JP2013532024A - 椎間関節治療のためのシステム - Google Patents
椎間関節治療のためのシステム Download PDFInfo
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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
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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
- A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
- A61B17/7067—Devices bearing against one or more spinous processes and also attached to another part of the spine; Tools therefor
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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
- A61F2/4405—Joints for the spine, e.g. vertebrae, spinal discs for apophyseal or facet joints, i.e. between adjacent spinous or transverse processes
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/16—Indifferent or passive electrodes for grounding
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- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
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- A—HUMAN NECESSITIES
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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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- 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
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- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- 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
- A61F2/4611—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 of spinal prostheses
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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
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- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
- A61F2002/3006—Properties of materials and coating materials
- A61F2002/3008—Properties of materials and coating materials radio-opaque, e.g. radio-opaque markers
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- A—HUMAN NECESSITIES
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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
- 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
- A61F2002/30317—The prosthesis having different structural features at different locations within the same prosthesis
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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
- 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
- A61F2002/30317—The prosthesis having different structural features at different locations within the same prosthesis
- A61F2002/30322—The prosthesis having different structural features at different locations within the same prosthesis differing in surface structures
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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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
- 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
- A61F2002/30317—The prosthesis having different structural features at different locations within the same prosthesis
- A61F2002/30324—The prosthesis having different structural features at different locations within the same prosthesis differing in thickness
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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
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30667—Features concerning an interaction with the environment or a particular use of the prosthesis
- A61F2002/30682—Means for preventing migration of particles released by the joint, e.g. wear debris or cement particles
- A61F2002/30685—Means for reducing or preventing the generation of wear particulates
-
- 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
- A61F2002/30754—Implants for interposition between two natural articular surfaces
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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
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- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
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- A61F2002/30841—Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
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- A—HUMAN NECESSITIES
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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
- A61F2/02—Prostheses implantable into the body
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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
- A61F2002/4629—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 connected to the endoprosthesis or implant via a threaded connection
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Abstract
Description
本出願は、2010年6月15日に出願された米国仮特許第61/355,140号に対する優先権を主張し、その内容は、参照により本明細書に組み込まれる。
本発明の実施形態は、椎間関節痛を治療するためのシステムに関する。より具体的には、本発明は、椎間関節痛を治療するための埋込システムに関する。
所定の実施形態では、ガイドプローブシャフト202は、約5ミリメートル〜約20ミリメートルの幅を有する。他の実施形態では、ガイドプローブシャフト202は、約12ミリメートルの幅を有する。
通路282の幅は、埋込片挿入治具310の主要部分312の幅よりも小さい。所定の実施形態では、通路282の幅は、約3ミリメートル〜約15ミリメートルであり得る。他の実施形態では、通路282の幅は、約5ミリメートル〜約10ミリメートルである。
ハンドル部分314との交差点に近位で、主要部分312は、その少なくとも一側面から延在する肩320を含むことができる。肩320は、ガイドカニューレ260上の第2の停止機構272に係合することによって、送達カニューレの中に挿入され得る距離を制限するために使用され得る。
端表面334は、凹状の表面322から離間される。所定の実施形態では、端表面間の距離は、約1ミリメートル〜約10ミリメートルであり得る。他の実施形態では、端表面間の距離は、約3ミリメートルであり得る。
一部の実施形態では、表面置換本体46がリーフレット284間に位置付けられるように離間した構成でリーフレット284を維持するリーフレット開大器(図示せず)を使用することが望ましい場合がある。リーフレット開大器の使用が望ましい場合、表面置換本体46が埋込片挿入治具310に取り付けられた後、埋込片挿入治具310が送達カニューレ280の中に挿入されるように、装填プロセスがわずかに変更され得る。
Claims (50)
- 上関節面および下関節面を含む、患者の椎間関節を治療するためのシステムであって、
椎間関節の上関節面と椎間関節の下関節面との間に配置可能である表面置換装置と、
前記表面置換装置に係合するように適合される埋込片挿入治具と、
