FR3054788A1 - DEPLOYABLE IMPLANT - Google Patents

Abstract

The present invention relates to a new implant for medical use for fixing at least two adjacent bone elements quickly, reliably and minimally invasive. This implant consists of a curved hollow rod comprising at least one deployable anchoring means for immobilizing said implant. The present invention also describes a method of attaching at least two adjacent bone elements implementing this new implant. This method is particularly suitable for the joining of at least two vertebrae for performing arthrodesis; said implant is then of curved shape which makes it particularly well suited to spine surgery.

Description

© Publication number: 3,054,788 (to be used only for reproduction orders) (© National registration number: 16 70438 ® FRENCH REPUBLIC

NATIONAL INSTITUTE OF INDUSTRIAL PROPERTY

COURBEVOIE © Int Cl ⁸ : A 61 B 17/70 (2017.01), A 61 B 17/58

A1 PATENT APPLICATION

©) Date of filing: 05.08.16. (© Priority: © Applicant (s): SPINE ARCH PATENT— FR. @ Inventor (s): FISCHER-LOKOU DAVID. ©) Date of availability of the request: 09.02.18 Bulletin 18/06. (56) List of documents cited in the preliminary search report: See the end of this brochure (© References to other related national documents: ® Holder (s): SPINE ARCH PATENT. ©) Extension request (s): © Agent (s): BARNY LUC.

DEPLOYABLE IMPLANT.

FR 3 054 788 - A1 _ The present invention relates to a new implant for medical use allowing the fixation of at least two adjacent bone elements in a rapid, reliable and minimally invasive manner. This implant consists of a curved and hollow rod comprising at least one deployable anchoring means making it possible to immobilize said implant. The present invention also describes a method of fixing at least two adjacent bone elements using this new implant. This method is particularly suitable for securing at least two vertebrae with a view to performing arthrodesis; said implant is then of curved shape which makes it particularly well suited to spine surgery.

DEPLOYABLE IMPLANT

The present invention relates to a new implant for medical use allowing the attachment of at least two adjacent bone elements quickly, reliably and minimally invasive. The present invention also describes a method of fixing at least two adjacent bone elements using this new implant. This method is particularly suitable for securing at least two vertebrae with a view to performing arthrodesis; said implant being of curved shape which makes it particularly well suited to spine surgery.

With regard to the aging of the population and also to the rhythm of life of the working population, bone problems generate or are part of the clinical picture of many pathologies. In addition, trauma linked to accidents, shocks and falls can also cause bone problems requiring surgical intervention. The possibility of fixing bone elements together in order to stabilize or correct a given position is therefore an important medical issue. Indeed, in the field of spine surgery in particular the fact of being able to join bone elements in order to stabilize given areas and / or to release compressed nerve bundles is often the only way to relieve patients.

In the field of orthopedic surgery, plates and screws are commonly used in order to stabilize adjacent bone areas or to give them a given position. The materials used are obviously solid and many mechanical constraints are imposed by the material and the material. To allow more adaptation and allow more possibilities for surgeons, different devices have been implemented in order to allow a better surgical response for each patient: surgical screws in combination at different angles, fixed plates, articulated plates, cages, etc.

In the particular field of spine surgery, surgeons generally use pedicle screws also called tulip screws to secure the vertebrae. These screws for medical use are straight screws which allow arthrodesis, that is to say bone fusion between at least two vertebrae. This technique is commonly used in case of fracture, scoliosis, instability and severe pain. Even if this technique is very commonly practiced, the installation of pedicle screws remains a difficult procedure which is reserved for specialized surgeons and is likely to cause false journeys. In the case of false paths, one or more screws not being correctly placed, they can injure the nerve roots or present a lack of solidity. To overcome this possibility of systems using false routes, several sophisticated guidance aids are used by surgeons such as navigation including infrared markings coupled with an intraoperative scanner. These navigation systems reduce the risk of trajectory error. However, the risk of error remains significant because arthrodeses performed to date require at least four pedicle screws and more often six to eight pedicle screws.

