FR2880795A1 - Intervertebral cage for treating degenerative vertebral rachis, comprises disc shape spacer with faces of opposite bases, side wall which connects the base faces, blade and an element to move the blade compared to a insole of wall parts - Google Patents

Intervertebral cage for treating degenerative vertebral rachis, comprises disc shape spacer with faces of opposite bases, side wall which connects the base faces, blade and an element to move the blade compared to a insole of wall parts Download PDF

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Publication number
FR2880795A1
FR2880795A1 FR0500446A FR0500446A FR2880795A1 FR 2880795 A1 FR2880795 A1 FR 2880795A1 FR 0500446 A FR0500446 A FR 0500446A FR 0500446 A FR0500446 A FR 0500446A FR 2880795 A1 FR2880795 A1 FR 2880795A1
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Prior art keywords
blade
faces
intervertebral cage
spacer
shoulders
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Granted
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FR0500446A
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French (fr)
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FR2880795B1 (en
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Hassan Razian
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Individual
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Individual
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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/4455Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
    • A61F2/447Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4611Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/28Bones
    • A61F2002/2835Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/3011Cross-sections or two-dimensional shapes
    • A61F2002/30112Rounded shapes, e.g. with rounded corners
    • A61F2002/30136Rounded shapes, e.g. with rounded corners undulated or wavy, e.g. serpentine-shaped or zigzag-shaped
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    • A61FFILTERS 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
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
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    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30405Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by screwing complementary threads machined on the parts themselves
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30471Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements connected by a hinged linkage mechanism, e.g. of the single-bar or multi-bar linkage type
    • AHUMAN NECESSITIES
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    • A61FFILTERS 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
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30576Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs
    • A61F2002/30578Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs having apertures, e.g. for receiving fixation screws
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30579Special structural features of bone or joint prostheses not otherwise provided for with mechanically expandable devices, e.g. fixation devices
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30772Apertures or holes, e.g. of circular cross section
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30772Apertures or holes, e.g. of circular cross section
    • A61F2002/30774Apertures or holes, e.g. of circular cross section internally-threaded
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30841Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
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    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0091Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements connected by a hinged linkage mechanism, e.g. of the single-bar or multi-bar linkage type
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0004Rounded shapes, e.g. with rounded corners

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Neurology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (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)
  • Prostheses (AREA)
  • Surgical Instruments (AREA)

Abstract

The spacer (1) is placed between the faces in regards to vertebral bodies. The blade (20) has two ends (25, 26) and is arranged between parts (6, 7) of the sidewall (5) and sides of the spacer. The blade comprises shoulders inserted into the vertebral bodies (50, 51) and assembled in co-operation with insole of the blade ends. The angle between the blade and the shoulders is 0-180[deg]. The shoulders are constituted by hook comprising concave open/closed loop. An auxiliary shoulder has screw perpendicular to the blade rotation plane. The auxiliary shoulder is assembled in co-operation with the shoulder in the shape of hook and formed in general plane of the hook with an angle 90[deg]. The interior of the concave loop is constituted by an opening which is tapped.

Description

CAGE INTERVERTEBRALE PERFECTIONNÉE A LAMEIMPROVED BLADE-IMPROVED INTERVERTEBRAL CAGE

La présente invention est relative à un perfectionnement à la cage intervertébrale telle que celle qui est décrite dans le FR-A-2 841 123 et qui trouve une application particulièrement avantageuse, mais non exclusivement, pour le traitement du rachis dégénératif.  The present invention relates to an improvement in the intervertebral cage such as that described in FR-A-2 841 123 and which finds a particularly advantageous application, but not exclusively, for the treatment of the degenerative spine.

