ES2303381T3 - Implante intervertebral. - Google Patents
Implante intervertebral. Download PDFInfo
- Publication number
- ES2303381T3 ES2303381T3 ES99931246T ES99931246T ES2303381T3 ES 2303381 T3 ES2303381 T3 ES 2303381T3 ES 99931246 T ES99931246 T ES 99931246T ES 99931246 T ES99931246 T ES 99931246T ES 2303381 T3 ES2303381 T3 ES 2303381T3
- Authority
- ES
- Spain
- Prior art keywords
- piece
- intervertebral implant
- implant according
- cavity
- intervertebral
- 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
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- 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
- A61F2/442—Intervertebral or spinal discs, e.g. resilient
- A61F2/4425—Intervertebral or spinal discs, e.g. resilient made of articulated components
-
- 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
- A61F2/30749—Fixation appliances for connecting prostheses to the body
-
- 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
- A61F2/442—Intervertebral or spinal discs, e.g. resilient
-
- 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
-
- A—HUMAN NECESSITIES
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- 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
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2/4611—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- 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
- A61F2002/30112—Rounded shapes, e.g. with rounded corners
- A61F2002/30131—Rounded shapes, e.g. with rounded corners horseshoe- or crescent- or C-shaped or U-shaped
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- 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
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- A61F2002/3011—Cross-sections or two-dimensional shapes
- A61F2002/30138—Convex polygonal shapes
-
- 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
- A61F2002/30317—The prosthesis having different structural features at different locations within the same prosthesis
- A61F2002/30324—The prosthesis having different structural features at different locations within the same prosthesis differing in thickness
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- 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
- A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- 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
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- A—HUMAN NECESSITIES
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- 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
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- 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
- A61F2002/305—Snap connection
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- 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
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- A61F2002/3065—Details of the ball-shaped head
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- 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
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Abstract
Implante intervertebral con una primera pieza (2) que presenta una superficie de apoyo (5) externa para un primer cuerpo de vértebra y una superficie interna con al menos un saliente (10) hacia dentro, y una segunda pieza(3) con una superficie de apoyo (13) externa para un segundo cuerpo de vértebra colindante al primer cuerpo de vértebra y una superficie interna, que se ha configurado como una cavidad (19), que se ha acondicionado como alojamiento para una pieza (4), que interacciona en un uso posterior con la primera pieza (2), que se caracteriza por que el saliente (10) de la primera pieza (2) se inserta en la cavidad (19) de la segunda pieza, para que ambas piezas (2, 3) se introduzcan juntas sin el elemento (4) en un espacio intermedio entre los cuerpos de las vértebras.
Description
Implante intervertebral.
La invención se refiere a un implante
intervertebral conforme al concepto general de la reivindicación 1
adjunta.
Un implante intervertebral de este tipo se
conoce, por ejemplo, de
US-A-5.314.477 o también de
US-A-5.507.816. Este implante
intervertebral sirve para sustituir uno de los discos
intervertebrales extirpados del espacio intervertebral, y de
acuerdo con ello el implante intervertebral debe presentar una
altura relativamente escasa, puesto que debe adaptarse en la
hendidura intervertebral. Esto es especialmente difícil cuando entre
la parte superior y la inferior todavía se ha de incrustar una
pieza articulada adicional como es el caso en el conocido implante
intervertebral de
US-A-5.314.477.
Las dificultades se dan también en los implantes
intervertebrales de dos piezas, especialmente cuando estos en sus
superficies de apoyo incluso llevan pasadores y otros resaltes que
deben servir para el anclaje del implante intervertebral en un
hueso. Estos se pueden emplear frecuentemente solo cuando el espacio
intervertebral se ha ensanchado mucho. Esto no solo es muy difícil
sino que entraña el peligro de que se produzcan heridas.
Puesto que el espacio intervertebral presenta
una altura relativamente escasa, también es difícil fijar en ambas
partes del implante intervertebral unos elementos de agarre, a los
cuales se pueda agarrar un instrumento de manejo. Normalmente este
tipo de instrumentos se pueden agarrar por separado, tanto por la
parte superior como por la inferior, por ejemplo, mediante
pasadores que se introducen en los orificios en la parte superior o
en la parte inferior, de manera que con el instrumento de
manipulación se colocan ambas partes del implante intervertebral en
el espacio intervertebral y si se diera el caso también se puede
modificar la distancia entre las partes, de manera que es posible
lograr un cierto ensanchamiento del espacio intervertebral. Para
ello nos remitimos por ejemplo al instrumento de manejo en forma de
tenaza en US-A-5.314.477.
