KR100701574B1 - Spine Insert - Google Patents

Abstract

The present invention is inserted and fixed between the spinous process existing on each of two adjacent vertebrae (pinous process) to maintain a constant spacing between the spinous process, and the upper face and inferior facet (superior facet) of the adjacent spine It relates to an intervertebral insert which binds and fixes so that there is no relative movement between the.

The intervertebral insert according to the present invention includes a spacer having two opposing notches for receiving spinous processes of two vertebrae, a band for fixing the two vertebrae and the spacer, and the spacer can pass therethrough. A through hole penetrating the side surface, and a depression in which the side surface is inwardly cured to be suitable for fixing the band passing through the through hole, wherein the band passes through the through hole and the spacer and the two spinous processes The two vertebrae and the spacer are fixed by tying the eight-character shape.

Spine, spinous process, articular process, interultra ligament, spinal stenosis, spacer, strap

Description

Spine Insert

1 is a cross-sectional view of the human spine.

2 illustrates a prior art.

3 is a perspective view of a spacer according to the present invention;

4 is a front view of the spacer according to the present invention;

5 is a right side view of the spacer according to the present invention;

6 is a perspective view of a strap according to the present invention.

7 and 8 illustrate a process of inserting the spacer into the body.

9 is a view showing the overall shape of the spacer inserted between the spinous process.

10 to 13 illustrate a process of installing a strap according to the first embodiment of the present invention.

14 is a view showing a shape in which a spacer and a strap are coupled according to a second embodiment of the present invention.

15 to 16 illustrate a process of installing a strap according to a second embodiment of the present invention.

Figure 17 is a view from the side after inserting the insert between the spinous process according to an embodiment of the present invention.

18 shows the concept of a human body lever;

Figure 19 is a schematic diagram showing the shape of the spine and intervertebral joints in a normal state.

20 is a schematic diagram showing the shape of the spine after inserting the spacer according to the prior art.

Figure 21 is a schematic diagram showing the shape of the spine after inserting the spacer according to the present invention.

22 is a perspective view showing the shape of a spacer according to another embodiment of the present invention.

FIG. 23 is a view illustrating a state in which the spacer of FIG. 22 is inserted between actual spines. FIG.

24 shows a cross-sectional shape of the spacer band in the form of FIG. 23.

25 is a perspective view showing the shape of a spacer according to another embodiment of the present invention.

FIG. 26 is a left side view of the spacer of FIG. 25; FIG.

FIG. 27 is a view illustrating a shape in which the spacer of FIG. 25 is inserted between actual spinous processes. FIG.

(Symbol description of main part of drawing)

30, 50, 60: spacers 31a, 32a: first flange

31b, 32b: second flange 33a: first notch

33b: second notch 34: first depression

35 through hole 36 second recess

40: strap 41: first hook

43: band 44: the second hook

TECHNICAL FIELD The present invention relates to a spinal insert, and more particularly, is inserted and fixed between spinous processes existing on adjacent spines to maintain a constant distance between spinous processes and adjacent lettuce. It relates to an intervertebral insert that binds and fixes so that there is no relative movement between the superior facet and the inferior facet.

1 is a cross-sectional view of the human spine. A number of spinous processes 3 are located on the back of the human body, and the vertebral body 8 is located on the opposite side. The spinal nerve 1 is located in the space between the spinous process 3 and the vertebral body 8, and the interspinous ligament 7 and the yellow ligament 6 are located between each spinous process 3. Then, the superficial ligaments 5 and the skin 20 exist from the spinous process 3 toward the back of the human body.

As the human body ages, the above-described degenerative change occurs in the spine, and as shown by the dotted line A, the gap between the spinous processes 3 becomes close, and the ligamentum flavum 6 loses its elasticity and becomes thick. It protrudes forward like a dotted line B. Compression of the spinous process 3 or the yellow ligament 6 by the above-described change in the spinal nerve 1 or the spinous nerve (not shown) connected to the spinal nerve 1 is called spinal stenosis.