La cage décrite dans ce document comporte essentiellement une entretoise sensiblement en forme de disque comportant deux faces de base opposées sensiblement planes et parallèles et une paroi latérale reliant les deux faces de base, cette paroi latérale comportant deux parties opposées, ladite entretoise étant apte à être disposée entre les faces en regard des deux corps vertébraux respectivement de deux vertèbres consécutives en remplacement du disque endommagé entre ces deux vertèbres, les deux faces de base de l'entretoise étant aptes à être placées au contact au moins partiel des deux corps vertébraux, au moins une lame comportant deux extrémités opposées conformées en biseau, et des moyens pour déplacer la lame par rapport à une première des deux parties de paroi latérale de façon que la lame soit apte à prendre deux positions: une première position dans laquelle la lame est entièrement située dans l'espace compris entre les premier et second plans contenant les deux faces de base de l'entretoise, et une seconde position dans laquelle les deux extrémités opposées de la lame émergent de part et d'autre du dit espace, les deux extrémités opposées de la lame comportant chacune un épaulement, ces deux épaulement étant respectivement réalisés de façon qu'ils soient sensiblement contenus dans des plans parallèles aux plans des deux faces de base opposées de l'entretoise et respectivement enfoncés dans les deux corps vertébraux quand la lame est dans sa seconde position.  The cage described in this document essentially comprises a substantially disk-shaped spacer comprising two substantially flat and parallel opposed base faces and a lateral wall connecting the two base faces, this lateral wall comprising two opposite parts, said spacer being capable of being arranged between the facing faces of the two vertebral bodies respectively of two consecutive vertebrae replacing the damaged disc between these two vertebrae, the two base faces of the spacer being adapted to be placed in contact at least partially with the two vertebral bodies, at the at least one blade having two opposing ends shaped in a bevel, and means for moving the blade relative to a first of the two side wall portions so that the blade is adapted to take two positions: a first position in which the blade is entirely located in the space between the first and second planes containing the two base faces of the spacer, and a second position in which the two opposite ends of the blade emerge on either side of said space, the two opposite ends of the blade each having a shoulder, these two shoulders. being respectively made so that they are substantially contained in planes parallel to the planes of the two opposite base faces of the spacer and respectively sunk into the two vertebral bodies when the blade is in its second position.

Cette cage donne de très bons résultats mais, dans son souci de toujours améliorer les produits dans le domaine médical, le Demandeur propose d'en réaliser un perfectionnement.  This cage gives very good results but, in its desire to always improve the products in the medical field, the Applicant proposes to carry out a development.

Plus précisément, la présente invention a pour objet une cage intervertébrale pour le traitement du rachis dégénératif, comprenant: une entretoise sensiblement en forme de disque comportant deux faces de bases opposées sensiblement planes et parallèles et une paroi latérale reliant les deux faces de bases, cette paroi latérale comportant deux parties opposées, ladite entretoise étant apte à être disposée entre les faces en regard des deux corps vertébraux respectivement de deux vertèbres consécutives en remplacement du disque endommagé entre ces deux vertèbres, les deux faces de bases de l'entretoise étant aptes à être placées au contact au moins partiel des deux corps vertébraux, - au moins une lame, ladite lame comportant deux extrémités opposées conformées en biseau, et des moyens pour déplacer ladite lame par rapport à une première des deux parties de paroi latérale de façon que la lame soit apte à prendre deux 10 positions: * une première position dans laquelle la lame est entièrement située dans l'espace compris entre les deux premier et second plans contenant les deux faces de bases de l'entretoise, et * une seconde position dans laquelle les deux extrémités opposées de ladite lame émergent de part et d'autre dudit espace, les deux extrémités opposées de ladite lame comportant chacune un épaulement, ces deux épaulements étant respectivement réalisés de façon que, lorsque la lame est dans sa seconde position, leurs directions générales soient sensiblement contenues dans des plans parallèles aux plans des deux faces de bases opposées de l'entretoise, les deux dits épaulements étant respectivement enfoncés dans les deux corps vertébraux quand ladite lame est dans sa seconde position, caractérisée par le fait que les deux directions générales respectivement des deux épaulements font entre elles un angle compris entre zéro degré et cent quatre-vingts degrés, valeurs limites comprises.  More specifically, the subject of the present invention is an intervertebral cage for the treatment of the degenerative spine, comprising: a substantially disk-shaped spacer comprising two opposite substantially planar and parallel base faces and a lateral wall connecting the two base faces, this side wall having two opposite parts, said spacer being adapted to be disposed between the facing faces of the two vertebral bodies respectively two consecutive vertebrae replacing the damaged disc between these two vertebrae, the two base faces of the spacer being adapted to be placed in at least partial contact with the two vertebral bodies, - at least one blade, said blade having two opposite ends shaped as a bevel, and means for moving said blade relative to a first of the two side wall portions so that the blade is able to take two 10 positions: * a first posit ion in which the blade is entirely located in the space between the two first and second planes containing the two base faces of the spacer, and * a second position in which the two opposite ends of said blade emerge from part and other said space, the two opposite ends of said blade each having a shoulder, these two shoulders respectively being made so that, when the blade is in its second position, their general directions are substantially contained in planes parallel to the planes of the two opposite base faces of the spacer, the two said shoulders being respectively driven into the two vertebral bodies when said blade is in its second position, characterized in that the two general directions respectively of the two shoulders are between them an angle between zero degrees and one hundred and eighty degrees, limit values included.