内部を通って延在する内部通路を有するガイドカニューレであって、前記ガイドカニューレ通路が、前記表面置換装置および前記埋込片挿入治具の少なくとも一部分を受容するように適合される、ガイドカニューレと、を備える、システム。 - 前記表面置換装置は、第1の表面置換部分と、第2の表面置換部分と、を備える、請求項1に記載のシステム。
- 前記表面置換装置は、比較的平坦な状態から、前記表面置換装置が前記上関節面のあらゆる多平面湾曲と実質的に一致する挿入状態に移行するのに十分な可撓性を示す、請求項1に記載のシステム。
- 前記表面置換装置は、少なくともその一表面に複数の歯を有する、請求項1に記載のシステム。
- 前記表面置換装置は、第1の係合特徴を備え、前記埋込片挿入装置は、前記第1の係合特徴と嵌合することができる第2の係合特徴を備え、嵌合後に前記第1の係合特徴と前記第2の係合特徴とを分離させる力は、少なくとも1ニュートンである、請求項1に記載のシステム。
- 前記第1の係合特徴は、第1の開口領域および第2の開口領域を備え、前記第1の開口領域は、前記表面置換装置の縁と交差し、前記第2の開口領域は、前記第1の開口領域と連通し、
前記第2の係合特徴は、第1の延在領域および第2の延在領域を備え、前記第2の延在領域は、前記埋込片挿入装置に取り付けられ、前記第1の延在領域は、前記埋込片挿入装置と反対側の前記第2の延在領域に取り付けられる、請求項5に記載のシステム。 - 前記埋込片挿入治具は、
近位端および遠位端を有する主要部分と、
前記近位端に近位で前記主要部分に取り付けられるハンドル部分と、
前記主要部分の幅より大きい幅を有する、前記主要部分および前記ハンドル部分のうちの少なくとも1つから延在する肩部分と、をさらに備える、請求項1に記載のシステム。 - 前記表面置換装置および前記埋込片挿入治具は、前記ガイドカニューレに対して摺動可能に装着される、請求項1に記載のシステム。
- 前記ガイドカニューレは、前記表面置換装置の縁に少なくとも部分的に適合する凹状遠位表面を有する、請求項1に記載のシステム。
- ガイドプローブ先端部を含むガイドプローブアセンブリをさらに備え、前記ガイドプローブアセンブリは、前記ガイドカニューレ通路の幅より小さい幅を有し、かつ前記ガイドカニューレ通路の高さより低い高さを有する、請求項1に記載のシステム。
- 前記ガイドプローブ先端部は、前記ガイドプローブアセンブリに着脱可能に装着される、請求項10に記載のシステム。
- 前記ガイドプローブ先端部の幅は、前記ガイドプローブアセンブリの幅より小さく、前記ガイドプローブ先端部の高さは、前記ガイドプローブアセンブリの高さより低い、請求項10に記載のシステム。
- 内部を通って延在する内部通路を有する送達カニューレをさらに備え、前記送達カニューレ通路は、前記表面置換装置および前記埋込片挿入治具の少なくとも一部分を受容するように適合され、前記ガイドカニューレ通路は、前記送達カニューレを受容するように適合される、請求項1に記載のシステム。
- 前記送達カニューレは、その遠位端の近位に装着される一対のリーフレットを備え、前記リーフレットは、弾性材料から製作される、請求項13に記載のシステム。
- 前記ガイドカニューレは、前記送達カニューレ対して摺動可能に装着され、前記表面置換装置および前記埋込片挿入治具は、前記送達カニューレに対して摺動可能に装着される、請求項13に記載のシステム。
- 前記埋込片挿入治具に係合することができる第1のハンドル区分と、
前記第1のハンドル区分に操作可能に接続される第2のハンドル区分であって、前記送達カニューレに係合することができる、第2のハンドル区分と、を備える、牽引治具をさらに備える、請求項1に記載のシステム。 - 前記第1のハンドル区分は、前記第2のハンドル区分に枢動可能に装着される、請求項16に記載のシステム。
- 上関節面および下関節面を含む、患者の椎間関節を治療するためのシステムであって、
椎間関節の上関節面および前記椎間関節の下関節面のうちの少なくとも1つの形状と選択的に適合するように構成される表面置換装置であって、第1の係合特徴を備える、表面置換装置と、
前記第1の係合特徴と嵌合することができる第2の係合特徴を有し、嵌合後に前記第1の係合特徴と前記第2の係合特徴とを分離させる力は、少なくとも1ニュートンである、埋込片挿入装置と、を備える、システム。 - 嵌合後に前記第1の係合特徴と前記第2の係合特徴とを分離させる力は、約1ニュートン〜約10ニュートンである、請求項18に記載のシステム。
- 前記第1の係合特徴は、第1の開口領域および第2の開口領域を備え、前記第1の開口領域は、前記表面置換装置の縁と交差し、前記第2の開口領域は、前記第1の開口領域と連通し、
前記第2の係合特徴は、第1の延在領域および第2の延在領域を備え、前記第2の延在領域は、前記埋込片挿入装置に取り付けられ、前記第1の延在領域は、前記埋込片挿入装置と反対側の前記第2の延在領域に取り付けられる、請求項18に記載のシステム。 - 前記第1の開口領域の幅は、前記第2の開口領域の幅より小さく、前記第1の延在領域の幅は、前記第2の延在領域の幅より大きく、前記第1の開口領域の幅は、前記第1の延在領域の幅より大きい、請求項20に記載のシステム。
- 前記表面置換装置は、第1の表面置換部分と、第2の表面置換部分と、を備え、前記第1の係合特徴は、前記第1の表面置換部分および前記第2の表面置換部分のうちの少なくとも1つに形成される、請求項18に記載のシステム。
- 前記第1の表面置換本体は、比較的平坦な状態から、前記第1の表面置換本体が前記上関節面のあらゆる多平面湾曲と実質的に一致する挿入状態に移行するのに十分な可撓性を示し、かつ
前記第2の表面置換本体は、比較的平坦な状態から、前記第2の表面置換本体が前記下関節面のあらゆる多平面湾曲と実質的に一致する挿入状態に移行するのに十分な可撓性を示す、請求項22に記載のシステム。 - 前記第1の表面置換本体および前記第2の表面置換本体は、それぞれ、第1の側面および第2の側面を備え、前記第1の側面は、そこから延在する複数の歯を有し、前記第2の側面は、実質的に平坦である、請求項22に記載のシステム。
- 複数の歯は、第1の歯群と、第2の歯群と、第3の歯群と、を備え、前記第1の歯群は、前記第2の歯群および前記第3の歯群と異なって配向される、請求項24に記載のシステム。
