WO2010092893A1 - Surgical operation system for lumbar interbody fusion and device for keeping lumbar interbody space to be used in surgical operation for lumbar interbody fusion - Google Patents

Surgical operation system for lumbar interbody fusion and device for keeping lumbar interbody space to be used in surgical operation for lumbar interbody fusion Download PDF

Info

Publication number
WO2010092893A1
WO2010092893A1 PCT/JP2010/051558 JP2010051558W WO2010092893A1 WO 2010092893 A1 WO2010092893 A1 WO 2010092893A1 JP 2010051558 W JP2010051558 W JP 2010051558W WO 2010092893 A1 WO2010092893 A1 WO 2010092893A1
Authority
WO
Grant status
Application
Patent type
Prior art keywords
portion
body
interbody
interbody fusion
vertebral bodies
Prior art date
Application number
PCT/JP2010/051558
Other languages
French (fr)
Japanese (ja)
Inventor
哲雄 佐藤
五十嵐 孝
憲正 瀬尾
Original Assignee
学校法人自治医科大学
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date

Links

Images

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/4455Joints 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
    • A61F2/446Joints 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603Special 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
    • A61F2/4611Special 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30721Accessories
    • A61F2/30744End caps, e.g. for closing an endoprosthetic cavity
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30003Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/30004The prosthesis made from materials having different values of a given property at different locations within the same prosthesis
    • A61F2002/30014The prosthesis made from materials having different values of a given property at different locations within the same prosthesis differing in elasticity, stiffness or compressibility
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/3011Cross-sections or two-dimensional shapes
    • A61F2002/30159Concave polygonal shapes
    • A61F2002/30179X-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30563Special structural features of bone or joint prostheses not otherwise provided for having elastic means or damping means, different from springs, e.g. including an elastomeric core or shock absorbers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30576Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30579Special structural features of bone or joint prostheses not otherwise provided for with mechanically expandable devices, e.g. fixation devices
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes, grooves
    • A61F2002/3085Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes, grooves with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface
    • A61F2002/30858Threads interrupted by grooves or sidewalls, e.g. flat sidewalls
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes, grooves
    • A61F2002/30878Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes, grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30884Fins or wings, e.g. longitudinal wings for preventing rotation within the bone cavity
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes, grooves
    • A61F2002/30878Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes, grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30891Plurality of protrusions
    • A61F2002/30892Plurality of protrusions parallel
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/3094Designing or manufacturing processes
    • A61F2002/30971Laminates, i.e. layered products
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2002/4475Joints for the spine, e.g. vertebrae, spinal discs hollow
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603Special 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
    • A61F2002/4625Special 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 with relative movement between parts of the instrument during use
    • A61F2002/4627Special 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 with relative movement between parts of the instrument during use with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0028Shapes in the form of latin or greek characters
    • A61F2230/0058X-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2250/00Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014Special 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
    • A61F2250/0018Special 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 elasticity, stiffness or compressibility
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00011Metals or alloys
    • A61F2310/00035Other metals or alloys
    • A61F2310/00131Tantalum or Ta-based alloys

Abstract

Disclosed are a surgical operation system for lumbar interbody fusion provided with a lumbar interbody fusion device which has a simple constitution and a small size, shows excellent handling properties, high reliability and high economical efficiency, enables the performance of a lumbar interbody fusion treatment within a short time and thus largely reduces the burden on a patient; and a device for keeping lumbar interbody space to be used in a surgical operation for lumbar interbody fusion. A surgical operation system for lumbar interbody fusion that is to be mounted in between lumbar bodies (L1, L2) adjacent to each other to fuse the lumbar interbody, comprising: a main body (11-11i), wherein outer surface-engagement parts (15, 14-14c) engaging to the opposing faces (L1a, L2a) of the lumbar bodies are formed on the outer surface of a substantially hollow cylindrical or tapered hollow conical board having a bottom at the front end and fitting for the lumbar interbody, and one or more guide holes (17-17d, 18-18d) penetrating along the lumbar body direction from the deep part of a female screw (16), which is provided in the hollow inner face (16a) in the back end side, to the outer surface while spreading out in the open-fan shape are formed; and a device (10-10k) for fixing the lumbar interbody which comprises one or more pins (30-30k) engageably placed in the guide holes and press screws (40-40k, 50) interconnecting with the female screw (16) and pressing the back end of the pins due to the thrust force thereof, and the front end side of which is guided along the guide holes due to the press screws pressing the back end of the pins so that the device is inserted into the lumbar bodies.

Description

Interbody surgical system and interbody fixation surgical interbody space holding device

The present invention relates to a modified disc space to a proper spacing fitted the interbody fixation devices interbody fusion surgery for fixing between vertebral bodies between two adjacent vertebral bodies (vertebrae), especially a short time readily burden of the patient by performing interbody fixation treatments, between reliable vertebral body to significantly reduce surgical stress fixed surgical system and interbody fixation surgical interbody space holding device on.

In spondylolisthesis and Heruniya spine (spinal) surgery due other defects or aging of the disc to be increased in recent years, the two vertebral bodies adjacent to the damaged disc (vertebrae) is fixed is fixed in the proper spacing. For this much, the entire disc damaged except annular body is excised, any support air gap or disc space between two discs between the vertebral bodies adjacent to avoid damage to the nerves extending along the spinal column it is necessary to arrange.

In early techniques, the two together bone material to promote fusion of the adjacent vertebral body is filled as a support between the vertebral bodies, plates or rods to stably connecting and fixing damaged the vertebral bodies It has been used. However, the vertebral body when it is fixed by the bone material, the fixing member such as a fixed plate or rod vertebral body to maintain stability of the vertebral bodies becomes longer extra encumbrance. In addition, these rods or plates transplant fixed to surgery is performed from the back of the spinal column by general anesthesia, behind the spine nerves tangled intricately extending along the muscles and the spinal column, or stripped these muscles , treatment or to so as not to damage the nerve is cumbersome take a long time major surgery, surgical stress was excessive.

In recent years, without using a said rod or plate porting fixed from behind of the spinal column, and excised intervertebral disc damaged from behind side or abdomen side, as complete arthrodesis is achieved, adjacent to form a disc space numerous attempts to develop an implant member or interbody fusion device for maintaining stability between the vertebral bodies that have been made in particular mainly in Europe and the United States.

Such is typical two examples proposed recently as interbody fusion device. In the following description, the biological "tip" portion of the dorsal direction with respect to the gear or vertebral bodies in the (human) or "tip", a part of the ventral direction is referred to as "rear" or "rear".

Figure 48 is a perspective view, FIG. 49 is a vertical sectional view of a state where the interbody fusion device of the second example of the conventional is fixed between the vertebral bodies of the interbody fusion device of the first example of the conventional (main part cross-section) it is.

First example interbody fusion device 100 of, as shown in FIG. 48, with the external thread 118 and 119 are formed in a tapered hollow frustoconical outer surface the front end 113 the trailing end 112 at opening or closing surface is open, consists body 111 parallel truncated side walls 122 are formed, is configured to be screwed through the external thread 118, 119 between the adjacent vertebral bodies (not shown). (See Patent Document 1).

Interbody fusion device of the second example, as shown in FIG. 49, with tapered hollow frustoconical outer surface the front end 253 the trailing end 256 at opening or closing surface is partially open external thread 258 and 259 are formed a body 251 parallel truncated side walls 262 are formed, the screw holes 267,267 of the pair provided inclined flared upper and lower vertebral bodies L4, L5 direction respectively adjacent to the rear end 256 is inserted, vertebral body L4, the bone screws 280,280 and a pair of threaded into inclined in L5, head of the bone screw 280,280 pair are screwed into the center of the rear end 256 281 and 283 made together from set screw 282 which presses the body 251 after being screwed through the external thread 258, 259 between the adjacent vertebral bodies L4, L5, 1 pair of bone screws 280,280 are vertebral body L4, structure that screwed diagonally into the L5 It is. (See Patent Document 2).

The first example and interbody fusion device of the second example, since both are of small size which can be inserted between the upper and lower vertebral bodies body 111,251 are adjacent, in particular the conventional rod or plate or the like can be the easily port secured between vertebral bodies in a relatively short time using a laparoscope from the abdomen side compared to surgery from massive rear side of implanting fixing, the patient's burden, surgical stress it is those that can be expected to significantly reduce.

Moreover, these interbody fusion device the previously required when porting fixed between the vertebral bodies, vertebral for holding the disc space to fix the proper spacing between two adjacent vertebral bodies (vertebrae) there are typical following example has recently been proposed in the body between the space holding device.

Figure 50 is a perspective view, FIG. 51 is a side in a state where the interbody space holding device of FIG. 50 is inserted between the vertebral bodies of a typical conventional interbody space holding device (ventral lordosis extended outer sleeve) it is a diagram.

Conventional typical interbody space holding device (ventral lordosis extended outer sleeve) 300, as shown in FIG. 50 and 51, the hollow tubular member elongate cylindrical external terminal 330 is provided at the rear end both the tip 310 of 302 are continuously provided, a plurality of teeth 312 respectively engaging the front portion of the adjacent vertebral bodies L6, L7, and high so as to restore the height of the disc space between the vertebral body L6, L7 a counter configured to a pair of extensions 320 and 322 are provided to extend in a 180 degree relationship to have is. (See FIG. 31, 32, etc. of Patent Document 3).

Japanese Unexamined Patent Publication No. 2007-75632 (priority claim number: US08 / 603,674) JP-T 2002-501784 Patent Publication No. (claiming priority number: US09 / 014,901) JP 2004-267786 Patent Publication No. (claiming priority number: US08 / 396,414)

However, since the interbody fusion device according an only configuration is screwed via an external thread 118, 119 between the upper and lower vertebral bodies body 111 adjacent to the patent document 1 (first example), there is proper spacing holding disadvantageously easily collapse between retracted or rotated to vertebral bodies from a proper position between the vertebral bodies after being inserted between the vertebral bodies.

In contrast, interbody fusion device described in Patent Document 2 (second example), after being screwed through the external thread 258, 259 between the vertebral bodies L4, L5 the body 251 adjacent a main body 251 since bone screws 280,280 pair inserted through the rear end 256 of a configuration in which screwing obliquely into the vertebral body L4, L5, proper interbody body 251 as in the Patent Document 1 and it is being improved to be capable of preventing the retraction and rotation from the position. However, the upper and lower vertebral bodies L4, L5 direction of each pair disposed inclined flared screw holes 267,267, the bone screws 280,280 and a pair of bone screw adjacent the rear end 256 280,280 omission structure and processing thereof retaining a set screw 282 is complicated, and further, so-called three-axis directions of the screwing operation of the bone screw 280,280 of a pair of intersecting these spindle body 251 and set screw 282 the need to do in narrow places laparoscopically use, the body 251, mechanism of transplant driver for screwing the bone screw 280,280 and set screw 282 is complicated laparoscopically with poor operability, cost there is a problem of so forth is also increased.

Further, interbody space holding device (ventral lordosis extended outer sleeve) 300 described in Patent Document 3, the cannula of the endoscope in the lens for abdominal portion formed to the front surface of the vertebral body L6, L7 adjacent from the human body abdominal a plurality of teeth with a height of the disc space through a pair of extensions 320 and 322 which are provided at the distal end 310 of the hollow tubular member 302 is restored by pushing inserted from the tip into the (not shown) 312 since but only to fix the vertebral body L6, L7 and piercing the front portion of the vertebral body L6, L7, relatively thereafter between the vertebral body fixing device when porting fixed between the vertebral bodies L6, L7 there is a disadvantage of easily displaced vertebra L6, L7 a large external force is loaded to the rear or right and left lateral engagement is disengaged with the plurality of teeth 312.

The present invention has been made in view of the problems of the prior art, an object of the present invention, in a simple configuration, simplification of the entire structure, miniaturization is achieved, operability, reliability and excellent economy, required quickly and easily into the burden of the patient by performing interbody fixation treatment, interbody comprises a interbody fusion device to significantly reduce surgical stress fixed surgical system and its surgical Do is to provide a space holding device between interbody with improved fixing surgical vertebral bodies reliability.

To achieve the above object, the interbody fusion surgical system of the invention of claim 1 includes two substantially hollow adjacent vertebral bodies (vertebrae) formed so as to hold the proper spacing has been front bottom between with an outer surface engaging portion which engages is formed on the opposite surface of the cylindrical or tapered hollow the frustoconical outer surface two vertebral bodies, appropriate depth of the internal thread is formed in a hollow inner surface of the rear side, further the female screw a main body one or more bent-shaped or straight-shaped guide hole which penetrates to the outer surface inclined flared is drilled from the tip the hollow inner surface radially towards the facing surface of the vertebral body, the guide hole to be loosely fitted accommodated, one or a plurality of pins of insertion has been bent shape or a straight shape distal end side along the respective guide holes, the screwed axially thrust into the internal thread of the body, after the pin and a pressing screw for pressing an end, After the serial body is being fitted and fixed through an outer surface engaging portion into the disc space between the vertebral bodies, it is pressed back end by the axial thrust of the pressing screw the pin is screwed into the internal thread of the body the distal end side are sequentially guided along the guide hole, characterized by comprising the interbody fusion device plugged into the vertebral body Te.

A second aspect of the present invention, and characterized in that a claim 1 interbody fusion surgical system according central outer diameter of the generally hollow cylindrical body is slightly formed on the thick drum-shaped to.

The invention according to claim 3, a interbody fusion surgical system of claim 1, wherein the pin is solid or hollow rod-like member or at least the distal end side or the entire length of any cross-sectional shape, including round or polygonal It is laminated wire with any cross-sectional shape that includes a plurality of thin plate or round or various flat over the made rod-like laminate of any cross-sectional shape including an integral round or polygonal, its distal end is sharpened like characterized in that it is formed.

The invention of claim 4 is the claims 1 to any one interbody fusion surgical system according to claim 3, wherein the one or more pins, internally threaded holes provided at the rear end proximal end portion is continuously provided is formed separately or integrally, from the pressing screw above the threaded direction of the body within the body by a reverse rotation operation, the body to between the vertebral bodies the of the fitting direction a removable from the body is removed from each of interbody by rotation and / or withdrawal operations in the reverse direction, after which the pin is inserted into the vertebral body, the pressing screw together withdrawn from the body, the pin is withdrawn from between the male thread portion the vertebral body by drawing driver with a tip portion which is screwed into the female screw hole in the proximal end configured to be removed from the body together with the body characterized in that it is.

The invention of claim 5 is the claim 4 interbody fusion surgical system according to the said pin base end portion of the internal thread in the hole, usually, interpolation is blind plugs with the engaged portion on the rear end portion it is fitted, prior to withdrawal operation of the pin can be taken out of the body is removed from the female screw hole by the driver provided with the engagement portion to which the blind plug is engaged with the engaged portion at the tip portion it is characterized in.

The invention of claim 6 is the claim 1 interbody fusion surgical system, wherein the outer surface engaging portion, characterized in that it is formed on the male screw shape.

The invention of claim 7 is a claim 1 interbody fusion surgical system, wherein the outer surface engaging portion, characterized in that it is formed in parallel to a plurality of spline teeth shape on the main shaft .

The invention of claim 8 is a claim 1 interbody fusion surgical system, wherein the outer surface engaging portion, characterized in that it is formed in parallel to a plurality of serrated to said main shaft.

The invention of claim 9, claim 1, an any one interbody fusion surgical system according to claims 6 to 8, the axial tipping and radial outer surface head of the outer surface engaging portion wherein the top portion is formed in a sharp edge shape.

The invention of claim 10 is a claim 1 or interbody fusion surgical system of any one of claims 9, the body has an opening for angiogenesis communicating respectively vertical and horizontal outer surface parts and bone ingrowth openings, characterized in that provided in plural.

