ES2358586T3 - Implante intervertebral. - Google Patents
Implante intervertebral. Download PDFInfo
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- ES2358586T3 ES2358586T3 ES03700311T ES03700311T ES2358586T3 ES 2358586 T3 ES2358586 T3 ES 2358586T3 ES 03700311 T ES03700311 T ES 03700311T ES 03700311 T ES03700311 T ES 03700311T ES 2358586 T3 ES2358586 T3 ES 2358586T3
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- intervertebral implant
- implant according
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- face
- longitudinal fixing
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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
- A61F2/4455—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
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- 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
- A61B17/86—Pins or screws or threaded wires; nuts therefor
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- 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
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- 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
- A61F2/4465—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 having a circular or kidney shaped cross-section substantially perpendicular to the axis of the spine
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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
- A61F2/02—Prostheses implantable into the body
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- A61F2/442—Intervertebral or spinal discs, e.g. resilient
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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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- 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
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- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
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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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- A61F2002/30476—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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- A61F2002/30329—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
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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
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- 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
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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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- 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
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- 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
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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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- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
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- A61F2310/00011—Metals or alloys
- A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys
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Abstract
Implante intervertebral que comprende un cuerpo tridimensional (10) con A) una cara superior (1) y una cara inferior (2) apropiadas para el contacto con las placas terminales de dos vértebras adyacentes; B) una cara lateral izquierda (3) y una cara lateral derecha (4); C) una cara anterior (5) y una cara posterior (6); D) un plano medio horizontal (7) situado entre la cara superior (1) y la cara inferior (2); E) un plano medio vertical (12) extendido desde la cara anterior (5) a la cara posterior (6); F) el cuerpo tridimensional (10) que presenta en su cara anterior (5) una placa frontal (8) a través de la cual pasa una pluralidad de agujeros (9) y en la cual pueden anclarse elementos de fijación longitudinal (20). caracterizado porque G) la mayoría de agujeros (9) perfora el cuerpo (10) y es apropiada para alojar los elementos de fijación longitudinal (20); y H) el implante intervertebral presenta, además, una placa de seguridad (18) que, en lo esencial, está fijada al cuerpo (10) o a la placa frontal (8) en forma paralela a la placa frontal (8) de modo tal, que los agujeros (9) pueden ser cubiertos, como mínimo en parte, por la placa de seguridad (18).
Description
La invención se refiere a un implante intervertebral, según el preámbulo de la reivindicación 1.
Por el documento GB-A-2 207 607 se conoce un implante intervertebral que presenta un aspecto en forma de herradura con una pluralidad de orificios cilíndricos. Los agujeros son lisos interiormente y sólo presentan un tope para las cabezas de los tornillos para hueso a insertar en ellos. La desventaja de dicha disposición consiste en que los tornillos de fijación insertados en ellos sólo pueden ser anclados en el hueso por medio de su vástago, sin que resulte una unión rígida con el implante intervertebral en forma de herradura. En cuanto se produce un debilitamiento del anclaje del vástago de tornillo, el implante intervertebral se torna móvil respecto del tornillo y los tornillos para hueso tienden a migrar, poniendo en peligro los vasos sanguíneos. El aflojamiento del implante intervertebral puede, además, producir una pseudoartrosis.
Por el documento US-A 2000/0010511 MICHELSON se conoce un implante intervertebral que en su parte frontal presenta dos agujeros con una rosca interior en la que pueden introducirse tornillos para hueso con cabeza roscada. En este implante es desventajoso, por un lado, el hecho de que los tornillos para hueso pueden volver a aflojarse y que no están bloqueados contra un desenroscado o desprendimiento. Por otra parte, existe el otro inconveniente de que los tornillos para hueso están fijados completamente en el cuerpo del implante mismo y, en consecuencia, este último experimenta un esfuerzo relativamente grande.
Los tornillos que sobresalen del borde anterior o anterolateral de la vértebra ponen en riesgo los vasos principales, como la aorta, la vena cava y vasos alimentadores como las arterias y venas lumbares. Las lesiones de los vasos principales tiene por resultado el desangrado interno en un tiempo brevísimo. El aflojamiento de los tornillos es más probable cuando no han sido afirmados angularmente.