Debido a las grandes fuerzas es necesario prever
para los elementos de agarre una cierta altura, por ejemplo, las
perforaciones deben tener un diámetro determinado. Se deduce una
altura mínima para la parte superior y para la parte inferior, y en
los implantes intervertebrales habituales se suman por tanto las
alturas de la parte superior y de la parte inferior, de manera que
incluso en un contacto directo de la parte superior y de la parte
inferior es inevitable una altura relativamente grande del implante
intervertebral.
El cometido de la invención es crear un implante
intervertebral conforme al género, de forma que se reduzca la
altura mínima para facilitar la introducción del implante
intervertebral en el espacio intervertebral.
Este cometido se resuelve con un implante
intervertebral del tipo descrito al principio según la invención
por las propiedades de la parte característica de la reivindicación
1 adjunta.
En una configuración de este tipo se puede
lograr una altura mínima de ambas partes o piezas contiguas del
implante intervertebral, puesto que se configuran unas zonas de
mayor altura como resaltos, junto a las cuales se encuentran las
hendiduras correspondientes, en las que se pueden sumergir los
resaltos de otras piezas. De todo ello se deduce que los elementos
de agarre para los instrumentos de manejo se sitúan juntos y se
pueden solapar al menos parcialmente, de manera que la altura total
de las piezas contiguas del implante intervertebral puede reducirse
claramente con respecto a la de los implantes corrientes. Por tanto
con ello se consigue una disposición intrincada de la pieza
superior y de la pieza inferior con un aprovechamiento máximo de la
altura del material que se encuentra disponible.
Es pues oportuno que los elementos de agarre
sean orificios enchufables o insertables para elementos de fijación
en forma de barra de un instrumento de manejo, pudiendo presentar
estos orificios un diámetro relativamente grande debido a la
construcción descrita y por tanto alojar barras de sujeción fuertes,
y sin embargo que exista una altura relativamente escasa del
implante intervertebral en las piezas que se encuentren en contacto
directo.
Por lo que es preferible que los orificios
insertables se extiendan básicamente en paralelo a las superficies
de apoyo, para evitar que la altura del lugar del implante
intervertebral aumente.
En una configuración preferida se ha previsto
que la segunda parte o pieza, en particular la pieza inferior
presente un engrosamiento central opuesto a la superficie de apoyo
inferior, que está rodeado de un reborde en forma de U.
Por lo que es preferible que la primera pieza,
en particular la pieza superior tenga un resalto central que se
adapte al engrosamiento básicamente complementario, es decir se
aproveche todo el volumen del engrosamiento para el resalto.
También se prefiere que los elementos de agarre
de la parte inferior se dispongan en ambos extremos del reborde en
forma de U, es decir se sitúen al exterior.
Por el contrario, los elementos de agarre de la
parte superior pueden estar situados en el resalto central de la
parte superior.
\newpage
Los elementos de agarre de la parte superior
pueden disponerse cerca de los bordes laterales del resalto central,
de forma que se pueda elegir la distancia de los elementos de
agarre relativamente grande tanto para la parte superior como para
la parte inferior.
Aquí se tiene que indicar que las expresiones
"pieza o parte inferior" y "pieza o parte superior" no
afirman necesariamente algo sobre la posición de montaje del
implante intervertebral en la columna vertebral, que la parte o
pieza designada con "pieza inferior" podía realmente estar
arriba en la columna. Lo meramente esencial es que la parte
superior y la parte inferior delimitan el implante intervertebral a
ambos lados opuestos del implante.
Se prefiere especialmente que la parte superior
y/o la parte inferior se configuren esencialmente en forma de
placas, de manera que estas partes presenten naturalmente según la
configuración conforme a la invención unos resaltos orientados
hacia la otra parte. La configuración en forma de placas lleva en
conjunto a una altura muy escasa del implante intervertebral.
