JPH01308557A - 人工椎間円板 - Google Patents

人工椎間円板

Info

Publication number
JPH01308557A
JPH01308557A JP62306823A JP30682387A JPH01308557A JP H01308557 A JPH01308557 A JP H01308557A JP 62306823 A JP62306823 A JP 62306823A JP 30682387 A JP30682387 A JP 30682387A JP H01308557 A JPH01308557 A JP H01308557A
Authority
JP
Japan
Prior art keywords
intervertebral disc
artificial intervertebral
lower member
hinge
disc according
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.)
Granted
Application number
JP62306823A
Other languages
English (en)
Other versions
JPH0570470B2 (ja
Inventor
Thomas P Hedman
トーマス　ピー　ヘッドマン
John P Kostuik
ジョン　ピー　コスティック
Geoffrey R Fernie
ジョーフリー　アール　ファーニー
Brian E Maki
ブライアン　イー　マーキ
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
HEALTH AND RES SERVICES Inc
Original Assignee
HEALTH AND RES SERVICES Inc
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by HEALTH AND RES SERVICES Inc filed Critical HEALTH AND RES SERVICES Inc
Publication of JPH01308557A publication Critical patent/JPH01308557A/ja
Publication of JPH0570470B2 publication Critical patent/JPH0570470B2/ja
Granted legal-status Critical Current

Links

Classifications

    • 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
    • A61F2/442—Intervertebral or spinal discs, e.g. resilient
    • A61F2/4425—Intervertebral or spinal discs, e.g. resilient made of articulated components
    • 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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • 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
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30462—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements retained or tied with a rope, string, thread, wire or cable
    • 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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • 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
    • A61F2002/30565—Special structural features of bone or joint prostheses not otherwise provided for having spring elements
    • A61F2002/30566—Helical springs
    • A61F2002/30568—Multiple spring systems including two or more helical springs
    • 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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • 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
    • A61F2002/30578—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs having apertures, e.g. for receiving fixation screws
    • 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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30621—Features concerning the anatomical functioning or articulation of the prosthetic joint
    • A61F2002/30624—Hinged joint, e.g. with transverse axle restricting the movement
    • 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
    • A61F2/442—Intervertebral or spinal discs, e.g. resilient
    • A61F2/4425—Intervertebral or spinal discs, e.g. resilient made of articulated components
    • A61F2002/443—Intervertebral or spinal discs, e.g. resilient made of articulated components having two transversal endplates and at least one intermediate component
    • 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
    • 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
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0075—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable

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)
  • Materials For Medical Uses (AREA)

