RU176747U1 - DEVICE FOR REPLACING AN INTERVERTEBRAL SPACE WITH AN INCREASING HEIGHT - Google Patents

Abstract

The utility model relates to medicine, namely to traumatology, orthopedics and vertebrology. The objective of the utility model is the replacement of the intervertebral space after removal of the intervertebral disc, the prevention of recurrence of radicular pain, as well as the correction of sagittal balance in the lower thoracic and lumbar spine. A useful model is a device with an increasing height from 0.8 cm to 1.1 cm or from 1.1 cm to 1.4 cm. It is made of VT-6 grade titanium alloy and consists of the following elements: the lower part is the “body”, for heights from 0.8 cm to 1.1 cm and for heights from 1.1 cm to 1.4 cm, the upper part is the “cover”, for heights from 0.8 cm to 1.1 cm and for heights from 1 , 1 cm to 1.4 cm, axial screw, bushings (two), tightening bracket for height from 0.8 cm to 1.1 cm, for height from 1.1 cm to 1.4 cm, cylinders (four) for heights from 0.8 cm to 1.1 cm and for heights from 1.1 cm to 1.4 cm. In the “body” and “cover” with internal surface rhnosti are wedge increasing towards the center of gravity, the center of which there is a trough for axial screw. The axial screw has a straight thread on one side to the middle of the length, and a reverse thread on the other side to the middle of the length. The screw is screwed around the edges of the sleeve. The assembled structure is fixed by a bracket held through the holes in the “housing” and “cover”, ensuring a stable position of the “cover”, “housing” and the axial screw. When the screw is rotated clockwise, the bushings come closer - the height of the device increases. The device can be used for minimally invasive replacement of the intervertebral space in the lower thoracic and lumbar spine with right and left access; to install the implant there is no need to remove the body of the vertebra and adjacent discs; possible surgical revision of the device in the long term.

Description

The utility model relates to medicine, namely to traumatology, orthopedics and vertebrology. The utility model provides replacement of the destroyed intervertebral discs in the lower thoracic and lumbar spine during their traumatic and degenerative lesions.

In the study of patent literature, we identified "Vertebral implant having adjustable postoperative dimensions" [RU 2495648 published 10.10.2013], including a group of inventions related to medicine. The vertebral implant contains a first vertebral fastener for attaching to the first portion of the spine, a second vertebral fastener for attaching to the second portion of the spine and a resizing device after implantation, located between the first and second vertebral fasteners and activated after surgical intervention carried out for installing the patient said vertebral implant, to ensure the movement of the first and second vertebral creams Pege elements relative to each other. Said device for resizing after implantation comprises lifting screws, driven by a gear train launched by a remotely controlled engine. A vertebral implant for distraction between the superior spinous process and the lower spinous process comprises a first support plate located below the upper spinous process; a second support plate located above the lower spinous process; and a device for resizing after implantation, located between said first and second support plates, actuated after implantation of said vertebral implant to a patient. Said device for resizing after implantation comprises lifting screws driven by a gear train. The rotation of said gear train causes said first support plate to press on the upper spinous process in the upper direction, and said second support plate to press on the lower spinous process in the lower direction and changes the distance between the first and second support plates. The invention provides the ability to control the size of the implant after surgery.

The disadvantages of this "Vertebral implant having adjustable postoperative dimensions" are due to: massive structure; numerous gears; the use of a “vertebral implant having adjustable postoperative dimensions” involves the destruction of the posterior supporting complex of the spinal column; the need for objective control of the three-dimensional spatial orientation of the vertebral motor segment when using the "Vertebral implant having adjustable postoperative dimensions"; the use of a “vertebral implant having adjustable postoperative dimensions” limits the minimally invasive technique of surgery; many nodes increase the likelihood of stability loss in the long term using a "Vertebral implant having adjustable postoperative dimensions"; bilateral administration of the device increases the risk of iatrogenic injury to the structures of the spinal canal and the roots of the spinal cord.

The prototype of the claimed utility model, as the closest in the totality of features, is the utility model “Telescopic prosthesis of the vertebral body” [RU 131294 published on 08.20.2013]. The telescopic prosthesis of the vertebral body contains an upper cylindrical base, at the end of which an upper supporting platform is made, a lower cylindrical base, at the end of which a lower supporting platform, an annular coupling and means for fixing the height of the prosthesis are made. An upper cylindrical base with an external thread and an annular coupling with an internal thread form a screw pair, and a lower cylindrical base with an annular groove and an annular coupling with an annular protrusion form a rotationally movable meshing connection. Central and slotted holes are made on the lateral and end surfaces of the prosthesis, and the area of the slotted and central holes should be 50-60% of the total surface area of the prosthesis. Along the outer perimeter of the upper and lower supporting platforms evenly in the form of a belt mounted latches arrow-shaped. The arrow-shaped latch may have a leg and a tip of rectangular or circular cross-section. In addition, the tip profile may have straight or concave faces. The threaded connection has a trapezoidal profile. Means for fixing the height of the prosthesis include threaded holes on the side surface of the lower cylindrical base and ridge semicircular recesses made along the perimeter of the lower end surface of the annular coupling and a locking screw. The lateral surface of the upper base is made of evenly spaced and alternating threaded sections and a cylindrical section on which slotted holes are made.

The disadvantages of the method are that the "Telescopic prosthesis of the vertebral body" in the claimed design cannot be used for minimally invasive replacement of the intervertebral space; to install the implant, it is necessary to remove the body of the vertebra and adjacent discs; the device cannot be used to replace the intervertebral space in the lower thoracic and lumbar spine; the use of the “Telescopic prosthesis of the vertebral body” does not imply its surgical revision in the long term.

