JP4898702B2 - 調節可能な脊椎安定化システム - Google Patents
調節可能な脊椎安定化システム Download PDFInfo
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- JP4898702B2 JP4898702B2 JP2007548481A JP2007548481A JP4898702B2 JP 4898702 B2 JP4898702 B2 JP 4898702B2 JP 2007548481 A JP2007548481 A JP 2007548481A JP 2007548481 A JP2007548481 A JP 2007548481A JP 4898702 B2 JP4898702 B2 JP 4898702B2
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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
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
- A61B17/1757—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the spine
-
- 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
- A61B17/7004—Longitudinal elements, e.g. rods with a cross-section which varies along its length
-
- 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
- A61B17/7004—Longitudinal elements, e.g. rods with a cross-section which varies along its length
- A61B17/7007—Parts of the longitudinal elements, e.g. their ends, being specially adapted to fit around the screw or hook heads
-
- 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
- A61B17/7011—Longitudinal element being non-straight, e.g. curved, angled or branched
- A61B17/7013—Longitudinal element being non-straight, e.g. curved, angled or branched the shape of the element being adjustable before use
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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
-
- 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
- A61B17/7032—Screws or hooks with U-shaped head or back through which longitudinal rods pass
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3472—Trocars; Puncturing needles for bones, e.g. intraosseus injections
-
- 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
-
- 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
- A61B17/701—Longitudinal elements with a non-circular, e.g. rectangular, cross-section
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
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- Oral & Maxillofacial Surgery (AREA)
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- Materials For Medical Uses (AREA)
- Orthopedics, Nursing, And Contraception (AREA)
Description
本出願は、2004年12月27日に出願された、発明の名称が「Adjustable Spinal Stabilization System」である米国特許出願11/024,171号の一部継続出願に関し、その米国特許出願11/024,171号は、2004年3月10日に出願された、発明の名称が「A Method and Apparatus for Flexible Fixation of a Spine」である米国特許出願10/798,014号の一部継続出願であり、その米国特許出願10/798,014号は、2003年12月5日に出願された、米国特許出願10/728,566号の一部継続出願である。
(発明の技術分野)
本発明は、脊柱を安定させるための方法およびシステムに関し、より具体的には、一つ以上のねじ型固定部材が患者の脊柱部位に移植および固定され、さまざまな断面の可撓性で半剛性の棒状または板状の構造体(以下、それぞれ「棒」または「板」という)を有する長手軸方向部材が、固定部材の上端に連結および固定されることにより脊柱の安定化を提供する、脊椎固定の方法およびシステムに関する。
