US20040068258A1 - Device for fixing bones in relation to one another - Google Patents

Device for fixing bones in relation to one another Download PDF

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Publication number
US20040068258A1
US20040068258A1 US10/456,535 US45653503A US2004068258A1 US 20040068258 A1 US20040068258 A1 US 20040068258A1 US 45653503 A US45653503 A US 45653503A US 2004068258 A1 US2004068258 A1 US 2004068258A1
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US
United States
Prior art keywords
blade
anchoring element
anchoring
back end
segment
Prior art date
Legal status (The legal status 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 status listed.)
Abandoned
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US10/456,535
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English (en)
Inventor
Fridolin Schlapfer
Martin Hess
Konrad Tagwerker
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
DePuy Spine LLC
DePuy Synthes Products Inc
Original Assignee
Synthes USA LLC
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
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Assigned to SYNTHES (USA) reassignment SYNTHES (USA) ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: TAGWERKER, KONRAD, HESS, MARTIN, SCHLAPFER, FRIDOLIN
Publication of US20040068258A1 publication Critical patent/US20040068258A1/en
Priority to US11/485,833 priority Critical patent/US7666207B2/en
Assigned to DEPUY SPINE, LLC reassignment DEPUY SPINE, LLC ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: SYNTHES USA, LLC
Assigned to HAND INNOVATIONS LLC reassignment HAND INNOVATIONS LLC ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: DEPUY SPINE, LLC
Assigned to DePuy Synthes Products, LLC reassignment DePuy Synthes Products, LLC CHANGE OF NAME (SEE DOCUMENT FOR DETAILS). Assignors: HAND INNOVATIONS LLC
Assigned to HAND INNOVATIONS LLC reassignment HAND INNOVATIONS LLC CORRECTIVE ASSIGNMENT TO CORRECT THE INCORRECT APPL. NO. 13/486,591 PREVIOUSLY RECORDED AT REEL: 030359 FRAME: 0001. ASSIGNOR(S) HEREBY CONFIRMS THE ASSIGNMENT. Assignors: DEPUY SPINE, LLC
Assigned to DEPUY SPINE, LLC reassignment DEPUY SPINE, LLC CORRECTIVE ASSIGNMENT TO CORRECT THE INCORRECT APPLICATION NO. US 13/486,591 PREVIOUSLY RECORDED ON REEL 030358 FRAME 0945. ASSIGNOR(S) HEREBY CONFIRMS THE ASSIGNMENT. Assignors: SYNTHES USA, LLC
Abandoned legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8625—Shanks, i.e. parts contacting bone tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7019—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other
    • A61B17/7025—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other with a sliding joint
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A61B2017/00858—Material properties high friction, non-slip

