WO2014042388A2

WO2014042388A2 - Cervical foraminal expander

Info

Publication number: WO2014042388A2
Application number: PCT/KR2013/008039
Authority: WO
Inventors: 김성민; 조도상; 천권수; 양인철; 김남훈
Original assignee: 동국대학교 산학협력단; 이화여자대학교 산학협력단
Priority date: 2012-09-11
Filing date: 2013-09-05
Publication date: 2014-03-20
Also published as: KR101365843B1; WO2014042388A3

Abstract

The present invention relates to a cervical foraminal expander to be inserted into the facet joint of two vertebral bodies, comprising: an insertion portion having an aperture and comprising a tip portion at one side so as to be inserted into the facet joint; a fixing portion connected to the other side of the insertion portion so as to be fixed to the lateral side of at least one vertebral body between the two vertebral bodies; and a mesh portion in which a bone graft substitute to be inserted into the aperture is impregnated. In addition, the present invention relates to a device for inserting a foraminal expander, comprising an insertion tool for inserting the foraminal expander into the facet joint, wherein the insertion tool comprises a guide portion for housing the foraminal expander at one side.

Description

Cervical intervertebral dilator

The present invention relates to a cervical intervertebral dilator for insertion into the posterior joint space of the spine.

In general, the intervertebral disc absorbs the load and impact of the body between the bones and bones of the vertebra, except for the part of the cervical spine, and acts as a buffer to distribute the impact like a spring. At this time, the intervertebral disc holds the vertebral bones so as not to escape, separates the two vertebral bones so that the vertebral nerves are not compressed, thereby smoothing the range of vertebral joints, and serves to smooth the movement of each vertebral bone.

However, due to factors such as aging, excessive sports, accidents, or bad posture, secondary joint narrowing (the path through which the nerves pass) is narrowed due to joint thickening around the spinal segment, intervertebral disc degeneration (depletion of intervertebral discs, volume reduction, etc.). do. As a result, the nerve roots coming out of the spinal cord through the intervertebral cavity are compressed, and the nerve roots are compressed by the narrowed intervertebral cavity, which may cause pain or weakness in the neck, shoulders, back, arms, and the like, and sensory disorders may occur. Direct compression of the spinal cord can also cause spondylopathy that can affect the entire body, such as gait dysfunction and poor bowel or bladder control.

As a method of treating a disease accompanying degenerative changes, an implant or prosthesis may be inserted into the posterior joint between two adjacent cervical vertebrae. In other words, it widens the narrowed intervertebral cavity to relieve the pressure of the nerve roots, and to relieve pain. The space between the upper and lower cervical spine of the joint is increased by the height of the implant, and the intervertebral space is enough to remove the pain felt by the patient. Make it wider.

Techniques for this have been disclosed in US Pat. No. 8118838. However, such implants are inserted between facet joints and secured to the upper and lower joint surfaces. By trying to preserve the motion between the facet joints, the upper and lower parts each have a joint, which can increase the implant size and can be complex. This can cause problems of durability due to long-term use, and may require a simple operation with a configuration of several parts.

In addition, the present invention is limited in the area of contact between the bone graft material entering the implant and the posterior joint surface, the structure is complicated.

The present invention is to solve the above problems, and provides an intervertebral dilator that promotes bone union by increasing the area in which the bone replacement system is in contact with the upper surface and the lower surface, including the mesh portion impregnated with the bone substitute system to the intervertebral dilator formed with an opening .

The present invention is a cervical intervertebral dilator for insertion into the posterior joint between two vertebral body, the opening is formed, the insertion portion is inserted into the posterior joint including a tip on one side; A fixing part connected to the insertion part from the other side and fixed to at least one side of the vertebral body of the two vertebral bodies; And a mesh part impregnated with a bone substitute inserted into the opening. To provide an intervertebral dilator comprising a.

In another aspect, the present invention comprises an insertion mechanism for inserting the intervertebral dilator in the back joint, the insertion mechanism is to provide an intervertebral dilator inserting apparatus including a guide for receiving the intervertebral dilator on one side.

According to the present invention, by inserting the intervertebral dilator in the posterior joint between the two vertebral bodies, the pain is alleviated, the opening is formed in the intervertebral dilator, and the upper surface of the posterior joint surface is included by including a mesh part impregnated with the bone substitute in the opening. By increasing the area where the lower surface touches, the union can progress rapidly, improving the stability of the implant.

