FR2636227A1 - Inter-spinal-body device for holding a normal spacing between two vertebrae - Google Patents

Inter-spinal-body device for holding a normal spacing between two vertebrae Download PDF

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Publication number
FR2636227A1
FR2636227A1 FR8811828A FR8811828A FR2636227A1 FR 2636227 A1 FR2636227 A1 FR 2636227A1 FR 8811828 A FR8811828 A FR 8811828A FR 8811828 A FR8811828 A FR 8811828A FR 2636227 A1 FR2636227 A1 FR 2636227A1
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Prior art keywords
rod
device according
central
characterized
parts
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FR8811828A
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French (fr)
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Francis Lesoin
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Ste de Fabrication de Material Orthopedique en Abrege Sofamor SNC
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Ste de Fabrication de Material Orthopedique en Abrege Sofamor SNC
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30721Accessories
    • A61F2/30724Spacers for centering an implant in a bone cavity, e.g. in a cement-receiving cavity
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/28Bones
    • A61F2002/2835Bone graft implants for filling a bony defect or an endoprosthesis cavity
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/30199Three-dimensional shapes
    • A61F2002/30224Three-dimensional shapes cylindrical
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • AHUMAN NECESSITIES
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    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30507Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a threaded locking member, e.g. a locking screw or a set screw
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30537Special structural features of bone or joint prostheses not otherwise provided for adjustable
    • A61F2002/3055Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting length
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes, grooves
    • A61F2002/30836Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes, grooves knurled
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes, grooves
    • A61F2002/30841Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes, grooves
    • A61F2002/30841Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
    • A61F2002/30843Pyramidally-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes, grooves
    • A61F2002/30878Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes, grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30891Plurality of protrusions
    • A61F2002/30892Plurality of protrusions parallel
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4631Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor the prosthesis being specially adapted for being cemented
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063Three-dimensional shapes
    • A61F2230/0069Three-dimensional shapes cylindrical

Abstract

This device, intended for holding a normal spacing between two vertebrae separated by a gap coming from at least partial extraction of one vertebra, comprises two end parts 1, 2 provided with spikes 7 for anchoring in the vertebral bodies, a central rod 5 received in notches 8, 9 in the pieces 1, 2 and fixed to the latter by radial screws 11, and a central sleeve 6 which is freely passed through by the rod 5 and is placed in abutment between the two pieces 1 and 2. This compact device can be fitted relatively easily by the surgeon and ensures good stability by axial mounting in the direction of the mechanical stresses. <IMAGE>

Description

La présente invention a pour objet un dispositif intercorporéal rachidien, destiné au maintien d'un écartement normal entre deux vertèbres séparées par un évidement provenant d'une extraction au moins partielle d'une vertèbre. The present invention relates to a spinal intercorporéal device intended to maintain a normal spacing between two vertebrae separated by a recess from an at least partial extraction of a vertebra.

Comme on le sait, il est nécessaire dans certains cas de procéder à une ablation au moins partielle d'une vertèbre, notamment à la suite d'une fracture par éclatement d'une vertèbre, en particulier dans la région dorso-lombaire, et pour le traitement d'une tumeur vertébrale. As we know, it is necessary in some cases to make an at least partial removal of a vertebra, especially following a burst fracture of a vertebra, especially in the thoracolumbar region, and treating a spinal tumor.

Le brevet européen 188 954 du 19 décembre 1985 décrit un dispositif d'étaiement adapté à cette fonction. European Patent 188 954 of 19 December 1985 describes a shoring device suitable for this function. Ce dispositif comprend deux embases munies chacune de moyens d'ancrage dans une des vertèbres, des vis équipées de tenons pouvant venir s'emboîter dans les embases, et un manchon taraudé de liaison entre les vis. This device comprises two sockets, each provided with means for anchoring in a vertebra, screws equipped with tenons that can to fit into the sockets, and a threaded sleeve connection between the screws.

