EP3073966A1 - Implant de remplacement de corps vertébral comprenant un engrenage à vis sans fin - Google Patents

Implant de remplacement de corps vertébral comprenant un engrenage à vis sans fin

Info

Publication number
EP3073966A1
EP3073966A1 EP14806229.2A EP14806229A EP3073966A1 EP 3073966 A1 EP3073966 A1 EP 3073966A1 EP 14806229 A EP14806229 A EP 14806229A EP 3073966 A1 EP3073966 A1 EP 3073966A1
Authority
EP
European Patent Office
Prior art keywords
implant
vertebral body
body replacement
worm
spreading device
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Withdrawn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
EP14806229.2A
Other languages
German (de)
English (en)
Inventor
Jochen Hutzel
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.)
Humantech Germany GmbH
Original Assignee
Humantech Germany GmbH
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Humantech Germany GmbH filed Critical Humantech Germany GmbH
Publication of EP3073966A1 publication Critical patent/EP3073966A1/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • 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
    • 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
    • A61F2002/30159—Concave polygonal shapes
    • A61F2002/30166—H-shaped or I-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
    • A61F2002/30224—Three-dimensional shapes cylindrical
    • 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
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30405—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by screwing complementary threads machined on the parts themselves
    • 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
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30518—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements with possibility of relative movement between the prosthetic parts
    • A61F2002/30523—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements with possibility of relative movement between the prosthetic parts by means of meshing gear teeth
    • A61F2002/30525—Worm gears
    • 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
    • A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
    • A61F2002/30556—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting thickness
    • 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
    • A61F2002/30579—Special structural features of bone or joint prostheses not otherwise provided for with mechanically expandable devices, e.g. fixation devices
    • 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
    • A61F2002/30836—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves knurled

