JP6499748B2 - 展開式脊椎インプラントシステム及び方法 - Google Patents
展開式脊椎インプラントシステム及び方法 Download PDFInfo
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- JP6499748B2 JP6499748B2 JP2017235004A JP2017235004A JP6499748B2 JP 6499748 B2 JP6499748 B2 JP 6499748B2 JP 2017235004 A JP2017235004 A JP 2017235004A JP 2017235004 A JP2017235004 A JP 2017235004A JP 6499748 B2 JP6499748 B2 JP 6499748B2
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- cavity
- spinal implant
- relative
- cap
- implant
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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Landscapes
- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Neurology (AREA)
- Heart & Thoracic Surgery (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Cardiology (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
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Description
障害の治療のための医療装置の観点で、より厳密には展開式脊椎インプラントを含んでいる外科用システム及び脊椎を治療するための方法の観点で、論じられている。
幾つかの実施形態では、開示されている外科用システム及び方法は、代わりに、腹臥位又は仰臥位の患者での外科的治療に採用されてもよいし、及び/又は、前方進入法、後方進入法、後正中進入法、側方進入法、後側方進入法、及び/又は前側方進入法を含む、脊椎への様々な外科的進入法を採用することもでき、他の身体領域に採用されてもよい。本開示は、更に、代わりに、脊柱の腰部、頸部、胸部、及び骨盤の領域を治療するための処置に関して採用されてもよい。本開示のシステム及び方法は、更に、例えば、訓練、試験、及び実演時に、動物、骨模型、及び他の非生体基質に対して使用されてもよい。
行することをいう。緩和は、疾患又は病態の徴候又は症状が現われる前に起こることもあれば、それらの出現後に起こることもある。而して、治療する又は治療は、疾患又は望ましからざる病態を予防すること又は疾患又は望ましからざる病態の予防(例えば、疾患が当該疾患に罹りやすいかもしれないがまだそれに罹っていると診断されていない患者に起こるのを予防すること)を含む。加えて、治療する又は治療は、徴候又は症状の完全緩和を要件とするのでもなければ、治癒を要件とするのでもなく、具体的には、患者への限界効果しかない処置を含む。治療には、疾患を抑制することであって例えばその発症を停止させること、又は疾患を軽減することであって例えば疾患の退行を引き起こすこと、を含めることができる。例えば、治療は、急性又は慢性の炎症を低減すること、疼痛の緩和と沈静化及び新しい靭帯、骨、又は他の組織の再成長を誘導すること、手術時の補助として、及び/又は何らかの修復処置、を含み得る。更に、付随の特許請求の範囲を含め明細書での使用に際し、「組織」という用語は、別途特に言及されていない限り、軟組織、靭帯、腱、軟骨、及び/又は骨、を含む。
の構成要素が描かれている。
技法を含む低侵襲性処置に関して採用される。幾つかの実施形態では、システム10は、椎骨の機械的支持機能を復元するための外科処置であって本開示の原理によるインプラントを採用する融合治療及び/又は固定治療を含む外科処置、例えば椎体部分切除術及び椎間板切除術など、に関して採用されてもよい。
する湾曲を含むという具合にインプラント20の全部分又は一部分のみが弓状に展開されるようになっている。
に関して採用されている。システム10は、更に、例えば、椎間板切除術、椎板切除術(laminectomy)、融合、椎弓切開術、椎弓切除術(laminectomy)、神経根牽引(nerve root retraction)、椎間孔拡大術、脊椎関節突起切除術、減圧、髄核又は円板置換術の様
な他の外科処置に関して採用されてもよく、またインプラント20の固着用のプレートやロッド及び骨係合締結具を含む骨移植片及び植込み式人工器官に関して採用されてもよい。
間S内に固着されて、椎骨V1、V2の融合及び固定のための骨成長と関連付けられる椎骨Vの部分を安定化及び不動化させる。インプラント20の終板表面E1及びE2との一体固定は、関節空間及び/又は終板表面E1、E2との係合によって提供される抵抗によって実現し易くなる。本体44が本体22に対して軸方向並進運動するのを阻止してインプラント20をここに記載の向き付けを含む選択されている展開された向き付け及び/又は短縮された向き付けに固定するためにロックが提供されていてもよい。
