FR2784291A1 - Intervertebral disc prosthesis has connecting pieces with through cells between plates and core - Google Patents
Intervertebral disc prosthesis has connecting pieces with through cells between plates and core Download PDFInfo
- Publication number
- FR2784291A1 FR2784291A1 FR9812661A FR9812661A FR2784291A1 FR 2784291 A1 FR2784291 A1 FR 2784291A1 FR 9812661 A FR9812661 A FR 9812661A FR 9812661 A FR9812661 A FR 9812661A FR 2784291 A1 FR2784291 A1 FR 2784291A1
- Authority
- FR
- France
- Prior art keywords
- core
- plates
- prosthesis
- cells
- plate
- 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
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Classifications
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- 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
- 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
- A61F2/442—Intervertebral or spinal discs, e.g. resilient
-
- A—HUMAN NECESSITIES
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- 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
- A61B17/7059—Cortical plates
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- A—HUMAN NECESSITIES
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- 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
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
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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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- 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
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
- A61F2002/30004—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis
- A61F2002/30009—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis differing in fibre orientations
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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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- 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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- 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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- 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
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
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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
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- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
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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
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- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
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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
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0028—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in fibre orientations
-
- 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
-
- 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
- A61F2310/00389—The prosthesis being coated or covered with a particular material
- A61F2310/00592—Coating or prosthesis-covering structure made of ceramics or of ceramic-like compounds
- A61F2310/00796—Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite
Landscapes
- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Neurology (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
Abstract
Description
L'invention concerne les prothèses de disque intervertébral. The invention relates to intervertebral disc prostheses.
On connaît d'après le document EP-0 317 972, une prothèse de disque intervertébral comprenant deux plateaux rigides, un noyau en matériau polymère synthétique déformable et deux organes de liaison reliant le noyau aux plateaux respectifs, en forme de champignon s'évasant à partir du plateau associé en direction de l'autre plateau. Cette forme assure un bon ancrage du noyau aux plateaux. Toutefois, les contraintes en compression, flexion et torsion subies par le noyau étant très élevées il est nécessaire d'améliorer encore la qualité de l'ancrage du noyau aux plateaux. Document EP-0 317 972 discloses an intervertebral disc prosthesis comprising two rigid plates, a core of deformable synthetic polymer material and two connecting members connecting the core to the respective plates, in the form of a mushroom flaring out. from the associated plateau towards the other plateau. This shape ensures good anchoring of the core to the plates. However, the compressive, bending and torsional stresses undergone by the core being very high, it is necessary to further improve the quality of the anchoring of the core to the plates.
Un but de l'invention est de fournir une prothèse de disque assurant un meilleur ancrage du noyau aux plateaux. An object of the invention is to provide a disc prosthesis ensuring better anchoring of the core to the plates.
En vue de la réalisation de ce but, on prévoit selon l'invention, une prothèse de disque intervertébral, comprenant deux plateaux, un noyau et des organes de liaison reliés aux plateaux respectifs et au noyau, dans laquelle les organes de liaison présentent des alvéoles profilées. In order to achieve this goal, there is provided according to the invention, an intervertebral disc prosthesis, comprising two plates, a core and connecting members connected to the respective plates and to the core, in which the connecting members have cells profiled.
Ainsi, les alvéoles profilées accroissent la surface de contact entre chaque organe de liaison et le noyau, et offrent de nombreuses facettes orientées différemment les unes par rapport aux autres. Ces deux facteurs améliorent l'ancrage du noyau à chaque organe de liaison, quelle que soit par ailleurs la forme générale de ces derniers. Thus, the profiled cells increase the contact surface between each connecting member and the core, and offer numerous facets oriented differently with respect to each other. These two factors improve the anchoring of the core to each connecting member, regardless of the general shape of the latter.
Avantageusement, chaque alvéole est profilée suivant un axe rectiligne. Advantageously, each cell is profiled along a rectilinear axis.
Ainsi, les alvéoles sont faciles à réaliser. Thus, the cells are easy to produce.
Avantageusement, les axes des alvéoles sont radiaux à un axe de la prothèse s'étendant de l'un à l'autre des plateaux. Advantageously, the axes of the cells are radial to an axis of the prosthesis extending from one to the other of the plates.
