EP0634913A1 - Crochet utilise pour traiter des deformations de la colonne vertebrale - Google Patents

Crochet utilise pour traiter des deformations de la colonne vertebrale

Info

Publication number
EP0634913A1
EP0634913A1 EP93902025A EP93902025A EP0634913A1 EP 0634913 A1 EP0634913 A1 EP 0634913A1 EP 93902025 A EP93902025 A EP 93902025A EP 93902025 A EP93902025 A EP 93902025A EP 0634913 A1 EP0634913 A1 EP 0634913A1
Authority
EP
European Patent Office
Prior art keywords
hook
hook according
longitudinal axis
blade
caudal
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
EP93902025A
Other languages
German (de)
English (en)
Inventor
Johannes Fridolin SCHLÄPFER
Martin Hess
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
AO Technology AG
Original Assignee
Synthes AG Chur
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Synthes AG Chur filed Critical Synthes AG Chur
Publication of EP0634913A1 publication Critical patent/EP0634913A1/fr
Ceased legal-status Critical Current

Links

Classifications

    • 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
    • A61B17/7034—Screws or hooks with U-shaped head or back through which longitudinal rods pass characterised by a lateral opening
    • 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
    • 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
    • A61B17/7056—Hooks with specially-designed bone-contacting part

Definitions

  • the invention relates to a hook, according to the preamble of claim 1.
  • Dorsal systems generally consist of at least one longitudinal beam, but mostly a left and a right, and individual anchoring elements. The latter form a force-transmitting connection between the spine and the side members.
  • wire cerclages are placed around the lamina and through the spinous processes of the vertebral bodies.
  • the application of wire cerclages is associated with a certain risk for the patient because it leads to spinal cord injuries can come.
  • the wires cut through the bone over time (high local voltage peaks cause bone resorption under the wire) or simply break.
  • the pedicle screws are generally screwed into the vertebral bodies through the pedicles.
  • the pedicles are very narrow in the upper thoracic spine and are difficult to locate due to their deformity. As a result, the use of pedicle screws in this area is risky. In addition, many surgeons generally shy away from using pedicle screws in the area of the thoracic spine.
  • the spine hooks are currently the most commonly used elements. Depending on the situation, they are attached to the lamina, the pedicle or the transverse process. Compared to wire cerclages, they offer the advantage that the load is transferred from the bone to the hook over a relatively large area and accordingly there is hardly any bone resorption at the point of contact between the bone and the hook. Compared to pedicle screws, the hooks have the major disadvantage that they can only transmit loads to the side members if they are pressed firmly against the bone. In the current systems, such a preload can only be applied via the side members. This makes it very difficult to individually manipulate the vertebrae in the deformation area with the hooks known today. The invention seeks to remedy this. The invention has for its object to provide a hook which is connected to the vertebra in a stable manner regardless of the longitudinal member carrying it.
  • the invention solves the problem with a hook, which has the features of claim 1.
  • the advantages achieved by the invention are essentially to be seen in the fact that, thanks to the independent, stable connection of the hook according to the invention to the vertebra, the hook can be individually manipulated and the spinal deformities to be treated can thereby be corrected step by step from the less deformed side .
  • the hook according to the invention can be fastened to a longitudinal beam - within a spinal fixation device - in various known ways.
  • the shaft part of the hook according to the invention has corresponding construction elements which allow the connection to the side member, for example as disclosed in EP-A 0 348 272.
  • FIG. 1 shows a perspective view of the pedicle hook according to the invention
  • Fig. 2 illustrates a side view of the pedicle hook of Fig. 1;
  • FIG. 3 shows a perspective, exploded view of a variant of the pedicle hook according to the invention.
  • FIG. 4 shows a longitudinal section through a further variant of the pedicle hook according to the invention with a separate extension arm and stabilizing extension.
  • the pedicle hook shown in detail in FIGS. 1 and 2 essentially consists of a shaft part 2 which can be fastened to a longitudinal beam 5 and a curved hook blade 3 adjoining it.
  • the shaft part 2 consists of a connecting device, which is published in the European published under the number EP-AI 524 441. Patent application is described in more detail. It is by means of a Cap 23 fixes the longitudinal beam 5 lying in a recess 21 of the shaft part 2 running transversely to the longitudinal axis 1.
  • This connecting device is described in more detail below with reference to FIG. 4.
  • any other known connection system can also be used to fix the shaft part 2 to the side member 5, for example in accordance with EP-AI 348 272.
  • the hooked blade 3 is convex on its rear side 34 and has two legs on its free end 31.
  • the two legs 33 form an indentation 32 adapted to the pedicle geometry.
  • the length of the two legs 33 can be selected to be of different lengths, as is described in detail in the Europ. Patent application is described.
  • the bent free end 31 of the hook blade 3 extends essentially perpendicular to the longitudinal axis 1.
  • An extension 8 is attached between the shaft part 2 and the hook blade 3, which extends in the same direction as the bent, free end 31 of the hook blade 3 and has a bore 82 at its free end 81 which can accommodate a bone screw 7.
