JP2007517539A - Interbody cage for lumbar fixation by transforaminal approach and its cage support device - Google Patents

Abstract

  The interbody cage according to the present invention has a main body having a curved shape, and the main body has a hollow portion (8, 9) and a hollow portion (8, 9) along the entire height of the cage at each end. And a horizontal notch in a direction perpendicular to. Said notches open towards each cutout (8, 9) and allow the interbody cage to be temporarily connected to the rod (19) of the cage support device (15). The cage support device (15) ensures the degree of freedom of the gradual rotation angle of the cage (1) depending on the position of its introduction between the vertebral bodies.

Description

The present invention relates to an interbody cage that allows fixation between two vertebral bodies of the spinal column, and to the cage support device for introducing it between the vertebral bodies.
US Patent Application Publication No. 2003/135275 French Patent Application Publication No. 2813519 European Patent Application No. 0716840 International Publication No. 01/62191 Pamphlet French Patent Application Publication No. 2736537

  The interbody cage according to the present invention is introduced between the vertebral bodies by a transforaminal approach that allows lumbar fixation of the vertebral bodies to be performed by installing one cage.

  An interbody cage for vertebral body fixation by a transforaminal approach according to the present invention has a body with a curved shape. The body has on the one hand at each end a hollow part provided over the entire height of the cage and on the other hand opens in each hollow part in a direction perpendicular to the direction of the hollow part and introduces it between the vertebral bodies. It has a horizontal notch that allows the interbody cage to be temporarily connected to the rod of the cage support device that ensures freedom of gradual rotation angle of the cage depending on the position.

  The interbody cage according to the present invention has two interior chambers throughout its height. The two internal chambers are separated by a central partition that connects the front and rear walls.

  The interbody cage according to the present invention has cutouts that are each separated from a nearby internal chamber by a vertical partition.

  The interbody cage according to the present invention has grooves provided on the upper and lower surfaces of each partition along the curved radius.

  The interbody cage according to the present invention connects two X-ray imaging markers arranged in the direction perpendicular to the thickness of the front wall at the partition portion, and connects the front wall and the rear wall at the central partition portion. It has an X-ray imaging marker arranged in the horizontal direction.

  The interbody cage according to the present invention has a thinner rear wall in which a blood vessel passage hole is opened in the internal chamber.

  The cage support device for introducing the interbody cage according to the present invention is composed of an ergonomic handle. The ergonomic handle has a side plane capable of marking the position of a mounting pin located at the free end of the rod having drive means at a predetermined distance from the handle. The drive means can translate the fixed tube along the rod and move it closer to or away from the mounting pin.

  The cage support device according to the invention has drive means consisting of a wheel, which on the one hand cooperates with the threaded part of the rod by means of a threaded bore and on the other hand is arranged in the extension part of the threaded bore. The chamber cooperates with a head fixed to a fixed tube.

  The cage support device according to the present invention has a mounting pin at the free end of the fixation tube, which is complementary to the outer shape of the end of the interbody cage, more specifically, while the cage is locked to the cage support device. It has a shape that is complementary to the contour that is placed around the notch so that it can be perfectly aligned.

  The cage support device according to the present invention has a wheel, the wheel chamber is given a predetermined dimension to cooperate with the head of the tube 25, the wheel being rodless without causing the tube to rotate. It is possible to rotate on the threaded part.

  The cage support device according to the present invention has a fixed tube. The fixed tube is slidable but non-rotatably mounted around the rod, and is moved closer to or away from the mounting pin depending on the direction of rotation of the wheel.

  The cage support device according to the present invention has a rod, and the mounting pin of the rod has a cylindrical shape arranged in a direction perpendicular to the main axis of the rod.

  The following description in connection with the accompanying drawings is given by way of non-limiting illustration to better understand the invention, its features, and the advantages it will provide.

  FIG. 1 shows an interbody cage 1 with a curved or kidney bean-shaped profile with all edges smoothed mainly at two ends.

  The interbody cage 1 is asymmetric in the horizontal plane but bilaterally in the vertical plane and can be approached or introduced from the left or right of the spine without the need to change the cage. In practice, the upper curved radius is smaller than the lower curved radius. A horizontal marker 13 is arranged near the upper edge.

  The interbody cage 1 has two internal chambers 2 and 3 over its entire height. The two internal chambers 2 and 3 are separated by a central partition 4 that connects the front wall 5 and the rear wall 6 to each other.

  The rear wall 6 having a smaller thickness is provided with a blood vessel passage hole 7 that opens into the internal chambers 2 and 3 of the interbody cage 1.

  The interbody cage 1 has cutouts 8 and 9, each at its end and over its entire height, each separated from a nearby inner chamber 2, 3 by a vertical partition 10, 11.

