FR2703580A1 - Intersomatic cervical cage - Google Patents

Intersomatic cervical cage Download PDF

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Publication number
FR2703580A1
FR2703580A1 FR9302558A FR9302558A FR2703580A1 FR 2703580 A1 FR2703580 A1 FR 2703580A1 FR 9302558 A FR9302558 A FR 9302558A FR 9302558 A FR9302558 A FR 9302558A FR 2703580 A1 FR2703580 A1 FR 2703580A1
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FR
France
Prior art keywords
cage
intersomatic
intersomatic fusion
vertebrae according
internal compression
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
FR9302558A
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French (fr)
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FR2703580B1 (en
Inventor
Robert Gilles
Albert P Alby
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Individual
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Individual
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Priority to FR9302558A priority Critical patent/FR2703580B1/en
Publication of FR2703580A1 publication Critical patent/FR2703580A1/en
Application granted granted Critical
Publication of FR2703580B1 publication Critical patent/FR2703580B1/en
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0017—Angular shapes
    • A61F2230/0026—Angular shapes trapezoidal
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0069—Three-dimensional shapes cylindrical
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0082—Three-dimensional shapes parallelepipedal
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0096—Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers
    • A61F2250/0098—Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers radio-opaque, e.g. radio-opaque markers

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Neurology (AREA)
  • Transplantation (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Cardiology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Prostheses (AREA)

Abstract

The invention relates to a device for internal retention and for intersomatic fusion of the vertebrae in case of discectomy, referred to by the name intersomatic cage. The characteristics of the cage are as follows: - it is made of polyethylene or an equivalent, optionally absorbable, material and introduces a shock-absorption factor which reduces the transmission of stresses. - Geometrically, the cage has the shape of a parallelepiped and may or may not comprise a central reinforcing partition (2). Its anterior (5) and posterior (6) faces have heights which are determined so as to retain an intervertebral space and normal lordosis. - The edges of each of the faces of the cage are provided with notches (11) intended to oppose displacements. - It is equipped, in its central region, with a radiopaque marker which makes it possible to monitor over time the displacement of the implant and allow conduction of perturbed radiological and MRI examinations. - Volumes are available for accommodating bone fragments of suitable dimensions.

Description

La présente invention concerne une cage de contention, désignée Cage Intersomatique destinée à être insérée entre deux vertèbres. Une telle insertion permet d'étayer l'espace libéré par la discectomie et de procéder à la mise en place d'un greffon osseux destiné à fusionner les deux vertèbres.The present invention relates to a compression cage, designated Intersomatic Cage intended to be inserted between two vertebrae. Such an insertion makes it possible to support the space freed up by the discectomy and to proceed with the establishment of a bone graft intended to merge the two vertebrae.

Le déroulement de la procédure prévoit les étapes suivantes:
1) Abord de la face antérieure du rachis cervical par incision dans un pli du cou.The procedure involves the following stages:
1) Approach of the anterior face of the cervical spine by incision in a fold of the neck.

2) Incision verticale sur la ligne médiane des muscles prévertébraux et mise en place
d'un écarteur autostatique transversal.2) Vertical incision on the midline of the pre-vertebral muscles and placement
a transverse autostatic spreader.

3) Repérage radiologique du disque exposé et mise en place de plots vissés au milieu
des corps vertébraux sus- et sous-jacents.3) Radiological identification of the exposed disc and placement of studs screwed in the middle
of the overlying and underlying vertebral bodies.

4) Distraction vertébrale et discectomie complète. Abrasion des lèvres antérieures
des plateaux adjacents.4) Vertebral distraction and complete discectomy. Abrasion of the anterior lips
adjacent trays.

5) Curetage des plateaux et mise àjour du spongieux sur chaque face intervertébrale
pour favoriser la conduction osseuse.5) Curettage of the plates and updating of the cancellous bone on each intervertebral surface
to promote bone conduction.

6) Remplissage de la cage à l'aide de deux parallélépipèdes d'os spongieux débordant
de 1 mm environ sur les 2 faces.6) Filling of the cage using two parallel spheres of spongy spongy bone
about 1 mm on both sides.

7) Mise en place de la cage. 7) Installation of the cage.

8) Ablation de la distraction et fermeture de l'incision. 8) Removal of distraction and closing of the incision.

Les implants métalliques présentent l'inconvénient d'être ngides, donc de transmettre intégralement les contraintes et de constituer, dans certaines conditions, un obstacle à une bonne reconstitution osseuse. De plus, leur poids est élevé et ils provoquent des artefacts au scanner et à l'IRM.Metal implants have the disadvantage of being ngid, therefore of fully transmitting the stresses and of constituting, under certain conditions, an obstacle to good bone reconstruction. They are also very heavy and cause CT and MRI artifacts.

La cage intersomatique, objet de la présente invention, apporte une solution à ces inconvénients.The intersomatic cage, object of the present invention, provides a solution to these drawbacks.

