NO314121B1 - Ekspanderbar osteosynteseholder - Google Patents
Ekspanderbar osteosynteseholder Download PDFInfo
- Publication number
- NO314121B1 NO314121B1 NO19991228A NO991228A NO314121B1 NO 314121 B1 NO314121 B1 NO 314121B1 NO 19991228 A NO19991228 A NO 19991228A NO 991228 A NO991228 A NO 991228A NO 314121 B1 NO314121 B1 NO 314121B1
- Authority
- NO
- Norway
- Prior art keywords
- branches
- holder
- spacer
- implant
- implant according
- Prior art date
Links
- 239000007943 implant Substances 0.000 claims abstract description 58
- 125000006850 spacer group Chemical group 0.000 claims abstract description 44
- 230000004927 fusion Effects 0.000 claims description 6
- 238000009434 installation Methods 0.000 claims description 6
- 210000000988 bone and bone Anatomy 0.000 description 9
- 239000000463 material Substances 0.000 description 6
- 230000000284 resting effect Effects 0.000 description 5
- 238000006073 displacement reaction Methods 0.000 description 3
- 238000002513 implantation Methods 0.000 description 3
- 238000004873 anchoring Methods 0.000 description 2
- 238000003780 insertion Methods 0.000 description 2
- 230000037431 insertion Effects 0.000 description 2
- 238000000034 method Methods 0.000 description 2
- 208000007623 Lordosis Diseases 0.000 description 1
- 230000002146 bilateral effect Effects 0.000 description 1
- 230000000295 complement effect Effects 0.000 description 1
- 238000007596 consolidation process Methods 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 230000014759 maintenance of location Effects 0.000 description 1
- 238000003825 pressing Methods 0.000 description 1
- 230000035939 shock Effects 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
Classifications
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- A61F2/446—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages having a circular or elliptical cross-section substantially parallel to the axis of the spine, e.g. cylinders or frustocones
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Landscapes
- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Transplantation (AREA)
- Animal Behavior & Ethology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
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Description
Den foreliggende oppfinnelse vedrører et osteosynteseimplantat som angitt i ingressen til det selvstendige krav 1.
Det tekniske området for opprinnelsen er innen benimplantater eller proteser og de kirurgiske teknikker for å benytte dem.
Hovedbruksområdet for oppfinnelsen er å tilveiebringe implantater som er konstruert for å bli skjøvet eller innført fra en retning bakfra mellom de motliggende overflatene av to etterfølgende ryggvirvler for å opprettholde en gitt avstand mellom dem og å gjenvinne stabiliteten til ryggsøylen, for eksempel etter en svikt i den korresponderende sammenføyning ved å fiksere de to virvlene isammen.
Flere teknikker er kjent på det nåværende tidspunkt for å gjenopprette en "normal" lombar lordosis på denne måten, ved å implantere enten en pode som i sin tid smelter ryggvirvlene sammen, eller en protese som fikserer dem sammen umiddelbart, mens den også gjør det mulig i sin tid å oppnå fusjon mellom ryggvirvlene.
I den andre av den ovenfor nevnte teknikkene, blir det gjort bruk av hovedsaklig implantater, også kjent som "holdere", der noen er hule, stive, og en del, med innside/utsideforbindelsesspor for å motta en benpode som, via nevnte spor, deretter smelter sammen med den tilliggende ryggvirvel på hver side. På dette området kan det refereres til patentsøknad WO 96/08205 publisert 21. mars 1996 om en "Intervertebral fusjonsholder av konisk form" og til EP-søknadsnummer 637 440 publisert 8. februar 1995 om et "Intersomatisk implantat for ryggsøylen". Uansett har holdere av disse typene utvendige dimensjoner som er gitt og faste, mens avstandene mellom ryggvirvelpar ikke er konstant. Skråningen til de motvendende virveloverflatene til hvilke en gitt vinkelposisjon skal bli bibragt tillater i tillegg ikke stive holdere å bli benyttet fra en retning bakfra, det vil si at de bare kan bli innført fra en retning forfra.
Som et resultat av dette har andre typer holdere blitt utviklet med to i det vesentlige parallelle forgreninger forbundet til et stivt legeme gjennom hvilket det er mulig å dreie et snekkesystem (wormscrew system) som så beveger en kile i skrudd tilkobling på nevnte skrue fra en første posisjon nær de fjerntliggende endene av forgreningene mot legemet som holder forgreningene sammen, og derved spre de to forgreningene vinklet fra hverandre. Det er så mulig å innføre en slik holder med en innledende flat form mellom ryggvirvlene, og den ønskede vinkel mellom forgreningene blir justert eller innstilt fra en tilgang bakfra ved å dreie drivaksen til kilen.
