KR100532548B1 - 팽창가능한 골접합 케이지 - Google Patents
팽창가능한 골접합 케이지 Download PDFInfo
- Publication number
- KR100532548B1 KR100532548B1 KR10-1999-7002021A KR19997002021A KR100532548B1 KR 100532548 B1 KR100532548 B1 KR 100532548B1 KR 19997002021 A KR19997002021 A KR 19997002021A KR 100532548 B1 KR100532548 B1 KR 100532548B1
- Authority
- KR
- South Korea
- Prior art keywords
- cage
- spacer
- implant
- branches
- expandable
- Prior art date
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Classifications
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- 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
- A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
- A61F2/446—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages having a circular or elliptical cross-section substantially parallel to the axis of the spine, e.g. cylinders or frustocones
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- A—HUMAN NECESSITIES
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- 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
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- A—HUMAN NECESSITIES
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- 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
- A61F2/30721—Accessories
- A61F2/30744—End caps, e.g. for closing an endoprosthetic cavity
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- A—HUMAN NECESSITIES
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- 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
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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- 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
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- A61F2/4611—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
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- 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
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- 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
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- 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
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Landscapes
- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Transplantation (AREA)
- Life Sciences & Earth Sciences (AREA)
- Veterinary Medicine (AREA)
- Cardiology (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Neurology (AREA)
- Physical Education & Sports Medicine (AREA)
- Prostheses (AREA)
- Surgical Instruments (AREA)
- Materials For Medical Uses (AREA)
- Food-Manufacturing Devices (AREA)
- Biological Depolymerization Polymers (AREA)
- Developing Agents For Electrophotography (AREA)
Abstract
팽창가능한 골접합 임플란트는, 오리피스 (8) 에 의해 구멍이 뚫려 있는 시트부 (7) 에 각기 일 단부가 연결되어 있는 분기부 (5) 를 가지며, 그들간의 소정의 거리를 유지하고 척추의 안정성을 복원시키기 위해 2개의 연속되는 척추골의 대면하는 면들 사이에 뒤쪽 방향으로부터 미끄러지기에 적합하다. 본 발명에 따르면, 상기 분기부 (5) 및 시트부 (7) 는, "정지" 위치에 있어, 원형 단면의 원통인 전반적인 외형을 가지는 중공의 케이지 (1) 를 한정하며, 상기 분기부 (5) 의 말단부 쪽으로 향한 상기 케이지 (1) 의 내부 공간 (9) 의 적어도 일부분은 큰 쪽의 저부가 상기 시트부 (7) 쪽으로 향한 원형의 원뿔대의 형태이며, 상기 임플란트는 3개 이상의 분기부 (5) 를 가지며, 또한 상기 내부 공간 (9) 내에는 상기 원뿔대의 큰 쪽의 저부와 상기 오리피스 (8) 를 통과하기에 적합한 1개 이상의 스페이서 (2) 를 가진다.
Description
본 발명은 팽창가능한 골접합 케이지에 관한 것이다.
본 발명의 기술분야는 이식가능한 골 임플란트 또는 보철, 및 이를 사용하는 외과 기술분야이다.
본 발명은, 예컨대 대응하는 관절의 파손 이후에 2개의 척추골들을 함께 고정함으로써 그들간의 소정의 거리를 유지하고 척추 또는 등뼈의 안정성을 복원시키기 위해, 2개의 연속되는 척추골들의 대면하는 면들 사이에 뒤쪽 방향으로부터 미끄러지거나 삽입되도록 구성된 임플란트를 제공하는 데에 주로 적용된다.
현재, 척추골들을 잠시후 서로 융착시키는 이식편 (graft) 을 이식하거나, 직접 척추골들을 고정하고 척추골 사이를 융착시킬 수 있는 보철을 이식하거나 하여, "정상인" 요추 전만을 복원시키는 몇 가지 기술이 알려져 있다.
두번째로 언급한 기술에서는, 그중 일부가 중공 및 강성이고 단일체인 "케이지" 로 알려져 있으며, 골 이식편을 수용하기 위한 내/외 상호소통 슬롯을 가지는 임플란트가 주로 사용되는데, 상기 골 이식편은, 상기 슬롯을 통해, 한쪽에서 인접한 척추골들과 융착한다. 이 분야에서는, "원뿔 모양의 추간 융착 케이지 (Intervertebral fusion cage of conical shape)" 라는 제하로 1996년 3월 21일자로 공고된 특허출원 WO 96/08205 호 및 "척추용 체간 임플란트 (Intersomatic implant for the spinal column)" 라는 제하로 1995년 2월 8일자로 공고된 특허출원 EP 637 440 호가 참조될 수 있다. 그러나, 이러한 타입의 케이지의 외형 치수는 소정의 값으로 정채져 있지만, 척추골 쌍들간의 거리는 일정하지 않다. 또한, 소정의 각도위치가 부여되는 대향 척추골 면들의 경사 때문에, 강성 케이지를 뒤쪽 방향으로부터 사용하는 것은 불가능하고, 오직 앞쪽 방향에서만 삽입할 수 있다.
