WO1993022975A1 - Appareil de visee sur la mise en place de vis de pedicule dans une vertebre - Google Patents

Appareil de visee sur la mise en place de vis de pedicule dans une vertebre Download PDF

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Publication number
WO1993022975A1
WO1993022975A1 PCT/CH1993/000082 CH9300082W WO9322975A1 WO 1993022975 A1 WO1993022975 A1 WO 1993022975A1 CH 9300082 W CH9300082 W CH 9300082W WO 9322975 A1 WO9322975 A1 WO 9322975A1
Authority
WO
WIPO (PCT)
Prior art keywords
pedicle
aiming device
legs
drill sleeve
leg
Prior art date
Application number
PCT/CH1993/000082
Other languages
German (de)
English (en)
Inventor
Robert Frigg
Original Assignee
Synthes Ag, Chur
Synthes (U.S.A.)
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
Application filed by Synthes Ag, Chur, Synthes (U.S.A.) filed Critical Synthes Ag, Chur
Publication of WO1993022975A1 publication Critical patent/WO1993022975A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
    • A61B17/1757—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the spine

Definitions

  • the invention relates to a target device according to the preamble of claim 1.
  • the implants are preferably fixed to the pedicles of the vertebral bodies.
  • So-called pedicle screws are preferably used. These screws are inserted dorsally into the pedicles freehand after the core hole has been drilled, also freehand. This procedure has prevailed above all in Europe, but can only be carried out with certainty only in the lumbar region of the spine (internal fixator).
  • the risk of injury to the spinal cord is high each time a pedicle screw is inserted. This danger increases extremely when pedicle screws are used in the thoracic area, where the pedicle diameter decreases.
  • the use of an image intensifier offers little help since the pedicles are covered by the vertebral body.
  • the invention seeks to remedy this.
  • the invention has for its object to provide a target device which allows a targeted and therefore safe setting of pedicle screws in spinal surgery, especially in the thoracic area.
  • the target device according to the invention is essentially a pair of pliers with an integrated drill sleeve, the pliers legs of which allow the pedicles to be held securely.
  • One forceps leg encompasses the pedicle medially, the second forceps leg encompasses the pedicle laterally.
  • the drill sleeve fixed to one or both forceps legs is oriented in such a way that the bore through this sleeve is carried out at a predetermined distance from the wall of the pedicle.
  • the drill sleeve can either be attached to only one of the two forceps legs (on the medial leg in the case of forceps intended for drilling in the right pedicle; on the lateral leg in the case of forceps intended for drilling in the left pedicle).
  • the drill sleeve is connected in an articulated manner to both legs, such that the drill sleeve always has the same regardless of the degree of opening of the pliers has the same distance to the two legs.
  • the advantage of this embodiment is that regardless of the width of the pedicle, the bore always lies centrally in the pedicle; it offers advantages especially when the pedicle is wide enough and the bore is in the center.
  • a drill stop element is attached to the drill sleeve-free pliers leg, which element is moved into the region of the front opening of the drill sleeve when the two legs are closed and prevents their free passage. In this way, the drilling process - if the pedicle cross-section is too thin - can be automatically prevented.
  • the two ends of the pliers legs are preferably bent upwards, but can also be adapted to the respective anatomical conditions in a different way.
  • the tips of the pliers are also designed so that they encompass the pedicle medially and laterally, like tissue protection. This protects the nerves located near the pedicle in the event of incorrect manipulation of the target device.
  • the second, lateral leg of the pliers expediently has a spacer element running in the latero-medial direction in the region of its front end, which is intended to surround the pedicle.
