EP0793463A1 - Implant for the fusion of two adjacent bony bodies, particularly two consecutive vertebrae - Google Patents

Implant for the fusion of two adjacent bony bodies, particularly two consecutive vertebrae

Info

Publication number
EP0793463A1
EP0793463A1 EP19950940320 EP95940320A EP0793463A1 EP 0793463 A1 EP0793463 A1 EP 0793463A1 EP 19950940320 EP19950940320 EP 19950940320 EP 95940320 A EP95940320 A EP 95940320A EP 0793463 A1 EP0793463 A1 EP 0793463A1
Authority
EP
Grant status
Application
Patent type
Prior art keywords
implant
blades
characterized
fusion
graft
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Withdrawn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
EP19950940320
Other languages
German (de)
French (fr)
Inventor
Philippe Chelius
Valéry Dehais
Sarkissian Yves Der
Alain Ducolombier
Joel Letendart
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
Objectif-Implants Belgique
Original Assignee
OBJECTIF-IMPLANTS BELGIQUE
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

Links

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
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4684Trial or dummy 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
    • A61F2/30Joints
    • 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
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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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    • 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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    • 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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    • 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
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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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    • 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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    • 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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    • 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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    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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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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    • A61F2002/30316The 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
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    • 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
    • A61F2230/0028Shapes in the form of latin or greek characters
    • A61F2230/0047Pi-shaped
    • 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
    • A61F2230/0063Three-dimensional shapes
    • A61F2230/0082Three-dimensional shapes parallelepipedal
    • 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
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00011Metals or alloys
    • A61F2310/00023Titanium or titanium-based alloys, e.g. Ti-Ni alloys

Abstract

According to the invention, said implant (2) has a general U shape, in other words it is comprised of two side blades (10) connected to each other at one end by means of a heel (11), at least one of said blades being provided with a cutting edge (12) at its free end, the implant (2) being conformed so that it provides for the taking of a monoblock bone graft (16).

Description

IMPLANT FOR THE MERGER OF TWO BODIES ADJACENT BONE INCLUDING TWO CONSECUTIVE VERTEBRATE

The present invention relates to an implant for the fusion of two adjacent bone bodies. This implant is mainly intended to be used to obtain the merging of two consecutive vertebrae, but can also be used for arthrodesis subtalar or tibio-talar.

It is known to use an intervertebral arthrodesis in the disc case of pathologies in order to restore proper disc height, in the case of narrow lumbar canal, in order to achieve earlier stabilizing vertebrae rendered necessary by the embrittlement of the posterior arch, or in cases of vertebral instabilities, to achieve the fusion of vertebrae become unstable.

This fusion is generally achieved by the introduction of a posterolateral bone graft, located on the articular processes, transverse processes on and on intervertebral blades. In the absence of the vertebral laminae due to laminectomy, grafts are implemented only in the posterolateral gutters, and a stabilizing metal material is implanted to immobilize the spine time that the fusion takes place.

This technique has the disadvantage of being relatively complex and time consuming to implement, given the addition of the stabilizing material, and not to allow to restore disc height sufficient.

It is also known to implant a bone graft into the intervertebral space after complete excision of the damaged disk. However, to obtain a solid fusion is uncertain, because of the stresses exerted on the graft and the graft-interfaces vertebrae. These constraints often lead to crushing and incorporation of the graft in one or other of • 1 vertebrae.

One technique involves implanting intervertebral cages at the affected disc, on either side of the axis of the spine.

These cages are cylindrical, hollow, externally threaded and comprise lateral windows. They receive a filling bone particles removed from a spongy bone, and then are engaged by screwing into the intervertebral housing previously drilled in the plates of the vertebrae to be fused.

Each cage is positioned so that two opposite windows are in contact with the plates, in order to permit bone growth within the cage.

This technique has the disadvantage of involving the use of a temporary distraction means vertebrae, traumatic enough, for the time necessary to housing drilling, filling and setting up cages.

Moreover and most importantly, it appears that the stability of the fusion obtained by these cages can not be guaranteed in time.

The duration of intervention is important elsewhere, which is not desirable for the patient.

It is also known from EP 0307241 to provide a cuboid cage, comprising upper windows, bottom and side. The outer surfaces of the cage are rough to allow the maintenance of the cage in its housing and promote bone growth.

