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
  • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
  • A61B17/8875—Screwdrivers, spanners or wrenches
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
  • A61B17/17—Guides or aligning means for drills, mills, pins or wires
  • A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
  • A61B17/1757—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the spine
• • 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
  • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
  • A61B17/8866—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices for gripping or pushing bones, e.g. approximators
• • 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
  • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
  • A61B17/8897—Guide wires or guide pins
• • 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
  • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
  • A61B17/90—Guides therefor

Definitions

• the invention relates to the field of spinal surgery and in particular that of the implantation of pedicular screw systems posteriorly.
• the invention relates more particularly to a device for locating an entry point of a pedicle of a vertebra for the purposes in particular of the implantation of a pedicle screw through the pedicle.
• the location device is intended primarily to locate the point of entry of a pedicle of a lumbar vertebra.
• the instrument comprises a locating unit connected to a gripping portion by a rod body.
• the locating unit comprises a recessed portion adapted to house the lower portion of the associated blade of the pedicle to be perforated, a locating fork adapted to engage the pedicle to be perforated and a conduit adapted to receive the drilling device.
• the conduit is arranged with respect to the locating fork so as to have a center positioned on a line extending from the center of the locating fork.
• the configuration of the locating unit and the arrangement of the elements that make it necessary to "clean" the vertebra around the pedicle to perforate in order to access the pedicle therefore requires a relatively invasive surgical procedure.
• the implementation of the instrument requires removal of a portion of vertebra to allow the placement of the rental unit at the pedicle.
• the instrument of the aforementioned application can not be implemented on lumbar vertebrae, access to the pedicle being prevented by the presence of blade which extends in a substantially vertical plane.
• the invention aims to remedy these problems by providing a locating device for quickly and accurately locate the entry point of a pedicle to be perforated for the purpose of placing a pedicle screw and guide an instrument of perforation according to an optimal trajectory avoiding any deterioration of the surrounding structures of the pedicle
• the invention also aims to provide a localization device that can be used directly on a lumbar vertebra without prior preparation of the latter or, when the patient's anatomy requires, with minimal preparation.
• preparation of the vertebra is meant in particular the removal of parts of the vertebra whose pedicle should be located to receive the pedicle screw.
• the invention also aims to provide a non-invasive rental device and easy implementation for the operator and without risk to the patient.
• the invention relates to a device for locating a point. for input of a pedicle of a vertebra for use with an instrument for perforating the pedicle, the locating device comprising an aiming body, of elongated shape, having two end openings interconnected by a guide channel defining a longitudinal guide axis of the perforating instrument, said aiming body being extended at one of its ends by an overlapping fork of the transverse process carried by the pedicle to be perforated, the overlapping fork comprising two extensions delimiting a receiving zone of the transverse process carried by the pedicle to be perforated, said zone having a first contact surface intended to come into contact with an area at the junction of the transverse process and the articular apophysis associated with the pedicle to be perforated, located offset from the guide axis.
• the point of entry of the pedicle to be perforated at the end of the placement of a pedicle screw is located quickly and precisely: it is sufficient to place the overlap fork on the transverse process, the contact surface abutting at the junction of the transverse process and the pedicle.
• the device for locating an entry point is such that the guide channel is placed in an optimal trajectory to aim and reach the pedicle by a perforation instrument avoiding any deterioration of the surrounding structures of the latter. this.
• the perforation instrument can then be introduced into the canal and slid to reach and perforated the pedicle at a given point.
