FR2814936A1 - Supple one-piece vertebral connector has central core with elastic fibres, fixings and polymerised resin covering - Google Patents
Supple one-piece vertebral connector has central core with elastic fibres, fixings and polymerised resin covering Download PDFInfo
- Publication number
- FR2814936A1 FR2814936A1 FR0012998A FR0012998A FR2814936A1 FR 2814936 A1 FR2814936 A1 FR 2814936A1 FR 0012998 A FR0012998 A FR 0012998A FR 0012998 A FR0012998 A FR 0012998A FR 2814936 A1 FR2814936 A1 FR 2814936A1
- Authority
- FR
- France
- Prior art keywords
- connection device
- resin
- core
- mechanical
- fibrous structure
- 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.)
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7001—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
- A61B17/7031—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other made wholly or partly of flexible material
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
- A61B17/7002—Longitudinal elements, e.g. rods
- A61B17/7004—Longitudinal elements, e.g. rods with a cross-section which varies along its length
Abstract
Description
<Desc/Clms Page number 1> <Desc / Clms Page number 1>
DISPOSITIF DE LIAISON VERTEBRALE SOUPLE ET MONOBLOC FONCTIONNANT DE MANIERE MULTIDIRECTIONNELLE ------------------------------
DOMAINE DE L'INVENTION
L'invention concerne un dispositif de liaison vertébrale postérieure monobloc qui stabilise les vertèbres dans toutes les directions et amortit toutes les sollicitations mécaniques en ne bloquant aucun degré de liberté. Ce dispositif va présenter des avantages fonctionnels qui vont apparaître au cours de la description
ART ANTERIEUR :
On connait de nombreux systèmes de fixations vertébrales postérieures rigidifiant un certain nombre de vertèbres en les privant de toute mobilité pour permettre ainsi d'encaisser toutes les contraintes mécaniques. Cependant, la première vertèbre adjacente à ce bloc rigide garde toute sa mobilité et cette discontinuité brutale entre le bloc rigide et cette vertèbre libre engendre très souvent une hypersollicitation des éléments de liaison. Il s'en suit une accélération de la dégénérescence de ce niveau. MULTIDIRECTIONALLY OPERATING FLEXIBLE VERTEBRAL CONNECTION DEVICE ------------------------------
FIELD OF THE INVENTION
The invention relates to a one-piece posterior vertebral connection device which stabilizes the vertebrae in all directions and absorbs all mechanical stresses while not blocking any degree of freedom. This device will have functional advantages which will appear during the description.
PRIOR ART:
Many posterior vertebral fixation systems are known to rigidify a certain number of vertebrae, depriving them of all mobility, thereby allowing all mechanical stresses to be absorbed. However, the first vertebra adjacent to this rigid block retains all of its mobility and this abrupt discontinuity between the rigid block and this free vertebra very often generates an overload of the connecting elements. It follows an acceleration of the degeneration of this level.
Ce problème n'a été que très partiellement résolu par des systèmes semi-rigides conçus pour créer une rigidité intermédiaire entre les vertèbres mobiles et les vertèbres fixes. Ces systèmes présentent les inconvénients suivants : - soient ils travaillent en traction excluant toute action en flexion et compression. C'est le cas de tous les dispositifs basés sur les ligaments artificiels. Ces systèmes sont peu élastiques et laissent
à l'appréciation de l'opérateur le soin de régler la tension rendant a apprec ainsi aléatoire les caractéristiques mécaniques dans les deux modes de fonctionnement possibles. This problem was only very partially solved by semi-rigid systems designed to create an intermediate stiffness between the mobile vertebrae and the fixed vertebrae. These systems have the following drawbacks: - either they work in traction, excluding any action in bending and compression. This is the case for all devices based on artificial ligaments. These systems are not very elastic and leave
at the operator's discretion, the tension should be adjusted, making the mechanical characteristics of the two possible operating modes random.
