ES2618519T3 - Prótesis de disco intervertebral - Google Patents

Prótesis de disco intervertebral Download PDF

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Publication number
ES2618519T3
ES2618519T3 ES03810553.2T ES03810553T ES2618519T3 ES 2618519 T3 ES2618519 T3 ES 2618519T3 ES 03810553 T ES03810553 T ES 03810553T ES 2618519 T3 ES2618519 T3 ES 2618519T3
Authority
ES
Spain
Prior art keywords
core
intervertebral disc
plate
disc prosthesis
lower plate
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
ES03810553.2T
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 ES2618519T3 publication Critical patent/ES2618519T3/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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    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • 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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    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • 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
    • A61F2/08—Muscles; Tendons; Ligaments
    • A61F2/0811—Fixation devices for tendons or ligaments
    • 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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    • A61F2002/30331—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
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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
    • A61F2002/30369—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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    • 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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    • A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
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    • A61F2/30—Joints
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    • 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)
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  • Prostheses (AREA)

Abstract

Prótesis de disco intervertebral que comprende al menos tres partes que incluyen una primera placa, denominada la placa superior (1), una segunda placa, denominada la placa inferior (2), y un núcleo (3), estando la superficie superior del núcleo (3) en contacto con al menos parte (10) de la superficie inferior de la placa superior (1) y estando la superficie inferior del núcleo (3) en contacto con al menos parte de la superficie superior de la placa inferior (2), y siendo la placa superior (1) móvil al menos con respecto al núcleo (3), la prótesis también comprende medios de cooperación entre la placa inferior (2) y el núcleo (3), para permitir movimientos de traslación limitados del núcleo (3) con respecto a la placa inferior (2) a lo largo de un eje sustancialmente paralelo a la placa inferior (2), y para permitir movimientos de rotación limitados del núcleo (3) con respecto a la placa inferior (2), alrededor de un eje sustancialmente perpendicular a la placa inferior (2), caracterizada porque dichos medios de cooperación comprenden: - medios macho situados unos enfrente de otros cerca de bordes de la placa inferior (2) y formados por dos pasadores, o un pasador y un taco, o dos tacos, o dos paredes en cooperación con - medios hembra formados por dos rebajes (30) en bordes del núcleo (3) y complementarios a dichos pasadores, tacos o paredes.

