FR2846223A1 - Flexible intervertebral connection device has two screws and connection acting as damper with three degrees of freedom and heads with radii at ends enabling rotation in connection opening - Google Patents

Flexible intervertebral connection device has two screws and connection acting as damper with three degrees of freedom and heads with radii at ends enabling rotation in connection opening Download PDF

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Publication number
FR2846223A1
FR2846223A1 FR0308437A FR0308437A FR2846223A1 FR 2846223 A1 FR2846223 A1 FR 2846223A1 FR 0308437 A FR0308437 A FR 0308437A FR 0308437 A FR0308437 A FR 0308437A FR 2846223 A1 FR2846223 A1 FR 2846223A1
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Prior art keywords
flexible
screws
connection device
heads
modular
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FR2846223B1 (en
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Johann Robin
Vincent Pointillart
Frederic Fortin
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7019—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other
    • A61B17/7031—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other made wholly or partly of flexible material
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7004—Longitudinal elements, e.g. rods with a cross-section which varies along its length
    • A61B17/7005—Parts of the longitudinal elements, e.g. their ends, being specially adapted to fit in the screw or hook heads
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7004—Longitudinal elements, e.g. rods with a cross-section which varies along its length
    • A61B17/7008—Longitudinal elements, e.g. rods with a cross-section which varies along its length with parts of, or attached to, the longitudinal elements, bearing against an outside of the screw or hook heads, e.g. nuts on threaded rods
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7004—Longitudinal elements, e.g. rods with a cross-section which varies along its length
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7032—Screws or hooks with U-shaped head or back through which longitudinal rods pass

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Neurology (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)
  • Surgical Instruments (AREA)

Abstract

The modular intervertebral connection device (1) has two screws and a connection (12') acting as a damper with three degrees of freedom. The connection has heads having radii (1211',1212') located at the ends enabling a rotation in the opening (111') of the connection.

Description

DISPOSITIF DE LIAISON VERTEBRALE SOUPLE ETFLEXIBLE VERTEBRAL CONNECTION DEVICE AND

MODULAIRE COMPORTANT UN ELEMENT REGLABLE  MODULAR WITH ADJUSTABLE ELEMENT

PERMETTANT DE TRAVAILLER DE MANIERE MULTIDIRECTIONNELLE  ALLOWING MULTIDIRECTIONAL WORKING

DOMAINE DE L'INVENTIONFIELD OF THE INVENTION

L'invention concerne un dispositif de liaison vertébrale postérieure modulaire qui stabilise les vertèbres dans toutes les directions, amortit toutes les sollicitations mécaniques en ne bloquant aucun 10 degré de liberté. Ce dispositif stabilise les vertèbres en permettant un réglage de l'écartement intervertébral ainsi qu'un choix de rigidité compatible avec les trois modes de travaux: compression  The invention relates to a modular posterior vertebral connecting device which stabilizes the vertebrae in all directions, absorbs all mechanical stresses while not blocking any degree of freedom. This device stabilizes the vertebrae by allowing adjustment of the intervertebral spacing as well as a choice of rigidity compatible with the three working modes: compression

torsion, flexion.torsion, bending.

ART ANTERIEUR:PRIOR ART:

