【０００１】[0001]
【発明の属する技術分野】本発明は、外科、脳神経外科
或いは整形外科の医療分野で使用される椎体間スペーサ
に関し、詳しくは、外傷又はなんらかの疾患によって頚
椎、胸椎、腰椎の椎体或いは椎間板に異常を起し、手術
によって椎体又は椎間板を切除した場合において、上下
の椎体間に挿入（介在）される椎体間スぺーサ（以下、
単にスペーサともいう）に関する。BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an intervertebral body spacer used in the medical field of surgery, neurosurgery or orthopedic surgery, and more particularly to a cervical, thoracic, lumbar vertebral body or intervertebral disc due to trauma or any disease. When an abnormality is caused and the vertebral body or intervertebral disc is resected by surgery, an intervertebral body spacer inserted (intervened) between upper and lower vertebral bodies
Simply referred to as a spacer).
【０００２】[0002]
【従来の技術】この種の椎体間スペーサ（人工椎体）と
しては、特開平５−１５５４８号公報記載の技術など各
種のものが提案されている。同公報には、外側椎筒内に
内側椎筒をその軸方向長さを可変に挿入した構造の人工
椎体が提案されている。このもは、その可変構造により
人工椎体の高さを患者ごと異なる椎体間の間隔に合わせ
て調節できるため、少数のもので総ての椎体治療に対応
できるとされている。2. Description of the Related Art As this kind of intervertebral body spacer (artificial vertebral body), various types have been proposed, such as the technique described in Japanese Patent Application Laid-Open No. H5-15548. The publication proposes an artificial vertebral body having a structure in which an inner vertebral cylinder is variably inserted into an outer vertebral cylinder in its axial length. It is said that the height of the artificial vertebral body can be adjusted according to the interval between vertebral bodies which differ from patient to patient by its variable structure, so that a small number of the vertebral bodies can be used for all vertebral body treatments.
【０００３】同公報中に開示された第１の人工椎体は、
内周面に雌ねじを備えて筒状を成す外側椎筒（雌ねじ
体）と、これにねじ込まれる雄ねじを外周面に備えて筒
状を成す内側椎筒（雄ねじ体）とで構成され、両者を螺
合してなるものである。これにより、手術において外側
椎筒を内側椎筒に対して回動（回転）させることで個人
差のある個々の患者ごとの椎体間の大きさに応じてその
高さを調節できる、というものである。[0003] The first artificial vertebral body disclosed in the publication is:
An outer vertebral cylinder (female screw body) having a female thread on the inner peripheral surface and having a cylindrical shape, and an inner vertebral cylinder (male screw body) having a male thread provided on the outer peripheral surface and having a cylindrical shape. It is made by screwing. In this way, the height can be adjusted according to the size between the vertebral bodies of individual patients with individual differences by rotating (rotating) the outer vertebral cylinder with respect to the inner vertebral cylinder during surgery. It is.
【０００４】また第２の人工椎体は、両端に右ねじと左
ねじを備えた外側椎筒（雌ねじ体）と、右ねじと左ねじ
とされた２つの内側椎筒（雄ねじ体）の３部品から構成
されたものである。このものでは、中間の外側椎筒の両
端にそれぞれ螺合する内側椎筒を右ねじ、左ねじで連結
したものであり、外側椎筒（雌ねじ体）を左右のいずれ
かに回動させることで、椎体間にセットした状態で高さ
調整ができるというものである。The second artificial vertebral body has an outer vertebral cylinder (female thread) having right and left threads at both ends and two inner vertebral cylinders (male thread) having right and left threads. It is composed of parts. In this device, the inner vertebrae screwed to both ends of the middle outer vertebral cylinder are connected with right and left screws, respectively, and the outer vertebral cylinder (female screw body) is rotated left or right. The height can be adjusted while being set between the vertebral bodies.
【０００５】さらに第３の人工椎体は、内側椎筒（雄ね
じ体）にリング状ナットを螺合すると共に、雌ねじでは
なく穴が形成された筒状の外側椎筒をその内側椎筒（雄
ねじ体）に摺動自在に外嵌（挿入）したものである。こ
のものでは、リング状ナットを回動（回転）してその位
置を調整し、外側椎筒を内側椎筒に挿入し、リング状ナ
ットで位置を規制して高さを調節する、というものであ
る。In the third artificial vertebral body, a ring-shaped nut is screwed into an inner vertebral cylinder (male screw body), and a cylindrical outer vertebral cylinder having a hole is formed instead of a female screw. The body is slidably fitted (inserted) to the body. In this method, the ring nut is rotated (rotated) to adjust its position, the outer vertebral cylinder is inserted into the inner vertebral cylinder, the position is regulated by the ring nut, and the height is adjusted. is there.
【０００６】[0006]
【発明が解決しようとする課題】前記した第１〜第３の
人工椎体によれば、ねじ機構によりその高さの調節がで
きるため、少数の人工椎体で総ての椎体治療に対応でき
るといったメリットがあるが、次のような解決すべき課
題がある。まず、前記第１の人工椎体では、外側椎筒と
これにねじ込まれる内側椎筒とで構成したものであるた
め、その人工椎体を椎体間に挿入した状態の下で、その
高さ（椎体間隔）を調節するのに具合が悪い。というの
は、このようにして内外椎筒の一方を回転さると、その
いずれかが椎体の端面において回動してしまうために椎
体と擦れ合い、椎体に傷を付けるためである。したがっ
て、挿入後の高さの調節に問題がある。According to the first to third artificial vertebral bodies described above, the height can be adjusted by a screw mechanism, so that all vertebral body treatments can be performed with a small number of artificial vertebral bodies. Although it has the merit of being able to do so, there are the following issues to be solved. First, the first artificial vertebral body is composed of an outer vertebral cylinder and an inner vertebral cylinder screwed into the outer vertebral body. It is not good to adjust (vertebral body spacing). This is because, when one of the inner and outer vertebral cylinders is rotated in this manner, one of them rotates on the end face of the vertebral body and thus rubs against the vertebral body, thereby damaging the vertebral body. Therefore, there is a problem in adjusting the height after insertion.
【０００７】また、第２の人工椎体では、中間の外側椎
筒の両端部に設けられた左右ねじ（雌ねじ）にそれぞれ
内側椎筒を螺合したものであるため、前記第１の人工椎
体における問題点は解消されるが、通常と異なる左ねじ
部品を含むという点で、製造や管理上に難点がある。In the second artificial vertebral body, the inner artificial vertebra is screwed into left and right screws (female screws) provided at both ends of the intermediate outer vertebra, respectively. Although the body problem is eliminated, there are difficulties in manufacturing and management in that it involves unusual left-hand threaded parts.
【０００８】さらに第３の人工椎体では、第１、第２の
もののような問題はないが、外側椎筒が、機械的な結合
によることなく分離自在に外嵌（遊嵌）されているだけ
であるため、取扱い時において外側筒体と内側筒体とが
容易に分離してしまう。このため、手術において椎体間
に挿入する際に分離しないように慎重に取扱う必要があ
ることから、医師の負担が大きい。Further, in the third artificial vertebral body, there is no problem as in the first and second vertebral bodies, but the outer vertebral cylinder is detachably fitted (freely fitted) without mechanical coupling. Therefore, the outer cylinder and the inner cylinder are easily separated during handling. For this reason, since it is necessary to handle carefully so as not to separate when inserting between vertebral bodies in surgery, a burden on a doctor is great.
