FR2775583A1 - SYSTEM FOR OSTEOSYNTHESIS OF THE RACHIS WITH LIGAMENT - Google Patents

SYSTEM FOR OSTEOSYNTHESIS OF THE RACHIS WITH LIGAMENT Download PDF

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Publication number
FR2775583A1
FR2775583A1 FR9802613A FR9802613A FR2775583A1 FR 2775583 A1 FR2775583 A1 FR 2775583A1 FR 9802613 A FR9802613 A FR 9802613A FR 9802613 A FR9802613 A FR 9802613A FR 2775583 A1 FR2775583 A1 FR 2775583A1
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Prior art keywords
connecting element
sleeve
screw
anchoring member
section
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Granted
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FR9802613A
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French (fr)
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FR2775583B1 (en
Inventor
Pierre Ange Moreno
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Stryker European Holdings I LLC
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Dimso SA
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Application filed by Dimso SA filed Critical Dimso SA
Priority to FR9802613A priority Critical patent/FR2775583B1/en
Priority to AU27314/99A priority patent/AU2731499A/en
Priority to PCT/FR1999/000469 priority patent/WO1999044527A1/en
Publication of FR2775583A1 publication Critical patent/FR2775583A1/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical 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
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7019—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other
    • A61B17/7022—Tethers, i.e. longitudinal elements capable of transmitting tension only, e.g. straps, sutures or cables
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical 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
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7032—Screws or hooks with U-shaped head or back through which longitudinal rods pass

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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)
  • Surgical Instruments (AREA)

Abstract

The invention concerns a vertebral osteosynthesis system comprising at least a member to be anchored (2) to a vertebra, an element linking (23) the member to another anchoring member (3), and a screw (16) for co-operating with the anchoring member (2) to clamp the linking element (23) on the anchoring member, the linking element (23) having a deformable transverse cross-section, the system comprising a deformable sleeve (24) for receiving the linking element (23). The sleeve receiving the linking element is capable of being clamped by the screw (16) on the anchoring member (2).

Description

L'invention concerne les systèmes d'ostéosynthèse pour la colonne vertébrale. The invention relates to osteosynthesis systems for the spine.

On connaît d'après le document FR-2 659 546 un système d'ostéosynthèse du rachis, comprenant des organes d'ancrage présentant chacun deux branches filetées intérieurement et aptes à recevoir entre elles une tige rigide de liaison des organes d'ancrage. Une bague fendue enfilée sur la tige est logée entre les branches. Une vis coopère avec le filet des branches pour serrer la bague et la tige sur l'organe d'ancrage. Document FR-2 659 546 discloses a spinal osteosynthesis system, comprising anchoring members each having two internally threaded branches and able to receive between them a rigid rod for connecting the anchoring members. A split ring threaded on the stem is housed between the branches. A screw cooperates with the thread of the branches to tighten the ring and the rod on the anchoring member.

Un capuchon interdit à cette fin l'écartement des branches l'une de l'autre. Ce système est de constitution simple. Il est facile et rapide à monter lors d'une intervention. Une fois installé, ce système constitue un ensemble entièrement quasi rigide.A cap prohibits the separation of the branches from one another for this purpose. This system is of simple constitution. It is easy and quick to assemble during an intervention. Once installed, this system constitutes an entirely rigid assembly.

Un but de l'invention est de fournir un système d'ostéosynthèse d'un type différent, notamment de constitution simple, facile et rapide à monter et ayant une fois installé un comportement mécanique différent de celui du système précité. An object of the invention is to provide an osteosynthesis system of a different type, in particular of simple constitution, easy and quick to assemble and having once installed a mechanical behavior different from that of the above-mentioned system.

En vue de la réalisation de ce but, on prévoit selon l'invention un système d'ostéosynthèse vertébral, comprenant au moins un organe d'ancrage à une vertèbre, un élément de liaison de l'organe à un autre organe d'ancrage, et une vis apte à coopérer avec l'organe d'ancrage pour serrer l'élément de liaison sur l'organe d'ancrage, dans lequel l'élément de liaison est de section transversale déformable. In order to achieve this goal, there is provided according to the invention a vertebral osteosynthesis system, comprising at least one member for anchoring to a vertebra, a member for connecting the member to another anchoring member, and a screw capable of cooperating with the anchoring member to tighten the connecting element on the anchoring member, in which the connecting element is of deformable cross section.

