FR2612070A1 - Posterior spinal osteosynthesis device - Google Patents

Posterior spinal osteosynthesis device Download PDF

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FR2612070A1
FR2612070A1 FR8703428A FR8703428A FR2612070A1 FR 2612070 A1 FR2612070 A1 FR 2612070A1 FR 8703428 A FR8703428 A FR 8703428A FR 8703428 A FR8703428 A FR 8703428A FR 2612070 A1 FR2612070 A1 FR 2612070A1
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plates
vertebrae
bars
plate
jaws
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FR2612070B1 (en
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PRIVAT JEAN MARIE
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PRIVAT JEAN MARIE
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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
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7049—Connectors, not bearing on the vertebrae, for linking longitudinal elements together
    • A61B17/7052—Connectors, not bearing on the vertebrae, for linking longitudinal elements together of variable angle or length
    • 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
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8061—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Neurology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Prostheses (AREA)

Abstract

This device comprises, in combination, two elongate plates 24, 25, perforated with holes for receiving screws 22 suitable for being screwed into the lumbar or dorsal vertebrae 8, 9, 10, and small transverse bars 11, 12 for attaching the plates 24, 25 by their ends, onto which these small bars 11, 12 are fixed by removable jaws 31, with freedom for displacement in rotation. This device makes it possible to reduce the length of the assembly, in order to limit it normally to three vertebrae, whilst providing better mechanical stability for the device, by virtue of the small transverse attachment bars. This short assembly also improves the flexibility of the vertebral column, compared to known long assemblies, which extend over a greater number of vertebrae.

Description

La présente invention a pour objet un dispositif d'ostéosynthèse rachidienne postérieure, destiné à la chirurgie du rachis dorsal et lombaire. The present invention relates to a posterior spinal osteosynthesis device, intended for surgery of the dorsal and lumbar spine.

Il est connu, pour redresser des vertèbres lombaires ou dorsales à la suite d'accidents ou de scoliose, d'utiliser des plaques allongées, percées d'un certain nombre de trous taraudés adaptés pour recevoir des vis devant être vissées dans les pédicules des vertèbres. Ces plaques s'étendent généralement sur une longueur de cinq ou six vertèbres, sont précintrées, réalisées en acier inoxydable de qualité chirurgicale ou en un alliage approprié, et sont obtenues par usinage, ou forgeage (matriçage) ou coulées. It is known, to straighten lumbar or dorsal vertebrae following accidents or scoliosis, to use elongated plates, pierced with a number of tapped holes adapted to receive screws to be screwed into the pedicles of the vertebrae . These plates generally extend over a length of five or six vertebrae, are pre-bent, made of surgical grade stainless steel or an appropriate alloy, and are obtained by machining, or forging (die forging) or casting.

Les deux trous extrêmes sont ovalisés, un crantage intermédiaire au milieu de ceux-ci permettant le choix entre deux positions pour les vis pédiculaires placées dans ces trous extrêmes. Ceci permet une bonne adaptation de la visée pédiculaire à la conformation anatomique, pour chaque cas individuel, quatre positions différentes des vis pédiculaires résultant en effet des combinaisons possibles. Le trou central permet un vissage pédiculaire éventuel au niveau de la vertèbre fracturée, en fonction de la forme anatomique de la fracture. Les trous intermédiaires autorisent un vissage articulaire renforçant la stabilité mécanique du montage. The two extreme holes are ovalized, an intermediate notch in the middle of them allowing the choice between two positions for the pedicle screws placed in these extreme holes. This allows a good adaptation of the pedicle aiming to the anatomical conformation, for each individual case, four different positions of the pedicle screws resulting in effect from the possible combinations. The central hole allows possible pedicle screwing at the level of the fractured vertebra, depending on the anatomical shape of the fracture. The intermediate holes allow articular screwing reinforcing the mechanical stability of the assembly.

Ces plaques, utilisées par paires, créent dans la partie correspondante de la colonne vertébrale une certaine rigidité et donc un manque de souplesse du rachis dorsal et lombaire, ce qui peut constituer une gêne pour le patient portant ce dispositif. These plates, used in pairs, create in the corresponding part of the spine a certain rigidity and therefore a lack of flexibility of the dorsal and lumbar spine, which can constitute a discomfort for the patient wearing this device.