Definitions

  • the present invention relates generally to orthopaedic fasteners, and in particular to a device for fixation of vertebral bodies.
  • Fixation systems may either be inserted and anchored from the posterior, whereby the anchoring is done by means of bone screws in the pedicles, or from the anterior or antero-lateral, in which case the anchoring is done by means of bone screws in the vertebral bodies.
  • fixation systems are anchored is heavily dependent on the quality of the bone structures. This is especially true of antero-laterally anchored fixation systems.
  • the greater the degree of osteoporosis the greater the danger that the bone screws will cut through the bone when subjected to even small loads.
  • the use of thick screws reduces the risk of cutting through the bone.
  • overly thick screws should be avoided lest there be excessive destruction of the bone structure in the vertebral body.
  • the hollow screw may be so heavily in-grown that it may be difficult to remove it if the area is to be inspected or, if removed, it will do serious damage to the bone (in some cases, for example, it has proved to be impossible to remove hollow screws inserted into the cervical vertebral column).
  • Intramedullary stabilization techniques have been developed that, with modification, may also be successfully employed in the spinal column to solve the problem of anchoring anterior and antero-lateral spinal-column fixation systems.
  • Intramedullary pins may be used to splint fractured tubular bones by providing an intramedullary connection between the proximal portion of the broken tubular bone and its distal portion. Because of its geometry, however, the intramedullary pin can withstand only minor rotational and axial loads. This may not be potentially problematic as long as the fractured bone is able under axial load to maintain its height and the fracture is more or less diaphyseal.
  • the intramedullary pin typically has to be anchored proximally and distally.
  • the intramedullary pin can provide not only splinting but, as in the case of the spinal column, may act as a proximately and distally anchored longitudinal support that can transfer forces and moments at all levels from proximal to distal.
  • the anchoring implants may be screws that are run transversely through the bone and the intramedullary pin on the proximal and distal sides. In patients with osteoporosis and in cases where the fractures lie close to the joint, anchoring the intramedullary pin with screws is often not a satisfactory approach.
  • spiral-twisted blade-shaped implants known in the related art and as used in clinical practice are not particularly suitable for use on spinal column.
  • the present invention relates to the fixation of bones, and in particular to the fixation of vertebral bodies.
  • the present invention is comprises a longitudinal support with a central axis and n anchoring elements (2 ⁇ i ⁇ n).
  • Each anchoring element having a longitudinal axes, a front end, and a back end.
  • the longitudinal axis of each anchoring elements may be arranged at an angle of between 65° and 115° relative to the central axis of the longitudinal support, while the anchoring elements are designed to abut the back end.
  • the anchoring elements may be shaped in the form of a blade toward the front end.
  • each anchoring element comprises means for receiving the longitudinal support with attachment means that can be controlled from the back end for reversibly locking the connection between the longitudinal support and the anchoring element.
  • the locked connection may prevent relative movement between the longitudinal support and the anchoring element and takes up forces and moments in all three axial directions of a three-dimensional coordinate system.
  • FIG. 1 is a top view of an embodiment of the device according to the invention.
  • FIG. 2 is a side view of the embodiment of the device according to the invention shown in FIG. 1;
  • FIG. 3 is a side view of another embodiment of the device according to the invention.
  • FIG. 4 is a perspective view of an embodiment of the anchoring element
  • FIGS. 5 a to 5 g are top views of various embodiments of the anchoring element
  • FIGS. 6 a and 6 b are side views of various embodiments of the anchoring element
  • FIGS. 7 a to 7 e are cross-sections of anchoring elements of various embodiments of the anchoring element
  • FIGS. 8 a and 8 b are perspective views of twisted anchoring segments in various embodiments of the anchoring element
  • FIGS. 9 a and 9 b are perspective views of anchoring segments consisting of multiple blades in various embodiments of the anchoring element
  • FIG. 10 is a perspective view of an embodiment of a spiral-shaped anchoring element that is equipped with a transport screw;
  • FIG. 11 is a perspective view of another embodiment of a 3-blade anchoring element that is equipped with a transport screw;
  • FIG. 12 is a perspective view of another embodiment of an anchoring element that is equipped with a transport device
  • FIG. 13 is a perspective view of an implantable anchoring element with a transport device
  • FIG. 14 a is a perspective view of an embodiment of the anchoring element with a surface structure
  • FIG. 14 b is a perspective view of another embodiment of the anchoring element with a surface structure
  • FIG. 14 c is a perspective view of an embodiment of the anchoring element with transverse-running holes
  • FIG. 15 is a perspective view of an embodiment of an anchoring element that is equipped with a threaded bush
  • FIGS. 16 a and 16 b are perspective views of devices for anchoring a transport device for inserting the anchoring element
  • FIGS. 17 a and 17 b are perspective views of another device for anchoring a transport device for inserting the anchoring element
  • FIG. 18 is a cross-section through a vertebral body with an implanted anchoring element
  • FIG. 19 is a view of a cut-out of a spinal column with an implanted device as described by the invention.
  • FIGS. 1 and 2 show an embodiment of the device according to the invention that comprises an anchoring element 3 with receiving means 7 for a longitudinal support 1 at the back end 6 of the anchoring element 3 .
  • the receiving means 7 consists of a receiving head 10 that is essentially circular-cylindrical and is coaxial with a longitudinal axis 4 of the anchoring element 3 , with a channel 11 that is open toward the back end 6 to receive the longitudinal support 1 .
  • the longitudinal support 1 is received in such a way that its central axis 2 runs vertical to the longitudinal axis 4 .
  • the anchoring element 3 contains an anchoring segment 27 , which is designed as an essentially parallelepiped blade 9 .
  • the blade 9 has a rectangular cross-section with a width B and a thickness D. At the front end 5 of the anchoring element 3 , the width B of the blade 9 converges to a point 14 .
  • external threading 12 that is concentric to the longitudinal axis 4 on the receiving head 10 and a nut 13 that can be screwed onto this external threading 12 are arranged at the back end 6 of the anchoring element 3 as immobilizing means 8 so that when the nut 13 is tightened, the longitudinal support 1 is axially clamped in the channel 11 , thereby locking the anchoring element 3 to the longitudinal support 1 .
  • FIG. 3 of the device according to the invention encompasses an anchoring element 3 , which has as an anchoring segment 27 a spiral-shaped blade 9 that is coaxial to the longitudinal axis 4 .
