FR2799116A1 - Intervertebral implant comprises pure or alloyed pyrocarbon and is placed between two vertebrae and interacts by means of friction with at least one of them - Google Patents
Intervertebral implant comprises pure or alloyed pyrocarbon and is placed between two vertebrae and interacts by means of friction with at least one of them Download PDFInfo
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- FR2799116A1 FR2799116A1 FR9912221A FR9912221A FR2799116A1 FR 2799116 A1 FR2799116 A1 FR 2799116A1 FR 9912221 A FR9912221 A FR 9912221A FR 9912221 A FR9912221 A FR 9912221A FR 2799116 A1 FR2799116 A1 FR 2799116A1
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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
- A61F2/4425—Intervertebral or spinal discs, e.g. resilient made of articulated components
-
- 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
- A61F2/0077—Special surfaces of prostheses, e.g. for improving ingrowth
-
- 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
- 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
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30576—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs
- A61F2002/30578—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs having apertures, e.g. for receiving fixation screws
-
- 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
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2002/30922—Hardened surfaces
-
- 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
- A61F2310/00005—The prosthesis being constructed from a particular material
- A61F2310/00161—Carbon; Graphite
-
- 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
- A61F2310/00395—Coating or prosthesis-covering structure made of metals or of alloys
- A61F2310/00407—Coating made of titanium or of Ti-based 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
- A61F2310/00574—Coating or prosthesis-covering structure made of carbon, e.g. of pyrocarbon
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- 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
La présente invention concerne un implant intervertébral apte à etre interposé entre deux vertèbres. The present invention relates to an intervertebral implant adapted to be interposed between two vertebrae.
L'invention est utilisée avantageusement pour traiter différentes pathologies du disque intervertébral cervical telles que les hernies discales liées ou non à une dégenérescence discale, et les dégénérescences discales entraînant des problèmes de statique rachidienne. The invention is advantageously used to treat various pathologies of the cervical intervertebral disk, such as disc herniations, whether or not related to disc degeneration, and disc degeneration leading to problems with spinal statics.
Le disque intervertébral constitue une des deux articulations situées entre deux corps vertébraux du rachis en association avec les articulations unco- vertebrales. L'ensemble des disques intervertébraux représente au niveau des cervicales environ 22 % de la hauteur du complexe vertébral. Le rôle du disque intervertébral est de permettre une plus grande mobilité entre chaque vertèbre, de répartir uniformément les forces sur chaque corps vertébral mais également d'en absorber une partie. The intervertebral disc constitutes one of the two articulations located between two vertebral bodies of the spine in association with the unco- vertebral articulations. The set of intervertebral disks represents about 22% of the vertebral complex at the cervical level. The role of the intervertebral disc is to allow greater mobility between each vertebra, to evenly distribute the forces on each vertebral body but also to absorb a part.
Le disque intervertébral cervical coopère avec les deux corps vertébraux supérieur et inférieur. The cervical intervertebral disc cooperates with both upper and lower vertebral bodies.
On distingue deux types d'hernies discales cervicales, l'hemie discale molle et l'hemie discale dure. There are two types of cervical disc herniations, soft disc herniation and hard disc herniation.
L'hemie discale molle correspond à une protrusion discale postéro-latérale. Elle est liée à une dégénérescence discale due à une diminution du degré d'hydratation du disque intervertébral. The soft disc hernia corresponds to a posterolateral disc protrusion. It is related to disc degeneration due to a decrease in the degree of hydration of the intervertebral disc.
L'hemie discale dure correspond à une excroissance qui provoque également une compression radiculaire. The hard disc hernia corresponds to an excrescence which also causes root compression.
En outre, la dégénérescence du disque intervertébral peut provoquer des problèmes d'immobilité rachidienne. Plus particulièrement, la perte de hauteur discale peut provoquer une perte de la lordose cervicale voire une inversion de courbure. In addition, the degeneration of the intervertebral disk can cause problems of spinal immobility. More particularly, the loss of disc height can cause a loss of cervical lordosis or a reversal of curvature.