L'invention a pour but de remédier à cet inconvénient.  The invention aims to remedy this drawback.

Suivant l'invention, le dispositif d'ostéosynthèse rachidienne postérieure est caractérisé en ce qu il comprend en combinaison
- deux plaques allongées, perforées de trous de réception de vis adaptées pour être vissées dans les vertèbres lombaires ou dorsales, la longueur de ces plaques correspondant à celle d'au moins trois vertèbres;
- et des moyens de solidarisation transversale des plaques par leurs extrémités.According to the invention, the posterior spinal osteosynthesis device is characterized in that it comprises in combination
- two elongated plates, perforated with screw receiving holes adapted to be screwed into the lumbar or dorsal vertebrae, the length of these plates corresponding to that of at least three vertebrae;
- And means for transversely joining the plates at their ends.

On constitue ainsi, grâce aux moyens de solidarisation transversale des plaques, un cadre qui renforce considérablement la stabilité de ce montage d'ostéosynthèse par rapport à la réalisation antérieure rappelée ci-dessus. De plus, ce cadre ne s'étend en principe que sur trois vertèbres, à savoir une vertèbre centrale fracturée ou détériorée et deux vertèbres latérales, permettant ainsi de conserver à la colonne vertébrale un maximum de souplesse. One thus constitutes, by means of the transverse securing of the plates, a frame which considerably reinforces the stability of this osteosynthesis assembly compared to the previous embodiment recalled above. In addition, this framework extends in principle only over three vertebrae, namely a fractured or deteriorated central vertebra and two lateral vertebrae, thus making it possible to keep the spine as flexible as possible.

Suivant un mode de réalisation de l'invention, les moyens de solidarisation transversale comprennent, à chaque extrémité des plaques, une barrette dont les parties terminales sont fixées dans des pinces constituées chacune par une extrémité de la plaque et par une mâchoire de serrage montée amoviblement sur ladite extrémité de la plaque. According to one embodiment of the invention, the transverse fastening means comprise, at each end of the plates, a bar, the terminal parts of which are fixed in clamps each constituted by one end of the plate and by a clamping jaw mounted removably on said end of the plate.

D'autres particularités et avantages de l'invention apparaitront au cours de la description qui va suivre, faite en référence aux dessins annexés qui en illustrent à titres d'exemples non limitatifs deux formes de réalisation
- la Figure i est une vue de dessus éclatée des divers éléments d'un dispositif d'ostéosynthèse selon une première forme de réalisation de l'inven tion;
- la Figure 2 est une vue de dessus des éléments du dispositif de la Figure 1 assemblés pour constituer un cadre susceptible d'être fixé à des vertèbres lombaires ou dorsales;
- la Figure 3 est une vue de dessous du cadre de la Figure 2;
- la Figure 4 est une vue en perspective éclatée d'une seconde forme de réalisation du dispositif d'ostéosynthèse selon l'invention;;
- la Figure 5 est une vue en élévation verticale du cadre d'ostéosynthèse de la Figure 4 assemblé et fixé sur des vertèbres du rachis dorsal ou lombaire.Other features and advantages of the invention will appear during the description which follows, given with reference to the accompanying drawings which illustrate by way of non-limiting examples two embodiments
- Figure i is an exploded top view of the various elements of an osteosynthesis device according to a first embodiment of the invention;
- Figure 2 is a top view of the elements of the device of Figure 1 assembled to form a frame capable of being fixed to lumbar or dorsal vertebrae;
- Figure 3 is a bottom view of the frame of Figure 2;
- Figure 4 is an exploded perspective view of a second embodiment of the osteosynthesis device according to the invention;
- Figure 5 is a vertical elevation view of the osteosynthesis frame of Figure 4 assembled and fixed on the vertebrae of the dorsal or lumbar spine.

Le dispositif d'ostéosynthèse rachidienne postérieure illustré aux Figures 1 à 3 comprend les éléments suivants
- deux plaques allongées similaires 1, 2, perforées de trous 3-7 de réception de vis 33-37 adaptées pour être vissées dans des vertèbres lombaires ou dorsales 8, 9, 10 (Figure 5);
- et des moyens de solidarisation transversale des plaques 1, 2 par leurs extrémités la, 2a.The posterior spinal osteosynthesis device illustrated in Figures 1 to 3 includes the following elements
- two similar elongated plates 1, 2, perforated with holes 3-7 for receiving screws 33-37 adapted to be screwed into lumbar or dorsal vertebrae 8, 9, 10 (Figure 5);
- And transverse securing means of the plates 1, 2 by their ends la, 2a.

