ES2211039T3 - Protesis interespinosa. - Google Patents
Protesis interespinosa.Info
- Publication number
- ES2211039T3 ES2211039T3 ES99904916T ES99904916T ES2211039T3 ES 2211039 T3 ES2211039 T3 ES 2211039T3 ES 99904916 T ES99904916 T ES 99904916T ES 99904916 T ES99904916 T ES 99904916T ES 2211039 T3 ES2211039 T3 ES 2211039T3
- Authority
- ES
- Spain
- Prior art keywords
- prosthesis
- ears
- interspinous
- prosthesis according
- ligature
- 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.)
- Expired - Lifetime
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7053—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant with parts attached to bones or to each other by flexible wires, straps, sutures or cables
-
- 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
- A61B17/82—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin for bone cerclage
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/842—Flexible wires, bands or straps
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
- A61B2017/06052—Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle
-
- 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
- A61F2/08—Muscles; Tendons; Ligaments
- A61F2/0811—Fixation devices for tendons or ligaments
-
- 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
- A61F2/30721—Accessories
- A61F2/30724—Spacers for centering an implant in a bone cavity, e.g. in a cement-receiving cavity
-
- 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
- A61F2002/30316—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
- A61F2002/30563—Special structural features of bone or joint prostheses not otherwise provided for having elastic means or damping means, different from springs, e.g. including an elastomeric core or shock absorbers
-
- 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
- A61F2002/30772—Apertures or holes, e.g. of circular cross section
- A61F2002/30777—Oblong apertures
-
- 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
- A61F2002/30772—Apertures or holes, e.g. of circular cross section
- A61F2002/30784—Plurality of holes
- A61F2002/30785—Plurality of holes parallel
-
- 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0028—Shapes in the form of latin or greek characters
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S606/00—Surgery
- Y10S606/907—Composed of particular material or coated
- Y10S606/91—Polymer
Landscapes
- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Neurology (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
Abstract
Prótesis interespinosa, realizada en un material multidireccionalmente flexible y elástico, y que comprende una porción interespinosa (5) que tiene un espesor ligeramente superior al espacio interespinoso anatómico cuando el raquis está en lordosis, de tal manera que esta poción (5) está ligeramente comprimida cuando la prótesis (2) está colocada entre las apófisis espinosas (3) de dos vértebras (4), caracterizada porque presenta dos pares de orejas (6) que forman resalte longitudinalmente a uno y otro lado de su porción interespinosa (5), teniendo estas orejas (6) unas alturas importantes con respecto a la altura total de la prótesis (2), del orden, para cada par de orejas (6), del 30 al 45% de esta altura total; cada par de orejas (6) forma un cuerpo con dicha porción interespinosa (5) y delimita un vaciado profundo (9) apto para recibir sin juego la apófisis espinosa (3) correspondiente, con una amplia superficie de contacto de estas orejas (6) y de esta apófisis (3).
Description
Prótesis interespinosa.
La presente invención se refiere a una prótesis
interespinosa, destinada a producir una asistencia discal y a
amortiguar los movimientos relativos de dos vértebras adyacentes
cuando tienen lugar movimientos de flexión o de extensión del
raquis.
La patente francesa nº 2 717 675 presentada a
nombre del solicitante, describe una prótesis que comprende un
cuerpo de material flexible y dos inserciones rígidas en forma de
V. El cuerpo está destinado a ser insertado entre las apófisis
espinosas de dos vértebras para mantener una separación anatómica
flexible entre éstas, permitiendo al mismo tiempo su movimiento
relativo. Las inserciones permiten delimitar unas ranuras para
recibir las apófisis espinosas de las dos vértebras y comprenden un
medio para fijar la prótesis a estas apófisis.
La prótesis según esta patente anterior es
satisfactoria en la práctica, pero ha resultado que podía ser
mejorada, en particular en lo que concierne a su estructura y a su
resistencia a los esfuerzos repetidos que sufre. Las uniones entre
el cuerpo de la prótesis y las inserciones son en efecto muy
solicitadas.
La solicitud de patente francesa nº 2 623 085
describe una cala con estructura en forma de H que presenta, sobre
solamente una de sus dos caras extremas, o sobre las dos, una
garganta dimensionada para recibir, con un ligero juego lateral,
una apófisis espinosa respectiva. Cada garganta está delimitada por
unos labios de pequeña altura que, vistos de lado, tienen una forma
en arco de círculo.
