JP7470731B2 - 展開可能なブレードを備えるインプラント - Google Patents
展開可能なブレードを備えるインプラント Download PDFInfo
- Publication number
- JP7470731B2 JP7470731B2 JP2022062252A JP2022062252A JP7470731B2 JP 7470731 B2 JP7470731 B2 JP 7470731B2 JP 2022062252 A JP2022062252 A JP 2022062252A JP 2022062252 A JP2022062252 A JP 2022062252A JP 7470731 B2 JP7470731 B2 JP 7470731B2
- Authority
- JP
- Japan
- Prior art keywords
- blade
- implant
- channel
- side edge
- drive member
- 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
Links
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Images
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Description
動部材の従動端を受け入れる。インプラントは、ねじ切り開口内に取り付けられている止めねじも含む。止めねじは、ブレード移動部材の従動端がガイド開口を通過することができるアンロック回転位置と、ブレード移動部材の駆動端がガイド開口を移動することを防止するロック回転位置との間で回転することができる。
図1は、インプラント100の一実施例を示す模式図である。インプラント100は、ケージまたは固定デバイスともいわれることがある。いくつかの実施形態において、インプラント100は、人体の一部に埋め込まれるように構成されている。いくつかの実施形態において、インプラント100は、脊椎に埋め込まれるように構成されてもよい。いくつかの実施形態では、インプラント100は、隣接する椎骨間に挿入して、椎骨間の支持を提供しおよび/または固定を助ける脊椎固定インプラントまたは脊椎固定デバイスであってもよい。
16も含んでもよい。さらに、インプラント100は、上側側部130および下側側部140も含んでもよい。
レードを含むことができるであろう。さらに別の実施形態では、1枚のブレードを使用することができるであろう。
本明細書で説明する実施形態は、インプラントが低プロファイルを維持することを許容する第1位置(「挿入位置」)から、ブレードを展開してそれを近位の上下の椎体に挿入する第2位置(「嵌め込み位置」または「展開位置」)まで移動することのできるインプラントを提供する。インプラントが第1(挿入)位置にあるとき、デバイスのブレードは、インプラントのボディ内に後退していてもよい(すなわち、ブレード自体が「後退位置」にあってもよい)。インプラントの第2(展開)位置では、ブレードは、インプラントを越えて上側(もしくは頭側)または下側(もしくは尾側)に延びて、椎体に入り、インプラントが時間とともに位置からずれることを防止する。このため、ブレード自体が「延伸位置」または「展開位置」にあると言われることもある。ブレードが展開されるとき、インプラントは、左右の回転に抵抗するとともに、屈曲および/または伸展に抵抗する。ブレードは、おおむね垂直方向(すなわち、上下方向)に移動するかもしれないが、実際の移動方向は実施形態によって変わってもよいことは認識されよう。たとえば、いくつかの実施形態では、ブレードは、インプラント内でやや傾斜させてもよく、垂直方向(または上下方向)に対してわずかな角度をもって展開してもよい。
レード高さが10mm未満になるようにインプラントを設計することができるであろう。
図8は、第1ブレード241の模式的な等角図である。第1ブレード241または単にブレード241は、外縁400と、内縁402と、第1外側縁404と、第2外側縁406とを含む。これらの縁は、遠位面408(すなわち、遠位方向に向けられる面)と近位面410(すなわち、近位方向に向けられる面)とをつなぎ合わせる。
とができる。第1突出部450が第1チャンネル方向460に摺動すると、第1ブレード241がインプラント100の上側側部で外向きに延びるように、第1ブレード241がブレード移動部材260に対して垂直に移動する(図6~図7を参照)。第1突出部450が第2チャンネル方向462に摺動すると、第1ブレード241がインプラント100の外部構造201内に後退するように、第1ブレード241がブレード移動部材260に対して垂直に移動する(図4~図5を参照)。同様に、第2ブレード242が下側側部でインプラント100から延びたり後退したりできるように、第2ブレード242の第2突出部455は、第2チャンネル352の第1および第2のチャンネル方向に摺動してもよい(図4~図7を参照)。この構成を使用して、ブレード移動部材260は、両方のブレードを反対方向に推進させ、それによって反応荷重を釣り合わせるとともに、ガイドバーにかかる片持ち荷重および摩擦を最小限にする。
図12は、ボディ200の模式図を示す。ボディ200は、外部構造201の後方側部および前方側部、ならびに外部構造201の少なくとも1つの外側側部を提供してもよい。