Ainsi, le système a une constitution simple. Il est facile et rapide à monter lors d'une intervention et permet la fixation aux organes d'ancrage d'un élément de liaison souple. Un tel élément, travaillant en tension, mais peu ou pas en compression, en torsion et en flexion, donne au système un comportement mécanique différent de celui obtenu avec une tige rigide. Le système peut comprendre seulement un ou plusieurs éléments de liaison à section déformable. Thus, the system has a simple constitution. It is easy and quick to assemble during an intervention and allows the attachment to the anchoring members of a flexible connecting element. Such an element, working in tension, but little or no compression, torsion and bending, gives the system a mechanical behavior different from that obtained with a rigid rod. The system may include only one or more connecting elements with a deformable section.

Alternativement, ceux-ci peuvent être placés en série sur des tronçons différents avec un ou plusieurs éléments de liaison rigide pour assurer une transition dans la répartition des contraintes. Dans ce cas, tous les organes d'ancrage pourront avantageusement être d'un même type standard pour recevoir indifféremment l'élément de liaison déformable ou un élément de liaison rigide.Alternatively, these can be placed in series on different sections with one or more rigid connecting elements to ensure a transition in the distribution of stresses. In this case, all of the anchoring members may advantageously be of the same standard type for indifferently receiving the deformable connecting element or a rigid connecting element.

Avantageusement, l'élément de liaison est souple. Advantageously, the connecting element is flexible.

Avantageusement, l'élément de liaison comprend un ligament ou un câble. Advantageously, the connecting element comprises a ligament or a cable.

Avantageusement, l'organe d'ancrage comporte deux branches adaptées à recevoir entre elles l'élément de liaison et présentant un filet pour coopérer avec la vis. Advantageously, the anchoring member comprises two branches adapted to receive between them the connecting element and having a thread for cooperating with the screw.

Avantageusement, le système comprend un manchon déformable apte à recevoir l'élément de liaison et à être serré par la vis sur l'organe d'ancrage. Advantageously, the system comprises a deformable sleeve capable of receiving the connecting element and of being tightened by the screw on the anchoring member.

Ainsi, on évite d'endommager l'élément de liaison lors du serrage. De plus, on facilite le coincement de l'élément de liaison par la vis. On pourra notamment prévoir que le manchon s'écrase sur l'élément de liaison lors du serrage. This prevents damage to the connecting element during tightening. In addition, it facilitates the wedging of the connecting element by the screw. We can in particular provide that the sleeve is crushed on the connecting element during tightening.

Avantageusement, le manchon présente une section transversale fermée. Advantageously, the sleeve has a closed cross section.

Avantageusement, le manchon est apte à recevoir au plus un tronçon longitudinal de l'élément de liaison. Advantageously, the sleeve is able to receive at most one longitudinal section of the connecting element.

Ainsi, l'élément de liaison relie deux organes d'ancrage par un tronçon unique. Thus, the connecting element connects two anchoring members by a single section.

Avantageusement, le manchon présente une face interne ayant au moins une extrémité évasée. Advantageously, the sleeve has an internal face having at least one flared end.

On facilite ainsi l'introduction de l'élément de liaison dans le manchon. This facilitates the introduction of the connecting element into the sleeve.

Avantageusement, le manchon présente une face externe ayant un tronçon médian de section rétrécie.  Advantageously, the sleeve has an external face having a median section of narrowed section.

On améliore ainsi le blocage du manchon dans l'organe d'ancrage à l'encontre de son coulissement. This improves the blocking of the sleeve in the anchoring member against its sliding.

Avantageusement, la vis présente une face inférieure destinée à s'étendre du côté de l'élément de liaison et de forme sensiblement sphérique. Advantageously, the screw has a lower face intended to extend on the side of the connecting element and of substantially spherical shape.

