JPH02111359A - 治療用物質を含むプロテーゼの円板 - Google Patents

治療用物質を含むプロテーゼの円板

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Publication number
JPH02111359A
JPH02111359A JP1191230A JP19123089A JPH02111359A JP H02111359 A JPH02111359 A JP H02111359A JP 1191230 A JP1191230 A JP 1191230A JP 19123089 A JP19123089 A JP 19123089A JP H02111359 A JPH02111359 A JP H02111359A
Authority
JP
Japan
Prior art keywords
disc
capsule
prosthetic
semipermeable membrane
fluid
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.)
Pending
Application number
JP1191230A
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English (en)
Inventor
Charles D Ray
チャールズ　ディー．レイ
Terry P Corbin
テリー　ピー．コービン
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.)
Cedar Surgical Inc
Original Assignee
Cedar Surgical Inc
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 Cedar Surgical Inc filed Critical Cedar Surgical Inc
Publication of JPH02111359A publication Critical patent/JPH02111359A/ja
Pending legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/02—Inorganic materials
    • A61L27/04—Metals or alloys
    • 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
    • A61F2/441—Joints for the spine, e.g. vertebrae, spinal discs made of inflatable pockets or chambers filled with fluid, e.g. with hydrogel
    • 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
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2/4603—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4611—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/40—Composite materials, i.e. containing one material dispersed in a matrix of the same or different material
    • A61L27/44—Composite materials, i.e. containing one material dispersed in a matrix of the same or different material having a macromolecular matrix
    • C—CHEMISTRY; METALLURGY
    • C08—ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
    • C08L—COMPOSITIONS OF MACROMOLECULAR COMPOUNDS
    • C08L67/00—Compositions of polyesters obtained by reactions forming a carboxylic ester link in the main chain; Compositions of derivatives of such polymers
    • C08L67/04—Polyesters derived from hydroxycarboxylic acids, e.g. lactones
    • 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
    • A61F2/3094—Designing or manufacturing processes
    • A61F2/30965—Reinforcing the prosthesis by embedding particles or fibres during moulding or dipping
    • 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
    • A61F2/442—Intervertebral or spinal discs, e.g. resilient
    • 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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/3006—Properties of materials and coating materials
    • A61F2002/30062—(bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
    • 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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/30224—Three-dimensional shapes cylindrical
    • A61F2002/30235—Three-dimensional shapes cylindrical tubular, e.g. sleeves
    • 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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30667—Features concerning an interaction with the environment or a particular use of the prosthesis
    • A61F2002/30677—Means for introducing or releasing pharmaceutical products, e.g. antibiotics, into the body
    • 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
    • A61F2002/448—Joints for the spine, e.g. vertebrae, spinal discs comprising multiple adjacent spinal implants within the same intervertebral space or within the same vertebra, e.g. comprising two adjacent spinal implants
    • 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
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2/4603—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2002/4625—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof with relative movement between parts of the instrument during use
    • A61F2002/4627—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof with relative movement between parts of the instrument during use with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument
    • 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
    • A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2210/0004—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof bioabsorbable
    • 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
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0069—Three-dimensional shapes cylindrical
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L2430/00—Materials or treatment for tissue regeneration
    • A61L2430/38—Materials or treatment for tissue regeneration for reconstruction of the spine, vertebrae or intervertebral discs
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S128/00—Surgery
    • Y10S128/20—Inflatable splint
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S424/00—Drug, bio-affecting and body treating compositions
    • Y10S424/07—Microporous membranes

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  • Health & Medical Sciences (AREA)
  • Chemical & Material Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Transplantation (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Medicinal Chemistry (AREA)
  • Neurology (AREA)
  • Vascular Medicine (AREA)
  • Dermatology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Epidemiology (AREA)
  • Cardiology (AREA)
  • Composite Materials (AREA)
  • Polymers & Plastics (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Inorganic Chemistry (AREA)
  • Materials Engineering (AREA)
  • Organic Chemistry (AREA)
  • Dispersion Chemistry (AREA)
  • Prostheses (AREA)
  • Medicinal Preparation (AREA)
  • Materials For Medical Uses (AREA)

