EP1732478A1 - Artificial intervertebral disk - Google Patents
Artificial intervertebral diskInfo
- Publication number
- EP1732478A1 EP1732478A1 EP05728248A EP05728248A EP1732478A1 EP 1732478 A1 EP1732478 A1 EP 1732478A1 EP 05728248 A EP05728248 A EP 05728248A EP 05728248 A EP05728248 A EP 05728248A EP 1732478 A1 EP1732478 A1 EP 1732478A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- intervertebral disc
- intermediate element
- elements
- shape
- vertebral bodies
- 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- Withdrawn
Links
Classifications
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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
- 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
- A61F2/4425—Intervertebral or spinal discs, e.g. resilient made of articulated components
-
- 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
- A61F2002/30112—Rounded shapes, e.g. with rounded corners
- A61F2002/30133—Rounded shapes, e.g. with rounded corners kidney-shaped or bean-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
- A61F2002/30199—Three-dimensional shapes
- A61F2002/302—Three-dimensional shapes toroidal, e.g. rings
-
- 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
- A61F2002/30563—Special structural features of bone or joint prostheses not otherwise provided for having elastic means or damping means, different from springs, e.g. including an elastomeric core or shock absorbers
-
- 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
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30841—Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
-
- 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
- A61F2/4425—Intervertebral or spinal discs, e.g. resilient made of articulated components
- A61F2002/443—Intervertebral or spinal discs, e.g. resilient made of articulated components having two transversal endplates and at least one intermediate component
-
- 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
- A61F2230/0004—Rounded shapes, e.g. with rounded corners
- A61F2230/0015—Kidney-shaped, e.g. bean-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
- A61F2230/0065—Three-dimensional shapes toroidal, e.g. ring-shaped, doughnut-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
- 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
-
- 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
- A61F2310/00389—The prosthesis being coated or covered with a particular material
- A61F2310/00395—Coating or prosthesis-covering structure made of metals or of alloys
- A61F2310/00407—Coating made of titanium or of Ti-based alloys
Definitions
- the invention relates to an artificial intervertebral disk that can be inserted between two adjacent vertebral bodies of a patient, each with an element assigned to the respective vertebral body, the elements being connected to one another in such a limited articulated manner by means of an intermediate element that both torsional torques and shear forces can thereby be transmitted.
- intervertebral disc In the human spine and in particular in the lumbar spine, the intervertebral disc (intervertebral disc) articulates an upper bony vertebral body with a lower bony vertebral body.
- Such an artificial intervertebral disc is known for example from EP 0 610 837 B1, in which two plates are connected to one another by an elastomeric core.
- the elastomeric core has an upper and a lower part, which include an intermediate part, the peripheral surface of which is concave. This is intended to reduce the forces generated at the contact surface between the plates and the core in the case of bending moments or transmission forces acting on the intervertebral disc in comparison to a core with straight sides.
- US Pat. No. 3,867,728 describes an intervertebral disc which, for example, consists of a single piece and has a concave outer surface.
- US Pat. No. 5,071,437 also describes an intervertebral disc prosthesis which has an upper flat plate, a lower flat plate and a flat elastomeric core which is enclosed between the plates.
- EP 0 747 025 B1 describes an artificial intervertebral disc for use between adjacent vertebrae with a first component with a concave recess and a second component with a projection that fits into the recess of the first components so that an unrestricted rotation and tilting movement between the first and the second component is achieved.
- a disadvantage of all previously known artificial intervertebral discs is that the natural joint properties can only be simulated inadequately. This restriction of the natural freedom of movement is clearly perceptible to the patient as disruptive when several vertebral bodies are replaced and the disadvantageous properties of the artificial intervertebral discs therefore add up.
- the invention has for its object to significantly improve the properties of an artificial intervertebral disc perceptible to the patient.
- an artificial intervertebral disc in which the two elements have a shape by which the elements are positively connected to the intermediate element.
- the invention is based on the consideration that the desired freedom of movement can be optimally modeled on the natural freedom of movement of the spine by means of an artificial intervertebral disc if the intermediate element is shaped in a respective way. elements is held in a form-fitting manner because both torsional torques and shear forces can be transmitted without any problems, without having to forego good deformation properties of the intervertebral disc.
- the intervertebral disc can in particular be designed such that at the same time the relative mobility of the elements with respect to one another, in particular thus a tilting movement, is substantially optimized, ie the mobility can be improved.
- the decoupling of the function of the transmission of the torsional torques and shear forces between adjacent vertebral bodies from the function of the articulated connection of the elements assigned to the vertebral body which according to the prior art is inadequate as a compromise as a result of the elastic properties of the intermediate element different properties is realized, to significantly different degrees of freedom according to the respective optimum.
- a particularly advantageous embodiment of the vertebral disc according to the invention is achieved in that the shape is concave and thereby forms, for example, a recess for the positive reception of the intermediate element.
- the contact surfaces are designed so that the static friction cannot be overcome in any case due to the shear and torsion load.
- the shape has a friction-optimized surface finish, because it reduces or prevents possible wear of the material of the intermediate element in a simple manner.
- the surfaces of the formation in the contact area are mirror-polished so that the friction and thus also the abrasion on the intermediate element is minimal during relative movements on the contact surfaces.
- the formation is provided with an oversize in relation to the intermediate element in such a way that one in particular by the Movement of the patient-induced compression of the intermediate element allows a defined deformation.
- the dimensions are slightly smaller compared to the cross-sectional area of the intermediate element, so that the deformation of the annular intermediate element, for example, which occurs during compression, allows its expansion parallel to the plane of the elements.
- the intermediate element could be designed as a disk which is equipped in its edge region with beads which engage in the correspondingly designed shape.