On connaissait dans un art très antérieur de nombreux systèmes de fixations vertébrales postérieures rigidifiant un certain nombre de vertèbres en les privant de toute mobilité pour permettre ainsi d'encaisser toutes les contraintes mécaniques. Cependant, la première vertèbre adjacente à ce bloc rigide garde toute sa mobilité 20 et cette discontinuité brutale entre le bloc rigide et cette vertèbre libre engendre très souvent une hypersollicitation des éléments de liaison. Il s'en suit une accélération de la dégénérescence de ce niveau. Dans un art antérieur plus récent on évite de rigidifier ou de bloquer les vertèbres en proposant des dispositifs admettant une 25 certaine mobilité; C'est ainsi que le brevet EP 0669 109 AI propose un premier type de dispositif amortisseur comme le montre la figure 1 de cet art antérieur récent qui permet de stabiliser les vertèbres lors des sollicitations. Dans cette invention une corde sans rigidité au départ traverse les têtes de vis fixées aux vertèbres; 30 elle est mise en place puis tirée pour assurer une rigidité, des petites vis (moyens 8) permettent de conserver cette rigidité après mise en place, et tension de ce ligament de liaison ( moyen 1), l'inconvénient d'un tel système est de ne pas être modulaire. Si on est amené à le démonter, on est obligé de relâcher toute la chaîne vertébrale pour refaire un montage complet, ce qui présente d'énormes inconvénients, temps d'intervention allongés, difficulté de remise en place... tous ces ennuis indésirables lors d'une intervention sont résolus par la présente invention. Le brevet EP 0516567A, décrit et revendique un autre dispositif de stabilisation qui comprend un amortisseur possédant un corps avec un renflement et des extrémités sphériques moyen 1 10 de la figure 2 de l'art antérieur, ce dispositif fonctionne essentiellement en traction compression, l'élément amortisseur de ce dispositif peut comporter en son centre une tige précontrainte en fabrication pour pouvoir travailler sans se rompre dans le mode de travail précédemment explicité, ce dispositif outre les difficultés 15 de fabrication qui lui sont inhérentes est fragile dans les deux autre  Many systems of posterior vertebral fixation were known in a very prior art to rigidify a certain number of vertebrae by depriving them of all mobility, thereby allowing all mechanical stresses to be absorbed. However, the first vertebra adjacent to this rigid block retains all of its mobility 20 and this abrupt discontinuity between the rigid block and this free vertebra very often generates over-stress on the connecting elements. It follows an acceleration of the degeneration of this level. In a more recent prior art one avoids stiffening or blocking the vertebrae by proposing devices admitting a certain mobility; This is how patent EP 0669 109 AI proposes a first type of shock-absorbing device as shown in FIG. 1 of this recent prior art which makes it possible to stabilize the vertebrae during stresses. In this invention a cord without rigidity at the start crosses the screw heads fixed to the vertebrae; 30 it is put in place then pulled to ensure rigidity, small screws (means 8) allow this rigidity to be preserved after installation, and tension of this connecting ligament (means 1), the drawback of such a system is not to be modular. If we have to dismantle it, we are forced to release the entire spinal chain to redo a complete assembly, which has enormous drawbacks, longer intervention times, difficulty in replacing ... all these undesirable troubles during of an intervention are resolved by the present invention. Patent EP 0516567A, describes and claims another stabilization device which comprises a shock absorber having a body with a bulge and spherical ends means 1 10 of Figure 2 of the prior art, this device operates essentially in compression compression, the damping element of this device can include in its center a post preloaded in manufacturing to be able to work without breaking in the working mode previously explained, this device besides the manufacturing difficulties 15 which are inherent to it is fragile in the other two

modes de travail que sont la flexion et la torsion.  working modes that are bending and twisting.

La présente invention résout ces difficultés par son aspect de démontage modulaire qui peut ne concerner qu'un seul espace entre deux vertèbres sans affecter les dispositifs voisins Contrairement aux 20 inventions citées de l'art antérieur, elle permet des actions localisées sur les éléments à bloquer, et ceux qui doivent rester souples dans la chaîne des liaisons intervertébrales, elle autorise aussi des  The present invention solves these difficulties by its modular disassembly aspect which can only concern a single space between two vertebrae without affecting neighboring devices. Unlike the 20 cited inventions of the prior art, it allows localized actions on the elements to be blocked. , and those who must remain flexible in the chain of intervertebral connections, it also authorizes

amortissements suivant des angles et des directions privilégiés.  depreciation at preferred angles and directions.

