FR3063890A1 - SYSTEM FOR POSITIONING AN INSERT BETWEEN TWO BONE PORTIONS - Google Patents

Abstract

The present invention relates to systems for positioning, between two bone portions, an Ins insert constituted by a solid body 10. The system according to the invention is characterized essentially by the fact that it comprises a cavity 12 in the body 10, an opening 14 in the wall 31 of the cavity between the inside of the cavity and the outside 15 of the body, a guide rod 20 whose distal end 22 is able to pass through the opening 14 to enter the cavity 12, a housing 30 in the wall of the cavity, the wall of the housing having a tapping 32 of a given shape, a portion 23 of cylindrical rod of revolution carrying a thread 24 complementary to the tapping 32, means for securing the rod portion 23 with the distal end 22 of the guide rod, and means 40 adapted to apply a force on the body 10 relative to 41 to the guide rod. Application, in particular, to inserts constituted by medical elements having the following functions: intersomatic cage function, disectomy function, bone block function, distracting function, a combination of at least two of these functions.

Description

® FRENCH REPUBLIC

NATIONAL INSTITUTE OF INDUSTRIAL PROPERTY © Publication number: 3,063,890 (to be used only for reproduction orders) © National registration number: 17 70262

COURBEVOIE © Int Cl ⁸ : A 61 F2 / 46 (2017.01), A 61 B 17/88

A1 PATENT APPLICATION

©) Date of filing: 17.03.17. (© Priority: © Applicant (s): FtAZIAN HASSAN - FR. @ Inventor (s): RAZIAN HASSAN. ®) Date of public availability of the request: 09/21/18 Bulletin 18/38. ©) List of documents cited in the preliminary search report: See the end of this booklet (© References to other related national documents: ® Holder (s): RAZIAN HASSAN. ©) Extension request (s): (© Agent (s): ABRITT.

TT SYSTEM FOR POSITIONING AN INSERT BETWEEN TWO BACK PORTIONS.

FR 3,063,890 - A1 yT) The present invention relates to systems for positioning, between two portions of bone, an insert Ins constituted by a solid body 10.

The system according to the invention is essentially characterized by the fact that it comprises a cavity 12 in the body 10, an opening 14 in the wall 31 of the cavity between the interior of the cavity and the exterior 15 of the body, a guide rod 20, the distal end 22 of which is capable of passing through the opening 14 to penetrate into the cavity 12, a housing 30 in the wall of the cavity, the wall of the housing comprising a tapping 32 of determined shape, a portion of rod 23 cylindrical of revolution carrying a thread 24 complementary to the internal thread 32, means for securing the rod portion 23 with the distal end 22 of the guide rod, and means 40 capable of applying a force to the body 10 relative to 41 to the guide rod.

Application, in particular, to inserts made up of medical elements having the following functions: function of the interbody cage, function of disectomy, function of calle bone, function of distraction, a combination of at least two of these functions.

SYSTEM FOR POSITIONING AN INSERT BETWEEN TWO BACK PORTIONS

The present invention relates to systems for positioning an insert between two portions of bone.

It is for example known that, depending on the trauma suffered by a spine, practitioners are required to perform two kinds of surgical intervention.

When the trauma only concerns an intervertebral disc and the two consecutive vertebrae framing this disc are in good condition, the practitioner can opt to replace the disc with a prosthesis whose functionality is substantially equivalent to that of the original disc, it that is to say, leaving the two vertebrae the possibility of moving relative to each other in rotational and / or translational movements.

On the other hand, when the trauma is more important, the practitioner can choose to join the two consecutive vertebrae by osteosynthesis. To do this, the intervertebral disc is partially or entirely destroyed and replaced by an interbody cage generally associated with an element promoting osteosynthesis, for example a bone graft.

These intersomatic cages can be implanted essentially by two routes, one called anterior, the other called posterior, each of these routes having its advantages and disadvantages.

However, it would seem obvious that implantation via the posterior route is the most normal since the path used by the practitioner for surgical intervention is relatively short. But it is very delicate because this path passes very close to essential elements for the patient's life, namely the spinal cord and the nerves which notably control the patient's movements.

It is for this reason that some practitioners sometimes opt for the so-called anterior route which in theory is less dangerous for the patient. Conversely, the intervention time is longer than that by the posterior route, which can present a drawback for the patient's health and recovery.

Numerous systems have therefore been produced for inserting a disc between two consecutive vertebrae, which allows implantation by the posterior route in particular.

Such a system is for example described and illustrated in FR 2 958 151 and its correspondent US 8 845 735, both in the name of the applicant.

This system gives good results but it does not make it possible to carry out all the functions which are requested by the surgeons practitioners.

Also, the object of the present invention is to provide a system for positioning an insert between two portions of bone which, in addition to the functions obtained with the system of the prior art defined by the two documents mentioned above , provides other functions which are often requested by surgeon practitioners.

