WO1994004100A1 - Intervertebral disk prosthesis - Google Patents

Intervertebral disk prosthesis Download PDF

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Publication number
WO1994004100A1
WO1994004100A1 PCT/FR1993/000825 FR9300825W WO9404100A1 WO 1994004100 A1 WO1994004100 A1 WO 1994004100A1 FR 9300825 W FR9300825 W FR 9300825W WO 9404100 A1 WO9404100 A1 WO 9404100A1
Authority
WO
WIPO (PCT)
Prior art keywords
plates
plate
characterized
prosthesis
prosthesis according
Prior art date
Application number
PCT/FR1993/000825
Other languages
French (fr)
Inventor
Keyvan Mazda
Original Assignee
Societe De Fabrication De Materiel Orthopedique - Sofamor
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
Priority to FR9210232A priority Critical patent/FR2694882B1/en
Priority to FR9210232 priority
Application filed by Societe De Fabrication De Materiel Orthopedique - Sofamor filed Critical Societe De Fabrication De Materiel Orthopedique - Sofamor
Publication of WO1994004100A1 publication Critical patent/WO1994004100A1/en

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Classifications

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    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION, OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS, OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS, OR SURGICAL ARTICLES
    • A61L27/00Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/02Inorganic materials
    • A61L27/10Ceramics or glasses
    • AHUMAN NECESSITIES
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00011Metals or alloys
    • A61F2310/00023Titanium or titanium-based alloys, e.g. Ti-Ni alloys
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00179Ceramics or ceramic-like structures
    • A61F2310/00185Ceramics or ceramic-like structures based on metal oxides
    • A61F2310/00203Ceramics or ceramic-like structures based on metal oxides containing alumina or aluminium oxide
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00179Ceramics or ceramic-like structures
    • A61F2310/00185Ceramics or ceramic-like structures based on metal oxides
    • A61F2310/00239Ceramics or ceramic-like structures based on metal oxides containing zirconia or zirconium oxide ZrO2
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION, OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS, OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS, OR SURGICAL ARTICLES
    • A61L2430/00Materials or treatment for tissue regeneration
    • A61L2430/38Materials or treatment for tissue regeneration for reconstruction of the spine, vertebrae or intervertebral discs

Abstract

Prosthesis comprising two plates (1, 2) secured to the corresponding vertebrae (L4, L5), and a ball joint linking the plates to one another, its centre of rotation (C), in an anterior-posterior plane (OX, OY) being offset rearwards in the posterior part of the plates. The ball joint with reference to a transversal plane (OX, OZ) is located substantially in the middle of the plates, and with reference to a vertical plane (OY, OZ) is located under the plate (1) of the lower vertebra (L5). The prosthesis also includes an elastic intercalary cushioning ring (10) having an opening (10a) for the passage of the joint (3) and being lodged in the space delimited between the plates and around the joint. This positioning of the centre of curvature (C) prevents straining of the articular apophyses during movements of the vertebrae, while the elastic ring (1) matches the prosthesis to the physiological lordosis of the vertebral column, cushioning the multiple stresses occurring during these movements.

Description

"Intervertebral disk prosthesis" The present invention relates to an intervertebral disc prosthesis.

As is known, an intervertebral disc is in the form of a biconvex lens attached by its sides to the articular surfaces of the body verté¬ braux. It consists of a hard peripheral portion (annulus) formed of concentric fiber strips, and a core (nucleus pulposus), soft and gelatinous, consisting of thin fibrous bundles separated by spaces filled with a mucosal tissue. An inter¬ vertebral disc is a deformable element enabling all possible relative motions (6 degrees of freedom), but which limits the amplitudes of the latter, especially in torsion, together with the intervertebral ligaments and bone bumpers. The intervertebral disc is a viscoelastic damping structure, which contributes to the strength and stability of the spine verticalized in weight status.

An intervertebral disc may suffer altéra- tions for various reasons, including aging and degeneration, can cause herniated discs.

