JP7535850B2 - 小関節面の補強のためのデバイス及び方法 - Google Patents
小関節面の補強のためのデバイス及び方法 Download PDFInfo
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Description
第1の固定部分と、
中央部と、
第2の固定部分と、
を備える椎間関節インプラントを補強するためのデバイスであって、
前記第1の固定部分が、近位表面、遠位表面、及び、前記近位表面と前記遠位表面との間に配置された内腔を含み、前記内腔が、可撓性の締付けバンドを受け入れるのに適しており、
前記第2の固定部分が、近位表面、遠位表面、及び、少なくとも1つのファスナー内腔を含む、デバイス。
前記第1の固定部分の長手方向軸線が前記第2の固定部分の長手方向軸線に対して角度を付けて配置されている、上記した項1に記載されたデバイス。
前記第1の固定部分の前記内腔の平面が前記第2の固定部分の前記内腔の平面に対して平行していない、上記した項1に記載されたデバイス。
前記第2の固定部分が少なくとも第2のファスナー内腔を含む、上記した項1に記載されたデバイス。
前記第2の固定部分が、椎骨の棘突起に固定されるように適合されている、上記した項4に記載されたデバイス。
可撓性の締付けバンドと、
近位表面、遠位表面、反管腔側表面、管腔表面、及び、前記可撓性の締付けバンドを受け入れるための内腔を含む小関節面補強デバイスと、
を備える、脊椎を治療するためのキット。
前記小関節面補強デバイスの前記遠位表面が小関節面の骨表面を係合させるように構成されている、上記した項6に記載されたキット。
前記小関節面補強デバイスの前記遠位表面が鋭利な係合部材を備える、上記した項6に記載されたキット。
前記小関節面補強デバイスが、椎骨に付着するように適合された第2の部分をさらに備える、上記した項6に記載されたキット。
前記小関節面補強デバイスの前記第2の部分が棘突起に付着するように適合されている、上記した項9に記載されたキット。
前記小関節面補強デバイスの前記第2の部分が椎弓板に付着するように適合されている、上記した項9に記載されたキット。
前記小関節面補強デバイスの前記第2の部分が少なくとも1つのファスナー内腔を含む、上記した項9に記載されたキット。
前記小関節面補強デバイスを椎骨に固定するためのファスナーをさらに備える、上記した項9に記載されたキット。
前記ファスナーがねじ又はボルトである、上記した項13に記載されたキット。
前記可撓性の締付けバンドを受け入れるように構成された接合部分を有するインプラントをさらに備える、上記した項6に記載されたキット。
椎間関節を固定に向けて準備するステップと、
可撓性の締付けバンドを椎間関節の第1の関節突起及び第2の関節突起に貫通させるステップと、
前記可撓性の締付けバンドを受け入れるための内腔を有する小関節面補強デバイスを、前記第1の関節突起の表面に当てて設置するステップであって、前記可撓性の締付けバンドが前記内腔を通って通過するようにする、ステップと、
前記可撓性の締付けバンドを固定するステップと
を含む、脊椎を治療するための方法。
前記小関節面補強デバイスをファスナーで椎骨に固定するステップをさらに含む、上記した項16に記載された方法。
前記小関節面補強デバイスをファスナーで椎骨に固定する前記ステップが、前記小関節面補強デバイスを、椎骨の棘突起、棘突起の基部、又は、椎弓板に固定することを含む、上記した項17に記載された方法。
脊椎の同じレベルで第2の椎間関節を固定に向けて準備するステップと、
第2の小関節面補強デバイスを前記第2の椎間関節の第1の関節突起に当てて設置するステップと、
第2の可撓性の締付けバンドを前記第2の椎間関節の前記第1の関節突起及び第2の関節突起に貫通させるステップと、
前記第2の可撓性の締付けバンドを固定するステップと
をさらに含む、上記した項16に記載された方法。