【０００９】本発明は、こうした問題点に鑑みてなされ
たもので、逆ねじや容易に分離する構成をとることな
く、しかも椎体間に挿入した状態でも高さの調節が問題
なくできる椎体間スペーサを提供することにある。SUMMARY OF THE INVENTION The present invention has been made in view of the above problems, and does not require a reverse screw or a structure that easily separates the vertebral body. It is to provide an interspacer.
【００１０】[0010]
【課題を解決するための手段】上記の目的を達成するた
め、請求項１記載の本発明は、上下の椎体に固着される
固着手段を上下に備え、該両固着手段相互間で螺合する
ねじ機構による高さ調節手段を有する椎体間スペーサに
おいて、一方の固着手段に対し、内周面に雌ねじを備え
た雌ねじ体及び外周面に雄ねじを備えた雄ねじ体のうち
の一方をねじの軸線回りに回動（回転）不能に設け、他
方の固着手段に対し、該雌雄両ねじ体のうちの他方をね
じの軸線回りに、分離することなく回動自在に設けたこ
とを特徴とする。In order to achieve the above object, the present invention according to the first aspect of the present invention comprises upper and lower fixing means fixed to upper and lower vertebral bodies, and a screw connection between the fixing means. In the intervertebral body spacer having a height adjusting means by a screw mechanism, one of a female screw body having an internal thread on an inner peripheral surface and a male screw body having an external thread on an outer peripheral surface is connected to one of the fixing means. It is provided so as not to be rotatable (rotatable) around the axis, and the other of the male and female screw bodies is rotatably provided around the axis of the screw without being separated from the other fixing means. .
【００１１】前記椎体間スペーサは次のように用いる。
まず、雌雄両ねじ体を螺合して椎体間の高さに合わせ
る。このように調節したスペーサを椎体間に挿入し、雌
雄両ねじ体のうちの回動自在のものを回動することによ
り、上下の固着手段を椎体間に挟ませる。そして、こう
することで両固着手段を回動させることなくその相互の
間隔すなわちスペーサの高さを調節できる。すなわち、
前記椎体間スペーサによれば固着手段が椎体と擦れ合う
ことがないから、スペーサを椎体間に挿入した後で、症
例に応じて最適寸法に微調節できる。しかも、構造的に
は通常の右ねじ構造だけで、左ねじ（逆ねじ）機構を要
しないことから、構成部品の製造や管理が容易である
し、構成部品が手術中に分離しないので手術における挿
入時の取扱いも容易となる。The interbody spacer is used as follows.
First, the male and female screw bodies are screwed together to match the height between the vertebral bodies. The spacer thus adjusted is inserted between the vertebral bodies, and the rotatable one of the male and female screw bodies is rotated, whereby the upper and lower fixing means are sandwiched between the vertebral bodies. Thus, the distance between the fixing means and the height of the spacer can be adjusted without rotating both fixing means. That is,
According to the intervertebral body spacer, since the fixing means does not rub against the vertebral body, it can be finely adjusted to an optimum size according to the case after inserting the spacer between the vertebral bodies. In addition, since the structure is only a normal right-handed screw structure and does not require a left-handed screw (reverse screw) mechanism, the manufacture and management of the components are easy. Handling during insertion is also easy.
【００１２】前記椎体間スペーサにおいては、一方の固
着手段に対し、外周面に雄ねじを備えた雄ねじ体をねじ
の軸線回りに回動不能に設け、他方の固着手段に対し、
内周面に雌ねじを備えた雌ねじ体をねじの軸線回りに、
分離することなく回動自在に設けたものとするのが好ま
しい。もっとも、これとは逆に雌雄両ねじ体を設けても
良い。すなわち、一方の固着手段に対し、内周面に雌ね
じを備えた雌ねじ体をねじの軸線回りに回動不能に設
け、他方の固着手段に対し、外周面に雄ねじを備えた雄
ねじ体をねじの軸線回りに、分離することなく回動自在
に設けてもよい。In the intervertebral body spacer, a male screw body having an external thread on the outer peripheral surface is provided so as to be non-rotatable around the axis of the screw with respect to one of the fixing means, and to the other fixing means.
A female screw body with a female screw on the inner peripheral surface around the screw axis,
It is preferable to be provided so as to be rotatable without being separated. However, conversely, both male and female screw bodies may be provided. That is, for one of the fixing means, a female screw body having an internal thread on the inner peripheral surface is provided so as not to rotate around the axis of the screw, and for the other fixing means, a male screw body having an external thread on the outer peripheral surface is formed of the screw. It may be provided to be rotatable around the axis without being separated.
【００１３】なおスペーサの全高さやその調節範囲は、
椎間板を切除して椎体間に挿入する場合や、１又は複数
の椎体を切除して補填する場合など、症例に応じて適宜
に設定すればよい。前記手段では、雌雄両ねじ体を螺合
した状態で、上下の固着手段相互間をねじの軸線方向に
貫通する中空構造とするのが好ましい。このようにして
おけば、中空部にボーンチップ（自家骨）や人工骨を収
容（装填）することができるので、椎体間の早期固定化
が図られるためである。The total height of the spacer and its adjustable range are as follows:
It may be set appropriately according to the case, such as when the intervertebral disc is cut and inserted between the vertebral bodies, or when one or more vertebral bodies are cut and supplemented. In the above-mentioned means, it is preferable that a hollow structure penetrates between the upper and lower fixing means in the axial direction of the screw in a state where the male and female screw bodies are screwed together. This is because a bone chip (autologous bone) or an artificial bone can be accommodated (loaded) in the hollow portion, so that the vertebral bodies can be fixed at an early stage.
【００１４】とくに、雌雄両ねじ体を螺合した状態で、
上下の固着手段相互間をねじの軸線方向に貫通する中空
構造とすると共に、雌ねじ体の周面であって螺合時にお
いて雄ねじ体のねじに対応する高さ部位に、雌ねじ体の
半径方向に貫通する貫通孔を設けておくとよい。このよ
うにしておけば、その貫通孔からポンチを打込むことで
螺合する雄ねじ体のねじ山を潰すことができるので、手
術後における回動防止を容易に達成できるためである。In particular, with both male and female screw bodies screwed together,
The hollow structure penetrates between the upper and lower fixing means in the axial direction of the screw, and at the peripheral surface of the female screw body and at the height corresponding to the screw of the male screw body at the time of screwing, in the radial direction of the female screw body It is preferable to provide a penetrating through hole. By doing so, the screw thread of the male screw body to be screwed can be crushed by driving a punch through the through hole, so that rotation prevention after surgery can be easily achieved.
【００１５】さらに、雌雄両ねじ体を螺合した状態で、
上下の固着手段相互間をねじの軸線方向に貫通する中空
構造とすると共に、雌ねじ体の周面であって螺合時にお
いて雄ねじ体のねじに対応する高さ部位に、雌ねじ体の
半径方向に貫通する貫通孔を設け、かつ雄ねじ体にはそ
の半径方向に貫通すると共にねじの軸線方向に長い形状
を成す貫通孔を設けてもよい。このようにしておけば、
雌雄両ねじ体の貫通孔相互を合致させることで、チタン
やステンレスなどの針金を通したり、ピンを打ち込ん
で、雌雄両ねじ体相互の回動防止を図ることができるた
めである。Further, with the male and female screw bodies screwed together,
The hollow structure penetrates between the upper and lower fixing means in the axial direction of the screw, and at the peripheral surface of the female screw body and at the height corresponding to the screw of the male screw body at the time of screwing, in the radial direction of the female screw body A penetrating through hole may be provided, and the male screw body may have a through hole that penetrates in the radial direction and has a shape that is long in the axial direction of the screw. If you do this,
By matching the through holes of the male and female screw bodies with each other, it is possible to prevent the mutual rotation of the male and female screw bodies by passing a wire such as titanium or stainless steel, or driving in a pin.
