FR2730405A1 - Spinal column prosthesis - Google Patents

Spinal column prosthesis Download PDF

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Publication number
FR2730405A1
FR2730405A1 FR9501561A FR9501561A FR2730405A1 FR 2730405 A1 FR2730405 A1 FR 2730405A1 FR 9501561 A FR9501561 A FR 9501561A FR 9501561 A FR9501561 A FR 9501561A FR 2730405 A1 FR2730405 A1 FR 2730405A1
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France
Prior art keywords
omnidirectional
elastic
directional
anchors
prosthetic
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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.)
Withdrawn
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FR9501561A
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French (fr)
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Individual
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Individual
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Application filed by Individual filed Critical Individual
Priority to FR9501561A priority Critical patent/FR2730405A1/en
Priority to EP95400558A priority patent/EP0677277A3/en
Publication of FR2730405A1 publication Critical patent/FR2730405A1/en
Withdrawn legal-status Critical Current

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002Longitudinal elements, e.g. rods
    • A61B17/7019Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other
    • A61B17/7026Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other with a part that is flexible due to its form
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002Longitudinal elements, e.g. rods
    • A61B17/7011Longitudinal element being non-straight, e.g. curved, angled or branched
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7035Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • A61B17/704Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other the longitudinal element passing through a ball-joint in the screw head
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7041Screws or hooks combined with longitudinal elements which do not contact vertebrae with single longitudinal rod offset laterally from single row of screws or hooks

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Neurology (AREA)
  • Surgery (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)
  • Prostheses (AREA)

Abstract

The spinal prosthetic assembly has a convenient number of elastic intervertebrae prosthetic shock absorbing connectors. These are, according to requirements, either omnidirectional (2a) or directional (2b). The first has two pedicular screw (3a,3b), one fitting the top (4a) and the other the bottom (4b) vertebrae, and anchors (5,6) joined by an omnidirectional dovetail connector (9). The other (2b) has two pedicular screws (14a,14b) fitting the top (15a) and bottom (15b) vertebrae and having anchors (17,18) joined by a directional dovetail connector (18). The omnidirectional prosthetic connecting element has a connector having a hollow cylindrical body cut helicoidally to make it axially elastic and a rectangular spiralled section. The upper and lower body parts have top and bottom dove tails which are fixed, after bending in situ, on the anchors while the body central hollow part is filled at rest with a visco-elastic shock absorbing fluid. All the parameters of the prosthesis elements are determined and fatigue tested before implanting in the patient.

Description

L'invention est du domaine des prothèses intervertébrales destinées à assurer la liaison sous charge entre deux parties défaillantes. The invention is in the field of intervertebral prostheses intended to ensure the connection under load between two failing parts.

Toutes les liaisons de ce genre font appel à une technique opératoire consistant à: - assujettir solidement une vis de fixation dans chaque partie osseuse intéréssée, - utiliser la partie dépassante de chacune de ces vis pour y placer un moyen d'ancrage, - relier deux de cesdits moyens d'ancrage par un dispositif de liaison approprié. All connections of this kind use an operating technique consisting of: - securely securing a fixing screw in each bone part involved, - using the protruding part of each of these screws to place an anchoring means, - connecting two of said anchoring means by an appropriate connecting device.

Les diffèrents genres de vis utilisées sont nombreux de même que les moyens d'ancrage qui prennent trés souvent leur origine dans les mécanismes d'assemblage classiques. The different kinds of screws used are numerous as are the anchoring means which very often originate in conventional assembly mechanisms.

Les dispositifs de liaison sont également répandus mais ceux concernés par l'invention comportent des éléments souples présentant des avantages par rapport aux dispositifs rigides connus tels qu'avec tiges par exemple. Connection devices are also widespread, but those concerned with the invention include flexible elements having advantages over known rigid devices such as with rods for example.

Parmi ces dispositifs de liaison souple, on peut retenir ceux impliquant un ressort avec amortissement viscoélastique ainsi que ceux présentant des fentes transversales d'élasticité. Among these flexible connection devices, we can retain those involving a spring with viscoelastic damping as well as those having transverse elasticity slots.