Disc degeneration is a functional and anatomical destruction of the disc, which seems to result from the effect of mechanical stress on a drive to the disorganization of road structures. Disc degeneration alters the mechanical behavior of the disc and results in a decrease in height of the intersomatic space, which causes a perturba¬ tion of functional articular disc together. This results in instability may cause harmful clinical consequences, including low back pain. Thus 1'instabilité segmental causes abnormal operation of the joint, inducing arthrosi- reaction, a source of pain and osteophytic process.

It is therefore proposed to replace the defective disk with an artificial disk, including many types of projects were considered. Thus some prosthetic joints have not removing any degree of freedom, while others overlook the contrary totale¬ ment certain movements and only allow a maximum degree of freedom. The authors of the first prostheses consider that the artificial disc should not in any way impose a movement, that the stability of the functional unit is provided by the retention of the remaining ligament brakes and an unconstrained articulation ensures bone / prosthesis sustainable link .

The authors of the second type of prosthesis feel physiologically useless certain degrees of freedom, and restore a degree of freedom considered essen¬ tial. Thus there is known a hinge prosthesis not allowing rotation only around a transverse axis. Prostheses articulated can be extremely varied and include such materials having flexibility, or implement mechanical means such as springs.

However these known designs do not entirely satisfactory, for example because the friction elements at 1'articulation remain too high (prosthesis described in FR 2659226), or because the instability of the observed prosthesis rota¬ tion. Moreover, the prosthesis described in the aforementioned patent permits an inclination and a flexion extension limited to 10 degrees in all planes, low value next to the natural mobility of a vertebra.

It is currently still relatively difficult to identify indications 1'arthroplastie disc, proposed especially for the treatment of low back pain and sciatica by instability, low back sciatica post¬ aisectomie, and spondylolisthesis grade I.

In fact, the purpose of the implant consisting of the disc prosthesis covered by 1'invention is threefold:

a) To be dimensioned to be able to restore normal height of the disc space. Indeed, dégéné¬ rescence disc altering the mechanical behavior of the disc and terminating in a decrease in height of the intersomatic space, causes disruption of functional articular disc together. This height nution dimi¬ causes mechanical load on the facet joints, and arthrogenic possible source of low back pain. It can displace upwardly and forwardly of the upper joint of the lower vertebra, resulting in a narrowing of the intervertebral foramen, possible cause of sciatica. b) Allow physiological mobility between the two instrumented vertebrae.

The instability may be due to herniated or dégéné¬ rescence induced by surgery. The boundaries between normal and abnormal mobility are not yet precisely defined. The segmental instability drags in- abnormal functioning of joints, indui¬ health as already indicated an osteoarthritic reaction. c) possess an intrinsic stability and allow an intersomatic movement.

Arthroplasty is for cases where far arthrodesis is indicated. It can be an interesting alternative to this intervention, not without consequences on adjacent floors. Indeed, all lumbar arthrodesis result in adjacent segments an increase in stresses and a déplace¬ ment centers of rotation, which may lead to hypermobility.

The long term monitoring of areas adjacent to arthrodesis shows a constant disc space narrowing from the fifteenth year, especially slipping or angular displacement whose frequency increases with the decrease. significant osteoarthritis can also be observed, a herniated disc or spondylolysis acquired this néocharnière.

The disc prosthesis covered by 1 the invention comprises two plates equipped with fastening means to corresponding vertebrae, and a hinge device 1'une plates 1'autre. According to the invention, the reticulation ar¬ device is a ball whose center of rotation, in an anteroposterior plane is shifted rearward in the posterior part of the plates and of the vertebral body in a transverse plane is substantially in the middle of the plates and the vertebral body, and a verti¬ cal plane is located under the plate of the lower vertebra; the prosthesis further comprises an intermediate ring damper, made of a flexible material, pierced with a passage opening for the patella and dimensioned to fit within the space defined between the plates and around the kneecap in substantially conforming to the contour plates.

The positioning of the center of curvature of the ball joint as defined in the present invention the advantage to avoid forcing the articular processes, as in the natural vertebrae, which had not hitherto been obtained with known prostheses.

