JP6441294B2 - 椎間関節癒合インプラントおよび癒合方法 - Google Patents
椎間関節癒合インプラントおよび癒合方法 Download PDFInfo
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- JP6441294B2 JP6441294B2 JP2016237460A JP2016237460A JP6441294B2 JP 6441294 B2 JP6441294 B2 JP 6441294B2 JP 2016237460 A JP2016237460 A JP 2016237460A JP 2016237460 A JP2016237460 A JP 2016237460A JP 6441294 B2 JP6441294 B2 JP 6441294B2
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Images
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- 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
- A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
- A61B17/7064—Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor
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- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- 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
- A61B17/7053—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant with parts attached to bones or to each other by flexible wires, straps, sutures or cables
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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
- A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
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- A—HUMAN NECESSITIES
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- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
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Description
本出願は、2012年2月23日出願の「VERTEBRAL FACET JOINT FUSION IMPLANT AND METHOD FOR FUSION」という名称の米国特許出願第13/403,698号の優先権を主張するものであり、その継続出願である。同出願の内容は、全体として参照により本明細書に組み込まれている。
[項1]
第1の骨部分および第2の骨部分に接触するようにインプラントを配置するステップであって、前記インプラントが、抑制部材を受けるように構成された境界面を有する、配置するステップと、
前記配置後、締付け具部材の一部分を前記境界面内へ挿入するステップと、
前記挿入後、前記締付け具部材を固定するステップであって、それにより、前記固定後、前記第1の骨部分および前記第2の骨部分が互いに癒合する、固定するステップと
を含むことを特徴とする方法。
[項2]
前記境界面が第1の境界面であり、前記インプラントが第2の境界面を含み、前記方法が、
前記締付け具部材を固定するステップであって、それにより、前記固定後、前記第1の骨部分および前記第2の骨部分が、少なくとも部分的にある物質によって互いに癒合する、固定するステップをさらに含み、
前記物質の少なくとも一部分が前記第2の境界面を通るように配置されることを特徴とする項1に記載の方法。
[項3]
前記物質が骨移植片であり、前記第1の骨部分および前記第2の骨部分が前記骨移植片を介して互いに癒合するように、前記第1の骨部分および前記第2の骨部分が互いに癒合することを特徴とする項2に記載の方法。
[項4]
前記締付け具部材が可撓性の締付けバンドであることを特徴とする項1に記載の方法。
[項5]
