KR20010012197A - 척추 수술에서 척추 몸체를 대체시키기 위한 이식장치 - Google Patents

척추 수술에서 척추 몸체를 대체시키기 위한 이식장치 Download PDF

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Publication number
KR20010012197A
KR20010012197A KR19997010146A KR19997010146A KR20010012197A KR 20010012197 A KR20010012197 A KR 20010012197A KR 19997010146 A KR19997010146 A KR 19997010146A KR 19997010146 A KR19997010146 A KR 19997010146A KR 20010012197 A KR20010012197 A KR 20010012197A
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KR
South Korea
Prior art keywords
cam
members
faces
support
implantable device
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Application number
KR19997010146A
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English (en)
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KR100533898B1 (ko
Inventor
이베스 크로제트
파올로 만지오네
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스뜨리케르 프랑스 에쓰.아.
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Publication of KR20010012197A publication Critical patent/KR20010012197A/ko
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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
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B65—CONVEYING; PACKING; STORING; HANDLING THIN OR FILAMENTARY MATERIAL
    • B65D—CONTAINERS FOR STORAGE OR TRANSPORT OF ARTICLES OR MATERIALS, e.g. BAGS, BARRELS, BOTTLES, BOXES, CANS, CARTONS, CRATES, DRUMS, JARS, TANKS, HOPPERS, FORWARDING CONTAINERS; ACCESSORIES, CLOSURES, OR FITTINGS THEREFOR; PACKAGING ELEMENTS; PACKAGES
    • B65D5/00—Rigid or semi-rigid containers of polygonal cross-section, e.g. boxes, cartons or trays, formed by folding or erecting one or more blanks made of paper
    • B65D5/001—Rigid or semi-rigid containers of polygonal cross-section, e.g. boxes, cartons or trays, formed by folding or erecting one or more blanks made of paper stackable
    • B65D5/005—Separate or attached stacking elements
    • B65D5/006—Separate corner posts and like elements
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B65—CONVEYING; PACKING; STORING; HANDLING THIN OR FILAMENTARY MATERIAL
    • B65D—CONTAINERS FOR STORAGE OR TRANSPORT OF ARTICLES OR MATERIALS, e.g. BAGS, BARRELS, BOTTLES, BOXES, CANS, CARTONS, CRATES, DRUMS, JARS, TANKS, HOPPERS, FORWARDING CONTAINERS; ACCESSORIES, CLOSURES, OR FITTINGS THEREFOR; PACKAGING ELEMENTS; PACKAGES
    • B65D5/00—Rigid or semi-rigid containers of polygonal cross-section, e.g. boxes, cartons or trays, formed by folding or erecting one or more blanks made of paper
    • B65D5/42—Details of containers or of foldable or erectable container blanks
    • B65D5/44—Integral, inserted or attached portions forming internal or external fittings
    • B65D5/48—Partitions
    • B65D5/48002—Partitions integral
    • B65D5/48022—Partitions integral formed by two parallel panels located in the base of a tray being folded up towards each other
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    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
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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
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4637—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for connecting or disconnecting two parts of a prosthesis
    • A61F2002/4638—Tools for performing screwing, e.g. nut or screwdrivers, or particular adaptations therefor
    • 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
    • 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
    • A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
    • 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
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0017—Angular shapes
    • 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
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • 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
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0069—Three-dimensional shapes cylindrical
    • 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
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/0036—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in thickness
    • 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
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/006—Additional features; Implant or prostheses properties not otherwise provided for modular
    • A61F2250/0063—Nested prosthetic parts

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Biomedical Technology (AREA)
  • Transplantation (AREA)
  • Public Health (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Neurology (AREA)
  • Mechanical Engineering (AREA)
  • Prostheses (AREA)
  • Materials For Medical Uses (AREA)

Abstract

본 발명의 이식장치는 상하 척추판을 지지하기 위한 제1 및 제2 지지 부재(20a, 20b)와, 두 지지 부재를 상하로 유지하기 위한 유지 부재(13a, 13b, 23)와, 상기 지지 부재 사이의 거리를 변화시키기에 적합한 적어도 하나의 이동 부재(30; 30a, 30b)를 포함한다. 본 발명에 따르면,상기 유지 부재가 두 지지 부재 사이에 구비되는 적어도 하나의 활주 부재(13a, 13b, 23)를 포함하고, 상기 각 이동부재가 평면에 수평이고 평행한 축을 중심으로 회전하기에 적합한 별개 위치를 갖는 캠(30a, 30b)에 의해 구성된다.