Slike holdere eller implantater er beskrevet for eksempel i europeisk patentsøknad EP 664 994 publisert 2. august 1995 med tittelen '•Vertebral intersomatic cage" eller i søknad nummer EP 2 719 763 publisert 17. november 1995 med tittelen "Vertebral implant".
Uansett er slike anordninger som er mere mekaniske enn hule og stive holdere og som derfor er mer komplekse, gir et mindre innvendig volum for fusjonspoden, og på grunn av deres flate form som ikke er sirkulært symmetrisk, selv om de er bedre for å sikre en gitt vinkel mellom ryggsøylene, krever en passasje av samme rektangulært tverrsnitt å bli forberedt for å motta dem, og dette kompliserer implementering.
Problemet er derfor å være istand til å ha implantater eller holdere som er tilgjengelig for å gjøre det mulig å samtidig forene formen til en konvensjonelt stiv holder, første og fremst for å lette implantering og dernest for å tilveiebringe et større innvendig volum, med muligheten til å øke diameteren til den fjerntliggende enden av holderen til en gitt verdi i forhold til dens ende som er plassert tilliggende dets kirurgiske innføringspunkt, etter at det har blitt satt på plass, og korresponderende til den bakre overflaten til rygghvirvlen, mens den har så få mekaniske deler som mulig.
En løsning på dette problemet er et ekspansivt osteosynteseimplantat
som har forgreninger som hver er forbundet i en ende til et sete gjennomhullet av en åpning, slik at nevnte forgreninger og setet utgjør en hul holder som i en "hvileposisjon", har en utvendig generell form som er sylindrisk eller kvasisylindrisk om linjen som genererer den ved å rotere om dens symmetriakse som enten er en rett linje eller som har et buet midtparti som for eksempel en konveks sirkulær bue med stor radius, og som har en retningskurve rundt hvilken genereringslinj en vandrer, og som derfor også definerer tverrsnittet av sylinderen, som er kvasisirkulær. Dette
tilveiebringer en sylinder som er enten en rett sirkulær sylinder eller en sylinder som det her blir henvist til som å være eggformet eller oval, og som det nedenfor blir henvist til som en sylinder eller en kvasisylinder; i det minste en del av det innvendige volumet av holderen mot de fjerntliggende endene av forgreningene er i form av en kvasisylindrisk avkortet kjegle hvis store base er mot nevnte sete, og der nevnte implantat har minst tre forgreninger og minst et skillestykke med dimensjoner som er kompatible med dimensjonene til den store basen på den avkortede kjeglen i nevnte innvendige volum i hvileposisjon, og muligens passende for å gå gjennom nevnte åpning.
I en "aktiv" posisjon, sprer nevnte avstandsstykke nevnte forgreninger fra hverandre, der nevnte innvendige volum går mot en sirkulær sylinder, og den utvendige formen til holderen går mot en tilnærmet avkortet kjegle, og med en gang avstandsstykket har blitt satt inn den ønskede posisjon, forblir ingen indre deler inne i rommet definert ved hjelp av nevnte forgreninger, avstandsstykket og åpningen.
Definisjonene på "hvile" og "aktive" posisjoner er vist ved hjelp av eksempler henholdsvis i figur 1,3A, 4A, 5A, 9,10 og 11, og i figurene 2, 3B, 3C, 4B og 5B. Hvileposisjonen er posisjonen til implantatet før det er satt på plass og mens det settes på plass, det vil si uten at avstandsstykket er posisjonert mellom dets forgreninger inne i holderen, slik at holderen har et sylindrisk utvendig volum med konstant tverrsnitt. Den aktive posisjonen er den endelige posisjonen til implantatet, det vil si mellom to ryggvirvler, med dens forgreninger spredd fra hverandre ved hjelp av avstandsstykket som er plassert i sin endelige justerte posisjon, der den generelle utvendige formen til holderen er tilnærmet i form av en avkortet kjegle, og som spres vekk fra setet, som korresponderer med enden av implantatet posisjonert mot dets kirurgiske innføringspunkt, mot dets fjerntliggende ende som er plassert dypere inn mellom ryggvirvlene.
