JP2005246061A - 椎骨または骨の動的安定化のためのアンカー要素および当該アンカー要素を使用した安定化器具 - Google Patents
椎骨または骨の動的安定化のためのアンカー要素および当該アンカー要素を使用した安定化器具 Download PDFInfo
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- A61B17/7035—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- 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
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
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- 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
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
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- A—HUMAN NECESSITIES
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- 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
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
- A61B17/7035—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
- A61B17/7037—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other wherein pivoting is blocked when the rod is clamped
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- 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
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
- A61B17/7002—Longitudinal elements, e.g. rods
- A61B17/7019—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other
- A61B17/7026—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other with a part that is flexible due to its form
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Abstract
【解決手段】 ロッドと骨または椎骨へしっかりと接続されているアンカー要素(2、4)との間の少なくとも1つの回転自由度を提供することによって、アンカー要素(2、4)へのトルク(M)の移動およびこのため骨または椎骨内へのしっかりとした取付けのゆるみまたは分離さえ防止することができる。
【選択図】 図5
Description
242号から、このタイプの安定化器具として剛性ロッドと一緒に使用される特許請求項1のプリアンブルに従ったアンカー要素が知られている。相互に対して安定化されるべき骨の部分または椎骨の相対運動が望ましくない場合、例えば骨折または他の欠陥のある位置が存在する場合には、剛性システムが使用される。
図1aおよびlbから明らかなように、第1の実施の形態に従うと、骨の部分または椎骨と、好ましくは長方形の断面を備えるロッド21とを接続させるためのアンカー要素1は、ねじ要素2、受入れ部3、受入れ部の中にねじ込まれる雌ねじ4および軸受部5を含む。
2のヘッド6の直径より小さいが、ねじ山区域7の直径よりは大きい。図2から明らかなように、軸受部5は、ボールソケット状セクション内にスリット30を含み、ボールソケット状セクションは軸受部の弾性を増加させる前記スリット30を備える平坦な前面15とは反対側の軸受部の側面に隣接する。好ましくは、軸受部5は有益な滑り特性を備える生体適合性プラスチック材料から製造される。好ましくは、ポリエチレン(PE)が使用される。この状況では、様々な分子量を生じさせる様々な架橋度の、例えば50,000g/molまでの分子量を備えるLDPEおよびLLDPE、200,000g/molまでの分子量を備えるHDPEまたは約6,000,000g/molの分子量を備えるUHMWP(超高分子量ポリエチレン)などを使用できる。軸受部のための材料としては、長期的損耗率が低いためにUHMWPを使用するのが好ましい。
第2の実施の形態
図4から7は、本発明の第2の実施の形態に従ったアンカー要素100を示している。第1の実施の形態の要素と同一である要素は、同じ参照番号で言及する。
