JP7557766B2 - Artificial intervertebral disc - Google Patents
Artificial intervertebral disc Download PDFInfo
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- JP7557766B2 JP7557766B2 JP2020160607A JP2020160607A JP7557766B2 JP 7557766 B2 JP7557766 B2 JP 7557766B2 JP 2020160607 A JP2020160607 A JP 2020160607A JP 2020160607 A JP2020160607 A JP 2020160607A JP 7557766 B2 JP7557766 B2 JP 7557766B2
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Description
本発明は、脊椎の上下方向で隣り合う上方側の椎体と下方側の椎体との間に装着されて椎体から受ける荷重を支持するとともに上方側の椎体と下方側の椎体との相対移動に追従する人工椎間板に関する。 The present invention relates to an artificial intervertebral disc that is attached between adjacent upper and lower vertebral bodies in the vertical direction of the spine to support the load received from the vertebral bodies and to follow the relative movement between the upper and lower vertebral bodies.
一般に、椎間板が外傷や加齢等により機能不全に陥った場合、椎間板の機能を代替する人工椎間板への置換術が行われている。
ここで、従来用いられている人工椎間板として、生体活性セラミックス材料からなる２枚の略板状体が生体適合性のある高分子弾性材料からなる略板状体の上面および下面に接着剤で一体的に取り付けられたものが知られている（例えば、特許文献１参照）。
Generally, when an intervertebral disc becomes dysfunctional due to trauma, aging, or the like, a replacement surgery for an artificial intervertebral disc that replaces the function of the intervertebral disc is performed.
Here, a conventional artificial intervertebral disc is known in which two roughly plate-shaped bodies made of a bioactive ceramic material are attached integrally with an adhesive to the upper and lower surfaces of a roughly plate-shaped body made of a biocompatible polymeric elastic material (see, for example, Patent Document 1).
しかしながら、特許文献１に記載された人工椎間板では、椎体に荷重や衝撃が加わって高分子弾性材料からなる略板状体が、生体活性セラミックス材料からなる２枚の略板状体の間で弾性変形を繰り返すことがある。
この場合、高分子弾性材料からなる略板状体と生体活性セラミックス材料からなる略板状体との接合が剥がれてしまい、高分子弾性材料からなる略板状体が生体活性セラミックス材料からなる２枚の略板状体の間から脱落するおそれがあった。
さらに、この脱落による機能損失を防止するために人工椎間板の装着部位を固定する必要があり、この固定施術によって装着部位の運動機能が著しく制限されるという問題があった。
However, in the artificial intervertebral disc described in Patent Document 1, when a load or impact is applied to the vertebral body, the approximately plate-shaped body made of polymer elastic material may repeatedly undergo elastic deformation between the two approximately plate-shaped bodies made of bioactive ceramic material.
In this case, the bond between the approximately plate-shaped body made of polymer elastic material and the approximately plate-shaped body made of bioactive ceramic material could come apart, and the approximately plate-shaped body made of polymer elastic material could fall off from between the two approximately plate-shaped bodies made of bioactive ceramic material.
Furthermore, in order to prevent functional loss due to the artificial disc falling out, it is necessary to fix the attachment site of the artificial disc, but this fixation procedure has the problem of significantly restricting the motor function of the attachment site.
そこで、本発明は、前述したような従来技術の問題を解決するものであって、すなわち、本発明の目的は、荷重を支持する弾性部材の脱落を抑制して優れた衝撃吸収性を発揮するとともに隣り合う椎体の相対移動に対して高い自由度で追従し、横方向の変形量を抑制して隣り合う椎体間の過度の横ずれを防止する人工椎間板を提供することである。
Therefore, the present invention is intended to solve the problems of the prior art as described above. In other words, the object of the present invention is to provide an artificial intervertebral disc that exhibits excellent shock absorption by preventing the elastic member that supports the load from falling off, and that follows the relative movement of adjacent vertebral bodies with a high degree of freedom, suppresses the amount of lateral deformation, and prevents excessive lateral slippage between adjacent vertebral bodies .
請求項１に係る発明は、脊椎の上下方向で隣り合う上方側の椎体と下方側の椎体との間に装着される人工椎間板であって、前記上方側の椎体に連結して前記上方側の椎体から荷重を受ける上側板状部分と、前記下方側の椎体に連結して前記下方側の椎体から荷重を受ける下側板状部分と、前記上側板状部分と前記下側板状部分との上下間に配置される弾性部材と、前記上側板状部分に上端を連結するとともに前記下側板状部分に下端を連結して前記弾性部材を囲繞した状態で前記上側板状部分と前記下側板状部分とを相対移動自在に変位させる筒状部分とで構成され、該筒状部分が、前記上側板状部分または前記下側板状部分のいずれか一方に固定される筒状の外側壁体と、前記上側板状部分または前記下側板状部分のいずれか他方に固定されて前記弾性部材を取り囲む筒状の内側壁体と、前記外側壁体の内周面に一体に外接する外側弾性層体と、前記内側壁体の外周面に一体に内接する内側弾性層体と、前記外側弾性層体の内周面と前記内側弾性層体の外周面との相互間に一体に配置されて前記外側弾性層体および前記内側弾性層体よりも変形しにくい剛性壁体とで構成されていることにより、前述した課題を解決するものである。
The invention according to claim 1 is an artificial intervertebral disc to be fitted between an upper vertebral body and a lower vertebral body adjacent in the vertical direction of the spine, comprising an upper plate-shaped portion connected to the upper vertebral body and receiving a load from the upper vertebral body, a lower plate-shaped portion connected to the lower vertebral body and receiving a load from the lower vertebral body, an elastic member disposed between the upper and lower plate-shaped portions, and a tubular portion having an upper end connected to the upper plate-shaped portion and a lower end connected to the lower plate-shaped portion, surrounding the elastic member, for displacing the upper plate-shaped portion and the lower plate-shaped portion so that they can move freely relative to each other ; The above-mentioned problem is solved by the cylindrical portion being composed of a cylindrical outer wall body fixed to either the upper plate-like portion or the lower plate-like portion, a cylindrical inner wall body fixed to the other of the upper plate-like portion or the lower plate-like portion and surrounding the elastic member, an outer elastic layer body integrally circumscribing the inner peripheral surface of the outer wall body, an inner elastic layer body integrally inscribing the outer peripheral surface of the inner wall body, and a rigid wall body integrally disposed between the inner peripheral surface of the outer elastic layer body and the outer peripheral surface of the inner elastic layer body and which is less likely to deform than the outer elastic layer body and the inner elastic layer body .
請求項２に係る発明は、請求項１に記載された人工椎間板の構成に加えて、前記上側板状部分と前記下側板状部分とが、円盤状に形成され、前記弾性部材が、円柱状に形成され、前記筒状部分が、円筒状に形成され、前記上側板状部分と前記下側板状部分と前記弾性部材と前記筒状部分との中心軸が、一致していることにより、前述した課題をさらに解決するものである。
The invention of claim 2 further solves the above-mentioned problems by, in addition to the configuration of the artificial intervertebral disc described in claim 1 , the upper plate-shaped portion and the lower plate-shaped portion are formed in a disk shape, the elastic member is formed in a cylindrical shape, the tubular portion is formed in a cylindrical shape, and the central axes of the upper plate-shaped portion, the lower plate-shaped portion, the elastic member, and the tubular portion are coincident.
請求項３に係る発明は、請求項１または請求項２に記載された人工椎間板の構成に加えて、前記弾性部材が、前記上側板状部分および前記下側板状部分に固定されていることにより、前述した課題をさらに解決するものである。
The invention of claim 3 further solves the above-mentioned problems by, in addition to the configuration of the artificial intervertebral disc described in claim 1 or claim 2 , the elastic member being fixed to the upper plate-shaped portion and the lower plate-shaped portion.
請求項４に係る発明は、請求項１または請求項２に記載された人工椎間板の構成に加えて、前記弾性部材より摩擦係数の小さい滑り部材が、前記弾性部材の上面または下面の少なくとも一方に設けられていることにより、前述した課題をさらに解決するものである。
なお、本明細書において、「上下」とは、人の頭側を上、足側を下とする。
The invention according to claim 4 further solves the above -mentioned problems by providing a sliding member having a smaller coefficient of friction than the elastic member on at least one of the upper and lower surfaces of the elastic member in addition to the configuration of the artificial intervertebral disc described in claim 1 or claim 2.
In this specification, "upper and lower" refers to the side of a person's head being upper and the side of the feet being lower.