- a particularly promising embodiment is achieved if the intermediate element has an annular, closed shape.
- the annular intermediate element has, at least in sections, an ogival, oval or circular cross-sectional area transversely to its annular central axis, in order to simultaneously ensure optimal power transmission between the elements and at the same time achieve the desired mobility.
- the corresponding shape is shaped at least in sections, in particular depending on the different body levels.
- the intermediate element has a cross-sectional area that deviates in sections in the direction of its ring-shaped central axis, which interacts with a correspondingly designed shape, so as to enable the torsional moments that occur by a positive fit between the intermediate element and the outer elements.
- constrictions can be provided for this in sections.
- the diameter of the cross-sectional area of the ring is modulated along the ring, so that even in the case of a ring which is circular in plan view, a rotational movement of the ring between the plate-shaped outer elements can be excluded.
- the cross-sectional area in the sagittal plane, the frontal plane and / or the transverse plane of the patient can be expanded in sections for this purpose.
- the material properties can be determined according to the respective requirements.
- an embodiment in which the intermediate element is made at least in sections from a polymer, in particular polymer proves to be particularly advantageous.
- ethylene which means it is less susceptible to wear and tear, and at the same time has high toughness and allows limited, elastic deformability.
- a particularly reliable connection of the intervertebral disc to the elements for anchoring in the bone on the sides facing the vertebral bodies is provided with anchoring spikes or elements which anchor themselves in the vertebral bodies during the implantation due to load.
- the elements are advantageously coated with their anchoring spikes or elements on the sides facing the vertebral bodies with titanium or other biocompatible materials which enable a direct bone connection.
- FIG. 1 shows a sectional side view of an artificial intervertebral disc according to the invention
- FIG. 2 shows a plan view of various intermediate elements for an artificial intervertebral disc according to the invention
- FIG. 4 shows an enlarged side view of only an extract of an intermediate element shown in FIG. 2;
- FIG. 5 shows another artificial intervertebral disc according to the invention in a sectional side view
- FIG. 6 shows the arrangement of the artificial intervertebral disc shown in FIG. 1 between two vertebral bodies of a spine.
- FIG. 1 shows a sectional side view of an artificial intervertebral disc 1 according to the invention, by means of which two adjacent vertebral bodies (not shown) of a patient are articulated.
- the artificial intervertebral disc 1 has an intermediate element 2 designed as an elastic ring, which is inserted in each case in a formation 3 of two outer elements 4, for example designed as metal plates.
- the outer elements 4 are attached to the bones of the vertebral bodies via anchoring pins 5, in particular special titanium anchors, which are known per se from hip arthroplasty.
- the radius D of the concave shape 3 has an excess compared to the diameter d of a circular cross-sectional area of the intermediate element 2, so that compression of the intermediate element 2, which is caused in particular by the movement of the patient, permits a defined deformation.
- FIG. 2 shows a plan view of various possible configurations of the intermediate element 2 of the artificial intervertebral disc 1 according to the invention, each of which has an annularly closed basic shape.
- Intermediate elements 2a, 2b, 2c with a circular, oval or kidney-shaped basic shape are shown as examples. Of course, these basic shapes can be provided in the same way even without intermediate openings, not shown.
- Figure 3 shows an example of various cross-sectional shapes of the intermediate element 2, which can be oval, circular or ogival on both sides.
- the cross-sectional shape can also differ in sections and, for example, vary between the different cross-sectional shapes shown.
- FIG. 4 shows an enlarged side view of an intermediate element 2 shown in FIG.
- Regular constrictions 6 of the circular cross-sectional shape in the direction of the annular central axis 7 of the intermediate element 2 can be seen, through which the torsional moments that occur can be transmitted by a positive engagement of the intermediate element 2 with the outer elements 4 shown in FIG.
- FIG. 1 An embodiment of a further artificial intervertebral disk 8 according to the invention that differs from FIG. 1 is shown in a sectional side view.
- the intervertebral disc 8 has outer elements 9 in the form of perforated discs with a central opening 10 so as to improve the integration of the vertebral bodies 11 shown in FIG. 6.
- FIG. 6 shows an arrangement of the artificial intervertebral disc 1 shown in FIG. 1 between two vertebral bodies 11 of a spine (not shown further).
- the intervertebral disc 1 is provided on its outer sides of the vertebral bodies 11 with the anchoring mandrels 5, which anchor themselves in the vertebral bodies 11 during the implantation by load.
- a biocompatible coating provided on the sides facing the vertebral bodies 11 enables a direct bone connection.
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- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Neurology (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
- Materials For Medical Uses (AREA)
Abstract
The invention relates to an artificial intervertebral disk (1) which can be inserted between two adjacent vertebral bodies of a patient and by means of which two adjacent vertebral bodies of a patient are joined in an articulated manner. Said artificial intervertebral disk (1) comprises an intermediate element (2) that is embodied as an elastic ring and is inserted into one respective molded portion (3) of two outer elements (4) which are configured as metal plates. The outer elements (4) are joined to the bones of the vertebral bodies via anchoring pins (5), especially titanium anchorings previously known in hip endoprosthetics. The radius (D) of the concave molded portion (3) is greater than the diameter (d) of a circular cross-sectional area of the intermediate element (2) such that compression of the intermediate element (2) caused particularly by the patient's movement allows for a defined deformation.
