EP1758622A1 - Kit zur behandlung von bandscheibendegeneration - Google Patents

Kit zur behandlung von bandscheibendegeneration

Info

Publication number
EP1758622A1
EP1758622A1 EP05773213A EP05773213A EP1758622A1 EP 1758622 A1 EP1758622 A1 EP 1758622A1 EP 05773213 A EP05773213 A EP 05773213A EP 05773213 A EP05773213 A EP 05773213A EP 1758622 A1 EP1758622 A1 EP 1758622A1
Authority
EP
European Patent Office
Prior art keywords
cells
intervertebral disc
connecting piece
vertebrae
assembly according
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Withdrawn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
EP05773213A
Other languages
English (en)
French (fr)
Inventor
Régis Le Couedic
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.)
Zimmer Spine SAS
Original Assignee
Zimmer Spine SAS
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 Zimmer Spine SAS filed Critical Zimmer Spine SAS
Publication of EP1758622A1 publication Critical patent/EP1758622A1/de
Withdrawn legal-status Critical Current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
    • A61B17/7035—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • A61B17/7037—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other wherein pivoting is blocked when the rod is clamped
    • 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
    • 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
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/701—Longitudinal elements with a non-circular, e.g. rectangular, cross-section
    • 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
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7011—Longitudinal element being non-straight, e.g. curved, angled or branched
    • 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
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7019—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other
    • A61B17/7026—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other with a part that is flexible due to its form
    • 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
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7019—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other
    • A61B17/7031—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other made wholly or partly of flexible material
    • 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
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/36—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
    • A61L27/38—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix containing added animal cells
    • A61L27/3804—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix containing added animal cells characterised by specific cells or progenitors thereof, e.g. fibroblasts, connective tissue cells, kidney cells
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/36—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
    • A61L27/38—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix containing added animal cells
    • A61L27/3839—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix containing added animal cells characterised by the site of application in the body
    • A61L27/3843—Connective tissue
    • A61L27/3852—Cartilage, e.g. meniscus
    • 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
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7004—Longitudinal elements, e.g. rods with a cross-section which varies along its length
    • 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
    • A61B17/7061—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant for stabilising vertebrae or discs by improving the condition of their tissues, e.g. using implanted medication or fluid exchange
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4611—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • 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
    • A61F2002/444—Intervertebral or spinal discs, e.g. resilient for replacing the nucleus pulposus
    • 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
    • A61F2002/4445—Means for culturing intervertebral disc tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L2430/00—Materials or treatment for tissue regeneration
    • A61L2430/38—Materials or treatment for tissue regeneration for reconstruction of the spine, vertebrae or intervertebral discs

