WO2021194035A1

WO2021194035A1 - Height-adjustable spinal fusion cage

Info

Publication number: WO2021194035A1
Application number: PCT/KR2020/015545
Authority: WO
Inventors: 강국진; 이상수; 최선각
Original assignee: 주식회사 엘앤케이바이오메드
Priority date: 2020-03-24
Filing date: 2020-11-06
Publication date: 2021-09-30

Abstract

The present invention relates to a spinal fusion cage, which is inserted between vertebral bodies at the lowest height, is height-adjustable while inserted therebetween, and can replace, with one cage, cages having a height within a predetermined range. Therefore, from the perspective of a manufacturer, product groups that must be produced are reduced, and stock can also be reduced. In addition, unlike conventional cages having preset heights at predetermined spaces, the height of present invention is linearly adjusted according to the spaces between the vertebral bodies of a patient, and thus surgery at the optimum height according to the patient's condition can be performed.

Description

Height-adjustable spinal fusion cage

The present invention relates to a spinal fusion cage that can be adjusted in height, and more particularly, to a spinal fusion cage that can be inserted between vertebrae at the lowest height and can adjust the height in the inserted state.

The vertebrae are made up of 32-35 vertebrae that make up the body and the intervertebral disk between the vertebrae.

The vertebrae are composed of 7 cervical vertebrae, 12 thoracic vertebrae, 5 lumbar vertebrae, 5 sacrum, and 3-5 coccyx. It merges to form 1 sacrum, and 3 to 5 coccyx fused to form 1 coccyx.

Spinal fusion has been one of the treatment methods for the treatment of serious spinal diseases for a long time. This spinal fusion is a surgical method that removes an intervertebral disc (disc) and inserts a cage to replace it, thereby fusion of adjacent vertebrae with each other.

When such spinal fusion is performed on the lumbar spine, depending on the cage insertion direction, Posterial Lumbar Interbody Fusion (PLIF), Transformational Lumbar Interbody Fusion (TLIF), Lateral lateral Lumbar Interbody Fusion, LLIF), oblique lumbar interbody fusion (OLIF), anterior lumbar interbody fusion (ALIF), and the like.

Posterior vertebral fusion (PLIF) is a method in which an incision is made along the midline of the spine, the vertebra is opened to expose all of the vertebrae, the posterior part of the vertebra is removed, the disc is removed, and a PLIF cage is inserted.

Posterior vertebral fusion (PLIF) has been performed for a long time among spinal fusions, and is a necessary method when performing two- or three-segment fusions. However, due to the surgical procedure, there is a high possibility of adhesions to the nerves, ligaments and muscles, the healing time is long due to the large incision area, and the sequelae are large depending on the person.

The PLIF cage has a pair of small cages placed on the left and right sides, and is the smallest cage used for all spinal fusions.

Transverse intervertebral foramen fusion (TLIF) is a surgical method in which small incisions are made along both sides of the vertebral muscles, minimally exposing the vertebral body, and then the vertebral joints are removed in the direction of the nerve foramen and a TLIF cage disc is inserted. This surgical technique is suitable for one-piece surgery as it has the advantage of reducing bleeding and shortening the operation time. Since most TLIF cages are arc-shaped, they are placed in a vertebral body and rotated so that the convex part of the TLIF cage faces ventral. The TLIF cage is larger than the PLIF cage, but the supporting area is smaller than the LLIF cage or ALIF cage, which will be mentioned later.

Anterior vertebral fusion (ALIF) has several advantages, such as quick recovery from surgery and no need to worry about adhesions. have. The ALIF cage has the advantage of having the largest support area among all spinal fusion cages.

Lateral vertebral fusion (LLIF) was developed to overcome the shortcomings of ALIF, PLIF, and TLIF. Since lateral vertebral fusion is performed through an incision in the side, it is possible to widen the distance between the vertebrae and the narrowed area compared to conventional back incisions, and has the advantage of little damage to surrounding tissues. However, since there are psoas muscle and peritoneum around the operation route, there is a problem such as paralysis of the thigh muscle if there is a mistake during the operation. LLIF cages are smaller than ALIF cages, but smaller than PLIF cages or TLIF cages.

A safer and more effective surgical method than such lateral fusion is oblique lumbar interbody fusion (OLIF) or anterior to psoas (ATP) fusion. In lateral vertebral fusion, the surgical route is performed in the direction described in the flank, and the 4th lumbar vertebrae (L4) and 5th lumbar vertebrae (L5) are difficult to operate with DLIF due to the psoas muscle and peritoneum. ), there are also possible advantages. In addition, the possibility of damaging the nerve in question in lateral fusion is significantly less.