Ce dispositif est constitué d'un nombre de pièces élevé, de sorte que sa fabrication est complexe et onéreuse, et que sa mise en place par le chirurgien est relativement longue et délicate. This device consists of a high number of parts, so that its manufacture is complicated and expensive, and its implementation by the surgeon is relatively long and delicate. De plus, son encombrement est élevé et sa stabilité ne donne pas toute satisfaction Moreover, its size is high and stability is not entirely satisfactory
Or, l'exérèse de plus en plus large des corps vertébraux nécessite la mise au point d'un matériel d'ostéosynthèse de plus en plus performant. But the removal of increasingly large vertebral bodies requires the development of an osteosynthesis material more efficient.

L'invention a donc pour but de réaliser un détracteur intercorporéal rachidien satisfaisant à cet impératif et ne présentant pas les inconvénients ci-dessus. The invention therefore aims to achieve a detractor intercorporéal spinal satisfying this requirement and does not have the above drawbacks.

Suivant l'invention, le dispositif comprend deux pièces d'extrémités pourvues de moyens d'ancrage dans les corps vertébraux, et une tige centrale reliant les pièces d'extrémités ainsi que des moyens pour solidariser ces dernières avec la tige. According to the invention, the device comprises two end pieces provided with means for anchoring in the vertebral body, and a central rod connecting the end pieces as well as means for securing the latter with the stem.

Selon un mode de réalisation possible, le dispositif comprend également un manchon central librement traversé par la tige et placé en appui entre les deux pièces d'extrémités. According to a possible embodiment, the device also includes a central sleeve freely traversed by the rod and placed in abutment between the two end pieces.

La tige et le manchon ont une longueur variable afin de pouvoir s'adapter à chaque cas et de permettre une restauration de la hauteur normale de la cavité entre les deux corps vertébraux. The rod and the sleeve have a variable length to be adaptable to each case and to allow restoration of normal height of the cavity between the two vertebral bodies.

Le manchon assure une meilleure stabilité du dispositif grâce à son contact avec la base des pièces d'extrémités. The sleeve ensures better stability of the device due to its contact with the base of the end parts.

D'autres particularités et avantages de l'invention apparaîtront au cours de la description qui va suivre, faite en référence au dessin annexé qui en illustre à titre d'exemples non-limitatifs deux modes de réalisation. Other features and advantages of the invention appear from the following description with reference to the accompanying drawing which illustrates by way of non-limiting examples two embodiments.

La figure 1 est une vue en perspective éclatee d'un mode de réalisation du dispositif intercorporéal rachidien selon l'invention. Figure 1 is an exploded perspective view of an embodiment of the spinal intercorporéal device according to the invention.

La figure 2 est une vue en bout d'une des pièces d'extrémités, de son côté dirigé vers la tige centrale et la pièce d'extrémité opposée. Figure 2 is an end view of one of the end parts of its side facing the central rod and the opposite end piece.

La figure 3 est une vue en perspective du dispositif des Fig.1 et 2 mis en place entre des corps vertébraux. Figure 3 is a perspective view of Fig.1 and 2 of the device seen in place between the vertebral bodies.

La figure 4 est une vue en perspective d'une variante de réalisation de la tige centrale. Figure 4 is a perspective view of an alternative embodiment of the central stem.

Le dispositif intercorporéal représenté au dessin comprend deux pièces d'extrémités identiques 1 et 2 pourvues de moyens d'ancrage dans les corps vertébraux 3,4, une tige centrale 5 reliant les pièces 1 et 2, ainsi que des moyens pour solidariser ces dernières avec la tige 5. De plus, le dispOSitif est complété par un manchon central 6 librement traversé par la tige 5 et placé en appui entre les pièces d'extrémités 1,2 (Fig.3) lorsque le dispositif est mis en place. The intercorporéal shown in the drawing device comprises two identical end pieces 1 and 2 provided with means for anchoring in the vertebral bodies 3,4, a central rod 5 connecting the pieces 1 and 2, as well as means for securing the latter with the rod 5. in addition, the device is completed by a central sleeve 6 freely crossed by the rod 5 and placed in abutment between the end pieces 1,2 (Fig.3) when the device is put in place.

