JP6062964B2 - 椎間インプラント用のアンカー装置およびシステム、椎間インプラント、および移植器具 - Google Patents
椎間インプラント用のアンカー装置およびシステム、椎間インプラント、および移植器具 Download PDFInfo
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- JP6062964B2 JP6062964B2 JP2014558133A JP2014558133A JP6062964B2 JP 6062964 B2 JP6062964 B2 JP 6062964B2 JP 2014558133 A JP2014558133 A JP 2014558133A JP 2014558133 A JP2014558133 A JP 2014558133A JP 6062964 B2 JP6062964 B2 JP 6062964B2
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- implant
- anchor
- plate
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- stopper
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- A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
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- A61F2/447—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section
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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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- A61F2/00—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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- A61F2/00—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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- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
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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
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
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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
- 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
- A61F2002/4625—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 with relative movement between parts of the instrument during use
- A61F2002/4627—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 with relative movement between parts of the instrument during use with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument
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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
- 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
- A61F2220/0008—Fixation appliances for connecting prostheses to the body
- A61F2220/0016—Fixation appliances for connecting prostheses to the body with sharp anchoring protrusions, e.g. barbs, pins, spikes
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- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Neurology (AREA)
- Transplantation (AREA)
- Heart & Thoracic Surgery (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Cardiology (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Physical Education & Sports Medicine (AREA)
- Prostheses (AREA)
Description
前記アンカーの幅よりも小さい幅を有する本体を含み、移植の間にこれを収容および案内するために、前記アンカーのプレートの少なくとも1つの曲率半径と実質的に同一の少なくとも1つの曲率半径を有する少なくとも1つの案内面を含む、少なくとも1つのホルダと、
ホルダに沿ってインパクタを摺動させることによって、ホルダ上に保持されたアンカーを押せるようにするため、ホルダの本体の長さよりも大きい長さの2つのアームを備え、ホルダの本体の幅以上の距離だけ離間して、ホルダを受容するようになっているヘッドを含む少なくとも1つのインパクタと、
インプラントを握持するための握持末端と称される第一末端と、押し末端と称される第二末端との間に延在する長手軸に沿った長尺形状の少なくとも1つのガイドであって、握持末端は、インプラントの少なくとも1つの保持配置と協働するように意図される少なくとも1つの握持用配置がその末端に設けられたヘッドを有し、ヘッドは、インプラントまで続いて、ホルダの本体およびインパクタのアームを少なくとも部分的に収容するように構成された形状および寸法を有する、長手通路が横切っており、ヘッドの通路は、ガイドのヘッド内へのホルダに沿ったインパクタの摺動の間、ガイドおよびホルダのこれら2つの案内面の間で前記アンカー装置を案内するように、ホルダの案内面を補完する、前記アンカー装置を案内するための少なくとも1つの表面を含む、ガイドとを含むことを特徴とする。
アンカー装置(1)(または「アンカー」)、および/または同一の、異なる、または相補的であってもよい複数のアンカー装置(1)を含むアンカーシステムと、
後部または椎間孔経路を通じての移植のために構成された体内ケージを含むがこれに限定されない、このようなアンカー装置(1)またはシステムのうちの1つ以上を受容するように構成された、椎間インプラント(2)と、
椎骨の間にインプラント(2)を移植して、1つ以上のアンカー装置(1)またはアンカーシステムを用いてインプラントを固定するための器具(3、4、5)。
インプラントの一部を横切るスリット、導管、またはアンカー装置(1)を受容するために配置されたその他のタイプのチャネルなど、アンカー装置(1)を受容するように設計された少なくとも1つの通路(21)を含む椎間インプラント(2)もまた、本発明の範囲に含まれる。好ましくは、このようなインプラントは、装置(1)の曲率にかかわらず変形を伴わずに通路(21)を通るこのアンカー装置(1)の通過を許容するように、少なくとも1つの湾曲した剛性のプレートを含む少なくとも1つのアンカー装置(1)を受容するように構成されている。ほとんどの構成において、通路(21)は、本開示の別の箇所で詳細に説明されるように、アンカー装置(1)の曲率およびインプラントの所望の固定に適した好ましくは直線的で傾斜した軌道に沿って、インプラント(2)の周辺からインプラント(2)の上面または下面まで、インプラント(2)を横切る。本明細書は椎間板について詳細に記載しておらず、むしろ関節固定向けに設計された椎体間ケージの様々な実施形態のみを記載している。それでもなお当業者は本開示を理解すれば、本発明による様々な特徴および様々な特徴の組み合わせを備えて構成されたアンカー装置(1)が、本明細書に記載されるようにアンカー(1)を受容するように構成された少なくとも1つの後部を含むプロテーゼとともに使用されてもよいことを理解するであろうし、後部という指定は移植の特定の状況の文脈に照らしている(たとえば、移植において取られるアプローチおよび/またはプロテーゼの設計)ことが理解される。たとえば、アンカー装置の挿入について本明細書に記載されるような通路を作り出すことが可能な周壁を提供するのに十分なレベルを椎骨接触プレートが有する椎間プロテーゼが、知られている。同様に、2つのプレートおよびプレートの間の可動コアを含み、プレートのうちの1つの周壁がコアの運動を制限する椎間プロテーゼが、知られている。したがって、本発明は、壁に少なくとも1つの通路(21)を形成し、たとえばコアなどプロテーゼの様々な部分の運動を妨害することなくプレートの周囲面から脊椎接触表面(下部または上部)まで前記壁を横切ることによって、このタイプのプロテーゼに適合することが可能である。