WO2012030141A2 - Espaceur inter-apophysaire - Google Patents

Espaceur inter-apophysaire Download PDF

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Publication number
WO2012030141A2
WO2012030141A2 PCT/KR2011/006408 KR2011006408W WO2012030141A2 WO 2012030141 A2 WO2012030141 A2 WO 2012030141A2 KR 2011006408 W KR2011006408 W KR 2011006408W WO 2012030141 A2 WO2012030141 A2 WO 2012030141A2
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WO
WIPO (PCT)
Prior art keywords
spinous process
main body
spacer
preventing member
departure
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/KR2011/006408
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English (en)
Korean (ko)
Other versions
WO2012030141A3 (fr
Inventor
김경학
김윤혁
김현집
김기정
윤상훈
현승재
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.)
SEOHANCARE CO Ltd
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SEOHANCARE CO Ltd
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Filing date
Publication date
Application filed by SEOHANCARE CO Ltd filed Critical SEOHANCARE CO Ltd
Publication of WO2012030141A2 publication Critical patent/WO2012030141A2/fr
Publication of WO2012030141A3 publication Critical patent/WO2012030141A3/fr
Anticipated expiration legal-status Critical
Ceased 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
    • A61L27/14—Macromolecular materials
    • 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
    • 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
    • A61B17/7053—Spinal positioners or stabilisers, e.g. stabilisers comprising fluid filler in an implant with parts attached to bones or to each other by flexible wires, straps, sutures or cables
    • 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