Conventional spinal fusion cages are made of a single body with no change in cross-sectional area or height by using a metal material such as titanium or a polymer material such as PEEK. Therefore, considering the patient's physique, height, race, gender, etc., it has a fairly large number of product configurations. That is, from the standpoint of the manufacturer, there was a burden of producing several hundred products by combining the three variables of width, length, and height.

In addition, although the interval between the patient's vertebrae does not increase at a regular interval, if it is manufactured as a group, it is necessary to select an appropriate height from an existing product group and perform the operation, so there is a problem that it cannot properly respond to each patient.

Various attempts have been made to solve this problem, and a spinal fusion cage with adjustable height has been developed.

US6176882 discloses such a height-adjustable cage. The cage of US6176882 includes a rectangular box-shaped wall with an open top and bottom, an engagement member moving up and down inside the wall, a pair of wedge members pushing the engagement member, and the pair of It is made to include an adjusting element (adjusting element) for adjusting the spacing between the wedge member and the wedge member by screwing. Therefore, US6176882 is only constrained by the box-shaped wall, and there is a problem in that the coupling member and the wedge member are not connected to each other, so that the coupling member is shaken.

In US9034041, the invention of claim 1 of Comparative Invention 4 largely includes a body assembly, an upper support member 718, and a lower support member 720, the body assembly comprising: It has a first portion 712 and a second portion 714 , wherein the first portion 712 and the second portion 714 are moved on a longitudinal axis by a control member. A gap between the upper support member 718 and the lower support member 720 is defined by a pair of first upper retaining members and a pair of second upper retaining members. Accordingly, US9034041 does not include a component for directly guiding the mutual movement of the upper support member 718 and the lower support member 720, so that the body assembly, the upper support member 718, and the lower support member 720 are not included. There is a problem with 720 oscillating relative to each other.

{Prior art literature}

[Patent Literature]

(Patent Document 1) US6176882

(Patent Document 2) US9034041

An object of the present invention devised to solve the above problems is to provide a spinal fusion cage that is inserted between the vertebrae at the lowest height, and that can adjust the height in the inserted state while stably supporting the movement of a pair of end plates is in

The present invention for achieving the above object, the first end plate and the second end plate in contact with the adjacent vertebral body; an end moving block connected to distal ends of the first end plate and the second end plate to be relatively movable; a proximal moving block connected to proximal portions of the first end plate and the second end plate to be relatively movable; an adjustment member capable of adjusting the distance between the distal movement block and the proximal movement block by adjusting the distance between the proximal movement block and the distal movement block by rotation; and disposed on the first end plate and the second end plate to support the load in the longitudinal direction or the width direction of the first end plate and the second end plate. It is a spinal fusion cage, characterized in that it is offset to one side with respect to the center of the width direction of the proximal movement block and the distal movement block, including a vertical guide portion to be.

The proximal moving block and the distal moving block are characterized in that one side has a high thickness and the other side has a low thickness in the width direction.

In addition, the proximal movement block is offset to the other side with respect to the center of the width direction, characterized in that the injection hole is formed.

In addition, the proximal movement block is characterized in that the pin member exposed to the inside of the adjustment member hole into which the adjustment member is inserted in order to support the rotation of the adjustment member is installed in a direction inclined with respect to the width direction.

In addition, injection grooves are formed in the first end plate and the second end plate so as not to interfere with the injection hole while the first end plate and the second end plate are close to each other.

In addition, block sliders are formed on the distal movement block and the proximal movement block, and plate sliders slid with respect to the block slider are formed on the first end plate and the second end plate.

In addition, the vertical guide portion includes a first vertical guide formed in a thickness direction of the first or second end plate, and a first vertical guide formed in a thickness direction of the first or second end plate and It has a second vertical guide sliding movement, the vertical guide is arranged in two pairs, one pair of the vertical guide is arranged on one side of the width direction of the first end plate and the second end plate, the other of the vertical guides The pair is characterized in that it is disposed on the other side in the width direction of the first end plate and the second end plate.

In addition, the first vertical guide is at least one pillar protruding in the thickness direction of the first or second end plate, the second vertical guide is characterized in that it has a channel surrounding a portion of the outer surface of the pillar.

In addition, the lengths of the pillars and channels disposed on one side of the first or second end plate in the width direction are longer than the lengths of the pillars and channels disposed on the other side.

In addition, the channel includes a first groove formed by a first groove concave in the width direction of the first or second end plate, and an extension portion protruding from the groove in a thickness direction of the first or second end plate. It is characterized in that it is formed by two grooves.

In addition, the periphery of the pillar is characterized in that the receiving portion for accommodating the extension is formed.

In addition, when two or more pillars are arranged, it is characterized in that one receiving groove is disposed between the pillars adjacent to each other.

