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
Authority
FR
France
Prior art keywords
chambers
chamber
fluid
conduit
communication
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.)
Pending
Application number
FR9916662A
Other languages
French (fr)
Inventor
Henry Graf
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
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 Individual filed Critical Individual
Priority to FR9916662A priority Critical patent/FR2803188A1/en
Priority to AT00985390T priority patent/ATE336952T1/en
Priority to US10/148,693 priority patent/US7291150B2/en
Priority to EP00985390A priority patent/EP1233711B1/en
Priority to DE60030313T priority patent/DE60030313T2/en
Priority to ES00985390T priority patent/ES2270888T3/en
Priority to AU21824/01A priority patent/AU778410B2/en
Priority to JP2001541414A priority patent/JP4294901B2/en
Priority to CA002392868A priority patent/CA2392868C/en
Priority to PCT/FR2000/003368 priority patent/WO2001039678A1/en
Priority to JP2001549561A priority patent/JP2003518978A/en
Priority to PCT/FR2000/003727 priority patent/WO2001049192A1/en
Priority to US10/168,679 priority patent/US7066957B2/en
Priority to AU30300/01A priority patent/AU782671C/en
Priority to EP00990839A priority patent/EP1241995A1/en
Priority to CA002395602A priority patent/CA2395602C/en
Publication of FR2803188A1 publication Critical patent/FR2803188A1/en
Priority to US11/982,761 priority patent/US8172880B2/en
Pending legal-status Critical Current

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Classifications

    • 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
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    • 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
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    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7019—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other
    • A61B17/702—Longitudinal 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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    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
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    • A61B17/7004—Longitudinal elements, e.g. rods with a cross-section which varies along its length
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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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    • A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/3006—Properties of materials and coating materials
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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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    • 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
    • A61F2002/443—Intervertebral or spinal discs, e.g. resilient made of articulated components having two transversal endplates and at least one intermediate component
    • 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
    • A61F2002/444—Intervertebral or spinal discs, e.g. resilient for replacing the nucleus pulposus
    • 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
    • A61F2002/448—Joints 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
    • A61F2002/4485—Joints 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
    • 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
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/005—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using adhesives
    • 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
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0065—Three-dimensional shapes toroidal, e.g. ring-shaped, doughnut-shaped
    • 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
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0071—Three-dimensional shapes spherical
    • 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

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Neurology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Vascular Medicine (AREA)
  • Surgery (AREA)
  • Molecular Biology (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Chemical & Material Sciences (AREA)
  • Dispersion Chemistry (AREA)
  • Prostheses (AREA)

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

La présente invention concerne un dispositif et un ensemble intervertébraux de stabilisation. The present invention relates to a device and an intervertebral stabilization assembly.

De manière habituelle, un tel dispositif est destiné remplacer tout ou partie d'un disque intervertébral, lorsque dernier a été détruit par la chirurgie ou la maladie. Usually, such a device is intended to replace all or part of an intervertebral disc, when the last was destroyed by surgery or disease.

L'invention se propose de réaliser un dispositif stabilisation qui assure un mouvement relatif entre les deux vertèbres qu'il relie, suffisamment proche du mouvement autorisé par un disque vertébral naturel, pour que n'appa raisse pas de dysfonctionnement majeur au niveau de l'ensemble la chaÎne vertébrale. 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> cet effet, elle a pour objet un dispositif de stabili sation intervertébral, destiné<B>à</B> relier deux vertèbres caractérisé en ce qu'il comprend<B>:</B> <B>-</B> au moins deux chambres destinées<B>à</B> être placées voisinage desdites vertèbres, lesdites chambres renfermant un fluide, et <B>-</B> des moyens de mise en communication fluidique desdites chambres avec un débit de fluide contrôlé. <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.

Selon d'autres caractéristiques de l'invention <B>-</B> les moyens de mise en communication comprennent au moins un conduit s'étendant entre lesdites chambres<B>;</B> <B>-</B> un premier conduit assure la communication entre lesdites chambres dans un premier sens, alors qu'un second conduit assure cette communication dans un second sens, oppose au premier, les sections de passage desdits premier et second conduits étant différentes<B>;</B> <B>-</B> les moyens de mise en communication fluidique comprennent au moins une membrane poreuse s'étendant entre lesdites chambres<B>;</B> <B>-</B> les moyens de mise en communication fluidique comprennent au moins un organe poreux, de part et d'autre duquel s'étendent lesdites chambres, cet organe étant mobile par rapport<B>à</B> ces chambres<B>;</B> <B>-</B> le dispositif comprend en outre des moyens de déplacement dudit fluide<B>à</B> l'intérieur de chaque chambre<B>;</B> <B>-</B> les moyens de déplacement comprennent au moins un piston mobile par rapport<B>à</B> ladite chambre<B>;</B> <B>-</B> les moyens de déplacement comprennent une paroi déformable de ladite chambre<B>;</B> lesdites au moins deux chambres appartiennent<B>à</B> un implant intradiscal <B>;</B> au moins des première et seconde chambres sont disposées part et d'autre de l'axe principal de la chaine vertébrale et il est prévu des moyens de mise en communication fluidique desdites première et seconde chambres<B>;</B> lesdites chambres appartiennent<B>à</B> un organe d'amortissement extradiscal <B>;</B> <B>-</B> le dispositif comprend au moins une chambre appartenant<B>à</B> un implant intradiscal et au moins une autre chambre appartenant<B>à</B> un organe d'amortissement extradiscal <B>-</B> ledit fluide d'amortissement comprend un notamment de l'air ou de l'azote<B>;</B> <B>-</B> au moins une chambre est pourvue d'un ressort travaillant en compression. 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.

