WO1994004100A1 - Prothese discale intervertebrale - Google Patents

Prothese discale intervertebrale 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
prosthesis according
prosthesis
ball joint
Prior art date
Application number
PCT/FR1993/000825
Other languages
English (en)
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
Application filed by Societe De Fabrication De Materiel Orthopedique - Sofamor filed Critical Societe De Fabrication De Materiel Orthopedique - Sofamor
Priority to AU49645/93A priority Critical patent/AU4964593A/en
Publication of WO1994004100A1 publication Critical patent/WO1994004100A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS 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
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/02—Inorganic materials
    • A61L27/10—Ceramics or glasses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS 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
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
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    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30907—Nets or sleeves applied to surface of prostheses or in cement
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/442—Intervertebral or spinal discs, e.g. resilient
    • A61F2/4425—Intervertebral or spinal discs, e.g. resilient made of articulated components
    • A—HUMAN NECESSITIES
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    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/02—Inorganic materials
    • A61L27/04—Metals or alloys
    • A—HUMAN NECESSITIES
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    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/14—Macromolecular materials
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    • A61F2/00—Filters 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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    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30004—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis
    • A61F2002/30024—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis differing in coefficient of friction
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    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30182—Other shapes
    • A61F2002/30187—D-shaped or half-disc-shaped
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30332—Conically- or frustoconically-shaped protrusion and recess
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS 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
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30563—Special structural features of bone or joint prostheses not otherwise provided for having elastic means or damping means, different from springs, e.g. including an elastomeric core or shock absorbers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS 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
    • A61F2/00—Filters 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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    • A61F2/00—Filters 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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    • A61F2310/00005—The prosthesis being constructed from a particular material
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS 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
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS 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
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00179—Ceramics or ceramic-like structures
    • A61F2310/00185—Ceramics or ceramic-like structures based on metal oxides
    • A61F2310/00203—Ceramics or ceramic-like structures based on metal oxides containing alumina or aluminium oxide
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS 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
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00179—Ceramics or ceramic-like structures
    • A61F2310/00185—Ceramics or ceramic-like structures based on metal oxides
    • A61F2310/00239—Ceramics or ceramic-like structures based on metal oxides containing zirconia or zirconium oxide ZrO2
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS 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
    • A61L2430/00—Materials or treatment for tissue regeneration
    • A61L2430/38—Materials or treatment for tissue regeneration for reconstruction of the spine, vertebrae or intervertebral discs

Definitions

  • the subject of the present invention is an intervertebral disc prosthesis.
  • an intervertebral disc is in the form of a biconvex lens attached by its faces to the articular surfaces of the vertebral bodies. It consists of a hard peripheral part (annulus), formed of concentric fibrous lamellae, and a central part (nucleus pulposus), gelatinous and soft, consisting of thin fibrous bundles separated by spaces filled with mucous tissue.
  • An intervertebral disc is a deformable element allowing all possible relative movements (6 degrees of freedom) but which limits the amplitudes of the latter, in particular in torsion, in association with the intervertebral ligaments and the bone buffers.
  • the intervertebral disc is a viscoelastic damping structure, which contributes to the resistance and stability of the verticalized spine in a state of gravity.
  • An intervertebral disc can be damaged for a variety of reasons, including aging and degeneration, which can cause herniated discs.
  • Disc degeneration corresponds to functional and then anatomical destruction of the disc, which seems to result from the effect of mechanical stresses on a disc with structures in the process of disorganization.
  • Disc degeneration modifies the mechanical behavior of the disc and results in a reduction in height of the intersomatic space, which leads to a disturbance of the functional disc-joint assembly. This results in instability which can cause annoying clinical consequences, in particular low back pain.
  • segmental instability leads to abnormal functioning of the articulars, inducing an arthritic reaction. as a source of pain and osteophytic processes.
  • the authors of the second type of prosthesis consider physiologically useless certain degrees of freedom, and restore a degree of freedom considered essential.
