EP3265032A1 - Cages intervertébrales et leurs applications - Google Patents
Cages intervertébrales et leurs applicationsInfo
- Publication number
- EP3265032A1 EP3265032A1 EP16709313.7A EP16709313A EP3265032A1 EP 3265032 A1 EP3265032 A1 EP 3265032A1 EP 16709313 A EP16709313 A EP 16709313A EP 3265032 A1 EP3265032 A1 EP 3265032A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- annular
- piece
- cage
- faces
- sides
- 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- Withdrawn
Links
- 238000003780 insertion Methods 0.000 claims abstract description 8
- 230000037431 insertion Effects 0.000 claims abstract description 8
- 230000000903 blocking effect Effects 0.000 claims abstract description 7
- 238000006073 displacement reaction Methods 0.000 claims abstract description 6
- 208000007623 Lordosis Diseases 0.000 description 19
- 210000000988 bone and bone Anatomy 0.000 description 15
- 238000000034 method Methods 0.000 description 9
- 230000004927 fusion Effects 0.000 description 8
- 230000002427 irreversible effect Effects 0.000 description 7
- 238000005516 engineering process Methods 0.000 description 5
- RTAQQCXQSZGOHL-UHFFFAOYSA-N Titanium Chemical compound [Ti] RTAQQCXQSZGOHL-UHFFFAOYSA-N 0.000 description 3
- 230000007850 degeneration Effects 0.000 description 3
- 239000007943 implant Substances 0.000 description 3
- 239000010936 titanium Substances 0.000 description 3
- 229910052719 titanium Inorganic materials 0.000 description 3
- 201000010099 disease Diseases 0.000 description 2
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 2
- 229910052588 hydroxylapatite Inorganic materials 0.000 description 2
- 208000014674 injury Diseases 0.000 description 2
- 238000012423 maintenance Methods 0.000 description 2
- 238000004519 manufacturing process Methods 0.000 description 2
- 239000000463 material Substances 0.000 description 2
- XYJRXVWERLGGKC-UHFFFAOYSA-D pentacalcium;hydroxide;triphosphate Chemical compound [OH-].[Ca+2].[Ca+2].[Ca+2].[Ca+2].[Ca+2].[O-]P([O-])([O-])=O.[O-]P([O-])([O-])=O.[O-]P([O-])([O-])=O XYJRXVWERLGGKC-UHFFFAOYSA-D 0.000 description 2
- 239000011148 porous material Substances 0.000 description 2
- 238000013519 translation Methods 0.000 description 2
- 230000008733 trauma Effects 0.000 description 2
- 229910000531 Co alloy Inorganic materials 0.000 description 1
- 241000282412 Homo Species 0.000 description 1
- 229910001069 Ti alloy Inorganic materials 0.000 description 1
- 210000001015 abdomen Anatomy 0.000 description 1
- 238000013459 approach Methods 0.000 description 1
- 239000000560 biocompatible material Substances 0.000 description 1
- 210000000845 cartilage Anatomy 0.000 description 1
- IUWCPXJTIPQGTE-UHFFFAOYSA-N chromium cobalt Chemical compound [Cr].[Co].[Co].[Co] IUWCPXJTIPQGTE-UHFFFAOYSA-N 0.000 description 1
- 238000013016 damping Methods 0.000 description 1
- 238000013461 design Methods 0.000 description 1
- 230000007257 malfunction Effects 0.000 description 1
- 210000005036 nerve Anatomy 0.000 description 1
- 230000007170 pathology Effects 0.000 description 1
- 230000002441 reversible effect Effects 0.000 description 1
- 230000035939 shock Effects 0.000 description 1
- 238000005245 sintering Methods 0.000 description 1
- 239000010935 stainless steel Substances 0.000 description 1
- 229910001220 stainless steel Inorganic materials 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 229910052715 tantalum Inorganic materials 0.000 description 1
- GUVRBAGPIYLISA-UHFFFAOYSA-N tantalum atom Chemical compound [Ta] GUVRBAGPIYLISA-UHFFFAOYSA-N 0.000 description 1
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
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- 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
- 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
- A61F2/4405—Joints for the spine, e.g. vertebrae, spinal discs for apophyseal or facet joints, i.e. between adjacent spinous or transverse processes
-
- 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
- A61F2002/30235—Three-dimensional shapes cylindrical tubular, e.g. sleeves
-
- 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
- A61F2002/30383—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
- A61F2002/3039—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove with possibility of relative movement of the rib within the groove
- A61F2002/30398—Sliding
- A61F2002/304—Sliding with additional means for limiting said sliding
-
- 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
- A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
- A61F2002/30487—Circumferential cooperating grooves and beads on cooperating lateral surfaces of a mainly longitudinal connection
-
- 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
- A61F2002/30538—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation
-
- 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
- A61F2002/30593—Special structural features of bone or joint prostheses not otherwise provided for hollow
-
- 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
- A61F2002/30601—Special structural features of bone or joint prostheses not otherwise provided for telescopic
Definitions
- the present invention relates to intervertebral cages, also called intersomatic cages, and their applications.