【００１６】そして、このように軸線方向に貫通する中
空構造とする場合には、その上下の開口端寄り部位の一
方に、微小な貫通孔を多数備えた蓋部材を取着しておく
とよい。このように蓋部材を取着しておけば、中空部に
自家骨や人工骨を収容する際に底となるため、自家骨等
の収容が容易となるためである。もっとも、前記上下の
開口端寄り部位の他方には、微小な貫通孔を多数備えた
取外し可能の蓋部材を取着しておくのが好ましい。この
様にしておけば、取外し可能の蓋部材を取外して自家骨
等を収容した後にその蓋部材を取着することで、患部へ
の挿入時において自家骨等がこぼれることが防止できる
ためである。In the case of a hollow structure penetrating in the axial direction as described above, a lid member provided with a large number of minute through holes may be attached to one of the upper and lower open end portions. . If the lid member is attached in this way, the bottom becomes a bottom when the auto bone or the artificial bone is housed in the hollow portion, so that the auto bone or the like can be easily housed. However, it is preferable to attach a removable lid member having a large number of minute through holes to the other of the upper and lower opening end portions. By doing so, it is possible to prevent the spilling of the autogenous bone or the like at the time of insertion into the affected part by removing the removable lid member and housing the autogenous bone or the like and then attaching the lid member. .
【００１７】前記固着手段は、椎体に固着されるもので
あればよく、その形状は適宜に設計すれば良く、とくに
限定されないが、前記固着手段のうちの椎体に対面する
側に複数の突起を設けるとよい。前記手段のスペーサ
は、椎体間に挿入されることから患者自身の体重で圧縮
力が加わるため、早期の融合が期待される。また椎体の
端面に凹部を設け、この凹部にスペーサの端部の固着手
段をなす部位を差込むようにセットして骨セメント等の
接着剤で固定することもできるが、このようにして固定
する場合には、その固定が複雑となるため手術時間が多
くかかる。これに対して、突起を設けておけば、その手
間もかからないし、突起が椎体の端面に容易に食い込
み、横ずれが防止されるなどの効果があるので早期の固
定が期待される。なお突起は椎体に食込むように突出形
成されていればよく、その大きさ、形状、数、配置は固
定が安定するように設ければよい。ただし、前記固着手
段のうちの少なくとも一方のものの椎体に対面する側の
面を、雌雄両ねじ体のねじの軸線に対し垂直とならない
ように構成してもよい。このようにすれば、椎体に前湾
角を付与できるためである。なお、雌雄両ねじ体のねじ
の軸線に対し垂直とならないように傾斜させる角度は椎
体に付与すべき前湾角を考慮して設定すればよい。The fixing means may be any one which can be fixed to the vertebral body, and its shape may be appropriately designed, and is not particularly limited, but a plurality of fixing means are provided on a side facing the vertebral body. Protrusions may be provided. Since the spacer of the means is inserted between the vertebral bodies, a compressive force is applied by the patient's own weight, so that early fusion is expected. It is also possible to provide a concave portion on the end surface of the vertebral body, insert the portion forming the fixing means of the end portion of the spacer into this concave portion, and fix it with an adhesive such as bone cement. In such a case, the fixation is complicated, so that a long operation time is required. On the other hand, if the projections are provided, there is an effect that the projections do not take much effort, the projections easily bite into the end face of the vertebral body, and the lateral displacement is prevented, so that early fixation is expected. The protrusions may be formed so as to protrude into the vertebral body, and the size, shape, number, and arrangement may be provided so that fixation is stable. However, the surface of the at least one of the fixing means facing the vertebral body may not be perpendicular to the axis of the screw of the male and female screw bodies. This is because a lordosis can be imparted to the vertebral body. The angle of inclination of the male and female screw bodies so as not to be perpendicular to the axis of the screw may be set in consideration of the lordosis angle to be given to the vertebral body.
【００１８】本発明のスペーサは、適度の強度があり、
生体親和性、非毒性ないし耐腐食性のある材料で製造す
れば良い。具体的には、チタン、チタン合金、コバルト
クロム合金（Ｃｏ−Ｃｒ合金）、ＳＵＳ３１６等のステ
ンレス鋼などの金属で製造するのが適している。この場
合、前記固着手段のうちの椎体に対面する側に、セラミ
ックをコーティングしておいてもよいし、セラミック部
材を接合又は組合わせてなるものとしてもよい。椎体へ
の固着が促進されるためである。The spacer of the present invention has a moderate strength.
What is necessary is just to manufacture with a biocompatible, non-toxic or corrosion-resistant material. Specifically, it is suitable to manufacture with a metal such as titanium, a titanium alloy, a cobalt chromium alloy (Co-Cr alloy), and stainless steel such as SUS316. In this case, the side of the fixing means facing the vertebral body may be coated with ceramic, or may be formed by joining or combining ceramic members. This is because fixation to the vertebral body is promoted.
【００１９】なお、コーティング、接合又は組合わせる
セラミックは生体親和性のよいものが好ましく、水酸ア
パタイト等のリン酸カルシウム系セラミックやバイオガ
ラスセラミックはとくに好ましい材質である。水酸アパ
タイトは椎体（骨組織）との親和性ないし固着性が良い
ためであり、チタン製のスペーサの椎体との接触部分に
水酸アパタイト等をコーティングしたものがとくに好ま
しい。また、前記金属のほか、セラミック（アルミナ、
ジルコニアなど）、ポリＬ乳酸、シリコンゴム、超高分
子量ポリエチレンなどのプラスチックを用いることもで
きる。The ceramics to be coated, bonded or combined are preferably those having good biocompatibility, and calcium phosphate ceramics such as hydroxyapatite and bioglass ceramics are particularly preferred materials. Hydroxyapatite has a good affinity or fixation with the vertebral body (bone tissue), and it is particularly preferable that a titanium spacer coated with hydroxyapatite or the like is in contact with the vertebral body. In addition to the above metals, ceramics (alumina,
Plastics such as zirconia), poly-L-lactic acid, silicone rubber, and ultra-high molecular weight polyethylene can also be used.
【００２０】[0020]
【発明の実施の形態】本発明に係る椎体間スペーサを具
体化した実施の形態について図１〜図７を参照して詳細
に説明する。本例のスペーサ１は、上下の椎体Ｚ，Ｚに
おける端面に固着される固着手段として、フランジ状の
着座部２及び着座部材３を下と上に備えている。そし
て、その相互間で螺合するねじ機構による高さ調節手段
が次のように構成されている。ただし、着座部２及び着
座部材３は、本例では平面視、略正方形を成し、略同じ
大きさとされている。DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS An embodiment embodying the intervertebral body spacer according to the present invention will be described in detail with reference to FIGS. The spacer 1 of the present example includes a flange-shaped seating portion 2 and a seating member 3 on the lower and upper sides as fixing means fixed to the end surfaces of the upper and lower vertebral bodies Z, Z. And the height adjusting means by the screw mechanism screwed between them is constituted as follows. However, the seat portion 2 and the seat member 3 have a substantially square shape in plan view in this example, and have substantially the same size.