Definitions

  • the present invention relates to a medical spacer, and more particularly, to a spinous process spacer inserted between the posterior spinous process of the vertebral body and suppressing stenosis between the spinous processes.
  • degenerative lumbar spinal canal stenosis is a phenomenon in which the spinal canal, intervertebral cavity, nerve roots, etc. are narrowed by the degeneration of the lumbar spine.
  • the resulting pressure on the nerves causes pain, numbness and cramps in the lower back, hips, and legs and causes nervous system disorders.
  • intervertebral fusion using an intervertebral insert cage and a posterior pedicle screw as a surgical treatment for the above diseases.
  • This fusion technique often removes or destroys many elements of the spine, such as the lamina and spinous processes, which can lead to structural deformation of the spine and instability of each region.
  • the fusion technique completely restricts the movement of the surgical site, which may cause a problem in that the movement of the adjacent segment is increased to accelerate lumbar degeneration.
  • the spinous process inserting the insertion of a fixing mechanism (a spinal process spacer) between the posterior spinal process of the vertebral body is being performed.
  • the spinous process spacer serves to lift the height of the lumbar segment reduced by the degeneration of the intervertebral disc to the height of the normal lumbar spine. Accordingly, the path through which the nerve bundle passes is no longer narrowed, limiting extension movements and making a slight bend to reduce pain.
  • a spinous process spacer used for spinous process implantation the U-shaped fastener (Interspinous-U) developed by Fixano, France, and St. X STOP, developed by Francis Medical Technologies, has been disclosed.
  • the U-shaped fixation mechanism is so rigid that it completely restricts the temple, which may cause degeneration of other adjacent lumbar segments like fusion.
  • the spinal ligament is removed without removing the spuraspinous ligament and interspinous ligament. ) From the side of the spine.
  • the procedure using the X-STOP one wing is inserted in a separated state and then the separated wing is fastened, so the procedure is inconvenient and the procedure takes a long time.
  • X-STOP is made of a titanium material having strength above bone
  • X-STOP does not absorb the cyclic load of the human body after the procedure, the cyclic load is transferred to the lower node as it is, and the spinous processes are damaged and secondary. May cause a risk of side effects.
  • the present invention has been made in view of the above problems, to facilitate the procedure and to reduce the procedure time, and to increase the decompression effect without interfering with the lumbar segment movement, and to prevent spinous process damage and secondary side effects It is an object of the present invention to provide a spinous process spacer applied to spinous process implantation of a structure that can be made.
  • the present invention in the spinous process spacer inserted between the adjacent spinous process to suppress the stenosis between the spinous process, a spacing part for spacing the spacing between the spinous process at a predetermined interval, and on one side of the spacing part A main body provided with a wing to prevent separation of the separation part, and a predetermined working space formed on the other side of the separation part;
  • the operation space is variably between the first position which is an insertable position and the second position which is a position which prevents the detachment of the main body.
  • the detachment preventing member may include an operation unit to be changed from the first position to the second position by the interference with the spinous process when inserted between the spinous processes.
  • the departure preventing member may include first and second departure preventing members installed in the working space to be rotated in opposite directions when varying from the first position to the second position.
  • the first departure preventing member includes: a first departure preventing part preventing the departure of the main body at the second position; A first interlocking portion interlocked with the second separation preventing member;
  • the first locking part may include a first locking part for locking the first release preventing part at the second position.
  • the second departure preventing member includes: a second departure preventing portion preventing the departure of the main body at the second position; A second interlocking unit interlocked with and interlocked with the first interlocking unit; It may include a second locking portion for locking the second departure preventing portion in the second position.
  • an end portion of at least one of the first release preventing portion and the second release preventing portion is formed to be tapered to facilitate insertion between the spinous processes at the first position.
  • Each of the first interlocking portion and the second interlocking portion may be formed of cog wheels that are meshed with each other.
  • the first locking portion and the second locking portion may be hooked to each other.
  • At least one of the first locking portion and the second locking portion may be hooked, ratcheted or screwed with respect to the main body.