Esto es lo que la invención pretende remediar. La invención se basa en el problema de crear un implante intervertebral que con elementos de fijación para hueso puede producir una unión rígida permanente, de modo que, aún frente a un debilitamiento de la estructura ósea, no se genera un aflojamiento entre el implante intervertebral y los elementos de fijación para hueso. Además, por medio de una placa frontal separada se quiere producir una banda de tensión para los elementos de fijación para hueso, de modo que el cuerpo de implante experimente un menor estrés, es decir, tensiones superpuestas. Por lo demás, una placa de seguridad permite la consolidación simultánea de todos los elementos de fijación para hueso.
Este objetivo es conseguido por la invención mediante un implante intervertebral que presenta las características de la reivindicación 1.
El estado actual de la técnica según el documento US-A-2002/0022843 ha sido valorado en el preámbulo.
Las ventajas alcanzadas por medio de la invención resultan, en lo esencial, de la unión rígida permanente, es decir, firme entre el implante intervertebral y los elementos de fijación longitudinal usados para su sujeción.
En la cara anterior del cuerpo tridimensional se encuentra una placa frontal dispuesta vertical respecto de un plano medio horizontal del implante intervertebral, a través de la que pasan los agujeros y en la que pueden anclarse los elementos de fijación longitudinal. Ello tiene, frente a implantes de dos piezas según el estado actual de la técnica en el que se implanta una placa frontal en un proceso quirúrgico separado, la ventaja de que la implantación del implante intervertebral es de un solo paso y, por lo tanto, más sencillo y rápido de ejecutar. Otra ventaja está basada en el hecho de que, de este modo, la fijación del implante intervertebral se produce en la vértebra, a ser posible, de modo frontal, es decir, allí donde por regla general existe buen material óseo. El resultado es una limitación del movimiento anterior, sin que por ello se genere un riesgo para las estructuras circundantes mayor que en el caso de un implante intervertebral según el estado actual de la técnica. La carga todavía es absorbida por el implante intervertebral bajo compresión y no por la placa frontal o los tornillos de fijación.
Paralela a la placa frontal puede fijarse una placa de seguridad, preferentemente por medio de una unión roscada, un cierre bayoneta o un cierre a presión. La placa de seguridad presenta, apropiadamente, un agujero central que, preferentemente, está dotado de una rosca interior. La placa frontal presenta, apropiadamente, un agujero central para el alojamiento de un elemento de sujeción.
En una forma de realización especial, como mínimo uno de los agujeros de la placa frontal está configurado de modo tal que un elemento de fijación alojado en él puede unirse de manera rígida con la placa frontal.
Por ejemplo, puede conseguirse una unión rígida porque, como mínimo, uno de los agujeros presenta una rosca interior. Consecuentemente, un tornillo para hueso correspondiente con una cabeza roscada puede ser atornillado de manera rígida al implante.
Una alternativa a ello consiste en que, como mínimo, uno de los agujeros se estrecha, cónicamente, contra la cara inferior, de modo que un tornillo para hueso con cabeza cónica correspondiente puede ser anclado rígidamente en el mismo. El agujero cónico tiene, preferentemente, un ángulo de cono menor que el ángulo de fricción resultante. Apropiadamente, la conicidad del agujero cónico es de 1 : 3,75 a 1 : 20,00, preferentemente de 1 : 5 a 1 : 15.
Los elementos de fijación de hueso pueden presentar una cabeza lisa, de modo que no se realiza una unión rígida con el implante, o bien una cabeza roscada, cabeza cónica o cabeza expansible, de modo que se realiza una unión rígida. Sin embargo, en ambos casos los elementos de fijación para hueso se aseguran mediante la placa de seguridad contra un posterior desenroscado, expulsión o caída fuera.
En una forma de realización especial, la placa frontal en el cuerpo tridimensional está configurada como inserto y, preferentemente, dispuesta desplazable de forma vertical al plano medio horizontal, de modo que pueda desplazarse sobre la vertical respecto del cuerpo tridimensional. De este modo, se consigue un "stress shielding" (protección contra o bien neutralización de tensiones mecánicas), que permite durante el proceso curativo un amoldamiento gradual de las placas terminales al implante intervertebral.
