HU0302127A2 - Reinforcing straps on the disc ring element - Google Patents

Reinforcing straps on the disc ring element Download PDF

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Publication number
HU0302127A2
HU0302127A2 HU0302127A HU0302127A HU0302127A2 HU 0302127 A2 HU0302127 A2 HU 0302127A2 HU 0302127 A HU0302127 A HU 0302127A HU 0302127 A HU0302127 A HU 0302127A HU 0302127 A2 HU0302127 A2 HU 0302127A2
Authority
HU
Hungary
Prior art keywords
characterized
device according
substantially cylindrical
material
cylindrical element
Prior art date
Application number
HU0302127A
Other languages
Hungarian (hu)
Inventor
Stephen D. Kuslich
Original Assignee
Spineology, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority to US25601400P priority Critical
Application filed by Spineology, Inc. filed Critical Spineology, Inc.
Priority to PCT/US2001/048890 priority patent/WO2002056802A1/en
Publication of HU0302127A2 publication Critical patent/HU0302127A2/en

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Classifications

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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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    • 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
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063Three-dimensional shapes
    • A61F2230/0065Three-dimensional shapes toroidal, e.g. ring-shaped, doughnut-shaped
    • 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
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00011Metals or alloys
    • A61F2310/00017Iron- or Fe-based alloys, e.g. stainless steel
    • 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
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00011Metals or alloys
    • A61F2310/00023Titanium or titanium-based alloys, e.g. Ti-Ni alloys
    • 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
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00011Metals or alloys
    • A61F2310/00035Other metals or alloys
    • A61F2310/00071Nickel or Ni-based alloys
    • 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
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00179Ceramics or ceramic-like structures

Abstract

FIELD OF THE INVENTION The present invention relates to a device for stabilizing a segment of a spinal motion. The essence of the invention is that the device comprises: a substantially cylindrical element, e.g. a strap (12) generally formed of plastic but minimally elastic material, and the substantially cylindrical member having a first end (30) and a second end (32), the substantially cylindrical member delimiting the inner space (14) and the first and second cylindrical elements (32). at its second end (30, 32) an opening is formed, and the substantially cylindrical element has a circumferential portion which is dimensioned such that the outer ring of the cartilage disc in the spinal column is aligned with its central axis, the central axis being the cylindrical element. positioned between the first and second ends (30, 32), the central axis is configured and arranged to be substantially axial with the cefalo-caudal axis of the agerine column when positioned in the immediate vicinity of the outer ring of the disc and substantially cylindrical. predetermined height and predetermined thickness of the element It is.

Description

EXAMPLES • · · · · · · · · · ··· ·

EXTRACT

STRENGTHENING PANEL FOR PORCKORONG RING

The present invention relates to a device for stabilizing the spinal motion segment.

The essence of the invention is that the device comprises:

a substantially cylindrical element, e.g. the strap (12), which is generally formed of plastic but minimally elastic materials, and the substantially cylindrical member has a first end (30) and a second end (32), the substantially cylindrical element is bounded by an inner space (14), and an opening at the first and second ends (30, 32), and the substantially cylindrical element has a circumferential portion that is sized to fit the immediate proximity of the outer ring (24) of the cartilage in the spinal column; the central axis is located between the first and second ends (30, 32), the central axis is configured and arranged to be substantially axial with the cefalo-caudal axis of the spinal column when the is located in the immediate vicinity of the outer ring of the disc, and the predetermined height and forward of the substantially cylindrical element specified thickness.

Figure 1

Acta number: 98951-9205 KK / Ho

DISCLOSURE íq'ío z

A1

STRENGTHENING PANEL FOR PORCKORONG RING

FIELD OF THE INVENTION The present invention relates to a reinforcing strap for a ring member of a disc which is designed as a support and / or a reinforcing and / or stabilizing member for the treatment of diseased spinal column discs.

The disc itself consists essentially of three parts, the first is the core, the nucleus 10 is the central part of the disc and is a substantially pressure-resistant cushion-like insert, the second is the annulus, the annular portion, which is a substantially circumferential part of a tension. it forms a resilient ring element and the third is a closure plate, which is the upper and lower limiting element of the disc, and which is bounded by the vertebrae vertebrae from below and above.

Based on numerous experience, abstract conclusion is that mechanical back pain is the most common and the most widespread disease of the spine. a state that affects a large part of the middle-aged population of modern society. Mechanical back pain can be caused by a number of factors, but the overwhelming majority, in the spinal column, are the result of a disorder of the cartilage, such as, for example. DDD (degenerative cartilage disorder), the most common cause of back pain.

The inventors have previously published a work entitled "The Lower Back Pain and Ischemic Connective Tissue Origin" and here, in fact, during the local anesthesia, tissue pain responses to lumbar vertebrae during surgery were reported (Orthopedic Clinic North America 1991; 22 (2): 181-187), where it is shown that the rim of the diseased tooth or the ring portion acts as a pain generator that causes mechanical back pain.

Acta number: 98951-9205 KK / Ho

A number of devices have been developed and invented to replace the disc or part of it and / or to stabilize the disc so as to reduce the pain associated with cartilage disorder. One of the inventors used it with relatively good results in more than 80,000 people. BAK Therapy ("Bagby and Kuslich Lumbar Fusion Method" - History, Techniques, and 2-year Follow-up Results of a United States Prospective, Multicenter Trial. Kuslich SD, Ulstrom CL, Griffith

SL, Ahern JW, Dowdle JD, Spiné 1998; 23: 1267-1279; "Summary of BAK Fusion Safety and Effectiveness," the Food and Drug Administration (FDA) (PMA 950002), PMA Document Mail Center (HFZ-401), Center Forum Disease and Radiological Health, Washington DC, September 20, 1996 published in a journal; and "Lumbar Cage Fusion for Back Pain" is an improved version of the BAK system. The use of the BAK method and the use of similar structured rigid metal implants raises a number of problems that make the solution far from ideal. These problems are as follows: relatively large, serious surgical excavation is required, a relatively large opening in the ring of the disc should be cut, relatively large amounts of metal need to be incorporated which reduces the contact of the respective surfaces in the end plate.

Any device that makes the treatment of degenerative disc disease easier and / or more effective and / or safer is very useful and would be a safer solution to treat hundreds of thousands of people suffering from this disease.

There are also several earlier patents for treating DDD disease, which are generally divided into four main classes:

The first class includes devices that are rigid, three-dimensional geometric, solid, porous or liquid-impermeable, and essentially act as support elements. When placed in the area of the intervertebral disc, between the adjacent vertebral bodies, this device allows and / or facilitates the passage of the bone over these elements and / or the device, thereby creating a bony fusion between two adjacent members. vertebral body. Such devices are described in the following patent specifications:

US 6,015,436 to Schönhöffer

US 6,010,502 to Bagby US 5,972,031 to Biedermann et al. U.S. Pat. No. 5,895,427 to Kuslich U.S. Patent No. 5,735,899 to Schwartz et al.