Description
Künstliche Zwischenwirbelscheibe Artificial intervertebral disc
Die Erfindung betrifft eine zwischen zwei benachbarten Wirbelkörpern eines Patienten einsetzbare künstliche Zwischenwirbelscheibe, mit jeweils einem dem jeweiligen Wirbelkörper zugeordneten Element, wobei die Elemente mittels eines Zwischenelementes derart eingeschränkt gelenkig miteinander verbunden sind, dass dadurch sowohl Torsionsdrehmomente als auch Scherkräfte übertragbar sind.The invention relates to an artificial intervertebral disk that can be inserted between two adjacent vertebral bodies of a patient, each with an element assigned to the respective vertebral body, the elements being connected to one another in such a limited articulated manner by means of an intermediate element that both torsional torques and shear forces can thereby be transmitted.
In der menschlichen Wirbelsäule und insbesondere in der Lendenwirbelsäu le verbindet die Zwischenwirbelscheibe (Bandscheibe) einen oberen knöchernen Wirbelkörper gelenkig mit einem unteren knöchernen Wirbelkörper.In the human spine and in particular in the lumbar spine, the intervertebral disc (intervertebral disc) articulates an upper bony vertebral body with a lower bony vertebral body.
Eine solche künstliche Zwischenwirbelscheibe ist beispielsweise durch die EP 0 610 837 B1 bekannt, bei der zwei Platten durch einen elastomeren Kern miteinander verbunden sind. Der elastomere Kern hat einen oberen und einen unteren Teil, die einen Zwischenteil einschließen, dessen periphere Oberfläche konkav ausgeführt ist. Dadurch sol I bei einwirkenden Biegemomenten oder Übertragungskräften auf die Zwischenwirbelscheibe die an der Berührungsfläche zwischen Platten und Kern hervorgerufenen Kräfte im Vergleich zu einem Kern mit geraden Seiten reduziert werden.
Durch die US 3 867 728 ist eine Zwischenwirbelscheibe beschrieben, die beispielsweise aus einem einzigen Stück besteht und eine konkave äußere Oberfläche aufweist.Such an artificial intervertebral disc is known for example from EP 0 610 837 B1, in which two plates are connected to one another by an elastomeric core. The elastomeric core has an upper and a lower part, which include an intermediate part, the peripheral surface of which is concave. This is intended to reduce the forces generated at the contact surface between the plates and the core in the case of bending moments or transmission forces acting on the intervertebral disc in comparison to a core with straight sides. US Pat. No. 3,867,728 describes an intervertebral disc which, for example, consists of a single piece and has a concave outer surface.
Weiterhin beschreibt auch die US 5 071 437 eine Bandscheibenprothese, welche eine obere flache Platte, eine untere flache Platte und einen flachen elastomeren Kern aufweisen, welcher zwischen den Platten eingeschlossen ist.Furthermore, US Pat. No. 5,071,437 also describes an intervertebral disc prosthesis which has an upper flat plate, a lower flat plate and a flat elastomeric core which is enclosed between the plates.
Die EP 0 747 025 B1 beschreibt eine künstliche Bandscheibe zum Einsatz zwischen benachbarten Wirbeln mit einer ersten Komponente mit einer konkaven Aussparung sowie ei- ner zweiten Komponente mit einem Vorsprung, der in die Aussparung der ersten Komponenten passt so dass eine uneingeschränkte Dreh- und Kippbewegung zwischen der ersten und der zweiten Komponente erreicht wird.EP 0 747 025 B1 describes an artificial intervertebral disc for use between adjacent vertebrae with a first component with a concave recess and a second component with a projection that fits into the recess of the first components so that an unrestricted rotation and tilting movement between the first and the second component is achieved.
Es sind ferner durch die DE 100 24 922 C1, die EP 10 41 945 A1, WO 02/080818 A 1 , die US 6368 350 B 1, die DE 42 13 771 C1, die EP 05 60 140 B1, die EP 1344508 A 1, die EP 13 44 507 A 1, die DE 42 08 115 A 1 , die EP 12 87 795 A 1, die DE 102 42 329 A 1 und die DE 197 10 392 C1 weitere Bandscheibenprothesen bekannt.There are also DE 100 24 922 C1, EP 10 41 945 A1, WO 02/080818 A1, US 6368 350 B1, DE 42 13 771 C1, EP 05 60 140 B1, EP 1344508 A. 1, EP 13 44 507 A1, DE 42 08 115 A1, EP 12 87 795 A1, DE 102 42 329 A1 and DE 197 10 392 C1 further known intervertebral disc prostheses.
Als nachteilig erweist sich bei allen bisher bekannten künstlichen Zwischenwirbelscheiben, dass die natürlichen Gelenkeigenschaften nur unzureichend nachgebildet werden können. Diese Einschränkung des natürlichen Bewegungsfreiraumes ist für den Patienten insbesondere dann deutlich als störend wahrnehmbar, wenn mehrere Wirbelkörper ersetzt werden und sich daher die nachteiligen Eigenschaften der künstlichen Zwischenwirbelscheiben summieren.A disadvantage of all previously known artificial intervertebral discs is that the natural joint properties can only be simulated inadequately. This restriction of the natural freedom of movement is clearly perceptible to the patient as disruptive when several vertebral bodies are replaced and the disadvantageous properties of the artificial intervertebral discs therefore add up.
Der Erfindung liegt die Aufgabe zugrunde, die für den Patienten wahrnehmbaren Eigenschaften einer künstlichen Zwischenwirbelscheibe wesentlich zu verbessern.The invention has for its object to significantly improve the properties of an artificial intervertebral disc perceptible to the patient.
Diese Aufgabe wird erfindungsgemäß mit einer künstlichen Zwischenwirbelscheibe gemäß den Merkmalen des Anspruchs 1 gelöst. Die Unteransprüche betreffen besonders zweckmäßige Weiterbildungen der Erfindung.This object is achieved according to the invention with an artificial intervertebral disc according to the features of claim 1. The subclaims relate to particularly expedient developments of the invention.