La présente invention, en améliorant par la simplicité des 25 moyens mis en oeuvre et les fonctions des inventions de l'art antérieur notamment citées; à savoir: fonctionnement multidirectionnel et amortissement des sollicitations dynamiques, qui résolvent également les problèmes de manière simple et efficace Les dessins permettant de comprendre l'invention sont Figures 1 et 2 de la planche 1/8: inventions de l'art antérieur Figure 3 de la planche 2/8: schéma du dispositif de liaison vertébral avec ses moyens en vue éclatée Figures 4, 5, et 6 de la planche 2/8: vue en perpective du dispositif permettant aux vis d'être en diverses positions figure 4: vue de profil du dispositif permettant aux vis d'être en fermeture ( resserrement) figure 5:vue de profil du dispositif permettant aux vis d'être en réglage neutre ( vis parallèles) figure 6: vue de profil du dispositif permettant aux vis d'être en ouverture (écartement) figure 7 planche 3/8: moyen essentiel du dispositif en 15 position neutre figure 8 planche 3/8 moyen essentiel du dispositif en position angulaire pour resserrement ou écartement Figures 9,10,11 et 12 de la planche 4/8 détails des moyens suivants: figure 9: détail de la tête de vis figure 10:anneau fileté à six pans figure Il rondelle d'appui figure 12: anneau fileté à six pans assemblé avec la rondelle d'appui. (vue de dessous) Figure 13 de la planche 4/8 dispositif prêt à être assemblé 25 Figure 14 de la planche 6/8 montre le dispositif implanté Figure 15 de la planche 6/8 montre une vue de profil de plusieurs dispositifs implantés de manière récurente Figures 16 et 17 de la planche 7/8 montrent une variante du dispositif amortisseur ( vue de dessous) et monté sur les vis Figures 18 planche 8/8: chaîne du dispositif assemblé admetttant une angulation Dans un premier mode de réalisation, le dispositif de liaison vertébral souple et modulaire 1 est constitué de deux vis identiques 11 d'un système ou moyen de liaison 12 qui joue le rôle 5 d'amortisseur suivant trois degrés de liberté ( flexion, compression, torsion) dont la forme a été particulièrement étudiée pour assurer diverses fonctions: écartements ou resserrements des vis résistance aux contraintes 10 statiques et dynamiques de l'environnement dans ces diverses positions Le moyen 12 s'intègre dans la tête de vis 11,en restant solidaire de celle-ci; ses extrémités 125 s'intègrent parfaitement dans des cavités 111 des têtes de vis 11 conçues pour cette fonction, 15 la pièce de liaison 12 reste ainsi parfaitement prisonnière dans tous  The present invention, by improving by the simplicity of the means used and the functions of the inventions of the prior art in particular cited; namely: multidirectional operation and damping of dynamic stresses, which also solve the problems in a simple and effective manner The drawings making it possible to understand the invention are Figures 1 and 2 of plate 1/8: inventions of the prior art Figure 3 of Plate 2/8: diagram of the vertebral connection device with its means in exploded view Figures 4, 5, and 6 of Plate 2/8: perspective view of the device allowing the screws to be in various positions Figure 4: view profile view of the device allowing the screws to be closed (tightening) Figure 5: profile view of the device allowing the screws to be in neutral setting (parallel screws) Figure 6: profile view of the device allowing the screws to be in opening (spacing) figure 7 board 3/8: essential means of the device in neutral position figure 8 board 3/8 essential means of the device in angular position for tightening or spacing Figures 9,10,11 and 12 of board 4/8 details of the following means: figure 9: detail of the screw head figure 10: threaded hexagon ring figure II support washer figure 12: threaded hexagon ring assembled with the support washer. (bottom view) Figure 13 on board 4/8 device ready to be assembled 25 Figure 14 on board 6/8 shows the implanted device Figure 15 on board 6/8 shows a side view of several devices implanted so recurring Figures 16 and 17 of plate 7/8 show a variant of the damping device (bottom view) and mounted on the screws Figures 18 plate 8/8: chain of the assembled device admitting an angulation In a first embodiment, the device flexible and modular vertebral connection 1 is made up of two identical screws 11 of a connection system or means 12 which acts as a shock absorber according to three degrees of freedom (flexion, compression, torsion) whose shape has been particularly studied to perform various functions: spacing or tightening of the screws resistance to static and dynamic stresses of the environment in these various positions The means 12 is integrated into the head of vi s 11, remaining integral with it; its ends 125 fit perfectly into cavities 111 of the screw heads 11 designed for this function, 15 the connecting piece 12 thus remains perfectly captive in all

les cas, ceci grâce à des moyens tels que des anneaux filetés à six pans creux 13, qui viennent fermer les cavités 111 des têtes de vis.  cases, this by means such as threaded rings with hexagon socket 13, which close the cavities 111 of the screw heads.

