WO2021153795A1 - 脊椎用インプラントおよび脊椎用インプラントの製造方法 - Google Patents
脊椎用インプラントおよび脊椎用インプラントの製造方法 Download PDFInfo
- Publication number
- WO2021153795A1 WO2021153795A1 PCT/JP2021/003452 JP2021003452W WO2021153795A1 WO 2021153795 A1 WO2021153795 A1 WO 2021153795A1 JP 2021003452 W JP2021003452 W JP 2021003452W WO 2021153795 A1 WO2021153795 A1 WO 2021153795A1
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- WIPO (PCT)
- Prior art keywords
- region
- spinal implant
- substrate
- implant according
- coating
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2002/448—Joints for the spine, e.g. vertebrae, spinal discs comprising multiple adjacent spinal implants within the same intervertebral space or within the same vertebra, e.g. comprising two adjacent spinal implants
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2002/4629—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof connected to the endoprosthesis or implant via a threaded connection
Definitions
- the present disclosure relates to a spinal implant that is inserted between adjacent vertebrae and prostheses the intervertebral disc.
- Patent Document 1 describes a vertebral implant having a land portion and a groove on the upper surface and the lower surface of the main body.
- Patent Document 2 describes a coating for medical implants, which contains a bone binder in part and an antibacterial metal agent containing silver.
- Patent Documents 3 and 4 describe a bioimplant having a coating film made of a calcium phosphate-based material.
- the spinal implant according to one aspect of the present disclosure includes a substrate and a coating film containing a calcium phosphate-based material and an antibacterial agent arranged on the substrate, and the surface of the substrate is provided with the coating film. It has one region and a second region exposed from the coating.
- the spinal implant according to one aspect of the present disclosure includes a substrate and a film thickness on the substrate containing a calcium phosphate-based material and an antibacterial agent, and the film thickness is a first region and the first region. It has a sixth region having a film thickness smaller than that of the sixth region.
- the method for manufacturing a spinal implant according to one aspect of the present disclosure includes a film forming step of partially forming a film containing a calcium phosphate-based material and an antibacterial agent on a substrate.
- the method for producing a spinal implant includes a step of preparing a substrate, the substrate contains a calcium phosphate-based material and an antibacterial agent, and the film thickness is smaller than that of the first region and the first region. Includes a step of forming a coating having a sixth region.
- FIG. 1 It is a figure which shows an example of the use form of the spinal implant which concerns on embodiment of this disclosure. It is a perspective view of a spinal implant. It is a top view of the spinal implant. It is a side view of a spinal implant. It is a figure which shows the cut surface when the spinal implant is cut along the line AA of FIG. It is a perspective view of the holding device of a spinal implant. It is a figure which shows the state which connected the spinal implant and the holding device.
- the antibacterial metal agent can be reduced in the coated spinal implant having the antibacterial metal agent. Specifically, it will be described below.
- the spinal implant according to the present embodiment is inserted between adjacent vertebrae in place of the intervertebral disc or to prosthesis the intervertebral disc, and is used to replace, correct or repair the height of the spinal structure.
- the spinal implant inserted between adjacent vertebrae is also called, for example, an interbody spacer, a block, a cage, or the like.
- FIG. 1 is a diagram showing an example of a usage pattern of the spinal implant 1.
- the direction indicated by the arrow described as "front” will be referred to as “front side” or “front side”.
- the direction indicated by the arrow described as rear is referred to as rear side or rear side.
- the direction indicated by the arrow described above is referred to as an upper side or an upper side.
- the direction indicated by the arrow described as below is referred to as a lower side or a lower side.
- the direction indicated by the arrow described as right is referred to as the right side.
- the direction indicated by the arrow marked left is referred to as the left side.
- the front side in FIG. 1 is the abdominal side in the human body
- the rear side in FIG. 1 is the back side in the human body.
- the spinal implant 1 is used in PLIF (Posterior Lumbar Interbody Fusion, posterior interbody fusion), which is one of the interbody fusion operations in surgery for herniated discs and the like.
- PLIF Posterior Lumbar Interbody Fusion, posterior interbody fusion
- the spinal implant 1 is inserted between the adjacent vertebrae 50 so as to prosthesis the excised portion of the intervertebral disc.
- the spinal implant 1 is inserted posteriorly, that is, from the back side in the anterior-posterior direction of the human body to the intervertebral bones while being held by a holding device 100 (see FIG. 6) having a rod-shaped rod portion.
- a holding device 100 see FIG. 6 having a rod-shaped rod portion.
- two spinal implants 1 are inserted between two adjacent vertebrae 50 so as to be arranged in the left-right direction.
- a metal rod (not shown) is laid across the two vertebrae 50 into which the spinal implant 1 is inserted and fixed to each vertebrae 50, whereby the two vertebrae 50 are fixed to each other.
- NS is inserted posteriorly, that is, from the back side in the anterior-posterior direction of the human body to the intervertebral bones while being held by a holding device 100 (see FIG. 6) having a rod-shaped rod portion.
- two spinal implants 1 are inserted between two adjacent vertebrae 50 so as to be arranged in the left-right direction.
- the spinal implant 1 is not limited to PLIF, but can also be used in other surgical methods such as TLIF (Transforaminal Lumbar Interbody Fusion, unilateral approaching posterior lumbar interbody fusion). In this case, the spinal implant 1 is inserted only on one side of the left-right direction between the vertebrae.
- TLIF Transforaminal Lumbar Interbody Fusion, unilateral approaching posterior lumbar interbody fusion
- FIGS. 2 to 5 are views showing the configuration of the spinal implant 1
- FIG. 2 is a perspective view of the spinal implant 1
- FIG. 3 is a top view of the spinal implant 1
- FIG. 4 is a side view of the spinal implant 1.
- FIG. 5 is a diagram showing a cut surface when cut along the line shown by AA in FIG.
- the spinal implant 1 is formed of a substantially rectangular parallelepiped-shaped substrate 2 extending in the anterior-posterior direction, and has an anterior surface 3, a posterior surface 4, a right side surface 5, a left side surface 6, and an upper surface 8. , And the bottom surface 9. Then, from the upper surface 8 to the lower surface 9, a hollow portion 7 having an elliptical shape as seen from the upper surface 8 and the lower surface 9 is provided, and one or a plurality of hole portions 5a and holes are provided in the right side surface 5 and the left side surface 6. A portion 6a is provided.
- the shapes of the plurality of holes 5a and the holes 6a seen from the right side surface 5 and the left side surface 6 are circular.