  The upper and lower surfaces of the interbody cage 1 have grooves 12 arranged along the curved radius at each end and in each partition 4, 10, and 11.

The interbody cage 1 has an X-ray imaging marker 13 made of tantalum wire that is positioned by the following method.
The two markers 13 are arranged in the vertical direction at the thickness of the front wall 5 and at the parts 10 and 11.
The marker 13 connects the front wall 5 and the rear wall 6 and is disposed in the horizontal direction at the site of the central partition 4.

  The interbody cage 1 has a horizontal notch 14 that is open in each hollowed portion 8, 9 at each end and can provide a connection between the cage and the cage support device 15.

  2 to 4 show a cage support device 15 that enables the introduction of an interbody cage 1 between the vertebral bodies of the spinal column.

  The cage support device 15 is composed of an ergonomic handle 16 having a side plane 17 and allows the position of a mounting pin 18 located at the end opposite to the handle to be marked.

  The ergonomic handle 16 is fixed to the rod 18. The rod 18 has a mounting pin 18 at its free end. The mounting pin 18 has a cylindrical shape that is arranged in a direction perpendicular to the main axis of the rod 19.

  The rod 19 has a threaded portion 20 adapted to cooperate with a threaded wheel 21 at a predetermined distance from the handle 16. This threaded wheel 21 has a large diameter chamber 23 in the extension of its threaded bore 22 that can receive the head 24 of a fixed tube 25.

  The chamber 23 is given a predetermined dimension to cooperate with the head 24 of the tube 25, and the wheel 21 rotates on the threaded portion 22 of the rod 19 without driving the tube 25 in the rotational direction. It is possible. This fixing in the rotational direction is obtained by the cooperation of the flat portion 27 provided on the rod 19 and the pin 28 in the tube 25.

  The fixed tube 25 is slidable but is non-rotatably mounted around the rod 19, and is moved closer to or away from the mounting pin 18 depending on the rotation direction of the wheel 21.

  Thus, the wheel 21 translates the fixed tube 25 along the rod as it is driven to rotate on the threaded portion of the rod 19 to move closer to or away from the mounting pin 18.

  The free end of the fixation tube 25 has a shape complementary to the outer shape of the end of the interbody cage 1 at the site of the attachment pin 18. More specifically, it has a profile that is arranged around the notch 14 so that it can be perfectly aligned with the interbody cage 1 while locking the cage to the cage support device 15.

  5-8 illustrate various steps of installing the interbody cage 1 to the cage support device 15 prior to being introduced between the vertebral bodies of the spinal column.

  In order to lock the interbody cage 1 to the cage support device 15, first the mounting pins 18 are inserted into the corresponding cutouts 8, 9 via notches or slits 14 (FIG. 5).

  Next, a rotation of 90 degrees is performed between the interbody cage 1 and the cage support device 15, and the mounting pins 18 are fixed in the corresponding cutout portions 8 and 9 (FIG. 6).

  The fixed tube 25 is translated by the wheel 21 until the outer wall of the interbody cage 1 is engaged with the end of the fixed tube 25.

  In this way, the outer wall of the interbody cage 1 is sandwiched between the end of the tube 25 having the complementary shape and the mounting pin 18 so that the interbody cage 1 is temporarily attached to the cage support device 15. It can be fixed (FIG. 7).

  8-11 illustrate the introduction of an interbody cage temporarily secured to the end of the cage support device 15 between the vertebral bodies 26 of the spinal column.

  One limitation is to limit as much as possible the size of the openings provided between the vertebral bodies 26 through which the interbody cage 1 and various instruments pass.

  For this reason, the interbody cage 1 is arranged in an extended portion of the cage support device 15. In this position it occupies the smallest space.

  Next, the cage support device 15 ensures a gradual rotation of the interbody cage 1 between the vertebral bodies 26, so that the cage and the cage support device 15 are at an angle of about 90 degrees so that the cage is relative to the vertebral body. That final position.

  The pressure applied by the surgeon to the handle 16 of the cage support device 15 ensures a gradual rotation of the interbody cage 1 relative to the cage support device 15, while the interbody cage 1 is sandwiched between the vertebral bodies 26. I'm stuck.

  The surgeon performs various positioning of the cage support device 15 relative to the interbody cage 1 sandwiched between the vertebral bodies 26. This is done by moving the tube 25 along the rod 19 until the cage is in its final position.

  To completely remove the interbody cage 1 from the cage support device 15, the wheel 21 is rotated to separate the tube 25 from the cage, and the handle 16 is rotated 90 degrees so that the attachment pin 18 is rotated by the corresponding cutout 8. , 9 need to be taken out.

  These various steps of positioning the cage support device 15 relative to the interbody cage 1 are facilitated by a flat 17 that allows the location of the mounting pin 18 to be visible to the surgeon.