前記境界面が第1の境界面であり、前記インプラントが第2の境界面をさらに含み、前記方法が、前記第1の骨部分と前記第2の骨部分との間に前記インプラントを配置する前に前記第2の境界面内へある物質を配置するステップをさらに含み、前記第1の骨部分および前記第2の骨部分が前記物質を介して互いに癒合するように、前記第1の骨部分および前記第2の骨部分が互いに癒合することを特徴とする項1に記載の方法。
[項6]
前記インプラントが、前記第1の骨部分の形状を実質的に補完するように構成された面を含むことを特徴とする項1に記載の方法。
[項7]
面および境界面を有するインプラントを備え、
前記面が、第1の骨部分の形状を実質的に補完する形状であり、前記境界面が、締付け具部材を受けるように構成され、
前記インプラントが、前記締付け具部材で固定されるように構成され、それにより、前記インプラントが前記締付け具部材によって固定された後、前記第1の骨部分および第2の骨部分が互いに癒合することを特徴とする装置。
[項8]
前記面が第1の面であり、前記インプラントが、前記第2の骨部分の形状を実質的に補完する形状の第2の面をさらに含むことを特徴とする項7に記載の装置。
[項9]
前記面が第1の面であり、前記インプラントが、前記第2の骨部分の形状を実質的に補完する形状の第2の面をさらに含むことを特徴とする項7に記載の装置。
[項10]
前記境界面が第1の境界面であり、前記インプラントが、骨移植片を受けるように構成された第2の境界面をさらに含み、前記第1の骨部分および前記第2の骨部分が、前記骨移植片を介して互いに癒合することを特徴とする項7に記載の装置。
[項11]
前記面の表面が粗面または多孔質であることを特徴とする項7に記載の装置。
[項12]
前記境界面が、前記面の実質的に中心に配置されることを特徴とする項7に記載の装置。
[項13]
前記境界面が第1の境界面であり、前記インプラントが、不規則な形状を有する第2の境界面をさらに含むことを特徴とする項7に記載の装置。
[項14]
前記境界面が第1の境界面であり、前記インプラントが複数の第2の境界面をさらに含み、前記複数の第2の境界面からの第2の境界面がそれぞれ、前記面の中心の周りで実質的に等距離のところに配置されることを特徴とする項7に記載の装置。
[項15]
締付け具部材と、
前記締付け具部材を受けるように構成された境界面を有するインプラントと、
を備え、
前記締付け具部材が、前記インプラントを第1の骨部分および第2の骨部分に固定するように構成され、それにより、固定後、前記第1の骨部分および前記第2の骨部分が互いに癒合することを特徴とするキット。
[項16]
前記境界面が、面の実質的に中心に配置されることを特徴とする項15に記載のキット。
[項17]
前記境界面が第1の境界面であり、前記インプラントが、不規則な形状を有する第2の境界面をさらに含むことを特徴とする項15に記載のキット。
[項18]
前記境界面が第1の境界面であり、前記インプラントが、骨移植片を受けるように構成された第2の境界面をさらに含み、前記第1の骨部分および前記第2の骨部分が前記骨移植片を介して互いに癒合することを特徴とする項15に記載のキット。
[項19]
前記締付け具部材が可撓性の締付けバンドであることを特徴とする項15に記載のキット。
[項20]
前記インプラントが面を含み、前記面が粗面または多孔質であることを特徴とする項15に記載のキット。
[項21]
前記インプラントが、前記第1の骨部分の形状を実質的に補完する形状の面をさらに含むことを特徴とする項15に記載のキット。
4 椎骨
6 繊維性の円板
8 前部
10 後弓
12 椎弓根
14 椎弓板
16 棘突起
18 横突起
20 上関節突起
22 下関節突起
24 小関節面
26 小関節面
28 椎間関節
30 横断面
32 前面
34 インプラント
36 第1の面
38 第2の面
40 多角形のインプラント
42 インプラント
44 外縁部
46 面
48 面
49 インプラント
50 屈曲、角度、または湾曲、インプラント
52 粗面
54 多孔質表面
56 湾曲または屈曲した円板
58 大きい方の面
60 高度に研磨された表面
62 小さい方の面
64 インプラント
66 円板
68 第1の面
70 第2の面
72 ワイヤまたはケーブル
74 インプラントに係合する部分
76 インプラント
78 締付け具境界面、開口、係合部分
80 骨または柔組織に係合または係留する部分
82 面
84 面
86 縁部
88 2部インプラント
90 インプラント
92 結び目
94 ナット
96 ねじ山付きの部分
98 締付け具リング
100 リング
102 中心内腔
104 側面内腔
106 回転可能ねじ
108 近位端
110 ねじ山付きの本体
112 遠位端
114 尖っていない先端部
116 湾曲した先端部
118 穿孔用の先端部
120 締付け具リング
122 突起
124 中心内腔
126 ねじまたはボルト
127 枢動可能ワッシャ
128 近位端
129 枢動表面
130 本体
132 遠位端
134 相補型の締付け具境界面
136 インプラントまたはスペーサ
138 平坦な2部インプラント
140 湾曲した2部インプラント
142 突起、釘、突起締付け具部材
144 インプラント
146 2部インプラント