En otra forma de realización, la placa frontal está fabricada de un material distinto al del cuerpo tridimensional, preferentemente de un material metálico. Como materiales metálicos son particularmente aptos el titanio o las aleaciones de titanio. La disposición completa de bandas de tensión (placa frontal y tornillos) también puede estar fabricada de acero para implantes o materiales metálicos altamente aleados, como CoCrMo o CoCrMoC. La ventaja del titanio es la histocompatibilidad y el buen comportamiento de adherencia al hueso, la ventaja de los materiales metálicos altamente aleados está en sus elevados valores de resistencia, que permiten construcciones afiligranadas.
Apropiadamente, la cara superior y/o la cara inferior del implante intervertebral no es plana sino, preferentemente, convexa. De este modo, se consigue un mejor amoldamiento a las placas terminales de las vértebras adyacentes. En otra forma de realización, las caras laterales del implante intervertebral son, en lo esencial, todas convexas.
Apropiadamente, los agujeros no perforan la cara lateral izquierda y derecha del implante intervertebral. También la cara anterior no es atravesada, ventajosamente, por los agujeros.
En otra forma de realización preferente, como mínimo dos de los agujeros se extienden paralelos. De este modo, se facilita la insertabilidad del implante intervertebral durante la implantación.
En otra forma de realización preferente, como mínimo dos de los agujeros se extienden divergentes, visto desde la cara frontal. De este modo, con los tornillos para hueso se llega a una zona de la vértebra que, a comparación con su centro, presenta una mejor calidad ósea.
En una forma de realización especial, los ejes de los agujeros incluyen respecto del plano medio horizontal un ángulo β en el intervalo de 20º a 60º, preferentemente de 36º a 48º. Apropiadamente, los ejes de los agujeros incluyen respecto del plano medio vertical un ángulo α en el intervalo de 10º a 45º, preferentemente de 27º a 33º. Con ello, se consigue un mejor acceso al colocar los tornillos.
En otra forma de realización, el plano medio horizontal no es perforado por los agujeros.
En una forma de realización especial, la cara superior y la cara inferior del cuerpo están dotadas de una estructuración, preferentemente en forma de dientes.
El implante intervertebral puede estar conformado como cuerpo hueco, cuyas superficies exteriores están dotadas, preferentemente, de perforaciones.
Según sean las circunstancias, dos, tres, cuatro o también más elementos de fijación longitudinal pueden conectarse de modo rígido con el implante intervertebral; apropiadamente, como mínimo un elemento de fijación debería perforar la cara superior y, como mínimo, un elemento de fijación perforar la cara inferior del implante intervertebral.
Preferentemente, se usan elementos de fijación longitudinal en forma de tornillos para hueso con una cabeza y un vástago, estando la cabeza dotada, preferentemente, de una rosca exterior que se corresponde con la rosca interior del agujero del implante intervertebral. En una segunda forma de unión rígida posible puede usarse, preferentemente, un tornillo para hueso en el que la cabeza se estrecha cónicamente hacia el vástago, correspondiéndose la conicidad de la cabeza con la conicidad del agujero del implante intervertebral.
En otra forma de realización, como mínimo dos elementos de fijación longitudinal perforan la cara superior y, como
mínimo, dos elementos de fijación longitudinal perforan la cara inferior. Con ello, el implante intervertebral recibe un
anclaje óptimo en las vértebras adyacentes.
Los elementos de fijación longitudinal configurados como tornillos para hueso presentan, preferentemente, una rosca
exterior autoperforante y de rosca cortante. Los elementos de fijación longitudinal también pueden estar
conformados como pasadores cilíndricos sin rosca, dotados de una punta de broca, preferentemente en forma de
trócar.
Otra variante consiste en que los elementos de fijación longitudinal están conformados como resortes helicoidales y,
finalmente, los elementos de fijación longitudinal también pueden estar configurados como cuchillas helicoidales de
una o más hélices.