In addition, the first groove portion is concave by a first groove wall disposed on the proximal side, a second groove wall spaced apart from the first groove wall and disposed on the distal end side, and a third groove wall connecting the first groove wall and the second groove wall. characterized in that it is formed.

In addition, the width direction thickness of the pillar is the same as the width direction depth of the first groove portion, the length direction thickness of the pillar is characterized in that the same as the longitudinal distance between the first groove wall and the second groove wall.

In addition, the second groove portion protrudes in the thickness direction of the first or second end plate and is disposed on the proximal side, and the first extension wall protrudes in the thickness direction of the first or second end plate and is disposed on the distal end side. is formed by an extension part comprising a second extension wall which becomes The first extension wall may form a plane with the first groove wall, the second extension wall may form a plane with the second groove wall, and the third extension wall may form a plane with the third groove wall.

In addition, the width direction depth of the second groove portion is characterized in that smaller than the width direction depth of the first groove portion.

In addition, a guide groove for guiding the insertion of the pillar is formed around the first groove portion.

In addition, the sum of the thicknesses in the longitudinal direction of the first and second extension walls is characterized in that the thickness is equal to or greater than the thickness in the longitudinal direction of the pillar.

In addition, the width direction thickness of the third extension wall is characterized in that the same as the width direction thickness of the pillar.

Further, in the case where two or more columns are disposed, the second extension wall of the proximal extension and the first extension wall of the distal extension in the two adjacent extensions are integrally formed.

In addition, the adjustment member is formed with a through hole, the distal movement block is formed with a communication hole communicating with the through hole, the communication hole is a spinal fusion cage, characterized in that communicated with the outside through the insertion portion.

Through the present invention, it is possible to replace a cage having a height within a certain range with one cage. Therefore, from the standpoint of the manufacturer, the number of products to be produced is reduced, and inventory can also be reduced. In addition, unlike the cage having a predetermined height at regular intervals in the prior art, since the height is linearly adjusted according to the patient's vertebral spacing, surgery can be performed at an optimal height according to the patient's condition.

In addition, since the cage is inserted at the lowest height, it is possible to reduce the burden of separately producing test inserts according to the existing proper intervertebral spacing, and from the point of view of doctors, the effort of securing insertion space while inserting a plurality of test inserts sequentially can be less

BRIEF DESCRIPTION OF THE DRAWINGS Fig. 1 is a perspective view in the proximal direction in a lowest-height state of an embodiment of a spinal fusion cage according to the present invention.

Fig. 2 is a distal perspective view of the lowest height state of the spinal fusion cage of Fig. 1;

3 is a plan view of the spinal fusion cage of FIG. 1 ;

Fig. 4 is a perspective view in the proximal direction in the highest state of the spinal fusion cage of Fig. 1;

Fig. 5 is a distal perspective view of the vertebral fusion cage of Fig. 1 in the highest state;

FIG. 6 is an exploded perspective view in the proximal direction of the spinal fusion cage of FIG. 1 .

FIG. 7 is an exploded perspective view in the distal direction of the spinal fusion cage of FIG. 1 .

FIG. 8 is a perspective view viewed from the upper side of the first end plate of the spinal fusion cage of FIG. 1 .

9 is a perspective view viewed from the lower side of the first end plate of the spinal fusion cage of FIG. 1 .

FIG. 10 is a perspective view seen from the upper side of the second end plate of the spinal fusion cage of FIG. 1 .

11 is a perspective view viewed from the lower side of the second end plate of the spinal fusion cage of FIG. 1 .

FIG. 12 is a partially enlarged view of FIG. 10 .

13 is a perspective view viewed from the proximal direction of the distal movement block of the spinal fusion cage of FIG. 1 .

FIG. 14 is a perspective view viewed from the distal direction of the distal movement block of the spinal fusion cage of FIG. 1 .

15 is a cross-sectional view of the distal movement block of the spinal fusion cage of FIG. 1 .

FIG. 16 is a perspective view viewed from the proximal direction of the proximal movement block of the spinal fusion cage of FIG. 1 .

FIG. 17 is a perspective view viewed from the distal direction of the proximal moving block of the spinal fusion cage of FIG. 1 .

18 is a cross-sectional view of the proximal moving block of the spinal fusion cage of FIG. 1 .

19 is a perspective view of an adjustment member of the spinal fusion cage of FIG. 1 ;

20 is a cross-sectional view of an adjustment member of the spinal fusion cage of FIG. 1 ;

Hereinafter, preferred embodiments of the present invention will be described with reference to the accompanying drawings. In adding reference numerals to the components of each drawing below, the same components should have the same reference numerals as much as possible even though they are shown on different drawings, and it is determined that the subject matter of the present invention may be unnecessarily obscured. Detailed description of known functions and configurations will be omitted.