In addition the prosthesis according 1'invention has at the same time the necessary mechanical strength and friction reduced at the joint by suitable dimensioning of the spherical system. Indeed the center of rotation is not too far from the articulation tion or too close to it, and so can reproduce a mobility close to the natural mobility.

D * Other features and advantages of 1'inven¬ tion will become apparent from the following description with reference to the accompanying drawings which illustrate an embodiment by way of example.

Figure 1 is an exploded perspective view of a pair of vertebrae equipped with constitu¬ tive elements of a disc prosthesis according to an embodiment of the invention.

Figure 2 is a top view of the bottom plate of the disc prosthesis of Fig.l.

Figure 3 is a longitudinal sectional view along 3/3 of the Fig.2 of the prosthesis according to the invention in a position where the two plates are parallel.

Figure 4 is an elevational view of the prosthesis of fig.l 3 viewed in a position where the two plates are inclined relative to each other.

Figure 5 is a longitudinal sectional view along 5-5 of Fig.6 of a second embodiment of the invention.

Figure 6 is a top view of the prosthesis of Fig.5.

Figure 7 is a longitudinal elevational view of the prosthesis of Fig.5 and 6 with its parallel plates.

Figure 8 is a view similar to Fig.7 with the plates forming an angle therebetween.

Figures 9, 10, 11 and 12 are views in perspec- spective of four alternative embodiments of the prosthesis according 1'invention.

There is shown in fig.l two adjacent vertebrae, for example the lumbar vertebrae L5 and L4, which may be connected by a disc prosthesis. This prosthesis comprises two plates 1 and 2 respectively secured to the lower vertebra L5 and to the upper vertebra L4, a articu¬ ball lation 3 of the two plates 1 and 2 1'une on each other, and a flexible ring 10 of damping interposed between the two plates 1 and 2 and traversed by the ball joint 3.

The plates 1, 2 are similar, have dimen¬ sions substantially equal to those of the vertebrae L5, L4 (these vertebrae can be located at other floors that L5-L4, including non lumbar levels) and approximately espouse the contour associated articular surfaces. Each plate 1, 2 thus has a curvilinear edge 4, substantially elliptical or oval, and a straight edge 5, intended to be adjacent the spinal canal, connects the two truncated ends of the ellipse 4. Furthermore each plate 1, 2 is pierced in its central part, with a through hole 6 into which is inserted a pellet 7, 8 respectively, having a body sized to be able to engage in the corresponding hole 6. The latter may advantageously be conical, as well as the complementary bases of the pellets 7, 8, which can thus be fastened detachably to the corresponding sheets or plates 1, 2.

The pellets 7, 8 together constitute the ar¬ reticulation 3 ball. The first wafer 7 inserted in the bottom plate 1 has a convex sphé- America surface 9 situated projecting with respect to the corresponding face of the plate 1, while its opposite surface 11, flat, flush with the opposite side facing 1'extérieur to the plate 1. the chip 8 of the upper plate 2 also protrudes from its side facing the plate 1, and has a concave spherical surface 12. the radius of curvature thereof is equal to (r ) of the spherical surface 9, to slide thereon by forming a ball joint. The opposite face 13 of the chip 8 is planar and flush with the outer face of the plate 2.

. The center of curvature or rotation C of the ball 3, 9 and remote surfaces 12 of radius r cour¬ Bure, is located as follows:

- C is the center in an anteroposterior plane (OX, OY), offset towards the rear in the rear part of the plates 1, 2 and of the vertebral bodies; - in a transverse plane (OX, OZ), the center of rotation C is substantially located in the middle of the plates 1,

2 and of the vertebral bodies;

- and in a vertical plane (OY, OZ), the center C is located just under the plate 1 covering the upper face of the lower vertebra, for example L5 in the example illustrated in Fig.l.

This positioning of the center C is a curvature radius t of approximately the height of the prosthesis when the plates 1, 2 are pa- rallèles, and half of this height.

