JP2005516648A - インプラントを椎骨空間内に導入する器具及び方法 - Google Patents
インプラントを椎骨空間内に導入する器具及び方法 Download PDFInfo
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- JP2005516648A JP2005516648A JP2003552149A JP2003552149A JP2005516648A JP 2005516648 A JP2005516648 A JP 2005516648A JP 2003552149 A JP2003552149 A JP 2003552149A JP 2003552149 A JP2003552149 A JP 2003552149A JP 2005516648 A JP2005516648 A JP 2005516648A
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- implant
- instrument
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/441—Joints for the spine, e.g. vertebrae, spinal discs made of inflatable pockets or chambers filled with fluid, e.g. with hydrogel
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- A61F2/02—Prostheses implantable into the body
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- A61F2/442—Intervertebral or spinal discs, e.g. resilient
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- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
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-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0048—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in mechanical expandability, e.g. in mechanical, self- or balloon expandability
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- A—HUMAN NECESSITIES
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- 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
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
- A61F2250/006—Additional features; Implant or prostheses properties not otherwise provided for modular
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Abstract
【解決手段】インプラント50、90、90´、102、102´を当初の形態から最小侵襲性の仕方にて椎間板空間S内に挿入するのに適した縮小した側方輪郭外形を有する変形した形態に移行させ得る形態とされたダイ部材70、110を有する、インプラント50、90、90´、102、102´を椎間板空間S内に導入する器具60、100及び方法である。1つの実施の形態において、ダイ部材70、110は、当初の形態にある間にインプラント50、90、90´、102、102´を受け入れ得る寸法とされた開口部72、120を有し、インプラント50、90、90´、102、102´とダイ部材70、110との間の相対的な変位によって、インプラント50、90、90´、102、102´が縮小した輪郭外形の変形した形態に向けて移行する。1つの特定の実施の形態において、開口部は、インプラント50、90、90´、102、102´の実質的に平坦な当初の形態に相応する実質的に矩形の断面を有する第一の部分122と、インプラント50、90、90´、102、102´の実質的に円筒状の変形した形態に相応する実質的に円形の断面を有する第二の部分124とを有する軸方向通路120を備えている。
Description
本発明の更なる目的、特徴、有利な効果、利点及び側面は、図面及び本明細書の記載から明らかになるであろう。
Claims (63)
- インプラントを椎骨空間(vertebral space)内に導入する器具において、
当初の形態にある間に、インプラントを受け入れ得る寸法とされた開口部を画成するダイ部材を備え、
該ダイ部材が、インプラントと該ダイ部材との間の相対的な変位によってインプラントが当初の形態から該当初の形態に対して縮小した側方輪郭外形を有する変形した形態に移行するようにする形態とされる、インプラントを椎骨空間内に導入する器具。 - 請求項1の器具において、
前記ダイ部材が、インプラントを当初の形態から折り畳んだ形態に移行させるのを容易にする多数の案内部を有する、器具。 - 請求項1の器具において、
前記開口部が、軸線に沿って伸びる通路を備え、該通路が、
当初の形態にある間、インプラントを受け入れ得るような寸法とされた第一の横方向寸法を画成する第一の部分と、
該第一の横方向寸法よりも小さい第二の横方向寸法を画成する第二の部分とを備え、
インプラントが前記通路の前記第二の部分に向けて軸方向に変位することにより、インプラントが当初の形態から変形した形態に向けて移行するようにした、器具。 - 請求項3の器具において、
前記通路の前記第一の部分が実質的に矩形の断面を有する、器具。 - 請求項3の器具において、