The invention of claim 11 is a claim 1 or interbody fusion surgical system of any one of claims 10, the entire surface or part of the rear end face of the body to the rear end of the pressing screw wherein the cap covering is formed.

The invention of claim 12 is a claim 11 interbody fusion surgical system, comprising: a boss to be loosely fitted in the pressure screw, is erected in axial symmetry to the outer surface of the boss, the pressing screw boss rear face to the cap portion and further comprising a pair of arms tip is pressed are respectively engaged secured to the abdomen side front surface of the adjacent vertebral bodies, a fixing brace made of.

The invention of claim 13 is a claim 1 to any one interbody fusion surgical system according to claim 12, is loosely fitted housed in the internal thread of the body, the rear end portion of the pin and further comprising an abutment arranged the friction plates.

The invention of claim 14 is a claim 13 interbody fusion surgical system according, the rear end portion of the pin, or engages in the friction plate as movement in at least the lateral direction is restricted characterized in that it is fixed.

The invention of claim 15 is a claim 1 to claim 14 interbody fusion surgical system according to any one of the interbody fusion device has a combination of laparoscope from the abdominal side vertebral body the fixed during surgery, characterized in that it is fixed between the vertebral bodies.

The invention of claim 16 is a claim 1 to claim 15 interbody fusion surgical system according to any one of the tip of the shaft portion of the hollow elongated gripping portion is provided at the rear end have tips engaging portion engaged with the rear end engagement portion formed on the rear end portion of the main body of the interbody fusion device, engaging a tip engaging portion to the rear end engagement portion of the main body and in state, interbody space holding device for holding a proper spacing between the vertebral bodies are inserted from the living abdomen in the cannula in endoscopic abdominal portion formed to the front surface of the vertebral bodies adjacent the two is inserted in the hollow portion, characterized in that it comprises a body fitted driver to fit between the vertebral bodies by pressing or / and rotating the body.

The invention of claim 17 is a interbody fusion surgical system of claim 16, wherein said body fitting driver, the tip engaging portion made of metal, the shaft portion and characterized in that the polymer material to.

The invention of claim 18, claim 16 or a claim 17 interbody fusion surgical system, wherein the interbody fusion device to the distal end of the shaft portion of the elongated gripping portion is provided at the rear end have tips engaging portion engaged with the rear end engagement portion formed on the rear end portion of the pressing screws, said tip engaging portion while engaging with the rear end engagement portion of the pressure screw inserted into the hollow portion of the main body fitted driver that is screwed into the female screw by rotating while pressing by inserting the female threaded portion of the body of the pressing screws fixed the interbody fusion device in the disc space It is sequentially guided along the guide hole of the tip end side of the pin by axial thrust, characterized by further comprising a pressure screw driver plugged into the vertebral body with.

The invention of claim 19 is a claim 18 interbody fusion surgical system, wherein the pressure screw driver tip engaging portion made of metal, the shaft portion and characterized in that the polymer material to.

Interbody Surgical interbody space holding device of the invention of claim 20, when the interbody fusion surgery of a living body, correct the proper spacing between two adjacent vertebral bodies (vertebrae) an apparatus for holding the disc space, the rear end grasping unit is provided, it is inserted to the front vicinity of the vertebral body through the cannula of the endoscope in the lens for abdominal portion provided on biological ventral Te a first shaft portion of the hollow elongated, extending in the axial direction at the tip portion of the first shaft portion, the left and right side surfaces of the adjacent vertebral bodies the clamping and fixing claw tip to secure each It is connected, characterized in that it comprises a vertebral body clamping mechanism having at least a clamp arm of each pair can be opened and closed in a perpendicular plane of the vertebral bodies.

The invention of claim 21 is a claim 20 interbody fusion surgical interbody space holding device, wherein the vertebral body clamping mechanism, wherein the fixing claw is continuously provided to the distal end, a rear end portion each but the formed continuously to the first shaft portion of the tip, in the free state with an elastic support portion for bullet supported is bent to open and expanded in the orthogonal plane of the vertebral body, respectively the fixed claw pair and the clamp arm of the first is fitted in a freely advancing / retracting the shaft portion, said forward tip portion of the second shaft portion of the hollow elongated gripping portion is provided at the rear end elastic close the clamp arm of each pair in the diameter direction by pressing the support part from the outside, the clamp opening the clamping arms of each pair by the distal end is retracted from said elastic supporting member in the diameter direction characterized in that it comprises an arm opening and closing tube, a.

The invention of claim 22 is a claim 20 interbody fusion surgical interbody space holding device, wherein the vertebral body clamping mechanism, wherein the fixing claw is continuously provided to the distal end, a rear end portion There said first clamp arm of each pair of swingably pivoted to the distal end of the shaft portion via a first support shaft in the plane perpendicular to the vertebral bodies, the first shaft portion forward / backward is freely fitted, respectively one end via a second shaft portion of the hollow elongated gripping portion is provided at the rear end, the second support shaft to the middle portion of each pair clamp arms together parts are pivoted swingably, each pair of link members which are swingably pivoted through a third support shaft to the distal end portion of each of its other end the second shaft portion If made, the second the third and the respective pair of link members by the shaft portion is advanced or retracted Is swung counter-clockwise or clockwise the support shaft as a fulcrum to close the clamp arm of each pair in the direction of reducing the diameter as a fulcrum the first support shaft in the plane perpendicular to the vertebral body or diameter direction characterized in that it constitutes a toggle mechanism to open.

The invention of claim 23 is a Interbody Surgical interbody space holding apparatus according to any one of claims 20 to claim 22, wherein the vertebral body to vertebral body holding surface of the fixed pawl and having a side surface a plurality of sharp projections which can pierce the of.

Interbody Surgical interbody space holding device of the invention of claim 24, when the interbody fusion surgery of a living body, correct the proper spacing between two adjacent vertebral bodies (vertebrae) an apparatus for holding the disc space, the rear end grasping unit is provided, it is inserted to the front vicinity of the vertebral body through the cannula of the endoscope in the lens for abdominal portion provided on biological ventral Te a first shaft portion of the hollow elongated, rotatably extending along the outer surface of the first shaft portion in the axial direction, a screw portion formed on the tip of one or both of the adjacent vertebral bodies an elongated locking screw which is to Riley to the front portion fixing said the first projecting from the distal end of the shaft portion, one or both of the front portion piercing possible for one or more of the adjacent vertebral bodies characterized in that it comprises a needle-like protrusion, the.

The invention of claim 25 is a Interbody Surgical interbody space holding apparatus according to any one of claims 20 to claim 24, wherein the vertebral the distal end of the first shaft portion It is extended in the opposing state slightly narrower interval than the outer diameter along opposite axial direction to the interbody space of the body, the proper the adjacent vertebral bodies by being inserted from the tip into the disc space and further comprising at least one pair of spacers formed in the outer shape to hold and fix the spacing.

According to the present invention, a compact interbody fusion device has a matching contour to the proper spacing between adjacent vertebral bodies, the pressure screw of the body the body after fixed fitted in between the vertebral bodies since the distal end side of the pressed pin only screwed into the internal thread is a simple configuration that is fixed plugged into the vertebral body is guided along the guide hole, all using the laparoscope from the body main axis direction it is possible to perform interbody fusion treated easily in a short time only by pressing or / and screwed operation by uniaxial. Thus, since the operation scale as compared with the conventional interbody fusion surgery can be greatly greatly reduced with operation time and recovery period together with the reduction, physical and mental burden on medical staff including patients and doctors, patients of surgical stress and further it is possible to significantly reduce the economic burden.

In addition, the pin that is plugged into the vertebral body fixing can be prevented retraction and rotation from the correct position between the vertebral bodies of the interbody fusion device main body, reliability of the interbody fixation together it is ensured, pressed and / or screwed by operating interbody fixing structure and all by uniaxial body main axis direction is greatly simplified and compact as described above, more excellent vertebral bodies both operability and economy the effect of the so that it is possible to provide interbody fusion surgical system equipped between fixation device.

According to the second aspect of the invention, in addition to having effects similar to those the invention of claim 1, since the central outer diameter of the substantially hollow cylindrical body is slightly formed on the thick drum-shaped, vertebral It has the effect of being firmly fixed between the body.

According to the invention of claim 3, in addition to having effects similar to those the invention of claim 1, since the tip of the pin is formed on the sharp, readily to facilitate insertion of the pin within the vertebral body. The pin comprising a hollow rod-like body or the rod-shaped laminate is relatively easily with easy front end portion is deformed such as bending is improved operability guided smoothly along the guide hole of the body, in particular rod-like laminate pins made of has the effect of so that the degree of freedom in design is improved can be easily formed into an arbitrary shape.

According to the fourth aspect of the invention, in addition to having effects similar to those invention according to any one of claims 1 to 3, interbody fixation device is fixed between the vertebral bodies through a pin If the inadvertent purulent disorders due event infection occurs after the taken out to the outside of the body with the body by pulling out from between the vertebral bodies by drawing driver screwing the pin into the female screw hole of the base end portion, the interbody there is an effect that can be re-fixed between the vertebral bodies interbody fusion device again subjected to treatment such as stuffing aggregate as necessary and antibiotics.

According to the invention of claim 5, in addition to having effects similar to those the invention of claim 4, interbody the inside female screw hole by removably fitted to the blind plugs in the female screw hole of the pin base end portion from possible to prevent intrusion of foreign matters such as cerebrospinal fluid or osteogenic material, to facilitate easy and quick screwing withdrawal drivers female screw hole of the pin base end portion of the blind plug prior to pulling operation removed from the internally threaded hole of the pin the effect of improving the operability of the interbody fusion device removal since it is.

According to the invention of claim 6, in addition to having effects similar to those the invention of claim 1, since the outer surface engaging portion are formed on the male screw shape, easily screwed the body between the vertebral bodies there is an effect that can be.

According to the invention of claim 7, in addition to having effects similar to those the invention of claim 1, since the outer surface engaging portion are formed in a plurality of parallel spline teeth shape on the main shaft, pushing the body only a short time can be fitted in between the vertebral body fixed to, the effect of improving the operability.

According to the invention of claim 8, in addition to having effects similar to those the invention of claim 1, since the outer surface engaging portion are formed in a plurality of parallel saw-tooth to said main shaft, to press the body reliability of fixing by easily fitted to stopper between vertebral bodies in a short time with only the effect can be ensured.

According to the invention of claim 9, claim 1, in addition to having effects similar to those invention according to any one of claims 6 to 8, the axial tipping and radial outer surface of the outer surface engaging portion since the top portion is formed in a sharp edge shape has the effect of further facilitating the insertion of the body into between vertebral bodies.

According to the invention of claim 10, in addition to having effects similar to those invention according to any one of claims 1 to 9, the opening and bone plurality of angiogenesis in vertical and horizontal body outer surface since for ingrowth openings are provided, these openings with a passage to promote highly in contact with vascularized tissue angiogenesis surrounding the vertebral bodies, adjacent vertebral bodies facing surface bleeding the effect of promoting become passages interbody fusion to facilitate bone in tissue growth from. Thus, when the interbody is once fixed, the interbody fusion device itself becomes a fixed body of a type of bone mass.

According to the invention of claim 11, in addition to having effects similar to those invention according to any one of claims 1 to 10, a cap formed at the rear end of the pressing screw of the rear end of the body by covering the entire surface or a part, a bone morphogenetic protein that promotes the fixation it is effective in preventing leakage of osteogenic materials to be filled into the hollow interior body contained in the liquid carrier. The cap, by finally abuts on the front portion of the rear end surface or vertebral body of the main body, the pressing screw for reverse rotation frictional force of the pressing screw comes up with defining a screwing margin of the pressing screw into the inner body also it has a reverse-rotation preventing effect and which by pins retaining effect of.

According to the invention of claim 12, boss invention and in addition to having a similar effect, the cap portion of the arm tip portion of a pair of loosely fixation brace the pressing screw pressure screw of claim 11 since part rear end face are respectively engaged fixed to the front surface portion of the adjacent vertebral bodies by being pressed, together with the interbody fusion are strongly reinforced, rotating friction pressure screw by stiffness reaction force of the arm force can be further improved the retaining effect of the reverse rotation preventing effect and a pin by which the pressing screw for up.

According to the invention of claim 13, in addition to having effects similar to those invention according to any one of claims 1 to 12, the pin rear end pressing of the pressing screw is performed via the friction plate press it from, the gap a lot lateral direction between the pressing screw and the pin rear surface side and the pin rear end portion main body internal thread portion inner surface for the pin rear surface with frictional force decreases does not receive the rotational force of the direct pressing screws without receiving a force about to be done almost pressure screw also has the effect of pin it is can be pushed forward smoothly with screwed a small torque.

According to the invention of claim 14, in addition to having effects similar to those the invention of claim 13, engages the friction plate as the movement of the rear end portion of the pin to at least the lateral direction is restrained or fixed because it is the pin with the pin rear portion particularly is screwed into the female screw by without also pressing screw small torque received little force about to be pushed in more lateral direction of the gap between the main body internal thread portion inner surface there is the effect of improving reliability can be pushed smoothly.

According to the invention of claim 15, in addition to having effects similar to those invention according to any one of claims 1 to 14, wherein the interbody fusion device is used in combination laparoscope from the abdominal side vertebral from being fixed between the vertebral bodies by the body between the fixed surgery, both surgical time and recovery time with surgery scale compared to interbody fusion surgery from conventional back side is greatly miniaturized greatly reduced it therefore has the effect of physical and mental burden on medical staff including patients and doctors, patients surgical stress further it is possible to greatly reduce the economic burden.

According to the invention of claim 16, in addition to having effects similar to those invention according to any one of claims 1 to 15, the tip engagement portion grips the rear grip portion of the body fitting driver pressing or / and rotate inserted inside the hollow portion of the interbody fixation apparatus main body rear portion endoscopic abdominal portion of the inserted interbody space holding device within the cannula in engagement with the in It has the effect of facilitating the fitting and fixing operation of the interbody fusion device body to between vertebral bodies by.

According to the invention of claim 17, in addition to having effects similar to those the invention of claim 16, the body fitting driver is made of tip engaging portion a hard metal, the shaft portion is high, such as lightweight resins overall it can compose a molecular material is lightweight, has an effect of improving the operability.

According to the invention of claim 18, in addition to having effects similar to those the invention of claim 16 or claim 17, after the pressure screw on the tip engaging portion grips the rear grip portion of the pressure screw driver end inserted in engagement with the hollow portion of the body fitting driver to its axis a pressure screw screwed into a female screw by rotating while pressing by inserting the female threaded portion of the body of the interbody fixation devices while guided along the sequentially guide hole of the tip end of the pin by the direction thrust can plugged into the vertebral body, it has the effect of facilitating the pin insertion fixing operation by uniaxial body main axis direction.

According to the invention of claim 19, in addition to having effects similar to those the invention of claim 18, made of a hard metal tip engaging portion main body fitted driver, the shaft portion, such as lightweight resin polymer overall it is possible to configure a material is lightweight, has an effect of improving the operability.

According to the invention of claim 20, the two adjacent interbody fusion surgical interbody space holding device for holding the disc space to fix the proper spacing between the vertebral bodies is fixed vertebral body clamping mechanism the left and right side surfaces of the adjacent vertebral bodies since the pinching respectively fixed by nails, then vertebral bodies relatively large external force is loaded backward or when the interbody fusion device is implanted fixed between the vertebral bodies at the right and left there is an effect that reliability is ensured interbody space retention in interbody fusion surgery for not displaced laterally of.

According to the invention of claim 21, in addition to having effects similar to those the invention of claim 20, each having an elastic support portion by advancing or retracting the fitted on the clamp arm open pipe to the first shaft portion from opening to closing or diameter direction a pair clamp arm direction of reducing the diameter, the effect of the structure and operation of the interbody space holding device for clamping and fixing the left and right side surfaces of adjacent vertebral bodies is simplified there is.