Description

척추 수술에서 척추 몸체를 대체시키기 위한 이식장치{Implant in Particular for Replacing a Body of Vertebrae in Backbone Surgery}
이러한 형태의 다양한 이식장치가 이미 공지되었고, 그리고 일반적으로 그들은 상하 중첩 척추판을 지탱하기 위한 두 부재와, 환자 척추의 형태학적 함수로서 요구되는 높이에 이식장치를 맞추기 위하여 상기 두 부재 사이의 거리를 변화시키기 위한 수단을 포함한다.
이식장치 높이 조정 수단은 나사-너트형 수단과 함께 회전 수단을 포함 할 수 있다.
공지된 이식 장치의 주요 결점은 회전 부재가 척추 칼럼의 축과 평행한 축을 중심으로 회전해야만 한다는 점이다. 이것은 이식장치를 원하는 높이로 하기가 극히 어려운데, 환자의 주어진 여건하에서 상기 부재를 회전시키기 위한 공구가 완전한 회전의 일부만 회전되어서 원하는 높이에 도달하기 위해서는 여러번 수동 조작을 하여야하기 때문이다. 이것은 지지 부재와 상하 중첩 척추판 사이의 슬립 발생의 위험없이 분리 목적에 필요한 축력을 발생시키도록 나사가 미세 하여야만 하는 점에서 더욱 나쁘다.
본 발명은 일반적으로 척추 수술용 이식장치, 특히 종양 또는 외상이 있는 척추 몸체 대체용의 신규한 이식장치에 관한 것이다.
도1 및 도2는 두 상이한 방향에서 도시한 본 발명 이식장치에 대한 확대 사시도,
도3 및 도4는 두 상이한 방향에서 도시한 조립된 상태의 본 발명 이식장치에 대한 개략도,
도5는 도3 및 도4의 조립된 이식장치의 측단면도,
도6은 도3 내지 도5의 조립된 이식장치의 정단면도,
도7은 도3 내지 도6의 조립된 이식장치의 정면도.
도8은 이식장치 변형예에 대한 확대 개략도이다.
본 발명은 주로 상기 결점을 해결하기 위한 척추몸체 대체용의 이식장치에 관한 것으로서, 이 이식장치는 분리 수행시에 정위치에 놓이면 핸들과 유사하고, 받을 수 있는 축방향 압축력에 대해 우수한 안정성을 갖는다.
따라서, 본 발명은 척추 수술에서 척추 몸체 대체용의 이식장치를 제공하는바, 상하 척추판을 지지하기 위한 제1 및 제2 지지 부재와, 두 지지 부재를 상하로 유지하기 위한 유지 부재와, 상기 지지 부재 사이의 거리를 변화시키기에 적합한 적어도 하나의 이동 부재를 포함하는 이식 장치에 있어서, 상기 유지 부재가 두 지지 부재 사이에 구비되는 적어도 하나의 활주 부재를 포함하고, 상기의 각 이동부재가 평면에 수평이고 평행한 축을 중심으로 회전하기에 적합한 별개 위치를 갖는 캠에 의해 구성된다.
본 발명의 양호한 그러나 제한 되지 않는 특징은 다음과 같다.
전체 또는 각각의 별개 위치 캠은 단면이 불규칙한 다각형 형태의 외측 라인을 갖고, 전체 또는 각각의 캠은 각 쌍에서의 면이 상호 평행하고 면의 각 쌍이 면의 다른 쌍 사이의 공간과 다른 일정한 거리로 이격되어진 다수의 쌍을 갖고, 캠은 면의 세 쌍을 갖고, 각 지지 부재는 한 면에 형성된 홈을 구비한 지지 판을 갖고, 면 쌍의 적어도 일부는 캠의 원주 방향에서의 길이가 각 홈의 폭보다 약간 짧도록 하는 방법으로 결정된다.
