FR2866228A1 - Cervical cage for use after cervical diskectomy, has branches with front ends spaced angularly by unscrewing screw and moving screw head away from connection portion, where head supports ends against pressure exerted by vertebral bodies - Google Patents

Cervical cage for use after cervical diskectomy, has branches with front ends spaced angularly by unscrewing screw and moving screw head away from connection portion, where head supports ends against pressure exerted by vertebral bodies Download PDF

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Publication number
FR2866228A1
FR2866228A1 FR0401635A FR0401635A FR2866228A1 FR 2866228 A1 FR2866228 A1 FR 2866228A1 FR 0401635 A FR0401635 A FR 0401635A FR 0401635 A FR0401635 A FR 0401635A FR 2866228 A1 FR2866228 A1 FR 2866228A1
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Prior art keywords
cage
screw
legs
branches
portion
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Granted
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FR0401635A
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French (fr)
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FR2866228B1 (en
Inventor
Pierre Richerme
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Kiscomedica
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Kiscomedica
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Publication of FR2866228B1 publication Critical patent/FR2866228B1/en
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Classifications

    • 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
    • A61F2/4455Joints 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
    • 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
    • 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
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4611Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
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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
    • A61F2/28Bones
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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
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    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/3011Cross-sections or two-dimensional shapes
    • A61F2002/30112Rounded shapes, e.g. with rounded corners
    • A61F2002/30131Rounded shapes, e.g. with rounded corners horseshoe- or crescent- or C-shaped or U-shaped
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30507Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a threaded locking member, e.g. a locking screw or a set screw
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30537Special structural features of bone or joint prostheses not otherwise provided for adjustable
    • A61F2002/30538Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation
    • 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
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30594Special structural features of bone or joint prostheses not otherwise provided for slotted
    • A61F2002/30596Special structural features of bone or joint prostheses not otherwise provided for slotted slots ending in apertures, e.g. for avoiding stress concentration at the ends of the slots
    • 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
    • A61F2/30767Special external or bone-contacting surfaces, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30772Apertures or holes, e.g. of circular cross section
    • A61F2002/30774Apertures or holes, e.g. of circular cross section internally-threaded
    • 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
    • A61F2/30767Special external or bone-contacting surfaces, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30772Apertures or holes, e.g. of circular cross section
    • A61F2002/30777Oblong apertures
    • 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
    • A61F2/30767Special external or bone-contacting surfaces, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30841Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external or bone-contacting surfaces, e.g. coating for improving bone ingrowth
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    • A61F2002/30878Special external or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30879Ribs
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
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    • A61F2002/30904Special external or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves serrated profile, i.e. saw-toothed
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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
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Abstract

The cage has a truncated V-block opening towards a connection portion (3) and including an apex oriented towards a front end of the cage. Branches (1, 2) have respective front ends (11, 21) angularly spaced by unscrewing a screw (5) and moving a head (51) of the screw away from the portion in direction of the apex. The head supports the front ends of the branches against pressure exerted by vertebral bodies.

Description

2866228 1 2866228 1

Cage cervicale réglable par voie antérieure La présente invention concerne un implant, dit cage antérieure, destiné à être implanté par voie antérieure entre les corps vertébraux de deux vertèbres cervicales à la place d'un disque déficient. anterior adjustable cervical cage The present invention relates to an implant, said front cage, adapted to be implanted by an anterior approach between the vertebral bodies of two cervical vertebrae in place of a defective disc. Une cage permet la fusion des corps vertébraux après discectomie du disque, tout en conservant la distance intervertébrale entre les deux corps vertébraux. A cage allows the fusion of the vertebral bodies after discectomy of the disc, while maintaining the intervertebral distance between the two vertebral bodies.

Plus particulièrement, l'invention est dirigée vers une cage intervertébrale cervicale réglable comme décrite dans le brevet français 2763836. More particularly, the invention is directed to an adjustable cervical intervertebral cage as described in French patent 2,763,836.

Cette cage comprend un corps monolithique sensiblement parallélépipédique en forme de C. Le corps est monolithique en forme de C composé de deux branches sensiblement parallèles et d'une portion de liaison postérieure reliant des extrémités postérieures des branches Une vis ayant une tige filetée qui s'étend entre les branches est vissée dans la portion de liaison. This cage comprises a substantially parallelepipedal monolithic shaped body C. The monolithic body is C-shaped with two substantially parallel legs and a posterior connecting portion connecting the rear ends of the branches A screw having a threaded rod which s' extends between the limbs is screwed into the connecting portion. La tête de la vis est en contact glissant avec des surfaces d'appui en regard d'un vé tronqué entre des extrémités antérieures libres des branches pour écarter angulairement les extrémités antérieures des branches. The head of the screw is in sliding contact with the bearing surfaces opposite a truncated vee between the free front ends of the legs to angularly deviate the front ends of the branches. Le vé est ouvert en direction antérieure et a un sommet orienté vers la portion de liaison. Vee is open in the anterior direction and has an apex facing the connecting portion.

Les dimensions de la cage sont généralement sélectionnées parmi un choix de quelques tailles pour s'adapter à l'anatomie du patient. the cage dimensions are generally selected from a choice of several sizes to fit the patient's anatomy. Cependant, la cage une fois choisie a un écartement des branches réglable par la tête de la vis. However, once chosen cage has a spacing of the branches adjustable by the screw head.

Au cours de l'intervention chirurgicale, après 35 implantation de la cage dans un logement ménagé entre les corps vertébraux, l'écartement angulaire des extrémités antérieures des branches est agrandi par le chirurgien en vissant la vis dans la portion de liaison postérieure, ce qui rapproche la tête de vis de la portion de liaison postérieure. During surgery, after implantation of the cage 35 in a housing formed between the vertebral bodies, the angular spacing front ends of the branches is enlarged by the surgeon by screwing the screw in the posterior connecting portion, which approximates the screw head of the posterior connecting portion. En conséquence les extrémités antérieures libres des deux branches de la cage sont écartées suivant un angle de quelques degrés ce qui permet de régler la position angulaire relative des corps vertébraux des deux vertèbres dans le plan antéro-postérieur. Consequently the free front ends of the two arms of the cage are spaced apart at an angle of a few degrees which allows to adjust the relative angular position of the vertebral bodies of the two vertebrae in the anterior-posterior plane.

