FR2856271A1 - Osteo-synthesis vertebral column plate, has connection head integrated with plate and movable in three directions of space so as to adapt itself to connection rod, and including opening to facilitate introduction of rod - Google Patents

Osteo-synthesis vertebral column plate, has connection head integrated with plate and movable in three directions of space so as to adapt itself to connection rod, and including opening to facilitate introduction of rod Download PDF

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FR2856271A1
FR2856271A1 FR0307569A FR0307569A FR2856271A1 FR 2856271 A1 FR2856271 A1 FR 2856271A1 FR 0307569 A FR0307569 A FR 0307569A FR 0307569 A FR0307569 A FR 0307569A FR 2856271 A1 FR2856271 A1 FR 2856271A1
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plate
rod
connection head
head
implant according
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FR2856271B1 (en
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Charles Khalife
Jean Francois Mallet
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7044Screws or hooks combined with longitudinal elements which do not contact vertebrae also having plates, staples or washers bearing on the vertebrae
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002Longitudinal elements, e.g. rods
    • A61B17/701Longitudinal elements with a non-circular, e.g. rectangular, cross-section
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7035Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • A61B17/7037Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other wherein pivoting is blocked when the rod is clamped

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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 plate (1) has a perforation (2) with opposed orientations housing a locking screw (11). A connection head (9) integrated with the plate is movable in three directions of space for adapting to a connection rod (7). The head has an opening to facilitate the introduction of the connection rod. Another locking screw housed inside walls of the canal rests against the connection rod.

Description

La présente invention concerne un implant en forme deThe present invention relates to an implant in the form of

plaque pour l'ostéosynthèse de la colonne vertébrale, utilisé lors de corrections relativement étendues, en association avec d'autres implants, pour augmenter la résistance et l'efficacité du montage. L'implant est généralement utilisé en extrémité de montage.  plate for osteosynthesis of the spine, used in relatively large corrections, in combination with other implants, to increase the strength and effectiveness of the assembly. The implant is generally used at the mounting end.

L'invention concerne plus particulièrement des perfectionnements à ce type d'implants. Plusieurs modèles d'implants vertébraux de ce type existent actuellement, et malgré les améliorations successives mises au point par les fabricants, aucun de ces implants ne donne une entière satisfaction.  The invention relates more particularly to improvements to this type of implants. Several models of vertebral implants of this type currently exist, and despite successive improvements developed by the manufacturers, none of these implants is entirely satisfactory.

Généralement les implants vertébraux en forme de plaque sont en monobloc et munis d'un canal destiné à loger une tige de liaison qui relie les différents implants entre eux, en se fixant à chaque implant par un système de blocage adapté. D'autres modèles d'implants du même type sont munis d'un connecteur additionnel qui permet de relier la tige de liaison à l'implant. Ces modèles comportent plusieurs éléments assemblés pour bloquer la tige, ce qui rend le montage plus encombrant et plus difficile à mettre en place, avec un fort risque d'apparition de métallose autour des implants à cause des multiples interfaces métalliques. Ces implants avec connecteur ne solutionnent pas non plus le problème de l'adaptation de la tige de liaison à l'implant.  Generally the plate-shaped vertebral implants are in one piece and provided with a channel intended to accommodate a connecting rod which connects the different implants together, by being fixed to each implant by a suitable blocking system. Other models of implants of the same type are provided with an additional connector which makes it possible to connect the connecting rod to the implant. These models have several elements assembled to block the rod, which makes the assembly more bulky and more difficult to set up, with a high risk of the appearance of metallosis around the implants because of the multiple metal interfaces. These connector implants also do not solve the problem of adapting the connecting rod to the implant.

La difficulté réside dans le façonnage de la tige pour qu'elle puisse s'adapter correctement aux différents implants en même temps, et surtout à l'implant en forme de plaque posé en extrémité, afin de corriger la déformation.  The difficulty lies in shaping the rod so that it can adapt correctly to the different implants at the same time, and especially to the plate-shaped implant placed at the end, in order to correct the deformation.