For å tilveiebringe bedre forankring i benet og for å unngå noen påfølgende vandring av holderen, er de utvendige overflatene til nevnte forgreninger forerrinnsvis enten riflet, fordypet eller gjenget ved bruk av et gjengeprofil som har utstikkende rifler eller lignende.
For å redusere enhver risiko for rotasjon etter implantering og dermed redusere enhver risiko for forskyvning av holderen mens man samtidig øker kontaktarealet med overflatene til rygghvirvlene, har også i det minste setet av implantatet og fortrinnsvis også sidene av forgreningene minst to valgfrie parallelle plan, hvert anbragt symmetrisk om implantatets akse mellom to påfølgende forgreninger. Disse planene, valgfritt assistert av den generelle eggformede formen av holderen, muliggjør bedre bibeholdelse etter ekspansjon ved å redusere enhver risiko for at implantatet roterer. Nevnte eggformede form kan i tillegg gjøre det mulig, på en bedre måte enn om den ytre genereringslinjen til den grunnleggende sylindriske formen av holderen i hvileposisjon har en rett linje, å vende tilbake etter ekspandering til en utvendig profil som er konisk og uten kurver, og derved tilveiebringe bedre fordelt trykk mot hvirvellegemet, og ved det hjelpe benpoden å ta bedre.
For å avstive holderen i dens bakre ende, spesielt hvis det er en stor åpning i setet som derved gjør det mulig å fylle holderen med benmateriale etter at holderen har blitt satt på plass og ekspandert, er åpningen til nevnte sete passende for å motta en plugg for å lukke det innvendige volumet av holderen. For eksempel kan pluggen bli skrudd inn i nevnte åpning, der åpningen i dette tilfellet også er gjenget. Under slike omstendigheter forhindrer pluggen benmaterialet fra å lekke ut, og avhengig av materialet som det er laget av, kan det også avstive holderen.
Ulike spesielle utførelsesformer er beskrevet nedenfor og i de medfølgende figurer. Resultatet er nye ekspansive osteosynteseimplantater som løser de nevnte problemer, spesielt for den ovenfor definerte hovedanvendelse.
Tilstedeværelsen av minst fire forgreninger, og muligens fire til åtte forgreninger, gjør det mulig å oppnå bilateral ekspansjon, og derved bedre fastklemming mot de to motliggende hvirveloverflatene, og fraværet av en sammenlenkende del eller stang mellom avstandsstykket som opprettholder nevnte ekspansjon og åpningen eller pluggen i endesetet sikrer et større innvendig volum for å motta en stor mengde benmateriale, og derved forbedre konsolideringen og sammenføyningen ved fusjon, spesielt mellom rygghvirvlene som skal holdes sammen. Nevnte fyllingsoperasjon blir gjort så mye enklere ved å ha en stor åpning i den bakre enden av holderen gjennom nevnte sete.
I tillegg gjør nevnte åpning det mulig å skrape hvirveloverflatene gjennom sporene plassert mellom forgreningene i bunn- og toppoverflatene av holderen.
I tillegg er ekspansjonssystemet som definert ovenfor svært enkelt, siden det innbefatter bare to deler, nemlig avstandsstykket og holderen (som valgfritt har en plugg plassert i sin ende og muligens også har et mellomliggende avstandsstykke, som nevnt nedenfor), men ingen forbindelseselement som blir igjen etter installasjon, siden enhver stang eller aksel for å posisjonere nevnte avstandsstykke og nevnte plugg blir påfølgende fjernet.
Den foreliggende oppfinnelse tilveiebringer derfor et antall fordeler i forhold til eksisterende implantater eller holdere, av den typen som allerede er nevnt, og andre fordeler kan også bli tilveiebragt, men disse som er angitt ovenfor er tilstrekkelig for å demonstrere nyheten og nytten i oppfinnelsen.
Osteosynteseimplantatet i henhold til den foreliggende oppfinnelse er kjennetegnet ved de i karakteristikken til det selvstendige krav 1 angitte trekk.