態では、インプラント20は2つの空洞154、155を含んでいる。空洞154、155は、各々、実質的に球状である面180、181と、軸A1に対してそれぞれ横断方向にある面182、183及び184、185を含んでいる。幾つかの実施形態では、面180、181、182、183、184、185は、係合を容易にするような、滑らかな、粗い、肌理がある、有孔である、半有孔である、凹みがある、及び/又は磨かれている面を含んでいてもよい。面180、181、182、183、184、185は、キャップ164の運動を拘束するストッパ的歯止めとして構成されている。
20 インプラント
22 外側本体
24 第1端
26 第2端
28 管状壁
30 内側表面
32 軸方向空洞
34 側方開口
36 円周空洞を画定している部分
38 円周空洞
40 帯
42 薬剤受け入れ用の開口
44 内側本体
46 第1端
48 第2端
50 管状壁
52 外側表面
54 段
56 軸方向スロット
57 係合面
58 ギヤラック
60 歯
62 螺旋ギヤ
63 歯
64 キャップ
66 外側表面
68 内側表面
70 平面状の面
72 角度の付けられた面
74 環状面
76 ストッパ
144 内側本体
146 第1端
148 第2端
152 外側表面
154、155 空洞
156 軸方向スロット
158 ギヤラック
160、163 歯
162 螺旋ギヤ
164 キャップ
166 外側表面
168 内側表面
169 平面状の面
170 平面状の面
174 環状面
180、181 球状面
182、183、184、185 軸A1に対して横断方向の面
186 支柱
188 開口
190 可動式支柱
192 ノブ部分
194 ステム部分
244 内側本体
246 第1端
248 第2端
252 外側表面
254 空洞
264 キャップ
276 ストッパ
286 支柱
A 長手方向軸
α、β 角度範囲、角度的向き付け
I 展開に利用される機械
d 漸増寸法
B、BB 器械を回転させる方向
C、D 本体が駆動される方向
E、F キャップの回転運動の方向
E 終板
S 椎骨空間
V 椎骨
Claims (20)
- 脊椎インプラントにおいて、
軸方向空洞を画定している壁を含む第1部材と、
第1端部と第2端部の間を延びていて長手方向軸を画定している第2部材であって、前記軸方向空洞に関しての配置及び前記第1部材に対しての並進運動に適するように構成されており、前記第1端部が空洞を含み、前記空洞が実質的に球状である面を含んでいる第2部材と、
組織と係合可能な外側表面及び前記外側表面の前記組織との係合に応えて前記第1端部に動的に係合するように配置されている内側表面を含む第3部材であって、前記内側表面から延びている支柱を備え、前記支柱が前記動的係合を容易にするべく前記空洞内に可動式に配置されるとともに、前記支柱が前記球状である面に対向する面を有している第3部材と、を備え、
前記実質的に球状である面および前記実質的に球状である面に対向する面は、前記脊椎インプラントの前記軸方向に沿って延びるように配置されている脊椎インプラント。 - 前記第3部材は、前記長手方向軸に対して複数の軸方向の向き付けに可動である第1軸を画定している、請求項1に記載の脊椎インプラント。
- 前記外側表面は、前記長手方向軸に対して横断方向に向き付けられている実質的に平面状の面を含んでいる、請求項1に記載の脊椎インプラント。
- 前記平面状の面は、前記長手方向軸に対して、実質的に0乃至20度の角度範囲で可動である、請求項3に記載の脊椎インプラント。
- 前記外側表面は、前記長手方向軸に対して、第1の角度的向き付けと第2の角度的向き付けの間で可動である実質的に平面状の面を含んでいる、請求項1に記載の脊椎インプラント。
- 前記第2の角度的向き付けは、前記第1の角度的向き付けに対して実質的に10度に配置されている、請求項5に記載の脊椎インプラント。
- 前記空洞は、実質的に球状の第1の面ならびに前記長手方向軸に対して横断方向に延びている第2及び第3の面によって画定されており、前記第1、第2、及び第3の面はそれぞれ、前記第3部材の前記第2部材に対する運動を拘束するストッパ的歯止めを画定している、請求項1に記載の脊椎インプラント。
- 前記ストッパ的歯止めのそれぞれは、前記第3部材の前記第2部材に対する複数の向き付けの1つに対応している、請求項7に記載の脊椎インプラント。
- 帯をさらに備えており、前記第1部材は、前記帯の配置に適するように構成されている円周溝を画定する内側表面を含んでおり、前記第2部材は、前記帯と係合可能な歯を有する螺旋ギヤを含む外側表面を備えている、請求項1に記載の脊椎インプラント。
- 前記空洞の面は、前記第3部材の前記第2部材に対する少なくとも1つの可動限界を画定している、請求項1に記載の脊椎インプラント。
- 脊椎インプラントにおいて、
軸方向空洞を画定している壁を含む外側本体と、
第1端部と第2端部の間を延びていて長手方向軸を画定している内側本体であって、前記軸方向空洞に関しての配置及び前記外側本体に対しての並進運動に適するように構成されており、前記第1端部が側方開口を画定する外側表面を含むとともに、空洞を含み、前記空洞が実質的に球状である面を含んでいる、内側本体と、
組織と係合可能な外側表面と、キャップに対して回転可能である側方支柱を含む内側表面とを含むキャップを含み、前記側方支柱は、前記外側表面の前記組織との動的係合を容易にするべく前記開口内に並進運動のために配置されるとともに、前記側方支柱が前記球状である面に対向する面を有している、前記キャップとを備え、