US 5,720,748 to Kuslich US 5,709,683 to Bagbv

US 5,700,291 to Kuslich

US 5,669,909 to Zdeblick US 5,514,180 to Heggeness et al. US 5,591,235 to Kuslich US 5,489,308 to Kuslich US 5,489,307 to Kuslich US 5,405,391 to Henderson et al.

US 5,263,953 to Bagby

US 5,059,193 to Kuslich US 5,015,255 to Kuslich US 5,015,247 to Michelson US 4,946,458 to Harms et al.

US 4,936,848 to Bagby '

US 4,834,757 to Bantigan

US 4,820,305 both to Harms et al.

20 US 4,501,269 to Bagby

US 4,401,112 to Rezaian

The second class refers to devices that are semi-rigid artificial coupling elements that allow displacement along one or more planes. Examples of these are disclosed in U.S. Pat. No. 4,759,769 and U.S. Patent No. 6,039,763. which are otherwise commercially available and manufactured by Link or Charite Intervertebral Disc Endoprosthesis.

The third class includes devices that are not rigid, cushion-like, and that replace • · • · · · · ·

The core of the disc is * Such artificial disc discs are disclosed in US 4,904,260, US 4,772,287 and US 5,192,326. descriptions.

Finally, mention is also made of the fourth class, which is a relatively new area that is initially a flexible expansion bag or ball-like element that becomes rigid when injected with a material that is resistant to the load. US 5,571,189 and US 5,549,679. descriptions, e.g. such devices, each of which is a porous bag or ball-like element ready for expansion, which is useful for stabilizing the spinal discs of the spinal column. In this fourth class, a porous pouch or ball-like element is enclosed, except for a mouthpiece through which bone tissue or other tissue material may be inserted. The pouch is inserted into the expanded intervertebral gap and the pouch is expanded when the appropriate tissue or filler is applied. Recent researches and developments by the inventors in the laboratory have shown that the fact that a thin-walled band or tire, either porous or non-porous, can be placed in the ring region of the disc disc with various solutions. these straps or tires, as will be described later, will greatly strengthen the ring and thereby support the moving parts of the spine and deform properly. compress those changes that reach the spinal column in any vector direction, such as tension. With these tools, rotation, flexible expansion, sideways bending, compression and splitting can be achieved. The experience of the inventors has shown that the radially applied straps or tires can properly incorporate, on the one hand, the inserted or injected materials placed in the central region of the expanded, expanded cartilage.

The present invention teaches how to use and design a simple strap or tire so that many of the functions described in the patents described above can be realized. For example, if comparing the present invention with the metal cylindrical body · implant, e.g. US 5,015,247. U.S. Pat. No. 4,878,915 to U.S. Pat. No. 4,743,256, or a rectangular implant formed by a metal wall or formed by a plastic wall. It can be concluded from the description of the present invention that the strap or the belt according to the invention is of the type described in U.S. Pat. The use of a tire results in a softer, finer, lighter, more flexible solution without sharp edges, and thus provides much greater safety when placed near sensitive organs such as large arteries or spinal cord.

The fully open structure of the outer portions adjacent to the lumpy bones of the cartilage allows it to be inserted more finely between the implanted material and the living bone. This close contact, without affecting the implanted material, leads to a faster procedure and a much closer biological overgrowth and growth through the central part of the implant.

It is also well known that the larger the contact surface between the implanted material and the living bone, the greater the rate of fusion, and vice versa, the lower the proportion of parts that do not occur. Thus, the present invention provides a number of particular advantages that are known in the art and not found in devices for internal fusion.

In addition to utilizing the benefits of devices implanted into the body and integrating with certain parts of the body, the present invention also provides a new and much more favorable solution for treating the diseased disc in two other categories, namely, the soft tissue part of the diseased cartilage. It can also be used to replace the disc.

Regarding the strengthening of the soft tissue part of the diseased tooth disc, many new solutions have been developed recently to help treat early and middle stage cartilage degeneration in a way that is much less invasive and much less drastic than what fusion surgery, such as for example, the method is to modulate the ring fabric by heat (Saal J. et al., North American Spiné Society 1999 and 2000), using polyester tension straps positioned between and around screws located above and below the disc, such as eg. U.S. Pat. No. 5,092,266. and a combined tensioning and expansion device which is located between these screws and which are in fact commercially available Dynesys devices from Sulzer Orthopedics Ltd. Although the first results of the aforementioned processes appear promising, however, in the present invention, we have drawn some attention to the dangers and shortcomings of these prior art systems. so for example:

In any case, when the ring fabric is thermally modified, it is necessary to apply a heat effect, whereas the present invention does not require the use of a heat effect. The heat on the local spinal nerves and arteries may optionally have an effect that causes them to suffer injury or, if necessary, lead to paralysis or to the complete death of a particular vessel. The present invention immediately stabilizes the ring rather than waiting until the damaged tissue heals and shrinks as a result of the heat.

In the case of the polymer retaining strap, which is located between the screws located above and below the disc, the present invention does not require the installation of these screws. The placement of the screws requires significant surgical excavation, which can result in damage to the muscles of the local muscles, the muscles of the tape, the vascular system and the nervous system. According to the invention, the solution is extremely small, through a smaller opening than the above, • by microsurgical method, which results in a significantly smaller possibility and design of collateral damage.

In the case of a tension-pulling combined device placed between the screws, the present invention directly stabilizes the tissue that causes the discogeneous pain and does it more than stabilize the ring with an external lifting system, all of which have the risk and disadvantage that due to the polyester tension strap and the screws.

The present invention differs from the prior art in its basic recognition. The core element used in the present invention is simple but very wide-ranging and effective by applying a stress-relieving circumferential strap along the outer circumference of the ring or close to its center. If the invention and the medical literature are examined more thoroughly and the known solutions are examined, there is no indication that the basic recognition of the invention has been disclosed in any form in the past. Experience has shown that the core idea of using a circumferential tension strap or belt to reinforce a damaged disc disc has resulted in a number of embodiments which, from simple fixation to a solution, involve the use of a filler with the vertebral body. or a radial fastening material as a substitute for a compressible or non-compressible core placed centrally. In other words, the basic recognition of the present invention is to create an element that allows surgery and / or other treatment to form a new and potentially better ring-shaped support and is less invasive, and It is well suited for the treatment of early and middle stage degenerative disc disease. A further object of the present invention is to provide a device which is less invasive to allow proper use of the vertebra support. Finally, the invention also discloses an improved support structure for core material (biological or non-biological, biochemical or inert, "· hydrophilic or non-hydrophilic, granular or amorphous") to replace or replace the core. to replace artificial vertebrae.