Les moyens de solidarisation transversale comprennent, à chaque extrémité la, 2a, une barrette 11, 12 dont les parties terminales lia, 12a aont fixées dans des pinces constituées chacune par une extrémité de la plaque 1, 2 et par une mâchoire 13, 14 de serrage montée amoviblement sur ladite extrémité la, 2a. Chaque extrémité la, 2a est évidée pour recevoir la mâchoire correspondante 13, 14, son épaisseur étant donc inférieure à l'épaisseur de la partie de la plaque 1, 2 située entre ses extrémités la et 2a. The transverse fastening means comprise, at each end 1a, 2a, a bar 11, 12 whose end portions 11a, 12a have been fixed in clamps each constituted by one end of the plate 1, 2 and by a jaw 13, 14 of clamp removably mounted on said end 1a, 2a. Each end 1a, 2a is hollowed out to receive the corresponding jaw 13, 14, its thickness therefore being less than the thickness of the part of the plate 1, 2 situated between its ends 1a and 2a.

Chaque mâchoire 13, 14 se présente, dans cet exemple d'exécution, sous la forme d'une pièce creuse ouverte sur une face et sur l'une des parois de laquelle est formée une encoche semi-circulaire 17, 18 adaptée pour recevoir la partie terminale correspondante lita, 12a d'une barrette 11, 12.Each jaw 13, 14 is, in this embodiment, in the form of a hollow part open on one face and on one of the walls of which is formed a semicircular notch 17, 18 adapted to receive the corresponding terminal part lita, 12a of a bar 11, 12.

De plus, chaque mâchoire 13, 14 et chaque extrémité correspondante la, 2a des plaques sont percées de trous respectifs 19, 21 taraudés pour recevoir des vis 22 de fixation des mâchoires 13, 14 sur les extrémités la, 2a, après introduction des parties terminales lia, 12a dans les encoches 17, 18. In addition, each jaw 13, 14 and each corresponding end 1a, 2a of the plates are pierced with respective holes 19, 21 tapped to receive screws 22 for fixing the jaws 13, 14 on the ends 1a, 2a, after introduction of the terminal parts 11a, 12a in the notches 17, 18.

Les extrémités des mâchoires 13, 14 situées vers l'intérieur des plaques 1, 2 présentent des arrondis 23 coopérant avec des redans transversaux 20 des plaques. Ces arrondis autorisent avantageusement aux mâchoires 13, 14 une certaine liberté de débattement en rotation autour des vis 22, et des déplacements corrélatifs des barrettes 11, 12, en fonction de la configuration locale des vertèbres, les trous 19, 21 et les vis 22 étant placés entre les arrondis 23 et les encoches 17, 18. En effet, le système de fixation transversale 11, 12, 13, 14 doit pouvoir être mobile afin de s'adapter à une éventuelle asymétrie des vertèbres au niveau des plaques 1 et 2. Les arrondis 23 autorisent ainsi un certain degré d'obliquité dans le positionnement des barrettes 11, 12 constituant les côtés hauts et bas du cadre. The ends of the jaws 13, 14 located towards the inside of the plates 1, 2 have rounded 23 cooperating with transverse steps 20 of the plates. These rounded advantageously allow the jaws 13, 14 a certain freedom of movement in rotation around the screws 22, and correlative movements of the bars 11, 12, depending on the local configuration of the vertebrae, the holes 19, 21 and the screws 22 being placed between the rounded 23 and the notches 17, 18. Indeed, the transverse fixing system 11, 12, 13, 14 must be able to be mobile in order to adapt to a possible asymmetry of the vertebrae at the level of the plates 1 and 2. The rounded 23 thus allow a certain degree of obliquity in the positioning of the bars 11, 12 constituting the top and bottom sides of the frame.

