FR2805457A1 - Intervertebral implant body and a support surface - Google Patents

Intervertebral implant body and a support surface Download PDF

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Publication number
FR2805457A1
FR2805457A1 FR0002320A FR0002320A FR2805457A1 FR 2805457 A1 FR2805457 A1 FR 2805457A1 FR 0002320 A FR0002320 A FR 0002320A FR 0002320 A FR0002320 A FR 0002320A FR 2805457 A1 FR2805457 A1 FR 2805457A1
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FR
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Application
Patent type
Prior art keywords
characterized
implant according
body
block
comprises
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
FR0002320A
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French (fr)
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FR2805457B1 (en )
Inventor
Frederic Hansen
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.)
Stryker Spine SAS
Original Assignee
Stryker Spine SAS
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Filing date
Publication date

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    • 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
    • A61F2/30Joints
    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/442Intervertebral or spinal discs, e.g. resilient
    • AHUMAN NECESSITIES
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    • 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
    • A61F2/30Joints
    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/4455Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
    • A61F2/447Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section
    • AHUMAN NECESSITIES
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    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • 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
    • A61B17/7059Cortical plates
    • AHUMAN NECESSITIES
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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
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Threaded wires, pins or screws; Nuts therefor
    • A61B17/8625Shanks, i.e. parts contacting bone tissue
    • A61B17/8635Tips of screws
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    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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    • A61F2002/30317The prosthesis having different structural features at different locations within the same prosthesis
    • A61F2002/30324The prosthesis having different structural features at different locations within the same prosthesis differing in thickness
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    • A61F2/02Prostheses implantable into the body
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    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30563Special structural features of bone or joint prostheses not otherwise provided for having elastic means or damping means, different from springs, e.g. including an elastomeric core or shock absorbers
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    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
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    • A61F2250/0036Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in thickness

Abstract

The invention concerns an intervertebral implant comprising a rigid body having two support surfaces on the end-plates of two adjacent and elastically deformable vertebrae, enabling to bring the two support surfaces closer together, and a cavity for receiving a block of material.

Description

La présente invention concerne les systèmes de liaisons vertébrales. The present invention relates vertebral link systems.

Lors de pathologies discales, une thérapie souvent utilisée consiste essentiellement à effectuer une ostéosynthèse par l'utilisation de cages rigides comportant une cavité ouverte vers les vertèbres supérieure et inférieure, apte à recevoir du greffon osseux ou toute autre substance favorisant la repousse osseuse. When disc pathology, a frequently used therapy consists essentially in performing a fixation with the use of rigid cage having a cavity open towards the upper and lower vertebrae, adapted to receive bone graft or other substances promoting bone regrowth. D'autre part, il est reconnu la repousse osseuse permettant d'obtenir la fusion recherchée est stimulée et accélérée proportionnellement aux contraintes subites par le greffon. On the other hand, it is recognized bone regrowth to obtain the desired fusion is stimulated and accelerated in proportion to the constraints by the sudden graft. Cependant au delà d'une certaine limite, les contraintes deviennent trop importantes et provoquent de ce fait effet inverse sur la qualité de la repousse osseuse, voire la nécrose des tissus osseux. But beyond a certain limit, the stresses become too great and cause thereby opposite effect on the quality of bone growth or necrosis of bone tissue. Les cages actuellement existantes absorbent la quasi totalité des contraintes sans déformation du fait de leur rigidité importante. The currently existing cages absorb almost all the constraints without distortion due to their rigidity. Ainsi, le greffon n'est quasiment pas stimulé, ce qui ne permet pas d'avoir les meilleurs conditions pour l'obtention d'une fusion. Thus, the graft is hardly stimulated, which does not have the best conditions for obtaining merger. Tel est le cas de l'implant décrit dans le document W097/37620. Such is the case of the implant described in W097 / 37620. Ce document décrit une cage-plaque présentant un corps ouvert rigide de forme globalement parallélipipédique ou ovoïde destinée à recevoir du greffon grâce à des faces supérieure et inférieure ouvertes. This document discloses a cage plate having a rigid open body of generally parallelepiped or ovoid shape for receiving the graft through top and bottom sides open. Les matériaux utilisés pour la fabrication de tels implants ne permettent pas l'optimisation de la fusion. The materials used for the manufacture of such implants do not allow optimization of the merger.