The patents, patent applications and articles referred to in the introduction as reference materials are taken into account in the description.

The invention is essentially an expandable tubular member or strap having side walls, optionally including a fill opening. However, in the case of an expandable strap, there is no need for a motherboard or bottom plate, or a topsheet, if any, as our experience has shown that an appropriate casing is created by placing this strap in the recessed intervertebral gap. The pressure inside the hinge acts primarily on the sidewalls and adjacent vertebral surfaces. The pressure of the bone filler at the lower and upper parts acts on the adjacent vertebrae, and this increases bone growth through the inside of the strap. The bone filler in the tube forms a natural bony top and bottom with the side walls of the strap.

The present invention provides a new device for supporting the ring of diseased and / or weakened disc. This support increases the resistance of the vertebrae to tension on the spine, and therefore it is a very significant result that the pain is reduced and the functioning of the spine improves in people suffering from degenerate cartilage disorder.

In addition to securing the diseased ring of the disc, the device according to the invention also provides a fastening element and includes a material that can be inserted or injected into the disc to heal the ring properly. and optionally replacing the natural nucleus or creating a bone fusion between adjacent cartilage bodies.

«·« · ·

A preferred embodiment of the invention is designed to form a substantially flexible implant that can be inserted into a cavity in the degenerate disc. The elasticity of the strap allows it to be inserted through a relatively small opening into the disc or between the vertebrae. The strap is inserted so that its fill opening, if any, is suitable for receiving a biological filler. The material that is placed inside the elastic strap allows the strap to expand sufficiently and fit into the shape of the gap formed in the vertebra or the disc, and expand accordingly there. The filler is added until sufficient material is present to expand the disc to the desired position. At this time, the filling opening of the strap is closed to prevent the filler from escaping.

The invention is at least one example. Embodiment 1 is designed to be in the form of a flexible strap or ring having the flexibility required for proper handling, but cannot be stretched along its circumference if it has reached the appropriate limits of its circumferential length. The strap may optionally have an input element forming a structural member, which is used for charging, but may optionally also be a design that is designed as a substantially fabric-like structure that allows the filling tube to penetrate through its walls and thereby be filled. the structure. In the latter case, the perforated wall essentially seeks to achieve a self-locking when the tube is retracted. The strap itself may have a flat or circular cross section. As with various inflatable balls, the strap itself is not required to be provided with a roof section or a lower part, since our experience has shown that a separate cover part and a lower part are unnecessary when the strap or ring is applied to itself includes injected material that is in the recessed vertebrae.

As long as the width of the strap is approximately equal to the height of the ring (or, in other cases, the distance from the vertebrae to the adjacent vertebrae of * * * · * * * **), the strap is a very suitable means of incorporating a material that is not is placed in the center of the cavity of the disc, without the need for a full spherical casing, e.g. such a ball-like element. Since the lower and upper openings of the strap are covered by the dense vertebrae in the case of the recessed intervertebral cavities, there is no need to place a separate filler or other material in this range.

The pressure within the cavity that occurs when the surgeon injects the material into the central region of the inside of the strap acts radially on the strap and adjacent vertebral surfaces. Since the inner cavity is filled with non-compressible material, e.g. bone filler or bioceramic beads or granules, the radial displacement of these materials beyond the strap circumference is prevented. For this reason, any further injected material is placed above and below the vertebral body. This operation increases the distance between the vertebral bodies and is essentially one and more. creates a vertebrae. This splitting has three known health outcomes and effects. It primarily stabilizes the movement of the particular segment by holding and sealing the ribbon-like structures appropriately. Second, it opens properly the openings that are for the transmission of the spinal nerves, the. neuronal amines and thus corrects certain types of nerve compressions. Thirdly, the improved stability is required to allow the bone to overgrow or to augment the bone so that fusion between the vertebral bodies is established. The pressure exerted by the bone filler on the upper and lower parts is substantially affected by the adjacent vertebrae. This results in a direct contact that promotes bone growth through the inside of the cavity.

The present invention is one of the preferred examples. Embodiment 1 is designed to be a continuous strap or ring that can be positioned around or around the outer circumference of the disc. An appropriate seam, or preferably a pound or woven string or band, such as is placed around the vertebra along its circumference and sufficiently bound to form a ring that is resistant to an appropriate voltage, may be sufficient. Modern endoscopic surgical instruments, combined with known surgical navigation systems, make the use of this solution practically more beneficial and safer than a few years ago.

A further preferred embodiment of the invention is designed to preform the strap to fit the anatomical structure of the patient.

It is possible to use various flexible elements that fit into the circumference of the disc, which may be bands, thicknesses and widths, materials made according to the pattern of both internal and external dimensions, or braided materials made of fibrous materials. The strap itself must be sufficiently flexible to be able to pass through a small opening in the ring, as is the case for normal spinal cord operations. After the spinal hernia is removed, the surgeon introduces the expandable expanding member, removes the degenerate core, the cartilage sealing disc, and the inner ring so that the outer ring remains intact. For this procedure or. examples of expandable deepening and punching means are disclosed in U.S. Pat. No. 5,445,639 and U.S. Pat. No. 60 / 182,610. descriptions.

The suitably sized strap can then be inserted through an orifice formed on the disc, and due to its own elasticity or due to the material injected inside the disc, the ring or strap expands radially and rests on the outer ring. By means of a filling tube with a suitable piercing element, the fabric material of the strap is perforated and allows the surgeon to fill the cavity with the appropriate filler and using considerable pressure. For injection of the filler, e.g. U.S. Application Serial No. 09 / 738,726, filed December 15, 2000, entitled "Device for Direct Bone Replacement", may also be used, and may also be used by the device "continuation in part application" No. 09/608079 is described in more detail, and »» H 4, which is referred to several times in our description. The resulting compressed filler is protected from further expansion by the vertebrae in the upper and lower parts, and the loop or ring radially passes from the liquid phase to a solid phase, a phenomenon known when the granulated material is subjected to compressive stress. In this respect, "Friction in Granular Flow"

c. reference is made by HM Jaeger, Chuang Liu, SR Nagel and TA Witten in "Europhysics Letter 11, 1990, or" Granular, Solid, Liquid and Gaseous Materials ". in the article by HM Jaeger, SR Nagel, and RP Behringer on "Rev. Mode. Phys. ”1996.