결과적으로, 강성의 몸체부에 2개의 대략 평행한 분기부를 연결시킨 다른 타입의 케이지가 개발되었는데, 이러한 구성에 의하면, 분기부들의 말단부에 가까운 초기위치로부터 상기 분기부들을 함께 이어놓은 몸체부 쪽으로 웨지를 나사상의 나사결합으로 이동시키는 워엄나사 장치를 회전시키는 것이 가능하다. 그러므로, 초기의 편평한 모양의 이러한 케이지를 척추골들간에 삽입하는 것이 가능하며, 웨지의 구동축을 회전시킴으로써, 분기부들간의 요망하는 각도를 뒤쪽 접근부로부터 조정하거나 설정한다.
이러한 케이지 또는 임플란트는, 예컨대 "척추골 체간 케이지 (Vertebral intersomatic cage)" 라는 제하로 1995년 8월 2일자로 공고된 유럽특허출원 EP 664 994 호 또는 "척추골 임플란트 (Vertebral implant)" 라는 제하로 1995년 11월 17일자로 공고된 유럽특허출원 EP 2 719 763 호에 개시되어 있다.
그러나, 이러한 장치는 중공 및 강성의 케이지보다 더 기계적이므로 더 복잡하며, 융착 이식편을 위한 내부 공간이 더 작고, 또한 그 모양은, 비록 척추골들간의 소정의 베어링 각도를 확보하는데 있어 더 양호한 것이라고는 해도, 원형 대칭이 아닌 편평한 모양이기 때문에, 이들을 수용하기 위한 동일한 직사각형 단면의 통로를 필요로 하여, 그 실시가 복잡해진다.
이와 같이 야기되는 문제점은, 첫째로는 이식을 용이하게 하기 위해, 둘째로는 안에 설치된 이후에 케이지의 말단부의 직경을 외과적인 삽입점에 인접하여 위치한 그의 단부에 대한 소정의 값으로 증가시키고, 가능한한 소수의 기계 요소들을 가지면서 척추골들의 뒤쪽면에 상당할 수 있는 가능성을 큰 내부 공간에 제공하기 위해, 종래의 강성 케이지의 모양을 동시에 결연하기에 유용한 임플란트 또는 케이지를 갖는다.
도 1 은 공통의 설치 축선 XX' 상에 정렬된 여러 가지 부품을 갖는 임플란트의 "정지" 위치에서의 일예를 나타내는 사시도이다.
도 2 는 도 1 의 3개의 부품이 함께 조립된 임플란트의 "작용" 위치에서의 사시도이다.
도 3a, 4a 및 5a 는 "정지" 위치에서의 본 발명의 임플란트의 또 다른 실시예를 나타내는 것으로서, 각각 케이지의 단면도, 케이지의 앞쪽면의 축방향 단면도 및 케이지의 뒤쪽면의 축방향 단면도이다.
도 3b, 4b 및 5b 는 동일한 케이지의 도 3a, 4a 및 5a 에 대응하는 도면으로서, 그 보충 요소들이 "작용" 위치로 함께 조립된 상태를 나타내는 도면이다.
도 3c 는 "작용" 위치에 있어 도 3, 4 및 5 에 도시된 실시예의 임플란트의 축선에 수직인 측면도이다.
도 6, 7 및 8 은 본 발명의 임플란트의 케이지의 실시예의 상세도이다.
도 9, 10 및 11 은 도 1 및 2 에 사시도로 도시된 임플란트의 실시예를 나타내는 것으로서, 각각 케이지의 단편적 측면도, 케이지의 앞쪽면의 축방향 단면도 및 케이지의 뒤쪽면의 축방향 단면도이다.
도 12, 13 및 14 는, 각각, 도 1, 2, 9, 10 및 11 의 실시예를 위한 비-나사식 단부 스페이서와, 도 3, 4 및 5 의 실시예를 위한 나사식 단부 스페이서 및/또는 중간 스페이서와, 본 발명의 임의의 실시예를 위한 폐쇄용 플러그를 나타내는 도면 및 단면도이다.
이같은 문제점을 해결하기 위한 방안으로서, 본 발명은, 오리피스에 의해 구멍이 뚫려 있는 시트부에 각기 일 단부가 연결되어 있는 분기부를 포함하는 팽창가능한 골접합 임플란트를 제공한다. 상기 분기부 및 시트부는, "정지" 위치에 있어, 그의 대칭 축선을 중심으로 회전함으로써 발생하는 발생선이 직선이거나 또는 큰 반경의 볼록한 원호와 같은 만곡 중앙부를 가지는 원통형 또는 준-원통형이며, 발생선이 이동하게 되는 디렉터 곡선을 가지며, 또한 준-원통의 단면을 한정하는 전반적인 외형을 가지는 중공의 케이지를 형성한다. 이것은, 정 원통이거나, 여기서는 "난형" 또는 "타원형" 이라고 불리우는 원통인데, 이하에서는 원통 또는 준-원통으로서 언급하기로 한다. 상기 분기부들의 말단부 쪽으로 향한 상기 케이지의 내부 공간의 적어도 일부분은 큰 쪽의 저부가 상기 시트부 쪽으로 향한 준-원형의 원뿔대의 형태이고, 상기 임플란트는 3개 이상의 분기부를 가지며, 또한 정지위치에 있어 상기 원뿔대의 큰 쪽의 저부의 치수에 적합하고 상기 오리피스를 통과하기에 적합한 치수의 1개 이상의 스페이서를 상기 내부 공간 내에서 가진다.