L'implant selon l'invention permet de remédier efficacement au problème primordial de l'adaptation de la tige à l'implant en extrémité et ceci dans les trois directions de l'espace.  The implant according to the invention makes it possible to effectively remedy the primordial problem of the adaptation of the rod to the implant at the end and this in the three directions of space.

L'implant selon l'invention est composé d'une plaque métallique comportant des perforations permettant la mise en place de vis qui vont réaliser l'ancrage osseux et munie d'une tête de connexion destinée à recevoir et bloquer la tige reliant les différents implants entre eux.  The implant according to the invention is composed of a metal plate comprising perforations allowing the installation of screws which will carry out the bone anchoring and provided with a connection head intended to receive and block the rod connecting the various implants between them.

Selon une caractéristique de l'invention, la tête de connexion, destinée à recevoir la tige de liaison, possède une articulation lui permettant d'effectuer des mouvements de rotation dans les 3 directions de l'espace pour s'adapter 5 à la tige, quelque soient la position et le cintrage de cette dernière.  According to a characteristic of the invention, the connection head, intended to receive the connecting rod, has an articulation allowing it to carry out rotational movements in the 3 directions of the space to adapt to the rod, whatever the position and the bending of the latter.

Selon une autre caractéristique de l'invention, la tête destinée à recevoir la tige de liaison, est solidaire de la Plaque et ne nécessite pas une opération de montage 10 supplémentaire durant l'acte chirurgical.  According to another characteristic of the invention, the head intended to receive the connecting rod, is integral with the plate and does not require an additional mounting operation during the surgical procedure.

Selon une disposition avantageuse de l'invention, la tête de connexion possède une ouverture vers le haut facilitant l'introduction de la tige de liaison.  According to an advantageous arrangement of the invention, the connection head has an upward opening facilitating the introduction of the connecting rod.

Selon une autre disposition avantageuse de l'invention 15 le système de blocage de la tige est constitué d'une seule vis introduite par vissage entre les parois verticales taraudées de la tête de connexion de la plaque.  According to another advantageous arrangement of the invention, the rod locking system consists of a single screw inserted by screwing between the vertical threaded walls of the connection head of the plate.

Selon une autre caractéristique de l'invention, le fait de serrer la vis de blocage sur la tige, tout le système devient solidaire et fixe, comparable à un implant monobloc.  According to another characteristic of the invention, the fact of tightening the locking screw on the rod, the whole system becomes integral and fixed, comparable to a one-piece implant.

Cette stabilité est assurée par une rondelle encastrée dans la tête de connexion, à profil interne en double cône, qui vient coiffer la tête de rotation et se bloquer contre elle sous l'effet de la pression de la tige durant le serrage. 25 D'autres caractéristiques et avantages de l'invention se dégageront de la description qui va suivre en regard des dessins annexés qui ne sont donnés qu'à titre d'exemples non limitatifs.  This stability is ensured by a washer embedded in the connection head, with an internal double cone profile, which covers the rotation head and locks against it under the effect of the pressure of the rod during tightening. Other characteristics and advantages of the invention will emerge from the description which follows with reference to the appended drawings which are given only by way of nonlimiting examples.

Les figures 1 à 7 représentent les différentes pièces 30 du système selon l'invention.  Figures 1 to 7 show the different parts 30 of the system according to the invention.

La figure 1 est une vue supérieure de la plaque avec sa tête et sa vis de blocage.  Figure 1 is a top view of the plate with its head and its locking screw.

La figure 2 est une vue frontale de la plaque.  Figure 2 is a front view of the plate.

La figure 3 est une vue en perspective de la plaque avec 35 deux vis d'ancrage osseux.  Figure 3 is a perspective view of the plate with two bone anchor screws.

La figure 4 est une vue en coupe de la tête montrant la rondelle et la tête de rotation.  Figure 4 is a sectional view of the head showing the washer and the rotation head.