Figure 1 shows a conceptual diagram applying the intervertebral dilator according to an embodiment of the present invention to the back joint.

Figure 2 shows a perspective view of the intervertebral dilator according to an embodiment of the present invention.

Figure 3 shows an exploded perspective view of the intervertebral dilator in accordance with an embodiment of the present invention.

Figure 4 shows a side view of the intervertebral dilator in accordance with an embodiment of the present invention.

Figure 5 shows a plan view of the intervertebral dilator according to an embodiment of the present invention.

Figure 6 shows a perspective view of the intervertebral dilator according to an embodiment of the present invention.

Figure 7 shows a side view of the intervertebral dilator in accordance with an embodiment of the present invention.

8 is an exploded perspective view of the intervertebral dilator according to an embodiment of the present invention.

Figure 9 shows a plan view of the intervertebral dilator in accordance with an embodiment of the present invention.

Figure 10 shows a perspective view of the intervertebral dilator according to an embodiment of the present invention.

Figure 11 shows a perspective view of the intervertebral dilator according to an embodiment of the present invention.

12 is a perspective view of the intervertebral dilator in accordance with an embodiment of the present invention.

13 is a perspective view of a mesh unit according to an embodiment of the present invention.

14 is a perspective view of a mesh unit according to an embodiment of the present invention.

15 is a perspective view of a mesh unit according to an embodiment of the present invention.

16 is a perspective view of a mesh unit according to an embodiment of the present invention.

Figure 17 shows a perspective view of the intervertebral dilator insertion device according to an embodiment of the present invention.

18 is a side view of the intervertebral dilator insertion device according to an embodiment of the present invention.

19 is a partially enlarged view of the intervertebral dilator insertion apparatus according to the embodiment of the present invention.

20 is an exploded perspective view of the intervertebral dilator insertion apparatus according to an embodiment of the present invention.

Figure 21 shows a partially enlarged perspective view of the intervertebral dilator insertion device according to an embodiment of the present invention.

Figure 22 shows a partially enlarged side view of the intervertebral hole insertion mechanism according to an embodiment of the present invention.

FIG. 23 shows the front view of FIG. 22.

24 is a perspective view of the intervertebral dilator in accordance with an embodiment of the present invention.

25 is a perspective view of the intervertebral dilator in accordance with an embodiment of the present invention.

FIG. 26 is a view of FIGS. 24 and 25 as viewed in the V direction.

27 is a perspective view of the intervertebral dilator in accordance with an embodiment of the present invention.

FIG. 28 is a view of FIG. 27 viewed in the V direction.

29 is a perspective view of the intervertebral dilator in accordance with an embodiment of the present invention.

FIG. 30 is a view of FIG. 29 viewed in the V direction.

The present invention relates to an intervertebral dilator, the cervical intervertebral dilator for insertion into the posterior joint between the two vertebral body, the opening is formed, the insertion portion is inserted into the posterior joint including a tip portion on one side; A fixing part connected to the insertion part from the other side and fixed to at least one side of the vertebral body of the two vertebral bodies; And a mesh part impregnated with a bone substitute inserted into the opening. It includes.

The tip portion is curved, characterized in that formed thinner than the thickness of the insertion portion except the tip portion.

In addition, the thickness of the insertion part may be set according to the shape of the posterior joint, and the angle θ formed by the insertion part and the fixing part is characterized in that it is substantially the same as the angle formed by the side of the back joint and the vertebral body.

In this case, the angle θ may be 110 ° to 150 ° when the fixing part is fixed downward, and the angle θ may be 20 ° to 60 ° when the fixing part is fixed upward.

In addition, the insertion part may include a radiopaque material, and the fixing part may include at least one hole for receiving a fixing screw in the facet joint surface.

The present invention also relates to an intervertebral dilator insertion apparatus, including an insertion mechanism for inserting the intervertebral dilator of the present invention into the posterior joint, and the insertion mechanism includes a guide portion for accommodating the intervertebral dilator on one side.

In addition, the insertion mechanism is extended in the longitudinal direction may include a grip on the other side, the guide portion may be made substantially parallel to the fixing portion of the intervertebral dilator, it may include a guide protrusion connected to the hole of the fixing portion. .

In particular, the guide portion is made substantially parallel to the fixing portion of the intervertebral dilator, it may further comprise a rotation preventing means.