Define the direction used in the description below. The distal direction is the direction in which the spinal fusion cage is inserted, and the proximal direction is opposite to the distal direction. The longitudinal direction means a direction on an imaginary straight line connecting the distal direction and the proximal direction. The thickness direction is the thickness direction of the end plate, that is, an imaginary straight direction toward the upper and lower vertebrae. In addition, the width direction is a direction perpendicular to both the longitudinal direction and the thickness direction, and means the horizontal direction of the end plate.

1 to 7 show the entire spinal fusion cage 100 according to the embodiment, and FIGS. 8 to 20 show each component constituting the spinal fusion cage 100 .

The spinal fusion cage 100 is provided between the first end plate 102 and the second end plate 122 that are largely disposed to face up and down, and the first end plate 102 and the second end plate 122 . The distal moving block 140 and the proximal moving block 170 which are disposed in and move according to the distance between the first end plate 102 and the second end plate 122, and the proximal moving block by rotation ( 170 ) and the distal moving block 140 by adjusting the distance between the distal moving block 140 and the proximal moving block 170 . And, it is disposed on the first end plate 102 and the second end plate 122 so that the load in the longitudinal direction or the width direction of the first end plate 102 and the second end plate 122 is applied. It includes a vertical guide portion formed to support.

The first end plate 102 and the second end plate 122 have a first end plate body 104 and a second end plate body 124 in contact with the vertebral body. The first end plate body 104 and the second end plate body 124 may be provided with toothed protrusions to prevent them from being separated with respect to the vertebral body. In addition, in the central portions of the first end plate body 104 and the second end plate body 124, a first window 118 and a second window 138 for inserting a bone graft material are provided, respectively. is formed

In addition,

first block seats

111 and 113 are formed at both ends of the first end plate body 104 in the longitudinal direction, and first plate rails 112 and 114 are formed at each of the

first block seats

111 and 113 . And, in the

first block seats

111 and 113,

first margins

110 and 116 are formed to provide a space in which the connecting part 144 of the adjusting member 180 or the distal moving block 140 is located, and the adjustment A part of the member 180 or a part of the connection part 144 of the end moving block 140 may be accommodated.

The first plate rails 112 and 114 are disposed so that a pair of rails face each other on both sides of the

first block seats

111 and 113 . The first plate rail 112 formed in the distal direction and the first plate rail 114 formed in the proximal direction are both formed from the surface of the first end plate body 104 in the thickness direction of the first end plate body ( 104) is formed to be inclined in a direction close to the center.

Similarly, second block seats 131 and 333 are formed at both ends of the second end plate body 124 in the longitudinal direction, and second plate rails 132 and 134 are formed at each second block seat 131 and 333 . In addition, second

spare portions

130 and 136 are formed in the second block seats 131 and 333 , and the second

spare portions

130 and 136 are a part of the adjusting member 180 or a connection portion 144 of the distal moving block 140 . ) may be acceptable.

The second plate rails 132 and 134 are arranged so that a pair of rails face each other on both sides of the

second block seats

130 and 136 . The second plate rail 132 formed in the distal direction and the second plate rail 134 formed in the proximal direction are both formed from the surface of the second end plate body 124 in the thickness direction of the second end plate body ( 124) is formed to be inclined in a direction close to the center.

The distal moving block 140 is formed by protruding the insertion portion 142 to facilitate insertion between the vertebrae in the distal direction. In addition, the distal moving block 140 has a connection portion 144 elongated in the proximal direction, and a connection screw portion 150 having a screw thread is formed inside the connection portion 144 . In addition, the end moving block 140 has a block projection 148 to correspond to the first block seat 116 of the first end plate 102 , and the second block seat of the second end plate 122 . It has a block projection (not shown) to correspond to (136). A first block rail 152 corresponding to the first plate rail 114 and a second block rail 148 corresponding to the second plate rail 136 are formed around the block protrusion 146 . In addition, the connection part 144 is formed offset to one side with respect to the center of the width direction of the end moving block 140 . This will be described below.

The proximal movement block 170 has an adjustment member hole 178 for rotatably supporting the adjustment member 180 therein. A support surface 174 is formed in contact with the rotation support 186 of the adjustment member 180 in the adjustment member hole 178 . In addition,

pinholes

176 and 177 in which the

pin members

192 and 194 are accommodated are formed in the proximal moving block 170 . The

pinholes

176 and 177 are formed in a direction inclined with respect to the width direction as shown in FIG. 17 , and their ends are exposed inside the adjustment member hole 178 . This will be described again below.

