WO2021200524A1 - Spine surgery instrument and system - Google Patents

Spine surgery instrument and system Download PDF

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Publication number
WO2021200524A1
WO2021200524A1 PCT/JP2021/012453 JP2021012453W WO2021200524A1 WO 2021200524 A1 WO2021200524 A1 WO 2021200524A1 JP 2021012453 W JP2021012453 W JP 2021012453W WO 2021200524 A1 WO2021200524 A1 WO 2021200524A1
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WO
WIPO (PCT)
Prior art keywords
spinal
pressing member
spinal surgery
side wall
surgery instrument
Prior art date
Application number
PCT/JP2021/012453
Other languages
French (fr)
Japanese (ja)
Inventor
一弘 長井
文也 中田
Original Assignee
京セラ株式会社
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 京セラ株式会社 filed Critical 京セラ株式会社
Priority to JP2022512054A priority Critical patent/JP7407273B2/en
Publication of WO2021200524A1 publication Critical patent/WO2021200524A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices

Definitions

  • This disclosure relates to spinal surgical instruments, as well as spinal implants and spinal surgical instruments systems.
  • a spinal implant that holds a fixation rod that fixes multiple spines to each other is known.
  • Spinal implants include fixation rods, spinal screws, connectors, and pressing members.
  • the pressing member is a member for fixing the fixing rod, and is called a set screw, a closure top, or the like.
  • Various spinal surgery instruments have been devised with a mechanism and structure devised so that surgery for installing spinal implants in the patient's body can be performed smoothly.
  • tool assemblies that include extension members.
  • the spinal surgery instrument has a first end and a second end, and holds a pressing member at the first end for fixing the rod to the accommodation groove provided in the spinal implant.
  • a possible rod-shaped holding portion and a tube-shaped guide portion having a penetrating portion on which the holding portion is arranged are provided, and the guide portion is provided in an axial direction from the holding portion toward the first end.
  • the system according to the present disclosure includes a plurality of spinal implants, a rod, a plurality of pressing members, and a spinal surgical instrument
  • the spinal implant includes a containment groove for accommodating the rod.
  • the pressing member can be attached using the spinal surgery instrument to secure the rod to the accommodation groove
  • the spinal surgery instrument has a first end and a second end, and the pressing member.
  • the first end is provided with a rod-shaped holding portion and a tube-shaped guide portion having a penetrating portion in which the holding portion is arranged.
  • the fixing rod is fixed by the pressing member while being housed in the housing of the spinal screw and / or the connector.
  • Spinal screws include, for example, standard screws and reduction screws.
  • the connector includes a connector having a plurality of accommodating portions and a connector having a rod-shaped portion.
  • the connector has a different shape than the spinal screw. Conventionally, when the pressing member is attached to the accommodating portion, the doctor has had to change the instrument to be used or replace the tip portion of the instrument to be used according to the object to which the pressing member is attached.
  • One aspect of the present disclosure provides a spinal surgical instrument capable of accurately attaching a pressing member to both the accommodations of a spinal screw and a connector.
  • FIG. 1 is a schematic view showing an example of a system 100 including a spinal surgery instrument 1.
  • System 100 is a system of spinal implant 60 and spinal surgery instrument 1.
  • the system 100 includes a plurality of spinal implants 60, a fixed rod 70 (rod), a plurality of pressing members 50, and a spinal surgical instrument 1.
  • Each spinal implant 60 includes a containment groove 63 that accommodates a fixation rod 70.
  • FIG. 1 shows a case where the spinal implant 60 is a standard screw as an example.
  • the spinal implant 60 is not limited to a standard screw and may be a reduction screw.
  • the spinal implant 60 may further include a pedicle screw, a pedicle screw with a reduction head, and / or a spinal laminar hook.
  • the spinal implant 60 may further include a connector 67 connecting the fixation rod 70.
  • the spinal surgery instrument 1 can be used when attaching the pressing member 50 to any of the spinal implants 60.
  • the reduction screw is suitable for performing a reduction treatment (a treatment for pulling a vertebra that is an affected part of a patient with spondylolisthesis and displaced to the anterior side of the human body backward and returning it to a normal position).
  • the connector 67 is, for example, a spinal implant 60 used at a position where a plurality of fixing rods 70 are connected in parallel.
  • FIG. 2 is an external view showing an example of a spinal implant 60.
  • the material of the spinal implant 60 include metals such as pure titanium, titanium alloys, cobalt alloys, cobalt-chromium alloys and stainless steel.
  • the titanium alloy include Ti-6Al-4V, Ti-15Mo-5Zr-3Al, Ti-6Al-2Nb-1Ta and the like.
  • the spinal implant 60 may have a pedestal 61 and a side wall 62. On the side of the pedestal 61 facing the spine, a screw portion (see FIG. 1) screwed into the spine may be arranged.
  • the threaded portion screwed into the spine is not directly related to the system 100. Therefore, in the spinal implant 60 shown in the following figures, the screw portion screwed into the spine is not shown.
  • the pedestal 61 has a first surface on the side facing the spine and a second surface on the side opposite to the surface facing the spine on which the side wall 62 is formed.
  • the side wall portion 62 protrudes from the second surface of the base portion 61.
  • a pair of side wall portions 62 are formed so as to project from the second surface substantially in parallel.
  • Each of the pair of side wall portions 62 has a top portion 69.
  • the accommodating groove 63 is a groove surrounded by the base portion 61 and the side wall portion 62.
  • the accommodating groove 63 may be a groove formed between the side wall portions 62 facing each other.
  • the bottom surface of the accommodating groove 63 may be formed by a base portion 61.
  • the accommodating groove 63 may be formed by a pair of side wall portions 62 whose side surfaces protrude from the second surface of the base portion 61.
  • the fixing rod 70 may be accommodated in the accommodating groove 63.
  • a pressing member 50 is attached to the accommodating groove 63.
  • the fixing rod 70 is a member that connects the spinal implants 60 that are adjacent to each other. That is, a plurality of the spinal implants 60 of the present embodiment are engaged with the vertebrae of the patient via the screw portion. Then, among the plurality of spinal implants 60 engaged with the vertebrae, the spinal implants 60 adjacent to each other are connected by a fixing rod 70.
  • the fixation rod 70 connecting the spinal implant 60a and the spinal implant 60b is accommodated in the accommodation groove 63 of the spinal implant 60a and in the accommodation groove 63 of the spinal implant 60b. Is also housed.
  • the fixation rod 70 is fixed to a spinal implant 60 installed in the first lumbar vertebra at one end and a spinal implant installed in the second lumbar vertebra at the other end. It is fixed at 60.
  • FIG. 3 is a perspective view showing an example of the pressing member 50 according to the embodiment of the present disclosure.
  • the pressing member 50 is a member that fixes the fixing rod 70 to the accommodating groove 63 provided in the spinal implant 60.
  • the pressing member 50 may be a set screw or a closure top.
  • the pressing member 50 may have a ring shape or a tubular shape. That is, the pressing member 50 has an outer surface 53 and an inner surface 54.
  • the pressing member 50 may have a male screw 51 formed on the outer surface 53.
  • the male screw 51 formed on the side surface of the pressing member 50 can be screwed with the female screw 64 formed on the side wall portion 62 of the accommodating groove 63 (see FIGS. 1 and 2). According to this configuration, the pressing member 50 can be fixed by being screwed into the accommodating groove 63.
  • FIG. 4 is an external view showing an example of the spinal surgery instrument 1.
  • FIG. 5 is an external view showing an example of the spinal surgery instrument 1 as in FIG.
  • the illustration of a part of the lock portion 30 and the guide portion 20 (for example, the first guide portion 21), which will be described later, is omitted.
  • a part of the guide portion 20 is shown in cross section.
  • the spinal surgery instrument 1 is an instrument for attaching (temporarily fixing) the pressing member 50 to the accommodating groove 63 of each spinal implant 60.
  • the spinal surgery instrument 1 may be, for example, an inserter for temporarily fixing the pressing member 50 to the accommodating groove 63.
  • the spinal surgery instrument 1 may be a driver for screwing and fixing the pressing member 50 temporarily fixed in the accommodation groove 63 of the spinal implant to the accommodation groove 63 with a predetermined strength.
  • the spinal surgery instrument 1 is composed of, for example, a metal, a polymer, or a complex thereof.
  • the metal constituting the spinal surgery instrument 1 may be SUS316 steel or the like.
  • the spinal surgery instrument 1 may have a holding portion 10 and a guide portion 20. As shown in FIG. 4, the spinal surgery instrument 1 may further include a lock portion 30.
  • FIG. 6 is an external view showing an example of the holding portion 10.
  • the holding portion 10 is a member capable of holding the pressing member 50.
  • the holding portion 10 has a columnar rod shape having a first end 11 and a second end 12.
  • the first end 11 is intended to be the end of the holding portion 10 on the side where the guide portion 20 is arranged
  • the second end 12 is intended to be the end opposite to the first end 11. There is.
  • the shape of the holding portion 10 is not limited to the columnar shape, and is an elliptical columnar shape, a square columnar shape, and a triangular shape. It may be columnar or the like.
  • the holding portion 10 may have a grip portion 40 in the vicinity of the second end 12.
  • the grip portion 40 is, for example, a handle gripped by a doctor (operator) who uses the spinal surgery instrument 1.
  • the doctor can grip the grip portion 40 and freely operate the spinal surgery instrument 1.
  • a doctor can rotate a line connecting the second end 12 and the first end 11 of the holding portion 10 as a rotation axis. By this rotation, the doctor can easily screw the pressing member 50 held by the first end 11 of the holding portion 10 into the accommodating groove 63.
  • FIG. 7 is a schematic view showing an example of a mechanism in which the holding portion 10 holds the pressing member 50.
  • FIG. 7 schematically shows a cross section in the vicinity of the pressing member 50 when the pressing member 50 is arranged in the vicinity of the first end 11.