La tête de vis maintient fléchies les branches sans soutien des extrémités antérieures libres. The screw head retains the flexed legs unsupported free front ends. Plus les branches sont écartées, plus la tête de vis est proche de la portion de liaison postérieure et moins les extrémités antérieures libres des branches sont soutenues à l'encontre des pressions exercées antagonistes par les corps vertébraux. More branches are spread over the screw head is located near the posterior connecting portion and under the free front ends of the legs are supported against pressure antagonists by the vertebral bodies.

Après fermeture du champ opératoire, la pression exercée ensuite par les corps vertébraux sur les extrémités antérieures libres des branches lors de la mobilité répétée de la colonne vertébrale peuvent conduire à des microfissures ou des cassures des branches de la cage, exigeant une autre intervention chirurgicale pour remplacer la cage défectueuse. After closing the surgical site, the pressure then exerted by the vertebral bodies at the free front ends of the branches during repeat mobility of the spinal column can lead to microcracks or fractures of the legs of the cage, requiring another surgery for replace the defective cage.

L'invention a pour objectif de fournir une cage cervicale réglable ne présentant pas les inconvénients précédents afin que les extrémités antérieures libres des branches soient mieux maintenues après réglage de l'écartement des branches. The invention aims to provide an adjustable cervical cage does not have the above drawbacks so that the free front ends of the branches are better maintained after adjustment of the spacing of the branches.

A cette fin, une cage cervicale réglable comprenant un corps monolithique en forme de C composé de deux branches sensiblement parallèles pour être introduites entre deux corps vertébraux cervicaux et d'une portion de liaison postérieure reliant des extrémités postérieures des branches, et une vis ayant une tige filetée qui s'étend entre les branches et est vissée dans la portion de liaison et une tête en contact avec des surfaces d'appui en regard d'un vé tronqué entre des extrémités antérieures des branches pour écarter angulairement les extrémités antérieures des branches, est caractérisée en ce que le vé tronqué est ouvert vers la portion de liaison et a un sommet orienté vers l'extrémité antérieure de la cage afin qu'après insertion de la cage entre les corps vertébraux, les extrémités antérieures des branches soient écartées angulairement par dévissage de la vis et éloignement de la tête de vis par rapport à la portion de liaison en directi To this end, an adjustable cervical cage comprising a monolithic body C-shaped with two substantially parallel legs for introduction between two cervical vertebral bodies and a posterior connecting portion connecting the rear ends of branches, and a screw having a threaded rod extending between the arms and is screwed into the connecting portion and a head in contact with bearing surfaces opposite a truncated vee between front ends of the legs to angularly deviate the front ends of the branches, is characterized in that the truncated vee is open towards the connecting portion and has an apex oriented towards the front end of the cage so that after insertion of the cage between the vertebral bodies, the anterior ends of the arms are angularly spaced apart by unscrewing the screw and away from the screw head relative to the connecting portion directi on du sommet du vé. is the top of the vee.

Après réglage de l'écartement des branches, la tête de vis maintient fléchies les branches et surtout, selon l'invention, soutient les extrémités antérieures libres des branches qui sont les plus écartées, à l'encontre des pressions exercées ensuite par les corps vertébraux sur ces extrémités antérieures lors de la mobilité répétée de la colonne vertébrale. After adjustment of the spacing of the branches, the screw head retains the flexed branches and especially, according to the invention supports free front ends of the branches are further apart, against the pressure subsequently exerted by the vertebral body on these front ends during repeat mobility of the spine. Cette caractéristique remédie à toute fatigue excessive des branches en évitant des microfissures ou des cassures de celles-ci et accroît la longévité de la cage. This feature obviates any excessive fatigue branches avoiding microcracks or breakage thereof and increase the longevity of the cage.

Le glissement de la tête de vis entre les surfaces d'appui est facilité lorsque tête de vis est convexe, particulièrement au moins légèrement bombée pour être en contact avec les surfaces d'appui en regard qui sont sensiblement tronconiques ou pyramidales tronquées. The sliding of the screw head between the bearing surfaces is facilitated when screw head is convex, preferably at least slightly curved to be in contact with the bearing facing surfaces which are substantially frustoconical or truncated pyramid.

La portion de liaison peut avoir une forme rectangulaire entre les extrémités postérieures de branche et comporter un bossage, par exemple rectangulaire, dans lequel la tige de vis est vissée et qui saille dans une double lumière pratiquée dans le corps de cage monolithique entre les branches et le moyen de liaison. The connecting portion may have a rectangular shape between the rear ends of branch and comprise a boss, for example rectangular, wherein the screw shank is screwed and which projects into a double lumen formed in the monolithic cage body between the legs and the connecting means. Le bossage offre un plus long taraudage pour la tige de vis ce qui facilite le vissage/dévissage de la vis, tout en renforçant la portion de liaison de la cage et particulièrement une zone centrale du corps monolithique comprise entre des portions postérieures des branches jouant le rôle d'articulation. The boss has a longer threaded bore for the screw shaft which facilitates the screwing / unscrewing of the screw, while reinforcing cage connecting portion and particularly a central area of ​​the monolithic body between the posterior portions of the branches acting as a hinge.

