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JPH08503876A - 椎間腔のための植接体 - Google Patents

椎間腔のための植接体

Info

Publication number
JPH08503876A
JPH08503876A JP7509471A JP50947195A JPH08503876A JP H08503876 A JPH08503876 A JP H08503876A JP 7509471 A JP7509471 A JP 7509471A JP 50947195 A JP50947195 A JP 50947195A JP H08503876 A JPH08503876 A JP H08503876A
Authority
JP
Japan
Prior art keywords
implant
grafted
bone
body according
implants
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.)
Granted
Application number
JP7509471A
Other languages
English (en)
Other versions
JP3643594B2 (ja
Inventor
フランコイス チャールズ ベッカーズ、ルイス
ヨハネス フリドリン シュラプフェル
Original Assignee
ジンテーズ アクチエンゲゼルシャフト,クール
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
Family has litigation
First worldwide family litigation filed litigation Critical https://patents.darts-ip.com/?family=3887349&utm_source=google_patent&utm_medium=platform_link&utm_campaign=public_patent_search&patent=JPH08503876(A) "Global patent litigation dataset” by Darts-ip is licensed under a Creative Commons Attribution 4.0 International License.
Application filed by ジンテーズ アクチエンゲゼルシャフト,クール filed Critical ジンテーズ アクチエンゲゼルシャフト,クール
Publication of JPH08503876A publication Critical patent/JPH08503876A/ja
Application granted granted Critical
Publication of JP3643594B2 publication Critical patent/JP3643594B2/ja
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

Links

Classifications

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    • A61F2/00Filters 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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    • A61F2/4455Joints 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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    • A61F2/447Joints 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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Abstract

(57)【要約】 椎間腔(25)のための植接体(6)は器具(9)により把持するための装置(8)を有するおおむね直方体状の本体(7)からなる。

Description