  • a cone segment 23 At the back end 8 of the anchoring element 3 , coaxial to the longitudinal axis 4 , are located a cone segment 23 that abuts the anchoring segment 27 and, also attached coaxially thereto, a threaded pin 25 .
  • the receiving means 7 consists essentially of a connecting element 36 with a hole in it, wherein the longitudinal support 1 is mounted so as to be able to move coaxially with respect to the central axis 2 (FIG. 2) and can be secured in place with a stop screw 35 .
  • a cavity 38 in the shape of a hollow sphere that runs through the connecting element 36 in which a slotted tensioning element 37 in the shape of a two-base spherical segment is mounted.
  • the tensioning element 37 is equipped with an inner cone 39 , in which the cone segment 23 can be received in the anchoring element 3 . Because the anchoring element 3 and the connecting element 36 are connected by means of the tensioning element 37 that can be rotated in the cavity around three axes that are vertical to one another, the angle between the central axis 2 of the longitudinal support 1 and the longitudinal axis 4 of the anchoring element 3 can be varied.
  • a ball head that can be connected to the longitudinal support 1 by means of a device to connect a longitudinal support 1 to an anchoring element 3 that is designed as a pedicle screw, as disclosed in WO 98/52482.
  • FIG. 4 shows an embodiment of the anchoring segment 27 that abuts the back end 6 of the anchoring element 3 . j over a length L.
  • the anchoring segment 27 consists essentially of a flat blade 9 that has a length L, a width B, and a thickness D. Length L and thickness D enclose the lateral surfaces 32 of the blade.
  • the cross-section of the blade 9 encompasses a first transverse axis 29 , which runs in the plane of the lateral surfaces 32 and is vertical with respect to the longitudinal axis 4 , and a second transverse axis 30 , which is vertical with respect to the lateral surfaces 32 and with respect to the longitudinal axis 4 .
  • the ratio of width B to thickness D is basically between 1 and 14 and preferably between 3 and 6. Owing to this ratio of width B to thickness D, the implant can be inserted into a vertebral body without major destruction of the bone. The blade 9 is then aligned in the bone with allowance for the action of load. If the blade 9 is implanted in a vertebral body in such a way that the first transverse axis 29 runs parallel to the longitudinal axis of the spinal column, the blade 9 has great resistance to bending stress but is in an unfavorable position with respect to cutting through the bone.
  • the blade 9 is implanted in the vertebral body in such a way that the second transverse axis 30 runs parallel to the longitudinal axis of the spinal column, the blade 9 is placed in a more favorable position as regards cutting through the bone, although this is achieved at the expense of reduced resistance to bending.
  • the blade 9 can be designed as follows:
  • the blade 9 is designed to be convex at the front end 5 (FIG. 5 d );
  • the blade 9 is rounded on one side at the front end 5 (FIG. 5 g );
  • both lateral edges of the blade 9 that lie in the lateral surfaces 32 are equally beveled (FIG. 7 d );
  • FIGS. 8 a and 8 b show two embodiments of a twisted blade 9 .
  • FIG. 8 a shows a blade 9 that is twisted by an angle of twist a over length L around an edge of the blade 9 that encloses length L and abuts one of the lateral surfaces 32 .
  • FIG. 8 b show the blade 9 that is twisted by a angle of twist ⁇ over length L around the longitudinal axis 4 as well.
  • the twisting can be left-handed or right-handed.
  • the lead of the twist can be defined as follows:
  • a lead of between 60 mm and 300 mm and preferably between 100 mm and 240 mm is advantageous.
  • FIG. 9 a shows another embodiment of the anchoring element 3 with a combination of blades 9 .
  • the anchoring element 3 comprises an anchoring segment 27 with two blades 9 that are connected by a hollow 28 that is arranged coaxially with regard to the longitudinal axis 4 over the entire length of the anchoring element 3 .
  • the two blades 9 are arranged in such a way that their first transverse axes 29 lie in one plane.
  • a hole 20 runs through the hollow 28 concentrically with respect to the longitudinal axis 4 .
  • the embodiment of the anchoring element 3 that is shown in FIG. 9 b is another combination of multiple blades 9 that comprises three blades 9 arranged in the shape of a star.
  • the one lateral surfaces 32 (FIG. 4) of the three blades 9 are connected to a coaxial hollow cylinder 28 parallel to the longitudinal axis 4 , whereby the first transverse axes 29 of the blades 9 enclose the central angles ⁇ , ⁇ , ⁇ .
  • An anchoring element 3 that comprises three or more blades 9 can also be designed in the shape of a spiral.
  • the blade-shaped anchoring implant is hammered in. Hammering in or near the spinal column is not recommended since there is the danger that vital neurologic and vascular structures may be damaged.
  • FIGS. 10 - 13 Possible ways of inserting the anchoring element 3 in a controlled manner using a transport device 15 are depicted in FIGS. 10 - 13 .
  • the transport device 15 shown in FIG. 10 includes a transport screw 16 with a screw tip 17 , a screw shaft 18 , a threaded segment 21 adjacent to the screw tip 17 , and a drive means 19 , whereby the drive means 19 can be operated from the back end 6 of the anchoring element 3 .
  • the transport screw 16 is able to turn freely relative to the anchoring element 3 . If the transport screw 16 is turned by means of the screwdriver 49 , it screws through the bone and pulls the anchoring element 3 along with it.
  • the threaded segment 21 can be integrated into the anchoring segment 27 , whereby the threads protrude radially over the thickness D of the blade or protrude over the anchoring segment 27 at the front end 5 of the anchoring element 3 . Moreover, the threaded segment 21 may protrude over only part of length L or over the entire length L.
  • the advantages of this transport device 15 lie in the fact that the transport screw 16 pulls the anchoring segment 27 directly into the bone. There is the disadvantage, however, that in the middle of the spinal column the bone is very porous, so that the transport screw 16 may pull out and the transport device could fail.
  • the transport device 15 includes a transport screw 16 , which is located in the hole 20 in the hollow 28 , protrudes over the front end 5 of the anchoring element 3 , and can be anchored in the counter corticalis.
  • a transport screw 16 which is located in the hole 20 in the hollow 28 , protrudes over the front end 5 of the anchoring element 3 , and can be anchored in the counter corticalis.
  • other elements such as pegs 46 (FIGS. 16 a and 16 b ) or hooks 47 (FIGS. 17 a and 17 b ), etc., with extensions can also be used.
  • the transport device 15 has an extension 63 that is connected to the transport screw 16 , protrudes coaxially over the anchoring element 3 over length segment A, and has an abutment 15 at the end, so that an expanding device 51 can be inserted between the abutment 50 and the back end 6 of the anchoring element 3 and the anchoring segment 27 can be forced into the bone by opening the expanding device 51 .
  • the transport screw 16 is anchored in the bone from the outset.
  • the U-shaped auxiliary device 48 that is symbolically depicted in FIG. 13 is anchored by means of, e.g., bone screws 52 in the cortex layer as an abutment in order to force the anchoring segment 27 at the back end 6 of the anchoring element 3 into the bone by means of an expanding device 51 .
