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
  • A61B17/7037—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
  • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
  • A61B17/86—Pins or screws or threaded wires; nuts therefor
  • A61B17/8665—Nuts
  • A61B2017/867—Nuts with integral locking or clamping means
  • A61B2017/868—Nuts with integral locking or clamping means self-locking due to part of nut being deformed upon tightening

Definitions

• the present invention relates to systems for osteosynthesis which find a particularly advantageous application for spinal osteosynthesis.
• the present invention is intended to provide a system for osteosynthesis, in particular spinal, which at least largely overcomes the above-mentioned drawback of the systems of the prior art, that is to say to say which can greatly facilitate the work of the practitioner during a surgical procedure, notably by making the locking of the bar between the two branches of the U easier and faster, with the main aim of reducing the duration of the procedure while securing this blockage, all for the best possible well-being of the patient.
• the present invention relates to a system for osteosynthesis comprising at least one pedicle screw and at least one bar defined along a longitudinal axis, as defined in appended claim 1.
• FIG. 1 is a perspective view of a first embodiment of the osteosynthesis system according to the invention
• FIG. 2 is a longitudinal sectional view of the osteosynthesis system according to the embodiment illustrated in FIG. 1, but illustrating another embodiment of the means for blocking one of its elements, in this case the tab ,
• FIGS. 3 and 4 both represent both second and third embodiments of the osteosynthesis system according to the invention, FIG. 3 being a longitudinal schematic section of all these two embodiments, FIG. FIG. 4 being a view from above, and
• FIGS. 5 to 7 show alternative embodiments of the osteosynthesis system according to the invention as represented in FIGS. 1 to 4, FIGS. 5 and 6 more particularly representing variants of the embodiments according to FIGS. 1 and 2, FIG. 7 being more particularly a variant of one of the embodiments according to Figures 3 and 4.
• the present invention relates to a system for osteosynthesis which finds a particularly advantageous application as a system for spinal osteosynthesis, and which comprises at least one pedicle screw 10 and at least one bar 50 defined along a longitudinal axis 51.
• the pedicle screw 10 comprises a U-shaped head 11, often referred to as a "tuning fork” by those skilled in the art, comprising two branches 12, 13 and a base 14 joining the two branches, defining between them an interbranch space 15, the distance between the two branches being at least equal to the largest transverse thickness of the bar 50,
• This pedicle screw further comprises a screw rod 16 having a first penetrating end 17, advantageously self-tapping, and, on its outer surface, a bone-type threading.
• the pedicle screw finally comprises means 20 for locking the bar 50 in the interbranch space 15.
• the osteosynthesis system must comprise at least one bar 50. In the context of the invention, it may therefore comprise several such bars, for example two as in the example illustrated in FIG. .
• the means 20 for locking the bar in the inter-branch space comprise at least one tab 21 and means for moving this tab 21 relative to the two branches 12, 13 in a plane substantially parallel to the longitudinal axis 51.
• These means of movement of the tab 21 are arranged so that the tab is adapted to take at least two positions P1, P2, namely: a first position P1 ( Figure 4) in which the tab does not cooperate not with the bar 50, and a second position P2 ( Figures 1 to 7) wherein the tab cooperates with at least one of the branches 12, 13 so further that at least a portion of the tab 21 is located in the interspaced space 15 and, directly or indirectly, applies on the bar 50 a pressing force Fp ( Figure 2) oriented towards the base 14 of the U.
• the means for moving the tab 21 relative to the two branches 12, 13 in a plane substantially parallel to the longitudinal axis 51, and preferably perpendicular to the axis of the screw rod 16 constitute a pivot 23, of any type, for example a rotation shaft, a ball, etc., defining an axis of rotation substantially orthogonal to the longitudinal axis 51, means for mounting the pivot in cooperation with a first of the two branches 12, 13, in this case the branch referenced 12 in all the figures, and means for mounting a first end 25 of the tab 21 in rotational cooperation with the pivot 23 so that the tab 21 is able to take by rotating its two first and second positions P1 and P2 defined above.
• This pivot can be realized in different ways, for example by a rotation shaft, a shaft screw which can be locked in the final when the lug 21 is in its second position P2, or even in the form of a propeller shaft or analog which blocks itself in its bearing when the leg 21 passes from its first position P1 to its second P2.
• the osteosynthesis system according to the invention further comprises at least temporary locking means of the lug 21 when it is in its second position P2.
• these at least temporary locking means of the lug 21 when it is in its second position P2 consist of at least one notch 26 of concave shape, three being represented in FIG. in the other second branch 13 so as to receive the second end 27 of the lug 21 when it is in its second position P2, by clipping to enable it to maintain this second position P2, the length of the lug being determined so that it comes in force dive into this notch using the elastic deformation inherent in any material.
• This notch 26 can be made on the surface of the second branch 13, FIG. 1, or in the bottom of a first groove 28 made in the wall 29 of the second branch 13 facing the inter-branch space 15, FIG.
• the plurality of notches 26 as shown in Figure 1 provides different types of blocking, from a slight temporary blocking to a more intense blocking.
• the embodiment described above can be made according to a variant such as that illustrated in FIG. 5.