More specifically, the subject of the present invention is a system for positioning an insert between two bone portions, said insert being made up of a solid body, characterized in that said system comprises:

• a cavity made in said body, • an opening made in the wall of the cavity between the inside of the cavity and the outside of said body, • a guide rod defined between a proximal end and a distal end, the distal end being shaped to be able to pass through said opening to penetrate into said cavity, to translate and pivot therein, • a housing produced in the wall of said cavity, the wall of said housing comprising a tapping of determined shape, • a portion of rod cylindrical of revolution carrying a complementary thread of said internal thread, • means for securing said rod portion with the distal end of said guide rod, and • means capable of applying a force to said body relative to said guide rod.

Other characteristics and advantages of the invention will become apparent during the following description given with reference to the drawing annexed by way of illustration but in no way limitative, in which the single figure represents, in schematic form and in section, an embodiment of the system. according to the invention for positioning an insert between two portions of bone, in this case two vertebrae or the like.

It should be noted that the figure represents only one embodiment of the object according to the invention, but that there may be others which meet the definition of this invention.

It is further specified that, when, according to the definition of the invention, the object of the invention comprises “at least one” element having a given function, the embodiment described may include several of these elements. Conversely, if the embodiment of the object according to the invention as illustrated comprises several elements of identical function and if, in the description, it is not specified that the object according to this invention must necessarily include a number particular of these elements, the subject of the invention could be defined as comprising “at least one” of these elements.

It is specified that when, in the present description, an expression defines alone, without any specific mention relating to it, a set of structural characteristics, these characteristics can be taken, for the definition of the object of the protection requested, when this is technically possible, either separately or in total and / or partial combination.

Finally, it is specified that, in the present description, if the adverb substantially is associated with a qualifier of a given means, this qualifier must be understood in the strict sense or approximated.

With reference to the appended figure, the present invention relates to a system for positioning, between two portions of bone, for example two vertebrae, an insert Ins consisting of a solid body 10.

According to a characteristic of the invention, the system comprises a cavity 12 produced in the body 10, an opening 14 produced in the wall 31 of the cavity between the interior of the cavity 12 and the exterior 15 of the body, a guide rod 20 defined between a proximal end 21 and a distal end 22, the distal end 22 being shaped to be able to pass through the opening 14 and penetrate into the cavity 12, translate there and pivot thereon around itself 'a longitudinal axis 25.

The guide rod can take different forms for example, be cylindrical of revolution or not, be straight or curved, rigid or even be relatively flexible at least in bending.

There is further provided a housing 30 produced in the wall 31 of the cavity 12, the wall of the housing comprising a thread 32 of determined shape.

In the illustrated embodiment, the housing 30 is constituted by the opening 14. However, it is clearly stipulated that this housing can be located in another place than that where the opening is made. Among other possibilities, it can be produced opposite this opening, substantially at point 26 where the axis 25 intersects the wall 31 of the cavity, as shown diagrammatically in broken lines in the figure. In this embodiment the housing can be blind (as illustrated) or through.

The system further comprises a portion of rod 23 cylindrical of revolution carrying a thread 24 complementary to the thread 32, and means for securing this portion of rod 23 with the distal end 22 of the guide rod 20.

In the illustrated embodiment, this portion of rod 23 consists of a portion of the distal end of the guide rod 20.

However, when the housing 30 is produced at point 26 of the body 10 as shown in broken lines in the single figure according to an alternative embodiment, the system includes means for securing the portion of rod 23 with the distal end 22 the guide rod 20 so that the axis of the distal end of the guide rod and the axis of the rod portion are collinear along the axis 25. These means consist, for example, of a lug or the like secured respectively to the portion of rod 23 and the distal end 22. As a preferred embodiment of these securing means, the distal end 22 of the rod 20, the portion of rod 23 and this tab are made in one piece.

Means 40 are also provided capable of applying a force to the body 10 relative to the guide rod 20.

These means 40 capable of applying a force on the body 10 relative to the guide rod 20 can be formed in different ways. However, as illustrated, they are preferably constituted by a complementary rod 50 defined between its proximal 51 and distal 52 ends and advantageously mounted along the guide rod 20, the distal end 52 of the complementary rod being shaped to be able to exert on the body 10 one of the following forces: pushing force, pulling force.

To exert a pushing force on the body 10, the distal end 52 of the complementary rod is shaped as a pusher capable of abutting on the part of the external surface of the wall 31 of the body 10 bordering the opening 14 by sliding along the guide rod 20.

Such a system finds particularly advantageous applications in the case where the insert Ins is constituted by a medical element having one of the following functions: function of the interbody cage, function of disectomy, function of bone calle, distracting function, a combination of 'at least two of these functions.

The system according to the invention operates and is used very schematically in the following manner described in the case of the embodiment illustrated in the single figure:

It is specified beforehand that the operation of the system according to the invention can be largely deduced from that which has been described in the documents referenced in the preamble to this description, in particular with regard to the introduction, in a given position, of the insert between the two portions of bone, namely two consecutive vertebrae or the like.

