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WO2019013559A1 - Cage de fusion vertébrale oblique autonome - Google Patents

Cage de fusion vertébrale oblique autonome Download PDF

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Publication number
WO2019013559A1
WO2019013559A1 PCT/KR2018/007880 KR2018007880W WO2019013559A1 WO 2019013559 A1 WO2019013559 A1 WO 2019013559A1 KR 2018007880 W KR2018007880 W KR 2018007880W WO 2019013559 A1 WO2019013559 A1 WO 2019013559A1
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WO
WIPO (PCT)
Prior art keywords
wall
screw
fusion cage
self
screw hole
Prior art date
Application number
PCT/KR2018/007880
Other languages
English (en)
Korean (ko)
Inventor
강국진
최윤서
Original Assignee
(주)엘앤케이바이오메드
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 (주)엘앤케이바이오메드 filed Critical (주)엘앤케이바이오메드
Publication of WO2019013559A1 publication Critical patent/WO2019013559A1/fr

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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, e.g. tourniquets
    • 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, setting implements or the like
    • 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 ; Bone stabilisers comprising fluid filler in an implant
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • 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
    • 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
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs

Definitions

  • the present invention relates to a self-standing, lateral spinal fusion cage, and more particularly, to a self-standing, lateral spinal fusion cage capable of being inserted in an oblique direction between an abdomen and a flank.
  • the vertebrae consist of 32 to 35 vertebrae and intervertebral discs between the vertebrae, which form the backbone of our body connecting the upper skull to the lower pelvis.
  • the vertebrae consist of 7 cervical, 12 thoracic, 5 lumbar, 5 sacrum, and 3 ⁇ 5 coccyx in the upper part, It merges into one sacrum, and 3 ⁇ 5 spines are united to become one sacrum.
  • spinal fusion is a surgical procedure in which adjacent vertebral bodies are fused together by inserting a cage that removes the intervertebral disc and replaces it.
  • the lumbar interbody fusion (PLIF), Transformational Lumbar Interbody Fusion (TLIF) and Direct lateral Lumbar Interbody Fusion (TLIF) Fusion, DLIF, Oblique Lumbar Interbody Fusion (OLIF), and Anterior Lumbar Interbody Fusion (ALIF).
  • PLIF lumbar interbody fusion
  • TLIF Transformational Lumbar Interbody Fusion
  • TLIF Direct lateral Lumbar Interbody Fusion
  • DLIF Oblique Lumbar Interbody Fusion
  • ALIF Anterior Lumbar Interbody Fusion
  • Posterior fusion is a method of incision along the center line of the spine, opening to expose all of the vertebral bodies, removing the posterior side of the vertebra, removing the disc, and inserting the PLIF cage.
  • Posterior lumbar interbody fusion is the oldest method of lumbar interbody fusion and is a necessary method for two or three intervertebral fusion.
  • PLIF Posterior lumbar interbody fusion
  • the PLIF cage is placed on both sides of a pair of small cages, the smallest of the cages used for all spinal fusion.
  • Transverse intervertebral disc fusion is a surgical procedure for inserting a disc into a TLIF cage, with a small incision along both sides of the vertebral muscle and exposing the vertebral body at least to the direction of the nerve ball.
  • This surgical technique is suitable for one-sided surgery because of the advantages of less bleeding and shortening of the operation time, but PLIF surgery is necessary when various operations are needed.
  • the TLIF cage is mostly arcuate, so it is inserted into the vertebral body and rotated so that the convex portion of the TLIF cage faces down.
  • the TLIF cage is larger than the PLIF cage, but the supporting area is smaller than the DLIF cage or ALIF cage that will be mentioned later.
  • Anterior cruciate ligament reconstruction has several advantages such as quick recovery of the operation and no need to worry about adhesion, but it has a disadvantage in that it requires advanced skill because it is incised forward and approaches the spine. have.
  • the ALIF cage has the largest support area among all spinal fusion cages.
  • Lateral lumbar interbody fusion has the advantage that the space between the vertebrae and vertebrae can be widened more widely than the existing incisional lumbar surgery because of the operation through the lateral incision.
  • problems such as psoas muscle and peritoneum around the operation path, and thigh muscle paralysis when there is a mistake during surgery.
  • the DLIF cage is smaller than the ALIF cage, but larger than the PLIF cage or the TLIF cage.
  • a safer and more effective method of operation than the lateral femoral fusion is the lateral femoral interbody fusion (OLIF).
  • OLIF lateral femoral interbody fusion
  • the possibility of damaging the nerves that are problematic in the lateral lumbar fusion is remarkably small.
  • OLIF cage uses a conventional PLIF cage or a cage that is slightly longer than the OLIF cage, the amount of BGM (bone graft material) filled in the window of the cage is small, There is also a disadvantage of.
