FR2710519A1 - Intervertebral lumbar cage (CH) - Google Patents

Intervertebral lumbar cage (CH) Download PDF

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Publication number
FR2710519A1
FR2710519A1 FR9311552A FR9311552A FR2710519A1 FR 2710519 A1 FR2710519 A1 FR 2710519A1 FR 9311552 A FR9311552 A FR 9311552A FR 9311552 A FR9311552 A FR 9311552A FR 2710519 A1 FR2710519 A1 FR 2710519A1
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FR
France
Prior art keywords
cage
intersomatic
bone
nut
bone fusion
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
FR9311552A
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French (fr)
Other versions
FR2710519B1 (en
Inventor
Robine Dominique
Herman Serge
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Individual
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Individual
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Publication date
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Priority to FR9311552A priority Critical patent/FR2710519B1/en
Publication of FR2710519A1 publication Critical patent/FR2710519A1/en
Application granted granted Critical
Publication of FR2710519B1 publication Critical patent/FR2710519B1/en
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
    • A61F2/446—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages having a circular or elliptical cross-section substantially parallel to the axis of the spine, e.g. cylinders or frustocones
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/3006—Properties of materials and coating materials
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    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0069—Three-dimensional shapes cylindrical
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys

Abstract

Intervertebral lumbar cage (CH) intended for internal retention during lumbar discectomy. It is characterised by a specific geometry which confers upon it properties able to promote osseous fusion and which makes it easier to position. The cage (1) is bullet-shaped and has wide slots with sharp edges (2) about the circumference and a distal notch (7) intended to hold it on a stable base during the operations of filling with bone and screwing and caulking of the base nut (5). This nut is provided with a threaded central hole which allows the cage to be placed between the vertebrae with the aid of an introduction tool. The rotational movements of the cage or the forward or rearward sliding movements of the cage are prevented, respectively, by the sharp edges which embed in the vertebral plateaus and by the abutment formed by the vertebral bodies between which it is fitted. The blocking effect is completed by the roughened surface of the cage. It is envisaged that the cage be made of titanium alloy or of equivalent materials, either absorbable or non-absorbable. These materials satisfy the criteria of biocompatibility and mechanical stability and allow computerised tomography and magnetic resonance examinations to be carried out free of interference.

Description

La presente invention concerne une cage de contention destinée à être insérée entre deux vertèbres pour étayer l'espace intervertébral.The present invention relates to a compression cage intended to be inserted between two vertebrae to support the intervertebral space.

L'insertion d'une telle cage permet de procéder à la mise en place d'un greffon osseux destiné à fusionner les deux vertèbres entre lesquelles il est placé.The insertion of such a cage makes it possible to place a bone graft intended to merge the two vertebrae between which it is placed.

La cage, objet de cette invention, est donc une cage de fusion osseuse intersomatique. Elle est plus particulièrement destinée à la reconstruction de la partie lombaire de la colonne vertébrale lorsque cclle-ci est atteinte de dégénéressences (spondylolisthésis ou autres) qui ne peuvent être résorbées par d'autres méthodes.The cage, object of this invention, is therefore an intersomatic bone fusion cage. It is more particularly intended for the reconstruction of the lumbar part of the spine when the latter is affected by degeneration (spondylolisthesis or others) which cannot be absorbed by other methods.

Cette reconstruction permet - lorsqu'elle est réussie - la restitution de la quasi totalité des fonctions mécaniques de la colonne lombaire.This reconstruction allows - when it is successful - the restitution of almost all the mechanical functions of the lumbar spine.

La fusion osseuse entre vertèbres lombaires, par abord postérieur, a été initiée dans les années 40 avec des fortunes diverses.Bone fusion between lumbar vertebrae, by posterior approach, was initiated in the 1940s with various fortunes.

Au début elle a été réalisée sans interposition de dispositif de contention intégré avec des résultats aléatoires.At the beginning it was carried out without the interposition of an integrated restraint device with random results.

En particulier l'écrasement et la migration de l'implant osseux constituait un obstable majeur.In particular, the crushing and migration of the bone implant was a major obstacle.