- intervertebral discs In humans, the degeneration of the intervertebral disc tends to reduce the intradiscal space and to narrow the foramens through which the nerve roots leave the spinal canal. As a reminder, the intervertebral discs are located in the spine between two consecutive vertebrae.
- An intervertebral disc includes a cartilage ring with a gelatinous core at its center. The intervertebral discs are elastic and thus contribute to the damping of the shocks suffered by a spine.
- the surgical treatment of this type of pathology of the spine may require the fusion of one or more vertebral segments in the best possible anatomical position.
- the technique requires to revitalize the vertebral endplates and to use a bone graft to promote fusion of the vertebrae.
- intersomatic cages are implanted between the vertebrae, bone graft can be installed in the cage and sometimes around in order to achieve the fusion.
- the intersomatic cages are generally conceived as a box having two lights, one on the lower face and one on the posterior face, the lateral faces being able also to be perforated. Sometimes these cages are not hollow but full, in this case no graft will be placed inside.
- "height" of a cage means the dimension measured in the direction corresponding to the thickness (or height) of an intervertebral disc.
- lordosantes expansive cages and cages called "lordosantes" have been found on the market.
- Latis® or Caliber® cages from Globus for expanding cages.
- Varlock® cages from the Kisco company for lording cages.
- the applicant has designed intervertebral cages giving complete satisfaction with the aforementioned criteria.
- annular internal male piece having two small sides and two long sides and thus four outer faces and four inner faces, an upper surface and a lower surface, and
- an outer annular female piece having two short sides and two long sides and therefore four outer faces and four inner faces, an upper surface and a lower surface
- annular inner male piece fitting and preferably wedging in the annular outer female piece, each of these two pieces having a generally parallelepipedal shape and therefore a longitudinal axis, the male piece annular inner member being slidable with respect to the annular outer female piece and comprising a device for blocking a longitudinal displacement of the annular inner male piece with respect to the annular outer female piece,
- the intervertebral cage being provided with a device for adjusting the height of the cage acting individually on one end and the other end of the longitudinal axis of the annular inner male piece,
- annular inner male piece and a corresponding small side of the annular outer female piece each being provided with a slot for insertion of a setting tool passing through the annular outer female piece for actuating the annular inner male piece
- one or more sides, preferably one side, of the annular outer female piece is provided with a light to enable the annular inner male piece to be moved in order to increase the height. of the cage and change the angle between the outer surfaces.
- the light is preferably provided in a small side of the annular outer female piece.
- the annular inner male piece is also provided on one or more sides, preferably only one side, of a light that can also be used for this purpose.
- a suitable tool is for example a screwdriver or a key acting directly or indirectly on the annular inner male piece, for example (indirect action) on a device for adjusting the height of the cage comprising two elongated rotary shafts with concentric axes, each shaft having a segment cam flattened and rotatable independently of the other.
- a device for adjusting the height of the cage comprising two elongated rotary shafts with concentric axes, each shaft having a segment cam flattened and rotatable independently of the other.
- the cages In horizontal section, if one considers the cages installed in the intervertebral space of an individual in standing position, the cages have a generally rectangular shape. They also have an upper surface and a lower surface. The upper surface of one and the lower surface of the other forming outer surfaces determine the height of the cage.
