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WO2013141150A1 - Implant interépineux - Google Patents

Implant interépineux Download PDF

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Publication number
WO2013141150A1
WO2013141150A1 PCT/JP2013/057367 JP2013057367W WO2013141150A1 WO 2013141150 A1 WO2013141150 A1 WO 2013141150A1 JP 2013057367 W JP2013057367 W JP 2013057367W WO 2013141150 A1 WO2013141150 A1 WO 2013141150A1
Authority
WO
WIPO (PCT)
Prior art keywords
prevention member
interspinous process
shaft portion
misalignment prevention
process implant
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/JP2013/057367
Other languages
English (en)
Japanese (ja)
Inventor
優 畑
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Terumo Corp
Original Assignee
Terumo Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Terumo Corp filed Critical Terumo Corp
Publication of WO2013141150A1 publication Critical patent/WO2013141150A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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 or setting implements
    • 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, e.g. stabilisers comprising fluid filler in an implant
    • A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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 or setting implements
    • 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, e.g. stabilisers comprising fluid filler in an implant
    • A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
    • A61B17/7065—Devices with changeable shape, e.g. collapsible or having retractable arms to aid implantation; Tools therefor

Definitions

  • the present invention relates to an interspinous process implant placed between two spinous processes of a lumbar vertebra, for example, an interspinous process implant used for treating lumbar spinal canal stenosis.
  • the spinal canal may become narrow due to degeneration of intervertebral disc herniation, degenerative spondylosis or ligaments placed around the lumbar vertebrae with aging.
  • the spinal canal becomes narrow, the spinal cord and nerves passing through the spinal canal are compressed, causing a disease called lumbar spinal canal stenosis.
  • the spinal cord and nerves are compressed, causing back pain, leg numbness, and the like.
  • the interspinous process implant described in Patent Document 1 includes a blocking member interposed between the spinous processes and a plurality of arms provided at both ends of the blocking member.
  • the plurality of arms have elasticity.
  • the plurality of arms are folded along the axial direction of the blocking member, and the entire interspinous process implant has a substantially I-shape.
  • the plurality of arms rotate around the end of the blocking member. Then, the entire interspinous process implant expands and expands in a substantially H shape.
  • This interspinous process implant is arranged in a tube-shaped member so-called cannula with a plurality of arms folded. Then, the cannula in which the interspinous process implant is disposed is inserted into a predetermined position, and the interspinous process implant is pushed out from the cannula between the spinous processes.
  • the plurality of arms rotate about the end of the blocking member at a substantially right angle, and expand and expand from the folded state.
  • blocking member clamps a spinous process. As a result, the interspinous process implant is placed at a predetermined position.
  • the arm portion was expanded and expanded by rotating around the end of the blocking member. Therefore, a large space is required for the arms to expand and expand. As a result, in the technique described in Patent Document 1, there is a risk that the tissue around the spinous process is damaged by the arm when the arm is deployed and expanded.
  • FIG. 15A shows a fifth embodiment of the interspinous process implant of the present invention
  • FIG. 15A is a front view showing a state in which the first deviation preventing member and the second deviation preventing member are expanded
  • FIG. 16A is a front view which shows the state which the displacement prevention member of this and the 2nd deviation prevention member reduced.
  • FIG. 16A shows a fifth embodiment of the interspinous process implant of the present invention
  • FIG. 16A is a side view showing a state where the first deviation preventing member and the second deviation preventing member are expanded
  • FIG. 16A shows a fifth embodiment of the interspinous process implant of the present invention
  • An interspinous process implant 1 shown in FIG. 1 is an implant that is used, for example, for the treatment of lumbar spinal canal stenosis and is placed between the spinous processes of adjacent vertebrae in the lumbar spine.
  • the interspinous process implant 1 includes a shaft portion 2, a first displacement prevention member 3, and a second displacement prevention member 4.
  • the interspinous process implant 1 is inserted into a living body by a puncture device 8 described later (see FIG. 4).
  • the first misalignment prevention member 3 is disposed on one side in the axial direction of the shaft portion 2, and the second misalignment prevention member 4 is disposed on the other side in the axial direction of the shaft portion 2.
  • the first misalignment prevention member 3 and the second misalignment prevention member 4 are arranged at a predetermined interval in the axial direction of the shaft portion 2.
  • the first misalignment prevention member 3 and the second misalignment prevention member 4 are formed by spiral springs in which a belt-like body 6 having elasticity is wound spirally in the same plane.
  • One end portion 6 a on the center side in the winding direction of the belt-like body 6 is fixed to the side surface portion 2 a of the shaft portion 2.
  • the other end portion 6b outside the winding direction in the strip 6 is a free end.
  • the first misalignment prevention member 3 and the second misalignment prevention member 4 are arranged so that the strips 6 positioned in the radially outward direction and the radially inward direction are in contact with each other against the elastic force. 2 is wound around the side surface portion 2a.