Erfindungsgemäß ist also eine künstliche Zwischenwirbelscheibe vorgesehen, bei der die beiden Elemente eine Ausformung aufweisen, durch welche die Elemente mit dem Zwi- schenelement formschlüssig verbunden sind. Die Erfindung geht dabei von der Überlegung aus, dass der gewünschte Bewegungsfreiraum dem natürlichen Bewegungsfreiraum der Wirbelsäule dann in optimaler Weise durch eine künstliche Zwischenwirbelscheibe nachempfunden werden kann, wenn das Zwischenelement in einer jeweiligen Ausformung der Ele-
mente formschlüssig gehalten ist, weil dadurch sowohl Torsionsdrehmomente als auch Scherkräfte problemlos übertragen werden können, ohne dass hierzu auf gute Verformungseigenschaften der Zwischenwirbelscheibe verzichtet werden muss. Dadurch kann die Zwischenwirbelscheibe insbesondere derart ausgeführt sein, dass zugleich die relative Beweg- lichkeit der Elemente zueinander, insbesondere also eine Kippbewegung wesentlich optimiert, d.h. die Beweglichkeit verbessert werden kann. Mit anderen Worten führt die Entkopplung der Funktion der Übertragung der Torsionsdrehmomente und Scherkräfte zwischen benachbarten Wirbelkörpern von der Funktion der gelenkigen Verbindung der den Wirbelkörper jeweils zugeordneten Elemente, die nach dem Stand der Technik einheitlich durch die elastischen Eigenschaften des Zwischenelementes in unzureichender Weise gleichsam als Kompromiss der unterschiedlichen Eigenschaften realisiert ist, zu wesentlich abweichenden Freiheitsgraden entsprechend dem jeweiligen Optimum. Erfindungsgemäß wird es also möglich, benachbarte Wirbelkörper derart gelenkig zu verbinden, dass ähnlichen mechanischen Eigenschaften, wie die der natürlichen Zwischenwirbelscheibe erreicht werden.According to the invention, an artificial intervertebral disc is therefore provided, in which the two elements have a shape by which the elements are positively connected to the intermediate element. The invention is based on the consideration that the desired freedom of movement can be optimally modeled on the natural freedom of movement of the spine by means of an artificial intervertebral disc if the intermediate element is shaped in a respective way. elements is held in a form-fitting manner because both torsional torques and shear forces can be transmitted without any problems, without having to forego good deformation properties of the intervertebral disc. As a result, the intervertebral disc can in particular be designed such that at the same time the relative mobility of the elements with respect to one another, in particular thus a tilting movement, is substantially optimized, ie the mobility can be improved. In other words, the decoupling of the function of the transmission of the torsional torques and shear forces between adjacent vertebral bodies from the function of the articulated connection of the elements assigned to the vertebral body, which according to the prior art is inadequate as a compromise as a result of the elastic properties of the intermediate element different properties is realized, to significantly different degrees of freedom according to the respective optimum. According to the invention, it is therefore possible to connect adjacent vertebral bodies in an articulated manner such that mechanical properties similar to those of the natural intervertebral disc are achieved.
Eine besonders vorteilhafte Ausführungsform der erfindungsgemäßen Wirbelscheibe wird dadurch erreicht, dass die Ausformung konkav ausgeführt ist und dadurch beispielsweise eine Ausnehmung zur formschlüssigen Aufnahme des Zwischenelementes bildet. Die Kontaktflächen sind dabei so gestaltet, dass in jedem Fall durch die Scherungs- und Torsionsbe- lastung die Haftreibung nicht überwunden werden kann.A particularly advantageous embodiment of the vertebral disc according to the invention is achieved in that the shape is concave and thereby forms, for example, a recess for the positive reception of the intermediate element. The contact surfaces are designed so that the static friction cannot be overcome in any case due to the shear and torsion load.
Dabei erweist es sich in der Praxis als besonders erfolg versprechend, wenn die Ausformung eine reibungsoptimierte Oberflächenbeschaffenheit aufweist, weil dadurch in einfacher Weise eine Verringerung bzw. Verhinderung eines möglichen Abriebs des Materials des Zwi- schenelementes erreicht wird. Beispielsweise sind im Kontaktbereich die Oberflächen der Ausformung spiegelglanzpoliert, so dass bei Relativbewegungen an den Kontaktflächen die Reibung und damit auch der Abrieb auf dem Zwischenelement minimal ist.In practice, it proves to be particularly promising if the shape has a friction-optimized surface finish, because it reduces or prevents possible wear of the material of the intermediate element in a simple manner. For example, the surfaces of the formation in the contact area are mirror-polished so that the friction and thus also the abrasion on the intermediate element is minimal during relative movements on the contact surfaces.
Eine andere ebenfalls besonders praxisgerechte Abwandlung wird hingegen dann erreicht, wenn die Ausformung zur Erzeugung eines Kraftschlusses zwischen beiden Elementen und dem Zwischenelement zumindest abschnittweise eine die Reibung erhöhende Oberflächen- strukturierung oder Rauheit aufweist. Auf diese Weise wird eine Gestaltung der Kontaktflächen erreicht, bei denen in jedem Fall durch die Scherungs- und Torsionsbelastung die Haftreibung nicht überwunden wird.Another modification, which is also particularly practical, is achieved, however, if the shape for generating a frictional connection between the two elements and the intermediate element has, at least in sections, a surface structure or roughness which increases the friction. In this way, a design of the contact surfaces is achieved in which the static friction is not overcome in any case due to the shear and torsional load.