  • the holding portion 10 includes a fixing portion 14 formed at the first end 11 in order to hold the pressing member 50.
  • the fixing portion 14 includes a screw 14a and a leaf spring member 14b.
  • the screw 14a is a member that fixes a portion of the leaf spring member 14b near the second end 12 to the holding portion 10.
  • the portion of the leaf spring member 14b near the first end 11 is urged outward from the center of the holding portion 10.
  • a portion of the leaf spring member 14b near the first end 11 abuts on the pressing member 50, and the pressing member 50 is fixed by a frictional force to hold the pressing member 50 in the holding portion 10.
  • the holding portion 10 may have a fixing portion 14 at the first end 11 to which the pressing member 50 can be fixed.
  • the fixing portion 14 may be configured to include a plurality of leaf spring members 14b. Further, the fixing portion 14 is not limited to the configuration in which the leaf spring member 14b and the screw 14a are combined. For example, the fixing portion 14 may be configured to include a ball plunger.
  • the holding portion 10 may further include a second contact portion 13 capable of contacting the lock portion 30, which will be described later.
  • the second contact portion 13 may include a member that urges the lock portion 30.
  • the second contact portion 13 may include an elastic member.
  • the elastic member may be, for example, a coil spring. The second contact portion 13 and the lock portion 30 will be described later.
  • FIG. 8 is an external view showing an example of the guide unit 20.
  • the guide portion 20 may be arranged in the vicinity of the first end 11 of the holding portion 10.
  • the guide portion 20 has a tube shape through which the holding portion 10 penetrates. That is, as shown in FIG. 7, the guide portion 20 has a tube shape having a penetrating portion 28 in which the holding portion 10 is arranged.
  • the guide portion 20 is, for example, a guide cylinder.
  • the guide portion 20 has a first contact portion 23 and a protruding portion 24.
  • the guide unit 20 may further include a first guide unit 21 and a second guide unit 22.
  • the first contact portion 23 can contact the top 69 (see FIG. 2) of the side wall portion 62 formed on the spinal implant 60.
  • the first contact portion 23 abuts on the opening-side end of the accommodation groove 63 formed in the spinal implant 60 (that is, the top 69 of the side wall portion 62), whereby the pressing member 50 is stably held in the accommodation groove 63.
  • the first direction is intended to be an axial direction from the holding portion 10 toward the first end 11. That is, the first direction is intended to be an axial direction from the second end 12 to the first end 11.
  • the direction opposite to the first direction may be hereinafter referred to as "second direction". That is, the second direction is intended to be an axial direction from the first end 11 to the second end 12.
  • the pressing member 50 can be stably attached to the accommodating groove 63 by abutting the first contact portion 23 with the end portion of the side wall portion 62 on the opening side of the accommodating groove 63.
  • the protruding portion 24 includes a first protruding portion 24a having a plate shape and a second protruding portion 24b having a plate shape arranged substantially parallel to the first protruding portion 24a. Further, the first protruding portion 24a and the second protruding portion 24b can come into contact with the side wall portion 62. That is, the protruding portion 24 may be able to come into contact with both of the pair of side wall portions 62 facing each other at the same time. According to this configuration, the protruding portion 24 abuts on the side wall portion 62 and further engages with the side wall portion 62, so that the spinal surgery instrument 1 can be stably held in the accommodating groove 63.
  • the protruding portion 24a and the second protruding portion 24b are simply referred to as the protruding portion 24.
  • the protrusion 24 may have a recess 27.
  • the recess 27 is a recess that can come into contact with the fixing rod 70 housed in the storage groove 63.
  • the first contact portion 23 of the guide portion 20 abuts on the side wall portion 62, the protrusion 24 engages between the walls of the accommodating groove 63, and the recess 27 of the protrusion 24 is fixed. It comes into contact with the rod 70.
  • the doctor who operates the spinal surgery instrument 1 can hold the fixing rod 70 inside the accommodating groove 63 by the protrusion 24. Therefore, the doctor can easily and smoothly fix the fixing rod 70 to the accommodation groove 63 provided in the spinal implant 60 by the pressing member 50 by using the spinal surgery instrument 1.
  • the penetration portion 28 is a hole that penetrates the guide portion 20 from the first direction to the second direction.
  • the holding portion 10 penetrates through the penetrating portion 28.
  • the holding portion 10 can be displaced along the axial direction with respect to the guide portion 20 in a state where the first contact portion 23 is in contact with the top portion 69 of the side wall portion 62 formed on the spinal implant 60.
  • the axial direction is intended to be a direction parallel to the line connecting the first end and the second end of the holding portion 10. According to this configuration, the holding portion 10 can move in the axial direction with respect to the guide portion 20 while maintaining the state in which the first contact portion 23 is in contact with the top portion 69 of the side wall portion 62. As a result, the doctor who operates using the spinal surgery instrument 1 can accurately attach the pressing member 50 to the accommodating groove 63.
  • the guide portion 20 When a force is applied to the spinal surgical instrument 1 in the first direction while the first contact portion 23 is in contact with the top 69 of the side wall portion 62 formed on the spinal implant 60, the guide portion 20 Draft in the second direction. When the guide portion 20 retracts in the second direction, the pressing member 50 held by the holding portion 10 moves toward the accommodating groove 63.
  • a doctor who performs an operation using a spinal surgery instrument 1 having such a guide portion 20 can easily position the pressing member 50 held by the holding portion 10 and accurately position the pressing member 50 in the accommodating groove 63. Can be attached.
  • the spinal surgery instrument 1 can reduce the size of the guide portion 20 as compared with the conventional instrument. Therefore, it is possible to provide a spinal surgery instrument 1 suitable for minimally invasive surgery, which has a lighter burden on the patient.
  • the width of the accommodating groove 63 that is, the distance between the pair of side wall portions 62 may be designed according to the diameter of the fixed rod 70. Therefore, if the thickness of the fixed rod 70 used is the same, the width of the accommodating groove 63 in the standard screw, the reduction screw, and the connector 67, that is, the distance between the pair of side wall portions 62 is substantially the same.
  • the guide portion 20 has a configuration in which the protruding portion 24 is engaged between the pair of side wall portions 62. Therefore, the guide portion 20 may be compatible with any of the standard screw, reduction screw, and connector 67 if the spinal implant 60 uses a fixed rod 70 of the same diameter.
  • the first guide portion 21 may have a substantially cylindrical shape.
  • the second guide portion 22 arranged at a position close to the spinal implant at the time of surgery may be a polygonal pillar-shaped tube through which the holding portion 10 penetrates.
  • the second guide portion 22 may be a pipe having a quadrangular prism shape.
  • the second guide portion 22 may be formed thinner than the first guide portion 21. As a result, the thickness of the guide portion 20 can be reduced. Therefore, it is possible to provide a spinal surgery instrument 1 suitable for minimally invasive surgery, which has a lighter burden on the patient. Further, by making the guide portion thin, it is possible to secure the wide field of view of the doctor who performs the operation using the spinal surgery instrument 1.
  • the second guide portion 22 may be formed with a first opening 25 and a second opening 26.
  • the first opening 25 and the second opening 26 function as windows in which the state of the holding portion 10 penetrating through the second guide portion 22 can be visually recognized from the outside of the second guide portion 22.
  • the pressing member 50 needs to be screwed into the accommodating groove 63 in the correct posture without being tilted. Since the first opening 25 and the second opening 26 are formed, the doctor can easily confirm the posture of the pressing member 50 held by the holding portion 10.
  • FIG. 9 is a perspective view showing an example of the lock portion 30.
  • the lock portion 30 has a tube shape through which the holding portion 10 penetrates.
  • the lock portion 30 is, for example, a lock cylinder.
  • the lock portion 30 is arranged at a position closer to the second end 12 than the guide portion 20. The lock portion 30 prevents the guide portion 20 from being separated from the holding portion 10.
  • the second contact portion 13 urges the guide portion 20 in the first direction in a state of being in contact with the lock portion 30.
  • the doctor can move the guide portion 20 in the second direction with respect to the holding portion 10.
  • the pressing member 50 held by the holding portion 10 is the first of the guide portions 20. 1 It is arranged at a position closer to the second end 12 than the contact portion 23. As a result, the pressing member 50 does not come into contact with the side wall portion 62 until the position of the pressing member 50 held by the holding portion 10 is correctly determined. Therefore, the doctor can smoothly attach the pressing member 50 to the accommodating groove 63 by using the spinal surgery instrument 1.
  • FIG. 10 is a schematic view showing how the pressing member 50 is attached to the standard screw 68.
  • FIG. 11 is a schematic view showing how the pressing member 50 is attached to the reduction screw 66.
  • FIG. 12 is a schematic view showing how the pressing member 50 is attached to the connector 67.
  • the second guide portion 22 is shown in a simplified cross section in order to make the arrangement of the pressing member 50 easy to understand. Further, in FIGS. 10 to 12, the first opening 25 and the second opening 26 are not shown for the sake of simplicity.
  • the standard screw 68 can come into contact with the first contact portion 23 in the direction of the opening of the accommodating groove 63 in the side wall portion 62.
  • the side wall portion 62 comes into contact with the first contact portion 23 in the second direction of the side wall portion.
  • the first contact portion 23 comes into contact with the side wall portion 62 at the top of the accommodating groove 63.
  • the top portion is a place most protruding from the base portion 61 of the side wall portion 62, and may be either a surface or a point formed by the side wall portion 62.
  • the first contact portion 23 abuts on the top 69 of the side wall portion 62, the protruding portion 24 abuts on the accommodating groove 63, and further engages with the side wall portion 62.
  • the pressing member 50 can be stably attached to the accommodating groove 63 of the standard screw 68.
  • the side wall portion 62 may have a female screw 64 formed on the surface forming the wall surface of the accommodating groove 63.