According to the invention of claim 22, in addition to having effects similar to those the invention of claim 20, the clamping arms of each pair of vertebral clamping mechanism is pivotally mounted to the distal end portion of the first shaft portion and includes a link member of each pair is pivotally attached to the distal end portion of the second shaft portion, diameter of the clamping arms of each pair in a plane perpendicular to the vertebral body by the second shaft portion is advanced or retracted from what has been constituting the toggle mechanism that opens the closed or expanded in the direction, clamping / fixing force of the left and right side surfaces of the adjacent vertebral bodies is strong reduction, the effect of further improving the reliability of the interbody space holding device is there.

According to the invention of claim 23, in addition to having effects similar to those invention of any one of claims 20 to claim 22, easily piercing the side surface of the plurality of pointed projections vertebral body fixing claw an effect of reliability is further improved to firmly fix / hold vertebral body was.

According to the invention of claim 24, the two adjacent interbody fusion surgical interbody space holding device for holding the disc space to fix the proper spacing between the vertebral bodies, the first shaft portion the outer surface and the elongated fixed respectively provided at distal threaded member and the needle-like projections, the respective front portions of one or both of the adjacent vertebral bodies screwed, since fixing with a retaining effect missing piercing the structure and operation with is simple, then the side of the vertebral body a relatively large external force is loaded backward or left and right when the interbody fusion device is implanted fixed between the vertebral bodies of the interbody space holding device there is an effect that reliability of the interbody space retention in interbody fusion surgery is ensured since no displaced towards.

According to the invention of claim 25, in addition to having effects similar to those invention of any one of claims 20 to claim 24, vertebral clamp mechanism or long in one interbody space holding device since having both a pair of spacers having an outer shape that holds to fix the proper spacing of adjacent vertebral bodies by being inserted into the fixing screw member / needle-like projections and the disc space, interbody fusion fixed and fixed / held in proper spacing between adjacent vertebral bodies in surgery can be performed in a short time at the same time. Accordingly, it is possible to shorten the operation time as compared with the conventional interbody fusion surgery, physical and mental burden on medical staff including patients and doctors, patients surgical stress further has the effect of reducing the economic burden .

Is an embodiment vertical sectional view showing the concept of interbody fusion surgery system (Example 1) (the main portion cross-section) of the present invention. It is a vertical sectional view showing the concept of the interbody fusion device of the first embodiment of the present invention (the main part cross-section). It is an A-A arrow view of FIG. (A) it is taken along line B-B sectional view of FIG. 2, (b) is taken along line C-C sectional view of FIG. (A), (b), (c), (d), (e), (f) is a partial sectional view illustrating a pin concept of another alternative embodiment of the present invention, respectively. Is a D-D arrow sectional view of FIG. It is a plan view of FIG. It is a longitudinal sectional view showing a fitted state to between vertebral bodies of the interbody fusion device main body of FIG. 2 (the main portion cross-section). It is a longitudinal sectional view showing a locking completion state to between vertebral bodies of the interbody fusion device of FIG. 2 (the main portion cross-section). It is E-E in arrow view of FIG. Is another embodiment longitudinal sectional view showing the locking completion state to between vertebral bodies of the interbody fusion device (Example 2) (main part cross-section) of the present invention. A F-F arrow view of FIG. 11. It is yet another embodiment of the vertical sectional view showing the concept of interbody fusion device (Example 3) (the main part cross-section) the present invention. A P-P arrow view of FIG. 13. It is yet another embodiment of the vertical sectional view showing the concept of interbody fusion devices of Example 4 (the main part cross-section) the present invention. (A) the G-G cross-sectional view taken along the friction plate of FIG. 15 is a H-H cross-sectional view along a line (b) is (a). It is yet another embodiment of the vertical sectional view showing the concept of interbody fusion device of Example 5 (the main part cross-section) the present invention. A Q-Q arrow view of FIG. 17. It is a plan view of FIG. 17. It is yet another embodiment vertical sectional view showing the concept of interbody fusion apparatus (Example 6) (main part cross-section) of the present invention. It is a R-R arrow view of FIG. 20. It is a plan view of FIG. 20. It is yet another embodiment of the vertical sectional view showing the concept of interbody fusion device of Example 7 (main part sectional) present invention. (A) is a vertical sectional view showing the concept of interbody fusion device of yet another embodiment of the present invention (Example 8) (main part cross), I-I Yashiyo of (b) is (a) parts is a cross-sectional view. It is yet another embodiment of the vertical sectional view showing the concept of interbody fusion apparatus (Example 9) (main part sectional) present invention. It is yet another embodiment vertical sectional view showing the concept of interbody fusion devices (Example 10) (main part cross-section) of the present invention. Vertical sectional view showing the concept of interbody space holding device according to an embodiment of the present invention (upper half section). It is a plan view of the interbody space holding device of FIG. 27 (upper half section). A U-U arrow view of FIG. 27. Plan view showing the concept of another embodiment of the interbody space holding apparatus of the present invention (upper half section). It is a longitudinal sectional view of the interbody space holding device of FIG. 30 (upper half section). It is V-V in arrow view of FIG. 31. It is a longitudinal sectional view showing still concept of interbody space holding device of another embodiment of the present invention (upper half section). It is a plan view of the interbody space holding device of FIG. 33 (upper half section). A W-W arrow view of FIG. 34. It is a vertical sectional view showing the concept of a body fitting driver of an embodiment of the present invention (upper half section). Is S-S arrow view of FIG. 36. Is a side view showing the concept of pressure screw driver of one embodiment of the present invention. It is a T-T arrow view of FIG. 38. It is a vertical sectional view showing the concept of the interbody fusion surgical system of alternative embodiment of applying the interbody space holding device of FIG. 33 of the present invention (the main part cross-section). (A) is a side view conceptually showing the lithotomy position status of patients in interbody fusion surgery of an embodiment of the present invention, the (b) is continued Trendelenburg position state of the patient (a) conceptually it is a side view showing the. Is a plan view conceptually showing the arrangement of ports for laparoscopic abdominal side of the patient in the interbody fusion surgery of an embodiment of the present invention. Is a side view schematically showing the treatment steps from the abdominal side of the patient in the interbody fusion surgery of an embodiment of the present invention. It is yet another embodiment of the vertical sectional view showing the concept of interbody fusion devices (Example 11) (main part sectional) present invention. Is X-X in arrow view of FIG. 44. It is yet another embodiment vertical sectional view showing the concept of interbody fusion devices (Example 12) (main part cross-section) of the present invention. It is a Y-Y arrow view of FIG. 46. It is a perspective view of a conventional first example of interbody fusion devices. Interbody fusion device of the second conventional example is a longitudinal sectional view of a state of being fixed between the vertebral bodies (the main part cross-section). Conventional typical interbody space holding device is a perspective view of (ventral lordosis extended outer sleeve). Interbody space holding device of FIG. 50 (ventral lordosis extended outer sleeve) is a side view of a state of being inserted between the vertebral bodies.

Hereinafter, the interbody fusion surgical system of the present invention, a specific example of a form for best implementing the surgical method and interbody space holding apparatus will be described in detail with reference to the accompanying drawings.

Figure 1 is one embodiment vertical sectional view showing the main configuration concept of the interbody fusion surgery system (Example 1) of the present invention (the main part cross-sectional), interbody Example 1 of FIG. 2 is the invention vertical sectional view showing the concept of a fixed apparatus 10 (main part cross-section), FIG. 3 is a-a sectional view taken along line of FIG. 2, FIG. 4 (a), (b) in each Figure 2 B-B sectional view taken along a line FIG, C-C sectional view taken along line, FIG. 5 (a), the pin concept of another alternative embodiment of (b), (c), (d), (e), (f) the present invention, respectively partial sectional view illustrating, FIG. 6 is D-D arrow sectional view of FIG. 2, FIG. 7 is a plan view of FIG. 2, the fitting state of Fig. 8 to between vertebral bodies L1, L2 of the interbody fusion device 10 vertical sectional view showing (main unit section), FIG. 9 is a longitudinal sectional view showing a locking completion state to between vertebral bodies L1, L2 of the interbody fusion device 10 (main part cross section), Fig. 10 in FIG. 9 E- E, which is an arrow view. The drawings appended hereto is a conceptual diagram showing the main configuration concepts expressed in knots scale enlarged radially than axially for both ease of internal structure.

Interbody surgical system of an embodiment of the present invention, as shown in FIG. 1, the male screw shape is fitted engaged between vertebral bodies L1, L2 substantially hollow cylindrical outer surface of the front bottom is the outer surface engaging portion 14, 15 of forming one or more guide holes 17 and 18 penetrating from the female screw 16 inside surface provided on the rear end side hollow inner surface 16a to widen the outer surface vertebral body direction is bored and body 11, one or more pins 30 are loosely fitted accommodated in the guide hole, and a difference in the vertebral body along the front end side of the pin presses the threaded pin-rear in the internal thread 16 in the guide hole writing a pressing screw 40, the two with the adjacent vertebral bodies (vertebrae) L1, L2 between the interbody fusion device 10 which fit into the disc space M to secure the vertebral bodies L1, L2, and interbody fusion device 10 prior to implantation fixed between vertebral bodies L1, L2, belly biological e.g. human MN A cannula K to be inserted into the endoscope in a port Ma drilled toward the center between the vertebral bodies L1, L2 from the MN1 side, inserted into the cannula K, proper spacing between vertebral bodies L1, L2 vertebral a state where the interbody space holding device 70 for holding the disc space M with fixed and engaged with the rear end engagement portion 29 of the body 11 of the interbody fusion device 10 to the distal end engagement portion 83 insert in the hollow portion of the body between the space holding device 70, a body fitting driver 80 which is fitted between the vertebral bodies L1, L2 and pressed by rotating the body 11, the pressing of the interbody fusion device 10 to the distal end engagement portion 93 inserted into the hollow body fitted driver 80 while engaging with the rear end engagement portion 44 of the screw 40, the pressure screw driver 90 causes threaded while pressing inserting the pressure screw 40 to the female screw portion 16 of the body 11 , comprising a.

Furthermore, since the treatment of observation and various pre / post during interbody fusion surgery, the endoscope both inserted separately from a plurality of endoscopic abdominal cavity (not shown) (or laparoscopic) or body fitted it is desirable to provide a capsule endoscope or the like which is Osamu設 to the driver 80 in the hollow.

Interbody fusion device 10 of the first embodiment of the present invention is formed in the vertebral body L1, substantially hollow cylindrical front end bottomed compatible with proper spacing between L2, facing surfaces of the vertebral bodies L1, L2 to the outer surface L1a, a body 11 externally threaded outer surface engaging portions 14 and 15 are formed to the outer surface top portion L2a portion is fitted engaged, it is formed on the rear face 13 side of the hollow inner surface 16a of the body 11 internal thread 16, vertebral bodies L1 from the depth of the female screw 16, L2 of the opposing surfaces L1a, a pair of bored through to the outer surface inclined in a substantially axial symmetric diverging radially towards the L2a guide hole 17, 18, is loosely fitted housed along the main axis C1 of the body 11 into the female screw 16, a pin 30, 30 of a pair of front end 32 side is inserted bent is guided along the respective pair of guide holes 17, 18 by screwed axially thrust the female screw 16, the pin 30 , A pressing screw 40 for pressing the 30 of the rear end 31, it is schematically composed.

Body 11 has a formed contour to retain the proper spacing between vertebral bodies L1, L2, facing surfaces of the two vertebral bodies L1, L2 L1a, substantially parallel surface or back side direction between L2a substantially hollow cylinder as shown in FIG. 1 so as to correspond to a case that is the 9 ° front and rear inclined surfaces shaped with respect to reduced shrinkage for example a horizontal plane, slightly central outer diameter for example 0.1mm order thick drum Jo to be formed. Body 11, depending on the size of such thickness i.e. the depth of the vertebral body L1, L2, in the vertebral body L1, L2 for example approximately the outer diameter of 18 ~ 22 mm which is accommodated between the total length of about 25 mm ~ 45 mm. In this case, the front end surface 12 of the body 11 is formed in a substantially conical shape which is not convex surface or illustrated, is disposed between the vertebral bodies L1, L2 sufficiently short of the nerve section so as not to touch the nerves of the back of the spinal column it is required.

Body 11 is formed from a sufficient strength and material or inert material having a biocompatible to withstand compressive forces of the mighty e.g. 1000kg order between vertebral bodies L1, L2. These materials, such as stainless steel medical grade (SUS), titanium (Ti), include a porous material such as porous tantalum composite material, Ti is preferred from the particular strength and weight point.

The outer surface of the body 11, opposite surface L1a vertebral body L1, L2, male thread 15 is formed as an outer surface engaging portion for engagement engagement gouge the outer surface top portion L2a unit. Is desirable extent to which the core diameter of the external thread 14 and 15 facing surface L1a of the vertebral bodies L1, L2, almost in contact with the distance between L2a, thread height of the external thread 14, 15 is, for example, approximately about 3 ~ 4 mm weak. External thread 14 and 15, it is desirable that the main body 11 by the high load on the spine is fully engaged in the vertebral body L1, the L2 so as not pushed out from between vertebral bodies L1, L2. The pitch of external thread 14 and 15, the interbody fusion device 10 in accordance with the threaded engagement amount needed to hold in place between the vertebral bodies L1, L2, for example, approximately 2 to approximately 3 mm. Thread height and pitch of the external thread 14 and 15, may of course be formed on the smaller value as needed.

In this embodiment, as shown in FIG. 3, 4, 6, 7, the body 11 is substantially parallel cut sides crown of the left and right sides of the rear of the outer surface, leaving the front face 12 side is cut at an appropriate width 19, 19 are formed. Thus, the external thread 15 of the front face 12 side is a whole circumference complete thread, male thread 14 formed on the upper and lower outer surface of the cross section cylinder behind the cut sides 19, 19 are formed has a portion screw. Axial tip (threaded end) and the radially outer surface top of the external thread 15 is formed in a sharp edge shape, the male screw 15 is fully threaded on the front end face 12 side, vertebral bodies L1 body 11 as the head screw it can make easily threaded between L2.

When forming the cut sides 19, 19 along the entire length of the main body 11, opposing surfaces L1a of the vertebral bodies L1, L2 without threaded body 11 when the body 11 in the transverse shown 90 °, easily inserted between L2a it is also possible to. In this case, by which the longitudinal body 11 to rotate after insertion 90 ° between vertebral bodies L1, L2, as shown in FIG. 8, the body 11 holds the proper spacing between vertebrae L1, L2 It is fixed. Further, the cut sides 19, 19 facing surface L1a vertebral body L1, L2, is suitable to provide an area for bone-shaped fixing by bone ingrowth between L2a.

Moreover, tongue rear end of the cut sides 19, 19 of the body 11, which upon insertion fixation to between vertebral bodies L1, L2 of the interbody fusion device 10, both provided at the distal end of the shaft of the implant driver (not shown) It has also become to be gripped by (Kyojigu). Incidentally, the graft driver can utilize any known, will be described later body fitting driver of an embodiment of the present invention which is fitted to the body 11 between the vertebral bodies L1, L2.

The hollow inner surface 16a drilled from the rear face 13 side of the main body 11, together with the female screw 16 of suitable depth is formed, in a substantially axially symmetric hollow inner surface 16a of the depth of the female screw 16 into the vertebral body L1, L2 direction widen the tilt angle Θ1 relative to the main axis C1, a pair of upper and lower guide holes 17, 18 penetrating to the outer surface along the inclined axis C2, C3 of Θ2 is bored. Inclination angle .theta.1, .theta.2 is appropriately determined according to the condition of the vertebral bodies L1, thickness and flexibility, etc. of the arrangement state and the pin 30 of L2, both may be set substantially equal to or slightly different tilt angles. In the same condition, the pushing force of the pin 30 tends as substantially proportional to the inclination angle .theta.1, .theta.2.