Definitions

  • the invention relates to a vertebral body replacement implant for the partial or complete replacement of vertebral bodies.
  • Corresponding vertebral body replacement implants are in the cervical, thoracic and lumbar spine in tumors or fractures of the spine or in degenerative or inflammatory diseases for partial or
  • vertebral body replacement implants are known from the prior art. Usually, these include an upper implant part with an upper vertebral contact surface and a lower implant part with a lower part
  • Swirl bearing surface wherein the swirl bearing surfaces are usually designed to abut the vertebral bodies.
  • the vertebral body replacement implants are introduced from the front or side in a starting position. The affected
  • Vertebral body can be removed in advance. After introducing the
  • Vertebrate body replacement implant in the starting position this is spread. In this case, usually the implant parts are pressed apart.
  • the vertebral body replacement implant can be individually adapted in this way to the respective extent of the existing space. Finally, it is fixed. In addition, stabilization can be done from the rear using pedicle screws and / or from the front via plates.
  • Vertebra replacement implants with mechanical spreading known.
  • Pneumatic spreading devices go from US 2010/0063510 AI, the
  • Vertebral body replacement implant in which the spreading takes place by means of a spindle winch with a spindle rod and an axial ring.
  • the axial ring is toothed and can be driven via a relatively complex designed tool, which is attached laterally to the vertebral body replacement implant.
  • the object is achieved by a vertebral body replacement implant or
  • Intervertebral implant comprising:
  • a spreading device which is in operative connection with the implant parts in order to press the implant parts apart
  • the spreading device for applying the spreading force comprises a spindle thread on a spindle rod, which in a
  • An essential idea of the present invention is the use of a worm drive for the expanding mechanism. This will be a stepless Adjustability of the distances of the upper implant part to the lower
  • Implant part achieved.
  • the necessary force is relatively low, so that only a very small torque must be applied. Furthermore, the
  • Vertebrate body replacement implant can be spread apart, but also made smaller again. Additional mechanisms for blocking the
  • Vortex body replacement implant in an end position are unnecessary.
  • the spreading device comprises a spindle thread with a spindle rod which is held in a rotatably mounted internal thread.
  • This is a relatively simple and robust mechanism that can be combined in a simple manner with the worm gear according to the invention.
  • the use of a spindle drive in this form makes it possible to attach one or both implant parts to the spreading device in such a way that they are easily replaceable and / or mountable.
  • the surgeons themselves can assemble or replace the implant in order to optimally adapt the implant to the patient-specific conditions.
  • the simple assembly of the implant parts also allows efficient production of the vertebral body replacement implant.
  • implant parts eg. B. with symmetrical, asymmetrical, elongated, elliptical or substantially rectangular
  • the upper and / or the lower implant part can be detachably connected to the spreading device.
  • a corresponding connection can be made for example via a latching connection.
  • a corresponding connection can be made via a screw connection or from a combination of latching / screw connection.
  • the upper and / or implant part may include an internal thread into which an upper or lower end plate fixing screw may be preassembled.
  • the end plate fixing screw can be screwed into a corresponding thread on the spreading device. The screw allows the already mentioned simple assembly and disassembly.
  • the thread of the end plate fixing screw is freely rotatable in relation to the respective implant part, so that the implant part is freely alignable relative to the spreading device. In that sense
  • Patient-specific conditions are also taken into account in the alignment of the implant parts relative to the spreading device, with a safe
  • the screw element for example, an end plate fixing screw
  • the screw element may be configured according to the invention in a special form.
  • Screw member may have a head portion and an adjoining cylinder portion.
  • the screw element according to the invention thus has a substantially T-shape, wherein the transverse bar is formed by the head portion and the longitudinal beam through the cylinder portion.
  • the head portion preferably protrudes mutually clearly beyond the cylinder portion, the head diameter is greater than the cylinder diameter.
  • the difference between the cylinder diameter and the head diameter can amount to a few millimeters.
  • the head diameter is at least 3% larger than the cylinder diameter, so that a resilient connection between the respective implant part and the spreading device can be produced.
  • the cylinder portion may have an external thread for screwing the
  • Sp Rudvortechnische include.
  • the internal thread serves that the
  • Screw element is held on the implant part.
  • the cylinder portion may comprise a thread-free portion.
  • the thread-free portion may be provided such that the screw element can be rotated in the screwed state without threaded engagement in the internal thread of the respective implant part.
  • the unthreaded portion is in the upper region of the
  • Cylinder portion for example, near the head portion.
  • the unthreaded portion and consequent free rotation of the endplate fixation screw in the respective implant part can have the advantage that the internal thread of the implant part does not have to be aligned with the internal thread of the spreader, since the thread outlet of the internal thread of the implant part after the pre-assembly of the end plate fixing screw with the implant part does not pass directly into the thread of the internal thread of the spreading device.
  • the screw element can be preassembled in the implant part, so that the final assembly facilitates. Due to the