This cage is also intended to be filled with cancellous bone pieces, then i pactée in intervertebral housing, previously developed. The present invention aims to remedy the aforementioned disadvantages of the prior art. It provides an intervertebral implant for obtaining a perfect fusion of the vertebrae, with adequate enhancement of the intervertebral disc and guarantee stability over time. This implant must be placed posteriorly without the risk of nerve damage at the Hard Mother or the roots, by a relatively simple and fast technical implementation. According to the invention, the implant has a generally U-shaped, that is to say, is constituted by two side blades connected to each other at one end by a lug, which at least one comprises a cutting edge at its free end, the implant being shaped to allow itself taking a monoblock bone graft.

Thus, the implant is not meant to be filled with very dense cancellous bone particles, with possible inclusion of air bubbles, as can be the case with conventional intervertebral cages. Rather, it serves itself to the collection, preferably in the iliac crest of a patient, a graft consisting of spongy bone "mass", significantly denser bones than an agglomeration of particles. This density corresponds substantially to that of cancellous bone of the vertebrae.

The graft taken just completely fill the implant, and is held in it, so it can be resized if necessary. The upper and lower openings defined by the blades have significantly larger dimensions than the windows arranged in existing cages and allow large contact surface of the graft with cancellous bone of the vertebrae. In addition, the graft is held laterally in the intervertebral space by the blades of the implant. All of these factors allows obtaining a perfect fusion of the vertebrae and graft, without crushing or graft insertion in cancellous bone. The merger thus obtained gives any guarantee of stability over time.

Moreover, the conventional operation of the implant filling is eliminated, allowing a significant gain at the time of intervention.

Advantageously, the blades have on their upper edges and / or lower teeth of the type "harpoon" or "tree".

These teeth are intended to be inserted into the cancellous bone of the vertebral plates, and to prevent any possibility of movement of the implant towards the rear. Moreover, their integration into the bone allows compression of the graft, the latter having, through direct debit, a width that fits perfectly with the maximum width of the implant, including tooth. This compressing ensures perfect application and a total immobilization of the graft relative to the vertebrae, which is entirely made conducive to good bone growth and thus obtaining a perfect fusion. The penetration of the teeth inside the vertebrae also enhances initiation of bone growth from achieve fusion.

According to a preferred embodiment of the invention, the length of the blades is uneven, in order to facilitate withdrawal of the graft.

The blades may be rectangular, trapezoidal, or parallelogram shaped.

One at least of the two plates may comprise a side light, also permit bone ingrowth by this lateral direction. Advantageously, the heel between the two blades is pierced with a threaded hole for mounting the implant to the end of an impaction tool, for removing the graft and for the introduction of the implant in intervertebral its housing.

Preferably, the distance between the blades is determined so that the area occupied by the bone graft in the upper and lower faces of the implant is at least 50% of the total area of ​​these faces.

For a good understanding, the invention is again described below with reference to the accompanying drawings showing by way of example, a preferred embodiment of the intervertebral implant it relates.

Figure 1 is a perspective view; FIG 2 is a side view, after taking the graft intended to fill it; Figure 3 is a top view; Figure 4 is an end view of the posterior side; Figure 5 is a posterior view of two implants placed into an intervertebral space, and Figure 6 is a side view of one of the two implants, after placement in an intervertebral space.

The figures show, from different angles, an implant 2 for obtaining the fusion of two consecutive vertebrae 3.4, at the level of an intervertebral disc 5.

This implant 2 has a generally U-shaped, that is to say, is constituted by two rectangular side plates 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 free end, bounded by their inner faces and the end faces beveled.

The blades 10 include teeth 13 of the type "harpoon" or "tree" on their upper and lower edges, and lateral slots 14.

The heel 11 connecting the two plates 10 is pierced with a threaded hole 15 for mounting the implant 2 on the end of an impaction tool (not shown).

The implant 2, when mounted on the tool, enables the direct intake of a monoblock bone graft 16 consists of cancellous bone "mass", preferably coming from the iliac crest of the patient.

The unequal length of the blades 10 facilitates taking the graft 16. It appears to Figures 2 to 4 that the graft 16 thus obtained fills completely the space defined by the blades 10 and the heel 11 and has a width corresponding the maximum width of the implant 2, teeth 13 including. The graft 16 is fully maintained in the implant 2 and can be resized if necessary.

In practice, as shown in Figures 5 and 6, intervertebral housing are drilled in the plates of the vertebrae 3 and 4 merge, on either side of the axis of the spine for receiving two implants 2 provided with a graft 16.