La presente invención tiene por objeto
proporcionar una prótesis interespinosa que asegura un perfecto
sostenimiento de las dos vértebras interesadas, y permitiendo por
consiguiente una perfecta asistencia discal, debiendo esta prótesis
poder resistir los esfuerzos repetidos ejercidos sobre ella por las
apófisis, debiendo estar conformada de manera que sufra sólo un
pequeño desgaste y debiendo presentar una estabilidad importante en
todas las direcciones, en particular con respecto a los movimientos
de "báscula lateral", es decir unos movimientos provocados por
la torsión del raquis según su eje.
La prótesis objeto de la presente solicitud de
patente está, de forma conocida, realizada en un material
multidireccionalmente flexible y elástico, y comprende una porción
interespinosa que tiene un espesor ligeramente superior al espacio
interespinoso anatómico cuando el raquis está en lordosis, de tal
manera que esta porción está ligeramente comprimida cuando la
prótesis es colocada entre las apófisis espinosas de dos
vértebras.
Según la invención, la prótesis presenta dos
pares de orejas que forman resalte longitudinalmente a uno y otro
lado de su porción interespinosa, y que tienen unas alturas
importantes con respecto a la altura total de la prótesis, del
orden, para cada par de orejas de 30 al 45% de esta altura total,
formando cada par de orejas un cuerpo con dicha porción
interespinosa y delimitando un vaciado profundo apto para recibir
sin juego la apófisis espinosa correspondiente, con una amplia
superficie de contacto de estas orejas y de esta apófisis.
Estos vaciados profundos aseguran un perfecto
mantenimiento de la prótesis en posición entre las apófisis
espinosas de las vértebras, en todas las direcciones, y en
particular con respecto a los movimientos que resultan de una
torsión del raquis según su eje, que tienden a crear una báscula
lateral de la prótesis.
Además y sobre todo, la combinación de esta
estructura de material multidireccionalmente flexible y elástico,
por una parte, y de estos dos pares de orejas de longitud
importante y que forman cuerpo con la porción interespinosa de la
prótesis, por otra parte, permite, cuando esta porción
interespinosa es puesta a compresión, llevar las orejas al apoyo
contra las caras laterales de las apófisis espinosas, por un efecto
de "autoapriete".
Este mantenimiento de la prótesis, aliado a la
flexibilidad de esta prótesis, permite reducir notablemente los
rozamientos entre la prótesis y las apófisis, lo que hace inútiles
las inserciones de material rígido de la prótesis según la técnica
anterior. La prótesis según la invención es por tanto monobloque,
lo que resuelve además los problemas ligados a la fabricación y
sobre todo a la resistencia en el tiempo de la prótesis según la
técnica anterior.
La prótesis según la invención conjuga un efecto
de supresión de los contactos nuevamente creados entre las facetas
a consecuencia de apoyos intensos y un efecto de reducción de la
presión interdiscal, que permite una ralentización del
envejecimiento discal.
Las indicaciones principales de esta prótesis
son:
- -
- artropatía de las facetas;
- -
- prevención de la degenerescencia discal que se produce consecutivamente a una artrodesis;
- -
- "alivio" del anulus discal subsistente después del tratamiento quirúrgico de una hernia discal.
Las caras internas de dos orejas de un mismo par
de orejas están preferentemente inclinadas de manera que converjan
una hacia la otra en dirección al fondo del vaciado que
delimitan.
Se obtiene así un relativo acuñado de la apófisis
por ligera deformación elástica de las orejas, que contribuye al
mantenimiento de la prótesis con respecto a las apófisis.
Las orejas tienen ventajosamente un espesor medio
relativamente importante con respecto a la anchura media de la
prótesis, del orden, para cada oreja, del 25 al 35% de esta anchura
media.
Estas orejas forman así perfectamente un cuerpo
con la porción interespinosa de la prótesis, lo que asegura su
resistencia a los esfuerzos repetidos sufridos por ésta.