Dans ce mode d'exécution des plaques 1, 2, celles-ci sont chacune percée de cinq trous, à savoir deux trous oblongs extrêmes 3, 4 permettant chacun de placer une vis pédiculaire dans deux positions différentes de façon connue en soi, un trou central 5 pour un vissage pédiculaire éventuel au niveau de la vertèbre fracturée, et deux trous intermédiaires 6, 7 destinés à recevoir des vis articulaires renforçant la stabilité mécanique du cadre! obtenu. In this embodiment of the plates 1, 2, these are each pierced with five holes, namely two extreme oblong holes 3, 4 each allowing to place a pedicle screw in two different positions in a manner known per se, a hole central 5 for possible pedicle screwing at the level of the fractured vertebra, and two intermediate holes 6, 7 intended to receive articular screws reinforcing the mechanical stability of the frame! got.

Après assemblage des différentes pièces visibles à la Figure 1, le cadre obtenu se présente sous la forme illustrée aux Figures 2 et 3. After assembling the different parts visible in Figure 1, the frame obtained is in the form illustrated in Figures 2 and 3.

Il convient de noter que les barrettes 11, 12 sont adaptées pour pouvoir être mises en place par des orifices de petits diamètres ménagés sur la ligne médiane à travers les épineuses ou les ligaments inter-épineux, de façon à ne pas endommager le complexe ligamentaire postérieur, facteur important de stabilité rachidienne. It should be noted that the bars 11, 12 are adapted to be able to be put in place by orifices of small diameters formed on the midline through the spines or the interspinous ligaments, so as not to damage the posterior ligament complex , an important factor in spinal stability.

Dans le second mode de réalisation illustré à la Figure 4, les extrémités 24a, 25a des plaques 24, 25 sont amincies par rapport au reste des plaques comme dans la réalisation précédente, mais présentent en outre, du côté des trous extrêmes 3, 4, des gradins 26, 27 à raison d'un par extrémité 24a, 25a. Chaque gradin 26, 27 est relié â la surface de la plaque par un redan 28 et présente une face transversale 26a, 27a qui constitue une butée d'appui pour les extrémités arrondies 29 des mâchoires correspondantes 31, sur la face intérieure de chacune desquelles est ménagée une gorge transversale en V 32 adaptée pour recevoir l'extrémité associée lia, 12a d'une barrette. Les trous 21 et les vis 22 sont réalisés entre les gorges 32 et les arrondis 29. In the second embodiment illustrated in FIG. 4, the ends 24a, 25a of the plates 24, 25 are thinned with respect to the rest of the plates as in the previous embodiment, but also have, on the side of the end holes 3, 4, bleachers 26, 27 at the rate of one per end 24a, 25a. Each step 26, 27 is connected to the surface of the plate by a step 28 and has a transverse face 26a, 27a which constitutes a bearing stop for the rounded ends 29 of the corresponding jaws 31, on the inner face of each of which is formed a V-shaped transverse groove 32 adapted to receive the associated end 11a, 12a of a bar. The holes 21 and the screws 22 are made between the grooves 32 and the rounded 29.

La Figure 5 illustre le montage du cadre d'ostéosynthèse de la Figure 4 sur trois vertèbres lombaires ou dorsales 8, 9, 10, auxquelles la fixation du cadre est assurée par des vis 33 à 37, engagées dans les trous respectifs 3, 6, 5, 7, 4 des plaques. Figure 5 illustrates the mounting of the osteosynthesis frame of Figure 4 on three lumbar or dorsal vertebrae 8, 9, 10, to which the fixation of the frame is ensured by screws 33 to 37, engaged in the respective holes 3, 6, 5, 7, 4 of the plates.

En plus des avantages mentionnés ci-dessus, le dispositif d'ostéosynthèse selon l'invention pré sente les autres avantages suivants
- il permet de réaliser des montages courts d'ostéosynthèse rachidienne postérieure, n'immobilisant qu'une vertèbre au-dessus et une vertèbre audessous du foyer vertébral pathologique instable, avec la même stabilité mécanique que des montages plus longs s'étendant sur quatre ou six vertèbres et ne mettant pas en oeuvre le principe du montage en cadre.In addition to the advantages mentioned above, the osteosynthesis device according to the invention has the following other advantages
- it allows for short montages of posterior spinal osteosynthesis, immobilizing only one vertebra above and one vertebra below the unstable pathological vertebral focus, with the same mechanical stability as longer montages extending over four or six vertebrae and not implementing the principle of frame mounting.