En una configuración preferida, tanto la parte
inferior como la superior presentan un alojamiento o soporte para
una pieza articulada. Esta pieza articulada, que se coloca entre la
parte superior y la inferior tras insertar el implante
intervertebral, apuntala la parte superior y la inferior una contra
la otra, asumiendo por ejemplo una función elástica y conduce
además a una cierta movilidad de ambas piezas de un implante
intervertebral, de manera que se consigue una movilidad del cuerpo
vertebral colindante.
Especialmente se prefiere que la pieza
articulada presente al menos un lado superior esférico, que se
agarre al engrosamiento abombado esférico.
Es una ventaja que se disponga el alojamiento
esférico en un resalto central de la pieza superior.
Además se prefiere que el engrosamiento central
de la parte inferior forme el alojamiento para la pieza
articulada.
Según una configuración preferida de la
invención, se ha previsto que la pieza articulada se encaje o
introduzca en el alojamiento por el lado, que soporta los elementos
de agarre para un instrumento de manejo. Se trata pues de
introducir los laterales de la pieza superior e inferior en el
espacio intervertebral, y también por este lado también se puede
introducir la pieza articulada entre las piezas ya colocadas del
implante intervertebral.
Es una ventaja que la pieza articulada se
inserte en el alojamiento a lo largo de una guía.
La pieza se ha configurado preferiblemente en
forma de placa.
Una configuración especialmente favorable se
consigue cuando la pieza rellena esencialmente por completo el
alojamiento central y sale del alojamiento con la superficie de
apoyo esférica.
La siguiente descripción de las configuraciones
preferidas de la invención nos aclara la invención junto con los
dibujos. Se muestran:
Figura
1
Una vista en perspectiva de la explosión de un
implante intervertebral con una parte o pieza superior, una
inferior y una pieza articulada entre ambas;
Figura
2
Una vista en perspectiva de la explosión de la
parte superior y de la parte inferior del implante intervertebral
sin pieza articulada;
Figura
3
Una vista similar a la de la figura 2 con la
pieza articulada insertada en la parte inferior;
Figura
4
Una vista en perspectiva de la parte superior y
de la parte inferior del implante intervertebral en una aproximación
máxima;
Figura
5
Una vista frontal del implante intervertebral de
la figura 4;
Figura
6
Una vista en perspectiva del implante
intervertebral con una pieza articulada incorporada y
Figura
7
Una vista de perfil del implante intervertebral
de la figura 6.
El implante intervertebral 1 representado en la
figura engloba tres piezas, es decir una pieza superior 2 en forma
de placa, una pieza inferior 3 en forma de placa y una pieza
articulada 4 configurada en gran parte en forma de placa.
La pieza superior 2 es plana por su lado
superior, de manera que se forma una zona de apoyo 5, sobre la que
se disponen los resaltos 6,7, que sirven para el anclaje de la pieza
superior 2 en un hueso de la columna, que descansa sobre la
superficie de apoyo 5 con su superficie terminal dirigida hacia un
espacio intervertebral.
La pieza superior 2 tiene un perfil
esencialmente rectangular, de manera que en el ejemplo representado
un canto longitudinal 8 se dobla hacia fuera.
A ambos lados de la parte estrecha de este canto
rectangular el grosor de la pieza superior en forma de placa 2 es
inferior que en una zona central, de manera que a lo largo de los
lados estrechos de la pieza superior 2 se forman unos resaltos 9
que miran hacia abajo y se encuentran en paralelo a estos cantos,
los cuales se abren hacia el lateral exterior. Entre ambos resaltos
9 se encuentra la zona central de la pieza superior 2, que presenta
un grosor o altura mayor y por tanto forma un saliente 10 hacia
abajo entre ambos resaltos 9. Este está limitado por un lado
inferior 11 que transcurre en paralelo a la superficie de apoyo 5,
en el cual se encuentra un engrosamiento esférico 12, que forma un
cojinete para la pieza articulada 4.
La pieza inferior 3 del implante intervertebral
1 se ha configurado asimismo en forma de placa y presenta en su
lado inferior una superficie plana de apoyo 13 con resaltos 14 y 15,
que corresponden a los resaltos 6 y 7 de la superficie de apoyo 5.