Abstract

(57)【要約】本公報は電子出願前の出願データであるた
め要約のデータは記録されません。

Description

【発明の詳細な説明】 （産業上の利用分野） 本発明は人体の脊柱用人工推間円板に関するものである
。
（従来の技術） 人体の脊柱は複数の脊椎骨とその脊椎骨の間にあって１
１％作用をする椎間円板からなっている。椎間円板は繊
維質の外被とその中に封入されたゲル状流体からなって
いる。椎間円板には人体が静止しているときには約１７
５ボンドの力ががかるが、椎間円板かかる力は約５００
ボンドにも達することがある０例えば、ｌフィート前に
ある１５ボンドの重りを体を曲げて持ち上げると脊柱に
はほぼ５００ボンドの力がかかる。このように大きな力
が作用するため、椎間円板は破裂しやすく、特に老化す
るほどその傾向がつよくなる。
椎間円板の破裂に対処するために多くの試みがなされた
。Ｉｆｉ準的な方法の一つは破裂した椎間円板を除去し
てその椎間円板で隔てられていた２１Ｗの脊椎骨を直接
・接合する方法である。この方法によるとその２個の脊
椎骨の相対的な運動が不可能になるため、脊柱が堅くな
るとともに、その２個の脊椎骨を接合した部分の上下の
部分に障害が発生ずるという問題がある。破裂した椎間
円板を高密度ポリエチレンあるいはシリコンで形成され
た人工弾性パッドと交換する方法も知られている。
しかしながら、椎間円板は通常１年間に百万回から五百
万回も伸縮するため、そのようなパッドは直に摩滅して
しまう、さらにそのようなパッドでは天然の椎間円板で
得られるようなコンプライアンス乃至自然復元力および
運動に対する束縛が得られない。
また、椎間円板の替わりにボールベアリングを使用する
ことも提案されているが、そのボールベアリングを正し
い位置に保持する方法がまだ確立されていない。
（発明の目的） 上記のような事情に監みて、本発明は性能が良く患者内
で長時間ａ　１ｆｆｉすることのできる人工椎間円板を
提供することを目的とするものである。
（発明の構成） 本発明によれば人体の脊柱の２個の脊椎骨間の天然椎間
円板と交換するための人工椎間円板であって、 （ａ）それぞれ後部と前部を有する上方部材と下方部材
、 （ｂ）前記上方部材と下方部材のそれぞれの前記後部を
中心とした相対的ヒンジ運動を許すようにその上方部材
と下方部材に設けられたヒンジ手段、 （Ｃ）前記上方部材と下方部材の間に配されて。
両者の前記前部を互いに離れる方向に付勢するスプリン
グ手段。
（ｄ）前記ヒンジ運動を許すようにして前記上方部材と
下方部材を互いに連結する連結手段、および （ｅ）前記上方部材をその上方にある第１の脊椎骨に剛
に固定する第１の固定手段と前記下方部材をその下方に
ある第２の脊椎骨に剛に固定する第２の固定手段゛、 からなる人工椎間円板が提供される。
（実施例） 本発明の一実施例の人工椎間円板２０を示す第１から７
図において、その人工椎間円板２０の前側は２２で示さ
れており、後側は２４で示されている。
人工椎間円板２０は−Ｌ方部材２６と下方部材２８を備
えている。上方部材２６は本質的に平らなに２面３０と
下面３２を、帽えている。下面３２の前部には２つの円
筒形四部３４が横に並んで設けられており、その各四部
３４の中心から６出ビン３６が下方に突出している。
上方部材２６の下面３２の後部には両側から横方向にそ
れぞれ延びる一対の半円筒状の清３８．４０が設けられ
ている０画情３８．４０の間には下方に突出する半円筒
状のヒンジ構成部４２が設けられており、そのヒンジ構
成部４２にはヒンジピン６６を挿入するための軸方向に
延びる貫通孔４４が設けられている。上方部材２６の上
面３゜の前縁および一側縁から一対のタブ４６が上方に
延びている。
下方部材２８は本質的に平らな下面４８と」二面５０を
備えている。上面５０の前部には２つの円筒形四部５２
が」１方部材２６の凹部３４とそれぞれ整列するように
設けられており、その各四部５２の中心から６出ビン５
３が上方に突出している。
下方部材２８の−Ｆ面５０の後部には両側から横方向に
それぞれ延びる一対の半円筒状のヒンジ構成部５４．５
６が設けられている０両ヒンジｔ１′４成部５４．５６
の間には半円筒状の清５８が設けられており、そのヒン
ジ構成部５４．５６にはヒンジピン６６を挿入するため
の軸方向に延びる断面長円形の孔６０．６２が設けられ
ている。孔６゜の外端は盲になっている。下方部材２８
の下面４８のｆｌｉ目号および一側縁から一対のタブ６