This phase of operation will therefore not be repeated here for the sole purpose of simplifying the present description.

It is however specified that, according to the illustrated embodiment, the distal end 22 of the guide rod 20 is introduced into the cavity 12 before the introduction of the insert between the two bone portions.

To do this, the distal end 22 is inserted into the opening 14 until the thread 24 abuts against the outer edge of the thread 32. Then the guide rod 20 and the body 10 are pivoted relative to one another. to the other on themselves along the axis 25 so that the thread cooperates by screwing in the thread 32, until this thread completely exceeds the thread to fully penetrate into the cavity 12 and take a position like that which is illustrated in the single figure.

We therefore now assume that the insert is already inserted between the two bone portions. With the system according to the invention, it is also possible to pivot it around the axis 25.

To do this, the distal end 22 of the guide rod 20 which was in abutment against the bottom 16 of the cavity 12 is moved back in a translation along the axis 25, passing through an intermediate position like that illustrated on the single figure, until the threaded rod portion 23 abuts against the inner edge 34 of the internal thread 32, that is to say the edge which is turned towards the inside of the cavity 12.

In this position, the recoil of the distal end 22 is stopped and, by means of the push rod 50, it is, for example manually, exerted a pushing force on the body 10, while keeping the guide rod 20 fixed, possibly by exerting on it a pulling force.

Under the simultaneous action of this pushing force exerted by the push rod 50 and the reaction force exerted by the guide rod 20, the internal thread 32 meshes on the thread 24 of the rod portion 23 which itself remains fixed since the rod 20 remains fixed, which causes the body 10 to rotate relative to the distal end 22 of the guide rod.

The pivoting of the body depends on the pitch of the thread 24 and on the complementary tapping 32. These data will be determined by a person skilled in the art as a function of the amplitude of the angular rotation desired for the body 10.

With such an insert, it is possible to perform the following functions:

(i) an intersomatic cage function to replace the intervertebral disc, by introducing a thin planar cage and then rotating it, (ii) a disectomy function to eliminate an undesirable bone part from at least one of the two parts d bone, by introducing a solid body 10 with a cutting element, (iii) a bone calle function by correctly positioning the two portions of bone relative to each other, (iv) a distracting function by repositioning the two portions of bone relative to each other, (v) a combination of at least two of the above functions.

When all the desired operations have been carried out and the insert has taken the position desired by the practitioner, the push rod 50 is removed without any particular problem, the rod 20 is decoupled from the body 10 in the opposite manner to that described above. without it being necessary to develop it in more detail, the body being left in place between the two portions of bone.

Claims (7)

1. System for positioning an insert (Ins) between two bone portions, said insert consisting of a solid body (10), characterized in that said system comprises: • a cavity (12) produced in said body (10), • an opening (14) produced in the wall (31) of the cavity between the interior of the cavity (12) and the exterior (15) of said body, • a guide rod (20) defined between a proximal end (21) and a distal end (22), the distal end being shaped to be able to pass through said opening (14) to enter said cavity (12), s 'translate and pivot therein, • a housing (30) produced in the wall (31) of said cavity (12), the wall of said housing comprising a thread (32) of determined shape, • a portion of rod (23) cylindrical of revolution carrying a thread (24) complementary to said tapping (32), • means for securing said rod portion (23) with the distal end (22) said guide rod (20), and • means (40) suitable for applying a force to said body (10) relative to (41) said guide rod (20). 2. System according to claim 1, characterized in that said housing (30) is constituted by said opening (14). 3. System according to one of claims 1 and 2, characterized in that, the distal end of the guide rod being defined along a longitudinal axis, it comprises means for securing said rod portion (23) with the distal end of said guide rod (20) so that the axis of the distal end of the guide rod (23) and the axis of said rod portion are collinear. 4. System according to one of claims 1 and 2, characterized in that said rod portion (23) consists of a portion of the distal end of the guide rod (20). 5 5. System according to one of the preceding claims, characterized in that the means (40) capable of applying a force to said body (10) relative to (41) said guide rod 20 are constituted by a complementary rod ( 50) defined between its proximal (51) and distal (52) ends and mounted in cooperation with the guide rod (20), the distal end (51) 10 of the complementary rod being shaped to be able to exert, on said body (10), one of the following forces: pushing force, pulling force. 6. System according to claim 5, characterized in that, to exert a pushing force on said body (10), the distal end (51) of 15 the complementary rod (50) is shaped as a pusher capable of coming into abutment on the external surface part of the wall (31) of the body (10) surrounding said opening (14), sliding along said guide rod (20 ). 7. System according to one of the preceding claims, characterized 20 by the fact that said insert (Ins) consists of a medical element having one of the following functions: function of an interbody cage, function of a disectomy, function of a calle bone, function of a distractor, a combination of at least two of these functions.