椎間板変性疾患(DDD)、脊椎狭窄症、脊椎すべり症などの脊柱変性疾患は、保存療法で改善しない場合に外科手術が必要になる。一般的に、最初に行う外科的手順は、脊椎除圧術である。その除圧の主な目的は、脊柱のある組織を摘出することにより脊柱管およびその神経根への圧力を軽減し、その圧力により生じる圧力や痛みを軽減または解消することにある。脊柱の組織が摘出されると痛みは軽減されるが、脊柱は弱くなる。よって、除圧手順後に脊椎を安定させるために、癒合手術(例えば、ALIF、PLIF、または後外側固定術)が必要になる場合が多い。しかしながら、外科的手順後、癒合によって最大の安定性を得るまでには時間をさらに要するので、脊椎固定装置は、一般的に、所望のレベルの癒合が達成されるまで脊柱を支持するために使用される。患者特有の事情や病状により、癒合手順を行わずに、脊椎固定術が除圧の直後に行われる場合がある。固定手術は、手術の直後に安定性を提供するため多くの症例において行われ、癒合手術が行われた場合も、十分な癒合と安定性が得られるまで脊椎を支える。
本発明は、損傷または弱体化した脊柱を安定させるための改善された方法およびシステムを提供することによって、上記およびその他の必要性に取り組む。
本発明は、図面を参照して以下に詳細に説明され、同様の要素については全体を通して同一の数字を使用して参照される。
Claims (18)
- 第一の椎骨を第二の椎骨に可撓性に安定化する際に使用するための接続ユニットであって、該接続ユニットは、
U形状チャンネルを有する第一の骨連結アセンブリ;
U形状チャンネルを有する第二の骨連結アセンブリ;および
中心軸を有する長手軸方向部材であって、該長手軸方向部材は、該第一の骨連結アセンブリのU形状チャンネル内に受け取られる第一の端部、該第二の骨連結アセンブリのU形状チャンネル内に受け取られる第二の端部、および該第一の端部と該第二の端部との間の可撓性部分を備え、該可撓性部分は、内部空洞を備える、長手軸方向部材;および
該長手軸方向部材の該可撓性部分に形成された該内部空洞に位置するテザーであって、該テザーは、該第一の端部および該第二の端部に連結しており、該長手軸方向部材は、該テザーが元の位置から第二の位置へと屈曲可能であり、該長手軸方向部材が該元の位置から該第二の位置に屈曲されるとき、該長手軸方向部材の一部分が第一の距離だけ動かされ;
該長手軸方向部材が該元の位置にあるとき該テザーがたるみ、そして該長手軸方向部材が第二の距離だけ動かされるとき該テザーが張られ、該張られたテザーが、該元の位置から離れる該長手軸方向部材のさらなる動きに抵抗し、該第二の距離がゼロより大きく、そして該第一の距離より小さい、接続ユニット。 - 前記テザーは、第一の端部および第二の端部を有し、該テザーの該第一の端部は、前記長手軸方向部材の該第一の端部に回転不可能に連結し、該テザーの該第二の端部は、調節部材に連結される、請求項1に記載の接続ユニット。
- 前記調節部材が、長手軸方向部材の前記第二の端部内に形成された内側にネジ山の入ったセクションと回転可能に係合するように構成された、外側にネジ山の入ったねじ部材であり、これによって、該外側にネジ山の入ったねじ部材の回転は、該テザーにおいて張力を調節する、請求項2に記載の接続ユニット。
- 前記外側にネジ山の入ったねじ部材が、滑り型継手によって前記テザーに連結されており、該滑り型継手は、該テザーに対する該外側にネジ山の入ったねじ部材の軸周りでの回転を可能にする、請求項3に記載の接続ユニット。
- 前記テザーが第一の端部および第二の端部を有し、該テザーの該第一の端部は、前記長手軸方向部材の前記第一の端部に回転可能に連結しており、該テザーの該第二の端部は、調節部材に堅固に連結されている、請求項1に記載の接続ユニット。
- 前記調節部材は、前記長手軸方向部材の前記第二の端部内に形成された内側にネジ山の入ったセクションと回転可能に係合するように構成された、外側にネジ山の入ったねじ部材であり、これによって、該外側にネジ山の入ったねじ部材の回転は、該テザーにおいて張力を調節する、請求項5に記載の接続ユニット。
- 前記長手軸方向部材の第一の端部が、滑り型継手によって前記テザーに連結されており、該滑り型継手は、該テザーに対する該長手軸方向部材の軸周りでの回転を可能にする、請求項6に記載の接続ユニット。
- 前記テザーが、前記長手軸方向部材の第一の端部および第二の端部に堅固に連結されている、請求項1に記載の接続ユニット。
- 前記テザーが第一の端部および第二の端部を有し、該テザーの該第一の端部は、前記長手軸方向部材の前記第一の端部に堅固に連結しており、該テザーの該第二の端部は、該長手軸方向部材の第二の端部を越えており、該テザーの該第二の端部は、内側にネジ山の入った調節部材と回転可能に係合するための外側にネジ山の入ったネジ山を有する、請求項1に記載の接続ユニット。
- 前記調節部材が、外部ナットを備え、該外部ナットが、前記長手軸方向部材の前記第二の端部に当接し、そして前記テザーにおける張力を調節するために回転させられ得る、請求項9に記載の接続ユニット。
- 前記外部ナットと、前記長手軸方向部材の前記第二の端部との間に置かれた座金をさらに備える、請求項10に記載の接続ユニット。
- 前記座金が、スリップリング、止め座金、またはスプリット止め座金を含む、請求項11に記載の接続ユニット。
- 前記長手軸方向部材が、円柱形の棒である、請求項1に記載の接続ユニット。
- 前記長手軸方向部材が、金属、金属合金、有機ポリマー、天然樹脂、合成樹脂、熱可塑性物質、エラストマーおよび複合材料を含む生体適合性材料を含む、請求項1に記載の接続ユニット。
- 前記テザーが、金属、金属合金、有機ポリマー、天然樹脂、合成樹脂、熱可塑性物質、エラストマーまたは複合材料を含む材料を含む、請求項1に記載の接続ユニット。
- 前記テザーが、繊維、複数の繊維の束、ワイヤ、複数のワイヤの束、リボン、複数のリボンの束、棒、または複数の棒の束を含む構造体を備える、請求項1に記載の接続ユニット。
- 前記テザーが、前記長手方向軸の前記中心軸からずれた位置で前記第一の端部および前記第二の端部に連結される、請求項1に記載の接続ユニット。
- 前記第一の端部、前記第二の端部および前記可撓性部分が一体に形成される、請求項1に記載の接続ユニット。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US11/024,171 | 2004-12-27 | ||
US11/024,171 US7815665B2 (en) | 2003-09-24 | 2004-12-27 | Adjustable spinal stabilization system |
PCT/US2005/046659 WO2006071742A2 (en) | 2004-12-27 | 2005-12-21 | Adjustable spinal stabilization system |
Publications (3)
Publication Number | Publication Date |
---|---|
