FR2803188A1 - Device and intervertebral stabilization assembly - Google Patents

Device and intervertebral stabilization assembly Download PDF

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Publication number
FR2803188A1
FR2803188A1 FR9916662A FR9916662A FR2803188A1 FR 2803188 A1 FR2803188 A1 FR 2803188A1 FR 9916662 A FR9916662 A FR 9916662A FR 9916662 A FR9916662 A FR 9916662A FR 2803188 A1 FR2803188 A1 FR 2803188A1
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FR
France
Prior art keywords
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lt
chambers
characterized
chamber
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Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
FR9916662A
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French (fr)
Inventor
Henry Graf
Original Assignee
Henry Graf
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Henry Graf filed Critical Henry Graf
Priority to FR9916662A priority Critical patent/FR2803188A1/en
Priority claimed from CA 2392868 external-priority patent/CA2392868C/en
Priority claimed from US10/168,679 external-priority patent/US7066957B2/en
Publication of FR2803188A1 publication Critical patent/FR2803188A1/en
Application status is Pending legal-status Critical

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Classifications

    • AHUMAN NECESSITIES
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/442Intervertebral or spinal discs, e.g. resilient
    • A61F2/4425Intervertebral or spinal discs, e.g. resilient made of articulated components
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    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002Longitudinal elements, e.g. rods
    • A61B17/7019Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other
    • A61B17/702Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other having a core or insert, and a sleeve, whereby a screw or hook can move along the core or in the sleeve
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    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
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    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2002/448Joints for the spine, e.g. vertebrae, spinal discs comprising multiple adjacent spinal implants within the same intervertebral space or within the same vertebra, e.g. comprising two adjacent spinal implants
    • A61F2002/4485Joints for the spine, e.g. vertebrae, spinal discs comprising multiple adjacent spinal implants within the same intervertebral space or within the same vertebra, e.g. comprising two adjacent spinal implants comprising three or more adjacent spinal implants
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2002/48Operating or control means
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/005Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using adhesives
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063Three-dimensional shapes
    • A61F2230/0065Three-dimensional shapes toroidal, e.g. ring-shaped, doughnut-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063Three-dimensional shapes
    • A61F2230/0071Three-dimensional shapes spherical
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00011Metals or alloys
    • A61F2310/00023Titanium or titanium-based alloys, e.g. Ti-Ni alloys

Abstract

The invention concerns a stabilising device (150) designed to link two vertebrae, comprising at least two chambers (156, 158, 186, 188) arranged proximate to said vertebrae, said chambers containing a shock absorbing fluid. Means (192, 194) are provided for providing fluid communication with controlled flow between said two chambers, thereby adequately damping the patient's movements.

Description

The present invention relates to a device and an intervertebral stabilization assembly.

Usually, such a device is intended to replace all or part of an intervertebral disc, when the last was destroyed by surgery or disease.

The invention proposes to provide a stabilizing device which ensures a relative movement between the two vertebrae that it connects, sufficiently close to the movement authorized by a natural vertebral disk, so that no major dysfunction at the level of the together the vertebral chain.

<B> A </ B> this effect, it relates to an intervertebral stabilization device, intended <B> to </ B> connect two vertebrae characterized in that it comprises <B>: </ B> < B> - </ B> at least two chambers intended <B> to </ B> be placed near said vertebrae, said chambers containing a fluid, and <B> - </ B> means for setting fluid communication of said chambers with controlled fluid flow.

According to other characteristics of the invention, the communication establishment means comprise at least one duct extending between said chambers; <B> <BR> <BR> <BR> - </ B> a first conduit provides communication between said chambers in a first direction, while a second conduit provides this communication in a second direction, opposed to the first, the passage sections of said first and second conduits being different <B>; </ B > <B> - </ B> the fluidic communication setting means comprise at least one porous membrane extending between said chambers <B>; </ B> <B> - </ B> the means for placing in communication fluidic comprise at least one porous member, on both sides of which extend said chambers, this member being movable relative to <B> to </ B> these chambers <B>; </ B> <B> - < / B> the device further comprises means for moving said fluid <B> to </ B> inside each chamber <B>; </ B> - </ B> the displacement means comprise at least one piston movable relative to said chamber; the displacement means comprise a deformable wall of said chamber; B> said at least two chambers belong to <B> to </ B> an intradiscal implant <B>; </ B> at least first and second chambers are disposed on either side of the main axis of the vertebral chain and means for fluidic communication of said first and second chambers are provided; said chambers belong to an extradiscal damping member; B> - </ B> the device comprises at least one chamber belonging <B> to </ B> an intradiscal implant and at least one other chamber belonging <B> to </ B> an extradiscal damping member <B> - </ B> said damping fluid comprises in particular air or nitrogen <B>; </ B> <B> - </ B> at least one chamber is provided with a spring working in compression.

The invention also relates to an intervertebral stabilization assembly comprising at least two intervertebral stabilization devices as defined above, at least first and second devices being arranged on either side of the main axis of the vertebral chain. .

