EP1663032A1 - Dispositif pour relier un support longitudinal a un os - Google Patents

Dispositif pour relier un support longitudinal a un os

Info

Publication number
EP1663032A1
EP1663032A1 EP03818768A EP03818768A EP1663032A1 EP 1663032 A1 EP1663032 A1 EP 1663032A1 EP 03818768 A EP03818768 A EP 03818768A EP 03818768 A EP03818768 A EP 03818768A EP 1663032 A1 EP1663032 A1 EP 1663032A1
Authority
EP
European Patent Office
Prior art keywords
axis
channel
rotation
connecting element
tilting
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Withdrawn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
EP03818768A
Other languages
German (de)
English (en)
Inventor
Stephan Hartmann
Armin Studer
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.)
Synthes GmbH
Original Assignee
Synthes GmbH
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 GmbH filed Critical Synthes GmbH
Publication of EP1663032A1 publication Critical patent/EP1663032A1/fr
Withdrawn legal-status Critical Current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
    • 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
    • A61B17/7035—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • A61B17/7038—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other to a different extent in different directions, e.g. within one plane only
    • 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
    • A61B17/7035—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • A61B17/704—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other the longitudinal element passing through a ball-joint in the screw head
    • 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
    • A61B17/60—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 for external osteosynthesis, e.g. distractors, contractors
    • A61B2017/603—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 for external osteosynthesis, e.g. distractors, contractors with three points of contact, e.g. tripod

