FR2736538A1 - Cage intersomatique pour rachis lombaire - Google Patents

Cage intersomatique pour rachis lombaire Download PDF

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FR2736538A1
FR2736538A1 FR9508413A FR9508413A FR2736538A1 FR 2736538 A1 FR2736538 A1 FR 2736538A1 FR 9508413 A FR9508413 A FR 9508413A FR 9508413 A FR9508413 A FR 9508413A FR 2736538 A1 FR2736538 A1 FR 2736538A1
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cage according
cage
faces
shutter
longitudinal direction
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FR2736538B3 (fr
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GASTAMBIDE DANIEL
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GASTAMBIDE DANIEL
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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
    • A61F2/4455Joints 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
    • AHUMAN NECESSITIES
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    • 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
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    • A61F2/30721Accessories
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    • 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
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    • 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
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    • 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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    • 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
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    • 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
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    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30405Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by screwing complementary threads machined on the parts themselves
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    • 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
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    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30593Special structural features of bone or joint prostheses not otherwise provided for hollow
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    • 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
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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Vascular Medicine (AREA)
  • Transplantation (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Cardiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Neurology (AREA)
  • Prostheses (AREA)

Abstract

La cage intersomatique cylindrique rigide comporte une cavité cylindrique (1) délimitée par une paroi périphérique (2) pourvue de lumières de communication osseuse (3), deux ou quatre faces latérales planes et ajourées (4 et 5), prolongées chacune d'un relief cranté anti recul (6) deux faces (5) externes latérales planes et inclinées selon la direction longitudinale, formant un premier angle compris entre 2 et 6 degrés, deux faces (4) externes supérieure et inférieure parallèles ou inclinées selon la direction longitudinale, formant alors un deuxième angle plus petit que le premier.