【発明の詳細な説明】 椎間腔のための植接体 本発明は請求項1の上位概念による椎間腔のための植接体に関する。このよう な植接体は主として椎体の骨橋を促進するために用いられ、椎間円板又は椎間板 の切除の後に椎体と脊柱の間に取り付けられる。 椎間板が損傷した時これを摘出し、生じた空隙を皮質海綿状骨で埋めることが できることは知られている。 この方法では椎体をまず拡開器によってできるだけ伸展して引き離す。特殊技 術はくさび形部材−いわゆる拡張器―を2つの椎体の間に挿入して、これらの椎 体を徐々に拡張して引き離すものである。その場合交互に左右で1mmだけ大き い直径の拡張器を夫々後部から取り付ける。最大可能な伸展に達した後拡張器を 上述の皮質海綿骨に置き換える。 この公知の技術は、骨を取り扱うこと及び正しい位置に置くことが困難であり 、修正がほとんど不可能であるという欠点がある。この技術のもう1つの欠点は 、隣接する椎体の元来凹曲する側面の間に移植骨を入れるために、椎間腔に長方 形又は円筒形空欠部をえぐり取り及び/又は削り取らなければならないことであ る。それは面倒であり、しかも椎体の損傷を招く。 ここで本発明が対策を講じようとする。本発明の根底にあるのは、特殊な形状 と挿入方式に基づき椎体間の極めて安定な係着を可能にし、その際椎体の骨性蓋 板を損傷することがない椎間腔のための植接体を提供する課題である。本発明の もう1つの課題は、拡張器を使わずに挿入することができる椎間腔のための植接 体を提供することにある。 本発明は請求項1の特徴を有する椎間腔のための植接体により上記の課題を解 決する。 本発明のその他の有利な構成が従属請求項で特徴づけられている。 本発明に基づく植接体は器具で把持するための装置を具備するから、植接体を 取り付けた後に移動し又は場合によっては再び取り出すことを可能にする外力を 植接体に比較的たやすく働かせることができる。 器具により把持するための装置は、回転力及び/又は軸方向力及び/又は横力 を植接体に働せることができるように、取付け点として形成することができる。 好適な実施態様においては、この取り付け点は少なくとも回転力を植接体に働 かせることを可能にするように形成されている。その場合植接体の回転によって 多かれ少なかれ植接体が緊定されるか又は一方の位置でそれ自体が完全に遊離し 、こうして椎体の間にたやすく挿入することができ、他方の位置では必要な緊定 ばならない。 別の実施態様では椎体に空欠部を穿設する必要がなく、椎体の周縁を損傷せず に、椎間腔に圧入することができるように、1つの平面では植接体の本体がレン ズ状に裁断された輪郭を有し、輪郭の大部分が椎間腔の矢状断面の双凹形と一致 するが、別の平面では同じ本体が主として平行で平坦な又は僅かに湾曲した側面 と丸みのついた端部を有する。 植接体は骨材料で充填することができるように中空であることが好ましい。 本発明を一層明らかにするために、当該の図面を参照しつつ好適な構成の幾つ かの例−但し本発明はこれに限るものではない―を次に説明する。 図1は2個の拡張器で伸展して引き離した2個の椎体の略図、 図2は拡張器を小さな直方体の骨に置き換えた図1のII−II線に沿った横断面 図、 図3は本発明に基づく植接体及びそのために使用される器具の斜視図、 図4は図3の矢印F4の方向に見た平面図、 図5は図3の矢印F5の方向に見た平面図、 図6は図4の、VI−VI線に沿った横断面図、 図7は椎体の間に挿入した後の図3による植接体の略図、 図8は2個の椎体の間に挿入し、90゜回転した後の図3による植接体の略図 図9は本発明の別の構成及びそのために使用される器具の略図、 図10は片側の丸みを有する本発明植接体の横断面図、 図11は対角線上の両側の丸みを有する本発明植接体の横断面図、 図12は2個の左右対象の本発明植接体の一対の配列の横断面図、 図13は関節間板腔を伸展することができる対をなして配列された左右対称の 本発明植接体の略図、 図14は関節間板腔にあって、第3の植接体により前部が連結された2個の扁 平な植接体の、隣接する椎体の蓋板の凹面への回転の前後の略図、 図15は海綿状骨材料又は骨伝導性又は骨誘導性材料の収容のための縦切り口 と骨成長のための壁部の横穴を有する本発明植接体の斜視図、 図16は蓋板の凹面への植接体の回転が一方の方向にだけ可能なように縦刻み を形成した、植接体と骨との間の縦刻み付き接触面を有する本発明植接体の斜視 図、 図17は一方の刻みが前方への並進を、他方の刻みが後方への並進を阻止する ように横刻みが形成された、植接体と骨との間の横刻み付き接触面を有する本発 明植接体の斜視図を示す。前方への並進の阻止は残留する椎間輪の負担の軽減を もたらす。この椎間輪は最近の研究によれば神経支配されており、従って前方圧 迫に対して疼痛信号で反応するのである。 本発明及び本発明の改良を次に幾つかの実施例の一部概略図による図示に基づ いて更に詳しく説明する。 図1及び2に基づき公知の技術をまず最初に説明する。 