  • the width of the spacer in the transverse spinous process may be tapered to gradually narrow toward the distal end of the spinous process toward the spinal body.
  • the separation portion of the main body is made of a polyether ether ketone (PEEK) material
  • at least one of the wing portion and the separation preventing member of the main body may be made of PEEK material or titanium material.
  • the present invention may further include a bending member formed on the main body and the separation preventing member, the bending member for bending the spinous process through the bending portion at the second position.
  • the bending member may be made of a polyester material.
  • At least one of the spaced apart portion, the wing portion, and the separation preventing member may include a spike portion formed at a portion opposite to the spinous process, thereby increasing the fixing force between the spinous process.
  • a surgical tool insertion hole may be formed in the wing portion of the main body.
  • the wing portion is spaced apart by a predetermined interval in the vertical direction of the wing portion and is formed with first and second insertion holes different in at least one of a shape and a size, so as to misinsert the surgical tool. You can prevent it.
  • the spinous process spacer according to the present invention is applied to a minimal incision that is performed without removing the spinal ligament, thereby minimizing skin incision and removal of biological tissue. Accordingly, there is an advantage that can reduce the surgical recovery time, and alleviate the pain.
  • the present invention has a structure in which the separation prevention member is locked after moving to the separation prevention position by interaction with the spinous process when inserting the spinous process spacer into the dissected spinal ligament, it is easy to perform the procedure and reduce the procedure time There is an advantage that it can.
  • the present invention is composed of a polyether ether ketone (PEEK) material which is a biopolymer that is harmless to the human body, and has a similar elastic modulus as the cortical bone of the human body. It can increase. Accordingly, since the human body load can be dispersed, there is an advantage that the risk of damage to the spinous processes and the risk of secondary side effects can be reduced.
  • PEEK polyether ether ketone
  • the shape of the separation portion is anatomically similar to the shape of the spine, it is possible to prevent the fracture of the spine due to load load by the spacer during the spinous process during the procedure.
  • FIG. 1 is a partial perspective view showing the main portion of the spine and spinous process spacer according to an embodiment of the present invention.
  • Figure 2 is an exploded perspective view showing a spinous process spacer according to a first embodiment of the present invention.
  • 3A and 3B are schematic cross-sectional views showing shapes at first and second positions of the spinous process spacer according to the first embodiment of the present invention.
  • 4A to 4C are schematic views for explaining the operation of the spinous process spacer according to the first embodiment of the present invention.
  • 5 and 6 are a cross-sectional view and a side view showing the main portion of the spinous process spacer according to the second embodiment of the present invention.
  • FIG. 7 is a cross-sectional view showing the spine of the spinous process spacer according to the second embodiment of the present invention in a state where it is treated.
  • FIG 8 is a plan view showing a spinous process spacer according to a third embodiment of the present invention.
  • 9 to 15 are schematic views for explaining various modifications of the locking structure of the spinous process spacer according to the present invention.
  • FIG. 16 is an exploded perspective view showing a spinous process spacer in accordance with a fourth embodiment of the present invention.
  • 17 is a perspective view showing an appearance at a second position of the spinous process spacer according to the fourth embodiment of the present invention.
  • FIG. 18 is a plan view of FIG. 17 illustrating a coupling relationship of spinous process spacers to spinous processes
  • FIG. 19 is a schematic cross-sectional view of a spinous process spacer according to a fourth embodiment of the present invention, illustrating a surgical tool insertion relationship.
  • FIG. 20 is a partial cross-sectional plan view of FIG. 17 illustrating a surgical tool insertion relationship
  • the first and second positions are defined as positions in which the spinous process spacers are arranged as shown in Figs. 3A and 3B, respectively.
  • FIG. 1 is a partial perspective view showing the main portion of the spine and spinous process spacer according to an embodiment of the present invention.
  • the vertebrae 1 includes a Vertebral body 2 consisting of several nodes, spinous processes 3 and 4 protruding rearwardly of the vertebral body 2 and a transverse protrusion 5. Include.
  • the spine (1) has seven kinds of ligaments (Ligament) to connect the spinal nodes, so that each spine has mobility.
  • the ligament includes an interspinous ligament 7 provided between neighboring spinous processes 3.
