JP2002532142A - 機械的挙動が改善された椎間板補綴具 - Google Patents
機械的挙動が改善された椎間板補綴具Info
- Publication number
- JP2002532142A JP2002532142A JP2000587707A JP2000587707A JP2002532142A JP 2002532142 A JP2002532142 A JP 2002532142A JP 2000587707 A JP2000587707 A JP 2000587707A JP 2000587707 A JP2000587707 A JP 2000587707A JP 2002532142 A JP2002532142 A JP 2002532142A
- Authority
- JP
- Japan
- Prior art keywords
- plate
- prosthesis
- plates
- contact
- intervertebral disc
- Prior art date
- Legal status (The legal status 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 status listed.)
- Granted
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/442—Intervertebral or spinal discs, e.g. resilient
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/442—Intervertebral or spinal discs, e.g. resilient
- A61F2/4425—Intervertebral or spinal discs, e.g. resilient made of articulated components
-
- 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
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30721—Accessories
- A61F2/30742—Bellows or hose-like seals; Sealing membranes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30108—Shapes
- A61F2002/3011—Cross-sections or two-dimensional shapes
- A61F2002/30112—Rounded shapes, e.g. with rounded corners
- A61F2002/30133—Rounded shapes, e.g. with rounded corners kidney-shaped or bean-shaped
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30448—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using adhesives
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30474—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using an intermediate sleeve interposed between both prosthetic parts to be coupled
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30518—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements with possibility of relative movement between the prosthetic parts
- A61F2002/30528—Means for limiting said movement
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30563—Special structural features of bone or joint prostheses not otherwise provided for having elastic means or damping means, different from springs, e.g. including an elastomeric core or shock absorbers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30576—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs
- A61F2002/30578—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs having apertures, e.g. for receiving fixation screws