Treatment of spinal stenosis includes treatment with drugs, physical therapy, surgery. Among these, surgical treatment is used when it is not treated by other treatment methods, and it removes bones and tissues compressing the nerves and fixes the spine with screws in preparation for instability of the spine. Generally known. However, the above-described surgical method requires extensive removal of bone and tissue, so general anesthesia is required, and a long operation time and a long recovery period after surgery are required. Therefore, elderly people who have weak energy often do not operate, there is a problem that often occurs when complications and other reasons do not obtain a satisfactory effect, there was a problem that costs a lot of surgery.

As a solution to this problem, there is a method of inserting the intervertebral insert between two spinous processes, a recent technique related to this in the Republic of Korea Patent Publication (Publication No. 2002-0068035) is shown in FIG.

A spacer 2 having two opposite notches is inserted between the two spinous processes 3a and 3b to accommodate the two spinous processes 3a and 3b of the two vertebrae. Here, each notch is defined by two flanges 11a, 12a, 11b, 12b, each having an inner wall, which insert also has ties 13a, 13b for holding the spacer 2 on the spinous process. Have. This tie wraps around the surface of the opposite spinous process from the bottom of the notch.

The ends of the ties are inserted and then pulled to hold the ties 13a and 13b in place, thereby retaining and retaining the spacers 2 in the spinous processes 3a and 3b. Also, in order to know the position of the spacer 2 inserted in the spine, an opaque transverse member to the X-ray can be inserted therein, which is thin enough and does not interfere with the observation on the X-ray and the central housing ( 14) is accommodated in.

In the prior art, in addition to the interultra ligaments between the spinous processus 3a and the spinous process 3b into which the spacer is inserted, the upper interultra ligaments and the lower interultra ligaments are removed, and then wrapped with ties 13a and 13b. Therefore, the ligament of the part without abnormality should be removed, causing inconvenience to the patient and increasing the procedure time. Then, the spacers 2 are wrapped in the horizontal lateral direction because they surround the upward flanges 11a and 11b and the spinous process 13a of the spacer 2 and surround the ends and the spinous processes 13b of the downward flanges 12a and 12b, respectively. Under force, the bearing capacity is weak and horizontal displacement can occur.

On the other hand, when the human body is aging or an abnormality occurs in the intervertebral disc (4), in addition to such spinal stenosis, relative movement between the superior facet and the inferior facet of the spine occurs, or above the disc Movement in the vertical or horizontal direction between the spinal column of the patient can cause great pain to the patient.

Therefore, in inserting an insert between two vertebrae, it is possible to reduce the burden on the patient and to simplify the procedure, and it is necessary to develop an intervertebral insert in which the insert and the two vertebrae are firmly fixed and fixed.

The present invention was made in view of the above-described needs, and an object of the present invention is to provide an intervertebral insert which maintains a constant interval in the period of extreme spine of two vertebrae and fixes the two vertebrae so that there is no relative movement.

It is also an object of the present invention to provide an intervertebral insert that can be placed between spinous processes by removing only the necessary interultra ligaments without the need for the removal of ancillary interultra ligaments.

In order to achieve the above object, an intervertebral insert comprising a spacer having two opposing notches for receiving spinous processes of two vertebrae, and a band for fixing the two vertebrae and the spacer, wherein the spacer is the band A through-hole penetrating the side surface to allow the light to pass therethrough, and a depression in which the side surface is inwardly curved in a predetermined curvature so as to be suitable for fixing the band passing through the through-hole, and the band passes through the through-hole to allow the spacer to pass through. And by binding the two spinous processes in the form of eight characters, the two vertebrae and the spacer are fixed.

In order to achieve the above object, in the intervertebral insert comprising a spacer having two opposing notches for receiving two spinal spinous processes and a band for fixing the two vertebrae and the spacer, the two opposite notches Is connected to the elastic wrinkles having elastic recovery against the external force given from the spinous process; Two through holes respectively provided in the two opposing notches to allow the band to pass therethrough; And a band passing through the two through holes to bind the spacer and the two spinal spinous processes.