  • the spinous process spacer 10 cuts the spinal ligament 7 and is inserted into the cutout portion 7a by a side approach insertion method. That is, the spinous process spacer 10 is inserted between neighboring spinous processes 3 and 4 to prevent stenosis between spinous processes 3 and 4.
  • the spinous process spacer 10 of the present invention may be used in a patient whose narrowing of the spinal canal or intervertebral cavity or a hypertrophy of a yellow ligament (Ligamentum flavum) is confirmed by diagnostic equipment such as X-ray or MRI. That is, when bent forward, it can be applied to patients with a limited physical function, which is symptomatic of relief of pain in legs, hips and groin.
  • the spinous process spacer 10 of the present invention is applied to the minimal incision that is performed without removing the interspinous ligament, thereby minimizing skin incision and removal of biological tissue of the patient.
  • FIG. 2 is an exploded perspective view showing the spinous process spacer according to the first embodiment of the present invention
  • Figures 3a and 3b is a view showing the spinous process spacer at each of the first position and the second position according to the first embodiment A schematic cross section.
  • the spinous process spacer 10 is the main body 20 is inserted between the spinous process (3, 4 of Fig. 1), and the main body 20 is installed in the main body 20 of It includes a departure prevention member 30 for preventing the departure.
  • the main body 20 includes a spaced portion 21 spaced apart from two neighboring spinous processes 3 and 4 by a predetermined interval, and a wing portion 25 provided on one side of the spaced portion 21, and the spaced portion 21. On the other side of the predetermined operating space 23 is formed.
  • Spacer 21 is located in the incision portion of the spinal ligament (7 of FIG. 1) after the procedure, to space between the two spinous process (3, 4).
  • Wing portion 25 is formed to protrude in the longitudinal direction (vertical direction) of the spine on one side of the spaced portion 21, to prevent the spaced portion 21 with the separation prevention member 30 after the procedure.
  • the separation preventing member 30 is rotatably installed in the operating space 23 of the main body 20. That is, the separation preventing member 30 is a first position (an separation prevention member position shown in FIG. 3A), which is an insertable position, and a second position (position prevention prevention shown in FIG. 3B), which is a position which prevents the separation of the main body 20. Member positions) are variably provided in the working space 23. In addition, the release preventing member 30 is locked at the second position, thereby preventing the reverse direction from being changed from the second position to the first position.
  • the anti-separation member 30 includes operating portions 31a and 41a which, when inserted between the spinous processes 3 and 4, change from the first position to the second position by interference with the spinous process.
  • the departure prevention member 30 is the first departure prevention member 31 and the second departure prevention member installed in the operating space 23 so as to rotate in conjunction with each other when the variable from the first position to the second position. 41 may be included.
  • the first departure preventing member 31 may include a first release preventing portion 33 which prevents the main body 20 from being separated from the second position, a first interlocking portion 35 interlocked with the second release preventing portion 43, and And a first locking portion 37 for locking the first departure preventing portion 33 in a second position.
  • the second departure preventing member 41 is installed in the working space 23 so as to be symmetrical with respect to the first departure preventing member 31, and the second departure preventing part for preventing the departure of the main body 20 in the second position ( 43), a second interlocking portion 45 which is interlocked with and interlocked with the first interlocking portion 35, and a second locking portion 47 for locking the second departure preventing portion 43 in the second position. .
  • Each of the first and second departure preventing portions 33 and 43 may be tapered as shown in FIG. 3A to facilitate insertion between the spinous processes 3 and 4 at the first position.
  • the fixing pin instead of the screw 27.
  • the screw 27 or the pin may be made of titanium (Titanium) material to function as a marker (marker).
  • the screw 27 or pin may be made of a polyether ether ketone (PEEK) material which is a kind of biopolymer.
  • Each of the first interlocking part 35 and the second interlocking part 45 may be formed of cog wheels that are geared to each other. Therefore, when the actuating parts 31a and 41a of at least one of the first and second departure preventing members 31 and 41 come into contact with the spinous processes 3 and 4, the first and second departure preventing members 31 are separated. 41 are interlocked with each other and rotated in opposite directions to each other. For example, when the spinous process spacer is arranged as shown in FIGS. 3A and 3B, when the actuating part 31a of the first release preventing member 31 is pressed, the first release preventing member 31 is a clock.