El implante intervertebral puede estar fabricado de cualquier material biocompatible, sin embargo, el cuerpo se
compone, apropiadamente, de un plástico biocompatible, preferentemente un plástico no reforzado. La ventaje
respecto de los plásticos reforzados con fibra ya conocidos por la implantología consiste en que no se dejan al
descubierto las fibras de refuerzo, lo que desde el punto de vista clínico es una desventaja. En un cuerpo compuesto
de un material no reforzado de este tipo, pueden usarse, apropiadamente, tornillos para hueso cuya rosca exterior
presenta un ángulo de flanco de carga en el intervalo de 11º a 14º, preferentemente 12º a 13º. Una inclinación
comparativamente reducida del flanco de carga produce una elevada fuerza de retención, por lo cual en el plástico
se reduce el alargamiento radial y el riesgo de fisuras. Apropiadamente, la rosca externa de los tornillos para hueso
presenta un ángulo de paso en el intervalo de 6º a 10º, preferentemente de 7º a 9º. Dicho ángulo de paso especial
produce un autobloqueo en la rosca y, de este modo, asegura el tornillo para hueso contra un desatornillado
autónomo.
Para mejorar el anclaje del tornillo para hueso en el cuerpo de plástico, el agujero puede ser un casquillo metálico
con rosca interior. El implante intervertebral también puede estar compuesto sólo en parte de un plástico
transparente a los rayos X y de metal en la zona de los agujeros, por ejemplo, de titanio o aleación de titanio. De
este modo, se consigue una mejor guía y anclaje de los tornillos para hueso en el implante intervertebral.
En otra forma de realización preferente, los agujeros también pueden presentar una pared interior lisa en la que
puede entallarse o moldearse la cabeza roscada de un elemento de fijación longitudinal metálico.
A continuación, la invención y los perfeccionamientos de la invención se explican en mayor detalle mediante la
ilustración parcialmente esquemática de un modelo de fabricación.
Presentan:
La figura 1, un despiece del implante intervertebral;
la figura 2, un elemento de fijación longitudinal en forma de tornillo;
la figura 3, una vista frontal del implante intervertebral según la figura 1;
la figura 4, una vista lateral del implante intervertebral según la figura 1;
la figura 5, una vista tridimensional en detalle del cuerpo del implante intervertebral, que muestra los elementos de
unión a la placa frontal según la figura 6;
la figura 6, una vista tridimensional en detalle de la placa frontal del implante intervertebral, que muestra los
elementos de unión al cuerpo según la figura 5; y
la figura 7, un implante intervertebral montado completamente, con placa frontal y placa de seguridad.
El implante intervertebral presentado en las figuras 1 a 7 comprende un cuerpo tridimensional 10 en forma de jaula
con una cara superior 1 y una cara inferior 2, aptos para el contacto con las placas terminales de dos vértebras
adyacentes, una cara lateral izquierda 3 y una cara lateral derecha 4, una cara anterior 5 y una cara posterior 6, un
plano medio horizontal 7 situado entre la cara superior 1 y la cara inferior 2, un plano medio vertical 12 extendido
desde la cara anterior 5 hasta la cara posterior 6, cuatro agujeros 9 que perforan el cuerpo 10, apropiados para
alojar elementos de fijación longitudinal 20.
El cuerpo 10 puede estar conformado como cuerpo hueco, cuyas superficies exteriores están dotadas de
perforaciones 19.
El cuerpo tridimensional 10 presenta en su cara anterior 5 una placa frontal 8 a través de la cual pasan los agujeros
9 y en la cual pueden anclarse los elementos de fijación longitudinal 20.
El implante intervertebral presenta, además, una placa de seguridad 18 que, mediante una unión roscada, está fijada
a la placa frontal 8 en forma paralela a la placa frontal 8 de modo tal, que los agujeros 9 pueden ser cubiertos en
parte por la placa de seguridad 18. Con este propósito, la placa de seguridad 18 presenta un agujero central 17.
Correspondiendo con ello, la placa frontal 8 presenta un agujero central 15 con rosca interior 14 para alojar un
elemento de sujeción 16 en forma de tornillo.
Los cuatro agujeros 9 en la placa frontal 8 presentan una rosca interior 11, de modo que, alojados allí, los elementos de fijación longitudinal 20 en forma de tornillo pueden conectarse en forma rígida con la placa frontal 8.