椎間板を取り除く時、拡張器3を取り付けることができるように、図1に示す ように2個の隣接する椎体1及び2をなるべく伸展して引き離す。椎体1及び2 が所望の間隔になった後に、図2に示すように拡張器3を移植骨4に置き換える 。椎体1及び2に空欠部を穿設した後、押圧部材5により移植骨4を椎体の間に 移植する。この技術が明細書の冒頭に述べた欠点を有することは明らかである。 そこで図3ないし6に示す本発明植接体がこの欠点を克服し、迅速に挿入し、 更に必要ならば力を加えて2個の椎体の間に緊定することを可能にする。植接体 6はおおむね器具9による把持のための装置8を備えた本体7からなる。器具9 による把持のための装置8は回転力、軸方向力及び/又は横力を好ましくはすべ ての方向に植接体6に働かせることができるように形成されている。 図3−6に示すように、装置8は少なくとも回転力Rを働かせることができる ように形成し、それに関連して植接体は上記の装置8の回転により植接体6の本 体7を椎体1及び2の間に大きな又は小さな間隔を置いて挿入することができる ことが好ましい。 図3−6による構成においては装置8は植接体6の軸方向後端部10で本体7 の内側に設けた空欠部からなる。空欠部は器具9を挿入することを可能にする。 図示のように、空欠部は多角形例えば六角形の軸方向開口からなることができ、 器具9を使用しなければならない。 器具9の挿入のために内側に設けた開口の使用、即ち前述の空欠部は、妨げに なる部材が植接体6から突出しないという利点をもたらす。 本体7は以下に述べる特徴の1つ又は幾つかを備えた特殊な形状を有すること が好ましい。 ―本体7の軸方向前端部12は丸みを付け又はくさび形に形成しなければならな い。なぜならこれは椎間腔25への挿入を容易にするからである。 ―本体7の軸方向前端部12の丸み13は、図5に示すように専ら最小直径D1 −図4を参照−と平行な横断面に沿って経過し、これに対して直角をなす横断面 に従って経過しないことが好ましい。 ―最小直径が通る側面14及び15は、丸み13を除き、平行かつ平坦であるこ とが好ましい。 −側面図で本体7は、図5に示すように面取りしたレンズ状の輪郭、即ち椎間腔 の矢状断面が有する自然の双凹形と一致する輪郭を有することが好ましい。側面 14及び15の間の中間部と側面16及び17は丸みを帯びている。 ―側面16及び17は1つの横断面に沿って少なくとも部分的に、なるべくは完 全に扁平であることが好ましい。側面17及び18が横方向に少なくとも部分的 に平坦であることは、緊定状態で傾倒に対する安定性を与えるという利点をもた らす。 ―本体7は移植物の充填のための単数個または複数個の開口または空欠 部を有する。図3ないし6によれば、側面16から側面17へ伸張する貫通する 開口18が選ばれる。開口18は平行する壁面19及び20を有する縦長のスロ ットからなることが好ましい。 ―植接体はチタン又は植接体に適したチタン合金で製造することが好ましい。 ―複数個の垂直穴を本体7に作り、その上で中間壁を削り取れば、図3の植接体 の本体7に開口18又は開口部(Schlitz)を設けることができる。 ―植接体6、正確に言えば本体7は約22mmの長さLを有し、ほぼ1.5m mの壁厚W1を余すまでくり抜くことが好ましい。装置8を備えた軸方向後端部 10は6mmの最小直径を有することが好ましい。装置8の部位の最小壁厚W2 及び器具の太さDを可能な限り大きくするために、上記の空欠部の最大直径の方 向が本体7の最大直径の方向と一致するように上記の空欠部を設ける。 第7図及び8に基づいて次に2個の椎体1及び2の間での植接体6の使用及び 取付けを説明する。 第7図には、キーに似た適当な器具9の端部にある植接体6を2個の椎体1及 び2の間にいかにして取付けることができるかを示す。その場合植接体6が最小 直径D1と共に椎体1及び2の向き合う側面22及び23の間に挿入される。な お植接体6は移植骨24で既に充填されている。次に植接体6を椎体1及び2の 間に嵌合又は緊定して取付けるために、器具9のキー21を90゜回転し、器具 9を除去した後、それによって図8に示す状態が得られる。移植骨24は椎体1 及び2に接続するから、植接体6は移植骨24の癒着により強固な保持を得るこ とができる。 植接体6は特別な補助手段なしで挿入することができるが、椎骨を予め楕円形 拡張器により左側と右側で伸展して引き離し、他の側で植接体6が緊定されるま でこの位置に保持すれば、操作を簡素化することができる。ところが植接体6の 存在は植骨面が再びずれて近接することを阻止するから、ここで最後の拡張器を 除去し、場合によっては第2の植接体6に置き換えることができる。