Hereinafter, exemplary embodiments of the present invention will be described in detail with reference to the accompanying drawings. In this process, the size or shape of the components shown in the drawings may be exaggerated for clarity and convenience of description. In addition, terms that are specifically defined in consideration of the configuration and operation of the present invention may vary depending on the intention or custom of the user or operator. Definitions of these terms should be made based on the contents throughout the specification.

In addition, the spirit of the present invention is not limited to the embodiments presented and those skilled in the art who understand the spirit of the present invention can easily implement other embodiments within the scope of the same idea, but this also falls within the scope of the present invention. Of course.

1 is a conceptual diagram applying the intervertebral cavity expander according to an embodiment of the present invention, Figure 2 is a perspective view of the intervertebral cavity expander according to an embodiment of the present invention, Figure 3 is an intervertebral cavity expander according to an embodiment of the present invention 4 is a side view of the intervertebral cavity expander according to an embodiment of the present invention, FIG. 5 is a plan view of the intervertebral cavity expander according to an embodiment of the present invention, and FIG. 6 is a perspective view of the intervertebral cavity expander according to an embodiment of the present invention. 7 is a side view of the intervertebral cavity expander according to an embodiment of the present invention, FIG. 8 is an exploded perspective view of the intervertebral cavity expander according to an embodiment of the present invention, FIG. 9 is a plan view of the intervertebral cavity expander according to an embodiment of the present invention. Figure 10 is a perspective view of the intervertebral cavity expander according to an embodiment of the present invention, Figure 11 is a perspective view of the intervertebral cavity expander according to an embodiment of the present invention, Figure 12 is an intervertebral cavity expander according to an embodiment of the present invention 13 is a perspective view of a mesh unit according to an embodiment of the present invention, FIG. 14 is a perspective view of a mesh unit according to an embodiment of the present invention, FIG. 15 is a perspective view of a mesh unit according to an embodiment of the present invention, and FIG. 19 is a perspective view of the mesh portion according to an embodiment of the present invention, Figure 17 is a perspective view of the intervertebral dilator insertion apparatus according to an embodiment of the present invention, Figure 18 is a side view of the intervertebral dilator insertion apparatus according to an embodiment of the present invention, Figure 19 Is an enlarged partial view of the intervertebral dilator insertion apparatus according to an embodiment of the present invention, Figure 20 is an exploded perspective view of the intervertebral dilator insertion apparatus according to an embodiment of the present invention, Figure 21 is an intervertebral dilator according to an embodiment of the present invention Partial enlarged perspective view of the insertion device, Figure 22 is a partially enlarged side view of the intervertebral hole insertion mechanism according to an embodiment of the present invention, Figure 23 is a front view of Figure 22, Figure 24 according to an embodiment of the present invention 25 is a perspective view of an intervertebral cavity expander according to an embodiment of the present invention, FIG. 26 is a view of FIGS. 24 and 25 viewed in the V direction, and FIG. 27 is an intervertebral cavity expander according to an embodiment of the present invention. 28 is a perspective view of FIG. 27 in a V direction, FIG. 29 is a perspective view of an intervertebral dilator according to an embodiment of the present invention, and FIG. 30 is a view of FIG. 29 viewed in a V direction. 1 to 30 will be described together with a view showing the intervertebral dilator 100 and the intervertebral dilator insertion device 300 according to the present invention.

As shown in Figure 1, the intervertebral dilator 100 according to an embodiment of the present invention is a structure for insertion into the posterior joint, is configured to restore the space of the narrowed intervertebral cavity, to support the load of the body, 110), the fixing unit 120 and the mesh unit 130 is configured.

As shown in FIG. 1, the insertion unit 110 is inserted between two adjacent vertebral bones and has a predetermined thickness for maintaining a predetermined space between the vertebral bones, and includes a tip portion 112 at one side and a high side at the other side. It is connected to the government (120).

At this time, between the two vertebral bone nodes means a posterior joint between two vertebral bodies, and more specifically, the two vertebral bodies mean the first and second

vertebral bodies

101 and 102.

Tip portion 112 of the present invention is curved in a "U" shape, it is characterized in that it is thinly formed to be easily inserted. More specifically, the tip part 112 may be formed thinner than the thickness of the insertion part 110 except for the tip part 112.