D'autre part, ce type de cage implantable ne laisse pas au chirurgien la possibilité de choisir la restauration d'une certaine mobilité entre les deux vertèbres instrumentées, en lieu et place de la fusion. On the other hand, this type of implantable cage does not allow the surgeon the ability to choose to restore a certain mobility between the two instrumented vertebrae, instead of melting. En effet, dans certains cas, il est plus judicieux de restaurer mobilité à l'étage vertébral pathologique que d'en effectuer l'arthrodèse. Indeed, in some cases it is better to restore mobility to pathological vertebral level than to perform arthrodesis. C'est le cas pour des patients jeunes et/ou aillant des corps vertébraux en excellent etat, où la réintervention ultérieure est certaine les étages adjacents -à l'étage instrumenté, si on effectue une fusion. This is the case of young patients and / or aillant vertebral bodies in excellent condition, where the subsequent reoperation is certain the adjacent stages -with the instrumented floor, if one carries out a fusion.

Un but de la présente invention est de fournir un implant assurant une fusion osseuse optimisée et de permettre le choix entre cette fusion et une restauration de la mobilité. An object of the present invention is to provide an implant providing optimized bone fusion and to allow the choice between this melting and restoration of mobility.

En vue de la réalisation de ce but, on prévoit selon la presente invention un implant intervertébral comprenant corps rigide présentant deux faces d'appui sur les plateaux de deux vertèbres adjacentes et déformable élastiquement avant réception du bloc, en permettant de rapprocher les deux faces d'appui l'une de l'autre, et une cavité de réception d'un bloc de matériau. In order to achieve this object there is provided according to the present invention an intervertebral implant comprising rigid body having two bearing faces of the plates of two adjacent vertebrae and deformable elastically before reception of the block, allowing to bring the two sides of support from each other, and a cavity for receiving a block of material.

Ainsi, dans le cas d'une fusion, la déformabilité du corps permet une meilleure fusion car les contraintes seront mieux réparties entre la structure et le greffon. Thus, in the case of a merger, the deformability of the body allows for better fusion constraints will be more evenly distributed between the structure and the graft. Dans le cas d'une restauration de mobilité, déformabilité du corps permet à l'implant de l'assurer. In the case of restoring mobility, deformability of the body allows the implant to provide.

Avantageusement, le corps est d'une seule pièce. Advantageously, the body is one piece. Avantageusement, le corps comporte une lame pliée formant faces d'appui. Advantageously, the body comprises a folded strip forming the bearing faces.

Avantageusement, la lame présente une épaisseur non uniforme le long de la lame. Advantageously, the blade has a non-uniform thickness along the blade. Ainsi, la déformation du corps est optimisée pour emploi de l'implant et pour la déformation recherchée. Thus, the deformation of the body is optimized for use of the implant and for the desired deformation.

Avantageusement, la lame définit moins en partie la cavité. Advantageously, the blade defines at least in part the cavity.

Avantageusement, le corps présente une zone de 'onction des faces d'appui. Advantageously, the body has a region of unction of the bearing faces.

Avantageusement, la zone de jonction et les faces d'appui donnent au corps un profil en U . Advantageously, the junction area and the support surfaces give the body a U-profile. Avantageusement, au moins une des faces d'appui comporte un profil adapté et complémentaire au profil du plateau vertébral avec lequel elle destinée à entrer en contact. Advantageously, at least one of the bearing surfaces comprises a suitable profile and the complementary profile of the vertebral plate with which it is intended to come into contact.

Avantageusement, le corps comporte moyens d'ancrage à une face des vertèbres contiguë plateau vertébral. Advantageously, the body comprises anchoring means to one face of the contiguous vertebrae endplate.

Avantageusement, le corps comporte moins deux pattes d'ancrage aux vertèbres respectives, chaque patte s'étendant en continuité de matière avec une seule des faces d'appui. Advantageously, the body comprises two legs anchor the respective vertebrae, each lug extending in continuity of material with one of the bearing faces.

Avantageusement, chaque patte étend en continuité de matière avec la face d'appui destinée à etre en appui sur le plateau de la vertèbre associé à cette patte. Advantageously, each tab extends in continuity of material with the bearing face intended to be supported on the plate of the vertebra associated with this foot.

Avantageusement, chaque patte étend en continuité de matière avec la face d'appui destinée à etre en appui sur le plateau vertébral associé à l'autre patte. Advantageously, each tab extends in continuity of material with the bearing face intended to be supported on the vertebral endplate associated with the other leg.