４が下方に延びている。
人工椎間円板２０はヒンジ構成部４２を講５８内に入れ
、ヒンジピン６６を孔６２．４４．６゜に挿通ずること
によって組み立てられる。ヒンジピン６６は大径の中央
部６８を有し、その中央部６８を孔４４に締まり碌めも
しくは圧入することに、１、って所定の位：ａに保持さ
れる。ヒンジピン６６は人工椎間円板２０の第１．２図
で見て左側から挿入される。孔６０の右端は盲になって
いる。
ヒンジピン６６の両端７０には後述するような理由でテ
ーパーがつけられている。
上方部材２６とｆ力部材２８は各一対の四部３４．５２
内に位置せしめられた各一対の螺旋圧縮スプリング乃至
コイルスプリングによって互いに離れる方向にヒンジピ
ン６６の周りに回動するように付勢されている。各対の
コイルスプリングは互いに同心の外側コイルスプリング
７２と内側コイルスプリング７４からなっている。内側
コイルスプリング７４は両端が６出ビン３６．５３の周
りにｈν合しており、それによって所定の位置に保持さ
れるようになっている。外側コイルスプリング７２は主
として、その両端が凹部３４．５２にｌｌ’４大するこ
とによっ−Ｃ所定の位置に保持されるようになっており
、内側コイルスプリング７４とは本質的に接触していな
い、外側コイルスプリング７２を構成するワイへ・−の
両端７６はコイルスプリング７２の両端面が平らになっ
て安定良くかつコンパクトに着座せしめられるように斜
めに切られている。
第５Ａ図に示すように、凹部３４．５２の後縁は後方に
向かって１０”から２０°の間の角度で傾斜しており、
それによって−Ｌ力部材２６と下方部材２８が１剤いて
コイルスプリングが弧を描いても凹部３４．５２の後縁
に当たらないようになっている。
人工椎間円板２０は人体の脊柱内に第８図に示すように
して組み込まれる。ずなわち１人工椎間円板２０は上側
の脊椎骨８０と下側の脊椎＋８２の間に組み込まれる０
人工椎間円板２ｏを組み込む際には、まず脊柱の周囲の
天然の筋肉や靭帯の外波をできるだけ傷つけないように
して天然の椎間円板を除去する。脊柱管自体は脊椎骨の
後部を通って走っているので邪魔にならない０次に、上
側の脊椎骨８０の破ｔ１８６で示す下方部分を除去して
１一方部材２６を取り付けるための平らな下面８８を形
成する。同様に、Ｔ　Ｉｌｌの脊椎骨８２の破線９０で
示ず−１一方部分を除去して下方部材２８を取りｆ・１
けるための平らな１−而９２を形成する。
次に、前ねじ９４と横ねじ９６をそれぞれ前と横のタブ
４６をとおして上側の脊椎骨８０にねじ込むことによっ
て上方部材２６を上側のをｌＩ骨８０に固定し、前ねじ
９４と横ねじ９６をそれぞれ前と横のタブ６４をとおし
て下側の脊椎骨８２にねじ込むことによって下方部材２
８を下側の脊椎骨８２に固定する。をＪｌｔ骨は外壁部
が最も強く、また中央部は極めて弱くなっている可能性
があるためねじ９４．９６は手前の外壁部から中央部を
通って反対側の外壁部をほぼ貫通する（ただし外１ｔ１
１に突き出さない）ような長さとする。前ねじ９４はで
きるだけ長く脊椎骨内を通り、しかも万一その１（さが
所定の長さより鴎かに長くても脊柱管を出つけることの
ないように、第３．４図に線９８で示すように、脊椎骨
の側縁に角度をなすようにねじ込まれる。また、横ねじ
９６はより大きな強度がＩｆられるようにできるだ１）
を１１を骨の中心の近くを通るように、線１００で示す
ように、脊椎骨前縁に対して角度をなすようにねじ込ま
れる。
また、第５から７Ｉ７ＩにＩ３いて前のタブと横のタブ
の高さの違いから分かるように、前ねじ９４と横ねじ９
６は互いに干渉しないように異なる高さを通される。
さらに、上方部ｔ４２６の上面３０と下方部材２８の下
面４８には焼結金属の粉末、ボール、メツシュ等の多孔
性材？１のコーティングを施すのが望ましい、これによ
って、周知のように、骨が多孔性金属内に成長して、人
工椎間円板２ｏと脊椎骨とのより強固な結合が得られる
。
第８図において、」−下の脊椎骨８０．８２の最ｔ＆面
間の距離１０２が」二側の脊椎骨８０とその上のをＩＩ
骨のＡ１ｔ＆面間の距、ｆｆ１ｌ　０４より大きいこと
から分かるように本実施例の人工ＪＩ間内円板ｏは元々
の椎間円板より背が高い、これは故意にそうされたもの
である。すなわち、脊椎骨の後面８４は痛みの中心とな
りやすいため、人工椎間円板２０の高さを大きくしてそ
の後面８４を通る負荷の伝達を小さくすることによって
痛みの発生頻度を１印えることができるのである。