Abstract

(57)【要約】本公報は電子出願前の出願データであるた
め要約のデータは記録されません。

Description

【発明の詳細な説明】 産業上の利用分野 本発明は、流体充満前及びその流体の修１１例をと同じ
であり得るブＩＪテーゼの円板（ｐｒＯ３ｔｈｏｔｉｃ
ｄ＋ｓｅ　）に関する。前記出願は、組織の内に伸びる
ことを誘因し且つ流体充満８を取囲む生体吸収０１能な
材料を註ぜ合せた強い不活性線維の外方層をＬｌするＩ
Ｉ技い円筒状のブ〔１デーＵの柑（ｆ　１５１の円板包
を記載している。流体は好ましくは円板間の核組織の生
来のし４’　ｌ’ｌジー（ｒｈｃｏ　Ｉｏｑｖ　）を模
倣する粘度及び速度ｒＪ１断行動を有する１ヱ変性のゲ
ルである。また、前記出願ＬＵ変質した円板をＪｉ復す
るために一対の包を埋没するための簡単な外Ｈ的装置を
記載している。前記出願の円板と同様に、対の１１ｉ現
な円板が＊　４ｆｆ　ｆＪ＋物のを椎、特に人のを椎の
変質した円板を修復するために埋没され得る。
従来の技術及び発明が解決しようとする課題正常な４（
を骨間の円板は輪と呼ばれる外り靭帯の輪を有し、それ
は隣接の椎骨を一緒に結合し且つコラーゲンｌＩＡ維で
構成され、該コラーゲン線ＨＡ、１椎骨へ連結され口つ
ηいに交差しているの′Ｃ″個々の線維の半分は椎骨が
いずれかの方向へ回転−する時に緊張し、それにより捩
じれ又ｌよ捩じり運動に抵抗する。ｍ骨の分節間の捩じ
り運Ｈ）は閏節面の関節によって更に制限さ′れる。
輪の内側深くに、滑り易＜且つ粘液性であり（約８５％
の水含ｍを有り゛る）且つ前から（υろへ又は側から側
への曲げ中に周りに移動する弛い組織の核髄質がある。
このため、椎骨の対向りる表面が曲げによって！ｊいに
それらの平行イｒｉｌｌ係を変える時に、核組織（よ周
りへ移動し、円板空間の両端に生ずる間隔（＆！！作用
）の変化を満たり。曲げによって、輪は下’Ｒの楔状に
された側で膨らみｆｌつ上方の楔状にされた側で緊張さ
れる、。
輪状ＦＡＲが弱められ又はちぎられたＢ、？に古典的な
円板ヘルニア形成が起こり且つ核の内方組織は永久的に
膨らみ、広げられ、又はその正常な輪状囲いから突き出
されるようになる。そのような場合に脚の痛みが、この
核組織（又は完全な弱められ、膨らんだ輪）がを柱管か
ら脚へ外方へ通る神経を圧縮ηることから生ずる。
持続的で無能にする背の痛みの主な原因は輪が変質リー
る過程にＪ：つて慢性的に炎症を起こりｈに生ずる。輪
の外側を取囲む枝からくる小さい神経は輪ね肺中へ短い
距１ｌＩＩ（おイらく６・〜８　ｗｒ　）だけ日入する
。輪の線ｍ層の間の接合の損失のための線維層間の一定
の異常な運動は小さい痛みの線維神経終末を伸ばし且つ
研磨することがある。このため患者は（Φかな動きに敏
感になる。これらの場合は痛い分節での椎骨間の円板に
なんらかの形の機械的制限を必要とする。最も永続的な
場合について（、玉、骨質の融合が椎骨を一緒に永久的
に鎖錠りることによって痛い運動を止めるためにしばし
ば行われる。多くの場合、若干の小さい運ＩＪ　（痛み
を生ずる運動より小さい運動）を許ずことは好ましいこ
とがある。若干の運動を保つことは近くの分節での機械
的旧傷を防止Ｊる助けをづる。現在、これらの可撓性の
融合をｆｌつ且つ維持する試みは信頼し得る稈に実ｆ１
可能−（はない。
核組織がヘルニア形成され又ｔよ外尋１によって除去さ
れる時、円板空間は狭く「１つく００Ｊ妨刊の多くを失
う。回転が輪及び核にス；ｌ　シー’Ｃ潜在的に破壊的
であることを考えると、回転１．Ｌ、除去され、ヘルニ
ア形成され又は変質した円板に代わるブ１．１テーゼの
装置にＪ：つてル１１限さ゛れると同時に曲げ、特に前
方及び後方の曲げを語Ｊことは（ＩＴましい。横方向の
曲げは重要性が少ない。円板空間の高さ及び椎骨の分節
の重要な運動の両方を保つために現在使用される装置を
知らないが、多数の患者はこれらの［１的に有効である
と苦われるプロチー１２の装置を評づる。例えば、米国
４’ｒ　ＩＩ”ｉ第３，８７５゜５９５号（フロニング
）は椎骨間の円板の核１ｌｌｆｉ背１全体に代わるよう
に形成されたプロｉ−げ（ｐｒｏｓｔｈｃｓｉｓ＞を示
している。フロニングの１プロテーゼは調節可能な圧力
゛Ｃ流体及び／叉はプラスチックを満たした中空の１１
１撓竹嚢状部月である。圧力はブロデーゼが試行錯誤に
よって最適な１１力を決定り−るために成る時間にわた
って所定の（ｒｌ′ｊＩｉにある間に増加され又は減少
されることができ、その時！ロデーゼのスデムが除去さ
れる。ｌｕＬ適り圧力は、正常な円板の特徴を複製７Ｊ
る特徴である８張する内容物の消耗を回避するに充分な
だ（Ｊ円板内で通常（トじる圧力下に流体又は水を保つ
慴質を右づる膨張する流体又（ニブラスチックを備える
ことによって無限の時間にわたって雑持される１　（第
１欄、第３０〜４］ｒ）。７０ニングのブ■】テーゼは
、ブロテ〜ゼを滑動不陸に係止するために隣接の椎骨の
骨質端板を通して押込まれたソケツ１へに嵌合１Ｊる棒
状突出部をもする。
米国特許用４，３４９．９２１号（クンツ）は、高密度
ポリ１チレン、ポリメタクリレート、ステンレス鋼、父
はり［Ｊムコバルト合金のような生物学的に受入れられ
青る材料から伯られ１−１つ−Ｆ来の円板に代わるよう
に１法的に形成された椎骨１ｍの円板ブ０テーゼを示し
ている。プ［１テアーゼの長子方向端の一方は取扱を容
易にづるため及び過大な深さまでｍ入するのをＮ１止づ
るために高められた７ランジを存することができると共
に他りの艮■＝方向端ＩＪ挿入を容易にηるために樹形
状にされている。上位及び１・１０面は「摩擦嵌合Ｊを
