JPH05103801A - Spacer for dilating vertebral canal - Google Patents

Abstract

PURPOSE:To provide the title spacer not detached from the interposed part between the vertebral arch and the massa lateralis atlantis before bone adhesion. CONSTITUTION:In the spacer 10 for delating a vertebral canal interposed between the massa lateralis atlantis 32 and vertebral arch 31 separated by cutting the side part of the vertebral canal 30 to delate the vertebral canal and tightly bound and fixed to the massa lateralis atlantis 32 and the vertebral arch 31 by suture 40, the groove 12 capable of being engaged with the suture 40 is formed to the surface 11 of the spacer 10 exposed to the outside of the vertebral canal 30.

Description

Detailed Description of the Invention

[0001]

FIELD OF THE INVENTION The present invention relates to a spacer for use in posterior spinal canal dilation of the spine.

[0002]

2. Description of the Related Art Generally, there is a method called spinal canal dilatation as one of surgical treatments for spinal diseases such as spinal stenosis and ossification of the posterior longitudinal ligament. This is a method in which a part of the vertebral arch is divided and the spinal canal is enlarged and fixed. Conventionally, the spinous process of the spinal canal or the ligament attached to the vertebral arch is cut to longitudinally divide the spinous process and then the spinal process. Enlarging the canal, and after enlarging, maintain the spinal canal in the expanded position by connecting the enlarged part of the spinal canal with a steel wire.
Alternatively, autogenous bone collected from the iliac bone of a patient or a spacer made of so-called bioceramics such as alumina or hydroxyapatite is sandwiched between the enlarged portions. In general, the autogenous bones and the spacers are formed in a simple prismatic simple shape, and the autogenous bones and the spacers are simply intervened in the enlarged portions that do not have a clamping force, so that they do not fall off. For this reason, a steel wire was firmly bound and fixed to the spinal canal in the enlarged region.

However, in the spinal canal magnifying operation by the above-mentioned method, the ligament attached to the spinous process or the vertebral arch of the spinal canal was cut, so that the spinous process does not exist until the ligament is restored. There is a defect that the stability and motility of the later enlarged spinal canal is impaired, and the need for long-term external fixation of the spine to compensate for this impaired stability results in postoperative spinal mobility. There was a defect that contributed to sexual dysfunction. Therefore, in recent years, as shown in FIG. 5, the spinal canal 1 is cut at both sides to separate it into the pedicle 2a side and the lateral mass 2b side, and a recess 2c is formed in the cut end face of the cut vertebral arch 2a. The vertebral arch 2a and outer mass 2b
A prismatic spacer 3 is provided between the
One of them to engage the recess 2c, thereby expanding the spinal canal 1 and allowing the spacer 3 to be separated by the suture 4 as shown in FIG. Two
A method of binding and fixing with b is adopted. According to this method, the spinous process 1a of the spinal canal 1
Since it is not necessary to cut the ligament (not shown) attached to the vertebral arch 2a, it is possible to accelerate postoperative recovery. Further, in the spacer 3 shown in FIG. 6, the inwardly projecting corner portion 3a of the spinal canal 1 is cut off to form a surface 3b as shown in FIG. It can be seen that the pressure (not shown) is not pressed.

[0004]

However, since the suture thread 4 is simply hung in contact with the peripheral surface of the spacer 3, an external force is applied to the portion of the spinal canal 1 by postoperative rehabilitation or the like. When added, there is a problem that the suture thread 4 hung on the peripheral surface of the spacer 3 may come off the spacer 3 and fall out of the spinal canal 1. In addition, the spacer 3 described above
Then, as shown in FIGS. 6 and 7, the suture thread 4 pulled out from the cut end surface of the outer mass 2b, that is, the suture thread 4
6 and 7, the corner portion 3a of the spacer 3 which is in contact with the portion is lifted up from the cut end surface of the outer mass 2b due to the tension of the portion indicated by reference numeral 4a, and accordingly, the inside of the spinal canal 1 With respect to the corner portion 3a and the surface 3b of the spacer 3 located in the direction of the spacer 3, the spacer 3 from the portion of the suture thread 4 which is in contact with the corner portion 3a and the surface 3b is indicated by reference numeral 4b in FIGS. Since a force in the direction of pushing out the spinal canal 1 is easily applied, the spacer 3
However, there is a problem that there is a risk of falling off from the spinal canal 1. The present invention has been made in view of the above-mentioned problems, and an object of the present invention is to provide a spacer for spinal canal dilation that does not fall off from an interposed portion between the vertebral arch and the lateral mass before bone union. And

