ES2575379T3 - Prótesis de disco intervertebral - Google Patents

Prótesis de disco intervertebral Download PDF

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Publication number
ES2575379T3
ES2575379T3 ES13170071.8T ES13170071T ES2575379T3 ES 2575379 T3 ES2575379 T3 ES 2575379T3 ES 13170071 T ES13170071 T ES 13170071T ES 2575379 T3 ES2575379 T3 ES 2575379T3
Authority
ES
Spain
Prior art keywords
intervertebral disc
plate
disc prosthesis
anchoring device
prosthesis
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
Application number
ES13170071.8T
Other languages
English (en)
Inventor
Jacques Beaurin
Jean-Marc Fuentes
Jean-Marc Vital
Thierry Dufour
Jean Huppert
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
LDR Medical SAS
Original Assignee
LDR Medical SAS
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by LDR Medical SAS filed Critical LDR Medical SAS
Application granted granted Critical
Publication of ES2575379T3 publication Critical patent/ES2575379T3/es
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/442—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
    • A61F2/44—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
    • A61F2/44—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
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B17/0642—Surgical staples, i.e. penetrating the tissue for bones, e.g. for osteosynthesis or connecting tendon to bone
    • A—HUMAN NECESSITIES
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    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B17/0644—Surgical staples, i.e. penetrating the tissue penetrating the tissue, deformable to closed position
    • A—HUMAN NECESSITIES
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    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B2017/0647—Surgical staples, i.e. penetrating the tissue having one single leg, e.g. tacks
    • 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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    • 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
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    • A61F2/0811—Fixation devices for tendons or ligaments
    • A61F2002/0876—Position of anchor in respect to the bone
    • A61F2002/0882—Anchor in or on top of a bone tunnel, i.e. a hole running through the entire bone
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    • 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
    • A61F2002/30354—Cylindrically-shaped protrusion and recess, e.g. cylinder of circular basis
    • 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
    • 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
    • A61F2002/30362—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 with possibility of relative movement between the protrusion and the recess
    • A61F2002/30364—Rotation about the common longitudinal axis
    • A61F2002/30365—Rotation about the common longitudinal axis with additional means for limiting said rotation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—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
    • A61F2002/30362—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 with possibility of relative movement between the protrusion and the recess
    • A61F2002/30369—Limited lateral translation of the protrusion within a larger recess
    • 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
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30383—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
    • A61F2002/3039—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove with possibility of relative movement of the rib within the groove
    • A61F2002/30392—Rotation
    • A61F2002/30393—Rotation with additional means for limiting said rotation
    • 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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    • A61F2002/30383—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
    • A61F2002/3039—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove with possibility of relative movement of the rib within the groove
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    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30576—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs
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    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
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    • 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
    • A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30884—Fins or wings, e.g. longitudinal wings for preventing rotation within the bone 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
    • A61F2/442—Intervertebral or spinal discs, e.g. resilient
    • A61F2/4425—Intervertebral or spinal discs, e.g. resilient made of articulated components
    • A61F2002/443—Intervertebral or spinal discs, e.g. resilient made of articulated components having two transversal endplates and at least one intermediate component
    • 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
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0008—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
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0008—Fixation appliances for connecting prostheses to the body
    • A61F2220/0016—Fixation appliances for connecting prostheses to the body with sharp anchoring protrusions, e.g. barbs, pins, spikes
    • 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
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • 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
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
    • 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
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0041—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting screws

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

Abstract

Dispositivo (4) de anclaje para anclar un implante, en particular una prótesis de disco intervertebral, en al menos una de las vértebras, entre las cuales dicha prótesis de disco intervertebral está prevista para insertarse, caracterizado porque dicho dispositivo (4) de anclaje comprende: - un cuerpo (40) que tiene la forma de una placa prevista para insertarse a través de una abertura (28) de forma rectangular en una placa (2) de dicha prótesis de disco intervertebral, afilándose el perfil de la placa formada por el cuerpo en su extremo previsto para penetrar en las vértebras, - una cabeza (41) de dimensiones mayores que aquellas de la abertura (28), de tal manera que dicha placa (2) de la prótesis de disco intervertebral está insertada a modo de sándwich entre la cabeza (41) del medio (4) de anclaje y dicha vértebra, cuando dicho cuerpo (40) está implantado en dicha vértebra.