D'autres caractéristiques et avantages de l'invention apparaîtront au cours de la description suivante donnée en regard des dessins annexés à titre illustratif mais nullement limitatif, dans lesquels: Les figures 1 et 2 représentent, sous forme schématique, un premier mode de réalisation de la cage intervertébrale perfectionnée selon l'invention, la figure 1 30 étant une vue en perspective et la figure 2 une vue de côté, et Les figures 3 et 4 représentent, sous forme schématique, un second mode de réalisation de la cage intervertébrale selon l'invention, la figure 3 étant une vue en perspective et la figure 4 une vue de côté.  Other features and advantages of the invention will emerge in the course of the following description given with reference to the accompanying drawings for illustrative but not limiting purposes, in which: FIGS. 1 and 2 show, in schematic form, a first embodiment of FIG. the improved intervertebral cage according to the invention, FIG. 1 being a perspective view and FIG. 2 a side view, and FIGS. 3 and 4 are schematic representations of a second embodiment of the intervertebral cage according to FIG. Figure 3 is a perspective view and Figure 4 is a side view.

Il est tout d'abord précisé que, sur les figures, les mêmes références désignent les mêmes éléments, quelle que soit la figure sur laquelle elles apparaissent et quelle que soit la forme de représentation de ces éléments. De même, si des éléments ne sont pas spécifiquement référencés sur l'une des figures, leurs références peuvent être aisément retrouvées en se reportant à l'autre figure.  It is first of all specified that, in the figures, the same references designate the same elements, whatever the figure on which they appear and whatever the form of representation of these elements. Similarly, if elements are not specifically referenced in one of the figures, their references can be easily found by referring to the other figure.

Il est aussi précisé que les figures représentent essentiellement deux modes de réalisation préférentiels de l'objet selon l'invention, mais qu'il peut exister d'autres modes de réalisation qui répondent à la définition de cette invention.  It is also stated that the figures essentially represent two preferred embodiments of the object according to the invention, but that there may be other embodiments that meet the definition of this invention.

Il est en outre précisé que, lorsque, selon la définition de l'invention, l'objet de l'invention comporte "au moins un" élément ayant une fonction donnée, le mode de réalisation décrit peut comporter plusieurs de ces éléments. Réciproquement, si le mode de réalisation de l'objet selon l'invention tel qu'illustré comporte plusieurs éléments de fonction identique et si, dans la description, il n'est pas spécifié que l'objet selon cette invention doit obligatoirement comporter un nombre particulier de ces éléments, l'objet de l'invention pourra être défini comme comportant "au moins un" de ces éléments.  It is furthermore specified that, when, according to the definition of the invention, the object of the invention comprises "at least one" element having a given function, the embodiment described may comprise several of these elements. Conversely, if the embodiment of the object according to the invention as illustrated has several elements of identical function and if, in the description, it is not specified that the object according to this invention must obligatorily comprise a number particular of these elements, the object of the invention may be defined as comprising "at least one" of these elements.

Il est enfin précisé que lorsque, dans la présente description, une expression définit à elle seule, sans mention particulière spécifique la concernant, un ensemble de caractéristiques structurelles, [par exemple E = E(p, s, ...)], ces caractéristiques peuvent être prises, pour la définition de l'objet de la protection demandée, quand cela est techniquement possible, soit séparément, [par exemple s, et/ou i, et/ou p, ...], soit en combinaison totale et/ou partielle, [par exemple E( s, , p) , et/ou E( s, i), et/ou 1( 'r, p), et/ou E( s, p)].  Finally, it is stated that when, in the present description, an expression alone defines, without any particular specific mention concerning it, a set of structural characteristics, [for example E = E (p, s, ...)], these characteristics can be taken, for the definition of the object of the requested protection, when technically possible, either separately, [eg s, and / or i, and / or p, ...], or in full combination and / or partial, [e.g. E (s,, p), and / or E (s, i), and / or 1 ('r, p), and / or E (s, p)].