-soient ils travaillent en compression avec une butée en traction, l'assistance en flexion et en torsion étant exclu. - or they work in compression with a stop in traction, assistance in bending and torsion being excluded.
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Quoiqu'il en soit : aucun des dispositifs connus ne résout entièrement le problème posé, à savoir : amortir toutes les solli- citations mécaniques auquelles une vertèbre mobile peut être soumise en ne bloquant aucun degré de liberté. Anyway: none of the known devices entirely solves the problem posed, namely: damping all the mechanical stresses to which a movable vertebra can be subjected while not blocking any degree of freedom.
Nous allons citer comme antériorité la plus proche : le brevet EP 0576 379 Al qui présente un amortisseur qui semble s'approcher le plus près tout au moins du point de vue du schéma
général de la présente invention ; la revendication 1 du présent brevet protège"un amortisseur uniaxial travaillant uniquement en compression tout en jouant le rôle d'une butée qui s'oppose à tout déplacement du piston au delà d'une valeur déterminée........ We will cite as closest anteriority: patent EP 0576 379 A1 which presents a damper which seems to approach the closest at least from the point of view of the diagram
general of the present invention; claim 1 of this patent protects "a uniaxial damper working only in compression while playing the role of a stop which prevents any movement of the piston beyond a determined value ........
Dans ce cas l'aspect fonctionnement multidirectionnel de la présente invention ne figure pas dans l'antériorité, de plus la imitation exponentielle du déplacement résolue par l'antériorité, est un problème qui n'a rien à voir avec celui que veut résoudre la présente invention. In this case the multidirectional operating aspect of the present invention does not appear in the anteriority, moreover the exponential imitation of the displacement resolved by the anteriority, is a problem which has nothing to do with that which the present wants to solve. invention.
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DESCRIPTION
Les dessins servant la compréhension de l'invention sont les suivants :
La figure 1 de la planche 1/3 présente un schéma du dispositif en coupe verticale avec l'ensemble de ses moyens
Les figures 2 et 3 et 3bis de la planche 1/3 (vues en coupe longitudinales et transversales) présentent une variante du dispositif avec une structure fibreuse différente
La figure 4 de la planche 2/3 montre une implantation du présent dispositif sur une colonne vertébrale. DESCRIPTION
The drawings serving to understand the invention are as follows:
Figure 1 of plate 1/3 shows a diagram of the device in vertical section with all of its means
Figures 2 and 3 and 3bis of plate 1/3 (longitudinal and transverse sectional views) show a variant of the device with a different fibrous structure
Figure 4 of Plate 2/3 shows an implantation of this device on a spine.
La figure 5 de la planche 2/3 montre un type de fixation possible du dispositif sur deux vertèbres pas forcément voisines. Figure 5 of the board 2/3 shows a possible type of attachment of the device on two vertebrae not necessarily adjacent.
La figure 6 de la planche 3/3 montre une gamme de dispositifs envisageables pour divers cas. Figure 6 of plate 3/3 shows a range of devices that can be envisaged for various cases.
Le dispositif de liaison 1 doit pouvoir offrir une tenue mécanique suffisante en restant du point de vue des contraintes subies, dans le domaine élastique en amortissant et en résistant à tous les modes de travail connus (traction, compression flexion , torsion et cisaillement). Ledit dispositif 1 comprend :
Un noyau central 11 constitué d'un réseau de fibres élastiques pouvant travailler en compression. The connecting device 1 must be able to offer sufficient mechanical strength while remaining from the point of view of the stresses undergone, in the elastic domain by damping and by resisting all known working modes (traction, compression bending, twisting and shearing). Said device 1 comprises:
A central core 11 consisting of a network of elastic fibers that can work in compression.
Ses caractéristiques mécaniques et physiques sont préalablement déterminées avant fabrication et mise en place. Il est adaptable au cas par cas. Its mechanical and physical characteristics are determined beforehand before manufacture and installation. It is adaptable on a case by case basis.