L'invention a également pour objet un ensemble stabilisation intervertébral comprenant au moins deux dispositifs de stabilisation intervertébraux tels que définis ci-dessus, au moins des premier et second dispositifs étant disposés de part et d'autre de l'axe principal de la chaÎne vertébrale. 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. .

L'invention va être décrite ci-dessous, en référence aux dessins annexés, donnés uniquement<B>à</B> titre d'exemples non limitatifs et dans lesquels<B>:</B> <B>-</B> la figure<B>1</B> est une vue schématique de côté, illustrant deux vertèbres voisines entre lesquelles sont destinés<B>à</B> être placés différents dispositifs de stabilisation conformes<B>à</B> l'invention<B>;</B> la<B>f</B> igure 2 est une vue de côté,<B>à</B> plus grande échelle, lustrant un premier mode de réalisation d'un dispositif de stabilisation conforme<B>à</B> l'invention<B>;</B> <B>-</B> la figure<B>3</B> est une vue analogue<B>à</B> la figure 2, illustrant une variante du dispositif de stabilisation décrit sur cette figure 2<B>;</B> <B>-</B> la figure 4 est une vue schématique de côté, illustrant un deuxième mode de réalisation d'un dispositif de stabilisation conforme<B>à</B> l'invention<B>;</B> <B>-</B> les<B>f</B> igures <B>5 à 8</B> sont des vues analogues<B>à</B> la figure 4, illustrant des variantes du dispositif de stabilisa tion décrit sur cette figure 4<B>;</B> <B>-</B> la figure<B>9</B> illustre une variante de réalisation d'une chambre appartenant<B>à</B> un dispositif de stabilisation selon l'invention<B>;</B> <B>-</B> les figures<B>10</B> et<B>il</B> sont des vues de dessus, illustrant deux dispositifs de stabilisation conformes<B>à</B> un troisième mode de réalisation de l'invention<B>;</B> <B>-</B> la<B>f</B> igure 12 est une vue de c8té illustrant un dispositif de stabilisation intervertébral conforme<B>à</B> un quatrième mode de réalisation de l'invention<B>;</B> et <B>-</B> la figure<B>13</B> est une vue de dessus, illustrant un ensemble de stabilisation intervertébral conforme<B>à</B> inven tion. 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.

La figure<B>1</B> représente deux vertèbres respectivement supérieure 2 et inférieure 2', destinées<B>à</B> être reliées par l'intermédiaire de différents types de dispositifs de stabilisation conformes<B>à</B> l'invention, qui seront décrits dans ce qui suit. Chaque vertèbre comprend un corps vertébral 4, 4 prolongé par un pédicule<B>6, 61,</B> une articulaire supérieure <B>8 81</B> et une articulaire inférieure<B>10,</B> lo'. on désigne par l'espace intervertébral, par 14, 141 les facettes articu laires en regard, et par<B>16</B> et 161 les capsules articulaires. on a également représenté, sur cette figure<B>1,</B> deux vis pediculaires <B>18, 18,</B> fixées dans les corps vertébraux 4, 41 correspondants. 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.

La figure 2 représente un dispositif de stabi isation intervertébral conforme<B>à</B> un premier mode de réalisation de <B>1</B> invention, qui forme un organe extra-discal 20. Ce dernier, qui est disposé<B>à</B> l'arrière de l'espace intervertébral 12, est propre<B>à</B> amortir un déplacement entre les vertèbres<B>,</B> 21. 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.

L'organe<B>d'</B>amortissement 20 comprend une cuve cylindrique 22 rigide, réalisée par exemple en métal, matière plastique, ou céramique. Cette cuve reçoit, dans son volume intérieur, un piston 24 qui est monté rotulant sur la tête<B>19</B> de la vis, laquelle vis s'étend au travers d'une ouverture<B>26</B> ménagée dans la cuve 22. Les parois latérales du piston sont séparées des parois intérieures en regard de la cuve par l'interme- diaire de deux joints toriques<B>28.</B> Par ailleurs, l'extrémité inférieure de la cuve 22 est solidarisée<B>à</B> la tête<B>191</B> de vis inférieure<B>181.</B> 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>

Les parois d'extrémité<B>30</B> de la cuve 22 définissent, avec parois d'extrémité en regard du piston 24, deux chambres respectivement supérieure<B>32A</B> et inférieure 34A. Ces dernières sont mises en communication par un conduit<B>36A,</B> s'étendant selon la direction principale de la cuve 22. Ce conduit, par exemple réalisé en métal ou matière plastique, est raccordé<B>à</B> la cuve 22 par sertissage, vissage ou encliquetage. section transversale de ce conduit 36A est sensiblement inférieure<B>à</B> la section transversale de chaque chambre<B>32A,</B> <B>.</B> Ce conduit<B>36A</B> possède par exemple un diamètre de passage inférieur<B>à</B> 2mm, avantageusement compris entre 0,2 et<B>0,9</B> mm. 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.

Les parois d'extrémité<B>30</B> de la cuve 22 sont en outre pourvues de butées<B>38,</B> réalisées en un matériau souple un polymère. Chaque chambre est remplie d'un fluide d'amortissement. Ce fluide comprend au moins un liquide, de l'eau ou de l'huile. 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.