Weiterhin erweist es sich als besonders praxisnah, wenn die Ausformung gegenüber dem Zwischenelement derart mit einem Übermaß versehen ist, dass eine insbesondere durch die
Bewegung des Patienten bedingte Kompression des Zwischenelementes eine definierte Verformung gestattet. Hierbei ist insbesondere durch die Flächenkrümmung der Ausformung im Vergleich zu der Querschnittsfläche des Zwischenelementes geringfügig kleiner bemessen, so dass die bei Kompression auftretende Verformung des beispielsweise ringförmigen Zwi- schenelementes dessen Ausdehnung parallel zur Ebene der Elemente gestattet.Furthermore, it proves to be particularly practical if the formation is provided with an oversize in relation to the intermediate element in such a way that one in particular by the Movement of the patient-induced compression of the intermediate element allows a defined deformation. In this case, due to the surface curvature of the shape, the dimensions are slightly smaller compared to the cross-sectional area of the intermediate element, so that the deformation of the annular intermediate element, for example, which occurs during compression, allows its expansion parallel to the plane of the elements.
Das Zwischenelement könnte als eine Scheibe ausgeführt sein, die in ihrem Randbereich mit Wülsten ausgestattet ist, die in die entsprechend ausgeführte Ausformung eingreifen. Eine besonders Erfolg versprechende Ausgestaltung wird hingegen dann erreicht, wenn das Zwischenelement eine ringförmig geschlossene Form aufweist. Hierdurch können in optimaler Weise die bei der Bewegung auftretenden Torsionsdrehmomente und Scherkräfte übertragen werden, wobei sich neben kreisförmigen auch ovale oder nierenförmige Zwischenelemente eignen, weil diese bereits aufgrund der von der Kreisform abweichenden Grundform eine formschlüssige Übertragung von Torsionsdrehmomenten gestattet.The intermediate element could be designed as a disk which is equipped in its edge region with beads which engage in the correspondingly designed shape. On the other hand, a particularly promising embodiment is achieved if the intermediate element has an annular, closed shape. As a result, the torsional torques and shear forces that occur during the movement can be transmitted in an optimal manner, oval or kidney-shaped intermediate elements being suitable in addition to circular ones, because these already permit a positive transmission of torsional torques due to the basic shape deviating from the circular shape.
Nach einer anderen ebenfalls besonders vorteilhaften Abwandlung weist das ringförmige Zwischenelement zumindest abschnittsweise eine ogivale, ovale oder kreisförmige Querschnittsfläche quer zu seiner ringförmigen Mittelachse auf, um so zugleich eine optimale Kraftübertragung zwischen den Elementen sicherzustellen und zugleich die gewünschte Beweglichkeit zu erreichen. Dabei ist die korrespondierende Ausformung zumindest abschnittsweise, insbesondere in Abhängigkeit der verschiedenen Körperebenen entsprechend geformt.According to another likewise particularly advantageous modification, the annular intermediate element has, at least in sections, an ogival, oval or circular cross-sectional area transversely to its annular central axis, in order to simultaneously ensure optimal power transmission between the elements and at the same time achieve the desired mobility. The corresponding shape is shaped at least in sections, in particular depending on the different body levels.
Weiterhin erweist es sich als besonders günstig, wenn das Zwischenelement eine in Richtung seiner ringförmigen Mittelachse eine abschnittsweise abweichende Querschnittsfläche aufweist, die mit einer entsprechend ausgeführten Ausformung zusammenwirkt, um so die auftretenden Torsionsmomenten durch einen Formschluss zwischen dem Zwischenelement und den äußeren Elementen zu ermöglichen. Beispielsweise können hierzu abschnittsweise Einschnürungen vorgesehen sein. Der Durchmesser der Ringquerschnittsfläche ist dabei längs des Ringes moduliert sein, so dass selbst bei einem in Draufsicht kreisförmig geformten Ring eine Drehbewegung des Ringes zwischen den plattenförmigen äußeren Elementen ausgeschlossen werden kann.Furthermore, it proves to be particularly advantageous if the intermediate element has a cross-sectional area that deviates in sections in the direction of its ring-shaped central axis, which interacts with a correspondingly designed shape, so as to enable the torsional moments that occur by a positive fit between the intermediate element and the outer elements. For example, constrictions can be provided for this in sections. The diameter of the cross-sectional area of the ring is modulated along the ring, so that even in the case of a ring which is circular in plan view, a rotational movement of the ring between the plate-shaped outer elements can be excluded.
Beispielsweise kann zu diesem Zweck die Querschnittsfläche in der Sagittalebene, der Frontalebene und/oder der Transversalebene des Patienten abschnittsweise erweitert sein.For example, the cross-sectional area in the sagittal plane, the frontal plane and / or the transverse plane of the patient can be expanded in sections for this purpose.
Grundsätzlich können die Materialeigenschaften entsprechend den jeweiligen Anforderungen bestimmt werden. Besonders vorteilhaft erweist sich in der Praxis eine Ausgestaltung, bei der das Zwischenelement zumindest abschnittsweise aus einem Polymer, insbesondere Po-
lyethylen besteht und dadurch geringe Verschleißanfälligkeit bei zugleich hoher Zähigkeit und eine eingeschränkte, elastische Verformbarkeit gestattet.In principle, the material properties can be determined according to the respective requirements. In practice, an embodiment in which the intermediate element is made at least in sections from a polymer, in particular polymer, proves to be particularly advantageous. there is ethylene, which means it is less susceptible to wear and tear, and at the same time has high toughness and allows limited, elastic deformability.
Weiterhin wird eine besonders zuverlässige Anbindung der Zwischenwirbelscheibe die Elemente zur Verankerung im Knochen auf den Wirbelkörpern zugewandten Seiten mit Veran- kerungsdornen oder -elementen versehen, die sich bei der Implantation durch Last in den Wirbelkörpern hineinverankern.Furthermore, a particularly reliable connection of the intervertebral disc to the elements for anchoring in the bone on the sides facing the vertebral bodies is provided with anchoring spikes or elements which anchor themselves in the vertebral bodies during the implantation due to load.