In addition, the proximal movement block 170 has a block projection 172 to correspond to the first block seat 110 of the first end plate 102 , and the second block seat of the second end plate 122 . It has a block projection (not shown) to correspond to 130 . A first block rail 152 corresponding to the first plate rail 112 is formed around the block projection 172 corresponding to the first block seat 110 . A second block rail 162 corresponding to the second plate rail 132 is formed around the block projection corresponding to the second block seat 130 . In addition, a fastening part 166 is formed on the side of the proximal moving block 170 to hold the spinal fusion cage 100 by a mechanism.

In addition, an injection hole 173 is formed in the proximal block 170 adjacent to the adjustment member hole 178 . The injection hole 173 is a space into which a bone graft material is inserted, and the adjustment member hole 178 is offset to one side with respect to the center of the spinal fusion cage 100 in the width direction, and the injection hole 173 is offset to the other side. In addition, the first and

second end plates

102 and 122 do not cover the injection hole 173 when the vertebral fusion cage 100 is low to stably inject a bone-forming material into the vertebral fusion cage 100 .

Injection grooves

115, 117, 135, 137 are formed so as to be delivered to the space. The

injection grooves

115 , 117 , 135 , and 137 are formed to be the same as or larger than the shape and size of the injection hole 173 when the first and

second end plates

102 and 122 are in the lowest state.

The

injection grooves

115 , 117 , 135 , and 137 are disposed on both sides in the longitudinal direction for convenience of production and direction change, but may be disposed only on one side where the actual injection hole 173 is located.

The distal moving block 140 and the proximal moving block 170 have a substantially wedge shape, and are raised or lowered by using the first end plate 102 and the second end plate 122 .

The adjusting member 180 may have a substantially bolt shape. That is, the adjustment member 180 has a head 190 , a rotation support portion 186 , and an adjustment screw portion 188 . The head 190 is formed in the proximal direction of the adjusting member hole 178, and the adjusting screw 188 passes through the adjusting member hole 178 and is screwed with the connecting screw 150 of the connecting part 144. do. The head 190 is formed with a tool seat that can be connected to an instrument (not shown). In addition, the rotation support portion 186 is formed on the adjustment member 180 to be rotated in contact with the support surface 174 formed in the adjustment member hole 178 . In addition, a pin seat portion 182 is formed around the rotation support portion 186 so that the ends of the

pin members

192 and 194 inserted through the pinhole 176 of the proximal movement block 170 are located. As a result, the adjustment member 180 is rotatable in place.

And, for guiding the insertion direction through the guide wire, a through hole 187 is formed in the adjusting member 180 in the longitudinal direction, and a communication hole communicating with the through hole 187 in the distal moving block 140 . 141 is formed, and a guide hole 143 communicating with the communication hole 141 is formed toward the insertion portion 142 of the distal moving block 140 .

Therefore, the user inserts and fixes a guide wire (not shown) to the site to be operated in advance, and the guide wire passes through the spinal fusion cage 100 through the guide hole 143, the communication hole 141, and the By inserting through the hole 187 , it is possible to insert the spinal fusion cage 100 in the intended orientation.

In particular, the adjusting member 180 is arranged to be offset to one side with respect to the center in the width direction, and for this purpose, the adjusting member hole 189 and the connecting part 144 are also arranged to be offset in the same direction. The reason why the adjustment member 180 is offset is to form the injection hole 170 separately from the adjustment member hole 189 . At this time, the proximal moving member 170 and the distal moving member 140 are formed to be inclined along the width direction, and offsetting the adjusting member 180 toward the thicker side is acceptable of the adjusting member 180 . It is desirable in design because the diameter can be maximized.

Accordingly, the position of the adjusting member 180 is biased toward one side of the pair of rails in which the first end plate rails 112 and 114 and the second end plate rails 132 and 134 are parallel to each other when viewed in a plan view. As a result, when the first and

second end plates

102 and 122 are moved up and down by the adjusting member 180, a moment is applied to the first end plate rails 112 and 114 and the second end plate rails 132 and 134. It may happen that it does not work properly. Therefore, in order to detail the force due to this moment, the first end plate rails 112 and 114 are offset by the

pin members

192 and 194 from supporting the adjusting member 180 at the upper and lower sides in the direction inclined with respect to the width direction. And it is possible to smoothly move up and down of the second end plate rails (132, 134).

The vertical guide portion includes a first vertical guide formed in a thickness direction of the first end plate 102 or the second end plate 122, and the first end plate 102 or the second end plate 122. It is formed in the thickness direction of the first vertical guide and made of a second vertical guide sliding movement.