Ceci ayant été précisé, la présente invention concerne un perfectionnement à une cage intervertébrale comme celle décrite dans le FR-A-2 841 123 pour, notamment, le traitement du rachis dégénératif.  This having been specified, the present invention relates to an improvement to an intervertebral cage such as that described in FR-A-2 841 123 for, in particular, the treatment of the degenerative spine.

Cette cage intervertébrale perfectionnée comprend essentiellement une entretoise 1 en forme de disque sensiblement parallélépipédique comportant avantageusement un logement en creux (ou plusieurs) dans lequel il est possible de placer un greffon osseux.  This improved intervertebral cage essentially comprises a substantially parallelepiped shaped disc-shaped spacer 1 advantageously comprising a hollow recess (or several) in which it is possible to place a bone graft.

Ce disque comporte deux faces de bases opposées 3, 4 sensiblement planes et parallèles entre elles et une paroi latérale 5 reliant les deux faces de bases. Dans une forme particulièrement avantageuse, cette paroi latérale comporte par exemple deux parties opposées 6, 7.  This disc comprises two faces of opposite bases 3, 4 substantially flat and parallel to each other and a side wall 5 connecting the two faces of bases. In a particularly advantageous form, this side wall comprises for example two opposite parts 6, 7.

L'entretoise 1 est apte à être disposée entre les faces en regard 8, 9 des deux corps vertébraux 10, 11 respectivement de deux vertèbres consécutives, en remplacement du disque endommagé qui se trouvait entre ces deux vertèbres, les deux faces de bases 3, 4 de l'entretoise 1 étant aptes à être placées au contact au moins partiel des faces en regard 8, 9 des deux corps vertébraux.  The spacer 1 is able to be arranged between the facing faces 8, 9 of the two vertebral bodies 10, 11 respectively of two consecutive vertebrae, replacing the damaged disc which was located between these two vertebrae, the two base faces 3, 4 of the spacer 1 being adapted to be placed in contact at least partially facing faces 8, 9 of the two vertebral bodies.

La cage comporte en outre au moins une lame 20 et des moyens 21 pour déplacer cette lame par rapport à une première des deux parties opposées de la paroi latérale 5, en l'occurrence au moins la partie 6 sur la figure 1, de façon que la lame puisse prendre deux positions: - une première position dans laquelle la lame est entièrement située dans l'espace compris entre les premier et second plans contenant les deux faces de bases 3, 4 de l'entretoise 1, et - une seconde position comme celle qui est illustrée sur les quatre figures, dans laquelle les deux extrémités opposées 25, 26 de la lame émergent de part et d'autres de cet espace.  The cage further comprises at least one blade 20 and means 21 for moving this blade relative to a first of the two opposite parts of the side wall 5, in this case at least the portion 6 in FIG. 1, so that the blade can take two positions: a first position in which the blade is entirely located in the space between the first and second planes containing the two base faces 3, 4 of the spacer 1, and a second position as that which is illustrated in the four figures, in which the two opposite ends 25, 26 of the blade emerge on either side of this space.

En outre, de façon avantageuse, les deux extrémités 25, 26 de la lame 20 sont conformées en biseau de façon à pouvoir pénétrer plus facilement dans l'os des corps vertébraux 10, 11 à la manière d'une lame de couteau ou analogue. Il est à noter que cette forme en biseau n'a pas été spécifiquement représentée sur les figures, essentiellement dans le but d'une simplification des dessins, mais elle est bien représentée notamment dans le document mentionné au préambule de la présente description.  In addition, advantageously, the two ends 25, 26 of the blade 20 are bevelled so as to be able to penetrate more easily into the bone of the vertebral bodies 10, 11 in the manner of a knife blade or the like. It should be noted that this beveled shape has not been specifically shown in the figures, essentially for the purpose of simplifying the drawings, but it is well represented in particular in the document mentioned in the preamble of the present description.