Au repos, sans sollicitation des branches par la tête de vis, de préférence la hauteur de chaque branche est inférieure à la demi-hauteur du corps de cage, et les branches sont séparées entièrement par une fente longitudinale s'étendant depuis le moyen de liaison postérieure. Break, without using branches by the screw head, preferably the height of each arm is less than half the height of the cage body, and the legs are fully separated by a longitudinal slot extending from the connecting means later. Cette fente permet de rapprocher, si nécessaire, les branches lors de l'implantation de la cage dans un logement osseux si la vis est assez vissée en direction postérieure, et surtout de réaliser des articulations monolithiques avec le reste du corps pour écarter les branches à l'angle souhaité. This slot allows to bring, if necessary, the legs during implantation of the cage in a bony housing if the screw is sufficiently screwed in posterior direction, and especially to make monolithic joint with the rest of the body to ward the branches the desired angle. La tête de vis écarte ainsi les branches à l'encontre de leur élasticité propre, c'est-à-dire à l'encontre d'un effort d'autant plus important que l'écartement des branches est grand. The screw head and spreads branches against their own elasticity, that is to say against an effort all the more important that the spacing of the branches is great.

D'autres caractéristiques et avantages de la présente invention apparaîtront plus clairement à la lecture de la description suivante de plusieurs réalisations préférées de l'invention, à titre d'exemples non limitatifs, en référence aux dessins annexés correspondants dans lesquels: - la figure 1 est une vue longitudinale de côté dans un plan antéropostérieur d'une cage cervicale réglable selon l'invention, à l'état de repos; Other features and advantages of the present invention will become apparent from reading the following description of several preferred embodiments of the invention, as non-limiting examples, with reference to the corresponding accompanying drawings in which: - Figure 1 is a longitudinal side view in an anteroposterior plane of an adjustable cervical cage according to the invention, in the rest state; - la figure 2 est une vue de dessus de la face supérieure du corps de la cage selon l'invention; - Figure 2 is a top view of the upper face of the body of the cage according to the invention; - la figure 3 est une vue en coupe axiale verticale prise le long de la ligne antéropostérieure III-III de la figure 1, montrant notamment la face inférieure d'une branche supérieure du corps de cage; - Figure 3 is a vertical axial section view taken along line III-III anteroposterior of Figure 1, particularly showing the underside of an upper branch of the cage body; - la figure 4 est une vue frontale distale antérieure de la cage à l'état de repos; - Figure 4 is a front distal end view of the cage in the rest state; - la figure 5 est une vue frontale proximale postérieure de la cage à l'état de repos; - Figure 5 is a rear proximal end view of the cage in the rest state; et - la figure 6 est une vue en coupe antéropostérieure prise le long de la ligne médiane VIII-VIII de la figure 5, lorsque la cage est à l'état de travail, les branches de la cage étant écartées par la tête d'une vis dévissée dans le corps de cage. and - Figure 6 is a sectional view taken along anteroposterior center line VIII-VIII of Figure 5, when the cage is in the working state, the limbs of the cage being separated by the head of a unscrewed screw in the cage body.

Une cage cervicale réglable selon l'invention est sensiblement parallélépipédique et symétrique par rapport à un axe longitudinal antéropostérieur AP. An adjustable cervical cage according to the invention is substantially rectangular and symmetrical about a longitudinal axis anteroposterior AP. La cage est décrite ci-après en référence aux figures 1 à 5 pour un état de repos, dite également "état fermé". The cage is described below with reference to Figures 1 to 5 to a rest state, also called the "closed state".

La cage ne comporte que deux éléments séparables: un corps de cage monolithique C et une vis 5. The cage comprises two separable elements: a monolithic cage body C and a screw 5.

Le corps C a un profil postéro-antérieur vertical sensiblement en forme de mâchoire en C. Il est composé essentiellement de deux branches sensiblement rectangulaires 1 et 2 et d'une portion de liaison 3 venues d'usinage et qui sont plus visibles, comme montré à la figure 1, dans un plan antéro-postérieur contenant l'axe AP, après implantation de la cage. The body C has a vertical posterior-anterior profile substantially shaped jaw C. It consists essentially of two substantially rectangular branches 1 and 2 and a connecting portion 3 come machining and which are more visible, as shown in Figure 1, in an anteroposterior plane containing the axis AP, after implantation of the cage.

Les branches ont chacune une hauteur inférieure à la moitié de la hauteur hors tout de la cage et s'étendent sensiblement symétriquement par rapport à un plan antéro-postérieur qui est sensiblement perpendiculaire au rachis cervical lorsque la cage est implantée. The legs each have a height less than half the overall height of the cage and extend substantially symmetrically with respect to an anteroposterior plane which is substantially perpendicular to the cervical spine when the cage is implanted. Au centre des deux branches 1 et 2 sont ménagées deus grandes lumières sensiblement rectangulaires 10 et 20 traversant les branches de bas en haut de manière à alléger la cage et pouvoir y introduire des greffons osseux. In the center of the two branches 1 and 2 are provided deus large substantially rectangular slots 10 and 20 passing through the arms from bottom to top so as to lighten the cage and able to introduce bone grafts.

La portion de liaison 3 est rectangulaire et s'étend dans un plan frontal entre des extrémités postérieures des deux branches 1 et 2. Des chants supérieur et inférieur 30 et des chants latéraux 31 chanfreinés de la portion de liaison 3 convergeant vers la direction postérieure afin de faciliter l'introduction de la cage dans un logement intervertébral. The connecting portion 3 is rectangular and extends in a frontal plane between rear ends of two branches 1 and 2. Upper and lower edges 30 and lateral edges 31 chamfered connecting portion 3 converging towards the posterior direction to to facilitate insertion of the cage into an intervertebral-disc compartment.