The invention will be described below, with reference to the accompanying drawings, given solely by way of non-limiting examples and in which <B>: </ B> <B> - </ B> > Figure <B> 1 </ B> is a schematic side view, illustrating two neighboring vertebrae between which are intended <B> to </ B> be placed different stabilizers conforming <B> to </ B> l invention <B>; </ B> <f> </ b> igure 2 is a side view, <B> to </ B> larger scale, shining a first embodiment of a device Stabilization conforming <B> to </ B> the invention <B>; </ B> <B> - </ B> Figure <B> 3 </ B> is a similar view <B> to </ B> FIG. 2, illustrating a variant of the stabilization device described in FIG. 2; FIG. 4 is a schematic side view, illustrating a second embodiment of FIG. a stabilization device conforming to the invention <B>; <B> </ B> <B> f </ B> igures <B> 5 to 8 < / B> are analog views FIG. 4, illustrating variants of the stabilization device described in this FIG. 4; FIG. 4 B> illustrates an alternative embodiment of a chamber belonging to a stabilization device according to the invention; <B> <B> - </ B> <B> FIGURES <B> 10 </ B> and <B> il </ B> are top views, illustrating two stabilizers conforming to a third embodiment of the invention, <B>; </ B> FIG. 12 is a side view illustrating an intervertebral stabilization device according to a fourth embodiment of the invention. BRIEF DESCRIPTION OF THE DRAWING FIG. > </ B> and <B> - </ B> Figure <B> 13 </ B> is a top view, illustrating a set of intervertebral stabilization conforming to the <B> to </ B> invention.

Figure <B> 1 </ B> represents two vertebrae respectively upper 2 and lower 2 ', intended <B> to </ B> be connected through different types of stabilizers conforming <B> to </ B> the invention, which will be described in the following. Each vertebra includes a vertebral body 4, 4 extended by a pedicle <B> 6, 61, </ B> an articular superior <B> 8 81 </ B> and a lower articular <B> 10, </ B> lo . the intervertebral space is designated by 14, 141 the articular facets opposite, and by <B> 16 </ B> and 161 the articular capsules. this figure <B> 1, </ B> has also been shown two pedicle screws <B> 18, 18, </ B> fixed in the corresponding vertebral bodies 4, 41.

FIG. 2 shows an intervertebral stabilization device conforming to a first embodiment of the invention, which forms an extra-discal organ 20. The latter, which is arranged <B> to </ B> the back of the intervertebral space 12, is clean <B> to </ B> cushion a movement between the vertebrae <B>, </ B> 21.

The damping member 20 comprises a rigid cylindrical vessel 22, made for example of metal, plastic or ceramic. This tank receives, in its internal volume, a piston 24 which is mounted swiveling on the head <B> 19 </ B> of the screw, which screw extends through an opening <B> 26 </ B> The side walls of the piston are separated from the inner walls facing the vessel by means of two O-rings. <B> 28. </ B> Furthermore, the lower end of the vessel 22 is secured <B> to </ B> head <B> 191 </ B> lower screw <B> 181. </ B>

The end walls <B> 30 </ B> of the tank 22 define, with end walls facing the piston 24, two chambers respectively upper <B> 32A </ B> and lower 34A. The latter are placed in communication via a duct <B> 36A, </ B> extending along the main direction of the tank 22. This duct, for example made of metal or plastic material, is connected <B> to </ B> the tank 22 by crimping, screwing or latching. Cross section of this duct 36A is substantially smaller <B> than </ B> the cross section of each chamber <B> 32A, </ B>. </ B> This duct <B> 36A </ B> has for example a passage diameter <B> to </ B> 2mm, advantageously between 0.2 and <B> 0.9 </ B> mm.

The end walls <B> 30 </ B> of the tank 22 are further provided with stops <B> 38, </ B> made of a flexible material a polymer. Each chamber is filled with a damping fluid. This fluid comprises at least one liquid, water or oil.

The operation of this damping member 20 following. When the patient leans forward according to the arrow F, this has the effect of moving the vertebrae 2, 21 and thus the pedicle screws <B> 18, 18 'away from each other. </ B> Thus, the piston 24 is directed to the upper wall <B> 30 </ B> tank 22 and thus flushes the fluid out of the upper chamber <B> 32A, </ B> towards the lower chamber 34A. flow, which occurs by the conduit <B> 36A, </ B> is materialized the arrow <B> <U> f. </ U> </ B>

it is understood that the speed of displacement of the fluid <B> to </ B> through the conduit <B> 36A, </ B> which conditions the speed of displacement of the piston 24 in the direction of the upper wall <B> 301, </ B> adjustable according to the section of the conduit, the length of the latter and the viscosity of the fluid used. presence of this fluid which must be removed from the chamber in order to allow a given movement of the patient, confers a damping component satisfactory <B> to </ B> this movement. During a large amplitude movement of the patient, the upper stop <B> 38 </ B> limits the aforementioned movement, by pressing the wall facing the piston 24 against this abutment <B> 38. </ B > The elastic nature of the latter confers an additional damping component. Alternatively, it can be provided that at least one chamber contains a hydrophilic body, such as hydrogel. As the stroke of the piston progresses, the latter presses on the hydrophilic body, so as to progressively release the fluid which was contained therein. .