Les traitements des hernies discales, en particulier des hernies discales cervicales, consistent en des traitements médicaux ou en des traitements chirurgicaux. Treatments for herniated discs, especially cervical disc herniations, consist of medical treatments or surgical treatments.
Lorsque le traitement médical est inefficace, on peut être amené à pratiquer une intervention chirurgicale d'ablation du disque. When the medical treatment is ineffective, it may be necessary to perform a surgical removal of the disc.
Lorsqu'il s'agit d'une hernie discale molle, différents types d'interventions chirurgicales peuvent être réalisés. L'intervention chirurgicale par la voie postérieure permet d'extraire le fragment du disque exclu. L'intervention chirurgicale par voie antérieure permet un abord direct sur le disque intervertébral endommagé et donc une excision complète de celui-ci avec ou sans adjonction d'un greffon osseux permettant de retrouver une hauteur normale de disque intervertébral mais supprimant totalement les possibilités de mobilité locale du rachis. When it comes to a soft disc herniation, different types of surgical procedures can be performed. The posterior surgical procedure makes it possible to extract the fragment of the excluded disc. The anterior surgical procedure allows a direct approach to the damaged intervertebral disk and thus a complete excision of it with or without the addition of a bone graft allowing to find a normal height of intervertebral disk but completely eliminating the possibilities of mobility local spine.
La pose d'un implant intervertébral tel que proposé la présente invention peut permettre avantageusement de rétablir l'espace intervertébral assuré précédemment par le disque sain et de rétablir le mouvement relatif entre les deux vertèbres contiguës. The installation of an intervertebral implant as proposed the present invention may advantageously allow to restore the intervertebral space provided previously by the healthy disc and restore the relative movement between the two contiguous vertebrae.
Plus particulièrement, selon l'invention, l'implant intervertebral est réalisé pyrocarbone pur ou allié et il coopère par frottement avec au moins une desdites vertèbres. More particularly, according to the invention, the intervertebral implant is made of pure or alloyed pyrocarbon and it cooperates by friction with at least one of said vertebrae.
Ainsi, le mouvement relatif des deux vertèbres est assuré par le frottement plateau vertébral de la vertèbre sur l'implant réalisé en pyrocarbone, matériau extrêmement résistant au frottement et dont les propriétés mecaniques se rapprochent de celles de l'os. La souplesse relative du pyrocarbone vis-à-vis du cartilage du plateau vertébral de ladite vertèbre est avantageuse vis-à vis de l'usure cartilage. Thus, the relative movement of the two vertebrae is ensured by the friction vertebral plateau of the vertebra on the implant made of pyrocarbon, a material extremely resistant to friction and whose mechanical properties are similar to those of the bone. The relative flexibility of the pyrocarbon vis-à-vis the cartilage vertebral plateau of said vertebra is advantageous vis-à-vis the cartilage wear.
Le pyrocarbone est un carbone artificiel obtenu craquage d'hydrocarbures vers 1450 C. II présente l'avantage d'être hemocompatible, résistant, et de présenter après polissage une surface particulièrement lisse et résistante aux frottements et qui ne produit pas une usure prématurée du cartilage cotyloïdien en regard de l'implant. Pyrocarbon is an artificial carbon obtained cracked with hydrocarbons around 1450 C. It has the advantage of being hemocompatible, resistant, and to present after polishing a particularly smooth surface and resistant to friction and which does not produce premature wear of the cartilage cotyloidal opposite the implant.
II est donc particulièrement avantageux pour constituer la surface de frottement d'un tel implant de cotyle. It is therefore particularly advantageous to constitute the friction surface of such an acetabular implant.