Dans l'exemple de réalisation décrit, chaque pièce d'extrémité 1,2 a une forme sensiblement cylindrique et ses moyens d'ancrage sont constitués par des pointes longitudinales 7 partant de l'une des faces du corps cylindrique. In the embodiment described, each end part 1.2 has a substantially cylindrical shape and anchoring means are constituted by longitudinal pins 7 extending from one of the faces of the cylindrical body. Ces pointes 7 sont par exemple au nombre de trois, et adaptées pour pouvoir se ficher dans le corps vertébral 3,4 sus et sous-jacent à la résection osseuse. These spikes 7 are for example three in number, and adapted to be able to file into the vertebral body above 3.4 and underlying bone resection. Dans chaque pièce terminale 1,2 est ménagée une encoche respective 8,9 ouverte latéralement et longitudinalement du coté opposé aux pointes 7, afin de pouvoir recevoir la tige centrale 5. In each end piece 1.2 is provided a respective notch 8.9 open laterally and longitudinally on the side opposite to the tips 7, to receive the central pin 5.

Les pièces 1,2 sont également équipées d'éléments de fixation de la tige 5, constitués dans l'exemple décrit par deux vis radiales il pour chaque pièce 1,2, traversant un trou taraudé qui débouche dans l'encoche 8 ou 9. Chaque vis Il est pourvue d'une tête lia profilée pour recevoir un outil de serrage, par exemple un profil à six pans. The parts 1,2 are also equipped with fastening elements of the rod 5, constituted in the example described by two radial screws it for each piece 1,2 passing through a threaded hole which opens into the notch 8 or 9. each screw is provided with a head profiled IIa for receiving a tightening tool, for example a hexagonal profile. Les vis 11 ont donc pour fonction de bloquer la tige 5 en place selon le même principe que celui mis en oeuvre dans le matériel de Cotrel et Dubousset. thus the screws 11 have the function of blocking the 5 up shaft according to the same principle as that implemented in the hardware and Cotrel Dubousset.

La tige 5 a une surface pourvue d'aspérités, par exemple des pointes de diamant, comme dans l'instrumentation de Cotrel-Dubousset. The rod 5 has a surface provided with irregularities, for example diamond-shaped, as in the Cotrel-Dubousset instrumentation.

La mise en place du dispositif intercorporéal qui vient d'être décrit nécessite une instrumentation spécifique, à savoir : un pousse trépied pour enfoncer les pièces d'extrémités 1 et 2 dans les corps vertébraux 3 et 4, et une clé pour le serrage des vis 11. The establishment of intercorporéal device which has just been described requires special instrumentation, including: a pushing tripod for driving the end pieces 1 and 2 into the vertebral bodies 3 and 4, and a wrench for tightening screws 11.

Le montage du dispositif selon l'invention s'effectue de la manière suivante Mounting the device according to the invention is carried out as follows
1. A l'étage cervical, l'abord antérolatéral unilatéral ou bilatéral permet l'exérèse d'un ou de plusieurs corps vertébraux 3,4. 1. At the cervical level, the first of the excision allows unilateral or bilateral anterolateral or more vertebral bodies 3.4. Par cette voie, le dispositif intercorporéal est mis en place. By this route, the intercorporéal device is set up. Les pièces 1,2 formant des trépieds sont fichées dans les corps vertébraux sus et sous-jacents à la résection osseuse. Parts 1,2 forming tripods are driven into the vertebral bodies above and underlying bone resection. La tige centrale 5 munie de son manchon 6 est introduite dans les encoches latérales 8 et 9 des pièces 1 et 2. Les vis 11 sont serrées sur 3a surface rugueuse de la tige 5, solidarisant les différentes pièces du dispositif. The central rod 5 provided with its sleeve 6 is inserted into the lateral notches 8 and 9 of the parts 1 and 2. The screws 11 are tightened on rough surface 3a of the rod 5, interconnecting the different parts of the device. Le montage est ensuite complété par la mise en place, de manière connue en soi, de greffons osseux ou de ciment acrylique. The assembly is then completed by the establishment, in a known manner, bone graft or acrylic cement.