  • additional drilling of the vertebral bodies may be required in order to anchor the auxiliary device 48 .
  • the anchor strength may be relatively low in the longitudinal axis 4 .
  • the transport devices 15 shown in FIGS. 10 - 12 may increase the anchoring strength.
  • FIGS. 14 a - 14 c show ways, without limitation, in which the design of the surface of the blade 9 may be altered to increase anchoring strength in the longitudinal axis 4 :
  • the saw-toothed or fish-scale-like design may be applied to only one of the surfaces enclosed by length L and width B, or it can be applied to both of these surfaces; or it can encompass only a portion of length L, or it can extend over the entire length L.
  • FIG. 14 c shows, in this case multiple holes 62 run through the blade 9 vertically with respect to the surfaces enclosed by length L and width B, so that the bone can grow through the holes 62 .
  • a threaded bush 40 with external threading 41 is located at the back end 6 of the anchoring element 3 .
  • the threaded bush 40 includes a coaxial hole 42 , which can slide over a cylindrical pin 43 that is arranged between the anchoring segment 27 and the cone end segment 23 .
  • this threaded bush 40 also helps to increase the anchoring strength of the anchoring element 3 in the bone.
  • This embodiment can be used in combination with the versions shown in FIGS. 10 - 14 .
  • FIGS. 16 a and 16 b show devices for anchoring the transport device 16 (FIG. 12) in the counter corticalis that can be used instead of a transport screw 15 (FIG. 12).
  • This is a hollow cylindrical peg 46 that is designed to be elastically radial from its first end 56 and its second end 57 by coaxial slots 56 in the radial direction (FIG. 16 a ).
  • the radial expansion of the peg 48 is accomplished by means of two expanding cones 53 that are coaxially arranged on an also-coaxial threaded rod 54 and that can be pushed against one another by the external threading on the threaded rod and by corresponding internal threading in the expanding cones 53 .
  • a wedge element 58 can also be used to expand the peg 46 radially.
  • a peg 46 is shown here that has coaxially penetrating slots 55 only from the second end 57 , so that the expansion of the peg 46 is accomplished by pulling the wedge element 58 inward coaxially by means of the threaded rod 54 .
  • the wedge element 58 can also be composed of 1, 2, or 3 parts.
  • FIG. 17 a and 17 b Another device for anchoring the transport device 16 (FIG. 12) in the counter corticalis is shown in FIG. 17 a and 17 b .
  • This is a hook 47 that expands radially relative to the longitudinal axis 4 of the anchoring element 3 (FIG. 1), tapers toward its tip 61 , and is forced together radially both before and during installation by a coaxially arranged bush 59 .
  • the hook 47 is inserted by means of a coaxial rod 60 . After the hook 47 is inserted, bush 59 is pulled off of the hook 47 over its end opposite the tip 61 , whereupon the hook 47 elastically expands radially and is thus anchored in the counter corticalis.
  • FIG. 18 shows a cross-section through a vertebral body 63 with an inserted anchoring element 3 that passes through the vertebral body 63 with a longitudinal axis 4 that runs transverse to the longitudinal axis of the spinal column.
  • FIG. 19 shows a side view of several vertebral bodies 63 with an implanted device according to the invention which, in this embodiment, comprises a telescoping longitudinal support 1 with a central axis 2 that runs parallel to the longitudinal axis of the spinal column and two anchoring elements 3 .
  • the present invention may provide a spinal-column fixation device that can be attached to the vertebral bodies by means of spiral-twisted, blade-like anchoring elements and that takes into account the following additional considerations:
  • the anchoring implants may be inserted before the longitudinal support is inserted, thus obviating the need for complicated targeting devices and for aligning the anchoring elements specifically with the longitudinal support;
  • the longitudinal support may be placed at the end of the anchoring implant
  • connections between the longitudinal support and anchoring implant may be polyaxial, play-free, and angularly stable, and may be locked and unlocked;
  • the angle between the longitudinal supports of the anchoring elements and the central axis of the longitudinal support may be fixed, may be varied around an axis, or may be adjusted polyaxially.
  • the surface of the blade may also be designed in different ways on a side that is enclosed by length L and width B or on the two sides that are enclosed by length L and width B.
  • the surface(s) of the blade may comprise:
  • the surface structures may be applied on one side, on both sides, or only partially on the surface of the blade.
  • the different blade designs can be combined with the different surfaces.
  • the anchoring element may be hammered in, or inserted into a vertebral body with the aid of a transport device. Uncontrolled hammering on the spinal column is generally not recommended (there is the risk of damaging neurologic and vascular structures).
  • Suitable transport systems include, without limitation, the following:
  • a transport screw is integrated into the blade (at the tip);
  • an element screw, pin, hook, etc. with extension anchored in the counter-corticalis serves as an abutment so that the blade can be pulled into the bone;
  • a device is anchored in the corticalis in order to force the anchoring element into the bone.
  • the invention may provide the following properties:
  • Devices that are connected to the spinal column cranially and caudally by one blade-shaped anchoring element apiece may be inserted higher up the spinal column than the bulky screw-anchored implants;
  • the device for fixation of bones may comprise:
  • E) at the back end ( 6 ) at least the anchoring element ( 3 . j ) comprises receiving means ( 7 ) for the longitudinal support ( 1 ) with stopping means ( 8 ; 34 ) for reversibly securing the connection between the longitudinal support ( 1 ) and anchoring element ( 3 . j ), and the secured connection does not permit any relative movement between the longitudinal support ( 1 ) and anchoring element ( 3 . j ), as well as taking up forces and moments in all three axial directions of a three-dimensional coordinate system.
  • At least one anchoring element ( 3 . j ) comprises a transport device ( 15 ) for inserting the anchoring element ( 3 . j ) into a bone parallel to the longitudinal axis ( 4 ).
  • the transport screw ( 16 ) comprises a screw tip ( 17 ), a screw shaft ( 18 ), a threaded segment ( 21 ) that abuts the screw tip ( 17 ), and drive means ( 19 ), and the drive means ( 19 ) can be operated from the back end ( 6 ) of the anchoring element ( 3 . j ).
  • the anchoring element ( 3 . j ) has an anchoring segment ( 27 ) that has at least one blade ( 9 ) and abuts the back end ( 6 ) over a length (L), whereby said blade has an essentially rectangular cross-section with a thickness (D) and a width (B) and the blade ( 9 ) has a first transverse axis ( 22 ) parallel to the long sides of the cross-section.
  • the anchoring element ( 3 . j ) has an anchoring segment ( 27 ) that has at least one blade ( 9 ) and abuts the back end ( 6 ) over a length (L) and at least the one blade ( 9 ) has a fish-scale-like surface structure, whereby the steep sides of the scales are oriented toward the back end ( 6 ) of the anchoring element ( 3 . j ).