<B> A </ B> conversely, when the patient leans backwards according to the arrow F '<B>, </ B> the piston 24 is directed towards the bottom wall <B> 30, </ B> of the tank 22, so that the <B> f </ B> luide is driven from this chamber 34A through the conduit <B> 36A, </ B> according to the arrow fl.

The <B> f </ B> igure <B> 3 </ B> represents an alternative embodiment of the damping member 20 described <B> to </ B> in Figure 2.

In this embodiment, it uses an additional conduit <B> 36B </ B> connecting the two chambers 32B, 34B. In addition, each duct <B> 36B, 37 </ B> is provided with a corresponding nonreturn valve 40, 42. In this way, the conduit 36B only allows a transfer of fluid from the upper chamber 32B to the lower chamber 34P, according to the arrow f, while the conduit <B> 37 </ B> ensures a movement of the fluid only from the chamber lower 34B to the upper chamber 32B, according to the arrow fl.

Advantageously, the transverse dimensions of the passage duct <B> 36B, </ B> ensuring the flow to the lower chamber, are greater than those of the duct <B> 37 </ B> ensuring the passage to the chamber greater <B> 32. </ B> This allows to confer a greater damping component in the direction of the intervertebral extension. In other words, the forward bending movements of the patient are damped to a lesser extent than the backward extension.

FIG. 4 illustrates an intervertebral stabilization device according to a second embodiment, which forms a disc implant <B> 52 </ B> intended to be inserted at least partially between the vertebral bodies 4, 41 vertebrae 2, 21 of the figure <B> 1. </ B>

This implant comprises a pocket 54, made of a deformable but substantially non-extensible material. This pocket 54 defines two chambers respectively before <B> 56A </ B> and rear <B> 58A, </ B> which are connected by a conduit <B> 60A, </ B> or throttling, putting in communication the volume interior of these two rooms. This duct <B> 60 </ B> has transverse dimensions substantially <B> to </ B> those of rooms <B> 56A, 58A. </ B>

The implant <B> 52 </ B> also comprises a coating formed by two shells 62. Each of these, which has a cross section substantially in a circular arc, is made of a rigid material, such as titanium. These shells <B> 62, </ B> which are placed on either side of a median plane of the pocket 54, are intended to contact the vertebral bodies 4, 4 . They are subject <B> to </ B> the pocket 54 for example by gluing.

Each chamber <B> 56A, 58A </ B> is filled by means of a fluid, similar to <B> to </ B> that contained in the aforementioned chambers <B> 32, </ B> 34. Once the implant <B> 52 </ B> is in place, when the patient leans forward in the direction of the arrow, this has the effect of compressing the chamber before <B> 56A </ B> and thus expelling the fluid that <B> y </ B> was initially contained, in the direction of the back chamber <B> 58A. </ B> This fluid flow, which occurs via the conduit <B> 60, </ B > is represented by the arrow <B> <U> f. </ U> </ B>

<B> A </ B> Conversely, when the patient leans backwards according to the arrow FI, there is, according to a similar phenomenon, a flow of fluid along the duct <B> 60, </ B > materialized by the arrow <B> <U> f '. </ U> </ B> The intensity of the damping thus conferred during the movements bending and extension of the patient, depends on the section of passage and the length of the conduit <B> 60, </ B> as well as the physicochemical characteristics, in particular the viscosity, of the fluid admitted to the chambers <B> 56A, 58A. </ B>

Figure <B> 5 </ B> represents an alternative embodiment of the implant <B> 52 </ B> of Figure 4. In this variant, the two chambers <B> 56B, </ B> 58B are connected, not by a conduit, but by a porous membrane 64, forming an interface between these two chambers. This membrane 64, which can extend the entire cross section of the chambers <B> 56B, 58B, </ B> is for example made of a textile material, such as <B> DACRON, </ B> or a metal porous. The presence of the pores of this membrane 64 makes it possible to delay, in a similar manner <B> to </ B> the use of the conduit <B> 60, </ B> the transfer of fluid between the two chambers. The damping component thus conferred depends in particular on the size and the number of pores of the membrane 64.

Figure <B> 6 </ B> represents a further alternative embodiment of the implant 52 described <B> to </ B> in Figure 4. In this figure <B>, <B>, the <B> chambers 56C, 58C </ B> are connected, not only by a first conduit <B> 65, </ B> but also by an additional conduit <B> 66, </ B> parallel to the conduit <B> 65. </ B> Each duct is provided with a respective non-return valve <B> 68, 70. </ B> In this way, the conduit <B> 65 </ B> allows a transfer of fluid only from the front chamber < B> 56C </ B> to the rear chamber <B> 58C, </ B> while the additional conduit <B> 66 </ B> ensures fluid transfer only in the opposite direction.

Advantageously, the transverse dimensions of the duct are greater <B> than those of the additional duct <B> 66, </ B> so that the fluid is easier <B> to </ B> even from flow towards the back chamber <B> 58C, </ B> which corresponds to the forward bending motion of the patient. In other words, this forward bending movement is damped to a lesser extent than the reverse backward extension movement.