- the inner male annular piece is provided to fit into the outer annular female piece.
- the annular inner male piece is slidable with respect to the annular outer female piece and comprises a device for blocking the longitudinal displacement of the annular inner male piece vis-à-vis the annular outer female piece.
- a device for blocking the longitudinal displacement of the annular inner male piece vis-à-vis the annular outer female piece for example the outer face of the short sides of the inner male piece is curved and bears on the inner side of the short sides of the annular outer female piece. As the short sides of the inner male piece are bulged, the inner male piece can be moved in pitching movements.
- This curved shape can come from a dome shape, for example hemispherical, said small sides. It can also come from a semi-cylindrical surface, that is to say a semi-round gutter shape (like a classic gutter of a house). In the latter case, the gutter is installed horizontally.
- the inner surfaces of the short sides of the annular outer female piece 2 are planar faces as shown in Figure 6 below.
- the inner surface of the short sides of the piece external female has a form of half-round gutters installed vertically as shown in Figures 1 to 5.
- the intervertebral cage is provided with a device for adjusting the height of the cage acting individually on one end and the other end of the longitudinal axis of the annular inner male piece.
- This device can take various forms.
- a system of the invention comprises a device comprising two elongate rotating shafts with concentric and independent axes, each shaft comprising a segment cam flattened and can be rotated independently of the other.
- the flattened segments of the cam are progressively more and more distant from the axis. Blocking occurs each time a flattened segment bears against the annular inner male piece.
- the flats serve both to adjust the height and to maintain the cage in the desired position by choosing a front and rear flat.
- the height of the cage can be increased equally along the longitudinal axis.
- the cam acts By turning one of the two, we only increase the height of the side along the longitudinal axis where the cam acts and we can thus obtain a lordosis.
- the outer faces of the long sides of the annular internal male piece or the internal faces of the long sides of the annular outer female piece or all these faces are each provided with two or more devices constituting each a system of elastic casing.
- An irreversible elastic casing system is a method of assembly where one or both elements of the assembly are deformed during the introduction. After the introduction, the elements can not be separated. According to the invention, this system is provided with multiple positions (or notches.) Thus, several adjustments are possible, and for each setting, a backward step is no longer possible.
- each device there are two devices on each long side, spaced apart from each other.
- each device is preferably installed near a small side.
- the irreversible casing system also includes a wedge attachment.
- the outer faces of the long sides of the inner annular male piece are provided with a pair of flexible tabs each provided with a protruding slat relative to the outer general surface of said long sides.
- Such a device comprises according to another embodiment for example a series of notches formed of several inclined slats installed parallel to each other.
- the system is rendered irreversible by using a surface perpendicular to the direction of movement in the disassembly direction while keeping a contact surface inclined in the direction of insertion.
- Such devices are preferably arranged to allow adjustment in height in steps of 0.3 to 3 millimeters, preferably from 0.5 to 2.5 millimeters, particularly from 1 to 2 millimeters. There is thus both a fine adjustment of the height and sufficient strength.
- each large side we find face to face two or more devices each constituting an elastic casing system.
- the devices are obviously installed in pairs face to face to form the irreversible nesting system.
- At least one and preferably only one of the two devices installed face-to-face is elastic.
- this device is advantageously mounted on an elastic tab.
- One can also have on one side a tooth and opposite a series of notches, or two sets of notches facing each other.
- An expandable cage of the invention may be made of any biocompatible material and corresponding to this type of implants.
- it can be made of titanium, titanium alloy, Peek, stainless steel, chromium-cobalt alloy, tantalum etc.
- the upper and lower surfaces intended to be in contact with the bone of the adjacent vertebral endplates may be coated with materials facilitating bone grip such as porous titanium or hydroxyapatite. They can also be made with technologies to obtain a so-called “trabecular” surface, that is to say that this surface is porous and with characteristics close to the human bone (pore diameters and porosity).
- the thickness (or height) of a cage according to the invention may, with reference to the end notches, be 4 to 16 mm, preferably 5 to 14 mm, more particularly 6 to 12 mm.