Pour éviter que le serrage de l'anneau fileté 13 vienne détériorer le moyen de liaison 12,une rondelle 14 est associée à un 20 pion de guidage 141 situé sur ladite rondelle 14. Ce pion de guidage 141 s'emboîte dans un orifice ajusté 142 placé sur l'anneau fileté 13, il assure ainsi une parfaite mise en place de l'ensemble; en évitant lors du serrage des effets de rotation préjudiciables au moyen 12. La combinaison de ces moyens 13 et 25 14 évite tout déchaussement de la pièce de liaison 12, vis à vis des têtes de vis.Le corps 124 du moyen de liaison 12 est de préférence cylindrique,il peut être une pièce moulée en matériau élastomère parfaitement adaptée aux diverses sollicitations qu'il subira au cours de sa vie. Il comporte des plans d'appui 1240 sur la vis 1 1( haut et 30 bas) dont on peut choisir au départ l'angle d'inclinaison. De chaque coté du corps 124 il existe au moins une face 1250 (verticale et de préférence plane ou à courbure imposée) qui comprend un dégagement horizontal 1200 qui permet au moyen 12 d'éviter de  To prevent the tightening of the threaded ring 13 from damaging the connection means 12, a washer 14 is associated with a guide pin 141 located on said washer 14. This guide pin 141 fits into an adjusted orifice 142 placed on the threaded ring 13, it thus ensures perfect positioning of the assembly; avoiding during the clamping effects of rotation detrimental to the means 12. The combination of these means 13 and 25 14 prevents any loosening of the connecting piece 12, with respect to the screw heads. The body 124 of the connecting means 12 is preferably cylindrical, it can be a molded piece of elastomeric material perfectly suited to the various stresses that it will undergo during its life. It has support surfaces 1240 on the screw 1 1 (top and bottom 30) which can be chosen at the outset. On each side of the body 124 there is at least one face 1250 (vertical and preferably flat or with imposed curvature) which includes a horizontal clearance 1200 which allows the means 12 to avoid

toucher les tissus environnant (fig 11).  touch the surrounding tissue (fig 11).

Le moyen de liaison 12 comporte deux extrémités 125 en forme de demicylindre inversés reliées au corps 124 par une liaison de préférence cylindrique 126 Le moyen de liaison 12 possède deux fonctions essentielles combinées -rigidité déterminée pour obtenir une bonne tenue mécanique lors des sollicitations notamment celles transmises par les vis -souplesse déterminée et combinée avec cette rigidité pour  The connection means 12 has two ends 125 in the form of inverted semi-cylinders connected to the body 124 by a preferably cylindrical connection 126 The connection means 12 has two essential combined functions - stiffness determined to obtain good mechanical strength during stresses, in particular those transmitted by the screws - flexibility determined and combined with this rigidity for

jouer le rôle d'amortisseur.act as a shock absorber.

En fonction des rigidités et de la souplesse à adopter on choisit les matériaux appropriés, dont la gamme peut aller de l'élastomère souple jusqu'à des matériaux métalliques tels que 15 acier inoxydable, titane, ou autre matériaux tels que composites avec ou sans fibres, pourvu qu'ils soient biocompatibles avec le milieu environnant.Ce moyen 12 doit pouvoir travailler soit: en traction compression uniquement, en flexion pure en torsion pure ou simultanément suivant les trois degrés de libertés dans les  Depending on the rigidities and the flexibility to be adopted, the appropriate materials are chosen, the range of which can range from flexible elastomer to metallic materials such as stainless steel, titanium, or other materials such as composites with or without fibers. , provided that they are biocompatible with the surrounding environment. This means 12 must be able to work either: in compression compression only, in pure bending in pure torsion or simultaneously according to the three degrees of freedom in the

modes de travail combinés et précédemment cités.  combined and previously mentioned working methods.

Ce moyen 12, satisfait aux précédentes fonctions, mais permet d'assurer de plus les fonctions suivantes: réglage optimisé de la distance 1 entre les 2 vis 1 1 réglage en resserrements ou en écartements des vis 11 à tête creuse (voir figures 2, 3 et 4) avec orientations angulaires possibles  This means 12 satisfies the previous functions, but also provides the following functions: optimized adjustment of the distance 1 between the 2 screws 1 1 adjustment in tightening or spacing of the screws 11 with hollow head (see Figures 2, 3 and 4) with possible angular orientations

desdites vis 11.of said screws 11.