Incidentally, both not shown, the tilting axis C2, C3, unless protrude the tip 32 of the pin 30 is pushed in from the outer surface of the vertebral bodies L1, L2, and asymmetrically arranged in any directions relative to the main axis C1 it may be, or may be disposed in the plane of the eccentric and any direction relative to the main axis C1.

Further, the main body 11, as shown in FIGS. 2 to 4, 6 and 7, etc., a plurality of openings, such as side opening 21, 22, 23 and upper and lower surfaces openings 24, 25, 26 are bored. Then, as shown in FIGS. 2-4, etc., small holes 28 to the side opening 21 and the communicating both upper and lower surfaces openings 24 in the distal end surface of the hollow inner surface 16a are bored. Side opening 21, 22 and 23 in contact with the vertebral bodies L1, L2 were highly vascularized surrounding tissues to promote angiogenesis, the opposing surfaces of the upper and lower surfaces openings 24, 25, 26 vertebral bodies L1, L2 L1a, promotes bony fixation by bone ingrowth between L2a. Therefore, it is desirable to bored to minimize communication with each other a large number of openings as long as they do not impair the strength to the body 11.

Further, the rear end face 13 of the main body 11, a plurality of, for example 6 partial arcuate opening along the rear end opening 27 and the circumference of the pair are drilled. The partial arc-shaped opening is a rear engaging portion 29 that engages distal engaging portion fitted in the body fitting driver described later for fitting the body 11 between the vertebral bodies L1, L2. Rear engaging portion 29, instead of such a partial arc-shaped opening, engaging the hexagonal tip engaging portion of the body fitting driver either example, the rear end face 13 side provided grooves hexagonal not shown it may be engaged.

Incidentally, the porous tantalum body 11 - in the case of using a porous material such as carbon composites, for example, US-in plex trade names "Hedoroseru (HEDROCEL)", the side opening 21, 22, 23 and top and bottom surfaces as described above it is not necessary to provide an opening 24, 25, 26, it can be perforated portion connected to each other to promote the ingrowth and vascularization of the bone. The porous material, with similar to bone structure of porous, since it has an elastic modulus close to the elastic modulus of human bone, the interbody fusion device of the present invention can be said optimum.

Pin 30, 30 of the pair are loosely fitted accommodated in parallel to the main shaft C1 direction vertically to the female screw 16, respectively rear 31 side of the distal end 32 side, respectively pair with extending along the major axis C1 of the main body 11 is inserted bent is guided along the guide hole 17, 18. Each tip 32 is formed in a suitably pointed shape, the body 11 vertebral bodies L1, in the valley diameter or less of the external thread 14 in the initial state before plugged in between L2, i.e. so as not to protrude from the root diameter guide hole 17, It is housed in 18 the outlet of.

Pin 30 of the embodiment is made solid or hollow rod-like body of any cross sectional shape such as round or polygonal, as shown in FIGS. 3-4, etc., for example, one side by a square bar of several mm, Ti softer than manufacturing of the body, and the like with appropriate flexibility and strength for example medical grade SUS.

Further, instead of the pin 30 consisting of solid or hollow integral rod-like body in this embodiment, FIG. 5 (a is a partial cross-sectional view of a definitive Likewise direction of the pin in FIGS. 4 (a) or (b) ) as shown in ~ (f), the wire 30Bn, 30En, 30Cn, integrally with 30Fn is laminated with at least a plurality of sheet materials over the front end side or the entire length 30An, 30Dn or round, various flat cross section such arbitrary section type can a round or respectively another variation of the pin 30A made of rod-like laminate of any cross-sectional shape such as polygon, 30B, 30C, 30D, 30E, also with 30F.

Variation of pins 30A, 30B, 30C are respectively diagrams 5 (a), (b), as shown in (c), at least the tip side or along the entire length a plurality of thin plate 30An, round wire 30Bn, oval flat wire 30Cn are laminated is formed on the rod-shaped laminate integral substantially square cross-sectional shape.

Variation of pins 30D, 30E, 30F are respectively diagrams 5 (d), (e), (f), the at least a tip side or a plurality of different thin plate width over the entire length 30Dn, round wire 30En , oval flat wire 30Fn are laminated is formed on the rod-shaped laminate integral rhombic cross-sectional shape.

Pins 30A such variations of a laminate, 30B, 30C, 30D, 30E, 30F are mutually thin plate 30An of the root portion to retain the shape, 30Dn or wire 30Bn, 30En, 30Cn, the 30Fn respectively It is integrally formed by adhering or welding the desirable. Thus, the tip side each thin plate 30An, 30Dn or wire 30Bn, 30En, 30Cn, 30Fn are guided along the guide hole 17, 18 of the body 11 because each free state easily relatively easily bent becomes, the operability guided smoothly is improved along the body of the guide hole. Furthermore, the pin 30A ~ 30F made of these laminates, it is easy to form laminated integrally into any shape, the degree of freedom in design is improved.

Therefore, the inner diameter of the female screw 16 and the hollow inner surface 16a, the outer diameter of the thickness and the body 11 of the pin 30 or 30A ~ 30F and is appropriately determined from the balance of strength and the like of both. The hollow inner surface 16a also has the role of the lower hole of the female screw 16.

Pressure screw 40, as shown in FIGS. 8 and 9, a substantially disc flange entirely or partially cover the size of the rear end face 13 of the rear end to the body 11 of the male screw portion 41 screwed into the internal thread 16 of the body 11 Jo cap 42 is continuously provided. The length of the cap 42 consecutive 設面 the male screw portion 41, the pin 30 corresponds to pin 30 pushing strokes corresponding to the length plugged into the vertebral body L1, L2, the stroke screw pressing screw 40 into the internal thread 16 cap 42 consecutive 設面 when is input it is desirable to set such a state of contact with the rear surface 13 side of the main body 11. The size of the cap 42 can be sized to cover between vertebral bodies L1, L2 as required. The material of the pressing screws 40, like the main body 11, SUS medical grade, Ti, include a porous material such as porous tantalum composite material, in particular strength and Ti from lightweight point, bone ingrowth and from promoting angiogenesis it is preferred such as a porous tantalum composite material.

The rear end surface of the cap 42, the distal engagement portion of the implant driver or below the pressure screw driver, for example, as a rear engagement part for engagement, as shown in FIG. 10, the cross groove 44 is formed. Rear engaging portion 44 may be drilled hexagonal hole which the tip engaging portion, for example formed in a hexagonal wrench-like implant driver or pressure screw driver (not shown) either in place of the cross groove is engaged .

Figure 27 is a longitudinal sectional view showing the concept of interbody fusion surgical interbody space holding device 70 of an embodiment of the present invention (upper half section), FIG. 28 interbody space holding device of FIG. 27 70 a plan view of the (upper half section), FIG. 29 is a U-U arrow view of FIG. 27.

One embodiment interbody space holding device 70 of the present invention, the rear end grasping unit 72 are provided on the cannula K endoscopic within the lens for abdominal portion Ma provided biological abdomen MN1 side (see FIG. 1) the first shaft portion 71 of the hollow elongate, and in the axial direction at the tip portion 71a of the first shaft portion 71 extends to be inserted to the front surface near the vertebral bodies L1, L2 through the adjacent vertebral body L1, L2 of the left and right sides of the holding device fixing claws 74b for sandwiching and fixing each having a clamping arm 74 and 74 of at least the one pair can be opened and closed by being connected to the distal end in the orthogonal plane of the vertebral bodies L1, L2 a body 70a, is fitted freely forward / backward to the first shaft portion 71, the grip portion 77 made from the second shaft portion 76 of the hollow elongated provided at a rear end, each by forward or backward a pair of the clamp arm 74 and 74 A clamp arm closing pipe 70b open to closed or enlarged to a radial direction, consisting of. Constitute a vertebral clamp mechanism and a holding device body 70a and the clamp arm open tube 70b.

Holding the device body 70a of this embodiment, as shown in FIG. 28, the fixing claws 74b are continuously provided at the distal end, a rear end portion is continuously provided to the distal end portion 71a of the first shaft portion 71, in the free state comprises a clamp arm 74, 74 of each pair having an elastic support portions 74a to bullet supported is bent to open the fixing claws 74b, respectively diametrically enlarged in a plane perpendicular to the vertebral bodies L1, L2.

Then, the clamp arm open tube 70b is reduced as indicated by two-dot chain line the clamp arm 74, 74 of each pair by the tip portion 76a of the second shaft portion 76 presses the elastic support portions 74a to advance from the outside closed in the radial direction to open the clamp arms 74 and 74 of each pair by the distal end 76a is retracted from the elastic support portions 74a to diameter direction indicated by two-dot chain line. Clamp arm 74, 74 of each pair is minimized closed when C1 axial position of the distal end portion 76a of the second shaft portion 76 is X1 (fully closed position), X2 of (vertebral bodies gripping / locking position) when the left and right sides of the vertebral body L1, L2 grip / fixed, open up when X3 (fully open position).

The vertebral body holding surface of the fixing claw 74b has a puncture can be more pointed projections 74c on the left and right sides of the vertebral body L1, L2.

The holding device main body 70a of this embodiment, along the first tip portion 71a to the vertebral body L1, facing axis direction slightly narrower interval than the outer diameter of L2 in the space M between the vertebral bodies of the shaft portion 71 opposite is extended in a state, at least one pair of spacers 73 formed on the outer shape to hold correct the vertebral body L1, L2 adjacent to the proper spacing by being inserted into the disc space M from the distal end , further comprising a 73. A pair of spacers 73, 73 and clamp arm 74, 74 of each pair provided in each plane the main shaft is shifted approximately 90 °.

Do you child stranded, the configuration of the holding device main body 70a, the structure and operation is simplified, a vertebral body L1, L2 of a pair of spacers 73, 73 are adjacent by being inserted into the disc space M from the tip proper holds to fix the intervals, the left and right sides of the vertebral body L1, L2 adjacent since the nipped respectively fixed by a fixing claw 74b having a plurality of pointed protrusions 74c of the clamp arm 74, 74 of each pair, proper spacing modifications vertebral body L1, L2 adjacent the interbody fusion surgery and reliable fixing / holding can be performed in a short time at the same time. Thus, it is possible to shorten the operation time as compared with the conventional interbody fusion surgery, physical and mental burden on medical staff including patients and doctors, patients surgical stress more be further reduced economic burden it can.

Figure 30 is deformed plan view showing the concept of the interbody fusion surgical interbody space holding device 70 'embodiment (the upper half section), FIG. 31 interbody space holding device of FIG. 30 of the present invention longitudinal sectional view of 70 '(upper half section), FIG. 32 is a V-V in arrow view of FIG. 31. The components having the same functions as the one embodiment of this embodiment are denoted by the same reference numerals and symbols for simplicity the description be different slightly geometry.

Interbody space holding device 70 'of this alternative embodiment, via the first support shaft P1 at the tip portion 71a of the embodiment similar to the first shaft portion 71, and a first shaft portion 71 vertebral bodies L1, L2 perpendicular plane in which swingably overlapping engagement of the pivoted, each pair clamp arm of the same fixing claws 74b and an embodiment is connected to the distal end of the support portion 74'a 74 ', a holding device body 70'a with 74', the embodiment similar to the second shaft portion 76 and the pair of clamp arms 74 ', the counter-overlapping surface side of the intermediate portion of the 74' with each one end via a second support shaft P2, P2 is pivotally mounted superimposed swingably, each other end portion protruding from the distal end portion 76a of the second shaft portion 76 bracket 78 to the third support shaft P3 around the pivotally overlapped together is by pivot And the clamp arm open tube 70'b having a link member 79, 79 of each pair which consists of.

Holding the device body 70'a and the clamp arm open tube 70'b constitute the vertebral body clamping mechanism. The vertebral bodies clamping mechanism alternative embodiment, the support portion 74'a is formed in a shape larger rigidity Unlike elastic support portion 74a having an appropriate elasticity of the embodiment, as shown in FIG. 30 , the second of each pair of the link members 79, 79 third support shaft P3 around is swung counter-clockwise or clockwise each pair clamp arm by a shaft portion 76 is moved forward or backward 74 ', constitute a toggle mechanism that opens the first closed or expanded direction reducing the diameter direction indicated either by a two-dot chain line a support shaft P1 as a fulcrum in a plane perpendicular to the vertebral bodies L1, L2 and 74' . Each pair of clamp arms 74 ', 74', C1 axial position of the distal end portion 76a of the second shaft portion 76 is X1' closed minimum when (fully closed position), X2 (vertebral bodies gripping / fixed position) left and right sides of the vertebral body L1, L2 grip / fixed time, open up when the X3' (fully open position).

Interbody space holding device 70 'of this variant embodiment, since the vertebral bodies clamping mechanism comprising a holding device body 70'a and the clamp arm open tube 70'b constitute a toggle mechanism, the adjacent vertebral bodies L1, clamping / fixing force of the left and right side surfaces of L2 is mighty of the reliability of the interbody space holding device can be further improved.

Also, interbody space holding device 70 'of this modified embodiment, similar to the first shaft portion 71 of the tip portion 71a the interbody space holding device 70 of the embodiment, the adjacent vertebral bodies L1, the L2 corrected to proper intervals further comprises at least one pair of spacers 73, 73 formed in the outer shaped to hold.

The first and second shaft portions 71 and 76 of the interbody space holding device 70,70' the above embodiment and alternative embodiments, as shown in FIG. 29 and 32, both e.g. substantially elliptic , it is formed in a hollow shape corresponding to the outer shape / dimensions of the vertebral body, such as substantially circular or substantially polygonal cross-section which substantially no oval or substantially square cross-section or shown. Then, for example, when, as the first shaft portion 71 than the shaft portion 81 of the body fitting driver becomes considerably large, in the first shaft portion 71, the interbody fusion device is inserted 10 or between vertebral the body 11 of the fixing device 10 for the insertion guide shaft portion 81 of the body fitting driver described later to fit between the vertebral bodies L1, L2, the maximum outer diameter of, for example 2mm interbody fusion device 10 or the shaft portion 81 greater extent the inner diameter of the guide tube 71b (indicated by two-dot chain line) may be provided if necessary.

Further, as shown in FIG. 27 to 29, may be provided in accordance with the reinforcing plate 75, 75 over hung on the inner surface corresponding to 74 and 74 parts clamp arm of the left and right front end portion of the first shaft portion 71 as required . In this case, the distance between the reinforcing plate 75, 75 is slightly for example, at least about 2mm larger than the maximum outer diameter thereof so as not to interfere with the interbody fusion device 10 or the shaft portion 81.

Figure 33 is a longitudinal sectional view showing still concept of interbody space holding device 70'' of another alternative embodiment of the present invention (upper half section), FIG. 34 interbody space holding device 70 'of FIG. 33 plan view of the '(upper half section), FIG. 35 is a W-W arrow view of FIG. 34. The components having the same function as the embodiment of this embodiment are denoted by the same reference numerals and symbols for simplicity the description be different slightly geometry.

Interbody space holding device 70'' this alternative variant embodiment, the rear end grasping unit 72 are provided on the cannula K (FIG. 1 of the endoscope in the lens for abdominal portion Ma provided biological abdomen MN1 side a first shaft portion 71 'of the hollow elongated to be inserted to the front surface near the vertebral bodies L1, L2 via the reference), rotatably extending along the axial direction on the outer surface of the first shaft portion 71' is a long fixing screw member 76'b which are threaded portion 76'a formed on the tip is to Riley to the front portion of one or both of the vertebral body L1, L2 adjacent fixed, the first shaft portion 71 projecting from the distal end portion 71'a of ', and a piercing possible one or more needle-like projections 71c on the front part one or both of the adjacent vertebral bodies L1, L2.

Elongate locking screw 76'b is rotatably inserted into the insertion hole 75c of the first rear support erected on the outer surface of the shaft portion 71 'members 75a and the front support member 75b, the rear end portion and a head portion 76'c having unillustrated driver or wrench engaging groove or hexagonal external shape.