前記通路の前記第二の部分が実質的に円形の断面を有する、器具。 - 請求項3の器具において、
前記通路の前記第一の部分が実質的に矩形の断面を有し、
前記通路の前記第二の部分が実質的に円形の断面を有する、器具。 - 請求項3の器具において、
前記通路が、前記第一の部分から前記第二の部分に向けて横方向に内方にテーパーが付けられ、インプラントが当初の形態から変形した形態に向けて移行するのを容易にするようにした、器具。 - 請求項3の器具において、
前記ダイ部材が、前記通路の少なくとも一部分に沿って軸方向に伸びる多数の折り畳み要素を有し、インプラントが当初の形態から変形した形態に向けて移行するのを容易にするようにした、器具。 - 請求項8の器具において、前記折り畳み要素が三角形の形態を有する、器具。
- 請求項8の器具において、
前記折り畳み要素が、前記通路の前記第一の部分から前記通路の前記第二の部分に向けて横方向に互いに向けて内方にテーパーが付けられ、インプラントが当初の形態から変形した形態に向けて移行するのを容易にするようにした、器具。 - 請求項8の器具において、
前記通路が、第一の面及び反対方向に向いた第二の面により境界付けられ、前記折り畳み要素の第一の系統が前記第一の面から伸び、
前記折り畳み要素の第二の系統が前記第二の面から伸びるようにした、器具。 - 請求項11の器具において、
前記折り畳み要素の前記第一の系統が、前記折り畳み要素の前記第二の系統に対して横方向にオフセットされる、器具。 - 請求項12の器具において、
前記折り畳み要素の前記第一の系統が、前記折り畳み要素の前記第二の系統に対して交番的な仕方にて横方向に配置される、器具。 - 請求項3の器具において、
前記ダイ部材が、前記通路の少なくとも一部分に沿って軸方向に伸びる1つの系統の溝を画成し、インプラントが当初の形態から変形した形態に向けて移行するのを容易にするようにした、器具。 - 請求項3の器具において、
前記第二の横方向寸法が前記第一の横方向寸法の1/2以下である、器具。 - 請求項15の器具において、
前記第二の横方向寸法が前記第一の横方向寸法の1/3以下である、器具。 - 請求項1の器具において、
椎骨空間内に挿入される前に、インプラントと係合し且つ該インプラントを変形した形態に選択的に保持し得るようにされた導入部材(delivery member)を更に備える、器具。 - 請求項17の器具において、
前記導入部材が前記ダイ部材に解放可能に結合される、器具。 - 請求項18の器具において、
前記導入部材が脆弱な接続部分により前記ダイ部材に解放可能に結合される、器具。 - 請求項17の器具において、
前記ダイ部材及び前記導入部材が単一部品の構造体として単一に形成される、器具。 - 請求項17の器具において、
前記導入部材が、少なくとも部分的に貫通して伸びるキャビティを画成し、該キャビティが、変形した形態にある間にインプラントを受け入れ得る寸法とされる、器具。 - 請求項21の器具において、
前記導入部材がカニューレ管を備える、器具。 - 請求項21の器具において、
前記導入部材が、前記キャビティ内に少なくとも部分的に配置され且つインプラントを前記キャビティから椎骨空間内に排出する排出部材を有する、器具。 - 請求項23の器具において、
前記排出部材が、前記キャビティに沿って軸方向に変位してインプラントと係合し且つインプラントを前記キャビティから椎骨空間内に排出するロッドを備える、器具。 - 請求項1の器具において、
インプラントと係合し且つインプラントを前記ダイ部材に対して変位させ、インプラントが当初の形態から変形した形態に向けて移行するようにされた少なくとも1つの力付与部材を更に備える、器具。 - 請求項25の器具において、
前記少なくとも1つの力付与部材が、インプラントと係合した少なくとも1つのフィラメント部材を備え、これにより、前記少なくとも1つのフィラメント部材を軸方向に緊張させる結果、インプラントが前記ダイ部材に対して軸方向に変位してインプラントが当初の形態から変形した形態に向けて移行するようにした、器具。 - 請求項24の器具において、
前記少なくとも1つのフィラメント部材が縫合材を備える、器具。 - 請求項27の器具において、
前記縫合材がインプラントにより画成された開口を通って伸びる縫合材ループを備える、器具。 - 請求項1の器具において、
前記ダイ部材が材料のブロックから出来ている、器具。 - インプラントを椎骨空間内に導入する器具において、
インプラントを受け入れ得る形態とされたキャビティを画成するキャリアカートリッジと、
基端及び末端を有し、該末端がインプラントを椎骨空間内に挿入し得る形態とされた展開カニューレ(deployment cannula)と、
前記キャリアカートリッジ及び前記展開カニューレの少なくとも一方により画成された少なくとも1つの折り畳みダイであって、前記キャビティから前記展開カニューレに向けた方向に内方に縮小するテーパーを形成し、インプラントが前記キャビティを通じて前記展開カニューレに向けて変位されたとき、インプラントが相対的に平坦な形態から実質的に円筒状の形態に向けて形態変化するようにした前記少なくとも1つの折り畳みダイとを備える、インプラントを椎骨空間内に導入する器具。 - 請求項30の器具において、
インプラントに力を付与して、インプラントを前記キャビティから前記展開カニューレに向けて変位させる手段を更に備える、器具。 - 請求項30の器具において、
インプラントを前記展開カニューレから椎骨空間内に排出する手段を更に備える、器具。 - 請求項30の器具において、
前記キャリアカートリッジを前記展開カニューレに解放可能に接続する手段を更に備える、器具。 - インプラントを椎骨空間内に導入する器具において、
インプラントを実質的に平坦な形態から非平坦な形態に移行させる手段と、
インプラントを前記非平坦な形態に選択的に保持する手段と、
インプラントを椎骨空間内に挿入する手段とを備える、インプラントを椎骨空間内に導入する器具。 - 脊柱(spine)の一部分を治療するシステムにおいて、
インプラントと、
当初の形態にある間に、インプラントを受け入れ得る寸法とされた開口部を画成するダイ部材とを備え、
該ダイ部材が、インプラントと該ダイ部材との間の相対的な変位によってインプラントが当初の形態から該当初の形態に対して縮小した側方輪郭外形を有する変形した形態に移行するようにする形態とされる、脊柱の一部分を治療するシステム。 - 請求項35のシステムにおいて、