Description

La présente invention concerne un implant intersomatique creux, destiné à former une structure rigide ouverte permettant de restituer l'espace intervertébral et offrant la perspective de reconstruction osseuse par apport d'os spongieux ou cortico-spongieux placé à l'intérieur de l'implant.
On connaît dà de tels implants présentant une forme parallélépipédique rectangle [US 4,834,757], cylindrique [WO 89/12431, WO 91/06261, US 4,501,269], ovoïde [WO 94/17759] ou sphérique [US 4,936,848]. Ces dispositifs restituent un espace intersomatique mais ils ne permettent pas de retrouver une lordose anatomique.
On connaît également un implant sous forme d'un tronc de cône [EiR 2708461] qui restitue la lordose rachidienne. Mais, l'implantation par voie postérieure d'une telle géométrie nécessite de réaliser une forte distraction des vertèbres affin de ménager un espace minimum entre les berges postérieures de deux plateaux vertébraux adjacents qui autorise le passage du profil antérieur d'encombrement maximum de l'implant.
La présente invention a pour objet de remédier à cet inconvénient et propose une cage à structure rigide ouverte comportant deux profils : un premier profil de faible encombrement non lordosant réduisant au minimum la distraction des vertèbres pour la mise en place de l'implant dans l'espace intercorporéal ; un deuxième profil lordosant qui, dans un deuxième temps, est mis au contact des corps vertébraux adjacents par une simple rotation.
Le dispositif de stabilisation intervertébrale est constitué selon la présente invention d'un corps creux de section circulaire, comportant une cavité interne destinée à contenir de l'os spongieux ou cortico-spongieux et maintenu au moyen d'un obturateur vissé. Cet apport osseux entre au contact des plateaux vertébraux à travers des ouvertures de communication pratiquées sur les faces latérales, supérieures et inférieures.
La cage comporte deux profils définis par quatres faces planes:
- un premier profil non lordosant (ou faiblement lordosant) dont l'encombrement en hauteur est limité pour autoriser la mise en place de l'implant dans l'espace intercorporéal sous une faible distraction,
- un deuxième profil lordosant permettant de restituer à la fois, I'espace intervertébral et la courbure anatomique. Le trait essentiel d'un tel profil est de présenter un encombrement maximal à sa partie distale plus important que l'espace ménagé entre les berges postérieures de deux plateaux vertébraux adjacents. De ce fait, le positionnement de l'implant en lordose anatomique est obtenu indirectement par son introduction dans l'espace intervertébral au moyen d'un premier profil de faible encombrement, puis par un simple basculement de la cage d'un angle de 90".
Un relief cranté réparti aux extrémités antérieure et postérieure prolonge les faces planes ajourées et assure une stabilisation pnmaire.
Les dessins annexés, donnés à titre d'exemple, permettent de mieux comprendre l'invention, les caractéristiques qu'elle présente et les avantages qu'elle est susceptible de procurer:
La figure 1 est une coupe longitudinale montrant le profil lordosant.
La figure 2 est une coupe longitudinale montrant le profil non lordosant.
La figure 3 est une vue d'une face latérale de la cage.
La figure 4 est une vue d'une face supérieure de la cage.
La figure 5 est une coupe transversale proche de l'extrémité distale.
La figure 6 est une coupe transversale proche de l'extrémité antérieure.
La figure 7 est une coupe transversale de l'extrémité de la cage.
La figure 8 est une vue de l'obturateur.
La figure 9 est une coupe transversale de l'obturateur.
On a représenté en Fig. 1 un mode de réalisation d'une cage intersomatique comportant une cavité interne cylindrique (1), délimitée par une paroi (2) pourvue de fenêtres de communication osseuse (3). Les surfaces planes supérieure et inférieure (4) sont inclinées dans la direction longitudinale, formant un premier angle compris entre 2 et 6 degrés. Elles sont prolongées à leurs extrémités d'un relief cranté anti-recul (6). Le cylindre creux est prolongé d'une paroi courbe (7).
On a montré en Fig. 2 une coupe longitudinale perpendiculaire à celle de la figure précédente. Les faces latérales planes (5) sont parallèles ou faiblement inclinées dans la direction longitudinale. Elles sont prolongées à leurs extrémités d'un relief cranté antirecul.
On a montré en Fig. 3 une vue extérieure d'une face supérieure. La lumière de communication osseuse (3) présente une large ouverture.
On a montré en Fig. 4 une vue extérieure d'une face latérale comportant notamment une fenêtre de communication osseuse (3).
La figure 5 est une vue de la cage en coupe A-A. Selon un mode de réalisation préféré, les reliefs anti-recul (6) prolongeant les faces planes ont un profil extérieur courbe ou rectiligne.
La figure 6 est une vue en coupe B-B. Les reliefs anti-recul (6) adoptent un profil extérieur courbe ou éventuellement rectiligne.
La figure 7 est une vue en coupe C-C. Deux trous longitudinaux lisses (10) sont ménagés dans l'épaisseur de la paroi. Leur forme coopère avec l'extrémité d'un ancillaire qui autorise la rotation de l'implant.
La figure 8 est une vue de face d'un obturateur comportant un filetage externe ( l l ) à pas à gauche, un filetage interne (12) à pas à droite.
La figure 9 est une coupe médiane de l'obturateur comportant une rainure (13) qui coopère à l'extrémité d'un outil autorisant son serrage.

Claims (9)