  • the reduction screw 66 has a longer side wall portion 62 in the second direction than the standard screw 68. Even in such a case, the spinal implant 60 and the guide portion 20 can be fixed regardless of the length of the side wall portion 62 by engaging the protruding portion 24 with the width of the accommodating groove 63.
  • the first contact portion 23 abuts on the top 69 of the side wall portion 62, the protruding portion 24 abuts on the accommodating groove 63, and further engages with the side wall portion 62.
  • the pressing member 50 can be stably attached to the accommodating groove 63 of the reduction screw 66.
  • the guide portion 20 may further have a peripheral edge portion 23a.
  • the guide portion 20 can accommodate the side wall portion 62 in the space formed by the first contact portion 23 and the peripheral edge portion 23a.
  • the peripheral edge portion 23a suppresses the deformation of the side wall portion 62 of the reduction screw 66 and the widening of the distance between the pair of side wall portions 62.
  • the connector 67 includes a second side wall portion 65 that forms an accommodating groove for accommodating another fixing rod 70.
  • the shape of the side wall portion 62 of the connector 67 in contact with the spinal surgery instrument 1 is the same as that of the standard screw 68 and the reduction screw 66. Therefore, the spinal surgery instrument 1 of the present disclosure can be used for the connector 67 as well.
  • the first contact portion 23 abuts on the top 69 of the side wall portion 62
  • the protruding portion 24 abuts on the accommodating groove 63, and further engages with the side wall portion 62.

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Medical Informatics (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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  • Surgical Instruments (AREA)
  • Prostheses (AREA)

Abstract

Provided is a spine surgery instrument allowing a pressing member to be installed correctly in a receiving portion of both a spine screw and a connector. The present invention is provided with: a stick-shaped holding part having a first end and a second end, and capable of holding, at the first end, a pressing member for fixing a rod in a receiving groove formed on a spine implant; and a tube-shaped guide part having a pass-through section wherein the holding part is disposed. The guide part has a protruding section that protrudes in the axial direction oriented from the holding part toward the first end, and abuts a pair of facing side walls from the receiving groove.

Description

脊椎手術用器具、システムSpine surgery instruments and systems
　本開示は脊椎手術用器具、ならびに脊椎用インプラントおよび脊椎手術用器具のシステムに関する。 This disclosure relates to spinal surgical instruments, as well as spinal implants and spinal surgical instruments systems.
　複数の脊椎を互いに固定する固定ロッドを保持する脊椎用インプラントが知られている。脊椎用インプラントには、固定ロッド、脊椎用スクリュー、コネクタ、および押圧部材が含まれる。押圧部材は、固定ロッドを固定するための部材であり、セットスクリューまたはクロージャートップなどと呼称される。 A spinal implant that holds a fixation rod that fixes multiple spines to each other is known. Spinal implants include fixation rods, spinal screws, connectors, and pressing members. The pressing member is a member for fixing the fixing rod, and is called a set screw, a closure top, or the like.
　脊椎用インプラントを患者の体内に設置するための手術を円滑に実施できるように工夫された機構・構造を備えるさまざまな脊椎手術用器具が考案されている。公知のものとしては、延設部材を備えるツールアセンブリがある。 Various spinal surgery instruments have been devised with a mechanism and structure devised so that surgery for installing spinal implants in the patient's body can be performed smoothly. Known are tool assemblies that include extension members.
　本開示の一態様に係る脊椎手術用器具は、第１端と第２端とを有し、ロッドを脊椎用インプラントに設けられた収容溝に固定するための押圧部材を前記第１端に保持可能な棒形状の保持部と、前記保持部が配された貫通部を有した、管形状のガイド部と、を備え、前記ガイド部は、前記保持部から前記第１端に向かう軸方向に沿って突出し、前記収容溝の対向する一対の側壁部に当接可能な突出部を含む。 The spinal surgery instrument according to one aspect of the present disclosure has a first end and a second end, and holds a pressing member at the first end for fixing the rod to the accommodation groove provided in the spinal implant. A possible rod-shaped holding portion and a tube-shaped guide portion having a penetrating portion on which the holding portion is arranged are provided, and the guide portion is provided in an axial direction from the holding portion toward the first end. Includes a protrusion that projects along and is capable of contacting a pair of opposite side wall portions of the accommodating groove.
　本開示の一様態に係るシステムは、複数の脊椎用インプラントと、ロッドと、複数の押圧部材と、脊椎手術用器具を備え、前記脊椎用インプラントは、前記ロッドを収容する収容溝を備え、前記押圧部材は、前記ロッドを前記収容溝に固定するために前記脊椎手術用器具を用いて取り付けることができ、前記脊椎手術用器具は、第１端と第２端とを有し、前記押圧部材を前記第１端に保持可能な棒形状の保持部と、前記保持部が配された貫通部を有した管形状のガイド部と、を備え、前記ガイド部は、前記保持部から前記第１端に向かう軸方向に沿って突出し、前記収容溝の対向する一対の側壁部に当接可能な突出部を含む。 The system according to the present disclosure includes a plurality of spinal implants, a rod, a plurality of pressing members, and a spinal surgical instrument, and the spinal implant includes a containment groove for accommodating the rod. The pressing member can be attached using the spinal surgery instrument to secure the rod to the accommodation groove, and the spinal surgery instrument has a first end and a second end, and the pressing member. The first end is provided with a rod-shaped holding portion and a tube-shaped guide portion having a penetrating portion in which the holding portion is arranged. Includes a protrusion that projects along the axial direction toward the end and is capable of contacting the pair of side walls of the accommodation groove that face each other.
　本開示の一様態によれば、脊椎用スクリューおよびコネクタのいずれの収容部に対しても、押圧部材を正確に取り付けることが可能な脊椎手術用器具を提供することができる。 According to the uniform state of the present disclosure, it is possible to provide a spinal surgical instrument capable of accurately attaching a pressing member to both the accommodating portion of the spinal screw and the connector.
本開示の実施形態に係る脊椎手術用器具を含むシステムの一例を示す模式図である。It is a schematic diagram which shows an example of the system including the instrument for spinal surgery which concerns on embodiment of this disclosure. 脊椎用インプラントの一例を示す外観図である。It is an external view which shows an example of the spinal implant. 押圧部材の一例を示す斜視図である。It is a perspective view which shows an example of a pressing member. 脊椎手術用器具の一例を示す外観図である。It is an external view which shows an example of the instrument for spinal surgery. 脊椎手術用器具の一例を示す外観図である。It is an external view which shows an example of the instrument for spinal surgery. 保持部の一例を示す外観図である。It is an external view which shows an example of the holding part. 保持部が押圧部材を保持する機構の一例を示す模式図である。It is a schematic diagram which shows an example of the mechanism which a holding part holds a pressing member. ガイド部の一例を示す外観図である。It is an external view which shows an example of a guide part. ロック部の一例を示す斜視図である。It is a perspective view which shows an example of a lock part. 標準スクリューへの押圧部材の取り付けの様子を示す模式図である。It is a schematic diagram which shows the state of attachment of the pressing member to a standard screw. リダクションスクリューへの押圧部材の取り付けの様子を示す模式図である。It is a schematic diagram which shows the state of attachment of the pressing member to a reduction screw. コネクタへの押圧部材の取り付けの様子を示す模式図である。It is a schematic diagram which shows the state of attachment of the pressing member to a connector.
　固定ロッドは、脊椎用スクリューおよび／またはコネクタの収容部に収容された状態で、押圧部材によって固定される。脊椎用スクリューには、例えば、標準スクリューおよびリダクションスクリュー等がある。 The fixing rod is fixed by the pressing member while being housed in the housing of the spinal screw and / or the connector. Spinal screws include, for example, standard screws and reduction screws.
　標準スクリューとリダクションスクリューとでは、収容部が形成されているスクリューヘッドの形状が異なっている。一方、コネクタには、収容部を複数備えたもの、および、ロッド状部分を備えたもの等がある。コネクタは、脊椎用スクリューとは異なる形状を有している。従来、押圧部材を収容部に取り付ける場合、医師は、押圧部材を取り付ける対象に応じて、使用する器具を変更したり、使用する器具の先端部を交換したりする必要があった。 The shape of the screw head in which the accommodating portion is formed is different between the standard screw and the reduction screw. On the other hand, the connector includes a connector having a plurality of accommodating portions and a connector having a rod-shaped portion. The connector has a different shape than the spinal screw. Conventionally, when the pressing member is attached to the accommodating portion, the doctor has had to change the instrument to be used or replace the tip portion of the instrument to be used according to the object to which the pressing member is attached.
　本開示の一態様は、脊椎用スクリューおよびコネクタのいずれの収容部に対しても、押圧部材を正確に取り付けることが可能な脊椎手術用器具を提供する。 One aspect of the present disclosure provides a spinal surgical instrument capable of accurately attaching a pressing member to both the accommodations of a spinal screw and a connector.
　〔実施形態〕
　以下、本開示の一実施形態について、詳細に説明する。 [Embodiment]
Hereinafter, one embodiment of the present disclosure will be described in detail.
　（システム１００）
　まず、本開示の一実施形態に係るシステム１００について、図１を用いて説明する。図１は、脊椎手術用器具１を含むシステム１００の一例を示す模式図である。 (System 100)
First, the system 100 according to the embodiment of the present disclosure will be described with reference to FIG. FIG. 1 is a schematic view showing an example of a system 100 including a spinal surgery instrument 1.
　システム１００は、脊椎用インプラント６０および脊椎手術用器具１のシステムである。システム１００は、複数の脊椎用インプラント６０、固定ロッド７０（ロッド）、複数の押圧部材５０、および脊椎手術用器具１を含んでいる。 System 100 is a system of spinal implant 60 and spinal surgery instrument 1. The system 100 includes a plurality of spinal implants 60, a fixed rod 70 (rod), a plurality of pressing members 50, and a spinal surgical instrument 1.