Dans une réalisation avantageuse, les moyens 21 définis ci-dessus, pour déplacer la lame 20 par rapport à une première 6 des deux parties de paroi latérale opposées de façon que la lame soit apte à apprendre deux positions, comportent par exemple un arbre monté en rotation suivant un axe 31 dans la première partie 6 de la paroi latérale 5, et des moyens pour monter la lame en coopération avec une extrémité de l'arbre.  In an advantageous embodiment, the means 21 defined above, for moving the blade 20 relative to a first 6 of the two opposite side wall portions so that the blade is able to learn two positions, comprise for example a shaft mounted in rotation along an axis 31 in the first portion 6 of the side wall 5, and means for mounting the blade in cooperation with one end of the shaft.

Cet arbre permet de transmettre la commande pour faire passer la lame 20 de sa première position à sa seconde position, et réciproquement s'il est par exemple nécessaire de retirer la cage intervertébrale après qu'elle ait été implantée.  This shaft is used to transmit the command to move the blade 20 from its first position to its second position, and reciprocally if it is for example necessary to remove the intervertebral cage after it has been implanted.

2880795 5 Les moyens pour faire passer, par rotation, la lame 20 de sa première position à sa seconde position et réciproquement, peuvent être constitués par des parties en saillie ou en creux de forme polygonale réalisées à l'extrémité de l'arbre sur la partie de face latérale 6, avec lesquelles peuvent coopérer des ancillaires sensiblement identiques à des outils classiques que l'on dénomme couramment clés à tube, tourne vis ou analogues.  The means for rotating, by rotation, the blade 20 from its first position to its second position and vice versa, may be constituted by protruding or recessed portions of polygonal shape made at the end of the shaft on the part of the side face 6, with which can cooperate ancillary substantially identical to conventional tools that are commonly known as tube wrenches, screw spindles or the like.

La cage peut aussi comporter des moyens pour maintenir la lame dans sa seconde position et l'empêcher de revenir à sa première position sous l'effet de quelque contrainte que ce soit qui serait exercée par le patient lui-même, tout en lui permettant de revenir à cette première position sous l'effet de forces extérieures exercées, par exemple, à l'aide d'un instrument ancillaire.  The cage may also include means for keeping the blade in its second position and preventing it from returning to its first position under the effect of any constraint whatsoever which would be exerted by the patient himself, while allowing him to return to this first position under the effect of external forces exerted, for example, using an ancillary instrument.

Selon une caractéristique importante de l'invention, les deux extrémités opposées 25, 26 de la lame émergeant de part et d'autre de l'espace lorsque la lame 20 est dans sa seconde position, comportent chacune un épaulement 41, 42, ces deux épaulements étant respectivement réalisés de façon que leurs directions générales, lorsque la lame 20 est dans sa seconde position, soient sensiblement contenues dans des plans parallèles aux plans des deux faces de bases opposées 3, 4 de l'entretoise, et respectivement enfoncés dans les deux corps vertébraux 10, 11 quand la lame est dans sa seconde position.  According to an important characteristic of the invention, the two opposite ends 25, 26 of the blade emerging on either side of the space when the blade 20 is in its second position, each comprise a shoulder 41, 42, these two shoulders being respectively made so that their general directions, when the blade 20 is in its second position, are substantially contained in planes parallel to the planes of the two opposite faces of bases 3, 4 of the spacer, and respectively sunk in the two vertebral body 10, 11 when the blade is in its second position.

Selon une caractéristique de l'invention, les deux directions générales respectivement des deux épaulements 41, 42 font entre elles un angle compris entre zéro degré et cent quatre-vingts degrés, valeurs limites comprises.  According to a feature of the invention, the two general directions respectively of the two shoulders 41, 42 are between them an angle between zero degrees and one hundred and eighty degrees, including limit values.

De cette façon, quand la lame 20 est dans sa seconde position, ses deux extrémités opposées 25, 26 avec leur épaulement respectif 41, 42 sont implantées dans l'os des corps vertébraux 10, 11 et assurent simultanément deux fonctions, à savoir: empêcher le glissement de la cage suivant l'axe 31 et s'opposer à l'écartement des deux corps vertébraux 10, 11 perpendiculairement à ce même axe 31. La lame 20 joue donc une fonction d'agrafe que les cages à lame de l'art antérieur n'avaient pas, mise à part celle décrite dans le document référencé ci-dessus.  In this way, when the blade 20 is in its second position, its two opposite ends 25, 26 with their respective shoulder 41, 42 are implanted in the bone of the vertebral bodies 10, 11 and simultaneously provide two functions, namely: prevent the sliding of the cage along the axis 31 and oppose the spacing of the two vertebral bodies 10, 11 perpendicularly to the same axis 31. The blade 20 therefore plays a staple function that the blade cages of the prior art had not, apart from that described in the document referenced above.