As shown in this figure <B> 6, </ B> at least one of the chambers belonging to <B> to </ B> the implant, in this case the front chamber <B> 56C, </ B> contains volume gas <B> 72, </ B> which can be for example air or even nitrogen.

The presence of this gas <B> 72 </ B> is advantageous, insofar as it induces an elastic effect during the compression of the chamber <B> 56C. </ B> Indeed, when the latter is compressed, it is first air <B> 72 </ B> which is driven away, so that the corresponding movement is amortized only to a very small extent. Once the air is flushed, it is then fluid initially contained in the chamber flowing in the conduit <B> 65, </ B> this gives a much greater damping component. In this way, during movements of small amplitude, only the air flows through conduit <B> 65, </ B> so these movements are only slightly damped. This is not embarrassing because, because of their small amplitude, such movements can not impair the physical integrity of the ient. On the other hand, when the aforesaid movements have a greater amplitude, fluid also flows through the conduit <B> 65, </ B> so that these movements are damped to a much greater extent.

Figure <B> 7 </ B> represents an additional variant of the implant <B> 52. </ B> In this variant, the implant <B> 52 </ B> does not have a pocket but has end 74 sealingly connecting the shells 62. These walls 74 are made of a deformable material but substantially non-extensible. By their, a cylinder trunk <B> 76, </ B> forming a piston, is housed in the interior volume of the implant <B> 52. </ B> This cylinder trunk, whose main axis is transverse relative to <B> to </ B> that of the implant <B> 52, </ B> forms a porous system. It contains, for example, a labyrinth system with small cells connected to each other by pores, which enables it to capture the fluid, so as to slow down the flow of the latter.

The movement of the piston from behind to the implant <B> 52 </ B> is imitated, in two opposite directions, by abutment means <B> 78. </ B> This piston <B> 76 < / B> defines, with the walls 74 opposite, two rooms before <B> 56D </ B> and rear <B> 58D. </ B>

During patient flexion or extension, the <B> 76 </ B> piston moves back and forth from the <B> 52 implant, </ B> causing compression of the implant. one of the chambers <B> 56D, 58D, </ B> so that fluid escapes in the direction of the other chamber through the pores of the piston <B> 76. </ B>

Figure <B> 8 </ B> represents an alternative embodiment of the figure <B>, </ B> in which the piston <B> 76, </ B> is rigid and watertight. This piston constitutes, as in the embodiment of the figure <B>, </ B> a pivot for the two shells <B> 62, </ B> which can pivot <B> 1 1 </ B> one by ratio <B> to 1 1 </ B> other around <B> 1 1 </ B> transverse main axis <B> A </ B> of this pivot. Fluid circulation between rooms <B> 56E </ B> and <B> 58E, </ B> that is not permitted by piston <B> 761, </ B> is provided through 'at least one channel <B> 78 </ B> in one of the rigid shells <B> 62. </ B>

Figure <B> 9 </ B> illustrates a further variation of the invention. It <B> y </ B> is shown a chamber <B> 56F, </ B> that can be used in one of the implants described with reference to the preceding figures. This <B> 56F </ B> includes a deformable but unstretchable bag <B> 80, whose open end is secured, for example by crimping, <B> to </ B> a rigid cover which is slidably mounted in a tank 84 <B> to </ B> closed bottom. The walls facing the bag <B> 80 </ B> and the tank 84 are separated by a lubricant <B> 86. </ B>

A conduit <B> 88 </ B> passes through the cover <B> 82, <B> to </ B> place the interior volume of the chamber <B> 56F </ B> with outside. Depending on the pressure conditions on chamber <B> 56F, </ B> the fluid escapes or <B> y </ B> is admitted, so that the edges of the lid rise or fall, < B> to </ B> sliding, along the side walls of tank 84. This embodiment is advantageous insofar as it guarantees a very satisfactory seal, given that this seal is provided <B> to </ B> both by the deformable walls of the bag and by the rigid walls the tank 84.

As shown in Figure <B> 9 </ B> in dotted lines, two chambers <B> 56F </ B> can be connected by conduits <B> 88, <B> in <B> to </ B> form an extra-discal organ, like that of Figures 2 and <B> 3. <B> These chambers <B> 56F </ B> can also be surrounded by shells, similar to those <B > 62. </ B> In this case, the ducts <B> 88 </ B> extend into the shells and at least one chamber may be surrounded by a helical spring.

Figure <B> 10 </ B> illustrates an intervertebral stabilization device conforming to another embodiment, which forms a disc implant 102. The latter comprises two elements respectively left 104 and right <B > 106, </ b> located on either side of the main axis <B> A </ B> of the vertebral chain which, when patient is in a standing position, is a vertical axis passing through the median plane P extending back in front of the east.

Each 104, <B> 106 </ B> element has two chambers respectively before <B> 108, </ B> 112 and back <B> 110, </ B> 114. The two chambers before <B> 108, </ B> 112 are placed in communication a conduit before <B> 116 </ B> while the two rear chambers <B> 110, </ B> 114 are connected a rear conduit <B> 118. </ B> The different chambers contain a similar fluid <B> to one of those described above, so that, depending on the pressure conditions exerted these chambers, it establishes a fluid communication between them. this.

chambers of the same element are separated by means of respective membranes 120, 122 which can be tight, or porous as the membrane 64 described above. In this way, the two chambers <B> 108, 110 </ B> and 112, 114 a considered element may possibly be placed in fluid communication.