通常は2個 の植接体6を取付けなければならない。 図7及び8ではっきり分るように、異なる直径D1及びD2を有する回転可能 な植接体6を使用すれば、これを椎体1及び2の間に自由に、あまり骨折らずに 挿入することができ、他方では回転することにより椎体の間に完全に保持するこ とができる。従って長方形又は円筒形の空間を得るために椎間腔25をくり抜き 又は削り取る必要もない。 植接体6の本体7は異なる直径D1及びD2を有するから、本体7は椎間腔2 5から簡単に除去される。植接体6を緊定の後に最小直径D1が椎体1及び2の 間にくるまで逆方向に回転すれば、再び取外すことができることは明白である。 椎間腔25の自然の双凹形と一致する形状の本体7を有する植接体6を使用す れば、椎体1及び2の側面22、23と移植骨24を移植した植接体6の側面1 6,17との間の完全な接続が自動的に生じる。 植接体6の回転という技術には次の利点がある。 ―蓋板が凹曲しているならばこの回転は、ある次元では平坦であって、別の次元 では蓋板の幾何学的形状に対応するように植接体6を形成する可能性をもたらす 。平坦な次元は後方からの差込みを容易にする。湾曲面は蓋板との最適な接触を もたらす。 −蓋板が平坦であれば、関節間板腔を拡開するために回転を利用することができ る。 ―植接体は挿入の後に初めて回転されるから植接体の表面に横歯を付けることが 可能である。 もちろん種々異なる形の植接体6を実現することができる。六角穴付きねじ用 方形又は楕円形開口からなる他の空欠部形状を使用することもできる。 器具9による把持のための装置8は、植接体6の内側に設けることが好ましい が、これは絶対に必要という訳でない。装置8が突出する部材又は軸方向後端部 10の特定の形状からなり、突出する部材又は軸方向後端部10を適当な器具に 固定して、必要な力を働かせることができるようにすることもできる。 本発明の別の構成によれば、装置8は回転力だけでなく、植接体6を取り付け る時に必要ならば椎体1及び2の間に圧入し、万一再び取り出す時及び緊定する 時に植接体6に引張力を働かせることができるように、同時に軸方向力、即ち圧 縮力も引張力も働かせることができるように構成されている。こうして植接体6 を処置の際に再び除去することが随時可能である。 このような構成を図9に基づいて示す。その場合装置8は回転力の行使を許容 する第1の取付け部材26と、植接体6に対する軸方向圧縮力及び引張力の行使 を可能にし、そのために軸方向ロックを具備する第2の取付け部材27とを連結 する。 第1の取付け部材26は図3の構成に示した空欠部からなる。第2の取付け部 材27は、例えば上記の六角形穴の壁面の開口部(Schlitz)の形の補助空欠部 からなる。この開口部(Schlitz)に当該の器具9のロッキング部材28が係合 することができる。図9に示すように、ロッキング部材28は球体等からなるこ とができ、器具9を六角形空欠部に挿入した後、このロッキング部材が半径方向 外側へ押圧され、上記の開口部(Schlitz)に係合する。 その場合器具9は種々の形状を有し、様々な仕方で操作することができる。図 9によれば、これはくさび30と連結された切換えグリップ29により実行する ことができる。一方、切換えグリップ29はロッキング部材28を押し離し又は 弛める。 別の変型ではキーの端部が割ってあり、キーが挿入される植接体6の開口の中 でキーを緊定することができるように、内部のピンの押し込み又はねじ込みによ り外径を拡大することができる。 別の変型によれば植接体6の丸み13を有する軸方向前端部12にも、器具9 のための取付けの可能性を設けることができる。この取付けの可能性は様々であ り、装置8と同様に植接体6に対する回転力、軸方向力及び/又は横力の行使を 可能にするように設計することが好ましい。取付けの可能性は多角形、例えば六 角形の開口からなる。十分に強固に癒着し、経腹腔的に除去せざるを得ないよう にならない内に植接体6にねじり力を働かせるために、この開口は適当な端片を 持つキーを取り付けることを可能にする。本発明は勿論経腹腔的に植接体を取り 付けることを可能にする取付け装置を一端に具備した植接体6にも関する。 図10及び11には、一部に丸みを帯びた横断面図を有する本発明植接体を示 す。 図10は軸方向前端部12の上縁に丸み31を有する植接体6の本体7を示す 。片側の丸み31の半径は、a)長方形横断面の長辺と丸みを帯びた縁端をよぎ る対角線との差が3mm未満、好ましくは1−2mmであり、b)小さい面が2 分の1未満、好ましくは3分の1未満だけ縮小されるように設計されている。即 ち支持面が植接体の全幅の少なくとも2/3に相当しなければならない。 