- 前記第1の表面置換本体および前記第2の表面置換本体は、それぞれ、固設表面および関節表面を画定し、前記システムは、椎間関節内への挿入時、前記関節表面が、摺動界面で相互に当接するように構成される、請求項22に記載のシステム。
- 前記第1の表面置換本体および前記第2の表面置換本体は、それぞれ、約5〜約13ミリメートルの範囲の直径によって画定される円形の形状を有する、請求項22に記載のシステム。
- 前記表面置換装置は、約0.25〜約4ミリメートルの厚さを有する、請求項18に記載のシステム。
- 前記埋込片挿入装置は、前記表面置換装置の厚さとほぼ同じの厚さを有する、請求項18に記載のシステム。
- 前記埋込片挿入装置の端部は、前記表面置換装置の縁の少なくとも一部分に対応する凹状の領域を含む、請求項18に記載のシステム。
- 前記表面置換装置は、100Nを超えない適合係数を示す、請求項18に記載のシステム。
- 前記表面置換装置は、ポリエーテルケトン系プラスチックから形成される、請求項18に記載のシステム。
- 前記歯の少なくとも1つは、先導面および後面によって画定され、前記少なくとも1つの歯が、第2の反対方向と比較して、対応する椎間関節の関節面に対する前記対応する表面置換本体の第1の方向への移動により明らかに抵抗するように、前記先導面と前記第1の主要面の平面とによって画定される角度は、前記後面と前記第1の主要面の平面とによって画定される角度より小さい、請求項12に記載のシステム。
- 前記複数の歯は、
第1の歯群であって、前記第1の歯群の各歯が前記第2の主要面に対する第1の延在の角度を画定する、第1の歯群と、
第2の歯群であって、前記第2の歯群の各歯が、前記第1の延在の角度とは異なる前記第1の主要面に対する延在の角度を画定する、第2の歯群と、を含む、請求項12に記載のシステム。 - 前記第1の歯群の各歯は、前記先導端により近位の先導面と、前記後端により近位の後面と、を含み、前記先導面および後面は、前記第1の主要面と反対側の先端部で交差し、さらに前記先導面の長さは、前記対応する歯が前記対応する表面置換本体の挿入の方向を前記先導端から前記後端に画定するように、前記後面の長さより長い、請求項15に記載のシステム。
- 前記基底ウェブは、実質的に均一な厚さを画定し、前記複数の歯は、前記先導端に近位の第1の歯と、前記後端に近位の第2の歯と、を含み、前記第1の歯の高さは、前記第2の歯の高さより高い、請求項12に記載のシステム。
- 上関節面および下関節面を含む、患者の椎間関節を治療するための方法であって、
表面置換装置上の第1の係合特徴を埋込片挿入治具上の第2の係合特徴と嵌合することにより、前記表面置換装置を前記埋込片挿入治具に固定する工程と、
内部を通って延在する内部通路を有するガイドカニューレの遠位端を、前記椎間関節の近位に位置付ける工程と、
前記表面置換装置が前記ガイドカニューレ通路の遠位端を通過するまで、前記ガイドカニューレ通路を通って前記表面置換装置を摺動させる工程と、
前記第1の係合特徴と前記第2の係合特徴とを分離するために、前記埋込片挿入治具に少なくとも1ニュートンの力を及ぼす工程と、を含む、方法。 - 前記表面置換装置は、第1の表面置換部分と、第2の表面置換部分と、を備え、前記第1の表面置換部分は、前記第2の表面置換部分に類似して成形される、請求項37に記載の方法。
- 前記第1の表面置換部分および前記第2の表面置換部分は、それぞれ、少なくともその一表面上に形成される複数の歯を有する、請求項38に記載の方法。
- 前記第1の係合特徴は、第1の開口領域および第2の開口領域を備え、前記第1の開口領域は、前記表面置換装置の縁と交差し、前記第2の開口領域は、前記第1の開口領域と連通し、前記第2の係合特徴は、第1の延在領域および第2の延在領域を備え、前記第2の延在領域は、前記埋込片挿入装置に取り付けられ、前記第1の延在領域は、前記埋込片挿入装置と反対側の第2の延在領域に取り付けられ、前記第1の延在領域は、前記表面置換装置が前記埋込片挿入治具に固定されるとき、前記第2の開口領域に収容される、請求項37に記載の方法。
- 前記表面置換装置は、約5ミリメートル〜約13ミリメートルの直径、および約0.25ミリメートル〜約4ミリメートルの厚さを有する、請求項37に記載の方法。
- 前記上関節面と前記下関節面との間にガイドプローブアセンブリを延在させることによって、前記椎間関節に接合線を画定することをさらに含み、前記ガイドプローブアセンブリは、前記ガイドカニューレ通路の幅より小さい幅を有し、前記ガイドプローブアセンブリは、前記ガイドカニューレ通路の高さより低い高さを有する、請求項37に記載の方法。
- 前記ガイドカニューレ通路を通して前記表面置換装置を摺動させる工程は、
送達カニューレであって、その遠位端に近位で装着される一対のリーフレットを備え、前記一対のリーフレットは、弾性材料から製作される、送達カニューレの内部通路を通して前記表面置換装置を摺動させる工程と、
前記ガイドカニューレ通路を通して前記送達カニューレを摺動させる工程と、を含む、請求項37に記載の方法。 - 前記埋込片挿入治具を牽引治具の第1のハンドル区分と係合させる工程と、
前記送達カニューレを前記牽引治具の第2のハンドル区分と係合させる工程と、
前記埋込片挿入治具を前記送達カニューレに対して移動させるために、第2のハンドル区分に対して前記第1のハンドル区分を枢動させる工程と、をさらに含む、請求項37に記載の方法。 - 前記第1の表面置換装置および前記第2の表面置換装置を送達カニューレの内部通路の中に積層構成で充填する工程であって、前記送達カニューレアセンブリは、遠位端を有し、前記遠位端で開口するように、前記送達カニューレ通路を画定する、前記第1および第2の表面置換装置を充填する工程と、
埋込片挿入治具を前記送達カニューレ通路の中に摺動可能に配置する工程であって、前記埋込片挿入治具の遠位部分は、前記上部表面置換装置及び下部表面置換装置と当接する、前記埋込片挿入治具を配置する工程と、
前記送達カニューレアセンブリの前記遠位端を前記椎間関節に送達する工程と、
前記第1の表面置換本体および前記第2の表面置換本体を前記遠位端から前記椎間関節の中に押し出すように、前記送達カニューレ通路内に前記埋込片挿入治具を遠位に摺動する工程と、をさらに含む、請求項38に記載の方法。 - 前記第1の表面置換本体および前記第2の表面置換本体は、それぞれ、第1の係合特徴を有し、前記埋込片挿入治具の前記遠位部分は、第2の係合特徴を有し、前記第1の係合特徴は、前記第2の係合特徴と嵌合可能である、請求項45に記載の方法。