Avantageusement, chaque patte fixation comporte au moins un orifice destiné à recevoir une vis osseuse. Advantageously, each attachment tab comprises at least one hole for receiving a bone screw. Avantageusement, le corps comprend un bloc en materiau non rigide. Advantageously, the body comprises a block of non-rigid material.

Avantageusement, le bloc comporte du greffon osseux et/ou toute substance favorisant la repousse osseuse. Advantageously, the block includes bone graft and / or bone growth promoting substance.

Ainsi l'implant peut réaliser une fusion. Thus the implant can achieve fusion. Avantageusement, le bloc comporte du ou des polymères biocompatibles et/ou tout autre matériau viscoélastique biocompatible. Advantageously, the block comprises the or biocompatible polymers and / or any other biocompatible viscoelastic material.

Ainsi, l'implant fait office de prothèse de disque permettant la restauration de la mobilité. Thus, the implant is disc prosthesis office to restore mobility.

On prévoit d'autre part une méthode d'implantation de l'implant comprenant un abord de la colonne vertébrale selon une voie antérieure, une discectomie, un avivement des plateaux inferieur et superieur de l'espace discal, une vérification des dimensions de l'espace discal, le choix du type de bloc suivant que l'on désire une fusion ou une restauration de mobilité, une insertion de l'implant dans l'espace discal préparé, l'ancrage de l'implant sur corps vertébraux, la fermeture de la voie d'abord. Is provided on the other hand a method for implantation of the implant comprising a first of the spine according to an anterior approach, a discectomy, a freshening of the lower and upper plates of the disc space, a dimensional checking the disc space, the selection of the next block type that is desired fusion or restore mobility, insertion of the implant into the prepared disc space, the anchoring of the implant to the vertebral bodies, the closing the way first.

D'autres caractéristiques et avantages de l'invention apparaîtront encore lors de la description qui suit d'un mode préféré de réalisation d'une variante donnés à titre d'exemples non limitatifs. Other features and advantages of the invention will appear during the following description of a preferred embodiment of a variant given by way of nonlimiting examples. Aux dessins annexés la figure la est une vue en perspective de l'implant selon l'invention selon un premier mode de réalisation; In the accompanying drawings Figure la is a perspective view of the implant of the invention according to a first embodiment; - figure lb est une vue de dessus de l'implant selon le premier mode de réalisation ; - Figure Ib is a top view of the implant according to the first embodiment; - figure 2 est une vue en perspective d'une des vis à de la figure 1 ; - Figure 2 is a perspective view of a screw of Figure 1; - la figure 3 est une vue en perspective d'un bloc selon le premier mode de réalisation ; - Figure 3 is a perspective view of a block according to the first embodiment; - la figure 4 est une vue en perspective corps selon premier mode de réalisation ; - Figure 4 is a perspective view body according to the first embodiment; la figure 5 est une vue de coté du corps selon le premier mode de réalisation ; Figure 5 is a side view of the body according to the first embodiment; - la figure 6 est une vue en perspective corps selon second mode de réalisation ; - Figure 6 is a perspective view body according to the second embodiment; la figure 7 est une vue de coté du corps selon le second mode de réalisation ; Figure 7 is a side view of the body according to the second embodiment; - la figure 8 est une vue de coté dans un plan sagittal d'une vertèbre cervicale. - Figure 8 is a side view in a sagittal plane of a cervical vertebra.

En référence aux figures la à 5, l'implant 1 comprend un corps 2 déformable élastiquement, un bloc 3 inclus au sein du corps 2 et des vis à os 4 de fixation. Referring to FIGS 5, the implant 1 comprises a body 2 elastically deformable, 3 included in the block body 2 and bone screws 4 fixing.