Selon un mode de réalisation préférentiel de l'invention, l'implant intervertébral comprend une embase comportant une patte de fixation à une vertèbre inférieure et un plateau supportant une pastille réalisée pyrocarbone coopérant par frottement avec une vertèbre supérieure, ledit plateau étant pourvu d'une collerette externe entourant ladite pastille. L'espace intervertébral est rétabli par l'implant intervertébral selon l'invention dont la hauteur totale de l'assemblage de l'embase et de la pastille de pyrocarbone correspond sensiblement à la hauteur intervertébrale à réinstaurer. According to a preferred embodiment of the invention, the intervertebral implant comprises a base comprising a fastening lug to a lower vertebra and a plate supporting a pyrolytic pellet cooperating by friction with an upper vertebra, said plate being provided with a outer flange surrounding said pellet. The intervertebral space is restored by the intervertebral implant according to the invention, the total height of the assembly of the base and the pellet of pyrocarbon substantially corresponds to the intervertebral height to be reinstated.
La forme et la structure résistante au frottement de la pastille en pyrocarbone permettent notamment à la vertèbre supérieure les mouvements suivants : la flexion, l'extension, la rotation et les mouvements combinés des trois mouvements précités. The shape and the friction-resistant structure of the pyrolytic pellet notably allow the upper vertebra the following movements: bending, extension, rotation and the combined movements of the three aforementioned movements.
Le matériau utilise pour la pastille de l'implant intervertébral selon l'invention est un biomatériau qui ne provoque pas d'usure prématurée du plateau vertébral de la vertèbre supérieure et qui ne s'use pas trop rapidement. The material used for the pellet of the intervertebral implant according to the invention is a biomaterial which does not cause premature wear of the vertebral plateau of the upper vertebra and which does not wear too quickly.
De plus, la collerette externe est une embase elliptique qui évite avantageusement la repousse osseuse latérale. In addition, the outer flange is an elliptical base that advantageously avoids lateral bone growth.
La description qui suivre en regard des dessins annexés, donnés à titre d'exemples non limitatifs, fera bien comprendre en quoi consiste l'invention et comment elle peut être réalisée. The following description with reference to the accompanying drawings, given by way of non-limiting examples, will make it clear what the invention consists of and how it can be achieved.
Sur les dessins annexés - la figure 1 est vue schématique en perspective de trois quart de l'implant intervertébral selon l'invention, avant assemblage de la pastille et de l'embase, - la figure 2 est une vue schématique en perspective de dessus un mode de réalisation de l'implant intervertébral selon l'invention après assemblage de pastille et de l'embase, - la figure 3 est vue de dessous de l'implant vertébral de la figure 2 , et - les figures 4a et 4b représentent schématiquement vue de dessus et de dessous un mode de réalisation préférentiel de l'implant vertébral selon l'invention. In the accompanying drawings - FIG. 1 is a diagrammatic perspective view of three quarters of the intervertebral implant according to the invention, before assembly of the pellet and the base, FIG. 2 is a diagrammatic perspective view from above of embodiment of the intervertebral implant according to the invention after assembly of the pellet and the base, - Figure 3 is a bottom view of the vertebral implant of Figure 2, and - Figures 4a and 4b show schematically seen from above and from below, a preferred embodiment of the vertebral implant according to the invention.
Sur les figures 1 à 4b, on a représenté un implant intervertébral 100 unipolaire qui comprend une embase 110 comportant une patte de fixation 111 à une vertèbre inférieure 1 et un plateau 112 supportant une pastille 120 réalisée en pyrocarbone et coopérant par frottement avec une vertèbre supérieure 2. FIGS. 1 to 4b show a unipolar intervertebral implant 100 which comprises a base 110 comprising a fixing lug 111 to a lower vertebra 1 and a plate 112 supporting a pellet 120 made of pyrocarbon and cooperating by friction with an upper vertebra 2.
Le plateau 112 de l'embase 110 comporte un logement 112a de forme généralement complémentaire de celle de la pastille 120 et dans lequel ladite pastille est montée à force pour former avec l'embase 110 une seule pièce. The plate 112 of the base 110 has a housing 112a of a shape generally complementary to that of the pellet 120 and wherein said pellet is force-fitted to form with the base 110 a single piece.