様々な実施形態において、プレート内の通路(21)はプレートの周壁からプレートを横切る必要はなく、代わりにプロテーゼ自体の周辺領域から脊椎終板まで延在する斜交軸(直線または湾曲)にしたがって、片側から反対側まで(すなわち、上面から下面またはその逆)プレートを横切ってもよく、アンカー(1)の保持ストッパ(たとえば14、140)および/または抜去ストッパ(15、150)は、プレートの上面または下面と接触(直接的にまたはプレート内に配置されたストッパ表面を介して)するようになっていてもよい。たとえば、各々が参照により本明細書に組み込まれる(本出願の譲受人によって出願された)フランス特許第2,879,436号明細書、国際公開第2006/120505号パンフレット、および米国特許出願公開第2006/0136063号明細書は、プレートの縁の付近のステムと嵌合するように構成されたアンカーの後部末端に湾曲部(鉤型)によって形成された保持ストッパを備える、直線アンカーを示しており、この一般的なアプローチは、本開示を完全に理解すれば、本明細書に開示される実施形態に適応することが可能である。本発明のアンカー(1)は、たとえば、湾曲していてもよく、および/またはこのようなプロテーゼとともに使用するために少なくとも1つのスロット(11)および/または1つ以上の保持ストッパ(たとえば、14、140)および/または1つ以上の抜去ストッパ(たとえば、15、150)を含んでもよく、付加的な特徴および/または本明細書に記載される特徴の組み合わせはこのような使用に適応してもよい。アンカーがプロテーゼのプレートを通じて横切るように設計されている場合、用語「後部」「部位」または「部分」または用語「周壁」は、プレートの周辺に近く、プロテーゼの周辺領域からアクセス可能な部分を指定するために使用されてもよい。
特定の実施形態において、器具類(3、4、5)は、椎骨の間にインプラント(2)を挿入するため、およびアンカー装置(1)をインプラント(2)内に案内してアンカー装置(1)を椎骨内に押し込むために、使用されてもよい。本発明は、器具類の要素(3、4、5)の組み合わせ、ならびにインパクタ(4)、アダプタまたはホルダ(3)、およびガイド(5)などの個別の各器具に関してもよい。その説明的な非限定例が図7A、図7B、図7C、図8A、図8B、図8C、図9A、および図9Bに示されているこのような器具類(3、4、5)は、本発明による椎間インプラント(2)の、椎骨の間の移植、および本発明による少なくとも1つのアンカー装置(1)の、これら椎骨のうちの少なくとも1つの中の移植を、対象とする。器具類は好ましくは、移植の間にアンカー装置を収容および案内するために、前記アンカー(1)の幅よりも小さい幅の本体(300)を有し、アンカー装置(1)のプレート(10)の少なくとも1つの曲率半径と実質的に等しい少なくとも1つの曲率半径を有する少なくとも1つの案内面(30)を含む、少なくとも1つのホルダ(3)(またはアダプタまたはラックまたはチャージャ)を含む。加えて、器具類は好ましくは、ホルダ(3)に沿ってインパクタ(4)を摺動させることによってホルダ上に適合するアンカー装置(1)を押せるように、ホルダ(3)を受容するようになっているヘッド(40)を有し、ホルダ(3)の本体(300)の長さよりも大きい長さであって、ホルダの本体(300)の幅以上の距離だけ離間している2つのアーム(401、402)を有する、少なくとも1つのインパクタ(4)を含む。最後に、器具類はまた好ましくは、インプラント(2)を保持するための、握持末端と称される第一末端と、押し末端と称される第二末端との間に延在する長手軸に沿った長尺形状の少なくとも1つのガイド(5)を含み、握持末端は、インプラント(2)の少なくとも1つの握持手段(26、27)と協働するように意図される少なくとも1つの握持用手段(56、57)をその末端に備えるヘッド(50)を有し、ヘッド(50)には、インプラントまで続いて、ホルダ(3)の本体(300)およびインパクタ(4)のアーム(401、402)を少なくとも部分的に収容するのに適した形状および寸法の長手通路が通っており、通路は、ホルダ(3)に沿ってガイド(5)のヘッド(50)内にインパクタ(4)を摺動させている間にこれら2つの案内面(30、53)の間で前記アンカー装置(1)を案内するために、ホルダ(3)の案内面(30)を補完する、前記アンカー装置(1)を案内するための少なくとも1つの表面(53)を含む。ホルダ(3)およびガイド(5)のこのような配置を用い、インプラント(2)内の通路(21)の入口の周りにインプラント(2)を保持するガイド(5)の配置と組み合わせて、器具類の内部でインプラント(2)内にアンカー(1)を案内するチャネルが形成される。このようなチャネルは、アンカー(1)の信頼できる案内を可能にして、不正確な移植の、および/またはアンカーの挿入によってアンカーまたはインプラントを損傷する危険性を回避する利点を有する。このようなチャネルは好ましくは妨害されず、こうして移植の間に突出する構造によるアンカーの不快感を回避する。