Le corps 2 est formé d'une lame décrivant un chemin ressemblant à un a . The body 2 is formed of a blade describing a path resembling a a. La boucle du a, comprend une face d'appui inférieure 10, un mur postérieur 11 reliant la face 10 à une face d'appui supérieure 12, l'ensemble décrivant une forme en U . The loop has, comprises a lower bearing face 10, a rear wall 11 connecting the surface 10 to an upper bearing face 12, all describing a U-shape. Les faces d'appui 10,12 sont opposées l'une à l'autre et s'étendent généralement dans deux plan parallèles entre eux. 10,12 the bearing faces are opposite one another and extend generally in two parallel plane between them. Cette boucle est de forme généralement parallélipipédique pour remplir au maximum l'espace discal. This loop is of generally parallelepipedal shape to fill to the maximum the disc space. Cette boucle délimite une cavité 20 qui est apte à recevoir le bloc 3. Ce bloc 3 pourra être constitué soit de greffon osseux ou de toute autre substance qui favorise la repousse osseuse comme les substituts osseux, soit d'un polymère biocompatible ou de tout autre matériau viscoélastique biocompatible. This loop defines a cavity 20 which is adapted to receive the block 3. The block 3 may be constituted either bone graft or other substance which promotes bone growth such as bone substitutes, or a biocompatible polymer or any other biocompatible viscoelastic material. Dans le premier cas, l'implant 1 sera utilisé dans le but obtenir une fusion entre les deux vertèbres instrumentées. In the first case, the implant 1 will be used in order to obtain a fusion between the two instrumented vertebrae. La déformabilité élastique de la lame en permet d'obtenir une répartition des contraintes entre le corps 2 et le bloc 3 constitué de greffon osseux Ainsi les contraintes supportées par le greffon permettent à ce dernier de produire un os de meilleure qualite pour la fusion. The elastic deformability of the blade makes it possible to obtain a distribution of stresses between the body 2 and 3 consisting of bone graft block Thus the stresses to which the graft enable the latter to produce a better quality bone fusion. Dans le second cas, l'implant 1 sera utilisé dans le but de restaurer la mobilité entre les deux vertèbres instrumentées. In the second case, the implant 1 will be used in order to restore mobility between the two instrumented vertebrae. La déformabilité élastique de la lame en a associée à la viscoélasticité du bloc 3 permet de reproduire les réactions mécaniques du disque vertébral naturel sain remplacé par l'implant 1. The elastic deformability of the blade is associated with the viscoelasticity of the box 3 allows to reproduce the mechanical responses of healthy natural intervertebral disc replaced by the implant 1.

Les branches du profil en a du corps 2 comprennent deux pattes 13 prolongeant la face d'appui inférieure 10 à angle droit avec celui-ci et permettant la fixation de l'implant 1 sur le corps de la vertèbre supérieure, et une patte 14 prolongeant la face d'appui supérieure 12 à angle droit avec celui-ci et permettant la fixation de implant sur le corps de la vertèbre inférieure. The branches of the profile has the body 2 comprises two tabs 13 extending the lower supporting face 10 at right angles therewith and permitting the fixing of the implant 1 on the body of the upper vertebra, and a tab 14 extending the top bearing face 12 at right angles therewith and for fixing on the implant body of the lower vertebra. En de dessus, comme représenté sur la figure lb, les pattes 13,14 sont inclinées l'une par rapport à l'autre pour être orientées de manière à suivre la courbure du mur antérieur des corps vertébraux auxquels elles sont fixées. In from above, as shown in Figure lb, the legs 13,14 are inclined relative to each other to be oriented so as to follow the curvature of the anterior wall of the vertebral bodies to which they are fixed. Chacune des pattes 13,14 comportent au moins un orifice 15 qui est apte à recevoir une vis à os 4 avec une tête 5 pour la fixation dans le corps vertébral. Each of the legs 13,14 comprise at least one orifice 15 that is adapted to receive a bone screw 4 with a head 5 for fixation in the vertebral body. L'orifice 15, de section généralement circulaire de préférence, comporte une surface 18 apte à recevoir la tête 5 de la vis à os 4. La surface 18 est sensiblement complémentaire de la surface 7 de la tête 5 de la vis à os 4 contiguë à la tige filetée. The orifice 15 of generally circular cross-section preferably has a surface 18 adapted to receive the head 5 of the bone screw 4. The surface 18 is substantially complementary to the surface 7 of the head 5 of the bone screw 4 contiguous to the threaded rod. D'autre part, chacune des vis à os 4 comprend des moyens de mise en oeuvre 8 sous la forme d'une empreinte en creux de section hexagonale, un filetage à os 6 et une entaille 9 située à l'extrémite opposée de la tête 5, selon l'axe de la vis qui permet l'autotaraudage de la vis dans le corps vertébral. On the other hand, each of the bone screw 4 includes implementation means 8 in the form of a hollow cavity of hexagonal cross-section, a bone thread 6 and a notch 9 located at the end opposite of the head 5, along the axis of the screw which allows the self-tapping screw in the vertebral body.