L'assemblage de l'embase et de la pastille est réalisé avantageusement en usine pour constituer une pièce unique facilement utilisée par le chirurgien. The assembly of the base and the pellet is advantageously made in the factory to form a single piece easily used by the surgeon.
Le logement 112a du plateau 112 de l'embase comprend un orifice central 112b dans lequel est engagé un téton d'ancrage (non représenté) de la pastille 120. Selon une variante non représentée l'orifice peut être excentré. Cette excentricité de l'orifice du logement du plateau permet de gagner en encombrement l'implant. The housing 112a of the plate 112 of the base comprises a central orifice 112b in which is engaged an anchor pin (not shown) of the patch 120. According to a variant not shown, the orifice may be eccentric. This eccentricity of the orifice of the housing of the plate makes it possible to gain space in the implant.
La pastille 120 réalisée en pyrocarbone pur ou allié présente une dimension correspondant aux dimensions du plateau vertébral de la vertèbre supérieure. Elle présente à cet effet un diamètre de l'ordre de 15 mm preférentiellement compris entre 13 et 16 mm. La pastille 120 présente une face 121 bombée polie qui lorsque la pastille est montée dans le logement 112a du plateau 112 de l'embase 110, fait légèrement saillie vers l'extérieur dudit plateau. Cette face bombée polie 121 vient au contact du plateau vertébral 2a de vertèbre supérieure 2. The pellet 120 made of pure or alloyed pyrocarbon has a dimension corresponding to the dimensions of the vertebral plateau of the upper vertebra. It has for this purpose a diameter of the order of 15 mm preferably between 13 and 16 mm. The pellet 120 has a polished domed face 121 which when the pellet is mounted in the housing 112a of the plate 112 of the base 110, protrudes slightly outwardly of said plate. This polished convex face 121 comes into contact with vertebral plateau 2a of upper vertebra 2.
La patte de fixation. 111 de l'embase 110 est pourvue de deux orifices 111a, 111b traversant pour le montage de deux vis d'ancrage (non représentées) dans le corps vertébral 1b de la vertèbre inférieure 1. The bracket. 111 of the base 110 is provided with two orifices 111a, 111b passing through for the mounting of two anchoring screws (not shown) in the vertebral body 1b of the lower vertebra 1.
En outre, avantageusement, le plateau 112 de l'embase 110 comprend sur face 112c tournée vers la vertèbre inférieure 1 des saillies en virgules 113 destinés à s'ancrer dans le plateau vertébral 1 a de la vertèbre inférieure 1. Ces saillies en virgule permettent de renforcer la fixation primaire l'implant intervertébral à la vertèbre inférieure 1. In addition, advantageously, the plate 112 of the base 110 includes on the face 112c facing the lower vertebra 1 of the protrusions in commas 113 for anchoring in the vertebral plate 1a of the lower vertebra 1. These projections in comma allow to strengthen the primary fixation of the intervertebral implant to the lower vertebra 1.
Selon la variante représentée sur les figures 4a et 4b, le plateau 112 de l'embase 110 ne comprend pas de saillies sur sa surface inférieure. According to the variant shown in Figures 4a and 4b, the plate 112 of the base 110 does not include projections on its lower surface.
Le plateau 112 et la patte de fixation 111 de l'embase 110 sont orientés par rapport à l'autre à 100 degrés environ et sont raccordés par partie de raccordement arrondie 110a. The plate 112 and the bracket 111 of the base 110 are oriented relative to each other at about 100 degrees and are connected by rounded connection portion 110a.
La partie de raccordement arrondie 110a fait partie intégrante de la patte de fixation et présente un rayon de courbure adapté au mieux à la morphologie de la vertèbre concernée. The rounded connection portion 110a is an integral part of the bracket and has a radius of curvature best adapted to the morphology of the vertebra concerned.