La placa frontal 8 se compone de titanio y el cuerpo tridimensional 10 de un plástico no reforzado transparente a los rayos X. Como se ilustra en las figuras 5/6, la placa frontal 8 está conformada como inserto para el cuerpo 10 y dispuesta en forma desplazable, vertical respecto del plano medio horizontal 7. Con este propósito, el cuerpo 10 presenta en las transiciones de la cara lateral izquierda 3 o de la cara lateral derecha 4 (figura 5) a la cara anterior 5 una ranura 27 semicircular cilíndrica extendida paralela al plano medio vertical 12. Correspondientemente, la placa frontal 8 presenta a la izquierda y a la derecha (figura 6) un riel semicircular cilíndrico 28 de igual extensión e igual dimensión. De este modo, en la fabricación del implante intervertebral, la placa frontal con sus dos rieles laterales 28 puede encajar y posicionarse fácilmente en las ranuras 27 respectivas del cuerpo 10.
Las caras laterales 1, 2, 3, 4, 5 y 6 del cuerpo 10 son todas conformadas convexas.
Los agujeros 9 no perforan la cara lateral izquierda 3 ni la cara lateral derecha 4; tampoco la cara frontal 5 es perforada completamente por los agujeros 9.
Los cuatro agujeros 9, vistos desde la cara anterior 5, se extienden todos divergentes (figura 7).
Los ejes 24 de los agujeros 9 incluyen respecto del plano medio horizontal 7 un ángulo β de 42º y respecto del plano medio vertical 12 un ángulo α de 30º.
Los agujeros 9 no perforan el plano medio horizontal 7, solamente los ejes 24 de los elementos de fijación longitudinal 20 insertados allí cortan el plano medio horizontal 7 del cuerpo 10.
Como se presenta en la figura 7, la cara superior 1 y la cara inferior 2 del cuerpo 10 están dotadas de una estructuración en forma de dientes 30.
Los elementos de fijación longitudinal 20 están conformados como tornillos para huesos. Como se presenta en la figura 2, los elementos de fijación longitudinal 20 insertados en los agujeros 9 presentan una cabeza 21, una punta 22, un vástago 23 y un eje 24. La cabeza 21 está dotada de una rosca exterior 25 que se corresponde con la rosca interior 11 del agujero 9, de modo que las cabezas 21 pueden ser ancladas de forma rígida en los agujeros 9. El vástago 23 está dotado de una rosca 26 autoperforante y de rosca cortante. El ángulo de flanco de carga de la rosca 26 es de 12,5°y el ángulo de paso de 8°.
Por medio de la fijación de la placa de seguridad 18 a la placa frontal 8, las cabezas 21 de los elementos de fijación longitudinal 20 son contactadas por la placa de seguridad 18, de modo que están aseguradas contra una expulsión o desenroscado.
Como se presenta en la figura 7, dos elementos de fijación longitudinal 20 perforan la cara superior 1 y dos elementos de fijación longitudinal 20 perforan la cara inferior 2 del cuerpo 10.
Para una explicación adicional de la invención sigue una breve descripción de la operación:
- 1.
- a) El implante intervertebral en forma de cuerpo tridimensional (10) es colocado por medio de un instrumento apropiado entre dos vértebras adyacentes;
- 2.
- b) cuatro elementos de fijación longitudinal 20 en forma de tornillos para hueso son atornillados en las vértebras por medio de un instrumental de puntería apropiado, a través de los agujeros 9 de la placa frontal 8.
- 3.
- c) la placa de seguridad 18 es fijada a la placa frontal por medio del elemento de sujeción 16 en forma de tornillo por encima de las cabezas 21 de los elementos de fijación longitudinal 20, de modo que las cabezas 21 de los elementos de fijación longitudinal 20, y con ello los tornillos mismos, son capturados entre la placa frontal 8 y la placa de seguridad 18 y asegurados contra un desplazamiento relativo respecto del cuerpo 10 (por ejemplo, por caída fuera o desenroscamiento). El elemento de sujeción 16 en forma de tornillo está dotado, preferentemente, de una rosca caracterizada por ser muy autobloqueante.