　＜脊椎用インプラント６０＞
　各脊椎用インプラント６０は、固定ロッド７０を収容する収容溝６３を備えている。図１には、脊椎用インプラント６０が標準スクリューである場合を例に挙げて図示している。脊椎用インプラント６０は、標準スクリューに限定されず、リダクションスクリューであってもよい。脊椎用インプラント６０は、さらにペディクルスクリュー、リダクションヘッド付きペディクルスクリュー、および／または、脊椎用ラミナーフックを含んでいてもよい。また、脊椎用インプラント６０は、さらに固定ロッド７０を連結するコネクタ６７を含んでもよい。脊椎手術用器具１は、いずれの脊椎用インプラント６０に対しても押圧部材５０を取り付ける際にも、使用可能である。ここで、リダクションスクリューは、リダクション処理（脊椎すべり症の患者の患部であって人体の前側にずれた椎骨を後方へ引っ張って正常な位置へ戻すための処理）を行うのに適している脊椎用インプラント６０である。コネクタ６７は、例えば、複数の固定ロッド７０同士が並列して継がれる箇所に用いられる脊椎用インプラント６０である。 <Spine implant 60>
Each spinal implant 60 includes a containment groove 63 that accommodates a fixation rod 70. FIG. 1 shows a case where the spinal implant 60 is a standard screw as an example. The spinal implant 60 is not limited to a standard screw and may be a reduction screw. The spinal implant 60 may further include a pedicle screw, a pedicle screw with a reduction head, and / or a spinal laminar hook. The spinal implant 60 may further include a connector 67 connecting the fixation rod 70. The spinal surgery instrument 1 can be used when attaching the pressing member 50 to any of the spinal implants 60. Here, the reduction screw is suitable for performing a reduction treatment (a treatment for pulling a vertebra that is an affected part of a patient with spondylolisthesis and displaced to the anterior side of the human body backward and returning it to a normal position). Implant 60. The connector 67 is, for example, a spinal implant 60 used at a position where a plurality of fixing rods 70 are connected in parallel.
　図２は、脊椎用インプラント６０の一例を示す外観図である。脊椎用インプラント６０の材質としては、例えば、純チタン、チタン合金、コバルト合金、コバルト－クロム合金またはステンレスなどの金属が挙げられる。チタン合金としては、例えば、Ｔｉ－６Ａｌ－４Ｖ、Ｔｉ－１５Ｍｏ－５Ｚｒ－３ＡｌまたはＴｉ－６Ａｌ－２Ｎｂ－１Ｔａなどが挙げられる。 FIG. 2 is an external view showing an example of a spinal implant 60. Examples of the material of the spinal implant 60 include metals such as pure titanium, titanium alloys, cobalt alloys, cobalt-chromium alloys and stainless steel. Examples of the titanium alloy include Ti-6Al-4V, Ti-15Mo-5Zr-3Al, Ti-6Al-2Nb-1Ta and the like.
　脊椎用インプラント６０は、台部６１および側壁部６２を有していてもよい。台部６１の、脊椎と対向する側には、脊椎にねじ込まれるネジ部（図１参照）が配されていてもよい。脊椎にねじ込まれるネジ部は、システム１００に直接関係しない。それゆえ、以降の図に示す脊椎用インプラント６０では、脊椎にねじ込まれるネジ部の図示を省略している。 The spinal implant 60 may have a pedestal 61 and a side wall 62. On the side of the pedestal 61 facing the spine, a screw portion (see FIG. 1) screwed into the spine may be arranged. The threaded portion screwed into the spine is not directly related to the system 100. Therefore, in the spinal implant 60 shown in the following figures, the screw portion screwed into the spine is not shown.
　台部６１は、脊椎と対向する側の第１面と、脊椎と対向する面と反対側の面であって、側壁部６２が形成されている側の第２面とを有している。 The pedestal 61 has a first surface on the side facing the spine and a second surface on the side opposite to the surface facing the spine on which the side wall 62 is formed.
　側壁部６２は、台部６１の第２面から突出している。一例において、一対の側壁部６２が略平行に第２面から突出して形成される。一対の側壁部６２のそれぞれは、頂部６９を有している。 The side wall portion 62 protrudes from the second surface of the base portion 61. In one example, a pair of side wall portions 62 are formed so as to project from the second surface substantially in parallel. Each of the pair of side wall portions 62 has a top portion 69.
　収容溝６３は、台部６１および側壁部６２とで囲まれた溝である。収容溝６３は、互いに向かい合う側壁部６２の間に形成される溝であってもよい。例えば、収容溝６３は、底面を台部６１によって形成されていてもよい。収容溝６３は、側面を台部６１の第２面から突出した１対の側壁部６２により形成されていてもよい。収容溝６３には、固定ロッド７０が収容され得る。また収容溝６３には、押圧部材５０が取り付けられる。 The accommodating groove 63 is a groove surrounded by the base portion 61 and the side wall portion 62. The accommodating groove 63 may be a groove formed between the side wall portions 62 facing each other. For example, the bottom surface of the accommodating groove 63 may be formed by a base portion 61. The accommodating groove 63 may be formed by a pair of side wall portions 62 whose side surfaces protrude from the second surface of the base portion 61. The fixing rod 70 may be accommodated in the accommodating groove 63. A pressing member 50 is attached to the accommodating groove 63.
　＜固定ロッド７０＞
　固定ロッド７０は、互いに隣り合う脊椎用インプラント６０同士を接続する部材である。すなわち、本実施形態の脊椎用インプラント６０は、その複数がスクリュー部を介して患者の椎骨に係合される。そして、椎骨に係合された複数の脊椎用インプラント６０のうち、互いに隣り合う脊椎用インプラント６０同士が、固定ロッド７０によって接続される。例えば、図１に示すように、脊椎用インプラント６０ａと脊椎用インプラント６０ｂとを接続する固定ロッド７０は、脊椎用インプラント６０ａの収容溝６３に収容され、かつ、脊椎用インプラント６０ｂの収容溝６３にも収容される。 <Fixed rod 70>
The fixing rod 70 is a member that connects the spinal implants 60 that are adjacent to each other. That is, a plurality of the spinal implants 60 of the present embodiment are engaged with the vertebrae of the patient via the screw portion. Then, among the plurality of spinal implants 60 engaged with the vertebrae, the spinal implants 60 adjacent to each other are connected by a fixing rod 70. For example, as shown in FIG. 1, the fixation rod 70 connecting the spinal implant 60a and the spinal implant 60b is accommodated in the accommodation groove 63 of the spinal implant 60a and in the accommodation groove 63 of the spinal implant 60b. Is also housed.
　例えば、第１腰椎と第２腰椎とを固定する場合、固定ロッド７０は、片端を第１腰椎に設置された脊椎用インプラント６０に固定され、他端を第２腰椎に設置された脊椎用インプラント６０に固定される。 For example, when fixing the first lumbar vertebra and the second lumbar vertebra, the fixation rod 70 is fixed to a spinal implant 60 installed in the first lumbar vertebra at one end and a spinal implant installed in the second lumbar vertebra at the other end. It is fixed at 60.
　＜押圧部材５０＞
　押圧部材５０の構成について、図３を用いて説明する。図３は、本開示の実施形態に係る押圧部材５０の一例を示す斜視図である。 <Pressing member 50>
The configuration of the pressing member 50 will be described with reference to FIG. FIG. 3 is a perspective view showing an example of the pressing member 50 according to the embodiment of the present disclosure.
　押圧部材５０は、固定ロッド７０を脊椎用インプラント６０に設けられた収容溝６３に固定する部材である。押圧部材５０は、セットスクリューまたはクロ―ジャートップであってよい。 The pressing member 50 is a member that fixes the fixing rod 70 to the accommodating groove 63 provided in the spinal implant 60. The pressing member 50 may be a set screw or a closure top.
　押圧部材５０は、図３に示すように、環形状または筒形状であってもよい。すなわち、押圧部材５０は、外側面５３および内側面５４を有している。押圧部材５０は、外側面５３に雄ネジ５１が形成されてよい。押圧部材５０の側面に形成されている雄ネジ５１は、収容溝６３の側壁部６２に形成された雌ネジ６４と螺合可能である（図１、図２参照）。この構成によれば、押圧部材５０は、収容溝６３へねじ込まれることによって固定され得る。 As shown in FIG. 3, the pressing member 50 may have a ring shape or a tubular shape. That is, the pressing member 50 has an outer surface 53 and an inner surface 54. The pressing member 50 may have a male screw 51 formed on the outer surface 53. The male screw 51 formed on the side surface of the pressing member 50 can be screwed with the female screw 64 formed on the side wall portion 62 of the accommodating groove 63 (see FIGS. 1 and 2). According to this configuration, the pressing member 50 can be fixed by being screwed into the accommodating groove 63.
　＜脊椎手術用器具１＞
　脊椎手術用器具１を構成する各部材について、図４および図５を用いて説明する。図４は、脊椎手術用器具１の一例を示す外観図である。図５は、図４と同様、脊椎手術用器具１の一例を示す外観図である。図５は、説明の簡略化のために、後述するロック部３０およびガイド部２０の一部（例えば、第１ガイド部２１）の図示が省略されている。また、図５は、ガイド部２０の一部が断面で示されている。 <Spine Surgical Instrument 1>
Each member constituting the spinal surgery instrument 1 will be described with reference to FIGS. 4 and 5. FIG. 4 is an external view showing an example of the spinal surgery instrument 1. FIG. 5 is an external view showing an example of the spinal surgery instrument 1 as in FIG. In FIG. 5, for the sake of simplification of the description, the illustration of a part of the lock portion 30 and the guide portion 20 (for example, the first guide portion 21), which will be described later, is omitted. Further, in FIG. 5, a part of the guide portion 20 is shown in cross section.