"작용" 위치에 있어, 상기 스페이서는 상기 분기부를 벌어지게 하며, 따라서 상기 내부 공간은 원통에 가까와지고, 상기 케이지의 외형은 대략 원뿔대에 가까와지며, 상기 스페이서가 요망하는 위치에 일단 위치되면, 상기 분기부, 스페이서 및 오리피스에 의해 한정되는 공간내에는 어떠한 내부 부분도 남지 않는다.
"정지" 위치 및 "작용" 위치의 정의는, 도 1, 3a, 4a, 5a, 9, 10 및 11, 그리고 도 2, 3b, 3c, 4b 및 5b 의 실시예에 의해 각각 도시되어 있다. "정지" 위치는, 설치전과 설치중의 임플란트의 위치이다. 즉, 케이지내에 분기부들 사이에 스페이서를 설치하지 않아, 상기 케이지가 일정한 단면의 원통형 외부 공간을 가지는 경우이다. "작용" 위치는, 2개의 척추골간의 임플란트의 최종 위치이다. 즉, 스페이서에 의해 벌어진 분기부들이 그의 최종 조정위치에 위치하고, 케이지의 전반적인 외형이 시트부쪽에서 먼쪽으로 벌어진 대략 절두원추 (frustoconical) 모양인 경우인데, 이는 척추골들 사이에 깊숙이 위치한 그의 단부 쪽으로, 외과적 삽입점 쪽으로 위치한 임플란트의 단부에 상당하다.
뼈에의 장착을 더 양호하게 하고 케이지의 어떠한 후속의 이동도 방지하기 위하여, 분기부들의 외면은 바람직하게는 깔쭉깔쭉하거나 홈을 갖도록 형성되며, 또는 돌출 융기부 등을 가지는 나사산 형상부를 이용하여 나사식으로 형성된다.
또한, 이식 이후에 회전되는 위험을 줄이고, 나아가 척추골들의 면과의 접촉부위를 증가시키면서도 케이지가 변위되는 위험을 줄이기 위해, 적어도 임플란트의 시트부 및 바람직하게는 분기부들의 면들은 선택적으로 평행한 2개 이상의 편평부를 가지는데, 각 편평부는 2개의 연속적인 분기부들간에 임플란트의 축선을 중심으로 대칭으로 배치된다. 케이지의 전반적인 난형 모양에 의해 택일적으로 지원되는 이들 편평부에 의하면, 임플란트의 회전위험을 줄임으로써 팽창후에 더 양호한 유지가 가능하게 된다. 더욱이, 상기 난형 모양에 의하면, 정지에서의 케이지의 기본적인 원통형 모양의 외부 발생선이 직선인 경우보다, 팽창 이후에 원뿔형이고 만곡부가 없는 외부 형상으로 복원하는 것이 더 양호하여, 척추골 몸체에 대해 더 양호하게 분배된 스러스트가 제공되므로, 뼈 이식편의 기능이 더 양호해진다.
후단부에서 케이지를 강화하기 위하여, 특히 시트부내에 큰 오리피스가 존재하는 경우, 케이지가 설치되어 팽창된 이후에 상기 케이지에 골제 물질을 충전하기가 용이하며, 상기 시트부의 오리피스는 케이지의 내부 공간을 폐쇄시키기 위한 플러그를 수용하기에 적합하다. 예컨대, 상기 플러그는 상기 오리피스 안으로 나사식으로 조여질 수 있으며, 이 경우는 마찬가지로 상기 오리피스도 나사식으로 형성된다. 이러한 상황하에서는, 상기 플러그는 골제 물질이 빠져나와 재료에 의존하게 되는 것을 방지하게 되므로, 케이지가 강화될 수 있다.
이하, 첨부도면을 참조하여 여러 가지의 특별한 실시예들을 설명한다. 이에 따르면, 서두에서 언급한 문제점들을 충족시키며, 특히 전술한 주요한 적용을 위한 신규의 팽창가능한 골접합 임플란트가 제공된다.