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Neurology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)
  • Surgical Instruments (AREA)
US10/456,535 2000-12-08 2003-06-09 Device for fixing bones in relation to one another Abandoned US20040068258A1 (en)

Priority Applications (1)

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US11/485,833 US7666207B2 (en) 2000-12-08 2006-07-13 Fixation device for bones

Applications Claiming Priority (1)

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PCT/CH2000/000654 WO2002045606A1 (de) 2000-12-08 2000-12-08 Vorrichtung zur fixation von knochen, insbesondere von wirbelkörpern relativ zueinander

Related Parent Applications (1)

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PCT/CH2000/000654 Continuation WO2002045606A1 (de) 2000-12-08 2000-12-08 Vorrichtung zur fixation von knochen, insbesondere von wirbelkörpern relativ zueinander

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EP (1) EP1339335B1 (pt)
JP (1) JP4588294B2 (pt)
AR (1) AR031616A1 (pt)
AT (1) ATE273661T1 (pt)
AU (1) AU2001216855A1 (pt)
BR (1) BR0017377B1 (pt)
CA (1) CA2433344C (pt)
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Cited By (21)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20050277919A1 (en) * 2004-05-28 2005-12-15 Depuy Spine, Inc. Anchoring systems and methods for correcting spinal deformities
US20060039947A1 (en) * 1998-09-11 2006-02-23 Gerhard Schmidmaier Biologically active implants
WO2007019710A1 (en) 2005-08-15 2007-02-22 Synthes Gmbh Osteosynthetic device
US20070093813A1 (en) * 2005-10-11 2007-04-26 Callahan Ronald Ii Dynamic spinal stabilizer
US20070093815A1 (en) * 2005-10-11 2007-04-26 Callahan Ronald Ii Dynamic spinal stabilizer
US20070093814A1 (en) * 2005-10-11 2007-04-26 Callahan Ronald Ii Dynamic spinal stabilization systems
US20080045951A1 (en) * 2006-08-16 2008-02-21 Depuy Spine, Inc. Modular multi-level spine stabilization system and method
US20090088782A1 (en) * 2007-09-28 2009-04-02 Missoum Moumene Flexible Spinal Rod With Elastomeric Jacket
US20090163955A1 (en) * 2007-12-19 2009-06-25 Missoum Moumene Polymeric Pedicle Rods and Methods of Manufacturing
US20090326584A1 (en) * 2008-06-27 2009-12-31 Michael Andrew Slivka Spinal Dynamic Stabilization Rods Having Interior Bumpers
US20090326583A1 (en) * 2008-06-25 2009-12-31 Missoum Moumene Posterior Dynamic Stabilization System With Flexible Ligament
US20100211104A1 (en) * 2009-02-13 2010-08-19 Missoum Moumene Dual Spring Posterior Dynamic Stabilization Device With Elongation Limiting Elastomers
US20100331886A1 (en) * 2009-06-25 2010-12-30 Jonathan Fanger Posterior Dynamic Stabilization Device Having A Mobile Anchor
US20110098747A1 (en) * 2009-04-15 2011-04-28 Synthes Usa, Llc Arcuate fixation member
US20110230971A1 (en) * 2009-04-15 2011-09-22 Synthes Usa, Llc Arcuate fixation member
US20130197527A1 (en) * 2006-06-12 2013-08-01 Smith & Nephew, Inc. Systems, methods and devices for tibial resection
US9445844B2 (en) 2010-03-24 2016-09-20 DePuy Synthes Products, Inc. Composite material posterior dynamic stabilization spring rod
CN105962993A (zh) * 2009-11-09 2016-09-28 斯伯威丁股份公司 医疗器械、医疗装置和外科手术方法
US9980824B2 (en) * 2014-09-03 2018-05-29 Globus Medical, Inc. Intervertebral implants and related methods of use
US20180250040A1 (en) * 2015-03-25 2018-09-06 Pier Giovanni Menci Intramedullary nail for the treatment of fractures of the long bones
US20220087724A1 (en) * 2019-02-09 2022-03-24 Mimeo Medical Gmbh Bone-anchoring device for a pedicle access