Les caractéristiques de la cage sont les suivantes: - Réalisée en polyéthylène ou matériau équivalent résorbable ou non, elle introduit grâce aux propriétés du matériau, un facteur d'amortissement qui réduit la transmission des contraintes.The characteristics of the cage are as follows: - Made of polyethylene or equivalent material, absorbable or not, it introduces, thanks to the properties of the material, a damping factor which reduces the transmission of stresses.

Géométriquement la cage a la forme d'un parallélépipède. Elle peut avoir une forme différente et comporter ou non une cloison médiane de renfort (2). Sa face antérieure (5) et postérieure '6) ont des hauteurs qui sont déterminées pour assurer la conservation d'un espace intervertébral et d'une lordose normale.  Geometrically the cage has the shape of a parallelepiped. It may have a different shape and may or may not include a central reinforcement partition (2). Its anterior face (5) and posterior '6) have heights which are determined to ensure the conservation of an intervertebral space and a normal lordosis.

- Les arêtes de chacune des faces de la cage sont munies de crans (11) destinés à s'opposer aux déplacements.- The edges of each of the faces of the cage are provided with notches (11) intended to oppose the displacements.

-Equipée dans sa partie centrale d'un marqueur radiopaque permettant de suivre, dans le temps, le déplacement de l'implant et permettre la conduite d'examens radiologiques et IRM perturbés.-Equipped in its central part with a radiopaque marker allowing to follow, in time, the displacement of the implant and to allow the conduct of disturbed radiological and MRI examinations.

- Des volumes disponibles pour loger des fragments osseux de dimensions convenables permettant la communication osseuse ininterrompue entre la vertèbre sus et sous-jacente amenant par là la fusion intersomatique.- Volumes available to accommodate bone fragments of suitable dimensions allowing uninterrupted bone communication between the vertebra above and underlying, thereby bringing about interbody fusion.

La cage intersomatique est caractérisée dans notre cas, par une géométrie particulière illustrée sur la planche 1/1 mais qui n'est pas limitative et d'autre part en ce que l'usage de matériau plastique, polyéthylène par exemple, est prévu pour sa réalisation.The intersomatic cage is characterized in our case, by a particular geometry illustrated on the plate 1/1 but which is not limiting and on the other hand in that the use of plastic material, polyethylene for example, is provided for its production.

D'autres matériaux, résorbables ou non, présentant des caractéristiques équivalentes peuvent être envisagés. Ce matériau assure une bonne tenue mécanique de la cage tout en introduisant un effet amortisseur qui amoindrit la gène.Other materials, absorbable or not, having equivalent characteristics can be envisaged. This material ensures good mechanical strength of the cage while introducing a damping effect which reduces the gene.

En emprisonnant de l'os spongieux, la cage favorise la fusion osseuse d'une manière permanente. Ceci par opposition aux insertions libres de partie d'os qui n'étant pas retenues in situ, auraient tendance, de ce fait, à migrer et induire un déséquilibre entre les faces des corps vertébraux.By trapping cancellous bone, the cage promotes bone fusion permanently. This in contrast to the free insertions of part of bone which are not retained in situ, would therefore tend to migrate and induce an imbalance between the faces of the vertebral bodies.

La figure 1 illustre les caractéristiques géométriques mais non limitatives de la cage.Figure 1 illustrates the geometric but not limiting characteristics of the cage.

Celle-ci est constituée par un parallélépipède irrégulier (1) comportant une cloison médiane (2) servant de renfort. Cette cloison dans ce cas détermine deux logements (3) et (4).This consists of an irregular parallelepiped (1) comprising a central partition (2) serving as reinforcement. This partition in this case determines two housings (3) and (4).

Chaque logement sera équipé d'un greffon osseux au moment de la mise en place. La cage peut avoir une surface différente pour le logement d'os, des séparations ou être alvéolée.Each accommodation will be equipped with a bone graft at the time of placement. The cage may have a different surface for housing bones, partitions or be alveolate.

La hauteur de la face postérieure (6) est suffisante pour permettre la conservation d'une hauteur cervicale normale. Celle de la face antérieure (5) est légèrement plus importante pour permettre d'obtenir le degré de lordose qui convient.The height of the posterior surface (6) is sufficient to allow the preservation of a normal cervical height. That of the anterior face (5) is slightly larger to allow the appropriate degree of lordosis to be obtained.

La face antérieure comporte deux perçages destinés à la mise en place de la cage au moyen d'une tige munie de deux picots rétractables. Cette tige est représentée en figure 2.The front face has two holes intended for the positioning of the cage by means of a rod provided with two retractable pins. This rod is shown in Figure 2.

Les faces latérales (9) et (10) sont en forme de trapèze isocèle. The lateral faces (9) and (10) are in the form of an isosceles trapezoid.

