JP2007517622A - 脊椎関節形成装置及び方法 - Google Patents
脊椎関節形成装置及び方法 Download PDFInfo
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- JP2007517622A JP2007517622A JP2006549487A JP2006549487A JP2007517622A JP 2007517622 A JP2007517622 A JP 2007517622A JP 2006549487 A JP2006549487 A JP 2006549487A JP 2006549487 A JP2006549487 A JP 2006549487A JP 2007517622 A JP2007517622 A JP 2007517622A
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- Prior art keywords
- joint
- artificial spinal
- artificial
- spinal joint
- graft
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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
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- A61F2/442—Intervertebral or spinal discs, e.g. resilient
- A61F2/4425—Intervertebral or spinal discs, e.g. resilient made of articulated components
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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
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
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- 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
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- 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
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- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
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- 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
- A61F2220/0075—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
-
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- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00005—The prosthesis being constructed from a particular material
- A61F2310/00161—Carbon; Graphite
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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
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
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- A61F2310/00179—Ceramics or ceramic-like structures
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- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
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- A61F2310/00395—Coating or prosthesis-covering structure made of metals or of alloys
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Abstract
Description
「二重関節運動脊椎装置及び方法」という名称の2005年1月7日に出願された米国特許出願;
「スプリット型脊椎装置及び方法」という名称の2005年1月7日に出願された米国特許出願;
「相互接続脊椎装置及び方法」という名称の2005年1月7日に出願された米国特許出願;