  • the bone screw 7 can be axially fixed either by the internal thread 83 of the bore 82 or - if the bore 82 is formed without an internal thread - solely by the longitudinal beam 5 that lies above it.
  • the extension 8 and the hooked blade 3 encompasses the lamina of the vertebra 91 in the cranial direction.
  • the extension 8 can either lie directly on the lamina of the vertebra 91 or - as shown in FIG.
  • the bore 82 in the pedicle hook is preferably positioned in such a way that the bone screw 7 to be inserted into the vertebra 91 leads through the pedicle of the vertebra 91 at a precisely defined distance from the deepest point of the indentation 32, preferably about 2 mm.
  • a screw with a flange can also be used, the bore 82 having to be designed accordingly.
  • a shorter threaded bolt can also be used, which is not screwed into the vertebra 91, but only sits with its tip on the lamina and thus presses the inferior part of the facet joint of the vertebra 91 against the hooked blade 3.
  • a caudal stabilizing extension 4 is attached to the convex rear side 34 of the hooked blade 3 and extends essentially in the opposite direction to the bent away hooked blade 3. It has at its free end 41 a bore 42 with or without an internal thread 43 for receiving a grub screw 6.
  • the caudal stabilization extension 4 supports the pedicle hook according to the invention in the caudal direction on the superior part of the facet joint of the vertebra 92 lying under the vertebra 91.
  • the caudal stabilization extension 4 either lies directly - as shown in FIG. 2 - on the joint of the vertebra 92 or can be by means of the Set screw 6 are spaced apart from the vertebra 92. In both variants, the pedicle hook is effectively prevented from tipping back. Tilting forward is already prevented by the extension 8.
  • FIG. 3 shows a variant of the pedicle hook according to the invention, in which the caudal stabilization extension 4, instead of directly on the hook blade 3, arises at the free end of a lateral arm 9 which extends essentially perpendicular to the longitudinal axis 1 and to the bent away hook blade 3.
  • the side arm 9 is attached between the shaft part 2 and the hook blade 3.
  • a one-sided rotational moment about the longitudinal axis of the spine can be exerted on the vertebra by means of the pedicle hook.
  • the main indication for the use of this embodiment is segmental correction in scoliosis.
  • the aim of the treatment of scoliosis is to bring the spine towards the side member 5 and to rotate back the twisted vertebrae.
  • the caudal stabilization extension 4 which is shown in FIG. 3 and is fastened in an L-shape to the lateral arm, has a bore 42 with an internal thread 43 at its free end 41.
  • a bone screw 7 or a threaded pin 6 can be inserted through the bore 42 as required, in order to bring about a fixation in the pedicle or a firm pressing on the lamina.
  • the caudal stabilizing extension 4 can also be formed without a bore 42, in which case it is expediently bent in such a way that it comes to lie directly on the bone.
  • a T-shaped construction can also be used, as is indicated by dash-dotted lines in FIG. 3, in that an additional extension 8 is provided on the side arm 9, which is preferably in the same direction as Free end 31 of the hook blade 3 runs.
  • This additional extension 8 is also provided at its free end 81 with a bore 82 with an internal thread 83, into which a bone screw 7 or a threaded pin 6 can be inserted as required.
  • the cantilever 9 with caudal stabilizing extension 4 can - as shown in Fig. 3 - be integrally connected to the shaft part 2 and the hook blade 3.
  • the bores 42 and 82 can either be provided with or without internal threads 43 and 83.
  • FIG. 4 shows the above-mentioned further variant of the pedicle hook according to the invention, in which the extension arm 9 with the caudal stabilizing extension 4 is designed as an independent, removable part.
  • the orientation of the caudal stabilization extension 4 is the same as in the embodiment already discussed, i.e. it runs essentially in the opposite direction to the bent hook blade 3.
  • the distance of the caudal stabilizing extension 4 from the longitudinal axis 1 of the pedicle hook is not fixed, but can be freely adjusted, both longitudinally and rotatively.
  • the end of the arm 9 directed towards the pedicle hook is designed as a hollow cylinder 44 which is longitudinally and rotatably movable in the recess 21 of the shaft part 2.
  • the sleeve 23 which can be put over the threaded part 22 of the shaft part 2 and has a corresponding recess 26 is fixed by means of the nut 24 against the hollow cylinder 44 and blocks it axially and rotatably.
  • the rotational stability of the caudal stabilizing extension 4 attached to the arm 9 is further improved by the adjusting screw 25 which can be inserted into a hole 45 of the hollow cylinder 44 from above (through the nut 24, sleeve 23 and shaft part 2). Since in this embodiment the longitudinal member 5 can no longer be inserted into the recess 21 of the shaft part 2, a separate cross member 10 is provided for this purpose, which can be inserted with one of its ends 11 into the bore 46 of the hollow cylinder 44 and fixed with the adjusting screw 25 and with its other end 12 can be connected to the side member 5.
  • the connection to the longitudinal beam 5 is only realized by an open receptacle 13 at the end 12, which is sufficient to transmit a torque about the longitudinal axis of the spine.
  • connection can be strengthened by means of an additional element (not shown in the drawing) which holds the cross member 10 and the longitudinal member 5 u. It is also possible to provide the cross member 10 with a hole for the side member 5 instead of an open receptacle 13. A set screw perpendicular to this hole stabilizes the side member in the hole.