  • the cervical interbody fusion technique has a small curvature in the vertebral body and a small inter-vertebral distance compared with the ALIF, there is an inconvenience that a separate plate is required to be fixed when the OLIF cage is fixed with the screw.
  • Patent Document 1 US 2016-0310294A1
  • Patent Document 2 US 9474624
  • the present invention relates to a self-standing, lateral spinal fusion cage, and more particularly, to a self-standing, lateral spinal fusion cage capable of being inserted in an oblique direction between an abdomen and a flank.
  • a spinal column comprising: a body inserted between a vertebra and having a pair of screw holes into which a screw is inserted; And a lock plate rotatably mounted on a plate mounting portion formed between the pair of screw holes in the main body, wherein the lock plate includes a pair of screw holes for opening the pair of screw holes, And an interference portion formed integrally with the non-interfering portion and adapted to lock the pair of screw holes in a predetermined angle range according to the rotation of the lock plate, wherein a screw hole is formed in the interfering portion In the spinal canal.
  • the head of the screw inserted into the screw hole of the main body is formed with a head screw.
  • the head of the screw inserted into the screw hole of the lock plate is formed with a head screw.
  • the lock plate is provided with a lock mechanism for covering a part or all of the screw inserted into the screw hole of the lock plate.
  • the lock plate is provided with a lock mechanism mounting portion provided with the lock mechanism, and the lock mechanism mounting portion can be provided with a tool before the lock mechanism is installed.
  • the body includes a front wall having the screw hole formed therein, a long side wall formed to be connected to one side of the front wall, a short side wall formed to be connected to the other side of the front wall and having a shorter length than the long side wall, And a transverse wall connecting the opposite end of the long side wall of the long side wall to the opposite side end of the short side wall, the transverse wall facing the back of the vertebral body, And an acute angle.
  • connection wall is formed between the front wall and the long side wall, and the connection wall is parallel to the lateral wall.
  • the height is gradually increased along a direction perpendicular to the transverse wall.
  • the connecting portion between the transverse wall and the long side wall is characterized in that the height gradually decreases along a direction orthogonal to the front wall.
  • the present invention can produce a self-standing, lateral spinal fusion cage which can be stably fixed to a vertebra without using a separate plate.
  • FIG. 1 is a perspective view of a self-standing, lateral side vertebra spinal fusion cage according to an embodiment of the present invention.
  • FIG. 2 is an exploded perspective view of the self-standing, labial spinal fusion cage of FIG. 1;
  • Fig. 3 is a plan view of the body in Fig. 2;
  • FIG. 4 is a perspective view of the self-standing, lateral spinal fusion cage of FIG. 1, in which a screw is inserted only into the main body.
  • FIG. 5 is a perspective view of the self-standing midsagittal spinal fusion cage of FIG. 1 in which a screw is inserted into a lock plate.
  • Fig. 6 is a plan view of Fig. 5.
  • FIG. 7 is a cross-sectional view of Fig.
  • FIG. 8 is a view showing a state in which the self-standing wrist spine fusion cage of FIG. 1 is applied.
  • reference numeral 100 denotes a self-standing, lateral-side vertebra spinal fusion cage according to an embodiment of the present invention.
  • the self-standing four-sided vertebra spinal fusion cage 100 includes a main body 102 to be inserted between the vertebrae 10 and a pair of screw holes And a lock plate 122 rotatably mounted on the plate mounting portion 114 formed between the plates 118 and 120.
  • a window 103 may be formed in the main body 102.
  • the body 102 may be made of a polymer material harmless to the human body such as polyether ether ketone (PEEK), or may be formed by bonding segments of a polymer material and segments of a metal material together.
  • PEEK polyether ether ketone
  • the metal is made of a metal material which is harmless to human body such as titanium or stainless steel.
  • the entire body may be made of a metal material.
  • the lock plate 122 may be made of a metal such as titanium or stainless steel because the load is considerably large.
  • the lock plate 122 is formed with a plate mounting portion 128 and is rotatably fixed to the plate mounting portion 114 formed on the main body 102.
  • the plate mounting portion 128 may be fixed by a rivet method or may be coupled to the inside of the main body 102 by using additional constituent means capable of engaging with the plate mounting portion 128.
  • the plate mounting portion 128 is formed as a tubular body, and as a further constituent means, a tube or a seal having a flange at one end abutting against the inner wall surface of the main body 102 is inserted into the plate mounting portion 128 Method can be used.
  • the locking plate 122 includes a non-interfering portion 129 for opening the pair of screw holes 118 and 120 in spite of the rotation of the locking plate 122, and a non-interfering portion 129 formed integrally with the non- And an interfering part 127 for locking the pair of screw holes 118 and 120 in a predetermined angular range according to the rotation of the lock plate 122.
