EP0793463A1 - Implantat zum verschmelzen zweier angrenzender knochenkörper, insbesondere zweier aufeinanderfolgender wirbel - Google Patents

Implantat zum verschmelzen zweier angrenzender knochenkörper, insbesondere zweier aufeinanderfolgender wirbel

Info

Publication number
EP0793463A1
EP0793463A1 EP95940320A EP95940320A EP0793463A1 EP 0793463 A1 EP0793463 A1 EP 0793463A1 EP 95940320 A EP95940320 A EP 95940320A EP 95940320 A EP95940320 A EP 95940320A EP 0793463 A1 EP0793463 A1 EP 0793463A1
Authority
EP
European Patent Office
Prior art keywords
implant
blades
fusion
graft
vertebrae
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.)
Withdrawn
Application number
EP95940320A
Other languages
English (en)
French (fr)
Inventor
Joel Letendart
Philippe Chelius
Yves Der Sarkissian
Valéry Dehais
Alain Ducolombier
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.)
Objectif-Implants Belgique
Original Assignee
Objectif-Implants Belgique
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
Priority claimed from FR9413685A external-priority patent/FR2726759B1/fr
Application filed by Objectif-Implants Belgique filed Critical Objectif-Implants Belgique
Publication of EP0793463A1 publication Critical patent/EP0793463A1/de
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4684—Trial or dummy prostheses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/4455—Joints 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
    • A61F2/447—Joints 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/442—Intervertebral or spinal discs, e.g. resilient
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603—Special 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
    • A61F2/4611—Special 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/28—Bones
    • A61F2002/2835—Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30138—Convex polygonal shapes
    • A61F2002/30151—Convex polygonal shapes rhomboidal or parallelogram-shaped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30138—Convex polygonal shapes
    • A61F2002/30153—Convex polygonal shapes rectangular
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30138—Convex polygonal shapes
    • A61F2002/30158—Convex polygonal shapes trapezoidal
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30159—Concave polygonal shapes
    • A61F2002/30169—Pi-shaped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/30261—Three-dimensional shapes parallelepipedal
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The 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
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30593—Special structural features of bone or joint prostheses not otherwise provided for hollow
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30594—Special structural features of bone or joint prostheses not otherwise provided for slotted, e.g. radial or meridian slot ending in a polar aperture, non-polar slots, horizontal or arcuate slots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
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    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
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    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
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    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
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    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters 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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    • A61F2002/4629—Special 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 connected to the endoprosthesis or implant via a threaded connection
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    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0017—Angular shapes
    • A61F2230/0019—Angular shapes rectangular
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0017—Angular shapes
    • A61F2230/0026—Angular shapes trapezoidal
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0028—Shapes in the form of latin or greek characters
    • A61F2230/0047—Pi-shaped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0082—Three-dimensional shapes parallelepipedal
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys

