JP4976371B2 - 多軸接続システム - Google Patents
多軸接続システム Download PDFInfo
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- JP4976371B2 JP4976371B2 JP2008503216A JP2008503216A JP4976371B2 JP 4976371 B2 JP4976371 B2 JP 4976371B2 JP 2008503216 A JP2008503216 A JP 2008503216A JP 2008503216 A JP2008503216 A JP 2008503216A JP 4976371 B2 JP4976371 B2 JP 4976371B2
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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
- A61B17/7035—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
-
- 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
-
- 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
-
- 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
- A61B17/7034—Screws or hooks with U-shaped head or back through which longitudinal rods pass characterised by a lateral opening
-
- 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
- A61B17/7035—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot 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
- A61B17/7041—Screws or hooks combined with longitudinal elements which do not contact vertebrae with single longitudinal rod offset laterally from single row of screws or hooks
-
- 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
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
- A61B17/8605—Heads, i.e. proximal ends projecting from bone
-
- 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
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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
- A61B17/7032—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
- A61B17/56—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
- A61B17/864—Pins or screws or threaded wires; nuts therefor hollow, e.g. with socket or cannulated
-
- 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
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
- A61B2017/8655—Pins or screws or threaded wires; nuts therefor with special features for locking in the bone
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Neurology (AREA)
- Animal Behavior & Ethology (AREA)
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- Heart & Thoracic Surgery (AREA)
- Veterinary Medicine (AREA)
- Biomedical Technology (AREA)
