JP6479010B2 - 自己固定機構を有する椎体間癒合装置 - Google Patents
自己固定機構を有する椎体間癒合装置 Download PDFInfo
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- Health & Medical Sciences (AREA)
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Description
本出願は、2013年8月22日に出願された仮出願第61/868,803号に対する優先権を主張するものであり、その全開示は、全ての目的のためにその全体が参照により本明細書に組み込まれる。
本開示は、概して、隣接する椎体を位置付け及び固定するための固定装置に関する。具体的には、本装置は、椎体間癒合装置を含み得る。
加齢に伴い、脊柱内の椎間板が劣化し始めることがある。その後、椎間板は、高さを失っていく。椎体間の高さの損失の結果として、脊柱管から出る神経が圧迫され締め付けられ、他の神経学的欠損の中でもとりわけ痛みを引き起こす。1つの解決策は、椎間板の代わりにスペーサーを挿入して高さを復元し、隣接する椎体間の癒合を促進して、高さの復元を恒久的に維持することである。さらなる固定も、脊髄分節を安定化するために必要とされ得る。通常、プレートが提供され、このプレートは、隣接する椎体の前方部分上に位置付けられ得る。場合により、このプレートの輪郭は、解剖の妨げになる。脊柱へのアプローチはまた、直接前方アプローチが血管解剖のナビゲーションまたは切断を必要とするという点で有意である。
本出願は、自己固定機構を有する椎体間癒合装置に関する。椎体間癒合装置の各々は、椎間板切除の後に椎体間の高さを維持するのを助けるために使用され得る。本装置が前方脊柱において特に有用である一方で、本装置は、脊柱の異なる領域においても使用され得る。
本発明は、添付の図面と合わせて読むとき、以下の詳細な説明から最良に理解され得る。慣行に従い、図面の種々の特徴が縮尺通りではないことが強調される。対照的に、種々の特徴の寸法は、明確さのために任意に拡大または低減される。図面には、以下の図が含まれる。
[図1]本出願の実施形態による、椎間板腔(disc space)内に埋め込み可能な椎体間癒合装置の例を示す。
[図2]自己固定機構を有する椎体間癒合装置の代替的な実施形態を示す。
[図3]自己固定機構を有する椎体間癒合装置の代替的な実施形態を示す。
[図4]自己固定機構を有する椎体間癒合装置の代替的な実施形態を示す。
[図5]自己固定機構を有する椎体間癒合装置の代替的な実施形態を示す。
[図6]複数のシャフト上に展開可能な羽根を有するスペーサー本体を含む代替的な椎体間癒合装置の上面斜視図を例証する。
[図7]単一のシャフト上に展開可能な羽根を有するスペーサー本体を含む代替的な椎体間癒合装置の上面斜視図を示す。
[図8A]ヒンジ付き刃を有する椎体間癒合装置の代替的な実施形態の上面斜視図を例証する。
[図8B]ヒンジ付き刃を有する椎体間癒合装置の代替的な実施形態の上面斜視図を例証する。
[図9A]展開可能な直線のまたは湾曲した釘を有する代替的な椎体間癒合装置を例証する。
[図9B]展開可能な直線のまたは湾曲した釘を有する代替的な椎体間癒合装置を例証する。
[図10A]図9A及び9Bに示される実施形態におけるばねタブ特徴を例証する。
[図10B]図9A及び9Bに示される実施形態におけるばねタブ特徴を例証する。
[図11A]展開可能なツーピース型釘を有する代替的な椎体間癒合装置を提供する。
[図11B]展開可能なツーピース型釘を有する代替的な椎体間癒合装置を提供する。
[図11C]展開可能なツーピース型釘を有する代替的な椎体間癒合装置を提供する。
[図11D]展開可能なツーピース型釘を有する代替的な椎体間癒合装置を提供する。
[図12A]隣接する骨を切断する1つ以上の組の羽根を有する代替的な椎体間癒合装置を示す。
[図12B]隣接する骨を切断する1つ以上の組の羽根を有する代替的な椎体間癒合装置を示す。
[図12C]隣接する骨を切断する1つ以上の組の羽根を有する代替的な椎体間癒合装置を示す。
[図12D]隣接する骨を切断する1つ以上の組の羽根を有する代替的な椎体間癒合装置を示す。
[図12E]隣接する骨を切断する1つ以上の組の羽根を有する代替的な椎体間癒合装置を示す。
[図12F]隣接する骨を切断する1つ以上の組の羽根を有する代替的な椎体間癒合装置を示す。
[図13A]ラック・アンド・ピニオン設計を通る展開可能なスパイクを有する代替的な椎体間癒合装置を示す。
[図13B]ラック・アンド・ピニオン設計を通る展開可能なスパイクを有する代替的な椎体間癒合装置を示す。
[図14]可動式斜面を使用する展開可能なスパイクを有する代替的な椎体間癒合装置を例証する。