Ce montage court préserve par ailleurs des espaces discaux libres, en assurant ainsi un gain de mobilité résiduelle sans compromettre la stabilité. This short assembly also preserves free disc spaces, thereby ensuring a gain in residual mobility without compromising stability.

- ce cadre d'ostéosynthèse peut être aisément mise en place, notamment par les chirurgiens déjà habitués au maniement des plaques vissées, et ce au moyen d'une instrumentation ancillaire simplifiée (c'est-à-dire qu'une instrumentation spéciale n'est pas nécessaire) dont la plupart des services utilisateurs potentiels sont déjà pourvus. - this osteosynthesis framework can be easily put in place, in particular by surgeons already used to handling the screwed plates, and this by means of simplified ancillary instrumentation (that is to say, special instrumentation does not is not necessary) which most potential user services already have.

De façon en principe exceptionnelle, en fonction de l'expansion du processus lésionnel, les plaques 1, 2 ou 24, 25 peuvent être percées de sept ou neuf trous afin de permettre l'exécution de montages plus longs, s'étendant sur quatre vertèbres (deux vertèbres centrales détériorées et une vertèbre de part et d'autre). In principle exceptionally, depending on the expansion of the lesional process, the plates 1, 2 or 24, 25 can be pierced with seven or nine holes in order to allow the execution of longer assemblies, spanning four vertebrae (two deteriorated central vertebrae and a vertebra on both sides).

Par ailleurs, les moyens de solidarisation transversale entre les plaques 1, 2, 24, 25 décrits ci-dessus ne sont fournis qu'à titre d'exemples et peuvent être remplacés par tout moyen équivalent, autorisant en particulier une certaine liberté de débattement en rotation des éléments transversaux. Furthermore, the transverse securing means between the plates 1, 2, 24, 25 described above are only provided by way of examples and can be replaced by any equivalent means, allowing in particular a certain freedom of movement in rotation of the transverse elements.

Le dispositif d'ostéosynthèse selon l'invention est mis en place sur le sujet de la manière suivante, celui-ci étant placé en position allongée sur le ventre (décubitus ventral)
- exposition des arcs postérieurs vertébraux;
- repérage et visée pédiculaires sous contrôle radiographique per opératoire, forage avec une mèche de diamètre adapté, par exemple de 3,2 mm de diamètre;
- mise en place des plaques fixées par les vis pédiculaires extrêmes, fixation optionnelle par vissage pédiculaire à travers le trou central, vissage articulaire intermédiaire;
- mise en place des barrettes transversales.The osteosynthesis device according to the invention is placed on the subject in the following manner, the latter being placed in a lying position on the stomach (prone position)
- exhibition of the posterior vertebral arches;
- pedicle location and aiming under radiographic control per operative, drilling with a drill bit of suitable diameter, for example 3.2 mm in diameter;
- positioning of the plates fixed by the extreme pedicle screws, optional fixing by pedicle screwing through the central hole, intermediate articular screwing;
- installation of transverse bars.

A titre d'exemple numérique indicatif, on peut utiliser des vis pédiculaires d'une longueur de 40 mm et de 3,5 mm de diamètre, des vis articulaires d'une longueur de 16 mm et d'un diamètre de 3,5 mm. As an indicative numerical example, pedicle screws 40 mm long and 3.5 mm in diameter can be used, articular screws 16 mm long and 3.5 mm in diameter. .

L'utilisation du cadre d'ostéosynthèse visé par l'invention est indiquée dans les cas suivants
a) en premier lieu : traumatismes du rachis dorsal et lombaire avec instabilité osseuse disco-ligamentaire, avec ou sans troubles neurologiques. Dans les cas d'instabilité osseuse, l'ostéosynthèse seule suffit, tandis que dans les cas d'instabilité discoligamentaire mixte, une arthrodèse par greffe postérieure ou corporectemie, et greffe antérieure, sera associée à l'ostéosynthèse pour "prendre le relais biologique" de l'ostéosynthèse à terme.The use of the osteosynthesis framework targeted by the invention is indicated in the following cases
a) first: trauma to the dorsal and lumbar spine with disco-ligamentous bone instability, with or without neurological disorders. In cases of bone instability, osteosynthesis alone is sufficient, while in cases of mixed discoligamentary instability, arthrodesis by posterior graft or corporectemia, and anterior graft, will be associated with osteosynthesis to "take over the biological relay". of osteosynthesis in the long term.