Description

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DESCRIPCION
Protesis de disco intervertebral
La presente invencion se refiere a una protesis de disco intervertebral prevista para sustituir los discos fibrocartilaginosos que unen las vertebras en la columna vertebral, en particular en la columna cervical.
Se conocen varios tipos de protesis en la tecnica anterior. Algunas de estas protesis, o bien debido a que estan compuestas de material compresible, o bien de bebido a que permiten un movimiento excesivo de las diferentes partes constituyentes de la protesis unas respecto a otras, pueden provocar con relativa facilidad la eyeccion de al menos una parte de la protesis fuera de las vertebras, lo cual no es deseable para el paciente.
El documento WO 03/005939 A2 divulga un dispositivo de anclaje de acuerdo con el preambulo de la reivindicacion 1.
El objetivo de la presente invencion es solucionar algunos inconvenientes de la tecnica anterior al proponer una protesis de disco intervertebral simple que haga posible limitar los movimientos de las diferentes partes constituyentes de la protesis unas respecto a otras.
Este objetivo se alcanza mediante el objetivo de la reivindicacion 1.
Adicionalmente se definen caractensticas ventajosas adicionales en las reivindicaciones dependientes.
Otras caractensticas y ventajas de la presente invencion resultaran mas claras al leer la descripcion mas adelante, con referencia a las figuras adjuntas, en las que:
- las figuras 1a y 1b representan respectivamente una vista desde abajo y una vista desde abajo en perspectiva de la placa superior de acuerdo con una realizacion,
- las figuras 2a y 2b representan respectivamente una vista desde arriba y una vista desde arriba en perspectiva de la placa inferior de acuerdo con una realizacion,
- las figuras 3a y 3b representan respectivamente una vista desde arriba y una vista desde arriba en perspectiva del nucleo de acuerdo con una realizacion,
- las figuras 4a y 4b representan respectivamente una vista desde arriba en perspectiva y una vista lateral de la protesis de disco intervertebral de acuerdo con la realizacion de las figuras 1a, 1b, 2a, 2b, 3a y 3b,
- las figuras 5a y 5b representan respectivamente una vista lateral y una vista seccionada a lo largo del plano D- D de la figura 5a de la protesis de disco intervertebral de acuerdo con una segunda realizacion,
- la figura 6a representa una vista lateral de la protesis de disco intervertebral de acuerdo con una tercera realizacion,
- las figuras 6b y 6d representan una vista seccionada a lo largo del plano A-A de la figura 6, presentando el nucleo respectivamente una ligera holgura y ninguna holgura con respecto a la placa inferior,
- las figuras 6c y 6e representan una vista seccionada a lo largo del plano B-B de la figura 6b y 6d respectivamente de la protesis de disco intervertebral,
- las figuras 7a y 8a respectivamente representan una vista desde arriba y una vista desde abajo en perspectiva de la placa inferior de acuerdo con las otras dos realizaciones,
- las figuras 7b y 8b representan respectivamente representan una vista lateral en perspectiva y una vista desde arriba en perspectiva de la placa inferior de las figuras 7a y 8a respectivamente, en las que los medios de anclaje de protesis estan insertados de acuerdo con las dos realizaciones diferentes,
- la figura 9a representa una vista desde arriba de la placa inferior de acuerdo con una cuarta realizacion,
- la figura 9b representa una vista seccionada de la placa inferior a lo largo del plano C-C de la figura 9a,
- las figuras 10a y 10b representan respectivamente una vista trasera y lateral de la placa superior de acuerdo con otra realizacion.
La protesis de disco intervertebral de acuerdo con la invencion es constituyente de una placa superior 1 que esta articulada con respecto a una placa inferior 2 por medio de un nucleo 3, tal como puede verse en particular en las figuras 4a, 4b, 5a y 6a. Una ventaja de la protesis de acuerdo con la invencion es que comprende partes simples que pueden estar disenadas para que la protesis se encaje sobre la columna cervical.
La placa superior 1, en particular visible en las figuras 1 a y 1b es ligeramente concava sobre al menos la parte 10 de su superficie inferior para encajar con la superficie superior ligeramente convexa del nucleo 3. La superficie superior del nucleo 3 es complementaria a la parte concava 10 de la placa superior 1, permitiendo el movimiento entre la placa superior 1 y el nucleo 3.