本発明の別の潜在的な対象は、椎間腔内への椎間インプラント(2)の移植を準備する、および/または椎間腔内に椎間インプラント(2)を移植する方法、および少なくとも1つの椎骨内へのインプラントの固定を準備する、および/または少なくとも1つの椎骨内にインプラントを固定する方法の、様々な実施形態に関する。これらの方法は、ガイド(5)上にインプラント(2)を組み付けるステップと、ホルダ(3)上にアンカー(1)を実装するステップと、インパクタ上にホルダを実装するステップと、たとえばガイドのヘッド(5)内のホルダの少なくとも部分的な貫入まで、ガイドに対してインパクタ(4)を配置するステップと、を含んでもよい。これらの様々なステップは、本明細書において説明される様々な実施形態に記載されるような、本発明の様々な対象の配置のおかげで、異なる順番で実行されることが可能である。
本明細書において説明される実施形態によるアンカー装置(1)を提供するステップと、
本明細書において説明される実施形態による脊椎インプラント(2)を提供するステップと、
本明細書において説明される実施形態による移植器具(3、4、5)を提供するステップと、
移植器具(3、4、5)を用いて脊椎インプラント(2)および/またはアンカーを握持するステップと、を含んでもよい。
脊柱の隣接する椎骨の間の椎間腔内に(または骨接合プレートの場合は脊柱の隣接する椎骨上に)脊椎インプラント(2)を挿入するステップと、
脊柱の軸に対して実質的に直角なアプローチ軸に沿って(隣接する椎骨のレベルで)アンカー装置(1)を提供するステップと、
移植器具(3、4、5)のインパクタ(4)を使用して、アンカー装置(1)がインプラント(2)の少なくとも一部を横断している状態で、移植器具(3、4、5)のガイド(5)のガイドヘッド(53)を通じて、およびインプラント(2)の通路(21)を通じてアンカー装置(1)を挿入するステップと、
移植器具(3、4、5)のインパクタ(4)を使用して、インプラント(2)を通じてアンカー装置(1)を完全に挿入し、隣接する椎骨のうちの1つにアンカー装置(1)の少なくとも一部を移植するステップと、を含んでもよい。
Claims (37)
- 少なくとも1つの椎骨内に少なくとも1つの椎間インプラント(2)を固定する装置(1)であって、前記装置は脊柱の周辺から、インプラント(2)の少なくとも一部を通る通路(21)を通じて挿入されるように意図されており、装置(1)は、前端と後端との間に延在する長手軸(L)に沿って伸長する、少なくとも1つの剛性のプレート(10)を含む本体を有し、プレート(10)は、その後端がインプラント(2)の通路(21)内に残留している間にその前端が少なくとも1つの椎骨に貫入して、前記椎骨に対して前記インプラント(2)を保持するように構成されており、装置(1)は、プレート(10)が、その長手軸(L)に対して実質的に平行に配向されてプレート(10)の少なくとも後方部分を2つの枝状部(12、13)に分割する、少なくとも1つのスロット(11)を含み、前記スロット(11)は、プレート(10)の前記後方部分に対して、そこに圧力がかけられたときに2つの枝状部(12、13)の接近を可能にするように構成されていることを特徴とする、装置(1)。
- 前記枝状部(12、13)のうちの少なくとも1つが、プレート(10)の長手軸(L)と非平行に配向され、インプラント(2)の相補的表面と協働してインプラント(2)内に装置(1)を保持するように構成された、少なくとも1つの抜去ストッパ(15、150)を含むことを特徴とする、請求項1に記載の装置(1)。
- 前記スロット(11)がプレート(10)をその厚みにおいて分割することを特徴とする、請求項1または2に記載の装置(1)。
- 前記スロット(11)がプレート(10)をその幅において分割することを特徴とする、請求項1から3のいずれか一項に記載の装置(1)。
- 前記スロット(11)が、その長さおよび/またはその幅および/またはその形状によってそこに圧力がかけられたときに、まとめて2つの枝状部(12、13)の接近を可能にするように構成されていることを特徴とする、請求項1から4のいずれか一項に記載の装置(1)。
- 前記スロット(11)の幅が、プレート(10)の長手軸(L)に沿って変化することを特徴とする、請求項1から5のいずれか一項に記載の装置(1)。
- 前端が、椎骨内への装置(1)の貫入を容易にする、少なくとも1つの面取り(18)または少なくとも1つの斜角を含むことを特徴とする、請求項1から6のいずれか一項に記載の装置(1)。
- 前端が、椎骨内への装置(1)の貫入を容易にする、少なくとも1つのノッチを含むことを特徴とする、請求項1から7のいずれか一項に記載の装置(1)。
- 本体(10)には、椎骨内に移植されたときに装置(1)の抜去に抵抗するように配向されたノッチ(16)が設けられていることを特徴とする、請求項1から8のいずれか一項に記載の装置(1)。
