FR2703580A1 - Intersomatic cervical cage - Google Patents

Intersomatic cervical cage Download PDF

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Publication number
FR2703580A1
FR2703580A1 FR9302558A FR9302558A FR2703580A1 FR 2703580 A1 FR2703580 A1 FR 2703580A1 FR 9302558 A FR9302558 A FR 9302558A FR 9302558 A FR9302558 A FR 9302558A FR 2703580 A1 FR2703580 A1 FR 2703580A1
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France
Prior art keywords
cage
characterized
intersomatic
fusion
internal contention
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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.)
Granted
Application number
FR9302558A
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French (fr)
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FR2703580B1 (en
Inventor
Robert Gilles
Albert P Alby
Original Assignee
Robert Gilles
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Priority to FR9302558A priority Critical patent/FR2703580B1/en
Publication of FR2703580A1 publication Critical patent/FR2703580A1/en
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Publication of FR2703580B1 publication Critical patent/FR2703580B1/en
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    • A61F2/4603Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4611Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
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    • A61F2230/0002Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0017Angular shapes
    • A61F2230/0026Angular shapes trapezoidal
    • 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
    • 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
    • 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
    • A61F2230/0082Three-dimensional shapes parallelepipedal
    • 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
    • A61F2250/00Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0096Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers
    • A61F2250/0098Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers radio-opaque, e.g. radio-opaque markers

Abstract

The invention relates to a device for internal retention and for intersomatic fusion of the vertebrae in case of discectomy, referred to by the name intersomatic cage. The characteristics of the cage are as follows: - it is made of polyethylene or an equivalent, optionally absorbable, material and introduces a shock-absorption factor which reduces the transmission of stresses. - Geometrically, the cage has the shape of a parallelepiped and may or may not comprise a central reinforcing partition (2). Its anterior (5) and posterior (6) faces have heights which are determined so as to retain an intervertebral space and normal lordosis. - The edges of each of the faces of the cage are provided with notches (11) intended to oppose displacements. - It is equipped, in its central region, with a radiopaque marker which makes it possible to monitor over time the displacement of the implant and allow conduction of perturbed radiological and MRI examinations. - Volumes are available for accommodating bone fragments of suitable dimensions. <IMAGE>

Description

La présente invention concerne une cage de contention, désignée Cage Intersomatique destinée à être insérée entre deux vertèbres. The present invention relates to a restraining cage, designated intersomatic cage for insertion between two vertebrae. Une telle insertion permet d'étayer l'espace libéré par la discectomie et de procéder à la mise en place d'un greffon osseux destiné à fusionner les deux vertèbres. Such integration helps to support the space freed by the discectomy and proceed with the establishment of a bone graft for merging the two vertebrae.

Le déroulement de la procédure prévoit les étapes suivantes: The course of the procedure foresees the following steps:
1) Abord de la face antérieure du rachis cervical par incision dans un pli du cou. 1) Access of the anterior aspect of the cervical spine in a neck incision by the fold.

2) Incision verticale sur la ligne médiane des muscles prévertébraux et mise en place 2) vertical incision in the midline of prevertebral muscles and establishment
d'un écarteur autostatique transversal. a transverse self-retaining retractor.

3) Repérage radiologique du disque exposé et mise en place de plots vissés au milieu 3) Radiation Locating the disk exposed and establishment of screwed studs in the middle
des corps vertébraux sus- et sous-jacents. of the above-vertebral body and underlying.

4) Distraction vertébrale et discectomie complète. 4) Spinal Distraction and complete discectomy. Abrasion des lèvres antérieures Abrasion earlier lips
des plateaux adjacents. adjacent plates.

5) Curetage des plateaux et mise àjour du spongieux sur chaque face intervertébrale 5) Curettage trays and last opening in the sponge on each side intervertebral
pour favoriser la conduction osseuse. to promote bone conduction.

6) Remplissage de la cage à l'aide de deux parallélépipèdes d'os spongieux débordant 6) Fill the cage with two cancellous bone parallelepipeds overflowing
de 1 mm environ sur les 2 faces. about 1 mm on the two faces.

7) Mise en place de la cage. 7) Implementation of the cage.

8) Ablation de la distraction et fermeture de l'incision. 8) Removal of the distraction and closing the incision.

Les implants métalliques présentent l'inconvénient d'être ngides, donc de transmettre intégralement les contraintes et de constituer, dans certaines conditions, un obstacle à une bonne reconstitution osseuse. Metal implants have the disadvantage of being ngides, so to fully convey the constraints and to constitute, in certain circumstances, a barrier to good bone reconstruction. De plus, leur poids est élevé et ils provoquent des artefacts au scanner et à l'IRM. Moreover, their weight is high and they cause artifact in CT and MRI.

La cage intersomatique, objet de la présente invention, apporte une solution à ces inconvénients. The interbody cage, object of the present invention provides a solution to these problems.