Dabei sind Vorteilhafterweise die Elemente mit ihren Verankerungsdornen oder -elementen auf den den Wirbelkörpern zugewandten Seiten mit Titan oder anderen biokompatiblen Materialien beschichtet, die eine direkte Knochenanbindung ermöglichen.The elements are advantageously coated with their anchoring spikes or elements on the sides facing the vertebral bodies with titanium or other biocompatible materials which enable a direct bone connection.
Die Erfindung lässt verschiedene Ausführungsformen zu. Zur weiteren Verdeutlichung ihres Grundprinzips ist eine davon in der Zeichnung dargestellt und wird nachfolgend beschrieben. Diese zeigt inThe invention permits various embodiments. To further clarify its basic principle, one of these is shown in the drawing and is described below. This shows in
Fig.1 eine geschnittene Seitenansicht einer erfindungsgemäßen künstlichen Zwischen- wirbelscheibe;1 shows a sectional side view of an artificial intervertebral disc according to the invention;
Fig.2 eine Draufsicht auf verschiedene Zwischenelemente für eine erfindungsgemäße künstliche Zwischenwirbelscheibe;2 shows a plan view of various intermediate elements for an artificial intervertebral disc according to the invention;
Fig.3 verschiedene Querschnittsformen der in Figur 2 gezeigten Zwischenelemente;3 different cross-sectional shapes of the intermediate elements shown in FIG. 2;
Fig.4 eine lediglich Ausschnittsweise dargestellte, vergrößerte Seitenansicht eines in Figur 2 gezeigten Zwischenelementes;FIG. 4 shows an enlarged side view of only an extract of an intermediate element shown in FIG. 2;
Fig.5 eine weitere erfindungsgemäße künstliche Zwischenwirbelscheibe in einer geschnittenen Seitenansicht;5 shows another artificial intervertebral disc according to the invention in a sectional side view;
Fig.6 die Anordnung der in Figur 1 dargestellten künstlichen Zwischenwirbelscheibe zwischen zwei Wirbelkörpern einer Wirbelsäule.6 shows the arrangement of the artificial intervertebral disc shown in FIG. 1 between two vertebral bodies of a spine.
Figur 1 zeigt eine geschnittene Seitenansicht einer erfindungsgemäßen künstlichen Zwischenwirbelscheibe 1 durch die zwei nicht dargestellte benachbarte Wirbelkörper eines Patienten gelenkig verbunden sind. Die künstliche Zwischenwirbelscheibe 1 hat ein als elastischer Ring ausgeführtes Zwischenelement 2, das in jeweils eine Ausformung 3 von zwei beispielsweise als Metallplatten ausgeführten äußeren Elementen 4 eingesetzt ist. Die äußeren Elemente 4 werden mit den Knochen der Wirbelkörper über Verankerungsdorne 5, ins-
besondere Titanverankerungen, die an sich aus der Huftendoprothetik bekannt sind, verbunden. Der Radius D der konkaven Ausformung 3 weist gegenüber dem Durchmesser d einer kreisförmigen Querschnittsfläche des Zwischenelementes 2 ein Übermaß auf, so dass eine insbesondere durch die Bewegung des Patienten bedingte Kompression des Zwischenele- mentes 2 eine definierte Verformung gestattet.FIG. 1 shows a sectional side view of an artificial intervertebral disc 1 according to the invention, by means of which two adjacent vertebral bodies (not shown) of a patient are articulated. The artificial intervertebral disc 1 has an intermediate element 2 designed as an elastic ring, which is inserted in each case in a formation 3 of two outer elements 4, for example designed as metal plates. The outer elements 4 are attached to the bones of the vertebral bodies via anchoring pins 5, in particular special titanium anchors, which are known per se from hip arthroplasty. The radius D of the concave shape 3 has an excess compared to the diameter d of a circular cross-sectional area of the intermediate element 2, so that compression of the intermediate element 2, which is caused in particular by the movement of the patient, permits a defined deformation.
Figur 2 zeigt eine Draufsicht auf verschiedene mögliche Ausformungen des Zwischenelementes 2 der erfindungsgemäßen künstlichen Zwischenwirbelscheibe 1 , die jeweils eine ringförmig geschlossene Grundform aufweisen. Beispielhaft dargestellt sind Zwischenele- mente 2a, 2b, 2c mit kreisförmiger, ovaler oder nierenförmiger Grundform. Selbstverständlich können diese Grundformen in gleicher Weise auch bei nicht gezeigten Zwischenelementen ohne Durchbrechung vorgesehen werden.FIG. 2 shows a plan view of various possible configurations of the intermediate element 2 of the artificial intervertebral disc 1 according to the invention, each of which has an annularly closed basic shape. Intermediate elements 2a, 2b, 2c with a circular, oval or kidney-shaped basic shape are shown as examples. Of course, these basic shapes can be provided in the same way even without intermediate openings, not shown.
Figur 3 zeigt beispielhaft verschiedene Querschnittsformen des Zwischenelementes 2, die oval, kreisförmig oder beidseitig ogival ausgeführt sein können. In Richtung der in Figur 4 dargestellten ringförmigen Mittelachse 7 des Zwischenelementes 2 kann die Querschnittsform auch abschnittsweise abweichend ausgeführt und beispielsweise zwischen den dargestellten unterschiedlichen Querschnittsformen variieren.Figure 3 shows an example of various cross-sectional shapes of the intermediate element 2, which can be oval, circular or ogival on both sides. In the direction of the annular central axis 7 of the intermediate element 2 shown in FIG. 4, the cross-sectional shape can also differ in sections and, for example, vary between the different cross-sectional shapes shown.