  • Screw element in the implant part further rotation of the screw member possible without causing damage to the internal thread of the respective implant part.
  • the upper and / or lower implant part may have notches or projections or indentations which produce a positive connection to the spreading device or to the element on which the respective implant part is mounted.
  • the detents can be arranged such that the respective implant part can be mounted rotationally fixed on the spreading device.
  • the detents are arranged to allow a plurality of mounting positions. For example, at least four mounting positions (eg 0, 90, 180, 270 degrees) can be offered. In a preferred embodiment, alignment is offered not only in 90 degree increments but also in 45, 40, 30, 20 or 15 degree increments.
  • the vertebral body replacement implant can be optimally adapted to patient-specific conditions. In particular, the implant parts could be optimally aligned.
  • the vertebral contact surfaces of the upper and lower implant part and / or the implant part itself have a substantially similar shape.
  • the vertebral body replacement implant according to the invention can also be used with slightly or strongly distinguishing upper and lower implant parts.
  • the top and / or bottom implant part in plan view have an elliptical, square or rectangular shape.
  • the swirl bearing surfaces may also be opposite the longitudinal axis of the
  • Vertebral body replacement implant be inclined.
  • one or both implant parts may have a wedge shape in side view.
  • the implant parts preferably protrude clearly beyond the spreading device at right angles on at least one side. at a substantially symmetrical supernatant may result in an I-shaped configuration of the implant.
  • the upper and / or the lower implant part may have a maximum diameter which is greater than a maximum diameter of the spreading device.
  • Size difference can be at least 5, 10, 15, 20, 30%.
  • implant systems can be manufactured and distributed with a spreading device and a plurality of differing implant parts.
  • the spreading device can be a guide, in particular a slide guide (for example, in a slot and / or by means of a pin), for
  • the guide can be used to prevent the rotation of one of the vortex contact surfaces when operating the worm gear. In this respect, no unnecessary rotational force is applied to the vertebral bodies.
  • the already described alignment of the implant parts can be done.
  • the position of the implant parts relative to one another and / or relative to the spreading device does not change in this case.
  • the spindle rod may have a substantially T-shaped configuration. The widening in the upper area makes it possible to provide an internal thread for fastening the upper implant part.
  • recesses may be provided for the already described detents, which are the rotationally fixed alignment of the upper implant part
  • a ring can be provided at the upper end of the spindle rod, which extends around a longitudinal axis of the spindle rod or a spindle rod shaft. On the inside of the ring that can be provided at the upper end of the spindle rod, which extends around a longitudinal axis of the spindle rod or a spindle rod shaft.
  • At least one vertebral contact surface may comprise a toothing for engagement in the respective vertebral body or any soft tissue that may still be present.
  • the spreading device thus consists of a spindle drive which is in operative connection with a worm wheel.
  • This worm gear serves as a mechanism for converting a rotational force into one
  • the worm can be used as a connection to this spindle drive.
  • the worm wheel can be used as a connection to this spindle drive.
  • the worm may comprise a tool holder.
  • this tool holder is aligned such that it from one side of the
  • the tool holder may comprise a multi-circular profile, for example for Torx bits.
  • polygonal profiles for example
  • the spreading device may comprise a housing for supporting the worm and / or the worm wheel.
  • the housing comprises a
  • Connecting device for receiving a fixing device may be a thread into which the fixing device is screwed.
  • the fixing device is simply a rod for holding the housing and thus for holding the
  • the fixing device can simultaneously comprise a tool for actuating the screw. In this case it is
  • connection device and the tool holder are arranged on the same side of the housing.
  • the housing can support the worm such that the longitudinal axis of the worm is perpendicular to the longitudinal axis of the spindle rod (spindle axis).
  • the spreading device can be designed such that the longitudinal axis of the worm runs parallel to a connection axis for the connection device.
  • the worm thread of the worm may have a pitch angle of less than 20 degrees. This low pitch angle provides a self-contained
  • the vertebral body replacement implant can at least partially from a
  • Metal alloy in particular made of a titanium alloy, be made.
  • Fig. 1 is a perspective view of a first
  • Vertebral body replacement implant with an upper and a lower implant part
  • Fig. 2 is an exploded perspective view of the
  • Vertebral body replacement implant according to FIG. 1;
  • FIG. 3 is an exploded side view of the vertebral body replacement implant of FIG. 1;
  • Fig. 4 is a side perspective view of the worm gear of the
  • Vertebral body replacement implant according to FIG. 1;
  • FIG. 5 shows a side view of the worm gear according to FIG. 4;
  • Fig. 6 is a schematic side view of the implant parts of a
  • Fig. 7 is a perspective view of a second one
  • Vertebral body replacement implant with a spreading device and an upper and a lower implant part;
  • FIG. 8 is a side view of the vertebral body replacement implant of FIG. 7;
  • Fig. 9 is a schematic section through the longitudinal axis of the
  • Vertebral body replacement implant according to Fig. 7;
  • FIG. 10 shows a schematic detailed view of the upper region of the section according to FIG. 9 after the pre-positioning of the implant part with preassembled end plate fixing screw;
  • Fig. 11 is a schematic plan view of the spreading device according to FIG.