Ainsi, on évite d'endommager l'élément de liaison ou le manchon lors du serrage. This prevents damage to the connecting element or the sleeve during tightening.

Le système pourra également présenter une ou plusieurs des caractéristiques suivantes - il comprend un organe d'ancrage à une vertèbre apte à être fixé à un élément de liaison rigide relié à un deuxième organe d'ancrage et comportant une unique partie de fixation latérale apte à relier simultanément l'organe à un élément de liaison souple relié à un troisième organe d'ancrage - l'organe d'ancrage comprend un corps apte à recevoir l'élément de liaison rigide et une bague apte à être montée sur le corps et portant la partie de fixation, la bague présentant une butée pour son blocage à rotation par rapport au corps - la butée est agencée pour venir en appui contre l'élément de liaison rigide - la butée comprend une partie cylindrique - le corps comprend deux branches aptes à recevoir entre elles l'élément de liaison rigide et à coopérer avec une vis pour la fixation de l'élément de liaison rigide, la bague étant apte à être montée sur les branches - la partie de fixation présente un orifice adapté à recevoir l'élément de liaison souple - l'orifice présente un bord évasé - le bord évasé s'étend d'un côté de la partie de fixation opposé à la butée - l'orifice est situé au droit ou au niveau d'un emplacement prévu pour l'élément de liaison rigide ; et - le système comprend un organe d'ancrage selon l'une des revendications précédentes.  The system may also have one or more of the following characteristics - it comprises a member for anchoring to a vertebra capable of being fixed to a rigid connecting element connected to a second anchoring member and comprising a single lateral fixing part suitable for simultaneously connect the member to a flexible connecting element connected to a third anchoring member - the anchoring member comprises a body capable of receiving the rigid connecting element and a ring capable of being mounted on the body and bearing the fixing part, the ring having a stop for locking it in rotation relative to the body - the stop is designed to come into abutment against the rigid connecting element - the stop comprises a cylindrical part - the body comprises two branches capable of receiving between them the rigid connecting element and cooperating with a screw for fixing the rigid connecting element, the ring being able to be mounted on the b ranches - the fixing part has an orifice adapted to receive the flexible connecting element - the orifice has a flared edge - the flared edge extends on one side of the fixing part opposite the stop - the orifice is located at right or at a location provided for the rigid connecting element; and - the system comprises an anchoring member according to one of the preceding claims.

D'autres caractéristiques et avantages de l'invention apparaîtront encore dans la description suivante d'un mode préféré de réalisation donné à titre d'exemple non limitatif. Aux dessins annexés : - la figure 1 est une vue partielle en perspective d'un système d'ostéosynthèse selon l'invention - les figures 2 et 3 sont des vues partielles en perspective montrant l'un des organes d'ancrage de la figure 1 respectivement à l'état éclaté et à l'état assemblé - les figures 4 et 5 sont des vues respectivement en perspective et de côté du manchon des figures 2 et 3 - la figure 6 est une vue partielle en perspective à plus grande échelle de l'autre organe d'ancrage de la figure 1 ; et - la figure 7 est une vue en perspective de la bague de l'organe de la figure 6. Other characteristics and advantages of the invention will become apparent in the following description of a preferred embodiment given by way of nonlimiting example. In the accompanying drawings: - Figure 1 is a partial perspective view of an osteosynthesis system according to the invention - Figures 2 and 3 are partial perspective views showing one of the anchoring members of Figure 1 respectively in the exploded state and in the assembled state - Figures 4 and 5 are respectively perspective and side views of the sleeve of Figures 2 and 3 - Figure 6 is a partial perspective view on a larger scale of the 'Another anchor of Figure 1; and - Figure 7 is a perspective view of the ring of the member of Figure 6.