En el lateral que se aleja de la superficie de apoyo 13 el grosor de
la pieza inferior 3 en la zona central es inferior al de la zona
exterior. Esta zona exterior con un grosor más grande tiene la
forma de una U con dos brazos paralelos 16, 17, que transcurren en
paralelo a los cantos estrechos de la pieza inferior 3 formada en
un perfil similar al de la pieza superior 2, y con un alma o brida
que une ambos brazos 16 y 17 en un lateral. La zona encerrada por
los brazos 16 y 17 y por el alma 18 forma una cavidad central 19,
cuya superficie equivale esencialmente a la superficie del saliente
central 10 de la pieza superior 2, mientras que la disposición y la
extensión de los brazos corresponden esencialmente a la disposición
y extensión del resalto 9 en la parte superior 2. Es posible
colocar la pieza superior 2 y la pieza inferior 3 de manera que el
saliente central 10 de la pieza superior 2 se sumerja en la cavidad
central 19, mientras que los brazos 16 y 17 de la parte inferior 3
se sumergen en el resalto 9 de la parte superior 2 (figura 4) y en
esta posición la pieza superior 2 y la pieza inferior 3 están lo más
cerca posible y presentan una
altura mínima.
altura mínima.
Las dimensiones se eligen de manera que
esencialmente los resaltos correspondientes se ven rellenados por
los salientes sumergidos.
En ambos brazos 16 y 17 de la pieza inferior 3
se realizan unas perforaciones de agujeros ciegos 20 y 21 en
paralelo a estos brazos 16, 17 desde sus extremos libres, cuyo
diámetro es relativamente grande en proporción a la altura de los
brazos 16, 17, y este diámetro es realmente más grande que el grosor
o la altura de la pieza inferior 3 en una zona de la cavidad
central 19.
En el saliente central 10 de la pieza superior 2
se han realizado unos agujeros ciegos 22 y 23 cerca de sus cantos
laterales, que se disponen en paralelo a los agujeros ciegos 20 y 21
de la pieza inferior 3. Estos agujeros ciegos 22 y 23 tienen un
diámetro relativamente grande, que corresponde a una parte esencial
de la altura del saliente 10 y es mayor que el grosor de la pieza
superior 2 en la zona del resalto 9.
Cuando la pieza superior 2 y la pieza inferior 3
se encuentran una junto a la otra tal como se ha descrito, los
agujeros ciegos 20 y 21 de la pieza inferior 3 y los agujeros ciegos
22 y 23 de la pieza superior 2 se solapan al menos parcialmente en
la dirección de la altura del implante intervertebral 1, tal como se
ve claramente en la representación de las figuras 4 y 5.
Las agujeros ciegos 20, 21, 22 y 23 sirven como
alojamiento o soporte para las prolongaciones en forma de barra de
un instrumento de manejo no representado en el dibujo y forman por
tanto unos elementos de agarre para este instrumento, que de este
modo se fija por separado a la pieza superior 2 y a la pieza
inferior 3. Con este instrumento de manejo es posible introducir la
pieza superior 2 y la pieza inferior 3 del implante intervertebral
1 en un espacio intervertebral. La escasa altura del implante
intervertebral 1 aligera esta introducción de forma que es posible
realizarla sin un gran ensanchamiento del espacio
intervertebral.
Tras introducir de este modo la pieza superior 2
y la pieza inferior 3, ambas piezas del implante intervertebral 1
se pueden abrir, es decir se incrementa su distancia por ejemplo con
ayuda del instrumento de manejo que sujeta la pieza superior 2 y la
pieza inferior 3.
En esta posición abierta o despatarrada de la
pieza superior 2 y de la pieza inferior 3 es posible encajar la
pieza articulada 4 entre la pieza superior 2 y la pieza inferior
3.
Esta pieza articulada 4 tiene esencialmente la
forma de una placa, que presenta un lateral inferior plano 24 y un
lateral superior 25 abombado. Las dimensiones externas de la pieza
articulada 4 en forma de placa corresponden a las de la cavidad
central 19 en la pieza inferior 3, de manera que la pieza articulada
4 pueda ser encajada en éste, por los lados donde se abren los
agujeros ciegos 20, 21, 22, 23. Para ello las regletas guía 26 se
agarran a los cantos laterales de la pieza articulada 4 en los las
correspondientes ranuras guía 27 en los brazos 16, 17, de forma que
se crea una guía intercambiable para la pieza articulada 4 que la
fija tras colocarla en la pieza inferior 3. La pieza articulada 4
encajada ocupa la cavidad 19 tras el encaje y sobresale con su lado
superior abombado 25 hacia arriba por encima del lado superior de la
pieza inferior 3. El lateral superior esférico 25 se sumerge de
modo complementario en la cavidad 12 abombada por el lado inferior
del saliente 10 y forma allí con la pieza superior 2 una
articulación esférica, que permite una cierta movilidad de la pieza
superior 2 frente a la pieza inferior 3 (figura 7).