本実施例の人工椎間円板２０を装着した患者が直立して
いるときには上方部材２６と下方部材２８は通常第８図
に示すような位置にあって互いに角度Ａをなしている。
角度Ａは腰椎の場合には通常的１４°である。患者が体
を後ろに反らせると上方部材２６と下方部材２８がなす
角は通常的２０°の角度Ｂとなる。後方への体の曲げは
上方部材２６の下面３２の後端と下方部材２８の上面５
０の後端の当接によって制限される。すなわち、上方部
材２６の下面３２の後端と下方部材２８の上面５０の後
端は第８図に１０３で示すようにストッパを形成し、上
方部材２６と下方部材２８の開きを制限する。患者が体
を前に曲げると−Ｅ方部材２６と下方部材２８がなす角
は通常的０°に近づく。
天然の椎間円板のコンプライアンスは通常単Ｃα圧縮比
あたり約１，５フート・ボンドである。このコンプライ
アンスに近づけるためにスプリング７２．７４は極めて
堅いものが使用される。一般に、各外側コイルスプリン
グ７２のばね定数は約１６７５ボンド／インチであり、
各内側コイルスプリング７４のばね定数は約２００ボン
ド／インチである。これによって２対のコイルスプリン
グの合計のばね定数は約３７５０ボンド／インチとなる
。
そのばね定数を抵抗トルク（第８図に示した角度に関し
て）が単位圧縮比あたり１．０から１．６５７−１−　
／ボンドとなるように患者に応じて調節することもでき
る。（ばね定数が大きいとスプリングが０．１インチ程
度しか動がないことには注意する必要があるが）スプリ
ングの径が一定でそのスプリングを形成するワイヤーの
径が一定の場合には巻数を変えることによってばね定数
を変えるのが一般的である。このようにして矢状面（ず
なわぢ脊柱を前後に通る垂直面）内における生体外生理
学的椎間円板堅さに近づける。
第６．７図に示すようにヒンジピン６６と両側の断面１
）円形の孔６０．６２の間には間隙１０５がある。この
間隙１０５によって第７図に示すように、上方部材２６
と下方部材２８の中心を前後に通る垂直面を中心として
両部材２６．２８が相対的に左右に代かに揺動するのが
許される。これは両部材の損（ｊＪを防ぐのに役立つと
ともに、付随的な効果として、人工椎間円板２０の位置
で患者が体を横に多少曲げるのを許す、また、ヒンジピ
ン６６の両端７０がテーパーしていることによって、体
を横に曲げたときに過度の圧力が一点に集中するのが防
ｆされるとともに、ヒンジピン６６内の周辺応力が小さ
くされる。
本実施例の人工椎間円板２０の重要な特徴の１つは下方
部材２６と下方部材２８が互いに結合されているととも
に、脊椎骨に剛に取り付けられるようになっていること
である。そのため、人工椎間円板２０が分解してしまっ
たり、その位置がずれてしまったりするおそれがなく、
また、事故があったときに、人工椎間円板２ｏの部分で
脊柱が離れてしまうようなおそれがない。
本実施例のもう１つの特徴は上方部（４２６の下方部材
２８に対するヒンジ運動の軸が両部材の中央部になく、
後部にあることである。これによって、脊柱管の近くで
生ずる運動の量を小さくすることができる。
本実施例のもう１つの特徴は上方部材２６および下方部
材２８を脊椎骨の前と一曲縁に脊椎骨に固定するように
したことである。このように、前と横で固定することに
よって、スプリングの力に対して良好なてこの作用が得
られる。横のタブは（前後方向に見て）ヒンジ運動の軸
の近くに位置させるのが望ましい。
人工椎１？ｉ１円板２０は適当なチタン合金（例えばチ
タン−６アルミニウム一４バナジウムＩＥＬＩ合金）、
コバルトクロムモリブデン合金等の生体と共存し得る金
属で形成される。このような金属は充分強度があるため
、人工椎間円板２ｏは相当長期に亘って人体内でｖ１能
することができる。ａの生体と共存し得る金属を使用し
てもよい、コイルスプリング７２．７４は冷間加工され
たチタン−６アルミニウム−４バナジウム１′？、Ｌ　
Ｔ合金で形成するのが望ましく、これによって圧縮可能
なプラスチックパッドを使用するのに比べてノ、ｉ命が
飛躍的に長くなる。また、スプリングに加わる応力がス
プリングが疲れ破壊しない程度に低く抑えられるように
設泪されている。すなわち、−杯に圧縮されたどきでも
荷重が最大荷重より充分小さくなるように設３１されて
諭る。
本実施例の人工椎間円板２０は垂直軸周りの回転運動を
許容しないが、本実施例の人工椎間円板２０は腰部の低
い部分の脊柱に使用するように怠ＩＡされており、その