Preferentemente, la cara anterior de la prótesis
se une respectivamente a las caras superior e inferior de la
prótesis por unas zonas talladas al bies y/o redondeadas, que
permiten el borrado total de los ángulos que formarían sino estas
caras dos a dos.
La prótesis puede así ser colocada al nivel de la
base de las apófisis espinosas, en la unión
lámina-espinosa de las vértebras, lo que reduce la
amplitud de los esfuerzos en torsión que las apófisis son
susceptibles de ejercer sobre ella.
Ventajosamente, la prótesis está perforada por lo
menos por un conducto transversal practicado al nivel de su porción
interespinosa, permitiendo este conducto el acoplamiento de una
unión destinada a unir estrechamente la prótesis a por lo menos una
de las apófisis espinosas.
Estas uniones tienen simplemente por objeto
asegurar la colocación de la prótesis, estando ésta, por su
estructura citada, autoapretada entre las apófisis.
Preferentemente, la pared de la porción
interespinosa que delimita este conducto está ensanchada a nivel de
los extremos de este conducto, para eliminar cualquier arista
susceptible de crear un punto de desgaste de dicha unión.
Según una forma de realización preferida de la
invención, en este caso, la prótesis comprende dos conductos
transversales que reciben cada uno una ligadura para unirla a la
apófisis espinosa de la vértebra correspondiente.
La prótesis según la invención está
ventajosamente dispuesta en una vaina textil que encaja con su
forma.
Esta vaina evita el contacto directo del material
sintético que la constituye, en particular silicona, con los
tejidos circundantes, y facilita la integración de la prótesis con
estos tejidos. Además, la misma constituye un medio de limitación
del estiramiento de la prótesis, que elimina cualquier riesgo de
rotura de ésta en caso de carga excepcionalmente elevada.
Ventajosamente, esta vaina comprende una
bandeleta cosida a ella en el lado posterior de la prótesis, que
puede servir de punto de anclaje para una ligadura protésica de
sustitución del ligamento inter y supraespinoso.
Para su mejor comprensión, la invención se
describe de nuevo a continuación con referencia al plano
esquemático anexo que representa, a título de ejemplo no
limitativo, una forma de realización preferida de la prótesis
interespinosa a la que se refiere.
La figura 1 es una vista en perspectiva de una
pieza de silicona que comprende esta prótesis;
las figuras 2 y 3 son unas vistas en sección de
esta pieza según respectivamente las líneas II-II y
III-III de la figura 1, y
las figuras 4 y 5 son vistas en perspectiva de la
prótesis en el curso de dos fases de implantación sobre unas
vértebras.
Las figuras 1 a 3 representan, bajo diferentes
ángulos, una pieza 1 de silicona que constituye el núcleo de una
prótesis interespinosa 2. Como aparece en las figuras 4 y 5, esta
prótesis 2 está destinada a ser dispuesta entre las apófisis
espinosas 3 de dos vértebras adyacentes 4 para amortiguar los
movimientos relativos de estas vértebras 4 cuando tienen lugar
movimientos de flexión o de extensión del raquis.
La pieza 1 comprende una porción interespinosa 5
y dos pares de orejas laterales 6 que forman resalte
longitudinalmente a uno y otro lado de esta porción 5.
La porción 5 tiene un espesor ligeramente
superior al espacio interespinoso anatómico cuando el raquis está
en lordosis; la misma está por tanto ligeramente comprimida cuando
la prótesis 2 está dispuesta entre las apófisis 3.
Esta porción 5 está perforada por dos conductos
transversales 7 que permiten, como muestran las figuras 4 y 5, la
introducción de dos ligaduras 8 que sirven para unir estrechamente
la prótesis 2 con cada una de las apófisis 3. La pared 5a de la
porción 5 que delimita cada uno de estos conductos 7 por el lado de
las orejas 6 correspondientes está ensanchado al nivel de los
extremos del conducto 7, para eliminar cualquier arista susceptible
de crear un punto de desgaste de la ligadura 8.
Las orejas 6 tienen unas alturas importantes con
respecto a la altura total de la prótesis 2, del orden, para las
orejas superiores e inferiores, del 33% y 40% de esta altura total,
respectivamente.