前記開口部が、1つの軸線に沿って伸びる通路を備え、該通路が、
当初の形態にある間に、インプラントを受け入れ得る寸法とされた第一の横方向寸法を画成する第一の部分と、
該第一の横方向寸法よりも小さい第二の横方向寸法を画成する第二の部分とを備え、
インプラントが前記通路の前記第二の部分に向けて軸方向に変位することによりインプラントが当初の形態から変形した形態に向けて移行するようにした、システム。 - 請求項36のシステムにおいて、
前記第二の横方向寸法が前記第一の横方向寸法の1/2以下である、システム。 - 請求項36のシステムにおいて、
前記第二の横方向寸法が前記第一の横方向寸法の1/3以下である、システム。 - 請求項35のシステムにおいて、
前記インプラントの前記当初の形態が実質的に平坦である、システム。 - 請求項35のシステムにおいて、
前記インプラントの前記変形した形態が実質的に円筒状である、システム。 - 請求項35のシステムにおいて、
前記インプラントの前記当初の形態が実質的に平坦であり、
前記インプラントの前記変形した形態が実質的に円筒状である、システム。 - 請求項35のシステムにおいて、
前記インプラントの前記変形した形態が折り畳んだ形態を備える、システム。 - 請求項35のシステムにおいて、
前記インプラントの前記変形した形態がロールした形態を備える、システム。 - 請求項35のシステムにおいて、
前記インプラントの前記変形した形態がカール(curl)した形態を備える、システム。 - 請求項35のシステムにおいて、
インプラントに取り付けられた少なくとも1つのフィラメント部材を更に備え、これにより、該少なくとも1つのフィラメント部材を緊張させる結果、前記インプラントが前記ダイ部材に対して軸方向に変位してインプラントが前記当初の形態から前記変形した形態に向けて移行するようにした、システム。 - 請求項35のシステムにおいて、
前記インプラントが、薄い可撓性の変形可能な材料で出来ており、前記当初の形態から前記変形した形態に向けて移行するのを容易にするようにした、システム。 - 請求項46のシステムにおいて、
前記インプラントが、弾性的に変形可能な材料で出来ており、前記変形した形態から前記当初の形態に向けて戻るよう形態変化するのを容易にするようにした、システム。 - 請求項35のシステムにおいて、
前記インプラントが、該インプラントが前記当初の形態から前記変形した形態に移行し且つ前記当初の形態に戻るよう形態変化するのを容易にする1つ以上の特徴部(features)を有する、システム。 - 請求項35のシステムにおいて、
前記インプラントが、隣接する椎骨間の椎骨間空間内に導入し得るようにされた補綴用髄核(prosthetic nucleus)である、システム。 - インプラントを椎骨空間内に導入する方法において、
インプラントを提供するステップと、
当初の形態にある間に、インプラントを受け入れ得る寸法とされた開口部を画成するダイ部材を提供するステップと、
インプラントをダイ部材に対して変位させるステップと、
インプラントを当初の形態から当初の形態に対して縮小した側方輪郭外形を有する変形した形態に移行させるステップとを備える、インプラントを椎骨空間内に導入する方法。 - 請求項50の方法において、
インプラントを変形した形態に一時的に保持するステップを更に備える、方法。 - 請求項50の方法において、
変形した形態にある間に、インプラントを椎骨空間内に挿入するステップを更に備える、方法。 - 請求項52の方法において、
導入部材を提供するステップと、
導入部材を変形した形態にある間にインプラントと係合させるステップと、
インプラントを挿入する前に変形した形態に選択的に保持するステップとを更に備える、方法。 - 請求項53の方法において、
導入部材がダイ部材に解放可能に結合され、
ダイ部材を挿入する前に導入部材から選択的に取り外すステップを更に備える、方法。 - 請求項54の方法において、
インプラントを取り外すステップが破断させるステップを備える、方法。 - 請求項52の方法において、
インプラントを当初の形態に向けて戻るよう形態変化させるステップを更に備える、方法。 - 請求項50の方法において、
成形ダイにおける開口部が軸線に沿って伸びる通路を備え、
該通路が、第一の横方向寸法を画成する第一の部分と、第一の横方向寸法よりも小さい第二の横方向寸法を画成する第二の部分とを有し、
通路の第一の部分が、当初の形態にある間に、インプラントを受け入れ得る寸法とされ、
インプラントを通路の第二の部分に向けて軸方向に変位させ、インプラントを当初の形態から変形した形態に向けて移行させるステップを更に備える、方法。 - 請求項57の方法において、
インプラントを通路の第一の部分内に予め装填するステップを更に備える、方法。 - 請求項50の方法において、
前記移行させるステップが折り畳むステップを備える、方法。 - 請求項50の方法において、
前記移行させるステップがロールするステップを備える、方法。 - 請求項50の方法において、
前記移行させるステップがカールするステップを備える、方法。 - 請求項50の方法において、
前記変位させるステップがインプラントに引張り力を付与するステップを備える、方法。 - 請求項50の方法において、
前記移行させるステップが、インプラントをダイ部材により画成された多数の案内部を横切って引抜き加工するステップを備える、方法。
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PCT/US2002/039712 WO2003051212A2 (en) | 2001-12-13 | 2002-12-12 | Instrumentation and method for delivering an implant into a vertebral space |
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WO2003051212A2 (en) | 2003-06-26 |
CN1615107A (zh) | 2005-05-11 |
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