請求項１に係る発明は、脊椎の上下方向で隣り合う上方側の椎体と下方側の椎体との間に装着される人工椎間板であって、上方側の椎体に連結して上方側の椎体から荷重を受ける上側板状部分と、下方側の椎体に連結して下方側の椎体から荷重を受ける下側板状部分と、上側板状部分と下側板状部分との上下間に配置される弾性部材とで構成されていることにより、上側板状部分に加わる上方側の椎体からの荷重や衝撃および下側板状部分に加わる下方側の椎体からの荷重や衝撃が弾性部材に伝達されて弾性部材が弾性変形するため、人工椎間板が椎体から受ける荷重や衝撃を吸収することができる。
また、上側板状部分に上端を連結するとともに下側板状部分に下端を連結して弾性部材を囲繞した状態で上側板状部分と下側板状部分とを相対移動自在に変位させる筒状部分を備えていることにより、上側板状部分または下側板状部分の一方が、筒状部分の弾性変形により他方に対して揺動自在となるため、隣り合う椎体の相対移動に追従することができることに加え、弾性部材の外周が筒状部分で取り囲まれているため、弾性部材が人工椎間板の側方に脱落することを防ぐことができる。
したがって、外部からの荷重や衝撃を吸収する弾性部材の脱落を抑制して優れた衝撃吸収性を発揮するとともに隣り合う椎体の相対移動に対して高い自由度で追従することができる。
さらに、筒状部分が、上側板状部分または下側板状部分のいずれか一方に固定される筒状の外側壁体と、上側板状部分または下側板状部分のいずれか他方に固定されて弾性部材を取り囲む筒状の内側壁体と、外側壁体の内周面に一体に外接する外側弾性層体と、内側壁体の外周面に一体に内接する内側弾性層体と、外側弾性層体の内周面と内側弾性層体の外周面との相互間に一体に配置されて外側弾性層体および内側弾性層体よりも変形しにくい剛性壁体とで構成されていることにより、筒状部分が外側壁体と内側壁体との相互間に複数の弾性層体と少なくとも１つの剛性壁体とを介在させた積層体構造となり、筒状部分が剛性壁体を有さない場合、すなわち、外側壁体と内側壁体との間を弾性体層のみで埋める場合に比べて弾性体層の厚みが小さくなるため、人工椎間板の横方向の変形量が抑制され、隣り合う椎体間の過度の横ずれを防止することができる。
The invention of claim 1 is an artificial intervertebral disc that is fitted between adjacent upper and lower vertebral bodies in the vertical direction of the spine, and is composed of an upper plate-shaped portion connected to the upper vertebral body and receiving loads from the upper vertebral body, a lower plate-shaped portion connected to the lower vertebral body and receiving loads from the lower vertebral body, and an elastic member arranged between the upper and lower plate-shaped portions, so that the load and impact from the upper vertebral body applied to the upper plate-shaped portion and the load and impact from the lower vertebral body applied to the lower plate-shaped portion are transmitted to the elastic member, which elastically deforms, and the artificial intervertebral disc can absorb the load and impact that it receives from the vertebral bodies.
Furthermore, by providing a tubular portion which connects its upper end to the upper plate-shaped portion and its lower end to the lower plate-shaped portion and which surrounds the elastic member, allowing the upper plate-shaped portion and the lower plate-shaped portion to be displaced freely relative to each other, one of the upper plate-shaped portion or the lower plate-shaped portion can freely swing relative to the other due to elastic deformation of the tubular portion, thereby enabling the artificial disc to follow the relative movement of the adjacent vertebrae. In addition, since the outer periphery of the elastic member is surrounded by the tubular portion, the elastic member can be prevented from falling off to the side of the artificial intervertebral disc.
Therefore, the elastic member that absorbs external loads and shocks is prevented from falling off, thereby exhibiting excellent shock absorption properties, and is able to follow the relative movement of adjacent vertebral bodies with a high degree of freedom.
Furthermore, the tubular portion is composed of a tubular outer wall body fixed to either the upper plate-like portion or the lower plate-like portion, a tubular inner wall body fixed to the other of the upper plate-like portion or the lower plate-like portion and surrounding the elastic member, an outer elastic layer body integrally circumscribing the inner peripheral surface of the outer wall body, an inner elastic layer body integrally inscribing the outer peripheral surface of the inner wall body, and a rigid wall body that is disposed integrally between the inner peripheral surface of the outer elastic layer body and the outer peripheral surface of the inner elastic layer body and is less likely to deform than the outer elastic layer body and the inner elastic layer body. As a result, the tubular portion has a laminated structure in which a plurality of elastic layer bodies and at least one rigid wall body are interposed between the outer wall body and the inner wall body, and the thickness of the elastic layer is smaller than when the tubular portion does not have a rigid wall body, i.e., when the space between the outer wall body and the inner wall body is filled with only an elastic layer, so that the lateral deformation of the artificial intervertebral disc is suppressed and excessive lateral slippage between adjacent vertebral bodies can be prevented.
請求項２に係る発明の人工椎間板によれば、請求項１に係る発明の人工椎間板が奏する効果に加えて、上側板状部分と下側板状部分とが円盤状に形成され、弾性部材が円柱状に形成され、筒状部分が円筒状に形成され、上側板状部分と下側板状部分と弾性部材と筒状部分との中心軸が一致していることにより、人工椎間板の周方向に対する方向性が無くなるため、人工椎間板の置換術を行う際に椎体の相互間に配置する人工椎間板の位置決めを必要とすることなく容易に装着することができる。
According to the artificial intervertebral disc of the invention of claim 2 , in addition to the effects achieved by the artificial intervertebral disc of the invention of claim 1 , the upper plate-shaped portion and the lower plate-shaped portion are formed in a disk shape, the elastic member is formed in a cylindrical shape, the tubular portion is formed in a cylindrical shape, and the central axes of the upper plate-shaped portion, the lower plate-shaped portion, the elastic member, and the tubular portion are aligned, so that the artificial intervertebral disc has no direction in the circumferential direction. Therefore, when performing an artificial intervertebral disc replacement surgery, the artificial intervertebral disc can be easily installed without the need to position the artificial intervertebral disc between the vertebral bodies.
請求項３に係る発明の人工椎間板によれば、請求項１または請求項２に係る発明の人工椎間板が奏する効果に加えて、弾性部材が、上側板状部分および下側板状部分に固定されていることにより、上側板状部分と下側板状部分との間隔を拡張する方向の引っ張り力が人工椎間板に加わった際に、上側板状部分と下側板状部分とに連結されている筒状部分の変形に加えて弾性部材も弾性変形するため、人工椎間板の引っ張り強度を増すことができる。
According to the artificial intervertebral disc of the invention of claim 3 , in addition to the effects achieved by the artificial intervertebral disc of the invention of claim 1 or 2 , since the elastic member is fixed to the upper plate-shaped portion and the lower plate-shaped portion, when a tensile force in a direction expanding the gap between the upper plate-shaped portion and the lower plate-shaped portion is applied to the artificial intervertebral disc, in addition to the deformation of the tubular portion connected to the upper plate-shaped portion and the lower plate-shaped portion, the elastic member also elastically deforms, thereby increasing the tensile strength of the artificial intervertebral disc.
請求項４に係る発明の人工椎間板によれば、請求項１または請求項２に係る発明の人工椎間板が奏する効果に加えて、弾性部材より摩擦係数の小さい滑り部材が、弾性部材の上面または下面の少なくとも一方に設けられていることにより、弾性部材のみが上側板状部分と下側板状部分との間に配置されている場合に比べて、滑り部材に対向する上側板状部分または下側板状部分の少なくとも一方が弾性部材に対して動き易くなるため、人工椎間板が椎体の揺動に対して滑らかに追従することができる。
According to the artificial intervertebral disc of the invention of claim 4 , in addition to the effects achieved by the artificial intervertebral disc of the invention of claim 1 or claim 2 , a sliding member having a smaller friction coefficient than the elastic member is provided on at least one of the upper and lower surfaces of the elastic member. This makes it easier for at least one of the upper and lower plate-like portions facing the sliding member to move relative to the elastic member compared to a case in which only the elastic member is disposed between the upper and lower plate-like portions, thereby enabling the artificial intervertebral disc to smoothly follow the rocking movement of the vertebral bodies.
本発明は、脊椎の上下方向で隣り合う上方側の椎体と下方側の椎体との間に装着される人工椎間板であって、上方側の椎体に連結して上方側の椎体から荷重を受ける上側板状部分と、下方側の椎体に連結して下方側の椎体から荷重を受ける下側板状部分と、上側板状部分と下側板状部分との上下間に配置される弾性部材と、上側板状部分に上端を連結するとともに下側板状部分に下端を連結して弾性部材を囲繞した状態で上側板状部分と下側板状部分とを相対移動自在に変位させる筒状部分とで構成され、この筒状部分が、上側板状部分または下側板状部分のいずれか一方に固定される筒状の外側壁体と、上側板状部分または下側板状部分のいずれか他方に固定されて弾性部材を取り囲む筒状の内側壁体と、外側壁体の内周面に一体に外接する外側弾性層体と、内側壁体の外周面に一体に内接する内側弾性層体と、外側弾性層体の内周面と内側弾性層体の外周面との相互間に一体に配置されて外側弾性層体および内側弾性層体よりも変形しにくい剛性壁体とで構成され、荷重を支持する弾性部材の脱落を抑制して優れた衝撃吸収性を発揮するとともに隣り合う椎体の相対移動に対して高い自由度で追従し、横方向の変形量を抑制して隣り合う椎体間の過度の横ずれを防止するものであれば、その具体的な実施態様は、如何なるものであっても構わない。 The present invention provides an artificial intervertebral disc that is fitted between an upper vertebral body and a lower vertebral body that are adjacent in the vertical direction of the spine, and is composed of an upper plate-shaped portion that is connected to the upper vertebral body and receives loads from the upper vertebral body, a lower plate-shaped portion that is connected to the lower vertebral body and receives loads from the lower vertebral body, an elastic member that is arranged between the upper and lower plate-shaped portions, and a tubular portion that is connected at its upper end to the upper plate-shaped portion and at its lower end to the lower plate-shaped portion, surrounding the elastic member, to displace the upper plate-shaped portion and the lower plate-shaped portion so that they can move relatively freely. The tubular portion is composed of a tubular outer wall body that is fixed to either the upper plate-shaped portion or the lower plate-shaped portion, and a tubular outer wall body that is fixed to either the upper plate-shaped portion or the lower plate-shaped portion. The specific embodiment may be any as long as it is composed of a cylindrical inner wall body fixed to the other of the lower plate-shaped portions and surrounding the elastic member, an outer elastic layer body integrally circumscribing the inner peripheral surface of the outer wall body, an inner elastic layer body integrally inscribing the outer peripheral surface of the inner wall body, and a rigid wall body disposed integrally between the inner peripheral surface of the outer elastic layer body and the outer peripheral surface of the inner elastic layer body and being less likely to deform than the outer elastic layer body and the inner elastic layer body, and suppresses the falling off of the elastic member that supports the load, exhibits excellent shock absorption properties, follows the relative movement of adjacent vertebral bodies with a high degree of freedom, and suppresses the amount of lateral deformation to prevent excessive lateral slippage between adjacent vertebral bodies .