  • the first, medial forceps limb can also have a spacer element running in the medio-lateral direction in the region of its front end, which is intended to surround the pedicle.
  • FIG. 1 shows a perspective view of the target device according to the invention in its application on the 9th thoracic vertebra
  • FIG. 2 shows a partial section, parallel to the frontal plane, through the 9th thoracic vertebra with the aiming device according to the invention attached to the right pedicle;
  • Fig. 3 shows a perspective view of a variant of the aiming device according to the invention, with a central drill sleeve in its application on the 9th thoracic vertebra;
  • FIG. 4 shows a cross section in the region of the drill sleeve of the aiming device according to FIG. 3;
  • FIG. 5 shows a partial section parallel to the frontal plane through the 9th thoracic vertebra with the aiming device according to FIG. 3 attached to the right pedicle.
  • 1 and 2 target device for Se zen of pedicle screws (here in the right pedicle of the 9th thoracic vertebra) consists essentially of a pair of pliers with two handles 1 and 2, a first, medial leg 3 and a second, lateral Leg 4, the front ends 5 and 6 of the two legs 3 and 4 being bent upward, so that a pedicle (here the right pedicle 7 of the 9th thoracic vertebra 9) can be encompassed.
  • the handles 1 and 2 are fastened by means of locking screws 11, 12 to a swivel joint 10, on which in turn the legs 3, 4 are articulated.
  • the force for moving the swivel joint 10 can be adjusted according to the individual wishes.
  • a drill sleeve 13 is fastened to the first, medial leg 3 with a rear opening 14 facing the handles 1, 2 and a front opening 15, through which, at a predetermined distance from the inner wall 16 of the pedicle, a bore in the right Pedicle 7 is feasible.
  • the drill sleeve 13 is attached to the second, lateral leg 4.
  • a drill drip element 17 is also attached to the lateral leg 4, which is free of the sleeve, and is moved into the region of the front opening 15 of the drill sleeve 13 when the two legs 3, 4 are closed.
  • the free passage of the drill 18 This prevents the drill sleeve 13, so that the drilling process cannot take place if the pedicle wall is too thin.
  • the second, lateral leg 4 has, in the region of its front end 6, which is intended for encircling the pedicle 7, a spacer element 19 running in the latero-medial direction, in the form of a rounded bolt.
  • the first, medial leg 3 also has, in the region of its front end 5, which is intended to surround the pedicle 7, a spacer element 20 running in the medio-lateral direction, in the form of a rounded bolt. Both spacer elements 19, 20 are arranged offset, so that a secure encirclement of the pedicle 7 is ensured.
  • a modified aiming device is shown in which the drill sleeve 13 is articulated to both legs 3, 4.
  • the joint consists of two pairs of hollow cylinders 23, 26 and 24, 26 connected by a web 25, one longer hollow cylinder 23 being movably arranged within the other, shorter hollow cylinder 24.
  • the drill sleeve 13 always remains the same distance from the two legs 3, 4 regardless of the degree of opening of the pliers.
  • All other construction elements correspond to those of the design according to FIGS. 1 and 2. It is thus possible to drill a hole in the right pedicle 7 with a drill 18 in a defined position and at a predetermined distance from the inner wall 16 of the pedicle, as shown in detail in FIGS. 4 and 5.
  • the drill 18 is precisely centered within the drill sleeve 13 by using a reduction drill sleeve 22.
  • the second, lateral leg 4 has in the region of its front end 6, which is intended for encircling the pedicle 7, a spacer element 19 running in the latero-medial direction, in the form of a rounded bolt, which, however, is in contrast to the embodiment 2 comprises the pedicle 7 from the dorsal side.
  • the preparation of the lamina differs depending on the vertebral body. In general, however, the lamina must be prepared from the dorsal side, i.e. to the extent that the forceps can be inserted and positioned on the desired pedicle.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Dentistry (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