前記可撓性の締付けバンドを受け入れるように構成された接合部分を有する小関節面インプラントを前記椎間関節の中へ挿入するステップをさらに含み、
前記可撓性の締付けバンドを前記椎間関節の前記第1の関節突起及び前記第2の関節突起に貫通させる前記ステップが、前記可撓性の締付けバンドを前記小関節面インプラントの前記接合部分に貫通させることも含む、上記した項16に記載された方法。
ファスナー部材が椎間関節を固定するのに使用されるときに骨への補強をもたらすことを目的とする椎間関節への配置のためのデバイスであって、骨接触側に、移動を防止するための鋭利な係合部材と、主な小関節面固定デバイスを受容するための貫通開口と、を有するデバイス。
少なくとも1つの追加のファスナーを受容するための第2の貫通開口をさらに備える、上記した項21に記載されたデバイス。
前記第2の貫通開口を通した配置のためのねじをさらに備える、上記した項21に記載されたデバイス。
本発明のさらなる態様は、以下の項の主題によっても提供される。
[項1]近位表面、遠位表面、及び、前記近位表面と前記遠位表面との間に配置された第1の内腔であってファスナー部材を受け入れるのに適した第1の内腔を含む第1の固定部分と、近位表面、遠位表面、及び、第2の内腔を含む第2の固定部分と、前記第1の固定部分と前記第2の固定部分との間の中央部とを備える、椎間関節インプラントを補強するためのデバイス。
[項2]前記第1の固定部分の長手方向軸線が前記第2の固定部分の長手方向軸線に対して角度を付けて配置されている、任意の前項に記載のデバイス。
[項3]前記第1の固定部分の前記第1の内腔の平面が前記第2の固定部分の前記第2の内腔の平面に対して平行していない、任意の前項に記載のデバイス。
[項4]前記第2の固定部分が少なくとも第2の内腔を含む、任意の前項に記載のデバイス。
[項5]ファスナー部材をさらに備える、任意の前項に記載のデバイス。
[項6]ファスナー部材と、近位表面、遠位表面、及び、前記近位表面と前記遠位表面との間に配置された内腔であって前記ファスナー部材を受け入れるのに適した内腔を含む小関節面補強デバイスと、を備える、脊椎を治療するためのキット。
[項7]前記小関節面補強デバイスの前記遠位表面が小関節面の骨表面を係合させるように構成されている、任意の前項に記載のキット。
[項8]前記小関節面補強デバイスの前記遠位表面が少なくとも1つの係合部材を備える、任意の前項に記載のキット。
[項9]前記小関節面補強デバイスが第2の固定部分をさらに備え、前記第2の固定部分が、近位表面、遠位表面、及び、少なくとも1つの内腔を含む、任意の前項に記載のキット。
[項10]前記小関節面補強デバイスの前記第2の固定部分が棘突起に付着するように適合されている、任意の前項に記載のキット。
[項11]前記小関節面補強デバイスの前記第2の固定部分が椎弓板に付着するように適合されている、任意の前項に記載のキット。
[項12]前記小関節面補強デバイスの固定部分が少なくとも1つの内腔を含む、任意の前項に記載のキット。
[項13]前記小関節面補強デバイスを椎骨に固定するように構成されたファスナーをさらに備える、任意の前項に記載のキット。
[項14]前記ファスナー部材を受け入れるように構成された接合部分を有するインプラントをさらに備える、任意の前項に記載のキット。
[項15]内腔を備える小関節面補強デバイスを第1の椎骨に隣接させて設置するステップと、ファスナー部材を内腔に通して通過させるステップと、前記ファスナー部材を椎間関節の第1の関節突起に貫通させるステップと、前記ファスナー部材を前記椎間関節の第2の関節突起に貫通させるステップと、前記ファスナー部材の一端を前記ファスナー部材の他端に固定することによって、前記小関節面補強デバイスを保持するステップと、を含む、脊椎を治療するための方法。
[項16]前記小関節面補強デバイスをファスナーで椎骨に固定するステップをさらに含む、任意の前項に記載の方法。