部分では自然な回転運動は極めて少ない。
次に、第９から１６図を参照して本発明の他の実施例の
人工椎間円板を説明する０本実施例は前記実施例と多く
の面で共通しているため、第９から１６１４では第１か
ら８図と対応する部分については第１から８図と同じ番
号にダッシュを付けて示した。
本実施例の人工４１間円板２０°と前記実施例の人工椎
間円板２０の違いは上方部材２６°と下方部材２８°を
ヒンジ運動可能に連結する方法にある０本実施例の人工
椎間円板２０゛にＪ３いては下方部材２８°は、そのＥ
面５０゛の後部を横方向に完全に横切る半円筒形のヒン
ジ構成部１０６を備えている。上方部材２６°の下面３
２°はそのヒンジ構成部１０６と賜金する半円筒形の凹
部１０８を備えている。そのヒンジ構成部１０６と凹部
１０８は上方部材２６°と下方部ｒ４２８°がそれぞれ
の後部を中心としてヒンジ運動するのを許容するように
協働する。
上方部材２６′と下方部材２８°はそれぞれの両側部に
設けられた孔１１２に挿通されたケーブル１１０によっ
て連結される。ケーブル１１０はその両端に熱成形され
たキャップ１１４を備えており、それによって上方部材
２６′と下方部材２８°が離れてしまうのを防止すると
ともに両者の開きを制限している。第１６図に示すよう
にケーブル１１０はフィルスプリング７２″、７４”の
垂直軸より僅かに後方に位置せしめられており、コイル
スプリングとケーブルの両者が協働して上方部材２６°
と下方部材２８゛の後部を互いに接近するように第１Ｏ
図および第１６図に示ず位置に付勢するモーメントを発
生ずるようになっている。患者の体重によって脊柱に通
常かかる荷重および筋肉と靭帯の張力も上方部材２６′
と下方部材２８゛の後部を互いに接近するように付勢す
るのに役立つ。
第１６図においてＡｏは患者が直立しているときの上方
部材２６°と下方部材２８゛の間の角度（通常１４°）
を示し、Ｂｏは患者が体を後ろに反らせたときの角度、
通常２０°を示している。
（ケーブル１１０は上方部材２６′と下方部材２８゛が
この角度まで■くのを許容するには充分な長さを有して
いる。）患者が体を萌に曲げると上方部材２６°と下方
部材２８°の間の角度は０に近づく、ケーブル１１０は
人工椎間円板２０°の端にあるため脊椎骨の横方向に突
き出しており、上方部材２６°と下方部材２８°の間の
角度が小さくなったとき、脊椎骨に当たらずに上方部材
２６″と下方部材２８′から上下に突き出ずことができ
る。そのような状態が第１６図に示されている。
第１４．１５ＶＡに示すように凹部１０８の上面１１６
は上方に凸になっている。ずなわち、上面１１６の両端
１１８は上方に湾曲している。これによって患者が体を
横に曲げたときに過度の圧力が一点に集中しないように
なっている。
なお、上記実施例においては、上方部材の下面と下方部
材の上面はほぼ平らにされているが、他の適当な形でも
よい、また、上方部材の平らな上面と下方部材の平らな
下面に歯を付けるなどの加工を施して、骨をより良くグ
リップできるようにしてもよい。
また、上記実ｂｋ例では螺旋圧縮スプリングを用いたが
、ねじりスプリング等池のばね手段を使用してもよい。
【図面の簡単な説明】
第１１には本発明の一実施例の人工椎間円板の分解斜視
図、第２図は第１１”ｌの人工椎間円板の組み立て状態
を示す斜視図、第３図は第１図の３−３線断面図、第４
図は第１図の４−４線断面図、第５図は第１図の矢印５
方向に見た後面図、第５Ａ図は第１図の人工椎間円板の
下方部材の一部の断面図、第６図は第２図の６−６線断
面図、第７図は上方部材と下方部材が互いに横に傾いた
状態を示す第６図と同様な図、第８図は第１図の人工椎
間円板を脊柱に絹み込んだ状態を示す斜視図、第９図は
本発明の他の実施例の人工椎間円板の分解斜視図、第１
０図は第９図の人工椎間円板の組み立て状態を示す斜視
図、第１１図は第９図の１１−１１線断面図、第１２図
は第９図の１２−１２線断面図、第１３図は第１０図の
矢印１３方向に見た後面図、第１４図は第１０図の１４
−１４線断面図、第１５図は上方部材と下方部材が互い
に横に傾いた状態を示す第１４図と同様な図、第１６図
は第１Ｏ図の人工椎間円板を脊柱に組み込んだ状態を示
す斜視図である。 ２０、、、　人工椎間円板 ２６、、、　　上方部材 ２８、、、　　下方部材 ４６．６４．、、　　タブ ６６　　、、、　　ヒンジピン ７２．７４　　、、、　　コイルスブリングＦＩＧ、１
３ ＦＩＧ、　ｌｅ）