Description

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DESCRIPCION
Protesis de disco intervertebral
La presente invencion se refiere a una protesis de disco intervertebral que tiene por objeto 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, 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 expulsion 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 desvela un dispositivo de anclaje de acuerdo con el preambulo de la reivindicacion 1.
El objeto 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 objeto se alcanza mediante una protesis de disco intervertebral como se define en la reivindicacion 1. Otras realizaciones de la invencion se definen en las reivindicaciones dependientes.
Otras caractensticas y ventajas de la presente invencion resultaran mas claras al leer la descripcion mas adelante, haciendo 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,
- las figuras 2a y 2b representan respectivamente una vista desde arriba y una vista desde arriba en perspectiva de la placa inferior,
- las figuras 3a y 3b representan respectivamente una vista desde arriba y una vista desde arriba en perspectiva del nucleo,
- 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 en seccion 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 una protesis de disco intervertebral,
- las figuras 6b y 6d representan una vista en seccion 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 en seccion 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 representan respectivamente una vista desde arriba y una vista desde abajo en perspectiva de las placas inferiores,
- las figuras 7b y 8b representan respectivamente 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 estan insertados medios de anclaje de la protesis de acuerdo con dos realizaciones diferentes,
- la figura 9a representa una vista desde arriba de otra placa inferior,
- la figura 9b representa una vista en seccion 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 otra placa superior.
La protesis de disco intervertebral de acuerdo con la invencion esta constituida por una placa superior 1 que se articula 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, visible en particular 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, como se muestra en las figuras 10a y 10b, para encajar mejor sobre la vertebra sobre la que va a encajarse la protesis, 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, como puede verse en particular en la figura 10b.
La placa inferior 2 es sustancialmente plana. En efecto, su superficie inferior no tiene que 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
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sustancialmente paralelos de la placa inferior 2. Cada pasador 20 esta curvado hacia el interior de la protesis y, por tanto, puede entrar en los rebajes 30 situados sobre el nucleo 3. El nucleo 3, visible en particular 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 las 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 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 permiten asf que el paciente se mueva y, en caso necesario, subsanar los defectos de posicionamiento de la protesis. Esta holgura tambien ofrece 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 las de cada pasador 20 de la placa inferior 3 para prevenir cualquier holgura del nucleo 3 con respecto a la placa inferior 2, tanto en la traslacion como en la 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 es 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 son reemplazados por un taco sobre el que se fija 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 de espiga 25 situados cerca del centro de la placa inferior 2. En este caso el nucleo 3, por complementariedad, no comprende ningun rebaje 30, sino dos huecos 35 bajo su superficie inferior. Las dimensiones de los pasadores de espiga 25 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 de espiga 25. El nucleo 3, por complementariedad, 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 la traslacion y en la 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, cerca de dos bordes 21, 22 sustancialmente paralelos de la placa inferior, pero mas lejos 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 iguales que las de cada pared de la placa inferior para permitir una ligera holgura en la traslacion y en la rotacion, o no.
En una realizacion adicional no mostrada, los componentes hembra estan situados sobre la placa inferior y los componentes macho sobre el nucleo.
La protesis de disco intervertebral de acuerdo con la invencion hace posible en particular corregir defectos de 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 vana entre 0 ° y 15 °. Para ajustar el angulo requerido de acuerdo con el paciente, simplemente es necesario seleccionar un nucleo 3 con un angulo adecuado entre el plano medio que representa su superficie superior y el plano que atraviesa su superficie inferior.
Cuando los componentes hembra estan situados sobre las placas inferiores y los componentes macho sobre el nucleo, el nucleo lordotico, en el que se forma un angulo agudo en la direccion delantera-trasera, puede formar parte entonces de la placa gracias a un saliente que entra en una cavidad o abertura de la placa inferior.
La inclinacion de las protesis conocidas en la tecnica anterior se obtiene, bien mediante la forma de la placa superior, cuando el nucleo es plano, o mediante 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 porque 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, no es probable que el nucleo de la presente invencion sea expulsado fuera de la protesis porque el angulo entre las placas es sustancialmente constante cuando la protesis esta colocada.
Si los cirujanos necesitan una lordosis determinada para un paciente, seleccionaran un nucleo 3 que no permita ninguna holgura con respecto a la placa inferior 2. Por el otro lado, si simplemente necesitan que la lordosis
permanezca dentro de un intervalo de valores, seleccionaran un nucleo que permita una ligera holgura en la traslacion y en la rotacion con respecto a la placa inferior 2.
En una realizacion alternativa, presentada en las figuras 7a, 7b, 8a y 8b, la protesis de disco intervertebral de acuerdo con la invencion puede estar anclada en la columna vertebral para impedir que la protesis se mueva bajo el 5 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 cerca del lado trasero de la protesis, haciendo posible la recepcion de los medios de anclaje 4, 5.
De esta manera, en el caso de las figuras 7a y 7b, la abertura 28 de la placa inferior 2 es rectangular, y el medio de anclaje 4 esta constituido por un cuerpo 40 y una cabeza 41. Las dimensiones de la cabeza 41 son ligeramente 10 mayores que las de la abertura 28 de la placa inferior 2, de tal manera que, una vez colocados los medios de anclaje 4 en una vertebra, la placa inferior 2 este intercalada entre la cabeza 41 del medio de anclaje 4 y dicha vertebra. Un angulo inferior a o igual a 90 ° esta comprendido entre el cuerpo 40 del medio de anclaje 4 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 de anclaje 5 tienen forma de clavo, con una cabeza de dimensiones mayores que las de las aberturas 29 para hacer 15 posible intercalar la placa inferior 2 entre la cabeza del medio de anclaje 5 y la vertebra sobre la que esta anclada la protesis.
Para los expertos en la materia debena quedar claro que la presente invencion solamente esta limitada por el alcance de las reivindicaciones adjuntas.

Claims (18)