Alternatively, the right front chamber <B> 108 </ B> can be brought into fluid communication with the left rear chamber 114, the left front chamber 112 being in this case in fluid communication with the right rear chamber <B> 110 </ B> These additional fluid relations can be realized additionally to the relationships allowed by the conduits <B> 116, 118. </ B>

The figure <B> il </ B> represents a disc implant 1021 comprising two rear chambers respectively right 124 and left <B> 126, </ B> as well as a front chamber <B> 128, </ B> s' extending over a substantial portion of the width of the disk. The rear chambers 124, 126 are in fluid communication via a conduit 130. In addition, each of these chambers , <B> 126 </ B> is in fluid communication with the front chamber <B> 126, </ B> through respective conduits <B> 1 </ B> 134.

The implants 102, 1021, described above, induce an additional damping component, when the patient leans on the sides, since they are calling <B> at </ B> chambers arranged on both sides. other of the axis <B> A. </ B>

FIG. 12 shows an intervertebral stabilization device conforming to an additional embodiment, which is generally designated by the reference 150. This device comprises a disc implant. B> 152, </ B> to be inserted at least partially into the intervertebral space 12. This implant 152 comprises two chambers respectively before <B> 156 </ B> and rear <B> 158, </ B> surrounded by two shells 162, similar to those <B> 62 </ B> described above.

The device <B> 150 </ B> also includes a damping member <B> 170, </ B> arranged analogously <B> to </ B> as previously described, <B> to </ B> > know <B> to </ B> the back of the intervertebral space 12. This body <B> 170 </ B> includes a rigid tub <B> 172 to </ B> inside which is arranged a piston 174, which comprises a head <B> 176, </ B> forming an upper end, whose transverse dimensions are close to those of the tank. An O-ring seal <B> 178 </ B> is mounted between the walls opposite the head <B> 176 </ B> and the tank <B> 172. </ B>

The piston head <B> 176 </ B> extends <B> to </ B> from a vertical <B> 180 </ B> rod which tightly passes through the bottom wall <B> 182 </ B> of the tank <B> 172, </ B> with interposition of an O-ring 184. The lower end of the rod <B> 180, </ B> opposite <B> to </ B > the head <B> 176, </ B> is mounted <B> to </ B> ball head on the head <B> 191 </ B> of the lower screw <B> 181. </ B>

The head <B> 17G </ B> delineates upper chamber <B> 186 </ B> and lower <B> 188, </ B> respectively <B> 172. </ B> The upper chamber <B> 18G </ B> receives a compression spring <B> 190, which extends vertically between the upper wall of the tank and the wall opposite the head <B> 176. </ B> The use of this spring <B> 190 </ B> allows the return of the piston 174 in its low position, which corresponds to a physiologically advantageous lordosed position of the patient.

The front chamber <B> 156 </ B> of the implant <B> 152 </ B> is in fluid communication with the upper chamber <B> 18G </ B> of the body <B> 170, < / B> via a conduit <B> 192, </ B> while the rear chamber <B> 158 </ B> is in fluid communication with the lower chamber <B> 188 </ B> through an additional conduit 194. In this way, when the patient leans forward according to the arrow F, fluid is driven from the front chamber <B> 156 </ B> towards the chamber upper <B> 18G, </ B> which helps <B> to </ B> lower the piston 174 into the tank <B> 172, to </ B> the opposite of the upper screw <B> 18 </ B> This rise induces a fluid displacement, through line 194, from the lower chamber <B> 188 </ B> to the rear chamber <B> 158. </ B> This bending movement is thus dampened by these different flows of fluid.

The amplitude of this damping can be modulated according to the characteristics of the fluid admitted in the different chambers and the passage section of the ducts <B> 192, </ B> 194. It is easy to imagine that, during a movement of Patient extension to the back occurs at both fluid flows and a movement of the piston 174, in opposite directions to those mentioned above.

In a variant, it is possible to add two additional ducts, each of ducts 192, 194, the four ducts thus formed being provided with non-return valves ensuring the flow of the fluid in a single direction. it can also be expected that the membrane <B> 196 </ B> separating the chambers before <B> 156 </ B> and back <B> 158 </ B> be porous, so <B> to </ B> allow fluid flow between these two chambers. it is also possible to eliminate this membrane <B> 196, </ B> so as <B> to </ B> form a single intradiscal chamber, put in communication with the lower chamber 174 by the conduit <B> 192, </ B> the other path 194 being deleted. It is also possible for the piston head 174 to be porous, such as that described above.

It is also possible for the two upper chambers <B> 186 </ B> and the lower <B> 188 </ B> to be in fluidic communication via a conduit, similar to <B> the <B> 36 </ B> described above. These chambers <B> 186, 188 </ B> can be put into communica tion by several ducts extending in the wall of the tank <B> 172. </ B> These ducts can be arranged below the others, so that the head <B> 176 </ B> of the piston, as and when <B> to </ B> measure of its movement, successively closes the outlets of these conduits. At the end of the movement, there remains therefore, in a chamber considered, a volume of residual fluid that can not be removed and constitutes a damping volume. The tank may comprise a double wall defining an annular fluid reserve housing. The tank may also be partially made of a porous material such as a ceramic.

