1. A bolt or nut tightening device comprising the combination of a tightening assisting unit having an outer shaft and an inner shaft coupled to a planetary gear mechanism coaxially therewith and rotatable in directions opposite to each other, the outer shaft having a reaction receiver projecting therefrom sideways, the inner shaft being provided with an engaging portion engageable with a bolt or nut to be tightened, and input means coupled to the planetary gear mechanism,
the outer shaft being provided with a tightening torque measuring unit, the tightening torque measuring unit comprising:
a strain sensor provided on the outer shaft,
a circuit board for converting the amount of strain of the outer shaft as detected by the strain sensor to an amount of tightening torque,
an indicator for indicating the amount of tightening torque,
a battery,
a mount tubular member fitted around and rotatable with the outer shaft, and
a case for accommodating the circuit board, the indicator and the battery,
the case being attached to an outer peripheral portion of the mount tubular member and projecting toward the same direction as the reaction receiver, the case being so sized as to be hidden by a contour of the reaction receiver and being so positioned as to be hidden behind the reaction receiver when seen from the forward end side of the engaging portion.
2. The bolt or nut tightening device according to claim 1 wherein the indicator is adapted to indicate digits of a numerical value as arranged in the direction of projection of the case.
3. The bolt or nut tightening device according to claim 1 wherein the input means is a power tightening machine having the two output shafts of an inner output shaft and an outer output shaft coaxial therewith, and an input receiver provided in the tightening assisting unit has a first connecting member for detachably connecting the outer shaft of the tightening assisting unit to the outer output shaft of the power tightening machine so as to be rotatable therewith, and a second connecting member for detachably connecting an input shaft of a system for rotatingly driving the engaging portion of the tightening assisting unit to the inner output shaft of the power tightening machine so as to be rotatable therewith.
4. The bolt or nut tightening device according to claim 1 wherein the input means is a power tightening machine having a single output shaft, and an input receiver provided in the tightening assisting unit has a connecting member for detachably connecting an input shaft of a system for rotatingly driving the engaging portion of the tightening assisting unit to the output shaft of the power tightening machine so as to be rotatable therewith.
5. The bolt or nut tightening device according to claim 1 wherein the input means is a manual wrench, and an input receiver provided in the tightening assisting unit has a connecting member for detachably connecting an input shaft of a system for rotatingly driving the engaging portion of the tightening assisting unit to an output shaft of the manual wrench so as to be rotatable therewith.
6. The bolt or nut tightening device according to claim 1 wherein the input means is a manual wrench, and an input receiver provided in the tightening assisting unit comprises a connecting member for detachably connecting an input shaft of a system for rotatingly driving the engaging portion of the tightening assisting unit to an output shaft of the manual wrench so as to be rotatable therewith and a one-way clutch attached to the tightening assisting unit for permitting the manual wrench to rotate in a desired direction but preventing the manual wrench from rotating in a direction opposite to the direction.
7. The bolt or nut tightening device according to claim 1 wherein the indicator is located orthogonal to the outer shaft.
8. The bolt or nut tightening device according to claim 1 wherein the mount tubular member is adapted to cover the strain sensor and is held between a peripheral wall provided at the outer shaft on the casing side thereof and a retaining ring mounted in the outer shaft on the engaging portion side thereof.
The claims below are in addition to those above.
All refrences to claim(s) which appear below refer to the numbering after this setence.
1. A method of supporting and augmenting a nucleus pulposus of an intervertebral disc in a spine comprising:
inserting a flexible one-piece biocompatible nucleus augmentation device into the disc space through and entirely beyond a defect in a posterior portion of an anulus;
wherein said nucleus augmentation device comprises an anchor, a connection member and a nucleus augmentation material, the nucleus augmentation material being at least partially attached to an anchor;
anchoring said nucleus augmentation material to a site within an anterior portion of the anulus or a vertebral body adjacent said anterior portion of the anulus;
providing a connection member;
wherein the connection member provides stiffness under tension and partially or fully prevents said nucleus augmentation material from migrating farther posterior with respect to the anchor; and
wherein the augmentation material comprises a channel or slit that receives the connection member and permits sliding along the connection member.
2. The method of claim 1, wherein one or more additional nucleus augmentation devices or nucleus augmentation materials are inserted into the disc.