  • the rotational force is such that the second departure preventing member 41 is rotated counterclockwise through the first and second interlocking portions (35, 45).
  • the first release preventing member 31 is rotated in the same manner.
  • first locking portion 37 and the second locking portion 47 fix the first release preventing member 31 and the second release preventing member 41 at the second position, respectively, by hooking and ratcheting. Lock with a combination of screws, etc.
  • first detachment preventing member 31 and the second detachment preventing member 41 are shown to be hooked to each other by way of example, a detailed description of the other coupling method will be described later.
  • the first locking portion 37 protrudes and includes a latch 37a formed on one side of the protruding portion.
  • the second locking portion 47 is formed in a concave shape that can accommodate the first locking portion 37, and includes a locking jaw 47a formed at a position corresponding to the clasp 37a. Therefore, when the separation prevention member is moved from the first position to the second position, the latch 37a is automatically caught by the locking jaw 47a at the second position, thereby preventing the first separation prevention member 31 and the second departure prevention member.
  • the member 41 is locked to each other.
  • the spaced portion 21 of the main body 20 may be made of polyether ether ketone (PEEK) material. Since it has a modulus of elasticity similar to that of the human cortical bone, the absorption rate of the repetitive load of the human body may be increased as compared with the production of titanium material. Accordingly, since the human body load can be dispersed, there is an advantage that the risk of damage to the spinous processes and the risk of secondary side effects can be reduced.
  • PEEK polyether ether ketone
  • At least one of the wing portion 25 and the separation preventing member 30 of the main body 20 may be made of a PEEK material or a titanium material.
  • the titanium material is composed of X-rays after the procedure, unlike PEEK, the shape is revealed, so the position of the spacer can be accurately known.
  • 4A to 4C are schematic views for explaining an operation of the spinous process spacer according to the exemplary embodiment of the present invention.
  • a spacer 10 is inserted between neighboring spinous processes 3 and 4 with the first and second departure preventing members 31 and 41 positioned at the first position.
  • the operating portions 31a and 41a come into contact with each of the spinous processes 3 and 4.
  • the first and second separation prevention members 31 and 41 rotate while interlocking with each other.
  • the first and second departure preventing members 31 and 41 are positioned at the second position, the first and second departures are caused by mutual locking between the first and second locking portions 37 and 47.
  • the prevention members 31 and 41 are fixed.
  • the spinous process spacer 10 according to the embodiment of the present invention configured as described above is to be locked to the release prevention member 20 is automatically changed to the release prevention position during the insertion procedure, thereby greatly reducing the operation time There is an advantage that it can.
  • the spinous process spacer 10 may move the spacer 10 to the spinous processes 3 and 4 at the second position (see FIG. 3B). It may further include a bending member 50 for bending. To this end, bending portions 25a, 33a, 43a are formed in each of the wing portion 25 and the separation preventing member 30 of the main body 20, and the bending portions 25a, 33a, 43a are formed. By using the bending member 50 to be bent through, the spacer 10 inserted between the spinous processes 3 and 4 may be bent.
  • the bending member 50 may be made of a polyester material.
  • the unit 60 may further include.
  • the spike portion 60 is formed at a portion facing the spinous process 3 and 4 of at least one of the spacer 21, the wing 25, and the separation preventing member 30.
  • the spike portion 60 may be formed in a sawtooth shape. By forming the spike portion 60 in this way, it is possible to prevent the spacer 10 from flowing between the spinous processes 3 and 4.
  • the first release preventing member 31 and the second release preventing member 41 may be locked by hooking with each other.
  • the first locking portion 237 is formed to protrude, and includes clasps 237a and 237b respectively formed on both sides of the protruding portion.
  • the second locking portion 247 is formed in a concave shape that can accommodate the first locking portion 237, and includes a pair of locking jaws 247a and 247b formed at positions corresponding to the latch 237a. . Accordingly, when the departure prevention member is moved from the first position to the second position, the latch 237 is automatically caught by the locking jaw 247 at the second position, and the first separation prevention member 31 and the second departure prevention member are moved. The member 41 is locked to each other.
  • first departure preventing member 31 and the second departure preventing member 41 may be fixed by a hook coupling to the main body 20, as shown in Figure 10 to 12b.
  • the first and second locking portions 337 and 347 protrude from the respective first and second release preventing wings 31 and 41 in the opposite direction to the inserting direction of the spacer to function as a latch.