Par la suite, la nécessité d'interposer un dispositif de contention intégré s'est imposée.Subsequently, the need to interpose an integrated restraint device arose.

De tels dispositifs de contention ont été réalisés sous des formes diverses (parallélipédiques, cylindriques avec filetages externes, etc...). ris sont souvent affectés des inconvénients inhérents à leurs formes telles que difficultés de mise en place et de préparation du site d'insertion, nécessité d'adjoindre un matériel d'ostéosynthèse postérieur pour faciliter la fusion osseuse - d'où artefacs au scanner ou à l'IRM.Such compression devices have been produced in various forms (parallelepiped, cylindrical with external threads, etc.). reefs are often affected by the disadvantages inherent in their forms such as difficulties in setting up and preparing the insertion site, need to add posterior osteosynthesis material to facilitate bone fusion - hence artefacs with the scanner or MRI.

La cage intersomatique objet de la présente invention vise à sunnonter ces inconvénients avec une mise en place plus sure.The interbody cage object of the present invention aims to overcome these drawbacks with a safer implementation.

Elle est caractérisée par une géométrie particulière et par le choix des matériaux qui lui confièrent les propriétés suivantes: - Biocompatibilité et résistance à I'écrasement. It is characterized by a particular geometry and by the choice of materials which give it the following properties: - Biocompatibility and resistance to crushing.

- Commodité de préparation du site d'implantation.- Convenience of site preparation.

- Volume de réceptacle convenant au logement d'une quantité d'os adéquate.- Receptacle volume suitable for housing an adequate amount of bone.

- Blocage de la cage en rotation. - Locking of the cage in rotation.

- Antéro ou postéro reptation du module interdite.- Antero or postero reptation of the module prohibited.

- Pas d'artefats engendrés au scanner ou à l'IRM.- No artifacts generated on CT or MRI.

La figure I de la planche 112 montre un mode de réalisation préférentiel mais non exclusif de la cage.Figure I of the board 112 shows a preferred but not exclusive embodiment of the cage.

Celle-ci est constituée d'un corps creux (1) en forme d'obus. L'intérieur du corps sera rempli d'os spongieux introduit en bourrant fortement.This consists of a hollow body (1) in the shape of a shell. The inside of the body will be filled with cancellous bone introduced by heavy stuffing.

Quatre larges lumières (2) avec arêtes vives sont aménagées régulièrement sur le pourtour du corps. Elles rendent possible un contact de l'os spongieux avec les plateaux vertébraux sus et sous jacents, ce qui permettra une fusion osseuse.Four large lights (2) with sharp edges are regularly fitted around the body. They make possible a contact of the cancellous bone with the vertebral plates above and underlying, which will allow a bone fusion.

lees arêtes vives s'incrusteront dans les plateaux correspondants des vertèbres sitôt que la distraction à laquelle celles-ci sont soumises pour la mise en place sera relâchée. the sharp edges will become embedded in the corresponding trays of the vertebrae as soon as the distraction to which they are subjected for the positioning is released.

Cette incrustation empêchera ainsi toute rotation de la cage.This incrustation will thus prevent any rotation of the cage.

Par ailleurs, préalablement à la mise en place de la cage, des logements auront été aménagés dans les plateaux vertébraux correspondants pour recevoir la tête (3) et le fond de la cage (4).Furthermore, prior to the positioning of the cage, housings will have been arranged in the corresponding vertebral plates to receive the head (3) and the bottom of the cage (4).

Ces logements sont respectivement situés à quelques millimètres des bords postérieur et antérieur des corps vertébraux qui constituent ainsi une butée empêchant tout mouvement d'avancée ou de recul de la cage.These housings are respectively located a few millimeters from the posterior and anterior edges of the vertebral bodies which thus constitute a stop preventing any movement of advancement or retreat of the cage.

De plus, les surfaces extérieures de la cage sont rendues rugueuses pour supprimer, par frottement, toute tendance au mouvement. II en résulte un blocage respectif de la cage et des vertèbres sus et sous jacentes. Ce blocage favorise la repousse bosseuse.In addition, the outer surfaces of the cage are made rough to eliminate, by friction, any tendency to movement. This results in a respective blockage of the cage and the above and underlying vertebrae. This blockage promotes bumpy regrowth.