[項17]前記小関節面補強デバイスをファスナーで椎骨に固定する前記ステップが、前記小関節面補強デバイスを、椎骨の棘突起、棘突起の基部、又は、椎弓板に固定することを含む、任意の前項に記載の方法。
[項18]インプラントを前記椎間関節に挿入するステップであって、前記インプラントが前記ファスナー部材を受け入れるように構成された接合部分を含む、ステップと、前記ファスナー部材を前記インプラントの前記接合部分に通して通過させるステップと
をさらに含む、任意の前項に記載の方法。
[項19]第2の椎間関節を準備するステップと、第2の内腔を備える第2の小関節面補強デバイスを第1の椎骨に隣接させて設置するステップと、第2のファスナー部材を前記第2の内腔に通して通過させるステップと、前記第2のファスナー部材を第2の椎間関節の第1の関節突起に貫通させるステップと、前記第2のファスナー部材を前記第2の椎間関節の第2の関節突起に貫通させるステップと、前記第2のファスナー部材の一端を前記第2のファスナー部材の他端に固定させることによって、前記第2の小関節面補強デバイスを保持するステップとをさらに含む、任意の前項に記載の方法。
[項20]第2のインプラントを前記第2の椎間関節の中へ挿入するステップであって、前記第2のインプラントが、前記第2のファスナー部材を受け入れるように構成された接合部分を含む、ステップと、前記第2のファスナー部材を前記第2のインプラントの前記接合部分に通して通過させるステップとをさらに含む、任意の前項に記載の方法。
1402 近位表面
1404 反管腔側表面
1406 遠位表面
1410 管腔表面
1416 突起
1420 中心内腔
1480 ファスナー部材(第2のファスナー部材)
1484 締付け機構
1490 左椎間関節
1492 右椎間関節
1500 小関節面補強デバイス
1502 下端
1504 上端
1506 内腔
1508 内腔
1510 中央部
1511 管腔表面
1516 突起
1521 管腔表面
1530 第1の固定部
1531 遠位表面
1540 第2の固定部
1541 遠位表面
1570 棘突起
1580 ファスナー部材
1584 締付け機構
1590 ファスナー
1600 小関節面補強デバイス
1600A 小関節面補強デバイス(第2の小関節面補強デバイス)
1602 下端
1604 上端
1606 内腔
1608 内腔
1608A 内腔
1610 中央部
1611 管腔表面
1616 突起
1621 管腔表面
1630 第1の固定部
1630A 第1の固定部
1631 遠位表面
1640 第2の固定部
1640A 第2の固定部
1641 遠位表面
1670 棘突起
1680 ファスナー部材
1680A ファスナー部材(第2のファスナー部材)
1684 締付け機構
1684A 締付け機構
1690 ファスナー
1690A ファスナー
1692 ナット
1694 ヘッド
1696 シャフト
Claims (19)
- 小関節面補強デバイス及びファスナー部材の組み合わせであって、前記小関節面補強デバイスは、近位表面、遠位表面、及び前記近位表面と前記遠位表面との間に延びる内腔を備え、
前記内腔は、前記ファスナー部材の遠位端部分に位置する締付け機構を有する可撓性の締付けバンドである前記ファスナー部材を受け入れるように構成されており、前記小関節面補強デバイスは関節突起の後部側を向いた外表面に配置されるように構成されており、前記小関節面補強デバイスは前記締付け機構を骨から離して保持しており、
前記小関節面補強デバイスは、小関節面のより大きな表面積と接触するように構成され、それにより前記ファスナー部材の力を分散させて前記小関節面の表面上の圧力を抜いて切り取りを防止し、
前記ファスナー部材を固定することは、前記締付け機構を通って前記ファスナー部材の近位端部分を前進させて前記ファスナー部材の輪を形成することを含み、前記小関節面補強デバイスは前記ファスナー部材の前記輪の中に保持される、小関節面補強デバイス及びファスナー部材の組み合わせ。 - 前記小関節面補強デバイスの1つの表面の少なくとも一部が、粗面を含む請求項1に記載の小関節面補強デバイス及びファスナー部材の組み合わせ。