　脊椎手術用器具１は、押圧部材５０を各脊椎用インプラント６０の収容溝６３に取り付ける（仮固定する）ための器具である。脊椎手術用器具１は、例えば、押圧部材５０を収容溝６３に仮固定するためのインサーターであってもよい。あるいは、脊椎手術用器具１は、脊椎用インプラントの収容溝６３に仮固定された押圧部材５０を、所定の強度で収容溝６３にねじ込んで固定するためのドライバーであってもよい。 The spinal surgery instrument 1 is an instrument for attaching (temporarily fixing) the pressing member 50 to the accommodating groove 63 of each spinal implant 60. The spinal surgery instrument 1 may be, for example, an inserter for temporarily fixing the pressing member 50 to the accommodating groove 63. Alternatively, the spinal surgery instrument 1 may be a driver for screwing and fixing the pressing member 50 temporarily fixed in the accommodation groove 63 of the spinal implant to the accommodation groove 63 with a predetermined strength.
　脊椎手術用器具１は、例えば、金属、高分子あるいはそれらの複合体から構成される。脊椎手術用器具１を構成する金属は、ＳＵＳ３１６鋼等であってもよい。 The spinal surgery instrument 1 is composed of, for example, a metal, a polymer, or a complex thereof. The metal constituting the spinal surgery instrument 1 may be SUS316 steel or the like.
　脊椎手術用器具１は、保持部１０およびガイド部２０を有していてもよい。図４に示すように、脊椎手術用器具１は、さらに、ロック部３０を備えていてもよい。 The spinal surgery instrument 1 may have a holding portion 10 and a guide portion 20. As shown in FIG. 4, the spinal surgery instrument 1 may further include a lock portion 30.
　［保持部１０］
　保持部１０について、図６を用いて説明する。図６は、保持部１０の一例を示す外観図である。保持部１０は、押圧部材５０を保持可能な部材である。保持部１０は、図６に示すように第１端１１と第２端１２とを有する円柱状の棒形状である。ここで、第１端１１は、保持部１０におけるガイド部２０が配置される側の端部を意図しており、第２端１２は、第１端１１の反対側の端部を意図している。 [Holding unit 10]
The holding portion 10 will be described with reference to FIG. FIG. 6 is an external view showing an example of the holding portion 10. The holding portion 10 is a member capable of holding the pressing member 50. As shown in FIG. 6, the holding portion 10 has a columnar rod shape having a first end 11 and a second end 12. Here, the first end 11 is intended to be the end of the holding portion 10 on the side where the guide portion 20 is arranged, and the second end 12 is intended to be the end opposite to the first end 11. There is.
　本明細書では、保持部１０として略円柱状の棒形状の部材を用いる場合を例に挙げて説明するが、保持部１０の形状は円柱状に限定されず、楕円柱状、四角柱状、および三角柱状などであってもよい。 In the present specification, a case where a substantially columnar rod-shaped member is used as the holding portion 10 will be described as an example, but the shape of the holding portion 10 is not limited to the columnar shape, and is an elliptical columnar shape, a square columnar shape, and a triangular shape. It may be columnar or the like.
　保持部１０は、図４および図５に示すように、第２端１２近傍に、把持部４０を有していてもよい。把持部４０は、例えば、脊椎手術用器具１を用いる医師（操作者）によって把持されるハンドルである。医師は、把持部４０を把持して、脊椎手術用器具１を自在に操作することができる。例えば、医師は、保持部１０の第２端１２と第１端１１とを結ぶ線を回転軸として回転させることができる。この回転により、医師は、保持部１０の第１端１１に保持されている押圧部材５０を収容溝６３に容易にねじ込むことができる。 As shown in FIGS. 4 and 5, the holding portion 10 may have a grip portion 40 in the vicinity of the second end 12. The grip portion 40 is, for example, a handle gripped by a doctor (operator) who uses the spinal surgery instrument 1. The doctor can grip the grip portion 40 and freely operate the spinal surgery instrument 1. For example, a doctor can rotate a line connecting the second end 12 and the first end 11 of the holding portion 10 as a rotation axis. By this rotation, the doctor can easily screw the pressing member 50 held by the first end 11 of the holding portion 10 into the accommodating groove 63.
　保持部１０において押圧部材５０が保持される機構について、図７を用いて説明する。図７は、保持部１０が押圧部材５０を保持する機構の一例を示す模式図である。図７では、押圧部材５０が第１端１１近傍に配置された場合における、押圧部材５０近傍の断面を模式的に示している。 The mechanism by which the pressing member 50 is held by the holding portion 10 will be described with reference to FIG. FIG. 7 is a schematic view showing an example of a mechanism in which the holding portion 10 holds the pressing member 50. FIG. 7 schematically shows a cross section in the vicinity of the pressing member 50 when the pressing member 50 is arranged in the vicinity of the first end 11.
　保持部１０は、押圧部材５０を保持するために、第１端１１に形成された固定部１４を備える。固定部１４は、ネジ１４ａおよび板バネ部材１４ｂを含む。ネジ１４ａは、板バネ部材１４ｂの第２端１２に近い部位を保持部１０に固定する部材である。板バネ部材１４ｂの第１端１１に近い部位は、保持部１０の中心から外側に向かう方向に付勢されている。板バネ部材１４ｂの第１端１１に近い部位が押圧部材５０に当接し、摩擦力によって押圧部材５０を固定することにより、保持部１０に押圧部材５０を保持する。このように、保持部１０は、押圧部材５０を固定可能な固定部１４を第１端１１に有していてもよい。 The holding portion 10 includes a fixing portion 14 formed at the first end 11 in order to hold the pressing member 50. The fixing portion 14 includes a screw 14a and a leaf spring member 14b. The screw 14a is a member that fixes a portion of the leaf spring member 14b near the second end 12 to the holding portion 10. The portion of the leaf spring member 14b near the first end 11 is urged outward from the center of the holding portion 10. A portion of the leaf spring member 14b near the first end 11 abuts on the pressing member 50, and the pressing member 50 is fixed by a frictional force to hold the pressing member 50 in the holding portion 10. As described above, the holding portion 10 may have a fixing portion 14 at the first end 11 to which the pressing member 50 can be fixed.
　なお、固定部１４は、板バネ部材１４ｂを複数備える構成であってもよい。また、固定部１４は、板バネ部材１４ｂとネジ１４ａとの組み合わせた構成に限定されない。例えば、固定部１４は、ボールプランジャーを含む構成であってもよい。 The fixing portion 14 may be configured to include a plurality of leaf spring members 14b. Further, the fixing portion 14 is not limited to the configuration in which the leaf spring member 14b and the screw 14a are combined. For example, the fixing portion 14 may be configured to include a ball plunger.
　保持部１０は、後述するロック部３０と当接可能な第２当接部１３をさらに備えてもよい。 The holding portion 10 may further include a second contact portion 13 capable of contacting the lock portion 30, which will be described later.
　第２当接部１３は、ロック部３０を付勢する部材を含んでいてもよい。第２当接部１３は、弾性部材を備えていてもよい。弾性部材は、例えば、コイルばねであってもよい。第２当接部１３およびロック部３０については後に説明する。 The second contact portion 13 may include a member that urges the lock portion 30. The second contact portion 13 may include an elastic member. The elastic member may be, for example, a coil spring. The second contact portion 13 and the lock portion 30 will be described later.
　［ガイド部２０］
　続いて、ガイド部２０について、図８を用いて説明する。図８は、ガイド部２０の一例を示す外観図である。 [Guide section 20]
Subsequently, the guide unit 20 will be described with reference to FIG. FIG. 8 is an external view showing an example of the guide unit 20.
　ガイド部２０は、保持部１０の第１端１１の近傍に配置されていてもよい。ガイド部２０は、保持部１０が中を貫通する管形状を有している。すなわち、ガイド部２０は、図７に示すように、保持部１０が配された貫通部２８を有する管形状である。ガイド部２０は、例えばガイドシリンダーである。 The guide portion 20 may be arranged in the vicinity of the first end 11 of the holding portion 10. The guide portion 20 has a tube shape through which the holding portion 10 penetrates. That is, as shown in FIG. 7, the guide portion 20 has a tube shape having a penetrating portion 28 in which the holding portion 10 is arranged. The guide portion 20 is, for example, a guide cylinder.
　ガイド部２０は、第１当接部２３および突出部２４を有している。ガイド部２０は、さらに、第１ガイド部２１および第２ガイド部２２を有していてもよい。 The guide portion 20 has a first contact portion 23 and a protruding portion 24. The guide unit 20 may further include a first guide unit 21 and a second guide unit 22.
　第１当接部２３は、脊椎用インプラント６０に形成された側壁部６２の頂部６９（図２参照）と当接可能である。第１当接部２３が脊椎用インプラント６０に形成された収容溝６３の開口側の端部（すなわち、側壁部６２の頂部６９）と当接することにより、押圧部材５０を安定して収容溝６３に取り付けることができる。ここで、第１方向は、保持部１０から第１端１１に向かう軸方向を意図している。すなわち、第１方向は、第２端１２から第１端１１に向かう軸方向を意図している。一方、第１方向とは反対の方向を以後「第２方向」と記す場合がある。すなわち、第２方向は、第１端１１から第２端１２に向かう軸方向を意図している。 The first contact portion 23 can contact the top 69 (see FIG. 2) of the side wall portion 62 formed on the spinal implant 60. The first contact portion 23 abuts on the opening-side end of the accommodation groove 63 formed in the spinal implant 60 (that is, the top 69 of the side wall portion 62), whereby the pressing member 50 is stably held in the accommodation groove 63. Can be attached to. Here, the first direction is intended to be an axial direction from the holding portion 10 toward the first end 11. That is, the first direction is intended to be an axial direction from the second end 12 to the first end 11. On the other hand, the direction opposite to the first direction may be hereinafter referred to as "second direction". That is, the second direction is intended to be an axial direction from the first end 11 to the second end 12.