- the spinal implant 1 is not limited to a substantially rectangular parallelepiped shape, and may be, for example, a substantially cubic shape. Further, the shape seen from the upper surface 8 and the lower surface 9 of the cavity 7 is not limited to an ellipse, and may be, for example, a circle or a quadrangle. Further, the shapes of the plurality of holes 5a and the holes 6a seen from the right side surface 5 and the left side surface 6 are not limited to a circle, and may be, for example, a quadrangle.
- the area of the opening surface (ellipse) of the cavity 7 is larger than the area of the opening surface (substantially circular) of the side holes 5a and 6a.
- the cavity 7 may be provided near the rear surface 4 of the substrate 2. That is, the distance from the cavity 7 to the front surface 3 may be smaller than the distance from the cavity 7 to the rear surface 4.
- the side hole portions 5a and 6a may be provided near the rear surface 4 of the substrate 2. That is, the distance from the side hole portions 5a, 6a to the front surface 3 may be smaller than the distance from the side surface holes 5a, 6a to the rear surface 4. Further, the holes 5a and 6a on the side surface penetrate the cavity 7, and the area of the opening surface on the right side surface 5 or the left side surface 6 side is larger than the area of the opening surface on the inner surface side of the cavity portion 7. Further, the holes 5a and 6a on the side surface may be tapered.
- the rear surface 4 is provided with a screw hole 4a (screw thread is not shown) and a recess 4b.
- the recess 4b is provided so as to form a groove (notch) from the rear surface 4 to the right side surface 5 or the left side surface 6 in the vicinity of the center of the rear surface 4 in the vertical direction.
- the cavity 7 can be said to be the first penetrating portion that penetrates the base 2 in the first direction, and is used for the spine. It can be said that the implant 1 includes a first penetrating portion that penetrates the substrate 2 in the first direction.
- the holes 5a and 6a penetrating the base 2 in the left-right direction are the second penetrating portions penetrating the base 2 in the second direction intersecting the first direction. It can be said. Then, it can be said that the spinal implant 1 includes a second penetrating portion that penetrates the base 2 in the second direction intersecting the first direction.
- metal, ceramics or plastic can be used for the substrate 2.
- metal stainless alloys, cobalt-chromium alloys, titanium, titanium alloys and the like can be used.
- titanium alloy an alloy to which at least one of aluminum, tin, zirconium, molybdenum, nickel, palladium, tantalum, niobium, vanadium, platinum and the like is added can be used.
- ceramics for example, alumina, zirconia, alumina-zirconia composite ceramics and the like can be used.
- plastic for example, polyethylene, a fluororesin, an epoxy resin, a polyetheretherketone (PEEK) resin, bakelite or the like can be used.
- the front surface 3 is formed in a slightly thick wall shape in the front-rear direction, and the central portion bulges toward the front direction (tip) to form a convex curved surface. Further, the front surface 3 has a tapered shape so that the width decreases toward the tip end. With such a shape, the anterior surface 3 has a tapered shape, so that the insertion can be facilitated when the spinal implant 1 is inserted between the vertebrae.
- the rear surface 4 is formed of a flat surface. As shown in FIG. 2, a screw hole 4a is formed in the central portion of the rear surface 4 so as to penetrate from the rear surface 4 to the cavity 7 in the front-rear direction.
- the screw hole 4a is screwed into the screw portion 101 formed at the tip of the rod portion of the holding device 100 for holding the spinal implant 1. That is, as an embodiment, the holding device 100 also has a function as an engaging tool, and the screw portion 101 may be able to engage with the screw hole 4a having a function as an engaging portion.
- a recess 4b is formed in the central portion of the rear surface 4 in the vertical direction.
- the tip of the rod portion of the holding device 100 comes into contact with the recess 4b (see FIG. 7). If the screw portion 101 can be screwed, the screw hole 4a does not have to penetrate. Further, the screw portion 101 of the holding device 100 can rotate independently of the tip of the rod portion. By rotating only the screw portion 101, the holding device 100 can be attached to and detached from the spinal implant 1 with the tip of the rod portion of the holding device 100 in contact with the recess 4b.
- the spinal implant 1 does not necessarily have to be held by the holding device 100 via the screw hole 4a.
- the holding device 100 has a mechanism capable of gripping the spinal implant 1, and the spinal implant 1 may be held by gripping.
- the substrate 2 is deflated from the front surface 3 to the rear surface 4, in other words, the cross-sectional area of the surface perpendicular to the front-rear direction (the area of the region surrounded by the outer edge) is larger toward the front surface 3 than the rear surface 4. It is formed to be. Further, the amount of change in the width of the substrate 2 in the left-right direction is smaller than the amount of change in the height in the up-down direction from the front surface 3 to the rear surface 4. More specifically, in the present embodiment, when the rear surface 4 and the front surface 3 are compared, the maximum value of the length along the left-right direction is constant, and the maximum value of the length along the vertical direction is constant. It may be larger.
- Such a shape can be adapted to the shape of a human vertebral body.
- the right side surface 5 and the left side surface 6 are formed so as to extend in the front-rear direction and are provided so as to face each other in the left-right direction. As shown in FIG. 2, holes 5a and 6a penetrating in the left-right direction are formed in the central portions of the right side surface 5 and the left side surface 6, respectively.
- the holes 5a and 6a are for promoting blood flow in the vicinity of the spinal implant 1 in a state of being inserted and fixed between the vertebrae.
- the spinal implant 1 is formed with a cavity 7 penetrating in the vertical direction from the upper surface 8 to the lower surface 9.
- the cavity 7 is filled with a bone-forming material.
- a plurality of ridge tooth portions 10 are formed on the upper surface 8 so as to project upward from the upper surface 8 and extend in the left-right direction in the plane of the upper surface 8.
- the lower surface 9 is formed with a plurality of ridge tooth portions 10 projecting downward from the lower surface 9 and extending in the left-right direction in the surface of the lower surface 9. That is, these plurality of ridged tooth portions 10 are provided as tooth portions protruding from the respective surfaces 8 and 9.
- the base 2 is formed so as to deflate from the front surface 3 to the rear surface 4" means the height of the apex along the vertical direction of the apex of the tooth portion 10. However, it means that it becomes smaller toward the rear.
- the plurality of ridge teeth 10 arranged on the upper surface 8 and the plurality of ridge teeth 10 arranged on the lower surface 9 may be located at positions corresponding to each other in the vertical direction. That is, one ridge tooth portion 10 arranged on the lower surface 9 may be located in the downward direction of one ridge tooth portion 10 arranged on the upper surface 8.
- the ridge tooth portion 10 is formed so that the inclination (inclination) in the front direction is gentler (smaller) than the inclination (inclination) in the rear direction.
- the spinal implant 1 is facilitated to move in the anterior direction and is difficult to move in the posterior direction.