La lame 20 peut être sensiblement plane, comme illustré sur les figures, ou courbée ou équivalent, mais présente dans son ensemble une forme générale définie dans un plan Pr sensiblement perpendiculaire à l'axe 31.  The blade 20 may be substantially flat, as illustrated in the figures, or curved or equivalent, but as a whole has a general shape defined in a plane Pr substantially perpendicular to the axis 31.

2880795 6 Les épaulements 41, 42 peuvent être réalisés de différentes façons. Deux des différents modes de réalisation possibles sont schématiquement représentés sur les figures 1 à 4.  The shoulders 41, 42 may be made in different ways. Two of the various possible embodiments are diagrammatically shown in FIGS. 1 to 4.

Dans le mode de réalisation illustré sur les figures 1 et 2, au moins l'un des deux épaulements 41, 42, et avantageusement les deux, est constitué par une première vis avantageusement à filetage osseux 50, 51 montée en coopération avec une première des deux extrémités 25, 26 de la lame 20, en passant par exemple dans un orifice 125, 126 réalisé dans une extrémité 25, 26 de la lame. Cette vis constitue un double épaulement de part et d'autre de la lame et permet de bien fixer l'extrémité de la lame, et donc la cage dans son ensemble, au corps de vertèbre.  In the embodiment illustrated in FIGS. 1 and 2, at least one of the two shoulders 41, 42, and advantageously both, is constituted by a first screw advantageously with a bone thread 50, 51 mounted in cooperation with a first two ends 25, 26 of the blade 20, for example through an orifice 125, 126 formed in an end 25, 26 of the blade. This screw is a double shoulder on both sides of the blade and allows to secure the end of the blade, and thus the cage as a whole, to the vertebra body.

Dans le mode de réalisation selon les figures 3 et 4, au moins l'un des deux épaulements 41, 42, et avantageusement les deux, est constitué par un crochet 52, 53 comportant une boucle concave 54, 55, le plan général du crochet étant sensiblement contenu dans le plan de rotation Pr de la lame 20.  In the embodiment according to FIGS. 3 and 4, at least one of the two shoulders 41, 42, and advantageously both, is constituted by a hook 52, 53 comprising a concave loop 54, 55, the general plane of the hook. being substantially contained in the plane of rotation Pr of the blade 20.

Bien entendu, comme illustré sur les figures 3 et 4, les deux extrémités 25, 26 de la lame comporte chacune un crochet, ce qui donne à la lame dans son ensemble une forme en "S".  Of course, as illustrated in Figures 3 and 4, the two ends 25, 26 of the blade each comprises a hook, which gives the blade as a whole an "S" shape.

Dans le cas de ce dernier mode de réalisation, la cage peut comporter en outre un épaulement auxiliaire 60, 61 monté en coopération avec l'épaulement en forme de crochet 52, 53, cet épaulement auxiliaire faisant avec le plan général Pr du crochet ou de la lame 20 un angle sensiblement égal à quatre vingt dix degrés. De cette façon, une extrémité de la lame comporte deux épaulements faisant entre eux un angle de quatre vingt dix degrés.  In the case of this last embodiment, the cage may further comprise an auxiliary shoulder 60, 61 mounted in cooperation with the hook-shaped shoulder 52, 53, this auxiliary shoulder forming with the general plane Pr hook or the blade 20 at an angle substantially equal to ninety degrees. In this way, one end of the blade has two shoulders forming between them an angle of ninety degrees.