例えば、上述した上側板状部分、下側板状部分、および、筒状部分の外側壁体と内側壁体の具体的な素材は、金属系材料、生体活性セラミックス材料、高強度樹脂などの、生体と適合する素材であり、あるいは、これらの素材の組み合わせであっても良い。
また、外側弾性層体、内側弾性層体、弾性部材の具体的な素材については、ポリエチレン系樹脂、シリコーン系ゴムなどであれば良いが、椎間板と同程度の弾力特性を発揮して生体と適合するものであれば、これら以外の如何なる素材であっても良い。
さらに、外側弾性層体と内側弾性層体との相互間に配置される剛性壁体の具体的な素材については、前述した外側弾性層体および内側弾性層体よりも変形しにくい素材、すなわち、剛性を発揮するチタン、コバルトクロム、ステンレス等の金属系材料や、上側板状部分、下側板状部分、および筒状部分の外側壁体と内側壁体と同素材を用いると良い。
For example, the specific materials of the above-mentioned upper plate-like portion, lower plate-like portion, and the outer wall and inner wall of the tubular portion may be materials that are compatible with the living body, such as metal-based materials, bioactive ceramic materials, and high-strength resins, or may be combinations of these materials.
Furthermore, the specific materials for the outer elastic layer, inner elastic layer, and elastic member may be polyethylene-based resin, silicone-based rubber, etc., but any other material may be used as long as it exhibits elastic properties similar to those of the intervertebral disc and is compatible with the living body.
Furthermore, the specific material of the rigid wall disposed between the outer elastic layer and the inner elastic layer may be a material that is less deformable than the aforementioned outer elastic layer and inner elastic layer, i.e., a metallic material such as titanium, cobalt chrome, stainless steel, etc. that exhibits rigidity, or the same material as the outer wall and inner wall of the upper plate-like portion, lower plate-like portion, and tubular portion.
また、本発明の人工椎間板を構成する上側板状部分、下側板状部分、筒状部分の外側壁体と内側壁体、これら外側壁体と内側壁体との間に配置される外側弾性層体と内側弾性層体と剛性壁体の具体的な平面形状については、椎骨の椎体の外周輪郭に沿うようなそら豆状あるいは略円形状であっても良いが、例えば、それぞれ中心軸を一致させた大小の同心円を成す形状であれば、人工椎間板として左右前後ばかりでなく全周のいずれの方向であっても自由度の高い優れた追従性を発揮し、しかも、椎体へ装着する際の周方向の位置決めが簡便となる。 The specific planar shapes of the upper plate-like portion, lower plate-like portion, and outer and inner walls of the tubular portion that constitute the artificial intervertebral disc of the present invention, and the outer elastic layer, inner elastic layer, and rigid wall that are arranged between these outer and inner walls, may be broad bean-shaped or approximately circular to fit the outer contour of the vertebral body of the vertebrae. However, if they are shaped like large and small concentric circles with their central axes aligned, the artificial intervertebral disc will exhibit excellent tracking ability with a high degree of freedom not only in the left and right, front and back directions, but also in any direction around the circumference, and will facilitate circumferential positioning when attached to the vertebral body.
また、本発明の人工椎間板は、上側板状部分が上方側の椎体に連結され、下側板状部分が下側の椎体に連結されていれば、本発明の人工椎間板を構成する筒状部分は、外側壁体が上側板状部分から垂下し、内側壁体が下側板状部分から立ち上がってもよいし、外側壁体が下側板状部分から立ち上がり、内側壁体が上側板状部分から垂下してもよい。 In addition, if the upper plate-like portion of the artificial intervertebral disc of the present invention is connected to an upper vertebral body and the lower plate-like portion is connected to a lower vertebral body, the tubular portion constituting the artificial intervertebral disc of the present invention may have an outer wall hanging down from the upper plate-like portion and an inner wall rising up from the lower plate-like portion, or the outer wall rising up from the lower plate-like portion and the inner wall hanging down from the upper plate-like portion.
また、上側板状部分の上面および下側板状部分の下面については、基本的には、椎体から加わる衝撃や荷重を受け易い平坦面、もしくは、椎体のやや窪んだ端面に装着する際に椎体側と合致し易い、椎体側に向かって緩やかに膨出した曲面を備えているが、さらに、上側板状部分の上面および下側板状部分の下面の具体的な形態については、椎体に装着する際に椎体に対して接着結合、凹凸係合などによって確実に固定するために椎体と接合し易い面造作や面加工が施されていてもよい。 The upper surface of the upper plate-like portion and the lower surface of the lower plate-like portion are basically flat surfaces that are easily subjected to impacts and loads from the vertebral body, or curved surfaces that bulge gently toward the vertebral body side and that easily match the vertebral body side when attached to the slightly recessed end surface of the vertebral body. Furthermore, the specific shape of the upper surface of the upper plate-like portion and the lower surface of the lower plate-like portion may be surface-finished or machined to easily join with the vertebral body so that they can be securely fixed to the vertebral body by adhesive bonding, concave-convex engagement, etc. when attached to the vertebral body.
さらに、本発明の人工椎間板の筒状部分は、基本的には、外側壁体、外側弾性層体、剛性壁体、内側弾性層体、内側壁体からなる５層積層体で構成されるが、積層体の積層数は
５層に限定されるものではなく、例えば、外側壁体、外側弾性層体、剛性壁体、中間弾性層体、剛性壁体、内側弾性層体、内側壁体からなる７層積層体で構成されても良い。
なお、本発明の人工椎間板に用いる筒状部分の外側壁体と内側壁体との相互間には、外側壁体に外接する外側弾性層体と、内側壁体に内接する内側弾性層体と、外側弾性層体と内側弾性層体との間に配置する剛性壁体とを介在させることが望ましいが、筒状部分の外側壁体と内側壁体との相互間において椎体間の相対移動に対する追従性を発揮することができれば剛性壁体を用いることなく単一の弾性層体を介在させた３層積層体で構成されても差し支えない。
Furthermore, the tubular portion of the artificial intervertebral disc of the present invention is basically composed of a five-layer laminate consisting of an outer wall body, an outer elastic layer body, a rigid wall body, an inner elastic layer body, and an inner wall body, but the number of layers in the laminate is not limited to five, and may be composed of, for example, a seven-layer laminate consisting of an outer wall body, an outer elastic layer body, a rigid wall body, an intermediate elastic layer body, a rigid wall body, an inner elastic layer body, and an inner wall body.
Between the outer wall and inner wall of the tubular portion used in the artificial intervertebral disc of the present invention, it is desirable to interpose an outer elastic layer circumscribing the outer wall, an inner elastic layer inscribing the inner wall, and a rigid wall disposed between the outer elastic layer and the inner elastic layer. However, as long as the outer wall and inner wall of the tubular portion can exhibit the ability to follow the relative movement between the vertebrae, a three-layer laminate with a single elastic layer interposed therebetween may be used without using a rigid wall.
以下、図１乃至図６Ｅに基づいて、本発明の第１実施例である人工椎間板１００を説明する。
ここで、図１は本発明の人工椎間板１００を椎体の相互間に装着した使用態様図であり、図２は本発明の第１実施例である人工椎間板１００の全体を示す斜視図であり、図３は図２に示す人工椎間板１００の正面断面図であり、図４Ａは図３に示す人工椎間板１００の組み立て分解図であり、図４Ｂは図４Ａに示す人工椎間板１００の正面断面図であり、図５Ａは図２に示す人工椎間板１００に用いた筒状部分の正面断面図であり、図５Ｂは図５ＡにおけるＡ－Ａ線で矢視した断面図である。
そして、図６Ａは図２に示す人工椎間板１００の基本的なセッティング状態の説明図であって、図６Ｂは図６Ａに示す人工椎間板１００が引っ張り荷重を受けた状態の動作説明図であり、図６Ｃは図６Ａに示す人工椎間板１００が圧縮荷重を受けた状態の動作説明図であり、図６Ｄは図６Ａに示す人工椎間板１００が左側に偏荷重を受けた状態の動作説明図であり、図６Ｅは図６Ａに示す人工椎間板１００が右側に偏荷重を受けた状態の動作説明図である。
An artificial intervertebral disc 100 according to a first embodiment of the present invention will now be described with reference to FIGS. 1 to 6E.