La partie de raccordement arrondie 110a s'étend entre le plateau et la partie centrale du bord supérieur de la patte de fixation 111. The rounded connection portion 110a extends between the plate and the central portion of the upper edge of the bracket 111.
Avantageuse, les faces de l'implant intervertébral 100 représenté sur les figures, en contact avec les vertèbres peuvent être recouvertes d'un revêtement d'hydroxyapatite, de titane poreux ou de tout autre revêtement ostéoconducteur ou conducteur. Cela permet d'obtenir une bonne ostéointégration de l'implant dans le rachis du patient. On peut prévoir en variante qu'une seule face de l'implant en contact avec la vertèbre soit recouverte d'un tel revêtement. Dans ce cas, il est préférable cette face soit la face du plateau de l'embase venant en contact avec le plateau vertébral de la vertèbre inférieure. Advantageously, the faces of the intervertebral implant 100 shown in the figures, in contact with the vertebrae may be covered with a coating of hydroxyapatite, porous titanium or any other osteoconductive or conductive coating. This makes it possible to obtain good osseointegration of the implant in the patient's spine. It can be provided alternatively that only one face of the implant in contact with the vertebra is covered with such a coating. In this case, it is preferable that this face is the face of the plate of the base coming into contact with the vertebral plate of the lower vertebra.
L'embase 110 est réalisée avantageusement en alliage de titane qui est un matériau biocompatible avec une durée de vie élevée. The base 110 is advantageously made of titanium alloy which is a biocompatible material with a long service life.
Selon une variante représentée sur la figure 4a, il est prévu que le plateau<B>11</B> soit pourvu d'une collerette externe 112d entourant la pastille 120. Cette collerette externe permet avantageusement d'éviter la repousse osseuse latérale. According to a variant shown in Figure 4a, it is expected that the plate <B> 11 </ B> is provided with an outer flange 112d surrounding the pellet 120. This outer flange advantageously avoids lateral bone growth.
hauteur totale de l'implant intervertébral est de l'ordre de 4 ou 6 mm. Un tel implant permet de restaurer la hauteur intervertébrale disponible lorsque le disque intervertébral est sain. total height of the intervertebral implant is of the order of 4 or 6 mm. Such an implant can restore the intervertebral height available when the intervertebral disc is healthy.
vis de fixation sont du type standard pour une plaque cervicale, par exemple diamètre 4 à pas spongieux et autotaraudeuses. Fixing screws are of the standard type for a cervical plate, for example spongy diameter 4 and self-tapping.
L'implant intervertébral 100 selon l'invention est mis en place de la façon suivante. The intervertebral implant 100 according to the invention is set up as follows.
Après avoir abordé le rachis d'un patient par la voie antero-latérale, le chirurgien procède à l'excision du disque intervertébral endommagé. II pratique un ravivement plateau vertébral de la vertèbre inférieure, là où prendra appui l'implant intervertébral par l'intermédiaire de la face inférieure du plateau supportant la pastille frottement. Le chirurgien ravive l'ensemble du plateau la vertèbre concernée mais respecte les apophyses unciformes. II procède par suite à la mise en place de l'implant intervertébral selon l'invention en choisissant préalablement la taille d'implant la plus adaptée, c'est-à-dire la taille l'embase supportant pastille de frottement et la hauteur de l'implant. II fixe l'implant de manière définitive dans la vertèbre inférieure à l'aide des deux vis fixation. Lorsque l'implant est fixé, la face bombée polie de la pastille en pyrocarbone est en contact avec le plateau vertébral de la vertèbre supérieure et coopère avec celui-ci par frottement. After having approached the spine of a patient by the antero-lateral route, the surgeon proceeds to the excision of the damaged intervertebral disc. He practices a revitalizing vertebral plateau of the lower vertebra, where the intervertebral implant will be supported by means of the lower face of the plate supporting the friction pad. The surgeon revives the entire vertebral plateau concerned but respects the apophyses unciform. It proceeds as a result of the establishment of the intervertebral implant according to the invention by previously choosing the most appropriate implant size, that is to say the size of the base bearing friction pad and the height of the implant. He permanently fixes the implant in the lower vertebra using the two fixation screws. When the implant is fixed, the polished convex face of the pyrolytic pellet is in contact with the vertebral plateau of the upper vertebra and cooperates with it by friction.