Thus the techniques used to date have several drawbacks including the complexity of the devices to be implanted, the transpedicular approach for the fixing screws of these devices which is relatively invasive and generates side effects (haemorrhages, nerve damage, etc.), the need for monitoring involving high-performance imaging techniques, which are all risk factors, technicality and costs that must be taken into account.

The presence of nerves, blood vessels and other tissues which must necessarily be preserved during bone surgeries imposes access routes and approaches limited to the surgeon. Trajectory errors are all the more numerous when the access route (s) are difficult or cramped. In certain cases, taking into account the spatial configuration of the bone elements to be joined, the techniques known from the prior art offer no solution. There is therefore a real need for new technical solutions opening up new possibilities for fixing specific elements.

bony in configurations

According to a first characteristic of the invention, the curved implant is one of these solutions, and has however never been proposed to date. Indeed, the implant according to the invention has the advantage of allowing the establishment of a solid fixation requiring a single access route. The curved shape makes it possible to work access paths offering working angles which are not suitable for the rectilinear screws known from the prior art.

Another advantage of the invention aims to strengthen the attachment of the implant by adding lateral means for anchoring it in the bone, and more particularly rigid means which are deployed laterally outside the implant.

The present invention provides a surgical implant

simple who allows to realise the fixation from at less two elements bony adj acents, by example of them vertebrae adj acentes, without risk of false traj and, without difficulty

special technique and without expensive technical assistance other than a simple x-ray machine. In the case of spine surgery, unlike the technique using pedicle screws, the implants according to the present invention are not positioned in the vertebral pedicles but allow the vertebral bodies to be joined directly to one another. The device is immediately stronger than the pedicle screws commonly used in the prior art. On the other hand the vertebral bodies being bulky, of the order of 4 x 5 x 3 cm, the risk of an extracorporeal path is very limited compared to the vertebral pedicles which are 1 x 0.8 cm and are quite difficult to even identify with efficient imaging techniques.

The present invention therefore also provides a new method of fixing at least two adjacent bone elements, for example two adjacent vertebrae, without risk of false path and without particular technical difficulty for a surgeon. This method also saves considerable time in the case of the stabilization of more than two adjacent bone elements such as several vertebral stages. In addition, this new surgical implant is placed directly in the bone element, without staples or nails, so an arthrodesis operation for example can be performed with the spine closed between the nerve bundles and without damaging the nerves.

In the present invention, the terms between quotation marks are used to describe the new surgical implant, the new method of fixation using it and the elements constituting it. They are used in the plural as in the singular.

By “patient” is meant a human being or an animal whose symptoms or pathology require the intervention of a surgeon to secure at least two bone elements together. For example, a patient is an individual who has suffered a vertebral fracture or has scoliosis, vertebral compression, etc. the method proposed for relieving the pain of said patient being the performance of an arthrodesis, that is to say the bone fusion between two vertebrae.

By “bone element” is meant anatomical bone elements requiring a surgical intervention for stabilization or repair but also any implant which replaces all or part of an anatomical bone element for example a metal implant or a metal alloy, ceramic, polymer, or any other biocompatible material.

According to one embodiment, the subject of the invention is a surgical implant for fixing at least two adjacent bone elements of a patient _r consisting of a rod intended to be inserted into a borehole made in the at least two elements adjacent bone, said implant being characterized in that the rod is curved and hollow so as to form a cavity substantially along the axis of the rod and open at its distal end _r said rod comprising at least one anchoring means deployable capable of projecting between a retracted position and a position deployed outside the rod once the latter is put into place within the bore so as to immobilize said implant.

By “rod” is meant a solid element, preferably of cylindrical shape and which constitutes the body of the implant according to the invention.