図11は横断面で植接体が対角線上に夫々丸み32を有する植接体6の本体7 の横断面図を示す、相対する丸み32の半径は、a)横断面の長辺と丸みを帯び た縁端をよぎる対角線との差が3mm未満、好ましくは0.5−1.0mmであ り、b)植接体の小さい方の面が2分の1未満、好ましくは3分の1未満だけ縮 小されるように設計されている。 図12に対称軸33に関して対称に配列された2組の植接体6の対を示す。そ の場合部分(a)の2つの上側の植接体6は図10による植接体、部分(b)の 2つの下側の植接体6は図11による植接体を示す。 図6に示す植接体6を整列(回転)すると椎間腔25が約3−4mm過伸展さ れ、それが蓋板の割れや結合組織の永久過伸展を招く恐れがある。ところが縁端 が丸み(31、32)を有するならば、過伸展が大幅に減少されるが、整列され た植接体の安定性もそれと共に減少するので対をなす植接体を相互に安定化する ために左右対称に配列しなければならない(図13)。 丸み31又は32の半径を適当に選定すれば、丸み31又は32を具備する2 個の植接体の整列が椎間腔25の僅か1mmの過伸展をもたらすに過ぎない。と ころがその代わり個々の整列された植接体6はあまり安定でない。整列されたの と同じく傾倒するのもたやすいからである。図13では2個の植接体6が相互の 左右対称な幾何学的形状により転倒を防止される。なぜなら植接体6は専ら組合 せとしてしか転倒せず、個別には転倒し得ないからである。 図13に図11による2個の左右対称に配列された植接体6を示す。その場合 本体7の丸み32は互いに対称になっている。植接体6の本体7は挿入の後に椎 体1及び2の間に水平に横たわり、次いで椎間腔25を伸展するために黒色で示 す位置7´に適当な器具9により90゜回転することができる。本体7の長方形 横断面は、隣接する椎体1、2の蓋板の凹面へ植接体6を90゜回転した後に椎 間腔25の1ないし4mm、好ましくは2−3mmの伸展が残るように構成され ている。 図14にはコネクタ34で前部が互いに連結され、椎間腔25(図平面)で扁 平に横たわる2個の植接体6を示す。図14の左側部分には植接体6の回転の前 の位置、図14の右側部分には隣接する椎体の蓋板の凹面へ90゜回転した後の 位置を示す。 植接体6の後端部は自由であり、前部だけがコネクタ34によって連結されて いるから(a)左右の植接体6の間の間隔と相互の整列が維持され、(b)植接 体6は縦軸35の回りに回転可能であり、(c)2つの植接体6を植接の前に及 び/又はその場でコネクタ34で結合することができる。 図15には海綿状骨材料若しくは骨伝導性又は骨誘導性材料を納めるための縦 切り口36及び骨成長のための壁部の横穴37を有する植接体6を示す。穴37 の直径は(a)縦開口部36に圧入された海綿状体が横に脱出せず、(b)海綿 状体に含まれる液が植接体6を押し込む時に横に脱出せず、海綿状体の術後膨張 を生じさせるために、植接の後に再び逆拡散することができ、(c)骨が穴37 を通って植接体(6)の中に成長することができるように設計することが好まし い。 図16には植接体6と骨との接触面が縦刻み38を具備する植接体6を示す。 縦刻み38は、矢印39、40で示唆するように、蓋板の凹面への植接体6の回 転が一方の方向にだけ可能であるように形成することが好ましい。 図17には植接体6と骨との接触面が横刻み41を具備する植接体6を示す。 横刻み41は、矢印42、43で示唆するように、一方の接触面が前方への並進 運動を、他方の接触面が後方への並進運動を阻止するように設計することが好ま しい。前方への並進運動の阻止は残留する椎間輪の負担を軽減する。この椎間輪 は最近の研究によれば神経支配されており、従って前方圧迫に対して疼痛信号で 反応するのである。 本発明は、例として示し、図に示したモデルに決して限らない―別紙の要約書 に示す定義の範囲から逸脱しなければ、このような拡張器及び付属の器具を種々 の形状と大きさで製造することができる。

Claims (1)

  1. 【特許請求の範囲】 1.器具(9)により把持するための装置(8)を備えたおおむね直方体状の 本体(7)からなることを特徴とする椎間腔(25)のための植接体(6)。 2.装置(8)が植接体(6)への回転力の行使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に記載の植接体。 3.装置(8)が本体(7)の内側に設けた、少なくとも1個の空欠部からな り、好ましくはキー状の器具(9)をこの空欠部に挿入し得ることを特徴とする 請求項1又は2に記載の植接体。 4.空欠部が本体(7)の内側に設けた六角穴からなることを特徴とする請求 項3に記載の植接体。 5.