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- General Health & Medical Sciences (AREA)
- Molecular Biology (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Vascular Medicine (AREA)
- Surgical Instruments (AREA)
- Prostheses (AREA)
Description
さらに、本発明について説明しこれについて請求する際、「締り嵌め」と言う用語は、2つまたはそれ以上の構成成分間の物理的接触を意味するためのものである。
さらに、本発明を後脊椎ロッド埋植に使用することができる。さらに、本発明によって与えられる制御可能な角度調整は任意の希望の数の平面において可能である。
さらに、軸方向に及び回転可能にロッドを取り付けることができる。さらに、本明細書において説明される要素を任意の希望のサイズで提供することができる(例えば、本明細書において説明される要素を任意の希望のカスタムサイズで提供することもできるし、小、中、大など一群のサイズから選択される任意の希望のサイズで提供することもできる)。
より明白な例を挙げると(この例は限定的でなく例示的であることを意図している)、希望のネジ山ピッチ、ネジ山外径、シャフト外径、シャフト外径対ネジ山外径の比及び(または)長さの骨ネジを提供でき、また任意の希望の内径、外径、側方オフセット、角度及び(または)長さの本体要素を提供することができる。
さらに、圧縮要素は希望の量のトルクが加えられたら圧縮要素の取り付け部分から分離するための「ブレークオフ」形態を持つことができる。
さらに、ファスナ組立体の1つまたはそれ以上の構成成分を、
(a)任意の生体適合性材料(外科医の希望に応じて骨の内殖を許容するまたはこれを防止するように生体適合性材料を処理することができる)、
(b)プラスティック、
(c)繊維、
(d)ポリマー、
(e)金属(チタンなど純金属及び(または)Ti−Al−Nb、Ti−6Al−4V、ステンレス鋼など合金)、及び
(f)これらの任意の組合せ、
のうちのいずれかから作ることができる。
さらに、カニュレーションを通じてファスナを案内するためのガイドワイヤの使用は例えば最小限の侵襲性の処置に有益であろう。
さらに、骨ネジを海綿状骨への配置に適合させることができる。さらに、ネジ山ではなく、ファスナは骨への取り付けのためにフックを採用することができる。
さらに、ファスナ頭の外面、ロッドの外面、保持リングの外面、保持リングの内面及び(または)本体の内面(例えば、上記の構成成分間の境界面エリア)は、境界面における摩擦を増大するために1つまたはそれ以上の形態を持つことができる。例えば、上記の構成成分のうちどれでも、粗面または処理面(例えばサンドブラストまたは刻みつきによって)、ネジ面、溝付き面、リッジ付き面、突起付き表面及び(または)凹みを持つ表面を持つことができる。
さらに、変形要素は、
(a)変形要素に利用される材料、
(b)ロッドに利用される材料、
(c)圧縮要素に利用される材料、
(d)ロッドが変形要素と接触するエリアのロッドの形状、
(e)変形要素の形状、
(f)圧縮要素が変形要素に接触するエリアの圧縮要素の形状、
(g)ロッドによって変形要素に加えられる荷重の方向、
(h)圧縮要素によって変形要素に加えられる荷重の方向、
(i)ロッドによって変形要素に加えられる荷重の規模、及び(または)圧縮要素によって変形要素に加えられる荷重の規模、
に応じて、変形することができる。
さらに、各ロッドに最低2つのファスナを使用することができる(例えば、安定化のために)。
さらに、取り付けツールとの境界を成すために任意のタイプ及び数の形態を利用することができる(例えば装置の本体の外面に配置される室。この種の室は取り付けツールの対応する引込み式ピンとかみ合うことができる)。
さらに、本明細書において説明されるステップを、希望の順番で実行することができる(任意の希望のステップを追加することができ、かつ(または)任意の希望のステップを削除することができる)。
Claims (23)
- 脊椎固定システムであり、
少なくとも1本のロッドと、
第一の端に頭を有する少なくとも1つのネジであり、該システムにおいて、該ネジがこれに関連する縦軸を有する、ネジと、
前記ロッド及び前記ネジが取り付けられる少なくとも1つの本体と、
前記本体と協働して前記ロッドを前記本体に取り付ける圧縮要素と、
を含み、
該システムにおいて、前記本体がネジ頭受容室を含み、該ネジ頭受容室は該ネジ頭受容室の縦軸に沿って前記ネジを受入れかつ前記ネジの前記頭を収容し、
該システムにおいて、前記本体が前記ロッドを受け入れるロッド受容路を含み、該ロッド受容路は、ロッドの径方向に伸びる径方向軸に沿って延伸し、かつ、ロッドの長手方向に伸びる長手方向軸に沿って延伸し、前記ロッドはロッド受容路の長手方向軸に沿ってロッド受容路内に配置され、前記圧縮要素はロッド受容路の径方向軸に沿って受容され、