Une structure fibreuse 12 qui participe avec le noyau 11 aux caractéristiques mécaniques qui doivent satisfaire les modes de travaux requis pour le dispositif 1. A fibrous structure 12 which participates with the core 11 in the mechanical characteristics which must satisfy the modes of work required for the device 1.
Des moyens de fixation tels que par exemple : deux tiges rigides 14 (a et b) qui comprennent à leurs extrémités deux filetages 141 (a et b) sur lesquels viennent se visser deux écrous 143 (a et b) et s'enfiler deux rondelles 144 (a et b), à pans coupés. Fastening means such as for example: two rigid rods 14 (a and b) which include at their ends two threads 141 (a and b) on which two nuts 143 (a and b) are screwed and two threaded washers 144 (a and b), with cut sides.
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Ces précédents moyens 141, 143, 144 viennent pincer la structure fibreuse 12 en assurant une tenue mécanique en flexion et traction. These previous means 141, 143, 144 pinch the fibrous structure 12 while ensuring mechanical resistance in bending and traction.
Un enrobage 13 constitué de préférence par une résine qui en se polymérisant vient lier l'ensemble des moyens, en assurant toutes les fonctions désirées, notamment : tenue mécanique, rigidité relative, souplesse, amortissement, bonne cohésion, et étanchéité avec absence de dégradation dans le temps de l'ensemble du dispositif. Le dispositif 1 ainsi constitué va donc pouvoir se positionner pour fonctionner de manière multidirectionnelle, par le type de conception adopté vérifié par des essais, et grâce à la nature des matériaux qui le constituent. A coating 13 preferably consisting of a resin which, by polymerizing, binds all of the means, ensuring all the desired functions, in particular: mechanical strength, relative rigidity, flexibility, damping, good cohesion, and sealing with no degradation in the whole device. The device 1 thus formed will therefore be able to position itself to operate in a multidirectional manner, by the type of design adopted verified by tests, and by virtue of the nature of the materials which constitute it.
Les matériaux du dispositif 1 répondant aux fonctionnalités précédemment décrites sont pour : le noyau central 11 : un réseau de fibres textiles tridimensionnelles, offrant des caractéristiques de souplesse et d'amor- tissement, renforcées ensuite par l'imprégnation d'une résine qui en se polymérisant assure de bonnes caractéristiques en compression. la structure fibreuse 12 : un textile dont le réseau de fibre est de préférence au départ bidirectionnel, et dont la forme peut être cylindrique adaptable à toutes les formes imposées présentant à ses extrémités deux têtes symétriques que l'on peut enfiler sur les tiges 14 (a et b) pour les rabattre et les bloquer ensuite entre les écrous et les rondelles : 143, 144. (figures 2,2bis et 3) les tiges filetées 14 et les écrous et rondelles 143 et 144 : un matériau rigide (composite ou métallique). 11 faut noter que les tiges filetées ne sont pas forcément coaxiales, et peuvent se raccorder à tout système de fixation vertébral postérieur ou antérieur rigide. La rondelle présente au moins un pan coupé de forme adaptée pour que ce dernier puisse se positionner en évitant un déchirement de l'enrobage 13 et déchaussement possible des tiges quand le dispostif 1 travaille en flexion. The materials of the device 1 meeting the previously described functionalities are for: the central core 11: a network of three-dimensional textile fibers, offering characteristics of flexibility and damping, then reinforced by the impregnation of a resin which polymerizer provides good compression characteristics. the fibrous structure 12: a textile, the fiber network of which is preferably bidirectional, and the shape of which can be cylindrical, adaptable to all the imposed shapes having at its ends two symmetrical heads which can be threaded onto the rods 14 ( a and b) to fold them down and then block them between the nuts and washers: 143, 144. (figures 2,2bis and 3) the threaded rods 14 and the nuts and washers 143 and 144: a rigid material (composite or metallic ). It should be noted that the threaded rods are not necessarily coaxial, and can be connected to any rigid posterior or anterior vertebral fixation system. The washer has at least one cutaway of suitable shape so that the latter can be positioned avoiding tearing of the coating 13 and possible loosening of the rods when the device 1 works in bending.