The use of a piston rod <B> 180 </ B> 174 passing through walls of the vessel <B> 172 </ B> is advantageous. Indeed, this rod <B> 180 </ B> and therefore the piston 174, can be connected <B> to </ B> the screw <B> 181 </ B> while providing that the latter is <B > to </ B> the outside of the tank <B> 172. </ B> This is interesting in terms of tightness in that it is necessary to provide only a sealing member in the vicinity of the opening of the tank, through which extends the aforementioned rod.

Providing an intervertebral stabilization device, comprising a disc implant and a damping member, disposed <B> to </ B> the rear of the intervertebral space, is also advantageous. In fact, the intervertebral implant makes it possible to restore the height of the disc. Moreover, since this implant contains a fluid, it is able to confer two neighboring vertebral bodies a certain freedom of mutual movement. Moreover, the extra-discal damping member makes it possible to regulate the movements authorized by the disc implant.

As shown in Figure <B> 13, </ B> the stabilizing device may be arranged offset from <B> to </ B> the main axis <B> A, to </ b> that the implant <B> 152 </ B> and the body <B> 170 </ B> are arranged on the same side of the plane P. Such an arrangement allows to remedy <B> to </ B> collapses asymmetrical intervertebral space, seen from behind.

Stabilizer <B> 150, </ B> can be combined with an additional <B> 150 1 <1> <1 B <1> <B> 1 1 < / B> axis <B> A </ B> and the plane P, so as <B> to </ B> form an intervertebral stabilization assembly. This device <B> 150 '</ B> shown in phantom, may be similar <B> to </ B> 150, </ B> with the understanding that it is possible to give it different dimensions , especially regarding the height of the implant <B> 1521, <B> to </ B> compensate for a slight asymmetrical collapse of the disc, in the back view.

The invention is not limited to the examples described and shown. Indeed, it is possible to connect, via an intervertebral stabilization device according to the invention, two vertebrae which are not neighbors.

The fluidic communication means described above control the flow of the fluid because they induce a limitation of the flow rate of this fluid, during its flow between the rooms thus connected. This can be done by conferring <B> to </ B> these means of communication of reduced dirty transv dimensions, or a significant length. These means induce a restriction, a slowing down of the fluid flow and / or a load loss of the latter. The flow rate of fluid between the chambers is kept at a lower value <B> at </ B> a limit value, which ensures that the passage of fluid from a first chamber to a second chamber is not too fast. A certain damping of the movements of the patient's column is thus created.

Claims (1)

  1. <U> CLAIMS </ U> Intervertebral stabilization device (20 <B> 52 </ B> 102 <B>; </ b>; </ b>; 150), <B> to < / B> connect two vertebrae 21), characterized in that it comprises <B>: </ B> <B> - </ B> at least two chambers <B> (32, </ B> 34 <B> 56 108, <b> 110, </ b> 114 <b>; </ b> 124, 126, <b> 128; 156, 158, 186, 188) </ B> for <B > to </ B> be placed in the vicinity of said vertebrae, said chambers containing a fluid, and <B> - </ B> means <B> (36, 37; 60, 66; </ B> 64 <B> 76 </ B> 118 <B> 130, </ B> 134 <B>; 192, </ B> 194) fluid communication of said chambers with a controlled fluid flow. <B>. </ B> Device according to claim 1, characterized in that the communication means comprise at least one conduit (36, 37; 60, 65). , 66; </ i> 116, 118; </ b> 12 <B>, 126 </ b> <b> 192, </ b> 194) extending between said chambers. <B> 3. </ B> Device according to claim 2, characterized in that a first conduit <B> (36B; 65) </ B> provides communication between said chambers (32B, 349 <B>; 56C , 58C) in a first direction, whereas a second conduit (37; G6) provides this communication in a second direction, opposite to the first one, the passage sections of said first and second ducts being different. 4. Device according to claim 1, wherein the fluidic communication means comprise at least one porous membrane extending between said chambers (56B, 58B). </ B> <B> 5. </ B> Device according to claim 1, characterized in that the means for setting fluid communication comprises at least one porous member <B>. ), </ B> on either side of which extend said chambers <B> (56D, 58D), </ B> this body being movable relative <B> to </ B> these rooms. <B> 6. </ B> Device according to any one of the preceding claims, characterized in that it further comprises displacement means (24 <B>; 76; 761; 82; </ B> 174) said fluid <B> to </ B> within each chamber. <B> 7. </ B> Device according to claim 6, characterized in that the displacement means comprise at least one piston (76 76; 82). 174) movable relative to said chamber <B> (32, <B> 56D, 58D 56E, 58E; 172, </ B> 174). <B> 8. </ B> Device according to claim 6, characterized in that the displacement means comprise a deformable wall of said chamber <B> (56A, 58A; 56B, 58B; 56C; , 58C 56F; 156, 158). Apparatus according to any one of the preceding claims, characterized in that said at least two chambers <B </ B> > (56, 58; 108, 110, 112, 114 <B>; </ B> 124, <B> 126) </ B> belongs to <B> to </ B> an intradiscal implant < B> (52; </ B> 102 <B>; </ B> 102 '). <B> 10. </ B> Device according to claim 9, wherein at least first <B> (108, 110; </ B> 124) and second (112, 114 <B>; 126) </ B> chambers are arranged on either side of the main axis <B> (A) </ B> of the vertebral chain and that means are provided < B> (116, 118; 130) </ B> of fluidic communication of said first and second chambers. <B> 11. </ B> Device according to any one of claims <B> 1 to 8, characterized in that said chambers <B> (32, </ B> 34) belong <B> at </ B> an extradiscal damping member (20). 12. Device according to any one of claims <B> 1 8, </ B> characterized in that it comprises at least one chamber <B> (156, 158) </ B> belonging <B> to </ B> an intradiscal implant <B> (152) </ B> and at least one other chamber <B> (186, 188) </ B> belonging <B> to </ B> a damping member <B> (170) extradiscal. <B> 13. </ B> Device according to any one of the preceding claims, characterized in that said damping fluid comprises a gas <B> (72), </ B> including air or nitrogen. 14. Device according to any one of the preceding claims, characterized in that at least one chamber <B> (186) </ B> is provided with a spring <B> (190) </ B> working in compression . <B> 15. </ B> Intervertebral stabilization assembly comprising at least two intervertebral stabilization devices <B> (150, 1501) </ B> according to <B> to </ B> according to any one of the preceding claims, at least first <B> (150) </ B> and second <B> (1501) </ B> devices being disposed on either side of the main axis <B> (A) </ B> of the vertebral chain.
FR9916662A 1999-12-29 1999-12-29 Device and intervertebral stabilization assembly Pending FR2803188A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
FR9916662A FR2803188A1 (en) 1999-12-29 1999-12-29 Device and intervertebral stabilization assembly