Beskrivelsen og figurene nedenfor viser to utførelsesformer av oppfinnelsen med fire forgreninger, men de er ikke begrensende på noen måte. Andre utførelsesformer er mulig innenfor omfanget av denne oppfinnelse, for eksempel utføresesformer med tre forgreninger eller utførelsesformer med mer enn fire. Figur 1 er et perspektivriss av et eksempel på et implantat i hvileposisjon, med dens ulike deler i innretning på en felles installasjonsakse XX'. Figur 2 er et perspektivriss av implantatet i figur 1 i det aktive posisjon, med de ovenfor nevnte tre deler sammenstilt. Figurene 3A, 4A og SA er henholdsvis et snittriss og to aksielle enderiss, et av den fremre overflaten og de andre av den bakre overflaten av en holder som viser en annen utførelsesform av et implantat i henhold til oppfinnelsen, i hvileposisjon. Figurene 3B, 4B og 5B viser de samme rissene som vist i figurene 3 A, 4A og 5A av den samme holderen, men med dens komplementære deler sammensatt i aktiv posisjon. Figur 3C er et sideriss vinkelrett til implanteringsaksen for utførelsesformen vist i figurene 3,4 og 5, i aktiv posisjon. Figurene 6,7 og 8 er figurer som viser utførelsesdetaljer for plantatholderen i henhold til oppfinnelsen. Figurene 9,10 og 11 er henholdsvis et sideveis delriss og to aksielle riss som viser den fremre overflaten og den bakre overflaten av utførelsesformen for plantatet vist i perspektiv i figurene 1 og 2. Figurene 12,13 og 14 er et overflateriss og et snittriss av henholdsvis: Et ikke-skrudd endeavstandsstykke for utførelsesformen i figurene 1,2,9,10 og 11; en skrudd ende og/eller mellomliggende avstandsstykke for en utførelsesform som gitt i figurene 3,4 og 5, og en lukkeplugg for enhver utførelsesform av oppfinnelsen.
Uansett utførelsesform innbefatter det ekspansive osteosynteseimplantatet på konvensjonell måte forgreninger 5, som hver er forbundet i en ende til et sete 7 gjennomhullet av en åpning 8. I samsvar med en essensiell karakteristikk av oppfinnelsen, innbefatter nevnte forgreninger 5 og setet 7 en hul holder 1 som i hvileposisjon som vist for utførelsesformene i figurene 1, 3 A, 4A og 5A og i figurene 9, 10 og 11 er av generelt utvendig form som er sylindrisk eller kvasisylindrisk og som har et tverrsnitt som også er rerningskurven for nevnte sylinder som er sirkulær eller kvasisirkulær, med genereringslinj en som kommer i kontakt med nevnte retningskurve og som genererer sylinderen eller kvasisylinderen ved å beveges rundt dens symmetriakse XX' som enten er en rett linje eller en konveks sirkulær bue med stor radius: Dette tilveiebringer enten en sirkulær symmetrisk rett sylinder som vist med heltrukne linjer 20\ i figur 3A, eller ellers en pseudosylinder som det i den foreliggende beskrivelse blir henvist til som oval eller eggformet, det vil si den har en noe utblokket utvendig form, som vist med lange og korte stiplede linjer 2O2 i figur 3A. Minst en del av det indre volum 9 i holderen 1 mot de fjerntliggende endene av forgreningene 5 er i form av en avkortet kjegle som er kvasisirkulært symmetrisk med dens store base som er nærmere nevnte sete 7, hvis inplantat har minst fire forgreninger 5 og minst ett avstandsstykke 2 passende for å gå gjennom nevnte åpning 8 og gjennom den store basen til den avkortede kjeglen inn i nevnte innvendige volum 9.
I figurene 2,3B, 4B, 5B og 3C, det vil si i den aktive posisjonen, sprer nevnte endeavstandsstykker 2 nevnte forgreninger 5 fra hverandre, der nevnte innvendige volum 9 så går mot en sylindrisk sylinder mens den utvendige formen til holderen 1 går mot en tilnærmet avkortet kjegle. I figur 3B for eksempel, viser den heltrukne linjen 20] den noe konkave formen som oppnås fra en regulær basesylinder i hvileposisjon mens korte og lange stiplede linjer 2O2 viser den rettere formen oppnådd fra en sylinder som i utgangspunktet var eggformet, som vist i figur 3A. Med en gang avstandsstykket 2 har blitt plassert i ønsket posisjon, blir ingen indre deler som har blitt benyttet for å tette implantatet og avstandsstykkene på plass tilbake inne i rommet definert av nevnte forgreninger 5, avstandsstykket 2 og åpningen 8.