生ずるために渦、波形又は突起のよう【１人面特性を猫
λ月つ隣接の椎骨の表面に７・１応するように凸面であ
る。
米国特許用３．８６７．７２８５３（スタブスタッドは
か）は種々の構造の椎骨間円扱ブ臼チーＵを示している
。これらのブ１コテ−Ｕのそれぞｔｌは、例えばシリコ
ーンゴム又はポリウレタンの」、うなエラストマーの強
化りｐ付ブｔコックのよう４ｉ弾竹ポリマーで作られた
芯と、聞いた孔組織て・内に伸びるのを受入れる材料の
外り表面を備えるカバーどを有する。図示されたプロテ
ーゼの大部分４１大の円板の形状に近似する形状の単一
の要家であり、「別の変形例１よ核励質が除去された生
米の円板の内部空間を占めるように並んで聞かれる形状
を有する複数ＩＭＪの可撓性の湾曲した棒状装本を含む
１（アブストラフ１〜の最１々から二番［１の分）。ａ
１２３図及び第２４図を参照されたい。甲−の又は多要
素のプロテーゼ′Ｃ″破壊された円板を修復するために
、椎骨間の空間は後方へ露出され１つ［Ｊ４弓切除が円
板空間へのより良い接近を得るため及び核髄質を除去し
且つプロチーげを挿入づる開口を備えるために行われる
・・・。を椎硬膜及び神経根は識別され、根は自由に切
開され、かつ−緒にそれらは横方向へ引込められてヘル
ニア形成を露出り゛る」（第１４欄、第１７〜２７行）
。ブ【］テチーを受入れる空間を作るために破壊されｌ
こ円板を一類した後、［プロテーゼの内に伸びる表面に
近接する端板は削られで弛んだ組織をきれいにし且つ出
血する表面を残して組織の内に伸びることにＪ、ってプ
ロテーゼの固定を促進する］　（第１４欄、第３５〜３
９行）。もし二要索のブ［Ｉ−７−ゼが使用されるなら
ば、［２つの分節はそれらを一緒にコード１２９によっ
て又は隣接の＋ｌｔ骨の１つ又は他の利用し得る組織へ
縫合することによって史に安定化されることができる］
　（第１４１１１、第４８〜５０行）。
椎骨の間に機械的に締着される椎骨間円板プロテーゼは
米国特許第４．５５４，９１４号（カップはか）、第４
，３０９，７７７号（バチル）、第３．４２６．３６４
号（ラム）、及び第４，６３６．２１７号（オジルビエ
はか）に示されている。
円板への血管の循環及び神経の供給は輪の外り層によっ
て制限され、神経は数ミリター１〜ルより多く貴人する
。内方の輪及び核への栄筏の大部分は椎骨体の端板を通
る拡散によって提供され、これらの骨は全く血管を有す
る。このため、中央の円板は体の最大の無血管及び非神
経支配の構造である。ちし椎骨の端板が硬性になる（硬
化される）ならば、種々の変質変化を起こることができ
る。
内方の円板への栄養警よゆっくり停止し、核及び輪の線
維の劣化、核の収縮、分節弛緩、蝕形成、円板空間圧壊
、自発的融合、及び他の変化を生ずる。
中央の円板の生理的分離は通常は循環する体液及び化学
品に対して完全であるので、生ｄ［を通して、円板が完
全のままであることを条！１として、内方円板にだけ特
有の母白質、Ｍ母及び他の化合物は体の成分の残りの成
分へ決して露呈されない。
イの結果として、円板層が＃）された時、隠れた内部円
板の成分は金体的な循環へ突然に露？されることがある
。多くの場合、抗原−抗体反応が、循環する免疫体系が
新しい「異様の」組織へ露呈される時に始まることがあ
る。自己の円板組織に対するフランク・アレルギー反応
が制御された初物実験で報告されている。
また、より重大な別の状態が起こることがあり、即ノう
外方の円板層に児られる繊細な自由な神経終末の複合し
た慢性の機械的及び化学的刺激である。
輪の割れが核物質をこれらの神経終末へ到達さぜ、輪の
線維の離層づる層の間の剪断ノＪが横開しｖ１通す゛る
自由神経終末を刺激する。これらの刺激は円板の外方輪
から生ずる機械的に誘発された急性の、口つ体位性の、
慢性の痛み知覚へ通じる。円板の前方の三方の−が深い
交感押杆の線維によって刺激され１つ接方の三方の二が
体幹の知覚線維によって刺澹されるので、複合した循環
性のが１泳が高く不愉快なｕつしばしば不１１にする痛
みを光住づる。現在、そのような一般の痛みに対する最
初の処置は、（イ）生活様式の変更、（［Ｉ）総合的４
ｆ活動水準の減少、（ハ）発展的イシ体操プログラム、
（ニ）抗炎症薬剤の使用、（ホ）外科的又は酵素の椎骨
板切除、又は（へ）骨の融合による機械的運動の停止で
ある。
課題を解決するための手段及び作用 本発明は、人の円板空間の高さに近い直径を有し１つ准
骨体の矢状方向の直径に近い良さをイＭ−する細長くさ
れた円筒状のプロチーじの椎骨間の円板包であって、該
包が、 化学的及び生物学的に不活性であり、１］つ半透膜を通
してゆっくり拡散し得る治療用物質を含む流体を囲む半
透膜を貝！ａする可撓性嚢と、流体を充満された膜を包
囲する強い３１の層とを含む。有効な治療用物質の中に
は、ホルモン、神経伝達物質ペプチド（ｎｃｕｒｏｔｒ
ａｎｓｍ已し０ｒｐｅｐｔｉｄｅ）　、抗炎症物質、神
経親和性因子、及び炎症の減らし、痛みを減らし、輪線
維又は核線維の修復を促進する作用をし、又は他の治療
作用を有Ｊるだめの物質がある。
臨床的研究が、局部麻酔（例えば１％リドカイン）のｆ
ｆ１（０，１ミリリットル位少ない）が機械的に痛い高
く敏感な円板の核の内側に注入され、痛みが通常は１０
秒以内に止み且つその後数時間完全に和らげられること
を明瞭に示している。そのような場合、円板空間の変質
変化はそれ自体特に重要でないが、不能にする痛みはそ
のような処ｎを要求する。
リドカイン又はブビバカインのような長く作用する麻酔
薬をおの流体中へ合体することによって、それらの半透
膜を通る徐々の透過は自由な神経終末を脱分極状態に保
ち、それにより痛みの放出を抑ｖＩＪる。メヂルブレド