- 前記保持ストッパ(14)が、装置(1)が固定されるように意図されるインプラント(2)の上の少なくとも1つの当接表面(25)と協働し、装置(1)が固定されるように意図される椎骨に対してインプラントプレート(2)を保持するように意図される、前端面と実質的に対向するように配向された少なくとも1つの当接表面を含むことを特徴とする、請求項1から9のいずれか一項に記載の装置(1)。
- 保持ストッパ(14)が、プレート(10)の少なくとも1つの辺および/または少なくとも1つの縁上に、少なくとも1つの突起しているタブを含むことを特徴とする、請求項1から10のいずれか一項に記載の装置(1)。
- 少なくとも1つの抜去ストッパ(15)が、前記スロット(11)の反対側で、装置(1)の枝状部(12、13)のうちの少なくとも1つから突起していることを特徴とする、請求項1から11のいずれか一項に記載の装置(1)。
- 前記スロット(11)の反対側で装置(1)の枝状部(12、13)から突起している前記抜去ストッパ(15)が、インプラント(2)内の装置(1)の挿入を容易にして、この斜角表面とインプラント(2)内の通路(21)の壁との接触によって装置(1)の枝状部(12、13)の相互に対する漸進的な接近を可能にする斜面を形成するように、その前端上に少なくとも1つの斜角表面を含むことを特徴とする、請求項12に記載の装置(1)。
- 前記少なくとも1つの抜去ストッパ(15)を切り離すように、2つの枝状部(12、13)を互いに接近させる、アンカーの抜去のための工具の末端を吊下するように構成された枝状部(12、13)の少なくとも1つに少なくとも1つの握持配置(141)を含むことを特徴とする、請求項1から13のいずれか一項に記載の装置(1)。
- 実質的に椎間腔の平面内にその長手軸(L)を有することによって、アンカー装置(1)が鉛直な脊柱の軸に対しておよそ90°の角度を形成するアプローチ軸に沿って椎体プレート内に移植可能なように構成された寸法および少なくとも曲率半径を有する、少なくとも1つの円弧または楕円弧を本体の湾曲したプレート(10)が描くことを特徴とする、請求項1から14のいずれか一項に記載の装置(1)。
- 一方では、前記プレート(10)がその曲率によって、その2つの末端の間に中間弧(AM)を画定し、他方では、2つの枝状部(12、13)が、各々中間弧(AM)の反対側で、互いに対してずれていることを特徴とする、請求項3から15のいずれか一項に記載の装置(1)。
- 2つの枝状部(12、13)が、2つの枝状部が互いに接近したときに、装置の総厚を増加させることなく、少なくとも部分的に、2つの枝状部(12、13)のうちの少なくとも後方部分が互いに覆うことができるように構成された、互いに補完的な形状を有することを特徴とする、請求項3から15のいずれか一項に記載の装置(1)。
- 前記スロット(11)が、プレート(10)の厚み内に、ただしプレート(10)の幅に対して直角ではない平面内に形成されることを特徴とする、請求項3から17のいずれか一項に記載の装置(1)。
- 前記スロット(11)が、曲率を描くことによって長手軸から逸脱することを特徴とする、請求項3から18のいずれか一項に記載の装置(1)。
- その曲率にもかかわらず変形することなく剛性アンカー装置(1)の通過を可能にするように、後部と称される少なくとも一部分が、請求項2から19のいずれか一項に記載の少なくとも1つのアンカー装置(1)を収容するように構成された少なくとも1つの通路(21)を備える、本体(20)を含む椎間インプラント(2)であって、この通路(21)は、その間にインプラント(2)が移植されるように設計された椎骨のうちの1つの終板の方向にアンカー装置(1)を配向するように、実質的にインプラント(2)の平面内に挿入された、アンカー装置(1)の曲率に適合する直線的および傾斜した経路に沿って、周辺から上面または底面までインプラント(2)内を通り、通路(21)は、請求項2から20のいずれか一項に記載のアンカー装置(1)の少なくとも1つの抜去ストッパ(15)を補完する少なくとも1つの表面を含むことを特徴とする、椎間インプラント(2)。
- アンカー装置(1)用の通路(21)を含む後部が、通路(21)の周りに、インプラント(2)の本体(20)からアンカー装置(1)を突出させることなくアンカー装置(1)の少なくとも1つの保持ストッパ(14)を収容するようにその表面(25)が構成されている、少なくとも1つの筐体を含むことを特徴とする、請求項20に記載のインプラント(2)。
- アンカー装置(1)用の通路(21)を含む後部が、通路(21)の周りに、前記少なくとも1つの抜去ストッパ(15)を切り離すために2つの枝状部(12、13)を互いに離れるように移動させることによって、アンカーを抜去するための工具の末端を吊下するように、アンカー装置(1)の握持配置(141)へのアクセスを提供するようにその表面(25)が構成されている、少なくとも1つの筐体を含むことを特徴とする、請求項20および21のいずれか一項に記載のインプラント(2)。
- 本体(20)が、後部の付近に、インプラント(2)を移植するための工具(5)の少なくとも1つの握持配置(26、27)を有することを特徴とする、請求項20から22のいずれか一項に記載のインプラント(2)。