  • the non-interfering portion 129 and the interfering portion 127 are in a form in which two semicircular (or arc-like) radii are in contact with each other.
  • the interference unit 127 When the interference unit 127 is lowered as shown in FIG. 4, the non-interfering portion 129 is upwardly opened and the screw holes 118 and 120 are opened. At this time, the screws 134 and 136 can be inserted and fixed through the screw holes 118 and 120. The screws 134 and 136 are fastened in a direction in which their distal ends are apart from each other, as shown in Fig.
  • the bushings 140 and 142 may be inserted into the screw holes 118 and 120, as shown in FIG.
  • the screw holes 118 may be damaged by the screws 134 and 136. Therefore, these damages can be prevented by the bushings 140 and 142 made of metal.
  • the shape of the bushings 140 and 142 may be a curved surface and the lower portions of the screws 134 and 136 may have curved surfaces corresponding to the curved surfaces of the bushings 140 and 142 to change the installation angles of the screws 134 and 136 It is possible.
  • a screw hole 124 is formed in the interference portion 127. 5, when the interference part 127 is upward and the non-interfering part 129 is downward, the screw hole 124 is located on the upper side, and the screw 138 is installed upward . At this time, the screw covers 123 located on both sides of the interference part 127 cover a part of the screw holes 118 and 120, thereby preventing the screws 134 and 136 from being pulled out.
  • a thread is formed in the screw hole 124 formed in the interference portion 127 and a head screw 139 formed on the head of the screw 138 is screwed to the screw, It is possible to prevent a pull-out.
  • a head screw and a thread can be similarly applied to the screws 134 and 136 and the screw holes 118 and 120.
  • a lock mechanism 130 may be installed on the lock mechanism mounting portion 126 as shown in FIG.
  • the lock mechanism 130 may have a shape of a bolt and a part of the bolt head may cover a part of the screw hole 124 or a screw cover 132 may be formed integrally with the bolt head, 124 may be used.
  • the lock mechanism mounting portion 126 may be coupled with a tool such as a holder before the lock mechanism 130 is installed.
  • the body 102 since the body 102 has a unique shape, it is possible to secure a support area comparable to that of the ALIF cage according to the prior art, while being suitable for the mastoid body fusion.
  • the main body 102 includes a front wall 104 on which the screw holes 118 and 120 are formed, a long side wall 106 connected to one side of the front wall 104, A front side wall 104 of the short side wall 108 and a short side wall 108 formed to be connected to the front side wall 106 and having a length shorter than that of the long side wall 106; And a transverse wall (110) connecting opposite ends.
  • the transverse wall 110 is directed rearward of the vertebral body 10 and the long side wall 106 and the transverse wall 110 are at an acute angle with respect to each other.
  • a connecting wall 107 is formed between the front wall 104 and the long wall 106 and the connecting wall 107 is parallel to the lateral wall 110.
  • the transverse wall 110 corresponds to the front side wall of the conventional ALIF cage 20, and the connecting wall 107 can be formed to correspond to the rear side wall of the conventional ALIF cage 20.
  • the vertical distance between the long side wall 106 and the short side wall 108 determines the width at which the self-standing midsagittal spinal fusion cage 100 is inserted.
  • the long side wall 106 and the short side wall 108 are substantially parallel to each other.
  • the self-standing midsagittal spinal fusion cage 100 is formed so that its height gradually increases along a direction orthogonal to the lateral wall 110, similar to the conventional ALIF cage 20. That is, the rear side of the patient is thinly disposed and the front side is thick.
  • the OLIF cage is similar to the PLIF cage in that the overall OLIF cage has a uniform overall thickness.
  • Such a special shape of the main body 102 makes it possible to insert into the side of the front side while circumscribing the conventional ALIF cage depicted in FIG. Further, the window 103 of the main body 102 can be filled with sufficient BGM.
  • the connecting portion 112 between the transverse wall 110 and the long side wall 106 is gradually lowered in the direction of insertion, that is, along the direction orthogonal to the front wall 104, , It is somewhat advantageous when first inserting the self-standing mitered spinal fusion cage 100 between the vertebral bodies.
  • Spikes may be formed on the upper surface of the main body 102.
  • the spikes are intended to be stably positioned between the vertebrae 10 and may be disposed parallel to the transverse walls 110.
  • FIG. 8 shows a state in which the self-standing cervical vertebra spinal fusion cage 100 is inserted into the vertebral body 10 and an insertion angle? Is 25 to 45 degrees, preferably 35 . Therefore, when the cage entry space is secured by a mechanism such as a retractor, the self-standing midsagittal spinal fusion cage 100 can be seated in the space between the vertebrae 10.