【００２１】下の椎体Ｚへの固着手段をなす着座部２
は、一定厚さの略正方形を成し、椎体Ｚに対面する側の
下面６には下方に突出する複数の小さい突起５を備えて
いる。本例ではこの突起５は四角（正方形）錐体形状を
なし、略全面に対し縦横に隙間なく設けられている。そ
して、着座部２の上面７の内周縁には円筒状をなす円筒
部８が一体的に立設され、その外周面には所定のピッ
チ、ねじ山の雄ねじ９ａが上端部から基（下）端部近傍
まで形成されて雄ねじ体９を形成している。そして、こ
の雄ねじ体９には次記するように内周面の略全体に雌ね
じ１１ａを備えた六角ナット状を成す雌ねじ体１１が螺
進、螺退自在に螺合されている。なお、雄ねじ体９をな
す円筒部８の外周面には、平面視所定の間隔（本例では
６０度間隔）で半径方向に内外周面に貫通する側面視縦
長で小判形をなす貫通孔１０が複数（本例では６）設け
られている。A seat 2 for fixing to the lower vertebral body Z
Has a plurality of small protrusions 5 projecting downward on a lower surface 6 on the side facing the vertebral body Z, which is substantially square with a constant thickness. In this example, the projections 5 have a quadrangular (square) pyramid shape, and are provided on substantially the entire surface without any gaps vertically and horizontally. A cylindrical portion 8 having a cylindrical shape is integrally erected on the inner peripheral edge of the upper surface 7 of the seating portion 2, and a male screw 9 a having a predetermined pitch and a thread is formed on the outer peripheral surface from the upper end portion (lower). It is formed up to the vicinity of the end to form the male screw body 9. A female screw body 11 having a hexagonal nut shape and having a female screw 11a on substantially the entire inner peripheral surface thereof is screwed to the male screw body 9 so as to be able to advance and retreat as described below. In the outer peripheral surface of the cylindrical portion 8 forming the male screw body 9, a through hole 10 having a vertically-long, oblong shape in side view penetrating through the inner and outer peripheral surfaces in a radial direction at a predetermined interval (in this example, an interval of 60 degrees) in plan view. Are provided (6 in this example).
【００２２】一方、上の椎体Ｚへの固着手段を成す着座
部材３は略正方形をなすと共に、その椎体Ｚに対面する
側の上面１２のうち中心（内周）寄り部位が、外周寄り
部位より低位となるように段付き状に削られて薄肉部１
３とされている（図５参照）。そして、外周寄りの厚肉
部１４の上面１２には下の着座部２と同様に、上方に突
出する複数の四角（正方形）錐体形状をなす突起１５が
その略全面に対し縦横に隙間なく設けられている。そし
て、この着座部材３の内周側の薄肉部１３には、略六角
ナット状を成す雌ねじ体１１がその軸線回りに、分離す
ることなく回動自在に装着されている。ただし、本例で
は着座部材３の内周側の薄肉部１３に、雌ねじ体１１の
上端寄り外周に周設された周溝１７が嵌着されて、分離
することなく回動自在となるように装着されている。な
お、雌ねじ体１１の着座部材３への装着は、例えば図５
中２点鎖線で示したように雌ねじ体１１の上端部１１ｂ
を薄肉円筒状に形成しておき、着座部材３を外嵌した後
その上端部１１ｂを外側に押し広げるようにかしめるこ
とでもよい。また、図示はしないが、雌ねじ体１１を、
周溝１７をなす部位を含む上の部分とそれより下の部分
とを螺合して一体化する構成（ねじ込みによる一体化構
造）としておき、周溝１７をなす部位に着座部材３を外
嵌した状態で両部分（部品）をねじ込んで雌ねじ体とす
るなど、適宜の構成とすればよい。On the other hand, the seating member 3 forming the means for fixing to the upper vertebral body Z has a substantially square shape, and a portion of the upper surface 12 on the side facing the vertebral body Z is closer to the center (inner circumference) than to the outer circumference. It is cut into a stepped shape so that it is lower than the part, and the thin part 1
3 (see FIG. 5). Like the lower seating portion 2, the upper surface 12 of the thick portion 14 near the outer periphery has a plurality of projections 15 in the shape of a quadrangular (square) pyramid protruding upward, with no vertical and horizontal gaps over substantially the entire surface. Is provided. A female screw body 11 having a substantially hexagonal nut shape is rotatably mounted on the thin portion 13 on the inner peripheral side of the seat member 3 around the axis thereof without being separated. However, in this example, a peripheral groove 17 provided around the outer periphery near the upper end of the female screw body 11 is fitted into the thin portion 13 on the inner peripheral side of the seat member 3 so that the female member 11 can rotate freely without being separated. It is installed. The mounting of the female screw body 11 to the seating member 3 is performed, for example, as shown in FIG.
The upper end portion 11b of the female screw body 11 as shown by the middle two-dot chain line
May be formed in a thin cylindrical shape, and after the seating member 3 is fitted to the outside, the upper end portion 11b may be crimped so as to be pushed outward. Although not shown, the female screw body 11 is
The upper part including the part forming the circumferential groove 17 and the part below it are screwed and integrated (integrated structure by screwing), and the seating member 3 is externally fitted to the part forming the circumferential groove 17. In this state, an appropriate configuration may be adopted, such as screwing both parts (parts) into a female screw body.
【００２３】本形態のスペーサ１は、これを椎体Ｚ，Ｚ
間に挿入して雄ねじ体９を保持するようにし、雌ねじ体
１１を軸線回りに左に回動させれば、スペーサ１の高さ
が高くなり、着座部２及び着座部材３における突起５，
１５が上下の椎体Ｚの端面に食込むようになる。さらに
雌ねじ体１１を回動させれば着座部２及び着座部材３は
横ずれ及び回動することなく、スペーサ１の高さのみが
高くなる構成とされている。なお、雌ねじ体１１を軸線
回りに右に回動させれば、スペーサ１の高さは低くな
る。The spacer 1 of the present embodiment is formed by
When the female screw 11 is rotated to the left around the axis, the height of the spacer 1 increases, and the protrusions 5 on the seat portion 2 and the seat member 3 are inserted.
15 bite into the end faces of the upper and lower vertebral bodies Z. Further, if the female screw body 11 is rotated, the seating portion 2 and the seating member 3 do not laterally shift and rotate, and only the height of the spacer 1 is increased. If the female screw body 11 is rotated to the right around the axis, the height of the spacer 1 is reduced.
【００２４】このような本形態において、雌ねじ体１１
の外周に設けられた周溝１７の上の外周フランジ１８
は、その上面（雌ねじ体１１の上端面）が着座部材３の
突起５の基部、つまり着座部材３の上面１２より上に突
出しないようにされている。なお、略六角ナット状をな
す雌ねじ体１１の内外周面（雌ねじ１１ａと外周面１１
ｂ）間には、平面視所定の間隔（本例では６０度間隔）
で半径方向に貫通する側面視円形をなす貫通孔２０が複
数（本例では６）設けられている。ただしこの貫通孔２
０の直径は雄ねじ体９の貫通孔１０の短径（幅）と略同
一とされ、螺合された際、スペーサ１の高さ調節時にお
いて雄ねじ体９の貫通孔１０に対応する高さ部位に設け
られている。In this embodiment, the female screw 11
Outer peripheral flange 18 on peripheral groove 17 provided on the outer periphery of
The upper surface (the upper end surface of the female screw body 11) does not project above the base of the projection 5 of the seat member 3, that is, the upper surface 12 of the seat member 3. Note that the inner and outer peripheral surfaces of the female screw body 11 having a substantially hexagonal nut shape (the female screw 11a and the outer peripheral surface 11
b) a predetermined interval in plan view (in this example, an interval of 60 degrees)
A plurality of (six in this example) through holes 20 are formed in a circular shape in a side view that penetrate in the radial direction. However, this through hole 2
The diameter of 0 is substantially the same as the minor diameter (width) of the through hole 10 of the male screw body 9, and when screwed together, a height portion corresponding to the through hole 10 of the male screw body 9 when adjusting the height of the spacer 1. It is provided in.