- the vertical height of the front surface 3 is smaller than the vertical height of the ridge tooth portion 10, and the rear surface 4 is inside the extension line of the virtual line connecting the vertices of the ridge tooth portion 10. Existing.
- the virtual line connecting the vertices of the plurality of ridge teeth 10 may be matched by a curved line. Further, when the virtual line connecting the vertices of the plurality of ridge teeth 10 is a curve, the vertices of the curve (virtual curve) may be located on the front three sides. That is, the distance between the apex of the virtual curve and the front surface 3 may be smaller than the distance between the apex of the virtual curve and the rear surface 4.
- the entire spinal implant 1 is not provided with a coating film containing a calcium phosphate-based material and an antibacterial agent, but a first region and a coating film on which the coating film is arranged. Includes a second region exposed from.
- the first region where the coating containing the calcium phosphate-based material and the antibacterial agent is arranged and the second region exposed from the coating can be distinguished by elemental analysis of the surface of each region.
- the method of elemental analysis can be carried out, for example, by mapping surface elements with an energy dispersive X-ray analysis (EDX) device, which is an accessory device of a general scanning electron microscope (SEM). Further, surface analysis methods such as X-ray photoelectron spectroscopy, Auger electron spectroscopy, and secondary ion mass spectrometry may be used. Further, the element may be confirmed by chemically analyzing the sample obtained by mechanically scraping off the surface of each region. Phosphorus, calcium, antibacterial components and the like are detected on the surface of the first region. On the surface of the second region, elements constituting the base material are detected, phosphorus, calcium, antibacterial components and the like are not detected, or are below the noise level.
- the coating is arranged only on the region other than the screw hole 4a (first region). ..
- the surface of the substrate of the spinal implant 1 is exposed as it is in the region of the screw hole 4a.
- the second region may be the entire screw hole 4a or a part of the screw hole 4a. Further, the second region is not limited to the screw hole 4a, and may be another part of the spinal implant 1.
- the portion of the surface of the substrate (second region) exposed from the coating film may be exposed from the coating film, and a film or layer different from the coating film may be formed.
- the spinal implant 1 can reduce the possibility that the capsule is peeled off and brought into the body while enjoying the advantage of having the capsule arranged.
- the film thickness of the boundary portion between the upper surface 8 and the right side surface 5 or the left side surface 6 or the boundary portion between the lower surface 9 and the right side surface 5 or the left side surface 6 is the film thickness of another region. It may be thicker than it is thick. That is, a thick film can be formed at the corners of the substrate.
- the film thickness of the edge of the opening of the cavity 7 may be thicker than the film thickness of the inner surface of the cavity 7. Further, the film may be formed so that the film thickness becomes thinner from the opening of the cavity 7 toward the inside.
- the base 2 is prepared for the production of the spinal implant 1.
- the substrate 2 can be formed, for example, by cutting a lump such as a round bar made of a metal material. By cutting, a substrate having each component such as a front surface 3, a rear surface 4, an upper surface 8, a lower surface 9, a right surface 5, a left surface 6, a cavity 7 and a hole 5a, 6a, etc. is prepared. Can be done.
- the base material to be the spinal implant 1 is provided with a cavity portion 7 penetrating in the vertical direction, holes 5a and 6a on the left and right side surfaces, and screw holes 4a on the rear surface (step of forming an engaging portion, hole forming step).
- the substrate 2 may be formed by cutting a lump of ceramics or resin, or may be formed by a method different from the cutting process.
- the spinal implant 1 has a coating formed by spraying a material containing a calcium phosphate-based material and an antibacterial agent onto a substrate.
- the antibacterial agent is, for example, silver
- the silver concentration in the sprayed coating is, for example, 0.05% by weight to 3.00% by weight.
- the calcium phosphate-based material one or a mixture of two or more selected from the group consisting of hydroxyapatite, ⁇ -3 calcium phosphate, ⁇ -calcium tertiary phosphate and calcium tetraphosphate can be used.
- thermal spraying method used for forming a thermal spray coating containing a calcium phosphate-based material examples include a flame spraying method, a high-speed flame spraying method, a plasma spraying method, and a cold spraying method.
- a flame spraying method a gas flame of oxygen and a flammable gas is used as a heat source to melt or nearly melt the sprayed material and spray it onto the surface of the base metal to form a film.
- the thermal spraying temperature is about 2700 ° C. and the thermal spraying rate is Mach 0.6.
- the thermal spray powder can be introduced into a gas frame torch of oxygen gas 50 psi and acetylene gas 43 psi with dry air of 100 psi, and thermal spraying can be performed at a thermal spray distance of 60 to 100 mm.
- the thickness of the thermal spray coating is 5 to 100 ⁇ m, preferably 20 to 40 ⁇ m. This is because if it is 5 ⁇ m or more, the entire area of the sprayed portion can be covered, and if it is 100 ⁇ m or less, the adhesive strength of the coating film does not decrease due to the residual stress during thermal spraying.
- the thermal spray coating of a calcium phosphate-based material containing an antibacterial material is formed by spraying a powder of a coating material in a molten (or semi-molten) state onto a base material (base) to cool, solidify, and deposit.
- the thermal spray coating may be referred to as a thermal spray layer or a coating layer.
- the formed sprayed coating may be heat-treated.
- the crystallinity of the calcium phosphate-based material can be increased to improve the stability of the film.
- the heat treatment is carried out under a reduced pressure of 10-2 Pa or less in a temperature range of 400 to 1000 ° C. for 0.5 to 7 hours. It is preferably in the temperature range of 550 to 850 ° C. for 1 to 5 hours.
- the sprayed coating may be hydrated.
- oxygen apatite is converted to hydroxyapatite, and the elution of silver ions can be stabilized.
- the hydration treatment is a step of adding water molecules to a substance, and can be performed, for example, by immersing the substance in water at 60 to 100 ° C. for 10 to 60 minutes.
- the silver concentration in the thermal spray coating can be adjusted by changing the amount of the silver raw material to be blended with the calcium phosphate-based material that is the thermal spray material.
- the silver concentration in the sprayed coating is 0.05% by weight to 3.00% by weight, preferably 0.05% by weight to 2.50% by weight, more preferably 0.05% by weight to 1.00% by weight, and further. It is preferably 0.1% by weight to 1.00% by weight. This is because the antibacterial property is sufficient when the weight is 0.05% by weight or more. Further, if it is 3.00% by weight or less, the burden on the living tissue can be suppressed.
- the coating process of the spinal implant 1 is as follows.
- a film containing a calcium phosphate-based material and an antibacterial agent is partially formed on the substrate (film forming step).
- the region in which the coating film containing the calcium phosphate-based material and the antibacterial agent is partially formed on the substrate is the first region, and the region of the substrate in which the coating film is not formed is the second region.