Le fonctionnement de cet organe d'amortissement 20 suivant. Lorsque le patient se penche en avant selon la fleche F, ceci a pour effet d'éloigner l'une de l'autre les vertèbres 2, 21 et donc les vis pédiculaires<B>18, 18'.</B> De la sorte, le piston 24 est dirigé vers la paroi supérieure<B>30</B> cuve 22 et chasse ainsi le fluide hors de la chambre supérieure<B>32A,</B> en direction de la chambre inférieure 34A. ecoulement, qui se produit par le conduit<B>36A,</B> est matérialisé la flèche<B><U>f.</U></B> 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>

on conçoit que la vitesse de déplacement du fluide<B>à</B> travers le conduit<B>36A,</B> qui conditionne la vitesse de déplace ment du piston 24 en direction de la paroi supérieure<B>301,</B> reglable en fonction de la section du conduit, de la longueur de ce dernier et de la viscosité du fluide employé. présence de ce fluide qui doit être chassé de la chambre considérée afin de permettre un mouvement donné du patient, confère une composante d'amortissement satisfaisante<B>à</B> ce mouvement. Lors d'un mouvement de grande amplitude du patient, la butée supérieure<B>38</B> permet de limiter le mouvement précité, par appui de la paroi en regard du piston 24 contre cette butée<B>38.</B> Le caractère élastique de cette dernière confère une composante d'amortissement supplémentaire. En variante, on peut prévoir qu'au moins une chambre contienne un corps hydrophile, tel de l'hydrogel. Au fur et<B>à</B> mesure de la course du piston ce dernier appuie sur le corps hydrophile, de manière<B>à</B> libérer progressivement le fluide qui<B>y</B> était contenu. 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> l'inverse, lorsque le patient se penche vers l'arrière selon la flèche F'<B>,</B> le piston 24 est dirigé vers la paroi inférieure<B>30,</B> de la cuve 22, de sorte que le<B>f</B> luide est chassé de cette chambre 34A par le conduit<B>36A,</B> selon la flèche fl. <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.

La<B>f</B> igure <B>3</B> représente une variante de réalisation de l'organe amortissement 20 décrit<B>à</B> la figure 2. The <B> f </ B> igure <B> 3 </ B> represents an alternative embodiment of the damping member 20 described <B> to </ B> in Figure 2.

Dans ce mode de réalisation, il fait appel un conduit supplémentaire<B>36B</B> reliant les deux chambres 32B, 34B. De plus, chaque conduit<B>36B, 37</B> est pourvu d'un clapet anti- retour 40, 42 correspondant. De la sorte, le conduit 36B permet uniquement un transfert de fluide de la chambre supérieure 32B vers la chambre inférieure 34P, selon la flèche f, alors que le conduit<B>37</B> assure un mouvement du fluide uniquement depuis la chambre inférieure 34B vers la chambre supérieure 32B, selon la flèche fl. 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.

De manière avantageuse, les dimensions transversales du conduit de passage<B>36B,</B> assurant l'écoulement vers la chambre inférieure, sont plus grandes que celles du conduit<B>37</B> assurant le passage vers la chambre supérieure<B>32.</B> Ceci permet de conférer une composante d'amortissement plus importante dans le sens de l'extension intervertébrale. En d'autres termes, les mouvements de flexion du patient vers l'avant sont amortis dans une mesure moindre que ceux d'extension vers l'arrière. 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.

La figure 4 illustre un dispositif de stabilisation intervertébral conforme<B>à</B> un second mode de réalisation, qui forme un implant discal<B>52</B> destiné être inséré au moins partiellement entre les corps vertébraux 4, 41 des vertèbres 2, 21 de la figure<B>1.</B> 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>

Cet implant comprend une poche 54, réalisée en un matériau déformable mais substantiellement non extensible. Cette poche 54 définit deux chambres respectivement avant<B>56A</B> et arrière<B>58A,</B> qui sont reliées par un conduit<B>60A,</B> ou étranglement, mettant en communication le volume intérieur de ces deux chambres. Ce conduit<B>60</B> présente des dimensions transversales sensiblement inférieures<B>à</B> celles des chambres <B>56A, 58A.</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>

L'implant<B>52</B> comprend également un enrobage formé par deux coquilles 62. Chacune de ces dernières, qui présente une section transversale sensiblement en arc de cercle, est réalisée en un matériau rigide, tel que du titane. Ces coquilles<B>62,</B> qui sont placées de part et d'autre d'un plan médian de la poche 54, sont destinées<B>à</B> entrer en contact avec les corps vertébraux 4, 4'. Elles sont assujetties<B>à</B> la poche 54 par exemple par collage. 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.

Chaque chambre<B>56A, 58A</B> est remplie au moyen d'un fluide, analogue<B>à</B> celui contenu dans les chambres<B>32,</B> 34 précitées. Une fois l'implant<B>52</B> mis en place, lorsque le patient se penche vers l'avant selon la flèche ceci a pour effet de comprimer la chambre avant<B>56A</B> et donc de chasser le fluide qui<B>y</B> était initialement contenu, en direction de la chambre arrière<B>58A.</B> Cet écoulement de fluide, qui s'effectue par le conduit<B>60,</B> est matérialisé par la flèche<B><U>f.</U></B> 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> l'inverse, lorsque le patient se penche vers l'arrière selon la flèche FI, il se produit, selon un phénomène analogue, un écoulement de fluide selon le conduit<B>60,</B> matérialisé par la flèche<B><U>f'.</U></B> L'intensité de l'amortissement ainsi conférée lors des mouvements flexion et d'extension du patient, dépend de la section de passage et de la longueur du conduit<B>60,</B> ainsi que des caractéristiques physico- chimiques, en particulier de la viscosité, du fluide admis dans les chambres<B>56A, 58A.</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>

La figure<B>5</B> représente une variante de réalisation de l'implant<B>52</B> de la figure 4. Dans cette variante, les deux chambres<B>56B,</B> 58B sont reliées, non pas par un conduit, mais par une membrane poreuse 64, constituant une interface entre ces deux chambres. Cette membrane 64, qui peut s'étendre toute la section transversale des chambres<B>56B, 58B,</B> est par exemple réalisée en une matière textile, telle du<B>DACRON,</B> ou en un métal poreux. La présence des pores de cette membrane 64 permet de retarder, de façon analogue<B>à</B> l'emploi du conduit <B>60,</B> le transfert de fluide entre les deux chambres. La composante d'amortissement ainsi conférée dépend en particu lier de la taille et du nombre des pores de la membrane 64. 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.