【００２５】なお、固着手段をなす着座部２及び着座部
材３はその外寸（１辺）が、１５〜３０ｍｍの略正方形
とされ、その対角寸法が椎体Ｚの端面の径と略同じか、
それより小さくされている。ただし、着座部２及び着座
部材３ともその４つの角が椎体Ｚの端面の皮質骨の上に
のる大きさとするのが好ましい。また、固着手段をなす
着座部２及び着座部材３相互間の間隔（スペーサ１の高
さ）は、例えば椎間板を切除掻爬した場合の補填では５
〜１５ｍｍ、１又は複数の椎体を切除した場合には２５
〜６０ｍｍの範囲で調節できる大きさとする。因みに本
例における雌ねじ体（六角体）の対角寸法（外径）は、
１２〜２６ｍｍとされ、ねじ径は、８〜１８ｍｍとされ
ている。なお、本例のスペーサ１を構成する各部材はチ
タン合金から形成されている。The outer dimensions (one side) of the seat portion 2 and the seat member 3 forming the fixing means are substantially square with a length of 15 to 30 mm, and the diagonal dimension thereof is substantially the same as the diameter of the end face of the vertebral body Z. Or
It is smaller than that. However, it is preferable that the four corners of both the seating portion 2 and the seating member 3 be large enough to be placed on the cortical bone on the end face of the vertebral body Z. Further, the distance between the seating portion 2 and the seating member 3 forming the fixing means (the height of the spacer 1) is, for example, 5 in the case where the intervertebral disc is resected and cured.
~ 15 mm, 25 if one or more vertebral bodies are resected
The size should be adjustable within the range of ６０60 mm. Incidentally, the diagonal dimension (outer diameter) of the female screw body (hexagon) in this example is
The diameter is 12 to 26 mm, and the screw diameter is 8 to 18 mm. Each member constituting the spacer 1 of this embodiment is formed of a titanium alloy.
【００２６】次にこのように構成された本形態のスペー
サ１の用い方について説明する（図１参照）。まず、こ
のスペーサ１をなす雌雄両ねじ体９，１１を患部の椎体
Ｚ，Ｚ間の間隔（症例）に合わせ、それよりやや小さめ
に高さを調節しておく。次に上下の椎体Ｚの端面間に挿
入し、着座部２及び着座部材３をその中心位置に配置す
る。そして要すれば雄ねじ体９或いは着座部２を保持
し、雌ねじ体１１をスペーサ１の高さが高くなるように
左に回動させ、適切高さに調節する。なお、椎体Ｚ，Ｚ
間への挿入に際しては、雄ねじ体９の内側（中空部）に
人工骨や別途採取した自家骨を収容しておくと、椎体Ｚ
との接合が早められるので好ましい。Next, a description will be given of how to use the thus configured spacer 1 of this embodiment (see FIG. 1). First, the male and female screw bodies 9 and 11 constituting the spacer 1 are adjusted to the interval (case) between the vertebral bodies Z and Z of the affected part, and the height is adjusted slightly smaller than that. Next, it is inserted between the end faces of the upper and lower vertebral bodies Z, and the seating portion 2 and the seating member 3 are arranged at the center position. If necessary, the male screw body 9 or the seating portion 2 is held, and the female screw body 11 is rotated to the left so that the height of the spacer 1 is increased, and is adjusted to an appropriate height. The vertebral bodies Z, Z
At the time of insertion between the vertebral bodies Z, if artificial bones or autologous bones separately collected are housed inside the male screw body 9 (hollow portion).
This is preferred because the bonding with the metal can be accelerated.
【００２７】このようにして挿入したスペーサ１の高さ
を調節する際には、上下の固着手段をなす着座部２及び
着座部材３の突起５，１５が上下の椎体Ｚの端面に若干
食込むようになる。このようになると、その横ずれや回
動が防止されるので椎体Ｚの端面にて擦れ合うことな
く、しかも間隔の微調節が正確にできる。すなわち、椎
体Ｚ，Ｚ間に挿入した状態のままでその高さの微調整が
できることから、椎体Ｚに傷をつけることなく正確な高
さ調節が容易にできる。また、逆ねじ（左ねじ）構造が
ないので、製造、管理上の問題もないし、雌雄の両ねじ
体９，１１を螺合状態にして挿入できるので、手術途中
での分離の危険性がなく、したがって、手術の安全性も
高い。When adjusting the height of the spacer 1 inserted in this manner, the seating portion 2 and the projections 5 and 15 of the seating member 3 serving as upper and lower fixing means slightly erode on the end surfaces of the upper and lower vertebral bodies Z. I will get into it. In this case, the lateral displacement and the rotation are prevented, so that the end faces of the vertebral bodies Z do not rub against each other, and the fine adjustment of the interval can be accurately performed. That is, since the height can be finely adjusted while being inserted between the vertebral bodies Z, the accurate height adjustment can be easily performed without damaging the vertebral body Z. Further, since there is no reverse screw (left-handed screw) structure, there is no problem in manufacturing and management, and since the male and female screw bodies 9 and 11 can be screwed and inserted, there is no danger of separation during the operation. Therefore, the safety of the operation is also high.
【００２８】なお本例における着座部２及び着座部材３
の突起５，１５の椎体Ｚの端面への食込みは、術後にお
いて、体重（自重）による圧縮（圧迫）により行われ
る。これにより、スペーサ１と椎体Ｚとは早期に結合す
るため、骨セメントによる固定などを要しないことか
ら、手術時間の短縮も図られる。なおこのような突起
５，１５は本発明において必須のものではないが、本形
態のように適宜の突起形状、配置で設けるのが好まし
く、その際には、なるべく多数とし等間隔で配置するの
が好ましい。The seat 2 and the seat 3 in this embodiment
Of the projections 5 and 15 into the end face of the vertebral body Z is performed by compression (compression) by body weight (self-weight) after the operation. As a result, since the spacer 1 and the vertebral body Z are connected at an early stage, fixation with bone cement or the like is not required, so that the operation time can be reduced. Note that such projections 5 and 15 are not essential in the present invention, but are preferably provided in an appropriate projection shape and arrangement as in the present embodiment. In this case, it is preferable to arrange as many as possible and arrange them at equal intervals. Is preferred.