Eine solche variierende Querschnittsform wird anhand der Figur 4 näher dargestellt, die eine vergrößerte Seitenansicht eines in Figur 2 gezeigten Zwischenelementes 2 zeigt. Zu erkennen sind regelmäßige Einschnürungen 6 der kreisförmigen Querschnittsform in Richtung der ringförmigen Mittelachse 7 des Zwischenelementes 2, durch welche die auftretenden Torsionsmomenten durch einen Formschluss des Zwischenelements 2 mit den in Figur 1 gezeig- ten äußeren Elementen 4 übertragen werden können.Such a varying cross-sectional shape is shown in more detail with reference to FIG. 4, which shows an enlarged side view of an intermediate element 2 shown in FIG. Regular constrictions 6 of the circular cross-sectional shape in the direction of the annular central axis 7 of the intermediate element 2 can be seen, through which the torsional moments that occur can be transmitted by a positive engagement of the intermediate element 2 with the outer elements 4 shown in FIG.
Eine gegenüber Figur 1 abweichende Ausführungsform einer weiteren erfindungsgemäßen künstlichen Zwischenwirbelscheibe 8 zeigt Figur 5 in einer geschnittenen Seitenansicht. Die Zwischenwirbelscheibe 8 hat dabei als Lochscheiben ausgeführte äußere Elemente 9 mit einer zentralen Durchbrechung 10 ausgeführt, um so die Integration der in Figur 6 gezeigten dargestellten Wirbelkörper 11 zu verbessern.An embodiment of a further artificial intervertebral disk 8 according to the invention that differs from FIG. 1 is shown in a sectional side view. The intervertebral disc 8 has outer elements 9 in the form of perforated discs with a central opening 10 so as to improve the integration of the vertebral bodies 11 shown in FIG. 6.
Figur 6 zeigt eine Anordnung der in Figur 1 dargestellten künstlichen Zwischenwirbelscheibe 1 zwischen zwei Wirbelkörpern 11 einer nicht weiter gezeigten Wirbelsäule. Zur Verankerung in den Wirbelkörpern 11 ist die Zwischenwirbelscheibe 1 auf ihren den Wirbelkörpern 11 Außenseiten mit den Verankerungsdornen 5 versehen, die sich bei der Implantation durch Last in den Wirbelkörpern 11 hineinverankern. Eine an den Wirbelkörpern 11 zugewandten Seiten vorgesehene biokompatible Beschichtung ermöglicht dabei eine direkte Knochenanbindung.
FIG. 6 shows an arrangement of the artificial intervertebral disc 1 shown in FIG. 1 between two vertebral bodies 11 of a spine (not shown further). For anchoring in the vertebral bodies 11, the intervertebral disc 1 is provided on its outer sides of the vertebral bodies 11 with the anchoring mandrels 5, which anchor themselves in the vertebral bodies 11 during the implantation by load. A biocompatible coating provided on the sides facing the vertebral bodies 11 enables a direct bone connection.
Claims
1. Eine zwischen zwei benachbarten Wirbelkörpern (11) eines Patienten einsetzbare künstliche Zwischenwirbelscheibe (1, 8), mit jeweils einem dem jeweiligen Wirbelkörper (11) zuge- ordneten Element (4, 9) , wobei die Elemente (4, 9) mittels eines Zwischenelementes (2) derart eingeschränkt gelenkig miteinander verbunden sind, dass dadurch sowohl Torsionsdrehmomente als auch Scherkräfte übertragbar sind, dadurch gekennzeichnet, dass die beiden Elemente (4, 9) eine Ausformung (3) aufweisen, durch welche die Elemente (4, 9) mit dem Zwischenelement (2) formschlüssig verbunden sind.1. An artificial intervertebral disc (1, 8) which can be inserted between two adjacent vertebral bodies (11) of a patient, each with an element (4, 9) assigned to the respective vertebral body (11), the elements (4, 9) being connected by means of a Intermediate element (2) are connected to one another in such a limited articulated manner that both torsional torques and shear forces can be transmitted thereby, characterized in that the two elements (4, 9) have a shape (3) through which the elements (4, 9) also the intermediate element (2) are positively connected.
2. Zwischenwirbelscheibe (1 , 8) nach Anspruch 1, dadurch gekennzeichnet, dass die Ausformung (3) konkav ausgeführt ist.2. Intervertebral disc (1, 8) according to claim 1, characterized in that the shape (3) is concave.
3. Zwischenwirbelscheibe (1 , 8) nach den Ansprüchen 1 oder 2, dadurch gekennzeichnet, dass-die Ausformung (3) eine Ausnehmung aufweist.3. Intervertebral disc (1, 8) according to claims 1 or 2, characterized in that the shape (3) has a recess.
4. Zwischenwirbelscheibe (1 , 8) nach zumindest einem der vorhergehenden Ansprüche, da- durch gekennzeichnet, dass die Ausformung (3) eine reibungsoptimierte Oberflächenbeschaffenheit aufweist.4. Intervertebral disc (1, 8) according to at least one of the preceding claims, characterized in that the shape (3) has a friction-optimized surface quality.
5. Zwischenwirbelscheibe (1 , 8) nach zumindest einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, dass die Ausformung (3) zur Erzeugung eines Kraftschlusses zwischen beiden Elementen (4, 9) und dem Zwischenelement (2) zumindest abschnittweise eine die Reibung erhöhende Oberf lächenstrukturierung oder Rauheit aufweist.5. Intervertebral disc (1, 8) according to at least one of the preceding claims, characterized in that the shape (3) for generating a frictional connection between the two elements (4, 9) and the intermediate element (2) at least in sections a surface structure increasing the friction or has roughness.