[0005]

In order to achieve the above object, a first aspect of the present invention is to provide a spinal canal, which is interposed between an outer mass and a vertebral arch cut by cutting a side portion of the spinal canal. To expand the
A spinal canal dilation spacer that is tightly bound and fixed between the outer mass and the vertebral arch by a suture, wherein the suture is provided on a peripheral surface portion of the spacer exposed to the outside of the spinal canal. The structure is such that the engaging groove is formed. Also,
A second aspect of the present invention is arranged between the lateral mass and the vertebral arch that have been cut off at the side portion of the spinal canal to expand the vertebral canal and suture the outer mass and the vertebral arch. A spacer for spinal canal dilation that is tightly bound and fixed between both sides of the spacer, and has engagement grooves formed on both sides of the spacer to engage the distal ends of the outer mass and the vertebral arch at the cut portion of the spinal canal. The structure is formed.

[0006]

Embodiments of the present invention will be described below with reference to the drawings. 1 shows a spacer for spinal canal dilatation according to a first embodiment of the present invention, FIG. 1 (a) is a perspective view, and FIG.
1B is a perspective view showing a state in which the spacer of FIG. 1A is tightly bound and fixed to a portion between a pedicle and an outer mass with a suture, and FIG. 1C is a side view of the same. As shown in FIG.
The spacer 10 according to the first embodiment of the present invention has a substantially rectangular shape having four corners 10a. As shown in FIG. 1 (b), the spinal canal 30 is cut at both sides to form the vertebral arch 31 side. And the outer mass 32 side, which is interposed between the vertebral arch 31 and the outer mass 32 with a suture 40.
It is fixed. Then, as shown in FIG. 1B, the spacer 1 fixed between the pedicle 31 and the outer mass 32.
One corner 10a of 0 is engaged with a recess 31a formed in the cut end surface of the vertebral arch 31, and the surface 11 of the spacer 10 exposed to the outside of the spinal canal 30 is As shown in FIG. 1 (a), a plurality of grooves 12 each having a substantially V-shaped cross section are provided at intervals with each other.
As shown in (b), the suture thread 40 is engaged.

Therefore, the suture thread 40 hung on the surface 11 of the spacer 10 is prevented from being displaced and coming off the spacer 10, so that the spacer 10 can be removed from the space between the vertebral arch 31 and the outer mass 32. It is prevented from falling off.
According to the spacer 10 of the first embodiment described above, the suture thread 40 pulled out from the cut end surface of the outer mass 32 is engaged with the groove 12 without contacting the corner portion 10a of the spacer 10. Therefore, the corner portion 10a of the spacer 10 located on the cut end face side of the outer mass 32 is
Is not lifted from the cut end surface of the outer mass 32, and thus, for the corner portion 10a of the spacer 10 located inside the spinal canal 30, the spacer 10 from the suture 40 contacting that portion is It becomes difficult to apply a force in the direction of pushing the outside of the spinal canal 30. And
From the suture thread 40 in contact with one end portion of the groove 12 of the spacer 10, that is, the suture thread 40 in the portion indicated by reference numeral 41 in FIG. 1C, to the spacer 10 side, the spacer 10 is attached to the spinal canal. Since it is easy to apply a force in the direction of pushing inward of 30, the spacer 1
0 is prevented from falling out between the pedicle 31 and the outer mass 32.