該システムにおいて、前記ネジ頭受容室と前記ロッド受容路が相互に側方にオフセットされ、かつ
該システムにおいて、前記ロッド受容路は、前記ロッド受容路の径方向軸と前記ネジ頭受容室の長手方向軸が斜角を成すように、前記ネジ頭受容室に対して相対的に傾斜する、
脊椎固定システム。 - 該脊椎固定システムにおいて、前記ネジ頭受容室と前記ロッド受容路が約8mmから約14mmまでの間隔で相互に側方にオフセットされる、請求項1に記載の脊椎固定システム。
- 該脊椎固定システムにおいて、前記ネジ頭受容室と前記ロッド受容路が約8mmの間隔で相互に側方にオフセットされる、請求項2に記載の脊椎固定システム。
- 該脊椎固定システムにおいて、前記ネジ頭受容室と前記ロッド受容路が約11mmの間隔で相互に側方にオフセットされる、請求項2に記載の脊椎固定システム。
- 該脊椎固定システムにおいて、前記ネジ頭受容室と前記ロッド受容路が約14mmの間隔で相互に側方にオフセットされる、請求項2に記載の脊椎固定システム。
- 該脊椎固定システムにおいて、前記ネジ頭受容室がテーパー状である、請求項1に記載の脊椎固定システム。
- 該脊椎固定システムにおいて、前記ネジ頭受容室がこれに受け入れられる前記ネジの前記縦軸に対して実質的に平行のネジ頭受容室軸に沿ってテーパー状である、請求項6に記載の脊椎固定システム。
- 該脊椎固定システムにおいて、前記圧縮要素が前記ロッド受容路に関連するネジ山と境界を成す止めネジを含む、請求項1に記載の脊椎固定システム。
- さらに、前記本体と協働して前記ネジを前記本体に取り付ける第2の圧縮要素を含む、請求項1に記載の脊椎固定システム。
- 該脊椎固定システムにおいて、前記第2の圧縮要素が前記ネジ頭受容室に関連するネジ山と境界を成す止めネジを含む、請求項9に記載の脊椎固定システム。
- 該脊椎固定システムにおいて、前記圧縮要素が前記ネジの前記頭を前記ネジ頭受容室のテーパー端に向かって押し付けて、前記本体及び前記ロッド受容路に受け入れられる前記ロッドに対して相対的な前記ネジの角度関係を固定する、請求項10に記載の脊椎固定システム。
- 該脊椎固定システムにおいて、前記本体及び前記ロッド受容路に受け入れられる前記ロッドに対する前記ネジの角度関係が、少なくとも部分的に(a)前記ネジの前記頭の外面の少なくとも一部と前記ネジ頭受容室の内面の少なくとも一部との間の締り嵌め、及び(b)前記ネジの前記頭の外面の少なくとも一部と前記圧縮要素との間の締り嵌め、によって固定される、請求項11に記載の脊椎固定システム。
- さらに、前記ネジの前記頭が前記ネジ頭受容室内部に配置されるとき少なくとも部分的に前記ネジの前記頭の周りに嵌まるサイズを持つ保持リングを含む、請求項11に記載の脊椎固定システム。
- 該脊椎固定システムにおいて、前記本体及び前記ロッド受容路に受け入れられる前記ロッドに対する前記ネジの角度関係が、少なくとも部分的に(a)前記ネジの前記頭の外面の少なくとも一部と前記保持リングの内面の少なくとも一部との間の締り嵌め、(b)前記保持リングの外面の少なくとも一部と前記ネジ頭受容室の内面の少なくとも一部との間の締り嵌め、及び(c)前記ネジの前記頭の外面の少なくとも一部と前記圧縮要素との間の締り嵌め、によって固定される、請求項13に記載の脊椎固定システム。
- 該脊椎固定システムにおいて、前記ネジが骨ネジである、請求項1に記載の脊椎固定システム。
- 該脊椎固定システムにおいて、前記骨ネジが脊椎の椎弓根部にねじ込まれるように構成される、請求項15に記載の脊椎固定システム。
- 該脊椎固定システムにおいて、前記骨ネジが有室骨ネジである、請求項15に記載の脊椎固定システム。
- 該脊椎固定システムにおいて、前記圧縮要素がツールを挿入できるように構成される、請求項1に記載の脊椎固定システム。
- 該脊椎固定システムにおいて、前記圧縮要素がツールからトルクを受けるための少なくとも1つのトルク受け形態を含む、請求項18に記載の脊椎固定システム。
- 該脊椎固定システムにおいて、前記トルク受け形態が、(a)少なくとも1つのへこみ、(b)少なくとも1つの突起及び(c)少なくとも1つの駆動面、を含むグループから選択される、請求項19に記載の脊椎固定システム。
- 該脊椎固定システムにおいて、前記ロッドが実質的に円形の断面を有する、請求項1に記載の脊椎固定システム。
- 該脊椎固定システムにおいて、前記ネジの前記頭が少なくとも部分的に球形である、請求項1に記載の脊椎固定システム。
- 脊椎固定システムであり、
少なくとも1本のロッドと、
第一の端に頭を有する少なくとも1つの骨ネジであり、該システムにおいて、該骨ネジがこれに関連する縦軸を有する、骨ネジと、
前記ロッド及び前記骨ネジが取り付けられる少なくとも1つの本体と、
前記本体と協働して前記ロッドを前記本体に取り付ける第一の圧縮要素と、
前記本体と協働して前記骨ネジを前記本体に取り付ける第二の圧縮要素と、
を含み、
該システムにおいて、前記本体が前記骨ネジの前記縦軸に沿って前記骨ネジを受け入れかつ前記骨ネジの前記頭を収容するネジ頭受容室を含み、