  • Fig. 1 shows a perspective view of the vertebral body replacement implant 100.
  • This essentially consists of a spreading device 30 with a housing 31, an upper implant part 10 arranged on one side of the housing 31 and a lower implant part 20 arranged on the opposite side of the housing 31.
  • On the side facing away from the housing 31 sides of the upper implant part 10 and the lower implant member 20 are each vertebral contact surfaces 11 and 21. These have a toothing for better contact closure with the vertebral bodies.
  • the swirl bearing surfaces 11, 21 are in that shown in Fig. 1
  • Embodiment circular They have a diameter of 20 to 50 mm, preferably about 23.5 mm.
  • another surface configuration of the swirl bearing surfaces 11 can take place (for example kidney-shaped).
  • the upper swirl bearing surface 11 may differ from the lower swirl bearing surface 21.
  • the swirl bearing surfaces 11 can take place (for example kidney-shaped).
  • Whirling surfaces 11, 21 does not necessarily have a substantially planar
  • the connecting device has a thread for screwing in the fixing device, wherein the thread of the connecting device extends substantially parallel to a screw axis 49. Accordingly, the tool holder 44 is aligned so that the screwing tool can be introduced along the screw axis 49.
  • Figs. 2 and 3 show the individual components of
  • Vertebral body replacement implant 100 is Vertebral body replacement implant 100.
  • the upper implant part 10 is composed of the upper swirl bearing surface 11 of an upper end plate fixing screw 17 with external thread.
  • a spindle rod 50 of the spreading device 30 has an internal bore with a thread for
  • the spindle rod 50 is connected to the upper one by means of the upper end plate fixing screw 17
  • Whirling surface 11 bolted This compound is screwed rotationally fixed by the shape of the spindle rod with two lateral key surfaces and the corresponding counter-profile in the upper swirl bearing surface 11 when tightening the Endplatten- Fixierschraube 17.
  • the crossbar forms the upper swirl bearing surface 11 and the longitudinal beam forms the spindle rod 50.
  • the lower implant part 20 has an opening which is formed corresponding to a lower end plate fixing screw 27.
  • This lower Endplatten- fixing screw 27 is inserted from below into the lower implant part 20 and screwed with a located on the underside of the housing 31 thread.
  • a worm wheel 41 is supported on the lower end plate fixing screw 27 inside the housing 31.
  • the lower end plate fixing screw 27 has a diameter substantially equal to that of the worm wheel 41.
  • Securing pin 25, which are integrally arranged on the upper side of the lower implant part 20 and in corresponding
  • Openings of the housing 31, ensure that the housing 31 with respect to the lower implant member 20 can not be rotated.
  • the axis of rotation of the worm wheel 41 is located on the spindle axis 54th
  • this spindle axis 54 is arranged slightly offset relative to the centers of the swirl bearing surface 11, 21.
  • the worm 43 is arranged in the housing 31 such that its
  • Worm axis 49 is perpendicular to the spindle axis 54.
  • the worm 43 is screwed to a nut such that it is rotatably held in the housing 31. As illustrated more fully by means of FIGS. 4 and 5, the worm 43 engages in the assembled state of the vertebral body replacement implant 100 in the worm wheel 41 a.
  • the spindle rod 50 and the worm wheel 41 form a spindle drive for lifting the upper implant part 10 with an expanding force F (FIG. 6).
  • the worm wheel 41 is formed as a ring, and has on its inside a worm wheel internal thread 48 which is formed corresponding to a spindle thread 56 on the spindle rod 50.
  • the assembled state see Fig. 4 and 5
  • the housing 31 has a corresponding guide.
  • the spindle rod 50 protrudes through a slot 33 ( Figure 2) corresponding to a two key surfaces
  • the rotation of the worm wheel 41 is initiated by the worm 43, the worm threads 47 in Schneckenradzähne 42 on the outside of the
  • Worm wheel 41 matures. Worm wheel 41 and worm 43 form
  • the upper implant part 10 raises or lowers relative to the housing 31 and lower implant part 20.
  • the vertebral body replacement implant 100 according to the invention form such that the upper implant part 10 and the lower implant member 20 simultaneously or separately raise and lower each other relative to the housing 31. Furthermore, it is possible to design the vertebral body replacement implant 100 in such a way that the lower implant part 20 is lowered or raised relative to the housing 31 and the upper implant part 10.
  • a rotation of the spindle rod 50 about the spindle axis 54 by the configuration of the spindle rod 50 and the slot 33 is avoided.
  • a pin guide or other positive guidance may be provided instead of this guide. It would also be possible to provide a guide rod or a guide pin on the upper implant part 10, which engages in the housing 31.
  • FIGS. 7-11 show a further embodiment of the inventive vertebrate body replacement implant 100 or vertebral body replacement implant.
  • the embodiment explained below is significantly longer than the
  • Embodiment of FIG. 1 It allows, as a substitute for several
  • Vertebral body to be used.
  • Vertebral body In the upper area of the
  • the lower part extends the vertebral body replacement implant 100 only so that it can be used as a replacement for multiple vertebral bodies.
  • the features shown below can be combined in any way with the embodiment of FIG. 1.
  • the described embodiment of the vertebral body replacement implant 100 can be used in shorter implants (cf., Fig. 1).
  • the vertebral body replacement implant 100 according to FIG. 7, as well as that shown in FIG. 1, an upper and lower implant part 10, 20, which are connected to the spreading device 30.
  • a tool holder 44 For spreading the vertebral body replacement implant 100 can a tool holder 44 a corresponding tool are mounted, which drives the worm gear 40.
  • the housing 31, in particular the lower cylindrical part, has elongated holes, which make it possible to
  • the upper and lower implant part 10, 20 is arranged centrally on the housing 31.
