JP5755297B2 - 拡張可能な取り付けデバイスおよび方法 - Google Patents
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- JP5755297B2 JP5755297B2 JP2013181781A JP2013181781A JP5755297B2 JP 5755297 B2 JP5755297 B2 JP 5755297B2 JP 2013181781 A JP2013181781 A JP 2013181781A JP 2013181781 A JP2013181781 A JP 2013181781A JP 5755297 B2 JP5755297 B2 JP 5755297B2
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Classifications
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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
- A61B17/84—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
- A61B17/70—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
- 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
- A61B17/8625—Shanks, i.e. parts contacting bone tissue
-
- 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
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/885—Tools for expanding or compacting bones or discs or cavities therein
- A61B17/8852—Tools for expanding or compacting bones or discs or cavities therein capable of being assembled or enlarged, or changing shape, inside the bone or disc
- A61B17/8858—Tools for expanding or compacting bones or discs or cavities therein capable of being assembled or enlarged, or changing shape, inside the bone or disc laterally or radially expansible
-
- 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
- A61B17/7097—Stabilisers comprising fluid filler in an implant, e.g. balloon; devices for inserting or filling such implants
- A61B17/7098—Stabilisers comprising fluid filler in an implant, e.g. balloon; devices for inserting or filling such implants wherein the implant is permeable or has openings, e.g. fenestrated screw
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/042—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors plastically deformed during insertion
Landscapes
- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Medical Informatics (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Neurology (AREA)
- Prostheses (AREA)
- Surgical Instruments (AREA)
Description
本願は、米国仮出願第60/985,087号(2008年11月2日出願)の利益を主張する。該仮出願は、その全体が参照により本明細書に引用される。
本発明は、概して、骨に取り付けるためのデバイスおよび方法に関する。
例えば、本発明は以下の項目を提供する。
(項目1)
縦軸および縦方向の長さを有する、生物学的埋め込みのための取り付けデバイスであって、
半径方向に拡張可能な区間および半径方向に拡張不能な区間を有するネジであって、該半径方向に拡張可能な区間は、半径方向に拡張可能な半径を有する、ネジと、
該ネジによって摺動可能に受け取られる拡張器要素であって、該拡張器要素は、拡張器頭部と、該拡張器頭部から縦方向に延びる第1の拡張器フィンガーと、該拡張器頭部から縦方向に延びる第2の拡張器フィンガーとを備える、拡張器要素と
を備える、デバイス。
(項目2)
上記半径方向に拡張可能な半径は、上記縦方向の長さが縦方向に収縮されると、半径方向に拡張するように構成されている、項目1に記載のデバイス。
(項目3)
上記ネジに回転可能に取り付けられる固定接合部をさらに備え、該固定接合部は、別個のデバイスに取り付くように構成されている、項目1に記載のデバイス。
(項目4)