該システムにおいて、前記ネジ頭受容室が、この中に受け入れられる前記骨ネジの前記縦軸に対して実質的に平行のネジ頭受容室軸に沿ってテーパー状であり、
該システムにおいて、前記本体が前記ロッドを受け入れるロッド受容路を含み、該ロッド受容路は、ロッドの径方向に伸びる径方向軸に沿って延伸し、かつ、ロッドの長手方向に伸びる長手方向軸に沿って延伸し、前記ロッドはロッド受容路の長手方向軸に沿ってロッド受容路内に配置され、前記圧縮要素はロッド受容路の径方向軸に沿って受容され、
該システムにおいて、前記第一の圧縮要素が前記ロッド受容路に関連するネジ山と境界を成す止めネジを含み、
該システムにおいて、前記第二の圧縮要素が前記ネジ頭受容室と関連するネジ山と境界を成す止めネジを含み、かつ
該システムにおいて、前記第二の圧縮要素が前記骨ネジの前記頭を前記ネジ頭受容室の前記テーパー端に向かって押し付けて、前記本体及び前記ロッド受容路に受け入れられる前記ロッドに対する前記骨ネジの角度関係を固定し、
該システムにおいて、前記ネジ頭受容室と前記ロッド受容路が相互に側方にオフセットされ、
該システムにおいて、前記ロッド受容路は、前記ロッド受容路の径方向軸と前記ロッド受容路の長手方向軸が斜角を成すように、前記ロッド受容路が前記ネジ頭受容室に対して相対的に傾斜し、
該システムにおいて、前記ネジ頭受容室と前記ロッド受容路が約8mmから約14mmまでの間隔で相互に側方にオフセットされ、
該システムにおいて、前記骨ネジが脊椎の椎弓根部の中へねじ込まれるように構成され、かつ
該システムにおいて、前記骨ネジの前記頭が少なくとも部分的に球形である、
脊椎固定システム。
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2006
- 2006-03-24 BR BRPI0608131-2A patent/BRPI0608131A2/pt not_active Application Discontinuation
- 2006-03-24 KR KR1020077024477A patent/KR20080031155A/ko not_active Application Discontinuation
- 2006-03-24 JP JP2008503216A patent/JP4976371B2/ja not_active Expired - Fee Related
- 2006-03-24 AU AU2006229952A patent/AU2006229952B2/en not_active Ceased
- 2006-03-24 WO PCT/US2006/010738 patent/WO2006104874A2/en active Application Filing
- 2006-03-24 CN CNA2006800096489A patent/CN101222879A/zh active Pending
- 2006-03-24 US US11/388,666 patent/US8062339B2/en active Active
- 2006-03-24 MX MX2007011810A patent/MX2007011810A/es unknown
- 2006-03-24 EP EP06739490A patent/EP1871302A4/en not_active Withdrawn
- 2006-03-24 CA CA002601948A patent/CA2601948A1/en not_active Abandoned
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2011
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WO2006104874A3 (en) | 2007-10-11 |
US8062339B2 (en) | 2011-11-22 |
MX2007011810A (es) | 2007-12-06 |
EP1871302A2 (en) | 2008-01-02 |
AU2006229952B2 (en) | 2009-04-23 |
CA2601948A1 (en) | 2006-10-05 |
JP2011143272A (ja) | 2011-07-28 |
JP2008534075A (ja) | 2008-08-28 |
EP1871302A4 (en) | 2012-05-02 |
US20060235392A1 (en) | 2006-10-19 |
KR20080031155A (ko) | 2008-04-08 |
BRPI0608131A2 (pt) | 2011-05-24 |
AU2006229952A1 (en) | 2006-10-05 |
CN101222879A (zh) | 2008-07-16 |
WO2006104874A2 (en) | 2006-10-05 |
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