  1. REVENDICATIONS
    I - Cage intersomatique cylindrique rigide comprennant une cavité cylindrique (1) délimitée par une paroi périphérique ( 2 ) pourvue de lumières de communication osseuse ( 3 ), caractérisée en ce que la paroi périphérique comporte quatre surfaces latérales planes ou ajourées assymétriques ( 4 ) ( 5 ), prolongées chacune d'un relief anti-recul ( 6 ).
  2. 2 - Cage selon la revendication 1, caractérisée en ce qu'elle comprend en sa partie médiane, deux faces ( 5 ) externes latérales planes et inclinées selon la direction longitudinale, formant un premier angle compris entre 2 et 6 degrés.
  3. 3 - Cage selon les revendications I et 2 caractérisée en ce qu'elle comprend en sa partie centrale, deux faces ( 4 ) externes supérieures et inférieures paralléles ou inclinées selon la direction longitudinale, formant alors un angle plus petit que le premier.
  4. 4 - Cage selon revendications 1 à 3 caractérisée en ce qu'un relief cranté ( 6 ),prolonge chacune des surfaces planes inclinées ( 5 ) et /ou chacune des surfaces planes ( 4 ), située à proximité de l'une de ses deux extrémités longitudinales.
  5. 5 - Cage selon l'une quelconque des revendications 1,2 et 3 caractérisée en ce que le cylindre creux est prolongé d'une paroi transversale courbe ( 7 ), de préférence sphérique ( 6 ).
  6. 6 - Cage selon les revendications 1 à 5 caractérisée en ce qu'elle comprend une extrémité longitudinale ouverte ( 8 ) comportant un filetage intérieur ( 9 ) de préférence avec un pas à gauche et pourvue de deux trous ( 10 ) longitudinaux lisses ménagés dans l'épaisseur de la paroi.
  7. 7 - Cage selon revendications I à 6 caractérisée en ce qu' elle comporte un obturateur fileté externe 11 qui coopére à l'extrémité ouverte du cylindre au cloisonnement de la dite cavité cylindrique.
  8. 8 - Cage selon revendications I à 7 caractérisée en ce que son obturateur comporte, au centre de sa surface circulaire un trou fileté ( 12 ) de préférence avec un pas à droite.
  9. 9 - Cage selon revendications 1 à 8 caractérisée en ce que son obturateur comporte une rainure ( 13 ) située sur la diagonale de l'une de ses faces planes, qui coopére à l'extrémité d'un outil autorisant son serrage.
FR9508413A 1995-07-12 1995-07-12 Cage intersomatique pour rachis lombaire Expired - Fee Related FR2736538B3 (fr)

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FR2736538B3 FR2736538B3 (fr) 1997-12-19

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Cited By (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0834295A1 (fr) * 1996-10-03 1998-04-08 Medinov-Amp Prothèse d'arthrodèse intersomatique vertébrale
FR2766085A1 (fr) * 1997-07-18 1999-01-22 Herve Carlier Implant pour etablir une fusion intervertebrale
FR2767675A1 (fr) * 1997-08-26 1999-03-05 Materiel Orthopedique En Abreg Implant intersomatique et ancillaire de preparation adapte pour permettre sa pose
WO2000045752A1 (fr) * 1999-02-04 2000-08-10 Aesculap Ag & Co. Kg Vis de liaison rehabitable pour l'arthrodese d'une articulation osseuse, notamment pour la stabilisation de deux vertebres
JP2003511200A (ja) * 1999-10-19 2003-03-25 エスディージーアイ・ホールディングス・インコーポレーテッド 脊柱インプラント及びインプラントを取り付けるための切削器具の準備付属品
AU769302B2 (en) * 1997-08-26 2004-01-22 Societe De Fabrication De Materiel Orthopedique - Sofamor Spinal implant and cutting tool preparation accesory for mounting the implant
US7169183B2 (en) 2000-03-14 2007-01-30 Warsaw Orthopedic, Inc. Vertebral implant for promoting arthrodesis of the spine
US8460380B2 (en) 2004-02-13 2013-06-11 Franz Copf, JR. Intervertebral implant and surgical method for spondylodesis of a lumbar vertebral column
US9011541B2 (en) 2002-10-21 2015-04-21 Warsaw Orthopedic, Inc. Systems and techniques for restoring and maintaining intervertebral anatomy
US9554919B2 (en) 2002-12-19 2017-01-31 DePuy Synthes Products, Inc. Intervertebral implant
USRE46647E1 (en) 2001-05-03 2017-12-26 DePuy Synthes Products, Inc. Intervertebral implant for transforaminal posterior lumbar interbody fusion procedure
US9918754B2 (en) 1999-10-20 2018-03-20 Warsaw Orthopedic, Inc. Instruments and methods for stabilization of bony structures

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US6719794B2 (en) 2001-05-03 2004-04-13 Synthes (U.S.A.) Intervertebral implant for transforaminal posterior lumbar interbody fusion procedure
US6635087B2 (en) 2001-08-29 2003-10-21 Christopher M. Angelucci Laminoplasty implants and methods of use