　この構成によれば、第１当接部２３が側壁部６２における収容溝６３の開口側の端部に当接することで、押圧部材５０を安定して収容溝６３に取り付けることができる。 According to this configuration, the pressing member 50 can be stably attached to the accommodating groove 63 by abutting the first contact portion 23 with the end portion of the side wall portion 62 on the opening side of the accommodating groove 63.
　突出部２４は、板形状を有している第１突出部２４ａと、第１突出部２４ａと略平行に配置される、板形状を有している第２突出部２４ｂとから成る。また、第１突出部２４ａおよび第２突出部２４ｂは側壁部６２に当接できる。すなわち、突出部２４は、一対の側壁部６２の、たがいに対向する一対の面の両方に同時に当接可能であってもよい。この構成によれば、突出部２４が側壁部６２に当接し、さらに側壁部６２に係合することで、脊椎手術用器具１を安定して収容溝６３に保持できる。以下、第１突出部２４ａと第２突出部２４ｂとを区別しない場合、単に突出部２４と記す。 The protruding portion 24 includes a first protruding portion 24a having a plate shape and a second protruding portion 24b having a plate shape arranged substantially parallel to the first protruding portion 24a. Further, the first protruding portion 24a and the second protruding portion 24b can come into contact with the side wall portion 62. That is, the protruding portion 24 may be able to come into contact with both of the pair of side wall portions 62 facing each other at the same time. According to this configuration, the protruding portion 24 abuts on the side wall portion 62 and further engages with the side wall portion 62, so that the spinal surgery instrument 1 can be stably held in the accommodating groove 63. Hereinafter, when the first protruding portion 24a and the second protruding portion 24b are not distinguished, they are simply referred to as the protruding portion 24.
　突出部２４は、凹部２７を有していてもよい。凹部２７は、収容溝６３に収容されている固定ロッド７０と当接可能な凹部である。この構成によれば、ガイド部２０の第１当接部２３が側壁部６２に当接し、突出部２４が収容溝６３の壁の間に係合し、さらに、突出部２４の凹部２７が固定ロッド７０と当接する。これにより、脊椎手術用器具１を操作する医師は、突出部２４によって固定ロッド７０を収容溝６３の内部へ抑え込むことができる。よって、医師は脊椎手術用器具１を用いて、押圧部材５０によって固定ロッド７０を脊椎用インプラント６０に設けられた収容溝６３に簡便かつ円滑に固定することができる。 The protrusion 24 may have a recess 27. The recess 27 is a recess that can come into contact with the fixing rod 70 housed in the storage groove 63. According to this configuration, the first contact portion 23 of the guide portion 20 abuts on the side wall portion 62, the protrusion 24 engages between the walls of the accommodating groove 63, and the recess 27 of the protrusion 24 is fixed. It comes into contact with the rod 70. As a result, the doctor who operates the spinal surgery instrument 1 can hold the fixing rod 70 inside the accommodating groove 63 by the protrusion 24. Therefore, the doctor can easily and smoothly fix the fixing rod 70 to the accommodation groove 63 provided in the spinal implant 60 by the pressing member 50 by using the spinal surgery instrument 1.
　貫通部２８は、ガイド部２０の第１方向から第２方向へ貫通する穴である。貫通部２８は、その中を、保持部１０が貫通する。 The penetration portion 28 is a hole that penetrates the guide portion 20 from the first direction to the second direction. The holding portion 10 penetrates through the penetrating portion 28.
　保持部１０は、第１当接部２３が脊椎用インプラント６０に形成された側壁部６２の頂部６９と当接した状態で、ガイド部２０に対して軸方向に沿って変位できる。軸方向とは、保持部１０の第１端と第２端とを結ぶ線に平行な方向を意図している。この構成によれば、第１当接部２３が側壁部６２の頂部６９に当接した状態を保ちつつ、保持部１０がガイド部２０に対して軸方向に動くことができる。これにより、脊椎手術用器具１を用いて手術する医師は、押圧部材５０を収容溝６３に正確に取り付けることができる。 The holding portion 10 can be displaced along the axial direction with respect to the guide portion 20 in a state where the first contact portion 23 is in contact with the top portion 69 of the side wall portion 62 formed on the spinal implant 60. The axial direction is intended to be a direction parallel to the line connecting the first end and the second end of the holding portion 10. According to this configuration, the holding portion 10 can move in the axial direction with respect to the guide portion 20 while maintaining the state in which the first contact portion 23 is in contact with the top portion 69 of the side wall portion 62. As a result, the doctor who operates using the spinal surgery instrument 1 can accurately attach the pressing member 50 to the accommodating groove 63.
　第１当接部２３が脊椎用インプラント６０に形成された側壁部６２の頂部６９と当接した状態で、脊椎手術用器具１に第１方向への力が加えられた場合、ガイド部２０は第２方向へ後退する。ガイド部２０が、第２方向へ後退することによって、保持部１０において保持された押圧部材５０は、収容溝６３に向けて移動する。 When a force is applied to the spinal surgical instrument 1 in the first direction while the first contact portion 23 is in contact with the top 69 of the side wall portion 62 formed on the spinal implant 60, the guide portion 20 Retreat in the second direction. When the guide portion 20 retracts in the second direction, the pressing member 50 held by the holding portion 10 moves toward the accommodating groove 63.
　このようなガイド部２０を有する脊椎手術用器具１を用いて手術を行う医師は、保持部１０に保持されている押圧部材５０の位置決めを容易に行い、押圧部材５０を収容溝６３に正確に取り付けることができる。 A doctor who performs an operation using a spinal surgery instrument 1 having such a guide portion 20 can easily position the pressing member 50 held by the holding portion 10 and accurately position the pressing member 50 in the accommodating groove 63. Can be attached.
　従来の器具は、収容溝６３の壁を形成する側壁部６２の外側に係合するガイド部が適用されていた。それゆえ、従来の器具のガイド部は、脊椎用インプラント６０の一対の側壁部６２を覆うことが可能な大きさよりも小さくすることができなかった。脊椎手術用器具１は、上記のようなガイド部２０を採用することによって、ガイド部２０のサイズを従来の器具に比べて小さくすることができる。よって、患者への負担がより軽い低侵襲手術に適した脊椎手術用器具１を提供することができる。 In the conventional instrument, a guide portion that engages with the outside of the side wall portion 62 that forms the wall of the accommodating groove 63 has been applied. Therefore, the guide portion of the conventional instrument could not be smaller than the size capable of covering the pair of side wall portions 62 of the spinal implant 60. By adopting the guide portion 20 as described above, the spinal surgery instrument 1 can reduce the size of the guide portion 20 as compared with the conventional instrument. Therefore, it is possible to provide a spinal surgery instrument 1 suitable for minimally invasive surgery, which has a lighter burden on the patient.
　収容溝６３の幅、すなわち一対の側壁部６２の間の距離は、固定ロッド７０の直径に合わせて設計されていてもよい。それゆえ、使用される固定ロッド７０の太さが同じであれば、標準スクリュー、リダクションスクリュー、およびコネクタ６７における収容溝６３の幅、すなわち一対の側壁部６２の間の距離は略同じである。 The width of the accommodating groove 63, that is, the distance between the pair of side wall portions 62 may be designed according to the diameter of the fixed rod 70. Therefore, if the thickness of the fixed rod 70 used is the same, the width of the accommodating groove 63 in the standard screw, the reduction screw, and the connector 67, that is, the distance between the pair of side wall portions 62 is substantially the same.
　ガイド部２０は、一対の側壁部６２の間に突出部２４が係合する構成を有している。それゆえ、ガイド部２０は、脊椎用インプラント６０が同じ直径の固定ロッド７０を用いる場合は、標準スクリュー、リダクションスクリュー、およびコネクタ６７のいずれに対しても適合し得る。 The guide portion 20 has a configuration in which the protruding portion 24 is engaged between the pair of side wall portions 62. Therefore, the guide portion 20 may be compatible with any of the standard screw, reduction screw, and connector 67 if the spinal implant 60 uses a fixed rod 70 of the same diameter.
　第１ガイド部２１は、略円筒形状であってもよい。一方、手術時に脊椎用インプラントに近い位置に配される第２ガイド部２２は、保持部１０が中を貫通する多角形柱形状の管であってよい。一例において、第２ガイド部２２は、形状が四角柱形状の管であってもよい。また、第２ガイド部２２は、第１ガイド部２１よりも細く形成されていてもよい。これにより、ガイド部２０の太さを細くすることができる。よって、患者への負担がより軽い低侵襲手術に適した脊椎手術用器具１を提供できる。また、ガイド部を細くすることによって、脊椎手術用器具１を用いて手術を行う医師の視界をできるだけ広く確保することができる。 The first guide portion 21 may have a substantially cylindrical shape. On the other hand, the second guide portion 22 arranged at a position close to the spinal implant at the time of surgery may be a polygonal pillar-shaped tube through which the holding portion 10 penetrates. In one example, the second guide portion 22 may be a pipe having a quadrangular prism shape. Further, the second guide portion 22 may be formed thinner than the first guide portion 21. As a result, the thickness of the guide portion 20 can be reduced. Therefore, it is possible to provide a spinal surgery instrument 1 suitable for minimally invasive surgery, which has a lighter burden on the patient. Further, by making the guide portion thin, it is possible to secure the wide field of view of the doctor who performs the operation using the spinal surgery instrument 1.
　また、第２ガイド部２２は、第１開口部２５および第２開口部２６が形成されていてもよい。第１開口部２５および第２開口部２６は、第２ガイド部２２の中を貫通する保持部１０の様子を第２ガイド部２２の外側から視認可能な窓として機能する。押圧部材５０は、傾斜させずに、正しい姿勢で収容溝６３にねじ込まれる必要がある。第１開口部２５および第２開口部２６が形成されていることにより、医師は、保持部１０に保持された押圧部材５０の姿勢を容易に確認することができる。 Further, the second guide portion 22 may be formed with a first opening 25 and a second opening 26. The first opening 25 and the second opening 26 function as windows in which the state of the holding portion 10 penetrating through the second guide portion 22 can be visually recognized from the outside of the second guide portion 22. The pressing member 50 needs to be screwed into the accommodating groove 63 in the correct posture without being tilted. Since the first opening 25 and the second opening 26 are formed, the doctor can easily confirm the posture of the pressing member 50 held by the holding portion 10.