装置(8)が少なくとも植接体(6)に対する軸方向力、圧縮力又は引張 力の行使が可能であるように形成されていることを特徴とする請求項1ないし4 のいずれか1つに記載の植接体。 6.器具(9)の取付けのための内側空欠部の形の装置(8)を有し、器具( 9)に対する軸方向ロッキング(Sperrung)を有する2個の取り付け部材(27 )が上記空欠部に設けられていることを特徴とする請求項1ないし5のいずれか 1つに記載の植接体。 7.装置(8)が少なくとも植接体(6)に対する横力の行使が可能でるよう に形成されていることを特徴とする請求項1ないし6のいずれか1つに記載の植 接体。 8.異なる直径(D1.D2)を有することを特徴とする請求項1ないし7の いずれか1つに記載の植接体。 9.その間で最小直径(D1)が伸張する側面(14及び15)の大部分が平 行かつ平坦であることを特徴とする請求項8に記載の植接体。 10.最大直径(D2)の縦断面図で植接体(6)が面取りしたレンズ状の輪 郭を有することを特徴とする請求項8又は9に記載の植接体。 11.面取りしたレンズ状の輪郭を挾む側面(15、16)が植接体(6)に 対して横方向に少なくとも部分的に平坦であることを特徴とする請求項10に記 載の植接体。 12.植接体の少なくとも一方の軸方向端部(10;12)が丸みを帯びてい ることを特徴とする請求項1ないし11のいずれか1つに記載の植接体。 13.本体(7)が移植材料(24)の充填のための単数個又は複数個の開口 (18)を有し、植接体(6)の最終的位置で移植材料(24)が椎体(1.2 )に接触するように上記の開口が設けられていることを特徴とする請求項1ない し12のいずれか1つに記載の植接体。 14.植接体(6)が平行な壁面(19、20)を備えた縦長のみぞの形の貫 通する開口(18)を具備することを特徴とする請求項1ないし13のいずれか 1つに記載の植接体。 15.2つの端部に装置(8、26)を具備することを特徴とする請求項1な いし14のいずれか1つに記載の植接体。 16.チタン又はチタン合金からなることを特徴とする請求項1ないし15の いずれか1つに記載の植接体。 17.片側の丸み(31)を備えた長方形横断面を有することを特徴とする請 求項1ないし16のいずれか1つに記載の植接体。 18.a)長方形横断面の長辺と丸みのある縁端をよぎる対角線との差が3m m未満、好ましくは1−2mmであり、 b)骨との接触面が丸み(31)によって2分の1未満、好ましくは3分の1 未満だけ縮小される。 ように片側の丸み(31)の半径が設計されていることを特徴とする請求項1 7に記載の植接体。 19.対角線上に両側の丸み(32)がある長方形横断面を有することを特徴 とする請求項1ないし18のいずれか1つに記載の植接体。 20.a)横断面の長辺と丸みのある縁端をよぎる対角線との差が3mm未満 、好ましくは0.5−1.0mmであり、 b).植接体の小さい方の面が2分の1未満好ましくは4分の1未満だけ縮小 される ように両側の丸み(32)の半径が設計されていることを特徴とする請求項1 9に記載の植接体。 21.このような植接体の一対配列で、その丸みを帯びた縁端が互いに対称に なっていることを特徴とする請求項19又は20に記載の植接体。 22.隣接する椎体の蓋板の凹面へ植接体を回転した後、1ないし4mm好ま しくは2−3mmの椎間腔(25)の伸展が残るように構成された長方形横断面 を有することを特徴とする請求項19ないし21のいずれか1つに記載の植接体 。 23.正方形に縮小された横断面を有し、隣接する椎体の端板の凹面へ植接体 を回転した後、椎間腔(25)の伸展が残らないことを特徴とする請求項19な いし21のいずれか1つに記載の植接体。 24. (a)左右の植接体(6)の間隔とその整列が維持され、 (b)植接体(6)がその縦軸(35)の周りに回転可能であり、 (c)2個の植接体(6)の植接の前に及び/又はその場でコネクタ(34)で 結合することができるように、 左右の植接体の前部がコネクタ(34)で連結し得るように植接体(6)の後端 部を構成したことを特徴とする請求項19ないし22のいずれか1つに記載の植 接体。 25.植接の前に又はその場で第2の植接体(6)で固定されるように構成さ れ、その際この結合が (a)植接体(6)の間の間隔及び角を維持し、 (b)隣接する椎体(1、2)の蓋板の凹面へ植接体(6)をその縦軸(35) の周りに回転することを許容する ことを特徴とする請求項19ないし22のいずれか1つに記載の植接体。 26.縦軸(35)の周りに蓋板の凹面へ回転した後、内側で別の植接体によ り角安定に連結されるように構成されていることを特徴とする請求項19ないし 22のいずれか1つに記載の植接体。 27.