By “curve” is meant a shape describing or comprising a portion in planar arc or in three dimensions, not necessarily regular. The stem can be of regular or mixed curved shape. When it is regular, the rod has a regular arc of curvature, that is to say that it corresponds to a regular arc of circle over its entire length. We will then speak of regular “curvature” or “arc of curvature”. When it is mixed, the rod has a straight part and at least one curved part without the rod necessarily having symmetry. In certain embodiments, the mixed rod may have two, three or more curved parts. We will then speak of a "curvature" or "arc of curvature" mixed.

By "hollow" is meant that the rod comprises, over all or part of its length, drilling in the longitudinal direction so as to form a cavity, said cavity being open at one of the ends of the rod (so as to be able to introduce ancillary for example by this open end). According to a particular embodiment, the cavity is open at the level of the so-called “rear” or “distal” end of the rod, the other end, called “front” or “proximal” being full and being able to have a pointed shape. intended to facilitate the penetration of the rod within the bony elements.

By "deployable anchoring means" means any means known to those skilled in the art that can pass from a position called "retracted", that is to say not coming to hinder in any way whatsoever insertion or removal by sliding of the rod within the orifice provided for this purpose in a position called "deployed", that is to say projecting outwardly from the rod so as to come s anchor in the bone and thus immobilize the implant.

According to a preferred form, said deployable anchoring means can easily pass from the retracted position to the deployed position, and vice versa, so as to be able to insert or remove the rod at the convenience of the surgeon for example. According to a preferred embodiment, the “retracted” position means inside the rod cavity.

By way of nonlimiting example, the anchoring means can consist of a protuberance, a stop, a hook, a ring, a relief, an imprint, a fin, or any equivalent means.

According to a particular form of the invention, the deployable anchoring means consists of a rigid element such as, for example, a rigid fin capable of deploying towards the outside of the rod. In other words, the subject of the present invention is an implant which, as described above, is characterized in that said at least one deployable anchoring means consists of at least one fin.

According to a preferred form of the invention, said at least one fin is made integrally with the rod by one of its sides forming a hinge with the body of the rod.

Still according to a preferred form, said at least one fin may have a chamfer or a rounding in its upper distal part which comes into contact with the bone or any general shape favoring the passage from the deployed position to the retracted position by pressing the 'bone on the fin when the stem is removed.

According to another preferred form of the invention, said at least one deployable anchoring means consists of a rigid element such as, for example, a rigid pin capable of deploying towards the outside of the rod. According to one embodiment, the implant may include several deployable anchoring means disposed on all or part of the rod. It is understood that, depending on the nature of the bone elements to be sealed, the arrangement of said deployable anchoring means may be adapted according to the general knowledge of those skilled in the art. By way of example, in the case of a use for securing two vertebrae, the rod according to the invention can comprise two series of deployable anchoring means, each series possibly comprising at least two means arranged close to the distal end of the rod for the first and close to the proximal end of the rod for the second. In this way, the anchoring means once deployed will be anchored in the bone material without any contact with the intervertebral space.

According to a preferred form, the stop of said at least one deployable anchoring means which comes into contact with the bone can be sharp or slightly sharpened so as to be able to enter the bone material without damaging it.

The surgical implant according to the invention is particularly suitable when said bone elements are vertebrae.

The shape of the rod determines the shape of the implant, so in a particular embodiment the rod is curved and the surgical implant once it is in place is also curved. In a specific embodiment, the rod is bent in different planes. According to another additional characteristic, the shape of the surgical implant is mixed, that is to say that it has one or more straight portion and one or more curved portion (s).

The curvature of the implant according to the invention is therefore not necessarily regular. The curvature of the implant according to the invention is therefore not necessarily regular. According to a particular form of the invention, the implant according to the invention will comprise at least one regular curved portion preferably of developed length between 20 and 180 mm describing an arc of radius typically between 60 and 150 mm. According to a more preferred form of the invention perfectly suited to the joining of two vertebrae in an adult patient the rod is of curved shape in a plane, of developed length of 70 mm describing an arc of 44.6 ° and of constant radius equal to 90mm. According to an additional characteristic, the rod is made of metal or of a metal-based alloy. In another embodiment, the rod is made of different biocompatible materials so as to have properties, in particular of different flexibility, along its sections. Of course, in specific embodiments, different treatments of the surface of the rod can be envisaged to ensure biocompatibility, the cutting edge, the spring effect, the sliding or, on the contrary, the adhesion of one or other of these elements.