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/442—Intervertebral or spinal discs, e.g. resilient
- A61F2/4425—Intervertebral or spinal discs, e.g. resilient made of articulated components
- A61F2002/443—Intervertebral or spinal discs, e.g. resilient made of articulated components having two transversal endplates and at least one intermediate component
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/005—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using adhesives
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0004—Rounded shapes, e.g. with rounded corners
- A61F2230/0015—Kidney-shaped, e.g. bean-shaped
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S606/00—Surgery
- Y10S606/907—Composed of particular material or coated
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S606/00—Surgery
- Y10S606/907—Composed of particular material or coated
- Y10S606/91—Polymer
Landscapes
- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Neurology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- Heart & Thoracic Surgery (AREA)
- General Health & Medical Sciences (AREA)
- Cardiology (AREA)
- Vascular Medicine (AREA)
- Transplantation (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Prostheses (AREA)
- Materials For Medical Uses (AREA)
- Braking Arrangements (AREA)
Abstract
Description
かつそれらに固定された圧縮性材料のクッションとからなる椎間板補綴具を開示
している。かかる補綴具は、2つの隣接する椎骨の間で実質的に移動可能である
。これは特に2つの椎骨間での圧縮運動や、互いに垂直な3軸方向の捩じり運動
を受けることができる。従って、この補綴具の機械的挙動は健全な自然の椎間板
のそれに近くなる。しかし、椎間板に対して、脊柱の長手方向に垂直な方向に各
椎骨から横方向の応力が加わると、他方の椎骨にもこの応力が伝わるという著し
い難点がある。これは本当の健全な椎間板では起こらない。このような「ずり応
力」は有害である。
できる、異なる種類の椎間板補綴具を利用可能にすることである。
間に挟持されたクッションとを備え、クッションが、プレートと接触している端
面を有する圧縮性ボディーを備える椎間板補綴具であって、前記端面の少なくと
も1つが、連係するプレートに対して相対的に、このプレートに平行な方向に自
由に変位可能である椎間板補綴具を提供する。
方向の応力を避けることが可能となる。こうして、健全な自然の椎間板の挙動が
より忠実に再現される。
部に対する横方向の突き当たり部を形成することができる凹部内に収容される。 ボディーと一方または両方のプレートとの間の横方向の相対的変位をこうして
制限することができる。
の面との接触領域を有する面を有しており、これら2つの面は、ボディーの方向
にプレートに加わる応力が増大すると、前記接触領域の表面積が増大するように
構成される。
は、圧縮の方向におけるボディーの寸法変化の関数として非常に僅かしか変動し
なくなる。換言すると、クッションの高さの変化の関数としてこの機械的反応を
示す曲線は、低い圧縮値に対しては水平に対してごくわずかしか傾斜しないので
、反応開始時にはほとんど力が加えられない。この機械的特性は健全な自然の椎
間板の特性を再現する。
いる面を有しており、これら2つの面は少なくとも1つの共通方向に湾曲してい
て、一方が凹面で他方が凸面である。
ら2つの面は、これらの要素の自動的な中心合わせを保証し、これらそ同軸配置
に再配置するようにする。凹面の少なくとも1つの曲率半径が凸面の対応する曲
率半径より大きいと、上述したように、表面積が可変の接触領域を与えるという
さらなる効果が得られる。
うに挙動し、このヒステリシス形状は、健全な自然の椎間板の挙動にさらに一層
近づいた補綴具の挙動をもたらす。
強める。
のチャンバーのプレートに平行な横断方向の断面の表面積がプレートを互いに近
づけるように動かす応力が変動しても実質的に不変であるように構成される。
よび2つの別の態様の説明から明らかとなろう。