ニゾロン又はデ４サメタゾンのようなＨ１槓可能なステ
ロイドを流体中へ合体することによって、それらの半透
膜を通る徐々の透過は乳房細胞によるアラ−１トン醇及
びヒスタミンの放出を減少し、それら両方はそうでな【
ノれば痛み受容体の自由な神経終末の焼けを誘発するで
あろう。また、完全に反対のアブ〔］−チが実行可能で
あり、即ら自由神経終末及び交感押杆末端の破壊を促進
し、それによりこれらの痛み受容体は離層された機械的
に不安定な輪層がら１除される。例えば、ブ［１チーＵ
の包の流体１よ６−ヒドロキシドパミン（ｈｙｄｒｏｘ
ｙｄｏｐａｉｉｎｃ　）　　（７ドレナリン作用の神経
終末を破壊する）又はビンブラスチン（ｖ＋ｎｂｌａｓ
ｔｉｎｅ　）　　（軸索の輸送を賄止すル）ヲ含むこと
ができ、これらの両方は知覚及び交感＃Ｉｌ経のａｍの
死及び向性後退を住する。
ｎの流体に合体され得る他の治療剤は、神経修復を促進
し且つ神経細胞の死を阻止じゃｌるポリペプチドのよう
な神経成長因子（ＮＧＦ）を含む。
ナノグラムの濃度で有効であるこの物質は現７］では細
菌遺伝子接合及び繁殖技術によつ（作られでいる。他の
治療剤はらざられた輪ＩｉＡ紐のような草木的な組織の
置換へ導く受容ａ胞の変ｔｇを発生ηることができる伝
染性成長因子を含む。
新規＜Ｅブ［ｌテーゼの円板包の對の半透ｎＬ＆可撓性
を有し且つ化学的及び生物学的に不活性であるべきであ
り、例えば、微孔質のボリテｉ〜ラフルオロエヂレン（
「Ｇｏｒｅ−ｒｅｘＪとして市販されている）又はボリ
テ１へラフルオロエチレンをプラズマ付着した配向され
たポリ（エチレンテレフタレート）ＬＭ紺の緊密に織ら
れた織物にューハンプシャーホリスの７トリアム・メデ
ィカル・＝１−ボレーシＥｌンによって「Ｐｌａｓｌａ
　ＨＥＪとして阪売されている）のような微孔質有機フ
ィルムである。半透膜の孔寸法は人の細胞の通過を阻止
するに充分小さくあるべきである１、人体の最小の細胞
１よ百１￥約７マイクし１メートルの赤血球ぐあるので
、凡用法は好ましくは７マイクロメードルより小さい。
赤血球はやや大ぎい孔に止められるが、これは孔を詰ま
らせる傾向があり、結局くれを使用不能にする。
１〜７マイク【］メートルのＡ−グーの孔寸法が殆どあ
らゆるイｊ効イ１治療剤を通Ｊことが一〇きる。
また、包は不透過性の有機フィルムからなることができ
、それは同様に可１蕗性を有するべきＴ″ある。適当な
不透過性有機フィルムは、配向されたポリ（エヂレンデ
レノタレ〜ト）、高密度ポリプロピレン、シリコーンゴ
ム、及びシリ：」−ン及びカーボネートのポリマーを含
み、その全ては化学的及び生物学的に不活性である。
［Ｇｏｒｅ−ＴｅｘＪ及びｌ　Ｐｌａｓｍａ　Ｈ［：Ｊ
半透膜のｉ方は管として販売され、その直径は人の円板
の厚さに近い。これらの管の１つは椎骨体の尖状直径に
近い長さに明所されることができ、目っその両端は不透
過性有機フィルムの円形体へ融６されることによって閉
じられることができる１、融石（よ熱シールによつＣ又
は超音波にＪ、って実施され（！ｌる。
図面の第１図に例示する包を形成するために、不透過性
フィルムの円形体の１つは同じ不透過竹材料の萱へ融も
されることができる。
鎖中に閉込められる流体は好ましくはａ骨間の核組織の
自然のレオロジーを模倣する粘度及び速度−剪ｔｌｉ行
動を有する揺変性のゲルである。揺変性のゲルは、無機
油（例えばシリコーン又はフルオロカーボン）と、ヒユ
ームドシリカのようなゲル化剤との混合物（好ましくは
約３〜１０重ａ１％の混合物を含み且つ６　ｒｐＨｌに
おいて１００〜１゜０００ｃｐｓの間のブルックフィー
ルド粘度を与える）であることがて゛きる。流体の粘度
は椎骨間の空間において曲げ中に正常な迅速性をもつ運
動を可能にすると同時に特にゆっくりした体位の変化中
に運動を制限するように選択される。カボット・］−ボ
レーションからの「Ｃａｂ−０−３ｉ　Ｉ特性及び作用
」と題する会報（９／８３日付り）は１０頁にｄ３いて
［Ｃａｂ−０−３ｉｌ　Ｊヒコームドシリ力が食品医療
品局（（−Ｄ△）によって体内及び局部利用のためのｚ
ｔ型製品使用し得ることを公認されていると報じている
。
好ましくは、嚢中の揺変竹ゲルはヒアルロン酸又はヒア
ルロン酎ナトリウムのようなバー１多糖類の水溶液のよ
うな水性であり、その両方は弾性及びゲル状性質を右し
且つ人体に自然に生ずる。そのようなゲル状溶液を含む
時、嚢は本来の人の円板と同様に作用する。それはその
半透膜を通して水を絞り出ケことによって圧力を緩和し
、且つ溶液が親水性であるので、嚢は水を患者の体から
ゆっくり回収することによってそれ自体更新乃ることが
できる。
新規な包の外方層はｋｆましくは組織の内に伸びること
を誘引する生物吸収可能な物質と渥ぜ合った強く不活性
の繊維で作られる。これらの繊維、並びに新規な円板包
の他のｇｙ素の繊ＩＩはカーボン又はポリマーで作られ
ることができ、該ポリマーは天然のポリマー又は常温延
伸ポリ（エチレン７レフタレート）ポリエステル繊維の
にうな合成ポリマーを含む。生物吸収可能な物質はポリ
ラフタンの又はポリグリコールの酸又は］ラーゲン（例
えば半合成）でなることができ、そのいずれも通常は組
織の内に沖びることによって置換され且つそのため周囲
の組織へ接合される。この生体組織による買換は埋設さ
れたプロテーゼの永久のｉｌ　１Ｍ性を保証する。追加
の有効な生物吸収可能な物質を挙げる米国特許用４．６
４３．７３４号（リン）を参照されたい。
生物吸収Ｉ１１能な物質はそれ自体謀Ｉｌｌ質であるこ
とができ且つ不活性ａｎと相互織りされることができる