1 is a diagram showing an embodiment of the artificial intervertebral disc 100 of the present invention mounted between vertebral bodies, FIG. 2 is a perspective view showing the entire artificial intervertebral disc 100 of the first embodiment of the present invention, FIG. 3 is a front cross-sectional view of the artificial intervertebral disc 100 shown in FIG. 2, FIG. 4A is an assembled and disassembled view of the artificial intervertebral disc 100 shown in FIG. 3, FIG. 4B is a front cross-sectional view of the artificial intervertebral disc 100 shown in FIG. 4A, FIG. 5A is a front cross-sectional view of a cylindrical portion used in the artificial intervertebral disc 100 shown in FIG. 2, and FIG. 5B is a cross-sectional view taken along line A-A in FIG. 5A.
6A is an explanatory diagram of the basic setting state of the artificial intervertebral disc 100 shown in FIG. 2, FIG. 6B is an explanatory diagram of the operation of the artificial intervertebral disc 100 shown in FIG. 6A when it is subjected to a tensile load, FIG. 6C is an explanatory diagram of the operation of the artificial intervertebral disc 100 shown in FIG. 6A when it is subjected to a compressive load, FIG. 6D is an explanatory diagram of the operation of the artificial intervertebral disc 100 shown in FIG. 6A when it is subjected to an unbalanced load on the left side, and FIG. 6E is an explanatory diagram of the operation of the artificial intervertebral disc 100 shown in FIG. 6A when it is subjected to an unbalanced load on the right side.
＜１．本発明の第１実施例である人工椎間板１００の基本構造＞
まず、本発明の第１実施例である人工椎間板１００は、図１に示すように、脊椎の上下方向で隣り合う上方側の椎体ＵＶと下方側の椎体ＤＶとの間に存在していた本来の椎間板を置換術により切除した後に装着される。
<1. Basic structure of the artificial intervertebral disc 100 according to the first embodiment of the present invention>
First, as shown in FIG. 1, the artificial intervertebral disc 100 according to the first embodiment of the present invention is attached after the original intervertebral disc that existed between an upper vertebral body UV and a lower vertebral body DV that are adjacent to each other in the vertical direction of the spine is removed by replacement surgery.
そして、この人工椎間板１００は、図２乃至図３に示すように、上方側の椎体ＵＶに連結する上側板状部分１１０と、下方側の椎体ＤＶに連結する下側板状部分１２０と、これらの上側板状部分１１０と下側板状部分１２０との上下間に配置される弾性部材１３０と、この弾性部材１３０を囲繞した状態で上側板状部分１１０と下側板状部分１２０との上下間を連結する筒状部分１４０とで構成され、これらの上側板状部分１１０と下側板状部分１２０と弾性部材１３０と筒状部分１４０との中心軸Ｃが一致する。
これにより、人工椎間板の周方向に対する方向的特異性を無くして椎体に対する装着時の位置決め負担を軽減するとともに、上側板状部分１１０と下側板状部分１２０とが上方側の椎体ＵＶと下方側の椎体ＤＶとから荷重を受けた場合、弾性部材１３０と筒状部分１４０とが上側板状部分１１０と下側板状部分１２０とを相対移動自在に変位させ、本来の椎間板の役割や機能と代替することができる。
As shown in Figures 2 and 3, the artificial intervertebral disc 100 is composed of an upper plate-like portion 110 connected to the upper vertebral body UV, a lower plate-like portion 120 connected to the lower vertebral body DV, an elastic member 130 arranged between the upper and lower plate-like portion 110 and 120, and a tubular portion 140 surrounding the elastic member 130 and connecting the upper and lower plate-like portion 110 and 120, and the central axes C of the upper plate-like portion 110, lower plate-like portion 120, elastic member 130 and tubular portion 140 are aligned.
This eliminates the directional specificity of the artificial intervertebral disc in the circumferential direction, reducing the burden of positioning when it is attached to the vertebral bodies, and when the upper plate-shaped portion 110 and the lower plate-shaped portion 120 are subjected to load from the upper vertebral body UV and the lower vertebral body DV, the elastic member 130 and the tubular portion 140 can displace the upper plate-shaped portion 110 and the lower plate-shaped portion 120 freely relative to each other, thereby substituting for the role and function of an original intervertebral disc.
＜２．本発明の第１実施例である人工椎間板１００の詳細構造＞
次に、図３乃至図５Ｂに基づいて、本実施例の人工椎間板１００の詳細構造を説明する。
2. Detailed structure of the artificial intervertebral disc 100 according to the first embodiment of the present invention
Next, the detailed structure of the artificial intervertebral disc 100 of this embodiment will be described with reference to Figs. 3 to 5B.
人工椎間板１００の上側板状部分１１０は、図３乃至図４Ｂに示すように、上方側の椎体ＵＶに接合する上面１１１と、筒状部分１４０の上端に連結する円形の下面１１２とを少なくとも備え、全体として円盤状に形成されている。
下面１１２の略中央には、上方側の椎体ＵＶに向けて凹形状に形成された円形の凹部１１２ａが設けられている。
弾性部材１３０の上面側がこの凹部１１２ａにはまり込むことで、弾性部材１３０は上側板状部分１１０と連結する。
As shown in Figures 3 to 4B, the upper plate-like portion 110 of the artificial intervertebral disc 100 has at least an upper surface 111 that is joined to the upper vertebral body UV and a circular lower surface 112 that is connected to the upper end of the tubular portion 140, and is formed in a disk shape overall.
A circular recess 112a is provided in the approximate center of the lower surface 112, and is formed in a concave shape toward the vertebral body UV on the upper side.
The upper surface side of the elastic member 130 fits into this recess 112 a , whereby the elastic member 130 is connected to the upper plate-like portion 110 .
他方、人工椎間板１００の下側板状部分１２０は、図３乃至図４Ｂに示すように、下方側の椎体ＤＶに接合する下面１２１と、筒状部分１４０の下端に連結する上面１２２とを少なくとも備え、全体として円盤状に形成されている。
上面１２２の略中央には、上面１２２の略中央に上面１２２の外周周辺から立ち上がる台座状に形成された台座部１２２ａが設けられている。
この台座部１２２ａの表面は、外周から中央に向けて緩やかに窪んでいる。
弾性部材１３０が台座部１２２ａの表面の窪みに載置されることで、弾性部材１３０は下側板状部分１２０と連結する。
On the other hand, the lower plate-like portion 120 of the artificial intervertebral disc 100 has at least a lower surface 121 that joins with the lower vertebral body DV and an upper surface 122 that connects to the lower end of the tubular portion 140, as shown in Figures 3 to 4B, and is formed in a disk shape overall.
A pedestal portion 122 a is provided at approximately the center of the upper surface 122 , the pedestal portion 122 a being formed in a pedestal shape rising from the outer periphery of the upper surface 122 .
The surface of the base portion 122a is gently recessed from the outer periphery toward the center.
The elastic member 130 is placed in the depression in the surface of the base portion 122 a , whereby the elastic member 130 is connected to the lower plate-shaped portion 120 .
また、人工椎間板１００の弾性部材１３０は、図３乃至図４Ｂに示すように、本来の椎間板と同程度の弾力特性を発揮して生体と適合するシリコーン系ゴムからなり、全体として円柱状に形成されている。
そして、この円柱状の弾性部材１３０に形成された上側対向面１３１が、上側板状部分１１０に形成された円形状の凹部１１２ａに対向して一体に連結されるとともに、円柱状の弾性部材１３０に形成された下側対向面１３２が、下側板状部分１２０に形成された円錐台状の台座部１２２ａに対向して一体に連結されている。
As shown in Figs. 3 to 4B, the elastic member 130 of the artificial intervertebral disc 100 is made of silicone rubber that exhibits elastic properties similar to those of a natural intervertebral disc and is compatible with the living body, and is formed into a cylindrical shape as a whole.
An upper opposing surface 131 formed on this cylindrical elastic member 130 is integrally connected to face a circular recess 112a formed in the upper plate-like portion 110, and a lower opposing surface 132 formed on the cylindrical elastic member 130 is integrally connected to face a truncated cone-shaped base portion 122a formed in the lower plate-like portion 120.
つぎに、人工椎間板１００の筒状部分１４０は、図３乃至図５Ｂに示すように、前述した上側板状部分１１０から垂下する筒状の外側壁体１４１と、下側板状部分１２０から立ち上がって弾性部材１３０を取り囲む筒状の内側壁体１４２と、外側壁体１４１の内周面に一体に外接する外側弾性層体１４３と、内側壁体１４２の外周面に一体に内接する内側弾性層体１４４と、外側弾性層体１４３の内周面と内側弾性層体１４４の外周面との相互間に一体に配置する剛性壁体１４５とで構成され、特に図４Ａの斜視図で示すように、全体として纏まり良く円筒状に形成されている。 Next, as shown in Figures 3 to 5B, the cylindrical portion 140 of the artificial intervertebral disc 100 is composed of a cylindrical outer wall 141 that hangs down from the upper plate-like portion 110 described above, a cylindrical inner wall 142 that rises from the lower plate-like portion 120 and surrounds the elastic member 130, an outer elastic layer 143 that is integrally circumscribed on the inner peripheral surface of the outer wall 141, an inner elastic layer 144 that is integrally inscribed on the outer peripheral surface of the inner wall 142, and a rigid wall 145 that is integrally disposed between the inner peripheral surface of the outer elastic layer 143 and the outer peripheral surface of the inner elastic layer 144. As shown in the perspective view of Figure 4A in particular, the cylindrical portion 140 is formed into a compact cylindrical shape as a whole.