• the overlapping fork comprises a portion connecting the aiming body and the extensions arranged to define a second contact surface adapted to come into contact with the articular process when the first contact surface is in contact with the area. of the junction of the transverse process and of the articular apophysis.
• the extensions are arranged at a distance from one another to allow a sliding of the overlap fork along the apophysis to the junction between the transverse process and the pedicle to be marked.
• the guide axis of the guide channel is parallel to the axis longitudinal viewpoint.
• the receiving region of the transverse process extends in a plane parallel to the guide axis of the guide channel.
• the receiving region of the transverse process has a U-shaped whose base is the first contact surface.
• the aiming body comprises, at the end opposite the end bearing the fork overlap, an arm extending along a longitudinal axis intersecting the guide axis.
• the longitudinal axis of the arm, the guide axis of the guide channel and the longitudinal axis of the aiming body are coplanar.
• the longitudinal axis of the arm has an angular spacing with the guide axis between 90 degrees and 150 degrees.
• the arm is arranged to allow the connection of a removable handle to the target body.
• the arm constitutes a handle of the aiming body.
• the aiming body and the overlapping fork are formed in one piece.
• the sighting device is for single use. BRIEF DESCRIPTION OF THE FIGURES
• FIG. 1 represents a schematic perspective view of a device for locating an entry point according to the invention
• FIG. 2 represents a view in longitudinal section of the device for locating the Figure 1 along axis II-II;
• FIG. 3 represents a side view of the locating device of FIG. 1;
• FIG. 4 shows a view of the locating device of Figure 1 in position on a vertebra and a perforation instrument.
• a locating device 1 of an entry point of a pedicle of a vertebra said device being intended to be implemented with a perforation instrument of the pedicle.
• the locating device 1 comprises a viewing body 2, an overlap fork 3 of a transverse process associated with the pedicle of the vertebra to be perforated and an arm 4 for grasping the locating device 1.
• the sight body 2 is traversed over its entire length by a channel 5.
• the channel defines a longitudinal guide axis AA of the perforation instrument. 5 will be discussed later as guide channel 5.
• guide channel 5 has a certain length has the advantage of preventing any deviation of the perforation instrument during the operation guidance.
• the guide channel 5 is provided in the aiming body 2 so as to define a guide axis AA parallel to the longitudinal axis CC of the aiming body 2.
• the channel 5 is arranged to have a guide axis AA offset from the longitudinal axis CC of the sight body 2 in a radial direction opposite the arm 4 ( Figure 2). It can of course be provided a guide channel having a guide axis coaxial with the longitudinal axis of the body of view without departing from the scope of the invention.
• the aiming body 2 is extended at one of its ends 21 by the overlap fork 3.
• the overlap fork 3 extends in a direction parallel to the guide axis. AA. It also presents a nominal width greater than the diameter of the sight body 2. It is of course obvious that the locating device 1 may be provided with an overlap fork 3 having a different profile without departing from the scope of the invention.
• the overlap fork 3 is formed of two lateral extensions 30, 31 delimiting a receiving zone 6 of the transverse process carried by the pedicle to be perforated.
• the extensions 30, 31 are arranged at a distance from one another so that the locating device 1 can be easily placed on the transverse process and slid along the latter to reach the level of a gutter located at the junction of the transverse process and the upper articular process, while providing a small clearance between the locating device 1 and the transverse process.
• the overlap fork 3 further has a first contact surface 32 intended to come into contact with the bottom of the gutter.
• the internal contact surface 32 defines the bottom of the receiving zone 6 of the transverse process.
• the first contact surface 32 is arranged to have a shape substantially complementary to that of the transverse apophysis.
• the overlap fork 3 is arranged so that the internal contact surface 32 is located at a determined distance from the guide axis AA, i.e. not aligned therewith. As will be understood below, the distance between the guide axis AA and the internal contact surface 32 is determined so that, when the positioning device 1 is in position on the transverse process, the internal surface of the contact 32 being in abutment on the bottom of the gutter, the perforation instrument inserted into the guide channel 5 is placed in a position ensuring the aim of an entry point of the pedicle.
• the overlap fork 3 comprises a portion connecting the aiming body 2 and the extensions 30, 31 arranged to define a second contact surface 33 adapted to come into contact with a face of the upper articular process (subsequently called the articular facet) when the first contact surface 32 is in contact with the bottom of the the gutter.