The objective of the claimed utility model is the replacement of the intervertebral space after removal of the intervertebral disc, prevention of recurrence of radicular pain, as well as correction of the sagittal balance in the lower thoracic and lumbar spine.

The problem is achieved by using a device for replacing the intervertebral space with an increasing height from 0.8 cm to 1.1 cm or from 1.1 cm to 1.4 cm.

The device for replacing the intervertebral space with increasing height is made of VT-6 grade titanium alloy, consists of the following elements: the lower part is the body, the upper part is the cover, an axial screw, two bushings, a plate for height, in the case and cover from the inner surface there are wedge-shaped elevations increasing towards the center, in the center of which there is a groove for an axial screw, there are 4 fixed cylinder guides in the cover along the edges, and accordingly there are 4 holes in the body into which are inserted during assembly cover guide cylinders, in the middle parts of the body and the cover on the surface side having elevations, there are grooves transverse to the grooves adjacent to each other, the axial screw has a right-hand thread on one side to the middle of the length, and a left-hand thread on the other side to the middle of the length in the middle, a section with a smaller diameter than adjacent sections is screwed onto the screw along the edges of the sleeve, the plate is made with an opening for a section of an axial screw with a smaller diameter than adjacent sections, with a through slot from the hole to the edge of the plate with a thickness for accommodation in the grooves of the housing and the cover, when rotating the screw in the clockwise direction of the sleeve converge - apparatus height is increased.

A general view of the device is shown in FIG. 1. The sliding prosthesis of the lumbar intervertebral disc is made of VT-6 grade titanium alloy and consists of the following elements: the lower part is the “body”, for heights from 0.8 cm to 1.1 cm [Fig. 2] and for heights from 1.1 cm to 1.4 cm [Fig. 3], the upper part is the “cover”, for heights from 0.8 cm to 1.1 cm [Fig. 4] and for heights from 1.1 cm to 1.4 cm [Fig. 5], an axial screw [FIG. 6], bushings (two) [Fig. 7], a tightening bracket for a height of 0.8 cm to 1.1 cm [Fig. 8], for heights from 1.1 cm to 1.4 cm [Fig. 9], cylinders (columns) (four) for heights from 0.8 cm to 1.1 cm [Fig. 10] and for heights from 1.1 cm to 1.4 cm [Fig. eleven]. The body and cover elements are bean-shaped on the outside, their internal device with the designation of the sizes, compliance with which is necessary for the production of a sliding prosthesis of the lumbar intervertebral disc, is shown in FIG. 1 and FIG. eleven.

A device for replacing the intervertebral space with increasing height can be implanted depending on the access in the direct or inverted 180 ° position. In the “case” and “cover” from the inner surface there are wedge-shaped elevations increasing to the center, in the center of which there is a groove for the axial screw in the longitudinal direction [Fig. 6]. In the “cover” along the edges there are 4 fixed guide cylinders (columns) with a diameter of 0.3 cm, a height of 0.8 cm for a height of 0.8 cm to 1.1 cm [Fig. 10] or 1.1 cm for heights from 1.1 cm to 1.4 cm [Fig. eleven]. Accordingly, in the “case” there are 4 holes with a diameter of 0.3 cm, into which during assembly the guide cylinders (columns) of the “cover” are inserted.

Axial screw [Fig. 6] with a diameter of 0.4 cm and a length of 3.2 cm. A hexagonal slot with a diameter of 0.2 cm is located on one end of the axial screw. The screw has a straight thread on one side to the middle of the length and a reverse thread on the other side to the middle of the length. thread. The screw is screwed around the edges of the sleeve. The cylindrical nut on one side has slots on the sides to connect with the implant device.

The axial screw is installed in the longitudinal grooves of the housing and cover [Fig. one].

The assembled structure is fixed by a bracket held through the technological holes in the “housing” and “cover” [Fig. 1 and 8]. The bracket provides a stable position for the “cover”, “body” and axial screw.

When the screw is rotated clockwise with a hexagonal screwdriver, the cylindrical nuts are shifted to the center, meet resistance from the side of the wedge-shaped elevations that increase towards the center, which leads to the base and the roof moving apart - increasing the height along the guide cylinders. During the reverse rotation of the axial screw, the “base” and “roof” are shifted along the guides to their original position, which is important if surgical revision of the device is necessary to replace the intervertebral space with increasing height.

Thus, in comparison with the prototype, the utility model “Devices for replacing the intervertebral space with increasing height” has the following advantages: it can be used for minimally invasive replacement of the intervertebral space; to install the implant there is no need to remove the body of the vertebra and adjacent discs; the device can be used for minimally invasive replacement of the intervertebral space in the lower thoracic and lumbar spine with right and left access; possible surgical revision of the device in the long term.

Claims (1)

The device for replacing the intervertebral space with increasing height is made of VT-6 grade titanium alloy, consists of the following elements: the lower part is the body, the upper part is the cover, screw screw, two bushings, a plate for height, in the case and cover from the inner surface there are wedge-shaped elevations rising to the center, in the center of which there is a groove for an axial screw, there are 4 fixed cylinder guides in the lid at the edges, and accordingly there are 4 holes in the body, which are inserted into the casing during assembly control cylinders of the lid, in the middle parts of the casing and the lid on the surface side having elevations, there are grooves transverse to the grooves adjacent to each other, the axial screw has a right-hand thread on one side to the middle of the length, and a left-hand thread on the other side to the middle of the length in the middle - a section with a smaller diameter than adjacent sections, screwed onto the screw along the edges of the sleeve, the plate is made with an opening for a section of an axial screw with a smaller diameter than adjacent sections, with a through slot from the hole to the edge of the plate and with a thickness for placement in the grooves of the housing and the cover, when the screw rotates clockwise, the bushings come closer - the height of the device increases.

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