Les premiers sont du genre omnidirectionnel en ce sens qu'outre l'absorbtion des efforts axiaux, tous les efforts transversaux sont absorbés dans toutes les directions latérales par flambage. The first are of the omnidirectional type in the sense that, in addition to the absorption of the axial forces, all the transverse forces are absorbed in all the lateral directions by buckling.

Les seconds ont des fentes transversales pouvant être dissymétriques leur confèrant de la sorte, outre l'élasticité et l'amortissement axial, une absorption des efforts latéraux dans une direction privilégiée afin de corriger un défaut tel qu'une scoliose par exemple. The second have transverse slots which can be asymmetrical, thus giving them, in addition to elasticity and axial damping, absorption of lateral forces in a preferred direction in order to correct a defect such as scoliosis for example.

L'invention sera bien comprise dans la suite du texte qui va montrer, par les dessins annexés, deux dispositifs de liaison l'un omnidirectionnel l'autre directionnel pouvant être utilisés diffèremment ou conjointement. The invention will be clearly understood in the following text which will show, by the appended drawings, two connecting devices, one omnidirectional the other directional, which can be used differently or jointly.

Sur la figure 1, on voit les vis de fixation qui sont repérées 1 selon l'axe ya-ya' et 2 selon l'axe yb-yb' et qui sont assujetties par vissage, d'une part sur la partie osseuse haute 3 et d'autre part, sur la partie osseuse basse 4; parties pour lesquelles l'assemblage omnidirectionnel repéré 10 dans son ensemble doit en assurer la liaison mécanique. In Figure 1, we see the fixing screws which are marked 1 along the axis ya-ya 'and 2 along the axis yb-yb' and which are secured by screwing, on the one hand on the upper bone part 3 and on the other hand, on the lower bone part 4; parts for which the omnidirectional assembly identified 10 as a whole must ensure its mechanical connection.

Sur les parties dépassantes des vis 1-2 formées d'un filetage 5 et 6, viennent se placer des colliers en deux parties 7a-7b et 8a-8b constituant les moyens d'ancrage pour lesquels le blocage est assuré par serrage des écrous 5a-6a. On the protruding parts of the screws 1-2 formed of a thread 5 and 6, are placed collars in two parts 7a-7b and 8a-8b constituting the anchoring means for which the blocking is ensured by tightening the nuts 5a -6a.

Les paramètres de correction apparaissant au moment de la pose tels que le désalignement des axes za-za' ,zb-zb'dù au défaut de parallèlisme des vis 1 et 2 ainsi que le contrôle de l'écartement el, doivent être réglés par torsion et adaptation des queues lOa et lOb du dispositif de liaison omnidirectionnel 10. The correction parameters appearing at the time of installation such as the misalignment of the axes za-za ', zb-zb'dù due to the lack of parallelism of the screws 1 and 2 as well as the control of the spacing el, must be adjusted by torsion and adaptation of the queues 10a and 10b of the omnidirectional link device 10.

Cedit dispositif de liaison omnidirectionnel 10 comporte de fait une partie élastique lOc située entre les queues lOa et lOb et qui peut être un ressort complèté d'un système d'amortissement. Said omnidirectional connection device 10 in fact comprises an elastic part lOc situated between the tails lOa and lOb and which can be a spring complete with a damping system.

La torsion des queues lOa-lOb qui s'obtient avec des outils en usage chirurgical orthopédique, peut être suffisamment précise pour venir s'ajuster trés exactement sur les moyens d'ancrage constitués des demi-colliers 7a-7b et 8a-8b. The torsion of the tails lOa-lOb which is obtained with tools for orthopedic surgical use, can be precise enough to come to fit very exactly on the anchoring means consisting of the half-collars 7a-7b and 8a-8b.

I1 est aisé de constater que le système réalise ainsi aprés pose, un ensemble bloqué dans lequel le dispositif de liaison contribue bien à assurer sa double fonction; d'une part axiale dans la direction Za-Zb' et, d'autre part, dans les directions radiales par flambage latéral du dispositif élastique confèrant ainsi à l'ensemble ainsi constitué, une fonction omnidirectionnelle. It is easy to see that the system thus achieves, after installation, a blocked assembly in which the connection device contributes well to ensuring its double function; on the one hand axial in the direction Za-Zb 'and, on the other hand, in the radial directions by lateral buckling of the elastic device thus giving the assembly thus formed, an omnidirectional function.