Two pairs of the vertical guides are disposed, and one pair of the vertical guides is disposed on one side in the width direction of the first end plate 102 and the second end plate 122, and the other pair of the vertical guides is the The first end plate 102 and the second end plate 122 are disposed on the other side in the width direction. That is, the following three cases occur. The first is a case in which first vertical guides are installed on both sides of the first end plate 102 and second vertical guides are installed on both sides of the second end plate 122 . The second is a case in which second vertical guides are installed on both sides of the first end plate 102 , and first vertical guides are installed on both sides of the second end plate 122 . Third, a first vertical guide and a second vertical guide are installed on both sides of the first end plate 102, respectively, and the second end plate 122 is disposed on both sides of the second end plate 122 so as to correspond to the first end plate 102. This is a case where the second vertical guide and the first vertical guide are installed. Hereinafter, the first case will be described as an example, and the remaining cases will be omitted because they are simple modifications.

The first vertical guide is first and

second pillar portions

106 and 108 protruding in the thickness direction of the first or

second end plates

102 and 122, and the second vertical guide is the first and second pillar portions ( It has first and

second channel portions

127 and 129 surrounding a portion of the outer surface of the 106 and 108 .

The first and

second pillar portions

106 and 108 are each composed of two proximal

first pillars

1061 and 1081 and distal

second pillars

1062 and 1082, and consist of one or three or more. It is also possible to configure.

In addition, a first accommodating portion 107 and a second accommodating portion 109 capable of accommodating the

extension portions

126 and 128 described below are formed in the first and

second pillar portions

106 and 108 . In the embodiment, since the two

first pillars

1061 and 1081 and the

second pillars

1062 and 1082 are disposed close to each other, the first accommodating part 107 and the second accommodating part 109 each have three third poles. It consists of first to third receiving

grooves

1071, 1072, 1073, 1091, 1092, and 1093.

The first and

second channel portions

127 and 129 correspond to the first pillar portion 106 and the second pillar portion 108 and are disposed concavely in the width direction on the second end plate 122 . It is formed by a first groove and a second groove formed by

extension portions

126 and 128 protruding from the first groove in the thickness direction of the second end plate 122 . Hereinafter, the first groove portion and the second groove portion will be described only in one direction of the second end plate shown in the drawings.

The first groove portion includes

first groove walls

1251 and 1254 disposed on the proximal side,

second groove walls

1252 and 1255 spaced apart from the

first groove walls

1251 and 1254 and disposed on the distal end side, and the first groove wall ( It is concavely formed by

third groove walls

1253 and 1256 connecting the

second groove walls

1252 and 1255 to 1251 and 1254 . In addition, when describing the position in the proximal direction among the second grooves, the first extension wall 1261 protrudes in the thickness direction of the second end plate 122 and is disposed on the proximal side, and the second end plate ( The common wall 1262 protruding in the thickness direction of 122 and corresponding to the second extension wall disposed on the distal end side compared to the first extension wall 1261, and the second end plate 122 protrude in the thickness direction and a third extension wall 1264 connecting the first extension wall 1261 and the common wall 1262 which is the second extension wall. In addition, when describing the position in the distal direction among the second grooves, the common wall 1262 protruding in the thickness direction of the second end plate 122 and corresponding to the first extension wall disposed on the relatively proximal side; , a second extension wall 1262 protruding in the thickness direction of the second end plate 122 and disposed on the distal end side compared to the common wall 1262 , and protruding in the thickness direction of the second end plate 122 . and a third extension wall 1265 connecting the common wall 1262 and the second extension wall 1263 . That is, the common wall 1262 corresponds to the second extension wall of the first groove portion located on the proximal side and the first extension wall of the first groove portion located on the distal end side. Since it is adjacent, one wall is used, which is A portion corresponding to the

second receiving grooves

1072 and 1092 . And, all of the extension walls constitute the

extension parts

126 and 128 .

Accordingly, the first groove portion and the second groove portion form a substantially U-shaped groove. In addition, the first extension wall 1262 and the common wall 1262 form a plane with the

first groove walls

1251 and 1254, and the common wall 1262 and the

second extension wall

1262 and 1263 are the It forms a plane with the

second groove walls

1262 and 1255 , and the

third extension walls

1253 and 1256 form a plane with the

third groove walls

1264 and 1265 . As a result, the first and second grooves form first and

second channels

1271 and 1291 and 1272 and 1292 as a whole, and the first and

second pillars

106 and 108 are A sliding motion is possible with respect to the first and

second channel portions

127 and 129 .