La figure 5 est une vue en coupe de la rondelle. - 3  Figure 5 is a sectional view of the washer. - 3

La figure 6 est une vue de la plaque en assemblage.  Figure 6 is a view of the plate in assembly.

La figure 7 est une vue de profil de la plaque en assemblage avec inclinaison de la tête.  Figure 7 is a side view of the plate in assembly with inclination of the head.

Les dessins annexés illustrent l'invention. On décrira ci-après, en faisant référence aux figures 1 à 7, le mécanisme de fonctionnement de la plaque à tête adaptable.  The accompanying drawings illustrate the invention. The operating mechanism of the adaptable head plate will be described below, with reference to FIGS. 1 to 7.

Un montage de correction de la colonne vertébrale, constitué de plusieurs types d'implants sous forme de crochets, vis, tiges et dispositif transversal est toujours réalisé de part 10 et d'autre de la ligne médiane constituée par les apophyses épineuses. La plaque selon l'invention est toujours située en fin du montage du côté inférieur pour augmenter sa résistance et sa stabilité.  A correction of the spine, consisting of several types of implants in the form of hooks, screws, rods and transverse device is always performed on either side of the midline formed by the spinous processes. The plate according to the invention is always located at the end of the assembly of the lower side to increase its resistance and its stability.

Selon une caractéristique de l'invention, tous les implants (fig.1 à 7), ainsi que les tiges de liaison (7) sont usinés avec un alliage métallique biocompatible et résistant pouvant être, par exemple, un alliage de titane.  According to a characteristic of the invention, all the implants (fig. 1 to 7), as well as the connecting rods (7) are machined with a biocompatible and resistant metal alloy which can be, for example, a titanium alloy.

L'implant selon l'invention est formé d'une plaque métallique (1) munie de perforations (2, 3), pour être fixée 20 au rachis à l'aide de vis osseuses (11), et d'une tête de connexion (9) destinée à relier la plaque (1) à la tige de liaison (7) qui relie les différents implants entre eux.  The implant according to the invention consists of a metal plate (1) provided with perforations (2, 3), to be fixed to the spine using bone screws (11), and a connection head (9) intended to connect the plate (1) to the connecting rod (7) which connects the different implants together.

Selon une conception avantageuse, les perforations (2, 3) de la plaque possèdent des angles de perçage opposés pour 25 correspondre à l'anatomie du rachis. Cette différence d'orientation permet aux vis osseuses (11) de lutter très efficacement contre les forces d'arrachement de l'implant.  According to an advantageous design, the perforations (2, 3) of the plate have opposite drilling angles to correspond to the anatomy of the spine. This difference in orientation allows the bone screws (11) to fight very effectively against the tearing forces of the implant.

Selon une caractéristique avantageuse, une des deux perforations (2, 3) possède un profil oblong pour permettre 30 à la vis osseuse (11) correspondante de se déplacer pour s'adapter correctement à l'anatomie du rachis.  According to an advantageous characteristic, one of the two perforations (2, 3) has an oblong profile to allow the corresponding bone screw (11) to move to adapt properly to the anatomy of the spine.

Selon une caractéristique essentielle de l'invention, la tête de connexion (9) destinée à rattacher la plaque (1) à la tige de liaison (7) est solidaire de la plaque.  According to an essential characteristic of the invention, the connection head (9) intended to attach the plate (1) to the connecting rod (7) is integral with the plate.

Selon une autre caractéristique essentielle de l'invention, la tête de connexion (9) peut pivoter, autour d'une tête sphérique (10) fixée dans la plaque (1), dans les trois directions de l'espace pour s'adapter parfaitement à la tige de liaison (7) quelque soient le cintrage et la - 4 position de cette dernière (fig.7).  According to another essential characteristic of the invention, the connection head (9) can pivot, around a spherical head (10) fixed in the plate (1), in the three directions of space to adapt perfectly to the connecting rod (7) whatever the bending and the - 4 position of the latter (fig. 7).