。他方、外方層、周方向フランジ、及び長手方向羽根は
不活性繊維（４Ｆ物吸収司能な物質でｖｉされているか
又は被覆されていないかのいずれか）で−緒に織られｎ
つ次に生物吸収可１先な物質を含浸されることができる
。
坤没後、密接な繊Ｈ賀接合が外方層及び骨の間に発達し
ている限り、プロテーゼの円板包の外方居中へ椎骨の体
骨の内に伸びることがあることは必要ではない。外方層
のＪａｍは好ましくは相当な圧力の包含を許寸ように織
られる。
ブロテーピの円板包１よ対で埋没されるべきＣある。そ
れらの埋没の外）１的丁順（前記出願で請求されでいる
）は次のステップを含む。
１）損傷した円板に隣接づる椎骨をジヤツキで端間りる
こと、 ２）実質的に仮状の骨を損傷した円板にその横方向縁の
それぞれの近くで他の骨から端間しで形成ツること、及
び ３）川長い円１ｎ状のプロチー１の円板包を各骨へ軸線
方向へ挿入り゛ること。
これらの包の２つが損傷した円板の輪の核中へ並んで仲
人され、それぞれが円板の横り内縁の１つの近くに横た
わる時、それらは高さと円板空間に４３１ノる前後方向
の曲げを含む運動との両方を維持するが、回転及び移動
を制限し口つ横方向への曲げを少ない程度に制限する。
好ましい後の外利的アプローチ（ユ、上述した外科的手
順のステップ１）の前ヌは後に切子面１１１節のそれぞ
れを通る窓を形成？Ｉ−るために１１ｍの孔をあけるこ
とを含む。次に接近のために窓を使用する時、外科医は
手順のステップ２）を行い且つ細片を孔から除去し且つ
損句した円板の核の伯の望ましくない物質を除去する。
次にステップ３）ぐ、プロテーゼの円板包が窓のそれぞ
れを通して骨へ挿入される。成る場合には、埋没された
円板包は、かなりヘルニア形成された円板又はかなり４
７１期のヘルニア形成を伴う収縮をし続けている円板に
円板高さ、特に望ましい目標を再確立りることができる
。
円板にあＧＪられた孔は好ましくは隣接の椎骨のｖ１板
を僅かに剥皮するに充分大ぎく、そのため骨及び隣接の
組織へのプロテーゼの包の付着を促進する。
前述したプロテーゼのアブＯ−チでは、孔は木質的に真
の尖状から約５〜１０″においでＵいの方へ角度付番プ
られ、且つこれは円板の他方の側から出るドリルピッｉ
への危険がある前に孔をより深くりる利点を備える。そ
の角度は全く小さいので、埋没されたブ１」デーゼの包
はあたかもそれらの軸線即らＩＩＩ長くされた方向が貞
の矢状方向に配置されるかのように実質的に作用する。
切子面関節の穿孔は前方のアプローチによって又は切子
面関節への中間で後方から旧慣した円板へ接近すること
によって回避されることができる。
後者のアプローチは移動する危険を含み、そのため０橙
神経を損傷するおそれがある。史に、これは円板中の孔
が矢状方向へ又は矢状方向から僅かに発散して延びるこ
とを必要とし、それにＪ、り孔は穿孔時に切子面窓を通
るよりも短いことを必要とする。他方、切子面関節の中
間への後方のアプローチはプロテーゼの円板包が破裂を
最小限にして所定の位置へ移動される杼皮技術によって
実行ヅることができる。
プロテーゼの包が皮下注射針によって刺されるように設
計された速隔室へ連結される時、室はＸ線透視υ制御下
で長い！１によって容易に接近し’ＩＡｌるように配置
されるべきて゛ある。もし埋没されたプロテーゼの円板
包が椎骨の体骨の再成形を生ずるならば、空間高さは哀
え、且゛〕再膨張がおそらく数回高さを回復するために
使用されることができる。異なる行動の押突性ゲルが種
々の患者で必四とされることがあり、プロテーゼの包を
埋没した後にゲルを修正りる能力は嚢の空所への遠隔接
近を与える室によって約される。
新規なプロテーゼの円板包のｎが針刺し可能な遠隔溜め
又は室へ配管によって連結される１１Ｓ、嚢ｔよ損傷し
た円板中へ挿入される後まで流体を充満される必要がな
い。新規な円板包が損傷した円板中へ挿入された後、皮
下注射＄１は流体を室中へ注入するために使用されるこ
とができ、それにより流体を配管を通して嚢中へ圧送し
１つ荷を膨らまぜる。このため指はその挿入後直らに膨
張されることができ、又はそれは円板空間の高さを調節
し又ｔよゆっくり増加するために一度に少し膨張され得
る。円板高さのゆっくりした回復は本来の弾性的回復を
許りが、突然の上界は円板の輪を更に破壊し又は分断す
ることがある。また、室はそれが膨らみ過ぎであると判
所された時にゲルを少し抽出するために皮下注射針によ
って使用されることがぐきる。
室が別刺し可能である時、それは異なる治療剤を４へ加
え又（よそれから抽出するために使用され得る。
室はそれが可撓性の不透過性フィルムで２つの隔室に分
離されている時に針刺し可能である必要はない。これら
の隔室の−・方は嚢と連通しｎつ揺斐性ゲルのよう４に
流体を含むと同時に他方の隔室は吸湿性物質を含み且つ
湿分透過性へＶで形成されることがて゛きる。体の湿分
は吸湿性物質を徐々に膨張さ「、それにより１′１変竹
物質の徐々の流れを強制して１１を徐々に膨らませる。
円板空間中のブ［１デーＵの円板包の横方向の膨らみを
制限するために、強く且つ不活性のｎ耗がｎを通して横
方向へ延びるように外方層に織り込まれ得る。・これら
の横力向ｍｔＩｉは外方層の強く且つ不活性のね雑と同
じである口とができる。プロテーゼの円板包が遠隔室か
ら更に膨張されるｈ１横方向線雑は主として円板高さの
増加を生ずる。
新規なプロテーゼの円板包は陥入されることができ、そ
れにより内部圧力が椎骨の負荷によって上昇し又は低−
トするにつれ゛（端は反転し又は外転りることができ、
圧力を周囲の組織に対して加える。ブ［１テーゼの円板
の包のｉｉＪ撓竹を訂−リ−この手段は構造の弾竹的延