2 and 3 show a spinal canal dilation spacer according to second and third embodiments of the present invention. The spacer 50 of the second embodiment shown in FIG. 2 (a) has a substantially rectangular shape, and when it is fixed between the vertebral arch 31 and the outer mass 32 as shown in FIG. 2 (b). On the surface 51 of the spinal canal 30 exposed to the outside, the suture thread 4 is attached.
A plurality of grooves 52 having a substantially V-shaped cross section for engaging 0 are arranged at intervals, and the corners of the inwardly exposed portion of the spinal canal 30 are cut off to form a surface 50b. ing. Therefore, according to the spacer 50, it is possible to further prevent the spinal dural tube (not shown) in the spinal canal 30 from being pressed, and the space inside the spinal canal 30 can be prevented. The force from the spacer 50 side is concentrated and applied to the extremely limited portion of the suture thread 40 located,
It is possible to prevent the strength of the suture thread 40 from being deteriorated and being cut.

The spacer 60 of the third embodiment shown in FIG. 3 (a), when fixed between the vertebral arch 31 and the outer mass 32, as shown in FIG. 3 (b), the spinal canal 30. A plurality of grooves 62 having a substantially V-shaped cross section which engages with the suture thread 40 are provided in a plurality of rows at intervals on the surface 61 exposed to the outside of the vertebral arch 31 and the outer mass 32. Substantially V-shaped projections 60b, 60b are formed in a portion in contact with the cut end surface, and the cut end surfaces of the vertebral arch 31 and the outer mass 32 are engaged with each other by the projections 60b, 60b and the peripheral surface of the spacer 60. A character-shaped engagement groove 60c is formed. Therefore, according to the spacer 60, the engaging groove 60c and the vertebral arch 3 can be further added.
1 and the engagement with the cut end surfaces of the outer mass 32 enhances the fixation of the spacer 60 between the pedicle 31 and the outer mass 32, so that the spacer 60 can be more easily removed from the space between the laminae 31 and the outer mass 32. More prevented.

In addition, the acute-angled portions of the tips of the protrusions 60b, 60b in the spacer 60 of the third embodiment are cut off as shown in FIG. 4, and the portion of the suture thread 40 in contact with the portion is cut from the spacer 60 side. The power of
The suture thread 40 may be prevented from being cut due to deterioration in strength. In addition, in the spacers 10, 50 and 60 of the first to third embodiments described above, the groove 1
2, 52, 62 are arranged in a plurality of rows at intervals, but as shown in FIG. 5 representatively showing the case of the spacer 10 of the first embodiment, an interval is provided between the mutual grooves 12. A plurality of rows may be provided without placing, and a required number of grooves may be provided only at a predetermined position. The shape of the groove is not limited to the substantially V shape.

Further, in the spacer 60 according to the third embodiment and its modified embodiment described with reference to FIGS. 3 (a), 3 (b) and 4, in addition to the engaging groove 60c, the suture thread 40 is provided. Although the groove 62 having a substantially V-shaped cross-section that engages with each other is provided, the groove 62 may be omitted, and in this case also, the spacer 6 between the vertebral arch 31 and the outer mass 32 is provided.
It is possible to prevent the dropping of 0.

Then, the spacer 1 of each of the above-mentioned embodiments
0, 50 and 60 are, for example, bioinert bioceramics such as alumina and zirconia having no bone-bonding property, hydroxyapatite, fluoroapatite, tricalcium phosphate, tetracalcium phosphate, calcium phosphate glass or crystallized glass. It is formed from bioactive bioceramics having bone binding property, but the latter bioactive bioceramics are more preferable than bioinert bioceramics, for example, metal, polymer compound, or general ceramics are coated by a thermal spraying method or the like. It may be the one that has been subjected to.