68. A similar topic is described in the material of the "Symposium on Segregation of Granulated Currents", which was in October 2000. This phase change was also observed in our laboratory experiments and was scientifically investigated and described in U.S. Patent No. 5,331,975. also described in detail in " Construction of structural fillers for punctured bone fracture " in the AM. J. Ortop. Journal of July 27, 1998, is available on pages 499-502. Reference is made to all of the materials described above in this specification. This phase change results in a construct that is able to stabilize the movement of a particular segment for a short period of time, while at the same time facilitating the formation of solid bone fusion.

In other words, the present invention provides a flexible implant that can be inserted into the cavity that can be placed in the diseased disc. The elasticity of the strap allows it to be inserted into the disc or between the vertebrae through a relatively small opening in the disc. The strap itself is then positioned so that its filling opening is suitable for receiving the filler material. This material enters the inside of the strap, causing the strap to expand to form a fit in the cavity of the vertebra or the disc. The filler is added until the disc or disc is found to be in the desired position. At this point, the filling opening in the band is closed, ** * »4 * * ·», or it is ensured that it is properly clogged, i.e. preventing the filler from escaping.

The invention will now be described by way of example. 5 and 6, with reference to the accompanying drawings, where

1 is a first example of the invention. Figure 3 shows a spatial drawing of a

Figure 2 is a side view of the embodiment shown in Figure 1, a

Figure 3 shows the example shown in Figure 1. is a top view of embodiment 10a

Figure 4 illustrates the invention as an example. Figure 3 shows a spatial drawing of an embodiment having an elongated filling opening, i

Figure 5 shows an embodiment of the invention used for replacing the disc, illustrating the device in a spatial drawing.

6, the invention is a further example. wherein the strap is formed of cast material, a

Figure 7 is a side view of an embodiment of the present invention. in a reduced state in a storage or conveying means, a

Fig. 8 shows the embodiment shown in Fig. 7 when the strap according to the invention is removed from the storage or transfer means;

Fig. 9 shows an example of a device according to the invention with the aid of a spatial drawing. in which the strap is formed as a woven, double-walled arrangement, a

Figure 10 shows a sectional view of the embodiment shown in Figure 9, a

Fig. 11 shows an improved version of the embodiment shown in Fig. 9 with the aid of a spatial drawing, wherein the strap is also provided with a further lateral support strip;

Figure 12 shows a lateral sectional view of the embodiment shown in Figure 11, a

Figure 13 is an example of Figure 11; In an embodiment of the present invention, an improved version is provided which is also provided with longitudinal support bands a

Figure 14 is a side sectional view of the embodiment shown in Figure 13;

15. the invention as an example. wherein the strap is formed as a single wall arrangement, a

Figure 16 is a perspective view of the embodiment shown in Figure 15, a

Figure 17 is an example of the invention. , a

Figure 18 shows the example shown in Figure 15. Embodiment 10 is shown in side view 10 and in partially reduced volume state, a

Fig. 19 is a plan view showing the filler insertion device that can be used for the strap according to the invention;

Fig. 20 is an example of Fig. 19. is a side view of the embodiment, a

Figure 21 is a plan view of the tool shown in Figure 19, a

Figure 22 shows the tool shown in Figure 19 when the strap according to the invention is an example. in the embodiment of the invention, the fibers are displaced, a

Fig. 23 is a plan view, partly in section, of the tool shown in Fig. 19 in the position where the filler is inserted;

Figure 24 shows a spatial drawing of a portion of the spine in a state where the device according to the invention is an example. embodiment is already in place, a

Figure 25 is a cross-sectional view of the spinal column provided with the device according to the invention, a

Figure 26 is a partial sectional view of Figure 25;

Fig. 27 is a cross-sectional view of a segment of the spinal column wherein the device according to the invention is an example; Embodiment A is positioned around the spinal column, a

Figure 28 shows the arrangement of the embodiment shown in Figure 27 on a spinal column using a spatial drawing, a

Figure 29 shows a portion of the spinal column in front view, a

Figure 30 is a front view of a segment of the backbone provided with the device according to the invention.

• · · · · ······ · · • ······ · ······· · ···the · · ·

The present invention relates to U.S. Patent Nos. 5,571,189 and 5,549,679. of the device disclosed in the patent specification essentially.

Returning to 1-3. 1 to 3, the invention is an example! An implant 10 according to an embodiment of the present invention, which is formed by a sidewall having a sidewall, is substantially tubular or annular. Preferably, the strap 12 has a circular cross-section, other cross-sections, such as an elliptical shape or other geometric shape.

The strap 12 is substantially bendable, flexible and plastic before the interior 14 is filled with the contents described below. In the initial position, the strap 12 can pass in a compressed state on a relatively small tube or inlet, as e.g. U.S. Patent Nos. 5,571,189 and 5,549,679. is described in the specification, the entire contents of which are hereby incorporated by reference. This feature of the strap 12 is extremely important since access to the cart disc is anatomically limited and, therefore, in the interest of safety, always strives to use the smallest aperture as the input that is meant to be introduced into the body.

The strap 12 can be formed in many ways. The material 16 of the strap 12 may be etched, woven or braided, e.g. a spinning element or a molded material such as e.g. FIG. The material 16 of the strap 12 may be a fluid permeable material, or may be a material having a density selected to allow the inlet or outlet of liquids or solutions, and to allow blood vessels and fibrous tissues or bone tissues to pass through or overlap. Beno latest. In the case where the material 16 is of porous structure, the pores or the gaps between the fibers should preferably be tight enough for the small particles of the filler to be properly gripped, e.g. ground bone material or other tissues, or solid particles formed from bone, or • "· ·" bone such as e.g. hydroxyapatite or other biocompatible materials that promote bone formation.

If the material 16 of the strap 12 is porous, as shown in FIGS. 1 to 4, the size of the pores or apertures 18 in the product is preferably in the range of 0.25 to 5 mm. The size of the pores or apertures 18 must be chosen so as to allow the tissue to be overgrown with the material inside.

The material 16 used in the present invention must be sufficiently flexible to be compressible and inserted through an opening smaller than the size of the expanded strap 12. As can be clearly seen in Figures 7 and 8, the strap 12 is flexible enough to be inserted into a chamber 50 which is part of a device 52, which may be a storage tube or a transfer device. Depending on the exact construction of the strap 12, the strap 12 itself can be compressed to a substantially smaller shape than the strap 12 which is then capable of properly accommodating the filler. The transmission means, e.g. the device 52 can also be inserted into a surgically excised opening, and the strap 12 can then be withdrawn from the chamber 50 with the plunger 56 or pushed in as shown by the arrow 54 in FIG. The strap 12, as shown in FIG. 5, can be used to recover and / or replace the disc 23 so that the strap 12 is positioned between two adjacent vertebral bodies 24. The strap 12 can be inserted through a small opening in the ring 21 of the disc 23, and when it is inside the disc, it can be charged from this opening. In another embodiment, the strap 12 is positioned within the hollow area of the vertebral body 24 to reinforce it or may be used to replace the entire 24 vertebral body. In order to maintain and secure the proper support force of the strap 12, a filler is used for the strap 12, which is preferably minimally elastic if it is of any elastic material.