The biocompatible materials constituting the deployable anchoring means can be identical to those used for the rod.

The present invention therefore relates to an implant as described above which is characterized in that the rod constituting it is made of one or more biocompatible materials which are flexible.

When the rod is made of a rigid material, the surgeon must drill into the bone elements to be assembled, the curvature of which is identical to that of the rod. When the rod is made of a solid but flexible material, the rod is capable of adapting to any curvature of the drilling carried out by the surgeon according to predefined parameters. Thus, according to an additional characteristic, the rod is made from one or more flexible biocompatible material (s). The rod may in particular have the shape of a nail. According to a particular embodiment, the implant according to the invention is characterized in that only some of the portions of the rod are flexible.

In general, whatever the shape of the implant according to the invention, it may be envisaged to produce only certain portions of the rod in a flexible material. For example, the flexible parts could be provided to be positioned outside the bone elements to be assembled, for example two vertebrae, so as to form a sort of hinge and to retain a certain flexibility in the implant.

The simplicity of this surgical implant makes it particularly adaptable to the morphology of the adjacent bone elements to be fixed together. In fact, it is easy to make "custom-made" surgical implants of substantially curved shape, with or without symmetry with respect to said curve, etc. All shapes are authorized in the present invention depending on the area to be implanted. For implantation at the vertebral level, a surgical implant of curved shape will be preferred, for example, in order to adapt to the morphology of the vertebrae and to their articulation. The curvature is then determined according to the morphology of the bone elements to be joined. The curvature of the implant according to the invention will not necessarily be flat and may have twists. The curvature of the implant according to the invention is not necessarily regular.

Typically, for an adult patient, the rod has a diameter of between 4 and 8 mm, preferably around 6 mm. The placement of the surgical implant therefore requires drilling of equal or slightly larger size, for example between 5 and 10 mm in diameter.

As indicated above, according to a preferred embodiment, the deployable anchoring means are arranged, in their retracted position, within a cavity made for this purpose in the rod. Thus, during the introduction of the rod, the latter do not interfere with the establishment of the rod. An alternative embodiment may consist in that, for example, said deployable anchoring means are "pressed" against the external wall of the rod (which may include an imprint for this purpose). Any other equivalent embodiment should of course be considered as falling within the scope of the present invention.

The transition from the “retracted” position to the “deployed” position, and vice versa, can be achieved by any technique known to those skilled in the art. Concretely, any technique making it possible to apply pressure to the deployable anchoring means can be envisaged, said pressure then pushing the deployable anchoring means so that they deploy from the “retracted” position in the cavity of the rod in the "deployed" position, then forming a projection on the outside of the rod.

According to one embodiment, it can be envisaged to inject a pressurized fluid, such as pressurized air, into the cavity.

According to other embodiments, it can be envisaged to use spring or elastic mechanisms.

According to another preferred embodiment, a mobile male element capable of sliding inside the rod cavity will be used so that the head of said mobile male element comes to abut against the deployable anchoring means and thus push them to deploy them towards the outside of the rod, for example like a screw in a dowel.

According to a preferred embodiment, the implant also comprises a movable male element insertable within the cavity of the rod, after the latter has been inserted into the bone elements to be stabilized so that the head of said movable male element comes abut against the deployable anchoring means and thus push them to make them protrude towards the outside of the rod. According to the embodiment chosen, and as will be described in more detail below, this movable male element can be left in place and participate in the rigidity of the implant or possibly be removed.

In a first alternative, this mobile male element can be considered as an integral part of the implant according to the invention.

In a second alternative, this movable male element could be considered as not forming an integral part of the implant according to the invention but as constituting an independent ancillary.