4개 이상의 분기부, 가능하게는 4개 내지 8개의 분기부를 설치하는 경우에는 좌우대칭의 팽창을 얻는 것이 가능하므로 척추골들의 2개의 대면하는 면들에 대해 더 양호한 재밍을 얻을 수 있고, 상기 팽창을 유지하는 스페이서와 오리피스 또는 단부 시트부의 플러그간에 이음부나 봉을 설치하는 경우에는 다량의 골제 물질을 수용하기 위한 대형의 내부 공간이 보장되므로, 특히 함께 고정되어야 하는 척추골들간의 융착에 의한 합체 및 이음이 향상된다. 상기 충전작업은, 상기 시트부를 통한 상기 케이지의 후단부에서 더 큰 오리피스를 갖게 함으로써 더 용이해진다.
더욱이, 상기 오리피스에 의하면, 상기 케이지의 바닥면과 상부면에 있어 분기부들 사이에 위치한 슬롯을 통해 척추골의 면을 문지르는 것이 가능하다.
또한, 전술한 바와 같은 팽창장치는, 설치 이후에 어떠한 이음 부재도 남기지 않고 2개의 부분, 즉 스페이서와 케이지만을 포함하고 (선택적으로 그의 단부에 위치한 플러그를 가지며, 가능하게는 후술하는 중간의 스페이서도 가짐), 상기 스페이서와 상기 플러그를 위치시키기 위한 임의의 봉 또는 축이 곧바로 제거되기 때문에, 아주 간단하다.
본 발명은, 전술한 현존의 임플란트 또는 케이지에 여러 가지의 이점을 제공하며, 발명의 신규성 및 유용성을 증명하기에 충분한 다른 이점이 제공될 수 있다.
이하의 설명 및 도면은 4개의 분기부를 가지는 본 발명의 실시예들을 설명하는 것이나, 이에 제한되는 것은 아니며, 예컨대 3개의 분기부를 가지는 실시예 또는 4개를 초과하는 분기부를 가지는 실시예와 같이, 본 발명의 범위를 일탈하지 않는 한도내에서 다른 여러 가지의 실시예들이 가능하다.
팽창가능한 골접합 임플란트는, 어떤 실시예이던지 간에, 종래 방식으로 분기부 (5) 를 포함하는데, 이들 각 분기부는 오리피스 (8) 에 의해 구멍이 뚫려 있는 시트부 (7) 에 일 단부가 연결되어 있다. 본 발명의 기본적 특징에 따르면, 상기 분기부 (5) 및 시트부 (7) 는, 도 1, 3a, 4a, 5a, 9, 10 및 11 의 실시예에 도시된 바와 같이, "정지" 위치에 있어, 중공의 케이지 (1) 를 형성하는데, 이 케이지의 전반적인 외형은 원통형 또는 준-원통형이고, 그 원통형 단면형상의 디렉터 곡선은 원형 또는 준-원형이며, 그의 대칭 축선 (XX') 을 중심으로 이동함으로써 상기 디렉터 곡선과 결합하고 상기 원통 또는 준-원통을 발생시키는 발생선은 직선이거나 또는 큰 반경의 볼록한 원호이다. 이것은, 도 3a 에 실선 (201) 으로 도시된 바와 같이 원형-대칭 정 원통이거나, 본 명세서에서 "난형" 또는 "타원형" 으로서 언급하는, 즉 도 3a 에 일점쇄선 (202) 으로 도시된 바와 같이 외측 모양이 약간 불룩한 형상인 가-원통 (pseudo-cylinder) 이다. 상기 분기부들 (5) 의 말단부 쪽으로 향한 상기 케이지 (1) 의 내부 공간 (9) 의 적어도 일부분은 큰 쪽의 저부가 상기 시트부 (7) 에 가까운 준-원형 대칭의 원뿔대의 형태이고, 상기 임플란트는 4개 이상의 분기부를 가지며, 또한 상기 오리피스 (8) 및 상기 원뿔대의 큰 쪽의 저부를 통과하여 상기 내부 공간 (9) 안으로 삽입되기에 적합한 1개 이상의 스페이서 (2) 를 가진다.
도 2, 3b, 4b, 5b 및 3c 에 있어, 즉 "작용" 위치에 있어, 상기 단부 스페이서 (2) 는 상기 분기부 (5) 를 벌어지게 하며, 따라서 상기 내부 공간 (9) 은 원형 원통에 가까와지는 반면에, 상기 케이지 (1) 의 외형은 대략 원뿔대에 가까와진다. 도 3b 에 있어서, 예컨대 실선 (201) 은 정지위치에 있어 정규의 저부 원통으로부터 얻어지는 약간 오목한 모양을 나타내고, 일점쇄선 (202) 은, 도 3a 에 도시된 바와 같이, 초기에는 난형이었던 원통으로부터 얻어지는 직선 모양을 나타낸다. 일단 상기 스페이서 (2) 가 요망하는 위치에 놓이면, 상기 분기부 (5), 스페이서 (2) 및 오리피스 (8) 에 의해 한정되는 공간내에는, 임플란트와 스페이서를 설치하는데 사용되었던 어떠한 내부 부분도 남지 않는다.