ポートを図12に図示しているが、他の実施形態は、任意のトラス状および/または格子状パターンを含め、任意の他のパターンで配置されるサポートを有することができるであろう。
ボディの対応する穴に整列させてもよい。
図16は、ブレードとインプラント100の他の構成要素との間の装着部が見える、インプラント100の模式的な上面図である。図17は、第1ブレード241とブレード移動部材260の一部とを含むインプラント100の領域650の模式的な拡大図であり、いくつかの装着点が明確に見える。
蟻継ぎ滑り接合などの互いに噛み合う接合を使用してブレードとブレード移動部材とを接続することは、嵌め込み中にブレードがブレード移動部材から外れるのを防ぐことを助ける。さらに、互いに噛み合う接合を用いて、ブレード移動部材を、ブレードを後退させるために使用することができる。
図22~図24は、一実施形態による止めねじ280のいくつかの模式図を示す。止めねじ280は、丸いセグメント284と平らなセグメント286とを備えるフランジ付き頭282を含む。止めねじ280は、ねじ切りボディ288と回転制限溝289とをさらに含む。
溝289に係合している状態では、止めねじ280は、ピン291が第1溝端293に当てて配設される第1回転位置と、ピン291が第2溝端295に当てて配設される第2回転位置との間でしか回転しなくてもよい。
異なる実施形態では、インプラントのサイズを変えることができるであろう。いくつかの実施形態では、インプラントは、任意の長さを有することができるであろう。実施形態は、40mmから60mmまでの範囲の長さを有することができるであろう。ある場合には、製造者は、40mmから60mmの間で5mm刻みで長さを変えられる複数のインプラントの選択肢を提供することができるであろう。いくつかの実施形態では、インプラントは、任意の高さを有することができるであろう。実施形態は、8mmから16mmまでの範囲の高さを有することができるであろう。ある場合には、製造者は、8mmから16mmまで2mm刻みで高さを変えられるインプラントを提供することができるであろう。実施形態は、18mm、22mm、26mmおよび他のサイズの幅(すなわち、前後軸)を有することができるであろう。
実施形態は、任意選択的に、1つまたは複数の整列機能を含んでもよい。例示的な整列機能は、透視撮影の位置付け用の窓、ブレード展開の検証用の窓、ブレード移動部材を1枚または複数枚のブレードと整列させるための窓、および種々の他の種類の整列機能を含むが、これだけに限定されない。図2を参照すると、インプラント100のボディ200は中央整列窓209を含む。さらに、ブレード241は整列窓297を含む。整列窓297は、ブレード241が完全に後退したときに、中央整列窓209と整列してもよい。さらに、ブレード移動部材260は、第1整列窓277および第2整列窓279を含む。窓277および窓279は、ブレード241およびブレード242が完全に展開されて後退したときに、インプラントボディの中心線に整列してもよい。これらの窓(すなわち、中央整列窓209、第1整列窓277および/または第2整列窓279)のうちの1つまたは複数は、透視撮影の位置付けを容易にしてもよく、ブレードの展開を確認するために使用されてもよい。たとえば、ある場合には、第1ブレード241および第2ブレード242が完全に展開されるとき、ブレードは、ブレード移動部材260の第1整列窓277を通り越してもよい。
。
インプラントの種々の構成要素は、特定の用途および/または医師による選択に応じて、金属(たとえば、チタン、チタン合金、ステンレススチール、コバルトクロム、または他の金属)、合成ポリマー(たとえば、PEEKまたはPEKK)、セラミック、および/またはそれらの組み合わせを含むがこれらに限定されない、人体に埋め込むのに好適な生体適合性材料から製造されてもよい。
いくつかの実施形態は、骨移植片または骨移植片代用品材料を含め、骨成長促進材料を使用してもよい。本明細書で用いられる場合、「骨成長促進材料」(BGPM)とは、骨の成長を助ける任意の材料である。骨成長促進材料は、リンカー分子またはバインダの使用により表面に凍結乾燥されるかまたは金属に付着される手段を含んでもよい。骨成長促進材料の例は、BMP-1、BMP-2、BMP-4、BMP-6およびBMP-7等の骨形成タンパク質(BMP)を含む、任意の材料である。これらは、幹細胞を骨形成細胞に変換するホルモンである。別の例には、rhBMP-2、rhBMP-4およびrhBMP-7等のリコンビナントヒトBMP(rhBMP)が挙げられる。さらに別の例には、血小板由来増殖因子(PDGF)、線維芽細胞増殖因子(FGF)、コラーゲン、BMP模倣ペプチド、およびRGDペプチドが挙げられる。一般に、これらの化学物質の組み合わせも使用してもよい。これらの化学物質は、スポンジ、基質またはゲルを使用して塗布することができる。
他の化学物質が挙げられる。
Claims (12)
- 上側表面と下側表面を含み、前記上側表面と前記下側表面とを延びる上下軸を定め、および上下軸に実質的に垂直な方向にボディを横に延びる横軸を定める前記ボディと、
前記ボディ内の第1の後退位置と、前記ボディから外向きに延びる第1の展開位置との間を移動できる第1のブレードと、
横軸に平行な方向に前記ボディを通って並進するように構成されたブレード駆動部材とを備えるインプラントであって、