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Neurology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • Cardiology (AREA)
  • Vascular Medicine (AREA)
  • Transplantation (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Prostheses (AREA)

Abstract

La présente invention concerne une cage de fusion vertébrale oblique autonome pouvant être insérée dans une direction inclinée entre l'abdomen et le flanc. La cage de fusion vertébrale oblique autonome comprend : un corps principal inséré entre des corps vertébraux et ayant une paire de trous de vis ayant des vis insérées dans celui-ci; et une plaque de verrouillage montée rotative sur une partie de montage de plaque formée entre la paire de trous de vis au niveau du corps principal. La plaque de verrouillage a : une partie de non-interférence permettant à la paire de trous de vis d'être dans un état ouvert indépendamment de la rotation de la plaque de verrouillage; et une partie d'interférence formée d'un seul tenant avec la partie de non-interférence et permettant à la paire de trous de vis d'être dans un état verrouillé dans une plage angulaire prédéterminée en fonction de la rotation de la plaque de verrouillage, un trou de vis étant prévu sur la partie d'interférence.
PCT/KR2018/007880 2017-07-13 2018-07-11 Cage de fusion vertébrale oblique autonome WO2019013559A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
KR10-2017-0089231 2017-07-13
KR20170089231 2017-07-13

Publications (1)

Publication Number Publication Date
WO2019013559A1 true WO2019013559A1 (fr) 2019-01-17

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ID=65002618

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Application Number Title Priority Date Filing Date
PCT/KR2018/007880 WO2019013559A1 (fr) 2017-07-13 2018-07-11 Cage de fusion vertébrale oblique autonome

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WO (1) WO2019013559A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
KR20210011786A (ko) * 2019-07-23 2021-02-02 이상호 사측방 삽입형 추간 케이지

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
KR20050059297A (ko) * 2001-04-06 2005-06-17 에스디지아이 홀딩스 인코포레이티드 전방 고정 시스템 및 방법
KR20080085010A (ko) * 2005-12-05 2008-09-22 스파인아트 에스에이 척추의 정형 및 체내 유합용 케이지
KR101524532B1 (ko) * 2014-12-01 2015-06-01 조대진 척추 임플란트용 추간 케이지
US20160045332A1 (en) * 2014-03-11 2016-02-18 Spinesmith Partners, L.P. Collapsible two-piece olif implant
JP2016527004A (ja) * 2013-07-17 2016-09-08 イスキュラプ インプラント システムズ エルエルシー 椎体間固定用の装置、システム、及び方法

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
KR20050059297A (ko) * 2001-04-06 2005-06-17 에스디지아이 홀딩스 인코포레이티드 전방 고정 시스템 및 방법
KR20080085010A (ko) * 2005-12-05 2008-09-22 스파인아트 에스에이 척추의 정형 및 체내 유합용 케이지
JP2016527004A (ja) * 2013-07-17 2016-09-08 イスキュラプ インプラント システムズ エルエルシー 椎体間固定用の装置、システム、及び方法
US20160045332A1 (en) * 2014-03-11 2016-02-18 Spinesmith Partners, L.P. Collapsible two-piece olif implant
KR101524532B1 (ko) * 2014-12-01 2015-06-01 조대진 척추 임플란트용 추간 케이지

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
KR20210011786A (ko) * 2019-07-23 2021-02-02 이상호 사측방 삽입형 추간 케이지
WO2021015478A3 (fr) * 2019-07-23 2021-05-14 이상호 Cage intervertébrale du type à insertion latérale oblique
KR102339110B1 (ko) * 2019-07-23 2021-12-13 이상호 사측방 삽입형 추간 케이지

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