  • the first deviation preventing member 3 and the second deviation preventing member 4 are in the direction of the radius of winding, that is, the normal line of the side surface portion 2a in the shaft portion 2, from the contracted state shown in FIG. Expand in the direction.
  • the first misalignment prevention member 3 and the second misalignment prevention member 4 extend substantially uniformly in the normal direction of the side surface portion 2a. Therefore, it is not necessary to consider the direction for expanding the first misalignment prevention member 3 and the second misalignment prevention member 4.
  • the vertebral arch 104 extends in an arc from the rear of the vertebral body 103.
  • the spinous process 105 is formed at a substantially central portion of the vertebral arch 104 and extends backward.
  • the transverse processes 106 are formed at both ends of the vertebral arch 104 in the left-right direction, and protrude and extend in the left-right direction.
  • the upper joint process 107 is formed in a pair at the upper end of the vertebral arch 104 and extends upwardly.
  • the lower joint process 108 is formed in a pair at the lower end of the vertebral arch 104 and extends downwardly.
  • the puncture device 8 has an inner needle 81 and an outer cylinder 85 into which the inner needle 81 is inserted.
  • the inner needle 81 has a main body portion 84 provided with a needle portion 82 at the distal end portion.
  • a base end portion of the main body portion 84 is fixed to an inner needle gripping portion 83 having a substantially rectangular cross section.
  • the main body 84 is formed to be bent at a predetermined angle.
  • the inner needle gripping portion 83 is gripped by the practitioner when the inner needle 81 is inserted into the outer cylinder 85 or when the inner needle 81 is removed from the outer cylinder 85.
  • FIGS. 1 and 5 to 11 are views for explaining a procedure for placing the interspinous process implant 1 in the living body 100.
  • FIG. 5A, 5B, and 6 are views for explaining a procedure for placing the interspinous process implant 1 in the living body 100.
  • FIG. 5A, 5B, and 6 are views for explaining a procedure for placing the interspinous process implant 1 in the living body 100.
  • the length of the insertion tube 10 is set, for example, in the range of 2.0 cm to 150 cm, and more preferably in the range of 3.0 cm to 25 cm.
  • the diameter is set in the range of 0.3 to 3.0 cm, more preferably in the range of 0.5 cm to 2.0 cm.
  • the insertion tube 10 is pushed forward between the two spinous processes 105 of the adjacent vertebra 102 through the passage formed by puncturing the puncture device 8. Then, the distal end portion of the insertion tube 10 is disposed at a predetermined position between the spinous processes 105.
  • the outer cylinder 85 may be used as the insertion tube 10.
  • FIG. 10 is a side view of the state shown in FIG. 9B as viewed from the side of the lumbar vertebra.
  • the first misalignment prevention member 3 and the second misalignment prevention member 4 are expanded substantially equally from the contracted state toward the radially outward direction. Therefore, the operation of housing the interspinous process implant 1 in the insertion tube 10 and the operation of inserting the insertion tube 10 between the spinous processes 105 are performed in the extending direction of the first displacement preventing member 3 and the second displacement preventing member 4. Can be done without consideration. This makes it possible to simplify the procedure.
  • the expanded first misalignment prevention member 3 and second misalignment prevention member 4 are arranged such that the strip 6 is swirled around the shaft 2 a plurality of times. Therefore, the contact area between the first misalignment prevention member 3 and the second misalignment prevention member 4 and the spinous process 105 can be increased, and the interspinous process implant 1 can be firmly fixed.
  • the first misalignment prevention member 3 and the second misalignment prevention member 4 are shaped so as to be swirled, they flexibly change so as to follow the operation of twisting the waist. Stable placement of the interprotrusion implant 1 is possible.
  • FIG. 11 is a front view showing a state in which the interspinous process implant 1 is placed between the spinous processes 105.
  • the interspinous process implant 1 is deformed as a whole from a substantially I shape to a substantially H shape by expanding the first misalignment prevention member 3 and the second misalignment prevention member 4. Thereby, the procedure of placing the interspinous process implant 1 between the two spinous processes 105 of the adjacent vertebrae 102 is completed.
  • the interspinous process implant 41 can be placed in a state of following the surface shape of the spinous process 105.
  • the implant may be displaced in the axial direction with respect to the spinous process 105. Therefore, by using the interspinous process implant 41 of the present invention, it is possible to prevent a shift during fluid injection.
  • the interspinous process implant 61 according to the sixth embodiment differs from the interspinous process implant 1 according to the first embodiment in that the first misalignment prevention member and the second misalignment prevention member are different. It is a configuration. Therefore, here, the first misalignment prevention member and the second misalignment prevention member will be described, and the same components as those in the first embodiment will be denoted by the same reference numerals and description thereof will be omitted.
  • the interspinous process implant 61 includes a shaft portion 2, and a first displacement prevention member 63 and a second displacement prevention member 64 attached to the shaft portion 2.
  • the first misalignment prevention member 63 and the second misalignment prevention member 64 are arranged without a gap in the axial direction of the shaft portion 2.