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le moyen d'enrobage 13 : une résine qui de préférence est de nature polyuréthane biocompatible, facile à mettre en oeuvre, moulable, éventuellement usinable pour adaptation et dont les variétés de caractéristiques desdites résines permettent de résoudre toutes les fonctionnalités désirées. the coating means 13: a resin which is preferably of biocompatible polyurethane nature, easy to use, moldable, optionally machinable for adaptation and whose varieties of characteristics of said resins make it possible to resolve all the desired functionalities.
L'application industrielle reste bien ciblée, a savoir : la résolution du problème de la dégénérescence par l'implantation du dispositif 1 ; il n'en reste pas moins que ce dispositif amortisseur monobloc peut fonctionner dans toutes les directions peut avoir des dimensions et formes multiples ainsi que des caractéristiques mécaniques variées grâce à la combinaison de tous les constituants. The industrial application remains well targeted, namely: the resolution of the problem of degeneration by the implantation of the device 1; the fact remains that this one-piece damping device can operate in all directions can have multiple dimensions and shapes as well as varied mechanical characteristics thanks to the combination of all the components.
C'est ainsi que la figure 6 de la planche 3/3 représente une gamme possible de dispositifs conçus comme il vient d'être décrit. This is how Figure 6 of Plate 3/3 shows a possible range of devices designed as just described.
Dans certains cas, des composants comme le noyau central 11 , la structure fibreuse 12 les écrous ou les rondelles peuvent être supprimés au sein du dispositif 1. Ainsi une multitude de combinaisons possibles permettra à l'opérateur de sélectionner un dispositif précis qui aura la réponse mécanique et la forme appropriées au cas à traiter. Ces dispositifs la, lb, lc, Id, le, If, lg, lh, li, dont chacun dépendra des caractéristiques à respecter (par exemple : tenue mécanique, forme, encombrement, étanchéité...) possédera après fabrication et rangement dans un présentoir une fiche signalétique correspondant à un numéro donné, et l'opérateur pourra ainsi choisir le dispositif adapté, qui lui convient pour l'implantation. In certain cases, components such as the central core 11, the fibrous structure 12, the nuts or the washers can be eliminated within the device 1. Thus a multitude of possible combinations will allow the operator to select a precise device which will have the response. mechanical and shape appropriate to the case to be treated. These devices la, lb, lc, Id, le, If, lg, lh, li, each of which will depend on the characteristics to be respected (for example: mechanical strength, shape, size, tightness ...) will have after manufacture and storage in a display a data sheet corresponding to a given number, and the operator will be able to choose the appropriate device, which suits him for the installation.
Le dispositif 1 se fixe de manière classique sur des vertèbres qui peuvent être voisines ou distantes grâce à un système de fixation composé le plus souvent de vis pédiculaires et d'un système de blocage de la tige sur ladite vis (figure 5). The device 1 is fixed in a conventional manner on vertebrae which can be close or distant thanks to a fixing system generally composed of pedicle screws and a system for locking the rod on said screw (FIG. 5).
Claims (5)
Priority Applications (1)
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FR0012998A FR2814936B1 (en) | 2000-10-11 | 2000-10-11 | MULTIDIRECTIONALLY OPERATING FLEXIBLE VERTEBRAL CONNECTION DEVICE |
Applications Claiming Priority (1)
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FR0012998A FR2814936B1 (en) | 2000-10-11 | 2000-10-11 | MULTIDIRECTIONALLY OPERATING FLEXIBLE VERTEBRAL CONNECTION DEVICE |
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FR2814936A1 true FR2814936A1 (en) | 2002-04-12 |
FR2814936B1 FR2814936B1 (en) | 2003-02-07 |
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FR0012998A Expired - Fee Related FR2814936B1 (en) | 2000-10-11 | 2000-10-11 | MULTIDIRECTIONALLY OPERATING FLEXIBLE VERTEBRAL CONNECTION DEVICE |
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