上記固定接合部は、1つより多い回転自由度を伴って上記ネジに回転可能に取り付けられる、項目3に記載のデバイス。
(項目5)
上記半径方向に拡張可能な区間は、2つの支柱を備えている、項目1に記載のデバイス。
(項目6)
上記ネジは、半径方向に延びるネジ山を備え、上記拡張器要素は、半径方向に延びるネジ山を備える、項目1に記載のデバイス。
(項目7)
上記取り付けデバイスは、取り付けデバイス縦軸を有し、該縦軸の少なくとも一部は、実質的に湾曲した構成を備えている、項目1に記載のデバイス。
(項目8)
上記拡張器要素は、実質的に平面的である、項目1に記載のデバイス。
(項目9)
椎弓根ネジであって、
半径方向に拡張可能な区間と、
多軸固定接合部と
を備える、椎弓根ネジ。
(項目10)
縦軸を有する取り付けデバイスを骨内で使用するための方法であって、
該取り付けデバイスを該骨内に挿入するステップと、
該取り付けデバイスの半径方向に拡張可能な長さを半径方向に拡張するステップと、
固定デバイスを該取り付けデバイスに取り付けるステップと
を含む、方法。
(項目11)
上記取り付けデバイスを取り付けるステップは、固定ロッドを取り付けるステップを含む、項目9に記載の方法。
(項目12)
半径方向に拡張するステップは、上記取り付けデバイスの半径方向に拡張可能な長さを上記骨の海綿状部分内で半径方向に拡張するステップを含む、項目9に記載の方法。
(項目13)
挿入するステップは、椎弓根内に挿入するステップを含む、項目9に記載の方法。
(項目14)
挿入するステップは、椎体内に挿入するステップを含む、項目9に記載の方法。
(項目15)
挿入するステップは、縦展開軸に沿って挿入するステップを含み、該縦展開軸の少なくとも一部は、実質的な曲率半径を有する、項目9に記載の方法。
(項目16)
挿入するステップは、螺設するステップを含む、項目9に記載の方法。
(項目17)
半径方向に拡張するステップは、上記取り付けデバイスを縦方向に圧縮するステップを含む、項目9に記載の方法。
(項目18)
半径方向に拡張するステップは、上記取り付けデバイスを回転させるステップを含む、項目9に記載の方法。
(項目19)
半径方向に拡張するステップは、上記取り付けデバイスを平面的に拡張するステップを含む、項目9に記載の方法。
(項目20)
上記取り付けデバイスは、弾力的区間を備え、半径方向に拡張するステップは、該弾力的区間から機械的制約を解放するステップを含む、項目9に記載の方法。
図30cは、拡張器ドライバ72が、拡張器52に対して、矢印36によって示される縦方向圧縮力を展開し得る様子を示す。周辺組織は、生体内抵抗力矢印78によって示されるように、縦方向圧縮力に抵抗し得る。拡張器52のフィンガーは、矢印38によって示されるように、半径方向に拡張し得る。拡張器52のフィンガーは、拡張可能な区間6(例えば、支柱26)を、矢印によって示されるように、半径方向外側に強制し得る。拡張可能な取り付けデバイス2は、変形可能または弾力的に半径方向に拡張し得る。
Trading Company, Inc.から市販のMP35N(登録商標))、モリブデン合金(例えば、2003年10月9日公開の国際公開第WO03/082363 A2号に開示され、参照することによって全体として本明細書に組み込まれるモリブデンTZM合金)、例えば、国際公開第WO03/082363号に開示されるタングステンレニウム合金、テレフタル酸ポリエチレン(PET)等のポリマー、ポリエステル(例えば、デラウェア州WilmingtonのE. I. Du Pont de Nemours and Companyから市販のDACRON(登録商標))、ポリエステルアミド(PEA)、ポリプロピレン、液晶ポリマー(例えば、日本国東京のKuraray Co., Ltd.から市販のVectran)等の芳香族ポリエステル、超高分子量ポリエチレン(すなわち、拡大連鎖高弾性または高性能ポリエチレン)繊維および/または糸(例えば、ニュージャージー州Morris TownshipのHoneywell International, Inc.から市販のSPECTRA(登録商標)FiberおよびSPECTRA(登録商標)Guard、またはオランダ国HeerlenのRoyal DSM N. V.から市販のDYNEEMA(登録商標))、ポリテトラフルオロエチレン(PTFE)、延伸PTFE(ePTFE)、ポリエーテルケトン(PEK)、ポリエーテルエーテルケトン(PEEK)、ポリエーテルケトンケトン(PEKK)(また、ポリアリールエーテルケトンケトン)、ナイロン、ポリエーテルブロックコポリアミドポリマー(例えば、フランス国ParisのATOFINAから市販のPEBAX(登録商標))、脂肪族ポリエステルポリウレタン(例えば、マサチューセッツ州WilmingtonのThermedics Polymer Productsから市販のTECOFLEX(登録商標))、ポリ塩化ビニル(PVC)、ポリウレタン、熱可塑性物質、フッ素化エチレンプロピレン(FEP)、ポリグリコール酸(PGA)、ポリLグリコール酸(PLGA)、ポリ乳酸(PLA)、ポリL乳酸(PLLA)、ポリカプロラクトン(PCL)、ポリエチルアクリラート(PEA)、ポリジオキサノン(PDS)、および擬ポリアミノチロシンベースの酸等の吸収性または再吸収性ポリマー、押し出しコラーゲン、シリコーン、亜鉛、エコー源性、放射性、放射線不透過性材料、生体材料(例えば、死体組織、コラーゲン、同種移植片、自己移植片、異種移植片、骨セメント、骨細片、骨形成粉末、骨ビーズ)、本明細書にリストアップされた他の材料のいずれか、またはそれらの組み合わせから成り得る。放射線不透過性材料の実施例は、硫化バリウム、酸化亜鉛、チタン、ステンレス鋼、ニッケルチタン合金、タンタル、および金である。