Claims (38)
- REIVINDICACIONES1. Implante intervertebral que comprende un cuerpo tridimensional (10) con A) una cara superior (1) y una cara inferior (2) apropiadas para el contacto con las placas terminales de dos vértebras adyacentes; B) una cara lateral izquierda (3) y una cara lateral derecha (4); C) una cara anterior (5) y una cara posterior (6); D) un plano medio horizontal (7) situado entre la cara superior (1) y la cara inferior (2); E) un plano medio vertical (12) extendido desde la cara anterior (5) a la cara posterior (6); F) el cuerpo tridimensional (10) que presenta en su cara anterior (5) una placa frontal (8) a través de la cual pasa una pluralidad de agujeros (9) y en la cual pueden anclarse elementos de fijación longitudinal (20). caracterizado porque G) la mayoría de agujeros (9) perfora el cuerpo (10) y es apropiada para alojar los elementos de fijación longitudinal (20); y H) el implante intervertebral presenta, además, una placa de seguridad (18) que, en lo esencial, está fijada al cuerpo(10) o a la placa frontal (8) en forma paralela a la placa frontal (8) de modo tal, que los agujeros (9) pueden ser cubiertos, como mínimo en parte, por la placa de seguridad (18).
-
- 2.
- Implante intervertebral según la reivindicación 1, caracterizado porque la placa de seguridad (18) puede ser fijada paralela a la placa frontal (8), preferentemente por medio de una unión roscada, un cierre bayoneta o un cierre a presión.
-
- 3.
- Implante intervertebral según la reivindicación 1 o 2, caracterizado porque la placa de seguridad (18) presenta un agujero central (17).
-
- 4.
- Implante intervertebral según la reivindicación 3, caracterizado porque la placa frontal (8) presenta un agujero central (15) para alojar un elemento de sujeción (16) dotado, preferentemente, de una rosca interior (14).
-
- 5.
- Implante intervertebral según una de las reivindicaciones 1 a 4, caracterizado porque la placa frontal en el cuerpo tridimensional está conformada como inserto y dispuesta desplazable.
-
- 6.
- Implante intervertebral según la reivindicación 5, caracterizado porque, como mínimo, uno de los agujeros (9) presenta una rosca interior (11).
-
- 7.
- Implante intervertebral según la reivindicación 5 o 6, caracterizado porque, como mínimo, un agujero (9) se estrecha, cónicamente, contra la cara inferior (2).
-
- 8.
- Implante intervertebral según la reivindicación 7, caracterizado porque el agujero cónico (9) tiene un ángulo de cono que es menor que el ángulo de fricción resultante.
-
- 9.
- Implante intervertebral según la reivindicación 8, caracterizado porque la conicidad del agujero cónico (9) se encuentra en el intervalo de 1: 3,75 a 1: 20,00, preferentemente en el intervalo de 1: 5 a 1: 15.
-
- 10.
- Implante intervertebral según una de las reivindicaciones 1 a 9, caracterizado porque la placa frontal (8) está configurada como inserto y, preferentemente, dispuesta vertical al plano medio horizontal (7).
-
- 11.
- Implante intervertebral según la reivindicación 10, caracterizado porque la placa frontal (8) en el cuerpo tridimensional (19) está dispuesta desplazable, vertical al plano medio (7).
-
- 12.
- Implante intervertebral según una de las reivindicaciones 1 a 11, caracterizado porque la placa frontal (8) está fabricada de un material distinto al del cuerpo tridimensional (10) y es, preferentemente, metálica.
-
- 13.
- Implante intervertebral según una de las reivindicaciones 1 a 12, caracterizado porque sus caras laterales (1, 2, 3, 4, 5, 6) están todas conformadas, en lo esencial, convexas.
-
- 14.
- Implante intervertebral según una de las reivindicaciones 1 a 13, caracterizado porque la cara superior (1) y/o la cara inferior (2) no están conformadas planas y, preferentemente, conformadas convexas.
-
- 15.
- Implante intervertebral según una de las reivindicaciones 1 a 14, caracterizado porque los agujeros (9) no perforan la cara lateral izquierda (3) y la cara lateral derecha (4).
-
- 16.
- Implante intervertebral según una de las reivindicaciones 1 a 15, caracterizado porque los agujeros (9) no perforan completamente la cara frontal (5).
-
- 17.
- Implante intervertebral según una de las reivindicaciones 1 a 16, caracterizado porque, como mínimo, dos de los agujeros (9) se extienden paralelos.
-
- 18.
- Implante intervertebral según una de las reivindicaciones 1 a 17, caracterizado porque, como mínimo, dos de los agujeros (9), vistos desde la cara frontal (1), se extienden divergentes.