On a illustré aux figures un système d'ostéosynthèse rachidien selon l'invention. Ce système comporte des organes d'ancrage 23, seulement deux organes ayant été représentés, comprenant chacun une vis pédiculaire 4 adaptée à être vissée dans une vertèbre ou une partie de vertèbre respective de la colonne à arthrodéser. Chaque vis 4 présente un corps allongé rectiligne fileté à visser dans la vertèbre, et une tête 6 présentant deux branches 8 s'étendant en regard et à distance l'une de l'autre. De façon connue en soi, les branches 8 définissent entre elles un logement adapté à recevoir un élément de liaison reliant plusieurs vis 4 les unes aux autres. Illustrated in the figures is a spinal osteosynthesis system according to the invention. This system comprises anchoring members 23, only two members having been shown, each comprising a pedicle screw 4 adapted to be screwed into a vertebra or part of the respective vertebra of the column to be arthrodesised. Each screw 4 has an elongated rectilinear threaded body to be screwed into the vertebra, and a head 6 having two branches 8 extending opposite and at a distance from each other. In a manner known per se, the branches 8 define between them a housing adapted to receive a connecting element connecting several screws 4 to each other.

Les deux branches 8 présentent une face externe cylindrique 10 à section circulaire, les deux cylindres ayant pour axe un axe longitudinal du corps de la vis 4. The two branches 8 have a cylindrical external face 10 of circular section, the two cylinders having for axis a longitudinal axis of the body of the screw 4.

Chaque organe d'ancrage 2, 3 comprend un capuchon 12 présentant une face interne cylindrique à section circulaire adaptée à être engagée extérieurement sur les deux branches 8 en reposant sur leur extrémité supérieure libre, en vue d'empêcher leur écartement mutuel.Each anchoring member 2, 3 comprises a cap 12 having a cylindrical inner face with circular section adapted to be engaged externally on the two branches 8 resting on their free upper end, in order to prevent their mutual spacing.

Les branches 8 présentent une face interne filetée 14 coaxiale au corps de la vis. Chaque organe d'ancrage 2, 3 comprend également une vis de serrage 16 ayant un filet externe 18 adapté à venir en prise avec le filet interne 14 des branches 8. Une face supérieure de la vis de serrage 16 présente une cavité 20 pour la manoeuvre de la vis de serrage au moyen d'un outil. Le capuchon 12 présente un orifice pour le serrage de la vis une fois le capuchon en place. Pour l'assemblage de chaque organe d'ancrage, on introduit l'élément de liaison entre les branches 8, puis on met la vis de serrage 16 en prise avec les branches 8 et on installe le capuchon 12. Lors du serrage de la vis 16 à travers le capuchon, la vis 16 vient serrer l'élément de liaison contre le fond de la tête de la vis pédiculaire 4 et ainsi immobiliser rigidement l'organe d'ancrage 2, 3 par rapport à l'élément de liaison. Les caractéristiques ci-dessus sont connues en soi des documents FR-2 659 546 et
FR-2 642 643.The branches 8 have a threaded internal face 14 coaxial with the body of the screw. Each anchoring member 2, 3 also comprises a clamping screw 16 having an external thread 18 adapted to come into engagement with the internal thread 14 of the branches 8. An upper face of the clamping screw 16 has a cavity 20 for maneuvering of the clamping screw using a tool. The cap 12 has an orifice for tightening the screw once the cap is in place. For the assembly of each anchoring member, the connecting element between the branches 8 is introduced, then the clamping screw 16 is engaged with the branches 8 and the cap 12 is installed. When the screw is tightened 16 through the cap, the screw 16 tightens the connecting element against the bottom of the head of the pedicle screw 4 and thus rigidly immobilizes the anchoring member 2, 3 relative to the connecting element. The above characteristics are known per se from documents FR-2 659 546 and
FR-2 642 643.