Il est également possible d'associer ou de combiner plusieurs 30 types de dispositifs 1 en choisissant un ou des moyens 12 de géométrie et de caractéristiques mécaniques différentes et appropriées à chaque cas. ceci, en fonction du positionnement du  It is also possible to associate or combine several types of device 1 by choosing one or more means 12 of different geometry and mechanical characteristics appropriate to each case. this, depending on the positioning of the

dispositif 1 à prendre en considération dans le milieu.  device 1 to be taken into consideration in the environment.

Dans un deuxième mode de réalisation, le dispositif vertébral 1 souple et modulaire est constitué des moyens suivants qui améliorent les performances du dispositif 1 tout en gardant la configuration générale: de deux vis 1l' dont la tête est de forme cylindrique  In a second embodiment, the flexible and modular vertebral device 1 is made up of the following means which improve the performance of the device 1 while keeping the general configuration: two screws 11 'whose head is cylindrical in shape

-d'un moyen 12' permettant une meilleure réponse mécanique et une plus grande élasticité en torsion et flexion.  -a 12 'means allowing better mechanical response and greater elasticity in torsion and bending.

Ce moyen 12' est lui même constitué de deux composants -d'un moyen central 121':pièce fabriquée dans un alliage de caractéristiques particulières permettant à la fois d'obtenir solidité et souplesse, il s'agit d'un alliage titane nickel biocompatible du type Titane ASTM B 265- 98 grade 2, Nickel, selon la norme ASTM  This means 12 ′ is itself made up of two components - of a central means 121 ′: part made of an alloy of particular characteristics allowing both to obtain solidity and flexibility, it is a biocompatible titanium nickel alloy Titanium ASTM B 265-98 grade 2, Nickel, according to ASTM standard

B39-79B39-79

-d'un moyen périphérique 122': pièce fabriquée en matériau élastique qui entoure le moyen 121' tout en trouvant appui sur les  -a peripheral means 122 ': part made of elastic material which surrounds the means 121' while finding support on the

vis vertébrales 1l' en épousant la forme cylindrique de leur tête.  1l 'vertebral screws by marrying the cylindrical shape of their head.

La combinaison des moyen 121' et 122' donne les rigidités  The combination of means 121 'and 122' gives the rigidities

et souplesses désirées en évitant au moyen 121' le risque de subir 20 une rupture par flambage sans cette combinaison.  and desired flexibility by avoiding by means 121 'the risk of undergoing buckling failure without this combination.

Le moyen 12' a comme caractéristique de pouvoir se monter avec bon ajustage dans les têtes de vis (ouverture ou cavité 1 1 1') Le moyen 121' qui fait partie du moyen 12' est une tige 25 surmontée de deux têtes 121'a et b qui a comme autre caractéristique essentielle de pouvoir tourner dans l'ouverture 111', sans interférer avec l'autre tête voisine 121' b, ceci grâce aux rayons 1211' et 1212' spécialement étudiés pour cet effet, et situées aux extrémités 121' a et b; il est donc possible d'intervenir sur un 30 module sans interaction ni obligation d'agir sur les autres moyens  The means 12 'has the characteristic of being able to be mounted with good adjustment in the screw heads (opening or cavity 1 1 1') The means 121 'which is part of the means 12' is a rod 25 surmounted by two heads 121'a and b which has the other essential characteristic of being able to rotate in the opening 111 ', without interfering with the other neighboring head 121' b, this thanks to the spokes 1211 'and 1212' specially studied for this purpose, and situated at the ends 121 'a and b; it is therefore possible to intervene on a module without interaction or obligation to act on the other means

12' adjacents à celui sur lequel on agit.  12 'adjacent to that on which one acts.

Il est donc possible d'orienter les moyens 12', les uns par rapport aux autres avec un angle pouvant aller de 0 à 300, ceci grâce au fait que les moyens 121 'a et b (extrémités de 121') peuvent s'orienter dans la cavité 111' des vis. Cette orientation des moyens 5 12' entre deux vis n'interfère en rien dans l'orientation du ou des  It is therefore possible to orient the means 12 ′, with respect to each other with an angle which can range from 0 to 300, this thanks to the fact that the means 121 ′ a and b (ends of 121 ′) can orient themselves in the cavity 111 'of the screws. This orientation of the means 5 12 ′ between two screws does not in any way interfere with the orientation of the one or more

moyens adjacents.adjacent means.

L'aspect modulaire est donc ici fondamental: on peut  The modular aspect is therefore fundamental here: we can

changer un élément du moyen 12' sans intervention sur la chaîne 10 vertébrale qui reste en place.  change an element of the means 12 'without intervention on the vertebral chain 10 which remains in place.