Il est même avantageux que cet épaulement auxiliaire 60, 61 soit constitué d'une seconde vis avantageusement à filetage osseux 70, 71, cette seconde vis étant apte à être implantée selon une direction sensiblement perpendiculaire au plan de rotation Pr en passant dans la boucle concave 54, 55. Selon cette structure, l'extrémité de la lame comporte en fait trois épaulements disposés à zéro, quatre-vingt dix et cent quatre-vingt-dix degrés les uns par rapport aux autres et définissant une forme en "T' qui assure un ancrage encore meilleur dans le corps de vertèbre.  It is even advantageous for this auxiliary shoulder 60, 61 to consist of a second screw advantageously with a bone thread 70, 71, this second screw being capable of being implanted in a direction substantially perpendicular to the plane of rotation Pr while passing through the concave loop. 54, 55. According to this structure, the end of the blade has in fact three shoulders arranged at zero, ninety and ninety degrees relative to each other and defining a shape in "T" which ensures even better anchoring in the vertebral body.

Les boucles concaves 54, 55 illustrées sur les figures 2 et 3 sont ouvertes, mais elles peuvent être fermées, comme dans le mode de réalisation selon les figures 1 et 2 dans lequel les orifices 125, 126 réalisés aux deux extrémités de la lame 20 constituent en fait l'intérieur des deux boucles.  The concave loops 54, 55 illustrated in FIGS. 2 and 3 are open, but they can be closed, as in the embodiment according to FIGS. 1 and 2, in which the orifices 125, 126 made at the two ends of the blade 20 constitute in fact inside the two loops.

Il est en outre précisé que l'intérieur d'au moins une boucle concave 54, 55, sinon avantageusement l'intérieur des deux, constitue l'un des orifices 125, 126 définis ci-dessus, et que, pour assurer un ancrage encore meilleur, il est possible que cet orifice soit taraudé, par exemple au même pas que les vis 50, 51 et/ou 70, 71 de façon que l'une de ces vis puisse se visser dans cet orifice taraudé.  It is further specified that the interior of at least one concave loop 54, 55, if not advantageously the interior of the two, constitutes one of the orifices 125, 126 defined above, and that, to ensure a still anchoring better, it is possible that this hole is threaded, for example at the same pitch as the screws 50, 51 and / or 70, 71 so that one of these screws can be screwed into this threaded hole.

Claims (1)