Sur la figure 2, on voit également dans un deuxième cas de figure,les vis de fixation qui sont repérées 11 selon l'axe yc-yc' et 12 selon l'axe Yd-Yd' et qui sont assujetties par vissage, d'une part sur la partie osseuse haute 13 et d'autre part sur la partie osseuse basse 14; parties pour lesquelles l'assemblage directionnel repéré 20 dans son ensemble doit en assurer la liaison mécanique. In FIG. 2, we also see in a second case, the fixing screws which are marked 11 along the axis yc-yc 'and 12 along the axis Yd-Yd' and which are secured by screwing, d ' on the one hand on the upper bone part 13 and on the other hand on the lower bone part 14; parts for which the directional assembly marked 20 as a whole must ensure its mechanical connection.

Sur les parties dépassantes des vis 11 et 12 constituées d'un filetage 15-16 viennent se placer des colliers en deux parties 17a-17b et 18a-18b enserrant une noix sphérique haute 21 fendue en 21a et basse 22 fendue en 22a permettant de la sorte l'orientation directe en cours d'opération selon l'axe zc-zc' du dispositif de liaison 20 qui comporte deux queues 20a-20b ainsi que le réglage selon e2
Un système élastique avec amortissement 20c possèdant des fentes transversales autorisent, outre le réglage de l'entr'axe e2 et l'élasticité axiale, un amortissement radial par flambage latéral qui peut être privilégié par rotation selon la direction v afin de corriger une scoliose par exemple.
On the protruding parts of the screws 11 and 12 made up of a thread 15-16 are placed collars in two parts 17a-17b and 18a-18b enclosing a spherical nut high 21 split in 21a and low 22 split in 22a allowing the so direct orientation during operation along the axis zc-zc 'of the connecting device 20 which has two tails 20a-20b as well as the adjustment according to e2
An elastic system with damping 20c having transverse slots allows, in addition to the adjustment of the center distance e2 and the axial elasticity, a radial damping by lateral buckling which can be favored by rotation in the direction v in order to correct scoliosis by example.

On voit de la sorte, que le praticien dispose de deux ensembles prothètiques qui peuvent être mis en pratique indépendamment les uns des autres sur un même sujet ou bien utilisés sur des patients diffèrents en fonction du confort recherché et/ou de la correction éventuelle à apporter.  It is thus seen, that the practitioner has two prosthetic sets which can be practiced independently of each other on the same subject or used on different patients according to the desired comfort and / or the possible correction to be made .

Claims (1)

REVENDICATION CLAIM Appareil prothétique souple intervertébral constitué de deux prothèses soit omnidirectionnelles soit directionnelles soit encore omnidirectionnelle ou directionnelle; ledit appareil étant caractérisé en ce que chaque prothèse omnidirectionnelle élastique avec amortissement du genre ressort (10) fixé à deux moyens d'ancrage (7a-7b) et (8a-8b) serrés par des écrous (5a-6a) sur les parties filetées (5-6) de vis (1-2) assujetties dans les parties osseuses à joindre tandis que les queues (iOa-10b) situées de part et d'autre d'une partie élastique (lOc) sont tordues avec précision pour venir s' ajuster très exactement dans lesdits moyens d'ancrage, chaque prothèse directionnelle élastique avec amortissement du genre à fente transversales dissymétriques (20) fixé sur deux moyens d'ancrage (17a-17b/18a-18b) enserrant des noix sphériques (21-22) fendues longitudinalement (21a-22a) qui reçoivent et bloquent les queues (20a-20b) dudit dispositif (20). Flexible intervertebral prosthetic device consisting of two prostheses either omnidirectional or directional or even omnidirectional or directional; said device being characterized in that each elastic omnidirectional prosthesis with spring-like damping (10) fixed to two anchoring means (7a-7b) and (8a-8b) tightened by nuts (5a-6a) on the threaded parts (5-6) of screws (1-2) fixed in the bony parts to be joined while the tails (iOa-10b) located on either side of an elastic part (lOc) are twisted with precision to come s '' very precisely adjust in said anchoring means, each elastic directional prosthesis with damping of the kind with asymmetrical transverse slot (20) fixed on two anchoring means (17a-17b / 18a-18b) enclosing spherical nuts (21-22 ) split longitudinally (21a-22a) which receive and block the tails (20a-20b) of said device (20).
FR9501561A 1994-03-18 1995-02-10 Spinal column prosthesis Withdrawn FR2730405A1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
FR9501561A FR2730405A1 (en) 1995-02-10 1995-02-10 Spinal column prosthesis
EP95400558A EP0677277A3 (en) 1994-03-18 1995-03-15 Spinal prosthetic assembly.