- the expansion of a cage according to the invention may be from 0 to 8 mm, preferably from 0 to 4 mm, preferably from 0 to 2 mm
- the dimension of the cage may range from 10 mm to 50 mm, preferably from 12 to 45 mm, more particularly from 14 to 40 mm.
- the dimension of the cage may range from 5 mm to 25 mm, preferably from 7 to 20 mm, more particularly from 8 to 12 mm.
- the surfaces of contact with the vertebrae may be left-shaped, for example dome-shaped or tile-shaped, and preferably flat.
- the outer surfaces may be angled relative to each other.
- the angle between the contact surfaces imparted by the use of the extreme settings can range from 0 to 25 degrees, preferably from 0 to 20 degrees, particularly from 0 to 12 degrees.
- the contact surfaces of the intervertebral cages are usually provided with asperities to allow attachment of the implant.
- these surfaces intended to be in contact with the bone of the adjacent vertebral endplates may be coated with materials facilitating bone grip such as porous titanium or hydroxyapatite. They can also be made with technologies to obtain a so-called “trabecular” surface, that is to say that this surface is porous and with characteristics close to the human bone (pore diameters and porosity).
- the intervertebral cages object of the present invention have very interesting qualities.
- they are able, like conventional intervertebral cages, to restore the normal space between the vertebrae and to use a bone graft to promote the fusion of the vertebrae, but also
- the present application also relates to a method of replacing an intervertebral disk, for example subject to degeneration following trauma, diseases or old age, in which two adjacent vertebrae are implanted between two vertebrae. a prosthesis above in the unexpanded position, then using a suitable adjustment tool inserted into the cage through the lights we adjust the chosen height or lordosis or both.
- the present application also relates to a method of fusion between two adjacent vertebrae in which is implanted between two adjacent vertebrae at least one cage above (a cervical or lumbar cage for anterior approach and two posterior lumbar cages) and installs a bone graft in a free volume of the cage accessible from the outside.
- the above methods include the steps of: - removing an intervertebral disc between two adjacent vertebrae, for example through the back or belly
- the adapted accessory instrument may be for example a simple cylindrical bar preferably having a handle, or a more complex device as described above, can be actuated by tools such as a flat screwdriver, cruciform or an Allen key.
- FIG. 1 represents a diagrammatic perspective view from above of a cage according to the invention, in which the inner part is inserted into the outer part,
- FIG. 2 represents a view comparable to that of FIG. 1, in which the internal part has not yet been inserted into the outer part, and where the parts have been rotated by 180 °,
- FIG. 3 represents a view comparable to that of FIG. 1, in which the inner part has been raised to increase the height of the assembly
- FIG. 4 represents a view comparable to that of FIG. 3, in which the height of the inner part has been increased in a differential manner to provide lordosis;
- FIG. 5 represents a longitudinal sectional view in profile of an intervertebral cage represented in FIG. 4,
- FIG. 6 represents a side view in longitudinal section of an intervertebral cage of the invention, of the type in which the short sides of the annular internal male piece have the shape of a semi-cylindrical surface, whereas the inner surfaces of the small ones sides of the outer annular female piece 2 are planar faces.
- FIG. 7 represents at the top a cross-sectional view of an annular internal male piece and at bottom a cross-sectional view in which the annular internal male piece is installed in an annular outer female piece,
- FIG. 8 represents at the top a perspective view of an annular outer female piece, and at the bottom a perspective view of an annular internal male piece,
- FIG. 9 represents a cross-sectional view in which the annular internal male part of FIG. 8 is installed in the annular outer female part of FIG. 8,
- FIG. 10 represents a view similar to that of FIG.
- FIG. 11 represents an exploded view of a cage of the invention in which an adjusting device is installed.
- FIG. 12 represents a perspective view of the adjustment device of FIG.
- a spinal cage of the invention consists of an annular internal male piece 1 fitted into an annular outer female piece 2.
- the inner male piece 1 and the outer female piece 2 are annular and therefore open in their center .
- Each of these two parts has a generally parallelepipedal ring shape and comprises two small sides 3, 4, 5, 6, and two long sides 7, 8, 9, 10, and therefore four outer faces and four inner faces, one surface upper 1 1, 12 and a lower surface 13, 14 masked in this figure.