In addition, the thickness of the insertion unit 110 of the present invention may be set according to the shape of the posterior joint. Specifically, in consideration of various convexities, the thickness of the insertion part 110 may be more suitably provided to the body structure of the patient to be implanted, and the thickness of the insertion part may be changed, which is not limited to any one form. Do not.

The fixing part 120 of the present invention is connected to the other side of the insertion part 110 and may be located on at least one side of the vertebral body of the two vertebral body sides. More specifically, the intervertebral dilator 100 of FIGS. 2 to 5 is a view showing an embodiment when the fixing unit 120 is located on the side of the second vertebral body 102, and in FIGS. 6 to 9. Intervertebral dilator 100 is a view showing an embodiment when the fixing part 120 is located on the side of the first vertebral body (101).

In addition, the insertion portion 110 and the fixing portion 120 of the present invention is inclined by a predetermined angle (θ) to be in close contact with the rear surface of the posterior joint. More specifically, the angle θ formed by the insertion unit 110 and the fixing unit 120 is characterized by being substantially the same as the angle formed by the side of the back joint and the vertebral body.

The predetermined angle θ means the angle formed by the posterior joint and the vertebral body, and it is preferable to measure the angle using a CT image of the patient before surgery and reflect the angle in the design.

More specifically, when the fixing part 120 is fixed downward as shown in Figure 4 may be 110 ° to 150 ° or 120 ° to 140 °, as shown in Figure 7 When fixed upwards it may be 20 ° to 60 ° or 30 ° to 50 °.

In addition, when the fixing part 120 is fixed downward, the angle may be reduced toward the lower cervical spine regardless of age or gender.

The fixing part 120 is a means for fastening the intervertebral dilator 100 of the present invention to the posterior joint more safely and accurately. More preferably, the fixing part 120 may include at least one fixing screw for fixing to the side of the vertebral body, and may include at least one hole 121 for accommodating the fixing screw.

In addition, the insertion unit 110 of the present invention is characterized in that it comprises an opening (111). Here, the opening 111 means a space that allows bone growth, and increases the contact surface of the bone material and the adjacent bone to maintain a more stable state, so that bone union can proceed quickly.

In addition, the insert 110 of the present invention may include a radiopaque material at least in part. The radiopaque material is a means for locating the intervertebral dilator 100 and may be included in the tip portion 112 or the opening 111 of the insertion portion 110.

On the other hand, the surface of the upper or lower surface of the intervertebral dilator 100 in contact with the adjacent vertebral bone is to have a surface that is more than a predetermined roughness to prevent the departure and minimize the change of the initial insertion position in the state implanted between the adjacent vertebral bone. Can be configured. As shown in FIG. 10, a protrusion 113 may be formed on an upper surface of the intervertebral dilator 100 that contacts an adjacent vertebral bone, and an unevenness 114 may be formed as shown in FIGS. 11 and 12. In particular, the insertion is possible, but in order not to fall out as shown in Figure 11 is a long inclined surface, the rear may form a short ratchet-shaped concave-convex 114, which is not limited to any one form.

In addition, the intervertebral dilator 100 according to the embodiment of the present invention may be made of PEEK (polyetheretherketone) material or titanium having a predetermined elasticity, which is harmless to the human body, and in addition, titanium, shape memory alloy, stainless steel, and the like. If the material is easy as the intervertebral dilator 100 of the present invention, such as plastic, it can be used.

Next, the present invention is characterized by including a mesh unit 130. More specifically, the mesh unit 130 of the present invention may be inserted into the opening 111 of the present invention by impregnating a bone substitute. For example, the mesh unit 130 may be inserted into a slide when the mesh unit 130 is inserted into the opening 111. The mesh unit 130 is in the form of a net, and may be in the form of a net, a net basket, or a dual structure of a net if it is a form for maintaining the bone substitute or the bone union safely and effectively, without being particularly limited. Any shape is possible as shown in 13 to 16.

Due to the bone structure impregnated in the mesh unit 130, the bone fusion can proceed rapidly by increasing the contact surface with the vertebral bone.

Here, as an example of the bone substitute material was used DBM (Demineralized bone matrix). This is a implant that has removed minerals present on the surface by chemical treatment, and means a therapeutic implant having bone conduction ability and osteoinductive ability.

In addition, the mesh unit 130 according to the embodiment of the present invention may be made of PEEK (polyetheretherketone) material or titanium, which is harmless to the human body and has a predetermined elasticity, in addition to titanium, shape memory alloy, stainless steel, and the like. If the material is easy as the intervertebral dilator 100 of the present invention, such as plastic, it can be used.