部112に隣接して設けられており、2つの自由脚114および115を形成する。雌ねじ山122は、自由脚114および115の内側で第1の端部112に隣接して設けられる。受入れ部102の第1の端部112に隣接するセクション内では、ボアホール120はねじ要素2のヘッド6の直径より大きい本質的に一定の直径を有する。第1のセクションに隣接していて受入れ部102の第2の端部へ伸びている第2のセクションでは、ボアホール120は第2の端部113に向かって先細になっている。球状セクション121は、その形状がねじ要素2のヘッド6の形状に適合する第2の端部113に隣接して設けられる。第2のセクション内のボアホールの直径は、第2の端部に隣接して、ねじ要素2のヘッド6の直径よりは小さいが、ねじ要素2のねじ切りシャフト7の直径よりは大きいように選択される。
ように同軸性で配列されるが、このとき2つの軸受部106、107内の長方形の窪み149、150は、ロッドを受入れるための2つの開口部が相互に対向していて軸受の内側で終了する前記開口部を備える2つの軸受部106、107によって形成された軸受内に形成されるように、各々相互に向かって整列される。組立てられた状態における窪み149、150により形成された開口部の幅は、これらの開口部に通して配置されたロッド21が予め定められた角度範囲、好ましくは約±10°の間で前後に旋回できるように設計されている。組立てられた状態での窪み149、150によって形成される開口部の高さは、ロッド21の対応する横断面よりわずかに大きい。軸受の外径は、軸受を第1および第2のクランプリング内にプレス嵌めすることをちょうど可能にする寸法取りされている。組立てられた状態では、フランジ様張出し部151は第2のリング105の肩147に寄り掛かっている。
るのに十分な程度にのみ離して受入れ部102内へねじ込まれる。これでアンカー要素100の予備組立てが完了する。
これはロッド状要素21と骨または椎骨との間の結合を生成し、このとき固定ロッド状要素21を備えるロッド取付部108は予め定められた角度範囲内で受入れ部102の主軸の周囲で回転することができる。角度範囲は、受入れ部102内のロッド21の寸法および窪み149の幅、開口部149の第1および第2の軸受部106内の長方形の窪み149、150の幅並びに第2のリング105内の窪み143の幅によって定められる。ロッド取付部108はロッド21と一緒に回転するが、他方軸受部106、107はプレス嵌めによって第1および第2のリング104、105内にしっかりと据えられる。受入れ部102に対するねじ軸の角度位置は固定されたままである。
第3の実施の形態
本発明の第3の実施の形態に従うと、ロッドと骨または椎骨との間の回転可能な接続は、図8aに示したようにロッド407と受入れ部408との間およびねじ要素と受入れ部との間の角度が固定される多軸ねじと、ねじ切りシャフト412が回転可能であるようにねじ要素のヘッド401がねじ切りシャフト412へ接続されるツーピースねじ切りシャフト400と、を使用することによって作り出される。図8aに示したように、多軸ねじは受入れ部408、加圧要素409、雌ねじ410、および雄ねじ411を含む。
ことができる程度にネック内へ押し込まれる。ネック403は次に、ピン404がバネ力の外向きの圧力下で窪み405の壁の長手穴406に係合するように窪み405内に滑り入れられる。これはねじ要素100のヘッド401とねじ切りシャフト412との接続を生じさせ、このときヘッド401はねじ要素のねじ切りシャフト412に対して同軸性で回転することができ、ねじ要素のねじ切りシャフト412は長手穴406の長さによって予め定められた角度範囲の間で相互に対して同軸で回転することができる。
Claims (13)
- 骨または椎骨内にロッド状要素(21、407)を取付けるためのアンカー要素(1、1’、100、415、420)であって、
骨または椎骨内に取付けるべきシャフト(7、412)とロッド状要素(21、407)を受入れるためにシャフト(7、421)へ接続される受入れ部(3、102、408、421)と、および受入れ部(3、102、408、421)内にロッド状要素(21、407)を固定するための固定器具(4、109、410)と、を備えており、ロッド状要素(21、407)の固定された状態では、シャフト(7、412)が受入れ部(3、102、408、421)によってロッド状要素(2l、407)へ、シャフト(7、412)がロッド状要素(2l、407)に対して少なくとも1つの回転自由度を備えて、しかし並進自由度を全く備えずに移動できるような可動方法で接続されることを特徴とする、アンカー要素。 - シャフト(7)が受入れ部(102)へしっかりと接続され、ロッド状要素(21)が受入れ部(102)内の取付部(102)でそれが回転可能であるように保持される、請求項1に記載のアンカー要素(100)。
- 取付部(108)が軸受要素(106、107)内に回転可能であるように据えられる、請求項2に記載のアンカー要素(100)。
- シャフト(7)および球状セグメント形のヘッド(6)からなる骨アンカー要素(2)を備える多軸ねじの形状で設けられる請求項3に記載のアンカー要素(100)であって、このとき受入れ部(102)の1つの端部に隣接して骨アンカー要素(2)の球状セグメント形のヘッド(6)を受入れるための球状座部(121)が設けられており、受入れ部(102)の他方の端に隣接して相互に対向する2つの窪み(140)が設けられており、これらが2つの自由脚(114、115)を形成しており、ねじ山(122)が自由脚(114、115)の内側に設けられており、そのねじ山ではリング状要素(104)が圧力要素(103)へ直接的または間接的に加えられる力を用いてねじ込まれ、次に骨アンカー要素(2)が予め定められた角度位置で受入れ部(102)に対する位置に固定されるようにこの圧力を骨アンカー要素(2)のヘッド(6)へ移すことができ、このとき軸受要素(106、107)がリング状要素(104)の内側に存在する、アンカー要素。
