EP3232990A1 - Cages vertébrales et instruments d'insertion desdites cages vertébrales - Google Patents

Cages vertébrales et instruments d'insertion desdites cages vertébrales

Info

Publication number
EP3232990A1
EP3232990A1 EP15813035.1A EP15813035A EP3232990A1 EP 3232990 A1 EP3232990 A1 EP 3232990A1 EP 15813035 A EP15813035 A EP 15813035A EP 3232990 A1 EP3232990 A1 EP 3232990A1
Authority
EP
European Patent Office
Prior art keywords
end plate
implant according
spinal implant
angle
spine
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Withdrawn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
EP15813035.1A
Other languages
German (de)
English (en)
Inventor
Heinrich Wecker
Alfons Kelnberger
Mateusz Juszczyk
Rebecca Murray
Nikolas Willmann
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.)
Ceramtec GmbH
Original Assignee
Ceramtec 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 Ceramtec GmbH filed Critical Ceramtec GmbH
Publication of EP3232990A1 publication Critical patent/EP3232990A1/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Withdrawn legal-status Critical Current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
    • A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
    • A61F2/447—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section
    • 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
    • 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
    • A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/025—Joint distractors
    • A61B2017/0256—Joint distractors for the spine
    • 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
    • A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
    • 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
    • A61L27/02—Inorganic materials
    • A61L27/10—Ceramics or glasses