- 後部が、その間にインプラント(2)が移植されるように意図される椎骨の各々へのアンカー装置(1)の固定を可能にするように、インプラント(2)の上面および下面のうちの1つに向かって各々が配向された、2つの通路(21)を含むことを特徴とする、請求項20から23のいずれか一項に記載のインプラント(2)。
- 本体(20)が、通路(21)を包含する後部の反対側に、椎骨の間のインプラント(2)の挿入を容易にするように、少なくとも1つの斜角部分(29)を含む前部を含むことを特徴とする、請求項20から24のいずれか一項に記載のインプラント(2)。
- 長手軸に沿って伸長し、少なくとも1つの孔(23、24)によって横切られ、少なくとも2つの外側面、上面、底面、後部、および前部を含む、本体(20)を備えるケージを構成し、本体(20)の形状および寸法は、後部または椎間孔経路を通じてのインプラントの移植のために構成されていることを特徴とする、請求項20から25のいずれか一項に記載のインプラント(2)。
- 上部および/または下部のうちの少なくとも1つには、椎骨の間のインプラント(2)の摺動に抵抗するノッチ(22)が設けられていることを特徴とする、請求項26に記載のインプラント(2)。
- 側面と上面および下面との間の接合部のうちの少なくともいくつかの少なくとも一部が、その間にインプラント(2)が移植されるように設計された隣接する椎骨と上面および下面が接触する最終位置に対して、その長手軸を中心に90°回転した位置でのインプラント(2)の挿入時に椎骨の間のインプラントの回転を容易にするために、斜角が付けられていることを特徴とする、請求項26および27のいずれか一項に記載のインプラント(2)。
- 請求項21から28のいずれか一項に記載の椎間インプラント(2)の、隣接する椎骨の間の移植のため、および請求項1から20のいずれか一項に記載の、アンカーと称される、少なくとも1つのアンカー装置(1)の、これら椎骨の少なくとも1つへの移植のための、器具類(3、4、5)であって、前記器具類は、
移植の間にアンカー装置を収容および案内するために、前記アンカー(1)の幅よりも小さい幅を有する本体(300)を含み、前記アンカー(1)のプレート(10)の少なくとも1つの曲率半径と実質的に等しい少なくとも1つの曲率半径を有する少なくとも1つの案内面(30)を含む、少なくとも1つのホルダ(3)と、
ホルダ(3)に沿ってインパクタ(4)を摺動させることによってホルダ上に保持されるアンカー装置(1)を押せるように、ホルダ(3)の本体(300)の長さよりも大きい長さであって、ホルダの本体(300)の幅以上の距離だけ離間している2つのアーム(401、402)を備える、ホルダ(3)を受容するようになっているヘッド(40)を含む少なくとも1つのインパクタ(4)と、
インプラント(2)を握持するための、握持末端と称される第一末端と、押し末端と称される第二末端との間に延在する長手軸に沿った長尺形状の少なくとも1つのガイド(5)であって、握持末端は、インプラント(2)の少なくとも1つの保持配置(26、27)と協働するように意図される少なくとも1つの握持用配置(56,57)を有するヘッド(50)をその末端に備え、ヘッド(50)には、インプラントまで続いて、ホルダ(3)の本体(300)およびインパクタ(4)のアーム(401、402)を少なくとも部分的に収容するように構成された形状および寸法の長手通路が横切っており、ヘッドの通路は、ホルダ(3)に沿ってガイド(5)のヘッド(50)内にインパクタ(4)を摺動させている間に、ガイドおよびホルダのこれら2つの案内面(30、53)の間で前記アンカー装置(1)を案内するように、ホルダ(3)の案内面(30)を補完する、前記アンカー装置(1)を案内するための少なくとも1つの表面(53)を含む、少なくとも1つのガイド(5)と、を含むことを特徴とする器具類(3、4、5)。 - インパクタ(4)が、ガイド(5)の長手軸に沿ってインパクタ(4)の摺動を案内するための案内配置(49)を有することを特徴とする、請求項29に記載の器具類(3、4、5)。
- 握持用配置(56、57)が、ハンドルまたはノブ(52)によって作動されたときに、握持用配置を取り付けるための配置を形成するインプラント(2)の筐体(26)の内外にガイド(5)の本体(51)を摺動するロッド(56)の握持末端を含むことを特徴とする、請求項29および30のいずれか一項に記載の器具類(3、4、5)。
- ロッド(56)が、ハンドルまたはノブ(52)によってロッドが作動されたときにインプラント(2)を固定するために筐体(26)の雌ねじ山と協働するねじ切り末端を有することを特徴とする、請求項31に記載の器具類(3、4、5)。
- 握持用配置(56、27)が、第一に、ハンドルまたはノブ(52)によって作動されたときに握持用配置を取り付けるための配置を形成するインプラント(2)の筐体(26)の内外にガイド(5)の本体(51)内を摺動する、ロッド(56)の握持末端と、第二に、インプラント(2)の本体(20)の側面の溝(27)と係合するように配置され、椎骨の間にインプラント(2)を位置決めするためのレバーアームの役割を果たせるようにする、タブ(57)とを含むことを特徴とする、請求項29から32のいずれか一項に記載の器具類(3、4、5)。