Definitions

  • the invention relates to a device for connecting a longitudinal beam to a bone, in particular a vertebral body, according to the preamble of patent claim 1.
  • a device with a fastening element for fixing a pedicle screw or a pedicle hook to a side member is known from EP 0 572 790.
  • the fastening element is firmly connected to the pedicle screw or pedicle hook and comprises a tilting element which can be rotated about an axis of rotation which is perpendicular to the central axis of the fastening element and perpendicular to the longitudinal axis of the longitudinal beam.
  • the longitudinal member lies on the upper surface of the tilting element which is curved coaxially to the longitudinal axis of the longitudinal member and is pressed against the tilting element by means of a tensioning element.
  • the lower surface of the tilting element which is curved coaxially to the axis of rotation, lies on the complementary bottom of the channel in the fastening element.
  • a disadvantage of this known device is that the lower surface of the tilting element, together with the base, only form a non-positive connection, so that with larger torques effective around the axis of rotation, an undesired rotation between the longitudinal member and the pedicle screw or pedicle hook can occur.
  • the invention seeks to remedy this.
  • the invention has for its object to provide a device which allows a positive locking of a hinge for relative rotation between the longitudinal beam and bone anchoring element.
  • the invention solves this problem with a device for connecting a longitudinal beam to a bone, in particular a vertebral body, which has the features of claim 1.
  • the second contact surface K2 forming the channel bottom has the three-dimensional macroscopic structuring.
  • the connecting element having the macroscopic structure is preferably made from a harder material than the tilting element, for example from a titanium alloy or a Ti / Al / niobium alloy.
  • the softer tilting element is preferably made of pure titanium. It can thereby be achieved that when the clamping means are tightened, the macroscopic structure on the contact surface K2 of the harder connecting element is pressed into the softer tilting element, so that a positive connection between the two parts is produced.
  • a torque exerted on the longitudinal beam by the lever forces of the bone anchoring element cannot therefore lead to a displacement of the two contact surfaces K1; K2 relative to one another, so that the angle between the central axis of the bone anchoring element and the longitudinal axis of the longitudinal beam when the bone anchoring element is fixed on the longitudinal beam is not changed at high torques, so that stable stabilization can be produced, for example, from adjacent vertebral bodies.
  • the two contact surfaces K1; K2 have a three-dimensional macroscopic structuring, the three-dimensional macroscopic structuring preferably being configured by complementary toothing with teeth parallel to the axis of rotation. It is thereby achievable that the positive connection between the connecting part and the tilting element can be achieved without deformation of one of the two parts.
  • the three-dimensional macroscopic structuring can comprise pyramid-shaped or conical teeth, or respectively truncated pyramid-shaped or truncated-cone teeth, here - if both contact surfaces K1; K2 are provided with macroscopic structuring - the structuring can be complementary.
  • the height of the three-dimensional macroscopic structuring measured perpendicular to the contact surface K1; K2 is preferably between 0.1 mm and 5 mm.
  • the tilting element comprises an upper, concave surface which can be brought into radial contact with a longitudinal beam and has a groove which runs transversely to the axis of rotation and transversely to the central axis.
  • the groove preferably has a recess in the middle between the two ends of the tilting element that intersect the longitudinal axis of the longitudinal member.
  • the tilting element comprises, on its side surfaces transverse to the axis of rotation, a circular arc-shaped groove which is concentric to the axis of rotation and which is closed at the ends of the tilting element which intersect the longitudinal axis of the longitudinal member. Furthermore, two pins engaging in the grooves are attached to the connecting element. As a result, the connecting element and the tilting element are held together loosely, so that none of the parts can be lost during the implantation and nevertheless alignment of the longitudinal beam in situ is not hindered.
  • the connecting element and the bone anchoring element are preferably made in one piece.
  • Figure 1 is a perspective view of an embodiment of the device according to the invention.
  • FIG. 2 shows a side view of the embodiment of the device according to the invention shown in FIG. 1;
  • Fig. 3 is a front view of the embodiment of the device according to the invention shown in Figs. 1 and 2.
  • FIG. 1 to 3 show an embodiment which, as the bone anchoring element 1, has a screw shaft 10 coaxial with the central axis 2 for screwing into a pedicle of a vertebral body.
  • the two legs 22 laterally delimiting the channel 25 each have a fixed end 20 and a free end 21.
  • the channel axis 27 is here perpendicular to the central axis 2.
  • the channel 25 has a width b which is selected such that the longitudinal member 3 is held transversely to its longitudinal axis 6 by the legs 22.
  • a bore 23 with an internal thread 24 is arranged in the connecting element 9, the bore axis of which is concentric with the central axis 2 and the internal diameter d of which is greater than the width b of the channel 25.
  • the clamping means 13 are designed here as a clamping screw 12 with a shaft which can be screwed coaxially into the internal thread 24, which is preferably designed as a sawtooth thread, in the connecting element 9, a front end 14 and a rear end 15.
  • An internal hexagon 16 for receiving a screwdriver is coaxially penetrating into the clamping screw 12 from the rear end 15 to the central axis 2.
  • the tilting element 8 is arranged in the channel 25 at the fixed ends 20 of the two legs 22.
  • the tilting element 8 is mounted in the channel 25 such that it can be rotated about an axis of rotation 7 which is transverse to the central axis 2 and transverse to the channel axis 27.
  • the channel 25 towards the rear End 5 of the screw shaft 10 delimiting channel bottom 26 is concave.
  • the channel bottom 26 delimits the channel 25 in a cross-sectional area that is orthogonal to the axis of rotation 7, viewed in the form of a circular arc, the center of the circular arc lying on the axis of rotation 7.
  • the tilting element 8 comprises two side surfaces 37; 38 orthogonal to the axis of rotation 7, a lower surface 28 directed towards the fixed end 20 of the connecting element 9, which is convex, and an upper surface 29 directed against the free end 21 of the connecting element is concave.
  • the lower, convex surface 28 is complementary to the channel floor 26, while the upper, concave surface 29 is designed such that a groove 36 is formed parallel to the longitudinal axis 6 of the longitudinal beam 3 for receiving the longitudinal beam 3, which is the middle between the two Tilting element 8, ends 39, 40 delimiting transverse to the channel axis 27, has a depression 30.
  • a longitudinal member 3 inserted into the channel 25 is placed on the upper, concave surface 29 of the tilting element 8 and can be rotated about the axis of rotation 7 together with the tilting element 8.
  • the side member 3 is pressed into the groove 36 and into the recess 36 and bent in the region of the recess 36, so that the fixation of the side member 3 is reinforced.
  • the tensioning screw 12 is rounded at its front end 14 and can be pressed onto the surface of the longitudinal beam 3 inserted into the channel 25.
  • the tensioning screw 12 comprises at its rear end 15 means 17 for receiving a screwdriver and is screwed into an internal thread 24 which is provided in a bore 23 penetrating from the free end 21 of the connecting element 9.
  • the channel 25 is U-shaped and open towards the free end 21 of the connecting element 9, so that the bore 23 with the internal thread 24 is penetrated diametrically by the channel 25.
  • the tilting element 8 is slidably mounted on the channel bottom 26.
  • the tilting element 8 is rotated when it is rotated about the axis of rotation 7.
  • the axis of rotation 7 is both perpendicular to the central axis 2 and perpendicular to the channel axis 27 and preferably falls axially on the central axis 2 with the point of contact between the front end 14 and Surface of the side member 3 together.
  • the tilting element 8 comprises on its side surfaces 37; 38 two grooves 33, which are closed against the two ends 39; 40 of the tilting element 8 and are curved concentrically in the manner of a circular arc on their length lying between the ends 39; 40 to the axis of rotation 7.
  • the channel floor 26 is provided with a macroscopic structure 35, which is designed here as a toothing and which can be pressed into the lower surface 28 of the tilting element 8 when the tensioning screws are tightened, so that a positive connection can be established between the connecting element 9 and the tilting element 8.