mouvement relatif des deux vertèbres est alors assuré par le frottement du plateau vertébral de la vertèbre supérieure sur la face bombée polie de la pastille en pyrocarbone de l'implant, matériau extrêmement résistant au frottement et dont les proprietés mécaniques se rapprochent de celles de l'os. L'espace intervertébral est assuré par la hauteur totale de l'implant. Les limitations mouvement d'amplitude des vertèbres ne sont pas assurées par l'implant mais le système capsulo-ligamentaire des vertèbres qui est préservé au maximum, notamment les fibres périphériques de l'implant.relative movement of the two vertebrae is then ensured by the friction of the vertebral plateau of the upper vertebra on the polished convex face of the implant pyrolytic pellet, a material extremely resistant to friction and whose mechanical properties are close to those of the bone. The intervertebral space is ensured by the total height of the implant. The limitations of amplitude movement of the vertebrae are not ensured by the implant but the capsulo-ligamentary system of the vertebrae which is preserved to the maximum, in particular the peripheral fibers of the implant.
La présente invention n'est nullement limitée au mode de réalisation décrit représentés mais l'homme du métier saura y apporter toute variante conforme à son esprit. The present invention is not limited to the embodiment described, but those skilled in the art will be able to make any variant within its spirit.
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FR9912221A FR2799116B1 (en) | 1999-09-30 | 1999-09-30 | INTERVERTEBRAL IMPLANT |
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FR9912221A FR2799116B1 (en) | 1999-09-30 | 1999-09-30 | INTERVERTEBRAL IMPLANT |
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US9173748B2 (en) | 2009-08-07 | 2015-11-03 | Ebi, Llc | Toroid-shaped spinal disc |
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US8262731B2 (en) | 2002-05-23 | 2012-09-11 | Pioneer Surgical Technology, Inc. | Artificial disc device |
US10314621B2 (en) | 2002-05-30 | 2019-06-11 | Warsaw Orthopedic, Inc. | Laminoplasty devices and methods |
US8105366B2 (en) * | 2002-05-30 | 2012-01-31 | Warsaw Orthopedic, Inc. | Laminoplasty plate with flanges |
WO2007059246A1 (en) * | 2005-11-16 | 2007-05-24 | Aoi Medical, Inc. | Intervertebral spacer |
FR2898487A1 (en) * | 2006-03-14 | 2007-09-21 | Spineart Sa Sa | PROSTHETICS OF INTERVERTEBRAL DISCS |
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US9693872B2 (en) | 2006-09-15 | 2017-07-04 | Pioneer Surgical Technology, Inc. | Intervertebral disc implant |
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US10980575B2 (en) | 2011-12-23 | 2021-04-20 | Pioneer Surgical Technology, Inc. | Instrument for inserting a spinal device |
US11696786B2 (en) | 2011-12-23 | 2023-07-11 | Pioneer Surgical Technology, Inc. | Instrument for inserting a spinal device |
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EP2907481A1 (en) * | 2014-02-12 | 2015-08-19 | HO-MED Handelsgesellschaft m.b.H. | Implant for insertion between vertebrae of the spine and construction kit for making such an implant |
US11147682B2 (en) | 2017-09-08 | 2021-10-19 | Pioneer Surgical Technology, Inc. | Intervertebral implants, instruments, and methods |
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CN108379665B (en) * | 2018-03-12 | 2020-11-03 | 四川大学 | Double-gradient artificial vertebral plate and preparation method thereof |
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