Applications Claiming Priority (17)

Application Number Priority Date Filing Date Title
FR9916662A FR2803188A1 (en) 1999-12-29 1999-12-29 Device and intervertebral stabilization assembly
CA 2392868 CA2392868C (en) 1999-12-01 2000-12-01 Intervertebral stabilising device
ES00985390T ES2270888T3 (en) 1999-12-01 2000-12-01 Intervertebral stabilization device.
AT00985390T AT336952T (en) 1999-12-01 2000-12-01 A device for intervertebral stabilization
PCT/FR2000/003368 WO2001039678A1 (en) 1999-12-01 2000-12-01 Intervertebral stabilising device
JP2001541414A JP4294901B2 (en) 1999-12-01 2000-12-01 Intervertebral stabilizing device
US10/148,693 US7291150B2 (en) 1999-12-01 2000-12-01 Intervertebral stabilising device
AU21824/01A AU778410B2 (en) 1999-12-01 2000-12-01 Intervertebral stabilising device
DE2000630313 DE60030313T2 (en) 1999-12-01 2000-12-01 A device for intervertebral stabilization
EP20000985390 EP1233711B1 (en) 1999-12-01 2000-12-01 Intervertebral stabilising device
EP20000990839 EP1241995A1 (en) 1999-12-29 2000-12-28 Device and assembly for intervertebral stabilisation
PCT/FR2000/003727 WO2001049192A1 (en) 1999-12-29 2000-12-28 Device and assembly for intervertebral stabilisation
CA 2395602 CA2395602C (en) 1999-12-29 2000-12-28 Device and assembly for intervertebral stabilisation
US10/168,679 US7066957B2 (en) 1999-12-29 2000-12-28 Device and assembly for intervertebral stabilization
AU30300/01A AU782671C (en) 1999-12-29 2000-12-28 Device and assembly for intervertebral stabilisation
JP2001549561A JP2003518978A (en) 1999-12-29 2000-12-28 Intervertebral stabilization device and assembly
US11/982,761 US8172880B2 (en) 1999-12-01 2007-11-05 Intervertebral stabilising device

Publications (1)

Publication Number Publication Date
FR2803188A1 true FR2803188A1 (en) 2001-07-06

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FR9916662A Pending FR2803188A1 (en) 1999-12-29 1999-12-29 Device and intervertebral stabilization assembly

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EP (1) EP1241995A1 (en)
JP (1) JP2003518978A (en)
AU (1) AU782671C (en)
CA (1) CA2395602C (en)
FR (1) FR2803188A1 (en)
WO (1) WO2001049192A1 (en)