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)
  • Prostheses (AREA)

Abstract

La présente invention concerne un dispositif pour relier un support longitudinal (3) à un os, en particulier à un corps vertébral, le dispositif comprenant: A) un élément d'ancrage d'os (1) qui peut être fixé à un os; B) un élément de liaison (9) mis en place à l'extrémité arrière (5) de l'élément d'ancrage d'os (1) et comprenant un canal (25) qui traverse l'élément de liaison (9) transversalement à l'axe central (2) et sert à recevoir un support longitudinal (3); C) un système de serrage (13) qui peut être relié à l'extrémité libre (21) de l'élément de liaison (9) et convient à la fixation d'un support longitudinal (3) introduit dans le canal (25); et D) un élément de basculement (8) disposé dans le canal (25), qui peut tourner autour d'un axe de rotation (7) qui est à la fois transversal à l'axe central (2) et à l'axe du canal (27). Selon l'invention: E) l'élément de basculement (8) présente une surface inférieure (28) incurvée de façon concentrique avec l'axe de rotation (7), ladite surface formant une première surface de contact (K1); F) le fond de canal (26) est complémentaire de la surface inférieure (28) de l'élément de basculement (8) de sorte que celui-ci forme une seconde surface de contact (K2) qui peut être mise en contact avec la première surface de contact (K1); et G) au moins l'une des deux surfaces de contact (K1;K2) présente une structure macroscopique tridimensionnelle (16).
EP03818768A 2003-09-26 2003-09-26 Dispositif pour relier un support longitudinal a un os Withdrawn EP1663032A1 (fr)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/CH2003/000643 WO2005030065A1 (fr) 2003-09-26 2003-09-26 Dispositif pour relier un support longitudinal a un os

Publications (1)

Publication Number Publication Date
EP1663032A1 true EP1663032A1 (fr) 2006-06-07

Family

ID=34383938

Family Applications (1)

Application Number Title Priority Date Filing Date
EP03818768A Withdrawn EP1663032A1 (fr) 2003-09-26 2003-09-26 Dispositif pour relier un support longitudinal a un os

Country Status (9)

Country Link
US (1) US20060271193A1 (fr)
EP (1) EP1663032A1 (fr)
JP (1) JP2007506457A (fr)
CN (1) CN1838919A (fr)
AR (1) AR045660A1 (fr)
AU (1) AU2003266088A1 (fr)
BR (1) BR0318508A (fr)
CA (1) CA2539831A1 (fr)
WO (1) WO2005030065A1 (fr)