Les caractéristiques de la cage sont les suivantes: - Réalisée en polyéthylène ou matériau équivalent résorbable ou non, elle introduit grâce aux propriétés du matériau, un facteur d'amortissement qui réduit la transmission des contraintes. The characteristics of the cage are: - made of polyethylene or equivalent material resorbable or not, it introduces due to the material properties, a damping factor that reduces the transmission of stresses.

Géométriquement la cage a la forme d'un parallélépipède. Geometrically the cage has the shape of a parallelepiped. Elle peut avoir une forme différente et comporter ou non une cloison médiane de renfort (2). It may have a different shape and optionally include a medial reinforcing partition (2). Sa face antérieure (5) et postérieure '6) ont des hauteurs qui sont déterminées pour assurer la conservation d'un espace intervertébral et d'une lordose normale. Its front face (5) and subsequent '6) have heights which are determined to ensure the preservation of an intervertebral space and normal lordosis.

- Les arêtes de chacune des faces de la cage sont munies de crans (11) destinés à s'opposer aux déplacements. - The ridges of each of the faces of the cage are provided with notches (11) for opposing the displacement.

-Equipée dans sa partie centrale d'un marqueur radiopaque permettant de suivre, dans le temps, le déplacement de l'implant et permettre la conduite d'examens radiologiques et IRM perturbés. -Equipée in the central part of a radiopaque marker for monitoring, over time, the displacement of the implant and allow the conduct radiology and MRI disturbed.

- Des volumes disponibles pour loger des fragments osseux de dimensions convenables permettant la communication osseuse ininterrompue entre la vertèbre sus et sous-jacente amenant par là la fusion intersomatique. - volumes available for accommodating bone fragments of suitable dimensions for the bone uninterrupted communication between the overlying vertebra and underlying thereby causing the interbody fusion.

La cage intersomatique est caractérisée dans notre cas, par une géométrie particulière illustrée sur la planche 1/1 mais qui n'est pas limitative et d'autre part en ce que l'usage de matériau plastique, polyéthylène par exemple, est prévu pour sa réalisation. The intersomatic cage is in this case characterized by a particular geometry illustrated in the 1/1 board but which is not limiting, and secondly in that the use of plastic material, eg polyethylene, is provided for its production.

D'autres matériaux, résorbables ou non, présentant des caractéristiques équivalentes peuvent être envisagés. Other materials, whether or not absorbable, having equivalent characteristics can be considered. Ce matériau assure une bonne tenue mécanique de la cage tout en introduisant un effet amortisseur qui amoindrit la gène. This material provides good mechanical strength of the cage while introducing a cushioning effect which reduces the gene.

En emprisonnant de l'os spongieux, la cage favorise la fusion osseuse d'une manière permanente. By trapping of the cancellous bone, the cage promotes bone fusion permanently. Ceci par opposition aux insertions libres de partie d'os qui n'étant pas retenues in situ, auraient tendance, de ce fait, à migrer et induire un déséquilibre entre les faces des corps vertébraux. This is in contrast to the free insertions bone party not being retained in situ, would tend, therefore, to migrate and induce an imbalance between the sides of the vertebral body.

La figure 1 illustre les caractéristiques géométriques mais non limitatives de la cage. Figure 1 illustrates the geometrical characteristics but not limiting of the cage.

Celle-ci est constituée par un parallélépipède irrégulier (1) comportant une cloison médiane (2) servant de renfort. It is constituted by an irregular parallelepiped (1) comprising a median partition (2) for reinforcement. Cette cloison dans ce cas détermine deux logements (3) et (4). The partition in this case defines two housings (3) and (4).

Chaque logement sera équipé d'un greffon osseux au moment de la mise en place. Each unit will be equipped with a bone graft at the time of implementation. La cage peut avoir une surface différente pour le logement d'os, des séparations ou être alvéolée. The cage may have a different surface for the bone housing, separations or be dimpled.

La hauteur de la face postérieure (6) est suffisante pour permettre la conservation d'une hauteur cervicale normale. The height of the posterior face (6) is sufficient to permit storage of a normal neck height. Celle de la face antérieure (5) est légèrement plus importante pour permettre d'obtenir le degré de lordose qui convient. That of the front face (5) is slightly larger to allow to obtain the degree of lordosis appropriate.

La face antérieure comporte deux perçages destinés à la mise en place de la cage au moyen d'une tige munie de deux picots rétractables. The front side has two bores for the introduction of the cage by means of a rod provided with two retractable bristle. Cette tige est représentée en figure 2. This rod is shown in Figure 2.

Les faces latérales (9) et (10) sont en forme de trapèze isocèle. The side faces (9) and (10) are shaped like an isosceles trapezium.