어떤 실시예이던지 간에, 상기 분기부 (5) 의 외면의 적어도 일부분에는, 도 7 에 상세히 도시된 바와 같이, 돌출 융기부를 가지는 나사산 형상부 (11) 가 형성된다. 특히, 일예로서, 약 20 mm 내지 25 mm 의 길이 (L) 를 가지는 케이지에 대하여는, 분기부 (5) 의 나사산 형상부 부분의 길이 (l) 는 1.5 mm 내지 2 mm의 피치를 가지는 13 mm 내지 16 mm 의 범위이며, 케이지의 원통의 외경 (D) 은 9 mm 내지 16 mm 이며, 나삿니 (111) 의 높이는 연속 나삿니간의 나사각 (β) 이 약 60°인 것에 대하여 0.7 mm 내지 0.9 mm 정도이며, 나사의 내부 형상부 (112) 는 약 0.4 mm 의 반경을 갖는다. 상기 형상부의 라운드 모양에 의하면 응력집중이 최소화되므로, 힘이나 충격이 큰 경우에도 견뎌낼 수 있다.
돌출 융기부를 가지는 이와 같은 외부 나사는, 임플란트의 오리피스 (8) 에 적합한 공구에 의해 사전에 뚫린 구멍 안에 조립된 이래, 임플란트를 삽입하는 동안에 충격 쇼크가 없다면 외상을 입지 않기 때문에 설치가 용이하며, 그곳에서 이러한 나사는 뼈에의 장착을 제공하므로 어떠한 후속의 이동도 회피된다.
상기 시트부 (7) 는 척추골의 형상에 더 밀접하게 조화되도록 서로에 대해서 평행하거나 또는 약간 경사진 2개 이상의 편평부 (6) 를 포함할 수도 있는데, 이들 각 편평부는, 도 1, 2, 9, 10 및 11 의 실시예들에 도시된 바와 같이, 2개의 연속적인 분기부 (5) 간에 각기 배치된다. 또다르게는, 상기 시트부 (7) 는, 도 3, 4 및 5 의 실시예에 도시된 바와 같이, 사각형 또는 가-사각형 단면을 형성하는 4개의 편평부를 가질 수도 있다. 이러한 시트부에 부가하여, 상기 분기부 (5) 자체는, 특히 임플란트의 단면이 준-원형인 경우에, 도 3 내지 5 의 실시예에 도시된 바와 같이, 적어도 시트부의 편평부와 정렬하는 각각의 편평부를 가질 수도 있으며, 또 다르게는, 도 1, 2 및 도 9 내지 11 의 실시예에 도시된 바와 같이, 편평부를 전혀 갖지 않을 수도 있다. 이러한 편평부는, 전술한 바와 같이, 모양이 약간 난형 또는 타원형인 길이방향 임플란트 단면으로 대체되거나 적어도 협동할 수도 있다.
상기 시트부 (7) 의 오리피스 (8) 에는, 도 6 에 도시된 바와 같은 나사산 형상부 (15) 를 형성할 수 있는 바, 그 나사 피치는 융기부와 골부에서 라운딩되어 있으며, 치수와 관련해서는, 오리피스 (8) 의 내경 (d) 은 7 mm 내지 10 mm 이며, 피치 (p') 는 1 mm 내지 1.5 mm 이며, 나삿니 깊이는 약 0.6 mm 이며, 나사면들간의 나사각 (γ) 은 약 30°이다.
다음에, 임플란트-설치 봉을 위한 장착점으로서 기능하도록 하기 위해, 또는 내부 공간 (9) 을 폐쇄할 목적으로 임플란트가 설치되어 분기부들이 단부 스페이서 (2) 에 의해 벌어진 이후에 첫째로는 케이지를 강화하고 둘째로는 상기 케이지내에 이식되었던 골제 물질이 뒤쪽 단부를 통해 배출되는 것을 방지하기 위해, 상기 내부 공간 (9) 을 폐쇄하기 위한 플러그 (3) 를 오리피스 (8) 안에 나사조립한다.
이러한 플러그 (3) 는 도 14a 의 도면 및 도 14b 의 측면도에 도시되어 있는 바, 이 플러그는, 도 6 에 나타낸 타입의 나사산 형상부 (152) 와, 정사각형, 육각형 등의 다각형의 중앙 오리피스 (17) 를 가지며, 또는 플러그를 조이고 푸는 것이 가능하도록 하기 위해 대응 단부를 가지는 봉의 단부를 그 안에 고착시키기에 적합한 임의의 수단에 의해 대체된다.
더욱이, 임플란트의 뒤쪽면과 상기 시트부 (7) 의 오리피스 (8) 의 주변에는, "보조" 설치 기구의 일부분을 봉 주위에 고착하는 기능을 하고 상기 케이지 (1), 스페이서, 및/또는 플러그 (3) 의 조종을 가능케하는 스터드 (studs) 또는 홈을 형성하는 것이 가능한 바, 이에 따르면 설치중에 임플란트의 위치를 더 강고하게 고정할 수가 있고, 임플란트를 이동시키지 않고서도 보조 기구의 철거를 용이하게 행할 수가 있다.