148 円板
150 突起
152 インプラント
154 突起
156 インプラント
158 ワイヤ
160 椎間関節インプラント、近位端
162 第1の側、遠位端
164 第2の側
166 締付け具境界面
168 物質境界面
260 インプラント
262 凹状の第1の面
264 凸状の第2の面
266 締付け具境界面
268 物質境界面
280 締付け具部材
282 近位端部
284 遠位端部
360 インプラント
380 締付け具部材
480 締付け具部材、バンド
482 近位端部
484 第1の部分
486 第2の部分
487 ラック歯車
488 遠位端部
489 第3の部分
490 締付け機構
494 歯車
580 締付け具部材、バンド
582 近位端部
584 第1の部分
586 第2の部分
587 ラック歯車
588 遠位端部
590 締付け機構
592 ラチェット
594 歯車
596 内腔
680 締付け具部材、バンド
682 近位端部
684 第1の部分
686 第2の部分
687 ラック歯車
688 遠位端部
690 締付け機構
692 単一のラチェット
694 歯車
696 内腔
772 補強片
774 支持部材
776 孔
780 締付け具部材、バンド
784 第1の部分
786 第2の部分
787 ラック歯車
788 遠位端部
790 締付け機構
792 ラチェット
880 締付け具部材、バンド
882 近位端部
884 第1の部分
886 第2の部分
887 ラック歯車
888 遠位端部
890 締付け機構
892 ラチェット
894 歯車
1060 インプラント
1062 凹状の第1の面
1064 凸状の第2の面
1066 締付け具境界面
1068 物質境界面
1160 インプラント
1162 凹状の第1の面
1164 凸状の第2の面
1166 締付け具境界面
1168 物質境界面
1260 インプラント
1262 凹状の第1の面
1264 凸状の第2の面
1266 締付け具境界面
1268 物質境界面
1360 インプラント
1362 凹状の第1の面
1364 凸状の第2の面
1366 締付け具境界面
1368 物質境界面
1369 突起
IAP1A 下関節突起
IAP1B 下関節突起
SAP2A 上関節突起
SAP2B 上関節突起
V1 椎骨
V2 椎骨
Claims (22)
- 面、第1の境界面、及び複数の第2の境界面を有する椎間関節インプラントを備え、
前記面が、第1の骨部分の形状を実質的に補完する形状であり、前記第1の境界面が、締付け具部材を受けるように構成され、前記複数の第2の境界面が、前記第1の境界面から離して配置されていると共に、前記第1の骨部分と第2の骨部分との癒合を助けるための物質を受けるように構成された開口部を含み、前記第1の境界面は、前記面の中心に配置されており、前記第2の境界面は、前記面上に、かつ前記第1の境界面の周りに分布しており、
前記椎間関節インプラントが、前記締付け具部材で固定されるように構成され、それにより、前記椎間関節インプラントが固定された後、前記第1の骨部分および前記第2の骨部分が少なくとも部分的に前記物質によって互いに癒合することを特徴とする装置。 - 前記複数の第2の境界面が不規則な形状になっていることを特徴とする、請求項1に記載の装置。
- 前記第1の境界面及び前記複数の第2の境界面が異なる形状を有することを特徴とする、請求項1に記載の装置。
- 前記第1の境界面が円形であり、前記複数の第2の境界面が不規則であることを特徴とする、請求項1に記載の装置。
- 前記第1の境界面及び前記複数の第2の境界面が異なるサイズを有することを特徴とする、請求項1に記載の装置。
- 前記複数の第2の境界面は、様々なサイズであることを特徴とする、請求項1に記載の装置。
- 前記装置が、骨部分に係合するように構成された一つ又は複数の突起をさらに備えることを特徴とする、請求項1に記載の装置。
- 前記装置が、前記第1の境界面と前記複数の第2の境界面のうちの1つの第2の境界面との間に配置された突起をさらに備えており、前記第2の境界面が前記第1の境界面から離して配置されていると共に物質を受けるように構成されていることを特徴とする、請求項1に記載の装置。
- 前記椎間関節インプラントが、移植後に隣接する小関節面の固有の構成に整合するのに十分な可鍛性を有することを特徴とする、請求項1に記載の装置。
- 前記面が、凹状の第1の面であることを特徴とする、請求項1に記載の装置。
- 締付け具部材と、
請求項1から10の何れか一項に記載の装置と、
を備えることを特徴とするキット。 - 面、第1の境界面、及び複数の第2の境界面を有する椎間関節インプラントを備え、
前記面が、第1の骨部分の形状を実質的に補完する形状であり、前記第1の境界面が、締付け具部材を受けるように構成され、前記複数の第2の境界面が、前記第1の境界面から離して配置されていると共に、前記第1の骨部分と第2の骨部分との癒合を助けるための物質を受けるように構成された開口部を含み、前記椎間関節インプラントの中央部分が、前記椎間関節インプラントの中心を実質的に中心とする前記椎間関節インプラントの前記第1の境界面を画定し、前記椎間関節インプラントの外側部分が、前記椎間関節インプラントの外縁部と前記椎間関節インプラントの前記第1の境界面との間に前記複数の第2の境界面を画定し、