3. A method of supporting and augmenting a nucleus pulposus of an intervertebral disc in a spine comprising:
inserting a flexible one-piece biocompatible nucleus augmentation device into the disc space through and entirely beyond a defect in a posterior portion of an anulus;
wherein said nucleus augmentation device comprises an anchor, a connection member and a nucleus augmentation material, the nucleus augmentation material being at least partially attached to an anchor;
anchoring said nucleus augmentation material to a site within an anterior portion of the anulus or a vertebral body adjacent said anterior portion of the anulus;
providing a connection member;
wherein the connection member provides stiffness under tension and partially or fully prevents said nucleus augmentation material from migrating farther posterior with respect to the anchor; and
threading the connection member through the augmentation material.
4. The method of claim 3, wherein the nucleus augmentation material is disc-shaped, cube-like, spheroid, ellipsoid, rhombohedral, cylindrical, or amorphous.
5. The method of claim 3, further comprising supporting at least one portion of an anulus fibrosus of the disc.
6. The method of claim 5, wherein the step of supporting at least one portion of an anulus fibrosus comprises supporting at least one portion of a region selected from the group consisting of one or more of following regions: anterior, anterior medial, anterior lateral, posterior, and lateral portion of the anulus fibrosus.
7. The method of claim 3, wherein the nucleus augmentation material comprises collagen.
8. The method of claim 3, wherein the nucleus augmentation material comprises hydrogel.
9. The method of claim 3, wherein the nucleus augmentation material comprises cellulose.
10. The method of claim 3, wherein the step of providing at least one connection member comprises providing at least one connector selected from the group consisting of: sutures, wires, rigid rods, broad bands, pins, woven tubes and webs.
11. The method of claim 3, wherein one or more additional nucleus augmentation devices or nucleus augmentation materials are inserted into the disc.
12. A method of supporting and augmenting a nucleus pulposus of an intervertebral disc in a spine comprising:
installing a first anchor in a site in an anterior portion of an anulus or a vertebral body adjacent said anterior portion of the anulus;
coupling at least one connector to said anchor;
positioning at least one plug of nucleus augmentation material entirely within the volume of the disc nucleus;
coupling said plug with said at least one connector;
wherein the connector provides stiffness under tension and partially or fully prevents nucleus augmentation material from migrating further posterior with respect to the anchor; and
inserting a barrier into an interior of the disc, entirely within the disc nucleus, and proximal to a defect in an anulus, thereby preventing passage of nucleus augmentation material through said defect.
13. The method of claim 12, further comprising affixing said barrier to said anulus.
14. The method of claim 12, wherein inserting said barrier comprises inserting a barrier with a larger area than an area of said defect.
15. The method of claim 12, wherein inserting said barrier comprises inserting a barrier comprising at least one of woven material, polyamide, polyester, polyethylene, an expanded material, expanded polytetrafluoroethylene, a biologic material, cross-linked collagen, and cellulose.
16. The method of claim 12, wherein inserting said barrier comprises inserting a barrier comprising an expandable component.
17. A method of supporting and augmenting a nucleus pulposus of an intervertebral disc in a spine comprising:
installing a first anchor in an anterior portion of the spine within a first endplate;
inserting a nucleus augmentation support member entirely within the region occupied by a disc nucleus;
coupling a connection member to said anchor, wherein the connection member is stiff under tension and partially or fully prevents the nucleus augmentation material from migrating further posterior with respect to the anchor;
coupling said nucleus augmentation support member to said connection member; and
wherein coupling said nucleus augmentation support member to said connection member comprises threading the connection member into said nucleus augmentation support member.
18. A method of supporting and augmenting a nucleus pulposus of an intervertebral disc in a spine comprising:
installing a first anchor in an anterior portion of the spine within a first endplate;
inserting a nucleus augmentation support member entirely within the region occupied by a disc nucleus;
coupling a connection member to said anchor;
wherein the connection member is stiff under tension and partially or fully prevents the nucleus augmentation material from migrating further posterior with respect to the anchor;
coupling said nucleus augmentation support member to said connection member; and
wherein coupling said nucleus augmentation support member to said second connection member comprises sliding the connection member into a slit or channel contained in said nucleus augmentation support member.