- 溝(27)が、器具類によるインプラント(2)の握持を改善するように、タブ(57)のスタッドを受容するための筐体(270)を含むことを特徴とする、請求項33に記載の器具類(3、4、5)。
- インパクタのヘッド(40)には、少なくとも1つのホルダ(3)を完全に収容することが可能であって、2つのアーム(401、402)を備えるのとは反対のヘッドの末端からのその取り外しを可能にするための、通路が横切っていることを特徴とする、請求項29から34のいずれか一項に記載の器具類(3、4、5)。
- ホルダが、インパクタ(4)のレベルアーム(401、402)以上の距離だけ離間した本体(300)の上面および下面の各々に、インパクタ(4)のアーム(401、402)上でホルダ(3)を安定化させるために、本体の幅よりも大きい幅のプレート(34)を含むことを特徴とする、請求項29から35のいずれか一項に記載の器具類(3、4、5)。
- ガイド(5)の握持末端が、長手軸を中心とするインプラントの回転を容易にするように、ガイド(5)の長手軸に対して直角ではないが、ガイド(5)の長手軸に直角な2つの軸を通る平面内に少なくとも1つの表面が配向されている、インプラントの後部を補完する形状を有する、請求項29から36のいずれか一項に記載の器具類(3、4、5)。
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- 2013-02-22 IN IN1584MUN2014 patent/IN2014MN01584A/en unknown
- 2013-02-22 CN CN201380010439.6A patent/CN104135971B/zh not_active Expired - Fee Related
- 2013-02-22 MX MX2014010119A patent/MX2014010119A/es unknown
- 2013-02-22 WO PCT/EP2013/053622 patent/WO2013124453A1/en active Application Filing
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- 2013-02-22 US US14/380,714 patent/US10245156B2/en active Active
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US20150250605A1 (en) | 2015-09-10 |
CN104135971A (zh) | 2014-11-05 |
FR2987256A1 (fr) | 2013-08-30 |
BR112014019499A8 (pt) | 2017-07-11 |
FR2987256B1 (fr) | 2014-08-08 |
RU2631208C2 (ru) | 2017-09-19 |
CN104135971B (zh) | 2016-12-21 |
AU2013224006A1 (en) | 2014-07-31 |
US9039774B2 (en) | 2015-05-26 |
JP2015507989A (ja) | 2015-03-16 |
BR112014019499A2 (ja) | 2017-06-20 |
US10350083B2 (en) | 2019-07-16 |
US10245156B2 (en) | 2019-04-02 |
AU2013224006B2 (en) | 2017-02-23 |
MX2014010119A (es) | 2014-09-08 |
EP2816977A1 (en) | 2014-12-31 |
CA2861579A1 (en) | 2013-08-29 |
RU2014128495A (ru) | 2016-04-10 |
EP3824848A1 (en) | 2021-05-26 |
US20130226300A1 (en) | 2013-08-29 |
IN2014MN01584A (ja) | 2015-05-08 |
ZA201405252B (en) | 2016-10-26 |
US20150051702A1 (en) | 2015-02-19 |
US11273056B2 (en) | 2022-03-15 |
IL233631A0 (en) | 2014-08-31 |
US20190388237A1 (en) | 2019-12-26 |
EP2816977B1 (en) | 2020-03-18 |
HK1200082A1 (en) | 2015-07-31 |
KR20140138767A (ko) | 2014-12-04 |
WO2013124453A1 (en) | 2013-08-29 |
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