Definitions

  • a spine cage is a spinal implant that can be used as an intervertebral disc replacement to merge vertebral bodies.
  • Spine cages for fusion of vertebral bodies are known. They are adapted in geometry to the anatomy of the human vertebral body, are located between two vertebral bodies and replace the intervertebral disc completely or partially.
  • Known components for fusion of vertebral bodies are based on metallic materials such as e.g. Tantalum or titanium, on plastics such as e.g. highly cross-linked PE materials (polyethylene) or PEEK (polyether ether ketone) or on silicon nitride.
  • metallic materials such as e.g. Tantalum or titanium
  • plastics such as e.g. highly cross-linked PE materials (polyethylene) or PEEK (polyether ether ketone) or on silicon nitride.
  • the invention has for its object to improve a spinal implant according to the preamble of claim 1 so that in the implanted state no wear and no abrasion occurs and it grows better in the tissue.
  • the spinal implant consists of a ceramic material and carries at least in some areas a porous ceramic foam occurs in the implanted state no wear and no abrasion and it grows better in the tissue.
  • the engaging elements are preferably teeth, grooves or cutting.
  • At least one elongated hole is arranged on the anterior wall, which connects the inner and the outer side wall.
  • This slot serves as an insertion opening for a deployment instrument. It can be arranged on the anterior wall and two spaced slots.
  • the two elongated holes are preferably arranged at the same distance from the depth axis and in each case on one side thereof. The insertion with an insert instrument is thereby facilitated, or occurs no tilting on.
  • the two slots converge, i. that they are arranged at an acute angle to the depth axis. This allows the insertion instrument to grip the implant better.
  • the upper and lower end plates are parallel to each other or the upper and lower end plates are at an angle to the medial plane, and the end plates continuously fall from the anterior to the posterior wall, with respect to the median plane.
  • the implant is better adapted to the natural shape of the vertebral body.
  • the upper and lower end plates are arranged in one embodiment at an angle between 0 ° and 10 °, preferably 2 ° to 5 °, each with respect to the median plane.
  • the upper end plate extends at an angle to the median plane that is one-half the angle of the lower end plate to the median plane. This serves for better anchoring zwichen the vertebral bodies.
  • the upper end plate extends at an angle of 4 ° and the lower end plate at an angle of 2 ° to the median plane.
  • the implant is better adapted to the natural shape of the vertebral body.
  • the spinal implant is preferably substantially rectangular from the anterior wall to the width axis and bends from the width axis to the posterior Wall the two side walls at an angle between 60 ° and 70 ° from the width axis.
  • Indentations are preferably present on the spinal implant, which are filled with the ceramic foam and / or the ceramic foam is applied directly to the surfaces of the spinal implant. By the indentations a receiving space for the ceramic foam is created.
  • These indentations also serve as attachment points for the insertion instrument.
  • recessed dogs are arranged on the upper and lower end plates and are located between the recesses engaging elements, which are preferably cutting. As a result, both indentations and cutting are arranged. The blades are anchored in the first time after implantation until the implant is ingrown by the ceramic foam.
  • FIGS. 1 a and 1 b show a first embodiment of a spine cage 1 according to the invention.
  • This spine cage 1 is trapezoidal in shape with a flat upper end plate 2 and a flat lower end plate 3 connected by side walls 4.
  • the outer edge 5 of both end plates 2, 3 are adjacent to the end plates 2, 3 protruding teeth 6, which serve better anchoring with the human vertebral bodies.
  • These teeth 6 can also be arranged at other locations of the end plates 2, 3 and in a different number. Instead of the teeth 6, other structures, such. B. grooves or cutting can be used.
  • the side walls 4 divide into an anterior wall 4a, posterior wall 4b and two longitudinal walls 4c.
  • On the anterior wall 4a is centrally a slot 7. This slot 7 is provided for the engagement of an explant instrument, which will be described later.
  • the indentation 8 leads to the anterior wall 4a, so that this does not protrude from the indentation 8 during engagement of the insertion instrument.
  • FIG. 1 c shows the described spine cage 1 from above.
  • the depth axis 10 and the width axis 11 pass through the longitudinal axis 9.
  • From the anterior wall 4a to the width axis 11 of the spine cage 1 is formed substantially rectangular.
  • From the width axis 11 to the posterior wall 4b the two side walls 4c bend at an angle between 60 ° and 70 ° from the width axis 11.
  • From the width axis 11 to the posterior wall 4b are optional chamfers 12 at the edge of the end plates 2, 3.
  • the teeth are not shown in this and the following figure 1d.
  • Figure 4d shows schematically a longitudinal side 4c, without indentation.
  • the upper end plate 2 extends at an angle of 4 ° to the center plane 13 and the lower end plate 3 at an angle of 2 ° to the median plane 13. Possible angles between 0 ° and 10 °, preferably 2 ° to 5 °.
  • the end plates 2, 3 thus fall continuously from the anterior 4a to the posterior wall 4b, in each case based on the median plane 13.
  • the trapezoidal shape follows the anatomy (uncinate processes).
  • the total angle is divided asymmetrically (here 4 ° and 2 °), but can also be divided symmetrically (eg 3 ° and 3 °). This applies preferably to plane end plates 2, 3.
  • FIG. 2 shows a spine cage 1 according to the invention in a variant with a curved upper end plate 2, shown schematically. This is an adaptation to the natural curvature of the lower vertebral endplate.
  • 3a shows a section of a side wall 4.
  • a recess 14 is present, which is filled with a ceramic foam 15. This results in a porous surface which causes a better ingrowth of the bone.
  • the recess 14 and thus the ceramic foam 15 are preferably arranged circumferentially on the side walls 4.
  • 3b shows a section of a side wall 4. On this no indentation is present, but the ceramic foam 15 is applied directly to the planar surface. This also gives a porous surface, which causes a better ingrowth of the bone.
  • the ceramic foam 15 is preferably arranged circumferentially on the side walls 4.
  • FIG. 4 shows the spine cage 1 according to FIG. 1 and an associated insertion instrument 16.
  • the insertion instrument 16 has fork tines 17, which engage in the indentations 8 (see FIG. 1) or in the lateral grooves.
  • the forks are tensioned, thus creating a non-positive connection via the grooves or V-grooves (V-belt principle).
  • V-grooves V-belt principle
  • FIGS. 5a, 5b, 5c, 5d, 5d show another spinal column cage 1 according to the invention.
  • Figures 5a, 5b show the spine cage 1 in two views, Figure 5c in a front view, i.
  • FIG. 5e shows this spine cage 1 together with the matching insertion instrument 19.
  • the spine cage 1 has in contrast to the spine cage 1 of Figure 1 no lateral indentations 8 and no central slot 7. Otherwise, he is the spine cage 1 of Figure 1 to two oval slots 18 identical.
  • slots 18 are spaced apart in the anterior wall 4a.
  • An important feature is that the two slots 18 converge, i. they are arranged at an acute angle to the depth axis 10.
  • the depth axis 10 and the width axis 11 intersect the longitudinal axis 9.
  • FIG. 5e shows this spine cage 1 together with the gripper or a forceps-like insertion instrument 19.
  • the insertion instrument 19 has two Spreader arms 20 which engage in the slots 18 and then spread.
  • the two spreading arms 20 are adapted to the slots 18 and converge as well. This creates a positive connection.
  • the interface slot 18 and Sp Gillarm 20 is independent of the size of the spine Cages. 1
  • a disadvantage is the only small contact surface between the Spreizarmen 20 and the slot 18.
  • the spine cage 1 of Figure 5e is shown only schematically.
  • FIG. 6 shows another embodiment of the spine cage 1 according to the invention.
  • This spine cage 1 differs from the spine cages 1 already described by the shape of the elongated holes 18 and a recess arranged between the oblong holes.
  • the spine cage 1 has in contrast to the spine cage 1 of Figure 1 no lateral indentations 8 and no central slot 7. It is important in this embodiment is that the slots are V-shaped. This has the advantage that a larger contact surface for the insertion instrument is present and thus better power transmission is possible.
  • a recess 21 in the manner of an arrow can be provided between the oblong holes 18. The arrow or the recess 21 shows the direction of installation to the surgeon and at the same time serves as an engagement element for a slide-in instrument.
  • FIGS. 7 show another embodiment of a spinal cage 1 according to the invention.
  • FIG. 7a shows the spine cage 1 in a view. It is easy to see that this spine cage 1 has no lateral recesses 8 and no central slot 7. It is important in this embodiment is that the slots 18 are formed trapezoid (asymetsch). As a result, the wall facing the lower end plate 3 of the elongated hole 18 is longer, ie has an even larger contact surface for the tool. Through the recess 21 is an unambiguous orientation of the spine cage 1 am Instrument achieved. In addition, can not be used the wrong way around by the formation of the elongated hole 18 as a trapezoid the insertion instrument.
  • FIG. 7b shows the spine cage 1 from the side. It can be seen that the upper end plate 2 is curved. The lower end plate 3, however, is flat. As shown in FIG. 7b, teeth 6 are also arranged on the end plates 2, 3.
  • Figure 7c shows the spine cage 1 from the anterior side with the trapezoidal elongated holes 18 and the recess 21.
  • Figure 7d shows the upper end plate 2 with the teeth 6.
  • Figure 7e shows the spinal cage 1 from the posterior side.
  • FIG. 8 shows the spine cage 1 according to FIG. 1 together with an explant instrument 22.
  • This explant instrument 22 is provided with a hammer head 23 and is inserted into the elongated hole 7 or slots 18 and locked by turning through 90 °. Thereafter, the spine cage 1 can be pulled out easily.
  • Figure 8a shows the explant instrument 22 inserted in the spine cage 1 and not yet locked.
  • Figure 8b shows the explant instrument 22 inserted into the spine cage 1 and locked.
  • FIG. 9a shows a spinal cage 1 with a circumferential groove 24 introduced on the upper end plate 2.
  • This groove 24 can, as also described in FIG. 3, be filled with a ceramic foam (not shown in FIG. 9).
  • This filling would be as shown in FIG.
  • FIG. 9b shows the spine cage 1 from the anterior side with the oblong holes 18 and the recess 21, and
  • FIG. 9c shows the spine cage 1 from the posterior side.
  • FIGS. 10a, 10b and 10c show a spine cage 1 according to the invention.
  • This spine cage 1 is trapezoidal in shape with an upper one End plate 2 and a lower end plate 3, which are connected by side walls 4.
  • the outer edge 5 of both end plates 2, 3 are adjacent to the end plates 2, 3 protruding teeth 6, which serve better anchoring with the human vertebral bodies.
  • These teeth 6 can also be arranged at other locations of the end plates 2, 3 and in a different number. Instead of the teeth 6, other structures, such. B. grooves or cutting can be used.
  • FIG. 10a shows a view of the spine cage 1
  • FIG. 10b shows a view on one side 4
  • FIG. 10c shows a view from above of the upper end plate 2.
  • the surfaces between the teeth 6 are provided with grooves 26 which are filled with a ceramic foam can be (not shown in Fig. 10).
  • the side walls 4 are also provided with grooves 26 which can be filled with a ceramic foam (not shown in Fig. 10).