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
FR9501561A FR2730405A1 (en) 1995-02-10 1995-02-10 Spinal column prosthesis

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FR2730405A1 true FR2730405A1 (en) 1996-08-14

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Cited By (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2002007622A1 (en) * 2000-07-25 2002-01-31 Spine Next Flexible linking piece for stabilising the spine
WO2004096080A2 (en) 2003-04-25 2004-11-11 Vertelink Corporation System and method for minimally invasive posterior fixation
WO2006037384A1 (en) * 2004-10-07 2006-04-13 Synthes Device for dynamic stabilisation of bones or bone fragments, especially vertebrae of the back
WO2007041265A1 (en) * 2005-09-30 2007-04-12 Paradigm Spine, Llc Hinged polyaxial screw and methods of use
US7611518B2 (en) 2000-09-18 2009-11-03 Zimmer Gmbh Pedicle screw for intervertebral support elements
US7927359B2 (en) 2005-10-06 2011-04-19 Paradigm Spine, Llc Polyaxial screw
US8012182B2 (en) 2000-07-25 2011-09-06 Zimmer Spine S.A.S. Semi-rigid linking piece for stabilizing the spine
US8029544B2 (en) 2007-01-02 2011-10-04 Zimmer Spine, Inc. Spine stiffening device
US8292929B2 (en) 2007-03-16 2012-10-23 Zimmer Spine, Inc. Dynamic spinal stabilization system and method of using the same
US8518080B2 (en) 2004-12-17 2013-08-27 Zimmer Gmbh Intervertebral stabilization system

Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4743260A (en) * 1985-06-10 1988-05-10 Burton Charles V Method for a flexible stabilization system for a vertebral column
EP0516567A1 (en) * 1991-05-30 1992-12-02 Société dite: "PSI" Shock-absorbing device for intervertebral stabilisation
FR2682280A1 (en) * 1991-10-11 1993-04-16 Biomecanique Integree Fixation device for spinal osteosynthesis rod
EP0538183A1 (en) * 1991-08-30 1993-04-21 SULZER Medizinaltechnik AG Prosthetic intervertebral disc
EP0576379A1 (en) * 1992-06-25 1993-12-29 Psi Use of dampers with improved damping at the end of stroke in a device for intervertebral stabilisation
FR2694182A1 (en) * 1992-07-31 1994-02-04 Psi Fastening for interpedicular vertebral prosthesis components - comprises bone-implanted shafts, with spherical heads engaged over upper portions for cooperation with prosthesis-attached rings
DE4243951A1 (en) * 1992-12-23 1994-07-07 Plus Endoprothetik Ag Rotkreuz Device for stiffening a spine and tools for its assembly and / or disassembly
DE4239716C1 (en) * 1992-11-26 1994-08-04 Kernforschungsz Karlsruhe Elastic implant for stabilising degenerated spinal column segments