Les parties de la lame faisant office de faces d'appui inférieure 10 et supérieure 12 sont conformées pour épouser au maximum la forme des plateaux vertébraux avec lesquels elles sont en contact. The parts of the blade serving as supporting surfaces 10 and less than 12 are shaped to conform to the maximum shape of the vertebral endplates with which they are in contact. Ainsi l'implant est mieux stabilisé dans l'espace discal Dans le mode de réalisation présenté dans les figures la à 5, les faces d'appui 10,12 sont conformées pour s'adapter aux plateaux vertébraux d'une vertèbre cervicale 40 présentée figure 8. La vertèbre cervicale 40 comporte un corps vertébral 41 présentant un plateau supérieur avec une face 43 et un plateau inférieur avec une face 42. En coupe suivant le plan sagittal médian à la figure 8, le plateau supérieur 43 de la vertèbre à un profil sensiblement rectiligne horizontal alors que le plateau inférieur 42 a un profil concave en aile d'avion complémentaire de celui convexe du plateau supérieur 12 du corps 2 comme il est décrit ci-après. Thus the implant is better stabilized in the disc space In the embodiment shown in the Figures 5, 10,12 the bearing surfaces are shaped to fit to the endplates of a cervical vertebra 40 shown FIG 8. the cervical vertebra 40 includes a vertebral body 41 having an upper plate with a face 43 and a lower plate with a face 42. in section along the median sagittal plane in FIG 8, the upper plate 43 of the vertebra to a profile substantially straight horizontal while the lower plate 42 has a concave profile complementary to the convex airfoil of the upper plate 12 of the body 2 as described below. La face d'appui inférieure 10 du corps 2 est apte à venir en contact avec le plateau 43 de la vertèbre 40. De ce fait, la face d'appui inférieure 10 a un profil sensiblement rectiligne horizontal dans le plan sagittal. The lower supporting face 10 of the body 2 is adapted to come into contact with the plate 43 of the vertebra 40. As a result, the lower supporting face 10 has a substantially straight horizontal profile in the sagittal plane. La face d'appui supérieure 12 du corps 2 est apte à venir en contact avec la plateau 42 de la vertèbre 40. De ce fait, la face d'appui supérieure 12 présente un profil constitué de deux tronçons de forme générale rectiligne 16,17 inclinés l'un par rapport à l'autre pour donner à ce profil une forme convexe. The upper bearing face 12 of the body 2 is adapted to come into contact with the plate 42 of the vertebra 40. Thus, the upper bearing face 12 has a profile consisting of two sections of generally straight 16.17 inclined with respect to one another to give the profile a convex shape. Le tronçon arrière 16 est plus long des deux tronçons. The rear section 16 is the longer of the two sections. Il s'étend, dans le plan sagittal, sur environ<B>80%</B> de la longueur du corps 2 Le tronçon 16 est légèrement incliné vers l'arrière du corps 2. Il est donc légèrement incliné rapport à la face d'appui inférieure 10. Le tronçon 17 est incliné vers l'avant du corps plus fortement que l'inclinaison du tronçon arrière 16 vers l'arrière. It extends in the sagittal plane, of about <B> 80% </ B> of the length of the body 2 The portion 16 is slightly inclined towards the rear of the body 2. Therefore, it is slightly inclined relative to the face lower support 10. the section 17 is inclined towards the front of the body more strongly than the inclination of the rear section 16 towards the rear. Sa longueur est environ égale au quart de celle tronçon arrière 16. Les deux tronçons 16,17 donnent la face d'appui supérieure 12 un profil proche de celui d'une aile d'avion. Has a length approximately equal to the quarter of the rear section 16. The two sections 16,17 give the upper bearing face 12 a profile close to that of an airplane wing.

Les faces d'appui 10,12 comportent au moins un orifice 30 traversant l'épaisseur de la lame, de section préférentiellement circulaire. The bearing faces 10,12 include at least one orifice 30 passing through the thickness of the blade, preferably of circular section. Cet orifice 30 met en communication la cavité interne 20 à la structure 2 avec la face d'appui 12 ou la face d'appui 10. Dans le cas du choix d'une fusion, cet orifice 30 permet la progression la fusion vers les plateaux 42,43 des vertèbres adjacentes. This port 30 communicates the inner cavity 20 to the structure 2 with the bearing surface 12 or the bearing face 10. In the case of selection of a merger, this orifice 30 allows the progression merging to the plates 42,43 of the adjacent vertebrae. Dans le cas du choix d'une restauration de mobilité, cet orifice 30 permet un renforcement de l'ancrage, car il y a repousse osseuse au sein de l'orifice 30 qui le recomblera sur l'épaisseur de la lame Préférentiellement, les faces d'appui 10,12 comportent une multitude d'orifices 30 de section circulaire et 'formément répartis sur faces d'appui 10, 12. In the case of choosing a restoration of mobility, this hole 30 allows a strengthening of the anchor because there bone regrowth in the hole 30 which recomblera on the blade thickness Preferably, the faces 10,12 of support comprise a multitude of holes 30 of circular cross-section and 'accordance distributed over the bearing faces 10, 12.