Avantageusement, les axes des alvéoles sont parallèles entre eux. Advantageously, the axes of the cells are parallel to each other.
Avantageusement, les axes des alvéoles sont parallèles à un axe de la prothèse s'étendant de l'un à l'autre des plateaux. Advantageously, the axes of the cells are parallel to an axis of the prosthesis extending from one to the other of the plates.
Avantageusement, chaque alvéole a un profil fermé dans un plan transversal à un axe de l'alvéole. Advantageously, each cell has a closed profile in a plane transverse to an axis of the cell.
Avantageusement, le profil est circulaire. Advantageously, the profile is circular.
Avantageusement, les alvéoles forment une structure en nid d'abeille. Advantageously, the cells form a honeycomb structure.
Ainsi, cette structure rend les organes de liaison particulièrement robustes sans nécessiter une masse de matériau importante, les alvéoles pouvant avoir des parois extrmement fines. Thus, this structure makes the connecting members particularly robust without requiring a large mass of material, the cells may have extremely thin walls.
Avantageusement, les organes de liaison sont rapportés sur les plateaux respectifs. Advantageously, the connecting members are attached to the respective plates.
Ainsi, les plateaux et les organes de liaison, fabriqués séparément, sont faciles et moins coûteux à réaliser. Thus, the plates and the connecting members, produced separately, are easy and less expensive to produce.
Alternativement, les organes de liaison sont d'une seule pièce avec les plateaux respectifs. Alternatively, the connecting members are in one piece with the respective plates.
Avantageusement, chaque organe de liaison a une largeur, perpendiculairement à un axe de la prothèse s'étendant de l'un à l'autre des plateaux, allant en diminuant depuis le plateau auquel il est relié, en direction de l'autre plateau jusqu'à une extrémité de l'organe de liaison. Advantageously, each connecting member has a width, perpendicular to an axis of the prosthesis extending from one to the other of the plates, decreasing from the plate to which it is connected, in the direction of the other plate up to 'at one end of the connecting member.
Ainsi, la forme de chaque organe de liaison offre une grande surface de contact avec le noyau pour un ancrage robuste, tout en permettant une grande amplitude de mouvement relatif entre les plateaux, notamment en flexion sans requérir de ménager une grande distance entre les plateaux. Thus, the shape of each connecting member offers a large contact surface with the core for a robust anchoring, while allowing a large range of relative movement between the plates, in particular in bending without requiring a large distance between the plates.
Avantageusement, chaque organe de liaison a une face externe tronconique en contact avec le noyau. Advantageously, each connecting member has a frustoconical external face in contact with the core.
D'autre part, on sait que dans une prothèse de disque intervertébral telle que celle du document EP-0 317 972, la forme du noyau de la prothèse étant cylindrique, sa capacité de soutien et de tenue dans les corps vertébraux ne peut tre satisfaisante qu'en charge statique. En effet, dès la mise en charge, le matériau utilisé pour le noyau de la prothèse, du fait de sa forme cylindrique, flue vers l'extérieur des deux corps vertébraux. En conséquence, ce comportement peut amener les risques suivants :
-compression des racines ;
-compression du canal vertébral si le fluage du
matériau est trop important ;
-dégradation précoce du matériau ;
-risque de descellement de l'implant ; et
-pas de possibilité de rotation.On the other hand, it is known that in an intervertebral disc prosthesis such as that of document EP-0 317 972, the shape of the core of the prosthesis being cylindrical, its ability to support and hold in the vertebral bodies cannot be satisfactory. than in static load. In fact, as soon as it is loaded, the material used for the core of the prosthesis, due to its cylindrical shape, flows towards the outside of the two vertebral bodies. Consequently, this behavior can lead to the following risks:
compression of the roots;
-compression of the vertebral canal if the creep of the
material is too important;
- early degradation of the material;
- risk of implant loosening; and
- no possibility of rotation.