935−940;Franklin et al, Uptake of Tetracycline by Aotic Aneurysm Wall and Its Effect on Inflammation and Proteolysis, Brit.J.Surgery, 86(6), 771−775;Xu et al, Sp1 Increases Expression of Cyclooxygenase−2 in Hypoxic Vascular Endothelium, J.Biological Chemistry, 275(32), 24583−24589;Pyo et al, Targeted Gene Disruption of Matrix Metalloproteinase−9(Gelatinase B) Suppresses Development of Experimental Abdominal Aortic Aneurysms, J.Clinical
Investigation, 105(11), 1641−1649において提供され、すべて参照することによって全体として本明細書に組み込まれる。
Claims (18)
- 長手方向軸および長手方向軸の長さを有する、生物学的埋め込みのための長手方向取り付けデバイスであって、該取り付けデバイスは、
半径方向に拡張可能な区間および半径方向に拡張不能な区間を有するネジであって、該半径方向に拡張可能な区間は、半径方向に拡張可能な外面を有し、該ネジは、第1のセルおよび第2のセルを有し、該第1のセルは、該第2のセルから長手方向にずれており、該第1のセルは、長手方向において該第2のセルに重なっている、ネジと、
該ネジ内で受け取られる拡張器要素であって、該拡張器要素は、該ネジに対して摺動可能なように構成され、該拡張器要素は、拡張器頭部を備える、拡張器要素と
を備える、取り付けデバイス。 - 前記半径方向に拡張可能な外面は、前記長手方向軸の長さが長手方向軸に収縮されると、半径方向に拡張するように構成されている、請求項1に記載の取り付けデバイス。
- 前記ネジに回転可能に取り付けられる固定接合部をさらに備え、該固定接合部は、別個のデバイスに取り付くように構成されている、請求項1に記載の取り付けデバイス。
- 前記固定接合部は、1つより多い回転自由度を伴って前記ネジに回転可能に取り付けられる、請求項3に記載の取り付けデバイス。
- 前記半径方向に拡張可能な区間は、2つの支柱を備えている、請求項1に記載の取り付けデバイス。
- 前記ネジは、半径方向に延びるネジ山を備え、前記拡張器要素は、半径方向に延びるネジ山を備える、請求項1に記載の取り付けデバイス。
- 前記取り付けデバイスは、取り付けデバイス長手方向軸を有し、該長手方向軸の少なくとも一部は、実質的に湾曲した構成を備えている、請求項1に記載の取り付けデバイス。
- 前記拡張器要素は、実質的に平面的である、請求項1に記載の取り付けデバイス。
- 長手方向椎弓根ネジであって、該椎弓根ネジは、
半径方向に拡張可能な区間であって、該半径方向に拡張可能な区間は、第1のセルおよび第2のセルを有し、該第1のセルは、該第2のセルから長手方向にずれている、半径方向に拡張可能な区間と、
多軸固定接合部と
を備える、椎弓根ネジ。 - 骨内への生物学的埋め込みのための、長手方向軸を有する長手方向取り付けデバイスであって、該取り付けデバイスは、
切断先端と、
該取り付けデバイスの半径方向に拡張可能な長さであって、該半径方向に拡張可能な長さは、第1の開セルおよび第2の開セルを有し、該第1のセルは、該第2のセルから長手方向にずれており、該第1のセルは、長手方向において該第2のセルに重なっている、半径方向に拡張可能な長さと、
取り付け可能な固定デバイスと
を含む、取り付けデバイス。 - 前記取り付けデバイスは、固定ロッドに取り付けるように構成されている、請求項10に記載の取り付けデバイス。
- 前記半径方向に拡張可能な長さは、第2の支柱と交差する第1の支柱を含む、請求項10に記載の取り付けデバイス。
- 前記第1および第2の開セルはV形状である、請求項10に記載の取り付けデバイス。
- 前記取り付けデバイスは、外部表面上にネジ山を含む、請求項10に記載の取り付けデバイス。
- 前記取り付けデバイスは、半径方向に拡張すると同時に長手方向に圧縮するように構成されている、請求項10に記載の取り付けデバイス。
- 前記取り付けデバイスは、回転しているときに半径方向に拡張するように構成されている、請求項10に記載の取り付けデバイス。
- 前記取り付けデバイスは、平面的に拡張可能である、請求項10に記載の取り付けデバイス。
- 前記取り付けデバイスは、弾性部分と、該弾性部分を制約する機械的な制約部とを備え、該機械的な制約部は、該弾性部分から取り外し可能なように構成されている、請求項10に記載の取り付けデバイス。
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US8556949B2 (en) * | 2007-11-14 | 2013-10-15 | DePuy Synthes Products, LLC | Hybrid bone fixation element and methods of using the same |
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EP2205162A1 (en) | 2010-07-14 |
EP2205162B1 (en) | 2015-09-09 |
JP2014000452A (ja) | 2014-01-09 |
JP6195868B2 (ja) | 2017-09-13 |
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JP2011502584A (ja) | 2011-01-27 |
EP2974672A1 (en) | 2016-01-20 |
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