Claims (18)

    【特許請求の範囲】
  1. （１）人体の脊柱の２個の脊椎骨間の天然椎間円板と交
    換するための人工椎間円板であって（ａ）それぞれ後部
    と前部を有する上方部材と下方部材、 （ｂ）前記上方部材と下方部材のそれぞれの前記後部を
    中心とした相対的ヒンジ運動を許すようにその上方部材
    と下方部材に設けられたヒンジ手段、 （ｃ）前記上方部材と下方部材の間に配されて、両者の
    前記前部を互いに離れる方向に付勢するスプリング手段
    、 （ｄ）前記ヒンジ運動を許すようにして前記上方部材と
    下方部材を互いに連結する連結手段、および （ｅ）前記上方部材をその上方にある第１の脊椎骨に剛
    に固定する第１の固定手段と前記下方部材をその下方に
    ある第２の脊椎骨に剛に固定する第２の固定手段、 からなることを特徴とする人工椎間円板。
  2. （２）前記第１の固定手段が前記上方部材から上方に突
    出して前記第１の脊椎骨の側面と重なる少なくとも２個
    のタブとそのタブを貫通して前記第１の脊椎骨内にねじ
    込まれるねじからなっており、前記第２の固定手段が前
    記下方部材から下方に突出して前記第２の脊椎骨の側面
    と重なる少なくとも２個のタブとそのタブを貫通して前
    記第２の脊椎骨内にねじ込まれるねじからなっているこ
    とを特徴とする特許請求の範囲第１項記載の人工椎間円
    板。
  3. （３）前記上方部材と下方部材の前記タブの少なくとも
    １個が前記上方部材あるいは下方部材の前面にあり、少
    なくとも１個が前記上方部材あるいは下方部材の側面に
    あることを特徴とする特許請求の範囲第２項記載の人工
    椎間円板。
  4. （４）前記側面にあるタブが前記ヒンジ手段の軸と前後
    方向に見てほぼ同じ位置にあることを特徴とする特許請
    求の範囲第３項記載の人工椎間円板。
  5. （５）前記ねじが総べて対応する脊椎骨をほぼ完全に貫
    通する長さを有することを特徴とする特許請求の範囲第
    ４項記載の人工椎間円板。
  6. （６）前記タブがそれぞれ高さが異なる位置にねじ穴を
    有しており、それによって前記ねじが互いに干渉しあわ
    ないようになっていることを特徴とする特許請求の範囲
    第２項から４項のいずれか１項記載の人工椎間円板。
  7. （７）前記ヒンジ手段が、前記上方部材と下方部材の中
    央を通って前後に延びる垂直面周りに前記上方部材と下
    方部材が相対的に左右に揺動するのを少なくともある程
    度は許容する手段を備えていることを特徴とする特許請
    求の範囲第１項記載の人工椎間円板。
  8. （８）前記連結手段がヒンジピンからなっていることを
    特徴とする特許請求の範囲第１項から３項のいずれか１
    項記載の人工椎間円板。
  9. （９）前記連結手段が前記上方部材と下方部材に互いに
    整列するようにそれぞれ設けられた孔に挿通サレタヒン
    ジピンからなっており、その孔とヒンジピンが、前記上
    方部材と下方部材の中央を通って前後に延びる垂直面周
    りに前記上方部材と下方部材が相対的に左右に揺動する
    のを少なくともある程度は許容するような寸法関係にな
    っていることを特徴とする特許請求の範囲第１項から３
    項のいずれか１項記載の人工椎間円板。
  10. （１０）前記連結手段が前記上方部材と下方部材に互い
    に整列するようにそれぞれ設けられた孔に挿通サレタヒ
    ンジピンからなっており、その孔とヒンジピンが、前記
    上方部材と下方部材の中央を通って前後に延びる垂直面
    周りに前記上方部材と下方部材が相対的に左右に揺動す
    るのを少なくともある程度は許容するような寸法関係に
    なっているとともに、前記ヒンジピンの両端部がテーパ
    ーしていることを特徴とする特許請求の範囲第１項から
    ３項のいずれか１項記載の人工椎間円板。
  11. （１１）前記連結手段が前記上方部材と下方部材の両側
    部にそれぞれ配された一対のケーブルからなっており、
    その各ケーブルが前記上方部材と下方部材に連結されて
    いることを特徴とする特許請求の範囲第１項記載の人工