ためのものである。これは、平面図で後方の臍部をもつ豆の概略形状を有する2
枚の平たいプレート4を備える。各プレート4は、中心の円形パネル6と、円形
パネルの周囲を円形パネルの平面内で包囲する境界部8とからなる。静止時に、
2枚のプレート4は、一定間隔をあけて互いに向かいあうように互いに平行に位
置し、両者の外側の輪郭は同じ位置にくる。各プレート4において、境界部8と
円形パネル6は、シール31の収容のためそれぞれ1つずつのミゾ27を有する。
部材10を備える。このクッションは、圧縮性の固体ボディー12を含み、本例の場
合、これは粘弾性材料、例えば、シリコーンから作製される。このボディーは、
有利にはショアA硬度が60〜100 の範囲内、本例では約80である。ボディー12は
、その主軸14を中心とする回転体の形状をとる。ボディーは、円筒形側面16と2
つの軸方向の端面18とを有し、端面は軸14にほぼ垂直で、やや球形の凸面形状の
ものである。従って、各端面18は互いに垂直な平面内で2つの同一の湾曲形状を
有する。ボディー12は円形パネル6と同軸に配置される。
つと接触している、平坦な内側中心面20を有する。従って、ボディーの凸状の球
面18は、プレートの平面20に当たっている。ボディー12は、各プレート4に対し
て、固定されずに当たっているので、ボディーは、プレートに平行な方向に、即
ち、主軸14に垂直な方向に、各プレートに対して移動可能となっている。プレー
ト4により加えられるボディー12の圧縮を考慮し、かつプレートとボディーの接
触面の形状を考慮すると、この方向の移動可能性は、ボディーの軸方向の各端面
18がこれが接触しているプレートの内面20上での、場合により滑りを伴わない、
回転 (ころがり) 運動により現れる。こうして、ボディー12は2つのプレートの
間で回転する。こうして、必要あらば、これらは互いに平行を保ちながら互いに
対して横方向に変位する。その結果、横方向の応力が1つの椎骨から他方の椎骨
に伝わることが避けられる。
れと同軸で、これから一定間隔で包囲している。これは軸14を中心とする回転対
称形状を有する。その壁面プロファイルは波形24になっていて、ベローズ22の軸
14を横断する断面の表面積を実質的に変化させずに、その軸方向14の長さを変化
させることができる。本例では、このベローズは、プレート4と同様に、チタン
またはチタン合金から作製されるので、ある程度の軸方向の強度を有していて、
圧縮バネを形成する。これはまた、軸14に垂直な方向にも変形することができる
か、または軸14もしくはこれに垂直な任意の軸を回転軸とする捩じりを受けるこ
とができる。
ているそれぞれの縁部に接合されている。この接合は漏れに対して気密にされて
いるので、ベローズ22と2つの円形パネル6は、ボディー12の周囲に、容積可変
の漏れ止め性のチャンバーを形成する。このチャンバーは、流体、本例ではガス
(ここでは空気) を包囲している。ボディー12に最も近い波形24の部分は、ガス
が円形パネル6の一方から他方に自由に循環できるようにするため、ボディーか
ら一定の間隔で離れている。
これは、プレートに固定されている2つの山に加え、8個の外側の山を有する。
ここでは、その外径は約30 mm で、内径は約17 mm である。その高さは、補綴具
に荷重がかかっていない時に10 mm である。ベローズの壁面は、各0.1 mm厚さの
1枚、2枚または3枚のシートから作製でき、この厚みの合計が壁面の厚みを形
成する。ベローズの固有強度は、この例では約1.6 N/mmである。
つの耳部25を有する。各耳部25は、これを円形パネルの中心の方向に向かってま
っすぐ貫通するオリフィス27を含んでおり、耳部25のプレート4とは反対側の面
には球形のくぼみがある。オリフィス27は、骨ねじ (骨接合用ねじ) 26の収容を
可能にし、この骨ねじの頭部28は、その下面側が耳部25の雌形の球形のくぼみと
共働する雄形の球形形状を有し、ねじ26はこれを差し込んだ耳部に対して自由な
向きをとることが可能である。
る椎骨の椎体内にねじ26を固定することができる。 しかし、さらに、隣接する椎骨と接触するプレート4の表面をヒドロキシアパ
タイトまたは骨成長を刺激できることがそれ自体公知の他の任意の物質で被覆し
た、長期固定も提供することができる。プレート表面を被覆する前に、該骨組織
とのより良好な界面を確保するため、該表面を処理して骨組織に対する固定点を
持つ多少とも多孔質の表面状態を得るようにしてもよい。
圧縮力Fの強度 (実質的にゼロであるそれらの変形は考慮しない) を、軸方向14
におけるクッションの長さl (即ち、2枚のプレート間の間隔) の変化の関数と
して示す曲線Cの状況を示す。この曲線は、同じ条件下でクッション10の機械的
反応Rも表す。この曲線Cは直線ではない。さらに、これはヒステリシス形状を
有する。即ち、起点0からの圧縮力Fの増大を示す曲線Caは、起点まで戻る圧縮
力Fの減少を示す曲線Cdとは別個の曲線であって、その全体が後者の曲線より上
にある。この顕著なヒステリシス形状は、主にボディーの粘弾性材料に、副次的
にはボディー12とクッション10の流体とび組合わせに、起因する。
部分Ca1 と、その後に続くより急激な勾配の部分Ca2 とを示す。圧縮力Fの減少
を示す方の曲線Cdは、圧縮力Fの最大値の付近では急勾配の部分Cd1 を示し、そ
の後に続く圧縮力Fの最小値の付近では、より緩やかな勾配の部分Cd2 を示す。
曲線CaおよびCdについて、起点付近に緩やかな勾配の部分が存在するのは主にボ
ディー12とプレート4の接触面18, 20の形状に起因し、これは、各プレートとボ