En référence aux figures 1 à 5, l'élément de liaison associé à l'organe d'ancrage 2 comprend un ligament 23 d'un type classique, à section transversale déformable, et un élément d'adaptation 24 ou trompette sous la forme d'un manchon. Le manchon 24 a une forme de révolution généralement cylindrique à section transversale circulaire fermée. Il présente une face interne 26 s'évasant à une extrémité axiale du manchon, et une face externe 28 ayant un tronçon longitudinal de diamètre rétréci par rapport aux extrémités axiales. Le plus petit diamètre du manchon 24 est choisi pour être légèrement supérieur au diamètre du ligament 23 de sorte qu'on ne peut enfiler qu'un tronçon de ligament dans le manchon. Le manchon a des dimensions (notamment une épaisseur) et un matériau tels que sa section transversale peut être facilement déformée voire écrasée. La partie médiane du manchon 24 enfilé sur le ligament 23 est destinée à être reçue entre les branches 8 de la tête de la vis pédiculaire 4. Les extrémités longitudinales du manchon, de plus grand diamètre externe que sa partie médiane, forment ainsi des butées à l'encontre du coulissement du manchon 24 hors de la vis 4 le long du ligament 23. Referring to Figures 1 to 5, the connecting element associated with the anchoring member 2 comprises a ligament 23 of a conventional type, with a deformable cross section, and an adaptation element 24 or trumpet in the form of 'a sleeve. The sleeve 24 has a generally cylindrical shape of revolution with a closed circular cross section. It has an internal face 26 which widens at an axial end of the sleeve, and an external face 28 having a longitudinal section of diameter narrowed relative to the axial ends. The smallest diameter of the sleeve 24 is chosen to be slightly greater than the diameter of the ligament 23 so that only one section of ligament can be threaded into the sleeve. The sleeve has dimensions (in particular a thickness) and a material such that its cross section can be easily deformed or even crushed. The middle part of the sleeve 24 threaded onto the ligament 23 is intended to be received between the branches 8 of the head of the pedicle screw 4. The longitudinal ends of the sleeve, of larger external diameter than its middle part, thus form stops at against the sliding of the sleeve 24 out of the screw 4 along the ligament 23.

La vis de serrage 16 présente une face inférieure 30 opposée à la cavité 20 et de forme sensiblement sphérique convexe. Cette face 30 vient en contact avec le manchon 24 lors de l'installation de la vis de serrage. Lors du serrage de la vis, cette face 20 déforme et écrase localement sur le ligament 23 la partie médiane du manchon 24. La section correspondante du ligament 23, également déformée sans être endommagée, est ainsi immobilisée dans le manchon 24 lequel est immobilisé rigidement sur la tête de la vis pédiculaire. The clamping screw 16 has a lower face 30 opposite the cavity 20 and of substantially spherical convex shape. This face 30 comes into contact with the sleeve 24 during installation of the clamping screw. When tightening the screw, this face 20 locally deforms and crushes on the ligament 23 the middle part of the sleeve 24. The corresponding section of the ligament 23, also deformed without being damaged, is thus immobilized in the sleeve 24 which is rigidly immobilized on the head of the pedicle screw.

L'extrémité évasée de la face interne 26 du manchon facilite l'introduction du ligament à l'intérieur de celui-ci. On peut ainsi relier entre elles plusieurs vis pédiculaires 4 au moyen du seul ligament 23. Le manchon pourrait être fendu et ainsi avoir une section transversale ouverte.The flared end of the internal face 26 of the sleeve facilitates the introduction of the ligament inside the latter. It is thus possible to connect together several pedicle screws 4 by means of the single ligament 23. The sleeve could be split and thus have an open cross section.

En référence aux figures 1, 6 et 7, l'organe d'ancrage 3 reçoit un élément de liaison rigide tel qu'une tige 32 destinée à relier entre elles plusieurs vis pédiculaires 4 de façon connue en soi des deux documents précités. En particulier, il pourra comprendre une bague fendue à face externe sphérique, enfilée sur la tige 32 et serrée entre la vis de serrage 16 et la tête de la vis pédiculaire 4 pour permettre le réglage de l'inclinaison de la tige 32 par rapport à la vis pédiculaire 4, puis leur immobilisation relative.  With reference to FIGS. 1, 6 and 7, the anchoring member 3 receives a rigid connection element such as a rod 32 intended to connect together several pedicle screws 4 in a manner known per se from the two aforementioned documents. In particular, it may include a split ring with a spherical external face, threaded on the rod 32 and clamped between the clamping screw 16 and the head of the pedicle screw 4 to allow the inclination of the rod 32 relative to the pedicle screw 4, then their relative immobilization.