- the general shape of these pieces can also be described as short rolled cylinders. In the middle of these parts, there is therefore an opening 15, 16.
- the cages Because of their parallelepipedal general shape, in horizontal section, the cages have a generally rectangular shape. They also have an upper surface and a lower surface. The upper surface of one 7 and the lower surface 12 of the other, invisible in this figure, form external surfaces that determine the height of the cage.
- the inner surface of the short sides 4, 6 of the outer female piece is curved and forms a vertical gutter.
- the outer surface of the short sides 3, 5 of the inner male piece is domed domed.
- One of the short sides 3 of the annular inner male piece 1 is provided with a lumen 17 opening into its opening 15. This light 17 is not visible in this figure.
- one of the short sides 4 of the outer annular female piece 2 is provided with a lumen 18 opening into its opening 16.
- the two lights are located in the same side of the cage.
- FIG. 2 represents a perspective view of a vertebral cage of FIG. 1 in which the two separate parts have been represented before introduction and engagement of the annular internal male part 1 in the annular outer female part 2.
- Each of the outer faces of the long sides of the inner male annular piece is provided with a pair of flexible tabs longitudinally spaced from each other, each provided with a protruding slat relative to the outer general surface of said long sides .
- Such a conformation allows the relative maintenance of the two parts by sintering, without it being necessary to provide notches in the inner surface of the long sides of the annular outer female part 2.
- the upper surface 1 1 of the annular inner male part 1 is provided with hooked reliefs. It is the same for the lower surface 14, invisible in this figure, of the outer annular female piece 2.
- FIG. 3 represents a perspective view of a spinal cage of FIG. 1 in which the annular internal male piece 1 has been introduced further into the annular outer female piece 2.
- FIG. 4 represents a cage according to the invention to which, thanks to the series of lamellae, a particular lordosis has been conferred (see angle a between the upper surface 11 of the annular inner male part 1 and the surfaces 12, 14 of the annular outer female part 2).
- FIG. 5 represents a longitudinal sectional view exploded in the length of a cage similar to that shown in FIG. 4. It makes it possible to better observe the conformation of the external surfaces of the short sides of the male part and the internal sides of the short sides of the annular outer female piece 2.
- the inner surfaces of the short sides of the outer annular female piece 2 are in the form of perpendicularly installed gutters.
- the outer surfaces of the short sides of the annular inner male part 1 have a dome shape. While being wedged in horizontal translation between the inner surfaces of the short sides of the outer annular female piece 2, the annular inner male piece 1 can, however, be inclined as seen above.
- one of the short sides 4 of the outer annular female piece 2 is provided with a slot 18 and that is the same 17 for one of the short sides of the annular inner male piece 1 .
- the two lights are located on the same side of the cage and are installed in coincidence with each other, which allows to insert a tool to spread the boxes relative to each other (movement H in Figure 3).
- the tool passes through the lumen 18 of the annular outer female part 2 and can be deployed inside, which pushes the annular internal male part 1 and thus separates the parts to increase the height of the assembly (movement H, Figure 3). This makes it possible to give height to the set but also, in the case where one spreads more than one side than the other, to create the desired lordosis. (Angle a in Figure 4).
- the cages of the invention are able not only to keep their structure, but also to resist compressive loads, but also shear (P forces and F forces on Figure 3).
- the openings of the upper and lower faces of the cages of the invention allow to install bone graft to cause a fusion.
- FIG. 6 represents a longitudinal sectional view in the length of a cage of the invention, the inner and outer surfaces of the annular inner male piece 1 and the annular outer female piece 2 having a conformation different from that of the cage previous.
- the lights of 2 pieces were not represented
- the short sides of the annular inner male part 1 may have a cylindrical shape, the axis of the cylinder being horizontal, and come into contact with flat faces constituting the inner surface of the short sides of the annular outer female piece. 2 as shown here in FIG.
- dome-shaped for example hemispherical and are in contact with half-round gutter-shaped surfaces constituting the inner surface of the short sides of the annular outer female piece 2 as shown in FIGS. 1 to 5.
- FIG. 7 also shows a cage of the same general structure, but in which the flexible lugs 21, carrying a single strip 20, are installed on the annular inner male part 1, while the surface of the outer female piece The annulus 2 facing it is smooth and thus a sliding in the insertion direction and a jamming in the opposite direction.