前記椎間関節インプラントが、前記締付け具部材で固定されるように構成され、それにより、前記椎間関節インプラントが固定された後、前記第1の骨部分および前記第2の骨部分が少なくとも部分的に前記物質によって互いに癒合することを特徴とする装置。 - 前記第1の骨部分が第1の椎骨の上関節突起であり、前記第2の骨部分が第2の椎骨の下関節突起であり、前記椎間関節インプラントが、前記第1の椎骨の前記上関節突起の小関節面と前記第2の椎骨の前記下関節突起の小関節面との間に配置されるようにサイズ決めかつ構成されていることを特徴とする、請求項12に記載の装置。
- 前記椎間関節インプラントは、前記椎間関節インプラントが前記第1の骨部分及び前記第2の骨部分に接触して配置されたときに、かつ前記締付け具部材が前記第1の骨部分及び前記第2の骨部分に対して固定されたときに、前記第1の骨部分と前記第2の骨部分との安定性を増大させるように構成された物質を含むことを特徴とする、請求項12に記載の装置。
- 前記椎間関節インプラントの第1の側が凹状であり、前記椎間関節インプラントの第2の側が凸状であることを特徴とする、請求項12に記載の装置。
- 前記椎間関節インプラントの第2の側が凸状であり、前記椎間関節インプラントの第1の側が凹状であり、それによって、前記締付け具部材の一部分が前記椎間関節インプラントの前記第1の境界面の中に配置されて前記締付け具部材が前記第1の骨部分及び前記第2の骨部分に対して固定されたときに、前記椎間関節インプラントの前記第1の側が前記第1の骨部分の外側表面に実質的に合うようになっていることを特徴とする、請求項12に記載の装置。
- 前記椎間関節インプラントが、コンプライアント材料で形成されており、前記締付け具部材の一部分が前記椎間関節インプラントの前記第1の境界面の中に配置されて前記締付け具部材が前記第1の骨部分及び前記第2の骨部分に対して固定されたときに、前記椎間関節インプラントの第1の側は、前記第1の骨部分の外側表面に実質的に合い、前記椎間関節インプラントの第2の側は、前記第2の骨部分の外側表面に実質的に合うことを特徴とする、請求項12に記載の装置。
- 前記第1の骨部分が第1の椎骨の上関節突起であり、前記第2の骨部分が第2の椎骨の下関節突起であり、前記椎間関節インプラントが、コンプライアント材料で形成されており、前記締付け具部材の一部分が前椎間関節記インプラントの前記第1の境界面の中に配置されて前記締付け具部材が前記第1の骨部分及び前記第2の骨部分に対して固定されたときに、前記椎間関節インプラントの第1の側は、前記上関節突起の外側表面に実質的に合い、前記椎間関節インプラントの第2の側は、前記下関節突起の外側表面に実質的に合うことを特徴とする、請求項12に記載の装置。
- 前記第1の境界面及び前記複数の第2の境界面が前記椎間関節インプラントの周縁部内にあることを特徴とする、請求項12に記載の装置。
- 前記複数の第2の境界面が前記第1の境界面を取り囲んでいることを特徴とする、請求項12に記載の装置。
- 前記第1の骨部分と前記第2の骨部分とが癒合するように、前記締付け具部材が前記第1の骨部分及び前記第2の骨部分を貫通して延在するように構成されていることを特徴とする、請求項12に記載の装置。
- 締付け具部材と、
請求項12から21の何れか一項に記載の装置と、
を備えることを特徴とするキット。
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US13/403,698 US9271765B2 (en) | 2011-02-24 | 2012-02-23 | Vertebral facet joint fusion implant and method for fusion |
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JP2018502693A (ja) | 2015-01-27 | 2018-02-01 | スパイナル・エレメンツ・インコーポレーテッド | 椎間関節インプラント |
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JP2017047283A (ja) | 2017-03-09 |
AU2012222230A1 (en) | 2013-08-29 |
JP6355925B2 (ja) | 2018-07-11 |
US9572602B2 (en) | 2017-02-21 |
JP2014523751A (ja) | 2014-09-18 |
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US10022161B2 (en) | 2018-07-17 |
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