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    REIVINDICACIONES
    1. Protesis de disco intervertebral que comprende al menos tres partes que incluyen una primera placa, denominada la placa superior (1), una segunda placa, denominada la placa inferior (2), y un nucleo (3), estando la superficie superior del nucleo (3) en contacto con al menos parte (10) de la superficie inferior de la placa superior (1) y estando la superficie inferior del nucleo (3) en contacto con al menos parte de la superficie superior de la placa inferior (2), y siendo la placa superior (1) movil al menos con respecto al nucleo (3), la protesis tambien comprende medios de cooperacion entre la placa inferior (2) y el nucleo (3), para permitir movimientos de traslacion limitados del nucleo (3) con respecto a la placa inferior (2) a lo largo de un eje sustancialmente paralelo a la placa inferior (2), y para permitir movimientos de rotacion limitados del nucleo (3) con respecto a la placa inferior (2), alrededor de un eje sustancialmente perpendicular a la placa inferior (2), caracterizada porque dichos medios de cooperacion comprenden:
    - medios macho situados unos enfrente de otros cerca de bordes de la placa inferior (2) y formados por dos pasadores, o un pasador y un taco, o dos tacos, o dos paredes en cooperacion con
    - medios hembra formados por dos rebajes (30) en bordes del nucleo (3) y complementarios a dichos pasadores, tacos o paredes.
  2. 2. Protesis de disco intervertebral de acuerdo con la reivindicacion 1, caracterizada porque un angulo impuesto entre los planos medios que atraviesan las placas se obtiene porque el nucleo (3) forma un angulo agudo en la direccion delantera-trasera (F).
  3. 3. Protesis de disco intervertebral de acuerdo con la reivindicacion 2, caracterizada porque las mismas placas (1,2) pueden montarse con nucleos (3) de diferentes grosores.
  4. 4. Protesis de disco intervertebral de acuerdo con una cualquiera de las reivindicaciones 2 o 3, caracterizada porque el angulo entre las placas superior (1) e inferior (2) vana entre 0° y 15°.
  5. 5. Protesis de disco intervertebral de acuerdo con una cualquiera de las reivindicaciones 1 a 4, caracterizada porque el nucleo (3) es movil con respecto a las placas superior (1) y/o inferior (2), lo que hace posible subsanar defectos de posicionamiento de las tres partes (1, 2, 3) de la protesis unas con respecto a otras.
  6. 6. Protesis de disco intervertebral de acuerdo con una cualquiera de las reivindicaciones 1 a 5, caracterizada porque al menos parte (10) de la superficie inferior de la placa superior (1) es concava y complementaria a la superficie convexa superior (31) del nucleo (3).
  7. 7. Protesis de disco intervertebral de acuerdo con una cualquiera de las reivindicaciones 1 a 6, caracterizada porque las dimensiones de cada medio macho son ligeramente menores que las de cada medio hembra para permitir una ligera holgura entre el nucleo (3) y la placa inferior (2).
  8. 8. Protesis de disco intervertebral de acuerdo con una cualquiera de las reivindicaciones 1 a 7, caracterizada porque las dimensiones de cada medio macho son sustancialmente iguales que las de cada medio hembra para evitar cualquier holgura entre el nucleo (3) y la placa inferior (2).
  9. 9. Protesis de disco intervertebral de acuerdo con una cualquiera de las reivindicaciones 1 a 8, caracterizada porque los medios macho de la placa inferior (2) son dos pasadores (20) curvados hacia el interior de la protesis y porque los medios hembra del nucleo (3) son dos rebajes (30) al nivel de la parte curvada de dichos pasadores.
  10. 10. Protesis de disco intervertebral de acuerdo con la reivindicacion 9, caracterizada porque al menos uno de los pasadores (20) es reemplazado por un taco equipado con una perforacion (200) sobre el cual un apendice (23) que utiliza una espiga (24) penetra en la perforacion (200).
  11. 11. Protesis de disco intervertebral de acuerdo con una cualquiera de las reivindicaciones 1 a 8, caracterizada porque los medios macho de la placa inferior (2) son dos paredes situadas una enfrente de la otra cerca de dos bordes (21, 22) de la protesis, y porque los medios hembra del nucleo (3) son dos rebajes.
  12. 12. Protesis de disco intervertebral de acuerdo con una cualquiera de las reivindicaciones 1 a 11, caracterizada porque el nucleo (3) se fabrica de polietileno.
  13. 13. Protesis de disco intervertebral de acuerdo con una cualquiera de las reivindicaciones 1 a 12, caracterizada porque la placa inferior (2) comprende una o mas aberturas (28, 29) cerca de su parte delantera, provistas para recibir los medios de anclaje (4, 5) de la protesis en una vertebra.
  14. 14. Protesis de disco intervertebral de acuerdo con la reivindicacion 13, caracterizada porque la abertura (28) de la placa inferior (2) es rectangular, y porque los medios de anclaje (4) consisten en un cuerpo (40), formando un angulo agudo con la placa inferior (2), y una cabeza (41).
  15. 15. Protesis de disco intervertebral de acuerdo con la reivindicacion 14, caracterizada porque las aberturas (29) de la placa inferior (2) son circulares, y porque los medios de anclaje (5) tienen forma de clavo.
  16. 16. Protesis de disco intervertebral de acuerdo con una cualquiera de las reivindicaciones 1 a 15, caracterizada porque la placa superior (1) es convexa en al menos parte de su superficie superior para encajar en la forma de las vertebras.
  17. 17. Protesis de disco intervertebral de acuerdo con una cualquiera de las reivindicaciones 1 a 16, caracterizada 5 porque las dimensiones del nucleo (3) son ligeramente menores que las dimensiones de la placa inferior (2), en un
    plano sustancialmente paralelo a la placa inferior (2).
  18. 18. Protesis de disco intervertebral de acuerdo con las reivindicaciones 6 y 17, caracterizada porque dichas dimensiones del nucleo (3) con respecto a las de la placa inferior (2), en combinacion con las dimensiones tanto de la altura del nucleo (3), en una direccion sustancialmente perpendicular a la placa inferior (2), como del radio de
    10 curvatura de la superficie convexa del nucleo (3), permiten que las placas superior (1) e inferior (2) no entren en contacto incluso en una inclinacion maxima de las placas (1,2).
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