• · · • ··

The strap 12 may be formed of a polymeric material 16 on which a plurality of perforations are formed or associated. The strap 12 may be a woven strap or injection molded, e.g. may be formed from Figure 6 or other materials known per se. The material of the band 12 should preferably have the ability of the bioabsorption rate, i.e. it should fit the bioabsorbing properties of the body. Any type of suture material that can be used in medical practice can be used to form the strap 12. The strap 12 itself may optionally be made of plastic or even metal. The strap 12 may also be formed of a solid material. The strap 12 may be partially or completely absorbent material, may be metal, plastic, woven, solid, film, or extruded, inflatable spherical.

The material 16 is a light, biocompatible, flexible and easy to handle material, but it must also be strong to resist tensions and have the ability not to break or break easily during insertion and expansion steps. When the device is expanded due to insertion of the filler as shown in FIG. 23, the strap 12 will expand into a predetermined shape and during this step the previously expanded cavity 20 between the vertebral bodies and / or within the vertebral body. as shown in FIG. 5 for segment 22. This charge causes the vertebral bodies 24 to separate from each other, and this stabilizes the particular segment of the spine visibly at the spinal segment 22 of the spine.

The 1-2. and 4-5. 1 to 3, the strap 12 can be characterized by having two ends 30 and 32. One or both ends 30 and 32 may be open as determined by the shape of the strap 12. Figure 5 shows that the strap 12 is used to replace the disc, and hence the apertures at the ends 30 and 32 can be characterized as smaller than the diameter of the vertebrae surrounding them, thereby ensuring that the filler material is 12 the strap 14 will remain in the interior. If only one end 30 or 32 is open, then the material 16, which covers one or more of the openings, is porous and thus allows the bone to pass through it, as we will return to later.

The 1-2. and 4-5. 1 to 3, the strap 12 is formed with a filling opening 26. The filling opening 26 must be large enough to form an appropriate passage, and must also be large enough to be suitable for introducing the filler insertion device into the inner space 14 of the strap 12. A device suitable for conducting through the filling opening 26 and inserting the filler is provided in accordance with FIG. U.S. Patent Application Publication.

Preferably, the filling opening 26 also includes elements that prevent the filler from escaping from the interior space 24. As an example in Figure 4! In an embodiment, the filling opening 26 is formed as an elongated passage 28 which is properly sealed or otherwise sealed after the filler is inserted.

As can be seen well in Figure 5, the strap 12 is inserted between two vertebral bodies 24, or into a disc 23 or other hollow region, e.g. the intervertebral vertebrae, and these spaces are filled with filler, the filler is pressed onto the vertebral surface 40 adjacent to the upper end and bottom 32 of the strap 12. The band 12 together with the vertebral surfaces 40 keeps the filler in the interior 14.

In some embodiments of the invention, the material 16 of the strap 12 is woven from one or more fibers and the fibers may be made from different materials already indicated. In the various embodiments shown in Figures 9-18, the strap 12 is made of one or more metal fibers, e.g. NITINOL may consist of 58 strands which are woven or woven into the desired shape. For material with a shape memory such as e.g. NITINOL or the like, e.g. steel, titanium, or other metal, the strap 12 has sufficient mechanical strength to withstand tension or expansion that occurs when the filler material is built up in the interior 14. In addition, the materials having the shape memory allow the strap 12 to be compressed before insertion as shown in FIGS. 7 and 8 and return to its original shape after insertion.

9-18. Figs. As shown in Figures 9-14. 1, the strap 12 may be formed as a double-walled strap or as a loop when the material itself is folded back. In such a double-wall arrangement, there is an inner wall 60 which is continuously formed with an outer wall 62, and there is a circular-shaped space 63, as can be seen in Figures 10 and 12.

Figures 12 and 14 show that the annular space 63 is in whole or in part, e.g. it can also be filled with a pharmaceutical agent, from which the drug can then be transferred to the site of implantation. The annular space 63 after implantation, when placed in the vertebral body, can be filled with biocompatible cement or other material, thereby achieving a further reinforcement of the strap 12.

In the case of a double-walled construction, the strap 12 has an increased strength, which also forms a further mechanical support element for the filler material contained in the interior 14. A further advantage of the double-walled arrangement is that it allows the various openings 18 on the inner wall 60 and the outer wall 62 to overlap one another. As a result, one, e.g. fibers 58 on the inner wall 60, on the other wall, e.g. the openings 18 on the outer wall 62 may be partially overlapped and thus effectively reduce the size of the apertures 18. As a result, the strap 12 formed as a double-wall construction does not require as much as 58 threads as in FIGS. Figs. Optionally, however, it may be desirable to form the strap 12 as a double-walled construction.

Referring to Figures 11 and 12, there is shown a double-walled strap 12 having one or more transverse projecting members 64 and 66. The separately formed support members 64 and 66 can be positioned in any way along the circumference of the strap 12. As an example! In an embodiment, the support members 64 and 66 are disposed at the first or upper end 30 and at the second or lower end 32. In addition, the support elements 64 and 66 are also provided between the inner wall 60 and the outer wall 62. The support elements 64 and 66 may also be used to reinforce the material 16 of the strap 12, e.g. such that the fibers 58 are woven around the support members 64 and 66, as shown in FIG.

The support elements 64 and 66 may be made of a similar material as the fibers 58, but may be of different material. In addition, the support members 64 and 66 may consist of one or more wires or threads which are braided or woven together and are in any case transverse. Optionally, one or more strands may be transverse or otherwise, in any case along or around the circumference of the strap 12.

In order for the strap 12 to be provided with one or more transverse wires or support members 64 and 66, the strap 12 also includes one or more longitudinal support elements 68, as best shown in FIGS. Here's an example! In an embodiment, the longitudinal support member 68 crosses vertically and passes through the band 12 and engages with the transverse supports 64 and 66. In addition, the longitudinal support members 68 are substantially perpendicular to the transverse supports 64 and 66. The longitudinal support elements 68 provide the belt 12 with an appropriate compression as support elements relative to the surrounding vertebra. The longitudinal support members 68 may also be woven into 58 fibers, but may optionally be independent woven fiber combinations. One example! In embodiment 6, the strap 12 is provided with longitudinal support elements 68, both transverse 64 and 66 · · · · · · · · · · · · · · · · · · · · · · · · · · · · «. ·· "·· ·· · *« «·· is provided with holding elements, and various 64, 66 and support members 68, functioning as a cross structure which retain the band 12 woven strands 58.