2. A l'étage dorso-lombaire, la voie d'abord est une voie postéro-latérale bilatérale par transverso-arthropédiculectomie, qui permet l'exérèse complète d'une ou plusieurs vertèbres en contrôlant l'axe radiculo-médullaire en première intention. 2. At the dorso-lumbar spine, the first track is a bilateral posterior lateral approach by transverso-arthropédiculectomie, which allows complete removal of one or more vertebrae by controlling radiculo-medullary axis in first-line . Par cette voie, le dispositif est mis en place. By this way, the device is set up. Les deux pièces terminales 1 et 2 sont fichées par leurs pointes 7 dans les corps 3,4 sus et sous-jacents. The two end pieces 1 and 2 are stuck by their tips 7 in the body 3,4 addition and underlying. La tige centrale 5 munie de son manchon 6 est introduite dans les encoches 8,9 des pièces 1,2, dont les vis 11 sont ensuite serrées, afin de solidariser les éléments du montage. The central rod 5 provided with its sleeve 6 is inserted into the notches 8.9 parts 1,2, the screws 11 are then tightened to secure the mounting elements. Le geste opératoire est alors complété par la mise en place de greffons osseux ou de ciment acrylique et d'une ostéosynthèse postérieure. The surgical procedure is then completed by the introduction of bone graft or acrylic cement and a posterior osteosynthesis.

Les avantages du dispositif selon l inven- tion sont les suivants The advantages of the device according to the invention are tion
- il est constitué d'un nombre de pièces réduit par rapport au dispositif antérieur rappelé ci-dessus, de sorte que sa fabrication est plu aisée et moins coûteuse, et que sa mise en place par le chirurgien est moins délicate et difficile. - it consists of a number of components reduced relative to the prior art device mentioned above, so that its manufacture is longer easier and less expensive, and its implementation by the surgeon is less delicate and difficult.

- son encombrement est réduit, ce qui facilite la mise en place de greffons osseux ou de ciment acrylique. - its size is reduced, which facilitates the implementation of bone grafts or bone cement.

- il permet de rétablir la partie antérieure du trépied vertébral 1,2 à l'étage cervical par abord antéro-latéral, et à l'étage dorso-lombaire par abord postéro-latéral, donc dans le même temps et par le même abord que la décompression radiculo-médullaire. - it allows to restore the anterior part of vertebral tripod 1.2 at the cervical level through anterolateral approach, and thoracolumbar floor by posterolateral first, so in the same time and by the same first that the radiculo-cord decompression.

- il assure une stabilité maximum par un montage axial dans le sens des contraintes mécaniques, et permet donc une exérèse la plus large possible du ou des corps vertébraux. - it ensures maximum stability for axial mounting in the direction of mechanical stress, and thus allows the widest possible resection or vertebral bodies.

Les indications de ce dispositif sont les suivantes The indications of this device are as follows
les tumeurs rachidiennes primitives ou secondaires qui nécessitent une exérèse la plus large possible pour être carcinologique. primitive or secondary spinal tumors that require a wide excision can to be carcinological. Le dispositif permet la réalisation d'une vertébrectomie complète tant à l'étage cervical que dorso-lombaire, par la stabilité qu'il apporte une fois la résection osseuse effectuée. The device allows the realization of a complete vertebrectomy both cervical level that back injury by the stability it brings once bone resection performed.

- les lésions traumatiques rachidiennes avec délabrements osseux importants d'un ou de plusieurs corps vertébraux. - traumatic lesions with significant spinal bone dilapidations of one or more vertebral bodies.

Dans le second mode de réalisation illustré à la Fig.4, la tige 5 et son manchon 6 sont remplacés par un bloc, constitué par une tige lisse 12 pourvue d'une saillie centrale cylindiique 13 réalisée d'une seule pièce avec la tige 12 et coaxiale à celle-ci. In the second embodiment shown in Fig.4, the rod 5 and the sleeve 6 are replaced by a block, constituted by a smooth rod 12 provided with a central projection cylindiique 13 formed in one piece with the shaft 12 and coaxial thereto.

Bien entendu les dimensions de la tige 12 et de la saillie 13 sont adaptées à chaque cas particulier, de manière que les pièces 1 et 2 prennent appui sur la saillie 13. Of course the dimensions of the shaft 12 and the projection 13 are adapted to each particular case, so that the pieces 1 and 2 are supported on the projection 13.