4개의 분기부 (5) 를 가지는 실시예에서는, 상기 케이지 (1) 는, 예컨대 도 9 의 화살표 Ⅷ 을 따라 도시한 바와 같이, 도 8 에 도시된 바와 같은 분기부간의 공간부를 형성하는 4개의 슬롯 (10) 을 갖는다. 이러한 슬롯들은, 첫째로는 인접한 추간 연골을 가지고 내부 공간 (9) 내에 수용되는 뼈 이식용 조직체의 융착을 향상시키는 기능과, 둘째로는 임플란트의 설치중에 분기부 (5) 의 변형을 더 양호하게 하는 기능을 하는데, 이러한 특정 부분의 분기부는 그들의 단부보다도 작은 단면이다. 더욱이, 이러한 슬롯들은, 분기부 (5) 의 말단부 쪽으로 위치한 단부 부분이 도 8 에 도시된 바와 같이 그들의 대향 단부보다 더 좁고 상기 분기부들의 인접한 쌍들의 말단부간에서 좁은 슬릿 (101) 으로 종결되는 길게 늘여진 모양일 수 있다. 적어도 주 슬롯 (10) 에 대한 이러한 모양에 따르면, 케이지가 팽창되면 평행한 가장자리를 구비한 슬롯을 갖도록 하는 것이 가능하다. 더욱이, 도 3a 에 도시된 바와 같은 일정한 폭의 초기 슬롯 대신에 상기와 같은 모양의 형상을 선택하게 되면, 케이지의 분기부 (5) 의 말단부와 스페이서 (2) 간의 베어링 표면적을 증가시키는 것이 가능하여, 강도가 증대된다.
도 1, 2, 9, 10 및 11 의 실시예에서는, 상기 케이지 (1) 의 내부 공간 (9) 을 한정하는 분기부들 (5) 의 내면은 평탄하며, 상기 공간은, 도 1 에 도시된 바와 같이, 그의 작용위치에 있어 상기 케이지의 내부 공간 (9) 의 직경보다 더 큰 직경을 가지는 쇼울더 (13) 에 의해 도 12 에 도시된 바와 같은 상기 스페이서 (22) 를 수용하고 보유하기에 적합한 축방향 하우징 (12) 을 그의 말단부에 포함한다.
상기 스페이서 (22) 는, 봉을 수용하기에 적합한 나사식 축방향 보어 (14) 를 가지는 바, 스러스트의 적용과 평행이동에 의해 단지 스페이서를 설치할 목적으로 상기 봉의 단부도 마찬가지로 나사식으로 형성되어 조화되며, 상기 설치 봉은 뒤이어 제거가 가능하다.
도 1 및 2 에 있어서는, 케이지 (1) 의 몸체부가 인접한 척추골들로부터의 압력에 기인한 큰 응력하에 분기부 (5) 의 말단부 근방의 앞쪽 단부에서 변형되어 분기부가 스페이서 (2) 둘레를 미끄러짐으로써 서로에 대해 이동하게 되는 것을 방지하기 위해, 상기 스페이서 (2) 에는 임플란트의 축선 (XX') 을 중심으로 대칭배치된 2개 이상의 스플라인 (18) 또는 다른 적절한 수단을 설치하는 것이 가능하다. 이러한 스페이서는 임플란트를 설치하기 이전에 분기부의 단부들로부터 그 안에 삽입됨으로써 케이지 (1) 내에 설치될 수도 있는데, 상기 시트부 (7) 는, 스페이서를 시트부를 통해 삽입할 필요가 있는 경우에는 상기 스페이서 (2) 를 설치하는 때에 상기 2개의 스플라인 (18) 이 안내되어 미끄러질 수 있도록 하는 2개 이상의 대응 홈 (19) 을 가지며, 상기 스플라인의 폭 (e) 은 인접하는 2개의 분기부 (5) 의 말단부간의 거리와 간격보다 크지 않다.
상기 장치는, 분기부들이 팽창된 이후에 변형되지 않도록 하는 추가의 장치를 포함할 수도 있는데, 예컨대 분기부 단부의 홈에 수용되고 분기부에 의한 변형이 가능한 외부 링이 바로 그것이다.
도 3, 4 및 5 에 도시된 실시예에서는, 상기 케이지 (1) 의 내부 공간 (9) 을 한정하는 분기부 (5) 의 내면은, 도 6 에 도시된 바와 같이, 시트부 (7) 의 오리피스 (8) 의 피치에 상당하는 피치를 갖고서 나사식으로 형성되며, 마찬가지로 상기 스페이서 (21) 또한, 도 13a 및 13b 에 도시된 바와 같이, 그에 상응하게 나사식으로 형성된다.
내부 나사산을 가지는 이 실시예에서는, 상기 케이지 (1) 는, 첫째로는 2개의 스페이서간에 한정되는 공간에 삽입되는 골제 물질을 압축하고, 둘째로는 케이지의 중앙 부분을 강화하기 위해, 단부 스페이서 (21) 와 마찬가지로 나사식으로 형성되고 그 뒤에서 조여질 수 있는 중간의 1개 이상의 스페이서 (4) 를 포함할 수도 있다.