En vue de pallier à cet inconvénient, on prévoit selon un mode préféré de réalisation de l'invention que le noyau présente une face externe apte à tre au contact du corps du patient, le noyau ayant une largeur, perpendiculairement à un axe de la prothèse s'étendant de l'un à l'autre des plateaux, allant en diminuant à partir de chaque plateau en direction de l'autre plateau, la largeur étant maximale au niveau de chaque plateau. In order to overcome this drawback, it is provided according to a preferred embodiment of the invention that the core has an external face capable of being in contact with the patient's body, the core having a width, perpendicular to an axis of the prosthesis extending from one to the other of the plates, decreasing from each plate in the direction of the other plate, the width being maximum at the level of each plate.
Ainsi, au moins sous une charge modérée, le noyau ne flue pas vers l'extérieur des plateaux. Cette tendance au fluage sera d'autant plus réduite, voire totalement éliminée, que la largeur du noyau ira en diminuant rapidement vers sa portion médiane. Thus, at least under a moderate load, the core does not flow outwards from the plates. This tendency to creep will be all the more reduced, or even totally eliminated, as the width of the core will decrease rapidly towards its middle portion.
Avantageusement, l'un des plateaux présente une face externe opposée à une face externe de l'autre plateau et inclinée par rapport à celle-ci. Advantageously, one of the plates has an external face opposite to an external face of the other plate and inclined with respect to the latter.
D'autres caractéristiques et avantages de l'invention apparaitront encore dans la description suivante de plusieurs modes préférés de réalisation donnés à titres d'exemples non limitatifs aux dessins annexés : -la figure 1 est une vue partielle latérale d'un rachis montrant 1'emplacement de la prothèse selon l'invention ; -la figure 2 est une vue en coupe axiale d'une prothèse de disque selon un premier mode de réalisation de l'invention ; -la figure 3 est une vue partielle en coupe transversale selon le plan III-III de l'un des organes de liaison de la figure 2 ; -les figures 4 et 5 sont des vues en coupe axiale de deuxième et troisième modes de réalisation des organes de liaison ; -la figure 6 est une vue partielle en perspective d'un quatrième mode de réalisation des organes de liaison ; et -la figure 7 est une vue simplifiée en coupe axiale d'une variante de réalisation. Other characteristics and advantages of the invention will appear in the following description of several preferred embodiments given by way of nonlimiting examples in the appended drawings: FIG. 1 is a partial side view of a spine showing 1 ' location of the prosthesis according to the invention; FIG. 2 is a view in axial section of a disc prosthesis according to a first embodiment of the invention; FIG. 3 is a partial view in cross section along the plane III-III of one of the connecting members in FIG. 2; FIGS. 4 and 5 are views in axial section of the second and third embodiments of the connecting members; FIG. 6 is a partial perspective view of a fourth embodiment of the connecting members; and FIG. 7 is a simplified view in axial section of an alternative embodiment.
En référence à la figure 1, la prothèse de disque intervertébral 2 selon l'invention est destinée à tre reçue entre deux plateaux vertébraux de deux vertèbres 4 d'un rachis. With reference to FIG. 1, the intervertebral disc prosthesis 2 according to the invention is intended to be received between two vertebral plates of two vertebrae 4 of a spine.