Cet appareil de visée sert à la mise en place de vis de pédicule dans un vertèbre. Il est constitué d'une pince comportant deux poignées (1, 2), une première branche médiane (3) et une deuxième branche latérale (4), les extrémités avant (5, 6) de ces deux branches (3, 4) étant conçues de façon à pouvoir maintenir un pédicule (7). Cette pince possède en outre une douille de perçage (13) fixée sur au moins une des deux branches (3, 4), avec une ouverture arrière (14) dirigée vers les poignées, et une ouverture avant (15) à travers laquelle un perçage dans le pédicule (7) peut être réalisé à une distance prédéterminée de sa paroi intérieure (16). Cet appareil de visée permet la mise en place précise et donc fiable de vis de pédicule pendant des opérations de la colonne vertébrale et, plus particulièrement, aussi dans le secteur thoracique.
PCT/CH1993/000082 1992-05-18 1993-03-24 Appareil de visee sur la mise en place de vis de pedicule dans une vertebre WO1993022975A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CH1577/92-4 1992-05-18
CH157792 1992-05-18

Publications (1)

Publication Number Publication Date
WO1993022975A1 true WO1993022975A1 (fr) 1993-11-25

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/CH1993/000082 WO1993022975A1 (fr) 1992-05-18 1993-03-24 Appareil de visee sur la mise en place de vis de pedicule dans une vertebre

Country Status (1)

Country Link
WO (1) WO1993022975A1 (fr)

Cited By (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0681848A1 (fr) * 1994-05-13 1995-11-15 Axel Arnold Ensemble des instruments pour l'insertion d'un tube de drainage dans un panneau en matière cellulaire
WO2001056479A1 (fr) * 2000-02-04 2001-08-09 Hôpital Sainte-Justine Guide-foret chirurgical et procede d'utilisation
WO2002045591A2 (fr) * 2000-10-24 2002-06-13 Sdgi Holdings, Inc. Guide de positionnement d'un appareil de fixation de vertebres
WO2002076309A1 (fr) * 2001-03-23 2002-10-03 Howmedica Osteonics Corp Instruments conçus pour l'insertion d'implants
EP1442714A1 (fr) * 2003-02-03 2004-08-04 Centerpulse Orthopedics Ltd. Accessoire de visée pour vertèbres
DE102004036377A1 (de) * 2004-07-27 2006-03-23 Cell Center Cologne Gmbh Sicherungsvorrichtung zum Gebrauch in der Wirbelsäulenchirurgie
EP1811912A2 (fr) * 2004-11-18 2007-08-01 DePuy Spine, Inc. Outil de preparation osseuse cervical et systemes de guidage pour implants
DE102009041647A1 (de) * 2009-07-24 2011-01-27 Schwarz, Markus, Dr. Vorrichtung zum Einbringen einer radialen Bohrung in einen menschlichen oder tierischen Knochen und eine Bohrhülse zum Führen eines Bohrers
EP2324781A1 (fr) * 2009-11-20 2011-05-25 DERU GmbH Instrument chirurgical de guidage de traitement de prolongements d'articulations de facettes sur des corps vertébraux
WO2013090872A1 (fr) * 2011-12-16 2013-06-20 Mahl Gregory Jay Dispositif destiné à fixer ou à retirer des composants dentaires ou chirurgicaux
EP2923664A1 (fr) * 2007-10-17 2015-09-30 ARO Medical ApS Systèmes et appareils de stabilisation de torsion

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2181746A (en) * 1939-02-04 1939-11-28 John R Siebrandt Combination bone clamp and adjustable drill guide
FR1056372A (fr) * 1954-02-26
US4633862A (en) * 1985-05-30 1987-01-06 Petersen Thomas D Patellar resection sawguide
DE8703654U1 (de) * 1987-03-11 1987-07-23 Schikorski, Michael M., Dr.med., 2000 Wedel Durchsteckdübel mit Verriegelungsscheibe für die Kompressionsverbindung knöcherner Fragmente in menschlichen und tierischen Körpern

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR1056372A (fr) * 1954-02-26
US2181746A (en) * 1939-02-04 1939-11-28 John R Siebrandt Combination bone clamp and adjustable drill guide
US4633862A (en) * 1985-05-30 1987-01-06 Petersen Thomas D Patellar resection sawguide
DE8703654U1 (de) * 1987-03-11 1987-07-23 Schikorski, Michael M., Dr.med., 2000 Wedel Durchsteckdübel mit Verriegelungsscheibe für die Kompressionsverbindung knöcherner Fragmente in menschlichen und tierischen Körpern