    椎間円板。
  12. （１２）前記各ケーブルが前記上方部材と下方部材に設
    けられた孔を通って延びていることを特徴とする特許請
    求の範囲第１１項記載の人工椎間円板。
  13. （１３）前記上方部材と下方部材が、互いに協働してそ
    の上方部材と下方部材のヒンジ運動の開きを制限するス
    トッパ手段をそれぞれ前記後部に備えていることを特徴
    とする特許請求の範囲第１項記載の人工椎間円板。
  14. （１４）前記スプリング手段が前記ヒンジ手段の前方に
    配されたコイルスプリングからなっていることを特徴と
    する特許請求の範囲第１項から３項のいずれか１項記載
    の人工椎間円板。
  15. （１５）前記スプリング手段が前記ヒンジ手段の前方に
    横に並べて配された２対のコイルスプリングからなって
    おり、その各対のコイルスプリングが互いに同心の外側
    コイルスプリングと内側コイルスプリングからなってい
    ることを特徴とする特許請求の範囲第１項から３項のい
    ずれか１項記載の人工椎間円板。
  16. （１６）前記上方部材、下方部材およびスプリング手段
    が総べてチタン−６アルミニウム−４バナジウムＥＬＩ
    合金およびコバルトクロムモリブデン合金の中から選択
    された生体と共存し得る合金で形成されていることを特
    徴とする特許請求の範囲第１項から３項のいずれか１項
    記載の人工椎間円板。
  17. （１７）前記スプリングが、天然の椎間円板の矢状面内
    における生体外生理学的堅さに似せられていることを特
    徴とする特許請求の範囲第１項から３項のいずれか１項
    記載の人工椎間円板。
  18. （１８）前記スプリング手段が単位圧縮比につき１．０
    から１．６５フート・ボンドの抵抗トルクを発揮するこ
    とを特徴とする特許請求の範囲第１項から３項のいずれ
    か１項記載の人工椎間円板。
JP62306823A 1987-02-12 1987-12-03 人工椎間円板 Granted JPH01308557A (ja)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CA000529548A CA1283501C (en) 1987-02-12 1987-02-12 Artificial spinal disc
CA529548 1987-02-12

Publications (2)

Publication Number Publication Date
JPH01308557A true JPH01308557A (ja) 1989-12-13
JPH0570470B2 JPH0570470B2 (ja) 1993-10-05

Family

ID=4134957

Family Applications (1)

Application Number Title Priority Date Filing Date
JP62306823A Granted JPH01308557A (ja) 1987-02-12 1987-12-03 人工椎間円板

Country Status (6)

Country Link
US (1) US4759769A (ja)
EP (1) EP0282161B1 (ja)
JP (1) JPH01308557A (ja)
AT (1) ATE79242T1 (ja)
CA (1) CA1283501C (ja)
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EP0282161B1 (en) 1992-08-12
JPH0570470B2 (ja) 1993-10-05
ATE79242T1 (de) 1992-08-15
EP0282161A1 (en) 1988-09-14
DE3873566D1 (de) 1992-09-17
CA1283501C (en) 1991-04-30
US4759769A (en) 1988-07-26
DE3873566T2 (de) 1993-01-21

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