Families Citing this family (21)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2007022790A1 (en) * 2005-08-23 2007-03-01 Synthes Gmbh An osteosynthetic clamp for attaching a bone anchor to a support rod
US8057519B2 (en) 2006-01-27 2011-11-15 Warsaw Orthopedic, Inc. Multi-axial screw assembly
US7833252B2 (en) 2006-01-27 2010-11-16 Warsaw Orthopedic, Inc. Pivoting joints for spinal implants including designed resistance to motion and methods of use
US7722652B2 (en) 2006-01-27 2010-05-25 Warsaw Orthopedic, Inc. Pivoting joints for spinal implants including designed resistance to motion and methods of use
US8353910B2 (en) * 2006-04-21 2013-01-15 Synthes Usa, Llc Hip helical implant
ES2751997T3 (es) 2008-01-14 2020-04-02 Conventus Orthopaedics Inc Aparato de reparación de fracturas
EP2523614A4 (en) 2010-01-15 2017-02-15 Conventus Orthopaedics, Inc. Rotary-rigid orthopaedic rod
US8961518B2 (en) 2010-01-20 2015-02-24 Conventus Orthopaedics, Inc. Apparatus and methods for bone access and cavity preparation
CN107569279A (zh) 2010-03-08 2018-01-12 康文图斯整形外科公司 用于骨修复的装置及方法
US9358122B2 (en) 2011-01-07 2016-06-07 K2M, Inc. Interbody spacer
US9050137B2 (en) * 2012-06-04 2015-06-09 Virak Orthopedic Research Llc Interchangeable orthopedic blade
JP6539652B2 (ja) 2013-12-12 2019-07-03 コンベンタス オーソピディックス， インコーポレイテッド 組織変位ツールおよび方法
US10045803B2 (en) 2014-07-03 2018-08-14 Mayo Foundation For Medical Education And Research Sacroiliac joint fusion screw and method
CA2917676A1 (en) 2015-01-13 2016-07-13 Stryker European Holdings I, Llc Growing rods and methods of use
US10413332B2 (en) 2016-04-25 2019-09-17 Imds Llc Joint fusion implant and methods
US10751071B2 (en) 2016-04-25 2020-08-25 Imds Llc Joint fusion instrumentation and methods
WO2019010252A2 (en) 2017-07-04 2019-01-10 Conventus Orthopaedics, Inc. APPARATUS AND METHODS FOR TREATING BONES
US11446064B2 (en) 2018-04-26 2022-09-20 Stryker European Operations Holdings Llc Orthopedic growing devices
US11596445B2 (en) 2019-02-24 2023-03-07 Blue Sky Technologies, LLC Implant for bone
DE102020004184A1 (de) 2020-07-11 2022-01-13 Mimeo Medical Gmbh Klingenartige Osteosynthesevorrichtung
US20230149030A1 (en) * 2021-11-12 2023-05-18 NextWave Medical, LLC Devices and Methods for Correction of Hip Deformities

Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3025853A (en) * 1958-07-07 1962-03-20 Christopher A Mason Fixation device for fractured femur
US4103683A (en) * 1977-06-03 1978-08-01 Neufeld John A Sub-trochanteric nail
US4978349A (en) * 1989-08-03 1990-12-18 Synthes (U.S.A.) Fixation plate
US5300074A (en) * 1990-12-17 1994-04-05 Synthes (U.S.A.) Two-part angle plate
US5501684A (en) * 1992-06-25 1996-03-26 Synthes (U.S.A.) Osteosynthetic fixation device
US5688273A (en) * 1995-10-23 1997-11-18 Fastenetix, Llc. Spinal implant apparatus having a single central rod and plow hooks
US5741256A (en) * 1997-01-13 1998-04-21 Synthes (U.S.A.) Helical osteosynthetic implant
US5888221A (en) * 1992-08-11 1999-03-30 Gelbard; Steven D. Spinal stabilization implant system
US6187007B1 (en) * 1996-07-31 2001-02-13 Synthes (Usa) Device for attaching fractured hip-joint heads