び及び反動を必要としない。
プロテーゼの円板包の一方がそれ自体後は出ようとでる
可能性に対して保護するために、包のそれぞれはカラー
のような周り向７ランジを設（〕ることかでき、該円周
方向ランジ（よ包の１ＩＩｊ人を容易にするが、抜は出
し又は自発的ｉ１出を困九にづるように形成される、。
包が挿入中又は埋没後に空間中で回転する可能性に対し
て保護するために、包は好ましくは長手方向フィン又は
羽根を備える。このような長手方向羽根及び周方向フラ
ンジの両方は外方層の線維と同じであり１ｑる強く且つ
不活性の線維で作られることができる。
新規のブロテーピの円板包が遠隔室を含む時、室、連結
配管、及び一対の１夷は好ましくは例えば吹込成形法に
よって同じ材料で作られる。嚢の円１笥状部分が半透膜
である時、針１１膜を通して横方向腺紺を引張るために
使用され丁［つまたそれらを外方層のね雑と織り合わせ
るために使用されることができ、好ましくは同時に外方
層及びその隆起部及びフランジを織る。
実施例 ０′３１図に承り細長くされたプロテーゼの円板包γＯ
（よ、組織の内に伸びることを誘引りる生物吸収可能な
線維と織り合ね「られた強くｎつ不活性のポリマーＩ！
２Ｈの網状構造からなる外方層γ２をイ」する。また、
該線維と強く且つ不活性のポリマー線維が織り合わせら
れ、この線維（１外方層γ２の外部面から突出する２つ
の周方向バンド叩ちフランジγ４と長手方向フィン即ち
羽根γ６とを形成するように構成される。
外方層１２は第２図に承りように揺変性ゲル２０を含む
嚢γ８を取囲み、該ゲルは１つまたはそれ以上の治療剤
を含む。小さい間２２が１１刺し可能な遠隔室２４へ貴
を連結する。プロテーゼの円板包γ０を第４図及び第５
図に示すように人のを椎中へ埋没された後、管２２は室
２４を第４図に示Ｊように配置させることを許し、それ
により揺変性ゲルは皮下注射客１を￥′ｒ祁区域中へお
Ｉ　７Ｊことなく挿入することによって室２４へ加えら
れ又はそれから抽出されることができる。
線維の外方層γ２の下で、嚢γ８の円筒状部分は半ｚｉ
！Ｊであり、Ｊ」つ円形端は不透過性有機フィルムであ
り、その縁は半透膜へ超音波によりシールされている。
埋没区域はし４及び１５＃１１骨の間で変質され又はヘ
ルニア形成された円板２６にある。第３図に示すように
、Ｍ２８及び２８ａが切子面３０及び３０ａの下方部分
にドリルあけされている。
これらの窓を使用して、一対の孔３ン及び３γａが円板
中へドリルあレプされてａ３す、合孔は損傷した円板２
６の横方向縁の近くにあり且つ矢状方向に対して約１０
°他方の孔の方へ角度付けられている。また、これらの
窓を使用して、穿孔細片及び円板の核のあり得る他の部
分が除去され、その後ブ［］チーぜの円板包γ０及びプ
ロテーゼの円板包ｔｅａがを椎神経を乱ずことなく孔３
γ及び３γａ中へそれぞれ軸線方向へ挿入されている。
第４図に示すように、プロテーゼの円板包γＯ及びγＯ
ａｔま孔３γ及び３γａ中へ挿入されＺ’　Ｊ−５す、
このため並んで配管され且つ離間されており、包のそれ
ぞれの細長くされた方向即ら１ｖＡ線は矢状方向に対し
て約１０°の角度て°延びる。第５図はプロラーゼの円
板包γ０及びγＯａが椎骨Ｌ４及び１−５の間の空間の
高さを円板２６の輪の緊張によって１ｉｌＪＪ　Ｉして
いることを示り−６これは円板空間のＵ「壊と弱化した
輪の膨らみとの複合作用によって生じた神経への圧力を
緩和する。
第２図を再び参照すると、多数のポリマー又は他の強く
且つ不活性の線維３２が円板包γ０の赤道を横方向に延
びている。これらの横方向１１３２の故に、プロテーゼ
の円板包γ０は忠省の介禮中のｇ！直方向圧力によって
平らにされるのに敗抗し、それにより円板包γＯ及びγ
Ｏａ／Ｊ（１５１ｉ、：埋設される腰椎椎骨Ｌ４及びＬ
５の間の間隔を維持する。長手方向羽根γ６及び／６ａ
はブ〔１デーＵの円板包の回転を抑制する作用をすると
同時に周方向フランジγ４及びγ４ａは４Ｉ骨間の空間
中に円板包をより良好に係止する。
ゆっくり故出しくηる治療剤を含む通π゛の埋没された
装置と異なり、新規の、プロテーゼの円板は主として８
４造的な要素であり且つ副次的に薬理学的に作用する装
置′Ｃある。叩ら、迫傷しに円板（ま既に機械的行動に
おいて変化されでいるので、正常な機械的機能の保存又
は回復は患者の安楽及びｂ１動性を戻す第１のステップ
である。新規なプ［］テチーの円板は治療剤を体内に徐
々に分与し得るので、それは薬理学的に作用覆る。薬理
学的に作用する伯の構造的埋没物は知られでいない。ど
れもｍ造的機能をも薬理学的に作用する埋没物ではない
。
【図面の簡単な説明】
全ての図【ま概略図であり、第１図は包を更に膨張さぜ
又（よ収縮さじる遠隔室を有りる本発明の好ましいＩ長
くされたプロテーゼの円板包の斜視図であり、第２図は
第１図の線２−２に沿った拡大中央断面図′Ｃあり、第
３図は第１図及び第２図のブロデーピの円板包の一対を
Ｌ４及びＬ５椎骨の間の変質した円板中へ埋没のために
便利な接近を提供すべく切子面の下方を通してドリルあ
けされた２つの窓を示す人のを椎の後面図であり、第４
図（よ第３図で準（Ｉｉｉされたａ椎の横断面図であっ
て、１４和骨を図示しない図であり、第５図は第４図の
線４−４に沿った縮尺した断面図である。 γＯ・・・細長くされたプロテーゼの円板包、ン２・・
・外方層、γ４・・・周囲フランジ、γ６・・・長手り
内羽根、γ８・・・嚢、２０・・・治療用ゲル、２２・
・・管、２４・・・円滑室、２６・・・損傷した円板、
２８．２８ａ・・・窓、３０．３０ａ・・・切子面、３
γ、３１ａ・・・孔、３２・・・強く且つ不活性の線維
。