- a film is formed with the screws for the coating forming step inserted into the screw holes 4a, and then the screws are removed.
- a film can be formed except for the screw holes 4a.
- the screw hole 4a may be completely filled with the screws for the coating forming step.
- the screws for the coating forming step are arranged so as to penetrate the screw holes 4a, for example. When roughening the surface, the surface may be roughened before the film is formed (roughening step).
- the coating method is not limited to thermal spraying methods such as frame thermal spraying, high-speed flame thermal spraying, and plasma thermal spraying.
- a physical vapor deposition method such as sputtering, ion plating, ion beam deposition, or ion mixing method, or a wet coating method such as a sol-gel method may be selected.
- the coating film may be directly arranged on the substrate 2 by the method described above, or may be arranged via an intermediate layer as described below. That is, a film may be formed on the surface of the substrate by a method such as coating, plating, thermal spraying, or vapor deposition, and this may be used as an intermediate layer to further form a film of the above-mentioned calcium phosphate-based material. Further, as a method for forming the intermediate layer, a method of additive manufacturing (additional manufacturing) may be used as a method for forming the intermediate layer. The intermediate layer may be metal, polymer or ceramics.
- a PEEK resin may be used as a substrate, an intermediate layer of titanium metal may be formed on a desired surface of the substrate, and then a film containing a calcium phosphate-based material and an antibacterial agent may be formed on the surface of the intermediate layer.
- the surgeon sets the spinal implant 1 in the holding device 100 for holding the spinal implant 1. Specifically, the threaded portion of the holding device 100 is screwed into the screw hole 4a of the spinal implant 1 with the rod portion of the holding device 100 sandwiching the recess 4b of the spinal implant 1. As a result, the spinal implant 1 is positioned with respect to the holding device 100, and the spinal implant 1 is held.
- the cavity 7 of the spinal implant 1 is filled with a bone-forming material.
- the surgeon inserts the spinal implant 1 between the vertebrae. Specifically, the surgeon inserts the front three sides of the spinal implant 1 from the back side of the human body into the intervertebral space from which the bone pressing the nerve and the intervertebral disc have been removed. Then, after arranging the spinal implant 1 on one of the left and right sides (for example, the right side) between the adjacent vertebrae 50, the holding device 100 is removed from the spinal implant 1, so that the spinal implant 1 is placed on the right side between the vertebrae. Install. If the installation position of the spinal implant 1 is shallower than the position assumed before the operation, the spinal implant 1 is driven using an impactor to adjust the installation position. Similarly, the surgeon places the spinal implant 1 on the left side of the adjacent vertebrae.
- the surgeon bridges a metal rod (not shown) between adjacent vertebrae and fixes this rod to each vertebra 50.
- a metal rod (not shown) between adjacent vertebrae and fixes this rod to each vertebra 50.
- adjacent vertebrae 50 can be fixed to each other.
- the bone-forming material filled in the cavity 7 is fused with the upper and lower vertebrae 50, so that the adjacent vertebrae 50 are firmly fixed.
- Backout problems may occur in the initial state where the spinal cage is fixed between the vertebrae, or in the state where the bone-forming material filled in the cavity is not sufficiently fused with the vertebrae.
- Backout means that the spinal implant 1 placed at a predetermined position between the vertebrae moves to the back side (posterior) of the patient and shifts.
- the inclination of the tooth portions 10 provided on the upper surface 8 and the lower surface 9 is steeper on the posterior surface than on the anterior surface. As a result, it is possible to make it difficult for the spinal implant 1 to move posteriorly, and it is possible to prevent the spinal implant 1 from backing out.
- a part of the surface of the spinal implant 1 may be roughened to have a roughened surface portion.
- the upper surface 8 and the lower surface 9 of the spinal implant 1 may be roughened.
- Roughening can be done, for example, by using at least one of thermal spraying and blasting.
- the thermal spraying material the material exemplified as the material of the substrate 2 can be used.
- the blasting process include sandblasting.
- the rough surface may be formed before the film is formed. After that, a film may be formed on the formed rough surface.
- the rough surface may be formed by roughening each surface of the substrate. Specifically, the upper surface 8 and the lower surface 9 are roughened from the first direction to form a rough surface, and the right side surface 5 and the left side surface 6 are roughened from the second direction. , A rough surface can be formed. Further, after that, the front surface 3 can be roughened from a third direction (front-back direction) intersecting the first direction and the second direction to form a rough surface.
- a rough surface having sufficient roughness may be formed on the front surface 3 by the roughening treatment performed on the upper surface 8, the lower surface 9, the right side surface 5 and the left side surface 6. be.
- the roughening process for the front surface 3 may be omitted.
- the rough surface may be formed on the inner surfaces of the cavity 7 and the holes 5a and 6a, respectively.
- the outer surfaces of the coating may be sprayed at the same time.
- Thermal spraying may be performed on the inner surfaces of the cavities 7 and the holes 5a and 6a to form a coating film containing the first region and the second region.
- the holding device 100 and the spinal implant 1 are screwed together to hold the spinal implant 1 by the holding device 100, but the holding device 100 holds the spinal implant 1. Is not limited to screws.
- a locking mechanism including a concave portion or a convex portion is provided on the base 2 of the spinal implant 1, and a part of the holding device 100 is fitted and locked to the locking mechanism to hold the spinal implant 1.
- a state in which a hole having a larger inner diameter than the diameter of the opening is provided in the substrate and a mechanism for making the outer diameter variable is provided at the tip of the holding device to reduce the outer diameter of the tip of the holding device. It may be a mechanism such as inserting it into the hole of the substrate with a tool, increasing the outer diameter inside the hole, and locking it.
- the holding device 100 also has a function as an engaging device, and the hole (engaging portion) that engages with the holding device has a locking mechanism that locks the holding device 100 and the base 2. You may.
- the spinal implant may be locked and held by a holding device that holds a part of the substrate.
- the second region exposed from the coating film has been described as the region of the screw hole 4a.
- the entire region along the depth direction of the screw hole 4a may be set as the second region, but it may be limited to a part of the region.
- the area on the side where the holding device 100 is inserted is a second area.
- the second region is not limited to the region of the screw hole 4a, and may be the region of the locking mechanism or the engaging portion described above. Further, not limited to these areas, when the spinal implant 1 is held by the holding device 100, the area in contact with a part of the holding device 100 or the area sliding with a part of the holding device 100 is set as the second area. May be good.
- the region other than the region described above is the first region in which the coating film is arranged, but a second region exposed from the coating film may be provided in addition to the region described above.
- a spinal implant 1 inserted between adjacent vertebrae is exemplified.