Diverses variantes d'exécution peuvent être apportées au dispositif qui vient d'étire décrit sans sortir du cadre de l'invention. Various alternative embodiments may be made to the device just described stretches within the scope of the invention. Ainsi la forme des pièces d'extrémités 1 et 2 peut varier, de même que le nombre de leurs pointes d'ancrage 7, qui pourraient de plus être remplacées par tout autre moyen d'ancrage équivalent. Thus the shape of the end pieces 1 and 2 may vary, as well as the number of anchoring points 7, which may further be replaced by any other equivalent anchoring means.

Claims (6)

    REVENDICATIONS
  1. 1. Dispositif intercorporéal rachidien, destiné au maintien d'un écartement normal entre deux vertèbres (3,4) séparées par un évidement provenant d'une extraction au moins partielle d'une vertèbre, caractérisé en ce qu'il comprend 1. Apparatus intercorporéal liquor, for the maintenance of normal spacing between two vertebrae (3,4) separated by a recess from an at least partial extraction of a vertebra, characterized in that it comprises
    - deux pièces d'extrémités (1,2) pourvues de moyens d'ancrage dans les corps vertébraux, - two end pieces (1,2) provided with means for anchoring in the vertebral body,
    - et une tige centrale (5) reliant les pièces d extrémités (1,2) ainsi que des moyens pour solidariser ces dernières à la tige. - and a central rod (5) connecting the ends of parts (1,2) and means for securing the latter to the rod.
  2. 2. Dispositif selon la revendication 1, ca ractérisé en ce qu'il comprend un manchon central (6) librement traversé par la tige (5) et placé en appui entre les deux pièces d'extrémités (1,2). 2. Device according to claim 1, ac terized in that it comprises a central sleeve (6) freely traversed by the rod (5) and positioned in abutment between the two end pieces (1,2).
  3. 3. Dispositif selon la revendication 1, ca ractérisé en ce que la tige (t2) est pourvue d'une saillie centrale cylindrique (13) réalisée d'une pièce avec la tige et coaxiale à celle-ci. 3. Device according to claim 1, ac terized in that the rod (t2) is provided with a cylindrical central projection (13) formed integrally with the rod and coaxial thereto.
  4. 4. Dispositif selon l'une des revendications 1 à 3, caractérisé en ce que dans chaque pièce d'extrémité (1,2), de préférence cylindrique, est ménagée une encoche (8,9) ouverte latéralement et longitudinalement du côté opposé aux moyens d'ancrage (7), afin de pouvoir recevoir la tige centrale (5), et lesdites pièces sont munies d'éléments de fixation de la tige aux pièces, par exemple des vis radiales (11) débouchant dans l'encoche (8,9). 4. Device according to one of claims 1 to 3, characterized in that each end piece (1.2), preferably cylindrical, is formed a notch (8,9) laterally and longitudinally open the side opposite the anchoring means (7), to receive the central pin (5), and said parts are equipped with fastening elements of the rod to the parts, for example of the radial screw (11) opening into the notch (8 , 9).
  5. 5. Dispositif selon l'une des revendications 1 à 4, caractérisé en ce que la tige (5) a une surface pourvue d'aspérités, par exemple des pointes de diamant. 5. Device according to one of claims 1 to 4, characterized in that the rod (5) has a surface provided with asperities, such as diamond tips.
  6. 6. Dispositif selon l'une des revendications 1 à 5, caractérisé en ce que les moyens d'ancrage des pièces d'extrémités sont des pointes (7) au nombre par exemple de trois. 6. Device according to one of claims 1 to 5, characterized in that the anchoring means of the end pieces are spikes (7) the number eg three.
FR8811828A 1988-09-09 1988-09-09 Inter-spinal-body device for holding a normal spacing between two vertebrae Pending FR2636227A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
FR8811828A FR2636227A1 (en) 1988-09-09 1988-09-09 Inter-spinal-body device for holding a normal spacing between two vertebrae

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
FR8811828A FR2636227A1 (en) 1988-09-09 1988-09-09 Inter-spinal-body device for holding a normal spacing between two vertebrae

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FR2636227A1 true true FR2636227A1 (en) 1990-03-16

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FR (1) FR2636227A1 (en)

Cited By (36)