　［ロック部３０］
　次に、ロック部３０の構成および機能について、図９を用いて説明する。図９は、ロック部３０の一例を示す斜視図である。 [Lock unit 30]
Next, the configuration and function of the lock portion 30 will be described with reference to FIG. FIG. 9 is a perspective view showing an example of the lock portion 30.
　ロック部３０は、保持部１０が中を貫通する管形状を有している。ロック部３０は、例えばロックシリンダーである。ロック部３０は、ガイド部２０より第２端１２に近い位置に配される。ロック部３０は、ガイド部２０が保持部１０から離脱することを防ぐ。 The lock portion 30 has a tube shape through which the holding portion 10 penetrates. The lock portion 30 is, for example, a lock cylinder. The lock portion 30 is arranged at a position closer to the second end 12 than the guide portion 20. The lock portion 30 prevents the guide portion 20 from being separated from the holding portion 10.
　ここで、ロック部３０および、ロック部３０に当接可能な第２当接部１３について、図４を用いて説明する。第２当接部１３は、ロック部３０に当接した状態で、ガイド部２０を第１方向に付勢する。医師は把持部４０を操作することにより、ガイド部２０を保持部１０に対して第２方向に移動させることができる。 Here, the lock portion 30 and the second contact portion 13 capable of contacting the lock portion 30 will be described with reference to FIG. The second contact portion 13 urges the guide portion 20 in the first direction in a state of being in contact with the lock portion 30. By operating the grip portion 40, the doctor can move the guide portion 20 in the second direction with respect to the holding portion 10.
　ロック部３０が第２当接部１３と当接した状態でガイド部２０が第２方向への力を受けていない状態では、保持部１０に保持された押圧部材５０は、ガイド部２０の第１当接部２３より第２端１２に近い位置に配置される。これにより、保持部１０にて保持された押圧部材５０の位置が正しく決められるまで、押圧部材５０が側壁部６２と当接しない。よって、医師は脊椎手術用器具１を用いて押圧部材５０を収容溝６３に円滑に取り付けることができる。 In a state where the lock portion 30 is in contact with the second contact portion 13 and the guide portion 20 is not receiving a force in the second direction, the pressing member 50 held by the holding portion 10 is the first of the guide portions 20. 1 It is arranged at a position closer to the second end 12 than the contact portion 23. As a result, the pressing member 50 does not come into contact with the side wall portion 62 until the position of the pressing member 50 held by the holding portion 10 is correctly determined. Therefore, the doctor can smoothly attach the pressing member 50 to the accommodating groove 63 by using the spinal surgery instrument 1.
　（さまざまな脊椎用インプラント６０への押圧部材５０の取り付け）
　以下では、さまざまな脊椎用インプラント６０への押圧部材５０の取り付けについて、図１０～図１２を用いて説明する。図１０は、標準スクリュー６８への押圧部材５０の取り付けの様子を示す模式図である。図１１は、リダクションスクリュー６６への押圧部材５０の取り付けの様子を示す模式図である。図１２は、コネクタ６７への押圧部材５０の取り付けの様子を示す模式図である。なお、図１０～図１２では、押圧部材５０の配置をわかりやすくするため、第２ガイド部２２を簡略化した断面にて示している。また、図１０～図１２では、簡略化のために、第１開口部２５および第２開口部２６の図示は省略されている。 (Attachment of pressing member 50 to various spinal implants 60)
In the following, attachment of the pressing member 50 to various spinal implants 60 will be described with reference to FIGS. 10 to 12. FIG. 10 is a schematic view showing how the pressing member 50 is attached to the standard screw 68. FIG. 11 is a schematic view showing how the pressing member 50 is attached to the reduction screw 66. FIG. 12 is a schematic view showing how the pressing member 50 is attached to the connector 67. In FIGS. 10 to 12, the second guide portion 22 is shown in a simplified cross section in order to make the arrangement of the pressing member 50 easy to understand. Further, in FIGS. 10 to 12, the first opening 25 and the second opening 26 are not shown for the sake of simplicity.
　図１０に示すように、標準スクリュー６８は、側壁部６２において収容溝６３の開口の方向において第１当接部２３と当接可能である。換言すれば、側壁部６２は、当該側壁部の第２方向で第１当接部２３と当接する。第１当接部２３は、収容溝６３の頂部で側壁部６２と当接する。ここで頂部とは、側壁部６２の台部６１から最も突出した場所のことであり、側壁部６２により形成される面または点のいずれでもよい。第１当接部２３は側壁部６２の頂部６９に当接し、突出部２４は収容溝６３に当接し、さらに側壁部６２に係合する。 As shown in FIG. 10, the standard screw 68 can come into contact with the first contact portion 23 in the direction of the opening of the accommodating groove 63 in the side wall portion 62. In other words, the side wall portion 62 comes into contact with the first contact portion 23 in the second direction of the side wall portion. The first contact portion 23 comes into contact with the side wall portion 62 at the top of the accommodating groove 63. Here, the top portion is a place most protruding from the base portion 61 of the side wall portion 62, and may be either a surface or a point formed by the side wall portion 62. The first contact portion 23 abuts on the top 69 of the side wall portion 62, the protruding portion 24 abuts on the accommodating groove 63, and further engages with the side wall portion 62.
　このような構成を備える脊椎手術用器具１を用いることによって、押圧部材５０を安定して、標準スクリュー６８の収容溝６３に取り付けることができる。側壁部６２は、収容溝６３の壁面を形成する面に、雌ネジ６４が形成されてもよい。 By using the spinal surgery instrument 1 having such a configuration, the pressing member 50 can be stably attached to the accommodating groove 63 of the standard screw 68. The side wall portion 62 may have a female screw 64 formed on the surface forming the wall surface of the accommodating groove 63.
　図１１に示すように、リダクションスクリュー６６は、標準スクリュー６８に比べ、側壁部６２の第２方向の長さが長い。このような場合であっても、収容溝６３の幅に突出部２４が係合することで側壁部６２の長さに関係なく脊椎用インプラント６０とガイド部２０とを固定できる。 As shown in FIG. 11, the reduction screw 66 has a longer side wall portion 62 in the second direction than the standard screw 68. Even in such a case, the spinal implant 60 and the guide portion 20 can be fixed regardless of the length of the side wall portion 62 by engaging the protruding portion 24 with the width of the accommodating groove 63.
　第１当接部２３は側壁部６２の頂部６９に当接し、突出部２４は収容溝６３に当接し、さらに側壁部６２に係合する。このような構成を備える脊椎手術用器具１を用いることによって、押圧部材５０を安定して、リダクションスクリュー６６の収容溝６３に取り付けることができる。 The first contact portion 23 abuts on the top 69 of the side wall portion 62, the protruding portion 24 abuts on the accommodating groove 63, and further engages with the side wall portion 62. By using the spinal surgery instrument 1 having such a configuration, the pressing member 50 can be stably attached to the accommodating groove 63 of the reduction screw 66.
　また、ガイド部２０は、さらに周縁部２３ａを有していてもよい。これにより、ガイド部２０は、第１当接部２３と周縁部２３ａとにより形成された空間に側壁部６２を収容できる。周縁部２３ａは、リダクションスクリュー６６の側壁部６２が変形したり、一対の側壁部６２の間隔が広がったりすることを抑制する。周縁部２３ａを備えるガイド部２０を適用した脊椎手術用器具１を用いることによって、押圧部材５０をリダクションスクリュー６６の収容溝６３に好適に取り付けることができる。 Further, the guide portion 20 may further have a peripheral edge portion 23a. As a result, the guide portion 20 can accommodate the side wall portion 62 in the space formed by the first contact portion 23 and the peripheral edge portion 23a. The peripheral edge portion 23a suppresses the deformation of the side wall portion 62 of the reduction screw 66 and the widening of the distance between the pair of side wall portions 62. By using the spinal surgery instrument 1 to which the guide portion 20 having the peripheral portion 23a is applied, the pressing member 50 can be suitably attached to the accommodating groove 63 of the reduction screw 66.
　図１２に示すように、コネクタ６７は、標準スクリュー６８またはリダクションスクリュー６６と異なり、別の固定ロッド７０を収容する収容溝を形成する第２側壁部６５を備えている。 As shown in FIG. 12, unlike the standard screw 68 or the reduction screw 66, the connector 67 includes a second side wall portion 65 that forms an accommodating groove for accommodating another fixing rod 70.
　コネクタ６７の側壁部６２において、脊椎手術用器具１と接する箇所の形状は、標準スクリュー６８およびリダクションスクリュー６６と同様の形状である。このため、コネクタ６７に対しても本開示の脊椎手術用器具１を用いることができる。 The shape of the side wall portion 62 of the connector 67 in contact with the spinal surgery instrument 1 is the same as that of the standard screw 68 and the reduction screw 66. Therefore, the spinal surgery instrument 1 of the present disclosure can be used for the connector 67 as well.
　すなわち、第１当接部２３は側壁部６２の頂部６９に当接し、突出部２４は収容溝６３に当接し、さらに側壁部６２に係合する。このような構成を備える脊椎手術用器具１を用いることによって、押圧部材５０を安定して、コネクタ６７の収容溝６３に取り付けることができる。 That is, the first contact portion 23 abuts on the top 69 of the side wall portion 62, the protruding portion 24 abuts on the accommodating groove 63, and further engages with the side wall portion 62. By using the spinal surgery instrument 1 having such a configuration, the pressing member 50 can be stably attached to the accommodating groove 63 of the connector 67.