A width direction depth of the second groove portion is smaller than a width direction depth of the first groove portion. In this case, the width direction thickness of the

first pillars

1061 and 1081 and the

second pillars

1062 and 1082 is the same as the width direction depth of the first groove portion, and the

first pillars

1061 and 1081 and the

second pillars

1061 and 1081 are the same as the width direction depth. The lengthwise thickness of the

pillars

1062 and 1082 is equal to the lengthwise distance between the

first groove walls

1251 and 1254 and the

second groove walls

1252 and 1255 .

Therefore, when the first and

second pillar portions

106 and 108 are inserted into the first and

second channel portions

127 and 129, the first and

second pillars

1061 and 1081 and the second pillar 1062 are formed in the first groove. ,1082) is surrounded by two longitudinal surfaces and one widthwise surface, but in the second groove, one width direction surface of the

first pillars

1061 and 1081 and the

second pillars

1062 and 1082 is entirely covered. Only a part of the two longitudinal sides is covered.

And, in order to support the force applied in the longitudinal direction, the sum of the longitudinal thicknesses of the first extension wall 1261 , the common wall 1262 , and the second extension wall 1263 is the first column 1061 . ,1081) and the second pillar (1062,1082) is preferably more than the thickness in the longitudinal direction. In addition, in order to maximize the force applied in the width direction, the width direction thickness of the third extension walls 1173 and 1373 is preferably the same as the width direction thickness of the

pillars

108 and 128 .

A guide groove 123 for guiding the insertion of the

first pillars

1061 and 1081 and the

second pillars

1062 and 1082 is formed around the first groove, so that when the spinal fusion cage 100 is assembled, or When the height is raised and then lowered again, the

pillars

108 and 128 are naturally guided toward the first groove.

Since the

extension parts

126 and 128 extend upwards of the first and second grooves and extend to the outside of the

first channels

1271 and 1291 and the second channels 1272 and 1292, processing is convenient, and the It has the advantage of maximizing the cross-sectional area of the column. In particular, since the cage whose height is adjusted as in the present invention has a structure that can be weak against shear force or torsion, the magnitude of the force that can be supported by the vertical guide is quite important, so the structure of the column and the extension in the present invention has a desirable feature in that the width of the column and the extension can be freely expanded according to the design intention of the designer.

The spinal fusion cage 100 is configured as described above, and by inserting an instrument such as a screwdriver into the tool groove 190 and rotating it in one direction, the proximal movement block 170 and the distal movement block 140 are moved. Close to each other, and as a result, it is possible to move the first end plate 102 and the second end plate 122 apart from each other. Similarly, the distance between the proximal movement block 170 and the distal movement block 140 is spaced apart by inserting the instrument and rotating it in the other direction, and as a result, the first end plate 102 and the second end A movement to approximate the distance between the plates 122 is possible.

As described above, the present invention has been described with reference to preferred embodiments of the present invention, but those skilled in the art can variously modify and change the present invention within the scope without departing from the spirit and scope of the present invention as described in the claims below. You will understand that it can be done.

Through the present invention, it is possible to respond to a height within a certain range with one cage, thereby reducing the inventory burden and production burden. It is expected to be widely used in the field because it has the advantage that the recovery time of the patient can also be greatly shortened.

{description of code}

100: spinal fusion cage 102: first end plate

104: first end plate body 106: first pillar

107: first accommodating part 108: second pillar part

109: second accommodating part 110, 116: first spare part

111,113: 1st block seat 112,114: 1st plate trail

115, 117: first injection groove 118: first window

122: second end plate 123: guide groove

124: second end plate body 126: first extension

127: first channel unit 128: second extension unit

129: second channel part 130, 136: second spare part

131,133: 2nd block seat 132,134: 2nd plate trail

135,137: second injection groove 138: second window

140: end movement block 141: communication hole

142: insertion part 143: guide hole

144: connection part 148, 172: block projection

150: connection screw part 152, 154: first block rail

162,164: second block rail 166: fastening part

170: proximal movement block 173: injection hole

174: support surface 176: pinhole

178: adjustment member hole 180: adjustment member

182: pin seat portion 186: rotation support portion

187: through hole 188: adjusting screw part

190: head 192, 194: pin member

1061,1081: the first pillar 1062,1082: the second pillar

1071,1091: first receiving home 1072,1092: second receiving home

1073,1093: third receiving groove 1251,1254: first groove wall

1252.1255: second groove wall 1253,1256: second groove wall

1261: first extension barrier 1262: common wall

1263: second extended barrier 1264, 1265: third extended barrier

1271,1291: first channel 1272,1292: second channel

Claims

a first end plate and a second end plate in contact with adjacent vertebrae;

an end moving block connected to distal ends of the first end plate and the second end plate to be relatively movable;

a proximal moving block connected to proximal portions of the first end plate and the second end plate to be relatively movable;

an adjustment member capable of adjusting the distance between the distal movement block and the proximal movement block by adjusting the distance between the proximal movement block and the distal movement block by rotation; and