Landscapes

  • 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)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un crochet utilisé pour traiter des déformations de la colonne vertébrale, qui comprend une section en forme de tige (2) comportant un axe longitudinal (1), sur laquelle un longeron (5) peut être fixé, transversalement à l'axe longitudinal (2), ainsi qu'un fer (3) raccordé à la section en forme de tige (2), qui est recourbé dans un sens opposé à l'axe longitudinal (1). Ce crochet comporte en outre un prolongement de stabilisation (4) qui s'étend sensiblement en sens inverse par rapport au fer (3). Ce crochet peut être fixé à la vertèbre de manière stable indépendamment du longeron qui le soutient.
EP93902025A 1993-02-05 1993-02-05 Crochet utilise pour traiter des deformations de la colonne vertebrale Ceased EP0634913A1 (fr)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/CH1993/000031 WO1994017746A1 (fr) 1993-02-05 1993-02-05 Crochet utilise pour traiter des deformations de la colonne vertebrale

Publications (1)

Publication Number Publication Date
EP0634913A1 true EP0634913A1 (fr) 1995-01-25

Family

ID=4548699

Family Applications (1)

Application Number Title Priority Date Filing Date
EP93902025A Ceased EP0634913A1 (fr) 1993-02-05 1993-02-05 Crochet utilise pour traiter des deformations de la colonne vertebrale

Country Status (2)

Country Link
EP (1) EP0634913A1 (fr)
WO (1) WO1994017746A1 (fr)

Families Citing this family (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2003099148A2 (fr) * 2002-05-21 2003-12-04 Sdgi Holdings, Inc. Cable de reduction et ancrage osseux
US20060293660A1 (en) 2005-06-03 2006-12-28 Lewis Edward L Connector for attaching an alignment rod to a bone structure
US7011659B2 (en) * 2003-03-17 2006-03-14 Lewis Edward L Connector for attaching an alignment rod to a bone structure
US20050080414A1 (en) * 2003-10-14 2005-04-14 Keyer Thomas R. Spinal fixation hooks and method of spinal fixation
DE102008035093B4 (de) * 2008-07-28 2016-01-14 Peter Brehm Befestigungselement zur Befestigung eines Implantats an einer Lamina eines Wirbels und Implantat zur Korrektur einer Wirbelsäulendeformität
CN103181816A (zh) * 2013-03-12 2013-07-03 中国人民解放军第二军医大学 一种带内固定芯的枢椎椎板钩

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2289164A1 (fr) * 1974-11-04 1976-05-28 Tornier Rene Perfectionnements aux dispositifs pour le traitement de la scoliose
FR2642642B1 (fr) * 1989-02-03 1997-08-22 Cotrel Yves Implant d'osteosynthese posterieure rachidienne

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See references of WO9417746A1 *

Also Published As

Publication number Publication date
WO1994017746A1 (fr) 1994-08-18

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