La portion de liaison 3 présente un bossage central par exemple rectangulaire 32 s'étendant perpendiculairement à l'axe AP, c'est-à-dire de bas en haut, avec une hauteur sensiblement inférieure à celle du corps de cage au repos, et saillant sur la médiatrice des côtés postérieurs des lumières 10 et 20. Le bossage 32 et la portion de liaison 3 sont percés d'un trou cylindrique taraudé 33 suivant l'axe antéro-postérieur de symétrie AP. The connecting portion 3 has a central boss 32 for example rectangular extending perpendicularly to the axis AP, that is to say from bottom to top, with a height substantially less than that of the cage body at rest, and projecting on the perpendicular bisector of the rear sides of the slots 10 and 20. the boss 32 and the connecting portion 3 are pierced by a threaded cylindrical hole 33 along the anteroposterior axis of symmetry AP.

Dans le sens antéro-postérieur, chaque branche 1, 2 comporte une portion centrale antérieure large 11, 21, deux portions latérales parallèles plus étroites 12, 22 et deux portions d'articulation postérieures parallèles 13, 23 liées à des extrémités latérales de la portion de liaison 3. Les faces externes de chaque branche 1, 2 c'est-à- dire de chaque ensemble de portions 11-12-13, 21-22-23 sont sensiblement planes et parallèles à l'axe AP. In the anteroposterior direction, each branch 1, 2 comprises a front central portion wider 11, 21, two narrower parallel side portions 12, 22 and two parallel posterior portions of articulation 13, 23 related to the lateral ends of the portion binding 3. the outer surfaces of each leg 1, 2 that is to say of each set of portions 11-12-13, 21-22-23 are substantially planar and parallel to the axis AP. Seulement les faces externes des portions centrales antérieures 11 et 21 et des portions latérales 12 et 22 des branches comprennent des dentures d'ancrage en dents de scie transversales 14 et 24 contribuant à un ancrage de la cage dans des corps vertébraux cervicaux après implantation de la cage et croissance osseuse. Only external surfaces of the anterior central portions 11 and 21 and side portions 12 and 22 of the branches comprise anchoring teeth in transverse sawtooth 14 and 24 contributing to an anchorage of the cage in the cervical vertebral body after implantation of the cage and bone growth.

En variante, l'une des deux dentures d'ancrage 14 et 24 est supprimée, ou bien au moins l'une des deux dentures est remplacée par un ensemble de picots de préférence coniques pointus. Alternatively, one of the two anchoring teeth 14 and 24 is suppressed or at least one of the two toothings is replaced by a set of sharp preferably conical pins.

Comme cela apparaît dans la figure 1, les branches 1 et 2 sont séparées par une fente lisse 41-42-43. As shown in Figure 1, the arms 1 and 2 are separated by a smooth 41-42-43 slot. La fente s'étend dans un plan antéropostérieur contenant l'axe AP et est positionnée sensiblement perpendiculairement au rachis cervical après implantation de la cage. The slit extends in an anteroposterior plane containing the AP axis and is positioned substantially perpendicular to the cervical spine after implantation of the cage. La fente est constituée d'une portion d'appui antérieure sensiblement tronconique ou pyramidale tronquée 41 entre les portions centrales antérieures de branche 11 et 21, d'une portion intermédiaire progressivement plus étroite 42 entre les portions latérales de branche 12 et 22, et d'une portion postérieure sensiblement cylindrique et plus large 43 entre les portions d'articulation postérieures 13 et 23 des branches. The slot consists of a front support portion substantially frustoconical or truncated pyramid 41 between the anterior central leg portions 11 and 21, an intermediate portion 42 progressively narrower between the side leg portions 12 and 22, and a substantially cylindrical rear portion and wider 43 between the rear joint portions 13 and 23 of the branches.

La portion d'appui 41 de la fente en partie antérieure du corps de cage est évasée en direction de la portion de liaison 3 et est formée par deux surfaces d'appui sensiblement semi-tronconiques ou serai-pyramidales en regard qui convergent vers l'extrémité antérieure de la cage. The bearing portion 41 of the slot in front part of the cage body is tapered in the direction of the connecting portion 3 and is formed by two bearing surfaces substantially semi-conical or semi-pyramidal opposite converging towards the front end of the cage. La petite base a antérieure de la portion 41 a un diamètre supérieur au diamètre du trou taraudé 33. Vue en coupe verticale antéro-postérieure selon la réalisation illustrée à la figure 1, les surfaces d'appui de la portion antérieure de fente 41 forment un vé tronqué ouvert vers la portion de liaison 3, avec un sommet orienté vers l'extrémité antérieure de la cage. The small base of the anterior portion 41 has a diameter greater than the diameter of the threaded hole 33. View anteroposterior vertical section according to the embodiment illustrated in Figure 1, the bearing surfaces of the anterior portion of slot 41 form a vee truncated open towards the connecting portion 3, with an apex oriented towards the front end of the cage.

La vis 5 comporte une tête au moins légèrement bombée 51 afin d'être en contact glissant avec les surfaces de la portion d'appui antérieure 41. La tête de vis 51 a son plus grand diamètre nettement plus grand que celui de la petite base de la portion de fente antérieure 41, et sensiblement plus petit que la grande base de la portion de fente 41. La hauteur de la tête de vis 51 est inférieure à la longueur de la portion de fente 41. The screw 5 has a head 51 at least slightly convex so as to be in sliding contact with the surfaces of the front support portion 41. The screw head 51 has its greatest diameter substantially larger than the small base of the front slot portion 41, and substantially smaller than the large base of the slot portion 41. the height of screw 51 of the head is less than the length of the slot portion 41.

La tige filetée 52 de la vis 5 a une extrémité postérieure filetée pour être vissée dans le trou taraudé 33. The threaded shank 52 of the screw 5 has a rear threaded end to be screwed into the threaded hole 33.

La longueur de la vis 5 est inférieure à la longueur du corps de cage C et sensiblement égale ou supérieure à la longueur de la fente 41-42-43 entre les branches 1 et 2 afin que la vis 5 soit toujours contenue dans le corps de cage C, quelle que soit l'état de la cage et donc quel que soit l'écartement des branches 1 et 2 imposé par la tête de vis 51. The length of the screw 5 is less than the length of the cage body C and substantially equal to or greater than the length of the slot 41-42-43 between the branches 1 and 2 so that the screw 5 is always contained in the body of cage C, regardless of the state of the cage and therefore regardless of the spacing of the branches 1 and 2 imposed by the screw head 51.