Landscapes

  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Vascular Medicine (AREA)
  • Transplantation (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Cardiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Neurology (AREA)
  • Prostheses (AREA)

Abstract

L'invention concerne un implant vertébral (1) comprenant une plaque d'extrémité supérieure (2) et une plaque d'extrémité inférieure (3), qui sont reliées par des parois latérales intérieures (50) et extérieures (4), les parois latérales extérieures (4) formant une paroi antérieure (4a), une paroi postérieure (4b) et deux parois longitudinales (4c), les parois latérales intérieures (50) enserrant un espace de logement et des éléments d'insertion (6) sont agencée sur la plaque d'extrémité supérieure (2) et sur la plaque d'extrémité inférieure (3) en faisant saillie de ces dernières. L'invention vise à ce que, une fois l'implant installé, aucune usure et aucune abrasion ne se produise et que l'implant vertébral (1) s'ancre d'une meilleure façon dans le tissu. À cet effet, selon l'invention, l'implant vertébral est constitué d'un matériau céramique et porte au moins par endroits une mousse céramique poreuse (15).
EP15813035.1A 2014-12-16 2015-12-16 Cages vertébrales et instruments d'insertion desdites cages vertébrales Withdrawn EP3232990A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102014226036 2014-12-16
PCT/EP2015/079918 WO2016096939A1 (fr) 2014-12-16 2015-12-16 Cages vertébrales et instruments d'insertion desdites cages vertébrales

Publications (1)

Publication Number Publication Date
EP3232990A1 true EP3232990A1 (fr) 2017-10-25

Family

ID=54884044

Family Applications (1)

Application Number Title Priority Date Filing Date
EP15813035.1A Withdrawn EP3232990A1 (fr) 2014-12-16 2015-12-16 Cages vertébrales et instruments d'insertion desdites cages vertébrales

Country Status (9)

Country Link
US (1) US20170367841A1 (fr)
EP (1) EP3232990A1 (fr)
JP (1) JP2017537746A (fr)
KR (1) KR20170096153A (fr)
CN (1) CN107205825A (fr)
BR (1) BR112017012730A2 (fr)
DE (1) DE102015225359A1 (fr)
RU (1) RU2017125255A (fr)
WO (1) WO2016096939A1 (fr)

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JP2017537746A (ja) 2017-12-21
CN107205825A (zh) 2017-09-26
US20170367841A1 (en) 2017-12-28
BR112017012730A2 (pt) 2018-01-02
WO2016096939A1 (fr) 2016-06-23
RU2017125255A (ru) 2019-01-18
DE102015225359A1 (de) 2016-06-16
KR20170096153A (ko) 2017-08-23

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