2 These implants are impacted in the housing by means of the abovementioned tool. When fully inserted into the housing, the tool is removed. The teeth 13 are inserted into the cancellous bone of the vertebral endplates and prevent any possible movement of implants 2 backwards.

This insertion causes the compression of the graft 16 over a height corresponding to that of the teeth 13, about 2 millimeters for each row of teeth. This setting compression allows a perfect application and a total capital of 16 grafts compared to 3.4 vertebrae, which is entirely made favorable to obtaining good bone growth and thus a perfect fusion .

In addition, the penetration of the teeth 13 inside the vertebrae enhances initiation of bone growth from achieve fusion.

The density of the graft 16 corresponds substantially to that of the spongy bone of the vertebrae 3.4, and the grafts 16 are held in place laterally by the blades 10 in the intervertebral housing.

It appears in the figures that the distance separating the blades 10 is determined so that the area occupied by the graft 16 at the upper and lower faces of the implant 2 is at least 50% of the total area of ​​these faces. The upper and lower openings defined by these blades 10 and allow large contact surfaces of the graft 16 and the cancellous bone of the vertebrae 3,4.

The side lights also allow bone growth according to the lateral direction.

The invention thus provides an intervertebral implant for obtaining a perfect fusion of the vertebrae, with appropriate enhancement of the intervertebral disc and guarantee of stability in time, this implant can be implemented by a posterior approach, according to a relatively simple technique and fast implementation.

Claims

1 - implant for fusion of two adjacent bone bodies, particularly two consecutive vertebrae, characterized in that it has a generally U-shaped, that is to say, is constituted by two lateral plates (10) connected to the to each other, at one end, by a heel (11), which at least one comprises a cutting edge (12) at its free end, the implant (2) being shaped to allow itself taking a monoblock bone graft (16).
2 - implant according to claim 1, characterized in that the blades (10) comprise on their upper and / or lower edges of the teeth (13) of type "harpoon" or "tree". 3 - implant according to claim 1 or claim 2, characterized in that the length of the blades (10) is uneven.
4 - An implant according to one of claims 1 to 3, characterized in that the blades (10) may be rectangular, trapezoidal, or parallelogram shaped.
5 - An implant according to one of claims 1 to 4, characterized in that at least one of the blades (10) comprises a lateral lumen (14). 6 - An implant according to one of Claims 1 to 5, characterized in that the shoulder connecting the blades (10) is pierced with a threaded hole (15) for mounting the implant on the end of a tool impaction.
7 - An implant according to one of claims 1 to 6, characterized in that the distance separating the blades (10) is determined so that the area occupied by the bone graft (16) at the upper and lower faces of the implant (2) represents at least 50% of the total area of ​​these faces.
EP19950940320 1994-11-16 1995-11-15 Implant for the fusion of two adjacent bony bodies, particularly two consecutive vertebrae Withdrawn EP0793463A1 (en)

Priority Applications (3)

Application Number Priority Date Filing Date Title
FR9413685 1994-11-16
FR9413685A FR2726759B1 (en) 1994-11-16 1994-11-16 Cage for melting lumbar vertebrae by bone graft interposition
PCT/FR1995/001507 WO1996014809A1 (en) 1994-11-16 1995-11-15 Implant for the fusion of two adjacent bony bodies, particularly two consecutive vertebrae

Publications (1)

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

Family

ID=9468826

Family Applications (1)

Application Number Title Priority Date Filing Date
EP19950940320 Withdrawn EP0793463A1 (en) 1994-11-16 1995-11-15 Implant for the fusion of two adjacent bony bodies, particularly two consecutive vertebrae

Country Status (2)

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

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US9380932B1 (en) 2011-11-02 2016-07-05 Pinnacle Spine Group, Llc Retractor devices for minimally invasive access to the spine
US10070970B2 (en) 2014-03-12 2018-09-11 Pinnacle Spine Group, Llc Interbody implants and graft delivery systems

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US9801732B2 (en) * 2009-10-30 2017-10-31 Spinefrontier, Inc System and method for an intervertebral implant assembly
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US9216096B2 (en) 2010-03-16 2015-12-22 Pinnacle Spine Group, Llc Intervertebral implants and related tools
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US9380932B1 (en) 2011-11-02 2016-07-05 Pinnacle Spine Group, Llc Retractor devices for minimally invasive access to the spine
US10070970B2 (en) 2014-03-12 2018-09-11 Pinnacle Spine Group, Llc Interbody implants and graft delivery systems

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