して回転可能であり、前記基部構成要素後端はねじ山の切られた空洞を含んでいる、基部構成要素と、
前記ねじ山の切られた空洞内に配置されるように構成されているねじ山の切られたねじと、
前記ピストン構成要素及び前記基部構成要素に係合するように配置されていて、前記ピストン構成要素及び前記基部構成要素に対して動かすことのできる楔であって、第1高さと第1傾斜角度を有する第1斜面及び第2高さと第2傾斜角度を有する第2斜面を備え、前記第1斜面は前記第2斜面から長手軸線方向に離間されている、楔と、を備えており、
前記ねじ山の切られたねじは、前記斜面がピストン構成要素の前記内側の面に係合してピストン構成要素を基部構成要素に対して枢動させ、その結果、前記構成要素同士が第1の折り畳み構成と第2の展開構成の間で展開するような前記楔の長手軸線方向並進をもたらすように前記楔と係合させることができ、
前記第2の展開構成は、前記ピストン構成要素の前記前端および前記後端が同等に展開するような初期展開と、前記ピストン構成要素の前記前端が前記ピストン構成要素の前記後端よりも大きく展開する二次展開とを含む、
椎間インプラント。 - 請求項1に記載の椎間インプラントであって、
前記第3構成要素が、前記第1斜面および第2斜面を有する第1面と、対向する平坦な第2面とを有し、
前記第2構成要素の内面は平らであり、前記構成要素同士が前記第1の折り畳み構成と、前記第2の展開構成との間で移動したとき、前記第2面に係合する、椎間インプラント。 - 請求項1に記載の椎間インプラントであって、
前記構成要素同士が前記第1の折り畳み構成と、前記第2の展開構成との間で移動したとき、前記第1構成要素の内面は、前記第1斜面と第2斜面に沿って滑動する、第1傾斜部分と第2傾斜部分とを有する、椎間インプラント。 - 請求項6に記載の椎間インプラントであって、
前記第1傾斜部分と第2傾斜部分は、長手軸線に対して鋭角をなして延びている、椎間インプラント。 - 請求項6に記載の椎間インプラントであって、
前記第1傾斜部分は、長手軸線に対して第1の角度をなして延び、前記第2傾斜部分は、長手軸線に対して第2の角度をなして延びており、前記第1の角度は前記第2の角度より大きい、椎間インプラント。 - 請求項8に記載の椎間インプラントであって、
前記第1の角度は30乃至60度であり、前記第2の角度は4乃至30度である、椎間インプラント。 - 請求項1に記載の椎間インプラントであって、
前記作動器は、遠位端と、工具の受け器を有する、遠位端反対側の近位端を有する、椎間インプラント。 - 請求項10に記載の椎間インプラントであって、
ピンが第3構成要素から離れており、前記作動器の遠位端が、前記第2構成要素の第2の壁に係合して、前記作動器を前記第2構成要素に保持するフランジを有する一方、前記椎間インプラントの動作において、前記作動器は、長手軸線に沿って反対方向に前記第2構成要素の並進をもたらすように動かされる、椎間インプラント。 - 請求項1に記載の椎間インプラントであって、
前記第3構成要素は、第1レールと、第2レールと、を備え、
前記第2構成要素は、前記第1レールと第2レールとの間で互いに離間する第1および第2の壁を備え、ピンが前記第1の壁および前記第1構成要素を貫通して延び、前記第1構成要素を前記第2構成要素に接続する、椎間インプラント。 - 請求項1に記載の椎間インプラントであって、
前記作動器は、前記第2構成要素のねじ山の切られた開口部内に位置決めされた、ねじ山の切られたねじである、椎間インプラント。 - 請求項1に記載の椎間インプラントであって、
前記ピンは、前記第2構成要素の細長いスロット内に配置され、これにより前記ピンは、前記構成要素同士が前記第1の折り畳み構成と、前記第2の展開構成との間で移動したとき、前記細長いスロット内で移動する、椎間インプラント。 - 請求項14に記載の椎間インプラントであって、
前記構成要素同士が前記第1の折り畳み構成と、前記第2の展開構成との間で移動したとき、前記ピンは、前記細長いスロットの第1端から前記第1端とは反対側の前記細長いスロットの第2端まで移動する、椎間インプラント。 - 請求項1に記載の椎間インプラントであって、