Pour monter la vis 5 dans le corps de cage C, les extrémités antérieures des branches sont écartées par une pince spécialement adaptée ou à force par la tête de vis 51 afin de franchir la petite base de la portion 41. Puis, si la vis est vissée dans le trou taraudé 33 sans écarter les branches 1 et 2 qui sont parallèles ou sensiblement fléchies vers l'axe AP, comme montré à la figure 1, la tête de vis 51 est positionnée au voisinage de l'extrémité postérieure de la portion d'appui 41. L'extrémité postérieure de la tige de vis 52 peut affleurer ou être sensiblement en retrait de l'extrémité postérieure du trou taraudé 33 jusqu'à ce que la tête de vis bute contre la portion de fente intermédiaire 42 plus étroite. To mount the screw 5 in the cage body C, the front ends of the branches are spaced apart by a clamp or specially adapted force by the screw head 51 to pass through the smaller base of the portion 41. Then, if the screw is screwed into the threaded hole 33 without discarding the legs 1 and 2 which are parallel or substantially bent towards the axis PA, as shown in Figure 1, the screw head 51 is positioned adjacent the rear end of the portion of support 41. the rear end of the screw rod 52 can be flush or substantially behind the rear end of the threaded hole 33 until the screw head abuts against the intermediate 42 narrowest slot portion. Par contre, lorsque les branches 1 et 2 sont au travail en réponse à des pressions opposées exercées par la tête de vis 51 sur les surfaces de la portion d'appui 41, la tête de vis 51 est située vers l'extrémité antérieure de la cage et peut affleurer ou être en retrait des chants antérieurs 18 et 28 des branches 1 et 2, et l'extrémité taraudée de la vis 5 est encore à l'intérieur du trou 33, comme montré à la figure 6. For against, when the arms 1 and 2 are at work in response to opposing pressure exerted by the screw head 51 on the surfaces of the bearing portion 41, the screw head 51 is located towards the front end of the cage and may be flush with or be recessed prior edges 18 and 28 of the arms 1 and 2 and the threaded end of the screw 5 is still within the hole 33, as shown in Figure 6.

Le chant antérieur 18, 28 de chacune des branches sensiblement au niveau des portions d'extrémité centrales 11 et 21 a un profil latéral arrondi, visible aux figures 2 et 3, qui est terminé sensiblement entre la portion centrale 11, 21 et les deux portions latérales 12, 22 de la branche par deux encoches 181, 281 afin que les portions centrales antérieures 11 et 21 constituent un tenon de préhension en queue d'aronde. The front edge 18, 28 of each of the arms substantially level with the central end portions 11 and 21 has a rounded side profile, visible in Figures 2 and 3, which is substantially completed between the central portion 11, 21 and the two portions side 12, 22 of the branch by two notches 181, 281 so that the anterior central portions 11 and 21 constitute a gripping stud dovetail. Le tenon en queue d'aronde 181-281 constitue un moyen de préhension démontable pour un outil, analogue à un porte-cage décrit dans le brevet français 2717068. En particulier, l'outil porte-cage comporte à une extrémité proximale d'un long corps tubulaire deux mâchoires longitudinales en regard qui sont maintenues par ressort contre un trou évasé du corps tubulaire et dont les extrémités proximales ont des rainures en queue d'aronde en vis-à-vis. The tenon dovetail 181-281 constitutes a removable gripping means for a tool, similar to a cage door disclosed in French patent 2717068. In particular, the carrier cage tool comprises a proximal end of a long tubular body two longitudinal opposite jaws which are maintained by spring against a flared hole of the tubular body and whose proximal ends have tail grooves dove vis-à-vis. En vissant une tête de manoeuvre taraudée sur l'extrémité distale filetée d'une tige traversant le corps tubulaire, la tige coulisse longitudinalement vers l'extrémité postérieure du corps afin de rapprocher les mâchoires et ainsi prendre le tenon 181-281 à l'extrémité antérieure de la cage. By screwing a threaded operating head on the threaded distal end of a rod passing through the tubular body, the stem slides longitudinally towards the posterior end of the body to close the jaws and thus take the 181-281 tenon at the end front of the cage.

Pour la discectomie par voie antérieure pour ménager un logement dans un disque déficient entre deux corps vertébraux de vertèbres cervicales CV1 et CV2 et pour remplacer le disque déficient par la cage cervicale réglable selon l'invention, un chirurgien utilise un outillage approprié, par exemple une râpe, un porte-cage et un tournevis. For discectomy anterior approach for securing a housing in a defective disc between two vertebral bodies of the cervical vertebrae CV1 and CV2 and to replace the defective disk by the adjustable cervical cage according to the invention, a surgeon using an appropriate tool, e.g. grater, a cage door and a screwdriver. L'outillage et la cage sont réalisés en un matériau biocompatible, par exemple titane ou alliage à base de titane, ou une matière plastique radio transparente. The tool and the cage are made of a biocompatible material, for example titanium or titanium based alloy, or a plastic radiolucent material.

La cage est réalisable en plusieurs tailles de manière à être adaptée à l'anatomie du patient. The cage is feasible in different sizes so as to be adapted to the patient's anatomy. L'outillage est en conséquence adapté aux tailles de la cage. The tooling is accordingly adapted to the size of the cage.