- the flexible tabs 21 are not installed parallel to the wall of the long sides of the annular inner male part 1, but substantially perpendicular to it. In addition, they are slightly inclined downward if you look from the inside to the outside of the room. Thus, the introduction of the inner male piece into the female piece external is facilitated, but moving in the opposite and upset.
- annular outer female part 2 does not need to have series 19 of slats installed on the internal faces , and can therefore be internally smooth.
- FIG. 8 it can be seen at the top that the inner faces of the long sides of the outer annular female piece 2 and the outer faces of the long sides of the annular inner male piece 1 are each provided with devices each constituting a casing system. irreversible elastic with multiple positions.
- the outer annular female piece 2 is provided on the inner faces of its long sides with two series 19 of inclined slats parallel as louvers (which would not be openwork on the model shown but can be perforated) over virtually the entire length of the long sides.
- the system is rendered irreversible by using a surface of the lamellae perpendicular to the direction of movement in the disassembly direction while keeping a contact surface inclined in the direction of insertion of the internal female part 1 into the outer female part 2.
- a surface of the lamellae perpendicular to the direction of movement in the disassembly direction while keeping a contact surface inclined in the direction of insertion of the internal female part 1 into the outer female part 2.
- the lumen 17 formed in a small side of the annular internal male piece 1 is elongate and open on the lower part of this piece.
- FIG. 9 which is a cross-sectional view of FIG. 8, except that the annular internal male part 1 has been introduced into the annular outer female part 2 from below, makes it possible to clearly observe the cooperation between the lamellae 20 independent of the internal annular male part 1 and the series 19 of lamellae installed on the inner faces of the annular outer female part 2.
- Figure 10 similar to that of Figure 4, illustrates another embodiment of the blocking of the longitudinal displacement of the annular inner male piece (1) vis-à-vis the annular outer female piece (2).
- a stud 22 has been installed in the middle position vis-à-vis the length of the cage, in the long sides 7, 9 of the internal male part 1.
- These studs can move in vertical translation in an oblong hole 23 passing through each of the long sides 8, 10 of the outer female part 2.
- a single stud extending from a long side to the other of the cage.
- FIG. 11 illustrates another embodiment of a device for adjusting the height of the cage acting individually on one end and the other end of the longitudinal axis of the annular inner male piece (1).
- the device used here comprises two internal elongated shafts 31, external, rotary with concentric and independent axes, each shaft 30, 31 having a flattened segment cam 32, 33 and rotatable independently of the other.
- the inner elongated shaft 30 is housed at one of its ends in a blind bore 34 provided in the short side of the annular outer female part 2 opposite the slots 17, 18.
- the cams 32, 33 bear against an upper surface. internal 35 of the annular inner male part 1.
- the inner shaft 30 is provided at its accessible end by the lumen 18 of the female part with a Torx® tip imprint as shown, Allen®, or the like to allow its rotation.
- the outer shaft 31 is for its part provided with the same side of grooves or grooves for the use of such a screwdriver flat or cruciform.
- the height of the cage can be increased equally along the longitudinal axis.
- the height is only increased on the side along the longitudinal axis in which the cam acts and thus a lordosis can be obtained.