Family Cites Families (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3433220A (en) 1966-12-30 1969-03-18 Robert E Zickel Intramedullary rod and cross-nail assembly for treating femur fractures
US4710075A (en) * 1986-10-01 1987-12-01 Boehringer Mannheim Corporation Adjustable drill gauge
FR2650173B1 (fr) 1989-07-26 1991-11-15 Jbs Sa Procede et dispositif de redressement, fixation, compression, elongation du rachis
DE4318150C2 (de) 1993-06-01 1996-08-01 Endocare Ag Osteosynthese-Hilfsmittel zur Versorgung subtrochanterer und pertrochanterer Frakturen sowie von Schenkelhalsfrakturen
JPH08257034A (ja) * 1995-03-18 1996-10-08 Ee & F:Kk 小児大腿骨骨切術・頸部骨折治療用の内固定部材及びその打込方法
DE29600879U1 (de) 1996-01-19 1996-03-28 Howmedica Gmbh Wirbelsäulenimplantat
WO1998031293A1 (de) * 1997-01-14 1998-07-23 Synthes Ag Chur Pedikelschraube mit zweigängigem gewinde
DE19720782B4 (de) 1997-05-17 2004-12-09 Synthes Ag Chur, Chur Vorrichtung zur Verbindung eines Längsträgers mit einer Pedikelschraube
JP3172703B2 (ja) * 1997-12-18 2001-06-04 株式会社ロバート・リード商会 骨固定装置
DE59804611D1 (de) 1998-08-21 2002-08-01 Synthes Ag Selbstschneidendes hohlzylindrisches knochenverankerungselement

Patent Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3025853A (en) * 1958-07-07 1962-03-20 Christopher A Mason Fixation device for fractured femur
US4103683A (en) * 1977-06-03 1978-08-01 Neufeld John A Sub-trochanteric nail
US4978349A (en) * 1989-08-03 1990-12-18 Synthes (U.S.A.) Fixation plate
US5300074A (en) * 1990-12-17 1994-04-05 Synthes (U.S.A.) Two-part angle plate
US5501684A (en) * 1992-06-25 1996-03-26 Synthes (U.S.A.) Osteosynthetic fixation device
US5888221A (en) * 1992-08-11 1999-03-30 Gelbard; Steven D. Spinal stabilization implant system
US5688273A (en) * 1995-10-23 1997-11-18 Fastenetix, Llc. Spinal implant apparatus having a single central rod and plow hooks
US6187007B1 (en) * 1996-07-31 2001-02-13 Synthes (Usa) Device for attaching fractured hip-joint heads
US5741256A (en) * 1997-01-13 1998-04-21 Synthes (U.S.A.) Helical osteosynthetic implant