  • a prosthesis forming a hinge is known which allows rotation only around a transverse axis.
  • the articulated prostheses can be extremely varied and include in particular materials having a certain flexibility, or else use mechanical means such as springs.
  • the arthroplasty is intended for cases where, until now, arthrodesis is indicated. It can be an interesting alternative to this intervention, not without consequences on the adjacent floors. In fact, all lumbar arthrodeses involve in the segments adjacent an increase in stresses and a displacement of the centers of rotation, which can lead to hypermobility.
  • the disc prosthesis targeted by the invention comprises two plates fitted with means for fixing to the corresponding vertebrae, as well as a device for articulating the plates one on the other.
  • the articulation device is a ball joint whose center of rotation, in an anteroposterior plane is offset backwards in the posterior part of the plates and of the vertebral body, in a transverse plane is located substantially in the middle of the plates and the vertebral body, and in a vertical plane is located under the plate of the lower vertebra;
  • this prosthesis further comprises an intermediate cushioning ring, made of a flexible material, pierced with an opening for passage of the patella and dimensioned to be housed in the space delimited between the plates and around the patella by substantially matching the contour of the plates.
  • the positioning of the center of curvature of the patella as defined according to the invention has the advantage of avoiding constraining the articular processes, as in natural vertebrae, which had not been obtained until now with known prostheses.
  • the prosthesis according to the invention has everything both the necessary mechanical resistance and reduced friction at the joint, thanks to the appropriate dimensioning of the ball joint system.
  • the center of rotation is neither too far from the joint, nor too close to it, and thus makes it possible to reproduce mobility close to natural mobility.
  • Figure 1 is an exploded perspective view of a pair of vertebrae equipped with the constituent elements of a disc prosthesis according to an embodiment of the invention.
  • Figure 2 is a top view of the lower plate of the disc prosthesis of Fig.l.
  • Figure 3 is a longitudinal sectional view along 3/3 of 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 to 3 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.
  • FIGS 9, 10, 11 and 12 are perspective views. pective of four alternative embodiments of the prosthesis according to the invention.
  • FIG.l two adjacent vertebrae, for example the lumbar vertebrae L5 and L4, which can be connected by a disc prosthesis.
  • This prosthesis comprises two plates 1 and 2, fixed respectively to the lower vertebra L5 and to the upper vertebra L4, a ball joint 3 of the two plates 1 and 2 one on the other, and a flexible ring 10 d damping inserted between the two plates 1 and 2 and traversed by the ball 3.
  • the plates 1, 2 are similar, have dimensions substantially equal to those of the vertebrae L5, L4 (these vertebrae may be located on other stages than L5-L4, including non-lumbar stages) and approximate the contour associated joint surfaces.
  • Each plate 1, 2 thus has a curvilinear edge 4, substantially elliptical or oval, and a rectilinear edge 5, intended to be contiguous to the spinal canal, connecting the two truncated ends of the ellipse 4.
  • each plate 1, 2 is pierced, in its central part, with a through hole 6 into which is inserted a respective pad 7, 8, having a body sized to be able to engage in the corresponding hole 6.
  • the latter can advantageously be conical, as can the complementary bases of the pellets 7, 8, which can thus be secured in a removable manner with the corresponding plates or plates 1, 2.
  • the pellets 7, 8 together constitute the articulation 3 with ball joint.
  • the first patch 7, inserted in the lower plate 1, has a convex spherical surface 9, projecting from the corresponding face of the plate 1, while its opposite surface 11, flat, is flush with the opposite face, turned towards 1'exterior of the plate 1.
  • the patch 8 of the upper plate 2 also protrudes from its face facing the plate 1, and has a concave spherical surface 12. The radius of curvature of the latter is equal to that (r) of the spherical surface 9, in order to be able to slide thereon by forming a ball joint.
  • the opposite face 13 of the patch 8 is planar and is flush with the outside face of the plate 2.