La déformation du corps 2 est maîtrisée par les variations de l'épaisseur de la lame le long du profil que décrit la face d'appui 12, le mur postérieur 11 et la face d'appui 10. Ainsi, la répartition de contraintes entre le corps 2 et le bloc 3 est optimisée. The deformation of the body 2 is controlled by the variations in the thickness of the blade along the profile described by the bearing face 12, the rear wall 11 and the bearing face 10. Thus, the distribution of stresses between the body 2 and the block 3 is optimized.

La cavité 20 apte à recevoir le bloc 3. Le choix de la composition du bloc 3 dépend de la volonté du chirurgien d'obtenir soit une fusion entre les deux vertèbres dans le cadre d'une arthrodèse, soit de restaurer une mobilite entre les deux vertèbres. The cavity 20 adapted to receive the block 3. The choice of the block composition 3 depends on the desire of the surgeon to obtain either a fusion between the two vertebrae as part of a fusion, either to restore mobility between the two vertebrae. Dans le premier cas, le bloc 3 sera constitué de greffon osseux et/ou de toute autre substance favorisant la repousse osseuse. In the first case, the block 3 will consist of bone graft and / or any other substance that promotes bone growth. Dans le deuxième cas, le bloc 3 sera constitué d'un ou de plusieurs polymères biocompatibles ou de tout autre matériau viscoélastique biocompatible. In the second case, the block 3 is composed of one or more biocompatible polymers, or other biocompatible viscoelastic material. Le bloc 3 présente surface externe complémentaire de celle de la cavité pour une parfaite adéquation avec la forme de la cavité 20 qui est délimité par le profil de la lame du corps 2 : la surface 10a est complémentaire de la face d'appui inférieure 10 du corps 2. La surface 12a est complémentaire de la face d'appui supérieure 12 du corps 2 et est constitué de deux tronçons 16a,17a complémentaires des tronçons <B>16,17</B> de la face d'appui 12. De même, la surface 11a est complémentaire la face interne du mur postérieur 11 du corps 2. The block 3 has complementary external surface of that of the cavity for a perfect match with the shape of the cavity 20 which is delimited by the blade profile of the body 2: the surface 10a is complementary to the lower supporting face 10 of the 2. the body surface 12a is complementary to the upper bearing face 12 of the body 2 and consists of two sections 16a, complementary sections 17a <B> 16,17 </ B> of the supporting face 12. from Similarly, the surface 11a is complementary to the inner face of the posterior wall 11 of the body 2.

La mise en place de l'implant 1 dans le corps du patient s'effectue au travers d'une voie d'abord antérieure qui permet d'accéder directement aux corps vertébraux, et sur leur face antérieure. The establishment of the implant 1 in the patient's body is done through an anterior approach, which provides direct access to the vertebral bodies, and on their front face. Le praticien y effectue une discectomie du disque intervertébral endommagé puis avive les plateaux inférieur de la vertèbre supérieure, et supérieur de la vertèbre inférieure délimitant l'espace discal. The practitioner will perform a discectomy of the damaged intervertebral disc and brightens the lower plates of the upper vertebrae and superior of the lower vertebra bounding the disc space. Après avoir vérifié la taille de cet espace discal ainsi dégagé, praticien prépare l'implant 1 à l'implantation : si le praticien décide de réaliser une fusion, il introduit dans la cavité 20 un bloc 3 de greffon et/ou de toute autre substance favorisant la repousse osseuse ; After checking the size of the disc space thus released, the practitioner prepares the implant 1 for implantation: if the physician decides to perform a merge, it introduced into the cavity 20 a block 3 of the graft and / or any other substance promoting bone growth; si le praticien décide de restaurer la mobilite, il introduit dans la cavité 20 un bloc 3 constitué de polymère (s) biocompatible(s) ou de tout autre matériau viscoélastique biocompatible. if the practitioner decides to restore mobility, it introduces into the cavity 20 a block 3 made of polymer (s) biocompatible (s) or any other biocompatible viscoelastic material. Une fois préparé, le praticien met en place l'implant 1 qu'il fixe avec les vis à os 4 aux corps vertébraux, au travers orifices 15 des pattes de fixation 13,14. Once prepared, the practitioner establishes that the implant 1 fixed with the bone screw 4 to the vertebral bodies, through orifices 15 13,14 fixing lugs. Il referme ensuite la voie d'abord. He then closed the surgical approach.