Elongate locking screw 76'B, rear support member 75a and the front support member 75b constitutes a vertebral body fixing mechanism 76 ', a rear end portion or gripping the first shaft portion 71' which is inserted into the cannula K the needle-like projections 71c of the pressing to the distal end portion through a section 72 after the puncture in the front portion of one or both of the vertebral body L1, L2 adjacent, via the head 76'c elongate locking screw 76 ' b is rotated while example clockwise pressed Riley and fixed to the front portion of one or both of the vertebral bodies L1, L2 and.

Interbody space holding device 70'' of this variant embodiment, the first shaft portion 71 'of the outer surface and the tip vertebral body fixing mechanism respectively provided on 71'A 76' and barbs 71c, adjacent vertebral bodies L1, respectively screwed to the front portion of one or both of the L2 that, since the fixing with a retaining effect piercing, as well as the structure and operation is simple, the interbody fusion device 10 thereafter trust interbody space holding the vertebral bodies L1, L2 a relatively large external force is loaded in the interbody fusion surgery since no displaced backward or left and right side when porting fixed between vertebral bodies L1, L2 sex is ensured.

Incidentally, the grip portion 72 and 77 includes first, second shaft portion 71,71', boss 72a which is fitted to the rear end 76 which is set to a length that sequentially exposed to the outside of the respective cannula K can have been formed in at least one pair or a plurality of handle (handle) like erected on the 77a, formed in a known cylindrical or other arbitrary grasping shape (not shown).

The first, second shaft portion 71,71', 76 of the tip and other clamping mechanisms, the rear member of the shaft portion except for the members such as vertebral body fixing mechanism 76 'and the spacer 73,73', for example it can be constructed of a lightweight polymeric material such as a resin. Interbody space holding device 70,70', 70'', it is desirable to improve the operability by weight of the entire like constituting in combination as much as possible lightweight Ti and polymeric materials.

Figure 36 is a longitudinal sectional view showing the concept of the body fitting driver 80 of an embodiment of the present invention (upper half section), FIG. 37 is S-S arrow view in FIG. 36, one embodiment of FIG. 38 is the invention side view showing the concept of pressure screw driver 90 of FIG. 39 is a T-T arrow view of FIG. 38.

Body fitting driver 80 of an embodiment, the grip portion 82 is provided at a rear end, the interbody space holding device 70,70', via the first shaft portion 71,71' of 70'' vertebral body L1, the shaft portion 81 of the hollow elongated to be inserted to the front surface near the L2, the rear end engagement portion 29 formed on the rear end face 13 of the body 11 of the interbody fusion device 10 to the distal end of the shaft portion 81 ( consisting tip engaging portion 83 which engages in Figure 3).

Gripper 82, the interbody space holding device 70,70', the rear end of the first shaft portion 71,71' rear end of the shaft portion 81 which is set to a length which is exposed to the outside of 70'' are formed in the loading has been at least one pair or a plurality of handle erected on the boss portion 82a (the handle) shape.

Tip engaging portion 83 is formed into a plurality of partial arc-shaped claw that engages fitted in part arcuate rear engagement portion 29 of the body 11 (FIG. 3), the tip of the nail parts are corner has a likely shape fitted to the rear end engagement portion 29, such as are cut. Incidentally, the tip engaging portion 83 is formed in a shape adapted to the desired shape of the rear end engagement portion 29.

Tip engaging portion 83 is a metal rigid, such as SUS and Ti, the shaft portion 81 can be constructed of a lightweight polymeric material, such as a resin. Body fitting driver 80, it is desirable to improve the operability by weight of the entire like constituting in combination as much as possible lightweight Ti and polymeric materials.

Pressure screw driver 90, the grip portion 92 is provided at a rear end, the shaft portion 91 of the elongated is inserted to the front near the vertebral bodies L1, L2 through the inside shaft portion 81 of the body fitting driver 80, the shaft portion consisting tip engaging portion 93 which engages with the rear engaging portion 44 formed on the rear end portion of the cap 42 of the pressure screw 40 (FIG. 10) to the tip 91.

Gripper 92, at least one pair or a plurality of handle erected on a boss portion 92a which is fitted to the rear end of the shaft portion 91 which is set to a length which is exposed to the outside of the body fitting driver 80 rear ( It is formed in the handle) shape. That is, pressure screw driver 90, as shown in FIG. 1, the vertebral bodies L1, the grip portion 92 is exposed to the outside from the rear end face of the body fitting driver 80 in locking completion state to between L2 interbody fusion device 10 It has a length sufficient to be gripped.

Tip of the distal engaging portion 93 93a is formed to engage example shaped screwdriver on the rear end engagement portion 44 of the pressure screw 40 (FIG. 10). Incidentally, like the rear end engagement portion 44 when it is formed to a not-shown example hexagonal hole in place of the cross groove, the tip portion 93a is shaped into a hexagonal wrench-like engaging in the hexagonal hole, the rear end is formed in a shape adapted to the desired shape of the engaging portion 44 (not shown).

Tip engaging portion 93 is a metal rigid, such as SUS and Ti, the shaft portion 91 can be constructed of a lightweight polymeric material, such as a resin. Pressure screw driver 90, it is desirable to whole improved operability and lighter including such form the shaft portion 91 in a hollow shape.

Incidentally, the grip portion 82 and 92 can be formed in a known cylindrical or other arbitrary grasping shape (not shown).

Here, a conceptual longitudinal sectional view of the interbody fusion surgical system of alternative embodiment of applying the interbody space holding device 70'' of the alternative embodiment (the main part cross-section) in FIG. 40.

Next, with reference to FIGS. 1,8,9,27 ~ 29, 36 ~ 39, 41 ~ 43, etc., among which the interbody fusion device 10 of the embodiment, formed from the abdomen MN1 side to the front surface of the spine viewing mirror for abdominal cavity endoscope neither shown via cannula K in Ma (or laparoscopic) or the capsule endoscope interbody space holding device 70 while observing, the body fitting driver 80 and pressure screw using a screwdriver 90, for interbody fusion surgical method fitted the disc M unit for fixing between vertebral bodies L1, L2 between the vertebral bodies L1, L2, illustrating a portion to be the essential characteristics thereof.

Before surgery, after the size and desired distraction optimum vertebral body fixing device 10 of the patients were determined evaluation, as shown in FIG. 41 (a), the patient alignment correction of distraction and vertebral body (vertebra) simultaneously can be placed on Ashidai dedicated state took called lithotomy position for bending the upward sideway-shape rather legs to spinal surgical table on Bd, human shoulders comprises an arm and a leg portion so as not to fall on the head side MN It is fixed.

Subsequently, as shown in FIG. 41 (b), tilting the spinal surgery table Bd, by raising the foot to Trendelenburg state condition called head low-waist high to lower the head, it starts the following operation.

In this Trendelenburg state, as shown in FIG. 42, a predetermined number of the position, for example by electrocautery mm approximately incision Mf the appropriately provided multiple places laparoscopic port Ma of the abdomen MN1, Mb, Mc, Md, set Me like, pneumoperitoneum gas is an inert gas such as CO2 for example in the abdominal cavity through the puncture needle, such as access needle to observe the surgical location corresponding to the vertebral bodies L1, L2 of interest therefrom inject. Thus, the pneumoperitoneum gas from the abdomen MN1 side injected intraperitoneally forces the bowel portion to the lower abdomen side, to secure the vertebral bodies L1, L2 near vision through the endoscope (or laparoscopic) . Port Ma is made of ports for the main laparoscope for inserting the interbody fusion device 10 is placed with the aim of substantially central portion between the vertebral bodies L1, L2. Port Mb is positioned several mm ~ 10 cm about the head toward the center axis on an example umbilical abdominal MN1. Abdominal wall, is located on a side of the vessel in the upper abdomen opposite the vertebral bodies L1, L2 parts.

Port Mc, Md are slightly staggered so as to face each other on the left and right side of the port Mb. Port Mc, and insert the appropriate retractor (not shown) (forceps) through Md, such as treatment for separating the appropriate entrails from the periphery of the vertebral body of interest is performed.

In this way, the port Ma of a plurality of locations provided in the abdomen MN1 side, Mb, Mc, Md, ventral and lateral sides adjacent the vertebral bodies L1, L2 through the endoscope (or laparoscopic) from Me both subjected to pretreatment such as push the bone margin of such dural follicles and transverse nerve root (not shown) on the side of the (pre-treatment step).

At this time, as shown in FIG. 43, for example for the treatment trocar sleeve Tr such Vaasa steps or bar support is placed in the port Ma portion. The trocar hollow cannula which is the outer tube of the sleeve Tr (or power shield sleeve) in K, various treatment instruments Tp later after is removed vent needle and the puncture needle is inserted to the vertebral column (spine) L unit that.

Then, through a cannula K inserted into the endoscopic port Ma portion provided on the abdomen MN1 side, as shown in FIG. 27 and 28, each pair clamp arm to the front near the vertebral body L1, L2 74, 74 and insert the interbody space holding device 70 of the closed state of the Fixed vertebral bodies L1, L2 adjacent by inserting a pair of spacers 73 and 73 from the distal end into the disc space M in a proper spacing while retaining in each left and right side surfaces of the vertebral bodies L1, L2 the adjacent closed again as to sandwich the fixing claws 74b to open the clamp arms 74 and 74 of each pair via a plurality of pointed protrusions 74c ( piercing) fixed (interbody space holding step). At this time, the opening and closing operation of the clamp arm 74, 74 of each pair, as described above, performed by retracting or advancing the clamp arm open tube 70b.

Then, both not shown, drill or hollow tubular graft driver using an endoscope inserted from the abdomen MN1 side into the first shaft portion 71 of the interbody space holding device 70 (or laparoscopic) cutter (perforator) by drilling a vertebral body L1, L2 pilot hole slightly smaller outer diameter than the outer diameter of the body 11 of the vertebral body fixing device 10 in the disc space M of until an appropriate depth (Shitaana穿setting process).

After the pilot hole drilled step, the first shaft of the tip engaging portion 83 to the interbody space holding device 70 the rear end engagement portion 29 from the MN1 flank in engagement of the body 11 of the body fitting driver 80 and inserted into section 71, the body 11 pressed and rotated to fix by screwing fitted to a predetermined position of the lower hole of the disc space M unit (body fitting step). In this case body 11, as shown in FIG. 8, the outer surface crown of the male screw 14 and 15 facing surface L1a of the vertebral bodies L1, L2, is screwed by engagement bite into L2a unit.

Then, as shown in FIGS. 8 and 9, the shaft portion 81 of the body fitting driver 80 from the abdomen MN1 side in a state where the rear end engagement portion 44 engaged pressing screw 40 at the tip engaging portion 93 of the pressure screw driver 90 insert within the pressure screw 40 screwing to rotate while pressed into the female screw portion 16 of the rear end face 13 of the main body 11 which is fitted and fixed between the vertebral bodies L1, L2, 1 at the tip 43 side of the male screw portion 41 each tilt angle Θ1 tip 32, 32 side of the pins 30, 30 by pressing the rear end 31 side of the pins 30, 30 of the pair, while sequentially bent guided along the guide hole 17, 18 of Θ2 counter face L1a, inserted and fixed to inclined within the vertebral body L1, L2 from L2a portion (pin insertion fixing step). At this time, while retaining sufficiently pressed by hand or mechanical rotation restraining means any separately so as not to rotate the grip portion 82 of the body fitting driver 80 (not shown), the pressure screw 40 cap 42 consecutive 設面 the body 11 screwed into the internal thread 16 to abut a predetermined stroke in the rear end face 13.

Thus the cap 42, by finally abuts against the rear end face 13 of the body 11, the reverse rotational friction force of the pressing screw 40 with threaded allowance predetermined stroke of the pressing screw 40 into the inside of the main body 11 is defined having a retaining effect of the reverse rotation preventing effect and the pin 30 by which the pressure screw 40 to up.

As described above, the interbody fusion device 10 is a compact having a matching profile to the proper spacing between vertebral bodies L1, L2, pressure screw 40 to the body 11 after the screwed between vertebral bodies L1, L2 from it is only pressed from the tip 32 of the pin 30 is bent along the guide hole 17, 18 vertebral bodies L1, bayonet fixed by a simple configuration in the L2 screwed into the internal thread 16 of the body 11, laparoscopic it can be carried out easily in a short time interbody fusion treated only with uniaxial around screwing operation from all main axis C1 direction in combination.

Thus, interbody fusion surgical system, the surgical method and interbody space holding apparatus of the present invention include surgery with surgery scale compared with the conventional interbody fusion surgery is greatly reduction since it is possible to significantly reduce both the time and the recovery period, physical and mental burden of medical staff, including the patient and the doctor, the patient's surgical stress further, it is possible to significantly reduce the economic burden. Then, it is possible to by a pin 30 that is plugged secured in vertebral body L1, L2 to prevent retraction and rotation of the proper position of the body 11, the reliability of the interbody fusion can be secured, vertebral body during the fixed structure and operation is greatly simplified and compact, and more advantageous both operability and economy.

Figure 11 is another embodiment (Example 2) vertical sectional view showing the locking completion state to between vertebral bodies L1, L2 of the interbody fusion device 10a according to the present invention (main unit cross section), Fig. 12 11 a F-F arrow view of.

Interbody fusion device 10a of Example 2, with respect to the interbody fusion device 10 of Example 1, is subjected over engages fixed to the front portion of the vertebral body L1, L2 adjacent loosely fitted in the pressing screw 50 that fixing brace 60 for reinforcing the fixation between the vertebral bodies L1, L2 by Rukoto is added only different and the other is exactly the same structure as in example 1. Therefore, where the component having the same function as in Example 1 are denoted by the same reference numerals even if some shapes slightly different.

Pressure screw 50, is exactly the same structure as the pressing screw 40 in interbody fusion device 10 of the first embodiment, the fixed brace 60 as compared to the male screw portion 51 pressure screw 40 screwed into the internal thread 16 of the body 11 but that is longer minute to be added are different only.

Further, the rear end surface of the cap 52 of the pressure screw 50, for example of the tip engaging portion 93 of the pressure screw driver 90 engages, although cross groove 54 as shown in FIG. 12 are formed, a cross groove engaging portion 93 both formed in a hexagonal wrench-like (not shown) instead of the 54 may be drilled groove-like hexagonal hole for engagement.

Fixed brace 60 includes a boss 61 which is loosely fitted to the male screw portion 51 of the pressure screw 50, is erected vertically axisymmetric to the boss 61 the outer surface, respectively, the bosses 61 parts rear end surface is pressed against the 52 parts cap pressure screw tip and the arm 62 of the pair being respectively engaged fixed to the front portion of the vertebral body L1, L2 adjacent consists Te.

As the material of the fixed brace 60, like the main body 11, SUS medical grade, include Ti, Ti is preferred from the particular strength and weight point.

Arm 62 is provided at the rear side of the cap 52 side, the tip is erected to the boss 61 the outer surface along the vertebral bodies L1, substantially to the L2 side 90 ° bent plate-like flange 62a, and a plate-like flange 62a It was formed on the cross-section substantially T-shaped comprising a web 62b. In this case, the arms 62 distal of the distal end portion is formed sharp tapered to facilitate secured engages bite on the abdomen side surface of the vertebral body L1, L2.

Next, this embodiment interbody space holding device 70 while the interbody fusion device 10a was observed by laparoscope both from the abdominal MN1 side not shown or the capsule endoscope or the like, the body fitting driver 80 and pressure screw using a screwdriver 90, for interbody fusion surgical method to fit the disc M unit for fixing between vertebral bodies L1, L2 between the vertebral bodies L1, L2, the interbody fusion device 10 of the example 1 If the describing different main characteristic portion.