On peut également envisager l'assemblage de plusieurs  We can also consider the assembly of several

dispositifs 1 comportant plusieurs moyens 12' et 11'.  devices 1 comprising several means 12 'and 11'.

En plus des possibilités déjà décrites dans la combinaison de plusieurs dispositifs, ce second mode de réalisation apporte une 15 réponse mécanique appropriée en tolérant un désalignement  In addition to the possibilities already described in the combination of several devices, this second embodiment provides an appropriate mechanical response by tolerating misalignment

relativement important des vis 11'.relatively large screws 11 '.

Cet aspect modularité en combinaison avec la rigidité et la souplesse apportées permettent des écartements et des orientations du dispositif 1 grâce au moyen 12' séparant les 2 vis, ce moyen est 20 primordial, il est interchangeable module par module sans  This modularity aspect in combination with the rigidity and flexibility provided allow spacings and orientations of the device 1 thanks to the means 12 ′ separating the 2 screws, this means is essential, it is interchangeable module by module without

perturber la chaîne intervertébrale.  disrupt the intervertebral chain.

Dans ce deuxième mode de réalisation à noter que les anneaux filetés 13'viennent fixer le dispositif 12'aux têtes de vis par simple serrage des têtes 121' a et b 25  In this second embodiment, note that the threaded rings 13 'secure the device 12' to the screw heads by simply tightening the heads 121 'a and b 25

Claims (9)