[図15A]変形可能なスパイクまたは釘を有する代替的な椎体間癒合装置を示す。
[図15B]変形可能なスパイクまたは釘を有する代替的な椎体間癒合装置を示す。
[図16A]展開可能なスパイクまたは釘を有する椎体間癒合装置の代替的な実施形態を示す。
[図16B]展開可能なスパイクまたは釘を有する椎体間癒合装置の代替的な実施形態を示す。
[図16C]展開可能なスパイクまたは釘を有する椎体間癒合装置の代替的な実施形態を示す。
[図17A]内部旋回鉤部材を含む代替的な椎体間脊椎癒合装置を示す。
[図17B]内部旋回鉤部材を含む代替的な椎体間脊椎癒合装置を示す。
[図18A]展開可能な中子を含む代替的な椎体間脊椎癒合装置を示す。
[図18B]展開可能な中子を含む代替的な椎体間脊椎癒合装置を示す。
[図18C]展開可能な中子を含む代替的な椎体間脊椎癒合装置を示す。
[図18D]展開可能な中子を含む代替的な椎体間脊椎癒合装置を示す。
[図18E]展開可能な中子を含む代替的な椎体間脊椎癒合装置を示す。
[図19]直列の動作を促進するための機構を有する椎体間癒合装置を例証する。
[図20A]多軸調節機能を提供するために骨ねじのヘッド内に組み込まれ得るユニバーサルジョイント(例えば、ボールジョイント)を例証する。
[図20B]多軸調節機能を提供するために骨ねじのヘッド内に組み込まれ得るユニバーサルジョイント(例えば、ボールジョイント)を例証する。
[図21]展開可能な釘、羽根などが、ウォーム及び/または歯付きウォームホイールによってどのように作動され得るかを例証する。
[図22]スペーサー本体を通して打ち込まれた湾曲したスパイクを通る展開可能な返しワイヤを有する、椎体間癒合装置の実施形態を例証する。
[図23]直線のまたは湾曲したラック・アンド・ピニオン機構を含む代替的な椎体間癒合装置を例証する。
[図24]スペーサーと椎体との間のキール接続を例証する。
本開示の実施形態は概して、独立型の椎体間癒合インプラントに関する。具体的には、インプラントは、スペーサー本体を含む。スペーサーは、端部部材と組み合わされ得る。1つ以上の固定部材、例えば、ねじ、釘、シム、中子、スパイク、ステープル、ピン、羽根、刃などが、装置を隣接する椎骨に固定するために使用され得る。固定部材はまた、装置の挿入及び固定の最適な容易性を提供するために、これらの組み合わせを含んでもよい。
Claims (10)
- 脊柱の椎体間の椎間空間の治療部位内への埋め込み用のインプラントであって、
上面及び下面を有するスペーサーであって、前記上面及び前記下面は各々、隣接する椎骨に係合するように構成された接触領域を有する、スペーサーと、
前記スペーサーに連結される端部部材であって、前記端部部材をある角度で横断する第1の穴および第2の穴を少なくとも有する、端部部材と、
前記第1の穴を通って延在するように構成された、ねじ山のない第1の固定部材であって、隣接する椎体内へ打ち込まれるように構成された湾曲したシムを含む、第1の固定部材と、
前記第2の穴を通って延在するように構成された、ねじ山を切った第2の固定部材と、を備える、前記インプラント。 - 前記シムは、前記シムの長手方向軸の少なくとも一部分に沿って延在するスプラインを含む、請求項1に記載の前記インプラント。
- 前記スプラインは、前記シムのヘッド部分で最大高さを有し、前記シムの最遠位端部に近位の最小高さに向かって先細になる、請求項2に記載の前記インプラント。
- 前記シムは、挿入器具を保持するように構成された開口部を含む丸みを帯びたヘッド部分を有する、請求項1に記載の前記インプラント。
- 前記シムは、平滑であり、実質的に円錐の形状を有する、請求項1に記載の前記インプラント。
- 前記スペーサーは、骨移植材料を受容するように構成される、前記上面から前記下面まで延在する開口部を画定する、請求項1に記載の前記インプラント。
- 前記第1の固定部材は、ブロック機構で前記端部部材内に保持され、前記ブロック機構は、前記第1の固定部材が前記端部部材内に完全に挿入されると、前記第1の固定部材をブロックするように構成されたばねタブである、請求項1に記載の前記インプラント。
- 前記第1の固定部材は、埋め込み後に拡張するように構成された先端を有する展開可能な固定部材である、請求項1に記載の前記インプラント。
- 前記展開可能な固定部材は、内側部分及び外側スリーブを含み、前記展開可能な固定部材が骨内に挿入されると、前記内側部分は、挿入方向と反対方向に引っ張られて、前記固定部材の前記先端を変形させて広げて開くことができる、請求項8に記載の前記インプラント。
- 前記第1の固定部材の後退を防止するように構成された第1のブロック機構と、
前記第2の固定部材の後退を防止するように構成された第2のブロック機構と、をさらに備える、請求項1に記載の前記インプラント。
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