Uansett utførelsesform er minst en del av den utvendige overflaten av nevnte forgreninger 5 gjenget med en gjengeprofil 11 som har utstående riller, som vist i detalj i figur 7. For eksempel for en holder som har en lengde L på ca. 20 til 25 mm, kan lengden 1 på det gjengede partiet til forgreningene 5 være i området 13 til 16 mm med en stigning p. på 1,5 til 2 mm, den utvendige diameteren D på den sirkulære sylinderen til holderen vil være fra 9 til 16 mm og høyden av en tann 111 i størrelsesorden 0,7 til 0,9 mm for en gjengevinkel p mellom påfølgende tenner som er ca. 60°, og med en innvendig profil 1 h av gjengen som har en radius på ca. 0,4 mm. Nevnte avrundede form på profilen minimaliserer spenningskonsentrasjoner, og gjør det derfor mulig å motstå store krefter og sammenstøt.
En slik utvendig gjenge med utstående riller letter derfor installasjonen siden den ikke er skadende, gitt at det ikke er noe sammenstøtssjokk mens nevnte implantat innføres siden den er skrudd inn i et hull som tidligere er borret ved hjelp av et hvilket som helst verktøy som er kompatibelt med åpningen 8 i implantatet, og med en gang den er på plass vil en slik gjenge også tilveiebringe forankring i benet og derved unngå enhver påfølgende forskyvning.
Setet 7 kan inkludere minst to flater 6 som er parallelle eller lett skrånet i forhold til hverandre for bedre å passe med profilet til rygghvirvlene, hver anbragt mellom to påfølgende forgreninger 5 som vist i utførelsesformene i henhold til figurene 1,2, 9,10 og 11. Alternativt kan setet 7 ha fire flater som danner et kvadratisk eller pseudo-kvadratisk tverrsnitt, som vist i utførelsesformene i figurene 3,4 og 5. I tillegg til setet, kan også selve forgreningene 5 ha respektive flater i det minste på linje med de som er på setet, som vist i utførelsesformene i figurene 3 og 5, spesielt hvis tverrsnittet til implantatet er kvasisirkulært, eller alternativt ikke ha noen plan i det hele tatt, som vist i utførelsesformene i figurene 1,2 og 9 til 11. Slike plan kan bli erstattet eller i det minste tilknyttet med et langsgående implantattverrsnitt som er lettere ovalt eller eggformet, som nevnt ovenfor.
Åpningen 8 i setet 7 kan bli gjenget med en gjengeprofil 15 som vist ved hjelp av eksempel i figur 6, med en gjengestigning som er avrundet både i toppen og i bunnen, og i tilknytning med dimensjonene gitt ovenfor ved hjelp av eksempel, kan en åpning 8 ha en innvendig diameter d på 7 til 10 mm, en stigning p' på 1 til 1,5 mm, en gjengedybde på ca. 0,6 mm, og en gjengevinkel y mellom gjengeveggene på ca. 30°.
En plugg 3 for å lukke det innvendige volumet 9 blir så skrudd inn i nevnte åpning 8, enten for å tjene som et forankringspunkt for en implantatsinstallerende stang, eller etter at implantatet har blitt satt på plass og forgreningene har blitt spredd fra hverandre ved hjelp av avstandsstykket 2 med hensikt om å lukke det innvendige volumet 9 først og fremst for å avstive holderen og for det andre å forhindre benmaterialet som har blitt implantert inne i holderen fra å komme ut igjen gjennom nevnte bakre ende.
En slik plugg 3 er vist forfra i figur 14A og fra siden i figur 14B, og som har et gjengeparti 152 av en type som er vist i figur 6, og en midtre åpning 17 av polygonal form som er kvadratisk, heksagonal eller lignende, eller som erstattes av ethvert middel egnet til å sikre deri den enden av stangen som har en kompatibel ende med formålet å muliggjøre for pluggen å bli skrudd inn og ut.
I tillegg er det mulig å danne på den bakre overflaten av implantatet og i omkretsen av åpningen 8 i setet 7, knatter eller spor som tjener til å sikre en del av den tilhørende mstallasjonsanordningen rundt stangen, som gjør det mulig for holderen 1, avstandsstykkene og/eller pluggen 3 å bli ført på en slik måte at den på en sikrere måte fikserer posisjonen til implantatet mens den blir satt på plass og for å lette demonteringen av hjelpeanordningen uten å bevege implantatet.