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FR2671715A1 (en) * 1991-01-17 1992-07-24 Jeanson Jean Francois Artificial ligament blocking device which can be used in surgery
EP0567424A1 (en) * 1992-04-24 1993-10-27 Bilbao Ortiz de Zarate, José Ramon Vertebral prosthesis for the substitution of a vertebra in malignant tumour surgery
EP0566810A1 (en) * 1992-04-21 1993-10-27 SULZER Medizinaltechnik AG Artificial spinal disc
US5290312A (en) * 1991-09-03 1994-03-01 Alphatec Artificial vertebral body
FR2703239A1 (en) * 1993-03-30 1994-10-07 Brio Bio Rhone Implant Medical Pin for interspinal prosthesis
EP0639351A2 (en) * 1993-08-20 1995-02-22 ULRICH, Heinrich Implant for the replacement of a vertebra and/or stabilisation and fixation of the spinal column
EP0693274A1 (en) * 1994-07-02 1996-01-24 ULRICH, Heinrich Implant for maintaining the normal spacing between two vertebrae
US5540688A (en) * 1991-05-30 1996-07-30 Societe "Psi" Intervertebral stabilization device incorporating dampers
FR2762778A1 (en) * 1997-05-02 1998-11-06 Stryker France Sa Implant particularly to replace a vertebral body in spine surgery
WO1998057601A1 (en) * 1997-06-16 1998-12-23 Paul Vanderschot Vertebral replacement implant
US5895426A (en) * 1996-09-06 1999-04-20 Osteotech, Inc. Fusion implant device and method of use
US6102950A (en) * 1999-01-19 2000-08-15 Vaccaro; Alex Intervertebral body fusion device
US6344057B1 (en) * 1994-11-22 2002-02-05 Sdgi Holdings, Inc. Adjustable vertebral body replacement
WO2004010880A1 (en) * 2002-07-26 2004-02-05 Edinowa Pty Ltd Spinal implant
US6783547B2 (en) * 2002-04-05 2004-08-31 Howmedica Corp. Apparatus for fusing adjacent bone structures
WO2004089260A1 (en) * 2003-04-03 2004-10-21 Sdgi Holdings, Inc. Apparatus and method for supporting vertebral bodies
US6866682B1 (en) 1999-09-02 2005-03-15 Stryker Spine Distractable corpectomy device
US7238205B2 (en) 2004-01-15 2007-07-03 Warsaw Orthopedic, Inc. Universal interference cleat
US7621953B2 (en) 2005-12-01 2009-11-24 Warsaw Orthopedic, Inc. End device for a vertebral implant
US7662185B2 (en) 1999-12-30 2010-02-16 Osteotech, Inc. Intervertebral implants
US7726002B2 (en) 2001-12-05 2010-06-01 Osteotech, Inc. Processes for making spinal intervertebral implant, interconnections for such implant
US7780708B2 (en) 2000-10-20 2010-08-24 Osteotech, Inc. Implant retaining device
US7837732B2 (en) 2003-11-20 2010-11-23 Warsaw Orthopedic, Inc. Intervertebral body fusion cage with keels and implantation methods
US7862618B2 (en) 2006-07-19 2011-01-04 Warsaw Orthopedic, Inc. Expandable vertebral body implants and methods of use
US7867279B2 (en) 2006-01-23 2011-01-11 Depuy Spine, Inc. Intervertebral disc prosthesis
US7935148B2 (en) 2006-01-09 2011-05-03 Warsaw Orthopedic, Inc. Adjustable insertion device for a vertebral implant
US8062366B2 (en) 2007-01-08 2011-11-22 Warsaw Orthopedic, Inc. Ratcheting expandable corpectomy/vertebrectomy cage
US8123757B2 (en) 2003-12-31 2012-02-28 Depuy Spine, Inc. Inserter instrument and implant clip
US8298235B2 (en) 2004-09-30 2012-10-30 Depuy Spine, Inc. Instrument and method for the insertion and alignment of an intervertebral implant
US8328871B2 (en) 2006-11-09 2012-12-11 Warsaw Orthopedic, Inc. Expanding vertebral body implant
US8333985B2 (en) 2004-01-27 2012-12-18 Warsaw Orthopedic, Inc. Non-glycerol stabilized bone graft
US8337559B2 (en) 2005-04-21 2012-12-25 Globus Medical, Inc. Expandable vertebral prosthesis
US8372157B2 (en) 2007-02-12 2013-02-12 Warsaw Orthopedic, Inc. Joint revision implant
US8425608B2 (en) 2008-01-18 2013-04-23 Warsaw Orthopedic, Inc. Lordotic expanding vertebral body spacer
US8579910B2 (en) 2007-05-18 2013-11-12 DePuy Synthes Products, LLC Insertion blade assembly and method of use
US8906033B2 (en) 2009-03-30 2014-12-09 DePuy Synthes Products, LLC Cervical motion disc inserter