前記作動器は前記第3構成要素に固定される、椎間インプラント。 - 請求項1に記載の椎間インプラントであって、
前記第2構成要素と第3構成要素の各々は、骨移植片を配置するようになっているバスケットを有し、前記バスケットは、前記構成要素同士が前記第1の折り畳み構成のとき並んだ構成であり、前記構成要素同士が前記第2の展開構成のとき垂直に積み重ねられた構成であるように、一連に配置されている、椎間インプラント。 - 請求項1に記載の椎間インプラントであって、
前記インプラントは前記第1構成要素、前記第2構成要素および前記第3構成要素を通って延びる開口部を有し、前記構成要素同士が前記第1の折り畳み構成と前記第2の展開構成の間で移動したときに、前記開口部は一定した体積を有する、椎間インプラント。 - 請求項1に記載の椎間インプラントであって、
前記構成要素同士が前記第1の折り畳み構成にあるとき、前記第1構成要素の内面は、前記第2構成要素の内面と係合し、
前記構成要素同士が前記第2の展開構成にあるとき、前記第1構成要素の内面は、前記第2構成要素の内面から離れている、椎間インプラント。 - 椎間インプラントにおいて、
空間を空けて離れている第1傾斜部分と第2傾斜部分とを有する内面を備える第1構成要素と、
ピンの周囲で前記第1構成要素に回転可能に接続される第2構成要素であって、前記ピンが前記第1構成要素と前記第2構成要素の開口を介して延びている、第2構成要素と、
前記第1構成要素と前記第2構成要素の間に位置決めされる第3構成要素であって、少なくとも第1斜面及び前記第1斜面から長手軸線方向に離間されている第2斜面を備えている、第3構成要素と、
前記第2構成要素を通って前記第3構成要素内へ延びる作動器であって、前記作動器は
前記第3構成要素に固定されるようになっており、前記作動器は前記第2構成要素に対して回転可能であり、また前記第2構成要素のねじ山の切られた内面と係合するねじ山の切られた外面を有する作動器とを備え、
前記第2構成要素に対する前記作動器の回転により、前記第3構成要素が、前記第1構成要素と前記第2構成要素に対して長手軸線方向に移動し、それにより前記第1斜面と第2斜面が前記第1傾斜部分と第2傾斜部分に沿って滑動して、第1の折り畳み構成から第2の展開構成へ前記構成要素同士を移動させ、
前記第2の展開構成は、前記第1構成要素の前端および後端が同等に展開するような初期展開と、前記前端が前記後端よりも大きく展開する二次展開とを含む、
椎間インプラント。
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AU2012355894B2 (en) | 2015-08-27 |
EP3403621A1 (en) | 2018-11-21 |
JP6126126B2 (ja) | 2017-05-10 |
EP3403621B1 (en) | 2021-12-29 |
AU2012355894A1 (en) | 2014-06-19 |
CN104023675B (zh) | 2016-08-10 |
US9445919B2 (en) | 2016-09-20 |
US20160374826A1 (en) | 2016-12-29 |
EP2793760B1 (en) | 2018-08-08 |
JP2017131679A (ja) | 2017-08-03 |
JP2015500707A (ja) | 2015-01-08 |
CN104023675A (zh) | 2014-09-03 |
US20130158664A1 (en) | 2013-06-20 |
US10195050B2 (en) | 2019-02-05 |
WO2013095789A1 (en) | 2013-06-27 |
EP2793760A1 (en) | 2014-10-29 |
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