Les arêtes de toutes les faces de la cage ainsi que celles de la cloison sont pourvues de crans (11), dont le profil est étudié pour qu'il réduise le risque de déplacement secondaire.The edges of all the faces of the cage as well as those of the partition are provided with notches (11), the profile of which is studied so that it reduces the risk of secondary displacement.

Ainsi la cage permettra, après déplacement concevable, que la fusion osseuse se fasse dans de bonnes conditions.Thus the cage will allow, after conceivable displacement, that the bone fusion takes place in good conditions.

Par ailleurs, les propriétés amagnétiques du matériau utilisé pour la réalisation de la cage permettront de conduire des examens au scanner ou à l'IRM sans artefacts.In addition, the non-magnetic properties of the material used to make the cage will make it possible to conduct CT or MRI exams without artifacts.

Ces examens sont facilités par l'existence d'un repère radiopaque incorporé verticalement au centre de la paroi médiane, qui permettra de quantifier la compression ou déplacement éventuel de la cage. These examinations are facilitated by the existence of a radiopaque mark incorporated vertically in the center of the median wall, which will make it possible to quantify the possible compression or displacement of the cage.

Claims (9)

REVENDICATIONS 1) Elément de contention interne et de fusion intersomatique des vertèbres lors de discectomie caractérisé en ce qu'il se présente sous forme d'une structure rigide en forme de cage destinée à emprisonner de l'os spongieux. 1) Element of internal compression and intersomatic fusion of the vertebrae during discectomy, characterized in that it is in the form of a rigid cage-shaped structure intended to trap spongy bone. 2) Elément de contention interne et de fusion intersomatique des vertèbres selon la revendication 1 caractérisé en ce que la structure rigide a la forme d'un parallélépipède.2) element of internal compression and intersomatic fusion of the vertebrae according to claim 1 characterized in that the rigid structure has the shape of a parallelepiped. 3) Elément de contention interne et de fusion intersomatique des vertèbres selon l'une quelconque des revendications 1 à 2 caractérisé en ce que les hauteurs respectives des faces antérieures (5) et postérieure (6) de la cage permettent la conservation d'une hauteur intervertébrale et d'une lordose normale.3) element of internal compression and intersomatic fusion of the vertebrae according to any one of claims 1 to 2 characterized in that the respective heights of the anterior (5) and posterior (6) faces of the cage allow the conservation of a height intervertebral and normal lordosis. 4) Elément de contention interne et de fusion intersomatique des vertèbres selon l'une quelconque des revendications 1 à 3 caractérisé en ce que les arêtes des faces sont munies de crans.4) element of internal contention and intersomatic fusion of the vertebrae according to any one of claims 1 to 3 characterized in that the edges of the faces are provided with notches. 5) Elément de contention interne et de fusion intersomatique des vertèbres selon l'une quelconque des revendications 1 à 4 caractérisé en ce que les faces latérales 9 et 10 sont en forme de trapèze isocèle.5) element of internal compression and intersomatic fusion of the vertebrae according to any one of claims 1 to 4 characterized in that the lateral faces 9 and 10 are in the form of an isosceles trapezoid. 6) Elément de contention interne et de fusion intersomatique des vertèbres selon l'une quelconque des revendications 1 à ce que la cage est réalisée en une matière polymère, résorbable ou non, telle que polyéthylène à haut poids moléculaire et amagnétique permettant les examens au scanner ou à l'IRM sans artefact.6) Element of internal compression and intersomatic fusion of the vertebrae according to any one of Claims 1, that the cage is made of a polymeric material, absorbable or not, such as polyethylene of high molecular weight and nonmagnetic allowing examinations by scanner. or MRI without an artifact. 7) Elément de contention interne et de fusion intersomatique des vertèbres selon l'une quelconque des revendications 1 à 6 caractérisé en ce que la cage comporte une cloison médiane de renfort dont les arêtes sont munies de crans.7) element of internal contention and intersomatic fusion of the vertebrae according to any one of claims 1 to 6 characterized in that the cage comprises a central reinforcement partition whose edges are provided with notches. 8) Elément de contention interne et de fusion intersomatique des vertèbres selon l'une quelconque des revendications I à 7 caractérisé en ce que le volume d'os emprisonné permet la communication osseuse entre la vertèbre inférieure et la vertèbre supérieure.8) Element of internal compression and intersomatic fusion of the vertebrae according to any one of claims I to 7 characterized in that the volume of trapped bone allows bone communication between the lower vertebra and the upper vertebra. 9) Elément de contention interne et de fusion intersomatique des vertèbres selon l'une quelconque des revendications 1 à 8 caractérisé en ce qu'il comporte un marqueur radiopaque permettant de suivre dans le temps son positionnement. 9) Element of internal compression and intersomatic fusion of the vertebrae according to any one of claims 1 to 8 characterized in that it comprises a radiopaque marker making it possible to follow its positioning over time.
FR9302558A 1993-03-03 1993-03-03 Cervical interbody fusion cage. Expired - Lifetime FR2703580B1 (en)

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