Similar to the transverse support elements 64 and 66, the longitudinal support members 68 may also be made of any suitable material. The material used may be the same as that of the fibers 58, but may be different. In addition, the longitudinal support members 68 may also be formed as one or more strands 58 which are arranged longitudinally.

15-18. Figs. wherein the strap 12 is formed as a single wall element, in contrast to the double wall structure described above. As shown in Figure 15, there is only one wall 70 used here, and this is not such as to create a continuous loop like

9 and 10, the openings in the two end portions 30 and 32 of a wall-shaped strap 12 shown in FIG. 15 are formed with a far not uniform or uniform flange 72. Since the material 16 of the strap 12 does not necessarily have the hardness to penetrate the bone of the surrounding disk, the non-uniform flange 72 of the strap 12 provides the strap 12 with a flange that is much more easily connected to the surface of the surrounding disk disc and so on. in a manner that prevents the strap 12 from slipping or otherwise moving underneath the step, which is a subsequent and filler injection step.

As shown in Figures 15 and 16, the single wall 12 formed with the wall 70 is substantially cylindrical in shape. The cylindrical shape can be compressed into the elongated configuration shown in Figures 7 and 8 before being inserted into the body. Of course, the strap 12 may take another shape, but after the strap 12 is inserted into the vertebral body, however, it will pick up a rounded shape. Fig. 18 shows how flexible a wall 12 formed with a wall 70 can be. Just as in previous embodiments, the strap 12 can be severely distorted in shape, compressible, or otherwise manipulated to provide the strap 12 with a reduced size ·· ····· · · * · · · «· ··· · · ····· · · Compress as shown in Figures 7 and 8. In the present invention, this deformation can be both longitudinal and radial, while retaining the ability to expand sufficiently after being inserted into the spinal area.

In the embodiment shown in Figures 22 and 23, the tool 100 is visible for the filling of the filler and which is inserted into the inner space 14 of the strap 12 by penetrating a portion thereof or one or more pores 18 thereof. The shape of the filler insertion tool 100 is shown in FIGS. 1 to 4 and essentially a longitudinal axis 104 having a truncated cone or a pointed end 102.

As described in 19-21. 1 to 3, the filling insertion tool 100 can be used in various embodiments of the invention. More detailed information about the tool 100 can be found in U.S. Pat. No. 9 / 738,726. , which was filed on December 15, 2000, entitled "Tool for Injection of Bone Direct Substitute", and is a continuing application of U.S. Pat. No. 09 / 608,079. filing, both are referred to herein.

The truncated conical end 102 of the tool 100 is dimensioned to increase the opening 18 and allow the tool 100 to penetrate into the interior space 14 by breaking the fibers 58 as best shown in FIG. When the fibers 58 are displaced, the pores 18 open to a nominal diameter of 0.25 to 5 mm, the openings are larger, large enough to penetrate a portion of the longitudinal axis 104 thereon.

The extent of the tool 100 penetrating into the interior space 14 should be sufficient to allow the side opening 106 to be located entirely within the interior 14 of the strap 12. The tool 100 may also be provided with more than one lateral opening 106.

«· ·····« «·» ·· · * · · · ····· ♦ · · ······ ·

Ifc. »♦ · · · · · · * ·« · ·

The tool 100 itself optionally includes a plunger and a cylinder or, optionally, a device for pushing the filler 108 within the shaft 104 through the lateral opening 106 into the inner space 14 of the strap 12.

The inner diameter of the shaft 104 is preferably from 1.5 to 5 mm, most preferably from 2.5 mm in diameter. The length of the lateral opening 106 is preferably 1.5 to 3 times greater than the inner diameter of the shaft 104.

The distal end 102 of the tool 100 is preferably configured at an angle 10 to direct the flow and remove any material consisting of compact discrete pieces.

Fig. 24 shows an embodiment of the strap 12, wherein the strap 12 is provided with at least one circumferentially displaceable clamp or retaining member 65. This fastening element 65 can be positioned in any way along the circumference of the strap 12, as previously mentioned. In the embodiment shown in Figure 24, each fastening element 65 is preferably located at the central portion 71 of the strap 12, has two ends 73 and 75 extending outwardly from one of the pores 18, whereupon these fastening members 73 and 75 can be screwed together and secured, or may be bound or otherwise combined in a manner known per se. When the strap 12 is properly filled with filler in any manner and in the above-described embodiments, the ends 73 and 75 can be connected to secure the center portion of the strap 12 and the strap 12 as shown in the figure will take a concave shape. up. The concave shape provides greater strength and greater flexibility for the vertebrae and the spine itself. When the ends 73 and 75 are properly tightened and secured, not only the strap 12 is taken up by the concave shape, but the filler contained therein is also compounded to join even more efficiently with the surrounding fabric and also with the strap 12 itself.

The presented as various examples! In embodiments, it may also be desirable to stimulate bone growth through the band 12 or through the filler 108 contained therein, by indirect or direct application of electric current, for example. As a different example! In the embodiments shown, the strap 12 may be provided with two portions 81 and 83 connected by electrical wires 91 and 93, such as e.g. Figure 25 is shown. The electric lines 91 and 93 are connected to a voltage source 95, by means of which a sufficiently high current can be transmitted to the band 12 to stimulate bone growth in the vicinity of the strap 12. The invention is at least one example! Embodiment III is designed such that the conductors 91 and 93 are introduced through pores 18 and directly stimulate the filler 108.

Parts 81 and 83 may optionally be part of an electrically conductive element 85 disposed within the inner and outer walls 62 of the strap 12, as shown in FIG. Optionally, the milky strap 12 may be formed of an electrically conductive material. One more example! In one embodiment, at least a portion of one or both of the inner and outer walls 60 is formed of an electrically conductive material and / or an electrically insulating material.

The invention is another example. Figures 27 and 28, wherein the implant 10 is characterized by having a linear element 200 or a plurality of linear elements 200 disposed around the disc disk 23 as shown in Figure 27. The element 200 may be of one or more braids or fibers, of fibrous material, of braids, or of other linear materials, and the element 200 has a first end 202 and a second end 204 that are capable of being bonded to one another or of a second end 204. way to each other. Preferably, the height of the element 200 should be large enough to cover the entire surface of the disc 23. Some materials suitable for making the element 200 include, or at least include, a building element, e.g. a retaining cord obtainable from Smith & Nephew Inc., or a line known as THE LOOP ™, available from Spineology Inc., and from Songer Cable from Medtronic Inc.