表面が好ましくは水酸化燐灰石又はチタンプラズマで被覆されているこ とを特徴とする請求項19ないし26のいずれか1つに記載の植接体。 28.多孔壁を有し、パーホレーシヨン(Perforation)(37)が好ましく は穴状であり、穴の直径が(a)縦長の開口部に圧入された海綿状体が横に脱出 せず、 (b)海綿状体の術後膨張を生じるために、海綿状体に含まれた液が植接体の移 植の後に再び逆拡散することができ、 (c)骨がパーホレーション(Perforation)を経て植接体の中に成長すること ができる ように設計されていることを特徴とする請求項13、14及び19−27のいず れか1つに記載の植接体。 29.植接体と骨の間の一方の接触面が植接体の縦方向のラスター構造を有す ることを特徴とする請求項19−28のいずれか1つに記載の植接体。 30.植接体と骨の間の両方の接触面が植接体の縦方向のラスター構造を有す ることを特徴とする請求項19−28のいずれか1つに記載の植接体。 31.ラスター構造の幾何学的形状が一方の方向への植接体の回転を許容し、 他方の方向への回転を阻止することを特徴とする請求項29又は30に記載の植 接体。 32.植接体と骨との間の一方の接触面が横ラスター構造を有することを特徴 とする請求項19−28のいずれか1つに記載の植接体。 33.植接体と骨との間の両方の接触面が横ラスター構造を有することを特徴 とする請求項19−28のいずれか1つに記載の植接体。 34.ラスター構造の幾何学的形状が植接体の前方へのずれを阻止することを 特徴とする請求項32又は33に記載の植接体。 35.ラスター構造の幾何学的構造が植接体の後方へのずれを阻止することを 特徴とする請求項32又は33に記載の植接体。 36.一方のラスター構造が植接体の前方へのずれを阻止し、他方のラスター 構造が後方へのずれを阻止するように、植接体と骨の間の両方の接触面のラスタ ー構造の幾何学的形状が形成されていることを特徴とする請求項32に記載の植 接体。 37.一方の接触面の縦ラスター構造と他方の接触面の横ラスター構造を有す ることを特徴とする請求項29又は32のいずれか1つに記載の植接体。 38.後方及び前方へのずれが阻止されるように個々の接触面の横ラスター構 造が設計されていることを特徴とする請求項32−35又は37のいずれか1つ に記載の植接体。 39.壁面(19)及び(20)が横スリットを有することを特徴とする請求 項13、14及び請求項19−17及び29−38のいずれか1つに記載の植接 体。 40.隣接する椎体の蓋板から骨が中に成長することができるように、空洞部 及びスリットが骨伝導性又は骨誘導性材料、好ましくは水酸化燐灰石で充填され ていることを特徴とする請求項39に記載の植接体。 41.a)一辺の長さa,b,cのおおむね直方体状の形状、 b)縦軸(35)が貫く軸方向前端面(12)及び軸方向後端面(10)、 c)横軸(44)が貫く2つの側面(14、15)、 d)横軸(45)が貫く上面(16)及び下面(17) を有する椎間腔(25)のための植接体において、 e)植接体(6)が器具(9)により把持するための装置(8)を有し f)軸方向前端面(12)及び/又は軸方向後端面(10)が長方形に形成され ていることを特徴とする植接体。
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DE59410425D1 (de) 2006-01-12
DE59410451D1 (de) 2007-05-24
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CA2151481A1 (en) 1995-03-30
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WO1995008306A1 (de) 1995-03-30
US5888224A (en) 1999-03-30
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CA2151481C (en) 2004-11-23
EP1464306B1 (de) 2007-04-11
EP0670702B1 (de) 2007-04-11
ES2255011T3 (es) 2006-06-16
EP1447061A1 (de) 2004-08-18
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EP1447061B1 (de) 2005-12-07
EP1464306B2 (de) 2014-06-11

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