- the spinal implant according to the present disclosure is not limited to the spinal implant 1 described above.
- a spinal rod for fixing the spine to a certain shape
- a spinal screw for fixing the spinal rod to the vertebrae.
- the spinal implants according to the present disclosure it is desirable that the second region exposed from the capsule is set to a region where the members (for example, the spinal rod and the spinal screw) are in contact with each other or slide.
- the entire spinal implant 1 is not provided with a film thickness containing a calcium phosphate-based material and an antibacterial agent, but a first region and a first region in which the film thickness is arranged. It may include a sixth region in which the film thickness is smaller than that of the coating film.
- the anterior surface 3 of the spinal implant 1, a part of the posterior surface 4 (the portion excluding the screw hole 4a and the recess 4b), the upper surface 5, the lower surface 9, the right side surface 5 and the left side surface 6 are covered with a coating.
- the inner surface of the holes 5a and 6a, the inner surface of the cavity 7, and the recess 4b are the sixth regions in which a film having a film thickness smaller than that of the first region is arranged.
- the first region may be the outer peripheral surface of the substrate 2, and the sixth region may be the inner surface of the cavity 7 and the inner surfaces of the holes 5a and 6a.
- the spinal implant 1 can reduce the total amount of the capsule as compared with the case where the entire spinal implant 1 is coated with the capsule, while enjoying the advantage of having the capsule arranged.
- the capsule has a sixth region having a film thickness smaller than that of the first region, it is possible to facilitate the formation of the capsule of the sixth region as compared with the capsule of the first region, and by extension, the implant for the spine.
- the manufacturing efficiency of 1 can be improved.
- the spinal implant 1 further includes a third region in which the film thickness of the capsule is smaller than that of the sixth region or is not coated (exposed from the capsule).
- the third region corresponds to the second region in the above-described first embodiment.
- the screw hole 4a is a third region where no coating is arranged.
- the surface of the substrate of the spinal implant 1 is exposed as it is in the region of the screw hole 4a.
- the third region may be the entire screw hole 4a or a part of the screw hole 4a. Further, the third region is not limited to the screw hole 4a, and may be another part of the spinal implant 1.
- the portion of the surface of the substrate (third region) exposed from the coating film may be exposed from the coating film, and a film or layer different from the coating film may be formed.
- the coating process of the spinal implant 1 is as follows.
- the film is formed so that the film thickness is different (film forming step).
- film forming step As a result, it is possible to form a first region and a sixth region having different film thicknesses for the coating film.
- the coating can be formed by applying a thermal spray coating on each surface of the substrate 2.
- the thickness of the coating film on the substrate 2 can be changed by adjusting the thermal spraying conditions such as the thermal spraying time, the thermal spraying direction, the composition of the thermal spraying material, and the thermal spraying temperature. For example, when the thickness of the coating film of the substrate 2 is increased, it can be realized by increasing the thermal spraying time, and when the thickness of the coating film of the substrate 2 is decreased, it is realized by shortening the thermal spraying time. It is possible.
- the upper surface 8 and the lower surface 9 can be sprayed from the first direction to form a coating, and the right side surface 5 and the left surface 6 can be sprayed from the second direction to form a coating. can. Further, after that, thermal spraying can be performed on the front surface 3 from a third direction (front-back direction) intersecting the first direction and the second direction to form a coating film. In this way, the first region of the coating can be formed on each surface of the substrate 2.
- a coating having a sufficient film thickness may be formed on the front surface 3 by thermal spraying on the upper surface 8, the lower surface 9, the right side surface 5 and the left side surface 6. In this case, thermal spraying on the front surface 3 may be omitted.
- the coating is formed on the inner surfaces of the cavity 7 and the holes 5a and 6a, respectively.
- the thermal spraying on the cavity 7 and the holes 5a and 6a is performed by shortening the irradiation time as compared with the case of forming the first region of the coating, thereby forming the coating of the sixth region having a film thickness smaller than that of the first region. Can be formed. Further, the formation of the sixth region of the coating film may be formed by reducing the amount of the material to be sprayed as compared with the case of forming the first region, for example.
- the outer surfaces of the coating (upper surface 8, lower surface 9, right side 5 and left side 6) are sprayed at the same time, and at the same time, the cavities 7 Thermal spraying may be performed on the inner surfaces of the holes 5a and 6a to form a coating film containing the first region and the sixth region. That is, the film thickness of the first region and the film thickness of the sixth region can be formed by performing thermal spraying on the substrate 2 assuming the shape of the substrate 2 and the amount of wraparound of the sprayed material.
- the film is formed on the inner surface of the recess 4b of the rear surface 4.
- the thermal spraying on the recess 4b can form a coating film in a third region having a film thickness smaller than that in the sixth region by shortening the irradiation time as compared with the case of forming two regions of the coating film.
- the formation of the third region of the coating film may be formed by reducing the amount of the material to be sprayed as compared with the case of forming the sixth region, for example.
- the third region of the coating film may be formed at the same time as the first region and the sixth region depending on the thermal spraying conditions.
- the rear surface 4 excluding the recess 4b may be a first region or a sixth region of the coating film.
- a film is formed with the screws for the coating forming step inserted in the screw holes 4a, and then the screws are removed. As a result, a film can be formed except for the screw holes 4a.
- the screw hole 4a may be completely filled with the screws for the coating forming step.
- the screws for the coating forming step are arranged so as to penetrate the screw holes 4a, for example. This may form a third region of the coating.
- the surface may be roughened before the film is formed (roughening step).
- the rough surface may be formed by roughening each surface of the substrate. Specifically, the upper surface 8 and the lower surface 9 are roughened from the first direction to form a rough surface, and the right side surface 5 and the left side surface 6 are roughened from the second direction. , A rough surface can be formed. Further, after that, the front surface 3 can be roughened from a third direction (front-back direction) intersecting the first direction and the second direction to form a rough surface. In this way, a fourth region of the rough surface can be formed on each surface of the substrate 2.
- a rough surface having sufficient roughness may be formed on the front surface 3 by the roughening treatment performed on the upper surface 8, the lower surface 9, the right side surface 5 and the left side surface 6. be.
- the roughening process for the front surface 3 may be omitted.
- the rough surface is formed on the inner surfaces of the cavity 7 and the holes 5a and 6a, respectively.
- the roughening treatment for the cavities 7 and the holes 5a and 6a has a fifth roughness smaller than that of the fourth region by shortening the treatment time as compared with the case of forming the fourth region of the rough surface.
- a rough surface of the region can be formed.
- the formation of the fifth region of the rough surface may be formed by reducing the amount of the material to be sprayed or the amount of sandblasting as compared with the case of forming the fourth region, for example.
- the outer surfaces of the coating may be sprayed at the same time.