b) En second lieu, le dispositif visé par l'invention peut également être mis en oeuvre dans les cas suivants
- fixation rachidienne après chirurgie des tumeurs vertébrales entraînant une instabilité (métastases, myélomes, tumeurs bénignes,...). La fixation ainsi réalisée corrige l'instabilité et empêche tous déplacements secondaires. Elle est également suivie d'un effet antalgique très net, lié à la suppression de la micro-instabilité;
- certaines instabilités d'origine rhumatismale ou dégénérative;
- certaines instabilités iatogènes post-chirurgicales; certaines instabilités d'origine infectieuse, notamment par spondylodiscite pottique. b) Secondly, the device covered by the invention can also be used in the following cases
- spinal fixation after surgery of vertebral tumors causing instability (metastases, myelomas, benign tumors, ...). The fixation thus produced corrects the instability and prevents any secondary displacements. It is also followed by a very clear analgesic effect, linked to the suppression of micro-instability;
- certain instabilities of rheumatic or degenerative origin;
- certain post-surgical iatogenic instabilities; certain instabilities of infectious origin, notably by pottic spondylodiscitis.

Claims (5)

REVENDICATIONS 1 - Dispositif d'ostéosynthèse rachidienne postérieure, caractérisé en ce qu'il comprend en combinaison 1 - Posterior spinal osteosynthesis device, characterized in that it comprises in combination - deux plaques allongées (1, 2; 24, 25) perforées de trous (3, 4, 5, 6, 7) de réception de vis adaptées pour être vissées dans les vertèbres lombaires ou dorsales (8, 9, 10), la longueur de ces plaques correspondant à celle d'au moins trois vertèbres; - two elongated plates (1, 2; 24, 25) perforated with holes (3, 4, 5, 6, 7) for receiving screws adapted to be screwed into the lumbar or dorsal vertebrae (8, 9, 10), the length of these plates corresponding to that of at least three vertebrae; - et des moyens (11, 12, 13, 14; 11, 12, 31) de solidarisation transversale des plaques par leurs extrémités. - And means (11, 12, 13, 14; 11, 12, 31) for transversely joining the plates by their ends. 2 - Dispositif selon la revendication 1, caractérisé en ce que les moyens de solidarisation transversale comprennent, à chaque extrémité des plaques (i, 2; 24, 25), une barrette (11, 12) dont les parties terminales (lia, 12a) sont fixées dans des pinces constituées chacune par une extrémité (la, 2a; 24a, 25a) de la plaque et par une mâchoire de serrage (13, 14: 31) montée amoviblement sur ladite extrémité de la plaque. 2 - Device according to claim 1, characterized in that the transverse securing means comprise, at each end of the plates (i, 2; 24, 25), a bar (11, 12) whose end portions (11a, 12a) are fixed in clamps each constituted by one end (la, 2a; 24a, 25a) of the plate and by a clamping jaw (13, 14: 31) mounted removably on said end of the plate. 3 - Dispositif selon la revendication 2, caractérisé en ce que chaque mâchoire (13, 14; 31) présente sur sa face intérieure un logement de retenue de la barrette associée (11, 12), par exemple une gorge transversale (32) en V ou une encoche (17, 18), et est percée, ainsi que l'extrémité (la, 2a; 24a, 25a) de la plaque, d'un trou (19, 21) de passage d'une vis (22) de fixation de la mâchoire (13, 14; 31) sur la plaque, l'extrémité de cette dernière étant évidée pour recevoir ladite mâchoire. 3 - Device according to claim 2, characterized in that each jaw (13, 14; 31) has on its inner face a housing for retaining the associated bar (11, 12), for example a transverse groove (32) in V or a notch (17, 18), and is pierced, as well as the end (la, 2a; 24a, 25a) of the plate, with a hole (19, 21) for the passage of a screw (22) of fixing the jaw (13, 14; 31) on the plate, the end of the latter being hollowed out to receive said jaw. 4 - Dispositif selon l'une des revendications 2 à 4, caractérisé en ce que les extrémités des mâchoires (13, 14; 31) de serrage situées vers l'in térieur des plaques (1, 2; 24, 25) présentent des arrondis (23; 29) et viennent en appui contre des redans correspondants (20; 26a, 27a) de la plaque limitant les évidements de réception des mâchoires, ce qui autorise une rotation des mâchoires (13, 14; 31) autour de leurs vis (22) et une liberté de débattement correspondante des barrettes (11, 12). 4 - Device according to one of claims 2 to 4, characterized in that the ends of the clamping jaws (13, 14; 31) located inwardly of the plates (1, 2; 24, 25) have rounded (23; 29) and bear against corresponding steps (20; 26a, 27a) of the plate limiting the recesses for receiving the jaws, which allows rotation of the jaws (13, 14; 31) around their screws ( 22) and a corresponding freedom of movement of the bars (11, 12). 5 - Dispositif selon l'une des revendications 3 et 4, caractérisé en ce que les trous (19, 21) des pinces et les vis (22) sont placés entre les logements (17, 18; 32) des barrettes et les arrondis (23, 29) des mâchoires (13, 14; 31) de serrage desdites barrettes.  5 - Device according to one of claims 3 and 4, characterized in that the holes (19, 21) of the clamps and the screws (22) are placed between the housings (17, 18; 32) of the bars and the rounded ( 23, 29) of the jaws (13, 14; 31) for clamping said bars.
FR8703428A 1987-03-12 1987-03-12 POSTERIOR SPINAL OSTEOSYNTHESIS DEVICE Expired - Fee Related FR2612070B1 (en)