ディーとの間の相互接触領域 (一般に円形) の表面積が、圧縮力Fが増大するに
つれて増大することを意味する。この増大は、接触領域の表面積が最大に達する
まで続き、その時点でボディーの端面18はその全体がプレート4に接触するよう
になっている。
接続を形成する。曲線Caでは、接続点Jaはプレートとボディーとの間の接触面積
が最大値に到達した時点の荷重Fに相当する。同様に、曲線Cdでは、接続点Jdは
この接触面積が最大値であることが終った時点の荷重Fに相当する。
大の長さ変化の25〜75%の範囲内に位置するΔl値に対応するようなものとする
ことができる。
徴を有する) において、各プレート4のボディー12に面する面20が凹部32 (この
場合にはU字型) を有していて、この凹部が対応する軸方向端部18が嵌まりこむ
ことができる横方向の突き当たり部を形成することが可能である。こうして、各
プレート4に対するボディー12の横方向の相対的な変位が一定範囲内に抑えられ
、または完全に防止される。
または2以上の方向に凹面となっており、面18も湾曲して、対応する1または2
以上の方向に凸面とすることができる。各方向について、面20の曲率半径は、対
応する方向の面18の曲率半径より大きい。ここでは面18と面20の2面どちらも球
形である。面18および面20の曲率半径は、例えば、それぞれ70〜80 mm および 1
40〜200 mmの範囲内であろう。このような配置は、脊柱の長手方向に垂直な全て
の方向へのボディー12のプレートに対する横方向の相対的な変位を可能にしなが
ら、2つの面の自動的な中心合わせを可能にする。
積が可変である接触表面18を有しており、プレートはボディーに対して横方向に
相対的に移動可能になっている。
特性を有する。図6の下側にある他方の端面は、平坦な円形形状であり、その相
手方のプレートとの接触領域は不変であって、プレートに固定されている。
当然である。 流体は液体でもよく、またはさらには液体とガスとの混合物でもよい。ガスは
例えば液体にいくらか可溶性のものである。
か、またはプレートの面20の曲率半径より大きな曲率半径の凹面にしてもよい。
プレートとボディーの2つの接触面をどちらも凸面状にしてもよい。
から独立して使用してもよい。
隔の変動の関数として示す曲線である。
Claims (10)
- 【請求項1】 2枚のプレート(4) とこれらのプレートの間に挟持されたク
ッション(10)とを備え、クッションが、プレート(4) と接触している端面(18)を
有する圧縮性ボディー(12)を備える椎間板補綴具であって、前記端面(18)の少な
くとも1つが、連係するプレートに対して、このプレートに平行な方向に自由に
変位可能であることを特徴とする、椎間板補綴具。 - 【請求項2】 ボディーの端部または各端部(18)が、プレート(4) の1つに
設けた、この端部に対する横方向の突き当たり部を形成することができる、凹部
(32)内に収容されていることを特徴とする、請求項1記載の補綴具。 - 【請求項3】 ボディーの端部または各端部が、連係するプレート(4) の面
(20)との接触領域を有する面(18)を有しており、これらの面(18, 20)が、ボディ
ー(12)の方向にプレート(4) に加わる応力が増大すると、前記接触領域の表面積
が増大するように構成されていることを特徴とする、請求項1または2記載の補
綴具。 - 【請求項4】 ボディーの端部または各端部(18)が、連係するプレート(4)
の面(20)と接触している面を有しており、これら2つの面(18, 20)が、少なくと
も1つの共通の方向に湾曲しており、一方が凹面で、他方が凸面であることを特
徴とする、請求項1〜3のいずれか1項に記載の補綴具。 - 【請求項5】 ボディー(12)が粘弾性材料、特にシリコーンから構成される
ことを特徴とする、請求項1〜4のいずれか1項に記載の補綴具。 - 【請求項6】 プレート(4) の間に介在する流体を含んでいることを特徴と
する、請求項1〜5のいずれか1項に記載の補綴具。 - 【請求項7】 流体がプレート(4) と接触していることを特徴とする、請求
項6記載の補綴具。 - 【請求項8】 流体がボディー(12)の周囲を包囲していることを特徴とする
、請求項6または7記載の補綴具。 - 【請求項9】 補綴具が流体を包囲するチャンバー(22)を備え、かつ、この
チャンバーのプレート(4) に平行な横断断面の表面積が、プレートを互いに近づ
けるように動かす応力が変動しても実質的に不変であるように構成されているこ
とを特徴とする、請求項6〜8のいずれか1項に記載の補綴具。 - 【請求項10】 腰部の椎間板補綴具であることを特徴とする、請求項1〜
9のいずれか1項に記載の補綴具。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
FR98/15672 | 1998-12-11 | ||
FR9815672A FR2787017B1 (fr) | 1998-12-11 | 1998-12-11 | Prothese de disque intervertebral a comportement mecanique ameliore |
PCT/FR1999/003073 WO2000035385A1 (fr) | 1998-12-11 | 1999-12-09 | Prothese de disque intervertebral a comportement mecanique ameliore |
Publications (2)