La figure<B>6</B> représente une variante supplémentaire de réalisation de l'implant 52 décrit<B>à</B> la figure 4. Sur cette figure<B>,</B> les chambres<B>56C, 58C</B> sont reliées, non seulement par un premier conduit<B>65,</B> mais également par un conduit supplémentaire<B>66,</B> parallèle au conduit<B>65.</B> Chaque conduit est pourvu d'un clapet anti-retour respectif<B>68, 70.</B> De la sorte, le conduit<B>65</B> permet un transfert de fluide uniquement depuis la chambre avant<B>56C</B> vers la chambre arrière<B>58C,</B> alors que le conduit supplémentaire<B>66</B> assure un transfert de fluide uniquement dans le sens opposé. 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.

De façon avantageuse, les dimensions transversales du conduit sont supérieures<B>à</B> celles du conduit supplémentaire <B>66,</B> de sorte que le fluide est plus facilement<B>à</B> même de s'écouler en direction de la chambre arrière<B>58C,</B> ce qui correspond au mouvement de flexion vers l'avant du patient. En d'autres termes, ce mouvement de flexion vers l'avant est amorti dans une mesure moindre que le mouvement inverse d'extension vers l'arrière. 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.

Comme le montre cette figure<B>6,</B> au moins une des chambres appartenant<B>à</B> l'implant, en l'occurrence la chambre avant<B>56C,</B> contient volume de gaz<B>72,</B> qui peut être par exemple de l'air ou bien encore de l'azote. 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.

La présence de ce gaz<B>72</B> est avantageuse, dans la mesure où elle induit un effet élastique lors de la mise en compres sion de la chambre<B>56C.</B> En effet, lorsque cette dernière est comprimée, c'est tout d'abord l'air<B>72</B> qui en est chassé, de sorte que le mouvement correspondant n'est amorti que dans une très faible mesure. fois l'air chassé, c'est ensuite fluide initiale ment contenu dans la chambre qui s'écoule dans le conduit<B>65,</B> ce confère une composante d'amortissement beaucoup plus importante. De la sorte, lors de mouvements de faibles amplitudes, seul l'air s'écoule au travers conduit<B>65,</B> de sorte ces mouvements ne sont que peu amortis. Ceci n'est pas genant car, du fait de leur faible amplitude, de tels mouvements ne peuvent porter atteinte<B>à</B> l'intégrité physique du ient. En revanche, lorsque les mouvements précités ont une amplitude plus grande, du fluide s'écoule également par le conduit<B>65,</B> de sorte que ces mouvements sont amortis dans une mesure beaucoup plus importante. 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> représente une variante supplémentaire de l'implant<B>52.</B> Dans cette variante, l'implant<B>52</B> est dépourvu de poche mais possède des parois d'extrémite 74 reliant de façon etanche les coquilles 62. Ces parois 74 sont réalisées en un matériau déformable mais sensiblement non extensible. Par leurs, un tronc de cylindre<B>76,</B> formant piston, est logé dans le volume intérieur de l'implant<B>52.</B> Ce tronc de cylindre, dont l'axe principal est transversal par rapport<B>à</B> celui de l'implant<B>52,</B> forme un système poreux. Il renferme par exemple un système de labyrinthe comportant de petites cellules reliées entre elles par des pores, ce qui lui permet de capter le fluide, de manière<B>à</B> provoquer un ralentissement de l'écoulement de ce dernier. 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.

Le mouvement du piston d'arrière en avant de l'implant <B>52</B> est imité, dans deux sens opposés, par des moyens de butée <B>78.</B> Ce piston<B>76</B> définit, avec les parois 74 en regard, deux chambres avant<B>56D</B> et arrière<B>58D.</B> 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>

Lors de mouvements de flexion ou d'extension du patient, le piston<B>76</B> se déplace d'arrière en avant de l'implant<B>52,</B> ce qui induit une compression de l'une des chambres<B>56D, 58D,</B> de sorte que du fluide s'en échappe en direction de l'autre chambre par l'intermédiaire des pores du piston<B>76.</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>

La figure<B>8</B> représente une variante de réalisation de la figure<B>,</B> dans laquelle le piston<B>76,</B> est rigide et étanche. Ce piston constitue, comme dans le mode de réalisation de la figure<B>,</B> un pivot pour les deux coquilles<B>62,</B> qui peuvent pivoter<B>1 1</B> une par rapport<B>à 1 1</B> autre autour de<B>1 1</B> axe principal transversal<B>A</B> de ce pivot. La circulation de fluide entre les chambres<B>56E</B> et<B>58E,</B> qui n'est pas permise par le piston<B>761,</B> est assurée par l'intermédiaire d'au moins un canal<B>78</B> ménagé dans une des coquilles rigides<B>62.</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>