캠면의 적어도 한 쌍의 면이, 캠의 원주 방향에서 상기 면과 인접 면사이의 전이역에 구비된 각각의 세트백 수단에 의하여 지지판에서 홈의 폭과 일치하는 길이를 갖는다. 전체 또는 각 캠이 전체 또는 각 활주 수단상에서 회전 및 병진 이동되도록 장착된다. 전체 또는 각 활주부가 이식장치의 한 부재로부터 형성된 중공 활주 형성 수직부와 이식장치의 다른 부재로부터 형성된 슬라이더 형성 부재를 포함하고, 활주부와 슬라이더가 그들을 통과하여 캠 장착 축을 통과하는 긴 개구를 갖는다. 상기 캠 장착 축이 캠의 중앙 통로 및 상기 긴 개구를 통과하고 너트에 접촉하는 나사에 의해 한정된다. 활주부의 긴 개구중의 하나가 너트의 회전을 방지하기 적합한 노치이다. 상기 지지 부재가 이식 장치의 상하에 놓이는 척추판과의 접촉을 위하여 외측면상에 티스를 갖는다. 본 발명의 이식 장치는, 두 지지 부재와, 중앙 부재와, 상부 지지 부재 및 중앙 부재사이와 하부 지지 부재 및 중앙 부재 사이에서 각각 작동하는 두 캠과, 상부 지지 부재 및 중앙 부재 사이와 하부 지지 부재 및 중앙 부재 사이에서 각각 작동하는 두 활주 형성 부재를 포함한다.
본 발명의 다른 양상, 목적 및 특징들이 첨부된 도면을 참조하여 설명되는 다음의 기술에 의하여 명백해 질 것이다.
도1 내지 도7을 참조하면, 척추 몸체 대체용의 이식장치가 도시 되었는바, 이 이식장치는 7개의 부재를 포함하는바, 즉 중앙부재(10)와, 상부 지지 부재와 하부 지지 부재를 각각 구성하는 두 지지부재(20a,20b)와, 별개의 위치를 가지며, 하나는 중앙부재(10)와 지지 부재(20a)사이에서 작동하고 다른 하나는 중앙부재(10)와 지지부재(20b)사이에서 작동하는 두 캠형성 부재(30a,30b)와, 조립된 이식장치를 소정 위치에 견고하게 지지하기 위한 두 너트(50a, 50b)와 협동하기 적합한 두 나사(40a,40b)를 포함한다.
중앙부재(10)는 수평 디스크 형태인 중간 판(11)을 포함한다. 중공 원통 직선부를 형성하는 제1활주부(13a)와 상기 직선부(13a)에 수직으로 나란하게 위치되고 중공 원통 직선부를 형성하는 제2활주부(13b)가 이 디스크로부터 상하로 각각 연장된다. 활주부(13a,13b)는 단면이 타원형이다. 각 활주부는 디스크(11)의 한 엣지 인접부로부터 연장되고 그 내부면에 각각의 타원형 관통 슬롯(15a,15b)을 외붐면에 수직의 긴 노치(14a, 14b)를 갖고, 노치는 슬롯보다 약간 넓고 합체되는 활주부의 자유단부를 향하여 개방된다.
한편, 각 활주부(13a, 13b)는 작은 각각의 세트백(setback)(16a, 16b)을 갖고, 타원형 슬롯(15a, 15b)이 대응 세트백의 하부 벽을 관통하여 통과한다.
마지막으로, 중앙부재(10)는 디스크(11)의 상부면에 소정 폭을 갖는 오목한 홈(12a)을 갖고, 이 홈은 디스크의 직경을 따라서 디스크의 대향 엣지까지 활주부(13a)로부터 멀리 연장된다. 동일하고 대칭인 홈(12b)이 디스크(11)의 하부면에 형성된다.
이식장치의 상부 부재(20a)는, 판과 합체되고 단면이 활주부(13a)의 내부단면보다 약간 작은 강체 슬라이더(23)가 하방으로 연장하는 상부 판(21)을 갖고, 상기 슬라이더(23)는 중앙부재(10)의 슬롯(15a)크기에 근접한 크기로서 슬라이더를 관통하는 슬롯(24)을 갖는다.