Il est clair que l'aménagement des logements dans les plateaux vertébraux - à l'aide de forets ou de fraises de dimensions adaptées - est grandement facilité par les formes géométriques simples de la cage.It is clear that the arrangement of the housings in the vertebral plates - using drills or cutters of suitable dimensions - is greatly facilitated by the simple geometric shapes of the cage.

Le fond de la cage (4) comporte un filetage sur lequel vient se visser un écrou (5).The bottom of the cage (4) has a thread on which is screwed a nut (5).

Cet écrou n'est monté qu'après avoir rempli la cage d'os spongieux. Après montage l'écrou est bloqué en place par matage.This nut is only mounted after filling the cage with cancellous bone. After mounting the nut is locked in place by matting.

L'écrou comporte à sa partie centrale un trou fileté (6) qui permettra l'installation du module cage J écrou sur un outillage - tel que tournevis à embout fileté - permettant sa mise en place.The nut has at its central part a threaded hole (6) which will allow the installation of the cage module J nut on a tool - such as screwdriver with threaded tip - allowing its installation.

Une fois celleti effectuée, I'outillage pourra être retiré. Once this is done, the tools can be removed.

La tète de la cage comporte une échancrure (7) permettant le maintien sur un socle lors du remplissage de la cage et du vissage de l'écrou.The head of the cage has a notch (7) allowing it to be held on a base when filling the cage and screwing the nut.

Cette échancrure accroît l'espace par lequel la repousse osseuse peut s'accomplir.This notch increases the space through which bone regrowth can be accomplished.

La réalisation de la cage intersomatique est prévue en alliage de titane avec ou sans revêtement Le choix de cet alliage n'exclut pas d'autres matériaux biocompatibles, résorbables ou non.The intersomatic cage is made of titanium alloy with or without coating. The choice of this alloy does not exclude other biocompatible materials, absorbable or not.

Une gamme de cages de tailles différentes est prévue pour répondre aux divers besoins.A range of cages of different sizes is provided to meet various needs.

L'appareillage d'un étage intervertébral est prévu à l'aide de deux cages intersomatiques.The apparatus of an intervertebral stage is provided using two interbody cages.

La planche 212 (figures 5 et 6) montre - à des fins informatives - la position occupée par ces cages. Plate 212 (Figures 5 and 6) shows - for information purposes - the position occupied by these cages.

Claims (6)

REVENDICATIONS 1) Cage de fission osseuse intersomatique, plus particuliérement destinée à la reconstruction de la colonne lombaire, caractérisée en ce qu'elle est constituée d'un corps creux en forme d'obus comportant, sur son pourtour, quatre large lumières munies d'arêtes vives.1) Cage of intersomatic bone fission, more particularly intended for the reconstruction of the lumbar spine, characterized in that it consists of a hollow body in the shape of a shell comprising, on its periphery, four large lights provided with edges vivid. 2) Cage de fusion osseuse intersomatique selon la revendication 1 caractérisée en ce qu'elle comporte un fond (4) qui porte un filetage sur lequel vient se visser un écrou (5).2) intersomatic bone fusion cage according to claim 1 characterized in that it comprises a bottom (4) which carries a thread on which is screwed a nut (5). 3) Cage de fusion osseuse intersomatique selon l'une quelconque des revendications I à 2 caractérisée en ce qu'elle comporte sur la tête (3) une échancrure (7) qui permet de la maintenir sur un socle pendant les opérations de remplissage avec de l'os spongieux et de vissage et de matage de l'écrou de fond.3) intersomatic bone fusion cage according to any one of claims I to 2 characterized in that it comprises on the head (3) a notch (7) which allows to maintain it on a base during the filling operations with cancellous bone and screwing and matting the bottom nut. 4) Cage de fusion osseuse intersomatique selon l'une quelconque des revendications l à 3 caractérisée en ce qu'elle est réalisée en alliage de titane, revêtu ou non, ou en tout autre matériau biocompatible, résorbable ou non ,résistant à l'écrasement et permettant les examens au scanner ou à L'IRE sans artefact.4) intersomatic bone fusion cage according to any one of claims l to 3 characterized in that it is made of titanium alloy, coated or not, or any other biocompatible material, absorbable or not, resistant to crushing and allowing CT or IRE exams without artifacts. 5) Procédé de mise en place de la cage de fusion osseuse intersomatique selon l'une quelconque des revendications 1 à 4 caractérisé en ce qu'on aménage à quelques millimètres des bords postérieur et antérieur des corps vertébraux qui constituent une butée des logements pour recevoir la tête (3) et le fond de la cage (4). 5) A method of setting up the intersomatic bone fusion cage according to any one of claims 1 to 4 characterized in that a few millimeters of the posterior and anterior edges of the vertebral bodies which constitute a stop of the housing to receive the head (3) and the bottom of the cage (4). 6) Procédé de mise en place de la cage de fusion osseuse intersomatique selon l'une quelconque des revendications I à 5 caractérisé en ce qu'on utilise une tige à embout fileté vissée sur l'écrou de fonds. 6) A method of setting up the intersomatic bone fusion cage according to any one of claims I to 5 characterized in that a rod with a threaded end screwed on the bottom nut is used.
FR9311552A 1993-09-29 1993-09-29 Lumbar interbody fusion cage (CH). Expired - Lifetime FR2710519B1 (en)