In order to achieve the above object, the intervertebral insert includes an upper body having a first notch; A lower body having a second notch opposite the first notch; A receiving cylinder provided on a lower surface of the upper body; And an insertion member provided on an upper surface of the lower body, a portion of which is inserted into the receiving cylinder and having a different inclination between the first angle formed at the insertion front side and the second angle formed at the insertion rear side.

Hereinafter, exemplary embodiments of the present invention will be described in detail with reference to the accompanying drawings. Advantages and features of the present invention and methods for achieving them will be apparent with reference to the embodiments described below in detail with the accompanying drawings. However, the present invention is not limited to the embodiments disclosed below, but will be implemented in various forms, and only the present embodiments are intended to complete the disclosure of the present invention, and the general knowledge in the art to which the present invention pertains. It is provided to fully convey the scope of the invention to those skilled in the art, and the present invention is defined only by the scope of the claims. Like reference numerals refer to like elements throughout.

Intervertebral insert according to the present invention may be composed of a spacer for maintaining a predetermined interval between two predetermined spinous process, and a strap for tying the spacer and the two spinous process so that the spacer is firmly fixed between the two spinous process. .

3 is a perspective view of the spacer 30 of the intervertebral insert according to the present invention. As such, the spacer 30 includes the first notch 33a and the second notch 33b, the first flanges 31a and 32a and the second flanges 31b and 32b, the first recess 34 and It may be configured to include a second depression 36 and the through-hole 35.

4 is a front view of the spacer 30 of FIG. 1 viewed in the direction (C). As shown in FIG. 4, the spacer 30 may have a symmetrical shape in the left and right directions but may not be a symmetrical shape in the vertical direction.

The spacer 30 is inserted between two spinous processes 3a and 3b in which spinal stenosis occurs, a first notch 33a which receives a lower part of the upper spinous process 3a among the two spinous processes and a lower spinous process among the spinous processes. It has the 2nd notch 33b which accommodates the upper part of 3b. In addition, the notches 33a and 33b are configured to face in opposite directions to each other, that is, to face each other, so as to support the compressive force in the vertical direction of the upper spinous process 3a and the lower spinous process 3b.

By the way, the shape of the lower part of spinous process and the upper part of spinous process is different. The lower part of the spinous process has a relatively narrow and long shape compared to the upper part of the spinous process, and the upper part of the spinous process has a relatively wider and shorter shape than the lower part of the spinous process. Accordingly, the first notch 33a and the first flanges 31a and 32a fit the lower shape of the spinous process and the second notch 33b and the second flanges 31b and 32b fit the upper shape of the spinous process. It is desirable to have different sizes.

In addition, the first notch 33a is defined by the first flanges 31a and 32a which prevent the upper spinous process 3a from moving in the horizontal direction, and the second notch 33b has the lower spinous process 3b in the horizontal direction. It is defined by the second flange (31b, 32b) to prevent movement to.

The first depression 34 is formed on the left side of the spacer 30, and the second depression 36 is formed on the right side of the spacer 30. The depressions 34 and 36 facilitate the pulling of both ends of the strap passing through the through hole 35, and the flanges 31a, 31b, 32a, and 32b to more tightly bind the spacer 30 and the spinous process. The inner side of the left and right outer side is inward at a predetermined curvature in the vertical direction. The curvature may be differently selected by the user as needed.

The through hole 35 is a hole penetrating the left and right of the spacer 30, and has a long slot shape to accommodate the width of the strap. A detailed description of the structure and shape will be given later in the description of FIG. 5.

5 is a right side view of the spacer 30 of FIG. 4 as viewed in the direction (D). As such, the side view does not have a symmetrical shape, in order for the shape of the spinous process and the notch to be suitable when the spacer 30 is inserted between the spinous process in the direction (E). In consideration of the general spinous process shape, the notches 33a and 33b may be formed to become narrower from the insertion front part to the insertion rear part.