【００２９】また、本例では雌ねじ体１１に貫通孔２０
を設けたため、それに入る適当な太さのポンチをその貫
通孔２０に挿入して打ち付けることで、雄ねじ体９のね
じ山を潰すことができるので、ねじの緩み、つまり高さ
の変動を容易に防止できる。そして要すれば、雌ねじ体
１１を適量回動してその貫通孔２０を雄ねじ体９の貫通
孔１０に合わせるようにしてテーパピンを打ち込むか、
ステンレス等の針金を通して縛り付けるなどしても雌ね
じ体１１の回動を容易に防止できる。さらに、複数の椎
体を切除し、その補填に使用されるもののように、スペ
ーサ１の高さが高く、雄ねじ体９のねじ９ａが長くなる
ものでは、雄ねじ体９のねじの基部（着座部寄り）に別
途、ロックナットを螺合しておき、高さの調節後このロ
ックナットと雌ねじ体１１とを締付けることでねじの緩
み防止手段とすることもできる。In this embodiment, the female screw body 11 has a through hole 20.
The thread of the male screw body 9 can be crushed by inserting a punch having an appropriate thickness into the through hole 20 and hitting the punch, so that loosening of the screw, that is, fluctuation in height can be easily performed. Can be prevented. If necessary, the female screw body 11 is rotated by an appropriate amount, and the taper pin is driven so that the through hole 20 is aligned with the through hole 10 of the male screw body 9 or
Even if the female screw body 11 is tied through a wire such as stainless steel, the rotation of the female screw body 11 can be easily prevented. Further, in the case where the height of the spacer 1 is high and the screw 9a of the male screw body 9 is long, such as one used for cutting and replenishing a plurality of vertebral bodies, the base of the screw of the male screw body 9 (seating portion) In addition, a lock nut may be separately screwed in, and after adjusting the height, the lock nut and the female screw body 11 may be tightened to provide a means for preventing screw loosening.
【００３０】さて次に別の実施形態について図８を参照
して説明するが、このスペーサ２１は、前記形態、つま
り上下のねじの軸線方向に貫通する中空構造のスペーサ
１において、その中空部の下の開口端寄り部位に、微小
な貫通孔２２を多数備えた蓋部材２３を取付けた点のみ
が相違するだけで、前記形態の変形例とでもいうべきも
のであるため、相違点のみ説明し同一部位には同一の符
号を付すに止める。Next, another embodiment will be described with reference to FIG. 8. In this embodiment, the spacer 21 has the same structure as that of the spacer 1 having the hollow structure penetrating in the axial direction of the upper and lower screws. The only difference is that a lid member 23 having a large number of minute through holes 22 is attached to the lower open end portion, and this is a modification of the above embodiment. The same portions are given the same reference numerals.
【００３１】すなわち、このものは、円筒状を成す雄ね
じ体９の基部内周面に雌ねじ２５が周設され、外周に雄
ねじを備えた円形の蓋部材２３をねじこみにより取付け
たものである。なお、蓋部材２３には貫通孔２２が多数
あけられている。しかして、このものでは、貫通孔２２
があるために血流を確保できる上に、この蓋部材２３が
取着されているため、自家骨や人工骨Ｋをこぼすことな
く容易に収容できる。なお、貫通孔２２は、血流を害す
ることなく、しかも入れられた自家骨等がこぼれない大
きさとするのがよく、円形の場合、直径０．５〜５ｍｍ
程度、とくに好ましくは直径２ｍｍ以下の穴とするとよ
い。That is, in this embodiment, a female screw 25 is provided on the inner peripheral surface of the base of the male screw body 9 having a cylindrical shape, and a circular lid member 23 provided with a male screw on the outer periphery is attached by screwing. The cover member 23 has a large number of through holes 22. However, in this case, the through hole 22
As a result, the blood flow can be ensured, and since the lid member 23 is attached, the autogenous bone and the artificial bone K can be easily accommodated without spilling. The through-hole 22 should preferably have a size that does not impair the blood flow and does not spill the inserted autologous bone or the like. In the case of a circular shape, the diameter is 0.5 to 5 mm.
The diameter of the hole is preferably about 2 mm or less.
【００３２】なお、図８中２点鎖線で示したように、下
だけでなく上の開口端寄り部位にも同様に、微小な貫通
孔を多数備えた取外し可能の蓋部材２５を取着しておく
のが好ましい。この様にしておけば、この蓋部材２５を
取外して自家骨等を収容した後にその蓋部材２５を取着
することで、患部への挿入時において自家骨等がこぼれ
ることが防止できるためである。なお、本形態では、そ
のような蓋部材２５は、雌ねじ体１１の雌ねじ１１ａの
上端部にねじ込むことでその取着が確保される。As shown by a two-dot chain line in FIG. 8, a removable lid member 25 having a large number of small through holes is similarly attached not only to the lower part but also to the upper part near the opening end. It is preferable to keep it. In this way, by removing the lid member 25 and housing the autogenous bone or the like and then attaching the lid member 25, it is possible to prevent the autogenous bone or the like from spilling at the time of insertion into the affected part. . In the present embodiment, such a cover member 25 is secured by being screwed into the upper end of the female screw 11a of the female screw body 11.
【００３３】さて次に別の実施形態について図９を参照
して説明するが、このスペーサ３１は、図１〜７に示し
た形態における雌ねじ体１１に代えて雄ねじ体３９を上
の固着手段つまり着座部材３に、分離することなく回動
自在に設けると共に、雄ねじ体９に代えて雌ねじ体４１
を下の固着手段つまり着座部２に回動不能に立設した点
のみがその構成上異なるものであり、本質的相違はな
く、作用及び効果についても基本的に同じであることか
ら、同一部位には同一の符号を付し、相違点を中心とし
て説明する。以下の各形態においても同様とする。Next, another embodiment will be described with reference to FIG. 9. In this spacer 31, instead of the female screw body 11 in the form shown in FIGS. The seating member 3 is rotatably provided without being separated, and the female screw body 41 is used instead of the male screw body 9.
Is different only in the configuration thereof in that it is non-rotatably mounted on the lower fixing means, that is, on the seating portion 2, there is no essential difference, and the operation and effect are basically the same. Are denoted by the same reference numerals, and the description will focus on the differences. The same applies to the following embodiments.
【００３４】すなわち、本形態では下の固着手段をなす
着座部２の上面７の内周縁に対し、円筒状をなす円筒部
４８を一体的に立設し、その内周面には所定のピッチ、
ねじ山の雌ねじ４１ａが形成され、雌ねじ体４１をなし
ている。そしてそのねじに対して次記するように外周面
に雄ねじ３９ａを備えた円筒状を成す雄ねじ体３９が螺
進、螺退自在に螺合されている。なお、雌ねじ体４１の
内外周面間には、平面視所定の間隔（本例では６０度間
隔）で半径方向に貫通する側面視円形をなす貫通孔２０
が複数設けられている。That is, in the present embodiment, a cylindrical portion 48 having a cylindrical shape is integrally erected on the inner peripheral edge of the upper surface 7 of the seating portion 2 serving as a lower fixing means, and a predetermined pitch is provided on the inner peripheral surface. ,
A female screw thread 41 a having a thread is formed, and forms a female screw body 41. A cylindrical male screw body 39 having a male screw 39a on the outer peripheral surface is screwed to the screw so as to be able to advance and retreat as described below. In addition, between the inner and outer peripheral surfaces of the female screw body 41, a through hole 20 having a circular shape in a side view penetrating in a radial direction at a predetermined interval in plan view (in this example, an interval of 60 degrees).
Are provided.