  • the implant parts 10, 20 have a substantially elliptical shape and clearly project beyond the housing 31 in the arranged state. In a side view results depending on the width of the implant parts used I to double T-shaped silhouette, the two transom through the
  • Implant parts 10, 20 are formed.
  • a maximum diameter dMax20 (FIG. 7) of the implant part 20, possibly also of the implant part 30, is significantly larger, for example twice as large, than a maximum diameter dMax30 of FIG
  • the housing 31 of the spreading device 30 is a substantially cylindrical sleeve, inside which the T-shaped spindle rod 50 is mounted.
  • the actual mechanism of the spreading device 30 is in the upper region of the housing 31.
  • the upper implant part 10 is connected via an upper end plate fixing screw 17 with a spindle rod end 51
  • the lower implant part 20 is screwed in a corresponding manner by means of a lower end plate fixing screw 27.
  • the upper end plate fixing screw 17 and the lower end plate fixing screw 27 are structurally identical or very similar and will be explained in more detail below.
  • the spreading device 30 of the embodiment according to FIGS. 7-11 in addition to the slotted guide on the slot 33 and a pin guide.
  • a pin 1 In order to prevent rotation of the spindle rod 50 when turning it in and out about its own axis, there is a bore in the housing 31, in which a pin 1 is located. This pin 1 engages in a Spindelstangennut 57 of the spindle rod 50 a.
  • the Spindelstangennut 57 extends in the longitudinal direction the spindle rod 50 and is formed corresponding to the pin 1, so that a rotation is effectively prevented.
  • connection between the upper implant part 10 and the spindle rod 50 will be explained below with reference to FIGS. 10 and 11.
  • the connection between the lower implant part 20 and the housing 31 is in
  • Fig. 10 shows the upper part of the spreading device 30 in a longitudinal section.
  • the spindle rod end 51 of the spindle rod 50 out.
  • the spindle rod head 51 has a diameter which is significantly larger than the diameter of the adjoining spindle shaft 55. It is composed of a disc with an annular shoulder. On the inside of the annular shoulder, an internal thread is provided into which a fixing screw external thread 19 (see Fig. 10) engages.
  • Implant parts 10, 20 a pre-positioning on the spindle rod end 51st
  • Fig. 11 shows the upper part of the spindle rod head 51 in plan view.
  • the outside of the annular shoulder of the spindle rod head 51 is provided with circularly arranged detents 52, 52 or protrusions or indentations.
  • FIG. 10 shows a schematic detail view of the upper region of the section according to FIG. 9 after the pre-positioning of the upper implant part 10 with preassembled end plate fixing screw 17 on the spindle rod end 51.
  • the contour of the upper implant part 10 is divided into four sections:
  • the upper implant part 10 is secured axially with the spindle rod head 51 by screwing in the end plate fixing screw 17.
  • Implant part 10,20 to the spreading device 30 are subsequently fixed by screwing in the end plate fixing screw 17.
  • the lower implant part 20 and the lower end of the housing 31 is formed in a corresponding manner.
  • Embodiment 1 Embodiment 1
  • Vertebral body replacement implant comprising:
  • the operative connection is in order to press the implant parts (10, 20) apart, as shown in FIG.
  • Worm gear (40) with a worm (43) and a worm wheel (41) includes.
  • Embodiment 2 is a diagrammatic representation of Embodiment 1:
  • Vertebral body replacement implant according to embodiment 1,
  • Embodiment 3 is a diagrammatic representation of Embodiment 3
  • Vortex body replacement implant according to one of the preceding embodiments, d a d u r c h e c e n e c h e n e that t
  • the spreading device (40) comprises a guide, in particular a slot (33), for rotationally fixed guidance of the / a spindle rod (50) in the axial direction along a spindle longitudinal axis (54).
  • Embodiment 4 is a diagrammatic representation of Embodiment 4:
  • Vortex body replacement implant according to one of the preceding embodiments, d a d u r c h e c e n e c h e n e that t
  • the worm wheel (41) comprises an internal thread (48) for engaging the spindle rod (50) and a worm gear toothing (42) on the outside of the worm wheel (41) for engaging the worm (43) of the worm gear (40) ,
  • Embodiment 5 is a diagrammatic representation of Embodiment 5:
  • Vortex body replacement implant according to one of the preceding embodiments, d a d u r c h e c e n e c h e n e that t
  • the worm (43) comprises a tool holder (44).
  • Embodiment 6 is a diagrammatic representation of Embodiment 6
  • Vortex body replacement implant according to one of the preceding embodiments, d a d u r c h e c e n e c h e n e that t
  • the tool holder (44) comprises a multi-circular profile.
  • Embodiment 7 is a diagrammatic representation of Embodiment 7:
  • Vertebral body replacement implant according to one of the preceding embodiments, characterized in that the spreading device (30) comprises a housing (31) for supporting the worm (43) and / or the worm wheel (41).
  • Embodiment 8 is a diagrammatic representation of Embodiment 8
  • Vortex body replacement implant according to one of the preceding embodiments, d a d u r c h e c e n e c h e n e that t
  • the housing (31) comprises a connection device for receiving a fixing device.
  • Embodiment 9 is a diagrammatic representation of Embodiment 9:
  • Vortex body replacement implant according to one of the preceding embodiments, d a d u r c h e c e n e c h e n e that t
  • the housing (31) supports the worm (43) in such a way that the longitudinal axis (49) of the worm (49) runs perpendicular to the / a spindle longitudinal axis (54).
  • Embodiment 10 is a diagrammatic representation of Embodiment 10:
  • Vortex body replacement implant according to one of the preceding embodiments, d a d u r c h e c e n e c h e n e that t
  • one / the worm thread (47) has a pitch angle of less than 20 degrees.
  • Embodiment 11 is a diagrammatic representation of Embodiment 11:
  • the vertebral body replacement implant is at least partially made of a metal alloy, in particular of a titanium alloy.