　以上、本開示に係る発明について、諸図面および実施例に基づいて説明してきた。しかし、本開示に係る発明は上述した各実施形態に限定されるものではない。すなわち、本開示に係る発明は本開示で示した範囲で種々の変更が可能であり、異なる実施形態にそれぞれ開示された技術的手段を適宜組み合わせて得られる実施形態についても本開示に係る発明の技術的範囲に含まれる。つまり、当業者であれば本開示に基づき種々の変形または修正を行うことが容易であることに注意されたい。また、これらの変形または修正は本開示の範囲に含まれることに留意されたい。 The invention according to the present disclosure has been described above based on various drawings and examples. However, the invention according to the present disclosure is not limited to each of the above-described embodiments. That is, the invention according to the present disclosure can be variously modified within the scope shown in the present disclosure, and the invention according to the present disclosure also relates to an embodiment obtained by appropriately combining the technical means disclosed in each of the different embodiments. Included in the technical scope. That is, it should be noted that those skilled in the art can easily make various modifications or modifications based on the present disclosure. It should also be noted that these modifications or modifications are within the scope of this disclosure.
１　　脊椎手術用器具
１０　保持部
１３　第２当接部
１４　固定部
２０　ガイド部
２１　第１ガイド部
２２　第２ガイド部
２３　第１当接部
２３ａ　周縁部
２４　突出部
２４ａ　第１突出部
２４ｂ　第２突出部
２５　第１開口部
２６　第２開口部
３０　ロック部
４０　把持部
５０　押圧部材
５１　雄ネジ
６０　脊椎用インプラント
６１　台部
６２　側壁部
６３　収容溝
６９　頂部
７０　固定ロッド（ロッド）
１００　システム 1 Spine surgical instrument 10 Holding part 13 Second contact part 14 Fixing part 20 Guide part 21 First guide part 22 Second guide part 23 First contact part 23a Peripheral part 24 Protruding part 24a First protruding part 24b Second Protrusion 25 1st opening 26 2nd opening 30 Lock 40 Grip 50 Pressing member 51 Male screw 60 Spine implant 61 Base 62 Side wall 63 Storage groove 69 Top 70 Fixed rod (rod)
100 system

Claims (15)

  1. 　第１端と第２端とを有し、ロッドを脊椎用インプラントに設けられた収容溝に固定するための押圧部材を前記第１端に保持可能な棒形状の保持部と、
    　前記保持部が配された貫通部を有した、管形状のガイド部と、を備え、
    　前記ガイド部は、前記保持部から前記第１端に向かう軸方向に沿って突出し、前記収容溝の対向する一対の側壁部に当接可能な突出部を含む、
    脊椎手術用器具。     A rod-shaped holding portion having a first end and a second end and capable of holding a pressing member for fixing the rod to the accommodation groove provided in the spinal implant at the first end.
    A tube-shaped guide portion having a penetrating portion on which the holding portion is arranged is provided.
    The guide portion includes a projecting portion that projects along the axial direction from the holding portion toward the first end and is capable of contacting a pair of side wall portions facing each other in the accommodating groove.
    Spinal surgery instruments.
  2. 　前記突出部は、前記一対の側壁部の、たがいに対向する一対の面の両方に同時に当接可能である、
    請求項１に記載の脊椎手術用器具。     The protrusion can simultaneously contact both of the pair of side wall surfaces facing each other.
    The spinal surgery instrument according to claim 1.
  3. 　前記ガイド部は、前記側壁部の頂部に当接可能な第１当接部をさらに有している、
    請求項１または２に記載の脊椎手術用器具。     The guide portion further has a first contact portion capable of contacting the top of the side wall portion.
    The spinal surgery instrument according to claim 1 or 2.
  4. 　前記保持部は、前記第１当接部が前記側壁部の頂部に当接した状態で、前記ガイド部に対して前記軸方向に沿って変位可能である、
    請求項３に記載の脊椎手術用器具。     The holding portion can be displaced along the axial direction with respect to the guide portion in a state where the first contact portion is in contact with the top of the side wall portion.
    The spinal surgery instrument according to claim 3.
  5. 　前記ガイド部より前記第２端に近い位置に配され、前記保持部が中を貫通する管形状のロック部を更に備え、
    　前記保持部は、前記ロック部と当接可能な第２当接部を備え、
    　前記第２当接部が前記ロック部に当接した状態で、前記ロック部は前記ガイド部を前記軸方向に付勢する、
    請求項１から４のいずれか１項に記載の脊椎手術用器具。     A tube-shaped lock portion is further provided, which is arranged at a position closer to the second end than the guide portion and through which the holding portion penetrates.
    The holding portion includes a second contact portion capable of contacting the lock portion.
    In a state where the second contact portion is in contact with the lock portion, the lock portion urges the guide portion in the axial direction.
    The spinal surgery instrument according to any one of claims 1 to 4.
  6. 　前記第２当接部は、弾性部材を備えている、
    請求項５に記載の脊椎手術用器具。     The second contact portion includes an elastic member.
    The spinal surgery instrument according to claim 5.
  7. 　前記第２当接部が前記ロック部に当接しており、かつ、前記ガイド部が前記軸方向とは反対の方向への力を受けていない状態において、前記保持部に保持された前記押圧部材は、前記ガイド部に向けられ、前記側壁部の頂部に当接可能な第１当接部より前記第２端に近い位置にある、
    請求項５または６に記載の脊椎手術用器具。     The pressing member held by the holding portion in a state where the second contact portion is in contact with the lock portion and the guide portion is not subjected to a force in a direction opposite to the axial direction. Is directed toward the guide portion and is located closer to the second end than the first contact portion capable of contacting the top of the side wall portion.
    The spinal surgery instrument according to claim 5 or 6.
  8. 　前記突出部は、板形状を有している第１突出部と、前記第１突出部と略平行な板形状を有している第２突出部とから成る、
    請求項１から７のいずれか１項に記載の脊椎手術用器具。     The protruding portion includes a first protruding portion having a plate shape and a second protruding portion having a plate shape substantially parallel to the first protruding portion.
    The spinal surgery instrument according to any one of claims 1 to 7.
  9. 　前記押圧部材の側面には雄ネジが形成されており、前記収容溝を形成する側壁部の内側の面の少なくとも一部には、前記雄ネジと螺合する雌ネジが形成されており、
    　前記保持部は、前記第２端と前記第１端とを結ぶ線を回転軸とする回転が可能であり、
    　前記保持部に保持された前記押圧部材は、前記回転によって前記収容溝内へねじ込まれる、
    請求項１から８のいずれか１項に記載の脊椎手術用器具。     A male screw is formed on the side surface of the pressing member, and a female screw screwing with the male screw is formed on at least a part of the inner surface of the side wall portion forming the accommodating groove.
    The holding portion can rotate about a line connecting the second end and the first end as a rotation axis.
    The pressing member held by the holding portion is screwed into the accommodating groove by the rotation.
    The spinal surgery instrument according to any one of claims 1 to 8.
  10. 　前記保持部は、前記第２端の近傍に、操作者が把持するための把持部を有する、
    請求項１から９のいずれか１項に記載の脊椎手術用器具。     The holding portion has a grip portion for the operator to grip in the vicinity of the second end.
    The spinal surgery instrument according to any one of claims 1 to 9.
  11. 　前記保持部は、前記押圧部材を固定可能な固定部を前記第１端に有する、
    請求項１から１０のいずれか１項に記載の脊椎手術用器具。     The holding portion has a fixing portion at the first end to which the pressing member can be fixed.
    The spinal surgery instrument according to any one of claims 1 to 10.
  12. 　前記第１当接部は、前記側壁部の外側に係合する周縁部をさらに有する、
    請求項３または４に記載の脊椎手術用器具。     The first contact portion further has a peripheral edge portion that engages with the outside of the side wall portion.
    The spinal surgery instrument according to claim 3 or 4.
  13. 　複数の脊椎用インプラントと、ロッドと、複数の押圧部材と、脊椎手術用器具を備え、
    　前記脊椎用インプラントは、前記ロッドを収容する収容溝を備え、
    　前記押圧部材は、前記ロッドを前記収容溝に固定するために前記脊椎手術用器具を用いて取り付けることができ、
    　前記脊椎手術用器具は、
    　　第１端と第２端とを有し、前記押圧部材を前記第１端に保持可能な棒形状の保持部と、
    　　前記保持部が配された貫通部を有した管形状のガイド部と、を備え、
    　前記ガイド部は、前記保持部から前記第１端に向かう軸方向に沿って突出し、前記収容溝の対向する一対の側壁部に当接可能な突出部を含む、
    システム。     Equipped with multiple spinal implants, rods, multiple pressing members, and spinal surgery instruments,
    The spinal implant comprises a containment groove for accommodating the rod.
    The pressing member can be attached using the spinal surgery instrument to secure the rod to the containment groove.
    The spinal surgery instrument is
    A rod-shaped holding portion having a first end and a second end and capable of holding the pressing member at the first end,
    A tube-shaped guide portion having a penetrating portion on which the holding portion is arranged is provided.
    The guide portion includes a projecting portion that projects along the axial direction from the holding portion toward the first end and is capable of contacting a pair of side wall portions facing each other in the accommodating groove.
    system.
  14. 　前記複数の脊椎用インプラントは、ペディクルスクリュー、および／または、脊椎用ラミナーフックを含む、
    請求項１３に記載のシステム。     The plurality of spinal implants include a pedicle screw and / or a spinal laminar hook.
    The system according to claim 13.
  15. 　前記複数の脊椎用インプラントは、前記ロッドを連結するコネクタを含む、
    請求項１３または１４に記載のシステム。     The plurality of spinal implants include a connector for connecting the rods.
    The system according to claim 13 or 14.
PCT/JP2021/012453 2020-04-03 2021-03-25 Spine surgery instrument and system WO2021200524A1 (en)

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