Publication Number | Publication Date |
---|---|
JP2002532142A true JP2002532142A (ja) | 2002-10-02 |
JP4214680B2 JP4214680B2 (ja) | 2009-01-28 |
Family
ID=9533877
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2000587707A Expired - Fee Related JP4214680B2 (ja) | 1998-12-11 | 1999-12-09 | 機械的挙動が改善された椎間板補綴具 |
Country Status (12)
Country | Link |
---|---|
US (1) | US6733532B1 (ja) |
EP (1) | EP1139935B1 (ja) |
JP (1) | JP4214680B2 (ja) |
KR (1) | KR20020012537A (ja) |
AT (1) | ATE361721T1 (ja) |
AU (1) | AU767081B2 (ja) |
CA (1) | CA2354167A1 (ja) |
DE (2) | DE1139935T1 (ja) |
ES (1) | ES2167294T1 (ja) |
FR (1) | FR2787017B1 (ja) |
WO (1) | WO2000035385A1 (ja) |
ZA (1) | ZA200104845B (ja) |
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- 1999-12-09 AT AT99958285T patent/ATE361721T1/de not_active IP Right Cessation
- 1999-12-09 KR KR1020017007283A patent/KR20020012537A/ko not_active Application Discontinuation
- 1999-12-09 DE DE69936062T patent/DE69936062T2/de not_active Expired - Lifetime
- 1999-12-09 AU AU15685/00A patent/AU767081B2/en not_active Ceased
-
2001
- 2001-06-14 ZA ZA200104845A patent/ZA200104845B/en unknown
Cited By (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP2010284540A (ja) * | 2003-11-03 | 2010-12-24 | Aesculap Implant Systems Inc | 人工椎間板 |
JP4695717B2 (ja) * | 2003-11-03 | 2011-06-08 | イシュラップ インプラント システムズ, インコーポレイテッド | 人工椎間板 |
JP2007517617A (ja) * | 2004-01-09 | 2007-07-05 | ウォーソー・オーソペディック・インコーポレーテッド | 相互連結される脊椎デバイスおよび方法 |
JP2007530182A (ja) * | 2004-04-02 | 2007-11-01 | ジンテーズ ゲゼルシャフト ミト ベシュレンクテル ハフツング | 椎間板プロテーゼまたは人口椎体 |
JP4734321B2 (ja) * | 2004-04-02 | 2011-07-27 | ジンテーズ ゲゼルシャフト ミト ベシュレンクテル ハフツング | 椎間板プロテーゼまたは人口椎体 |
US11890202B2 (en) | 2007-06-20 | 2024-02-06 | 3Spine, Inc. | Spinal osteotomy |
Also Published As
Publication number | Publication date |
---|---|
AU1568500A (en) | 2000-07-03 |
WO2000035385A1 (fr) | 2000-06-22 |
KR20020012537A (ko) | 2002-02-16 |
FR2787017B1 (fr) | 2001-04-27 |
US6733532B1 (en) | 2004-05-11 |
JP4214680B2 (ja) | 2009-01-28 |
EP1139935A1 (fr) | 2001-10-10 |
FR2787017A1 (fr) | 2000-06-16 |
CA2354167A1 (fr) | 2000-06-22 |
DE69936062D1 (de) | 2007-06-21 |
ES2167294T1 (es) | 2002-05-16 |
ZA200104845B (en) | 2001-09-07 |
DE1139935T1 (de) | 2002-08-22 |
ATE361721T1 (de) | 2007-06-15 |
DE69936062T2 (de) | 2008-01-10 |
EP1139935B1 (fr) | 2007-05-09 |
AU767081B2 (en) | 2003-10-30 |
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