En référence aux figures 2 et 3, la prothèse 2 comporte deux plateaux 6 supérieur et inférieur, de forme plate, à faces supérieure 8 et inférieure 10. Les faces de chaque plateau pourront tre parallèles entre elles. Alternativement, les deux faces de chaque plateau pourront tre légèrement inclinées l'une par à l'autre, comme illustré de façon exagérée sur la figure 7. Chaque plateau 6 a en plan une forme générale de haricot, connue en soi. Chaque plateau est prolongé audelà de sa face externe, supérieure 8 pour le plateau supérieur et inférieure 10 pour le plateau inférieur, par deux pattes 12 s'étendant à des bords 36 du plateau et présentant un orifice apte à recevoir une vis 14 destinée à tre ancrée dans la vertèbre 4 associée de façon connue en soi. La prothèse est ainsi disposée de sorte que la face externe de chaque plateau est en contact surfacique avec le plateau vertébral de la vertèbre associée, avec en outre, interposition entre la vertèbre et la prothèse d'une couche 16 d'un revtement
HAP (hydroxyapatite) connue en soi, favorisant la croissance osseuse et améliorant encore l'ancrage. Les deux plateaux 6 s'étendent généralement parallèlement l'un à l'autre, à distance l'un de l'autre et avec leurs bords 36 en coïncidence. Ils définissent un axe 19 de la prothèse, s'étendant de l'un à l'autre des plateaux et passant par leur centre.With reference to FIGS. 2 and 3, the prosthesis 2 comprises two upper and lower plates 6, of flat shape, with upper 8 and lower faces 10. The faces of each plate may be parallel to one another. Alternatively, the two faces of each tray may be slightly inclined one to the other, as illustrated in an exaggerated manner in FIG. 7. Each tray 6 has in plan a general shape of a bean, known in itself. Each tray is extended beyond its outer, upper 8 for the upper and lower 10 for the lower tray, by two tabs 12 extending to the edges 36 of the tray and having an orifice capable of receiving a screw 14 intended to be anchored in the associated vertebra 4 in a manner known per se. The prosthesis is thus arranged so that the external face of each plate is in surface contact with the vertebral plate of the associated vertebra, with, in addition, interposition between the vertebra and the prosthesis of a layer 16 of a coating.
PAH (hydroxyapatite) known per se, promoting bone growth and further improving anchoring. The two plates 6 generally extend parallel to one another, at a distance from each other and with their edges 36 in coincidence. They define an axis 19 of the prosthesis, extending from one to the other of the plates and passing through their center.
La prothèse 2 comporte deux organes de liaison 18 présentant en l'espèce une face plane 20 perpendiculaire à l'axe 19 et une face conique 22 à pointe arrondie 24, d'axe 19, et destinée à tre en contact avec le noyau 38. The prosthesis 2 comprises two connecting members 18 having in this case a flat face 20 perpendicular to the axis 19 and a conical face 22 with rounded tip 24, of axis 19, and intended to be in contact with the core 38.
Ainsi, chaque organe de liaison a une largeur 1 mesurée perpendiculairement à l'axe 19 allant en diminuant depuis le plateau 6 associé, jusqu'à sa pointe arrondie 24 en direction de l'autre plateau. Thus, each connecting member has a width 1 measured perpendicular to the axis 19 decreasing from the associated plate 6, to its rounded tip 24 in the direction of the other plate.
Chaque organe de liaison 18 est rapporté sur le plateau 6 associé au moyen d'une vis 26 introduite par la face externe du plateau dans un orifice central de celui-ci et s'étendant suivant l'axe 19 dans l'organe de liaison 18. Each connecting member 18 is attached to the plate 6 associated by means of a screw 26 introduced by the external face of the plate in a central orifice thereof and extending along the axis 19 in the connecting member 18 .
La prothèse comprend, pour chaque organe de liaison 18 au moins un picot 28, en l'espèce deux par organe de liaison, occupant une position distante de l'axe 19 et s'6tendant chacune à la fois dans le plateau 6 et 1'organe de liaison 18 associ6, pour interdire leur rotation relative autour de l'axe 19. The prosthesis comprises, for each connecting member 18 at least one pin 28, in this case two per connecting member, occupying a position distant from the axis 19 and each extending in both the plate 6 and 1 ' associated connecting member 18, to prevent their relative rotation about the axis 19.
Chaque organe de liaison 18 présente des alvéoles 30 profilées chacune suivant un axe rectiligne 32. Les axes 32 sont ici parallèles entre eux et en outre, parallèles à l'axe 19. Les alvéoles 30 ont ici un profil fermé en section transversale à l'axe 32. Le profil est en l'espèce circulaire. Les alvéoles 30 débouchent à leurs deux extrémités axiales respectivement sur la face plane 20 et la face conique 22 de l'organe de liaison. Each connecting member 18 has cells 30 each profiled along a rectilinear axis 32. The axes 32 are here parallel to each other and also parallel to the axis 19. The cells 30 here have a closed profile in cross section to the axis 32. The profile in this case is circular. The cells 30 open at their two axial ends respectively on the flat face 20 and the conical face 22 of the connecting member.
Les organes de liaison 18 sont disposés avec leurs pointes 24 en regard et à distance l'une de l'autre.The connecting members 18 are arranged with their points 24 facing and at a distance from each other.