- Thermal spraying may be performed on the inner surfaces of the cavities 7 and the holes 5a and 6a to form a coating film containing the first region and the sixth region.
- the above-mentioned first region may overlap with the fourth region because it is the front surface 3, the posterior surface 4, the upper surface 8, the lower surface 9, the right side surface 5, and the left side surface 6 of the spinal implant 1. Further, since the sixth region is the inner surface of the cavity 7 and the inner surfaces of the holes 5a and 6a, the sixth region may overlap with the fifth region.
- the third region exposed from the coating film has been described as the region of the screw hole 4a.
- the entire region along the depth direction of the screw hole 4a may be set as the third region, but it may be limited to a part of the region.
- the area on the side where the holding device 100 is inserted is a third area.
- the third region is not limited to the region of the screw hole 4a, and may be the region of the locking mechanism or the engaging portion described above.
- a region in contact with a part of the holding device 100 or a region sliding with a part of the holding device 100 is set as a third region. May be good.
- the region other than the region described above is the first region or the sixth region in which the coating film is arranged, but a third region exposed from the coating film may be provided in addition to the region described above.
- the inner surface of the holes 5a and 6a, the inner surface of the cavity 7, and the recess 4b are set as the sixth region, but the recess 4b may be the first region. Further, the surface other than the screw hole 4a that does not face the outside may be the sixth region.
- a spinal implant 1 inserted between adjacent vertebrae is exemplified.
- the spinal implant according to the present disclosure is not limited to the spinal implant 1 described above.
- a spinal rod for fixing the spine to a certain shape
- a spinal screw for fixing the spinal rod to the vertebrae.
- the third region exposed from the capsule is set to a region where the members (for example, the spinal rod and the spinal screw) are in contact with each other or slide.
- the spinal implant according to one aspect of the present disclosure includes a substrate and a coating film containing a calcium phosphate-based material and an antibacterial agent arranged on the substrate, and the surface of the substrate is provided with the coating film. It has one region and a second region exposed from the coating.
- the calcium phosphate-based material in the coating has the effect of improving bone conductivity and bone fixation.
- the antibacterial agent in the coating has the effect of reducing the adhesion and growth of bacteria.
- the spinal implant can be inserted into the body at the time of surgery or the like while holding the second region exposed from the coating film of the substrate.
- the coating is less likely to peel off from the holding part. Therefore, it is possible to reduce the possibility that the coating is peeled off and brought into the body as compared with the case where the entire surface of the substrate is covered.
- the spinal implant according to one aspect of the present disclosure may further include an engaging portion that is arranged in the second region and can be engaged with an engaging device.
- the second region is provided with an engaging portion that can be engaged with the engaging device, it is possible to prevent the coating film from peeling off during engagement.
- the engaging portion may have a locking mechanism including a concave portion or a convex portion for locking the engaging device and the substrate.
- the engaging device and the substrate can be locked by a locking mechanism including a concave portion or a convex portion without using an adhesive, a magnetic force, or the like.
- the spinal implant according to one aspect of the present disclosure may have a screw hole in the engaging portion.
- the spinal implant can be easily attached to the holding device and can be easily removed by using the screw hole.
- the substrate may have a roughened rough surface portion, and the coating film may cover at least a part of the roughened surface portion.
- the adhesiveness between the spinal implant and the spine can be improved by bringing the rough surface portion into contact with the spine.
- the capsule is directly arranged on the substrate.
- the configuration of the spinal implant is simplified, so that the manufacturing cost can be suppressed.
- the method for manufacturing a spinal implant according to one aspect of the present disclosure includes a film forming step of partially forming a film containing a calcium phosphate-based material and an antibacterial agent on a substrate.
- the method for manufacturing a spinal implant includes a step of forming an engaging portion capable of engaging with an engaging device on the substrate before the coating forming step, and the coating forming step includes a step of forming an engaging portion.
- the coating may be formed by removing the engaging portion.
- the method for manufacturing a spinal implant according to one aspect of the present disclosure includes a hole forming step of forming a screw hole in the substrate before the coating forming step, and in the coating forming step, the screw hole is formed in the substrate. May be used to form the film except for.
- the method for manufacturing a spinal implant according to one aspect of the present disclosure includes a roughening step of roughening a part of the substrate to form a roughened surface portion before the coating forming step, and the coating forming step includes a roughening step of forming a roughened surface portion.
- the film may be formed so as to cover at least a part of the rough surface portion.
- the surface may be roughened by at least one of thermal spraying and blasting in the roughening step.
- the spinal implant according to one aspect of the present disclosure includes a substrate and a film thickness on the substrate containing a calcium phosphate-based material and an antibacterial agent, and the film thickness is a first region and the first region. It has a sixth region having a film thickness smaller than that of the sixth region.
- the calcium phosphate-based material in the coating has the effect of improving bone conductivity and bone fixation.
- the antibacterial agent in the coating has the effect of reducing the adhesion and growth of bacteria.
- antibacterial metal agents are also costly, so it is desirable to use as few as possible. Then, according to the above configuration, since the film thickness of a part of the film is made thinner than that of the other areas, the total amount of the antibacterial metal agent can be reduced as compared with the case where the film is not made thinner. Thereby, for example, the cost can be reduced.
- the spinal implant according to one aspect of the present disclosure may further include a first penetrating portion that penetrates the substrate in the first direction.
- the first penetrating portion can be filled with a bone-forming material, whereby the joint between the spinal implant and the vertebra can be facilitated.
- the first region is located on the outer peripheral surface of the substrate, and the sixth region is located on the inner surface of the first penetrating portion. You may.
- the film thickness of the coating film on the inner surface of the first penetrating portion is made smaller than the film thickness of the coating film on the outer peripheral surface, so that the antibacterial property of the region that is likely to come into direct contact with the vertebra is maintained. At the same time, the total amount of silver contained in the antibacterial agent can be reduced.
- the capsule has a third region having a film thickness smaller than that of the sixth region, and the first region and the third region are the outer periphery of the substrate. It may be located on a surface.
- the third region is a holding portion for holding the spinal implant, peeling of the coating film due to holding of the spinal implant can be suppressed. Therefore, according to the above configuration, it is possible to prevent the capsule from peeling off and being carried into the body with the holding of the spinal implant.
- the surface of the substrate may have a fourth region and a fifth region having a surface roughness smaller than that of the fourth region.
- the surface roughness of a predetermined region of the substrate can be reduced as needed.
- the first region may overlap the fourth region.
- a region belonging to both the first region and the fourth region can be provided.
- the sixth region may overlap with the fifth region.
- a region belonging to both the sixth region and the fifth region can be provided.