상기 단부 및 중간 스페이서 (21, 4) 는, 설치중에 그들을 조종하기 위하여 대응하는 모양의 웅형 단부를 가지는 제거가능한 봉을 수용하기에 적합한 다각형 모양의 각각의 축방향 오리피스 (16) 를 갖는다.
상기 케이지 (1) 의 내부 공간 (9) 의 절두원추 모양은, 예컨대 6°내지 9°범위내의 슬로프 반각 (α) 을 가질 수도 있다.
Claims (14)
- 오리피스 (8) 에 의해 구멍이 뚫려 있는 시트부 (7) 에 각기 일 단부가 연결되어 있는 분기부 (5) 를 포함하는 팽창가능한 골접합 임플란트에 있어서,상기 분기부 (5) 및 시트부 (7) 는, "정지" 위치에 있어, 준-원형 단면의 준-원통형인 전반적인 외형을 가지는 중공의 케이지 (1) 를 형성하고, 상기 분기부 (5) 의 말단부 쪽으로 향한 상기 케이지 (1) 의 내부 공간 (9) 의 일부 또는 전부는 큰 쪽의 저부가 상기 시트부 (7) 쪽으로 향한 준-원형의 원뿔대의 형태이고, 상기 임플란트는 3개 이상의 분기부 (5) 를 포함하며, 또한 상기 원뿔대의 큰 쪽의 저부의 치수에 적합한 치수의 단부 스페이서 (2) 를 상기 내부 공간 (9) 내에서 포함하며, 상기 스페이서 (2) 가 분기부가 팽창되는 요망하는 위치에 일단 위치되면, 케이지는 스페이서 (2) 를 유지할 수 있고 상기 스페이서 (2) 와 오리피스 (8) 사이에는 어떠한 내부 연결도 남지 않으며, 상기 분기부 (5), 스페이서 (2) 및 오리피스 (8) 에 의해 한정되는 공간은 골제 물질을 수용하기에 적절한 것을 특징으로 하는 팽창가능한 골접합 임플란트.
- 제 1 항에 있어서, "작용" 위치에 있어, 상기 스페이서 (2) 는 상기 분기부 (5) 를 벌어지게 하고, 상기 내부 공간 (9) 은 원통에 가깝게 되는 한편 상기 케이지 (1) 의 외형은 대략 원뿔대에 가깝게 되는 것을 특징으로 하는 팽창가능한 골접합 임플란트.
- 제 1 항 또는 제 2 항에 있어서, 상기 분기부 (5) 의 외면의 일부 또는 전부에는 돌출 융기부를 가지는 나사산 형상부 (11) 가 형성된 것을 특징으로 하는 팽창가능한 골접합 임플란트.
- 제 1 항 또는 제 2 항에 있어서, 상기 시트부 (7) 는 2개의 연속적인 분기부 (5) 간에 각기 형성된 2개의 편평부 (6) 를 포함하는 것을 특징으로 하는 팽창가능한 골접합 임플란트.
- 제 1 항 또는 제 2 항에 있어서, 상기 시트부 (7) 의 오리피스 (8) 는 상기 케이지 (1) 의 내부 공간 (9) 을 폐쇄하기 위한 플러그 (3) 를 수용하기에 적합한 것을 특징으로 하는 팽창가능한 골접합 임플란트.
- 제 1 항 또는 제 2 항에 있어서, 상기 케이지 (1) 의 내부 공간 (9) 을 한정하는 분기부들 (5) 의 내면은 평탄하고, 상기 내부 공간 (9) 은 "작용" 위치에 있어 상기 케이지의 내부 공간 (9) 의 직경보다 더 큰 직경을 가지는 쇼울더 (13) 에 의해 상기 스페이서 (22) 를 수용하고 보유하기에 적합한 축방향 하우징 (12) 을 그의 말단부에 가지는 것을 특징으로 하는 팽창가능한 골접합 임플란트.
- 제 6 항에 있어서, 상기 스페이서 (22) 는 제거가능한 설치 봉을 수용하기에 적합한 나사식 축방향 보어 (14) 를 포함하고, 상기 봉의 단부가 나사식으로 형성되어 서로 조화되는 것을 특징으로 하는 팽창가능한 골접합 임플란트.
- 제 6 항에 있어서, 상기 스페이서 (2) 는 임플란트의 축선을 중심으로 대칭배치된 2개의 스플라인 (18) 을 포함하고, 그 스플라인의 폭 (e) 은 인접하는 2개의 분기부 (5) 의 말단부간의 요망 틈새 거리보다 크지 않은 것을 특징으로 하는 팽창가능한 골접합 임플란트.
- 제 1 항 또는 제 2 항에 있어서, 상기 케이지 (1) 의 내부 공간 (9) 을 한정하는 분기부들 (5) 의 내면은 나사식으로 형성되고, 상기 스페이서 (21) 도 그에 상응하게 나사식으로 형성된 것을 특징으로 하는 팽창가능한 골접합 임플란트.