La figure<B>9</B> illustre une variante supplémentaire de l'invention. Il<B>y</B> est montré une chambre<B>56F,</B> susceptible d'être utilisée dans l'un des implants décrits en référence aux figures précédentes. Cette chambre<B>56F</B> comprend sac<B>80,</B> déformable mais non extensible, dont l'extrémité ouverte est fixée, par exemple par sertissage,<B>à</B> un couvercle rigide, qui est monté coulissant dans une cuve 84<B>à</B> fond fermé. Les parois en regard du sac<B>80</B> et de la cuve 84 sont séparées par un lubrifiant<B>86.</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>

Un conduit<B>88</B> traverse le couvercle<B>82,</B> de manière<B>à</B> mettre en communication le volume intérieur de la chambre<B>56F</B> avec l'extérieur. En fonction des conditions pression s'exerçant sur la chambre<B>56F,</B> du fluide s'en échappe ou bien <B>y</B> admis, de sorte que les bords du couvercle montent ou descendent,<B>à</B> coulissement, le long des parois latérales de cuve 84. Ce mode de réalisation est avantageux dans la mesure où il garantit une étanchéité très satisfaisante, étant donne que cette étanchéité est assurée<B>à</B> la fois par les parois déformables du sac et par les parois rigides la cuve 84. 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.

Comme le montre la figure<B>9</B> en lignes pointillees, deux chambres<B>56F</B> peuvent être reliées par les conduits<B>88,</B> de manière<B>à</B> former un organe extra-discal, du même que celui 20 des figures 2 et<B>3.</B> Ces chambres<B>56F</B> peuvent également être entourées par des coquilles, analogues a celles <B>62.</B> Dans ce cas, les conduits<B>88</B> s'étendent dans les coquilles et au moins une chambre peut être entourée par un ressort hélicoïdal. 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.

La figure<B>10</B> illustre un dispositif de stabilisation intervertébral conforme<B>à</B> un autre mode de réalisation, qui forme un implant discal 102. Ce dernier comprend deux éléments respectivement gauche 104 et droit<B>106,</B> disposés de part et d'autre de l'axe principal<B>A</B> de la chaîne vertébrale qui, lorsque patient se trouve en position debout est un axe vertical passant par le plan médian P s'étendant arrière en avant du ient. 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.

Chaque élément 104,<B>106</B> comprend deux chambres respecti vement avant<B>108,</B> 112 et arrière<B>110,</B> 114. Les deux chambres avant<B>108,</B> 112 sont mises en communication un conduit avant<B>116</B> alors que les deux chambres arrière<B>110,</B> 114 sont reliées un conduit arrière<B>118.</B> Les différentes chambres renferment un fluide analogue<B>à</B> un de ceux décrits ci-dessus, de sorte que, en fonction des conditions de pression s'exer çant ces chambres, il s'instaure une communication fluidique entre celles-ci. 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.

chambres d'un même élément sont séparées au moyen de membranes respectives 120, 122 qui peuvent être etanches, ou bien poreuses comme la membrane 64 décrite ci-dessus. De la sorte, les deux chambres<B>108, 110</B> et 112, 114 un élément considéré peuvent être éventuellement mises en communication fluidique. 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.

En variante, la chambre avant droite<B>108</B> peut être mise en communication fluidique avec la chambre arrière gauche 114, la chambre avant gauche 112 étant dans ce cas mise en communication fluidique avec la chambre arrière droite<B>110.</B> Ces relations fluidiques supplémentaires peuvent être réalisées de façon additionnelle aux relations permises par les conduits<B>116, 118.</B> 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>

La figure<B>il</B> représente un implant discal 1021 comprenant deux chambres arrière respectivement droite 124 et gauche<B>126,</B> ainsi qu'une chambre avant<B>128,</B> s'étendant sur une partie substant le de la largeur du disque. Les chambres arrière 124,<B>126</B> sont mises en communication fluidique par l'intermé diaire<B>d</B> un conduit<B>130.</B> De plus, chacune de ces chambres 124, <B>126</B> est mise en communication fluidique avec la chambre avant <B>126,</B> par l'intermédiaire de conduits respectifs<B>1</B> 134. 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.

Les implants 102, 1021, décrits ci-dessus, induisent une composante supplémentaire d'amortissement, lorsque patient se penche sur les c8tés, étant donné qu'ils font appel<B>à</B> des chambres disposées de part et d'autre de l'axe<B>A.</B> 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>

La figure 12 représente un dispositif de stabilisation intervertébral conforme<B>à</B> un mode supplémentaire de réalisa tion, qui est désigné dans son ensemble par la référence<B>150.</B> Ce dispositif comprend un implant discal<B>152,</B> destiné être inséré au moins partiellement dans l'espace intervertébral 12. Cet implant 152 comprend deux chambres respectivement avant <B>156</B> et arrière<B>158,</B> entourées par deux coquilles 162, analogues celles<B>62</B> décrites ci-dessus. 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.