  • the main body 20 includes a locking step 313 formed at a position corresponding to each of the first and second locking portions 337 and 347 at the second position. Therefore, when the first and second departure preventing blades 31 and 41 are rotated from the first position to the second position, each of the first and second locking portions 337 and 347 in the second position engages the locking step ( While automatically caught by 313, each of the first release preventing member 31 and the second release preventing member 41 is locked with respect to the main body 20.
  • each of the first and second locking portions 437 and 447 is formed to be elastically deformable on a plate surface of each of the first and second release barriers 31 and 41.
  • Clasps 437a and 447a are formed at the ends of the first and second locking portions 437 and 447.
  • the engaging groove 413 is formed at the position corresponding to each of the first and second locking portions 437 and 447 at the second position in the portion where the operating space of the main body 20 is formed. Therefore, each of the clasps 437a and 447a is automatically caught by the catching groove 413 in the second position, so that each of the first release preventing member 31 and the second release preventing member 41 with respect to the main body 20. Locked.
  • each of the first and second locking portions 537 and 547 is formed to be elastically deformable on the outer circumference of each of the first and second release preventing wings 31 and 41.
  • Clasps 537a and 547a are formed at the ends of the first and second locking portions 537 and 547.
  • the engaging groove 513 is formed in the operating space of the main body 20 at positions corresponding to the first and second locking portions 537 and 547 at the second position. Accordingly, each of the latches 537a and 537b is automatically caught in the locking groove 513 in the second position, so that each of the first release preventing member 31 and the second release preventing member 41 is relative to the main body 20. Locked.
  • first departure preventing member 31 and the second departure preventing member 41 may be fixed by screwing the main body 20, as shown in Figure 13a to 14b.
  • first fastening holes 637 and 647 penetrating the plate surface are formed in each of the first and second departure preventing wings 31 and 41.
  • each of the pair of second fastening holes 613 is formed at a position corresponding to the first fastening holes 637 and 647 in the working space of the main body 20. Therefore, by fastening the second fastening hole 613 and the first fastening hole 637, 647 through the fastening screw 615 in the second position, the first departure preventing member 31 and the second departure preventing member ( 41) each may be locked relative to the body 20.
  • the first release preventing member 31 and the second release preventing member 41 may be fixed to the main body 20 using one fastening screw 715.
  • fastening grooves 737 and 747 through which the fastening screw 715 penetrate the first and second separation preventing members 31 and 41 are formed, respectively.
  • a fastening hole 713 is formed at a position corresponding to the fastening grooves 737 and 747 in the working space of the main body 20. Therefore, through the fastening screw 715 in the second position, it is screwed through the fastening grooves (737, 747). In this case, as the working space is narrowed, the first release preventing member 31 and the second release preventing member 41 may be pressed to lock the main body 20.
  • first departure preventing member 31 and the second departure preventing member 41 may be fixed by a ratchet coupling to the main body 20, as shown in FIG.
  • ratchet teeth 837 and 847 are formed in each of the first and second departure preventing wings 31 and 41.
  • the main body 20 includes a detent 813 formed at a position corresponding to the ratchet teeth 837 and 847 of the working space. Therefore, when the separation prevention member is moved from the first position to the second position, the ratchet teeth 837 and 847 elastically deform the detent 813 to avoid interference, thereby smoothly moving.
  • the detent 813 suppresses reverse rotation of the first and second release preventing members 31 and 41, thereby preventing the first release preventing member 31 and the second release preventing member 41 in the second position. Each can be locked against the body 20.
  • the present invention has a structure in which the release preventing member is locked after moving to the anti-separation position by the interaction with the spinous process when the spacer is inserted into the injured spinal ligament, or by simple screwing.
  • 16 to 20 are views for explaining the spinous process spacer according to the fourth embodiment of the present invention.
  • the spinous process spacer 10 is the main body 120 is inserted between the spinous process (3, 4 of Fig. 1), and the main body 120 is installed in the main body 120 of It includes a departure prevention member 130 for preventing the departure.
  • the main body 120 includes a spacing portion 121 spaced apart from two neighboring spinous processes 3 and 4 by a predetermined interval, and a wing portion 125 provided on one side of the spacing portion 121, and the spacing portion 121.