ここで、筒状部分１４０を形成する内側壁体１４２の内周面は、図３および図４Ｂに示すように、弾性部材１３０の外周面１３３に対して所定の間隙Ｇ１を介して下側板状部分１２０から立ち上がるように設けることにより、弾性部材１３０が圧縮変形した場合の筒状部分１４０に対する弾性部材１３０の弾力的な自由度を確保している。 Here, as shown in Figures 3 and 4B, the inner peripheral surface of the inner wall body 142 forming the cylindrical portion 140 is arranged to rise from the lower plate-like portion 120 with a predetermined gap G1 between it and the outer peripheral surface 133 of the elastic member 130, thereby ensuring the elastic freedom of the elastic member 130 relative to the cylindrical portion 140 when the elastic member 130 is compressed and deformed.
同様に、筒状部分１４０の一部を形成する内側壁体１４２、内側弾性層体１４４、剛性壁体１４５、外側弾性層体１４３の上端面は、図３に示すように、面一に形成して上側板状部分１１０の下面１１２に対して所定の間隙Ｇ２を空けるように配置することにより、弾性部材１３０が圧縮変形した場合の筒状部分１４０に対する上側板状部分１１０の弾力的な自由度を確保している。 Similarly, the upper end surfaces of the inner wall 142, inner elastic layer 144, rigid wall 145, and outer elastic layer 143, which form part of the tubular portion 140, are formed flush as shown in FIG. 3 and positioned to leave a predetermined gap G2 with respect to the lower surface 112 of the upper plate portion 110, thereby ensuring the elastic freedom of the upper plate portion 110 relative to the tubular portion 140 when the elastic member 130 is compressed and deformed.
筒状部分１４０の一部を形成する外側壁体１４１、外側弾性層体１４３、剛性壁体１４５、内側弾性層体１４４の下端面は、図３に示すように、面一に形成して下側板状部分１２０の上面１２２に対して所定の間隙Ｇ３を空けるように配置することにより、弾性部材１３０が圧縮変形した場合の筒状部分１４０に対する下側板状部分１２０の弾力的な自由度を確保している。 The lower end surfaces of the outer wall 141, outer elastic layer 143, rigid wall 145, and inner elastic layer 144, which form part of the cylindrical portion 140, are formed flush as shown in FIG. 3 and positioned to leave a predetermined gap G3 with respect to the upper surface 122 of the lower plate-like portion 120, thereby ensuring the elastic freedom of the lower plate-like portion 120 relative to the cylindrical portion 140 when the elastic member 130 is compressed and deformed.
そして、筒状部分１４０を構成する外側壁体１４１と内側壁体１４２とについては、上側板状部分１１０および下側板状部分１２０と同様に、生体活性セラミックス材料を用いるが、これ以外の椎骨などと適合する素材であれば良い。
また、本実施例では、外側壁体１４１は上側板状部分１１０と、内側壁体１４２は下側板状部分１２０とそれぞれ接着剤により一体に接合しているが、一体成型しても良い。
The outer wall 141 and inner wall 142 constituting the tubular portion 140 are made of a bioactive ceramic material, similar to the upper plate portion 110 and the lower plate portion 120, but any other material that is compatible with the vertebrae etc. may be used.
In this embodiment, the outer wall 141 is bonded integrally to the upper plate portion 110 and the inner wall 142 is bonded integrally to the lower plate portion 120 by adhesive, but they may be integrally molded.
筒状部分１４０を構成する外側弾性層体１４３、内側弾性層体１４４の素材については、前述した弾性部材１３０と同様に、生体と適合するシリコーン系ゴムを採用している。
また、外側弾性層体１４３と内側弾性層体１４４との相互間に配置される剛性壁体１４５の素材については、前述した外側弾性層体１４３および内側弾性層体１４４よりも変形しにくい素材、すなわち、剛性を発揮するチタンを採用しているが、これ以外であっても良い。
The outer elastic layer 143 and inner elastic layer 144 constituting the tubular portion 140 are made of a silicone rubber that is compatible with living organisms, similar to the elastic member 130 described above.
The material of the rigid wall 145 disposed between the outer elastic layer 143 and the inner elastic layer 144 is less deformable than the outer elastic layer 143 and the inner elastic layer 144 described above, that is, titanium which exhibits rigidity, but other materials may also be used.
＜３．本発明の第１実施例である人工椎間板１００の動作説明＞
本実施例の人工椎間板１００を脊椎の上下方向で隣り合う上方側の椎体ＵＶと下方側の椎体ＤＶとの間に存在していた本来の椎間板を置換術により切除した後に装着して使用した場合の動作を、模式的に示した図６Ａ乃至図６Ｅに基づいて、以下に説明する。
3. Description of the Operation of the Artificial Intervertebral Disc 100 According to the First Embodiment of the Present Invention
The operation of the artificial intervertebral disc 100 of this embodiment when it is attached and used after an original intervertebral disc that existed between an upper vertebral body UV and a lower vertebral body DV that are adjacent in the vertical direction of the spine has been removed by replacement surgery will be described below with reference to schematic diagrams shown in Figures 6A to 6E.
まず、図６Ａに示す人工椎間板１００は、本来の椎間板を置換術により切除した後に装着した際に基本的なセッティング状態であって、人工椎間板１００の置換術後に上方側の椎体ＵＶが下方側の椎体ＤＶに対して上方に向けて引っ張り力を受けた場合、上方側の椎体ＵＶに連結された上側板状部分１１０も、同様に下方側の椎体ＤＶに連結された下側板状部分１２０に対して上方に向けた引っ張り力を生じて引っ張られる。
そして、この上側板状部分１１０に生じた引っ張り力が、弾性部材１３０と筒状部分１４０とに伝達され、図６Ｂの上向きの矢印で示すように、これらの弾性部材１３０と筒状部分１４０とが弾性変形して伸張することにより吸収される。
この時、弾性部材１３０の外周囲は、筒状部分１４０に取り囲まれているため、筒状部分１４０から側方へ飛び出すことはない。
First, the artificial intervertebral disc 100 shown in Figure 6A is in a basic setting state when attached after the original intervertebral disc has been removed by replacement surgery, and when the upper vertebral body UV receives an upward pulling force against the lower vertebral body DV after replacement surgery of the artificial intervertebral disc 100, the upper plate-like portion 110 connected to the upper vertebral body UV also generates an upward pulling force against the lower plate-like portion 120 connected to the lower vertebral body DV and is similarly pulled.
The tensile force generated in the upper plate-like portion 110 is then transmitted to the elastic member 130 and the tubular portion 140, and is absorbed by the elastic member 130 and the tubular portion 140 elastically deforming and stretching, as shown by the upward arrow in Figure 6B.
At this time, since the outer periphery of the elastic member 130 is surrounded by the cylindrical portion 140 , the elastic member 130 does not protrude sideways from the cylindrical portion 140 .
他方、人工椎間板１００の置換術後に上方側の椎体ＵＶが下方側の椎体ＤＶに向けて荷重や衝撃による押圧を受けた場合、上方側の椎体ＵＶに連結された上側板状部分１１０も、同様に下方側の椎体ＤＶに連結された下側板状部分１２０に向けた荷重や衝撃による押圧が負荷される。
この時、この上側板状部分１１０に負荷された荷重や衝撃による押圧力が、弾性部材１３０と筒状部分１４０とに伝達され、図６Ｃの下向きの矢印で示すように、これらの弾性部材１３０と筒状部分１４０とが弾性変形して圧縮されることにより吸収される。
On the other hand, if the upper vertebral body UV is subjected to pressure due to a load or impact toward the lower vertebral body DV after replacement surgery of the artificial intervertebral disc 100, the upper plate-like portion 110 connected to the upper vertebral body UV is also subjected to pressure due to the load or impact toward the lower plate-like portion 120 connected to the lower vertebral body DV.
At this time, the pressing force due to the load or impact applied to the upper plate-like portion 110 is transmitted to the elastic member 130 and the tubular portion 140, and is absorbed by the elastic deformation and compression of the elastic member 130 and the tubular portion 140, as shown by the downward arrow in Figure 6C.
さらに、人工椎間板１００の置換術後に上方側の椎体ＵＶが下方側の椎体ＤＶに対して左側に荷重や衝撃などの偏荷重を受けた場合、上方側の椎体ＵＶに連結された上側板状部分１１０も、同様に下方側の椎体ＤＶに連結された下側板状部分１２０に対して左側に偏荷重が負荷される。
この時、この上側板状部分１１０の左側に生じた荷重や衝撃による偏荷重が、弾性部材１３０と筒状部分１４０とに伝達され、図６Ｄの左向きの矢印で示すように、これらの弾性部材１３０と筒状部分１４０の左側とで圧縮変形を生じるとともに右側で伸びを生じることにより吸収される。
Furthermore, if, after replacement surgery for the artificial intervertebral disc 100, the upper vertebral body UV receives an unbalanced load such as a load or impact to the left side relative to the lower vertebral body DV, the upper plate-like portion 110 connected to the upper vertebral body UV will also be subjected to an unbalanced load to the left side relative to the lower plate-like portion 120 connected to the lower vertebral body DV.
At this time, the unbalanced load due to the load or impact generated on the left side of the upper plate-like portion 110 is transmitted to the elastic member 130 and the tubular portion 140, and is absorbed by compressive deformation occurring on the left side of the elastic member 130 and the tubular portion 140 and elongation occurring on the right side, as shown by the leftward arrow in Figure 6D.