La discectomie est pratiquée par râpage de l'espace intervertébral entre les corps vertébraux au moyen de la râpe. The discectomy is performed by buffing the disc space between the vertebral bodies by means of the rasp. La tête de celle-ci a une forme générale pyramidale tronquée à section rectangulaire convergeant en direction postérieure et sensiblement analogue au contour du corps de cage intervertébral C selon l'invention. The head thereof has a general pyramidal shape converging truncated rectangular section posterior direction and substantially similar to the contour C of the intervertebral cage body according to the invention. Le long corps de la râpe est guidé dans un guide cylindrique creux, comme décrit dans le brevet français 2715293. Le râpage aboutit à la formation d'un logement de dimensions analogues à celles de la cage entre les corps vertébraux CV1 et CV2, comme montré à la figure 6. Along the body of the rasp is guided in a hollow cylindrical guide, as described in the French patent 2715293. The grating results in the formation of a similar size to those of the housing cage between the vertebral bodies CV1 and CV2 as shown in Figure 6.

Puis l'extrémité antérieure en queue d'aronde 181-281 du corps de cage C portant la vis 5 complètement incluse dans celui-ci est saisie par le porte-cage précité, afin que la cage soit implantée par voie antérieure dans le logement formé entre les corps vertébraux CV1 et CV2 en maintenant et 2866228 11 positionnant la cage grâce au porte-cage. Then the front end dovetail 181-281 of the cage body C on the screw 5 completely included therein is captured by the cage door supra, so that the cage is implanted by an anterior approach in the formed housing between the vertebral bodies CV1 and CV2 maintaining and positioning the cage 2866228 11 through carrier cage. Les chants chanfreinés postérieurs 30 et 31 de l'âme 3 du corps de cage facilitent la pénétration du corps C dans le logement. The posterior chamfered edges 30 and 31 of the core 3 of the cage body facilitate the penetration of the body C in the housing. Si nécessaire, les branches 1 et 2 peuvent se rapprocher en fléchissant au niveau des portions d'articulation 13 et 23 et ainsi réduisant notamment la largeur de la portion intermédiaire de fente étroite 42, ce qui facilite également la pénétration du corps C dans le logement. If necessary, the legs 1 and 2 can be closer by flexing at the hinge portions 13 and 23 and thus in particular reducing the width of the intermediate portion of narrow slot 42, which also facilitates penetration of the body C in the housing .

En variante, au moins l'une des branches 1 et 2, particulièrement la branche supérieure 1 de la cage, présente une surface externe supérieure qui est convexe au moins sur une portion antérieure 11 pour épouser sensiblement la concavité de la face inférieure du corps vertébral susjacent contre laquelle elle est appliquée. Alternatively, at least one of the branches 1 and 2, especially the upper leg 1 of the cage, has an upper external surface which is convex at least on a front portion 11 to substantially conform to the concavity of the bottom face of the vertebral body overlying against which it is applied.

Lorsque la cage est complètement située dans le logement intervertébral à l'emplacement souhaité, le cas échéant après avoir frappé sur la tête du porte- cage pour enfoncer la cage, le chirurgien retire le porte-cage en dévissant la tête de celui-ci, ce qui écarte des mâchoires à l'extrémité postérieure du porte-cage de manière à dissocier le porte-cage et le corps de cage C. L'extrémité d'un tournevis est ensuite introduite dans une fente 53 de la tête sensiblement bombée 51 de la vis 5 pour dévisser la vis dans le trou taraudé 33 et ainsi déplacer la vis 5 axialement dans la fente entre les branches 1 et 2 en direction antérieure. When the cage is completely situated in the intervertebral-disc compartment in the desired location, where appropriate after having struck on the head of the carrier cage to drive the cage, the surgeon removes the cage carrier by removing the head thereof, which deviates from the jaw at the rear end of the holder shaft so as to dissociate the cage door and the cage body C. the end of a screwdriver is then inserted into a slot 53 of the substantially domed head 51 of the screw 5 to unscrew the screw into the threaded hole 33 and thereby move the screw 5 axially in the slot between the branches 1 and 2 in the anterior direction. Au début du dévissage, la tête de vis 51 glisse contre les surfaces en regard de la portion d'appui antérieure 41 en vé tronqué de la fente. At the beginning of unscrewing, the screw head 51 slides against the opposing surfaces of the front support portion 41 of truncated V-shaped slot. Le dévissage contraint la tête de vis 51 à exercer des poussées opposées sur les deux surfaces de la portion d'appui de fente 41, tronconique ou pyramidale tronquée, de manière à écarter les branches 1 et 2 en sens contraires d'un angle AN de quelques degrés, comme montré à la figure 6. L'angle AN est adapté à l'angle de lordose plus ou moins accentué en fonction de la physiologie du patient et particulièrement est adapté à la position relative des corps CV1 et CV2 des deux vertèbres cervicales. Forced unscrewing the screw head 51 to exert opposite thrusts on both surfaces of the bearing portion of slot 41, frustoconical or truncated pyramid, so as to move the legs 1 and 2 in opposite directions of an angle AN few degrees, as shown in Figure 6. the angle AN is adapted to the angle of lordosis more or less accentuated depending on the physiology of the patient and particularly is adapted to the relative position of CV1 and CV2 of the body two cervical vertebrae .

L'écartement des branches est effectué grâce aux paires de portions de fente postérieures 13 et 23 qui jouent le rôle d'articulations opposées par rapport au plan de symétrie antéro-postérieur de la cage sensiblement perpendiculaire au rachis cervical, lesquelles portions d'articulation 13 et 23 sont monolithiques avec le corps de cage. The spacing of the legs is performed through the pairs of posterior slot portions 13 and 23 which act as opposing joints with respect to the antero-posterior plane of symmetry of the cage substantially perpendicular to the cervical vertebrae, which joint portions 13 and 23 are monolithic with the cage body. Grâce à cet écartement, les faces externes des branches supérieure et inférieure 1 et 2 de la cage sont mises en contact intime avec les corps vertébraux CV1 et CV2 respectivement. With this spacing, the outer faces of the upper and lower arms 1 and 2 of the cage are brought into intimate contact with the vertebral bodies CV1 and CV2, respectively. Les dentures 14 et 24 ancrent la cage entres les deux corps vertébraux. The toothings 14 and 24 anchor the cage between the two vertebral bodies.