Claims (18)

    【特許請求の範囲】
  1. （１）人の円板空間の高さに近い直径を有し且つ椎骨体
    の矢状方向の直径に近い良さを有する細長くされた円筒
    状のプロテーゼの椎骨間の円板包であつて、該包が、 化学的及び生物学的に不活性であり、且つ半透膜を通し
    てゆつくり拡散し得る治療用物質を含む流体を囲む半透
    膜を具備する可撓性嚢と、 流体を充満された膜を包囲する強い繊維の層とを含む、 プロテーゼの椎骨間の円板包。
  2. （２）治療用剤が、ホルモン、神経伝達物質ペプチド、
    抗炎症物質、神経親和性因子、麻酔薬、沈積ステロイド
    、及び成長因子の少なくとも１つからなる特許請求の範
    囲第１項に記載のプロテーゼの円板包。
  3. （３）半透膜が微孔質有機フイルムである特許請求の範
    囲１項に記載のプロテーゼの円板包。
  4. （４）微孔質有機フイルムが微孔質のポリテトラフルオ
    ロエチレンである特許請求の範囲第３項に記載のプロテ
    ーゼの円板包。
  5. （５）半透膜がポリテトラフルオロエチレンをプラズマ
    句着した配向されたポリ〈エチレンテレフタレート〉繊
    維の緊密に織られた織物である特許請求の範囲第１項に
    記載のプロテーゼの円板包。
  6. （６）半透膜の孔寸法が人の細胞の通過を阻止するに充
    分小さい特許請求の範囲第１項に記載のプロテーゼの円
    板包。
  7. （７）半透膜の孔寸法が１〜７マイクロメートルのオー
    ダーである特許請求の範囲第６項に記載のプロテーゼの
    円板包。
  8. （８）嚢が可撓性不透過性有機フイルムをも具備する特
    許請求の範囲第１項に記載のプロテーゼの円板包。
  9. （９）半透膜が管であり、その直径が人の円板の厚さに
    近く、且つその厚さが椎骨体の矢状方向の直径に近く、
    且つ管の端が不透過性有機フイルムにシールされている
    特許請求の範囲第８項に記載のプロテーゼの円板包。
  10. （１０）嚢を充満する流体が椎骨間の核組織の自然のレ
    オロジーを模倣する粘度及び速度−剪断行動を有するゲ
    ルである特許請求の範囲第１項に記載のプロテーゼの円
    板包。
  11. （１１）嚢を充満する流体がムコ多糖類の水溶液である
    特許請求の範囲第１０項に記載のプロテーゼの円板包。
  12. （１２）ムコ多糖類がヒアルロン酸及びヒアルロン酸ナ
    トリウムから選ばれる特許請求の範囲第１１項に記載の
    プロテーゼの円板包。
  13. （１３）外方層中へ織込まれ且つ半透膜を通して横方向
    へ延びて横方向膨らみを制限する強く且つ不活性の線維
    を有する特許請求の範囲第１項に記載のプロテーゼの円
    板包。
  14. （１４）生物吸収可能な材料が不活性線維と織り合わさ
    れている特許請求の範囲第１３項に記載のプロテーゼの
    円板包。
  15. （１５）前記生物吸収可能な材料が前記不活性線維と織
    り合わされた線維からなる特許請求の範囲第１４項に記
    載のプロテーゼの円板包。
  16. （１６）前記生物吸収可能な材料が不活性線維に被覆さ
    れている特許請求の範囲第１４項に記載のプロテーゼの
    円板包。
  17. （１７）前記膜の内部及び外部の室と連通する中空な配
    管と、流体を室中へ注入し且つそれから抽出する装置と
    を含む特許請求の範囲第１項に記載のプロテーゼの円板
    包。
  18. （１８）人の円板空間の高さに近い直径を有し且つ椎骨
    体の矢状方向の直径に近い長さを有する細長くされた円
    筒状のプロテーゼの椎骨間の円板包であつて、該包が、 化学的及び生物学的に不活性であり、且つ半透膜を通し
    てゆつくり拡散し得る治療用物質を含む流体を囲む可撓
    性嚢であつて、半透膜を具備し、それを通して治療用物
    質がゆつくり拡散し得るが、細胞がそれを通過しない可
    撓性嚢と、 流体を充満された膜を包囲する強い繊維の層とを含む、 細長くされた円筒状のプロテーゼの椎骨間の円板包。
JP1191230A 1987-08-20 1989-07-24 治療用物質を含むプロテーゼの円板 Pending JPH02111359A (ja)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US07/087,424 US4772287A (en) 1987-08-20 1987-08-20 Prosthetic disc and method of implanting
US223400 1988-07-25
US07/223,400 US4904260A (en) 1987-08-20 1988-07-25 Prosthetic disc containing therapeutic material