- 제 9 항에 있어서, 상기 케이지 (1) 는 단부의 스페이서 (21) 와 마찬가지로 나사식으로 형성된 중간의 제 2 스페이서 (4) 를 포함하는 것을 특징으로 하는 팽창가능한 골접합 임플란트.
- 제 9 항에 있어서, 상기 스페이서 (21,4) 는, 그들을 조종하여 안에 설치할 수 있도록 하기 위해 대응 웅형 모양의 단부를 포함하는 제거가능한 봉을 수용하기에 적합한 다각형 모양의 각각의 축방향 오리피스 (16) 를 가지는 것을 특징으로 하는 팽창가능한 골접합 임플란트.
- 제 1 항 또는 제 2 항에 있어서, 상기 케이지 (1) 의 전반적인 외형은 원통형이고, 대칭 축선 (XX') 을 중심으로 회전함으로써 발생하는 상기 원통의 발생선은 상기 케이지에 난형의 길이방향 모양을 부여하는 큰 반경의 원호와 같은 만곡 중앙부를 가지는 것을 특징으로 하는 팽창가능한 골접합 임플란트.
- 제 7 항에 있어서, 상기 스페이서 (2) 는 임플란트의 축선을 중심으로 대칭배치된 2개의 스플라인 (18) 을 포함하고, 그 스플라인의 폭 (e) 은 인접하는 2개의 분기부 (5) 의 말단부간의 요망 틈새 거리보다 크지 않은 것을 특징으로 하는 팽창가능한 골접합 임플란트.
- 제 10 항에 있어서, 상기 스페이서 (21,4) 는, 그들을 조종하여 안에 설치할 수 있도록 하기 위해 대응 웅형 모양의 단부를 포함하는 제거가능한 봉을 수용하기에 적합한 다각형 모양의 각각의 축방향 오리피스 (16) 를 가지는 것을 특징으로 하는 팽창가능한 골접합 임플란트.
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FR9611452A FR2753368B1 (fr) | 1996-09-13 | 1996-09-13 | Cage d'osteosynthese expansive |
FR96/11452 | 1996-09-13 |
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KR20000044042A KR20000044042A (ko) | 2000-07-15 |
KR100532548B1 true KR100532548B1 (ko) | 2005-12-02 |
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KR10-1999-7002021A KR100532548B1 (ko) | 1996-09-13 | 1997-09-12 | 팽창가능한 골접합 케이지 |
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US (9) | US6129763A (ko) |
EP (1) | EP1014899B1 (ko) |
JP (1) | JP4107397B2 (ko) |
KR (1) | KR100532548B1 (ko) |
CN (1) | CN1158979C (ko) |
AT (1) | ATE273674T1 (ko) |
AU (1) | AU715283B2 (ko) |
BR (1) | BR9712820A (ko) |
CA (1) | CA2266126C (ko) |
CZ (1) | CZ290106B6 (ko) |
DE (1) | DE69730360T2 (ko) |
ES (1) | ES2225964T3 (ko) |
FR (1) | FR2753368B1 (ko) |
IL (1) | IL128695A (ko) |
NO (1) | NO314121B1 (ko) |
PL (1) | PL185352B1 (ko) |
PT (1) | PT1014899E (ko) |
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1996
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- 1997-09-12 CA CA002266126A patent/CA2266126C/fr not_active Expired - Lifetime
- 1997-09-12 ES ES97919092T patent/ES2225964T3/es not_active Expired - Lifetime
- 1997-09-12 AT AT97919092T patent/ATE273674T1/de active
- 1997-09-12 CZ CZ1999893A patent/CZ290106B6/cs not_active IP Right Cessation
- 1997-09-12 KR KR10-1999-7002021A patent/KR100532548B1/ko not_active IP Right Cessation
- 1997-09-12 AU AU43055/97A patent/AU715283B2/en not_active Expired
- 1997-09-12 WO PCT/FR1997/001617 patent/WO1998010722A1/fr active IP Right Grant
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- 1997-09-12 EP EP97919092A patent/EP1014899B1/fr not_active Expired - Lifetime
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- 1997-09-12 CN CNB971978913A patent/CN1158979C/zh not_active Expired - Fee Related
- 1997-09-12 JP JP51332698A patent/JP4107397B2/ja not_active Expired - Lifetime
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1999
- 1999-03-12 NO NO19991228A patent/NO314121B1/no unknown
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2001
- 2001-09-14 US US09/951,751 patent/US20020040243A1/en not_active Abandoned
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2002
- 2002-04-16 US US10/124,044 patent/US7828848B2/en not_active Expired - Fee Related
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2006
- 2006-06-07 US US11/448,335 patent/US20060241774A1/en not_active Abandoned
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2013
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US11219531B2 (en) | 2019-04-10 | 2022-01-11 | Wenzel Spine, Inc. | Rotatable intervertebral spacing implant |
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