Consequently, although the description below applies more particularly to the second alternative, it should be understood that the invention is aimed both at the integrated embodiment in which the implant comprises a rod forming the body of the implant and a mobile male element, but also the “kit of part” mode which comprises an implant consisting of the rod and an independent ancillary device consisting of said mobile male element, the assembly forming a kit according to the invention.

The present invention therefore also relates to an assembly or a kit which comprises an implant as described above and an ancillary comprising a hollow body with a proximal end adapted to be fixed on the distal end of the rod and a male element mobile sliding within said hollow body and capable of sliding within the cavity of the rod so that the head of said mobile male element abuts against the deployable anchoring means and thus allows them to be pushed to make them protrude outside the stem.

Preferably, said movable male element consists of two portions, a distal portion intended to be removed after the implant has been placed and a proximal portion intended to remain in place within the cavity of the rod in order to maintain pressure on the anchoring means so as to keep them in the “deployed” position. In this embodiment, the withdrawal of the proximal portion of the movable male element will result in a passage from the "deployed" position to the "retracted" position of the anchoring means, thus allowing the removal of the implant by a simple traction of the surgeon.

According to yet another particular embodiment of the invention, an assembly or kit is envisaged which comprises an implant as described above and an ancillary device as described above comprising a movable male element consisting of two portions, a distal portion intended to be removed after placement of the implant and a proximal portion intended to remain in place within the cavity of the rod in order to maintain pressure on the anchoring means so as to maintain them in the “deployed” position.

By way of nonlimiting example, as will be illustrated below in the figures, it may be used an ancillary type "syringe" consisting i) of a rigid or semi-rigid hollow body with an end adapted to come cooperate with the distal end of the rod and the other end being open and ii) a movable male element sliding inside said body in the manner of a piston, said movable male element possibly comprising two portions.

The invention also provides a method of fixing at least two adjacent bone elements, implementing the surgical implant according to the invention, consisting in:

- practice drilling with the characteristics defined by the surgeon according to the bone elements to be joined,

- insert the rod into the well thus drilled, then

deploying said at least one deployable anchoring means.

The present invention relates, according to a particular embodiment, to a method of fixing at least two adjacent vertebrae which implements a surgical implant as described above, said method consisting in:

drill using a drilling tool with the characteristics defined by the surgeon according to the vertebrae to be secured, then

- insert the rod into the well thus drilled using a medical fluoroscopy placement tool, then

deploying said at least one deployable anchoring means by applying pressure on said at least one anchoring means so as to make it slide from a “retracted” position to a “deployed” position.

According to a more particular embodiment, the present invention relates to a method of fixing at least two adjacent vertebrae which implements a surgical implant as described above, said method consisting in:

drill using a drilling tool with the characteristics defined by the surgeon according to the vertebrae to be secured, then

insert the rod into the well thus drilled using an ancillary device as described above comprising i) a rigid or semi-rigid hollow body with an end adapted to come to cooperate with the distal end of the rod and the the other end being open and ii) a movable male element sliding inside said body in the manner of a piston applying pressure to the movable male element so that the latter comes to be inserted within the cavity produced for this purpose in the rod, slides along the rod so as to abut on said at least one deployable anchoring means thus applying pressure on the latter so that it can pass from the "retracted" position in the "deployed" position.

According to yet a more particular embodiment, the present invention relates to a method of fixing at least two adjacent vertebrae which implements a surgical implant as described above _r said method consisting in:

- drill using a drilling tool with the characteristics defined by the surgeon according to the vertebrae to be joined _r then

insert the rod into the well thus drilled using an ancillary device as described above comprising i) a rigid or semi-rigid hollow body with an end adapted to come to cooperate with the distal end of the rod and the the other end being open and ii) a movable male element composed of a detachable distal portion and a proximal portion which slides within said body in the manner of a piston

- apply a pressure on the male element mobile of way that has this last come fit into within the cavity performed at this effect in the rod, slide along of

the rod so as to abut on said at least one deployable anchoring means thus applying pressure on the latter so that it can pass from the "retracted" position to the "deployed" position

- unhook the distal portion of the movable male element so that only the proximal portion remains within the cavity of the rod in order to put pressure on said at least one deployable anchoring means.