6. Zwischenwirbelscheibe (1 , 8) nach zumindest einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, dass die Ausformung (3) gegenüber dem Zwischenelement (2) der- art mit einem Übermaß versehen ist, dass eine insbesondere durch die Bewegung des Patienten bedingte Kompression des Zwischenelementes (2) eine definierte Verformung gestattet.6. Intervertebral disc (1, 8) according to at least one of the preceding claims, characterized in that the shape (3) relative to the intermediate element (2) der- Type is provided with an oversize that a compression of the intermediate element (2), which is caused in particular by the movement of the patient, allows a defined deformation.
7. Zwischenwirbelscheibe (1 , 8) nach zumindest einem der vorhergehenden Ansprüche, da- durch gekennzeichnet, dass das Zwischenelement (2) eine ringförmig geschlossene Form aufweist.7. Intervertebral disc (1, 8) according to at least one of the preceding claims, characterized in that the intermediate element (2) has an annular, closed shape.
8. Zwischenwirbelscheibe (1 , 8) nach zumindest einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, dass das Zwischenelement (2) kreisförmig, oval oder nierenförmig ausgeführt ist.8. Intervertebral disc (1, 8) according to at least one of the preceding claims, characterized in that the intermediate element (2) is circular, oval or kidney-shaped.
9. Zwischenwirbelscheibe (1 , 8) nach zumindest einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, dass das ringförmige Zwischenelement (2) zumindest abschnittsweise eine ogivale, ovale oder kreisförmige Querschnittsfläche quer zur seiner ringförmigen Mittelachse (7) aufweist.9. Intervertebral disc (1, 8) according to at least one of the preceding claims, characterized in that the annular intermediate element (2) has at least in sections an ogival, oval or circular cross-sectional area transverse to its annular central axis (7).
10. Zwischenwirbelscheibe (1 , 8) nach zumindest einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, dass das Zwischenelement (2) eine in Richtung seiner ringförmigen Mittelachse (7) eine abschnittsweise abweichende Querschnittsfläche (Einschnürung 6) aufweist, die mit entsprechen ausgeführten Ausformung (3) zusammenwirkt.10. Intervertebral disc (1, 8) according to at least one of the preceding claims, characterized in that the intermediate element (2) has a cross-sectional area (constriction 6) which deviates in sections in the direction of its ring-shaped central axis (7) and which has a correspondingly shaped configuration (3rd ) interacts.
11. Zwischenwirbelscheibe (1 , 8) nach zumindest einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, dass Querschnittsfläche in der Sagittalebene, der Frontalebene und/oder der Transversalebene des Patienten abschnittsweise erweitert ist.11. Intervertebral disc (1, 8) according to at least one of the preceding claims, characterized in that cross-sectional area in the sagittal plane, the frontal plane and / or the transverse plane of the patient is expanded in sections.
12. Zwischenwirbelscheibe (1 , 8) nach zumindest einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, dass das Zwischenelement (2) zumindest abschnittsweise aus einem Polymer, insbesondere Polyethylen besteht.12. Intervertebral disc (1, 8) according to at least one of the preceding claims, characterized in that the intermediate element (2) consists at least in sections of a polymer, in particular polyethylene.
13. Zwischenwirbelscheibe (1 , 8) nach zumindest einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, dass die Elemente (4, 9) zur Verankerung im Knochen auf den13. Intervertebral disc (1, 8) according to at least one of the preceding claims, characterized in that the elements (4, 9) for anchoring in the bone on the
Wirbelkörpern (11) zugewandten Seiten mit Verankerungsdornen (5) oder -elementen versehen sind.Vertebral bodies (11) facing sides are provided with anchoring pins (5) or elements.
14. Zwischenwirbelscheibe (1 , 8) nach zumindest einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, dass die Elemente (4, 9) mit ihren Verankerungsdornen (5) oder -elementen auf den den Wirbelkörpern (11) zugewandten Seiten mit Titan oder anderen biokompatiblen Materialien beschichtet sind. 14. Intervertebral disc (1, 8) according to at least one of the preceding claims, characterized in that the elements (4, 9) with their anchoring spikes (5) or elements on the sides of the vertebral bodies (11) facing titanium or other biocompatible materials are coated.
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DE102004016032A DE102004016032B4 (en) | 2004-03-30 | 2004-03-30 | Artificial intervertebral disc |
PCT/DE2005/000373 WO2005094734A1 (en) | 2004-03-30 | 2005-03-03 | Artificial intervertebral disk |
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EP1732478A1 true EP1732478A1 (en) | 2006-12-20 |
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EP (1) | EP1732478A1 (en) |
JP (1) | JP4646974B2 (en) |
AU (1) | AU2005229466B2 (en) |
DE (1) | DE102004016032B4 (en) |
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EP1820476B1 (en) * | 2003-11-18 | 2011-05-11 | Zimmer GmbH | Spinal disc implant |
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- 2005-03-03 EP EP05728248A patent/EP1732478A1/en not_active Withdrawn
- 2005-03-03 US US10/599,524 patent/US7785369B2/en not_active Expired - Fee Related
- 2005-03-03 JP JP2007505362A patent/JP4646974B2/en not_active Expired - Fee Related
- 2005-03-03 AU AU2005229466A patent/AU2005229466B2/en not_active Ceased
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US20070185579A1 (en) | 2007-08-09 |
AU2005229466A1 (en) | 2005-10-13 |
JP2007530183A (en) | 2007-11-01 |
DE102004016032A1 (en) | 2005-11-17 |
DE102004016032B4 (en) | 2006-07-13 |
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