In practice the center of rotation C can be located below the lower surface SI of the plate 1 (Fig.3), at a distance dl between Omm - that is, to be on the surface if -even - and about 5mm as appropriate.

On the other hand, the center of rotation C is placed from the middle M of the straight side 5 of the plate 1 adjacent to the spinal canal at a distance from the side 5 of between about 1/3 and half of the width L of the plate 1 from the medium M: in Fig.3 the center C is located substantially between the distance d2 = 1 / 3.The and the distance d3 = 1 / 2.The. By way of non-limiting numerical example d2 = 4 mm, d3 = 10mm and L = 20mm, so that C is in a 6mm area in breadth.

The prosthesis further comprises a interca¬ lar damping ring 10, made of a suitable flexible material, pierced with a passage opening 10a of the ball 3. The flexible ring 10 is dimensioned to be accommodated in the space tab delimited between the plates 1, 2 and around the ball joint 3 by marrying sensi¬ ably the contour of the plates. A uncompressed free state (fig.l), the elastic ring 10 has a variable thickness in its front part to its rear part. Its anterior part has a maximum thickness H, which decreases gradually, on either side of the center of the edge of the anterior portion, JUS that the posterior portion of the ring 10, which is épais¬ sor h and significantly lower than H. the ring 10 is thus in the form of an asymmetrical workpiece whose opposite faces are inclined 1'une relative to each other, by moving towards the rear part. Each plate 1, 2 has, on its face from which protrudes the corresponding pad 7, 8, a central annular extra thickness 14, 15. This latter is contiguous with the associated pad 7, 8 it surrounds to form a reinforcement come integral with the remainder of the plate. Preferably, as shown, the reinforcements 14 and 15 have a conical surface, the thickness of which decreases from the wafer 7, 8.

In each plate 1, 2 are formed a plurality of holes 16 suitably distributed along the edges of the plate. These holes 16 are arranged to receive pins 17 fixed in the plate 1, 2 by any suitable means such as screwing their cylindrical base 17a. Their tips 17b, impacted in the subchondral bone of the vertebral plates, ensure the fixing of the plates 1, 2 to the vertebrae such as L5 L4, L5 ...

The pellets 7, 8 forming the ball joint articulation 3 are of small dimensions compared to those of the plates 1, 2, and are generally selected of a material having the best possible tribological characteristics (mechanical properties: static, dynamic and resistance wear), and of course biostable. Their coefficient of friction should be low and their life and that of the plates 1, 2, very high (eg 40 years).

These pellets 7, 8 may be made of a suitable material such as a ceramic including an oxide such as alumina or sintered zirconia, a synthetic stone, metal alloy with surface treatment (diamond deposition etc).

The flexible ring 10 of damping is preferably, advantageously made of an elastomer of suitable hardness.

The plates 1, 2 are provided in standard number, suitable for all possible morphotypes bodies verté¬ braux. The bearings 3 are against greater in number, adapted to the morphology of each individual and each vertebral level. It is thus possible a range of parts (plates 1, 2, ball 3, the elastic rings 10) suitable for all patients and disc heights allowing combinations infinite in number, adapted to each particular case.

Besides the technical advantages already mentioned, the disc prosthesis according 1'invention has the following advantages. By appropriate dimensioning of the ball 3 and the position of its center of rotation C, defined above, the rubbing surfaces are reduced and the friction caused by the tilting of the plates 1, 2 with respect to the other (Fig.4) remains low. This results in reduced wear of the pads 7, 8. Furthermore, the surfaces 9, 12 of the articulation, however, have a sufficient radius of curvature not to cause excessive instability of the prosthesis, while providing a suitable three-dimensional mobility, virtually identical to that of natural vertebrae.