【００３５】一方、上の椎体Ｚへの固着手段を成す着座
部材３は図１のものと実質的に同一に形成されている。
そして、この着座部材３は、その内周縁の薄肉部１３を
介して略円筒状を成す雄ねじ体３９の上端寄り外周の上
のフランジ１８と下の六角リング部１８ａ間に周設され
た周溝１７に、分離することなく回動自在に装着されて
いる。なお、六角リング部１８ａは回動部とされ、スパ
ナを噛ませて雄ねじ体３９を回動させるように構成され
ている。On the other hand, the seating member 3 forming the means for fixing to the upper vertebral body Z is formed substantially the same as that of FIG.
The seat member 3 has a circumferential groove formed between the upper flange 18 and the lower hexagonal ring portion 18a on the outer periphery near the upper end of the male screw body 39 having a substantially cylindrical shape via the thin portion 13 on the inner peripheral edge thereof. 17, it is rotatably mounted without being separated. The hexagonal ring portion 18a is a rotating portion, and is configured to bite a wrench to rotate the male screw body 39.
【００３６】しかして、このようなスペーサ３１は、適
当な高さに調節した後で椎体Ｚ，Ｚ間に挿入し、雌ねじ
体４１を保持するようにして雄ねじ体３９を軸線回りに
左に回動させれば、スペーサ３１の高さが高くなり、着
座部２及び着座部材３における突起５，１５が上下の椎
体Ｚの端面に接し、そして食込むようになるなど、図１
のものと同様の作用ないし効果がある。After the spacer 31 is adjusted to an appropriate height, the spacer 31 is inserted between the vertebrae Z, Z, and the male screw 39 is held to the left around the axis so as to hold the female screw 41. When rotated, the height of the spacer 31 increases, and the projections 5 and 15 of the seating portion 2 and the seating member 3 contact the end faces of the upper and lower vertebral bodies Z and bite.
It has the same function or effect as that of the above.
【００３７】なお、固着手段は、前記形態のように着座
部或いは着座部材とすることなく、椎体の端面に嵌入さ
れるような形状であってもよい。図示はしないが、前記
形態の着座部や着座部材における小さい突起に代えて食
込ませることができないような大きめの凸部を設けたも
のとしてもよい。椎体の端面に病変部があるような場合
においてその部分を切除掻爬すると凹部ができることか
ら、大きな凸部を切除してできる凹部に挿入し、骨セメ
ントで固定するのである。また、フランジ状の着座部或
いは着座部材とする場合でも、その平面形状は略円形と
してもよいし、八角形などの多角形としてもよい。さら
に、椎体の端面の新生骨が結合しやすい場合には、前記
形態におけるような四角錐形状の突起に代えて、椎体に
対面する側の表面全体に微小突起を無数設けておくか、
粗面化処理をしておくだけでもよい。The fixing means may be shaped to fit into the end face of the vertebral body without being a seat or a seat member as in the above embodiment. Although not shown, a large protrusion that cannot be bitten may be provided instead of the small projection on the seating portion or the seating member of the above-described embodiment. When there is a lesion on the end face of the vertebral body, a portion is formed by excision and curetation of the portion, so that a large convex portion is cut and inserted into the formed concave portion, and fixed with bone cement. Further, even in the case of a flange-shaped seating portion or seating member, its planar shape may be substantially circular or may be polygonal such as octagon. Furthermore, when the new bone on the end face of the vertebral body is easily bonded, instead of the quadrangular pyramid-shaped projections as in the above-described embodiment, an infinite number of microprojections are provided on the entire surface facing the vertebral body,
The surface may be simply roughened.
【００３８】なお、本発明に係るスペーサにおいては、
固着手段を成す着座部や着座部材における椎体に対面す
る側にセラミックをコーティングしておいてもよいが、
図１０に示したスペーサ５１のように着座部２や着座部
材３における椎体Ｚに対面する側にセラミック部材５
５，５６を接着剤などにより接合、或いは図示しないが
嵌合しておいてもよい。In the spacer according to the present invention,
Ceramic may be coated on the side facing the vertebral body of the seating portion and the seating member forming the fixing means,
Like the spacer 51 shown in FIG. 10, the ceramic member 5 is provided on the side of the seat 2 or the seat member 3 facing the vertebral body Z.
5 and 56 may be joined by an adhesive or the like, or may be fitted together (not shown).
【００３９】さらに、前記形態では固着手段をなす着座
部或いは着座部材の面に対し、雌雄両ねじ体のねじの軸
線が略垂直となるものを例示したが、本発明では例えば
図１１に示したスペーサ６１のように、回動不能とされ
た着座部６２の下面６６を雄ねじ体のねじの軸線に対し
垂直とならないように角α傾斜させて、或いは図中２点
鎖線で示したように、着座部材３の上面１２も同様に傾
斜させて椎体Ｚに前湾角が付くようにしておいてもよ
い。このようにしておけば、椎体（腰椎）に前湾が必要
な場合でもそれが容易に確保される。なお傾斜角αは前
湾角に応じて設定すればよい。Further, in the above-described embodiment, the screw axis of the male and female screw bodies is substantially perpendicular to the surface of the seating portion or the seating member forming the fixing means. Like the spacer 61, the lower surface 66 of the non-rotatable seating portion 62 is inclined at an angle α so as not to be perpendicular to the axis of the screw of the male screw body, or as shown by a two-dot chain line in the drawing. The upper surface 12 of the seating member 3 may be similarly inclined so that the vertebral body Z has a lordosis angle. In this way, even if the vertebral body (lumbar vertebra) requires a lordosis, it can be easily secured. Note that the inclination angle α may be set according to the fore-bay angle.
【００４０】なお、上下の固着手段の平面形状や突起
は、上下ともに同じものとする必要はない。また突起を
設けるにしても、下の固着手段にのみ設けてもよい。さ
らに、分離することなく回動自在とする構造は、前記形
態ではナット状の雌ねじ体の外周面又は雄ねじ体の外周
面に周溝を設け、この周溝に他方の固着手段を成す着座
部材を装着したものを例示したが、本発明ではこれに限
定されない。It is not necessary that the upper and lower fixing means have the same planar shape and projection. Further, even if the projection is provided, it may be provided only on the lower fixing means. Furthermore, in the above-mentioned configuration, the structure that is rotatable without being separated is provided with a circumferential groove on the outer circumferential surface of the nut-shaped female screw body or the outer circumferential surface of the male screw body, and a seating member that forms the other fixing means in this circumferential groove. The attached one is exemplified, but the present invention is not limited to this.
【００４１】例えば、図１２に示したように、ナット状
の雌ねじ体１１の上寄り部位の内周面を拡径し、その内
周に沿って周溝７７を設けておき、この周溝７７に対
し、固着手段を成す着座部材３の下に設けられた外向円
形フランジ７８を、分離することなく回動自在に装着し
てもよい。また、図１３に示したように円筒状の雄ねじ
体３９の上寄り部位の内周面を拡径し、その内周に沿っ
て周溝７７を設けておき、この周溝７７に対し、固着手
段を成す着座部材３の下に設けられた外向円形フランジ
７８を、分離することなく回動自在に装着してもよい。
本発明は、その要旨を逸脱しない範囲において適宜設計
変更して具体化できる。For example, as shown in FIG. 12, the inner peripheral surface of the upper portion of the nut-shaped female screw body 11 is enlarged, and a circumferential groove 77 is provided along the inner circumference. On the other hand, an outward circular flange 78 provided below the seat member 3 forming the fixing means may be rotatably mounted without being separated. Further, as shown in FIG. 13, the inner peripheral surface of the upper part of the cylindrical male screw body 39 is enlarged in diameter, and a circumferential groove 77 is provided along the inner circumference. The outward circular flange 78 provided below the seating member 3 constituting the means may be rotatably mounted without being separated.