Publications (1)

Publication Number Publication Date
JPH02111359A true JPH02111359A (ja) 1990-04-24

Family

ID=26776962

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Application Number Title Priority Date Filing Date
JP63204922A Expired - Fee Related JP2771991B2 (ja) 1987-08-20 1988-08-19 人工椎間板カプセル及びその埋め込み方法
JP1191230A Pending JPH02111359A (ja) 1987-08-20 1989-07-24 治療用物質を含むプロテーゼの円板

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Application Number Title Priority Date Filing Date
JP63204922A Expired - Fee Related JP2771991B2 (ja) 1987-08-20 1988-08-19 人工椎間板カプセル及びその埋め込み方法

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US (2) US4772287A (ja)
EP (2) EP0304305B1 (ja)
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CA (1) CA1324864C (ja)

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JP2003518021A (ja) * 1999-12-06 2003-06-03 エスディージーアイ・ホールディングス・インコーポレーテッド 椎間板の治療装置及び方法
JP2007111546A (ja) * 1994-05-06 2007-05-10 Disc Dynamics Inc 関節再表面仕上げシステム
JP2007283121A (ja) * 1994-10-17 2007-11-01 Raymedica Inc 人工脊椎円板核
JP2010515527A (ja) * 2007-01-08 2010-05-13 バイオフォーム・メディカル・インコーポレーテッド 組織増大に用いるための植え込み組成物

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CH671691A5 (ja) * 1987-01-08 1989-09-29 Sulzer Ag
US5258043A (en) * 1987-07-20 1993-11-02 Regen Corporation Method for making a prosthetic intervertebral disc
US5108438A (en) * 1989-03-02 1992-04-28 Regen Corporation Prosthetic intervertebral disc
US4772287A (en) * 1987-08-20 1988-09-20 Cedar Surgical, Inc. Prosthetic disc and method of implanting
US5282856A (en) * 1987-12-22 1994-02-01 Ledergerber Walter J Implantable prosthetic device
DE8807485U1 (de) * 1988-06-06 1989-08-10 Mecron Medizinische Produkte Gmbh, 1000 Berlin Endoprothese der Zwischenwirbelscheibe
US6210412B1 (en) 1988-06-13 2001-04-03 Gary Karlin Michelson Method for inserting frusto-conical interbody spinal fusion implants
US5772661A (en) 1988-06-13 1998-06-30 Michelson; Gary Karlin Methods and instrumentation for the surgical correction of human thoracic and lumbar spinal disease from the antero-lateral aspect of the spine
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CA1324864C (en) 1993-12-07
US4904260A (en) 1990-02-27
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