- 軸受要素(106、107)が圧力嵌めによってリング状要素(104)へしっかりと接続される、請求項4に記載のアンカー要素(100)。
- シャフト(7)に隣接してヘッド(6)が設けられており、これが軸受要素(5、5’)内の受入れ部(3)内でそれがロッド状要素に対して回転可能であるように保持される、請求項1に記載のアンカー要素(1、1’)。
- 軸受要素(5、106、107)が生体適合性のプラスチック材料から、好ましくはポリエチレンから製造される、請求項3から6のいずれかに記載のアンカー要素(1、100)。
- シャフト(412)に隣接してヘッド(401)が設けられており、ヘッドは受入れ部(408)内に固定することができ、そしてヘッド(401)およびシャフト(412)はそれらが回転可能であるように相互へ接続される分離可能な部分である、請求項1に記載のアンカー要素(415)。
- シャフト(412)に隣接してヘッド(401)が設けられており、ヘッドは受入れ部(421)内へしっかりと接続することができる、またはその一体部分であり、そしてヘッドおよびシャフト(412)はそれらが回転可能であるように相互へ接続される分離可能な部分である、請求項1に記載のアンカー要素(420)。
- 回転運動を制限するためのリミットストップ(149、150、406)が設けられる、前述の請求項のいずれか1項に記載のアンカー要素(1、1’、100、415、420)。
- 骨または椎骨内に固定されるシャフト(7、412)が骨ねじ山を含む、前述の請求項のいずれか1項に記載のアンカー要素。
- 少なくとも2つのアンカー要素(202、202’)およびこれらを接続するロッド状要素(201)を備える安定化器具(200)であって、このとき少なくとも1つのアンカー要素が前述の請求項のいずれか1項に記載のいずれかに従って設けられる、安定化器具。
- 骨または椎骨内にロッド状要素(21、407)を取付けるためのアンカー要素(1、1’、100、415、420)であって、骨または椎骨内に取付けるべきシャフト(7、412)と、ロッド状要素(21、407)を受入れるためにシャフト(7、421)へ接続される受入れ部(3、102、408、421)と、および受入れ部(3、102、408、421)内にロッド状要素(21、407)を固定するための固定器具(4、109、410)と、を備えており、ロッド状要素(21、407)の固定された状態では、シャフト(7、412)が受入れ部(3、102、408、421)によってロッド状要素(2l、407)へ回転可能な方法で接続されること、そしてシャフト(7、412)およびロッド状要素(2l、407)の相対運動を1つの回転自由度へ制限する誘導面が設けられることを特徴とする、アンカー要素。
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DE102004010380A DE102004010380A1 (de) | 2004-03-03 | 2004-03-03 | Verankerungselement und Stabilisierungseinrichtung zur dynamischen Stabilisierung von Wirbeln bzw. Knochen mit einem solchen Verankerungselement |
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JP2010514499A (ja) * | 2006-12-28 | 2010-05-06 | デピュイ スパイン、インコーポレイテッド | 脊椎固定ねじ |
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CN117717404B (zh) * | 2024-02-08 | 2024-05-10 | 中国人民解放军总医院第一医学中心 | 骨钉结合器及脊柱稳定*** |
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US20110015677A1 (en) | 2011-01-20 |
EP2286747A3 (de) | 2013-01-02 |
US20140350606A1 (en) | 2014-11-27 |
EP1579816A1 (de) | 2005-09-28 |
JP4817676B2 (ja) | 2011-11-16 |
EP2286747B1 (de) | 2015-04-08 |
EP1579816B1 (de) | 2013-06-19 |
US20050203516A1 (en) | 2005-09-15 |
US9282999B2 (en) | 2016-03-15 |
US8808330B2 (en) | 2014-08-19 |
DE102004010380A1 (de) | 2005-09-22 |
EP2286747A2 (de) | 2011-02-23 |
US9936978B2 (en) | 2018-04-10 |
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