- 上関節面および下関節面を含む、患者の椎間関節を治療するためのキットであって、
椎間関節の上関節面の形状に少なくとも部分的に適合する形状に選択的に移行するように構成される上部表面置換装置と、
前記椎間関節の下関節面の形状に少なくとも部分的に適合する形状に選択的に移行するように構成される下部表面置換装置であって、前記上部表面置換装置が前記下部表面置換装置から分離される、下部表面置換装置と、
挿入治具セットであって、
内部通路を有する送達カニューレと、
内部通路を有するガイドカニューレと、
前記送達カニューレ通路内に摺動可能に受容されるように寸法決定される埋込片挿入装置と、を備える挿入治具セットと、を備える、キットであり、
前記上部表面置換装置、前記下部表面置換装置、および前記埋込片挿入装置が、前記送達カニューレ通路内に摺動可能に受容され、前記上部表面置換装置および前記下部表面置換装置が、前記埋込片挿入装置の遠位領域に隣接して相互に対して積層される挿入配置を提供するように構成される、キット。 - 前記上部表面置換装置及び前記下部表面置換装置のうちの少なくとも1つは、第1の係合特徴を備え、前記埋込片挿入装置は、前記第1の係合特徴と嵌合することができる第2の係合特徴を備え、嵌合後に前記第1の係合特徴と前記第2の係合特徴とを分離させる力は、少なくとも1ニュートンである、請求項47に記載のキット。
- 前記上部表面置換装置および前記下部表面置換装置は、同一であり、前記上部表面置換装置および前記下部表面置換装置は、それぞれ、約5ミリメートル〜約13ミリメートルの直径、および約0.25ミリメートル〜約4ミリメートルの厚さを有する、請求項47に記載のキット。
- 前記上部表面置換装置および前記下部表面置換装置は、それぞれ、ポリエーテルケトン系材料から形成される、請求項47に記載のキット。
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- 2011-05-24 BR BR112012031947A patent/BR112012031947A2/pt not_active IP Right Cessation
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- 2011-05-24 CN CN2011800389495A patent/CN103237525A/zh active Pending
- 2011-05-24 WO PCT/US2011/037737 patent/WO2011159440A1/en active Application Filing
- 2011-05-24 EP EP11723831.1A patent/EP2582330A1/en not_active Withdrawn
- 2011-05-24 RU RU2012155518/14A patent/RU2012155518A/ru not_active Application Discontinuation
- 2011-05-24 CA CA2802791A patent/CA2802791A1/en not_active Abandoned
- 2011-05-24 KR KR1020137001034A patent/KR20130122929A/ko not_active Application Discontinuation
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JP2018527150A (ja) * | 2015-09-14 | 2018-09-20 | ジゴフィックス・リミテッド | 小関節面伸延及び固定人工器官 |
JP2019000626A (ja) * | 2017-05-25 | 2019-01-10 | ストライカー・ユーロピアン・ホールディングス・I,リミテッド・ライアビリティ・カンパニー | 固定特徴部及び挿入特徴部が一体化された融合ケージ |
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JP7466267B2 (ja) | 2017-05-25 | 2024-04-12 | ストライカー・ユーロピアン・オペレイションズ・ホールディングス・リミテッド・ライアビリティ・カンパニー | 固定特徴部及び挿入特徴部が一体化された融合ケージ |
JP2021506357A (ja) * | 2017-12-06 | 2021-02-22 | ジゴフィックス・リミテッド | 椎間伸延および癒合プロテーゼ |
JP7231945B2 (ja) | 2017-12-06 | 2023-03-02 | ジゴフィックス・リミテッド | 椎間伸延および癒合プロテーゼ |
Also Published As
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US8663293B2 (en) | 2014-03-04 |
AU2011265712B2 (en) | 2015-10-08 |
CA2802791A1 (en) | 2011-12-22 |
CN103237525A (zh) | 2013-08-07 |
EP2582330A1 (en) | 2013-04-24 |
US20110307061A1 (en) | 2011-12-15 |
KR20130122929A (ko) | 2013-11-11 |
JP5675969B2 (ja) | 2015-02-25 |
AU2011265712A1 (en) | 2013-02-14 |
WO2011159440A1 (en) | 2011-12-22 |
US20140243896A1 (en) | 2014-08-28 |
US9314277B2 (en) | 2016-04-19 |
RU2012155518A (ru) | 2014-07-20 |
BR112012031947A2 (pt) | 2017-04-18 |
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