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- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Neurology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- Heart & Thoracic Surgery (AREA)
- General Health & Medical Sciences (AREA)
- Cardiology (AREA)
- Vascular Medicine (AREA)
- Transplantation (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Prostheses (AREA)
Abstract
Description
Claims
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
FR1551917A FR3033247B1 (fr) | 2015-03-06 | 2015-03-06 | Cages intervertebrales et leurs applications |
PCT/EP2016/054625 WO2016142282A1 (fr) | 2015-03-06 | 2016-03-04 | Cages intervertébrales et leurs applications |
Publications (1)
Publication Number | Publication Date |
---|---|
EP3265032A1 true EP3265032A1 (fr) | 2018-01-10 |
Family
ID=53274589
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP16709313.7A Withdrawn EP3265032A1 (fr) | 2015-03-06 | 2016-03-04 | Cages intervertébrales et leurs applications |
Country Status (5)
Country | Link |
---|---|
US (1) | US20180036137A1 (fr) |
EP (1) | EP3265032A1 (fr) |
CN (1) | CN107427370A (fr) |
FR (1) | FR3033247B1 (fr) |
WO (1) | WO2016142282A1 (fr) |
Families Citing this family (9)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8597360B2 (en) * | 2004-11-03 | 2013-12-03 | Neuropro Technologies, Inc. | Bone fusion device |
US10292830B2 (en) | 2011-08-09 | 2019-05-21 | Neuropro Technologies, Inc. | Bone fusion device, system and method |
WO2014151934A1 (fr) | 2013-03-15 | 2014-09-25 | Neuropro Technologies, Inc. | Dispositif, appareil et procédé de fusion osseuse sans corps |
US10500061B2 (en) * | 2015-08-13 | 2019-12-10 | K2M, Inc. | Adjustable spinal implant |
US10786367B2 (en) * | 2016-07-21 | 2020-09-29 | Seaspine, Inc. | Expandable implant |
TR201620372A3 (tr) * | 2016-12-30 | 2018-08-27 | Tobb Ekonomi Ve Teknoloji Ueniversitesi | Geni̇şleyebi̇li̇r bi̇r kafes |
TR201620379A2 (tr) | 2016-12-30 | 2018-07-23 | Tobb Ekonomi Ve Teknoloji Ueniversitesi | Bi̇r açici aparat |
US10729560B2 (en) | 2017-01-18 | 2020-08-04 | Neuropro Technologies, Inc. | Bone fusion system, device and method including an insertion instrument |
CN116196155B (zh) * | 2023-02-23 | 2024-01-26 | 重庆富沃思医疗器械有限公司 | 一种腰椎椎间融合器 |
Family Cites Families (10)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6183517B1 (en) * | 1998-12-16 | 2001-02-06 | Loubert Suddaby | Expandable intervertebral fusion implant and applicator |
US20040087947A1 (en) * | 2002-08-28 | 2004-05-06 | Roy Lim | Minimally invasive expanding spacer and method |
US8696751B2 (en) * | 2008-12-10 | 2014-04-15 | Coalign Innovations, Inc. | Adjustable distraction cage with linked locking mechanisms |
US9050194B2 (en) * | 2009-05-06 | 2015-06-09 | Stryker Spine | Expandable spinal implant apparatus and method of use |
CN102625682B (zh) * | 2009-07-22 | 2015-04-01 | 斯普耐技术有限责任公司 | 采用同轴螺纹齿轮套机构的椎体撑开与融合装置 |
US9532883B2 (en) * | 2012-04-13 | 2017-01-03 | Neuropro Technologies, Inc. | Bone fusion device |
WO2013158294A1 (fr) * | 2012-04-16 | 2013-10-24 | Biospine, Llc | Dispositifs de fusion intersomatique ajustables à broches multiples et procédés d'utilisation |
US20140094917A1 (en) * | 2012-10-02 | 2014-04-03 | Anthony A. Salerni | Expandable fusion cage with cam adjuster |
US9463099B2 (en) * | 2013-03-15 | 2016-10-11 | Expanding Orthopedics Inc. | Orthopedic expandable devices |
US9668876B2 (en) * | 2013-12-05 | 2017-06-06 | Spinal Elements, Inc. | Expandable interbody device |
-
2015
- 2015-03-06 FR FR1551917A patent/FR3033247B1/fr active Active
-
2016
- 2016-03-04 US US15/554,665 patent/US20180036137A1/en not_active Abandoned
- 2016-03-04 CN CN201680013179.1A patent/CN107427370A/zh active Pending
- 2016-03-04 EP EP16709313.7A patent/EP3265032A1/fr not_active Withdrawn
- 2016-03-04 WO PCT/EP2016/054625 patent/WO2016142282A1/fr active Application Filing
Also Published As
Publication number | Publication date |
---|---|
FR3033247B1 (fr) | 2017-03-24 |
FR3033247A1 (fr) | 2016-09-09 |
CN107427370A (zh) | 2017-12-01 |
WO2016142282A1 (fr) | 2016-09-15 |
US20180036137A1 (en) | 2018-02-08 |
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