After or before the same pilot bore drilled process as in Example 1, respectively facing surfaces L1a of the front portion of the adjacent vertebral bodies L1, L2, arm 62 distal end portion of the fixed brace 60 to appropriately position the L2a is engaging groove L1b of substantially T-shaped engaging and bored L2b (fixed brace engagement grooves drilled step).

Then, following the same body fitting process as in Example 1, the rear end engagement of the pressing screws 50 inserted through the screw portion 51 in the boss 61 of the distal engaging portion 93 to the fixed brace 60 of the pressing screw driver 90 inserted into the shaft portion 81 of the body fitting driver 80 to engagement unit 54 in engagement with, while the pressing screws 50 is pressed and inserted into the female screw portion 16 of the body 11 which is fixed fitted between vertebral bodies L1, L2 rotating screwing in and guided along the leading edge 32, 32 side of the pins 30, 30 by pressing the rear end 31 side of the pins 30, 30 at the distal end surface 53 of the external thread portion 51 into the guide hole 17, 18 in sequence bent so while the opposing surface L1a, thereby bayonet fixed inclined vertebral bodies L1, the L2 from L2a portion, the arm 62 distal end portion of the fixed brace 60 by the axial thrust from the cap 52 the front end face of the pressure screw 50 Respectively vertebral bodies L1, L2 of the front portion of the engagement groove L1b, engaged and fixed to pressing the L2b (pin plug and the fixed brace fixing step). At this time, while holding firmly pressed by hand or mechanical rotation restraining means any separately so as not to rotate the grip portion 82 of the body fitting driver 80 (not shown), the pressure screw 50 cap 52 consecutive 設面 fixed brace 60 boss rear face to a predetermined abutting stroke screwed into the internal thread 16.

That is, the interbody fusion method in the second embodiment, at least pre-treatment step, the interbody space holding step, the prepared hole drilled step, body fitting step, the fixed brace engaging groove bored process, pin insertion and fixing reinforcement having a tool fixing step.

Interbody surgical system and surgical method using the interbody fusion device 10a of Example 2, in addition to having the same advantages as in Example 1, loosely fitted to the pressing screw 50 fixed the arm 62 distal end of a pair of brace 60 are respectively engaged fixed to the front portion of the vertebral body L1, L2 boss 61 parts rear end face of the cap portion 52 of the pressure screw 50 is adjacent by being pressed from a simple operation for interbody fusion is firmly reinforced, it is possible to easily improve the reliability of the interbody fusion. Further, it is possible to have an appropriate rigidity to the arm 62, the stiffness reaction force by the reverse rotation preventing effect and the pin 30 by which the pressure screw 50 for reverse rotation frictional force of the pressing screw 50 is held up the retaining effect can be further improved.

Figure 13 is also a longitudinal sectional view showing the concept of interbody fusion device 10b of another embodiment (Embodiment 3) of the present invention (main unit cross section), Fig. 14 is a P-P arrow view in FIG. 13 .

Interbody fusion device 10b of the third embodiment, with respect to the interbody fusion device 10 of the first embodiment, only in that the outer shape of the main body 11b is formed in a substantially tapered hollow truncated cone shape is different, other it is exactly the same structure as in example 1. Thus omitted here, even if some shape to the component having the same function as in the first embodiment is slightly different are denoted by the same reference numerals, since the individual descriptions overlap.

The outer shape of the main body 11b of the third embodiment is formed in a substantially tapered frustoconical having a taper along its length at an angle for example approximately 9 ° correspond to the normal lordosis angle of the vertebral bodies L2 below. Frustoconical taper angle of the main body 11b is spread so as to form a vertebral body L1, L2 is proper lordosis angle adjacent when the body 11b is fitted in position over the outer diameter of the front and rear ends it is possible to define the amount.

Figure 15 is a further embodiment of the present invention vertical sectional view showing the concept of interbody fusion device 10c (Example 4) (main part cross-section), the friction plate 55 of the (a) is 15 to 16 G-G cross-sectional view taken along section is H-H cross-sectional view along a line (b) is (a).

Interbody fusion device 10c of the fourth embodiment, with respect to interbody fusion device 10b of Example 3, is loosely fitted housed in the female screw 16 of the main body 11b, the 31 parts of the rear end of the pin 30, 30 in that the friction plate 55 disposed in contact is added differ by the other is exactly the same structure as in example 3. Therefore, where the component having the same function as in Example 3 are denoted by the same reference numerals even if some shapes slightly different.

The contact surface of the pin rear end 31 and 31 parts of the friction plates 55, FIG. 16 (a), (b) as shown in a pair of appropriate depth pin rear end 31 and 31 parts are fitted pin fixing grooves 55a, 55a are bored in.

Left and right by the pin rear end 31 and 31 parts are fitted pin fixing groove 55a, in 55a, for movement in the vertical direction is constrained, through the friction plate 55 by the pressing screw 40 or 50 (FIGS. 8-12) If the pin rear end 31, 31 parts is pressed the tip 32 side is inserted into the vertebral bodies L1, the L2, in particular pin rear end 31 and 31 parts of many gaps between the internal thread 16 portion surface of the main body 11b left moving skidding direction (escape) that without the pin 11 is easily inserted into the vertebral bodies L1, the L2 along the guide hole 17, 18 is pushed forward smoothly.

Further, to restrain movement due skidding pin rear 31 parts of (relief), without providing the pin fixing grooves 55a, welded or secured by adhesion to the friction plate 55 to the pin rear end 31 and 31 parts of it may be.

In contrast, without the use of moving restraint pin rear end 31 and 31 parts, such as the pin fixing grooves 55a and the sticking may only abut arranged friction plates 55 simply pin rear end 31 and 31 parts of . In any case, by disposing the friction plate 55, the friction plate 55 from the pin rear 31 parts pressing of the pressing screw 40 or 50 is carried out via a pressure screw 40 or 50 and the pin rear 31 , the pin rear 31 and 31 parts for the pin rear end 31 side with frictional force decreases does not receive the rotational force of the direct pressure screw 40 or 50 of the 31 surface side of the female thread 16 portion surface of the main body 11b without receiving little force that moves skidding in the gap with many lateral direction (relief) so, that the pin 30 is pushed forward smoothly with even pressure screw 40 or 50 is screwed into the internal thread 16 with a small torque it is possible.

Figure 17 is also a longitudinal sectional view showing the concept of interbody fusion device 10d of another embodiment (Example 5) of the present invention (main unit cross section), Fig. 18 is Q-Q arrow view of FIG. 17, FIG. 19 is a plan view of FIG. 17.

Interbody fusion device 10d of the fifth embodiment is that the outer surface engaging portion 14 of the main body 11 is formed on the male screw-shaped in interbody fusion device 10 of the first embodiment, the outer surface engaging the body 11d part 14a is point only differ that are formed at a plurality of spline teeth shape parallel to the main axis C1, the other is exactly the same structure as in example 1. Thus omitted here, even if some shape to the component having the same function as in the first embodiment is slightly different are denoted by the same reference numerals, since the individual descriptions overlap.

In this embodiment, since the outer surface engaging portion 14a is formed in a plurality of spline teeth shape parallel to the main axis C1, for screwing the body 11,11b in the Examples 1-3 by simply pressing the body 11d in a short time since it is possible to omit the rotary operation can be fitted and fixed between the vertebral bodies L1, L2, the operability is improved.

Further, the radially outer surface crown of the spline teeth is the outer surface engaging portion 14a and the axial tip portion is formed in a sharp edge shape, thereby easily fitted between the vertebral bodies L1, L2 by pressing the body 11d be able to.

Figure 20 is also a longitudinal sectional view showing the concept of interbody fusion device 10e of another embodiment (Embodiment 6) of the present invention (main unit cross section), Fig. 21 R-R arrow view of FIG. 20, FIG. 22 is a plan view of FIG. 20.

Interbody fusion device 10e according to the sixth embodiment is that the outer surface engaging portion 14b of the main body 11d in interbody fusion device 10d of Embodiment 5 is formed on the spline teeth shape, the outer surface engaging the body 11e by engaging portion 14c is only that it is formed in a plurality of serrated parallel to the main axis C1 are different, the other is exactly the same structure as in example 1 or 5 or the like. Thus omitted here, even though partially different shape slightly to components having the same function as in Example 1 or 5 are given the same reference numerals, since the individual descriptions overlap.

In this embodiment, since the outer surface engaging portion 14a is formed in a plurality of serrated parallel to the main axis C1, the rotation for screwing the body 11,11b in the Examples 1-3 by simply pressing the body 11e operating a short time fitted to be fixed between the vertebral bodies L1, L2 because it can be dispensed, the operability is improved.

Further, since the saw teeth before and after each end surface is an outer surface engaging portion 14a is rearwardly inclined, radially outer surface parietal and axial tip portion is formed in a sharp edge shape, vertebral body by pressing the body 11e L1, it is possible to easily fit between L2, reliability of fixing by retaining body 11e can be secured.

Figure 23 is a further embodiment of the present invention vertical sectional view showing the concept of interbody fusion device 10f (Example 7) (the main portion cross-section).

Interbody fusion device 10f in Example 7, to the interbody fusion device 10 of Example 1, except that the shape of the pin 30a is formed in a relatively short straight, and the tip of the pressing screw 40a in the shape of 43a only differs other is exactly the same structure as in example 1. Thus omitted here, even if some shape to the component having the same function as in the first embodiment is slightly different are denoted by the same reference numerals, since the individual descriptions overlap.

A pair of pins 30a of Example 7, 30a are formed in a relatively short straight, is loosely fitted housed in each pair of guide holes 17, 18. Each tip 32a is formed in a suitably pointed shape, in the initial state before the main body 11 is inserted into the between vertebral bodies L1, L2, as indicated by the two-dot chain line in FIG. 23, in the valley diameter or less of the external thread 14 that is accommodated in the outlet of the guide hole 17, 18 so as not to protrude from the root diameter.

Pressure screw 40a has the external thread portion 41 and the cap 42 of the same shape as the pressing screw 40 Example 1, the tip portion 43a of the male screw portion 41 is extended slightly thin round bar from hollow inner surface 16a, its front end corner pin 30a, the rear end 31a of 30a, the inclined surface 43a that is cut so as to abut against the 31a are formed.

In Figure 24 (a) is also a longitudinal sectional view showing the concept of interbody fusion device 10g of another embodiment (Example 8) of the present invention (the main part cross-sectional), (b) it is (a) I- an I Yashiyo sectional view.

The interbody fusion apparatus 10g of Example 8, with respect to interbody fusion device 10e of Example 7, except that the shape of the pin 30b is formed in a relatively long straight, and a pair of pins 30b, a pair of guide holes 17a for accommodating the 30b, the arrangement of 18a only differs other is exactly the same structure as in example 7. Thus omitted here, even if some shape to the component having the same function as in Example 7 is slightly different are denoted by the same reference numerals, since the individual descriptions overlap.

Pin 30b of the pair of Example 8, 30b is formed in a relatively long straight, a pair of guide holes 17a, which will be described later, respectively, are loosely fitted housed in 18a. Each tip 32b is formed in a suitably pointed shape in an initial state (standby position) before the body 11 is inserted into the between vertebral bodies L1, L2, as indicated by the two-dot chain line in FIG. 24 (a), within the valley diameter or less of the external thread 14, i.e. the guide hole 17a, it is accommodated in the outlet of 18a so as not to protrude from the root diameter.

A pair of guide holes 17a provided in the main body 11g, the pin 30b, 30b to be accommodated in the 18a, as shown in FIG. 24 (b), are arranged eccentrically to the left and right, for example with respect to the central axis of the main body 11g . Thus, it is possible to avoid a pair of pins 30b, the rear end 31b in the standby position 30b, the mutual interference of the 31b portion.

The inclination axis C2, C3 is the center axis of the pair of guide holes 17a, 18a has been arranged in the respective substantially parallel plane to the central axis in this embodiment, the distal end 32b of the pin 30b is pushed Te unless protrude from the outer surface of the vertebral bodies L1, L2, is disposed on the main shaft C1 for each may be located and asymmetrically in any direction, or eccentric and any direction in the plane with respect to the main axis C1 it may be.

Figure 25 is a further embodiment of the present invention vertical sectional view showing the concept of interbody fusion device 10h (Example 9) (main unit cross section).

Interbody fusion device 10h of Example 9, with respect to interbody fusion device 10g of Example 8, respectively moderate pair of pins 30c, 30c and the guide hole 17c, the shape of 18c in the distal direction in that it is formed in a concave arc or curved differ by the other is exactly the same structure as in example 8. Thus omitted here, even if some shape to the component having the same function as in Example 8 is slightly different are denoted by the same reference numerals, since the individual descriptions overlap.

Concave arc or curved pair of guide holes 17c provided in the main body 11h, 18c, as to avoid a pair of pins 30c, the rear end 31c of the 30c waiting position, the mutual interference of 31c portion, of the main body 11h is eccentric to the central axis for example on the left and right, pushed the tip 32c of pin 30c as long as not protrude from the outer surface of the vertebral bodies L1, L2, can be placed along any direction.

Figure 26 is yet another embodiment of the present invention vertical sectional view showing the concept of interbody fusion devices 10i (Example 10) (main unit section).

Interbody fusion device 10i of Example 10, with respect to interbody fusion device 10h of Example 9, respectively moderate pair of pins 30d, 30d and the guide hole 17d, the shape of the 18d toward the distal end that it is formed on the convex arc or curved shape only different other is exactly the same structure as in example 9. Thus omitted here, even though partially different shape slightly to components having the same function as in Example 9 are denoted by the same reference numerals, since the individual descriptions overlap.

Also in Example 10, convex arc or curved pair of guide holes 17d provided in the main body 11i, 18 d are avoided pair of pins 30d, the rear end 31d at 30d waiting position, the mutual interference of 31d portion as to, eccentrically to the left and right for example with respect to the central axis of the main body 11i, it pushed the tip 32d of the pin 30d as long as not protrude from the outer surface of the vertebral bodies L1, L2, can be placed along any direction .

Figure 44 is a state also vertical sectional view showing the concept of interbody fusion apparatus 10j according to another embodiment (Example 11) (main unit section), Figure 45 is removal of the pressure screw 40j in Figure 44 of the present invention it is X-X in arrow view.

Interbody fusion device 10j of Example 11, with respect to the interbody fusion device 10 of the first embodiment, a pair of pins 30j, 30j are integrally proximal end 33 of female screw hole 34 is provided at the rear end that it is continuously provided is formed, in that the internal thread hole 34 coaxial with the insertion hole 44 of the base end portion 33 to the pressure screw 40j is opened only differ other in exactly the same structure as in example 1 is there. Therefore, where the component having the same function as in Example 1 are denoted by the same reference numerals even if some shapes slightly different.

Incidentally, the main body 11 to the 11i by reverse rotation operation to the screwing direction of the pressure screw 40,40j the body 11 to 11i in the above embodiments including this embodiment, the body 11 to 11i are interbody the insertion direction to be taken out each detached outside from between the vertebral bodies by rotation and / or withdrawal operations in the reverse direction.

Interbody fusion device 10j of this embodiment, when the pin 30j, the inadvertent purulent disorders due event infection after being fixed between the vertebral bodies through 30j has occurred, the body of the pressure screw 40j 11 together pulled out from the pin 30j, it can be removed from the body with the body 11 by pulling out from the vertebral body by pulling the driver 95 having a male screw portion 95a screwed into the female screw hole 34 of the base end portion 33 a 30j. Then, again interbody fusion device 10j after subjected to treatments such as packed aggregates or the like, if necessary or antibiotics between vertebral bodies can be re-fixed between the vertebral bodies.