En una realizacion alternativa, parte de la superficie superior de la placa superior 1 es convexa, tal como se muestra en las figuras 10a y 10b, para encajar mejor sobre la vertebra sobre la que la protesis va a encajarse, siendo la parte inferior de la vertebra concava. En este caso la parte convexa de la placa superior 1 esta situada en la parte frontal de la placa superior, tal como puede verse particularmente en la figura 10b.
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La placa inferior 2 es sustancialmente plana. En efecto, su superficie inferior no necesita ser convexa o concava dado que la parte de arriba de las vertebras es sustancialmente llana. En la realizacion de las figuras 2a, 2b, 7a y 8a la placa inferior 2 comprende dos pasadores 20 situados uno enfrente del otro sobre dos bordes 21, 22 sustancialmente paralelos de la placa inferior 2. Cada pasador 20 esta curvado hacia el interior de la protesis y puede por tanto entrar en los rebajes 30 situados sobre el nucleo 3. El nucleo 3, particularmente visible en las figuras 3a y 3b comprende una superficie inferior sustancialmente plana provista para encajar sobre la placa inferior 2. El nucleo 3 es delgado (por ejemplo 3 mm de grosor) para una protesis cervical, o mas grueso (por ejemplo 15 mm) para una protesis lumbar.
En la realizacion de las figuras 3a, 3b, 4a y 4b las dimensiones de cada rebaje 30 del nucleo 3 son ligeramente mayores que aquellas de cada pasador 20 de la placa inferior 2, para limitar la holgura del nucleo 3 con respecto a la placa inferior 2, ambos en traslacion a lo largo de un eje sustancialmente en paralelo con la placa inferior 2, y en rotacion alrededor de un eje sustancialmente en perpendicular a la placa inferior 2. El movimiento entre la placa superior y el nucleo 3, asf como la holgura del nucleo 3 con respecto a la placa inferior 2 por tanto permite al paciente moverse, y en caso necesario, compensar los defectos de posicionamiento de la protesis. Esta holgura ofrece por tanto la ventaja de impedir el desgaste prematuro debido a la tension aplicada a la protesis.
En la realizacion de las figuras 5a y 5b las dimensiones de cada rebaje 30 del nucleo 3 son sustancialmente las mismas que aquellas de cada pasador 20 de la placa inferior 3 para prevenir cualquier holgura del nucleo 3 con respecto a la placa inferior 2, ambos en traslacion y rotacion. En el ultimo caso, el unico movimiento de la protesis autorizado es el de la placa superior 1 con respecto al nucleo 3.
En la realizacion en las figuras 9a y 9b, uno de los pasadores 20 esta reemplazado por un taco equipado con una perforacion 200. Un apendice 23 se fija sobre el taco por medio de una espiga 24 que penetra en la perforacion 200. En una realizacion alternativa ambos pasadores estan reemplazados por un taco sobre el que esta fijado un apendice 23.
En la realizacion de las figuras 6a, 6b, 6c, 6d y 6e la placa inferior 2 no comprende ningun pasador 20 sino dos pasadores 25 de espiga situados proximos al centro de la placa inferior 2. En este caso el nucleo 3, de manera complementaria, no comprende ningun rebaje 30 sino dos huecos 35 bajo su superficie inferior. Las dimensiones de los pasadores 25 de espiga de la placa inferior 2 y los huecos 35 del nucleo 3 son tales que en la realizacion alternativa representada en las figuras 6b y 6c, se permite una ligera holgura en la traslacion y en la rotacion, y en la realizacion alternativa representada en las figuras 6d y 6e no se permite ninguna holgura.
En otra realizacion, no mostrada, la placa inferior 2 comprende un nervio sobre su superficie superior y ningun pasador 20 o pasador 25 de espiga. El nucleo 3, de manera complementaria, comprende una ranura bajo su superficie inferior. Las dimensiones del nervio de la placa inferior y la ranura del nucleo son tales que, en una realizacion alternativa se permite una ligera holgura en traslacion y rotacion, y en otra realizacion alternativa, no se permite ninguna holgura.
En otra realizacion no mostrada la placa inferior 2 comprende, en lugar de los pasadores 20, dos paredes dispuestas una enfrente de la otra, proximas a dos bordes 21, 22 sustancialmente paralelos de la placa inferior, pero alejadas en la protesis que los pasadores 20. El nucleo 3 comprende rebajes complementarios con respecto a las paredes. Las dimensiones de cada rebaje del nucleo en esta realizacion son, o bien ligeramente mayores, o sustancialmente las mismas que aquellas de cada pared de la placa inferior para permitir una ligera holgura en traslacion y rotacion, o no.