Plus l'écartement requis est grand, plus la tête de vis 51 est proche du chant d'extrémité antérieure des branches 1 et 2 et participe au soutien des portions antérieures 11 et 21 des branches légèrement fléchies à l'opposé. Over the required distance, the more the screw head 51 is close to the anterior end edge of the arms 1 and 2 and helps support the forward portions 11 and 21 of the arms slightly bent the opposite. Le soutien des extrémités antérieures 11 et 21 des branches par la tête de vis 51 évite tout risque de microfissures ou de cassures des branches de la cage lors de la mobilité répétée ultérieure de la colonne vertébrale. The support of front ends 11 and 21 of the arms by the screw head 51 avoids any risk of microcracks or fractures of the legs of the cage during the subsequent repeated mobility of the spine. En outre, l'effort demandé lors du dévissage de la vis 5 à l'encontre de l'élasticité propre des portions d'articulation 13 et 23 est de plus en plus élevé, ce qui ne nécessite aucune butée de fin de course d'écartement des branches. Moreover, the effort required during the unscrewing of the screw 5 against the resilience of the joint portions 13 and 23 is increasingly high, which does not require any of end stop of spacing of the branches.

L'écartement angulaire AN des deux branches 1 et 2 de la cage C adapté à l'inclinaison relative des deux corps vertébraux CV1 et CV2 dans un plan antéropostérieur correspond sensiblement à une augmentation de l'épaisseur de la cage à son extrémité antérieure de quelques dixièmes de mm à 2 mm environ. The angular spacing AN of the two branches 1 and 2 of the cage C adapted to the relative inclination of the two vertebral bodies CV1 and CV2 in an anteroposterior plane substantially corresponds to an increase of the thickness of the cage at its front end a few tenths of a mm to about 2 mm.

Les lumières 10 et 20 favorisent une croissance osseuse intervertébrale ultérieure pour que la cage soit complètement noyée dans le milieu osseux. The lights 10 and 20 promote interbody bone growth later to the cage is completely embedded in the bone environment. Des greffons osseux peuvent remplir préalablement les lumières. Bone grafts can first complete the lights.

Claims (8)

REVENDICATIONS
1 - Cage cervicale réglable comprenant un corps monolithique (C) en forme de C composé de deux branches sensiblement parallèles (1, 2) et d'une portion de liaison postérieure (3) reliant des extrémités postérieures (13, 23) des branches, et une vis (5) ayant une tige filetée (52) qui s'étend entre les branches (1, 2) et est vissée dans la portion de liaison (3) et une tête (51) en contact avec des surfaces d'appui en regard d'un vé tronqué (41) entre des extrémités antérieures (11, 21) des branches (1, 2) pour écarter angulairement les extrémités antérieures des branches, caractérisée en ce que le vé tronqué est ouvert vers la portion de liaison (3) et a un sommet orienté vers l'extrémité antérieure de la cage (C) afin que les extrémités antérieures (11, 21) des branches (1, 2) soient écartées angulairement par dévissage de la vis (5) et éloignement de la tête de vis (51) par rapport à la portion de liaison (3) en direction du sommet du vé. 1 - Cage adjustable cervical comprising a monolithic body (C) C-shaped with two substantially parallel legs (1, 2) and a portion of back link (3) connecting the posterior ends (13, 23) of the legs, and a screw (5) having a threaded rod (52) extending between the legs (1, 2) and is screwed into the connecting portion (3) and a head (51) in contact with bearing surfaces opposite a truncated vee (41) between forward ends (11, 21) of the legs (1, 2) to angularly deviate the front ends of the branches, characterized in that the truncated vee is open towards the connecting portion ( 3) and has an apex oriented towards the front end of the cage (C) so that the front ends (11, 21) of the legs (1, 2) are angularly spaced apart by unscrewing the screw (5) and away from the screw head (51) relative to the connecting portion (3) towards the top of the vee.
2 - Cage conforme à la revendication 1, caractérisée en ce qu'au moins une portion antérieure (11) de l'une des branches (1, 2) a une surface externe qui est convexe. 2 - Cage according to claim 1, characterized in that at least a front portion (11) of one of the branches (1, 2) has an outer surface which is convex.
3 - Cage conforme à la revendication 1 ou 2, caractérisée en ce que la tête de vis (51) est au moins légèrement bombée (51) pour être en contact avec les surfaces d'appui en regard (41) qui sont sensiblement tronconiques ou pyramidales tronquées. 3 - Cage according to claim 1 or 2, characterized in that the screw head (51) is at least slightly curved (51) to be in contact with the bearing facing surfaces (41) which are substantially frustoconical or truncated pyramid.
4 - Cage conforme à l'une quelconque des 35 revendications 1 à 3, dans laquelle la vis (5) a une longueur inférieure à la longueur du corps de cage (C), et la tête de vis (51) est sensiblement en retrait de chants (18, 28) des extrémités antérieures (11, 21) des branches (1, 2) lorsque la tête de vis (51) écarte les surfaces d'appui (41). 4 - Cage according to any one of 35 claims 1 to 3, wherein the screw (5) has a length less than the length of the cage body (C) and the screw head (51) is substantially recessed songs (18, 28) of the front ends (11, 21) of the legs (1, 2) when the screw head (51) separates the contact surfaces (41).
- Cage conforme à l'une quelconque des revendications 1 à 4, caractérisée en ce que la portion de liaison (3) comporte un bossage (32) dans lequel la tige de vis (52) est vissée et qui saille dans une double lumière (10, 20) pratiquée dans le corps de cage monolithique (C) entre les branches (1, 2) et la portion de liaison. - Cage according to any one of claims 1 to 4, characterized in that the connecting portion (3) comprises a boss (32) wherein the screw shaft (52) is screwed which projects into a double lumen ( 10, 20) formed in the monolithic cage body (C) between the legs (1, 2) and the connecting portion.
6 - Cage conforme à l'une quelconque des revendications 1 à 5, comprenant une fente longitudinale s'étendant entre les branches (1, 2) depuis les extrémités antérieures de branche (11, 21) jusqu'au moyen de liaison (3), et comportant une portion antérieure (41) incluant lesdites surfaces d'appui pour la tête de vis (51), une portion intermédiaire plus étroite (42), et une portion postérieure plus large (43) devant la portion de liaison (3). 6 - Cage according to any one of claims 1 to 5, comprising a longitudinal slot extending between the legs (1, 2) from the front ends of leg (11, 21) to the connecting means (3) , and having a front portion (41) including said abutment surfaces for the screw head (51), a narrower intermediate portion (42) and a wider rear portion (43) to the connecting portion (3) .
7 - Cage conforme à l'une quelconque des revendications 1 à 6, dans laquelle les branches (1, 2) comportent chacune une portion centrale antérieure large (11, 21) dans laquelle est ménagée l'une des surfaces d'appui pour la tête de vis (51), deux portions latérales plus étroites (12, 22), et deux portions d'articulation postérieures (13, 23) liées à des extrémités latérales de la portion de liaison (3). 7 - Cage according to any one of claims 1 to 6, wherein the limbs (1, 2) each comprise a large anterior central portion (11, 21) in which is formed one of the bearing surfaces for the screw head (51), two narrower side portions (12, 22) and two posterior portions of articulation (13, 23) associated with the lateral ends of the connecting portion (3).
8 - Cage conforme à la revendication 7, dans laquelle des faces externes des portions centrales antérieures (11, 21) et des portions latérales (12, 22) des branches (1, 2) comprennent des dentures d'ancrage (14, 24). 8 - Cage according to claim 7 wherein the external faces of the anterior central portions (11, 21) and side portions (12, 22) of the legs (1, 2) comprise anchoring teeth (14, 24) .
9 - Cage conforme à l'une quelconque des revendications 1 à 8, dans laquelle les extrémités antérieures (11, 21) des branches (1, 2) ont des chants (18, 181; 28, 281) ayant un contour en forme de tenon de préhension. 9 - Cage according to any one of claims 1 to 8, wherein the front ends (11, 21) of the legs (1, 2) have edges (18, 181; 28, 281) having a shaped contour gripping stud.
- Cage conforme à l'une quelconque des revendications 1 à 9, caractérisée en ce qu'elle est en matière plastique radio-transparente. - Cage according to any one of claims 1 to 9, characterized in that it is X-ray transparent plastic.
FR0401635A 2004-02-17 2004-02-17 Cage adjustable cervical anterior approach Expired - Fee Related FR2866228B1 (en)