일련의 티스(26)가 아래에 설명되는 이유로 판(21)의 상부면에 형성되는바, 상기 티스는 특히 피라미드 형상이다. 판(21)의 하부면은 중앙부재(10)의 중심 디스크(11)상의 홈(12a)과 동일한 크기와 형상으로 형성된 홈(22)을 갖는다. 이 경우에, 하부 부재(20b)는 상부 부재(20a)와 180°로 상하가 뒤 바뀐 점을 제외하고는 완전하게 동일하다. 중앙부재(10)와 상부 부재(20a)사이에서 작용하는 별개 위치 캠(30a)을 형성하는 부재는 단면이 불규칙적이고 일반적으로 육각형이다. 특히 부재(30a)는, 직각의 거리(d1)로 서로 이격된 상호 평행한 대향의 면(31, 31')(도6 참조)과, d1 보다 큰 직각의 거리(d2)로 이격된 중간 크기의 상호 평행한 대향 면(32, 32')과, d2 보다 큰 직각의 거리(d3)로 이격된 상호 평행한 대향의 작은 면(33, 33')을 갖는다. 면(31, 33)과 면(31', 33')사이의 전이역은 약간 둥글다. 면(32, 33)과 면(32', 33')사이의 전이역이 각각의 세트백(321, 321')에 대하여 구비되는바, 그 하부는 각 면(32, 32')과 평행하고 중앙부재(10)의 중앙 디스크(11)의 각 면과 부재(20a, 20b)의 판(21)의 내부면에 형성된 홈(12a, 12b)의 깊이와 동일하다.
한편, 부재(30a)의 다양한 면의 길이(즉, 원주 방향의 치수)는 다음과 같다.
큰 면(31, 31')은 홈(12a, 12b, 22)의 폭 보다 크다. 세트 백(321, 321')의 폭을 적절히 선택함으로써 중간 면(32, 32')은 홈(12a, 12b, 22)의 폭보다 약간 짧은 길이를 갖고, 작은 면(33, 33')은 홈(12a, 12b, 22)의 폭보다 약간 작은 효율적인 길이를 갖는다.
부재(30a)는 또한 육각형 단면의 확대부(35)에서 부재의 측면중의 하나에서 종료되는 중앙 관통 보어(34)를 구비하고, 이것은 아래에 설명되는 바와같이 공구 수용을 위한 소켓을 형성한다. 이 경우에, 부재(10, 20b)사이에서 작동하기 위한 캠 형성부재(30b)는 완전하게 부재(30a)와 동일하다.
마지막으로, 본 발명의 이식장치는, 공구 구동용의 소켓(43)을 구비한 헤드(41)와, 나사 섕크(shank, 42)와, 각각이 나사의 나사산까지 통과되는 테이퍼 보어(51)를 갖는 둥근 모서리를 구비한 정방형 외측 라인의 두 너트(50a, 50b)를 갖는다.
이점에서, 소켓(35)의 단면은 나사(40a, 40b) 헤드(41)의 그것 보다 큰 반면, 상기 소켓의 깊이는 상기 헤드(41)의 축 방향 치수보다 크다. 나사 섕크(42)의 외경은 부재(30a, 30b)를 관통하는 보어(34)의 직경보다 약간 작고, 각 너트(50a, 50b)의 측면은 부재(10)의 활주부(13a, 13b)에 형성된 노치(14a, 14b)의 폭보다 약간 작도록 선택된다.
아래에서 본 발명의 이식장치가 어떻게 조립되고, 이식장치를 정위치 시킨후에 의사에 의하여 어떻게 실시되는 지를 설명한다.
먼저, 이식 장치는 부재(20a, 20b)의 슬라이더(23)를 부재(10)의 각 활주부(13a, 13b)에 삽입 시킴으로써 조립된다. 그 후에, 캠 형성 부재(30a, 30b)가 부재(20a)의 판(21)과 판(11)사이에 또는 부재(20b)의 판(21)과 판(11)사이에 예비 위치되어서 각각의 보어(34)가 각각의 슬롯(15a, 15b)에 등록된다. 이어서 나사(40a, 40b)는 각각의 너트(50a, 50b)에 나사 결합되는 슬롯(15a, 15b)과 노치(14a, 14b)의 각 통로(35, 34)에서 접촉된다.