When the surgeon judges it applicable depending on the bone elements to be assembled and the material constituting the rod, it can be envisaged to use a drilling and positioning tool which employs the rod forming the surgical implant having a pointed distal end as head drilling. In this embodiment there is no prior drilling step when the method according to the invention is applied.

It will be readily understood that the rod of the implant according to the invention can be inserted like a nail by simple percussion or any other push on its external end, without it being necessary to impart any rotational movement to it. The implant stem according to the invention can even be inserted in this way in a borehole or a housing having a certain curvature, which is strictly impossible for a traditional rigid screw. If the borehole has a constant radius of curvature and lying in a single plane, that is to say without torsion, the rod of the implant according to the invention may be rigid but must have the same radius of curvature as said drilling. If the radius of curvature of the borehole is not constant or if it has one or more twists, the rod of the surgical implant according to the invention must necessarily have a certain flexibility.

The characteristics of the invention mentioned above, as well as others, will appear more clearly on reading the following description of an exemplary embodiment, said description referring to the attached figures, among which:

Figure 1 shows a longitudinal sectional view of the rod (4) constituting the surgical implant with the deployable anchoring means (8) in the "retracted" position;

Figure 2 shows a longitudinal sectional view of the rod (4) constituting the surgical implant with the deployable anchoring means (8) in the "deployed" position;

Figure 3 shows a view of the implant in a conventional embodiment with the rod (4) at the time when it will be inserted into the bore (5) made in two adjacent vertebrae (2; 3) with the means of deployable anchor (8) in the retracted position. Also shown is an ancillary device consisting of a rigid hollow body (11), the proximal end (12) of which is positioned at the level of the open distal end (7) of the rod (4) and of a movable male element. (13) in two portions (13 '; 13' ') in the high position;

Figure 4 shows the rod (4) forming the implant placed in the borehole (5) with the ancillary in place, the movable male element (13) always in the high position. The arrow shown in this figure illustrates the pressure which will be exerted by the surgeon on said movable male element (13);

Figure 5 shows the implant anchored within the adjacent bone elements (2; 3) with the movable male element (13) completely inserted within the cavity (6) of the rod (4) thus projecting the means d deployable anchor (8) to the outside of the rod (4) as shown by the arrows.

This example of setting up an implant according to the invention describes the joining of two adjacent vertebrae (2; 3) using a surgical implant as described above. The embodiment illustrated in Figures 1 and 2 shows a rod (4) of curved shape with a regular arc of curvature.

More particularly, there is shown in Figure 1 a surgical implant according to the invention consisting of a rod (4) curved and hollow so as to form within it a cavity (6) open at its distal end (7) . In this embodiment, the proximal end is solid and is in the form of a point. The rod (4) shown comprises in this embodiment 4 deployable anchoring means (8) consisting of fins shown in the retracted position inside the cavity (6).

Figure 2 illustrates the implant according to the invention comprising said 4 deployable anchoring means (8) shown in the deployed position. As is clear from this figure, the fins constituting the deployable anchoring means (8) project outwardly from the rod (4) so as to be able to anchor directly within the bone material constituting the elements to be united. Whether in this figure or in Figure 1, there is also shown an embodiment with the distal end (7) open so as to allow a fluid or an ancillary to be inserted within the cavity (6 ) in which the fins (8) are retracted and thus press on the latter to deploy them. According to the embodiment shown, the fins (8) have a base stop with a length (X) greater than the length (Y) of the stop which comes into contact with the bone.