Cited By (26)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0834295A1 (fr) * 1996-10-03 1998-04-08 Medinov-Amp Prothèse d'arthrodèse intersomatique vertébrale
FR2766085A1 (fr) * 1997-07-18 1999-01-22 Herve Carlier Implant pour etablir une fusion intervertebrale
EP0897704A1 (fr) * 1997-07-18 1999-02-24 Hervé Carlier Implant pour établir une fusion intervertébrale
US20090164015A1 (en) * 1997-08-16 2009-06-25 Mingyan Liu Spinal implant and cutting tool preparation accessory for mounting the implant
US8480745B2 (en) 1997-08-26 2013-07-09 Warsaw Orthopedic, Inc. Spinal implant and cutting tool preparation accessory for mounting the implant
US7465305B2 (en) 1997-08-26 2008-12-16 Warsaw Orthopedic, Inc. Spinal implant and cutting tool preparation accessory for mounting the implant
FR2767675A1 (fr) * 1997-08-26 1999-03-05 Materiel Orthopedique En Abreg Implant intersomatique et ancillaire de preparation adapte pour permettre sa pose
AU741518B2 (en) * 1997-08-26 2001-12-06 Societe De Fabrication De Materiel Orthopedique - Sofamor Spinal implant and cutting tool preparation accesory for mounting the implant
WO1999009913A3 (fr) * 1997-08-26 1999-05-06 Soc D Fabrication Materiel Ort Implant spinal et accessoire de preparation formant outil de coupe utilise pour le montage de l'implant
US6610089B1 (en) 1997-08-26 2003-08-26 Sdgi Holdings, Inc. Spinal implant and cutting tool preparation accessory for mounting the implant
AU769302B2 (en) * 1997-08-26 2004-01-22 Societe De Fabrication De Materiel Orthopedique - Sofamor Spinal implant and cutting tool preparation accesory for mounting the implant
US6746484B1 (en) 1997-08-26 2004-06-08 Society De Fabrication De Materiel De Orthopedique, S.A. Spinal implant
US7112224B2 (en) 1997-08-26 2006-09-26 Sdgi Holdings, Inc. Spinal implant and cutting tool preparation accessory for mounting the implant
KR100654078B1 (ko) * 1997-08-26 2006-12-07 소시에떼 드 파브리까시옹 마뜨리엘 오르쏘뻬디끄(소파모르) 척추 이식편
WO2000045752A1 (fr) * 1999-02-04 2000-08-10 Aesculap Ag & Co. Kg Vis de liaison rehabitable pour l'arthrodese d'une articulation osseuse, notamment pour la stabilisation de deux vertebres
FR2789297A1 (fr) * 1999-02-04 2000-08-11 Aesculap Ag & Co Kg Vis de liaison rehabitable pour l'arthrodese d'une articulation osseuse, notamment pour la stabilisation de deux vertebres
JP2003511200A (ja) * 1999-10-19 2003-03-25 エスディージーアイ・ホールディングス・インコーポレーテッド 脊柱インプラント及びインプラントを取り付けるための切削器具の準備付属品
US9918754B2 (en) 1999-10-20 2018-03-20 Warsaw Orthopedic, Inc. Instruments and methods for stabilization of bony structures
US7169183B2 (en) 2000-03-14 2007-01-30 Warsaw Orthopedic, Inc. Vertebral implant for promoting arthrodesis of the spine
USRE46647E1 (en) 2001-05-03 2017-12-26 DePuy Synthes Products, Inc. Intervertebral implant for transforaminal posterior lumbar interbody fusion procedure
US9011541B2 (en) 2002-10-21 2015-04-21 Warsaw Orthopedic, Inc. Systems and techniques for restoring and maintaining intervertebral anatomy
US9737415B2 (en) 2002-10-21 2017-08-22 Warsaw Orthopedic, Inc. Systems and techniques for restoring and maintaining intervertebral anatomy
US10420655B2 (en) 2002-10-21 2019-09-24 Warsaw Orthopedic, Inc. Systems and techniques for restoring and maintaining intervertebral anatomy
US11399955B2 (en) 2002-10-21 2022-08-02 Warsaw Orthopedic, Inc. Systems and techniques for restoring and maintaining intervertebral anatomy
US9554919B2 (en) 2002-12-19 2017-01-31 DePuy Synthes Products, Inc. Intervertebral implant
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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