「モバイル軸受脊椎装置及び方法」という名称の2005年1月7日に出願された米国特許出願;
「支持構造装置及び方法」という名称の2005年1月7日に出願された米国特許出願;
「中央関節運動脊椎装置及び方法」という名称の2005年1月7日に出願された米国特許出願;
「後方脊椎装置及び方法」という名称の2005年1月7日に出願された米国特許出願。
Claims (69)
- 脊椎の後方から移植するようになった素子を備えた、椎間板及び脊椎関節突起関節の少なくとも一部を代替するための人工脊椎関節において、
スペーサと;
天然の骨表面に取り付けるようになった第1の表面と、上記スペーサの一部を受け入れて保持するように形状づけられた第2の表面と、上方の関節突起部材とを有する上方の保持部材と;
天然の骨表面に取り付けるようになった第1の表面と、上記スペーサの一部を受け入れて保持するように形状づけられた第2の表面と、下方の関節突起部材とを有する下方の保持部材と;
を有し、
体内に移植した後に、上記スペーサが上記上方及び下方の保持部材のうちの少なくとも一方に関して摺動自在に装着され、上記上方及び下方の関節突起部材は、天然の関節突起関節の案内運動を少なくとも部分的に代替する人工関節突起関節を形成するように、脊椎の曲げ運動中に、一方が他方上で摺動することを特徴とする人工脊椎関節。 - 上記スペーサが上記上方及び下方の保持部材の一方と一体的に形成されることを特徴とする請求項1に記載の装置。
- 上記上方及び下方の保持部材の各々がセグメントからなり、上記スペーサが上記人工関節の上記セグメント間に位置することを特徴とする請求項1に記載の装置。
- 上記上方及び下方の保持部材の上記セグメントが一緒に接続されることを特徴とする請求項3に記載の装置。
- 上記上方及び下方の上記セグメントが体内空間内で一緒に対応的に嵌合する外側部分を有することを特徴とする請求項4に記載の装置。
- 天然の椎間板の一部が上記上方及び下方の保持部材のうちの少なくとも一方を体内空間内で保持することを特徴とする請求項1に記載の装置。
- 上記上方及び下方の保持部材のうちの少なくとも一方を天然の骨材料に取り付けるための少なくとも1つの茎スクリューを更に有することを特徴とする請求項1に記載の装置。
- 1以上の天然の靭帯の機能を補足又は代替するために上記上方及び下方の保持部材間を延びる張力バンドを更に有することを特徴とする請求項1に記載の装置。
- 上記スペーサが人工板であることを特徴とする請求項1に記載の装置。
- 上記セグメントが体内空間内で一緒に結合されることを特徴とする請求項3に記載の装置。
- 上記上方の保持部材が左右の部分を有し、上記下方の保持部材が当該上方の上記左右の部分とそれぞれ整合する左右の部分を有することを特徴とする請求項1に記載の装置。
- 上記スペーサが上記上方及び下方の保持部材の双方と一体的に形成されることを特徴とする請求項1に記載の装置。
- 上位の椎骨と下位の椎骨との間にカップリングの少なくとも一部を生じさせるための人工脊椎関節において、
前方の関節交換素子と;
上記前方の関節素子に結合され、上位及び下位の椎骨のほぼ円筒状の本体部分の一方又は双方を越えて当該前方の関節交換素子から後方に延びるブリッジと;
上記ブリッジに結合された後方の関節交換素子と;
を有することを特徴とする人工脊椎関節。 - 上記前方の関節交換素子と上記ブリッジとの間のカップリングが剛直なカップリングであることを特徴とする請求項13に記載の人工脊椎関節。
- 上記後方の関節交換素子と上記ブリッジとの間のカップリングが剛直なカップリングであることを特徴とする請求項13に記載の人工脊椎関節。
- 上記人工脊椎関節が同人工脊椎関節を上位の椎骨に固定するためのファスナーを受け入れる接続部を有することを特徴とする請求項13に記載の人工脊椎関節。
- ファスナーを受け入れる上記接続部が茎スクリューのための接続部であることを特徴とする請求項16に記載の人工脊椎関節。
- ファスナーを受け入れる上記接続部が上記前方の関節交換素子と一体になっていることを特徴とする請求項16に記載の人工脊椎関節。
- ファスナーを受け入れる上記接続部が上記後方の関節交換素子と一体になっていることを特徴とする請求項16に記載の人工脊椎関節。
- ファスナーを受け入れる上記接続部が茎スクリューのための接続部であることを特徴とする請求項19に記載の人工脊椎関節。
- 上記人工脊椎関節が同人工脊椎関節を下位の椎骨に固定するためのファスナーを受け入れる接続部を有することを特徴とする請求項13に記載の人工脊椎関節。
- ファスナーを受け入れる上記接続部が茎スクリューのための接続部であることを特徴とする請求項21に記載の人工脊椎関節。
- ファスナーを受け入れる上記接続部が上記前方の関節交換素子と一体になっていることを特徴とする請求項21に記載の人工脊椎関節。
- ファスナーを受け入れる上記接続部が上記後方の関節交換素子と一体になっていることを特徴とする請求項21に記載の人工脊椎関節。
- ファスナーを受け入れる上記接続部が茎スクリューのための接続部であることを特徴とする請求項25に記載の人工脊椎関節。
- 茎スクリューを更に有することを特徴とする請求項13に記載の人工脊椎関節。
- 上記人工脊椎関節と上位の椎骨又は下位の椎骨との間の表面の部分が骨の成長を促進させるように設計された材料を含むことを特徴とする請求項13に記載の人工脊椎関節。
- 骨の成長を促進させるように設計された上記材料がビード形状の材料であることを特徴とする請求項27に記載の人工脊椎関節。