8 REVENDICATIONS8 claims 1. Cage intervertébrale pour le traitement du rachis dégénératif, comprenant: une entretoise (1) sensiblement en forme de disque comportant deux faces de bases opposées (3, 4) sensiblement planes et parallèles et une paroi latérale (5) reliant les deux faces de bases, cette paroi latérale comportant deux parties opposées (6, 7), ladite entretoise étant apte à être disposée entre les faces en regard (8, 9) des deux corps vertébraux (10, 11) respectivement de deux vertèbres consécutives en remplacement du disque endommagé entre ces deux vertèbres, les deux faces de bases de l'entretoise étant aptes à être placées au contact au moins partiel des deux corps vertébraux, - au moins une lame (20), ladite lame comportant deux extrémités opposées (25, 26) conformées en biseau, et des moyens (21) pour déplacer ladite lame par rapport à une première (6) des deux parties de paroi latérale de façon que la lame soit apte à prendre deux positions: * une première position dans laquelle la lame est entièrement située dans l'espace compris entre les deux premier et second plans contenant les deux faces de bases (3, 4) de l'entretoise (1), et * une seconde position dans laquelle les deux extrémités opposées (25, 26) de ladite lame (20) émergent de part et d'autre dudit espace, les deux extrémités opposées (25, 26) de ladite lame comportant chacune un épaulement, ces deux épaulements (41, 42) étant respectivement réalisés de façon que, lorsque la lame (20) est dans sa seconde position, leurs directions générales soient sensiblement contenues dans des plans parallèles aux plans des deux faces de bases opposées (3, 4) de l'entretoise, les deux dits épaulements étant respectivement enfoncés dans les deux corps vertébraux quand ladite lame (20) est dans sa seconde position, caractérisée par le fait que les deux directions générales respectivement des deux épaulements (41, 42) font entre elles un angle compris entre zéro degré et cent quatre-vingts degrés, valeurs limites comprises.  An intervertebral cage for degenerative spine treatment, comprising: a substantially disk-shaped spacer (1) having two substantially plane and parallel opposing base faces (3, 4) and a side wall (5) connecting the two faces of the spine; bases, this side wall having two opposite parts (6, 7), said spacer being adapted to be disposed between the facing faces (8, 9) of the two vertebral bodies (10, 11) respectively of two consecutive vertebrae replacing the disc damaged between these two vertebrae, the two base faces of the spacer being adapted to be placed in at least partial contact with the two vertebral bodies, - at least one blade (20), said blade having two opposite ends (25, 26) beveled, and means (21) for moving said blade relative to a first (6) of the two sidewall portions so that the blade is adapted to take two positions: * a first position in which the blade is entirely located in the space between the first and second planes containing the two base faces (3, 4) of the spacer (1), and * a second position in which the two opposite ends (25, 26) of said blade (20) emerge on either side of said space, the two opposite ends (25, 26) of said blade each having a shoulder, these two shoulders (41, 42) being respectively made of so that when the blade (20) is in its second position, their general directions are substantially contained in planes parallel to the planes of the two opposite base faces (3, 4) of the spacer, the two said shoulders being respectively depressed in both vertebral bodies when said blade (20) is in its second position, characterized in that the two general directions respectively of the two shoulders (41, 42) are between them an angle between zero degrees and one hundred and eighty degrees, including limit values. 2. Cage intervertébrale selon la revendication 1, caractérisée par le fait qu'au moins l'un des deux épaulements (41, 42) est constitué par une première vis (50, 51) montée en coopération avec une première des deux extrémités (25, 26) de ladite lame (20).  2. Intervertebral cage according to claim 1, characterized in that at least one of the two shoulders (41, 42) is constituted by a first screw (50, 51) mounted in cooperation with a first of the two ends (25). , 26) of said blade (20). 3. Cage intervertébrale selon l'une des revendications 1 et 2, caractérisée par le fait qu'au moins l'un des deux épaulements (41, 42) est constitué par un crochet (52, 53) comportant une boucle concave (54, 55), le plan général dudit crochet étant sensiblement contenu dans le plan de rotation (Pr) de ladite lame.  3. Intervertebral cage according to one of claims 1 and 2, characterized in that at least one of the two shoulders (41, 42) is constituted by a hook (52, 53) having a concave loop (54, 55), the general plane of said hook being substantially contained in the plane of rotation (Pr) of said blade. 4. Cage intervertébrale selon la revendication 3, caractérisée par le fait qu'elle comporte un épaulement auxiliaire (60, 61) monté en coopération avec ledit épaulement en forme de crochet (52, 53), ledit épaulement auxiliaire faisant avec le plan général (Pr) du crochet un angle sensiblement égal à quatre vingt dix degrés.  4. Intervertebral cage according to claim 3, characterized in that it comprises an auxiliary shoulder (60, 61) mounted in cooperation with said hook-shaped shoulder (52, 53), said auxiliary shoulder forming with the general plane ( Pr) of the hook an angle substantially equal to ninety degrees. 5. Cage intervertébrale selon la revendication 4, caractérisée par le fait que ledit épaulement auxiliaire (60, 61) est constitué d'une seconde vis (70, 71) , ladite seconde vis étant apte à être implantée selon une direction sensiblement perpendiculaire au plan de rotation (Pr) de la lame, et en passant dans la boucle concave (54, 55).  5. intervertebral cage according to claim 4, characterized in that said auxiliary shoulder (60, 61) consists of a second screw (70, 71), said second screw being adapted to be implanted in a direction substantially perpendicular to the plane rotating (Pr) the blade, and passing through the concave loop (54, 55). 6. Cage intervertébrale selon l'une des revendications 3 à 5, caractérisée par le fait que ladite boucle concave (54, 55) est une boucle ouverte.  6. intervertebral cage according to one of claims 3 to 5, characterized in that said concave loop (54, 55) is an open loop. 7. Cage intervertébrale selon l'une des revendications 3 à 5, caractérisée par le fait que ladite boucle concave (54, 55) est une boucle fermée.  7. Intervertebral cage according to one of claims 3 to 5, characterized in that said concave loop (54, 55) is a closed loop. 8. Cage selon l'une des revendications 3 à 7, caractérisée par le fait que 30 l'intérieur d'au moins une boucle concave (54, 55) constitue un orifice (125, 126), ledit orifice étant taraudé.  8. Cage according to one of claims 3 to 7, characterized in that the interior of at least one concave loop (54, 55) constitutes an orifice (125, 126), said orifice being tapped.
FR0500446A 2005-01-17 2005-01-17 PERFECTED BLADE CUTTER FOR BLADE Expired - Fee Related FR2880795B1 (en)

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