[0013]

As described above, according to the spinal canal enlargement spacer according to the first aspect of the present invention, the space between the vertebral arch and the lateral mass of the spinal canal is interposed and bound with sutures. Since the groove to which the suture is engaged is formed in the peripheral surface portion of the spacer to be fixed that is exposed to the outside of the spinal canal, the suture is prevented from coming off the spacer, and the bone is fused before bone fusion. It is possible to prevent the spacer from falling off from the interposition part between the pedicle and the lateral mass.
Further, according to the spacer for spinal canal enlargement according to the second aspect of the present invention, on both sides of the spacer that is interposed in the portion of the spinal canal that is separated from the vertebral arch and the outer mass and is bound and fixed with sutures, Since the engaging grooves for engaging the distal ends of the outer mass and the vertebral arch in the cut portion of the spinal canal respectively are formed, it is possible to enhance the fixation of the spacer between the vertebral arch and the outer mass, and before the bone fusion. Further, it is possible to prevent the spacer from falling off from the interposed portion between the pedicle and the lateral mass.

[Brief description of drawings]

1 shows a spacer for spinal canal magnifying surgery according to a first embodiment of the present invention, FIG. 1 (a) is a perspective view, and FIG. 1 (b) is a perspective view.
1 is a perspective view showing a state in which the spacer of FIG. 1 (a) is tightly bound and fixed to a portion between a vertebral arch and an outer mass with a suture, FIG.
(C) is the same side view.

2 shows a spacer for spinal canal dilatation according to a second embodiment of the present invention, FIG. 2 (a) is a perspective view and FIG. 2 (b).
FIG. 3 is a side view showing a state in which the spacer of FIG. 2 (a) is tightly bound and fixed to a portion between the vertebral arch and the outer mass with a suture.

FIG. 3 shows a spacer for spinal canal magnifying surgery according to a third embodiment of the present invention, FIG. 3 (a) is a perspective view, and FIG. 3 (b) is a perspective view.
FIG. 4 is a side view showing a state in which the spacer of FIG. 3 (a) is tightly bound and fixed to a portion between a vertebral arch and an outer mass with a suture thread.

FIG. 4 is a side view showing a state in which a spacer according to a modified example of the spacer of FIG. 3 (a) is tightly bound and fixed to a portion between a vertebral arch and an outer mass with a suture.

FIG. 5 is a perspective view showing a state in which a conventional spacer for vertebral canal dilation surgery is tightly bound and fixed to a portion between a vertebral arch and an outer mass with a suture.

FIG. 6 is a side view showing a state in which a conventional spinal canal magnifying spacer is tightly bound and fixed to a portion between a vertebral arch and an outer mass with a suture.

FIG. 7 is a side view showing a state in which a spacer for spinal canal magnifying surgery according to another conventional example is tightly bound and fixed to a portion between a vertebral arch and an outer mass with a suture.

[Explanation of symbols]

 10, 50, 60 spacer 11, 51, 61 surface (circumferential surface portion) 12, 52, 62 groove 30 spinal canal 31 vertebral arch 32 outer mass 40 suture thread 60c engagement groove

Claims (2)

[Claims] 1. A spinal canal, which is interposed between a lateral mass and a vertebral arch separated by cutting a side portion of the vertebral canal to expand the vertebra, and a suture between the outer mass and the pedicle. A spacer for vertebral canal enlargement that is tightly bound and fixed to the outer peripheral portion of the spacer exposed to the outside of the vertebral canal, wherein a groove for engaging the suture is formed. Characteristic spinal canal enlargement spacer. 2. The spinal canal is opened by being interposed between the lateral mass and the vertebral arch cut off by cutting a side portion of the vertebral canal and sutured between the outer mass and the vertebral arch. A spacer for spinal canal dilation that is tightly bound and fixed to both sides of the spacer. Engagement grooves are formed on both sides of the spacer to engage the distal ends of the outer mass and the vertebral arch at the cut portion of the spinal canal. The spacer for vertebral canal dilation that is characterized in that