前記実質的に球状である面および前記実質的に球状である面に対向する面は、前記脊椎インプラントの前記軸方向に沿って延びるように配置される、脊椎インプラント。 - 前記第1端部は、前記空洞の反対側にある第2空洞を含んでおり、
前記脊椎インプラントは、前記動的係合を容易にするべく前記内側及び外側の表面を通って前記第2空洞内へ延びている可動式支柱をさらに備えている、請求項1に記載の脊椎インプラント。 - 前記第2空洞は、実質的に球状の第1の面ならびに前記長手方向軸に対して横断方向に延びている第2及び第3の面によって画定されており、前記第1、第2、及び第3の面はそれぞれ、前記第3部材の前記第2部材に対する運動を拘束するストッパ的歯止めを画定している、請求項12に記載の脊椎インプラント。
- 前記第2空洞は、前記空洞と同軸である、請求項12に記載の脊椎インプラント。
- 前記可動式支柱は、ノブ部分及びステム部分を含んでおり、前記ステム部分は、前記第2空洞に可動式に配置されるのに適する構成である、請求項12に記載の脊椎インプラント。
- 前記内側表面は、実質的に平面状の面及び環状面を含んでおり、前記実質的に平面状の面及び前記環状面は、前記外側表面の前記組織との係合に応えて前記第1端部に動的に係合するにあたり前記第3部材の前記長手方向軸に対する回転を容易にさせる前記第1端部との前記係合に適するように構成されている、請求項1に記載の脊椎インプラント。
- 前記第1部材は、側方開口を含んでおり、
前記第2部材は、スロットを有する管状壁を含んでおり、前記スロットは、複数の歯をそれに沿って配置させているギヤラックを有しており、
前記脊椎インプラントは、前記歯に係合するように前記側方開口を通って延びている器械を備え、前記器械は、前記脊椎インプラントを展開させる形で前記第2部材を前記第1部材に対して並進運動させるように、前記第1部材及び前記第2部材に対して回転可能である、請求項1に記載の脊椎インプラント。 - 前記第1端部は、前記空洞の反対側にある第2空洞を含んでおり、
前記脊椎インプラントは、前記動的係合を容易にするべく前記内側及び外側の表面を通って前記第2空洞内へ延びている可動式支柱をさらに備えており、
前記第2空洞は、実質的に球状の第4の面ならびに前記長手方向軸に対して横断方向に延びている第5及び第6の面によって画定されており、前記第4、第5、及び第6の面はそれぞれ、前記第3部材の前記第2部材に対する運動を拘束するストッパ的歯止めを画定している、請求項7に記載の脊椎インプラント。 - 歯が、螺旋構成に離間されており、かつ、前記長手方向軸に対して角度的向き付けに配置されている、請求項9に記載の脊椎インプラント。
- 脊椎インプラントにおいて、
軸方向空洞及び側方開口を画定している壁を含む第1部材と、
第1端部と第2端部との間を延びていて長手方向軸を画定している第2部材であって、前記軸方向空洞に関しての配置及び前記第1部材に対しての並進運動に適するように構成されており、前記第1端部は、実質的に球状である面を含む第1空洞、及び前記第1空洞の反対側にある第2空洞を含んでおり、前記第2部材は、スロットを有する管状壁を含んでおり、前記スロットは、複数の歯をそれに沿って配置させているギヤラックを有している、第2部材と、
組織と係合可能な外側表面及び前記外側表面の前記組織との係合に応えて前記第1端部に動的に係合するように配置されている内側表面を含む第3部材であって、前記内側表面から延びている支柱を備え、前記支柱が前記動的係合を容易にするべく前記第1空洞内に可動式に配置され、前記支柱が前記球状である面に対向する面を有している第3部材と、
前記動的係合を容易にするべく前記内側及び外側の表面を通って前記第2空洞内へ延びている可動式支柱と、
前記歯に係合するように前記側方開口を通って延びている器械であって、前記脊椎インプラントを展開させる形で前記第2部材を前記第1部材に対して並進運動させるように前記第1部材及び前記第2部材に対して回転可能である器械と、
帯と、を備え、前記第1部材は、前記帯の配置に適するように構成されている円周溝を画定する内側表面を含んでおり、前記第2部材は、前記帯と係合可能な歯を有する螺旋ギヤを含む外側表面を備え、
前記実質的に球状である面および前記実質的に球状である面に対向する面は、前記脊椎インプラントの前記軸方向に沿って延びるように配置されている、脊椎インプラント。
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EP2948105B1 (en) | 2018-08-29 |
US20150351927A1 (en) | 2015-12-10 |
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WO2014116353A1 (en) | 2014-07-31 |
US20200261236A1 (en) | 2020-08-20 |
EP3248574A1 (en) | 2017-11-29 |
CN104936555A (zh) | 2015-09-23 |
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US11672670B2 (en) | 2023-06-13 |
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