Les arêtes de toutes les faces de la cage ainsi que celles de la cloison sont pourvues de crans (11), dont le profil est étudié pour qu'il réduise le risque de déplacement secondaire. The edges of all sides of the cage and those of the partition are provided with notches (11) whose profile is designed so that it reduces the risk of secondary displacement.

Ainsi la cage permettra, après déplacement concevable, que la fusion osseuse se fasse dans de bonnes conditions. Thus the cage will after moving conceivable that bone fusion takes place in good conditions.

Par ailleurs, les propriétés amagnétiques du matériau utilisé pour la réalisation de la cage permettront de conduire des examens au scanner ou à l'IRM sans artefacts. Furthermore, the non-magnetic properties of the material used for the realization of the cage will conduct CT scans or MRI without artifacts.

Ces examens sont facilités par l'existence d'un repère radiopaque incorporé verticalement au centre de la paroi médiane, qui permettra de quantifier la compression ou déplacement éventuel de la cage. These examinations are facilitated by the existence of a radiopaque marker embedded vertically in the center of the median wall, which will quantify the compression or possible displacement of the cage.

Claims (9)

REVENDICATIONS
1) Elément de contention interne et de fusion intersomatique des vertèbres lors de discectomie caractérisé en ce qu'il se présente sous forme d'une structure rigide en forme de cage destinée à emprisonner de l'os spongieux. 1) The element of internal contention and interbody fusion of the vertebrae during diskectomy characterized in that it is in the form of a rigid structure shaped cage for entrapping cancellous bone.
2) Elément de contention interne et de fusion intersomatique des vertèbres selon la revendication 1 caractérisé en ce que la structure rigide a la forme d'un parallélépipède. 2) The element of internal contention and intersomatic fusion of vertebrae according to claim 1 characterized in that the rigid structure has the shape of a parallelepiped.
3) Elément de contention interne et de fusion intersomatique des vertèbres selon l'une quelconque des revendications 1 à 2 caractérisé en ce que les hauteurs respectives des faces antérieures (5) et postérieure (6) de la cage permettent la conservation d'une hauteur intervertébrale et d'une lordose normale. 3) The element of internal contention and intersomatic fusion of vertebrae according to one of claims 1 to 2, characterized in that the respective heights of front faces (5) and rear (6) of the cage allows the preservation of a height intervertebral and normal lordosis.
4) Elément de contention interne et de fusion intersomatique des vertèbres selon l'une quelconque des revendications 1 à 3 caractérisé en ce que les arêtes des faces sont munies de crans. 4) Item of internal contention and intersomatic fusion of vertebrae according to one of claims 1 to 3, characterized in that the edges of the faces are provided with notches.
5) Elément de contention interne et de fusion intersomatique des vertèbres selon l'une quelconque des revendications 1 à 4 caractérisé en ce que les faces latérales 9 et 10 sont en forme de trapèze isocèle. 5) Item of internal contention and intersomatic fusion of vertebrae according to one of claims 1 to 4 characterized in that the lateral faces 9 and 10 are shaped like an isosceles trapezium.
6) Elément de contention interne et de fusion intersomatique des vertèbres selon l'une quelconque des revendications 1 à ce que la cage est réalisée en une matière polymère, résorbable ou non, telle que polyéthylène à haut poids moléculaire et amagnétique permettant les examens au scanner ou à l'IRM sans artefact. 6) The element of internal contention and intersomatic fusion of vertebrae according to one of Claims 1 that the cage is made of a polymeric material, resorbable or not, such as polyethylene and high molecular weight non-magnetic allowing CT scans or MRI without artifact.
7) Elément de contention interne et de fusion intersomatique des vertèbres selon l'une quelconque des revendications 1 à 6 caractérisé en ce que la cage comporte une cloison médiane de renfort dont les arêtes sont munies de crans. 7) Item of internal contention and intersomatic fusion of vertebrae according to one of claims 1 to 6 characterized in that the cage comprises a median partition reinforcement whose edges are provided with notches.
8) Elément de contention interne et de fusion intersomatique des vertèbres selon l'une quelconque des revendications I à 7 caractérisé en ce que le volume d'os emprisonné permet la communication osseuse entre la vertèbre inférieure et la vertèbre supérieure. 8) Item of internal contention and intersomatic fusion of vertebrae according to any one of claims I to 7 characterized in that the volume of bone trapped allows bone communication between the lower vertebra and the upper vertebra.
9) Elément de contention interne et de fusion intersomatique des vertèbres selon l'une quelconque des revendications 1 à 8 caractérisé en ce qu'il comporte un marqueur radiopaque permettant de suivre dans le temps son positionnement. 9) Item of internal contention and intersomatic fusion of vertebrae according to one of claims 1 to 8, characterized in that it comprises a radiopaque marker to track its position over time.
FR9302558A 1993-03-03 1993-03-03 Cage cervical interbody. Expired - Lifetime FR2703580B1 (en)

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