Cited By (49)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10646622B2 (en) 1998-09-11 2020-05-12 Gerhard Schmidmaier Biologically active implants
US20060039947A1 (en) * 1998-09-11 2006-02-23 Gerhard Schmidmaier Biologically active implants
US8114427B2 (en) 1998-09-11 2012-02-14 Gerhard Schmidmaier Biologically active implants
US20050277919A1 (en) * 2004-05-28 2005-12-15 Depuy Spine, Inc. Anchoring systems and methods for correcting spinal deformities
US8992578B2 (en) 2004-05-28 2015-03-31 Depuy Synthes Products Llc Anchoring systems and methods for correcting spinal deformities
US8540754B2 (en) 2004-05-28 2013-09-24 DePuy Synthes Products, LLC Anchoring systems and methods for correcting spinal deformities
US7901435B2 (en) 2004-05-28 2011-03-08 Depuy Spine, Inc. Anchoring systems and methods for correcting spinal deformities
US20110077688A1 (en) * 2004-05-28 2011-03-31 Depuy Spine, Inc. Anchoring systems and methods for correcting spinal deformities
US9125696B2 (en) * 2005-08-15 2015-09-08 DePuy Synthes Products, Inc. Osteosynthetic device
KR101216245B1 (ko) 2005-08-15 2012-12-28 신세스 게엠바하 골접합장치
US20100331895A1 (en) * 2005-08-15 2010-12-30 Berend Linke Osteosynthetic device
WO2007019710A1 (en) 2005-08-15 2007-02-22 Synthes Gmbh Osteosynthetic device
US20070093815A1 (en) * 2005-10-11 2007-04-26 Callahan Ronald Ii Dynamic spinal stabilizer
US20070093814A1 (en) * 2005-10-11 2007-04-26 Callahan Ronald Ii Dynamic spinal stabilization systems
US20070093813A1 (en) * 2005-10-11 2007-04-26 Callahan Ronald Ii Dynamic spinal stabilizer
US20130197527A1 (en) * 2006-06-12 2013-08-01 Smith & Nephew, Inc. Systems, methods and devices for tibial resection
US7806913B2 (en) 2006-08-16 2010-10-05 Depuy Spine, Inc. Modular multi-level spine stabilization system and method
US8814909B2 (en) 2006-08-16 2014-08-26 DePuy Synthes Products, LLC Modular multi-level spine stabilization system and method
US20110022095A1 (en) * 2006-08-16 2011-01-27 Depuy Spine, Inc. Modular Multi-Level Spine Stabilization System and Method
US8486112B2 (en) 2006-08-16 2013-07-16 DePuy Synthes Products, LLC Modular multi-level spine stabilization system and method
US20080045951A1 (en) * 2006-08-16 2008-02-21 Depuy Spine, Inc. Modular multi-level spine stabilization system and method
US20090088782A1 (en) * 2007-09-28 2009-04-02 Missoum Moumene Flexible Spinal Rod With Elastomeric Jacket
US9232968B2 (en) 2007-12-19 2016-01-12 DePuy Synthes Products, Inc. Polymeric pedicle rods and methods of manufacturing
US20090163955A1 (en) * 2007-12-19 2009-06-25 Missoum Moumene Polymeric Pedicle Rods and Methods of Manufacturing
US20090326583A1 (en) * 2008-06-25 2009-12-31 Missoum Moumene Posterior Dynamic Stabilization System With Flexible Ligament
US20090326584A1 (en) * 2008-06-27 2009-12-31 Michael Andrew Slivka Spinal Dynamic Stabilization Rods Having Interior Bumpers
US20100211104A1 (en) * 2009-02-13 2010-08-19 Missoum Moumene Dual Spring Posterior Dynamic Stabilization Device With Elongation Limiting Elastomers
US8641734B2 (en) 2009-02-13 2014-02-04 DePuy Synthes Products, LLC Dual spring posterior dynamic stabilization device with elongation limiting elastomers
US9925056B2 (en) 2009-04-15 2018-03-27 DePuy Synthes Products, Inc. Arcuate fixation member
US11617654B2 (en) 2009-04-15 2023-04-04 DePuy Synthes Products, Inc. Arcuate fixation member
US20110230971A1 (en) * 2009-04-15 2011-09-22 Synthes Usa, Llc Arcuate fixation member
US10716680B2 (en) 2009-04-15 2020-07-21 DePuy Synthes Products, Inc. Arcuate fixation member
US9408715B2 (en) 2009-04-15 2016-08-09 DePuy Synthes Products, Inc. Arcuate fixation member
US20110098747A1 (en) * 2009-04-15 2011-04-28 Synthes Usa, Llc Arcuate fixation member
US9445913B2 (en) 2009-04-15 2016-09-20 DePuy Synthes Products, Inc. Arcuate fixation member
US10105236B2 (en) 2009-04-15 2018-10-23 DePuy Synthes Products, Inc. Arcuate fixation member
US10806592B2 (en) 2009-04-15 2020-10-20 DePuy Synthes Products, Inc. Arcuate fixation member
US8641766B2 (en) 2009-04-15 2014-02-04 DePuy Synthes Products, LLC Arcuate fixation member
US20100331886A1 (en) * 2009-06-25 2010-12-30 Jonathan Fanger Posterior Dynamic Stabilization Device Having A Mobile Anchor
US9320543B2 (en) 2009-06-25 2016-04-26 DePuy Synthes Products, Inc. Posterior dynamic stabilization device having a mobile anchor
US20170119447A1 (en) * 2009-11-09 2017-05-04 Spinewelding Ag Medical device, apparatus, and surgical method
CN105962993A (zh) * 2009-11-09 2016-09-28 斯伯威丁股份公司 医疗器械、医疗装置和外科手术方法
US10342587B2 (en) * 2009-11-09 2019-07-09 Spinewelding Ag Medical device, apparatus, and surgical method
US9445844B2 (en) 2010-03-24 2016-09-20 DePuy Synthes Products, Inc. Composite material posterior dynamic stabilization spring rod
US9980824B2 (en) * 2014-09-03 2018-05-29 Globus Medical, Inc. Intervertebral implants and related methods of use
US10117687B2 (en) * 2015-03-25 2018-11-06 Pier Giovanni Menci Intramedullary nail for the treatment of fractures of the long bones
US20180250040A1 (en) * 2015-03-25 2018-09-06 Pier Giovanni Menci Intramedullary nail for the treatment of fractures of the long bones
US20220087724A1 (en) * 2019-02-09 2022-03-24 Mimeo Medical Gmbh Bone-anchoring device for a pedicle access
US11638599B2 (en) * 2019-02-09 2023-05-02 Mimeo Medical Gmbh Bone-anchoring device for a pedicle access

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US7666207B2 (en) 2010-02-23
WO2002045606A1 (de) 2002-06-13
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EP1339335B1 (de) 2004-08-18
CA2433344A1 (en) 2002-06-13
EP1339335A1 (de) 2003-09-03
PT1339335E (pt) 2005-01-31
SI1339335T1 (en) 2005-02-28
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CA2433344C (en) 2009-05-19
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ES2223617T3 (es) 2005-03-01
AU2001216855A1 (en) 2002-06-18
ATE273661T1 (de) 2004-09-15
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DE50007524D1 (de) 2004-09-23
US20060271053A1 (en) 2006-11-30

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