  • the other side of the predetermined operating space 123 is formed.
  • Spacer 121 is located in the incision portion of the spinal ligament (7 of Figure 1) after the procedure, to space between the two spinous process (13, 4).
  • the spacer 121 may have a shape as shown in FIG. 18. That is, the widths W1 and W2 of the spacing portions in the transverse direction of the spinous process 3 may be tapered to gradually narrow toward the distal direction of the spinous process 3 at the vertebral body 2. That is, the end width W1 of the vertebral body 2 side of the spacing part 121 is formed wider than the end width W2 of the spacing part 121 end side of the spinous process 3. This takes into account that the widthwise direction of the spinous process 3 becomes narrower toward the distal end from the vertebral body 2 side.
  • the load may be evenly distributed to the spine.
  • the wing portion 125 is formed to protrude in the longitudinal direction (vertical direction) of the spine on one side of the spaced portion 121, thereby preventing the spaced portion 121 from being separated along with the separation preventing member 130 after the procedure.
  • the surgical tool insertion hole 172 may be formed in the wing 125.
  • the wing part 125 is a surgical tool insertion hole 172 which is spaced apart by a predetermined interval in the vertical direction of the wing part 125 and has at least one of a shape and a size different from each other. Insertion holes 127a and 127b may be formed. This is to prevent misinsertion of the spinous process spacer 10 mounted on the surgical tool 200.
  • first and second insertion holes 127a and 127b are different from each other.
  • first and second insertion holes 127a and 127b are formed on one side of the wing portion 125, as shown in Fig. 20, in a diagonal direction with respect to the side surface thereof. Can be formed. This is to prevent the spacer 10 from falling off from the surgical tool 200 when the surgical tool 200 is rotated during the procedure through the surgical tool 200 due to restrictions on the operating space.
  • the separation preventing member 130 is rotatably installed in the operating space 123 of the main body 120. That is, the separation preventing member 130 is a first position (an separation prevention member position illustrated in FIG. 19), which is an insertable position, and a second position (position prevention illustrated in FIG. 17), which is a position which prevents separation of the main body 120. Member positions) are variably installed in the working space 123.
  • the departure preventing member 130 is not locked by a separate locking means in the second position, unlike the departure prevention member (30 in Fig. 1) of the spinous process spacer according to the first embodiment, the reverse direction in the second position
  • the change to the first position is prevented by the spinous processes 3 and 4 pressing the operating part 131a.
  • the operation unit 131a allows the separation preventing member 130 to be changed from the first position to the second position by the interference with the spinous processes 3 and 4 during the procedure.
  • the departure prevention member 130 is the first departure prevention member 131 and the second departure prevention member 131 which is installed in the working space 123 to be rotated in the opposite direction when the variable from the first position to the second position. ) May be included.
  • the first departure preventing member 131 includes a first departure preventing part 133 to prevent the main body 120 from being separated from the second position.
  • the second departure preventing member 141 is installed in the working space 123 so as to be symmetrical with respect to the first departure preventing member 131, and the second departure preventing part for preventing the departure of the main body 120 in the second position ( 143).
  • Each of the first and second departure preventing parts 133 and 143 may be tapered as shown in FIGS. 16, 17 and 19 to facilitate insertion between the spinous processes 3 and 4 at the first position. Can be formed.
  • the fastening holes 131b at predetermined positions of the first and second departure preventing members 131 and 141 and the main body 121 corresponding to the rotation centers of the first and second departure preventing members 131 and 141, respectively. , 141b and 123a, and by coupling the pins 129 to the fastening holes 131b, 141b and 123a, respectively, the first and second release preventing members 131 and 141 to the main body 120.
  • the pin 129 may be formed of a titanium material so as to function as a marker. It is also possible to couple the screws instead of the pins 127.
  • the spinous process spacer 110 further includes a bending member (see 50 in FIG. 7) for bending the spacer 110 to the spinous processes 3 and 4 at the second position (FIG. 18). It may include. To this end, bending grooves 125a, 133a, and 143a are formed in each of the wing portions 125 and the separation preventing member 130 of the main body 120, and the bending grooves 125a, 133a, and 143a are formed.
  • the spacer 110 inserted between the spinous processes 3 and 4 may be bent.
  • the bending groove 125a formed in the wing portion 125 is perpendicular to the wing portion 125 as shown in FIG. 19 to secure a space for inserting the bending member 50 during the procedure. It may be formed in a straight line.