- 骨の成長を促進させるように設計された上記材料がプラズマスプレー材料であることを特徴とする請求項27に記載の人工脊椎関節。
- 上記人工脊椎関節が少なくとも:
上方の前方関節交換素子と;
上記上方の前方関節交換素子に結合された上方のブリッジと;
上記上方のブリッジに結合された上方の後方関節交換素子と;
を有する上方の部材;及び
下方の前方関節交換素子と;
上記下方の前方関節交換素子に結合された下方のブリッジと;
上記下方のブリッジに結合された下方の後方関節交換素子と;
を有する上方の部材;
を有することを特徴とする請求項13に記載の人工脊椎関節。 - 上記上方の部材が上記下方の部材に接続するように形状づけられることを特徴とする請求項30に記載の人工脊椎関節。
- 上記上方の前方関節交換素子が上記下方の前方関節交換素子に接続するように形状づけられることを特徴とする請求項30に記載の人工脊椎関節。
- 上記上方の後方関節交換素子が上記下方の後方関節交換素子に接続するように形状づけられることを特徴とする請求項30に記載の人工脊椎関節。
- 上記上方の後方関節交換素子が張力バンドにより上記下方の後方関節交換素子に接続されることを特徴とする請求項33に記載の人工脊椎関節。
- 上記ブリッジが人工茎の少なくとも一部であることを特徴とする請求項13に記載の人工脊椎関節。
- 上位の椎骨と下位の椎骨との間にカップリングの少なくとも一部を生じさせるための人工脊椎関節において、
少なくとも、
左方の上方部材と;
上記左方の上方部材と一緒に関節運動する左方の下方部材と;
右方の上方部材と;
上記右方の上方部材と一緒に関節運動する右方の下方部材と;
を有する前方の関節交換素子;
を有し、
上記左方の上方部材及び上記右方の上方部材の各々が互いに接続するように形状づけられ、上記左方の下方部材及び上記右方の下方部材が各々互いに接続するように形状づけられることを特徴とする人工脊椎関節。 - 上記左方の下方部材及び上記右方の下方部材がロック及びキーパターンを介して互いに接続するように形状づけられることを特徴とする請求項36に記載の人工脊椎関節。
- 上記左方の上方部材及び上記右方の上方部材がロック及びキーパターンを介して互いに接続するように形状づけられることを特徴とする請求項36に記載の人工脊椎関節。
- 上位の椎骨と下位の椎骨との間にカップリングの少なくとも一部を生じさせるための人工脊椎関節において、
少なくとも、
左方の上方部材と;
上記左方の上方部材と一緒に関節運動する左方の下方部材と;
右方の上方部材と;
上記右方の上方部材と一緒に関節運動する右方の下方部材と;
を有する前方の関節交換素子;
を有し、
上記左方の下方部材及び上記右方の下方部材の各々が互いに接続するように形状づけられことを特徴とする人工脊椎関節。 - 上記左方の下方部材及び上記右方の下方部材がロック及びキーパターンを介して互いに接続するように形状づけられることを特徴とする請求項36に記載の人工脊椎関節。
- 人工脊椎関節を移植する方法において、
患者の背中に切開部を形成する工程と;
脊椎椎間板から脊椎椎間板材料の少なくとも一部を除去する工程であって、切開部を通して椎間板材料にアクセスする工程を含む除去工程と;
切開部を通して移植片を挿入する工程と;
を有し、
移植片を挿入する上記工程が椎間板及び関節突起関節の少なくとも一部を代替する移植片を挿入する工程を有することを特徴とする方法。 - 上記人工脊椎関節の少なくとも一部をその中に配置する空間を提供するように関節突起関節の少なくとも一部をトリミングする工程を更に有することを特徴とする請求項41に記載の方法。
- 上記移植片を挿入する上記工程が、
上記移植片の第1の上方部分を移植する工程と;
続いて、上記移植片の第1の下方部分を移植する工程と;
を有することを特徴とする請求項41に記載の方法。 - 上記移植片を挿入する上記工程が少なくとも当該移植片の第1の上方部分及び該移植片の第1の下方部分を備えたユニットを移植する工程を有することを特徴とする請求項41に記載の方法。
- 上記移植片を挿入する上記工程が上記第1の上方部分と上記第1の下方部分との間の結束により一体化されたユニットを移植する工程を有することを特徴とする請求項44に記載の方法。
- 上記移植片を挿入する上記工程が梱包材料により一体化されたユニットを移植する工程を有することを特徴とする請求項44に記載の方法。
- 上記移植片を挿入する上記工程が手術器具により一体化されたユニットを移植する工程を有することを特徴とする請求項44に記載の方法。
- 上記移植片を挿入する上記工程が、一体的に形成されるが上記上方部分及び上記下方部分への力の適用により変形できる状態を維持するユニットを移植する工程を有することを特徴とする請求項44に記載の方法。
- 上記挿入工程が大後頭孔脊椎開口を通して達成されることを特徴とする請求項41に記載の方法。
- 大後頭孔開口が左方の大後頭孔開口であることを特徴とする請求項49に記載の方法。
- 大後頭孔開口が右方の大後頭孔開口であることを特徴とする請求項49に記載の方法。
- 先に挿入された上記移植片とは反対の側の開口を通して付加的な移植片素子を椎間板空間の少なくとも一部内へ挿入する工程を更に有することを特徴とする請求項41に記載の方法。
- 付加的な移植片素子を挿入する上記工程が先に挿入した上記移植片と実質上同じ機能を遂行する移植片を挿入する工程を有することを特徴とする請求項52に記載の方法。