The through hole 35 penetrates the left and right of the spacer 30 and has a width C enough to pass through the width w of the strap 40 as shown in FIG. 6. The through hole 35 has a height h such that three straps 40 are press-fitted, that is, barely penetrated. However, since the pressure must be applied between the straps 40 passing through the through hole 35 in the direction of the thickness t of the strap to have a predetermined frictional force, the height h of the through hole is three times the thickness t of the strap. It is formed smaller by a predetermined value α than the size. If the α is large, the frictional force between the straps is large, and if the α is small, the frictional force is small, the α value may be determined according to the frictional force required. The α value may be determined by experience, but may be approximately the thickness t of the strap.

The spacer 30 is preferably made of a metal that is harmless to the human body, such as titanium.

6 is a perspective view of the strap 40 of the intervertebral insert according to the present invention. The strap 40 binds the two spinous processes 3a and 3b and the spacer 30 in the form of eight characters, and a band 43 for fixing the spacer 30 by using a frictional force of a strap material. , Hooks 41 and 44 formed at both ends of the band 43, and connecting portions 42 and 45 connecting the hooks 41 and 44 to the band 43.

The hooks 41 and 44 are divided into a first hook 41 and a second hook 44. The first hook 41 serves to penetrate the interpolar ligaments near the upper portion of the upper spinous process 3a, and its shape is determined according to the shape of the upper part of the upper spinous process 3a. Then, the second hook 44 serves to penetrate the interpolar ligaments near the upper portion of the lower spinous process 3b, and the shape thereof is determined according to the shape of the upper part of the lower spinous process 3b. Thus, in general, the size and radius of curvature of the first hook 41 is larger than the size and radius of curvature of the second hook 44.

The band 43 has a relatively large width w and a relatively small thickness t, the ends of which are narrow in width so that they can be connected to the hooks 41 and 44. The band 43 may be made of a material harmless when inserted into the human body having a predetermined friction or more, such as materials such as synthetic fibers such as polyester, natural leather, artificial leather and the like.

7 and 8 are views illustrating a process of inserting the spacer 30 into the body of the patient. First, as shown in FIG. 7, the ligament 5, which is the portion into which the spacer 30 is to be inserted, is lifted up, and the inter ligament 7a of the portion is removed. Next, the spacer 30 is inserted into a space between the two spinous processes 3a and 3b from which the inter ligament 7a is removed.

9 is a view showing a shape of the spacer 30 viewed from the back of the shape inserted between the two spinous processes (3a, 3b) through the process shown in FIGS. In this way, the spacer 30 is inserted between the two spinous processes 3a and 3b, and the spinous processes 3a and 3b are held by the notches 33a and 33b facing each other in the spacer 30, respectively. However, due to the various bending actions of the spinal column, each spinous process may have some momentum in the left and right directions, so that the spacer 30 must be fixed by the strap 40. After that, the strap installation process will be illustrated by separating only the portion (F) of FIG. 9 for convenience.

As described above, in the present invention, the first embodiment and the second embodiment are presented as a method of fixing the spacer 30 by the strap 40.

10 to 13 illustrate a process of installing a strap according to the first embodiment of the present invention. First, the first hook 41 passes through the through hole 35 of the spacer 30 (see FIG. 10). Then, the first hook 41 is allowed to penetrate a portion near the upper portion of the upper spinous process 3a of the upper interultra ligament 7b (see FIG. 11). The first hook 41 once again penetrates the through hole 35 of the spacer 30, and the second hook 44 penetrates near the lower portion of the lower spinous process protrusion 3b of the lower interultra ligament 7c. (See FIG. 12).

Thereafter, the first hook 41 and the second hook 44 are removed, and both ends of the band 43 are pulled firmly in the direction of the arrow in FIG. As such, when pulling the band 43, the band 43 is in close contact with the depressions 34 and 36 of the spacer 30 so that the spacer 30 and the spinous processes 3a and 3b are more firmly coupled. do. Then, the end portion of the band where the first hook is removed is made a knot 46 in the portion of the band surrounding the lower spinous process 3b, and the band surrounding the upper end and lower spinous process 3a the end of the band where the second hook is removed. Make a knot (47) on the part of.