I utførelsesformene vist med fire forgreninger 5, har nevnte holder 1 fire spor 10 som
danner mellomrom mellom forgreningene som vist i figur 8, sett langs pilen VHI i figur 9 for eksempel. Slike spor tjener for det første til å forbedre fusjonen av benpoden som har blitt rommet i det innvendige volumet 9 sammen med de tilliggende hvirvelskivene, og for det andre for å oppnå bedre deformasjon av forgreningene 5 under instalasjon av implantatet, der forgreningene i dette spesielle partiet er av et tverrsnitt som er mindre enn i sine ender. I tillegg kan slike spor være avlange i form med deres ender plassert mot de fjerntliggende ender av forgreningene 5 som er trangere enn deres motsatte ender, som vist i figur 8, og som ender i en trang spalte 10i mellom de fjerntliggende endene av tilliggende par med nevnte forgreninger. En slik form, i det minste for hovedsporet 10, gjør det mulig å ha et spor med parallelle kanter etter at holderen har blitt ekspandert. Ved å velge en profil av denne form i stedet for et innledende spor med konstant bredde som vist i figur 3 A, gjør det i tillegg mulig å øke det bærende overflatearealet mellom avstandsstykket 2 og de fjerntliggende endene av forgreningene 5 i holderen, og slik tilveiebringe større styrke.
I utførelsesformene i figurene 1,2, 9,10 og 11, er de innvendige overflatene på forgreningene 5 som definerer det innvendige volumet 9 glatte, slik at volumet da inkluderer et aksielt hus 12 i sine fjerntliggende ender som er passende for å motta nevnte avstandsstykke 2i som vist i figur 12, og for å holde den ved hjelp av en skulder 13 med større diameter enn dens i det innvendige volum 9 for holderen i dens aktive posisjon, som vist i figur 1.
Nevnte avstandsstykke 22 har et gjenget aksielt hull 14 egnet for å motta en stang hvis ende i det minste er likeledes gjenget og kompatibel for å sette avstandsstykket på plass alene ved å påføre trykk og ved å bli beveget ved forflytning, der nevnte installasjonsstang deretter er fjernbar.
For å unngå enhver risiko for at legemet til holderen 1 deformeres i sin bakre ende nær de fjerntliggende endene av forgreningene 5 under store spenninger på grunn av trykk fra tilstøtende rygghvirvler, som kan ha den effekten at forgreninger beveges mot hverandre ved å gli rundt avstandsstykket 2, er det utfra figurene 1 og 2 mulig å tilveiebringe avstandsstykket med minst to splinter 18 eller andre midler som er anbragt symmetrisk om aksen XX' til implantatet. Et slikt avstandsstykke blir enten satt på plass innvendig i holderen 1 før implantatet blir satt på plass ved å bli opptatt deri fra ende av forgreningene, eller ellers har setet 7 minst to kompatible groper 19 som tillater nevnte to splinter 18 å gli derlangs når avstandsstykket 2 blir satt på plass hvis det behøver å å bli innført gjennom setet, og der bredden e av tappene ikke er større enn avstanden og mellomrommet mellom de fjerntliggende endene av to tilstøtende forgreninger 5.
Anordningen kan inkludere tilleggssystemer slik at forgreningene ikke deformeres etter at de har blitt ekspandert, for eksempel en utvendig ring mottatt i en grop i endene av forgreningene og som er deformerbar ved hjelp av forgreningene.
I utførelsesformen vist i figurene 3,4 og 5 blir de innvendige overflatene til forgreningene 5 som definerer det innvendige volumet 9 for holderen 1 gjenget med en gjengestigning som er ekvivalent med den i åpningen 8 i setet 7, det vil si som vist i figur 6, og nevnte avstandsstykke 2\ er gjenget på kompatibel måte, som vist i figurene 13A og 13B.
I denne utførelsesformen med en innvendig gjenge, kan nevnte holder 1 også inkludere minst et annet mellomliggende avstandsstykke 4 som er gjenget slik som endegj enges tykket 2\ og istand til å bli skrudd bak det for for det første å presse sammen benmaterialet som kan ha blitt innført i rommet definert mellom de to avstandsstykkene og for det andre for å avstive det midtre partiet av holderen.
Nevnte ende og mellomliggende avstandsstykker 2\ og 4 har respektive polygonale aksielle åpninger 16 egnet for å motta en fjembar stang som har en håndende av kompatibel form for å føre dem mens de blir installert.
Den avkortede kjegleformen på innsidevolumet 9 til holderen 1 kan ha en vinkelhalvdel med skråning a i området 6° til 9°, for eksempel.
Claims (13)
1.