• the outer contact surface 33 of substantially flat shape, is located between the internal contact surface 32 and the outlet opening 21 of the guide channel 5.
• the aiming body 2 further comprises, at the end opposite the end bearing the overlap fork 3, an arm 4, of axis BB intersecting the guide axis AA, said arm allowing the gripping the locating device 1.
• the gripping of the locating device 1 is performed by means of a removable handle (not shown) adapted to be mounted on said arm 4.
• the arm 4 constitutes a connection arm of a gripping means to the aiming body 2.
• the arm 4 advantageously comprises longitudinal assembly ribs 40.
• the arm 4 is arranged so that its axis, the guide axis AA and the longitudinal axis of the target body 2 are coplanar.
• the arm 4 has an angular spacing with the aiming body 2, and therefore with the guide channel 5, between 90 degrees and 150 degrees. This thus facilitates the manipulation of the locating device 1 to place the gripping fork 3 adequately on the transverse process.
• the angular spacing is of the order of 120 degrees. This inclination of the arm 4 relative to the sighting body 2 makes it possible naturally to give good positioning to the guide channel 5 with respect to the transverse process so as to guarantee the aim of the pedicle.
• the arm 4 and the overlap fork 3 are formed in one piece with the sighting body 2. It is of course obvious that the invention is not limited to such a configuration, and that may be provided a locating device 1 whose arm 4 and / or the overlap fork 3 are separate parts, able to be removably attached to the sighting body 2.
• the location device 1 is for single use.
• it is advantageously made of polymer.
• in the arm 4 is configured in the illustrated embodiment to ensure the attachment of a handle on the locating device 1. It can also be provided, according to an alternative embodiment that the arm
• the arm 4 is configured to form directly a handle of the sight body 2. It may be then expected that the arm 4 is removably mounted on the body. The arrangement of such an arm 4 will then be similar to the latter of the connecting arm described above.
• the locating device does not include arms, the locating device then being held.
• Figure 4 shows the locating device 1 in position on one of the transverse processes 110 of a vertebra 100.
• the establishment of the locating device on the vertebra 100 is performed as follows.
• the locating device 1 is first placed on the transverse process 110, the overlap fork 3 overlapping the latter. The locating device 1 is then slid along the transverse process 110 in the direction of the trough 111 situated at the junction between the transverse process 110 and the upper articular process 112 associated with the pedicle 115 to be perforated, until it reaches said gutter 111. Once the first contact surface 32 of the overlap fork 3 comes into contact with the bottom of the gutter 111, the locating device 1 is tilted so as to place the second contact surface 33 in abutment with the The locating device 1 is then in position to allow an adequate location of the entry point 114 of the pedicle 115.
• the perforation instrument 7 is then inserted into the guide channel 5 and slid from the inlet opening 20 of said guide channel 5 to the outlet opening 21 of the latter. The displacement of the perforation instrument 7 in the guide channel
• the entry point 114 of the pedicle 115 is automatically reached by the perforation instrument 7 from the offset position of the overlap fork 3 with the channel 5, and more particularly the offset between the bottom of the reception space 6 constituting the first contact surface and the guide axis of the guide channel 5.

Landscapes

• Health & Medical Sciences (AREA)
• Surgery (AREA)
• Orthopedic Medicine & Surgery (AREA)
• Life Sciences & Earth Sciences (AREA)
• Biomedical Technology (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Engineering & Computer Science (AREA)
• Heart & Thoracic Surgery (AREA)
• Medical Informatics (AREA)
• Molecular Biology (AREA)
• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Veterinary Medicine (AREA)
• Oral & Maxillofacial Surgery (AREA)
• Dentistry (AREA)
• Surgical Instruments (AREA)

Applications Claiming Priority (2)

Publications (1)

Family

ID=50290126

Family Applications (1)

Country Status (4)

Families Citing this family (3)

Family Cites Families (17)

• 2014
  • 2014-01-10 FR FR1450164A patent/FR3016280B1/fr not_active Expired - Fee Related
• 2015
  • 2015-01-09 WO PCT/FR2015/050045 patent/WO2015104507A1/fr active Application Filing
  • 2015-01-09 US US15/110,490 patent/US20160324561A1/en not_active Abandoned
  • 2015-01-09 EP EP15702545.3A patent/EP3091913A1/de not_active Withdrawn

Non-Patent Citations (2)

Also Published As

Similar Documents

Legal Events