-
- 19.
- Implante intervertebral según una de las reivindicaciones 1 a 18, caracterizado porque los ejes (24) de los agujeros (9) incluyen respecto del plano medio horizontal (7) un ángulo (β) en el intervalo de 20º a 60º, preferentemente de 36º a 48º.
-
- 20.
- Implante intervertebral según una de las reivindicaciones 1 a 19, caracterizado porque los ejes (24) de los agujeros (9) incluyen respecto del plano medio horizontal (12) un ángulo (α) en el intervalo de 10º a 45º, preferentemente de 27º a 33º.
-
- 21.
- Implante intervertebral según una de las reivindicaciones 1 a 20, caracterizado porque los agujeros (9) no perforan el plano medio horizontal (7).
-
- 22.
- Implante intervertebral según una de las reivindicaciones 1 a 21, caracterizado porque el cuerpo (10) se compone de plástico, preferentemente un plástico no reforzado.
-
- 23.
- Implante intervertebral según una de las reivindicaciones 1 a 22, caracterizado porque el agujero (9) presenta un casquillo metálico con rosca interior (11).
-
- 24.
- Implante intervertebral según una de las reivindicaciones 1 a 23, caracterizado porque se compone en parte de un material transparente a los rayos X, preferentemente un plástico, y en la zona de los agujeros (9) de un metal, preferentemente sobre la base de titanio.
-
- 25.
- Implante intervertebral según una de las reivindicaciones 1 a 24, caracterizado porque los agujeros (9) presentan una pared interior lisa en la que puede entallarse o moldearse la cabeza roscada de un elemento de fijación longitudinal (20) metálico.
-
- 26.
- Implante intervertebral según una de las reivindicaciones 1 a 25, caracterizado porque su cara superior (1) y cara inferior (2) están dotadas de una estructuración, preferentemente en forma de dientes (30).
-
- 27.
- Implante intervertebral según una de las reivindicaciones 1 a 26, caracterizado porque está conformado como cuerpo hueco, cuyas superficies exteriores están dotadas, preferentemente, de perforaciones (19).
-
- 28.
- Implante intervertebral según una de las reivindicaciones 1 a 27 con, como mínimo, dos elementos de fijación longitudinal (20) insertables en los agujeros (9), caracterizado porque los elementos de fijación longitudinal (20) insertados en los agujeros (9) presentan una cabeza (21), una punta (22), un vástago (23) y un eje (24) y porque las cabezas (21) pueden ser ancladas en los agujeros (9).
-
- 29.
- Implante intervertebral según la reivindicación 28, caracterizado porque las cabezas (21) pueden ser contactadas por las placas de seguridad (18) fijadas al cuerpo (10) o a la placa frontal (8).
-
- 30.
- Implante intervertebral según la reivindicación 28 o 29, caracterizado porque los ejes (24) de los elementos de fijación longitudinal (20) cortan el plano medio horizontal (7) del cuerpo (10).
-
- 31.
- Implante intervertebral según una de las reivindicaciones 28 a 30, caracterizado porque, como mínimo, un elemento de fijación longitudinal (20) perfora la cara superior (1) y, como mínimo, un elemento de fijación longitudinal
(20) perfora la cara inferior (2). -
- 32.
- Implante intervertebral según una de las reivindicaciones 28 a 31, caracterizado porque la cabeza (21) está dotada de una rosca exterior (25) que se corresponde con la rosca interior (11) del agujero (9).
-
- 33.
- Implante intervertebral según una de las reivindicaciones 28 a 32, caracterizado porque la cabeza (21) se estrecha, cónicamente, hacia el vástago (23) y la conicidad de la cabeza (21) corresponde, preferentemente, a la conicidad del agujero (9).
-
- 34.
- Implante intervertebral según una de las reivindicaciones 28 a 33, caracterizado porque, como mínimo, dos elementos de fijación longitudinal (20) perforan la cara superior (1) y, como mínimo, dos elementos longitudinales de fijación (20) perforan la cara inferior (2).
-
- 35.
- Implante intervertebral según una de las reivindicaciones 28 a 34, caracterizado porque los elementos de fijación longitudinal (20) están conformados como tornillos para hueso, cuyo vástago (23) está dotado de una rosca (26) que, preferentemente, es autoperforante y de rosca cortante.