Osteosynteseimplantat innbefattende forgreninger (5) hver forbundet i en ende til et sete (7) gjennomhullet av en åpning (8), hvilket implantat kan ekspanderes fra en "hvile"-posisjon til en "aktiv" posisjon, idet implantatet innbefatter et avstandsstykke for å spre nevnte forgreninger i nevnte "aktive" posisjon, hvilket avstandsstykke er plassert i et innvendig volum (9) i implantatet, der implantatet er karakterisert ved at nevnte forgreninger (5) og sete (7) utgjør en hul holder (1) som, i nevnte "hvile"-posisjon har en utvendig generell form som er kvasisylindrisk med kvasisirkulært tverrsnitt, og minst en del av det innvendige volumet (9) av holderen (1) mot de fjerntliggende ender av nevnte forgreninger (5) i form av en kvasisirkulær avkortet kjegle hvis store base er mot nevnte sete (7), hvis implantat har minst tre forgreninger (5), idet avstandsstykket (2) er kompatibelt med dimensjonene til den store basen til den avkortede kjegle, og der avstandsstykket (2) kan drives av en fjernbar stang, hvorved det med en gang etter at avstandsstykket (2) har blitt drevet til å spre forgreningene (5) fra hverandre og den fjembare stangen har blitt fjernet er igjen et større innvendig volum for fusjonspode.
2.
Implantat i henhold til krav 1, karakterisert ved at i nevnte "aktive" posisjon går nevnte innvendige volum (9) mot en sirkulær sylinder mens den utvendige formen til holderen (1) er en tilnærmet avkortet kjegle.
3.
Implantat i henhold til krav 1 eller 2, karakterisert v e d at minst en del av de utvendige overflatene av nevnte forgreninger (5) er gjenget med et gjengeprofil (11) som har en utstikkende rille.
4.
Implantat i henhold til et hvilket som helst av kravene 1 til 3, karakterisert ved at setets (7) sylindriske overflate er avflatet på to diametralt plasserte sider (6) beliggende mellom to forgreninger (5).
5.
Implantat i henhold til et hvilket som helst av kravene 1 til 4, karakterisert ved at åpningen (6) på setet (7) er egnet for å motta en plugg (3) for å lukke det innvendige volumet (9) av holderen (1).
6.
Implantat i henhold til et hvilket som helst av kravene 1 til 5, karakterisert ved at de innvendige overflatene til forgreningene (5) som definerer det innvendige volumet (9) av holderen (1) er glatte, hvis volum har et aksielt hus (12) i sin fjerntliggende ende egnet for å motta nevnte avstandsstykke (2i) og for å holde det ved hjelp av en skulder (13) med en diameter som er større enn diameteren til det innvendige volumet (9) av holderen i "aktiv" posisjon.
7.
Implantat i henhold til krav 6, karakterisert ved at nevnte avstandsstykke (22) inkluderer et gjenget aksielt hull (14) som er egnet for å motta den fjernbare installasjonsstangen, og der minst enden av stangen også er gjenget og kompatibel.
8.
Implantat i henhold til krav 6 eller 7, karakterisert ved at nevnte avstandsstykke (2) inkluderer minst to tapper (18) anbragt symmetrisk om implantatets akse, der breddene til tappene ikke er større enn den ønskede spalteavstanden mellom de fjerntliggende endene av to tilstøtende forgreninger (5)-
9.
Implantat i henhold til et hvilket som helst av kravene 1 til 5, karakterisert ved at de innvendige overflatene til forgreningene (5) som definerer det innvendige volum (9) av holderen (1) er gjenget, og der nevnte avstandsstykke (2i) også er gjenget på kompatibel måte.
10.
Implantat i henhold til krav 9, karakterisert ved at nevnte holder (1) har minst et mellomliggende, andre avstandsstykke (4) gjenget lik endeavstandsstykket (2i).
11.
Implantat i henhold til krav 9 eller 10, karakterisert ved at nevnte avstandsstykker(2i, 4) har respektive aksielle åpninger (16) av polygonal form egnet for å motta en fjernbar stang som har minst en ende med kompatibel hannform for å føre dem og sette dem på plass.
12.
Implantat i henhold til et hvilket som helst av kravene 1 til 11, karakterisert ved at den generelle utvendige formen av holderen (1) er en sylinder hvis genereringslinje som genererer den ved å rotere den om dens symmetriakse XX' har et buet midtparti som for eksempel en sirkulær bue med stor radius.
13.
Implantatet i henhold til et hvilket som helst av kravene 1 til 12, karakterisert ved at det innbefatter fire forgreninger (5).