Figure 3 shows an embodiment of the implant according to the invention. Shown is the rod (4) which is curved and hollow with a cavity (6) within which the fins (8) are folded forming deployable anchoring means. The rod (4) is shown while it is going to be inserted into the borehole (5) made for this purpose by the surgeon within the two bone elements (2; 3) to be joined. In this embodiment, the rod (4) is shown as being inserted and pushed into the borehole (5) via an ancillary. As indicated above, the use of such an ancillary is in no way limiting and should only be considered as a form of the invention. The ancillary device comprises a rigid or semi-rigid hollow body (11) forming a tube, with a proximal end (12) adapted to the distal end (7) of the rod being open so as to receive a movable male element (13) sliding within the cavity formed by said coming to cooperate with (4) and the other hollow body end

11 'like a piston. The movable male element (13) consists of a distal portion (13 ') intended to be removed which constitutes its part and a proximal portion (13' ') intended to remain inserted within the cavity (6 ) of the rod (4). For the sake of clarity, the distal portion (13 ') is shown hatched with spaced lines while the proximal portion (13' ') is shown hatched with tight lines. The hollow body (11) is shown in white section (no filling). According to a preferred form, the proximal end (12) is designed to come to stow or "clip" on the distal end (7) of the rod (4). According to another embodiment, the proximal end (12) has a diameter slightly greater than the diameter of the distal end (7) of the rod (4) so that it can be positioned by overlapping around said distal end ( 7) of the rod (4). In practice, the surgeon will be able to set up the ancillary once the rod (4) is installed in the borehole (5) or else use the ancillary as a tool to push the rod (4) and thus insert it completely into the drilling (5). A combination of these two uses could obviously be made by manual insertion of the rod (4) then subsequent pushing with the ancillary.

Figure 4 shows the rod (4 (within the two vertebral bodies (2; 3) that emerges from this figure, the rod inserted in the borehole once positioned at the to be secured. As (4) is completely

5) and only the ancillary positioned at the distal end (7) of the rod (4) is outside the vertebrae. At this stage, the mobile male element (13) is in the high position, that is to say engaged within the rigid body (11) forming the ancillary but not protruding beyond the proximal (12). Thus, at this stage, (13) is in no way engaged within pitch of the end of the movable male element the cavity of the rod

In the mode shown, the proximal portion (13 '') is completely inserted within the hollow body (11) while the distal portion (13 ') is not. As also illustrated, the surgeon will only have to apply pressure to the movable male element (13) as shown by the arrow. Such pressure will have the effect of introducing the proximal portion (13 '') of the movable male element (13) within the cavity (6) of the rod (4) while the distal portion (13 ') is inserted within the hollow body (11). The end of the proximal portion (13 '') will thus abut on the fins (8) which are retracted within this same cavity (6). Under this pressure, the fins (8) will be propelled towards the outside of the rod (4) so as to be anchored directly in the bone material forming the vertebrae (2; 3). In this embodiment applied to the joining of two vertebrae, the fins (8) forming an anchoring means are retracted within the rod (4) and are arranged so as to be positioned at the level of the central bone part. forming each vertebra. Preferably, no fin is arranged at the intervertebral junction.

Figure 5 shows the surgical implant in its final position within two vertebral bodies (2; 3) in our example. The fins (8) are deployed (as illustrated by the arrows in the drawing) so as to be firmly anchored in the vertebrae. The pedicles of the vertebrae are not affected by the placement of the surgical implant, which avoids any problem of false path and / or nerve or vascular damage. It only remains for the surgeon to remove the ancillary with the distal portion (13 ') of the movable male element (13). In this embodiment, the proximal portion (13 '') will be detached from the distal portion (13 '), the proximal portion (13' ') remaining inserted within the rod (4) so as to maintain pressure on the fins (8). Although not shown, it is easily understandable that the surgeon can easily remove the implant using the ancillary device. The latter will be returned to position at the open distal end (7) of the rod (4) so as to allow the distal portion (13 ') of the movable male element (13) to come together with the proximal portion (13 '') of the movable male element (13) which remains in place within the cavity (6) of the rod (4). The surgeon will then only have to remove the movable male element (13) in its entirety. This will remove the pressure exerted by the proximal portion (13 '') on the fins (8) and thus allow them to return to the retracted position in order to be able to remove the implant.