REVENDICATIONS 1- Dispositif de liaison vertébral souple et modulaire comportant deux vis d'accrochages aux vertèbres (1 1) caractérisé 5 en ce qu'il possède un moyen de liaison (12) fabriqué dans un matériau souple, ayant une forme particulière constitué d'un corps cylindrique (124) aux extrémités duquel on trouve deux têtes de fixation identiques et symétriques (125) permettant au moyen (12) 10 d'être facilement monté et démonté de manière modulaire, ledit moyen (12) jouant le rôle d'un amortissseur suivant trois degrés de liberté, la forme et les matériaux ayant été particulièrement étudiés pour assurer diverses fonctions essentielles notamment: écartements ou resserrements des vis, résistance aux contraintes statiques et 15 dynamiques de l'environnement dans diverses positions, grâce à son  1- Flexible and modular vertebral connection device comprising two screws for attachment to the vertebrae (1 1) characterized in that it has a connection means (12) made of a flexible material, having a particular shape consisting of a cylindrical body (124) at the ends of which there are two identical and symmetrical fixing heads (125) allowing the means (12) 10 to be easily assembled and disassembled in a modular manner, said means (12) acting as a shock absorber according to three degrees of freedom, the shape and the materials having been particularly studied to ensure various essential functions in particular: spacing or tightening of the screws, resistance to static and dynamic stresses of the environment in various positions, thanks to its aptitude aux montages et démontages.  aptitude for assembly and disassembly. 2- Dispositif de liaison vertébral souple et modulaire selon la revendication 1 caractérisé en ce que les extrémités (125) du moyen (12) s'intègrent parfaitement dans les cavités (111) des têtes de vis 20 (11) conçues pour cette fonction, ladite pièce de liaison (12) restant parfaitement prisonnière dans tous les cas, ceci grâce à des moyens tels que anneaux filetés à six pans creux (13) qui viennent  2- flexible and modular vertebral connection device according to claim 1 characterized in that the ends (125) of the means (12) fit perfectly into the cavities (111) of the screw heads 20 (11) designed for this function, said connecting piece (12) remaining perfectly captive in all cases, this by means such as threaded rings with hexagon socket (13) which come fermer les cavités (111) des têtes de vis.  close the cavities (111) of the screw heads. 3- Dispositif de liaison vertébral souple et modulaire selon les 25 revendications 1 et 2 caractérisé en ce que le moyen de liaison (12) est relié à une rondelle (14), elle même associée à un pion de guidage (141) situé sur ladite rondelle (14), ce pion de guidage (141) s'emboîtant dans un orifice de guidage ajusté (142) placé sur l'anneau fileté (13), cette combinaison de moyens assurant ainsi 30 une parfaite mise en place de l'ensemble, en évitant les effets de rotation et de déchaussement préjudiciables au moyen (12) lors des  3- flexible and modular vertebral connecting device according to claims 1 and 2 characterized in that the connecting means (12) is connected to a washer (14), itself associated with a guide pin (141) located on said washer (14), this guide pin (141) fitting into an adjusted guide hole (142) placed on the threaded ring (13), this combination of means thus ensuring perfect positioning of the assembly , avoiding the detrimental effects of rotation and loosening by means (12) during divers sollicitations appliquées ou subies.  various stresses applied or suffered. 4 -Dispositif de liaison vertébral souple et modulaire selon les  4 - Flexible and modular vertebral connection device according to the revendications 1, 2 et 3 caractérisé en ce que le moyen de liaison (12) possède un corps (124) dont la forme est de préférence cylindrique, fabriquée en matériau élastomère parfaitement adaptée  Claims 1, 2 and 3 characterized in that the connecting means (12) has a body (124) whose shape is preferably cylindrical, made of perfectly adapted elastomeric material aux diverses sollicitations à subir, ledit corps (124) comportant des plans d'appui (1240) dont on peut choisir au départ l'angle d'inclinaison au moins une face (1250), de préférence plane ou à courbure 10 imposée, elle même comprenant un dégagement horizontal (1200) permettant audit moyen (12) de ne pas toucher les tissus environnants. -Dispositif de liaison vertébral souple et modulaire selon les revendication 4 caractérisé en ce que le moyen de liaison (12) 15 comporte deux extrémités (125) en forme de demi-cylindre inversés reliés au corps (124) par une liaison de préférence cylindrique (126) procurant ainsi deux fonctions essentielles -rigidité déterminée pour obtenir une bonne tenue mécanique lors des sollicitations notamment celles transmises par les vis -souplesse déterminée et combinée à cette rigidité pour jouer  to the various stresses to be subjected, said body (124) comprising support planes (1240) of which it is possible to choose at the outset the angle of inclination of at least one face (1250), preferably planar or with imposed curvature 10, it even comprising a horizontal clearance (1200) allowing said means (12) not to touch the surrounding tissues. -Flexible and modular vertebral connecting device according to claim 4 characterized in that the connecting means (12) 15 comprises two ends (125) in the form of inverted half-cylinders connected to the body (124) by a preferably cylindrical connection ( 126) thus providing two essential functions - determined rigidity to obtain good mechanical strength during stresses in particular those transmitted by the screws - determined flexibility and combined with this rigidity to play le rôle d'amortisseur.the role of shock absorber. 