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Neurology (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)
PCT/JP2013/057367 2012-03-23 2013-03-15 Implant interépineux Ceased WO2013141150A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP2012066594 2012-03-23
JP2012-066594 2012-03-23

Publications (1)

Publication Number Publication Date
WO2013141150A1 true WO2013141150A1 (fr) 2013-09-26

Family

ID=49222609

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/JP2013/057367 Ceased WO2013141150A1 (fr) 2012-03-23 2013-03-15 Implant interépineux

Country Status (1)

Country Link
WO (1) WO2013141150A1 (fr)

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20090216274A1 (en) * 2008-02-21 2009-08-27 Zimmer Gmbh Expandable interspinous process spacer with lateral support and method for implantation
JP2009544456A (ja) * 2006-06-16 2009-12-17 カイフォン・ソシエテ・ア・レスポンサビリテ・リミテ 経皮的脊椎インプラント及び方法
JP2011502573A (ja) * 2007-11-02 2011-01-27 ランクス インコーポレイテッド 脊椎インプラントおよび方法
US20110190817A1 (en) * 2009-11-06 2011-08-04 Synthes Usa, Llc Minimally invasive interspinous process spacer implants and methods

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2009544456A (ja) * 2006-06-16 2009-12-17 カイフォン・ソシエテ・ア・レスポンサビリテ・リミテ 経皮的脊椎インプラント及び方法
JP2011502573A (ja) * 2007-11-02 2011-01-27 ランクス インコーポレイテッド 脊椎インプラントおよび方法
US20090216274A1 (en) * 2008-02-21 2009-08-27 Zimmer Gmbh Expandable interspinous process spacer with lateral support and method for implantation
US20110190817A1 (en) * 2009-11-06 2011-08-04 Synthes Usa, Llc Minimally invasive interspinous process spacer implants and methods

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