When the surgeon judges it applicable depending on the bone elements to be assembled and the material constituting the rod (4), it can be envisaged to use a drilling and positioning tool which employs the rod (4) of the surgical implant having a pointed distal end as a drill head. In this embodiment there is no prior drilling step when the method according to the invention is applied.

This method is particularly suitable for fixing several adjacent vertebrae in a patient with a lumbar problem requiring the intervention of a surgeon because it avoids the insertion of pedicle screws according to the techniques currently used, which is less invasive and greatly limits the side effects associated with the vertebra fixation operation. In addition, the operation can be considered with the spine closed under fluoroscopic control, passing between the nerve bundles and without damaging the nerves.

Firstly a drilling (5) is carried out with a first drilling tool. Then a positioning tool, which may not consist of the ancillary, is used to place the rod (4) from the cortex through the tender part of the first vertebral body and finally to the second vertebral body to be fixed. In a second step, the fins (8) forming deployable anchoring means are deployed by any technique known to those skilled in the art. The present invention also relates to kits or kits containing the material necessary for the implementation of the method described above.

According to a first embodiment, the present invention relates to kits or kits containing a surgical implant in one of the embodiments detailed above.

According to a second embodiment, the present invention relates to kits or kits containing a surgical implant in one of the embodiments detailed above and an ancillary in one of the embodiments detailed above.

In a preferred embodiment, the kit or kit comprises a curved-shaped surgical implant and a kit of ancillaries.

According to a third embodiment, the present invention relates to kits or kits comprising a surgical implant in one of the embodiments detailed above, an ancillary in one of the embodiments detailed above, and a tool for drilling and / or a rod setting tool (4) independent of the ancillary.

Claims (8)

1. Surgical implant for fixing at least two adjacent bone elements ( 2; 3) of a patient, consisting of a rod (4) intended to be inserted into a 10 drilling (5) carried out in the at least two adjacent bone elements (2; 3), characterized in that said rod (4) is curved and hollow so as to form a cavity (6) substantially along the axis of the rod (4) and open at its distal end (7), said 15 rod (4) comprising at least one deployable anchoring means (8) capable of sliding between a retracted position and a position deployed outside the rod (4) once the latter has been placed in the borehole ( 5) so as to immobilize said implant. 2. Surgical implant according to claim 1, characterized in that said at least one deployable anchoring means (8) consists of at least one wing. 3. Surgical implant according to any one of the preceding claims, characterized in that the 25 rod (4) is made of one or more biocompatible materials which are flexible. 4. Surgical implant according to any one of the preceding claims, characterized in that the portions of the rod (4) positioned outside the 30 bone elements (2; 3) to be assembled are flexible. 5. Surgical implant according to any one of claims 1 to 4 characterized in that it further comprises a movable male element (13) insertable within 10 15 the cavity (6) of the rod (4) so that the head of said movable male element (13) abuts against the deployable anchoring means (8) and thus push them to make them protrude towards outside of the rod (4). 6. Implant according to claim 5, characterized in that said movable male element (13) consists of two portions, a distal portion (13 ') intended to be removed after placement of the implant and a proximal portion (13' ') intended to remain in place within the cavity (6) of the rod (4) in order to maintain pressure on the anchoring means (8) so as to keep them in the "deployed" position. 7. Kit comprising a surgical implant according to any one of claims 1 to 6. 8. Kit according to claim 7, characterized in that it comprises an ancillary device consisting of a hollow body (11) with a proximal end (12) adapted to be fixed on the distal end (7) of the rod ( 4) and of a movable male element (13) sliding within said hollow body (11) and capable of coming to slide within the cavity (6) of the rod (4) so that the head of said element movable male (13) comes to abut against the deployable anchoring means (8) and thus push them to make them project towards the outside of the rod (4). 1/4