Las caras internas de dos orejas 6 de un mismo
par de orejas están inclinadas de forma que converjan una hacia la
otra en dirección al fondo del vaciado 9 que ellas delimitan entre
sí; en el ejemplo representado en el plano, el ángulo formado por
las dos paredes de las orejas superiores es del orden de 27º,
mientras que el ángulo formado por las dos paredes de las orejas
inferiores es del orden de 43º.
Las orejas 6 tienen además un espesor medio
relativamente importante con respecto a la anchura media de la
prótesis 2, del orden, para las orejas superiores e inferiores, del
27% y del 30% de esta anchura media, respectivamente.
Aparece además en las figuras 1 y 2 que la cara
anterior de la pieza 1 se une respectivamente a las caras superior
e inferior de ésta por las zonas 10 talladas al bies o redondeadas,
que permiten el borrado total de los ángulos que formarían sino
estas caras anterior y superior o inferior entre ellas.
La pieza 1 está dispuesta en una vaina textil 11,
de poliester, que encaja con su forma y que está perforada por
orificios en correspondencia con las aberturas de los conductos
7.
Esta vaina 11 comprende una bandeleta 12 cosida a
ella en el lado posterior de la prótesis 2, destinada a servir de
punto de anclaje para una ligadura protésica de sustitución del
ligamento inter y supraespinoso.
Aparece en las figuras 4 y 5 que cada ligadura 8
está constituida por una trenza de la que un extremo está engarzado
sobre el extremo de una aguja curva 15 y cuyo otro extremo presenta
un aro 16.
En la práctica, la prótesis 2 está insertada en
el espacio interespinoso destinado a recibirla. Gracias a sus zonas
10, la misma puede ser insertada en el fondo de este espacio, hasta
la unión entre las láminas y las espinosas de las vértebras 4.
Cada ligadura 8 es introducida en el conducto 7
que le corresponde, y después es acoplada, gracias a la aguja 15,
alrededor de la apófisis espinosa 3 correspondiente, y después a
través del aro 16. Después del tensado adecuado de la ligadura 8,
una pieza de tope (no representada) que comprende un collarín de
tope y un manguito susceptible de ser engarzado alrededor de la
ligadura 8, es acoplada sobre esta ligadura 8 hasta que dicho
collarín queda apoyado contra el aro 16. Dicho manguito es entonces
engarzado sobre la ligadura 8 para asegurar la fijación de esta
ligadura, y el extremo libre inutilizado de la ligadura 8 es
cortado a ras de este manguito.
Desde luego la invención no está limitada a la
forma de realización descrita anteriormente a título de ejemplo
sino que abarca, por el contrario, todas las variantes de
realización. Así, la pieza 1 podría ser utilizada sola, sin la
vaina 11, constituyendo esta pieza 1 entonces ella misma la prótesis
según la invención.
Claims (9)
1. Prótesis interespinosa, realizada en un
material multidireccionalmente flexible y elástico, y que comprende
una porción interespinosa (5) que tiene un espesor ligeramente
superior al espacio interespinoso anatómico cuando el raquis está
en lordosis, de tal manera que esta poción (5) está ligeramente
comprimida cuando la prótesis (2) está colocada entre las apófisis
espinosas (3) de dos vértebras (4), caracterizada porque
presenta dos pares de orejas (6) que forman resalte
longitudinalmente a uno y otro lado de su porción interespinosa (5),
teniendo estas orejas (6) unas alturas importantes con respecto a la
altura total de la prótesis (2), del orden, para cada par de orejas
(6), del 30 al 45% de esta altura total; cada par de orejas (6)
forma un cuerpo con dicha porción interespinosa (5) y delimita un
vaciado profundo (9) apto para recibir sin juego la apófisis
espinosa (3) correspondiente, con una amplia superficie de contacto
de estas orejas (6) y de esta apófisis (3).
2. Prótesis según la reivindicación 1,
caracterizada porque las caras internas de dos orejas (6) de
un mismo par de orejas están inclinadas de manera que converjan una
hacia la otra en dirección al fondo del vaciado (9) que
delimitan.
3. Prótesis según la reivindicación 1 o la
reivindicación 2, caracterizada porque las orejas (6) tienen
un espesor medio relativamente importante con respecto a la anchura
media de la prótesis (2), del orden, para cada oreja (6), del 25 al
35% de esta anchura media.