• the means for temporarily locking the tab 21 are constituted by the fact that the tab is shaped as a hook 59 adapted to cooperate by hooking with a complementary part 58 made on the second branch 13, emphasizing that this complementary part may be a part of the second branch 13 itself.
• This complementary portion 58 is also advantageously arranged so that the cooperation of the hook-shaped tab 59 and this complementary part 58 brings the two branches 12, 13 closer together in order to grip the bar better, as shown in FIG.
• the means for moving the tab 21 with respect to the two branches 12, 13 in a plane substantially parallel to the longitudinal axis 51 consist of two second and third grooves 31, 32 made in opposition in the two opposite walls 29, 30 of the two branches 12, 13, and in that the tab 21 consists of an oblong part, this part having (i) a length greater than the distance separating the two facing walls and at most equal to the distance separating the bottoms of the two opposite grooves, (ii) a thickness at most equal to the width of the second and third grooves, and (iii) a width less than the distance separating the two opposite walls.
• the means 20 for blocking the bar 50 in the inter-branch space 15 furthermore comprise an insert 78 capable of being inserted. between the lug 21 and the bar 50, and means 79 for mounting the insert 78 in rotation on the lug 21, for example by free crimping or clipping or the like.
• This embodiment makes it possible to guide the lug 21 when it is inserted into the interspaced space 15, by overlapping the bar 50 with this insert 78 as illustrated, and then, after having pivoted the lug 21 as described above. , to distribute all the efforts on the bar 50 and thus still better maintain it in the interbranch space 15.
• the means for moving the tab 20 with respect to the two branches 12, 13 in a plane substantially parallel to the longitudinal axis 51 are constituted, again with reference to FIGS. 4 which represent in fact two possible embodiments, by a fourth groove 32, which is the same as the third groove mentioned in the above description of the second embodiment, made in one second 13 of the two branches 12, 13, this fourth groove 32 opening into the inter-branch space 15, and a through-hole 34 formed in the other first branch 12 and opening into the inter-branch space 15 substantially facing the fourth groove 32.
• the tab 21 consists of a piece of oblong shape and has the following structural characteristics: (i) a length greater than the distance separating the two walls opposite the two branches 12, 13, and (ii) a thickness at most equal to the smallest width respectively of the fourth groove 32 and the through-hole 34. These characteristics allow the lug 21 to take its second position P2 in the following way: it is first introduced into the through-hole 34, then translated along the arrow Ft and inserted into the fourth groove 32, to come exercise the force pressure Fp on the bar 50 oriented towards the base 14 of the U, this force being produced essentially by elastic reaction of the material of the lug 21 on the two branches 12, 13 with which it cooperates during its translation Ft.
• the face 60 of the lug 21, by which this tab bears directly on a surface portion 62 of the bar 50 when it is in its second a position P2 and applies on the bar 50 a pressing force Fp oriented towards the base 14 of the U comprises a groove 61 having a shape substantially complementary to the surface portion 62 of bar 50, so that the groove 61 is adapted to marry this portion of surface 62, helping to maintain the bar 50 while adding an additional temporary locking of the tab in its second position P2.
• the osteosynthesis system comprises means 18 for coupling the second end 19 of the screw rod 16 with the base 14 of the head 11.
• These coupling means can be of different types. However, according to the needs of the practitioner to use the osteosynthesis system, they will preferably be chosen from one of the three following means: (i) fixing the second end 19 of the screw rod 16 on the base of the head 11, for example by welding, screwing, etc., (ii) one-piece production of the head 11 and the screw rod 16, (iii) male-female spherical interlocking between a spherical male part integral with the second end.
• This last means (iii) is diagrammatically illustrated in FIG. 2, partly in dashed lines, the lower circle being able to represent the section transverse bar 50, or represent the section of the spherical male defined above.
• This embodiment makes it possible to orient the head 11 with respect to the screw rod 16, in particular when the latter is already implanted in a bone medium.
• FIG. 6 it represents a variant of the embodiment of the osteosynthesis system according to FIGS. 1, 2 and 5.
• first branch 12 may in some cases be the second branch 13, and vice versa. It also shows that the tab 21 secured to a branch 12, 13 can plunge into the interspaced space 15 without reaching the other branch 13, 12. It also shows that the osteosynthesis system may comprise several bars 50 arranged in the space intersbranches 15, not superimposed as shown in Figure 2, on top of each other in a plane substantially parallel to the axis of the screw rod 16, but juxtaposed next to each other in a plane substantially perpendicular to this axis. In addition, this embodiment shows that the lug 21 can pass entirely on the bar 50 it must block, or press on it only by its end.

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• 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)
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• Surgical Instruments (AREA)

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• 2009
  • 2009-07-22 FR FR0903607A patent/FR2948276B1/fr active Active
• 2010
  • 2010-07-19 WO PCT/FR2010/000514 patent/WO2011010012A1/fr active Application Filing
  • 2010-07-19 US US13/386,101 patent/US20120116463A1/en not_active Abandoned
  • 2010-07-19 EP EP10747907A patent/EP2456375A1/de not_active Withdrawn

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