Here, the pin 30j, without removing the pressure screw 40j if space withdrawing 30j from vertebral body to pull the tip portion 32j is hidden in the guide hole 17 of the body 11 can be secured in the female screw 16 completely from the body 11 well, it is possible to screwing the male screw portion 95a of the tip into the female screw hole 34 of the pressure screw 40j withdrawal driver 95 is inserted into the Created insertion hole 4 to be the pin 30j proximal end 33, after can be taken outside the body with the body 11 pins 30j, a 30j are withdrawn from the vertebral body by the withdrawal operation.

The pin 30j Within female screw hole 34 of the base portion 33, usually, but not blind plug (not having engaged portions such as the rear end portion for example, Phillips screwdriver groove and hexagon socket, a male screw portion 95a of FIG. 44 and corresponding) is fitted into the pin 30j, prior to the withdrawal operation 30j, the blind plug by the driver (not shown) provided in the distal end portion of the engaging portion engaged with the engaged portion it can be taken to remove outside from inside the internal thread hole 34.

From preventing foreign matter interbody in cerebrospinal fluid and osteogenic materials enter into the female screw hole 34 by the pin 30j proximal end 33 internally threaded hole 34 removably fitted to the blind plugs in the pin of the female screw hole of the pin base end portion by removing the blind plug before pulling operation can be easily easily and quickly screwed withdrawal driver, the operability is improved interbody fusion device 10j removal.

Incidentally, the blind plug which is inserted into the female screw hole 34, both into the insertion hole 44 of the pressure screw 40j of screwed state in the female screw 16 of the body 11 is inserted through the driver (not shown) after the blind plug it can be removed from within the internally threaded hole 34 is engaged with the engaged portion of the end portion.

Also, the case without the through hole 44 in the pressing screw, pin while inserting the blind plug above the female screw hole 34 30j, a 30j mounted in the internal thread 16 of the body 11, the interbody fusion device during removal can be carried out sequentially blind plug from taking out the pressure screw to external pins 30j, the extraction operation of 30j.

Figure 46 is a state further vertical sectional view showing the concept of interbody fusion device 10k according to another embodiment (Example 12) (main unit section), FIG. 47 has been removed the pressure screw 40k in Figure 46 of the present invention it is X-X in arrow view.

Interbody fusion device 10k of Example 12, with respect to interbody fusion device 10j of Example 11, the pair of pins 30k, 30k is the base end portion 33k of the female screw hole 34k is provided at the rear end individually that it is continuously provided is formed on each female screw hole 34k of the base end portion 33k on the pressing screw 40k only in that a pair of insertion holes 45, 45 of the coaxial is established are different, other than the example 11 it is exactly the same configuration. Thus where the components having the same functions as in Example 11 are denoted by the same reference numerals even if some shapes slightly different.

The rotation and withdrawal from the main body 11 by the rotating operation of a direction opposite to the screwing direction of the pressure screw 40k also body 11 of this embodiment, the insertion direction to between the main body 11 also vertebral body in the opposite direction It has become removable in each detached outside from between the vertebral bodies by the operation.

Interbody fusion device 10k in this embodiment also, the pin 30k, when the accidental purulent disorders due event infection after being fixed between the vertebral bodies through a 30k occurs, the pressure screw 40k body 11 together pulled out from the pin 30k, 30k proximal portion 33k, female screw hole 34k of the 33k, respectively taking out the body with the body 11 by pulling out from the vertebral body by pulling the driver 96 having a male screw portion 96a screwed into 34k can. Then, again interbody fusion device 10k from performing treatment such packed aggregates or the like, if necessary or antibiotics between vertebral bodies can be re-fixed between the vertebral bodies.

The pin 30k also proximal portion female screw hole 34k of the 33k, usually, but not blind plug (not having engaged portions such as the rear end portion for example, Phillips screwdriver groove and hexagon socket, a male screw portion 96a of FIG. 46 driver equivalent) is inserted, the pin 30k, prior to the withdrawal operation of 30k, with an engagement portion to which the blind plug is engaged to each of the engaged portion in the tip (not shown) the detached from the female screw hole 34k can be removed from the body.

Hereinafter, the blind plug and pin 30k, withdrawal operations 30k, so can be carried out in the same manner as in Example 11, the detailed description thereof is omitted.

Other various embodiments noted above, the shape of the members, the size and material can be arbitrarily changed. For example, although not shown, the pin 30,30A ~ 30F, 30a ~ 30d, 30j, 30k, if extreme one on either side of the vertebral bodies L1, L2, or multiple arrangement such as two pairs in a substantially axisymmetric or asymmetric it is also possible to. However, the pin 30,30A ~ 30F, 30a ~ 30d, 30j, 30k, the outer diameter in accordance with increasing the number becomes narrower correspondingly to the space contained within the internal thread 16 of the body 11, 11b ~ 11i.

Further, for example, may be an outer surface engaging portion 14b of the main body 11 in Embodiment 5 to form a radially outer surface crown of the spline teeth in a plurality of continuous serrated.

Further, instead of the cross section T-shaped arms 62 of a pair of fixed brace 60, at least the front end portion in the one plate, further one or more forming a sharp pin-like projection on the front face of the plate it is also possible to. By providing such such sharp pin-like projections or sharp edges on the arm 62 distal end, the engagement groove in the front portion of the vertebral body L1, L2 L1b, without providing a L2b (fixed brace engaging groove bored omit the step), it is also possible to an arm 62 tip directly inserted fixing the pin-like projection or pointed blade is pressed against the front portion of the vertebral body L1, L2.

Furthermore, for example, the body fitting driver 80, not shown, it may be a linked detachable shaft portion 81 in the longitudinal direction divided into two. Tip Accordingly, it became in a state where the top engagement with the engagement portion 93 engages the rear end engagement portion 44 of the pressure screw 40,50,40a the pressure screw driver 90, short separate the gripping portion 82-side shaft portion 81 easily inserted into the engagement portion 83 side shaft portion 81, then the gripping portion 82-side shaft portion 81 can be re-connected, the operability is improved.

The above described embodiments of the interbody fusion device 10, 10a ~ 10i, 10j, 10k are two adjacent vertebral bodies L1, disc space and fitted into M portions vertebral body between the L2 L1, L2 between a interbody fusion device for fixing the, can be fitted directly into the disc M, fitted between vertebral bodies L1, L2 after removing necessary disc M was crushed damaged due Heruniya other defects or aging it may be.

10,10a, 10b, 10c, 10d, 10e, 10f, 10g, 10h, 10i, 10j, 10k interbody fusion device 11,11b, 11c, 11d, 11e, 11g, 11h, 11i body 12 front face 13 rear face 14 outer surface engaging portion ((partial) male thread)
14a outer surface engaging portion (spline teeth)
14b distal end portion (sharp edge)
14c outer surface engaging portion (serrated)
15 outer surface engaging portion (Full male thread)
16 female thread 16a hollow inner surface 17,17a, 17c, 17d, 18,18a, 18c, 18d guide hole 19 cut sides 21, 22, 23 side openings 24, 25, 26 upper and lower surfaces opening 27 rear opening 28 eyelet 29, 44, 54 rear engagement portion 30,30A, 30B, 30C, 30D, 30E, 30F, 30a, 30b, 30c, 30d, 30j, 30k pin 30An, 30Dn thin plate 30Bn, 30En, 30Cn, 30Fn wires 31, 31a, 31b , 31c, 31d, 31j, 31k (pin) the rear end 32,32a, 32b, 32c, 32d, 32j, 32k (pin) tip 33,33k proximal end 34,34k female screw hole 40, 40a, 40j, 40k , 50 pressure screw 41,41j, 41k, 51,95a, 96a externally threaded portion 42 42j, 42k, 52 caps 43, 53 distal end face 43a tip 43b inclined surfaces 44, 45 insertion hole 55 friction plate 55a pin fixing groove 60 fixed brace 61 boss 62 arm 62a flange 62b web 70,70', 70'' ( interbody surgical) interbody space holding device 70a, 70'a holding device body 70b, 70'b clamp arm open pipe 71,71' first shaft portion 71a, 71'a, 76a tip 71b guide cylinder 71c barbs 72,77,82,92 grip portion 72a, 77a, 82a, 92a boss 73,73' spacer 74,74' clamp arm 74a elastically supporting portion 74'a supporting portion 74b fixed claw 74c pointed protrusion 75 reinforcement plate 75a rear support members 75b front support member 75c insertion hole 7 The second shaft portion 76 'vertebral body fixing mechanism 76'a screw portion 76'b elongate locking screw 76'c head 78 bracket 79 linking member 80 body fitted drivers 81 and 91 the shaft portion 83, 93 distal engaging portion 90 pressure screw driver 95, 96 pull driver Bd spinal surgery table C1 (the body of) the main shaft C2, C3 (guide hole) tilting axis (center axis)
K cannula L vertebral column (spine)
L1, L2 vertebral body (vertebra)
L1a, L2a facing surface L1b, L2b engaging groove M intervertebral disc (disc space)
Ma, Mb, Mc, Md, Me (endoscopic) port Mf incision MN biological (human)
MN1 belly (part)
MN2 back (part)
P1 first support shaft P2 second support shaft P3 third support shaft X1, X1' fully closed position X2 vertebral gripping / locking position X3, X3' fully open position .theta.1, .theta.2 tilt angle

Claims (25)

  1. Outer surface which engages the opposite surface of the formed front bottom substantially hollow cylindrical or tapered hollow the frustoconical outer surface two vertebral bodies to hold the proper spacing between two adjacent vertebral bodies (vertebrae) the engaging portion is formed, as appropriate depth of the female screw is formed in a hollow inner surface of the rear end side, tilted further from the tip hollow inner surface of the female screw flared radially towards the facing surface of the vertebral body outer surface a body one or a plurality of bent-shaped or straight-shaped guide hole penetrating is drilled up,
    One or a plurality of pins of loosely fitted stowed bent shape or a straight shape in the guide hole,
    The screwed axially thrust into the internal thread of the body, a pressure screw for pressing the rear end of the pin,
    Equipped with a,
    After the body is being fitted and fixed through an outer surface engaging portion into the disc space between the vertebral bodies, it is pressed back end by the axial thrust of the pressing screw the pin is screwed into the internal thread of the body interbody surgical system, wherein a distal end side to mount an interbody fusion device plugged into the vertebral body is successively guided along the guide hole Te.
  2. Interbody surgical system of claim 1, wherein the central outer diameter of the generally hollow cylindrical body is slightly formed on the thick barrel shape.
  3. It said pins, wires having any cross-sectional shape that includes a plurality of thin plate or round or various flat over solid or hollow rod-like member or at least the distal end side or the entire length of any cross-sectional shape, including round or polygonal is laminated any cross-section consists of rod-like laminate shape, interbody fusion surgical system according to claim 1, characterized in that the tip portion is formed in a pointed shape that includes an integral round or polygonal Te.
  4. The one or more pins, end group female screw hole is provided are continuously provided is formed separately or integrally at the rear end,
    From said pressure screw is in the body by a rotation operation of a direction opposite to the screwing direction into said body, said body vertebral by rotation and / or withdrawal operations in the opposite direction to the insertion direction to between the vertebral bodies detached from each intersomitic be retrievable from the body,
    After the pin has been inserted into the vertebral body, said together with the pressure screw is withdrawn from the body, by drawing driver with an external thread portion at the distal end of the pin is screwed into the female screw hole in the proximal end withdrawn from between the vertebral bodies, according to claim 1 or interbody fusion surgical system of any one of claims 3, characterized in that it is configured to be removed from the body together with the body.
  5. The said pin base end portion of the internal thread in the hole, usually blind plugs having engaged portions are fitted into the rear end,
    Prior to withdrawal operation of said pin, characterized in that the blind plug can be taken out the to be removed from the female screw hole by the driver with the tip portion of the engaging portion engaged with the engaged portion outside 4. interbody fusion surgical system according.
  6. It said outer surface engaging portion, interbody fusion surgical system according to claim 1, characterized in that it is formed in a male thread shape.
  7. It said outer surface engaging portion, claim 1 interbody fusion surgical system according to characterized in that it is formed in a plurality of parallel spline teeth shape on the main shaft.
  8. Said outer surface engaging portion, interbody fusion surgical system according to claim 1, characterized in that it is formed in parallel to a plurality of serrated to said main shaft.
  9. Claim 1, characterized in that axial tip and the radially outer surface top of the outer surface engaging portion are formed on the sharp edged, interbody according to any one of claims 6 to 8 fixed surgical system.
  10. The body, according to any one of claims 1 to claim 9, characterized in that the vascularization openings communicating respectively vertical and horizontal outer surface and bone ingrowth opening is provided with a plurality of interbody surgery system.
  11. Claims 1 to interbody of any one of claims 10 fixed surgery, characterized in that the cap covering the entire surface or part of the rear end face of the body to the rear end of the pressing screw is formed system.
  12. A boss which is loosely fitted in the pressure screw,
    Is erected in axial symmetry to the outer surface of the boss, the pair of arms are pressed boss rear face tip cap portion of the pressure screw are respectively engaged secured to the abdomen side front surface of the adjacent vertebral bodies When, further interbody fusion surgical system according to claim 11, further comprising a fixing brace made of.
  13. Loosely fitted housed in the internal thread of the body, interbody according to any one of claims 1 to 12, characterized by further comprising a friction plate that is disposed in contact with the rear end portion of the pin fixed surgical system.
  14. The rear end portion of the pin is at least claim 13 interbody fusion surgical system wherein the being engaged or fixed to the friction plate as movement is restrained in the lateral direction.
  15. The interbody fusion apparatus, any one of claims 1 to 14, characterized in that it is fixed between the vertebral bodies by combination with interbody fusion surgery to laparoscopic from the abdominal side of the patient interbody surgical system according.
  16. Have tips engaging portion engaged with the rear end engagement portion formed on the rear end portion of the main body of the interbody fusion device to the distal end of the shaft portion of the grip portion is provided at the rear end hollow elongated ,
    The tip engaging portion while engaging with the rear end engagement portion of the body, adjacent the two are inserted from the living abdomen in the cannula of the endoscope in the lens for abdominal portion formed to the front surface of the vertebral bodies is inserted in the hollow portion of the interbody space holding device for holding a proper spacing between the vertebral body, characterized in that it comprises a body fitted driver to fit between the vertebral bodies by pressing or / and rotating the body It claims 1 to any one interbody fusion surgical system according to claim 15,.
  17. The body fitting driver, the tip engaging portion made of metal, the shaft portion interbody fusion surgical system of claim 16, wherein the the polymer material.
  18. It has tips engaging portion engaged with the rear end engagement portion formed on the rear end of the pressing screw of the interbody fusion device to the distal end of the shaft portion of the elongated gripping portion is provided at the rear end ,
    The tip engaging portion is inserted into the pressing screw rear end engagement the while engaging with the engagement body in the hollow portion of the fitting driver, of the pressure screw and fixed the interbody fusion device in the disc space pressing the plugged into the vertebral body by sequentially guided along the guide hole of the tip end side of the pin by its axial thrust screwed into the female screw by rotating while pressing by inserting the female threaded portion of the body claim 16 or claim 17 interbody fusion surgical system according to, further comprising a screw driver.
  19. The pressure screw driver tip engaging portion made of metal, the shaft portion interbody fusion surgical system of claim 18, wherein the the polymer material.
  20. During interbody fusion surgery vivo, a device for holding the disc space to fix the proper spacing between two adjacent vertebral bodies (vertebrae),
    Rear grip portion is provided, a first shaft portion of the hollow elongated via a cannula of the endoscope in the lens for abdominal portion provided on the biological abdomen side is inserted to the front vicinity of the vertebral body,
    Extending along the axial direction at the tip portion of the first shaft portion, the fixing claws for clamping each fixed left and right side surfaces of the adjacent vertebral bodies in the orthogonal plane of the vertebral body is connected to the distal end openable interbody fusion surgical interbody space holding apparatus comprising: a vertebral body clamping mechanism having at least a clamp arm of each pair, the.
  21. The vertebral body clamping mechanism,
    Are each fixed claw continuously provided at the tip is continuously provided on the tip portion of the rear end portion of the first shaft portion, in a free state open diametrically enlarged in the orthogonal plane of the vertebral body, respectively the fixed claw a clamp arm of each pair having an elastic support part that is bent to the bullet supported as,
    Wherein the first fitted freely forward / backward in the shaft portion, the tip portion of the second shaft portion of the grip portion is provided a hollow elongated presses the elastic supporting portion is advanced from the outside to the rear end and a clamp arm open tube to open the clamp arms of each pair in the diameter direction by retreat from the respective 1 to close the pair clamp arm direction of reducing the diameter, the distal end the elastic support portion by interbody surgical interbody space holding device according to claim 20, wherein a.
  22. The vertebral body clamping mechanism,
    Tip each fixing claw is continuously provided on each rear end portion is pivotally mounted swingably in the orthogonal plane of the vertebral body through a first support shaft to the distal end portion of the first shaft portion and the clamp arm of the pair,
    Wherein the first fitted freely forward / backward in the shaft portion, and a second shaft portion of the hollow elongated gripping portion is provided at the rear end,
    With each one end via a second support shaft is pivotally attached swingably to the middle portion of each of a pair clamping arms, each other end first in the distal portion of the second shaft portion each pair of link members which are swingably pivoted through a third support shaft, made of,
    Wherein each of said pair of link members of said third counterclockwise or clamping arms of the respective pair is swung clockwise the support shaft as a fulcrum by the second shaft portion is advanced or retracted 20. interbody fusion surgical vertebral of, wherein the forming the first toggle mechanism to open or closed diameter direction reducing the diameter direction support shaft as a fulcrum in a plane perpendicular to the vertebral bodies body between the space holding device.
  23. For interbody fixation surgery according to any one of claims 20 to claim 22, characterized in that it has a side surface a plurality of sharp projections which can pierce the said vertebral body to vertebral body holding surface of the fixed pawl interbody space holding device.
  24. During interbody fusion surgery vivo, a device for holding the disc space to fix the proper spacing between two adjacent vertebral bodies (vertebrae),
    Rear grip portion is provided, a first shaft portion of the hollow elongated via a cannula of the endoscope in the lens for abdominal portion provided on the biological abdomen side is inserted to the front vicinity of the vertebral body,
    Rotatably extending along the axial direction on the outer surface of the first shaft portion, an elongated threaded portion formed at the tip is then fixed Riley to one or both of the front surface portion of the adjacent vertebral bodies a locking screw,
    Wherein projecting from the front end portion of the first shaft portion, between the adjacent vertebral bodies and one or both the piercing can be one or more needle-like projections on the front portion of the vertebral body, characterized in that it comprises a fixing surgical interbody space holding device.
  25. It is extended in the opposing state slightly narrower interval than the outer diameter along opposite axial direction to the interbody space of the vertebral body to the distal end of the first shaft portion, inserted into the disc space from the distal portion any of claims 20 to claim 24 and further comprising at least one pair of spacers formed in the outer shape to hold and fix the adjacent vertebral bodies in a proper distance by being interbody surgical interbody space holding apparatus according to 1, wherein.
PCT/JP2010/051558 2009-02-10 2010-02-04 Surgical operation system for lumbar interbody fusion and device for keeping lumbar interbody space to be used in surgical operation for lumbar interbody fusion WO2010092893A1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
JP2009029014 2009-02-10
JP2009-029014 2009-02-10