Selon une disposition avantageuse de l'invention la tête de connexion (9) possède un canal (12), destiné au logement de la tige de liaison (7), ouvert vers le haut et délimité par deux parois verticales (5, 6) pour faciliter l'entrée de la tige.  According to an advantageous arrangement of the invention, the connection head (9) has a channel (12), intended for housing the connecting rod (7), open upwards and delimited by two vertical walls (5, 6) for facilitate entry of the rod.

Les deux parois verticales (5, 6) de la tête (9) sont taraudées sur leurs faces internes pour recevoir une vis de blocage (4) destinée à bloquer la tige de liaison (7).  The two vertical walls (5, 6) of the head (9) are tapped on their internal faces to receive a locking screw (4) intended to block the connecting rod (7).

Selon une autre disposition avantageuse le serrage de la vis de blocage (4) pousse la tige (7) contre une rondelle (8) qui coiffe la tête de rotation (10), et en se bloquant contre elle, empêche toute mobilité de la tête de connexion (9) rendant le système entièrement stable comparable à un 15 implant monobloc.  According to another advantageous arrangement, the tightening of the locking screw (4) pushes the rod (7) against a washer (8) which covers the rotation head (10), and by blocking against it, prevents any mobility of the head connection (9) making the system completely stable comparable to a monobloc implant.

Selon une autre caractéristique avantageuse de l'invention, la rondelle (8) qui coiffe la tête sphérique (10) de rotation possède une coupe interne en double cône (13, 14) permettant de doubler la surface de contact avec la 20 sphère (10) et d'augmenter efficacement le blocage du système de rotation.  According to another advantageous characteristic of the invention, the washer (8) which covers the spherical head (10) of rotation has an internal cut in double cone (13, 14) making it possible to double the contact surface with the sphere (10 ) and effectively increase the blocking of the rotation system.

Selon une conception avantageuse de l'invention, l'axe de fixation de la tête de connexion (9) à la plaque (1) est aligné avec l'axe des perforations (2, 3) destinées à 25 recevoir les vis osseuses (11).  According to an advantageous design of the invention, the axis of attachment of the connection head (9) to the plate (1) is aligned with the axis of the perforations (2, 3) intended to receive the bone screws (11 ).

Selon une caractéristique avantageuse de l'invention, la tige de liaison (7), logée dans la tête de connexion (9), se positionne toujours au dessus des vis osseuses (11) empêchant leur desserrage et une éventuelle migration. - 5  According to an advantageous characteristic of the invention, the connecting rod (7), housed in the connection head (9), is always positioned above the bone screws (11) preventing their loosening and possible migration. - 5

Claims (9)