Le dispositif<B>150</B> comprend également un organe dl amortis sement<B>170,</B> disposé de façon analogue<B>à</B> celui 20 décrit précédemment,<B>à</B> savoir<B>à</B> l'arrière de l'espace intervertébral 12. Cet organe<B>170</B> comprend une cuve rigide<B>172 à</B> l'intérieur de laquelle est disposé un piston 174, qui comprend une tête <B>176,</B> formant extrémité supérieure, dont les dimensions transversales sont voisines de celles de la cuve. Un joint torique d'étanchéité<B>178</B> est monté entre les parois en regard de la tête<B>176</B> et de la cuve<B>172.</B> 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>

La tête<B>176</B> du piston s'étend<B>à</B> partir d'une tige<B>180</B> verticale qui traverse, de façon étanche, la paroi inférieure <B>182</B> de la cuve<B>172,</B> avec interposition d'un joint torique 184. L'extrémité inférieure de la tige<B>180,</B> opposée<B>à</B> la tête<B>176,</B> est montée<B>à</B> rotule sur la tête<B>191</B> de la vis inférieure<B>181.</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>

La tête<B>17G</B> délimite des chambre respectivement supé rieure<B>186</B> et inférieure<B>188,</B> de la cuve<B>172.</B> La chambre supérieure<B>18G</B> reçoit un ressort<B>190,</B> travaillant en compres sion, qui s'étend verticalement entre la paroi supérieure de la cuve et la paroi en regard de la tête<B>176.</B> L'emploi de ce ressort<B>190</B> permet le rappel du piston 174 dans sa position basse, qui correspond<B>à</B> une posture lordosée du patient, physiologiquement avantageuse. 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.

La chambre avant<B>156</B> de l'implant<B>152</B> est mise en communication fluidique avec la chambre supérieure<B>18G</B> de l'organe<B>170,</B> par l'intermédiaire d'un conduit<B>192,</B> alors que la chambre arrière<B>158</B> est mise en communication fluidique avec la chambre inférieure<B>188</B> par l'intermédiaire d'un conduit supplémentaire 194. De la sorte, lorsque le patient se penche vers l'avant selon la flèche F, du fluide est chassé de la chambre avant<B>156</B> en direction de la chambre supérieure <B>18G,</B> ce qui contribue<B>à</B> faire descendre le piston 174 dans la cuve<B>172, à</B> l'opposé de la vis supérieure<B>18.</B> Cette remontée induit un déplacement de fluide, par le conduit 194, de la chambre inférieure<B>188</B> vers la chambre arrière<B>158.</B> Ce mouvement de flexion est donc amorti par ces différents écoulements de fluide. 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.

L'amplitude de cet amortissement peut être modulée en fonction des caractéristiques du fluide admis dans les différentes chambres et de la section de passage des conduits <B>192,</B> 194. On conçoit aisément que, lors d'un mouvement d'extension du patient vers l'arrière, il se produit<B>à</B> la fois des écoulements de fluide et un mouvement du piston 174, selon des sens opposés ceux précités. 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.

En variante, on peut prévoir d'adjoindre deux conduits supplémentaires, chacun des conduits<B>192,</B> 194, les quatres conduits ainsi formés étant pourvus de clapets anti-retour assurant l'écoulement du fluide dans un unique sens. on peut également prévoir que la membrane<B>196</B> séparant les chambres avant<B>156</B> et arrière<B>158</B> soit poreuse, de manière<B>à</B> permettre un écoulement de fluide entre ces deux chambres. on peut également prévoir de supprimer cette membrane<B>196,</B> de manière <B>à</B> former une unique chambre intradiscale, mise en communica tion avec la chambre inférieure 174 par le conduit<B>192,</B> l'autre conduit 194 étant alors supprimé. On peut également prévoir que la tête<B>176</B> du piston 174 soit poreux, comme celui <B>76</B> décrit ci-dessus. 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.

On peut également prévoir que les deux chambres supé rieure<B>186</B> et inférieure<B>188</B> soient mises en communication fluidique par un conduit, analogue<B>à</B> celui<B>36</B> décrit ci- dessus. Ces chambres<B>186, 188</B> peuvent être mises en communica tion par plusieurs conduits s'étendant dans la paroi de la cuve<B>172.</B> Ces conduits peuvent être disposés les uns au- dessous des autres, de sorte que la tête<B>176</B> du piston, au fur et<B>à</B> mesure de son mouvement, obture successivement les débouchés de ces conduits. En fin de mouvement, il subsiste donc, dans une chambre considérée, un volume de fluide résiduel qui ne peut être chassé et constitue un volume d'amortissement. La cuve peut comporter une double paroi définissant un logement annulaire de réserve de fluide. La cuve peut également être réalisée partiellement en un matériau poreux tel qu'une céramique. 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.

emploi d'une tige<B>180</B> de piston 174 traversant des parois de la cuve<B>172</B> est avantageux. En effet, cette tige<B>180</B> et donc le piston 174, peuvent être reliés<B>à</B> la vis<B>181</B> tout en prévoyant que cette dernière se trouve<B>à</B> l'extérieur de la cuve<B>172.</B> Ceci est intéressant en termes d'étanchéité dans la mesure où il est nécessaire de prévoir uniquement un organe d'étanchéité au voisinage de l'ouverture de la cuve, au travers de laquelle s'étend la tige précitée. 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.

Prévoir un dispositif de stabilisation intervertébral, comprenant un implant discal et un organe d'amortissement, disposé<B>à</B> l'arrière de l'espace intervertébral, est également avantageux. En effet, l'implant intervertébral permet de restaurer la hauteur du disque. De plus, étant donné que cet implant renferme un fluide, il est apte<B>à</B> conférer deux corps vertébraux voisins une certaine liberté de mouvement mutuelles. Par ailleurs, l'organe d'amortissement extra-discal permet de réguler les mouvements autorisés par l'implant discal. 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.

Comme le montre la figure<B>13,</B> le dispositif de stabilisa tion peut être disposé de façon décalée par rapport<B>à</B> l'axe principal<B>A, à</B> savoir que l'implant<B>152</B> et l'organe<B>170</B> sont disposés d'un même côté du plan P. Un tel agencement permet remédier<B>à</B> des effondrements asymétriques de l'espace intervertébral, en vue de derrière. 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.