前記ブレード駆動部材が横軸に沿って第1の方向に移動すると、前記第1のブレードは前記第1の展開位置に向かって移動し、
前記ブレード駆動部材が前記第1の方向とは反対の第2の方向に移動すると、前記第1のブレードは前記第1の後退位置に向かって移動するように、前記ブレード駆動部材の動きを逆転させることができ、
前記第1の展開位置において、前記第1のブレードは、上下軸に対して第1の非ゼロかつ斜めの角度で前記上側表面から伸長している、インプラント。 - 前記ボディ内に第2の後退位置を有し、前記ボディから外向きに延びる第2の展開位置とを有する第2のブレードをさらに含み、
前記ブレード駆動部材が前記第1の方向に沿って横に移動すると、前記第2のブレードは前記第2の展開位置に向かって移動し、
前記ブレード駆動部材が前記第1の方向とは反対の前記第2の方向に移動すると、前記第2のブレードは前記第2の後退位置に向かって移動し、
前記第2の展開位置において、前記第2のブレードは、上下軸に対して第2の非ゼロかつ斜めの角度で前記下側表面から伸長している、請求項1に記載のインプラント。 - 前記第1のブレードは、ボディの中心線(上下軸に平行な線であって、前記ブレード駆動部材が移動する軸と交わる線のことをいう。)からオフセットされた第1の位置から延び、前記第1のブレードは、前記ボディの中心線に対して角度が付けられている、請求項1に記載のインプラント。
- 前記第2のブレードは、前記ボディの中心線からオフセットされ、前記第1の位置の反対側にある第2の位置から延び、
前記第2のブレードは、前記第1の非ゼロかつ斜めの角度と前記第2の非ゼロかつ斜めの角度とが実質的に等しく、互いに反対向きになるように、前記ボディの中心線に対して角度が付けられている、請求項2に記載のインプラント。 - 前記第1のブレードは、外縁と、内縁と、第1の側縁と、第2の側縁とを有し、前記第1のブレードは、前記第1の側縁および前記第2の側縁のみが前記ボディと接触しながら、前記第1の後退位置と前記第1の展開位置との間を移動する、請求項1に記載のインプラント。
- 前記ボディが前記第1の側縁を保持するための第1の保持チャンネルと、前記第2の側縁を保持するための第2の保持チャンネルとを含み、前記第1の保持チャンネルおよび前記第2の保持チャンネルはそれぞれ横軸に対してゼロ以外の角度が付けられている、請求項5に記載のインプラント。
- 上側表面と下側表面を含み、上側表面と下側表面とを延びる上下軸を定め、および上下軸に実質的に垂直な方向にボディを横に延びる横軸を定める前記ボディと、
前記ボディ内の第1の後退位置と、前記ボディから外向きに延びる第1の展開位置との間を移動できる第1のブレードと、
横軸に平行な方向に前記ボディを通って並進するように構成されたブレード駆動部材とを備えるインプラントであって、
前記ブレード駆動部材が横軸に沿って第1の方向に移動すると、前記第1のブレードは前記第1の展開位置に向かって移動し、
前記第1の展開位置において、前記第1のブレードは、上下軸に対して第1の非ゼロかつ斜めの角度で前記上側表面から伸長し、
前記ボディ内の第2の後退位置と、前記ボディから外向きに延びる第2の展開位置との間を移動できる第2のブレードをさらに含み、
前記ブレード駆動部材が横軸に沿って前記第1の方向に移動すると、前記第2のブレードは前記第2の展開位置に向かって移動し、
前記第2の展開位置において、前記第2のブレードは、上下軸に対して第2の非ゼロかつ斜めの角度で前記下側表面から伸長している、インプラント。 - 前記第1のブレードは、ボディの中心線(上下軸に平行な線であって、前記ブレード駆動部材が移動する軸と交わる線のことをいう。)からオフセットされた第1の位置から延び、第1のブレードは、前記ボディの中心線に対して角度が付けられている、請求項7に記載のインプラント。
- 前記第2のブレードは、前記ボディの中心線からオフセットされた、前記第1の位置の反対側にある第2の位置から延び、
前記第2のブレードは、前記ボディの中心線に対して角度が付けられており、前記第1の非ゼロかつ斜めの角度と前記第2の非ゼロかつ斜めの角度が実質的に等しく、向きが互いに反対になるようにされている、請求項8に記載のインプラント。 - 前記第1のブレードは、外縁、内縁、第1の側縁および第2の側縁を有し、前記第1のブレードは、前記第1の側縁および前記第2の側縁のみが前記ボディと接触しながら、前記第1の後退位置と前記第1の展開位置との間を移動する、請求項7に記載のインプラント。
- 前記第2のブレードは、外縁、内縁、第1の側縁および第2の側縁を有し、前記第1の側縁および前記第2の側縁に沿ってのみ前記ボディと接触している、請求項7に記載のインプラント。
- 前記ブレード駆動部材の動きは反転されることができ、前記ブレード駆動部材が前記第1の方向とは反対の第2の方向に移動すると、前記第1のブレードが前記第1の後退位置に向かって移動し、前記第2のブレードは前記第2の後退位置に向かって移動する、請求項7に記載のインプラント。
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CN113952086A (zh) | 2022-01-21 |
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