4. Prótesis según una de las reivindicaciones 1 a
3, caracterizada porque su cara anterior se une
respectivamente a sus caras superior e inferior por unas zonas (10)
talladas al bies y/o redondeadas, que permiten el borrado total de
los ángulos que formarían sino estas caras dos a dos.
5. Prótesis según una de las reivindicaciones 1 a
4, caracterizada porque está perforada por lo menos por un
conducto transversal (7) practicado a nivel de su porción
interespinosa (5), permitiendo este conducto (7) la introducción de
una ligadura (8) destinada a unir estrechamente la prótesis (2) a
por lo menos una de las apófisis espinosas (3).
6. Prótesis según la reivindicación 5,
caracterizada porque la pared (5a) de la porción
interespinosa (5) que delimita dicho conducto (7) está ensanchada a
nivel de los extremos de este conducto (7), para eliminar cualquier
arista susceptible de crear un punto de desgaste de dicha ligadura
(8).
7. Prótesis según la reivindicación 5 o la
reivindicación 6, caracterizada porque comprende dos
conductos transversales (7) que reciben cada uno una ligadura (8)
para unirla a la apófisis espinosa (3) de la vértebra (4)
correspondiente.
8. Prótesis según una de las reivindicaciones 1 a
7, caracterizada porque está colocada en una vaina textil
(11) que encaja con su forma.
9. Prótesis según la reivindicación 8,
caracterizada porque la vaina (11) comprende una bandeleta
(12) cosida a ella en el lado posterior de la prótesis, destinada a
servir de punto de anclaje a una ligadura protésica de sustitución
del ligamento inter- y supraespinoso.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
FR9802300A FR2775183B1 (fr) | 1998-02-20 | 1998-02-20 | Prothese inter-epineuse |
FR9802300 | 1998-02-20 |
Publications (1)
Publication Number | Publication Date |
---|---|
ES2211039T3 true ES2211039T3 (es) | 2004-07-01 |
Family
ID=9523367
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
ES99904916T Expired - Lifetime ES2211039T3 (es) | 1998-02-20 | 1999-02-19 | Protesis interespinosa. |
Country Status (6)
Country | Link |
---|---|
US (1) | US6626944B1 (es) |
EP (1) | EP1056408B1 (es) |
DE (1) | DE69913659T2 (es) |
ES (1) | ES2211039T3 (es) |
FR (1) | FR2775183B1 (es) |
WO (1) | WO1999042051A1 (es) |
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PL124738B1 (en) * | 1980-04-15 | 1983-02-28 | Politechnika Slaska Im Wincentego Pstrowskiego | Implant for internal spine stabilization |
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FR2806616B1 (fr) * | 2000-03-21 | 2003-04-11 | Cousin Biotech | Cale interepineuse et dispositif de fixation sur le sacrum |
FR2811540B1 (fr) * | 2000-07-12 | 2003-04-25 | Spine Next Sa | Implant intervertebral amortissant |
FR2816197B1 (fr) * | 2000-11-07 | 2003-01-10 | Jean Taylor | Prothese inter-epineuse, outil et procede pour sa preparation |
-
1998
- 1998-02-20 FR FR9802300A patent/FR2775183B1/fr not_active Expired - Fee Related
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1999
- 1999-02-19 WO PCT/FR1999/000383 patent/WO1999042051A1/fr active IP Right Grant
- 1999-02-19 ES ES99904916T patent/ES2211039T3/es not_active Expired - Lifetime
- 1999-02-19 DE DE69913659T patent/DE69913659T2/de not_active Expired - Lifetime
- 1999-02-19 EP EP99904916A patent/EP1056408B1/fr not_active Expired - Lifetime
- 1999-02-19 US US09/622,513 patent/US6626944B1/en not_active Expired - Lifetime
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WO1999042051A1 (fr) | 1999-08-26 |
EP1056408B1 (fr) | 2003-12-17 |
FR2775183A1 (fr) | 1999-08-27 |
US6626944B1 (en) | 2003-09-30 |
DE69913659T2 (de) | 2004-06-09 |
DE69913659D1 (de) | 2004-01-29 |
EP1056408A1 (fr) | 2000-12-06 |
FR2775183B1 (fr) | 2000-08-04 |
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