他方、人工椎間板１００の置換術後に上方側の椎体ＵＶが下方側の椎体ＤＶに対して右側に荷重や衝撃などの偏荷重を受けた場合、上方側の椎体ＵＶに連結された上側板状部分１１０も、同様に下方側の椎体ＤＶに連結された下側板状部分１２０に対して右側に偏荷重が負荷される。
この時、この上側板状部分１１０の右側に生じた荷重や衝撃による偏荷重が、弾性部材１３０と筒状部分１４０とに伝達され、図６Ｅの右向きの矢印で示すように、これらの弾性部材１３０と筒状部分１４０の右側とで圧縮変形を生じるとともに左側で伸びを生じることにより吸収される。
On the other hand, if the upper vertebral body UV receives an unbalanced load such as a load or impact to the right of the lower vertebral body DV after replacement surgery of the artificial intervertebral disc 100, the upper plate-like portion 110 connected to the upper vertebral body UV will also be subjected to an unbalanced load to the right of the lower plate-like portion 120 connected to the lower vertebral body DV.
At this time, the unbalanced load caused by the load or impact generated on the right side of the upper plate-like portion 110 is transmitted to the elastic member 130 and the tubular portion 140, and is absorbed by compressive deformation occurring on the right side of the elastic member 130 and the tubular portion 140 and elongation occurring on the left side, as shown by the right-facing arrow in Figure 6E.
以上の図６Ａ乃至図６Ｅに基づいた人工椎間板１００の動作説明から明らかなように、本実施例の人工椎間板１００は、上側板状部分１１０や下側板状部分１２０に加わる荷重や衝撃が弾性部材１３０に伝達され、この弾性部材１３０が弾性変形し、人工椎間板１００が受ける荷重や衝撃を吸収するようになっている。
同時に、上側板状部分１１０に上端を連結されるとともに下側板状部分１２０に下端を連結された筒状部分１４０の弾性変形により、上側板状部分１１０または下側板状部分１２０の一方が、他方に対して揺動自在となる。
As is clear from the above description of the operation of the artificial intervertebral disc 100 based on Figures 6A to 6E, in the artificial intervertebral disc 100 of this embodiment, the load and impact applied to the upper plate-shaped portion 110 and the lower plate-shaped portion 120 are transmitted to the elastic member 130, and this elastic member 130 elastically deforms, thereby absorbing the load and impact received by the artificial intervertebral disc 100.
At the same time, due to elastic deformation of the tubular portion 140, whose upper end is connected to the upper plate portion 110 and whose lower end is connected to the lower plate portion 120, either the upper plate portion 110 or the lower plate portion 120 becomes freely swingable relative to the other.
また、筒状部分１４０が、筒状の外側壁体１４１と筒状の内側壁体１４２と外側弾性層体１４３と内側弾性層体１４４と剛性壁体１４５とで構成されていることにより、筒状部分１４０が外側壁体１４１と内側壁体１４２との間に２つの弾性層体と１つの剛性壁体１４５を介在させた積層体構造となり、筒状部分１４０が剛性壁体１４５を有さない場合、すなわち、外側壁体１４１と内側壁体１４２との間を弾性体層のみで埋める場合に比べて弾性体層の厚みが小さくなる。 In addition, since the cylindrical portion 140 is composed of a cylindrical outer wall 141, a cylindrical inner wall 142, an outer elastic layer 143, an inner elastic layer 144, and a rigid wall 145, the cylindrical portion 140 has a laminated structure with two elastic layers and one rigid wall 145 between the outer wall 141 and the inner wall 142, and the thickness of the elastic layer is smaller than when the cylindrical portion 140 does not have the rigid wall 145, i.e., when only an elastic layer is filled between the outer wall 141 and the inner wall 142.
さらに、上側板状部分１１０と下側板状部分１２０とが円盤状に形成され、弾性部材１３０が円柱状に形成され、筒状部分１４０が円筒状に形成され、これらの中心軸が一致していることにより、人工椎間板１００における如何なる周方向の荷重や衝撃であっても追従可能になっている。 Furthermore, the upper plate-shaped portion 110 and the lower plate-shaped portion 120 are formed in a disk shape, the elastic member 130 is formed in a cylindrical shape, and the tubular portion 140 is formed in a cylindrical shape, and the central axes of these are aligned, so that the artificial intervertebral disc 100 can follow any circumferential load or impact.
＜４．本発明の第１実施例である人工椎間板１００の奏する効果＞
上述したような本実施例の人工椎間板１００は、上方側の椎体ＵＶに連結する上側板状部分１１０と、下方側の椎体ＤＶに連結する下側板状部分１２０と、上側板状部分１１０と下側板状部分１２０との上下間に配置される弾性部材１３０と、この弾性部材１３０を囲繞した状態で上側板状部分１１０と下側板状部分１２０に連結する筒状部分１４０とで構成されているため、外部からの荷重や衝撃を吸収する弾性部材１３０の脱落を抑制して優れた衝撃吸収性を発揮するとともに隣り合う椎体ＤＶの相対移動に対する自由度の高い追従性を発揮することができる。
4. Effects of the artificial intervertebral disc 100 according to the first embodiment of the present invention
The artificial intervertebral disc 100 of the present embodiment as described above is composed of an upper plate-like portion 110 connected to the upper vertebral body UV, a lower plate-like portion 120 connected to the lower vertebral body DV, an elastic member 130 arranged between the upper and lower plate-like portions 110 and 120, and a tubular portion 140 connected to the upper plate-like portion 110 and the lower plate-like portion 120 while surrounding the elastic member 130. This prevents the elastic member 130, which absorbs external loads and impacts, from falling off, thereby exhibiting excellent shock absorption properties and allowing for a high degree of freedom in following the relative movement of adjacent vertebral bodies DV.
そして、前述した筒状部分１４０が、上側板状部分１１０から垂下する筒状の外側壁体１４１と、下側板状部分１２０から立ち上がる筒状の内側壁体１４２と、外側壁体１４１に外接する外側弾性層体１４３と、内側壁体１４２に内接する内側弾性層体１４４と、外側弾性層体１４３と内側弾性層体１４４との間に配置する剛性壁体１４５とを有しているため、人工椎間板の横方向の変形量が抑制され、隣り合う椎体間の過度の横ずれを防止することができる。 The aforementioned cylindrical portion 140 has a cylindrical outer wall 141 that hangs down from the upper plate portion 110, a cylindrical inner wall 142 that rises from the lower plate portion 120, an outer elastic layer 143 that circumscribes the outer wall 141, an inner elastic layer 144 that inscribes the inner wall 142, and a rigid wall 145 that is disposed between the outer elastic layer 143 and the inner elastic layer 144. This suppresses the amount of lateral deformation of the artificial intervertebral disc, and prevents excessive lateral displacement between adjacent vertebrae.
また、上側板状部分１１０と下側板状部分１２０とが円盤状に形成され、弾性部材１３０が円柱状に形成され、筒状部分１４０が円筒状に形成され、上側板状部分１１０と下側板状部分１２０と弾性部材１３０と筒状部分１４０との中心軸Ｃが一致していることにより、人工椎間板１００の置換術を行う際に椎体ＵＶ、ＤＶの相互間に人工椎間板１００を容易に装着することができる。 In addition, the upper plate-like portion 110 and the lower plate-like portion 120 are formed in a disk shape, the elastic member 130 is formed in a cylindrical shape, and the tubular portion 140 is formed in a cylindrical shape. The central axes C of the upper plate-like portion 110, the lower plate-like portion 120, the elastic member 130, and the tubular portion 140 are aligned, so that the artificial disc 100 can be easily attached between the vertebral bodies UV and DV when performing replacement surgery for the artificial disc 100.
さらに、弾性部材１３０が、上側板状部分１１０と下側板状部分１２０とに固定されているため、人工椎間板１００の引っ張り強度を増すことができるなど、その効果は甚大である。 Furthermore, since the elastic member 130 is fixed to the upper plate portion 110 and the lower plate portion 120, the tensile strength of the artificial intervertebral disc 100 can be increased, which is a significant advantage.
以下、図７Ａ乃至図７Ｃに基づいて、本発明の第２実施例である人工椎間板２００を説明する。
ここで、図７Ａは、本発明の第２実施例である人工椎間板２００の基本的なセッティング状態の説明図であり、図７Ｂは、図７Ａに示す人工椎間板２００が引っ張り荷重を受けた状態の動作説明図であり、図７Ｃは、図７Ａに示す人工椎間板２００が右側に偏荷重を受けた状態の動作説明図である。
An artificial intervertebral disc 200 according to a second embodiment of the present invention will now be described with reference to FIGS. 7A to 7C.
Here, FIG. 7A is an explanatory diagram of the basic setting state of the artificial intervertebral disc 200 according to the second embodiment of the present invention, FIG. 7B is an explanatory diagram of the operation of the artificial intervertebral disc 200 shown in FIG. 7A when it is subjected to a tensile load, and FIG. 7C is an explanatory diagram of the operation of the artificial intervertebral disc 200 shown in FIG. 7A when it is subjected to an offset load on the right side.
また、本発明の第２実施例である人工椎間板２００は、上述した本発明の第１実施例である人工椎間板１００と比較すると、上側板状部分２１０と弾性部材２３０との取付形態のみが異なっており、その他の構成については、基本的に何ら変わることがないため、上述した第１実施例の人工椎間板１００と同一の部分、部材について対応する２００番台の符号を付すことにより、その重複する説明を省略する。 The artificial intervertebral disc 200 of the second embodiment of the present invention differs from the artificial intervertebral disc 100 of the first embodiment of the present invention described above only in the attachment form between the upper plate-shaped portion 210 and the elastic member 230. The other configurations are basically the same, so that the same parts and members as those of the artificial intervertebral disc 100 of the first embodiment described above are given the corresponding reference numerals in the 200 range, and redundant explanations will be omitted.