En l'espèce, le capuchon 12 de l'organe d'ancrage 3 comporte une patte 34 ou oreille s'étendant en saillie d'une face externe du capuchon. Cette patte 34 présente un orifice débouchant 35 disposé de sorte qu'une fois le capuchon 12 en place, l'orifice 35 s'étend au droit ou au niveau de la tige 32 le long de la vis pédiculaire. In this case, the cap 12 of the anchoring member 3 has a lug 34 or ear projecting from an outer face of the cap. This tab 34 has a through orifice 35 arranged so that once the cap 12 in place, the orifice 35 extends to the right or at the level of the rod 32 along the pedicle screw.

En outre, le capuchon 12 présente une joue cylindrique 36 à section circulaire prolongeant vers le bas sur toute la hauteur de la patte 34 la face latérale cylindrique du capuchon. Cette joue 36 présente à l'opposé de la patte 34 un bord vertical rectiligne 38 parallèle à un axe du capuchon. Cette joue s'étend autour de l'axe du capuchon sur un secteur angulaire d'environ 1200. La joue 36 est contiguë à la patte 34 par son autre bord vertical. L'orifice 35 présente une extrémité évasée 40 du côté opposé à la joue 38. La section, sensiblement rectangulaire, de l'orifice 35 est juste supérieure à celle du ligament 23 et ne peut recevoir qu'un seul tronçon de celui-ci. Une extrémité longitudinale libre 42 du ligament présente un noeud, représenté de façon simplifiée sur les figures, qui lorsque le ligament 23 traverse l'orifice 35, vient en appui contre le bord évasé 40 de celui-ci pour bloquer le ligament.In addition, the cap 12 has a cylindrical cheek 36 of circular section extending downward over the entire height of the lug 34 the cylindrical side face of the cap. This cheek 36 has, opposite the tab 34, a straight vertical edge 38 parallel to an axis of the cap. This cheek extends around the axis of the cap over an angular sector of approximately 1200. The cheek 36 is contiguous to the tab 34 by its other vertical edge. The orifice 35 has a flared end 40 on the side opposite to the cheek 38. The substantially rectangular section of the orifice 35 is just greater than that of the ligament 23 and can receive only a single section of it. A free longitudinal end 42 of the ligament has a knot, shown in a simplified manner in the figures, which when the ligament 23 passes through the orifice 35, bears against the flared edge 40 thereof to block the ligament.

Le ligament étant relié à d'autres organes d'ancrage dont un seul, 2, a été illustré, il se produit une traction sur le ligament 23, qui place le bord 38 de la joue en butée contre la tige 32 (au besoin en ayant préalablement fait tourner le capuchon 12 autour de son axe), interdisant ainsi la rotation du capuchon 12 par rapport à la vis pédiculaire 4 et à la tige 32. La tige 32 est rigidement reliée à d'autres vis pédiculaires 4 d'un type classique, reliées entre elles uniquement par la tige. The ligament being connected to other anchoring members of which only one, 2, has been illustrated, there is a traction on the ligament 23, which places the edge 38 of the cheek in abutment against the rod 32 (if necessary in having previously rotated the cap 12 around its axis), thus preventing rotation of the cap 12 relative to the pedicle screw 4 and to the rod 32. The rod 32 is rigidly connected to other pedicle screws 4 of a type classic, connected together only by the rod.

Le système d'ostéosynthèse comprend ainsi une partie rigide, constituée par les vis 3 reliées rigidement entre elles par la tige 32, et une partie souple constituée par les vis 2 reliées entre elles par le ligament. La vis 3 qui est illustrée constitue la frontière entre les deux parties du système. Sur le plan du comportement mécanique, on réalise ainsi une transition de contrainte entre la partie rigide de la colonne et sa partie totalement libre. The osteosynthesis system thus comprises a rigid part, constituted by the screws 3 rigidly connected to each other by the rod 32, and a flexible part constituted by the screws 2 connected to each other by the ligament. The screw 3 which is illustrated constitutes the border between the two parts of the system. In terms of mechanical behavior, a stress transition is thus made between the rigid part of the column and its completely free part.

L'élément de liaison à section déformable pourra comprendre un câble.  The connecting element with deformable section may include a cable.