In the first embodiment, the spacer and the two vertebrae are supported and bound by knots at both ends of the band. In the second embodiment, the knot binding and the friction between the bands are simultaneously used.

14 is a view showing a shape in which the spacer 30 and the strap 40 are coupled according to the second embodiment of the present invention. As such, when the band 43 of the strap 40 penetrates the through hole 35 of the spacer 30 three times in the shape of an eight-character shape, the band 43 of the strap 40 moves in the thickness direction of the band 43 from the inner surface of the through hole 35. A pressing compression force Fc is formed, which in turn acts likewise between adjacent bands. A frictional force Ft between the bands is generated in proportion to the frictional force of the compression force Fc and the band 43. Of course, there is also a frictional force between the inner surface of the through hole 35 and the band 43, but since it is relatively small compared to the frictional force (Ft) between the bands, the main frictional force acts between the bands 43 Can be. In another embodiment, the frictional force between the inner surface of the through hole 35 and the band 43 may be relatively larger than the friction force Ft between the bands. For this purpose, the band 43 and the through hole 35 may be The configuration can be changed as appropriate.

15 to 16 illustrate a process of installing a strap according to a second embodiment of the present invention, which is a process connected after the process described with reference to FIGS. 10 to 12. Therefore, in the second embodiment, the processes of FIGS. 10 to 12 are performed first as in the first embodiment.

In the second embodiment, first, the first hook 41 passes through the through hole 35 of the spacer 30 (see FIG. 10). Then, the first hook 41 is allowed to penetrate a portion near the upper portion of the upper spinous process 3a of the upper interultra ligament 7b (see FIG. 11). The first hook 41 once again penetrates the through hole 35 of the spacer 30, and the second hook 44 penetrates near the lower portion of the lower spinous process protrusion 3b of the lower interultra ligament 7c. (See FIG. 12).

Then, like the first hook 41, the second hook 44 is also lowered to pass through the through hole 35 once again, and then the hooks 41 and 44 at both ends of the band 43 are removed. And both ends of the band 43 are firmly pulled in the arrow direction of FIG. 14 (refer FIG. 15). As a result, the band 43 is locked by friction, and the spinous processes 3a and 3b are held firmly in the notch. As such, when the band 43 is locked, the band 43 is in close contact with the depressions 34 and 36 of the spacer 30 so that the spacer 30 and the spinous processes 3a and 3b are more firmly coupled. do.

Finally, knots 48 and 49 are formed to connect both ends of the band 43 with the bands surrounding the spinous processes 3a and 3b (see FIG. 16). Fixing the spinous process (3a, 3b) and the spacer 30 by the band is mainly due to the friction between the band, the knot (48, 49) serves as an auxiliary for the fixing.

17 is a view as viewed from the side after inserting the spacer-band composite insert into the spinous process (3a, 3b) according to an embodiment of the present invention. Here, the spacer 30 maintains the spinous processes 3a and 3b by a predetermined interval (interval between notches), and supports the compression force F2 acting between the spinous processes. Then, the band 43 applies a predetermined bearing force F1 so as not to open the spinous process period by integrally binding the spacer 30 and the top and bottom spinous processes 3a and 3b. As such, when the two spinous processes 3a and 3b are held by the band 43 so as not to spread, the interval between the spinous processes 3a and 3b and the vertebral bodies 8a and 8b located on the opposite side is narrowed. Various problems can be solved.

In other words, the load applied from the outside is distributed at an appropriate ratio between the vertebral body and the intervertebral joint, so that the pressure on the intervertebral joint and the pressure on the disk can be reduced, thereby preserving the disk completely, and maintaining the space between the vertebrae properly. Will be. Therefore, when the insert of the present invention is used, not only various diseases caused by narrowing the spacing between spinous processes but also various diseases caused by narrowing the spacing between the vertebral bodies can be protected together.