En una realizacion adicional no mostrada, los componentes femeninos estan situados sobre la placa inferior y los componentes masculinos sobre el nucleo.
La protesis de disco intervertebral de acuerdo con la invencion hace posible en particular corregir defectos en la lordosis y anadir lordosis a la columna, por ejemplo la columna cervical. Por tanto la presencia de un angulo agudo en la direccion delantera-trasera F, figura 4b, entre la placa superior 1 y la placa inferior 2 de la protesis es necesaria. Por ejemplo, el angulo esta entre 0° y 15°. Para ajustar el angulo necesario de acuerdo con el paciente es simplemente necesario seleccionar un nucleo 3 con un angulo adecuado entre el simple plano que representa su superficie superior y el plano que pasa a traves de su superficie inferior.
Cuando los componentes femeninos estan situados sobre las placas inferiores y los componentes masculinos sobre el nucleo, el nucleo lordotico en el que se forma un angulo agudo en la direccion delantera-trasera puede estar integrado entonces con la placa mediante un saliente que entra en una cavidad o apertura de la placa inferior.
La inclinacion de las protesis conocidas en la tecnica anterior se obtiene, o bien por la forma de la placa superior, cuando el nucleo es plano, o por la posicion de la placa superior con respecto al nucleo, cuando dicho nucleo es convexo. Con respecto al primer caso de la tecnica anterior mencionada en este documento el mecanizado de la protesis de acuerdo con la presente invencion es mas economico dado que el nucleo esta compuesto de un material menos caro (por ejemplo polietileno) que el del que se componen las placas. Con respecto al segundo caso de la tecnica anterior mencionado en el presente documento, el nucleo de la presente invencion no es propenso a ser
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expulsado fuera de la protesis dado que el angulo entre las placas es sustancialmente constante cuando la protesis esta colocada.
Si un cirujano necesita una lordosis determinada para un paciente, seleccionara un nucleo 3 que no permita ninguna holgura con respecto a la placa inferior 2. Por el otro lado si necesitan simplemente que la lordosis permanezca dentro de un intervalo de valores, seleccionaran un nucleo que permita una ligera holgura en traslacion y en rotacion con respecto a la placa inferior 2.
La protesis de disco intervertebral de acuerdo con la invencion, en una realizacion alternativa, presentada en las figuras 7a, 7b, 8a y 8b puede estar anclada en la columna vertebral para impedir que la protesis se mueva bajo el efecto del resultado transversal de la fuerza ejercida por la columna vertebral sobre la protesis colocada, lo que aumenta con la lordosis. En este caso, la placa inferior 2 comprende una o varias aberturas 28, 29 situadas proximas al lado trasero de la protesis, haciendo posible el alojamiento de los medios 4, 5 de anclaje.
De esta manera, en el caso de las figura 7a y 7b, la abertura 28 de la placa inferior 2 es rectangular, y el medio 4 de anclaje esta constituido por un cuerpo 40 y una cabeza 41. Las dimensiones de la cabeza 41 son ligeramente mayores que aquellas de la abertura 28 de la placa inferior 2, de tal manera que una vez que los medios 4 de anclaje estan colocados en una vertebra, la placa inferior 2 esta insertada a modo de sandwich entre la cabeza 41 del medio 4 de anclaje y dicha vertebra. Un angulo inferior a o igual a 90° esta comprendido entre el cuerpo 40 del medio 4 de anclaje y la placa inferior 2.
En el caso de las figuras 8a y 8b dos aberturas circulares 29 estan comprendidas en la placa inferior 2 y los medios 5 de anclaje tienen forma de una, con una cabeza de dimensiones mayores que aquellas de las aberturas 29 para hacer posible insertar a modo de sandwich la placa inferior 2 entre la cabeza del medio 5 de anclaje y la vertebra sobre la que esta anclada la protesis.
Debena resultar claro a todos aquellos expertos en la materia que la presente invencion permite realizaciones en numerosas formas espedficas diferentes sin desviarse del alcance de la invencion que se reivindica. Por consiguiente, las presentes realizaciones deben ser consideradas como ilustraciones, pero pueden modificarse en el campo definido por el alcance de las reivindicaciones adjuntas, y la invencion no debe limitarse a los detalles dados anteriormente.