JP2008525118A JP2008525118A (ja) | 2008-07-17 |
JP2008525118A5 JP2008525118A5 (ja) | 2008-12-11 |
JP4898702B2 true JP4898702B2 (ja) | 2012-03-21 |
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Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
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JP2007548481A Expired - Fee Related JP4898702B2 (ja) | 2004-12-27 | 2005-12-21 | 調節可能な脊椎安定化システム |
Country Status (4)
Country | Link |
---|---|
EP (2) | EP1830723A4 (ja) |
JP (1) | JP4898702B2 (ja) |
CA (1) | CA2591848C (ja) |
WO (1) | WO2006071742A2 (ja) |
Families Citing this family (37)
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US7833250B2 (en) | 2004-11-10 | 2010-11-16 | Jackson Roger P | Polyaxial bone screw with helically wound capture connection |
US8876868B2 (en) | 2002-09-06 | 2014-11-04 | Roger P. Jackson | Helical guide and advancement flange with radially loaded lip |
US7377923B2 (en) | 2003-05-22 | 2008-05-27 | Alphatec Spine, Inc. | Variable angle spinal screw assembly |
US7967850B2 (en) | 2003-06-18 | 2011-06-28 | Jackson Roger P | Polyaxial bone anchor with helical capture connection, insert and dual locking assembly |
US7766915B2 (en) | 2004-02-27 | 2010-08-03 | Jackson Roger P | Dynamic fixation assemblies with inner core and outer coil-like member |
US8366753B2 (en) | 2003-06-18 | 2013-02-05 | Jackson Roger P | Polyaxial bone screw assembly with fixed retaining structure |
US7776067B2 (en) | 2005-05-27 | 2010-08-17 | Jackson Roger P | Polyaxial bone screw with shank articulation pressure insert and method |
US8926670B2 (en) | 2003-06-18 | 2015-01-06 | Roger P. Jackson | Polyaxial bone screw assembly |
US8979900B2 (en) | 2003-09-24 | 2015-03-17 | DePuy Synthes Products, LLC | Spinal stabilization device |
US7137985B2 (en) | 2003-09-24 | 2006-11-21 | N Spine, Inc. | Marking and guidance method and system for flexible fixation of a spine |
US8926672B2 (en) | 2004-11-10 | 2015-01-06 | Roger P. Jackson | Splay control closure for open bone anchor |
US20100331887A1 (en) | 2006-01-09 | 2010-12-30 | Jackson Roger P | Longitudinal connecting member with sleeved tensioned cords |
US9168069B2 (en) | 2009-06-15 | 2015-10-27 | Roger P. Jackson | Polyaxial bone anchor with pop-on shank and winged insert with lower skirt for engaging a friction fit retainer |
US8444681B2 (en) | 2009-06-15 | 2013-05-21 | Roger P. Jackson | Polyaxial bone anchor with pop-on shank, friction fit retainer and winged insert |
US7901437B2 (en) | 2007-01-26 | 2011-03-08 | Jackson Roger P | Dynamic stabilization member with molded connection |
US7811309B2 (en) | 2005-07-26 | 2010-10-12 | Applied Spine Technologies, Inc. | Dynamic spine stabilization device with travel-limiting functionality |
EP2049030A4 (en) * | 2006-07-24 | 2012-07-18 | Nuvasive Inc | SYSTEMS AND METHODS FOR DYNAMIC SPINAL STABILIZATION |