La pieza articulada 4 puede llevar un saliente
de encastre 28 en su lateral inferior plano 24, de forma que al
encajar la pieza articulada 4 en la pieza inferior 3 se enclave
elásticamente en una escotadura 29, que se encuentre en la base de
la cavidad 19; de esta forma la pieza articulada 4 se fija en la
cavidad 19 también en la guía intercambiable.
La pieza superior 2 y la pieza inferior 3 se han
fabricado preferiblemente de metal tolerado por el cuerpo, por
ejemplo, de titanio, mientras que la pieza articulada 4 es
preferiblemente de un material plástico asimismo tolerado por el
cuerpo, por ejemplo de polietileno. Estas superficies de apoyo 5 ó
13 se pueden configurar para ser toleradas por el hueso. Es decir
estas superficies pueden ser revestidas de una capa para obtener un
anclaje óptimo con el material óseo colindante.
Claims (19)
1. Implante intervertebral con una primera pieza
(2) que presenta una superficie de apoyo (5) externa para un primer
cuerpo de vértebra y una superficie interna con al menos un saliente
(10) hacia dentro, y una segunda pieza(3) con una superficie
de apoyo (13) externa para un segundo cuerpo de vértebra colindante
al primer cuerpo de vértebra y una superficie interna, que se ha
configurado como una cavidad (19), que se ha acondicionado como
alojamiento para una pieza (4), que interacciona en un uso posterior
con la primera pieza (2), que se caracteriza porque el
saliente (10) de la primera pieza (2) se inserta en la cavidad (19)
de la segunda pieza, para que ambas piezas (2, 3) se introduzcan
juntas sin el elemento (4) en un espacio intermedio entre los
cuerpos de las vértebras.
2. Implante intervertebral conforme a la
reivindicación 1, que se caracteriza porque se dispone de
unos elementos de agarre (20, 21, 22, 23) para un instrumento de
manejo, con ayuda de los cuales se introducen la primera (2) y la
segunda pieza (3) en el espacio intermedio.
3. Implante intervertebral conforme a la
reivindicación 2, que se caracteriza porque los elementos de
agarre (20, 21, 22, 23) son orificios para elementos de sujeción en
forma de barra de un instrumento de manejo.
4. Implante intervertebral conforme a la
reivindicación 3, que se caracteriza porque los orificios
(20, 21, 22, 23) se entienden esencialmente en paralelo a las
superficies de apoyo (5, 13).
5. Implante intervertebral conforme a una de las
reivindicaciones anteriores, que se caracteriza porque la
segunda pieza (3) presenta una cavidad central (19) situada frente
a una de sus superficies de apoyo (13), que está rodeada de un
reborde en forma de U (16, 17, 18).
6. Implante intervertebral conforme a la
reivindicación 5, que se caracteriza porque la primera pieza
(2) dispone de un saliente central (10) que se adapta esencialmente
a la cavidad (19).
7. Implante intervertebral conforme a la
reivindicación 5 ó 6, que se caracteriza porque se disponen
unos elementos de agarre (20, 21) de la segunda pieza (3) a ambos
extremos del reborde en forma de U (16, 17, 18).
8. Implante intervertebral conforme a la
reivindicación 6 ó 7, que se caracteriza porque los
elementos de agarre (22, 23) de la primera pieza (2) se disponen en
el saliente central (10) de la primera pieza (2).
9. Implante intervertebral conforme a la
reivindicación 8, que se caracteriza porque los elementos de
agarre (22, 23) de la primera pieza (2) se colocan cerca del reborde
lateral del saliente central (10).
10. Implante intervertebral conforme a una de
las reivindicaciones anteriores, que se caracteriza porque
la primera pieza (2) y/o la segunda pieza (3) se configuran
esencialmente en forma de placas.