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
FR9611452A FR2753368B1 (fr) | 1996-09-13 | 1996-09-13 | Cage d'osteosynthese expansive |
PCT/FR1997/001617 WO1998010722A1 (fr) | 1996-09-13 | 1997-09-12 | Cage d'osteosynthese expansive |
Publications (3)
Publication Number | Publication Date |
---|---|
NO991228D0 NO991228D0 (no) | 1999-03-12 |
NO991228L NO991228L (no) | 1999-05-12 |
NO314121B1 true NO314121B1 (no) | 2003-02-03 |
Family
ID=9495900
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
NO19991228A NO314121B1 (no) | 1996-09-13 | 1999-03-12 | Ekspanderbar osteosynteseholder |
Country Status (20)
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US (9) | US6129763A (no) |
EP (1) | EP1014899B1 (no) |
JP (1) | JP4107397B2 (no) |
KR (1) | KR100532548B1 (no) |
CN (1) | CN1158979C (no) |
AT (1) | ATE273674T1 (no) |
AU (1) | AU715283B2 (no) |
BR (1) | BR9712820A (no) |
CA (1) | CA2266126C (no) |
CZ (1) | CZ290106B6 (no) |
DE (1) | DE69730360T2 (no) |
ES (1) | ES2225964T3 (no) |
FR (1) | FR2753368B1 (no) |
IL (1) | IL128695A (no) |
NO (1) | NO314121B1 (no) |
PL (1) | PL185352B1 (no) |
PT (1) | PT1014899E (no) |
RU (1) | RU2195894C2 (no) |
TR (1) | TR199900545T2 (no) |
WO (1) | WO1998010722A1 (no) |
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1996
- 1996-09-13 FR FR9611452A patent/FR2753368B1/fr not_active Expired - Lifetime
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1997
- 1997-09-12 AT AT97919092T patent/ATE273674T1/de active
- 1997-09-12 RU RU99107286/14A patent/RU2195894C2/ru not_active IP Right Cessation
- 1997-09-12 JP JP51332698A patent/JP4107397B2/ja not_active Expired - Lifetime
- 1997-09-12 EP EP97919092A patent/EP1014899B1/fr not_active Expired - Lifetime
- 1997-09-12 ES ES97919092T patent/ES2225964T3/es not_active Expired - Lifetime
- 1997-09-12 PL PL97332161A patent/PL185352B1/pl not_active IP Right Cessation
- 1997-09-12 AU AU43055/97A patent/AU715283B2/en not_active Expired
- 1997-09-12 BR BR9712820-1A patent/BR9712820A/pt not_active IP Right Cessation
- 1997-09-12 CZ CZ1999893A patent/CZ290106B6/cs not_active IP Right Cessation
- 1997-09-12 WO PCT/FR1997/001617 patent/WO1998010722A1/fr active IP Right Grant
- 1997-09-12 KR KR10-1999-7002021A patent/KR100532548B1/ko not_active IP Right Cessation
- 1997-09-12 PT PT97919092T patent/PT1014899E/pt unknown
- 1997-09-12 CA CA002266126A patent/CA2266126C/fr not_active Expired - Lifetime
- 1997-09-12 CN CNB971978913A patent/CN1158979C/zh not_active Expired - Fee Related
- 1997-09-12 TR TR1999/00545T patent/TR199900545T2/xx unknown
- 1997-09-12 DE DE69730360T patent/DE69730360T2/de not_active Expired - Lifetime
- 1997-09-12 US US09/117,469 patent/US6129763A/en not_active Expired - Lifetime
- 1997-09-12 IL IL12869597A patent/IL128695A/en not_active IP Right Cessation
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1999
- 1999-03-12 NO NO19991228A patent/NO314121B1/no unknown
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2000
- 2000-06-05 US US09/587,596 patent/US6371989B1/en not_active Expired - Lifetime
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2001
- 2001-09-14 US US09/951,751 patent/US20020040243A1/en not_active Abandoned
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2002
- 2002-04-16 US US10/124,044 patent/US7828848B2/en not_active Expired - Fee Related
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2006
- 2006-06-07 US US11/448,335 patent/US20060241774A1/en not_active Abandoned
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2010
- 2010-09-21 US US12/887,283 patent/US8435299B2/en not_active Expired - Fee Related
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2013
- 2013-04-16 US US13/863,857 patent/US8992621B2/en not_active Expired - Fee Related
- 2013-04-16 US US13/863,964 patent/US8790407B2/en not_active Expired - Fee Related
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2015
- 2015-02-24 US US14/629,648 patent/US20150230934A1/en not_active Abandoned
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