La prothèse comporte un noyau 38 ou corps intermédiaire réalisé en un matériau biocompatible déformable par exemple à base de silicone et connu en soi. Le noyau 38 s'étend continûment de la face inférieure interne 10 du plateau supérieur 6 jusqu'A la face supérieure interne 8 du plateau inférieur 6. Le noyau 38 s'étend au contact de la face conique 22 de chaque organe de liaison 18 et à l'intérieur de chaque alvéole 30 qu'il remplit totalement. Le noyau 38 s'étend de l'un à l'autre des bords périphériques 36 des plateaux. Il présente une face externe 37 apte à tre au contact du corps du patient et ainsi non recouverte par un autre élément de la prothèse. The prosthesis comprises a core 38 or intermediate body made of a deformable biocompatible material, for example based on silicone and known per se. The core 38 extends continuously from the internal lower face 10 of the upper plate 6 to the internal upper face 8 of the lower plate 6. The core 38 extends in contact with the conical face 22 of each connecting member 18 and inside each cell 30 which it completely fills. The core 38 extends from one to the other of the peripheral edges 36 of the plates. It has an external face 37 capable of being in contact with the patient's body and thus not covered by another element of the prosthesis.
Le noyau 38 a une largeur L, mesurée perpendiculairement à l'axe 19, allant en à partir de chaque plateau en direct de l'autre plateau jusqu'à une portion médiane 39 du noyau s'étendant entre les deux organes de liaison 18. La largeur L est maximale au niveau de chaque plateau 6. La face externe 37 du noyau a ici une forme concave, courbe en coupe radiale, sensiblement symétrique de révolution autour de l'axe 19 et donnant au noyau une forme en diabolo. The core 38 has a width L, measured perpendicular to the axis 19, going from each plate directly from the other plate to a middle portion 39 of the core extending between the two connecting members 18. The width L is maximum at the level of each plate 6. The external face 37 of the core here has a concave shape, curve in radial section, substantially symmetrical of revolution around the axis 19 and giving the core a diabolo shape.
Cette prothèse peut tre comprimée suivant l'axe 19, fléchie autour d'un axe quelconque perpendiculaire à l'axe 19, ou tordue autour de cet axe 19 sans menacer l'ancrage du noyau 38 aux organes de liaison 18 et sans fluage du noyau hors du périmètre des plateaux 6. Il peut amortir les chocs et revenir à sa position et à sa forme initiales sans déformation. Le plateau 6 et les organes de liaison 18 peuvent tre réalisés en titane ou en alliage de titane biocompatible. La face inférieure 10 du plateau supérieur et la face supérieure 8 du plateau inférieur seront de préférence parallèles entre elles. Dans ce cas, les deux faces de chaque plateau pourront présenter l'inclinaison relative précitée, les plateaux étant orientés de sorte que cette inclinaison se trouve doublée entre la face supérieure 8 du plateau supérieur et la face inférieure 10 du plateau inférieur, comme on le voit sur la figure 7. Alternativement, les deux faces de chaque plateau pourront tre parallèles entre elles. Ces différentes possibilités sont fonction de l'étage du rachis instrumenté, de l'état des plateaux vertébraux contigus à la prothèse et de la pathologie du patient. This prosthesis can be compressed along the axis 19, flexed around any axis perpendicular to the axis 19, or twisted around this axis 19 without threatening the anchoring of the core 38 to the connecting members 18 and without creep of the core outside the perimeter of the plates 6. It can absorb shocks and return to its original position and shape without deformation. The plate 6 and the connecting members 18 can be made of titanium or of a biocompatible titanium alloy. The lower face 10 of the upper plate and the upper face 8 of the lower plate will preferably be parallel to each other. In this case, the two faces of each plate may have the aforementioned relative inclination, the plates being oriented so that this inclination is doubled between the upper face 8 of the upper plate and the lower face 10 of the lower plate, as is see in FIG. 7. Alternatively, the two faces of each plate may be parallel to each other. These different possibilities depend on the stage of the instrumented spine, the state of the vertebral endplates adjacent to the prosthesis and the patient's pathology.