The present invention can be embodied by appropriately changing the design without departing from the gist thereof.
【００４２】[0042]
【発明の効果】以上の説明から明らかなように本発明の
スペーサによれば、適当高さに調節して上下の固着手段
を椎体間にて挟ませるようにした後、雌雄両ねじ体のう
ちの回動自在のものを回動することで、両固着手段を回
動させることなくスペーサの高さを調節できる。すなわ
ち、固着手段が椎体と擦れ合うことがないから、スペー
サを椎体間に挿入した後で最適寸法に高さを調節でき
る。しかも、構造的には通常の右ねじ構造だけで、左ね
じ（逆ねじ）機構を要しないことから、構成部品の製造
や管理が容易であるし、構成部品が手術中に分離しない
ので手術における挿入時の取扱いも容易となる。As is apparent from the above description, according to the spacer of the present invention, after adjusting the height to an appropriate level and holding the upper and lower fixing means between the vertebral bodies, the male and female screw bodies are By rotating one of the rotatable members, the height of the spacer can be adjusted without rotating both fixing means. That is, since the anchoring means does not rub against the vertebral bodies, the height can be adjusted to optimal dimensions after the spacer is inserted between the vertebral bodies. In addition, since the structure is only a normal right-handed screw structure and does not require a left-handed screw (reverse screw) mechanism, the manufacture and management of the components are easy. Handling during insertion is also easy.
【図１】本発明の椎体間スペーサの実施形態例を示す半
断面正面図。FIG. 1 is a half sectional front view showing an embodiment of an intervertebral body spacer according to the present invention.
【図２】図１の椎体間スペーサを構成する着座部及び雄
ねじ体の縦断面図。FIG. 2 is a longitudinal sectional view of a seat portion and a male screw body constituting the intervertebral body spacer of FIG. 1;
【図３】図２の平面図。FIG. 3 is a plan view of FIG. 2;
【図４】図２の底面図。FIG. 4 is a bottom view of FIG. 2;
【図５】図１の椎体間スペーサを構成する着座部材及び
雌ねじ体の縦断面図。FIG. 5 is a longitudinal sectional view of a seat member and a female screw body constituting the intervertebral body spacer of FIG. 1;
【図６】図５の平面図。FIG. 6 is a plan view of FIG. 5;
【図７】図５の底面図。FIG. 7 is a bottom view of FIG. 5;
【図８】本発明の椎体間スペーサの別の実施形態例を示
す半断面正面図。FIG. 8 is a half sectional front view showing another embodiment of the interbody spacer of the present invention.
【図９】本発明の椎体間スペーサの別の実施形態例を示
す半断面正面図。FIG. 9 is a half sectional front view showing another embodiment of the intervertebral body spacer of the present invention.
【図１０】本発明の椎体間スペーサの別の実施形態例を
示す半断面正面図。FIG. 10 is a half sectional front view showing another embodiment of the interbody spacer of the present invention.
【図１１】本発明の椎体間スペーサの別の実施形態例を
示す半断面正面図。FIG. 11 is a half sectional front view showing another embodiment of the intervertebral body spacer of the present invention.
【図１２】椎体間スペーサを構成する着座部材及び雌ね
じ体の別例の縦断面図。FIG. 12 is a longitudinal sectional view of another example of a seating member and a female screw body constituting an intervertebral body spacer.
【図１３】椎体間スペーサを構成する着座部材及び雄ね
じ体の別例の縦断面図。FIG. 13 is a longitudinal sectional view of another example of a seat member and a male screw body constituting an intervertebral body spacer.
１，２１，３１，５１，６１ 椎体間スペーサ ２，６２ 着座部（固着手段） ３ 着座部材（固着手段） ５，１５ 複数の突起 ６，６６ 着座部の椎体に対面する側の面 ９，３９ 外周面に雄ねじを備えた雄ねじ体（高さ調節
手段） １１，４１ 内周面に雌ねじを備えた雌ねじ体（高さ調
節手段） １０ 雌ねじ体の半径方向に貫通する貫通孔 １２ 着座部材の椎体に対面する側の面 ２０ 雌ねじ体の半径方向に貫通する貫通孔 ２３ 蓋部材 ５５，５６ 固着手段の椎体に対面する側のセラミック
部材 Ｚ 上下の椎体1, 21, 31, 51, 61 Intervertebral body spacer 2, 62 Seating part (fixing means) 3 Seating member (fixing means) 5, 15 Plural projections 6, 66 Surface of seating part facing vertebral body 9 , 39 A male screw body provided with a male screw on the outer peripheral surface (height adjusting means) 11, 41 A female screw body provided with a female screw on the inner peripheral surface (height adjusting means) 10 A through hole penetrating in the radial direction of the female screw body 12 Seating member Surface facing the vertebral body 20 through hole penetrating in the radial direction of the female screw body 23 lid member 55, 56 ceramic member on the side facing the vertebral body of the fixing means Z upper and lower vertebral bodies
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP10377657AJP2000197652A (en) | 1998-12-28 | 1998-12-28 | Spacer between centra |
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP10377657AJP2000197652A (en) | 1998-12-28 | 1998-12-28 | Spacer between centra |
| Publication Number | Publication Date |
|---|---|
| JP2000197652Atrue JP2000197652A (en) | 2000-07-18 |
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP10377657APendingJP2000197652A (en) | 1998-12-28 | 1998-12-28 | Spacer between centra |
| Country | Link |
|---|---|
| JP (1) | JP2000197652A (en) |
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP2006520665A (en)* | 2003-03-20 | 2006-09-14 | エスディージーアイ・ホールディングス・インコーポレーテッド | Vertebral replacement device |
| JP2008184000A (en)* | 2007-01-29 | 2008-08-14 | Showa Corp | Steering device |
| JP2009519063A (en)* | 2005-12-13 | 2009-05-14 | デル・ゲゼルシャフト・ミット・ベシュレンクテル・ハフツング | Face joint prosthesis |
| US8992617B2 (en) | 2007-03-13 | 2015-03-31 | DePuy Synthes Products, LLC | Adjustable intervertebral implant |
| US9877840B2 (en) | 2008-09-04 | 2018-01-30 | DePuy Synthes Products, Inc. | Adjustable intervertebral implant |
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP2006520665A (en)* | 2003-03-20 | 2006-09-14 | エスディージーアイ・ホールディングス・インコーポレーテッド | Vertebral replacement device |
| JP2009519063A (en)* | 2005-12-13 | 2009-05-14 | デル・ゲゼルシャフト・ミット・ベシュレンクテル・ハフツング | Face joint prosthesis |
| JP2008184000A (en)* | 2007-01-29 | 2008-08-14 | Showa Corp | Steering device |
| US8992617B2 (en) | 2007-03-13 | 2015-03-31 | DePuy Synthes Products, LLC | Adjustable intervertebral implant |
| US9877840B2 (en) | 2008-09-04 | 2018-01-30 | DePuy Synthes Products, Inc. | Adjustable intervertebral implant |
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| Date | Code | Title | Description |
|---|---|---|---|
| A977 | Report on retrieval | Free format text:JAPANESE INTERMEDIATE CODE: A971007 Effective date:20040811 | |
| A131 | Notification of reasons for refusal | Free format text:JAPANESE INTERMEDIATE CODE: A131 Effective date:20041005 | |
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