Dans second mode de réalisation illustré par les figures 6 et 7, le corps 102 de l'implant est toujours formé d'une lame qui décrit un chemin ressemblant a un U . In the second embodiment illustrated in FIGS 6 and 7, the body 102 of the implant is always formed of a plate which describes a path resembling a U. Il comporte toujours une face d'appui inférieure 110 similaire à la face d'appui 10 précédente, un mur postérieur 111 similaire au mur 11 précédent, une face d'appui supérieure 112 similaire à la face appui supérieure 12 précédente. It always has a lower support surface 110 similar to the previous support surface 10, a posterior wall 111 similar to the previous wall 11, an upper support surface 112 similar to the top bearing face 12 previous. La fixation à la vertèbre sus-jacente s'effectue par une patte de fixation 113 prolongeant la face d'appui supérieure 112. La fixation à la vertèbre sous-jacente s'effectue par deux pattes de fixation 114 prolongeant la face d'appui inférieure 110. Les moyens d'ancrages sont identiques que ceux du mode de réalisation précédent. The attachment to the vertebra is via a bracket 113 extending the upper support surface 112. The attachment to the underlying vertebra is carried out by two mounting lugs 114 extending the lower supporting face 110. the means of anchors are the same as those of the previous embodiment. La lame a ici une forme en U et non plus une forme en a sorte que les deux branches su U ne se croisent , comme dans le mode précédent. The blade has here a U-shape rather than a shape in a way that the two branches U su not intersect, as in the previous mode. La lame en U du corps 112 délimite un cavité 20 identique apte à recevoir le bloc 3. La mise en place de ce second mode réalisation ne diffère pas de mise en place du premier mode de réalisation. The blade U the body 112 defines a cavity 20 adapted to receive identical block 3. The establishment of this second embodiment does not differ from implementation of the first embodiment.

lame peut être remplacée un ressort hélicoïdal apte à recevoir un bloc de biomatériaux en son âme. blade may be replaced a coil spring adapted to receive a block of biomaterials in its core.

vis osseuses peuvent comporter un mécanisme de blocage vis-à-vis des pattes de fixation pour éviter leur recul. bone screws may have vis-à-vis fixing lugs locking mechanism to prevent their decline.

vis osseuses peuvent être polyaxiales vis-à- vis pattes de fixation. polyaxial bone screws can be screw-vis fixing lugs.

Claims (16)