Claims (10)

REVENDICATIONS 1. Système d'ostéosynthèse vertébrale, comprenant au moins un organe d'ancrage (2) à une vertèbre, un élément de liaison (23) de l'organe (2) à un autre organe d'ancrage (3), et une vis (16) apte à coopérer avec l'organe d'ancrage (2) pour serrer l'élément de liaison (23) sur l'organe d'ancrage, caractérisé en ce que l'élément de liaison (23) est de section transversale déformable. 1. Vertebral osteosynthesis system, comprising at least one anchoring member (2) to a vertebra, a connecting element (23) of the member (2) to another anchoring member (3), and a screw (16) able to cooperate with the anchoring member (2) to tighten the connecting element (23) on the anchoring member, characterized in that the connecting element (23) is of section deformable transverse. 2. Système selon la revendication 1, caractérisé en ce que l'élément de liaison (23) est souple. 2. System according to claim 1, characterized in that the connecting element (23) is flexible. 3. Système selon la revendication 1 ou 2, caractérisé en ce que l'élément de liaison (23) comprend un ligament ou un câble. 3. System according to claim 1 or 2, characterized in that the connecting element (23) comprises a ligament or a cable. 4. Système selon l'une quelconque des revendications 1 à 3, caractérisé en ce que l'organe d'ancrage (2) comporte deux branches (8) adaptées à recevoir entre elles l'élément de liaison et présentant un filet (14) pour coopérer avec la vis (16). 4. System according to any one of claims 1 to 3, characterized in that the anchoring member (2) comprises two branches (8) adapted to receive between them the connecting element and having a net (14) to cooperate with the screw (16). 5. Système selon l'une quelconque des revendications 1 à 4, caractérisé en ce qu'il comprend un manchon déformable (24) apte à recevoir l'élément de liaison (23) et à être serré par la vis (16) sur l'organe d'ancrage (2). 5. System according to any one of claims 1 to 4, characterized in that it comprises a deformable sleeve (24) adapted to receive the connecting element (23) and to be tightened by the screw (16) on the 'anchor member (2). 6. Système selon la revendication 5, caractérisé en ce que le manchon (24) présente une section transversale fermée. 6. System according to claim 5, characterized in that the sleeve (24) has a closed cross section. 7. Système selon la revendication 5 ou 6, caractérisé en ce que le manchon (24) est apte à recevoir au plus un tronçon longitudinal de l'élément de liaison (23). 7. System according to claim 5 or 6, characterized in that the sleeve (24) is adapted to receive at most a longitudinal section of the connecting element (23). 8. Système selon l'une quelconque des revendications 5 à 7, caractérisé en ce que le manchon (24) présente une face interne (26) ayant au moins une extrémité évasée.  8. System according to any one of claims 5 to 7, characterized in that the sleeve (24) has an internal face (26) having at least one flared end. 9. Système selon l'une quelconque des revendications 5 à 8, caractérisé en ce que le manchon (24) présente une face externe (28) ayant un tronçon médian de section rétrécie. 9. System according to any one of claims 5 to 8, characterized in that the sleeve (24) has an external face (28) having a median section of narrowed section. 10. Système selon l'une quelconque des revendications 1 à 9, caractérisé en ce que la vis (16) présente une face inférieure (30) destinée à s'étendre du côté de l'élément de liaison (23) et de forme sensiblement sphérique.  10. System according to any one of claims 1 to 9, characterized in that the screw (16) has a lower face (30) intended to extend on the side of the connecting element (23) and of substantially shape spherical.
FR9802613A 1998-03-04 1998-03-04 SYSTEM FOR OSTEOSYNTHESIS OF THE RACHIS WITH LIGAMENT Expired - Fee Related FR2775583B1 (en)

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FR9802613A FR2775583B1 (en) 1998-03-04 1998-03-04 SYSTEM FOR OSTEOSYNTHESIS OF THE RACHIS WITH LIGAMENT
AU27314/99A AU2731499A (en) 1998-03-04 1999-03-03 Backbone osteosynthesis system with ligament
PCT/FR1999/000469 WO1999044527A1 (en) 1998-03-04 1999-03-03 Backbone osteosynthesis system with ligament

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