Cited By (23)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0681848A1 (fr) * 1994-05-13 1995-11-15 Axel Arnold Ensemble des instruments pour l'insertion d'un tube de drainage dans un panneau en matière cellulaire
WO2001056479A1 (fr) * 2000-02-04 2001-08-09 Hôpital Sainte-Justine Guide-foret chirurgical et procede d'utilisation
WO2002045591A2 (fr) * 2000-10-24 2002-06-13 Sdgi Holdings, Inc. Guide de positionnement d'un appareil de fixation de vertebres
WO2002045591A3 (fr) * 2000-10-24 2003-03-13 Sdgi Holdings Inc Guide de positionnement d'un appareil de fixation de vertebres
US6669698B1 (en) 2000-10-24 2003-12-30 Sdgi Holdings, Inc. Vertebrae fastener placement guide
US7060068B2 (en) 2000-10-24 2006-06-13 Sdgi Holdings, Inc. Vertebrae fastener placement guide
WO2002076309A1 (fr) * 2001-03-23 2002-10-03 Howmedica Osteonics Corp Instruments conçus pour l'insertion d'implants
US6540753B2 (en) 2001-03-23 2003-04-01 Howmedica Osteonics Corp. Instrumentation for implant insertion
EP1442714A1 (fr) * 2003-02-03 2004-08-04 Centerpulse Orthopedics Ltd. Accessoire de visée pour vertèbres
DE102004036377A1 (de) * 2004-07-27 2006-03-23 Cell Center Cologne Gmbh Sicherungsvorrichtung zum Gebrauch in der Wirbelsäulenchirurgie
EP1811912A2 (fr) * 2004-11-18 2007-08-01 DePuy Spine, Inc. Outil de preparation osseuse cervical et systemes de guidage pour implants
EP1811912A4 (fr) * 2004-11-18 2009-06-17 Depuy Spine Inc Outil de preparation osseuse cervical et systemes de guidage pour implants
US7621916B2 (en) 2004-11-18 2009-11-24 Depuy Spine, Inc. Cervical bone preparation tool and implant guide systems
US8298236B2 (en) 2004-11-18 2012-10-30 Depuy Spine, Inc. Cervical bone preparation tool and implant guide systems
EP2923664A1 (fr) * 2007-10-17 2015-09-30 ARO Medical ApS Systèmes et appareils de stabilisation de torsion
US9814495B2 (en) 2007-10-17 2017-11-14 Aro Medical Aps U/Stiftelse Methods, systems and apparatuses for torsional stabilization
US10524842B2 (en) 2007-10-17 2020-01-07 Aro Medical Aps U/Stiftelse Methods, systems and apparatuses for torsional stabilization
DE102009041647A1 (de) * 2009-07-24 2011-01-27 Schwarz, Markus, Dr. Vorrichtung zum Einbringen einer radialen Bohrung in einen menschlichen oder tierischen Knochen und eine Bohrhülse zum Führen eines Bohrers
EP2324781A1 (fr) * 2009-11-20 2011-05-25 DERU GmbH Instrument chirurgical de guidage de traitement de prolongements d'articulations de facettes sur des corps vertébraux
CN102068301A (zh) * 2009-11-20 2011-05-25 Deru股份公司 外科导引器械和处理椎体小关节突的方法
JP2011104362A (ja) * 2009-11-20 2011-06-02 Deru Gmbh 椎体関節突起を加工するための外科用案内器具及び方法
WO2013090872A1 (fr) * 2011-12-16 2013-06-20 Mahl Gregory Jay Dispositif destiné à fixer ou à retirer des composants dentaires ou chirurgicaux
US9351814B2 (en) 2011-12-16 2016-05-31 Gregory Jay Mahl Device for attaching or removing dental or surgical components

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