- the spinal implant according to one aspect of the present disclosure may further include a second penetrating portion penetrating the substrate in the second direction, which is the direction intersecting the first direction.
- blood flow can be promoted through the second penetrating portion.
- the second penetrating portion may have a plurality of penetrating holes arranged apart from each other.
- blood flow can be promoted through a plurality of through holes.
- the sixth region may be located on the inner surface of the second penetrating portion.
- the film thickness of the inner surface of the second penetrating portion which is unlikely to come into direct contact with the vertebra, can be reduced.
- the method for producing a spinal implant includes a step of preparing a substrate, the substrate contains a calcium phosphate-based material and an antibacterial agent, and the film thickness is smaller than that of the first region and the first region. Includes a step of forming a coating having a sixth region.
- a coating film having a third region having a film thickness smaller than that of the sixth region is further formed on the outer surface of the substrate. It may be a thing.
- the method for manufacturing a spinal implant according to one aspect of the present disclosure may include a step of forming a rough surface on at least a part of the surface of the substrate before forming the coating.
- a coating may be formed so as to cover at least a part of the rough surface in the step of forming the coating.
- the rough surface may be formed by at least one of thermal spraying and blasting in the step of forming the rough surface.
Abstract
Description
以下、本開示の一実施形態について、詳細に説明する。本実施形態に係る脊椎用インプラントは、椎間板の代わり、または椎間板を補綴するために、隣接する椎骨間に挿入され、脊柱構造の高さを置換、矯正または修復するために用いられるものである。なお、隣接する椎骨間に挿入される脊椎用インプラントは、例えば、椎体間スペーサ、ブロック、ケージ等とも呼ばれる。
まず、図1を参照して脊椎用インプラント1の使用形態について説明する。図1は、脊椎用インプラント1の使用形態の一例を示す図である。なお、説明の便宜上、以下では、前と記載された矢印が示す方向を前側または前方と称する。また、後と記載された矢印が示す方向を後側または後方と称する。また、上と記載された矢印が示す方向を上側または上方と称する。また、下と記載された矢印が示す方向を下側または下方と称する。また、右と記載された矢印が示す方向を右側と称する。また、左と記載された矢印が示す方向を左側と称する。また、図1における前側が人体における腹部側であり、図1における後側が人体における背中側である。
次に、図2~図5を参照して、脊椎用インプラント1の構成について説明する。図2~図5は、脊椎用インプラント1の構成を示す図であり、図2は脊椎用インプラント1の斜視図、図3は脊椎用インプラント1の上面図、図4は脊椎用インプラント1の側面図、図5は図4のA―Aで示す線において切断したときの切断面を示す図である。
脊椎用インプラント1の製造方法について説明する。まず、脊椎用インプラント1の製造のために、基体2を準備する。基体2は、例えば、金属材料からまる丸棒などの塊を切削加工することによって形成することができる。切削加工することにより、前面3、後面4、上面8、下面9、右側面5、左側面6、空洞部7および孔部5a、6a等の、各構成要素を備えた、基体を準備することができる。すなわち、脊椎用インプラント1となる基体に、上下方向に貫通する空洞部7、左右側面に孔部5a、6a、後面にネジ孔4aを設ける(係合部を形成する工程、孔形成工程)。なお、基体2は、セラミックスまたは樹脂の塊を切削することによって形成してもよいし、切削加工と異なる方法によって成形してもよい。
次に、脊椎用インプラント1の被膜方法について説明する。本実施形態に係る脊椎用インプラント1は、基体上にリン酸カルシウム系材料および抗菌剤を含む材料を溶射することによって被膜が形成されている。抗菌剤は例えば銀であり、溶射被膜中の銀濃度は、例えば0.05重量%~3.00重量%である。リン酸カルシウム系材料としては、ヒドロキシアパタイト、α-第3リン酸カルシウム、β-第3リン酸カルシウムおよび第4リン酸カルシウムから成る群から選択される1種または2種以上の混合物を用いることができる。
中間層としては、金属、高分子またはセラミックスであってもよい。例えば、PEEK樹脂を基体とし、チタン金属の中間層を基体の所望の表面に形成した後、リン酸カルシウム系材料と抗菌剤とを含む被膜を中間層の表面上に形成してもよい。
次に、本実施形態に係る脊椎用インプラント1を、椎骨間に挿入する際の手順について説明する。
脊椎用インプラント1の表面の一部を粗面化し、粗面部を有するようにしてもよい。例えば、脊椎用インプラント1の上面8および下面9を粗面化してもよい。粗面化は、例えば、溶射およびブラスト処理の少なくともいずれかを用いることにより行うことができる。溶射材料としては、基体2の材料として例示した材料を用いることができる。ブラスト処理としてはサンドブラスト等が挙げられる。また、3Dプリンタ等を用いて脊椎用インプラント1の表面に多孔質構造を形成する等の処理を行うことにより粗面化することも可能である。上面8および下面9を粗面化することにより、粗面された部分が脊椎と接触し、脊椎用インプラント1と脊椎との固着性を向上させることができる。
また、本実施形態では、保持器具100と脊椎用インプラント1とをネジにより螺合させることで、保持器具100により脊椎用インプラント1を保持しているが、保持器具100による脊椎用インプラント1の保持はネジに限られるものではない。