In addition, the present invention relates to an intervertebral dilator insertion device 300 including an insertion mechanism 200 for inserting the intervertebral dilator 100 into the back joint.

17 to 23, it extends in the longitudinal direction and includes a guide part 210 for accommodating the intervertebral dilator 100 on one side and a grip part 220 on the other side. In particular, the guide part 210 includes a guide protrusion 211 connected to the hole 121 of the fixing part 120, and the guide part 210 and the guide protrusion 211 are parallel to the fixing part 120. Is configured to substantially, one surface of the guide portion 210 and the guide protrusion 211 is characterized in that the same inclined surface as the fixing portion 120.

In addition, the guide portion 210 of the present invention may further include a rotation preventing means (212). 24 and 25 are perspective views of the intervertebral cavity expander 100 according to an embodiment of the present invention, FIG. 26 is a view of FIGS. 24 and 25 viewed in the V direction, and 27 is an intervertebral cavity expander 100 according to an embodiment of the present invention. 28 is a perspective view of FIG. 27 in the V direction, 29 is a perspective view of the intervertebral dilator 100 according to an embodiment of the present invention, FIG. 30 is a view viewed from the V direction.

The rotation preventing means 212 may vary depending on the shape of the guide groove 122 of the fixing part 120 as shown in FIGS. 24 to 30, but is not limited thereto.

And in consideration of the thickness of the front (A) and rear (P) and various convexities, the intervertebral dilator 100 according to the present invention is more preferably provided to the body structure of the patient to be implanted, injection molding, It is possible to easily produce by using hot forming and hot pressing.

The above embodiments are merely illustrative of the contents of the present invention, but the scope of the present invention is not limited to the above embodiments. The embodiments of the present invention are provided to more completely explain the present invention to those skilled in the art.

100: intervertebral dilator

101: first vertebral body / 102: second vertebral body

110: inserting portion / 111: opening

112: tip portion / 113: projection

114: unevenness / 120: fixed part

121: hole / 122: guide groove

130: mesh portion

200: insertion mechanism

210: guide portion / 211: guide projection

212: anti-rotation means / 220: grip

300: intervertebral expander insertion device

Claims

In cervical intervertebral dilator for insertion into the posterior joint between two vertebral bodies,

An opening part is formed and an insertion part inserted into the posterior joint including a tip part at one side;

A fixing part connected to the insertion part from the other side and fixed to at least one side of the vertebral body of the two vertebral bodies; And

A mesh part impregnated with a bone substitute inserted into the opening; Intervertebral dilator comprising.
The method of claim 1,

The tip portion is curved, intervertebral dilator, characterized in that formed thinner than the thickness of the insertion portion except the tip portion.
The method of claim 1,

Intercalator dilator, characterized in that the thickness of the insert can be set according to the shape of the posterior joint.
The method of claim 1,

The inter-hole expander, characterized in that the angle formed by the insertion portion and the fixing portion (θ) is substantially the same as the angle formed by the side of the back joint and the vertebral body.
The method of claim 4, wherein

The angle (θ) is intervertebral dilator, characterized in that 110 ° to 150 ° when the fixing portion is fixed downward.
The method of claim 4, wherein

The angle (θ) is intervertebral dilator, characterized in that 20 to 60 ° when the fixing portion is fixed upward.
The method of claim 1,

And the insertion portion comprises a radiopaque material.
The method of claim 1,

The fixing unit intervertebral dilator, characterized in that it comprises at least one hole for receiving a fixing screw in the facet joint.
An intervertebral dilator insertion apparatus comprising an insertion mechanism for inserting the intervertebral dilator according to any one of claims 1 to 8, wherein the insertion mechanism comprises a guide portion for receiving the intervertebral dilator on one side.
The method of claim 9,

The insertion mechanism extends in the longitudinal direction intervertebral ball expander insertion device comprising a grip portion on the other side.
The method of claim 9,

The guide portion interdigital dilator inserting device is made substantially parallel to the fixing portion of the intervertebral dilator, comprising a guide projection connected to the hole of the fixing portion.
The method of claim 9,

The guide portion is made in parallel with the fixing portion of the intervertebral dilator, intervertebral dilator insert, characterized in that it further comprises a rotation preventing means.