すなわち、本発明の第２実施例の人工椎間板２００を構成する円柱状の弾性部材２３０は、この弾性部材２３０の上側対向面２３１が、図７Ｂに示すように、上側板状部分２１０に形成された円形状の凹部２１２ａに連結されることなく対向配置され、下方の円柱状の下側対向面２３２が、下側板状部分２２０に形成された円錐台状の台座部２２２ａに対向して一体に連結されている。 In other words, the cylindrical elastic member 230 constituting the artificial intervertebral disc 200 of the second embodiment of the present invention is arranged such that the upper opposing surface 231 of this elastic member 230 faces the circular recess 212a formed in the upper plate-like portion 210 without being connected to it, as shown in FIG. 7B, and the lower cylindrical lower opposing surface 232 faces and is integrally connected to the truncated cone-shaped base portion 222a formed in the lower plate-like portion 220.
これにより、図７Ａに示す本発明の第２実施例の人工椎間板２００は、本来の椎間板を置換術により切除した後に装着した際に基本的なセッティング状態であって、人工椎間板２００の置換術後に上方側の椎体ＵＶが下方側の椎体ＤＶに対して上方に向けて引っ張り力を受けた場合、上方側の椎体ＵＶに連結された上側板状部分２１０も、同様に下方側の椎体ＤＶに連結された下側板状部分２２０に対して上方に向けた引っ張り力を生じて引っ張られる。
この時、この上側板状部分２１０に生じた引っ張り力が、上側板状部分２１０に一体に連結されていない弾性部材２３０には伝達されずに筒状部分２４０のみに伝達され、図７Ｂの上向きの矢印で示すように、この筒状部分２４０が生じる伸びによる弾性変形で吸収されるため、第１実施例である人工椎間板１００の筒状部分１４０に比較すると、引っ張り力に対する抗力は少ないが変形度合いは増加する。
なお、弾性部材２３０の外周囲は、筒状部分２４０に取り囲まれているため、第１実施例である人工椎間板１００と同様に、筒状部分２４０から側方へ飛び出すことはない。
As a result, the artificial intervertebral disc 200 of the second embodiment of the present invention shown in Figure 7A is in a basic setting state when attached after the original intervertebral disc has been removed by replacement surgery, and when the upper vertebral body UV receives an upward pulling force against the lower vertebral body DV after replacement surgery of the artificial intervertebral disc 200, the upper plate-like portion 210 connected to the upper vertebral body UV also generates an upward pulling force against the lower plate-like portion 220 connected to the lower vertebral body DV and is similarly pulled.
At this time, the tensile force generated in the upper plate-like portion 210 is not transmitted to the elastic member 230, which is not integrally connected to the upper plate-like portion 210, but is transmitted only to the tubular portion 240, and as shown by the upward arrow in Figure 7B, the tensile force is absorbed by elastic deformation caused by the elongation generated in the tubular portion 240. Therefore, compared to the tubular portion 140 of the first embodiment of the artificial intervertebral disc 100, there is less resistance to the tensile force, but the degree of deformation is increased.
Since the outer periphery of the elastic member 230 is surrounded by the cylindrical portion 240, it will not protrude laterally from the cylindrical portion 240, similar to the artificial intervertebral disc 100 of the first embodiment.
さらに、例えば、本発明の第２実施例の人工椎間板２００の置換術後に上方側の椎体ＵＶが下方側の椎体ＤＶに対して右側に荷重や衝撃などの偏荷重を受けた場合、第１実施例の人工椎間板１００と同様に、この上側板状部分２１０の右側に生じた荷重や衝撃による偏荷重が、弾性部材２３０と筒状部分２４０とに伝達され、図７Ｃの右向きの矢印で示すように、これらの弾性部材２３０と筒状部分２４０の右側とで圧縮変形を生じることにより吸収される。 Furthermore, for example, if the upper vertebral body UV receives an unbalanced load such as a load or impact on the right side of the lower vertebral body DV after replacement surgery of the artificial intervertebral disc 200 of the second embodiment of the present invention, the unbalanced load caused by the load or impact on the right side of the upper plate-like portion 210 is transmitted to the elastic member 230 and the tubular portion 240, and is absorbed by compressive deformation occurring between the elastic member 230 and the right side of the tubular portion 240, as shown by the rightward arrow in Figure 7C, just as in the artificial intervertebral disc 100 of the first embodiment.
なお、本発明の第２実施例の人工椎間板２００の置換術後に上方側の椎体ＵＶが下方側の椎体ＤＶに対して左側に荷重や衝撃などの偏荷重を受けた場合も、第１実施例の人工椎間板１００と同様に、この上側板状部分２１０の左側に生じた荷重や衝撃による偏荷重が、弾性部材２３０と筒状部分２４０とに伝達され、図示しないが、これらの弾性部材２３０と筒状部分２４０の左側とで圧縮変形を生じることにより吸収される。 In addition, even if the upper vertebral body UV receives an unbalanced load such as a load or impact on the left side of the lower vertebral body DV after replacement surgery with the artificial intervertebral disc 200 of the second embodiment of the present invention, the unbalanced load caused by the load or impact on the left side of the upper plate-like portion 210 is transmitted to the elastic member 230 and the cylindrical portion 240, and is absorbed by compressive deformation occurring between the elastic member 230 and the left side of the cylindrical portion 240, as in the artificial intervertebral disc 100 of the first embodiment.
上述したような本実施例の人工椎間板２００は、本発明の第１実施例である人工椎間板１００と比較すると、隣り合う椎体ＤＶの相対移動に対するより自由度の高い追従性を発揮することができる。 The artificial intervertebral disc 200 of this embodiment as described above can exhibit a higher degree of freedom in following the relative movement of adjacent vertebral bodies DV compared to the artificial intervertebral disc 100 of the first embodiment of the present invention.
以下、図８Ａ乃至図８Ｃに基づいて、本発明の第３実施例である人工椎間板３００を説明する。
ここで、図８Ａは、本発明の第３実施例である人工椎間板３００の基本的なセッティング状態の説明図であり、図８Ｂは、図８Ａに示す人工椎間板３００が引っ張り荷重を受けた状態の動作説明図であり、図８Ｃは、図８Ａに示す人工椎間板３００が右側に偏荷重を受けた状態の動作説明図である。
An artificial intervertebral disc 300 according to a third embodiment of the present invention will now be described with reference to FIGS. 8A to 8C.
Here, FIG. 8A is an explanatory diagram of the basic setting state of the artificial intervertebral disc 300 according to the third embodiment of the present invention, FIG. 8B is an explanatory diagram of the operation of the artificial intervertebral disc 300 shown in FIG. 8A when it is subjected to a tensile load, and FIG. 8C is an explanatory diagram of the operation of the artificial intervertebral disc 300 shown in FIG. 8A when it is subjected to an unbalanced load on the right side.
また、本発明の第３実施例である人工椎間板３００は、上述した本発明の第１実施例である人工椎間板１００、および、第２実施例である人工椎間板２００と比較すると、上側板状部分３１０の形状と、上側板状部分３１０と弾性部材３３０との取付形態とが異なっており、その他の構成については、基本的に何ら変わることがないため、上述した第１実施例の人工椎間板１００と同一の部分、部材について対応する３００番台の符号を付すことにより、その重複する説明を省略する。 The artificial intervertebral disc 300 of the third embodiment of the present invention is different from the artificial intervertebral disc 100 of the first embodiment of the present invention described above and the artificial intervertebral disc 200 of the second embodiment of the present invention in the shape of the upper plate-shaped portion 310 and the attachment form between the upper plate-shaped portion 310 and the elastic member 330. The other configurations are basically the same, so that the same parts and members as the artificial intervertebral disc 100 of the first embodiment described above are given the corresponding reference numerals in the 300 range, and redundant explanations will be omitted.
すなわち、本発明の第３実施例の人工椎間板３００を構成する上側板状部分３１０は、図８Ｂに示すように、下面３１２も上面３１１と同様に椎体側に向かって緩やかに膨出した曲面となっている。
さらに、本発明の第３実施例の人工椎間板３００を構成する円柱状の弾性部材３３０は、図８Ｂに示すように、この弾性部材３３０の上側対向面３３１が、上側板状部分３１０に形成された円形状の下面３１２に連結されることなく対向配置されているとともに、シリコーン系樹脂からなる弾性部材３３０より摩擦係数の小さいポリテトラフルオロエチレンからなるフッ素系樹脂の滑り部材３５０が、弾性部材３３０の上側対向面３３１に接着層３６０を介して設けられている。
これにより、本発明の第２実施例の人工椎間板２００のように、弾性部材２３０が上側板状部分２１０の下面２１２に一体に連結することなく対向配置しているのみの場合に比べると、図８Ｃの右向きの矢印で示すように、滑り部材３５０に対向する上側板状部分３１０が、弾性部材３３０に対して動き易くなるため、人工椎間板３００が椎体ＵＶの揺動に対して滑らかに追従することができる。
That is, in the upper plate-shaped portion 310 constituting the artificial intervertebral disc 300 of the third embodiment of the present invention, the lower surface 312 is also a curved surface that bulges gently toward the vertebral body side, just like the upper surface 311, as shown in FIG. 8B.