Definitions

  • the present invention relates to a set for the treatment of degeneration of an intervertebral disc.
  • the intervertebral disc is a means of joining the vertebral bodies together, the shape of which is that of a biconvex lens which adapts and attaches to the articular surfaces of the bodies of the vertebrae. They are made up of two parts: a very hard peripheral part of very tight texture and a central part which is a soft and gelatinous substance. For various reasons, pathologies of the intervertebral disc can lead to more or less significant degeneration of this disc which then can no longer fulfill its normal function between the vertebrae.
  • the inventors have demonstrated that after the implantation of regeneration cells in the damaged intervertebral disc, the lesion or necrosis of the cells constituting the disc does not disappear or does not disappear sufficiently due to the mechanical pressure exerted on this disc by the vertebrae which surround it. Besides, the inventors have also highlighted that part of the degeneration of the cells of the intervertebral disc could have a purely mechanical origin or that this purely mechanical origin could have created conditions favorable to the degeneration of this disc for other biological lesions.
  • the object of the invention is achieved by a set of treatment for the degeneration of an injured intervertebral disc placed between two vertebrae which is characterized in that it comprises cells analogous or not to those of the intervertebral disc and implantable in said disc; and at least one device for stabilizing the two vertebrae comprising two screws, each screw being intended to be screwed into one of the vertebrae, an elongated connecting piece, and two securing members for securing the head of each of said screws to one of the ends of said connecting piece, whereby excessive mechanical stresses are not applied to the intervertebral disc.
  • the cells implanted in the intervertebral disc will allow the regeneration of the cells of the intervertebral disc and that this regeneration will be possible thanks to the presence of the stabilization device which is screwed into the vertebrae and therefore maintains a spacing between those -this. It thus limits the mechanical stresses applied to the intervertebral disc during treatment.
  • the invention can be used for patients who have undergone partial or total resection of the spinous processes of the vertebrae or whose spinous processes have too poor a bone quality (for example osteoporosis).
  • the intervertebral disc between the fifth lumbar and the sacrum since the first vertebra of the latter generally does not have a spinous process.
  • the invention can therefore be used in cases where interspinous stabilization cannot be carried out for physiological reasons.
  • the implantable cells used can be obtained by various methods such as the removal from an intervertebral disc of the patient, the removal from the bone marrow of the patient of adult stem cells or also by removal of embryonic stem cells.
  • the treatment assembly advantageously comprises means for injecting the cells into the disc, these injection means possibly being of the syringe-cannula type.
  • the connecting piece of the vertebra stabilization device has a certain flexibility.
  • - Figure 1 shows the assembly for treating the degeneration of an intervertebral disc according to the invention
  • - Figure 2A is a sectional view of a first embodiment of the connecting piece of the immobilizer
  • - Figure 2B is a perspective view of the first embodiment immobilizer
  • - Figure 3A is a perspective view of a second embodiment of the connecting piece of the immobilizer
  • - Figure 3B is a perspective view of the embodiment of Figure 3A
  • - Figure 4 is an exploded view of a third embodiment of the immobilization device.
  • FIG 1 there is shown in a simplified manner on the one hand a vertebra stabilization device 10 comprising two screws 12 and 14, a connecting piece 16 and two fixing devices 18 and 20 for immobilizing the connecting piece 16 by compared to screw 12 and 14. Also shown are injectable cells for the regeneration of the intervertebral disc, these cells being symbolically referenced 22 and shown in a culture dish 24. The means for injecting the cells 26 have also been shown.
  • the injection means 26 are constituted in the particular embodiment of the invention represented in this figure by a syringe body 28 and a cannula 30.
  • the device for stabilizing the vertebrae 10 which constitutes a part of the treatment assembly is intended to allow the fixing of a given spacing between the vertebrae surrounding the DI intervertebral disc to be treated and to avoid excessive mechanical stress being applied to this disc.
  • this treatment assembly includes injectable cells for disc therapy, the reflection or implantation of the cells which can take place at the same time as the installation of the stabilization device, or after, as is will explain later.
  • Vertebra stabilization devices are themselves well known for their function of spacing and securing the vertebrae. Such intervertebral immobilization devices are notably described in patent applications FR 02 12397, WO 02/07621 and WO 02/07622.
  • the stabilization device 10 consists essentially of two pedicle screws 12 and 14 which are screwed into the body of the two vertebrae to be secured.
  • Each screw 12 and 14 is equipped with a securing device 18 and 20 for securing the heads of the screws with a connecting piece 16 which thus defines the spacing between the two vertebrae.
  • the connecting piece 16 has a certain flexibility.