On peut associer au dispositif de stabilisation<B>150,</B> un disposit' supplémentaire<B>150 1 ,</B> placé de<B>1 1</B> autre côté de<B>1 1</B> axe <B>A</B> et du plan P, de manière<B>à</B> former un ensemble de stabilisa tion intervertébral. Ce dispositif<B>150'</B> représenté en traits mixtes, peut être analogue<B>à</B> celui<B>150,</B> étant entendu qu'il est possible de lui conférer des dimensions différentes, en particulier en ce qui concerne la hauteur de l'implant<B>1521,</B> de façon<B>à</B> compenser un léger effondrement asymétrique du disque, en vue de derrière. 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.

L'invention n'est pas limitée aux exemples décrits et représentés. En effet, on peut prévoir de relier, par l'intermédiaire d'un dispositif de stabilisation interverté- bral conforme<B>à</B> l'invention, deux vertèbres qui ne sont pas voisines. 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.

Les moyens de mise en communication fluidique décrits ci- dessus contrâlent l'écoulement du fluide car ils induisent une limitation du débit de ce fluide, lors de son écoulement entre les chambres ainsi reliées. Ceci peut s'operer en conférant <B>à</B> ces moyens de mise en communication des dimensions transver sales réduites, ou bien encore une longueur importante. Ces moyens induisent une restriction, un ralentissement de ,écoulement du fluide et/ou une perte charge de ce dernier. Le débit de fluide entre les chambres est conservé a une valeur inférieure<B>à</B> une valeur limite, ce qui garantit que le passage du fluide d'une première chambre vers une seconde chambre n'est pas trop rapide. Un certain amortisse ment des mouvements de la colonne du patient est ainsi créé.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)

<U>REVENDICATIONS</U> Dispositif de stabilisation intervertébral (20<B>52</B> 102<B>;</B> 102'<B>; 150),</B> destiné<B>à</B> relier deux vertèbres 21), caractérisé en ce qu'il comprend<B>:</B> <B>-</B> au moins deux chambres<B>(32,</B> 34<B>; 56 108,</B> <B>110,</B> 114<B>;</B> 124, 126,<B>128 ; 156, 158, 186, 188)</B> destinées <B>à</B> être placées au voisinage desdites vertèbres, lesdites chambres renfermant un fluide, et <B>-</B> des moyens<B>(36, 37 ; 60, 66 ;</B> 64<B>; 76</B> 118 <B>130,</B> 134<B>; 192,</B> 194) de mise en communication fluidique desdites chambres avec un débit de fluide contr8lé. <B>.</B> Dispositif selon la revendication<B>1,</B> caracterisé en ce que les moyens de mise en communication comprennent au moins un conduit<B>(36, 37 ;<I>60, 65, 66 ;</I> 116, 118 ;</B> 12<B>, 126</B> <B>192,</B> 194) s'étendant entre lesdites chambres. <B>3.</B> Dispositif selon la revendication 2, caracterisé en ce qu'un premier conduit<B>(36B ; 65)</B> assure la communication entre lesdites chambres (32B, 349<B>; 56C, 58C)</B> dans un premier sens, alors qu'un second conduit<B>(37 ; G6)</B> assure cette communication dans un second sens, opposé au premier, les sections de passage desdits premier et second conduits étant différentes. 4. Dispositif selon la revendication<B>1,</B> caracterisé en ce que les moyens de mise en communication fluidique compren nent au moins une membrane poreuse (64) s'étendant entre lesdites chambres (56B,<B>58B).</B> <B>5.</B> Dispositif selon la revendication<B>1,</B> caracterisé en ce que les moyens de mise en communication fluidique compren nent au moins un organe poreux<B>(76),</B> de part et d'autre duquel s'étendent lesdites chambres<B>(56D, 58D) ,</B> cet organe étant mobile par rapport<B>à</B> ces chambres. <B>6.</B> Dispositif selon l'une quelconque des revendications précédentes, caractérisé en ce qu'il comprend en outre des moyens de déplacement (24<B>; 76 ; 761 ; 82 ;</B> 174) dudit fluide <B>à</B> l'intérieur de chaque chambre. <B>7.</B> Dispositif selon la revendication<B>6,</B> caractérisé en ce que les moyens de déplacement comprennent au moins un piston (24<B>; 76 76, ; 82</B> 174) mobile par rapport ladite chambre<B>(32,</B> 34<B>56D, 58D 56E, 58E ; 172,</B> 174). <B>8.</B> Dispositif selon la revendication<B>6,</B> caractérisé en ce que les moyens de déplacement comprennent une paroi déformable de ladite chambre<B>(56A, 58A ; 56B, 58B ; 56C, 58C</B> <B>56F ; 156, 158).</B> <B>9.</B> Dispositif selon l'une quelconque des revendications précédentes, caractérisé en ce que lesdites au moins deux chambres<B>(56, 58 ; 108, 110,</B> 112, 114<B>;</B> 124,<B>126)</B> appartien nent<B>à</B> un implant intradiscal <B>(52 ;</B> 102<B>;</B> 102'). <B>10.</B> Dispositif selon la revendication<B>9,</B> caractérisé en ce qu'au moins des première<B>(108, 110 ;</B> 124) et seconde (112, 114<B>; 126)</B> chambres sont disposées de part et d'autre de l'axe principal<B>(A)</B> de la chaîne vertébrale et en ce qu'il est prévu des moyens<B>(116, 118 ; 130)</B> de mise en communication fluidique desdites première et seconde chambres. <B>11.</B> Dispositif selon l'une quelconque des revendications <B>1 à 8,</B> caractérisé en ce que lesdites chambres<B>(32,</B> 34) appartiennent<B>à</B> un organe d'amortissement (20) extradiscal. 12. Dispositif selon l'une quelconque des revendications <B>1 8,</B> caractérisé en ce qu'il comprend au moins une chambre <B>(156, 158)</B> appartenant<B>à</B> un implant intradiscal <B>(152)</B> et au moins une autre chambre<B>(186, 188)</B> appartenant<B>à</B> un organe d'amortissement<B>(170)</B> extradiscal. <B>13.</B> Dispositif selon l'une quelconque des revendications précédentes, caractérisé en ce que ledit fluide d'amortisse ment comprend un gaz<B>(72),</B> notamment de l'air ou de l'azote. 14. Dispositif selon l'une quelconque des revendications précédentes, caractérisé en ce qu'au moins une chambre<B>(186)</B> est pourvue d'un ressort<B>(190)</B> travaillant en compression. <B>15.</B> Ensemble de stabilisation intervertébral comprenant au moins deux dispositifs de stabilisation intervertébraux <B>(150, 1501)</B> conformes<B>à</B> l'une quelconque des revendications précédentes, au moins des premier<B>(150)</B> et second<B>(1501)</B> dispositifs étant disposés de part et d'autre de l'axe principal<B>(A)</B> de la chaîne vertébrale.<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 1999-12-01 1999-12-29 DEVICE AND INTERVERTEBRAL STABILIZATION ASSEMBLY Pending FR2803188A1 (en)