In addition, the band 43 of the insert according to the present invention prevents relative movement of the upper intervertebral joint 9b and the lower intervertebral joint 9a, that is, also plays a role of fixing the intervertebral joint. Considering the lever mechanism of the human spine, the intervertebral joints 9a and 9b serve as support points, the vertebrae act as action points, and the muscles act as force points. Of these, fixing the intervertebral joints 9a and 9b serving as a supporting point so as not to be damaged is an important factor for the spine to perform its role. The effects of fixing the intervertebral joint include a variety of effects such as relief of pain caused by the movement of the intervertebral joint, reduction of sequelae after the procedure, and prevention of spinal stenosis due to movement restriction.

On the other hand, to help understand the lever mechanism of the spine, reference is made to FIG. 18 showing the configuration of the first type lever. A band 43 is located at the force point portion of the lever to apply a force F1 to press the two spinous processes 3a and 3b, which causes the sagittal section of the spine to become lordosis. At this time, the length of the lever arm is lengthened by the pulled extensor muscles, so that the load (W) applied to the vertebrae 8a and 8b is balanced using the intervertebral joints 9a and 9b as a supporting point. The extensors here produce a posterior shear force that cancels out the upper body or external moment and offsets the anterior shear force generated by the upper body or external load.

The load W on the vertebrae is determined mainly by muscle forces by extensor muscles (erector spinae muscles) located in the low back of the back. This applies to the principle of the body lever, in which muscle forces act on the vertebrae by the muscle arms. At this time, the longer the length of the muscle of the lever arm (lever arm) according to the formula Fxa = Wxb increases the range of action on the vertebral body.

When the two pole protrusions are pressed by the ligamentoplasty according to the present invention, the lumbar lumbar restores the original lordosis shape, thereby increasing the length of the extensor. In other words, as the length of the lever arm increases, the range of action is increased even by the same muscle force, so that the load acting on the vertebra can be offset by that much.

19 to 21 are schematic views for comparing the operation of the prior art and the present invention. 19 is a schematic diagram showing the shape of the spine and intervertebral joints in a normal state. Here, it can be seen that the intervertebral joints 9a and 9b serve as a support point of the spinal lever, and the spinous processes 3a and 3b and the vertebral bodies 8a and 8b are located at both sides thereof. In Fig. 19, the interval between the spinous processes 3a and 3b and the interval between the vertebral bodies 8a and 8b maintain normal intervals.

20 is a schematic diagram showing the shape of the spine after inserting the spacer according to the prior art. Conventionally, when inserting a spacer without a band or tying the upper spinous process 3a and the lower spinous process 3b with the spacer using a tie as in the technique of FIG. 2, respectively, the upper and lower spinous processes 3a and 3b and the spacer are integrated together. In the case of failure of fixation, the relative movement between the spinous processes 3a and 3b may occur, and when any force is applied to the intervertebral joints 9a and 9b serving as a support point of the spinal lever, the intervertebral joints 9a and 9b. Relative movements may occur in the liver, which may be accompanied by various diseases due to the degeneration of the support point, so that the spinal lever may not function properly. In addition, the gap between the spinous processes 3a and 3b may be somewhat widened. In this case, the interval between the vertebrae 8a and 8b may be narrowed, and the possibility of worsening of a disease such as spinal stenosis after the procedure may exist.

Figure 21 is a schematic diagram showing the shape of the spine after inserting the spacer according to the present invention. In the present invention, by fixing the upper and lower spinous processes 3a and 3b and the spacer 30 by using the band 43, the relative movement of the intervertebral joints 9a and 9b does not occur, so that the action of the spinal lever is maintained even after the procedure. It is preserved as it is. In addition, various diseases directly occurring in the intervertebral joints 9a and 9b may be prevented due to movements or impacts of the intervertebral joints 9a and 9b.