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

Abstract

L'espaceur inter-apophysaire ci-décrit est destiné à être interposé entre les apophyses épineuses postérieures d'un corps vertébral de manière à inhiber la sténose inter-apophysaire. L'espaceur inter-apophysaire ci-décrit comprend un corps principal comportant une partie espacement pour espacer les apophyses épineuses d'une distance prédéterminée, et une partie lame formée d'un côté de la partie espacement pour empêcher la séparation de la partie espacement, ledit corps principal comportant également un espace interventionnel prédéterminé formé de l'autre côté de la partie espacement, et un élément anti-séparation monté dans ledit espace interventionnel de façon que l'élément anti-séparation puisse être déplacé entre une première position, qui est une position d'insertion, et une seconde position pour empêcher la séparation du corps principal, ledit élément anti-séparation empêchant la séparation de la partie espacement, et étant bloqué dans la seconde position.
PCT/KR2011/006408 2010-08-30 2011-08-30 Espaceur inter-apophysaire Ceased WO2012030141A2 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
KR10-2010-0084076 2010-08-30
KR20100084076 2010-08-30

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Publication Number Publication Date
WO2012030141A2 true WO2012030141A2 (fr) 2012-03-08
WO2012030141A3 WO2012030141A3 (fr) 2012-06-21

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KR (1) KR101724649B1 (fr)
WO (1) WO2012030141A2 (fr)

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP3011921A1 (fr) * 2014-10-23 2016-04-27 Lechoslaw Franciszek Ciupik Implant d'espaceur de processus ilio-spinal
EP3213704A1 (fr) 2016-02-26 2017-09-06 LDR Medical Système d`implants d`arthrodèse rachidienne
CN108601663A (zh) * 2016-01-28 2018-09-28 华沙整形外科股份有限公司 可扩张植入物和插入工具

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
KR101647446B1 (ko) * 2014-10-20 2016-08-10 주식회사 메드릭스 극돌기간 융합형 임플란트
KR101647450B1 (ko) 2014-10-20 2016-08-10 주식회사 메드릭스 극돌기간 다이나믹 임플란트

Family Cites Families (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7959652B2 (en) * 2005-04-18 2011-06-14 Kyphon Sarl Interspinous process implant having deployable wings and method of implantation
KR100464179B1 (ko) * 2002-11-05 2005-01-05 김진구 육각형 또는 사각형 반짝이 제조장치
KR20050119791A (ko) * 2004-06-17 2005-12-22 주식회사 경원메디칼 척추 극돌기 확장장치
EP1824403A1 (fr) * 2004-12-16 2007-08-29 Horst Döllinger Implant destine au traitement de la stenose du canal rachidien lombaire
WO2009036156A1 (fr) * 2007-09-14 2009-03-19 Synthes Usa, Llc Ecarteur interépineux
CA2734995A1 (fr) * 2008-08-28 2010-03-04 Synthes Usa, Llc Entretoise interepineuse derivee d'os

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP3011921A1 (fr) * 2014-10-23 2016-04-27 Lechoslaw Franciszek Ciupik Implant d'espaceur de processus ilio-spinal
CN105534582A (zh) * 2014-10-23 2016-05-04 莱科斯劳.F.邱皮克 棘突间撑开器植入物
US9707017B2 (en) 2014-10-23 2017-07-18 Lechoslaw Franciszek Ciupik Interspinous process spacer implant
CN105534582B (zh) * 2014-10-23 2021-02-09 莱科斯劳.F.邱皮克 棘突间撑开器植入物
CN108601663A (zh) * 2016-01-28 2018-09-28 华沙整形外科股份有限公司 可扩张植入物和插入工具
EP3213704A1 (fr) 2016-02-26 2017-09-06 LDR Medical Système d`implants d`arthrodèse rachidienne
US10456268B2 (en) 2016-02-26 2019-10-29 Ldr Medical, S.A.S. System of spinal arthodesis implants

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KR20120021276A (ko) 2012-03-08
WO2012030141A3 (fr) 2012-06-21
KR101724649B1 (ko) 2017-04-12

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