11. Implante intervertebral conforme a una de
las reivindicaciones anteriores, que se caracteriza porque
presenta una pieza con forma de pieza articulada (4), que se inserta
en la cavidad (19) de la segunda pieza (2) configurada como
alojamiento.
12. Implante intervertebral conforme a la
reivindicación 11, que se caracteriza porque la pieza
articulada (4) presenta un lateral superior esférico (25), que se
incluye en una cavidad abombada (12) de la primera pieza (2).
13. Implante intervertebral conforme a la
reivindicación 12, que se caracteriza porque la cavidad
esférica (12) se dispone en el saliente central (10) de la primera
pieza (2).
14. Implante intervertebral conforme a una de
las reivindicaciones 11 hasta 13, que se caracteriza porque
la pieza articulada (4) se encaja por el lateral en el alojamiento
(19), que lleva los elementos de agarre (20, 21, 22, 23) para un
instrumento de manejo.
15. Implante intervertebral conforme a la
reivindicación 14, que se caracteriza porque la pieza
articulada (4) se encaja en el alojamiento (19) a lo largo de una
guía (26, 27).
16. Implante intervertebral conforme a una de
las reivindicaciones 11 hasta 15, que se caracteriza porque
la pieza articulada (4) se ha configurado esencialmente en forma de
placa.
17. Implante intervertebral conforme a una de
las reivindicaciones 12 hasta 16, que se caracteriza porque
la pieza articulada (4) llena esencialmente el alojamiento central
(19) y sobresale del alojamiento (19) con el lateral superior (25)
esférico.
18. Implante intervertebral conforme a una de
las reivindicaciones anteriores, que se caracteriza porque en
la disposición encajada la altura total de la segunda pieza
acoplada con la primera pieza (2) es inferior a la suma de las
alturas por separado de la primera pieza (2) y de la segunda pieza
(3).
19. Implante intervertebral conforme a una de
las reivindicaciones 2 hasta 18, que se caracteriza porque
al menos en el saliente (10) de la primera pieza (2) y en los
laterales opuestos (16, 17) de la segunda pieza (3) se han previsto
elementos de agarre (20, 21, 22, 23) para el instrumento de manejo,
de forma que en el estado encajado de la primera y segunda pieza (2,
3) los elementos de agarre (20, 21, 22, 23) se sitúan uno junto a
otro y se solapan al menos parcialmente en la dirección de la altura
del implante intervertebral (1).
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE29911422U DE29911422U1 (de) | 1999-07-02 | 1999-07-02 | Zwischenwirbelimplantat |
PCT/EP1999/004628 WO2001001893A1 (de) | 1999-07-02 | 1999-07-02 | Zwischenwirbelimplantat |
Publications (1)
Publication Number | Publication Date |
---|---|
ES2303381T3 true ES2303381T3 (es) | 2008-08-01 |
Family
ID=26062622
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
ES99931246T Expired - Lifetime ES2303381T3 (es) | 1999-07-02 | 1999-07-02 | Implante intervertebral. |
Country Status (13)
Country | Link |
---|---|
US (6) | US6936071B1 (es) |
EP (2) | EP1194088B1 (es) |
JP (1) | JP4192262B2 (es) |
AR (1) | AR024632A1 (es) |
AT (1) | ATE388677T1 (es) |
AU (5) | AU780719B2 (es) |
BR (1) | BR9917397A (es) |
CA (1) | CA2391330C (es) |
DE (3) | DE59914691D1 (es) |
ES (1) | ES2303381T3 (es) |
MX (1) | MXPA01013413A (es) |
NZ (1) | NZ516410A (es) |
WO (1) | WO2001001893A1 (es) |
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1999
- 1999-07-02 CA CA002391330A patent/CA2391330C/en not_active Expired - Fee Related
- 1999-07-02 AU AU72245/00A patent/AU780719B2/en not_active Ceased
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- 1999-07-02 JP JP2001507397A patent/JP4192262B2/ja not_active Expired - Fee Related
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- 1999-07-02 WO PCT/EP1999/004628 patent/WO2001001893A1/de active IP Right Grant
- 1999-07-02 US US10/018,402 patent/US6936071B1/en not_active Expired - Lifetime
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