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
JP2010550492A JP5553268B2 (en) 2009-02-10 2010-02-04 Interbody surgical system and interbody fixation surgical interbody space holding device

Publications (1)

Publication Number Publication Date
WO2010092893A1 true true WO2010092893A1 (en) 2010-08-19

Family

ID=42561735

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/JP2010/051558 WO2010092893A1 (en) 2009-02-10 2010-02-04 Surgical operation system for lumbar interbody fusion and device for keeping lumbar interbody space to be used in surgical operation for lumbar interbody fusion

Country Status (2)

Country Link
JP (2) JP5553268B2 (en)
WO (1) WO2010092893A1 (en)

Cited By (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2012141715A1 (en) * 2011-04-15 2012-10-18 Synthes Usa, Llc Fixation assembly
EP2618787A2 (en) * 2010-09-23 2013-07-31 DePuy Synthes Products LLC Stand alone intervertebral fusion device
WO2013116464A1 (en) 2012-01-31 2013-08-08 Blackstone Medical, Inc. Intervertebral disc prosthesis and method
JP2013539396A (en) * 2010-09-03 2013-10-24 グローバス メディカル インコーポレイティッド Expandable fixation device and installation method thereof
US8882775B2 (en) 2011-04-15 2014-11-11 DePuy Synthes Products, LLC Fixation assembly
JP2015054235A (en) * 2013-09-11 2015-03-23 ソルコ バイオメディカル シーオー.,エルティーディー. Spiked cage
US9248028B2 (en) 2011-09-16 2016-02-02 DePuy Synthes Products, Inc. Removable, bone-securing cover plate for intervertebral fusion cage
US9526620B2 (en) 2009-03-30 2016-12-27 DePuy Synthes Products, Inc. Zero profile spinal fusion cage
US9662225B2 (en) 2012-03-06 2017-05-30 DePuy Synthes Products, Inc. Nubbed plate
US9687354B2 (en) 2008-03-26 2017-06-27 DePuy Synthes Products, Inc. Posterior intervertebral disc inserter and expansion techniques
US9693876B1 (en) 2012-03-30 2017-07-04 Ali H. MESIWALA Spinal fusion implant and related methods
JP2017148159A (en) * 2016-02-23 2017-08-31 合碩生技股▲分▼有限公司 Skeletal fixation device
WO2017186966A1 (en) * 2016-04-28 2017-11-02 Ldr Medical Bone anchoring system, associated implant and instrumentation

Citations (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5702391A (en) * 1995-05-16 1997-12-30 Lin; Chih-I Intervertebral fusion device
US5800550A (en) * 1996-03-13 1998-09-01 Sertich; Mario M. Interbody fusion cage
US5800547A (en) * 1994-08-20 1998-09-01 Schafer Micomed Gmbh Ventral intervertebral implant
US6063088A (en) * 1997-03-24 2000-05-16 United States Surgical Corporation Method and instrumentation for implant insertion
JP2001515749A (en) * 1997-09-10 2001-09-25 ユナイテッド ステイツ サージカル コーポレイション Implant insertion method and apparatus
JP2002501784A (en) * 1998-01-28 2002-01-22 エスディージーアイ・ホールディングス・インコーポレーテッド Fixing device and fixing method for between vertebral bodies
JP2002518132A (en) * 1998-06-23 2002-06-25 ディムソ(ディストリビュション、メディカル、デュ、シュド‐ウエスト) Intervertebral implant having a fixed component
JP2002518067A (en) * 1998-06-09 2002-06-25 ケイ.ミチェルソン ゲアリー Between adjacent vertebral bodies, a device for preparing a space for receiving the insert
JP2002528172A (en) * 1998-10-28 2002-09-03 エスディージーアイ・ホールディングス・インコーポレーテッド Interbody fusion assembly
JP2004267786A (en) * 1988-06-13 2004-09-30 Gary Karlin Michelson Apparatus for inserting spinal implant
JP2007075632A (en) * 1996-02-19 2007-03-29 Warsaw Orthopaedic Inc Spinal fusion implant, and tool for insertion and revision

Family Cites Families (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4892545A (en) * 1988-07-14 1990-01-09 Ohio Medical Instrument Company, Inc. Vertebral lock
JPH0975367A (en) * 1995-09-12 1997-03-25 M Ii Syst:Kk Guide for drilling collum femoris part
US6447546B1 (en) * 2000-08-11 2002-09-10 Dale G. Bramlet Apparatus and method for fusing opposing spinal vertebrae
US7588573B2 (en) * 2002-09-23 2009-09-15 Warsaw Orthopedic, Inc. Expansion tool for adjustable spinal implant
CN1882285B (en) * 2003-11-20 2011-05-11 瑞特医疗技术公司 Guide clamp for guiding placement of a guide wire in a femur
EP2117470B1 (en) * 2007-02-06 2013-03-06 Pioneer Surgical Technology, Inc. Intervertebral implant devices
US8465546B2 (en) * 2007-02-16 2013-06-18 Ldr Medical Intervertebral disc prosthesis insertion assemblies

Patent Citations (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2004267786A (en) * 1988-06-13 2004-09-30 Gary Karlin Michelson Apparatus for inserting spinal implant
US5800547A (en) * 1994-08-20 1998-09-01 Schafer Micomed Gmbh Ventral intervertebral implant
US5702391A (en) * 1995-05-16 1997-12-30 Lin; Chih-I Intervertebral fusion device
JP2007075632A (en) * 1996-02-19 2007-03-29 Warsaw Orthopaedic Inc Spinal fusion implant, and tool for insertion and revision
US5800550A (en) * 1996-03-13 1998-09-01 Sertich; Mario M. Interbody fusion cage
US6063088A (en) * 1997-03-24 2000-05-16 United States Surgical Corporation Method and instrumentation for implant insertion
JP2001515749A (en) * 1997-09-10 2001-09-25 ユナイテッド ステイツ サージカル コーポレイション Implant insertion method and apparatus
JP2002501784A (en) * 1998-01-28 2002-01-22 エスディージーアイ・ホールディングス・インコーポレーテッド Fixing device and fixing method for between vertebral bodies
JP2002518067A (en) * 1998-06-09 2002-06-25 ケイ.ミチェルソン ゲアリー Between adjacent vertebral bodies, a device for preparing a space for receiving the insert
JP2002518132A (en) * 1998-06-23 2002-06-25 ディムソ(ディストリビュション、メディカル、デュ、シュド‐ウエスト) Intervertebral implant having a fixed component
JP2002528172A (en) * 1998-10-28 2002-09-03 エスディージーアイ・ホールディングス・インコーポレーテッド Interbody fusion assembly

Cited By (25)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9687354B2 (en) 2008-03-26 2017-06-27 DePuy Synthes Products, Inc. Posterior intervertebral disc inserter and expansion techniques
US9526620B2 (en) 2009-03-30 2016-12-27 DePuy Synthes Products, Inc. Zero profile spinal fusion cage
US9592129B2 (en) 2009-03-30 2017-03-14 DePuy Synthes Products, Inc. Zero profile spinal fusion cage
JP2013539396A (en) * 2010-09-03 2013-10-24 グローバス メディカル インコーポレイティッド Expandable fixation device and installation method thereof
EP2618787A4 (en) * 2010-09-23 2014-07-09 Depuy Synthes Products Llc Stand alone intervertebral fusion device
EP2618787A2 (en) * 2010-09-23 2013-07-31 DePuy Synthes Products LLC Stand alone intervertebral fusion device
US8882775B2 (en) 2011-04-15 2014-11-11 DePuy Synthes Products, LLC Fixation assembly
WO2012141715A1 (en) * 2011-04-15 2012-10-18 Synthes Usa, Llc Fixation assembly
US9138279B2 (en) 2011-04-15 2015-09-22 DePuy Synthes Products, Inc. Fixation assembly
US9248028B2 (en) 2011-09-16 2016-02-02 DePuy Synthes Products, Inc. Removable, bone-securing cover plate for intervertebral fusion cage
EP2809250A4 (en) * 2012-01-31 2015-10-07 Blackstone Medical Inc Intervertebral disc prosthesis and method
US9198764B2 (en) 2012-01-31 2015-12-01 Blackstone Medical, Inc. Intervertebral disc prosthesis and method
JP2015504772A (en) * 2012-01-31 2015-02-16 ブラックストーン メディカル,インコーポレイテッド Intervertebral disc prosthesis and method
WO2013116464A1 (en) 2012-01-31 2013-08-08 Blackstone Medical, Inc. Intervertebral disc prosthesis and method
US9814594B2 (en) 2012-01-31 2017-11-14 Blackstone Medical, Inc. Intervertebral disc prosthesis and method
US9283085B2 (en) 2012-01-31 2016-03-15 Blackstone Medical, Inc. Intervertebral disc prosthesis and method
US9668877B2 (en) 2012-03-06 2017-06-06 DePuy Synthes Products, Inc. Nubbed plate
US9662225B2 (en) 2012-03-06 2017-05-30 DePuy Synthes Products, Inc. Nubbed plate
US9872781B2 (en) 2012-03-06 2018-01-23 DePuy Synthes Products, Inc. Nubbed plate
US9693876B1 (en) 2012-03-30 2017-07-04 Ali H. MESIWALA Spinal fusion implant and related methods
US9775722B2 (en) 2013-09-11 2017-10-03 Ldr Medical Cage having spike
JP2015054235A (en) * 2013-09-11 2015-03-23 ソルコ バイオメディカル シーオー.,エルティーディー. Spiked cage
JP2017148159A (en) * 2016-02-23 2017-08-31 合碩生技股▲分▼有限公司 Skeletal fixation device
WO2017186966A1 (en) * 2016-04-28 2017-11-02 Ldr Medical Bone anchoring system, associated implant and instrumentation
FR3050634A1 (en) * 2016-04-28 2017-11-03 Ldr Medical Bone anchoring system, implant and associated instrumentation

Also Published As

Publication number Publication date Type
JP2014193364A (en) 2014-10-09 application
JP5553268B2 (en) 2014-07-16 grant
JPWO2010092893A1 (en) 2012-08-16 application
JP5769217B2 (en) 2015-08-26 grant

Similar Documents

Publication Publication Date Title
US6685724B1 (en) Laparoscopic surgical instrument and method
US5441059A (en) Method of minimally invasive surgery
US6371968B1 (en) Cavity retaining tool for bone surgery, a cavity retaining tool for general surgery, an endoscopic surgery system involving the use of a cavity retaining tool, and a procedure for surgery
US20060116689A1 (en) Surgical instrumentation and method for treatment of a spinal structure
US7166073B2 (en) Method and device for microsurgical intermuscular spinal surgery
US8361152B2 (en) Facet joint implants and delivery tools
US6921403B2 (en) Method and apparatus for spinal distraction and fusion
US20050107789A1 (en) Method for interconnecting longitudinal members extending along a spinal column
US6638265B1 (en) Laparoscopy cannula adapter and assembly
EP1281360B1 (en) Surgical instrument for endoscopic use
US20080262318A1 (en) Minimally open interbody access retraction device and surgical method
US20110040301A1 (en) Vertebral facet joint drill and method of use
US20090105774A1 (en) Rod insertion instrument and method of use
US20110270325A1 (en) Polyaxial bottom-loading screw and rod assembly
US6830578B2 (en) Trocar
US20100324607A1 (en) Pedicle screw with expansion anchor sleeve
US6835201B2 (en) Trocar
US5843039A (en) Surgical treatment
US8142479B2 (en) Interspinous process implants having deployable engagement arms
US20090222046A1 (en) Minimally Invasive Retraction Device Having Removable Blades
US20070255282A1 (en) Dilating stylet and cannula
WO2006042188A2 (en) A spinal implant stabilization system
US6569168B2 (en) Intervertebral distractor and implant insertion instrument
US20090221879A1 (en) Minimally Invasive Retractor Having Separable Blades
US20110257487A1 (en) Lateral and Anterior Lateral Retractor System

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 10741170

Country of ref document: EP

Kind code of ref document: A1

DPE1 Request for preliminary examination filed after expiration of 19th month from priority date (pct application filed from 20040101)
WWE Wipo information: entry into national phase

Ref document number: 2010550492

Country of ref document: JP

ENP Entry into the national phase in:

Ref document number: 2010550492

Country of ref document: JP

Kind code of ref document: A

NENP Non-entry into the national phase in:

Ref country code: DE

122 Ep: pct app. not ent. europ. phase

Ref document number: 10741170

Country of ref document: EP

Kind code of ref document: A1