On the other hand, even when the deformation between the vertebrae 8a and 8b is narrowed, that is, in a situation in which spinal stenosis may occur, the gap between the vertebrae 8a and 8b is maintained at a predetermined level or more with the support of the reinforced muscle force, thereby preventing it. can do. At this time, the original lordosis can be restored by fixation by the band. However, in consideration of individual differences in patients, it is preferable to select the height h so as not to become a local kyphosis state.

Until now, the spacer 30 according to an embodiment of the present invention is made of a solid material to ensure a certain distance between the two spinous processes. However, the relative movement between the spine may occur depending on the movement of the patient after the procedure. If the spacer is completely fixed, the movement may not only be uncomfortable, but may also adversely affect other normal vertebrae. Therefore, it is necessary to devise a spacer having a structure having elastic force so that the interval of the spacer can be varied within a limited range in accordance with the above movement.

Hereinafter, some spacers according to another embodiment of the present invention having such a structure will be presented. 22 is a perspective view showing the shape of the spacer 50 according to another embodiment of the present invention.

The spacer 50 is provided with flanges 51a, 51b, 52a, 52b and notches 53a, 53b similarly to the spacer 30 described above, but has elastic pleats 54 for imparting elasticity to the spacer 50. Is further included, and the notches 53a and 53b are slightly different in that the through holes 55a and 55b are provided.

The elastic pleated portion 54 is located on the insertion front side and has a form of one or more pleats for imparting elasticity. Due to these structural characteristics, even if the spacer 50 itself is made of a rigid metal such as titanium, the spacing of the spacer 50 may be elastically changed within a predetermined range. In more detail, the elastic wrinkle part 54 is connected to the first notch 53a and is formed in a vertical direction with a straight portion 57a and a straight portion connected to the second notch 53b and formed in a vertical direction. 57b and a curved portion 56 connecting the two straight portions.

The straight portions 57a and 57b are provided to ensure a distance by at least the height of the heights of the straight portions 57a and 57b between the spinous processes so that the vertebrae do not become excessive extensions. The curved portion 56 is then used to maintain the elasticity of the elastic pleat 54 during extension or flexion.

FIG. 23 is a diagram illustrating a shape in which a spacer 50 is inserted between actual spines. The through-holes 55a and 55b of the spacer 50 are fitted with a band 43 as in the embodiment of FIG. 3, wherein the band 43 has an upper spinous process 3a, a lower spinous process 3b, and a spacer 50. ). Thus, the cross section of the shape in which the band 43 is bundled is shown in FIG. The band surrounds the upper spinous process 3a and the lower spinous process 3b one or more times so as to intersect in an eight-character shape. Thereafter, the distal end of the band 43 is knotted and fixed.

When the band 43 passes through the through-holes 55a and 55b, the elastic wrinkles 54 and the band 43 do not come into contact with the elastic wrinkles 54 in the left and right directions in FIG. 23. It is preferable to be provided at a position having a space of.

When the spacer 50 is installed between the spinous processes as shown in FIG. 23, the spacing between the two spinous processes may be elastically deformed to some extent, thereby adaptively responding to the movement of the patient while maintaining the spacing between the spinous processes. That is, normal movement of the spine is allowed while abnormal movements can be limited. In addition, since the opposite notch and the spinous process of the spacer 50 do not directly contact each other, and the band 43 is interposed in the middle, a buffering effect against external impact can be expected.

Meanwhile, a spacer 60 according to another embodiment of the present invention is shown in FIG. 25. The spacer 60 may be separated into an upper body 61 and a lower body 62 each having a notch.

The lower surface of the upper body 61 is provided with a receiving cylinder 63, the upper surface of the lower body 62 is provided with an insertion member (64). A part of the insertion member 64 is inserted into the receiving cylinder 63, but no other connecting means is provided.