Dans le mode de réalisation de la figure 4, les alvéoles 30 sont profilées suivant des axes rectilignes 32 radiaux par rapport à l'axe 19. Les alvéoles s'étendent en direction de l'axe 19 depuis la face conique 22 jusqu'à la face plane 20 de l'organe de liaison. L'inclinaison des axes 32 des alvéoles par rapport à l'axe 19 peut tre quelconque ou perpendiculaire à cet axe. In the embodiment of FIG. 4, the cells 30 are profiled along rectilinear axes 32 radial with respect to the axis 19. The cells extend in the direction of the axis 19 from the conical face 22 to the flat face 20 of the connecting member. The inclination of the axes 32 of the cells with respect to the axis 19 can be arbitrary or perpendicular to this axis.
Dans le mode de réalisation de la figure 5, les axes rectilignes 32 des alvéoles profilées sont parallèles entre eux et font un angle quelconque non nul par rapport à l'axe 19. In the embodiment of FIG. 5, the rectilinear axes 32 of the profiled cells are parallel to each other and form any non-zero angle with respect to the axis 19.
Dans le mode de réalisation de la figure 6, les alvéoles 30 ont un profil transversal hexagonal et sont disposées pour former une structure en nid d'abeille. In the embodiment of Figure 6, the cells 30 have a hexagonal transverse profile and are arranged to form a honeycomb structure.
On pourra prévoir que les organes de liaison 18, au lieu d'tre rapportés sur les plateaux 6, sont formés d'une seule pièce avec ceux-ci. Provision may be made for the connecting members 18, instead of being attached to the plates 6, to be formed in one piece with them.
La liaison par vis de chaque organe de liaison 18 au plateau 6 associé pourra tre remplacée par un autre moyen de fixation tel qu'un clipsage. The screw connection of each connecting member 18 to the associated plate 6 may be replaced by another fixing means such as clipping.
La face externe 37 du noyau pourra avoir une forme différente et par exemple pourra présenter deux faces tronconiques dont les petites sections seules sont en contact mutuel ou bien sont séparées par une partie médiane cylindrique. The external face 37 of the core may have a different shape and for example may have two frustoconical faces whose small sections alone are in mutual contact or are separated by a cylindrical middle part.
Le bord périphérique de chaque organe de liaison 18 peut s'étendre à distance et à l'intérieur du bord périphérique 36 du plateau 6 associé comme sur la figure 2, ou bien coïncider avec ce bord, les plateaux 6, les organes de liaison 18 et le noyau 38 ayant alors la mme largeur maximale. The peripheral edge of each connecting member 18 can extend at a distance and inside the peripheral edge 36 of the associated plate 6 as in FIG. 2, or else coincide with this edge, the plates 6, the connecting members 18 and the core 38 then having the same maximum width.
La face 22 de chaque organe de liaison pourra avoir une forme autre que celle conique illustrée, par exemple, une forme sphérique convexe. The face 22 of each connecting member may have a shape other than that illustrated, for example a convex spherical shape.
Les caractéristiques relatives à la forme de la face externe 37 du noyau et à sa position par rapport aux plateaux 6 pourront tre mises en oeuvre indépendamment de 1'existence des organes de liaison 18 et des alvéoles les traversant. The characteristics relating to the shape of the external face 37 of the core and to its position relative to the plates 6 may be implemented independently of the existence of the connecting members 18 and of the cells passing through them.
Il en est de mme pour les caractéristiques concernant la forme de la face des organes de liaison 18 en contact avec le noyau 38. The same applies to the characteristics concerning the shape of the face of the connecting members 18 in contact with the core 38.