Definitions

  • the present invention relates to an implant allowing the fusion of two adjacent bone bodies.
  • This implant is mainly intended to be used to obtain the fusion of two consecutive vertebrae, but can also be used for arthrodeses under Astragalian or Tibio-Astragalian.
  • intervertebral arthrodesis in cases of disc pathologies, in order to restore an adequate disc height, in cases of narrowing of the lumbar canal, in order to achieve the anterior stabilization of the vertebrae made necessary by the weakening of the posterior arch, or in cases of vertebral instabilities, in order to achieve the fusion of the vertebrae which have become unstable.
  • This arthrodesis is generally obtained by the establishment of a posterolateral bone graft, implanted on the articular processes, on the transverse processes and on the intervertebral blades.
  • the grafts are placed only in the posterolateral grooves, then a metallic stabilization material is implanted to immobilize the spine while the fusion takes place.
  • This technique has the drawback of being relatively complex and time-consuming to implement, taking into account the addition of this stabilization material, and of not making it possible to restore sufficient disc height.
  • One technique consists of implanting intervertebral cages at the level of the affected disc, on either side of the axis of the spine.
  • These cages are cylindrical, hollow, externally threaded and include side windows. They receive a filling of bone particles taken from a cancellous bone, then are engaged by screwing in intervertebral housings previously drilled in the plates of the vertebrae to be fused.
  • Each cage must be positioned so that two opposite windows are in contact with the trays, in order to make possible bone growth inside the cage.
  • This technique has the disadvantage of involving the use of a means of temporary distraction of the vertebrae, which is fairly traumatic, during the time necessary for drilling the housings, filling and placing the cages.
  • the duration of intervention is also important, which is hardly desirable for the patient.
  • This cage is also intended to be furnished with pieces of cancellous bone, then is compacted in the intervertebral housings, previously arranged.
  • the present invention aims to remedy the aforementioned drawbacks of the prior techniques. It provides an intervertebral implant allowing the perfect fusion of the vertebrae, with adequate enhancement of the intervertebral disc and guaranteed stability over time. This implant must be able to be placed posteriorly, without risk of nerve damage at the level of the hard mother or at the level of the roots, by a relatively simple and rapid technique of implementation.
  • the implant has a general U-shape, that is to say is constituted by two lateral blades connected to each other, at one end, by a heel, at least one of which comprises a sharp edge at its free end, this implant being shaped to allow the removal of a one-piece bone graft itself.
  • the implant is not intended to be filled with spongy spongy bone particles, with the risk of inclusion of air bubbles, as may be the case with conventional intervertebral cages.
  • it is itself used for the removal, preferably in the iliac crest of the patient, of a graft constituted by cancellous bone "of mass", clearly denser than an agglomeration of bone particles. This density corresponds substantially to that of the cancellous bone of the vertebrae.
  • the graft removed comes to completely fill the implant, and is maintained in the latter, so that it can be cut again if necessary.
  • the upper and lower openings delimited by the blades have much larger dimensions than the windows in the existing cages, and allow large areas of contact of the graft with the cancellous bone of the vertebrae.
  • the graft is held laterally in the intervertebral space by the implant blades. All of these factors allow obtaining a perfect fusion of the vertebrae and the graft, without crushing or inserting the graft into the cancellous bone. The fusion thus obtained gives any guarantee of stability over time.
  • the blades have on their upper and / or lower edges teeth of the "harpoon” or "fir" type.
  • teeth are intended to be inserted into the cancellous bone of the vertebral plates, and to prevent any possibility of movement of the implant backwards.
  • their insertion into the bone allows compression of the graft, the latter having, thanks to direct sampling, a width which corresponds perfectly to the maximum width of the implant, including teeth.
  • This compression ensures perfect application and total immobilization of the graft relative to the vertebrae, which is entirely favorable for good bone growth, and therefore for obtaining a perfect fusion.
  • the penetration of the teeth inside the vertebrae also promotes the initiation of bone growth to achieve fusion.
  • the length of the blades is uneven, in order to facilitate the removal of the graft.
  • the blades can be rectangular, trapezoidal, or in the shape of a parallelogram.
  • At least one of the two blades may include a lateral lumen, to also allow bone growth in this lateral direction.
  • the heel connecting the two blades is pierced with a threaded hole allowing the mounting of the implant on the end of an impacting tool, for the removal of the graft then for the placement of the implant in its intervertebral housing.
  • the distance separating the blades is determined so that the area occupied by the bone graft at the upper and lower faces of the implant represents at least 50% of the total area of these faces.
  • Figure 1 is a perspective view
  • Figure 2 is a side view, after removal of the graft intended to garnish it
  • Figure 3 is a top view
  • Figure 4 is an end view, on the rear side
  • Figure 5 is a rear view of two implants placed in an intervertebral space
  • Figure 6 is a side view of one of the two implants, after placement in an intervertebral space.
  • the figures represent, from different angles, an implant 2 making it possible to obtain the fusion of two consecutive vertebrae 3,4, at the level of an intervertebral disc 5.
  • This implant 2 has a general U shape, that is to say is constituted by two rectangular lateral blades 10, connected to each other, at one end, by a heel 11.
  • the blades 10 have a length uneven and have sharp edges 12 at their ends free, delimited by their internal faces and by beveled end faces.
  • the blades 10 include teeth 13 of the "harpoon” or “fir” type on their upper and lower edges, and lateral slots 14.
  • the heel 11 connecting the two blades 10 is pierced with a threaded hole 15 allowing the mounting of the implant 2 on the end of an impaction tool (not shown).
  • the implant 2 once mounted on this tool, allows direct removal of a monobloc bone graft 16 consisting of cancellous bone "of mass", preferably originating from the iliac crest of the patient.
  • the unequal length of the blades 10 facilitates the removal of the graft 16. It appears in FIGS. 2 to 4 that the graft 16 thus obtained completely fills the space delimited by the blades 10 and the heel 11, and that it has a corresponding width at the maximum width of the implant 2, teeth 13 included.
  • the graft 16 is perfectly maintained in the implant 2 and can be resized if necessary.
  • intervertebral housings are drilled in the plates of the vertebrae 3 and 4 to be fused, on either side of the axis of the spine, to receive two implants 2 provided with a plugin 16.
  • These implants 2 are impacted in the housings by means of the aforementioned tool. When they are fully inserted into the housings, the tool is removed. The teeth 13 are inserted into the cancellous bone of the vertebral plates, and prevent any possibility of movement of the implants 2 backwards.
  • This insertion causes the grafts 16 to compress over a height corresponding to that of the teeth 13, that is to say approximately 2 millimeters for each row of teeth. This compression allows perfect application and total immobilization of the grafts 16 relative to the vertebrae 3,4, which is entirely favorable for obtaining good bone growth, and therefore perfect fusion. .
  • the penetration of the teeth 13 inside the vertebrae promotes the initiation of bone growth from which the fusion takes place.
  • the density of the grafts 16 corresponds substantially to that of the cancellous bone of the vertebrae 3,4, and the grafts 16 are held in place laterally by the blades 10 in the intervertebral housings.
  • the distance separating the blades 10 is determined so that the surface occupied by the graft 16 at the level of the upper and lower faces of the implant 2 represents at least 50% of the total surface of these faces.
  • the upper and lower openings delimited by these blades 10 thus allow wide contact surfaces of the graft 16 and of the cancellous bone of the vertebrae 3,4.
  • the lateral lights also allow bone growth in this lateral direction.
  • the invention thus provides an intervertebral implant making it possible to obtain perfect fusion of the vertebrae, with adequate enhancement of the intervertebral disc and guarantee of stability over time, this implant being able to be placed by posterior route, according to a relatively simple technique. and quick to implement.
EP95940320A 1994-11-16 1995-11-15 Implantat zum verschmelzen zweier angrenzender knochenkörper, insbesondere zweier aufeinanderfolgender wirbel Withdrawn EP0793463A1 (de)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
FR9413685 1994-11-16
FR9413685A FR2726759B1 (fr) 1994-11-16 1994-11-16 Cage pour fusion de vertebres lombaires par interposition de greffons osseux
PCT/FR1995/001507 WO1996014809A1 (fr) 1994-11-16 1995-11-15 Implant permettant la fusion de deux corps osseux adjacents, notamment de deux vertebres consecutives