REVENDICATIONS 1- Implant pour ostéosynthèse du rachis, en forme de plaque, destiné à s'attacher d'un côté aux vertèbres par l'intermédiaire de vis osseuses (11), et de l'autre à une tige (7) reliant les implants entre eux, grâce à une tête de 5 connexion (9), caractérisé en ce que la tête de connexion (9) est solidaire de la plaque (1) et peut pivoter dans les trois directions de l'espace autour d'une tête sphérique (10) fixée à la plaque (1), l'ensemble devenant complètement fixe après le serrage de la vis de blocage (4) contre la 10 tige de liaison (7).  1- Implant for osteosynthesis of the spine, in the form of a plate, intended to attach on one side to the vertebrae by means of bone screws (11), and on the other to a rod (7) connecting the implants between them, thanks to a connection head (9), characterized in that the connection head (9) is integral with the plate (1) and can pivot in the three directions of space around a spherical head ( 10) fixed to the plate (1), the assembly becoming completely fixed after tightening the locking screw (4) against the connecting rod (7). 2- Implant selon la revendication 1, caractérisé en ce que la tête de connexion (9) qui représente le seul lien entre la tige de liaison (7) et la plaque (1), possède un canal (12) ouvert vers le haut, pour faciliter l'introduction de la tige (7), délimité par deux branches verticales (5, 6) taraudées de l'intérieur et destinées à recevoir la vis de blocage (4).  2- implant according to claim 1, characterized in that the connection head (9) which represents the only link between the connecting rod (7) and the plate (1), has a channel (12) open upwards, to facilitate the introduction of the rod (7), delimited by two vertical branches (5, 6) threaded from the inside and intended to receive the locking screw (4). 3- Implant selon les revendications 1 et 2 caractérisé en ce que la tête de connexion (9) de l'implant peut pivoter, dans les trois directions de l'espace, autour d'une tête sphérique (10) fixée à la plaque (1).  3- Implant according to claims 1 and 2 characterized in that the connection head (9) of the implant can pivot, in the three directions of space, around a spherical head (10) fixed to the plate ( 1). 4- Implant selon les revendications 1 et 3 caractérisé en ce que la tête de connexion (9) est munie d'une rondelle (8) encastrée, qui s'interpose entre la tête sphérique (10) 25 et la tige de liaison (7) pour assurer la rigidité de l'ensemble en se fixant solidement sur la tête sphérique (10) lors du serrage de la vis de blocage (4) contre la tige de liaison (7).  4- Implant according to claims 1 and 3 characterized in that the connection head (9) is provided with a recessed washer (8), which is interposed between the spherical head (10) 25 and the connecting rod (7 ) to ensure the rigidity of the assembly by attaching securely to the spherical head (10) when tightening the locking screw (4) against the connecting rod (7). 5- Implant selon les revendications 1 et 4 caractérisé 30 en ce que la rondelle (8) possède un profil intérieur en double cône (13, 14), qui vient coiffer la tête sphérique (10) et assurer un blocage optimal contre cette dernière en doublant la surface de contact avec elle.  5- implant according to claims 1 and 4 characterized in that the washer (8) has an inner profile in double cone (13, 14), which covers the spherical head (10) and ensure optimal locking against the latter in doubling the contact surface with it. 6- Implant selon la revendication 1 caractérisé en ce que la plaque (1) de l'implant comprend des perforations (2, 3) à angles de perçage opposés pour permettre aux vis osseuses (11) de s'adapter à l'anatomie du rachis et de lutter contre un arrachement éventuel.  6- Implant according to claim 1 characterized in that the plate (1) of the implant comprises perforations (2, 3) with opposite drilling angles to allow the bone screws (11) to adapt to the anatomy of the spine and to fight against possible tearing. 7- Implant selon les revendications 1 et 6 caractérisé en ce que au moins une des perforations (2, 3) de la plaque (1) est oblongue pour permettre à la vis osseuse (11) correspondante de respecter les variations anatomiques et morphologiques.  7- Implant according to claims 1 and 6 characterized in that at least one of the perforations (2, 3) of the plate (1) is oblong to allow the corresponding bone screw (11) to respect the anatomical and morphological variations. 8- Implant selon les revendications 1 à 3, caractérisé en ce que l'axe de fixation de la tête de connexion (9) à la plaque (1) est aligné avec l'axe des perforations (2, 3).  8- Implant according to claims 1 to 3, characterized in that the axis of attachment of the connection head (9) to the plate (1) is aligned with the axis of the perforations (2, 3). 9- Implant selon les revendications, 1, 2, 3 et 8,  9- Implant according to claims 1, 2, 3 and 8, caractérisé en ce que la tige de liaison (7) bloquée dans la 15 tête de connexion (9) empêche le desserrage et la migration des vis osseuses (11).  characterized in that the connecting rod (7) locked in the connection head (9) prevents loosening and migration of the bone screws (11).
FR0307569A 2003-06-23 2003-06-23 SPINAL OSTEOSYNTHESIS PLATE WITH ADAPTABLE HEAD Expired - Fee Related FR2856271B1 (en)

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