Claims (6)

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    REIVINDICACIONES
    1. Dispositivo (4) de anclaje para anclar un implante, en particular una protesis de disco intervertebral, en al menos una de las vertebras, entre las cuales dicha protesis de disco intervertebral esta prevista para insertarse, caracterizado porque dicho dispositivo (4) de anclaje comprende:
    - un cuerpo (40) que tiene la forma de una placa prevista para insertarse a traves de una abertura (28) de forma rectangular en una placa (2) de dicha protesis de disco intervertebral, afilandose el perfil de la placa formada por el cuerpo en su extremo previsto para penetrar en las vertebras,
    - una cabeza (41) de dimensiones mayores que aquellas de la abertura (28), de tal manera que dicha placa (2) de la protesis de disco intervertebral esta insertada a modo de sandwich entre la cabeza (41) del medio (4) de anclaje y dicha vertebra, cuando dicho cuerpo (40) esta implantado en dicha vertebra.
  2. 2. Dispositivo (4) de anclaje de acuerdo con la reivindicacion 1, caracterizado porque la cabeza (41) presenta una superficie plana para apoyarse la protesis de disco intervertebral contra una superficie plana de la placa (2).
  3. 3. Dispositivo (4) de anclaje de acuerdo con una de las reivindicaciones 1 o 2, caracterizado porque la cabeza (41) esta dimensionada y/o comprende al menos un recorte para dejar espacio para los movimientos de un nucleo movil (3) sobre dicha placa (2) de la protesis de disco intervertebral.
  4. 4. Dispositivo (4) de anclaje de acuerdo con una de las reivindicaciones 1 a 3, caracterizado porque un angulo, inferior o igual a 90° esta contenido entre el cuerpo (40) del dispositivo (4) de anclaje y la placa (2) de la protesis de disco intervertebral, cuando dicho dispositivo (4) de anclaje esta insertado completamente a traves de dicha abertura (28).
  5. 5. Dispositivo (4) de anclaje de acuerdo con una de las reivindicaciones 1 a 4, caracterizado porque dicha cabeza (41) esta dimensionada para no sobresalir de la periferia de la placa (2) de dicha protesis de disco intervertebral cuando dicha abertura (28) esta proxima a esta periferia de la placa (2).
  6. 6. Dispositivo (4) de anclaje de acuerdo con las reivindicaciones 4 y 5, caracterizado porque dicho angulo del dispositivo (4) de anclaje y la posicion periferica de dicha abertura (28) permite un anclaje de dicha protesis de disco intervertebral en la vertebra, mediante dicho dispositivo (4) de anclaje, tras la insercion de dicha protesis de disco intervertebral entre dos vertebras adyacentes.
ES13170071.8T 2002-11-05 2003-10-31 Prótesis de disco intervertebral Expired - Lifetime ES2575379T3 (es)

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FR0213833A FR2846550B1 (fr) 2002-11-05 2002-11-05 Prothese de disque intervertebral
FR0213833 2002-11-05

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FR2824261B1 (fr) 2001-05-04 2004-05-28 Ldr Medical Prothese de disque intervertebral et procede et outils de mise en place
FR2827156B1 (fr) * 2001-07-13 2003-11-14 Ldr Medical Dispositif de cage vertebrale avec fixation modulaire
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US7682396B2 (en) 2010-03-23
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US20060155377A1 (en) 2006-07-13
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