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US4553273A (en) * 1983-11-23 1985-11-19 Henry Ford Hospital Vertebral body prosthesis and spine stabilizing method
EP0188954A1 (en) * 1984-12-21 1986-07-30 Youssef Hassan Daher Support device for use in a vertebral prosthesis

Cited By (53)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2671715A1 (en) * 1991-01-17 1992-07-24 Jeanson Jean Francois Artificial ligament blocking device which can be used in surgery
US5540688A (en) * 1991-05-30 1996-07-30 Societe "Psi" Intervertebral stabilization device incorporating dampers
US5290312A (en) * 1991-09-03 1994-03-01 Alphatec Artificial vertebral body
EP0566810A1 (en) * 1992-04-21 1993-10-27 SULZER Medizinaltechnik AG Artificial spinal disc
US5370697A (en) * 1992-04-21 1994-12-06 Sulzer Medizinaltechnik Ag Artificial intervertebral disk member
EP0567424A1 (en) * 1992-04-24 1993-10-27 Bilbao Ortiz de Zarate, José Ramon Vertebral prosthesis for the substitution of a vertebra in malignant tumour surgery
FR2703239A1 (en) * 1993-03-30 1994-10-07 Brio Bio Rhone Implant Medical Pin for interspinal prosthesis
EP0639351A2 (en) * 1993-08-20 1995-02-22 ULRICH, Heinrich Implant for the replacement of a vertebra and/or stabilisation and fixation of the spinal column
EP0639351A3 (en) * 1993-08-20 1995-03-29 Ulrich Heinrich
EP0693274A1 (en) * 1994-07-02 1996-01-24 ULRICH, Heinrich Implant for maintaining the normal spacing between two vertebrae
US6344057B1 (en) * 1994-11-22 2002-02-05 Sdgi Holdings, Inc. Adjustable vertebral body replacement
US6315795B1 (en) 1996-09-06 2001-11-13 Osteotech, Inc. Fusion implant device and method of use
US5895426A (en) * 1996-09-06 1999-04-20 Osteotech, Inc. Fusion implant device and method of use
US6045580A (en) * 1996-09-06 2000-04-04 Osteotech, Inc. Fusion implant device and method of use
WO1998049975A1 (en) * 1997-05-02 1998-11-12 Stryker France S.A. Implant in particular for replacing a body of vertebrae in backbone surgery
US6375683B1 (en) 1997-05-02 2002-04-23 Stryker France S.A. Implant in particular for replacing a vertebral body in surgery of the spine
FR2762778A1 (en) * 1997-05-02 1998-11-06 Stryker France Sa Implant particularly to replace a vertebral body in spine surgery
BE1011217A3 (en) * 1997-06-16 1999-06-01 Vanderschot Paul INTER CORP OREEL IMPLANT FOR SURGICAL OR ENDOSCOPIC anterior corpectomy AFTER MERGER IN HEIGHT thoraco-lumbar spine.
US6299644B1 (en) 1997-06-16 2001-10-09 Paul Vanderschot Vertebral replacement implant
WO1998057601A1 (en) * 1997-06-16 1998-12-23 Paul Vanderschot Vertebral replacement implant
US6102950A (en) * 1999-01-19 2000-08-15 Vaccaro; Alex Intervertebral body fusion device
US7648529B2 (en) 1999-09-02 2010-01-19 Stryker Spine Telescoping spinal implant
US6866682B1 (en) 1999-09-02 2005-03-15 Stryker Spine Distractable corpectomy device
US7662185B2 (en) 1999-12-30 2010-02-16 Osteotech, Inc. Intervertebral implants
US8672980B2 (en) 2000-10-20 2014-03-18 Warsaw Orthopedic, Inc. Implant retaining device