EP1891904B1 (en) * | 2006-08-24 | 2013-12-25 | Biedermann Technologies GmbH & Co. KG | Bone anchoring device |
US20080147122A1 (en) * | 2006-10-12 | 2008-06-19 | Jackson Roger P | Dynamic stabilization connecting member with molded inner segment and surrounding external elastomer |
US20090099608A1 (en) * | 2007-10-12 | 2009-04-16 | Aesculap Implant Systems, Inc. | Rod assembly for dynamic posterior stabilization |
DE602008004213D1 (de) | 2008-05-06 | 2011-02-10 | Biedermann Motech Gmbh | Stangenförmiges Implantat, insbesondere zur dynamischen Stabilisierung der Wirbelsäule |
US9668771B2 (en) | 2009-06-15 | 2017-06-06 | Roger P Jackson | Soft stabilization assemblies with off-set connector |
CN103917181A (zh) | 2009-06-15 | 2014-07-09 | 罗杰.P.杰克逊 | 包括套接杆和具有低外形边缘锁的摩擦配合保持件的多轴骨锚 |
US8998959B2 (en) | 2009-06-15 | 2015-04-07 | Roger P Jackson | Polyaxial bone anchors with pop-on shank, fully constrained friction fit retainer and lock and release insert |
US11229457B2 (en) | 2009-06-15 | 2022-01-25 | Roger P. Jackson | Pivotal bone anchor assembly with insert tool deployment |
WO2013043218A1 (en) | 2009-06-15 | 2013-03-28 | Jackson Roger P | Polyaxial bone anchor with pop-on shank and winged insert with friction fit compressive collet |
KR20120104563A (ko) | 2009-12-30 | 2012-09-21 | 신세스 게엠바하 | 통합형 다중재료 임플란트 및 제조 방법 |
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FR2718946B1 (fr) * | 1994-04-25 | 1996-09-27 | Soprane Sa | Tige souple pour fixateur d'ostéosynthèse lombo-sacrée. |
DE19746687C2 (de) * | 1997-10-22 | 2001-02-15 | Gerd Werding | Vorrichtung zur externen Fixierung von gebrochenen Knochen, insbesondere der Extremitäten |
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DE10327358A1 (de) * | 2003-06-16 | 2005-01-05 | Ulrich Gmbh & Co. Kg | Implantat zur Korrektur und Stabilisierung der Wirbelsäule |
US7137985B2 (en) * | 2003-09-24 | 2006-11-21 | N Spine, Inc. | Marking and guidance method and system for flexible fixation of a spine |
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2005
- 2005-12-21 JP JP2007548481A patent/JP4898702B2/ja not_active Expired - Fee Related
- 2005-12-21 CA CA2591848A patent/CA2591848C/en not_active Expired - Fee Related
- 2005-12-21 WO PCT/US2005/046659 patent/WO2006071742A2/en active Application Filing
- 2005-12-21 EP EP05855251A patent/EP1830723A4/en not_active Withdrawn
- 2005-12-21 EP EP12000069A patent/EP2449989A1/en not_active Withdrawn
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WO2004105577A2 (en) * | 2003-05-23 | 2004-12-09 | Globus Medical, Inc. | Spine stabilization system |
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WO2006071742A2 (en) | 2006-07-06 |
CA2591848A1 (en) | 2006-07-06 |
EP1830723A2 (en) | 2007-09-12 |
EP1830723A4 (en) | 2010-03-10 |
CA2591848C (en) | 2012-08-07 |
JP2008525118A (ja) | 2008-07-17 |
EP2449989A1 (en) | 2012-05-09 |
WO2006071742A3 (en) | 2006-12-07 |
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