    <U>Revendications</U> <U> Claims </ U>
  1. 1. Implant intervertébral comprenant un corps rigide (2 ;102) présentant deux faces d'appui sur les plateaux de deux vertèbres adjacentes une cavité (20) de réception d'un bloc (3) de matériau, caractérisé en ce que le corps déformable élastiquement avant réception du bloc, permettant de rapprocher les deux faces d'appui l'une de l'autre. 1. An intervertebral implant comprising a rigid body (2; 102) having two bearing faces on the plates of two vertebrae adjacent a cavity (20) for receiving a block (3) of material, characterized in that the deformable body elastically before reception of the block, to bring the two support surfaces to one another.
  2. 2. Implant selon la revendication 1 caractérisé en ce que le corps est d'une seule pièce. 2. Implant according to claim 1 characterized in that the body is in one piece.
  3. 3. Implant selon la revendication 1 ou 2 caractérisé en ce que le corps comporte une lame pliée formant les faces d'appui. 3. Implant according to claim 1 or 2 characterized in that the body comprises a folded strip forming the bearing faces.
  4. 4. Implant selon la revendication caractérisé en ce que la lame présente une épaisseur non uniforme le long de la lame. 4. Implant according to claim characterized in that the blade has a non-uniform thickness along the blade.
  5. 5. Implant selon la revendication 3 ou 4 caractérisé en ce que la lame définit au moins en partie la cavité. 5. Implant according to claim 3 or 4, characterized in that the blade defines at least partially the cavity.
  6. 6. Implant selon l'une des revendications 1 à 5 caractérisé en ce que le corps présente une zone de jonction des faces d'appui. 6. Implant according to one of claims 1 to 5 characterized in that the body has a junction area of ​​the bearing faces.
  7. 7. Implant selon la revendication caractérisé en ce que la zone de jonction et les faces d'appui donnent au corps un profil en U . 7. Implant according to claim characterized in that the junction zone and the bearing faces give the body a U-profile.
  8. 8. Implant selon l'une des revendications 1 à 7 caractérisé en ce qu'au moins une des faces d'appui comporte un profil adapté et complémentaire au profil du plateau vertébral avec lequel elle est destinée à entrer en contact. 8. Implant according to one of claims 1 to 7 characterized in that at least one of the bearing surfaces comprises a suitable profile and the complementary profile of the vertebral plate with which it is intended to come into contact.
  9. 9. Implant selon l'une des revendications 1 à 8 caractérisé en ce que le corps comporte des moyens d'ancrage à une face des vertèbres contiguë au plateau vertébral. 9. Implant according to one of claims 1 to 8 characterized in that the body comprises anchoring means to one side of the vertebrae adjacent to the endplate.
  10. 10. Implant selon l'une des revendications 1 à 9 caractérisé en ce que le corps comporte au moins deux pattes d'ancrage aux vertèbres respectives, chaque patte s'étendant en continuité de matière avec une seule des faces d'appui 10. Implant according to one of claims 1 to 9 characterized in that the body comprises at least two anchoring legs to the respective vertebrae, each lug extending in continuity of material with one of the bearing faces
  11. 11. Implant selon la revendication 10 caractérisé en ce que chaque patte s'étend en continuite de matière avec la face d'appui destinée à être en appui sur le plateau de la vertèbre associé à cette patte 11. Implant according to claim 10 characterized in that each tab extends for continuity with the supporting face intended to rest on the plate of the vertebra associated with that tab
  12. 12. Implant selon la revendication 10 caracterisé en ce que chaque patte s'étend en continuite de matière avec la face d'appui destinée à être en appui sur le plateau vertébral associé à l'autre patte. 12. Implant according to claim 10 characterized in that each tab extends for continuity with the bearing face intended to be supported on the vertebral endplate associated with the other leg.
  13. 13. Implant selon l'une des revendications 10 à 12 caractérisé en ce que chaque patte de fixation comporte au moins un orifice destiné à recevoir vis osseuse. 13. Implant according to one of claims 10 to 12 characterized in that each bracket comprises at least one port for receiving bone screws.
  14. 14. Implant selon l'une des revendication 1 à 13 caractérisé en ce qu'il comprend un bloc en matériau non rigide. 14. Implant according to one of claims 1 to 13 characterized in that it comprises a block of non-rigid material.
  15. 15. Implant selon la revendication 14 caractérisé en ce que le bloc comporte du greffon osseux et/ou toute substance favorisant la repousse osseuse 15. Implant according to claim 14 characterized in that the block includes the bone graft and / or bone growth promoting substance
  16. 16. Implant selon la revendication 14 caractérisé en ce que le bloc comporte du ou des polymères biocompatibles et/ou tout autre matériau viscoélastique biocompatible. 16. Implant according to claim 14 characterized in that the block comprises the or biocompatible polymers and / or any other biocompatible viscoelastic material.
FR0002320A 2000-02-24 2000-02-24 Intervertebral implant body and a support surface Expired - Fee Related FR2805457B1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
FR0002320A FR2805457B1 (en) 2000-02-24 2000-02-24 Intervertebral implant body and a support surface

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
FR0002320A FR2805457B1 (en) 2000-02-24 2000-02-24 Intervertebral implant body and a support surface
AU3574101A AU3574101A (en) 2000-02-24 2001-02-22 Intervertebral implant with rigid body and support surfaces
PCT/FR2001/000515 WO2001062190A1 (en) 2000-02-24 2001-02-22 Intervertebral implant with rigid body and support surfaces

Publications (2)

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FR2805457A1 true true FR2805457A1 (en) 2001-08-31
FR2805457B1 FR2805457B1 (en) 2002-10-11

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FR (1) FR2805457B1 (en)
WO (1) WO2001062190A1 (en)

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FR2805457B1 (en) 2002-10-11 grant

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