本開示の他の実施形態について、以下に説明する。なお、説明の便宜上、上記実施形態にて説明した部材と同じ機能を有する部材については、同じ符号を付記し、その説明を繰り返さない。すなわち、本実施形態において言及していない構成については、上述した実施形態1における構成と同様である。
本実施形態に係る脊椎用インプラント1では、脊椎用インプラント1の全体に、リン酸カルシウム系材料と抗菌剤とを含む被膜が配されているものではなく、被膜が配された第1領域、第1領域よりも被膜の膜厚が小さい第6領域を含むものであってよい。
脊椎用インプラント1の被膜工程は、以下の通りである。被膜は、膜厚が異なるように、形成する(被膜形成工程)。これにより、被膜について、膜厚の異なる第1領域および第6領域を形成することができる。被膜の形成は、基体2の各面に対して、溶射被膜を行なうことによって形成することができる。基体2上の被膜の厚みは、溶射により形成する場合、例えば、溶射時間、溶射方向、溶射材料の構成、溶射温度などの溶射条件を調整することで変えることができる。例えば、基体2の被膜の厚みを大きくする場合には溶射時間を長くすることにより実現することが可能であり、基体2の被覆の厚みを小さくする場合には溶射時間を短くすることで実現することが可能である。
粗面の形成は、基体の各面を粗面化することによって行われればよい。具体的には、上面8、下面9に対して第1方向から粗面化処理を行ない、粗面を形成し、右側面5、左側面6に対して第2方向から粗面化処理を行ない、粗面を形成することができる。また、その後、前面3に対して、第1方向および第2方向に交わる第3方向(前後方向)から粗面化処理を行ない、粗面を形成することができる。このようにして、基体2の各面に対して粗面の第4領域を形成することができる。
また、本実施形態では、被膜から露出している第3領域を、ネジ孔4aの領域として説明した。ここで、ネジ孔4aの深さ方向に沿った全領域を第3領域としてもよいが、一部の領域にとどめてもよい。ただし、保持器具100を差し込む側の領域については第3領域とすることが望ましい。また、第3領域は、ネジ孔4aの領域に限られるものではなく、上述した係止機構や係合部の領域であってもよい。また、これらの領域に限らず、保持器具100によって脊椎用インプラント1を保持する際に、保持器具100の一部と接する領域、あるいは保持器具100の一部と摺動する領域を第3領域としてもよい。以上で説明した領域以外は被膜が配された第1領域または第6領域とすることが望ましいが、以上で説明した領域以外にも被膜から露出している第3領域を設けてもよい。
本開示の一態様に係る脊椎用インプラントは、基体と、前記基体上に配された、リン酸カルシウム系材料と抗菌剤とを含む被膜とを備え、前記基体の表面は、前記被膜が配された第1領域と、前記被膜から露出している第2領域とを有する。
2 基体
3 前面
4 後面
4a ネジ孔(係合部、係止機構)
4b 凹部
5 右側面
5a 孔部
6 左側面
6a 孔部
7 空洞部
8 上面
9 下面
10 突条歯部
100 保持器具(係合器具)
101 ネジ部
Claims (28)
- 基体と、
前記基体上に配された、リン酸カルシウム系材料と抗菌剤とを含む被膜とを備え、
前記基体の表面は、前記被膜が配された第1領域と、前記被膜から露出している第2領域とを有する、脊椎用インプラント。 - 前記第2領域に配された、係合器具と係合可能な係合部を、さらに備える、請求項1に記載の脊椎用インプラント。
- 前記係合部は、前記係合器具と前記基体とを係止する凹部または凸部を含む係止機構を有する、請求項2に記載の脊椎用インプラント。
- 前記第2領域に、ネジ孔を有する、請求項1~3のいずれかに記載の脊椎用インプラント。
- 前記係止機構は、前記第2領域に設けた開口部の直径よりも内部の直径が大きな孔部と、前記係合器具に配され、前記孔部に挿通可能で、外径が変更可能な先端部とを含む、請求項3に記載の脊椎用インプラント。
- 前記係止機構は、前記係合器具に配され、前記係合部を挟持可能な挟持部を含む、請求項3に記載の脊椎用インプラント。
- 前記基体は、粗面化された粗面部を有し、前記被膜は当該粗面部の少なくとも一部を被覆している、請求項1~6のいずれかに記載の脊椎用インプラント。
- 前記粗面部は、前記第1領域に配され、前記粗面部の表面粗さは、前記第2領域の表面粗さより大きい、請求項7に記載の脊椎用インプラント。
- 前記被膜は、前記基体に直接、配されている、請求項1~8のいずれかに記載の脊椎用インプラント。
- 前記基体を第1方向に貫通する第1貫通部を、さらに備える、請求項1~9のいずれかに記載の脊椎用インプラント。
- 第1方向と交わる方向である第2方向に前記基体を貫通する第2貫通部を、さらに備える、請求項1~10のいずれかに記載の脊椎用インプラント。
- 前記第2貫通部は、互いに離れて配された複数の貫通孔を有している、請求項11に記載の脊椎用インプラント。
- 前記基体の表面は、第4領域と、前記第4領域よりも表面粗さが小さい第5領域を有している、請求項1~12のいずれかに記載の脊椎用インプラント。
- 前記第1領域は、前記第4領域に重なっている、請求項13に記載の脊椎用インプラント。
- 前記被膜は、前記第1領域よりも膜厚が小さい第6領域を、さらに有する、請求項1~14のいずれかに記載の脊椎用インプラント。
- 基体と、
前記基体上に配された、リン酸カルシウム系材料と抗菌剤とを含む被膜とを備え、
前記被膜は、第1領域と、前記第1領域よりも膜厚が小さい第6領域とを有する、脊椎用インプラント。 - 前記第1領域は、前記基体の外周面に位置しており、
前記第6領域は、前記基体を第1方向に貫通する第1貫通部の内面に位置している、請求項15または16に記載の脊椎用インプラント。 - 前記基体の表面は、第4領域と、前記第4領域よりも表面粗さが小さい第5領域を有し、前記第6領域は、前記第5領域に重なっている、請求項15~17のいずれかに記載の脊椎用インプラント。
- 前記第6領域は、第1方向と交わる方向である第2方向に前記基体を貫通する第2貫通部の内面に位置している、請求項15~18のいずれかに記載の脊椎用インプラント。
- 基体に、リン酸カルシウム系材料と抗菌剤とを含む被膜を部分的に形成する工程を含む、脊椎用インプラントの製造方法。
- 前記被膜を形成する前に、前記基体に係合器具と係合可能な係合部を形成する工程を含み、
前記被膜を形成する工程において、前記係合部を除いて前記被膜を形成する、請求項20に記載の脊椎用インプラントの製造方法。 - 前記被膜を形成する前に、前記基体にネジ孔を形成する工程を含み、
前記被膜を形成する工程において、前記基体に、前記ネジ孔を除いて前記被膜を形成する、請求項20または21に記載の脊椎用インプラントの製造方法。 - 前記被膜を形成する前に、前記基体の表面の少なくとも一部に粗面を形成する工程を含む、請求項20~22のいずれかに記載の脊椎用インプラントの製造方法。
- 前記被膜を形成する工程において、
前記粗面の少なくとも一部を被覆するように被膜を形成する、請求項23に記載の脊椎用インプラントの製造方法。 - 前記粗面を形成する工程において、
溶射およびブラスト処理の少なくともいずれか一方によって粗面を形成する、請求項23または24に記載の脊椎用インプラントの製造方法。 - 前記粗面を形成する工程において、アディティブマニュファクチャリングにより前記粗面を形成する工程を含む、請求項23または24に記載の脊椎用インプラントの製造方法。
- 前記被膜を形成する工程において、
第1領域と前記第1領域よりも膜厚の小さい第6領域を有する被膜を形成する、請求項20~26のいずれかに脊椎用インプラントの製造方法。 - 基体を準備する工程と、
前記基体に、リン酸カルシウム系材料と抗菌剤とを含み、第1領域と前記第1領域よりも膜厚の小さい第6領域を有する被膜を形成する工程と、を含む、脊椎用インプラントの製造方法。
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