US7780708B2 (en) 2000-10-20 2010-08-24 Osteotech, Inc. Implant retaining device
US7726002B2 (en) 2001-12-05 2010-06-01 Osteotech, Inc. Processes for making spinal intervertebral implant, interconnections for such implant
US6783547B2 (en) * 2002-04-05 2004-08-31 Howmedica Corp. Apparatus for fusing adjacent bone structures
WO2004010880A1 (en) * 2002-07-26 2004-02-05 Edinowa Pty Ltd Spinal implant
US8574298B2 (en) 2002-07-26 2013-11-05 Edinowa Pty Ltd. Spinal implant
US8012213B2 (en) 2003-04-03 2011-09-06 Warsaw Orthopedic, Inc. Apparatus and method for supporting vertebral bodies
US8613769B2 (en) 2003-04-03 2013-12-24 Warsaw Orthopedic, Inc. Apparatus and method for supporting vertebral bodies
US7563281B2 (en) 2003-04-03 2009-07-21 Warsaw Orthopedic, Inc. Apparatus and method for supporting vertebral bodies
WO2004089260A1 (en) * 2003-04-03 2004-10-21 Sdgi Holdings, Inc. Apparatus and method for supporting vertebral bodies
US7837732B2 (en) 2003-11-20 2010-11-23 Warsaw Orthopedic, Inc. Intervertebral body fusion cage with keels and implantation methods
US8491653B2 (en) 2003-11-20 2013-07-23 Warsaw Orthopedic, Inc. Intervertebral body fusion cage with keels and implantation methods
US8123757B2 (en) 2003-12-31 2012-02-28 Depuy Spine, Inc. Inserter instrument and implant clip
US9072610B2 (en) 2003-12-31 2015-07-07 DePuy Synthes Products, Inc. Inserter instrument and implant clip
US7238205B2 (en) 2004-01-15 2007-07-03 Warsaw Orthopedic, Inc. Universal interference cleat
US8333985B2 (en) 2004-01-27 2012-12-18 Warsaw Orthopedic, Inc. Non-glycerol stabilized bone graft
US8298235B2 (en) 2004-09-30 2012-10-30 Depuy Spine, Inc. Instrument and method for the insertion and alignment of an intervertebral implant
US8337559B2 (en) 2005-04-21 2012-12-25 Globus Medical, Inc. Expandable vertebral prosthesis
US7674294B2 (en) 2005-12-01 2010-03-09 Warsaw Orthopedic, Inc. End device for a vertebral implant
US7621953B2 (en) 2005-12-01 2009-11-24 Warsaw Orthopedic, Inc. End device for a vertebral implant
US7935148B2 (en) 2006-01-09 2011-05-03 Warsaw Orthopedic, Inc. Adjustable insertion device for a vertebral implant
US7867279B2 (en) 2006-01-23 2011-01-11 Depuy Spine, Inc. Intervertebral disc prosthesis
US7862618B2 (en) 2006-07-19 2011-01-04 Warsaw Orthopedic, Inc. Expandable vertebral body implants and methods of use
US8328871B2 (en) 2006-11-09 2012-12-11 Warsaw Orthopedic, Inc. Expanding vertebral body implant
US8062366B2 (en) 2007-01-08 2011-11-22 Warsaw Orthopedic, Inc. Ratcheting expandable corpectomy/vertebrectomy cage
US8372157B2 (en) 2007-02-12 2013-02-12 Warsaw Orthopedic, Inc. Joint revision implant
US8579910B2 (en) 2007-05-18 2013-11-12 DePuy Synthes Products, LLC Insertion blade assembly and method of use
US8425608B2 (en) 2008-01-18 2013-04-23 Warsaw Orthopedic, Inc. Lordotic expanding vertebral body spacer
US8906033B2 (en) 2009-03-30 2014-12-09 DePuy Synthes Products, LLC Cervical motion disc inserter

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