During the three-dimensional movements of the plates 1, 2 and the corresponding vertebrae, the elastic ring 10 provides a damping function of the multiple constraints that limit the movements, the opposite faces of the ring 10 remains always in contact with the corresponding faces of plates 1. the variation of the height or thickness of the ring 10 of the front to back has the advantage of adapting to the physiologi¬ that lordosis of the lumbar spine. H / h ratio is thus adaptable to the spinal posture of profile, depending on the disc floor concerned. The inclination of the faces of the ring 10 on 1'une 1'autre may vary depending 1'étage and morphology of the patient. For example it can reach 15 ° at L5 / S1. It should also be noted that the fact that 1'épaisseur of the anterior part of 1'anneau 10 is greater than that of its rear part enables earlier game development of flexible material Consti- tutif of this ring. This therefore leads to the production of a soon 1'apparition damping effect of a movement of the vertebral bodies associated with the prosthesis. Moreover, the appropriate choice of a flexible material for the ring 10, allows obtaining an optimum stiffness to reproduce the slopes of rotations of a healthy disk in the diver¬ its loads. Finally, the prosthesis according to the invention will provides stiffness and damping very close or even identical to those of a natural disc. The establishment by the surgeon for the prosthesis which has just been described is as follows.

Firstly the surgeon places on the lower vertebra L5 for example, the corresponding plate 1, the center properly relative to the vertebral body, and fixed by pressing the pins 17 in the vertè¬ fiber.

Then the surgeon places on the upper vertebra, for example L4, the upper plate 2, by appropriately positioning the relative to the bottom plate 1.

The surgeon then placed between the plates 1, 2 a "sandwich" composite formed by the assembly of the elastic ring 10 and the ball joint 3, formed by the pads 7, 8. It places this assembly into the central zone between the plates 1, 2, with the pellets 7, 8 opposite conical holes 6, and then releases the previously imposed distrac¬ tion to the vertebral bodies receiving the plates 1, 2. This results in impaction which causes entry conical bases pellets 7, 8 in the holes 6, and securing force with the plates 1, 2.

The values ​​of the angular amplitudes of elements possible with the prosthesis according mouve¬ 1'invention are close below a healthy disc amplitudes:

L5 / S1 18 ° ≤14 °

Figure imgf000014_0001
4th

The prosthesis according to the invention ensures by its sturdiness restoring 1'espace interbody height H, while exhibiting intrinsic stability, that is to say do not allow a mobility not physiolo¬ cal, especially in translation.

The materials that may be used for the incorporation of the prosthesis are of course biocom- patible and must be biologically neutral, i.e. non-toxic, insensitive to corrosion. In addition they must not be pro-inflammatory, mechanical and biological qualities that should not be altered by the sterilization method chosen. For example the plates 1, 2 can be stainless steel, stellite titanium or titanium alloy.

The present titanium alloy the advantage of possessing advantage radiological and magnetic characteristics for Pictures monitoring spinal pathology, as well as excellent bio-tolerance and high mechanical characteristics.

In the second embodiment of the invention will, illustrated in Fig.5 to 8, each pellet 21 and 22 is housed in a respective cup 23, 24 for receiving formed in the support plate 25, 26 associated. The pastil¬ 21, 22 partially protrude from their bowls 23, 24 housing, in which they are mounted freely, not by force. Around each cuvette and each pellet, the annular extra thickness 29, 31 is conical and has a height at the top IL substantially equal to the thickness d. of the plate 25, 26.

The pellets 21, 22 are tapered, along their receiving troughs 23, 24, and have a taper angle than 1 to about 7 °, and preferably 5 e.

In addition the prosthesis illustrated in Fig.5 to 8 is similar to fig.l to 4, in particular for positioning the center of rotation C. The soft damping ring 10 has not been shown however.

The arrangement of cuvettes 23, 24 for receiving the pellets 21, 22 whose external dimensions corres¬ lay to the inner dimensions of the cuvettes in which they are not fixed and they can be easily removed if necessary after a certain time without having to separate the plates 25, 26 vertebrae and replace, presents a apprécia¬ advantage ble. In fact avoids the plates flexi¬ a local bility at the through holes 6 of the previous embodiment, flexibility is not souhai¬ table due to localized forces clamping the pellets which are subjected.