5 36. Implante intervertebral según una de las reivindicaciones 28 a 35, caracterizado porque los elementos de fijación longitudinal (20) están conformados como pasadores cilíndricos sin rosca dotados de una punta de broca, preferentemente en forma de trócar. - 37. Implante intervertebral según una de las reivindicaciones 28 a 36, caracterizado porque los elementos de fijación 10 longitudinal (20) están configurados como resortes helicoidales.
- 38. Implante intervertebral según una de las reivindicaciones 28 a 37, caracterizado porque los elementos de fijación longitudinal (20) están configurados como cuchillas helicoidales de una o más hélices.15 39. Implante intervertebral según una de las reivindicaciones 28 a 38, caracterizado porque la rosca (26) del vástago(23) de los elementos de fijación longitudinal (20) presenta un ángulo de flanco de carga en el intervalo de 11°a 14°, preferentemente de 12°a 13°.
- 40. Implante intervertebral según una de las reivindicaciones 1 a 39, caracterizado porque, como mínimo, uno de los20 agujeros (9) en la placa frontal (8) está configurado de modo tal, que un elemento de fijación longitudinal (20) alojado en el mismo es conectable de manera rígida con la placa frontal (8) en el sentido hacia la cara inferior (2), por medio de una rosca interior del, como mínimo, único agujero (9) o por medio de un estrechamiento cónico del, como mínimo, único agujero (9).
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US10327910B2 (en) | 2013-03-14 | 2019-06-25 | X-Spine Systems, Inc. | Spinal implant and assembly |
US9566169B2 (en) | 2014-03-13 | 2017-02-14 | DePuy Synthes Products, Inc. | ACIS allograft designs |
US9867718B2 (en) | 2014-10-22 | 2018-01-16 | DePuy Synthes Products, Inc. | Intervertebral implants, systems, and methods of use |
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2003
- 2003-02-06 DE DE50313446T patent/DE50313446D1/de not_active Expired - Lifetime
- 2003-02-06 EP EP11009997A patent/EP2457541A1/de not_active Withdrawn
- 2003-02-06 CA CA2515247A patent/CA2515247C/en not_active Expired - Fee Related
- 2003-02-06 ES ES03700311T patent/ES2358586T3/es not_active Expired - Lifetime
- 2003-02-06 AT AT03700311T patent/ATE496593T1/de active
- 2003-02-06 WO PCT/CH2003/000089 patent/WO2004069106A1/de active Application Filing
- 2003-02-06 EP EP03700311A patent/EP1589909B1/de not_active Expired - Lifetime
- 2003-02-06 BR BRPI0317820-0A patent/BRPI0317820B1/pt not_active IP Right Cessation
- 2003-02-06 AU AU2003201614A patent/AU2003201614B2/en not_active Expired
- 2003-02-06 EP EP10014938A patent/EP2335656B1/de not_active Expired - Lifetime
- 2003-02-06 ES ES10014938T patent/ES2393099T3/es not_active Expired - Lifetime
- 2003-02-06 JP JP2004567675A patent/JP4977323B2/ja not_active Expired - Lifetime
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2004
- 2004-01-07 TW TW093100340A patent/TWI315196B/zh not_active IP Right Cessation
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2005
- 2005-08-08 US US11/199,599 patent/US7846207B2/en active Active
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2009
- 2009-04-29 US US12/432,088 patent/US7862616B2/en not_active Expired - Lifetime
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2010
- 2010-12-15 US US12/969,330 patent/US8764831B2/en not_active Expired - Lifetime
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2011
- 2011-10-28 US US13/284,650 patent/US8709085B2/en not_active Expired - Lifetime
- 2011-10-28 US US13/284,676 patent/US8715354B2/en not_active Expired - Lifetime
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2014
- 2014-05-09 US US14/273,760 patent/US9463097B2/en not_active Expired - Lifetime
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2015
- 2015-07-16 US US14/801,336 patent/US10064740B2/en not_active Expired - Lifetime
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2018
- 2018-08-13 US US16/101,980 patent/US10660765B2/en not_active Expired - Lifetime
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2020
- 2020-05-07 US US16/868,824 patent/US20200261244A1/en not_active Abandoned
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