Abstract

L'invention concerne un implant de remplacement de corps vertébral, comprenant : - une partie d'implant supérieure (10) comprenant une surface supérieure d'appui de vertèbre (11) ; - une partie d'implant inférieure (20) comprenant une surface inférieure d'appui de vertèbre (21) ; et - un dispositif d'écartement (30), qui est en liaison fonctionnelle avec les parties d'implant (10, 20) pour écarter les parties d'implant (10, 20) l'une de l'autre. Le dispositif d'écartement (30) comprend un engrenage à vis sans fin (40) doté d'une vis sans fin (43) et d'une roue tangente (41) pour appliquer une force d'écartement (F). Le dispositif d'écartement (30) comprend un filet d'axe (56) sur une tige d'axe (50) pour appliquer la force d'écartement (F). La tige d'axe est maintenue dans un filet intérieur (48) de la roue tangente (41) monté rotatif.
EP14806229.2A 2013-11-28 2014-11-28 Implant de remplacement de corps vertébral comprenant un engrenage à vis sans fin Withdrawn EP3073966A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102013113168.9A DE102013113168A1 (de) 2013-11-28 2013-11-28 Wirbelkörperersatzimplantat mit Schneckengetriebe
PCT/EP2014/075905 WO2015079011A1 (fr) 2013-11-28 2014-11-28 Implant de remplacement de corps vertébral comprenant un engrenage à vis sans fin

Publications (1)

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EP3073966A1 true EP3073966A1 (fr) 2016-10-05

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DE (1) DE102013113168A1 (fr)
WO (1) WO2015079011A1 (fr)

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FR3012030B1 (fr) 2013-10-18 2015-12-25 Medicrea International Procede permettant de realiser la courbure ideale d'une tige d'un materiel d'osteosynthese vertebrale destinee a etayer la colonne vertebrale d'un patient
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WO2015079011A1 (fr) 2015-06-04

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