The first end plate and the second end plate are disposed on the first end plate and the second end plate to support the load in the longitudinal direction or the width direction of the first end plate and the second end plate. including a vertical guide part,

The spinal fusion cage, characterized in that the adjustment member is offset to one side with respect to the center of the width direction of the proximal movement block and the distal movement block.
The spinal fusion cage according to claim 1, wherein the proximal movement block and the distal movement block have a high thickness on one side and a low thickness on the other side in the width direction.
The spinal fusion cage according to claim 2, wherein an injection hole is formed in the proximal moving block by being offset to the other side with respect to the center in the width direction.
According to claim 1, wherein the proximal movement block is characterized in that the pin member exposed to the inside of the adjustment member hole into which the adjustment member is inserted in order to support the rotation of the adjustment member is installed in an inclined direction with respect to the width direction. Spinal fusion cage.
According to claim 3, wherein the first end plate and the second end plate is characterized in that the injection groove is formed so as not to interfere with the injection hole in a state in which the first end plate and the second end plate are close to each other. Spinal fusion cage.
The spinal fusion according to claim 1, wherein block sliders are formed on the distal movement block and the proximal movement block, and plate sliders sliding with respect to the block slider are formed on the first and second end plates. cage.
According to claim 1,

The vertical guide part includes a first vertical guide formed in a thickness direction of the first or second end plate, and a sliding motion with the first vertical guide formed in a thickness direction of the first or second end plate. It has a second vertical guide that

Two pairs of the vertical guides are arranged,

One pair of the vertical guides is disposed on one side of the first end plate and the second end plate in the width direction,

The other pair of the vertical guides is a spinal fusion cage, characterized in that disposed on the other side in the width direction of the first end plate and the second end plate.
The method according to claim 7, wherein the first vertical guide is at least one pillar protruding in the thickness direction of the first or second end plate, and the second vertical guide has a channel surrounding a part of the outer surface of the pillar. Spinal fusion cage.
[Claim 10] The spinal fusion cage of claim 9, wherein the lengths of the posts and channels disposed on one side in the width direction of the first or second end plate are longer than the lengths of the posts and channels disposed on the other side.
9. The method of claim 8, wherein the channel includes a first groove concavely disposed in the width direction of the first or second end plate, and an extension portion protruding from the groove in a thickness direction of the first or second end plate. Spinal fusion cage, characterized in that it is formed by the second groove formed by the.
The spinal fusion cage according to claim 8, wherein a receiving portion for accommodating the extended portion is formed around the pillar.
[Claim 11] The spinal fusion cage according to claim 10, wherein when two or more posts are disposed, one receiving groove is disposed between adjacent posts.
The third groove wall according to claim 10, wherein the first groove portion includes a first groove wall disposed on a proximal side, a second groove wall spaced apart from the first groove wall and disposed on a distal end side, and a third groove wall connecting the first groove wall and the second groove wall. Spinal fusion cage, characterized in that formed concave by.
14. The method of claim 13, wherein the width direction thickness of the pillar is equal to the width direction depth of the first groove portion, and the length direction thickness of the pillar is the same as the longitudinal distance between the first groove wall and the second groove wall. Spinal fusion cage.
11. The method of claim 10, wherein the second groove portion protrudes in the thickness direction of the first or second end plate and a first extension wall disposed on the proximal side, and protrudes in the thickness direction of the first or second end plate. Formed by an extension portion comprising a second extension wall disposed on the distal end side and a third extension wall protruding in the thickness direction of the first or second end plate and connecting the first extension wall and the second extension wall and the first extension wall forms a plane with the first groove wall, the second extension wall forms a plane with the second groove wall, and the third extension wall forms a plane with the third groove wall. Spinal fusion cage.
The spinal fusion cage according to claim 15, wherein a width direction depth of the second groove portion is smaller than a width direction depth of the first groove portion.
The spinal fusion cage according to claim 10, wherein a guide groove for guiding the insertion of the column is formed around the first groove portion.
The spinal fusion cage according to claim 15, wherein the sum of the longitudinal thicknesses of the first and second extended walls is equal to or greater than the longitudinal thickness of the column.
16. The spinal fusion cage according to claim 15, wherein a thickness of the third extension wall in a width direction is equal to a thickness of the column in a width direction.
16. The spinal fusion cage of claim 15, wherein the second extension wall of the proximal extension and the first extension wall of the distal extension in two adjacent extensions when two or more posts are disposed.
The spinal fusion according to claim 1, wherein the adjusting member has a through hole, the distal moving block has a communication hole communicating with the through hole, and the communication hole communicates with the outside through the insertion unit. cage.