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US7029475B2 (en) 2003-05-02 2006-04-18 Yale University Spinal stabilization method
US7615068B2 (en) 2003-05-02 2009-11-10 Applied Spine Technologies, Inc. Mounting mechanisms for pedicle screws and related assemblies
US7635379B2 (en) 2003-05-02 2009-12-22 Applied Spine Technologies, Inc. Pedicle screw assembly with bearing surfaces
US7699875B2 (en) 2006-04-17 2010-04-20 Applied Spine Technologies, Inc. Spinal stabilization device with weld cap
US7713287B2 (en) 2003-05-02 2010-05-11 Applied Spine Technologies, Inc. Dynamic spine stabilizer
US7713288B2 (en) 2005-08-03 2010-05-11 Applied Spine Technologies, Inc. Spring junction and assembly methods for spinal device
US7811309B2 (en) 2005-07-26 2010-10-12 Applied Spine Technologies, Inc. Dynamic spine stabilization device with travel-limiting functionality
US7931675B2 (en) 2004-06-23 2011-04-26 Yale University Dynamic stabilization device including overhanging stabilizing member
US8652175B2 (en) 2003-05-02 2014-02-18 Rachiotek, Llc Surgical implant devices and systems including a sheath member

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EP1233711B1 (en) 1999-12-01 2006-08-23 Henry Graf Intervertebral stabilising device
US6579319B2 (en) 2000-11-29 2003-06-17 Medicinelodge, Inc. Facet joint replacement
US20050080486A1 (en) 2000-11-29 2005-04-14 Fallin T. Wade Facet joint replacement
FR2817461B1 (en) 2000-12-01 2003-08-15 Henry Graf Device for intervertebral stabilization
US7090698B2 (en) 2001-03-02 2006-08-15 Facet Solutions Method and apparatus for spine joint replacement
US8562649B2 (en) 2004-02-17 2013-10-22 Gmedelaware 2 Llc System and method for multiple level facet joint arthroplasty and fusion
US7588578B2 (en) 2004-06-02 2009-09-15 Facet Solutions, Inc Surgical measurement systems and methods
US8419770B2 (en) 2003-12-10 2013-04-16 Gmedelaware 2 Llc Spinal facet implants with mating articulating bearing surface and methods of use
CA2552522A1 (en) * 2004-01-09 2005-07-28 Sdgi Holdings, Inc. Split spinal device and method
US7597694B2 (en) 2004-01-30 2009-10-06 Warsaw Orthopedic, Inc. Instruments and methods for minimally invasive spinal stabilization
US7815664B2 (en) 2005-01-04 2010-10-19 Warsaw Orthopedic, Inc. Systems and methods for spinal stabilization with flexible elements
US7993373B2 (en) 2005-02-22 2011-08-09 Hoy Robert W Polyaxial orthopedic fastening apparatus
US8333789B2 (en) 2007-01-10 2012-12-18 Gmedelaware 2 Llc Facet joint replacement
US7722647B1 (en) 2005-03-14 2010-05-25 Facet Solutions, Inc. Apparatus and method for posterior vertebral stabilization
US8764801B2 (en) 2005-03-28 2014-07-01 Gmedelaware 2 Llc Facet joint implant crosslinking apparatus and method
JP2010515543A (en) 2007-01-10 2010-05-13 ファセット ソリューションズ インコーポレイテッド Taper lock fixed system

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US7988707B2 (en) 2003-05-02 2011-08-02 Yale University Dynamic spine stabilizer
US7615068B2 (en) 2003-05-02 2009-11-10 Applied Spine Technologies, Inc. Mounting mechanisms for pedicle screws and related assemblies
US7635379B2 (en) 2003-05-02 2009-12-22 Applied Spine Technologies, Inc. Pedicle screw assembly with bearing surfaces
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US7713287B2 (en) 2003-05-02 2010-05-11 Applied Spine Technologies, Inc. Dynamic spine stabilizer
US9034016B2 (en) 2003-05-02 2015-05-19 Yale University Dynamic spine stabilizer
US8652175B2 (en) 2003-05-02 2014-02-18 Rachiotek, Llc Surgical implant devices and systems including a sheath member
US8333790B2 (en) 2003-05-02 2012-12-18 Yale University Dynamic spine stabilizer
US7029475B2 (en) 2003-05-02 2006-04-18 Yale University Spinal stabilization method
US7931675B2 (en) 2004-06-23 2011-04-26 Yale University Dynamic stabilization device including overhanging stabilizing member
US8500781B2 (en) 2004-06-23 2013-08-06 Yale University Method for stabilizing a spine
US9005252B2 (en) 2004-06-23 2015-04-14 Yale University Method for stabilizing a spine
US9681893B2 (en) 2004-06-23 2017-06-20 Yale University Method for stabilizing a spine
US7811309B2 (en) 2005-07-26 2010-10-12 Applied Spine Technologies, Inc. Dynamic spine stabilization device with travel-limiting functionality
US7713288B2 (en) 2005-08-03 2010-05-11 Applied Spine Technologies, Inc. Spring junction and assembly methods for spinal device
US7699875B2 (en) 2006-04-17 2010-04-20 Applied Spine Technologies, Inc. Spinal stabilization device with weld cap

Also Published As

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AU782671B2 (en) 2005-08-18
CA2395602A1 (en) 2001-07-12
EP1241995A1 (en) 2002-09-25
AU782671C (en) 2006-08-31
WO2001049192A1 (en) 2001-07-12
JP2003518978A (en) 2003-06-17
AU3030001A (en) 2001-07-16
CA2395602C (en) 2008-09-23

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