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4743260A (en) * 1985-06-10 1988-05-10 Burton Charles V Method for a flexible stabilization system for a vertebral column
EP0516567A1 (en) * 1991-05-30 1992-12-02 Société dite: "PSI" Shock-absorbing device for intervertebral stabilisation
EP0538183A1 (en) * 1991-08-30 1993-04-21 SULZER Medizinaltechnik AG Prosthetic intervertebral disc
FR2682280A1 (en) * 1991-10-11 1993-04-16 Biomecanique Integree Fixation device for spinal osteosynthesis rod
EP0576379A1 (en) * 1992-06-25 1993-12-29 Psi Use of dampers with improved damping at the end of stroke in a device for intervertebral stabilisation
FR2694182A1 (en) * 1992-07-31 1994-02-04 Psi Fastening for interpedicular vertebral prosthesis components - comprises bone-implanted shafts, with spherical heads engaged over upper portions for cooperation with prosthesis-attached rings
DE4239716C1 (en) * 1992-11-26 1994-08-04 Kernforschungsz Karlsruhe Elastic implant for stabilising degenerated spinal column segments
DE4243951A1 (en) * 1992-12-23 1994-07-07 Plus Endoprothetik Ag Rotkreuz Device for stiffening a spine and tools for its assembly and / or disassembly

Cited By (24)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2812186A1 (en) * 2000-07-25 2002-02-01 Spine Next Sa FLEXIBLE CONNECTION PIECE FOR SPINAL STABILIZATION
US8012182B2 (en) 2000-07-25 2011-09-06 Zimmer Spine S.A.S. Semi-rigid linking piece for stabilizing the spine
WO2002007622A1 (en) * 2000-07-25 2002-01-31 Spine Next Flexible linking piece for stabilising the spine
US7785349B2 (en) 2000-09-18 2010-08-31 Zimmer Gmbh Pedicle screw for intervertebral support elements
US8764802B2 (en) 2000-09-18 2014-07-01 Zimmer Gmbh Pedicle screw for intervertebral support elements
US7985248B2 (en) 2000-09-18 2011-07-26 Zimmer Gmbh Pedicle screw for intervertebral support elements
US7846182B2 (en) 2000-09-18 2010-12-07 Zimmer Gmbh Pedicle screw for intervertebral support elements
US7611518B2 (en) 2000-09-18 2009-11-03 Zimmer Gmbh Pedicle screw for intervertebral support elements
US7758618B2 (en) 2000-09-18 2010-07-20 Zimmer Gmbh Pedicle screw for intervertebral support elements
EP1622525A4 (en) * 2003-04-25 2008-10-22 Warsaw Orthopedic Inc System and method for minimally invasive posterior fixation
US8317838B2 (en) 2003-04-25 2012-11-27 Warsaw Orthopedic System and method for minimally invasive posterior fixation
WO2004096080A2 (en) 2003-04-25 2004-11-11 Vertelink Corporation System and method for minimally invasive posterior fixation
EP1622525A2 (en) * 2003-04-25 2006-02-08 Vertelink Corporation System and method for minimally invasive posterior fixation
WO2006037384A1 (en) * 2004-10-07 2006-04-13 Synthes Device for dynamic stabilisation of bones or bone fragments, especially vertebrae of the back
US8518080B2 (en) 2004-12-17 2013-08-27 Zimmer Gmbh Intervertebral stabilization system
US8523905B2 (en) 2004-12-17 2013-09-03 Zimmer Gmbh Intervertebral stabilization system
US8608778B2 (en) 2004-12-17 2013-12-17 Zimmer Gmbh Intervertebral stabilization system
US8613757B2 (en) 2004-12-17 2013-12-24 Zimmer Gmbh Intervertebral stabilization system
WO2007041265A1 (en) * 2005-09-30 2007-04-12 Paradigm Spine, Llc Hinged polyaxial screw and methods of use
US8470001B2 (en) 2005-10-06 2013-06-25 Paradigm Spine, Llc Polyaxial screw
US7927359B2 (en) 2005-10-06 2011-04-19 Paradigm Spine, Llc Polyaxial screw
US8206422B2 (en) 2007-01-02 2012-06-26 Zimmer Spine, Inc. Spine stiffening device and associated method
US8029544B2 (en) 2007-01-02 2011-10-04 Zimmer Spine, Inc. Spine stiffening device
US8292929B2 (en) 2007-03-16 2012-10-23 Zimmer Spine, Inc. Dynamic spinal stabilization system and method of using the same

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