- 上位の椎骨と下位の椎骨との間にカップリングを生じさせるための装置において、
椎間板空間内で椎間板の一部を代替するための第1の手段と;
少なくとも1つの関節突起関節を代替するための第2の手段と;
上記第1の手段を上記第2の手段に剛直に結合するための第3の手段と;
を有することを特徴とする装置。 - 上記第1の手段及び上記第2の手段を剛直に結合する工程が当該第1の手段を当該第2の手段に一体的に接続する工程を有することを特徴とする請求項54に記載の装置。
- 上記第3の手段が上記第1の手段から後方へ及び椎間板空間の外方へ延びることを特徴とする請求項54に記載の装置。
- 上記第1の手段が上方部分及び下方部分を有し、上記上方部分が上記下方部分に関して運動できることを特徴とする請求項54に記載の装置。
- 上記第1の手段が、
上位の椎骨に取り付けるようになった左方の上方部分と;
上位の椎骨に取り付けるようになった右方の上方部分と;
下位の椎骨に取り付けるようになった左方の下方部分と;
下位の椎骨に取り付けるようになった右方の下方部分と;
を有することを特徴とする請求項54に記載の装置。 - 上記第2の手段が、
互いに関して摺動できる、左方の上方関節突起部材及び左方の下方関節突起部材と;
互いに関して摺動できる、右方の上方関節突起部材及び右方の下方関節突起部材と;
を有することを特徴とする請求項58に記載の装置。 - 上記第3の手段が、
上記左方の上方部分を上記左方の上方関節突起部材に接続するための左方の上方接続手段と;
上記左方の下方部分を上記左方の下方関節突起部材に接続するための左方の下方接続手段と;
上記右方の上方部分を上記右方の上方関節突起部材に接続するための右方の上方接続手段と;
上記右方の下方部分を上記右方の下方関節突起部材に接続するための右方の下方接続手段と;
を有することを特徴とする請求項59に記載の装置。 - 上記第2の手段を上位又は下位の椎骨に固定するための第4の手段を更に有することを特徴とする請求項54記載の装置。
- 上位及び下位の椎骨端板間に人工脊椎関節を移植する方法において、
患者の背中に切開部を形成する工程と;
外側の環区域を備えた椎間板にアクセスする工程と;
切開部を通して椎間板の少なくとも一部を除去する工程と;
外側の環の一部を椎骨端板の一方に取り付けた状態で保持する工程と;
外側の環区域の保持された部分に当接するように切開部を通して移植片を挿入する工程と;
を有し、上記移植片が椎間板及び関節突起関節の少なくとも一部を代替することを特徴とする方法。 - 外側の環区域の部分が下位の椎骨端板に取り付けられることを特徴とする請求項62に記載の方法。
- 外側の環区域の一部を保持する上記工程が外側の環区域の約300度を保持する工程を有することを特徴とする請求項62に記載の方法。
- 外側の環区域の一部を保持する上記工程が外側の環区域の前方部分を保持する工程を有することを特徴とする請求項62に記載の方法。
- 上記移植片が第1及び第2の保持部分を有し、移植片を挿入する上記工程が椎骨端板間からの上記第1及び第2の保持部分の移動を制限する工程を有することを特徴とする請求項62に記載の方法。
- 上記第1及び第2の保持部分が接続されることを特徴とする請求項66に記載の方法。
- 上記第1及び第2の保持部分がほぼ前方中心線位置で接続されることを特徴とする請求項67に記載の方法。
- 上記第1及び第2の保持部分が相互係止構造により接続されることを特徴とする請求項67に記載の方法。
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JP2006549469A Pending JP2007517616A (ja) | 2004-01-09 | 2005-01-10 | スプリット脊椎デバイスおよび方法 |
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JP2006549448A Pending JP2007517607A (ja) | 2004-01-09 | 2005-01-10 | 人工脊椎関節 |
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JP2006549487A Expired - Fee Related JP4589932B2 (ja) | 2004-01-09 | 2005-01-10 | 脊椎関節形成装置及び方法 |
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JP2006549469A Pending JP2007517616A (ja) | 2004-01-09 | 2005-01-10 | スプリット脊椎デバイスおよび方法 |
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DE202004015198U1 (de) * | 2004-09-24 | 2004-11-25 | Aesculap Ag & Co. Kg | Implantatsystem |
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JP2008532642A (ja) * | 2005-03-08 | 2008-08-21 | ザ サード スターリン、チェスター | 椎間関節安定化処置 |
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