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Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2014088521A3 (en) * 2012-12-06 2014-09-04 Kamil Bal Intervertebral expandable cage system and its instrument
US9788971B1 (en) 2013-05-22 2017-10-17 Nuvasive, Inc. Expandable fusion implant and related methods
US9801734B1 (en) 2013-08-09 2017-10-31 Nuvasive, Inc. Lordotic expandable interbody implant
US10195053B2 (en) 2009-09-18 2019-02-05 Spinal Surgical Strategies, Llc Bone graft delivery system and method for using same
US10245159B1 (en) 2009-09-18 2019-04-02 Spinal Surgical Strategies, Llc Bone graft delivery system and method for using same

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Publication number Priority date Publication date Assignee Title
FR2715293A1 (en) 1994-01-26 1995-07-28 Biomat Vertebral intersomatic cage.
FR2717068A1 (en) 1994-03-14 1995-09-15 Biomat Intersomatic cage insertable between two vertebral bodies
FR2763836A1 (en) 1997-05-30 1998-12-04 Biomat Cervical cage INTERVERTEBRAL
US20020068976A1 (en) * 2000-12-04 2002-06-06 Jackson Roger P. Posterior expandable fusion cage
DE20211616U1 (en) * 2002-07-16 2002-09-19 Aesculap Ag & Co Kg Intervertebral implant
FR2843017A1 (en) * 2002-08-01 2004-02-06 Biomet Merck France inter-somatic Implant

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2715293A1 (en) 1994-01-26 1995-07-28 Biomat Vertebral intersomatic cage.
FR2717068A1 (en) 1994-03-14 1995-09-15 Biomat Intersomatic cage insertable between two vertebral bodies
FR2763836A1 (en) 1997-05-30 1998-12-04 Biomat Cervical cage INTERVERTEBRAL
US20020068976A1 (en) * 2000-12-04 2002-06-06 Jackson Roger P. Posterior expandable fusion cage
DE20211616U1 (en) * 2002-07-16 2002-09-19 Aesculap Ag & Co Kg Intervertebral implant
FR2843017A1 (en) * 2002-08-01 2004-02-06 Biomet Merck France inter-somatic Implant

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10245159B1 (en) 2009-09-18 2019-04-02 Spinal Surgical Strategies, Llc Bone graft delivery system and method for using same
US10195053B2 (en) 2009-09-18 2019-02-05 Spinal Surgical Strategies, Llc Bone graft delivery system and method for using same
US9579213B2 (en) 2012-12-06 2017-02-28 Kamil Bal Intervertebral expandable cage system and its instrument
WO2014088521A3 (en) * 2012-12-06 2014-09-04 Kamil Bal Intervertebral expandable cage system and its instrument
US9788971B1 (en) 2013-05-22 2017-10-17 Nuvasive, Inc. Expandable fusion implant and related methods
US10219915B1 (en) 2013-05-22 2019-03-05 Nuvasive, Inc. Expandable fusion implant and related methods
US9801734B1 (en) 2013-08-09 2017-10-31 Nuvasive, Inc. Lordotic expandable interbody implant

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