• · · «*

• · • · · ·

In some embodiments of the invention, one of which is shown in FIG. 28, the element 200 is of the same material as that of the foregoing, FIGS. 1 and 2, and includes a plurality of pores or apertures 18. When attached to the disc 23, the element 200 can be fastened or tightened tightly around the disc disk 23 as shown in Figures 29 and 30. The tightening of the element 200 around the disc disk 23 results in the compression disk 23 being compressed to tighten the ring 21 towards its center, thereby limiting the threads 58 of the ring 21. This tight bond stabilizes the segment 22 of the spinal column and substantially stiffens this part of the spine.

In Fig. 29, the ring 21 of the disc 23 is shown in the actuating segment 22 of the spine before the element 200 is properly fastened and tightened around it. It can be clearly seen that the ring 21 of the disc 23 has a certain height 206 and a given circumference 208. When the element 200 is placed and then tightened and tightened around the ring 21, as shown in FIG. 30, the circumference of the ring 21 is visibly smaller, i.e. the circumference 208 'is observed, but at the same time, the circumference of the ring 208 is observed. the height of the disc was increased and its height was 206 '.

When the ends 202 and 204 of the element 200 are fastened around the disc disk 23, the member 200 forms a substantially continuous strip similar to the previous embodiments. When the element 200 is secured around the disc disk 23, it preferably takes up a concave shape relative to the vertebral bodies surrounding it, as shown in Figure 28. When secured around the disc 23, the disc 23 can be further treated with other therapeutic additives, including the filler, which is applied to the openings or pores 18 in the prior art. 1 to 3, FIG.

The invention as an example! and embodiments of the invention can be realized with the various embodiments of the present invention and the scope of the claims as described in the claims.

Of course, the invention is not limited to the examples shown, other embodiments that are readily apparent to those skilled in the art are also conceivable. The embodiments set forth in the dependent claims may also be implemented in any combination and in a manner obvious to one skilled in the art.

· · ····· ·· * · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · ·

Claims (51)