Claims (14)
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
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FR9812661A FR2784291B1 (en) | 1998-10-09 | 1998-10-09 | HIGH RESISTANCE INTERVERTEBRAL DISC PROSTHESIS |
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Application Number | Priority Date | Filing Date | Title |
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FR9812661A FR2784291B1 (en) | 1998-10-09 | 1998-10-09 | HIGH RESISTANCE INTERVERTEBRAL DISC PROSTHESIS |
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FR2784291A1 true FR2784291A1 (en) | 2000-04-14 |
FR2784291B1 FR2784291B1 (en) | 2001-03-09 |
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FR9812661A Expired - Fee Related FR2784291B1 (en) | 1998-10-09 | 1998-10-09 | HIGH RESISTANCE INTERVERTEBRAL DISC PROSTHESIS |
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Cited By (6)
Publication number | Priority date | Publication date | Assignee | Title |
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WO2006078663A2 (en) * | 2005-01-19 | 2006-07-27 | Nexgen Spine, Inc. | Elastomeric intervertebral disc prosthesis |
FR2894459A1 (en) * | 2005-12-14 | 2007-06-15 | Frederic Fortin | PROSTHESIS OF IMPERFINABLE IMPLANTABLE BRAVERAL INTERVERTEBRAL DISC |
US8814938B2 (en) | 2005-10-24 | 2014-08-26 | K2M, Inc. | Intervertebral disc replacement and associated instrumentation |
US8864831B2 (en) | 2005-01-19 | 2014-10-21 | K2M, Inc. | Fixation of elastomer to rigid structures |
US9011542B2 (en) | 2006-09-26 | 2015-04-21 | K2M, Inc. | Intervertebral prosthesis endplate having double dome and surgical tools for implanting same |
US10561504B2 (en) | 2016-01-19 | 2020-02-18 | K2M, Inc. | Surgical instrument and methods of use thereof |
Families Citing this family (2)
Publication number | Priority date | Publication date | Assignee | Title |
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CA2495373C (en) | 2002-08-15 | 2012-07-24 | David Gerber | Controlled artificial intervertebral disc implant |
US8470045B2 (en) | 2008-05-05 | 2013-06-25 | K2M, Inc. | Endplate for an intervertebral prosthesis and prosthesis incorporating the same |
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EP0179695A1 (en) * | 1984-09-26 | 1986-04-30 | Pierre Kehr | Vertebral prosthesis, in particular for cervical vertebrae |
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GB2207607A (en) * | 1987-08-06 | 1989-02-08 | Showell A W | Spinal implants |
EP0317972A1 (en) * | 1987-11-24 | 1989-05-31 | Asahi Kogaku Kogyo Kabushiki Kaisha | Artificial intervertebral disc |
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Cited By (12)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2006078663A2 (en) * | 2005-01-19 | 2006-07-27 | Nexgen Spine, Inc. | Elastomeric intervertebral disc prosthesis |
WO2006078663A3 (en) * | 2005-01-19 | 2007-01-04 | Nexgen Spine Inc | Elastomeric intervertebral disc prosthesis |
US7776092B2 (en) | 2005-01-19 | 2010-08-17 | Nexgen Spine, Inc. | Elastomeric intervertebral disc prosthesis |
US8864831B2 (en) | 2005-01-19 | 2014-10-21 | K2M, Inc. | Fixation of elastomer to rigid structures |
US8814938B2 (en) | 2005-10-24 | 2014-08-26 | K2M, Inc. | Intervertebral disc replacement and associated instrumentation |
US9277930B2 (en) | 2005-10-24 | 2016-03-08 | K2M, Inc. | Intervertebral disc replacement and associated instrumentation |
FR2894459A1 (en) * | 2005-12-14 | 2007-06-15 | Frederic Fortin | PROSTHESIS OF IMPERFINABLE IMPLANTABLE BRAVERAL INTERVERTEBRAL DISC |
WO2007068812A2 (en) * | 2005-12-14 | 2007-06-21 | Fortin Frederic | Intervertebral disc prosthesis implantable by a posterior route |
WO2007068812A3 (en) * | 2005-12-14 | 2007-08-02 | Frederic Fortin | Intervertebral disc prosthesis implantable by a posterior route |
US9011542B2 (en) | 2006-09-26 | 2015-04-21 | K2M, Inc. | Intervertebral prosthesis endplate having double dome and surgical tools for implanting same |
US9642631B2 (en) | 2006-09-26 | 2017-05-09 | K2M, Inc. | Intervertebral prosthesis endplate having double dome and surgical tools for implanting same |
US10561504B2 (en) | 2016-01-19 | 2020-02-18 | K2M, Inc. | Surgical instrument and methods of use thereof |
Also Published As
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