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EP0716840A3 (en) * 1994-12-12 1996-09-18 Surgical Dynamics Inc Conically-shaped fusion cage and method of implantation
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EP1023010A1 (en) * 1997-07-24 2000-08-02 Techsys Medical, L.L.C. An interbody fusion device having partial circular section cross-sectional segments
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EP1131020A1 (en) * 1998-10-30 2001-09-12 MICHELSON, Gary Karlin Self-broaching, rotatable, push-in interbody fusion implant and method for deployment thereof
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US8460380B2 (en) 2004-02-13 2013-06-11 Franz Copf, JR. Intervertebral implant and surgical method for spondylodesis of a lumbar vertebral column
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FR2726759A1 (en) * 1994-11-16 1996-05-15 Atlas Implants Osteosynthesis implant for fusing adjacent vertebrae
WO1996014809A1 (en) * 1994-11-16 1996-05-23 Atlas Implants Implant for the fusion of two adjacent bony bodies, particularly two consecutive vertebrae
FR2727004A1 (en) * 1994-11-18 1996-05-24 Euros Sa Lumbar and lumbar-sacral posterior stabiliser
EP0716840A3 (en) * 1994-12-12 1996-09-18 Surgical Dynamics Inc Conically-shaped fusion cage and method of implantation
EP1175878A2 (en) * 1994-12-12 2002-01-30 Surgical Dynamics, Inc. Conically-shaped fusion cage
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US6471724B2 (en) 1995-03-27 2002-10-29 Sdgi Holdings, Inc. Methods and instruments for interbody fusion
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US8075622B2 (en) 1995-10-16 2011-12-13 Warsaw Orthopedic, Inc Intervertebral spacers
US7311734B2 (en) 1995-10-16 2007-12-25 Warsaw Orthopedic, Inc. Intervertebral spacers
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FR2742044A1 (en) * 1995-12-11 1997-06-13 Medinov Sa Spinal inter vertebral bone prosthesis
WO1997023174A1 (en) * 1995-12-21 1997-07-03 Colorado Interbody-type intervertebral implant
FR2742652A1 (en) * 1995-12-21 1997-06-27 Colorado INTERVERTEBRAL IMPLANT, INTERSOMATIC CAGE TYPE
US6102948A (en) * 1996-01-16 2000-08-15 Surgical Dynamics Inc. Spinal fusion device
EP0784967A3 (en) * 1996-01-19 1998-03-18 Howmedica GmbH Spine implant
AU715937B2 (en) * 1996-01-19 2000-02-10 Stryker European Holdings I, Llc Spine implant
US6019760A (en) * 1996-01-19 2000-02-01 Howmedica Gmbh Spine implant
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WO1998004217A1 (en) * 1996-07-26 1998-02-05 Heinrich Ulrich Implant for bonding two adjacent vertebrae of the vertebral column
US5782832A (en) * 1996-10-01 1998-07-21 Surgical Dynamics, Inc. Spinal fusion implant and method of insertion thereof
US6190414B1 (en) 1996-10-31 2001-02-20 Surgical Dynamics Inc. Apparatus for fusion of adjacent bone structures
US6063088A (en) * 1997-03-24 2000-05-16 United States Surgical Corporation Method and instrumentation for implant insertion
EP1772119A3 (en) * 1997-04-25 2007-12-05 Stryker France S.A. Two-part intersomatic implants