6 -Dispositif de liaison vertébral souple et modulaire selon  6 - Flexible and modular vertebral connection device according to l'une quelconque des précédentes revendications caractérisé en ce 25 que le moyen (12) essentiel à ce dispositif est fabriqué dans un choix de matériaux dont la rigidité et la souplesse sont prédéterminées en fonction de chaque cas, la gamme et la nature de ces matériaux, pouvant aller de l'élastomère souple jusqu'à des matériaux très rigides par exemple métalliques tels que acier inoxydable, titane, 30 ou autres matériaux composites adaptés et biocompatibles avec le milieu environnant, ainsi que des matériaux composites contenant  any one of the preceding claims, characterized in that the means (12) essential to this device is manufactured from a choice of materials, the rigidity and flexibility of which are predetermined according to each case, the range and the nature of these materials , which can range from flexible elastomer to very rigid materials, for example metallic materials such as stainless steel, titanium, 30 or other suitable composite materials which are biocompatible with the surrounding medium, as well as composite materials containing des fibres. -fibers. - 7-Dispositif de liaison vertébral souple et modulaire (1) selon la revendication 1 caractérisé en ce qu'il possède: -deux vis (11') dont la tête est de forme cylindrique -un moyen (12') composé lui-même de deux moyens (121' 5 et 122') permettant une bonne réponse mécanique de manière multidirectionnelle et une grande élasticité en torsion et flexion du dispositif (1) 8-Dispositif de liaison vertébral souple et modulaire (1) selon 10 la revendication 7 caractérisé en ce que que les moyens ('121') et (122') ont les caractéristiques mécaniques suivantes: moyen central (121'): pièce fabriquée dans un alliage de caractéristiques particulières permettant à la fois d'obtenir solidité et souplesse. moyen périphérique (122') pièce fabriquée en matériau  7-flexible and modular vertebral connection device (1) according to claim 1 characterized in that it has: -two screws (11 ') whose head is cylindrical in shape -a means (12') itself composed of two means (121 '5 and 122') allowing a good mechanical response in a multidirectional manner and a high elasticity in torsion and bending of the device (1) 8-Flexible and modular vertebral connection device (1) according to claim 7 characterized in that the means ('121') and (122 ') have the following mechanical characteristics: central means (121'): part made of an alloy of particular characteristics allowing both to obtain solidity and flexibility. peripheral medium (122 ') piece made of material élastique entourant le moyen (121'), tout en trouvant appui sur les vis vertébrales (11'), en épousant la forme cylindrique de leur tête, la combinaison des moyens (121' et 122') donnant les rigidités et souplesses désirées en évitant au moyen (121') le risque de subir 20 une rupture par flambage sans cette combinaison.  elastic surrounding the means (121 '), while finding support on the vertebral screws (11'), by marrying the cylindrical shape of their head, the combination of means (121 'and 122') giving the desired stiffness and flexibility, avoiding by means (121 ') the risk of undergoing buckling failure without this combination. 9-Dispositif de liaison vertébral souple et modulaire (1) selon  9-Flexible and modular vertebral connection device (1) according to les revendications 1, 7 et 8 caractérisé en ce que le moyen (121') est une tige surmontée de deux têtes (121'a et b) qui peut se monter  Claims 1, 7 and 8 characterized in that the means (121 ') is a rod surmounted by two heads (121'a and b) which can be mounted avec un bon ajustage dans les têtes de vis (ouverture 111').  with a good adjustment in the screw heads (opening 111 '). 10-Dispositif de liaison vertébral souple et modulaire (1) selon  10-Flexible and modular vertebral connection device (1) according to les revendications 1,7, 8 et 9 caractérisé en ce que le moyen (12') possède des têtes (121'a et b) ayant des rayons (1211' et 1212') situés aux extrémités desdites têtes (121' a et b) permettant une rotation dans l'ouverture (111 ') du moyen (12'), ceci se traduisant 30 par une possible intervention sur un module du dispositif (1) sans  claims 1,7, 8 and 9 characterized in that the means (12 ') has heads (121'a and b) having spokes (1211' and 1212 ') located at the ends of said heads (121' a and b ) allowing rotation in the opening (111 ') of the means (12'), this resulting in a possible intervention on a module of the device (1) without interaction ni obligation d'agir sur les autres moyens (12') du ou  interaction or obligation to act on the other means (12 ') of the des modules adjacents.adjacent modules. 11- Dispositif de liaison vertébral souple et modulaire (1) selon la revendication 10 caractérisé en ce que les modules (12') par l'orientation possible des moyens ( 121') dans l'ouverture (11 1') 5 de la vis (11') et selon la position des vis (11') dans la chaine vertébrale admettent un désalignement des uns par rapport aux autres, pouvant atteindre 300, ceci sans interférence avec les  11- Flexible and modular vertebral connection device (1) according to claim 10 characterized in that the modules (12 ') by the possible orientation of the means (121') in the opening (11 1 ') 5 of the screw (11 ') and depending on the position of the screws (11') in the spinal chain admit a misalignment with respect to each other, up to 300, this without interference with the moyens adjacents.adjacent means.
FR0308437A 2002-10-24 2003-07-10 FLEXIBLE AND MODULAR INTERVERTEBRAL CONNECTION DEVICE HAVING MULTIDIRECTIONAL WORKING ELEMENT Expired - Fee Related FR2846223B1 (en)

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US20170056073A1 (en) * 2013-09-16 2017-03-02 Aesculap Ag Connection element and spine stabilization system
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DE102013110173A1 (en) * 2013-09-16 2015-03-19 Aesculap Ag Connecting element and spine stabilization system
US9717533B2 (en) 2013-12-12 2017-08-01 Roger P. Jackson Bone anchor closure pivot-splay control flange form guide and advancement structure
US10064658B2 (en) 2014-06-04 2018-09-04 Roger P. Jackson Polyaxial bone anchor with insert guides
WO2020008331A1 (en) * 2018-07-02 2020-01-09 Praktyka Lekarska Espinen Piotr Szydlik System of implants for stabilization of the spine

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