  • two stabilization devices are used, each device being mounted on either side of the spinous processes of the vertebrae.
  • implantable cells usable for the regeneration of the intervertebral disc can have different origins: They can be cells taken from the patient at the level of the disc itself and cultured in an adequate medium (possibly in three-dimensional) such as (alginate ball, porous structure in PLA / TGA, collagen foam); It is also possible to use autologous adult stem cells taken from the bone marrow, for example from the iliac crest, then placed in a culture medium identical to those which have been mentioned above. Finally, treated embryonic stem cells can be used in the same manner as previously indicated.
  • These cells can be implanted in the intervertebral disc to be treated at the same time as the placement of the intervertebral implant or else be the subject of a fully-fledged operation taking place before or after the placement of the intervertebral implant. In all cases, similar results are obtained.
  • the operational steps are as follows: - with regard to the installation of the patient undergoing the operation, he is placed in the prone position. A position of physiological lumbar lordosis is desirable. - the surgeon proceeds to expose the two vertebrae adjacent to the disc to be treated.
  • each screw head is intended to receive the end cylindrical 36, 38 of the connecting piece 16.
  • the ends 36 and 38 of the connecting piece are immobilized with respect to the screws by means of clamping screws 40 and 42 which cooperate with a thread formed in the recesses 34 of the heads screws 32.
  • the central part 44 of the connecting piece 16 is made of a material having a certain elasticity to allow limited movement between the vertebrae. This possibility improves patient comfort.
  • the relative movement of the two vertebrae is limited, which avoids the application of excessive mechanical stresses to the intervertebral disc.
  • WO 02/076221 This device differs from that which has been described in connection with FIGS. 2A and 2B only by the embodiment of the central part of the connecting piece which is referenced 16 '.
  • the central part 46 of the connecting piece is constituted by two parallel arms 48 and 50 which are connected at their ends to the cylindrical end portions 36 and 38 of the connecting piece.
  • the central part 46 has at its center a recess 50 which gives this central part a certain deformability while giving the same mechanical resistance as the end portions 36 and 38.
  • FIG. 4 we will describe a third embodiment of the vertebra stabilization device which is described in more detail in French patent application No.
  • each pedicle screw referenced 12 'in the figures comprises a threaded body 60 and a spherical fixing head 62.
  • the connecting piece which is referenced 16 "has the form of an elongated piece having a substantially planar upper face 64 and a lower face 66 also substantially planar.
  • the fixing device which bears the reference 18 ' is first constituted by a ring-shaped part 68.
  • the upper part of the ring 68 is pierced with an orifice 70 which opens into the axial passage 72 of the ring.
  • the orifice 70 is tapped to cooperate with a fixing screw 74.
  • the ring also has in its lower part a recess 76 which comprises an insertion part 78 authorizing the passage of the spherical head 62 of the screw 12 'and a retaining portion 80 which can cooperate with the lower part of the spherical head 62 of the screw to maintain the latter in the space passage 72 of the ring 68.
  • the fastening device 18 ′ finally comprises an intermediate part 82 whose upper face 84 is planar and whose lower face 86 defines a spherical cap capable of cooperating with the upper part of the spherical head 62 of the screw 12 .
  • the fixing piece 68 is engaged on the spherical head 62 of the screw by its insertion housing 78 and then it has been pivoted about its axis. to bring the head of the screw the spherical head 62 of the screw above the retaining recess 80.
  • the intermediate piece 82 and the end of the connecting piece 16 are then placed in the axial passage 72 By screwing the screw 74 including the threaded orifice 70 of the ring, the tightening and therefore the immobilization of the connecting piece 16 "is obtained with respect to the spherical head 62 of the pedicle screws 12 '.
EP05773213A 2004-05-25 2005-05-24 Kit zur behandlung von bandscheibendegeneration Withdrawn EP1758622A1 (de)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
FR0405611A FR2870718B1 (fr) 2004-05-25 2004-05-25 Ensemble de traitement de la degenerescence d'un disque intervertebral
PCT/FR2005/001280 WO2005118015A1 (fr) 2004-05-25 2005-05-24 Ensemble de traitement de la degenerescence d'un disque intervertebral

Publications (1)

Publication Number Publication Date
EP1758622A1 true EP1758622A1 (de) 2007-03-07

Family

ID=34947858

Family Applications (1)

Application Number Title Priority Date Filing Date
EP05773213A Withdrawn EP1758622A1 (de) 2004-05-25 2005-05-24 Kit zur behandlung von bandscheibendegeneration

Country Status (8)

Country Link
US (1) US20080039943A1 (de)
EP (1) EP1758622A1 (de)
JP (1) JP2008500084A (de)
KR (1) KR20070034479A (de)
AU (1) AU2005249740B2 (de)
FR (1) FR2870718B1 (de)
WO (1) WO2005118015A1 (de)
ZA (1) ZA200609826B (de)

Families Citing this family (57)

* Cited by examiner, † Cited by third party
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KR20070034479A (ko) 2007-03-28
US20080039943A1 (en) 2008-02-14
JP2008500084A (ja) 2008-01-10
WO2005118015A1 (fr) 2005-12-15
FR2870718A1 (fr) 2005-12-02

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