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FR8703428A FR2612070B1 (en) 1987-03-12 1987-03-12 POSTERIOR SPINAL OSTEOSYNTHESIS DEVICE

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FR2612070B1 FR2612070B1 (en) 1992-09-18

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EP0383992A2 (en) * 1989-02-08 1990-08-29 Acromed Corporation Transverse connector for spinal column corrective devices
EP0410309A1 (en) * 1989-07-20 1991-01-30 Lutz Biedermann Stabilising element for bones
US5092893A (en) * 1990-09-04 1992-03-03 Smith Thomas E Human orthopedic vertebra implant
US5102412A (en) * 1990-06-19 1992-04-07 Chaim Rogozinski System for instrumentation of the spine in the treatment of spinal deformities
FR2680673A1 (en) * 1991-08-26 1993-03-05 Medical Op Device for stabilisation of a spine, in particular of the human spine, by a posterior route
US5330473A (en) * 1993-03-04 1994-07-19 Advanced Spine Fixation Systems, Inc. Branch connector for spinal fixation systems
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EP0689799A1 (en) * 1994-06-28 1996-01-03 Acromed Corporation Transverse connector for spinal column corrective devices
US5601554A (en) * 1993-03-04 1997-02-11 Advanced Spine Fixation Systems, Inc. Branch connector for spinal fixation systems
WO2009036541A3 (en) * 2007-09-21 2009-08-06 Paulo Tadeu Maia Cavali Flexible, sliding, dynamic implant system, for selective stabilization and correction of the vertebral column deformities and instabilities
US7942900B2 (en) 2007-06-05 2011-05-17 Spartek Medical, Inc. Shaped horizontal rod for dynamic stabilization and motion preservation spinal implantation system and method
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EP0383992A2 (en) * 1989-02-08 1990-08-29 Acromed Corporation Transverse connector for spinal column corrective devices
EP0383992A3 (en) * 1989-02-08 1990-11-22 Acromed Corporation Transverse connector for spinal column corrective devices
US5084049A (en) * 1989-02-08 1992-01-28 Acromed Corporation Transverse connector for spinal column corrective devices
EP0410309A1 (en) * 1989-07-20 1991-01-30 Lutz Biedermann Stabilising element for bones
US5102412A (en) * 1990-06-19 1992-04-07 Chaim Rogozinski System for instrumentation of the spine in the treatment of spinal deformities
US5092893A (en) * 1990-09-04 1992-03-03 Smith Thomas E Human orthopedic vertebra implant
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US5382248A (en) * 1992-09-10 1995-01-17 H. D. Medical, Inc. System and method for stabilizing bone segments
US5330473A (en) * 1993-03-04 1994-07-19 Advanced Spine Fixation Systems, Inc. Branch connector for spinal fixation systems
US5601554A (en) * 1993-03-04 1997-02-11 Advanced Spine Fixation Systems, Inc. Branch connector for spinal fixation systems
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