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US7887539B2 (en) 2003-01-24 2011-02-15 Depuy Spine, Inc. Spinal rod approximators
DE102005009282A1 (de) * 2005-02-22 2006-08-24 Aesculap Ag & Co. Kg Implantatsystem und Befestigungselement für ein Implantatsystem
US7951175B2 (en) 2005-03-04 2011-05-31 Depuy Spine, Inc. Instruments and methods for manipulating a vertebra
US7951172B2 (en) 2005-03-04 2011-05-31 Depuy Spine Sarl Constrained motion bone screw assembly
US7722651B2 (en) 2005-10-21 2010-05-25 Depuy Spine, Inc. Adjustable bone screw assembly
GB0521582D0 (en) 2005-10-22 2005-11-30 Depuy Int Ltd An implant for supporting a spinal column
GB0600662D0 (en) 2006-01-13 2006-02-22 Depuy Int Ltd Spinal support rod kit
US8348952B2 (en) 2006-01-26 2013-01-08 Depuy International Ltd. System and method for cooling a spinal correction device comprising a shape memory material for corrective spinal surgery
US8089029B2 (en) 2006-02-01 2012-01-03 Boston Scientific Scimed, Inc. Bioabsorbable metal medical device and method of manufacture
CA2663220A1 (fr) 2006-09-15 2008-03-20 Boston Scientific Limited Dispositifs medicaux et procedes de realisation desdits dispositifs
US20080077143A1 (en) * 2006-09-25 2008-03-27 Zimmer Spine, Inc. Apparatus for connecting a longitudinal member to a bone portion
US9204908B2 (en) 2007-07-26 2015-12-08 Dynamic Spine, Llc Segmental orthopedic device for spinal elongation and for treatment of scoliosis
EP2182871B1 (fr) 2007-07-26 2014-07-02 Glenn R. Buttermann M. D. Dispositif orthopédique segmentaire pour élongation spinale et pour le traitement de la scoliose
GB0720762D0 (en) 2007-10-24 2007-12-05 Depuy Spine Sorl Assembly for orthopaedic surgery
US8608746B2 (en) 2008-03-10 2013-12-17 DePuy Synthes Products, LLC Derotation instrument with reduction functionality
US8709015B2 (en) 2008-03-10 2014-04-29 DePuy Synthes Products, LLC Bilateral vertebral body derotation system
US10973556B2 (en) 2008-06-17 2021-04-13 DePuy Synthes Products, Inc. Adjustable implant assembly
US8668732B2 (en) 2010-03-23 2014-03-11 Boston Scientific Scimed, Inc. Surface treated bioerodible metal endoprostheses
AU2011264818B2 (en) * 2010-06-10 2015-06-18 Globus Medical, Inc. Low-profile, uniplanar bone screw
US9968378B1 (en) * 2015-07-22 2018-05-15 University Of South Florida Adaptation sphere saddle
EP3146921B1 (fr) * 2015-09-23 2024-03-27 Ozer, Ali Fahir Vis pediculaire
US11311316B2 (en) * 2020-09-04 2022-04-26 Warsaw Orthopedic, Inc. Spinal implant system and methods of use
US11931081B2 (en) * 2020-09-21 2024-03-19 Globus Medical Inc. Monoaxial-uniplanar hybrid screw

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DE59301618D1 (de) 1992-06-04 1996-03-28 Synthes Ag Osteosynthetisches Befestigungselement
DE4243951C2 (de) * 1992-12-23 1997-07-03 Plus Endoprothetik Ag Vorrichtung zur Versteifung eines aus wenigstens zwei Wirbeln bestehenden Wirbelsäulenabschnitts
FR2731344B1 (fr) * 1995-03-06 1997-08-22 Dimso Sa Instrumentation rachidienne notamment pour tige
US6406492B1 (en) * 1999-04-08 2002-06-18 Sulzer Carbomedics Inc. Annuloplasty ring holder
ES2154227B1 (es) * 1999-06-30 2001-11-16 Surgival Co S A Sistema poliaxial de fijacion de vertebras.
FR2833151B1 (fr) * 2001-12-12 2004-09-17 Ldr Medical Implant d'ancrage osseux a tete polyaxiale
US6837889B2 (en) * 2002-03-01 2005-01-04 Endius Incorporated Apparatus for connecting a longitudinal member to a bone portion

Non-Patent Citations (1)

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Title
See references of WO2005030065A1 *

Also Published As

Publication number Publication date
CN1838919A (zh) 2006-09-27
BR0318508A (pt) 2006-09-12
AR045660A1 (es) 2005-11-02
CA2539831A1 (fr) 2005-04-07
US20060271193A1 (en) 2006-11-30
AU2003266088A1 (en) 2005-04-14
WO2005030065A1 (fr) 2005-04-07
JP2007506457A (ja) 2007-03-22

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