Priority Applications (17)

Application Number Priority Date Filing Date Title
FR9916662A FR2803188A1 (en) 1999-12-29 1999-12-29 DEVICE AND INTERVERTEBRAL STABILIZATION ASSEMBLY
PCT/FR2000/003368 WO2001039678A1 (en) 1999-12-01 2000-12-01 Intervertebral stabilising device
US10/148,693 US7291150B2 (en) 1999-12-01 2000-12-01 Intervertebral stabilising device
EP00985390A EP1233711B1 (en) 1999-12-01 2000-12-01 Intervertebral stabilising device
DE60030313T DE60030313T2 (en) 1999-12-01 2000-12-01 DEVICE FOR INTERMEDIATE STABILIZATION
ES00985390T ES2270888T3 (en) 1999-12-01 2000-12-01 INTERVERTEBRAL STABILIZATION DEVICE.
AU21824/01A AU778410B2 (en) 1999-12-01 2000-12-01 Intervertebral stabilising device
JP2001541414A JP4294901B2 (en) 1999-12-01 2000-12-01 Intervertebral stabilizer
CA002392868A CA2392868C (en) 1999-12-01 2000-12-01 Intervertebral stabilising device
AT00985390T ATE336952T1 (en) 1999-12-01 2000-12-01 DEVICE FOR INTERVERBEL STABILIZATION
JP2001549561A JP2003518978A (en) 1999-12-29 2000-12-28 Intervertebral stabilization device and assembly
PCT/FR2000/003727 WO2001049192A1 (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
EP00990839A EP1241995A1 (en) 1999-12-29 2000-12-28 Device and assembly for intervertebral stabilisation
CA002395602A CA2395602C (en) 1999-12-29 2000-12-28 Device and assembly for intervertebral stabilisation
US11/982,761 US8172880B2 (en) 1999-12-01 2007-11-05 Intervertebral stabilising device

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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
US7713288B2 (en) 2005-08-03 2010-05-11 Applied Spine Technologies, Inc. Spring junction and assembly methods for spinal device
US7713287B2 (en) 2003-05-02 2010-05-11 Applied Spine Technologies, Inc. Dynamic spine stabilizer
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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US6579319B2 (en) 2000-11-29 2003-06-17 Medicinelodge, Inc. Facet joint replacement
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US8353933B2 (en) 2007-04-17 2013-01-15 Gmedelaware 2 Llc Facet joint replacement
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US7722647B1 (en) 2005-03-14 2010-05-25 Facet Solutions, Inc. Apparatus and method for posterior vertebral stabilization
AU2008204784A1 (en) 2007-01-10 2008-07-17 Facet Solutions, Inc. Taper-locking fixation system
US10821003B2 (en) 2007-06-20 2020-11-03 3Spline Sezc Spinal osteotomy
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US8333790B2 (en) 2003-05-02 2012-12-18 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
US9655651B2 (en) 2003-05-02 2017-05-23 Yale University Dynamic spine stabilizer
US9034016B2 (en) 2003-05-02 2015-05-19 Yale University Dynamic spine stabilizer
US7713287B2 (en) 2003-05-02 2010-05-11 Applied Spine Technologies, Inc. Dynamic spine stabilizer
US7029475B2 (en) 2003-05-02 2006-04-18 Yale University Spinal stabilization method
US8652175B2 (en) 2003-05-02 2014-02-18 Rachiotek, Llc Surgical implant devices and systems including a sheath member
US7988707B2 (en) 2003-05-02 2011-08-02 Yale University Dynamic spine stabilizer
US9005252B2 (en) 2004-06-23 2015-04-14 Yale University Method for stabilizing a spine
US8500781B2 (en) 2004-06-23 2013-08-06 Yale University Method for stabilizing a spine
US7931675B2 (en) 2004-06-23 2011-04-26 Yale University Dynamic stabilization device including overhanging stabilizing member
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
WO2018078647A1 (en) 2016-10-24 2018-05-03 Indius Medical Technologies Pvt. Ltd. Self-actuating growing rod systems
EP3528725A4 (en) * 2016-10-24 2020-06-24 Indius Medical Technologies Pvt. Ltd. Self-actuating growing rod systems

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

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