본 이식장치가 정위치 되기전에, 캠 형성부재(30a, 30b)는 안정적인 지지력을 제공하기 위하여 초기에 그들의 최소 위치, 즉 홈(12a, 12b, 22)의 한 측면에서 돌출하고, 각각의 판에 접하는 면(31)을 지지하는 큰면(31, 31')을 갖는 위치에 세팅된다. 이 단계에서, 나사(40a, 40b)는 죄어지지 않고, 따라서 부재(30a, 30b)가 회전되도록 한다. 이 최소 위치 형상에서, 본 이식장치는 의사에 의하여 상하 중첩척추판 사이에 정위치되고, 필요하다면, 의사는 이것을 가능하게 하기 위하여 적은 양의 분리를 수행 할 수 있다.
한번 이식장치가 정위치되면, 공구는 회전을 분산시키기 위하여 부재(30a, 30b)의 소켓(35)내로 접촉하고, 그것에 의해서 이들 부재를, 면(32, 32')이 각 판을, 더욱 정확하게는 홈(22, 12a 또는 22, 12b)의 하부를 지지 하는 중간 위치와, 면(33, 33')이 각 판을, 더욱 정확하게는 홈(22, 12a 또는 22, 12b)의 하부를 지지하는 최고 높이의 위치로 가져간다.
부재(30a, 30b)에의 후방 접근이 큰 양의 토크 발생을 초래하기 때문에, 이 회전은 상하 중첩 척추판 사이의 제어된 분리를 수행 할 수 있게 해준다. 이 분리 작동동안의 이식 장치의 안정성은 캠의 구동으로부터 야기되는 축력하에서 상하 중첩 척추판내로 바이트(bite)되는 상하 판(21)의 티스(26)에 의해 보장된다. 이 점에서, 각각이 세개의 분명한 위치를 갖는 두 개의 캠 형성 부재의 존재는 이식 장치 높이의 만족할 만한 다양성을 줄 수 있고, 이 높이들은 캠 높이의 다음의 조합에 의하여 각각 얻어진다.
d1 및 d1, d1 및 d2, d1 및 d3, d2 및 d2
d2 및 d3, d3 및 d3
이 점에서, 상이한 형상의 두 부재(30a, 30b)를 사용함으로써, 조합의 수는 더욱 증가될 수 있다.
홈(12a, 22 또는 12b, 22)에 유지되는 캠(30a, 30b)의 표면(32', 32 또는 33 , 33')은 또한, 상하 중첩 척추판이 분리된 후에 그들에 의해 야기되는 큰 압축력이 존재하는 경우에도 캠의 각 위치의 안전성을 보장함으로써 이식장치의 안정성에 공헌한다.
최소 높이(표면(31, 31')이 지지면인 경우)의 위치에서의 캠의 안정성은 표면이 길기 때문에 보장된다. 이식장치가 원하는 높이로 조정된 후에, 나사(40a, 40b)가 원하는 위치에 다양한 부재의 고정을 강화하기 위해서 적절한 공구 수단에 의해 죄어지고, 너트(50a, 50b)가 노치(14a, 14b)내에서의 어떤 회전에 대해서도 블럭된다.
도8은 낮은 높이의 이식장치를 얻기 원할때 사용되는 본 발명의 변형예를 도시한다. 이는 도1 내지 도7의 실시예와 두 척추간 트러스트 부재(100, 200)와 합체되는 단지 하나의 캠 형성 부재(30)만이 구비되는 점이 상이하다. 트러스트 부재(100)는 하부면에 티스(26), 활주부(13) 및 상부면에 홈(12)을 구비하는 하부 판(11)을 갖는다. 트러스트 부재(200)는 상부 면에 티스(26), 슬라이더(23) 및 하부면에 (도시되지 않은) 홈을 구비한 상부판(21)을 갖는다. 캠(30), 나사(40) 및 너트(50)는 전술한 실시예의 대응 부재와 동일하다.
자연적으로 본 발명은 전술한 실시예에 한정되지 않고, 당업자라면 본 발명의 정신의 범위내에서 다양한 변형과 변화가 가능하다.