  1. PATIENT INDIVIDUAL POINTS
    A device for stabilizing a spinal motion segment comprising:
    a substantially cylindrical element, e.g. the strap (12), which is generally formed of plastic but minimally elastic materials, and the substantially cylindrical member has a first end (30) and a second end (32), the substantially cylindrical element is bounded by an inner space (14), and an opening at the first and second ends (30, 32), and the substantially cylindrical element has a circumferential portion which is dimensioned so as to fit in the immediate vicinity of the outer ring (21) of the disc in the spinal column; the central axis is located between the first and second ends (30, 32), the central axis is configured and arranged to be substantially axial with the cefalo-caudal axis of the spinal column when the is located in the immediate vicinity of the outer ring of the disc, and the predetermined height and forward of the substantially cylindrical element specified thickness.
  2. Device according to claim 1, characterized in that the predetermined height of the substantially cylindrical element is between 0.25 and 20 mm measured along the central axis.
  3. Device according to claim 1 or 2, characterized in that the substantially cylindrical element has a thickness in the range of 0.01 to 5 mm.
  4. 4. Referring to 1-3. Device according to one of Claims 1 to 3, characterized in that the material of the substantially cylindrical element is non-porous.
  5. 5. Device according to one of Claims 1 to 4, characterized in that the material of the substantially cylindrical element is porous.
    «*
  6. 6. Device according to one of Claims 1 to 4, characterized in that the substantially cylindrical element is made of an electrically conductive material.
  7. 7. Device according to any one of Claims 1 to 3, characterized in that the substantially cylindrical element is formed as a smoothly driven or non-smoothed tube.
  8. 8. Referring to Figures 1-7. Device according to one of Claims 1 to 3, characterized in that the substantially cylindrical element is sufficiently flexible to be able to deform to a periodically elongated loop such that the substantially cylindrical element can be guided through an opening of the outer ring of the disc and the diameter of this opening is substantially the same. with a predetermined height of the cylindrical element periodically deformed.
  9. Device according to claim 8, characterized in that the material of the substantially cylindrical element is a material having a shape-retaining memory, i.e., the substantially cylindrical element is deformed by introducing it through an opening formed on the outer ring of the disc and into the interior of the disc. positioned where the substantially cylindrical member can expand again and lie on the ring of the disc.
  10. Device according to claim 9, characterized in that the material is at least partially NITINOL.
  11. Device according to claim 8 or 9, characterized in that the material is selected from a group of materials consisting of a polymeric material, a metal wire, a woven material, a braided material, a liquid impermeable material, and any combination thereof.
  12. 12. Device according to one of Claims 1 to 4, characterized in that the material of the substantially cylindrical element is selected from the group consisting of: "woven fibers, woven fibers, fibers, cords, wires, rope-like materials, sutures, or any of the following: combination.
  13. Device according to claim 1, characterized in that the tubular body 5 is a polymer or cement material which hardens after injection and forms the main body of the substantially cylindrical element.
  14. 14. References 1-13. Device according to one of Claims 1 to 3, characterized in that the substantially cylindrical element is configured and arranged to be positioned within the hollow area of the outer ring of the disc and the first end (30) is directly adjacent to the first adjacent vertebra, while the second end (30) is directly adjacent to the first peripheral vertebra. the end (32) is directly adjacent to the second adjacent vertebra.
  15. 15. Referring to Figures 1-14. Device according to one of Claims 1 to 3, characterized in that the material of the substantially cylindrical element further comprises pores or openings (18), and the plurality of apertures (18) are dimensioned to allow penetration of material selected from any of the following groups. : a suspension of liquids, solutions, small particles, and any combination thereof, the plurality of apertures (18) are designed and arranged to allow the bony parts to be covered with fibrous elements, both through the substantially cylindrical element and through it. and the device is disposed in the interior of the disc (14), and the plurality of apertures (18) are configured to fix the filler in the interior of the substantially cylindrical element.
  16. Device according to claim 15, characterized in that the openings (18) are formed as perforations.
  17. 17. References 1-16. Device according to one of Claims 1 to 3, characterized in that the inner space (14) is filled with a composition that stimulates bone growth.
  18. 18. References 1-17. Device according to any one of Claims 1 to 3, characterized in that the filler comprises at least part of a group of substances which stimulate the bone or stimulate the growth of the spongy bone or fibrous web, and include the following substances: at least one hormone, at least one pharmaceutical agent , at least one virus, genetic material, or any combination thereof.
  19. A device comprising a substantially resilient substantially cylindrical member dimensioned to fit and expand when introduced into a vertebra or a hollow region of the vertebra, the substantially cylindrical member defining an inner space (14). this inner space (14) extends from one end (30) of the substantially cylindrical element to the other end (32), and an opening is formed at the at least one end; the cylindrical element is configured and arranged to expand from a reduced state to an expanded state when a filler (108) is introduced into the interior space (14), and the substantially cylindrical element comprises at least one filling opening (26) through which filler (108) can be introduced into the interior space (18).
  20. Device according to claim 19, characterized in that the at least one filling opening (26) is designed to prevent the filler (108) from escaping from the interior space (14).
  21. Device according to claim 19 or 20, characterized in that the elastic, substantially cylindrical element comprises a series of openings (18), e.g. pores, the pores are sized so as to allow the inlet or suspension of liquids, solutions or small particles. they also allow the bones or fibrous elements to overflow through the device when the device is placed in the hollow region of the vertebra or the vertebrae, the pores are sized, "·" · «« ·· * »» » "4 · •» * »* · t ·» · «« «« · «» »« · ί 4 to the filler (108) is fixed within the interior space of the substantially tubular element (14).
  22. 22. The device of claim 21, wherein the apertures (18) have a first diameter in the range of 0.25 to 5 mm.
  23. Device according to claim 21 or 22, characterized in that the at least one filling opening (26) is formed as at least one opening.
  24. Device according to claim 22 or 23, characterized in that the at least one filling opening (26) has a predetermined diameter, the predetermined diameter of the filling opening (26) being greater than the first diameter of the apertures (18).
  25. 25. The 19-24. Device according to one of Claims 1 to 3, characterized in that the hollow area is formed on the vertebrae or between the vertebrae adjacent to the vertebrae.
  26. 26. Device according to one of Claims 1 to 3, characterized in that the hollow region of the vertebra is formed by the holes drilled in the vertebra and the device is inserted into the extruded part of the vertebra.
  27. 27. Articles 19-26 Device according to one of Claims 1 to 3, characterized in that the hollow region of the vertebral column is formed in the vertebral body and the device is inserted into this extruded region of the vertebral body in its reduced size state.
  28. 28. The 25-27. Device according to any one of Claims 1 to 3, characterized in that at least one end of the device in its expanded state is directly adjacent to at least one adjacent vertebra.
  29. 29. The 19-28. Device according to one of Claims 1 to 3, characterized in that the first end defines an upper opening, the second end defines a lower opening, and the upper and lower openings of the · · · * * are directly adjacent to the vertebrae surrounding them.
  30. 30. For the purposes of FIGS. Device according to one of Claims 1 to 3, characterized in that the substantially cylindrical element is made of polymeric material.
  31. 31. The 21-30. Device according to one of Claims 1 to 3, characterized in that the substantially cylindrical element is made of woven material, wherein the woven material is formed from at least one strand (58).
  32. Device according to claim 31, characterized in that the at least one fiber is formed at least partially of a material having a shape memory.
  33. Device according to claim 31 or 32, characterized in that the woven material is a biocompatible material comprising at least one of steel, titanium, NITINOL and other alloys.
  34. 34. The 21-33. Device according to one of Claims 1 to 4, characterized in that the substantially tubular element is made of a liquid impermeable material.
  35. The device of claim 34, further comprising a plurality of apertures (18) which are perforations.
  36. 36. Device according to one of Claims 1 to 3, characterized in that it comprises at least one longitudinally formed support element (68).
  37. 37. The device of claim 36, wherein said at least one longitudinal support member is at least one strand.
  38. 38. A 31-37. Device according to one of Claims 1 to 4, characterized in that it comprises at least one transverse support (64, 66).
    - * · »Λ ♦ ♦«
  39. A device according to claim 38, characterized in that the transverse support (64, 66) is arranged around the at least one opening formed at the end.
  40. 40. Articles 36-39. Device according to one of Claims 1 to 5, characterized in that it comprises at least one transverse support element (64, 66) and the at least one transverse support (64, 66) is perpendicular to the longitudinal support (68) when the device is in the expanded state.
  41. 41. Articles 22-40. Device according to one of Claims 1 to 3, characterized in that a filler is formed in cooperation with the insertion tool (100) and the filling insert tool (100) is designed and arranged to be inserted into one of the pores or at least one pore, which pores are from the first diameter to the second diameter, and the second diameter is dimensioned to allow the inserting tool (100) to penetrate into the interior of the device (14).
  42. 42. The 31-41. Device according to one of Claims 1 to 3, characterized in that the substantially tubular member is formed with an inner wall (60) and an outer wall (62), the inner wall (60) and the outer wall (62) are in continuous contact with each other and the inner wall (60) is in contact with each other. a space part is formed between the wall (60) and the outer wall (62).
  43. Device according to claim 42, characterized in that the at least one transverse support (64, 66) is disposed in the space formed by the inner and outer walls (60, 62) and the at least one transverse support (64, 66) ) is at least one strand.
  44. 44. Device according to one of Claims 1 to 4, characterized in that it can be used in combination with a transfer tube, wherein the transfer tube forms a storage chamber (50), and the storage chamber (50) forms a passage (28) with the substantially tubular member in its reduced state. from the chamber (50) to the hollow region of the vertebral column or to the vertebrae.
  45. 45. Articles 19-44. Device according to one of Claims 1 to 3, characterized in that the filler is a bioceramic composition.
  46. 46. The 19-45. Device according to one of Claims 1 to 3, characterized in that the filler (108) is a bioceramic composition or a bone filler in combination with a bone growth stimulating chemical and the bone growth stimulating chemical is selected from the group consisting of an autogenous protein, an allogeneic protein or a combination thereof.
  47. 47. The device of claim 46, wherein the bone growth stimulating chemical is a bone morphogen protein.
  48. 48. Device according to one of Claims 1 to 3, characterized in that the filler (108) is combined with a virus and the virus stimulates bone formation.
  49. 49. Articles 19-48. Device according to one of Claims 1 to 3, characterized in that the filler (108) is subjected to electrical stimulation.
  50. 50. The 19-49. Device according to any one of claims 1 to 3, characterized in that it is subjected to electrical energy stimulation.
  51. 51. The 19-50. Device according to one of Claims 1 to 3, characterized in that the substantially tubular member is provided with at least one circumferential member and that the at least one circumferential member is configured and arranged to contract the central portion of the substantially tubular member when the substantially tubular member is expanded. is arranged so as to form a substantially concave surface of the substantially tubular member.
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HU0302127A 2000-12-15 2001-12-17 Reinforcing straps on the disc ring element HU0302127A2 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
US25601400P true 2000-12-15 2000-12-15
PCT/US2001/048890 WO2002056802A1 (en) 2000-12-15 2001-12-17 Annulus-reinforcing band

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EP (1) EP1341489B1 (en)
JP (2) JP4202134B2 (en)
KR (1) KR100631787B1 (en)
AT (1) AT387163T (en)
AU (2) AU2002246690B2 (en)
CA (2) CA2429149C (en)
DE (1) DE60133033T2 (en)
HU (1) HU0302127A2 (en)
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