  • This center C is, in an anteroposterior plane (OX, OY), offset backwards in the posterior part of the plates 1, 2 and the vertebral bodies; - in a transverse plane (OX, OZ), the center of rotation C is located substantially in the middle of the plates 1,
  • 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 corresponds to a radius of curvature t comprised approximately between the height of the prosthesis when the plates 1, 2 are parallel, and half of this height.
  • 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 say being on the surface IF it - same - and about 5mm depending on the case.
  • d2 4mm
  • d3 10mm
  • L 20mm
  • the prosthesis further comprises an intermediate cushioning ring 10, made of a suitable flexible material, pierced with an opening 10a for passage of the ball joint 3.
  • the flexible ring 10 is sized to be able to be accommodated in space interlayer delimited between the plates 1, 2 and around the ball joint 3, closely matching the contour of the plates.
  • the flexible ring 10 In the uncompressed free state (FIG. 1), the flexible ring 10 has a variable thickness from its front part to its rear part. Its front part has a maximum thickness H, which decreases regularly, on either side of the center of the edge of this front part, up to the rear part of the ring 10, the thickness of which h is thus clearly less than H.
  • the ring 10 is therefore in the form of an asymmetrical piece whose opposite faces are inclined relative to one another, approaching towards the rear part.
  • Each plate 1, 2 comprises, on its face from which the corresponding pad 7, 8 projects, a central annular allowance 14, 15.
  • the latter is contiguous to the associated pad 7, 8 which it surrounds by forming a reinforcement, coming of material with the rest of the plate.
  • the reinforcements 14 and 15 have a conical surface, the thickness of which decreases from the pad 7, 8.
  • each plate 1, 2 are formed a set 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 points 17b, impacted in the subchondral bone of the vertebral plates, ensure the fixation of the plates 1, 2 to the vertebrae such as L5 L4, L5 ...
  • the pads 7, 8 forming the ball joint 3 are small compared to those of the plates 1, 2, and are generally chosen from a material having the best possible tribological characteristics (mechanical characteristics: static, dynamic and resistance wear), and of course biostable. Their coefficient of friction must be low and their lifespan, as well as that of the plates 1, 2, very long (for example 40 years).
  • pellets 7, 8 can be made of a suitable material such as a ceramic, in particular a sintered oxide such as alumina or zirconia, a synthetic stone, a metal alloy with surface treatment (deposit of diamond, etc.).
  • a suitable material such as a ceramic, in particular a sintered oxide such as alumina or zirconia, a synthetic stone, a metal alloy with surface treatment (deposit of diamond, etc.).
  • the flexible damping ring 10 is preferably advantageously made of an elastomer of suitable hardness.
  • the plates 1, 2 are provided in standard number, suitable for all possible morphotypes of the vertebral bodies.
  • the ball joints 3 are on the other hand in greater number, adapted to the morphology of each individual and of each vertebral stage. We can thus produce a range of parts (plates 1, 2, ball joints 3, flexible rings 10) adapted to all the disc heights of the patients and allowing combinations in infinite number, adapted to each particular case.
  • the disc prosthesis according to the invention has the following advantages. Thanks to the appropriate dimensioning of the ball joint 3 and to the position of its articulation center C, defined above, the friction surfaces are reduced and the friction caused by the tilting of the plates 1, 2 one relative to the the other (Fig. 4) remains weak. This results in reduced wear of the pellets 7, 8. Furthermore, the surfaces 9, 12 of the articulation have, however, a radius of curvature sufficient not to cause excessive instability of the prosthesis, while ensuring it a suitable three-dimensional mobility, practically identical to that of natural vertebrae.
  • the flexible ring 10 provides a function of damping of multiple stresses which limits the movements, the opposite faces of the ring 10 always remaining in contact with the corresponding faces of the plates 1.
  • the variation in height, or thickness of the ring 10 from front to back has the advantage of adapting it to physiologic lordosis of the lumbar spine.