Furthermore, as shown in FIG. 8B, the cylindrical elastic member 330 constituting the artificial intervertebral disc 300 of the third embodiment of the present invention is disposed such that an upper opposing surface 331 of this elastic member 330 faces the circular lower surface 312 formed on the upper plate-like portion 310 without being connected thereto, and a sliding member 350 made of a fluorine-based resin made of polytetrafluoroethylene, which has a smaller friction coefficient than the elastic member 330 made of a silicone-based resin, is provided on the upper opposing surface 331 of the elastic member 330 via an adhesive layer 360.
As a result, as shown by the right-facing arrow in Figure 8C, the upper plate-shaped portion 310 facing the sliding member 350 can move more easily relative to the elastic member 330, as compared to the artificial intervertebral disc 200 of the second embodiment of the present invention, in which the elastic member 230 is simply arranged opposite the underside 212 of the upper plate-shaped portion 210 without being integrally connected thereto, and the artificial intervertebral disc 300 can smoothly follow the oscillations of the vertebral bodies UV.
なお、本発明の第３実施例である人工椎間板３００では、滑り部材３５０を弾性部材３３０の上側対向面３３１に設けたが、このような人工椎間板３００の変形例として、弾性部材３３０の下側対向面３３２にのみ、あるいは、弾性部材３３０の上側対向面３３１と下側対向面３３２との両面に設けても良い。 In the artificial intervertebral disc 300 according to the third embodiment of the present invention, the sliding member 350 is provided on the upper facing surface 331 of the elastic member 330. However, as a modification of this artificial intervertebral disc 300, the sliding member 350 may be provided only on the lower facing surface 332 of the elastic member 330, or on both the upper facing surface 331 and the lower facing surface 332 of the elastic member 330.
以上、本発明に係る人工椎間板について第１実施例乃至第３実施例を用いて説明したが、本発明は、これらの実施例に限定されるものではない。その他、本発明は、その主旨を逸脱しない範囲で当業者の知識に基づき種々の改良、修正、変更を加えた態様で実施できるものである。 The artificial intervertebral disc according to the present invention has been described above using the first to third embodiments, but the present invention is not limited to these embodiments. In addition, the present invention can be implemented in various forms with various improvements, modifications, and changes based on the knowledge of those skilled in the art without departing from the spirit of the invention.
また、上述した第１実施例乃至第３実施例は、技術的に可能である限り組み合わせることができ、これらを組み合わせたものも本発明の特徴を含む限り本発明の範囲に包含される。 Furthermore, the first to third embodiments described above can be combined as far as technically possible, and combinations of these are also included within the scope of the present invention as long as they include the features of the present invention.
１００ 、２００ 、３００ ・・・人工椎間板
１１０ 、２１０ 、３１０ ・・・上側板状部分
１１１ 、２１１ 、３１１ ・・・上面
１１２ 、２１２ 、３１２ ・・・下面
１１２ａ、２１２ａ ・・・凹部
１２０ 、２２０ 、３２０ ・・・下側板状部分
１２１ 、２２１ 、３２１ ・・・下面
１２２ 、２２２ 、３２２ ・・・上面
１２２ａ、２２２ａ、３２２ａ・・・台座部
１３０ 、２３０ 、３３０ ・・・弾性部材
１３１ 、２３１ 、３３１ ・・・上側対向面
１３２ 、２３２ 、３３２ ・・・下側対向面
１３３ 、２３３ 、３３３ ・・・外側面
１４０ 、２４０ 、３４０ ・・・筒状部分
１４１ 、２４１ 、３４１ ・・・外側壁体
１４２ 、２４２ 、３４２ ・・・内側壁体
１４３ 、２４３ 、３４３ ・・・外側弾性層体
１４４ 、２４４ 、３４４ ・・・内側弾性層体
１４５ 、２４５ 、３４５ ・・・剛性壁体
３５０ ・・・滑り部材
３６０ ・・・接着層
ＵＶ ・・・上方側の椎体
ＤＶ ・・・下方側の椎体
Ｃ ・・・中心軸
Ｇ１、Ｇ２、Ｇ３ ・・・間隙
100 , 200 , 300 ... Artificial intervertebral disc 110 , 210 , 310 ... Upper plate-shaped portion 111 , 211 , 311 ... Upper surface 112 , 212 , 312 ... Lower surface 112a, 212a ... Recessed part 120 , 220 , 320...Lower plate-like portion 121, 221, 321...Lower surface 122, 222, 322...Upper surface 122a, 222a, 322a...Pedestal portion 130, 230, 330...Elastic member 131, 231 , 331 ... Upper opposing surface 132 , 232 , 332 ... Lower opposing surface 133 , 233 , 333 ... Outer surface 140 , 240 , 340 Cylindrical portion 141, 241, 341 Outer wall body 142, 242, 342 Inner wall body 143, 243, 343 Outer elastic layer body 144, 244, 344 Inner elastic layer Layers 145, 245, 345... rigid walls
350 ... Sliding member
360: Adhesive layer UV: Upper vertebral body DV: Lower vertebral body C: Central axis G1, G2, G3: Gap
Claims (4)
前記上方側の椎体に連結して前記上方側の椎体から荷重を受ける上側板状部分と、
前記下方側の椎体に連結して前記下方側の椎体から荷重を受ける下側板状部分と、
前記上側板状部分と前記下側板状部分との上下間に配置される弾性部材と、
前記上側板状部分に上端を連結するとともに前記下側板状部分に下端を連結して前記弾性部材を囲繞した状態で前記上側板状部分と前記下側板状部分とを相対移動自在に変位させる筒状部分とで構成され、
該筒状部分が、
前記上側板状部分または前記下側板状部分のいずれか一方に固定される筒状の外側壁体と、
前記上側板状部分または前記下側板状部分のいずれか他方に固定されて前記弾性部材を取り囲む筒状の内側壁体と、
前記外側壁体の内周面に一体に外接する外側弾性層体と、
前記内側壁体の外周面に一体に内接する内側弾性層体と、
前記外側弾性層体の内周面と前記内側弾性層体の外周面との相互間に一体に配置されて前記外側弾性層体および前記内側弾性層体よりも変形しにくい剛性壁体とで構成されていることを特徴とする記載の人工椎間板。 An artificial intervertebral disc that is attached between adjacent upper and lower vertebral bodies in the vertical direction of the spine,
an upper plate-like portion that is connected to the upper vertebral body and receives a load from the upper vertebral body;
a lower plate-like portion connected to the lower vertebral body and receiving a load from the lower vertebral body;
an elastic member disposed between the upper plate portion and the lower plate portion;
a cylindrical portion having an upper end connected to the upper plate portion and a lower end connected to the lower plate portion, the cylindrical portion displacing the upper plate portion and the lower plate portion so as to be movable relative to each other while surrounding the elastic member ;
The cylindrical portion is
a cylindrical outer wall body fixed to either the upper plate portion or the lower plate portion;
a cylindrical inner wall body fixed to the other of the upper plate portion or the lower plate portion and surrounding the elastic member;
an outer elastic layer integrally circumscribing an inner peripheral surface of the outer wall body;
an inner elastic layer integrally inscribed on an outer circumferential surface of the inner wall body;
The artificial intervertebral disc according to the present invention is characterized in that it is composed of a rigid wall body which is disposed integrally between the inner peripheral surface of the outer elastic layer body and the outer peripheral surface of the inner elastic layer body and which is less likely to deform than the outer elastic layer body and the inner elastic layer body .
前記弾性部材が、円柱状に形成され、
前記筒状部分が、円筒状に形成され、
前記上側板状部分と前記下側板状部分と前記弾性部材と前記筒状部分との中心軸が、一致していることを特徴とする請求項１に記載の人工椎間板。 The upper plate-shaped portion and the lower plate-shaped portion are formed in a disk shape,
The elastic member is formed in a cylindrical shape,
The tubular portion is formed in a cylindrical shape,
2. The artificial intervertebral disc according to claim 1 , wherein the central axes of said upper plate-shaped portion, said lower plate-shaped portion, said elastic member and said tubular portion are aligned with each other.
3. The artificial intervertebral disc according to claim 1 , wherein a sliding member having a smaller friction coefficient than said elastic member is provided on at least one of the upper and lower surfaces of said elastic member.
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| JP2002532141A (en) | 1998-12-11 | 2002-10-02 | デ・イ・エム・エス・オ（ディストリビュシオン・メディカル・デュ・シュド−ウエスト） | Intervertebral disc prosthesis |
| JP2005527296A (en) | 2002-05-23 | 2005-09-15 | パイオニア ラボラトリーズ インコーポレイテッド | Artificial intervertebral disc device |
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| AU624627B2 (en) * | 1988-08-18 | 1992-06-18 | Johnson & Johnson Orthopaedics, Inc. | Functional and biocompatible intervertebral disc spacer containing elastomeric material of varying hardness |
| JPH05277141A (en) * | 1992-03-30 | 1993-10-26 | Tokai Rubber Ind Ltd | Artificial disc |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| JP2002532141A (en) | 1998-12-11 | 2002-10-02 | デ・イ・エム・エス・オ（ディストリビュシオン・メディカル・デュ・シュド−ウエスト） | Intervertebral disc prosthesis |
| JP2005527296A (en) | 2002-05-23 | 2005-09-15 | パイオニア ラボラトリーズ インコーポレイテッド | Artificial intervertebral disc device |
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