Of course they may alternatively be of cylindrical shape and the walls of the corresponding bowls. But this geometry does not facilitate the installation and later the possible removal of the pellets. It has been found that it could produce a significant membership of the walls of pellets to the walls of the bowls, likely to hamper their removal. This is why the slight taper pellets 21, 22 and their troughs 23, 24 is advantageously provided, because it avoids this disadvantage. The forces exerted by the patient on the plates 25, 26 are reduced due to the presence of funds 27 28, e thickness. sufficient, for example 3/4 of the thickness d. each plate or even cete d_ value. And the plates exhibit no local mechanical weakness to bending.

The reinforcement or annular extra thickness 29, 31 of each plate 25, 26 also increases the surface of contact faces between the conical walls of the cuvettes 23, 24 and pads 21, 22, thanks to the increase in their height in relation to thickened portions 14, 15 of the previous embodiment. This increase is indeed necessitated by the development funds 27 28.

Such an arrangement allows a prosthesis whose total height can be adjusted to the desired height by the surgeon, after consultation with local spinal radiographs system 1'opéré.

For the total height to give the prosthesis, the surgeon has a set number of ball joints 21, 22 whose height is gradually Believe health, for example 11, 13 and 15 centimeters. For each of these games, the faces of the radius of curvature into contact 9, 12 forming the ball head is adapted so that it is approximately between the height H of the prosthesis when the plates 25, 26 are parallel to each other (as shown in Fig.7), and half of this height.

Fig.8 illustrates the respective position of the plates 25, 26 in their maximum opening angle A, for example 32 °. The Fig.9 to 12 illustrate various possible embodiments of the means for fixing the plate or plates to the vertebral bodies, to replace the pins 17. Thus 9 shows the plates 32, 33 whose surface 34 facing the vertebrae is knurled, Fig.lO shows the trays 35, 36 with a corrugated surface 37, Fig.ll shows the trays 38, 39 having curved surfaces 41. Fig.12 shows the plates 42, 43 with surfaces 44 of support the vertebral bodies has undergone a suitable treatment: fixing a metal fabric in known manner, projection of a metal or a ceramic, or adhesive coating. This surface treatment may moreover be combined with variants of Fig.9 to 11 to be applied to surfaces 34, 37, 41.

The pins 17 can also be replaced by screws or studs. However, the fixation cement (méthylmétha- methacrylate copolymer) is not feasible, given the moth-eaten proxi¬ nervous elements and heat generation during polymerization. For non lumbar levels, the flexible ring 10 may not exhibit the asymmetry described and thus have a uniform thickness.

It should be noted that the disc prosthesis according to the invention does not include a free room, con¬ trairement certain disc prostheses known. This has the advantage of eliminating any risk of ejection of such a free play against the aorta or to the spinal canal.