  In practice, this is arranged in the same plane as the flat part 17 is arranged.

  It should be further understood that the above description has been given by way of example and limits the scope of the invention which is not to be expanded by replacing the details of implementation described with any other equivalents. Not what you want.

1 is a perspective view showing an interbody cage according to the present invention. FIG. FIG. 4 shows a cage support device that allows for the introduction of an interbody cage between vertebral bodies of the spinal column. It is detail drawing which shows the cage support apparatus of this invention. It is detail drawing which shows the cage support apparatus of this invention. FIG. 5 shows the fixation of the interbody cage to its cage support device before being introduced between the vertebral bodies of the spinal column. FIG. 5 shows the fixation of the interbody cage to its cage support device before being introduced between the vertebral bodies of the spinal column. FIG. 5 shows the fixation of the interbody cage to its cage support device before being introduced between the vertebral bodies of the spinal column. It is a figure which shows installation of the interbody cage between the vertebral bodies of the spinal column by a cage support apparatus. It is a figure which shows installation of the interbody cage between the vertebral bodies of the spinal column by a cage support apparatus. It is a figure which shows installation of the interbody cage between the vertebral bodies of the spinal column by a cage support apparatus. It is a figure which shows installation of the interbody cage between the vertebral bodies of the spinal column by a cage support apparatus.

Claims (12)

An interbody cage for fixation of a vertebral body (26) by a transforaminal approach comprising:
Having a body with a curved shape, on the one hand at each end it has a hollow (8, 9) provided over the entire height of the cage and on the other hand in the direction of the hollow (8, 9) A rod (15) of the cage support device (15) that opens in each cut-out portion (8, 9) in the vertical direction and secures a degree of freedom of the gradual rotation angle of the cage according to its introduction position between the vertebral bodies. The interbody cage is characterized by having a horizontal notch (14) that enables the interbody cage to be temporarily connected to 19). The interbody cage according to claim 1,
It has two internal chambers (2, 3) over its entire height, and the two internal chambers (2, 3) are separated by a central partition (4) that connects the front wall (5) and the rear wall (6) to each other. An interbody cage, characterized in that The interbody cage according to claim 2,
The interbody cage, wherein the cut-out parts (8, 9) are separated from the nearby internal chambers (2, 3) by vertical partitions (10, 11). The interbody cage according to claim 2 and 3,
The interbody cage is characterized in that grooves (12) are provided on the upper and lower surfaces of each partition (4, 10, and 11) along the curved radius. The interbody cage according to claim 2,
Two X-ray imaging markers (13) arranged in a direction perpendicular to the thickness of the front wall (5) at the partition (10, 11) and the front wall (5) at the center partition (4). ) And the rear wall (6), and has a marker (13) arranged in the horizontal direction. The interbody cage according to claim 2,
An intervertebral body cage characterized in that a blood vessel passage hole (7) is opened in the inner wall (2, 3) in the rear wall (6) having a smaller thickness. A cage support device for introducing the interbody cage (1) according to claim 1,
The ergonomic handle (16) is composed of an ergonomic handle (16) which is mounted on a free end (18) of a rod (19) having a drive means (21) at a predetermined distance from the handle (16). ), And the drive means (21) translates the fixed tube (25) along the rod (19) to approach the mounting pin (18). Cage support device characterized in that it can be moved away or away. A cage support device for introducing an interbody cage (1) according to claim 7,
The drive means consists of a wheel (21), which on the one hand cooperates with the threaded part (20) of the rod (19) by means of a threaded bore (22) and on the other hand a threaded bore (22). Cage support device, which cooperates with a head (24) fixed to a fixed tube (25) by means of a chamber (23) arranged in an extension of the head. A cage support device for introducing an interbody cage (1) according to claim 7,
The free end of the fixation tube (25) is complementary to the outer contour of the end of the interbody cage (1) at the location of the mounting pin (18), more specifically, the cage support device (15) is attached to the cage. Cage support device characterized in that it has a shape that is complementary to the contour that is arranged around the notch (14) so that it can be perfectly aligned during locking. A cage support device for introducing an interbody cage (1) according to claim 8,
The chamber (23) is given a predetermined dimension to cooperate with the head (24) of the tube (25), and the wheel (21) is a rod without driving the tube (25) in the direction of rotation. A cage support device capable of rotating on a threaded portion (22) of (19). A cage support device for introducing an interbody cage (1) according to claim 8,
The fixed tube (25) is slidable but is mounted non-rotatably around the rod (19), and is moved closer to or away from the mounting pin (18) depending on the direction of rotation of the wheel (21). A cage support device characterized by that. A cage support device for introducing the interbody cage (1) according to claim 1,
The cage support device according to claim 1, wherein the mounting pin (18) has a cylindrical shape arranged in a direction perpendicular to the main axis of the rod (19).

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