Publications (1)

Publication Number Publication Date
EP0793463A1 true EP0793463A1 (de) 1997-09-10

Family

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Family Applications (1)

Application Number Title Priority Date Filing Date
EP95940320A Withdrawn EP0793463A1 (de) 1994-11-16 1995-11-15 Implantat zum verschmelzen zweier angrenzender knochenkörper, insbesondere zweier aufeinanderfolgender wirbel

Country Status (2)

Country Link
EP (1) EP0793463A1 (de)
WO (1) WO1996014809A1 (de)

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US9216096B2 (en) 2010-03-16 2015-12-22 Pinnacle Spine Group, Llc Intervertebral implants and related tools
US9380932B1 (en) 2011-11-02 2016-07-05 Pinnacle Spine Group, Llc Retractor devices for minimally invasive access to the spine
US10070970B2 (en) 2013-03-14 2018-09-11 Pinnacle Spine Group, Llc Interbody implants and graft delivery systems

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KR100553297B1 (ko) * 1997-04-25 2006-02-20 스뜨리케르 프랑스 두 부품으로 구성된 체강내의 임플란트
US5865848A (en) * 1997-09-12 1999-02-02 Artifex, Ltd. Dynamic intervertebral spacer and method of use
FR2769827B1 (fr) * 1997-10-17 2000-05-19 Sdm Implant pour arthrodese rachidienne inter-somatique
DE19826619A1 (de) * 1998-06-17 1999-12-30 Ulrich Gmbh & Co Kg Implantat zur Fusion zweier Wirbel
US6193757B1 (en) 1998-10-29 2001-02-27 Sdgi Holdings, Inc. Expandable intervertebral spacers
FR2788686B1 (fr) 1999-01-26 2001-06-08 Scient X Implant intersomatique a introduction sagittale apte a un decalage lateral dans le plan frontal
DE20117773U1 (de) * 2001-10-31 2003-03-20 Koenigsee Implantate & Instr Implantat zur Stabilisierung der Vertebrae cervicales
ATE462383T1 (de) 2002-09-24 2010-04-15 Bogomir Gorensek Stabilisierungsvorrichtung für bandscheiben und verfahren dafür
US8267939B2 (en) 2008-02-28 2012-09-18 Stryker Spine Tool for implanting expandable intervertebral implant
US9801732B2 (en) * 2009-10-30 2017-10-31 Spinefrontier, Inc System and method for an intervertebral implant assembly
EP3123982B1 (de) 2011-08-16 2018-05-23 Stryker European Holdings I, LLC Expandierbares implantat
US10342675B2 (en) 2013-03-11 2019-07-09 Stryker European Holdings I, Llc Expandable implant
US10828077B2 (en) 2017-09-22 2020-11-10 Howmedica Osteonics Corp. Distal radius wedge screw

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US9216096B2 (en) 2010-03-16 2015-12-22 Pinnacle Spine Group, Llc Intervertebral implants and related tools
US9649203B2 (en) 2010-03-16 2017-05-16 Pinnacle Spine Group, Llc Methods of post-filling an intervertebral implant
US9788973B2 (en) 2010-03-16 2017-10-17 Pinnacle Spine Group, Llc Spinal implant
US9380932B1 (en) 2011-11-02 2016-07-05 Pinnacle Spine Group, Llc Retractor devices for minimally invasive access to the spine
US10070970B2 (en) 2013-03-14 2018-09-11 Pinnacle Spine Group, Llc Interbody implants and graft delivery systems

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