Claims

CLAIMS 1. A prosthesis intervertebral disc comprising two plates (1, 2) equipped with fixing means to the corresponding vertebrae (L4, L5), and a device (7, 8) of articulation of the plates one above the other, carac¬ terised in that the articulation device is a ball (3) whose center of rotation (C), in an anteroposterior plane (OX, OY) is offset rearward in the posterior part of the plates and of the vertebral body in a transverse plane (OX, OZ) is located substantially in the middle of the plates and the vertebral body, and in a vertical plane (0Y, 0Z) is located under the plate (1) of the lower vertebra (L5) and in that said prosthesis further comprises an intermediate damping ring (10) made of flexible material, having an opening (10a) for passage of the ball (3) and dimensioned to fit within the space delimited between the plates and around the kneecap substantially matching the contour of the plates. 2. A prosthesis according to claim 1, characterized in that the ball joint (3) is constituted by a first pad (7) with a convex spherical surface (9) and a second wafer (8) with a concave spherical surface (12) receiving the convex spherical surface, two spherical surfaces having the same radius of curvature (r) and the pellets being mounted in the central portions of the respective plates (1,
2) on the faces vis-à-vis which they protrude.
3. A prosthesis according to claim 2, characterized in that each plate (1, 2; 25,26) having a straight side (5) intended to be positioned near the spinal canal and a contour (4) substantially oval complementary, or elliptical, the disc (7; 22) convex sphériqu surface (9) is mounted in the plate (1; 26) of green re bottom and its center of rotation (C) is located, from the middle (M) of straight side of the adjacent plate spinal canal at a distance of said side between about one-third (d2) and half (d3) of the width (L) of the plate from said medium and under the plate of the lower vertebra , the center of rotation is located at a distance (dl) of the plate between 0 and about 5 mm.
4. Prosthesis according to claim 2 or 3, characterized in that each plate (1,2; 25,26) compor¬ you, on the face from which protrudes the pad (7, 8; 21,22), an overthickness central annular (14,15; 29,31) contiguous to the wafer it surrounds by forming reinforcement.
5. A prosthesis according to claim 4, characterized in that the reinforcement (14,15; 29,31) has a conical surface, the thickness (hl) decreases from the wafer (7, 8).
6. A prosthesis according to one of Claims 2 to 5, characterized in that the pads (7,8; 21,22) have a conical base adapted to conjugates conical holes in the plates (1,2; 25,26 ).
7. A prosthesis according 1'une of claims 1 to 6, characterized in that the plates of the fixing means
(1,2; 25,26 ...) to the vertebrae (L5, L4) comprise conical pins (17) screwed in holes (16) formed in the plates and suitably distributed thereon or a knurling (34 ) or a corrugated surface (37) or a convex surface (41).
8. A prosthesis according to any one of 1'une revendica¬ tions 1 to 7, characterized in that the fastening plates (42, 43) to the vertebrae is provided by a metal fabric (44), a projected metal or a ceramic (e) on the surface of the plate opposite the vertebra, or by gluing, or by combination of these means with either a knurled surface (34) or undulating (37) or convex (41).
9. A prosthesis according 1'une of claims 1 to 8, characterized in that the plates (1,2; 25,26 ...) have identical dimensions and substantially equal to those of a vertebra, in particular lumbar.
10. A prosthesis according to one of claims 1 to 9, characterized in that 1'anneau flexible (10) amortisse¬ ment has an anterior portion of maximum thickness (H) greater than that (h) of Part rear, said thickness (H) decreases regularly from the center to the edge of the anterior portion to the posterior portion, and the ring of opposed faces (10) in an uncompressed state, are correspondingly inclined relative to 1'une 1'au¬ be.
11. A prosthesis according to one of claims 1 to 10, characterized in that the pads (7,8; 21,22) of the ball (3) are made in one of the solvents sui¬ materials: ceramic frit including oxide such as alumina or zirconia, synthetic stone, metal alloy with surface treatment.
12. A prosthesis according to one of claims 1 to 11, characterized in that the elastic ring (10) is made of elastomer of suitable hardness.
13. A prosthesis according to one of Claims 2 to 12, characterized in that each pellet (21, 22) is accommodated in a pan (23, 24) for receiving formed in the support plate (25, 26) of which it forms part projection and in which it is freely mounted.
PCT/FR1993/000825 1992-08-24 1993-08-24 Intervertebral disk prosthesis WO1994004100A1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
FR9210232A FR2694882B1 (en) 1992-08-24 1992-08-24 Intervertebral disk prosthesis.
FR9210232 1992-08-24

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
AU49645/93A AU4964593A (en) 1992-08-24 1993-08-24 Intervertebral disk prosthesis

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WO1994004100A1 true WO1994004100A1 (en) 1994-03-03

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MX (1) MX9305071A (en)
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TW (1) TW280767B (en)
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FR2694882A1 (en) 1994-02-25
AU4964593A (en) 1994-03-15
TW280767B (en) 1996-07-11
ZA9306156B (en) 1994-09-19
CN1090485A (en) 1994-08-10
FR2694882B1 (en) 1994-10-21
TR26927A (en) 1994-08-24
MX9305071A (en) 1994-04-29

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