Claims (12)

  1. 상하 척추판을 지지하기 위한 제1 및 제2 지지 부재(100, 200 ; 20a, 20b)와, 두 지지 부재를 상하로 유지하기 위한 유지 부재(13, 23 ; 13a, 13b, 23)와, 상기 지지 부재 사이의 거리를 변화시키기에 적합한 적어도 하나의 이동 부재(30; 30a, 30b)를 포함하는 척추 몸체 대체용의 이식장치에 있어서,
    상기 유지 부재가 두 지지 부재 사이에 구비되는 적어도 하나의 활주 부재(13, 23 ; 13a, 13b, 23)를 포함하고, 상기 각 이동부재가 평면에 수평이고 평행한 축을 중심으로 회전하기에 적합한 별개 위치를 갖는 캠(30, 30a, 30b)에 의해 구성되는 것을 특징으로 하는 이식장치.
  2. 제1항에 있어서,
    전체 또는 각각의 별개 위치 캠(30, 30a, 30b)은 단면이 불규칙한 다각형 형태의 외측 라인을 갖는 것을 특징으로하는 이식장치.
  3. 제2항에 있어서,
    전체 또는 각각의 캠(30, 30a, 30b)은 각 쌍에서의 면이 상호 평행하고 면의 각 쌍이 면의 다른 쌍 사이의 공간과 다른 일정한 거리(d1, d2, d3)로 이격되어진 면(31, 31'; 32, 32'; 33, 33')의 다수의 쌍을 갖는 것을 특징으로하는 이식장치.
  4. 제3항에 있어서,
    캠은 면(31, 31'; 32, 32'; 33, 33')의 세 쌍을 갖는 것을 특징으로하는 이식장치.
  5. 제3항 또는 제4항에 있어서,
    각 지지 부재는 한 면에 형성된 홈(12, 22; 12a, 12b, 22)을 구비한 지지 판(11, 21 ; 21a, 21b)을 갖고, 면(32, 32'; 33, 33')쌍의 적어도 일부는 캠의 원주 방향에서의 길이가 각 홈의 폭보다 약간 짧도록 결정되는 것을 특징으로하는 이식장치.
  6. 제5항에 있어서,
    캠면의 적어도 한 쌍의 면(32, 32')이, 캠의 원주 방향에서 상기 면과 인접 면(33, 33')사이의 전이역에 구비된 각각의 세트백(321, 321')수단에 의하여 지지판에서 홈(12, 22 ; 12a, 12b, 22)의 폭과 일치하는 길이인 것을 특징으로 하는 이식장치.
  7. 제1항 내지 제6항중 어느 한 항에 있어서,
    전체 또는 각 캠(30 ; 30a, 30b)이 전체 또는 각 활주 수단상에서 회전 및 병진 이동되도록 장착되는 것을 특징으로 하는 이식장치.
  8. 제7항에 있어서,
    전체 또는 각 활주 수단이 이식장치의 한 부재(10, 100)로부터 형성된 중공 활주 형성 수직부(13; 13a, 13b)와 이식장치의 다른 부재(200; 20a, 20b)로부터 형성된 슬라이더 형성 부재(23)를 포함하고, 활주부와 슬라이더가 그들을 통과하여 캠 장착 축(40 ; 40a, 40b)을 통과하는 긴 개구(14, 15, 24 ; 14a, 15a, 24 ; 14b, 15b, 24)를 갖는 것을 특징으로 하는 이식장치.
  9. 제8항에 있어서,
    상기 캠 장착 축이 캠의 중앙 통로(34) 및 상기 긴 개구를 통과하고 너트(50 ; 50a, 50b)에 접촉하는 나사(40 ; 40a, 40b)에 의해 한정되는 것을 특징으로 하는 이식장치.
  10. 제9항에 있어서,
    활주부의 긴 개구(14 ; 14a ; 14b)중의 하나가 너트(50 ; 50a, 50b)의 회전을 방지하기 적합한 노치인것을 특징으로 하는 이식장치.
  11. 제1항 내지 제10항 중의 어느 한 항에 있어서,
    상기 지지 부재(100, 200 ; 20a, 20b)가 이식 장치의 상하에 놓이는 척추판과의 접촉을 위하여 외측면상에 티스(26)를 갖는 것을 특징으로 하는 이식장치.
  12. 제1항 내지 제11항 중의 어느 한 항에 있어서,
    이식 장치가, 두 지지 부재(20a, 20b)와, 중앙 부재(10)와, 상부 지지 부재(20a) 및 중앙 부재(10)사이와 하부 지지 부재(20b) 및 중앙 부재(10)사이에서 각각 작동하는 두 캠(30a, 30b)과, 상부 지지 부재(20a) 및 중앙 부재(10)사이와 하부 지지 부재(20b) 및 중앙 부재(10)사이에서 각각 작동하는 두 활주 형성 부재(13a, 23 ; 13b, 23)를 포함하는 것을 특징으로 하는 이식장치.
KR10-1999-7010146A 1997-05-02 1998-04-30 척추 수술에서 척추체를 대체하는 임플란트 KR100533898B1 (ko)

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FR9705465A FR2762778B1 (fr) 1997-05-02 1997-05-02 Implant notamment pour le remplacement d'un corps vertebral en chirurgie du rachis
FR97/05465 1997-05-02
PCT/FR1998/000879 WO1998049975A1 (fr) 1997-05-02 1998-04-30 Implant notamment pour le remplacement d'un corps vertebral en chirurgie du rachis

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DE986350T1 (de) 2001-07-05
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KR100533898B1 (ko) 2005-12-07
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EP0986350B1 (fr) 2003-01-02
WO1998049975A1 (fr) 1998-11-12
CA2289559C (fr) 2006-04-18
AU737948B2 (en) 2001-09-06
US6375683B1 (en) 2002-04-23
ATE230246T1 (de) 2003-01-15
CA2289559A1 (fr) 1998-11-12
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