Reference is made to FIG. 26 for a more detailed view of the engagement relationship between the insert 64 and the receiving cylinder 63. While the receiving cylinder 63 has a simple cylindrical shape, the insertion member 64 has a shape such that a part thereof can be inserted into the receiving cylinder 63, and the first angle of the left portion (insertion front side) 66a has a conical shape having a steeper slope than the second angle 66b of the right part (insertion rear part side). Of course, no special connecting means for connecting the receiving cylinder 63 and the inserting member 64 is provided, so that the first angle 66a and the second angle allow relative movement between the receiving cylinder 63 and the inserting member 64. More preferably, the angle 66b is formed in a curved shape rather than a straight shape.

However, the reason why the first angle 66a has a steeper slope than the second angle 66b is that the receiving cylinder 63 makes it difficult to rotate to the right with respect to the insertion member 64, and to rotate to the left is relatively To make it easy. That is, to prevent excessive extension and to have some flexibility with respect to the flexure.

Referring back to FIG. 25, band fixing protrusions 65a and 65b are formed at one point of the upper body 61 and one point of the lower body 62, respectively, so that the fixing protrusions 65a are formed through the band 43. , 65b). In the region where the band 43 is elastic, the gentle inclination of the second angle 66b allows for some flexibility in flexion. In addition, as the flexibility of the extension is not allowed due to the steep inclination of the first angle 66a, the notch and the contact point of the spinous line may be naturally contacted when the lordosis is caused by the somewhat elasticity of the band 43.

FIG. 27 is a view illustrating a shape in which a spacer 60 is inserted between actual spines. The band fixing protrusions 65a and 65b are bundled by the band 43. The portion having the first angle 66a of the insertion member 64 is in contact with the inner surface of the receiving cylinder 63 so that the tension of the band is reduced. Can be maintained. A separate band may tie up and down the spinous process (3a, 3b) at a point near the pivot of the spacer 60.

In this way, the spacer 60 has a structure having a separate body to independently fix each spinous process, can allow the movement of the spinous process to the maximum, and because there is an independent power point can enjoy the effect of the human body lever.

In the embodiment of FIGS. 22 and 25, the cross-sectional shape of the notch (see FIG. 24) is simply displayed in a form in which the notch and the flange form a right angle, but of course, the cross-sectional shape may be implemented to be curved so as to be suitable for the cross-sectional shape of the spinous process. It will be apparent to those skilled in the art.

Although embodiments of the present invention have been described above with reference to the accompanying drawings, those skilled in the art to which the present invention pertains may implement the present invention in other specific forms without changing the technical spirit or essential features thereof. I can understand that. Therefore, it should be understood that the embodiments described above are exemplary in all respects and not restrictive.

According to the present invention, there is no need to remove the incidental interultra ligament, reducing the physical burden on the patient receiving the procedure, there is an advantage that the procedure is easy from the point of view of the doctor. In particular, the procedure does not require resection and denervation of extensors located on both sides of the back.

In addition, according to the present invention, it is possible to prevent the gap between the vertebrae to be narrowed while maintaining the interval between the spinous processes more than a predetermined, and also to prevent the relative movement of the upper intervertebral joint and the lower intervertebral joint.

In addition, according to the present invention, it is possible to provide an intervertebral insert that can be adaptively adapted to spinal spinous processes of people having various inclinations.

Claims (3)

An intervertebral insert comprising a spacer having two opposing notches for receiving two spinal spinous processes and a band for securing the two vertebrae and the spacer, An elastic pleat portion connecting the two opposite notches and having elastic recovery with respect to an external force given from the spinous process; Two through holes respectively provided in the two opposing notches to allow the band to pass therethrough; And An intervertebral insert comprising a band passing through the two through holes to bind the spacer and the two spinal spinous processes. The method of claim 1, wherein the elastic wrinkle portion A first straight portion connected to a first notch among the notches and formed in a vertical direction, a second straight portion connected to a second notch among the notches and formed in a vertical direction, and a curve connecting the two straight portions Intervertebral inserts comprising portions. The method of claim 1, wherein the through hole is The intervertebral insert, characterized in that provided in a position having a predetermined distance from the elastic wrinkles so that the elastic wrinkles and the band does not contact when passing through the band through the through hole.

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