WO1998048738A1 (en) * 1997-04-25 1998-11-05 Stryker France S.A. Two-part intersomatic implant
US8840666B2 (en) 1997-04-25 2014-09-23 Stryker France Two part intersomatic implant
US8449613B2 (en) 1997-04-25 2013-05-28 Stryker France Two part intersomatic implant
EP2308426A1 (en) 1997-04-25 2011-04-13 Stryker France Intersomatic implants in two parts
US6824564B2 (en) 1997-04-25 2004-11-30 Stryker France, Sas Two-part intersomatic implant
US10792164B2 (en) 1997-04-25 2020-10-06 Stryker European Operations Holdings Llc Intersomatic implants
US6855168B2 (en) 1997-04-25 2005-02-15 Stryker France Intersomatic implants in two parts
US7056341B2 (en) 1997-04-25 2006-06-06 Stryker France Two part intersomatic implant
EP1772119A2 (en) * 1997-04-25 2007-04-11 Stryker France S.A. Two-part intersomatic implants
EP1769777A1 (en) * 1997-04-25 2007-04-04 Stryker France S.A. Two parts interbody implant
FR2764795A1 (en) * 1997-06-19 1998-12-24 Sarl Sra Inervertebral spinal fixation cage
EP1023010A1 (en) * 1997-07-24 2000-08-02 Techsys Medical, L.L.C. An interbody fusion device having partial circular section cross-sectional segments
EP1023010A4 (en) * 1997-07-24 2004-12-22 Techsys Medical L L C An interbody fusion device having partial circular section cross-sectional segments
EP1818026A3 (en) * 1997-07-24 2008-04-02 K2 Medical, L.L.C. An interbody fusion device having partial circular section cross-sectional segments
EP1131020A1 (en) * 1998-10-30 2001-09-12 MICHELSON, Gary Karlin Self-broaching, rotatable, push-in interbody fusion implant and method for deployment thereof
US7056342B2 (en) 1998-10-30 2006-06-06 Sdgi Holdings, Inc. Self-broaching, rotatable, push-in interbody spinal fusion implant and method for deployment thereof
US7396365B2 (en) 1998-10-30 2008-07-08 Warsaw Orthopedic, Inc. Method for inserting a fusion cage having a height substantially the same as the height between adjacent vertebral endplates
EP1131020A4 (en) * 1998-10-30 2003-06-11 Michelson Gary K Self-broaching, rotatable, push-in interbody fusion implant and method for deployment thereof
US7537616B1 (en) 1999-10-20 2009-05-26 Warsaw Orthopedic, Inc. Impacted orthopedic bone support implant
WO2001028461A2 (en) * 1999-10-20 2001-04-26 Sdgi Holdings, Inc. Impacted orthopedic bone support implant
WO2001028461A3 (en) * 1999-10-20 2002-01-03 Sdgi Holdings Inc Impacted orthopedic bone support implant
US8460380B2 (en) 2004-02-13 2013-06-11 Franz Copf, JR. Intervertebral implant and surgical method for spondylodesis of a lumbar vertebral column
US9597198B2 (en) 2006-02-15 2017-03-21 Ldr Medical Transforaminal intersomatic cage for an intervertebral fusion graft and an instrument for implanting the cage
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FR2927250A1 (en) * 2008-02-11 2009-08-14 Neuro France Implants Nfi Sarl Intersomatic cage for vertebra arthrodesis, has end whose diameter is lower than diameter of another end, where each end is equipped with handling seam for permitting seam to be cooperated with transmission authorizing tool

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