- 前記小関節面補強デバイスは、少なくとも1つの突起をさらに備える、請求項1に記載の小関節面補強デバイス及びファスナー部材の組み合わせ。
- 前記小関節面補強デバイスの1つの表面の少なくとも一部が多孔質表面を含む請求項1に記載の小関節面補強デバイス及びファスナー部材の組み合わせ。
- 前記小関節面補強デバイスの少なくとも一部は、小関節面の形状に準拠するために展性がある請求項1に記載の小関節面補強デバイス及びファスナー部材の組み合わせ。
- 前記小関節面補強デバイスは、実質的に円形の断面を有する請求項1に記載の小関節面補強デバイス及びファスナー部材の組み合わせ。
- 前記小関節面補強デバイスは、円筒形である請求項1に記載の小関節面補強デバイス及びファスナー部材の組み合わせ。
- 前記小関節面補強デバイスの前記内腔は、円形である請求項1に記載の小関節面補強デバイス及びファスナー部材の組み合わせ。
- 前記小関節面補強デバイスは、骨への応力を低減する請求項1に記載の小関節面補強デバイス及びファスナー部材の組み合わせ。
- 前記小関節面補強デバイスの近位表面は、挿入ツールと機械的に相互嵌合する機構を備える請求項1に記載の小関節面補強デバイス及びファスナー部材の組み合わせ。
- 前記小関節面補強デバイスの近位面が、前記ファスナー部材の一部と機械的に相互嵌合する機構を備える請求項1に記載の小関節面補強デバイス及びファスナー部材の組み合わせ。
- 前記小関節面補強デバイスの直径は、2mmから20mmの範囲である請求項1に記載の小関節面補強デバイス及びファスナー部材の組み合わせ。
- 前記小関節面補強デバイスの前記内腔の直径は、0.5mmから10mmの範囲である請求項1に記載の小関節面補強デバイス及びファスナー部材の組み合わせ。
- 前記小関節面補強デバイスは、内腔を含む第1の固定部分と、第2の内腔を含む第2の固定部分と、をさらに含み、前記小関節面補強デバイスの前記第1の固定部分および前記第2の固定部分は、前記小関節面補強デバイスの中央部分によって接続されている請求項1に記載の小関節面補強デバイス及びファスナー部材の組み合わせ。
- 前記小関節面補強デバイスの前記第2の固定部分は、第3の管腔を含む請求項14に記載の小関節面補強デバイス及びファスナー部材の組み合わせ。
- 前記小関節面補強デバイスの前記第1の固定部分の長手方向軸は、前記小関節面補強デバイスの前記第2の固定部分の長手方向軸に対して角度をつけて配置されている請求項14に記載の小関節面補強デバイス及びファスナー部材の組み合わせ。
- 前記小関節面補強デバイスの前記第1の固定部分の平面は、前記小関節面補強デバイスの前記第2の固定部分の平面と平行ではない、請求項14に記載の小関節面補強デバイス及びファスナー部材の組み合わせ。
- 前記小関節面補強デバイスの前記第1の固定部分は、関節突起の後部側を向いた外表面に配置するように構成されており、前記小関節面補強デバイスの前記第2の固定部分は、棘突起の外面に配置するように構成されている請求項14に記載の小関節面補強デバイス及びファスナー部材の組み合わせ。
- 前記小関節面補強デバイスの前記第1の固定部分は、関節突起の後部側を向いた外表面に配置するように構成されており、前記小関節面補強デバイスの前記第2の固定部分は、椎弓板の外面に配置するように構成されている請求項14に記載の小関節面補強デバイス及びファスナー部材の組み合わせ。
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AU2014327083C1 (en) | 2019-10-24 |
EP3049004A4 (en) | 2016-09-28 |
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