  • the H / h ratio thus adapts to the spinal static profile, depending on the disc floor concerned.
  • the inclination of the faces of the ring to one another may vary depending on the floor and the morphology of the patient. For example, it can reach 15 ° in L5 / S1.
  • the thickness of the front part of the ring 10 is greater than that of its rear part allows the flexible material made up to be brought into play earlier. guardian of this ring. This therefore results in the production of a damping effect upon the appearance of a movement of the vertebral bodies associated with the prosthesis.
  • the suitable choice of a flexible material for the ring 10 allows obtaining an optimal stiffness to reproduce the slopes of the rotations of a healthy disc in the diver ⁇ its stresses.
  • the prosthesis according to the invention makes it possible to obtain a stiffness and a damping very close to or even identical to those of a natural disc. The implantation by the surgeon of the prosthesis which has just been described is done as follows.
  • the surgeon places on the lower vertebra, for example L5, the corresponding plate 1, the center suitably with respect to the vertebral body, and fixes it by pressing the pins 17 into the vertebra.
  • the surgeon places the upper plate 2 on the upper vertebra, for example L4, by positioning it appropriately relative to the lower plate 1.
  • the prosthesis according to the invention guarantees, by its solidity, the restoration of the intersomatic space of height H, while having intrinsic stability, that is to say not allowing non-physiological mobility, especially in translation.
  • the materials capable of being used for the constitution of the prosthesis are of course biocompatible and must be biologically neutral, that is to say non-toxic, insensitive to corrosion. In addition, they must not be pro-inflammatory, their mechanical and biological qualities not to be altered by the mode of sterilization chosen.
  • the plates 1, 2 can be made of stainless steel, titanium stellite or titanium alloy.
  • the titanium alloy has the advantage of having advantageous radiological and magnetic characteristics for iconographic monitoring of spinal pathology, as well as excellent biotolerance and high mechanical characteristics.
  • each pellet 21 and 22 is housed in a respective receiving bowl 23, 24 formed in the associated support plate 25, 26.
  • the pads 21, 22 partially project from their housing bowls 23, 24, in which they are mounted freely, and not by force.
  • the annular allowance 29, 31 is conical and has a height at the top IL substantially equal to the thickness d. from plate 25, 26.
  • the pellets 21, 22 are conical, like their receiving cups 23, 24, and have a taper angle of 1 to 7 ° approximately, and preferably 5 e .
  • FIGS. 5 to 8 is similar to that of FIGS. 1 to 4, in particular for the positioning of the center of rotation C.
  • the flexible damping ring 10 has not, however, been shown.
  • the arrangement of bowls 23, 24 for receiving the pellets 21, 22 whose external dimensions correspond to the internal dimensions of the bowls, in which they are not fixed and from which they can be easily removed if necessary after a certain time, without having to separate the plates 25, 26 from the vertebrae and replacing them has an appreciable advantage.
  • each plate 25, 26 also increases the surface of the faces in contact between the conical walls of the cups 23, 24 and the pellets 21, 22, by virtue of the increase in their height relative to the extra thicknesses 14, 15 of the previous embodiment. This increase is indeed required by the adjustment of funds 27, 28.
  • Such an arrangement makes it possible to produce a prosthesis whose total height can be adapted to the height desired by the surgeon, after consultation of the radiographs of the local spinal system of the patient.
  • the surgeon has a set of several ball joints 21, 22 the height of which is progressively increased, for example 11, 13 and 15 centimeters.
  • the radius of curvature of the contacting surfaces 9, 12 forming the patella is adapted so that it is approximately comprised between the height H1 of the prosthesis when the plates 25, 26 are parallel to each other (as shown in Fig. 7), and half this height.
  • FIG.8 illustrates the respective position of the plates 25, 26 in their maximum angular opening A, for example approximately 32 °.
  • Figs. 9 to 12 illustrate various possible embodiments of the means for fixing the plates or plates to the vertebral bodies, replacing the pins 17.
  • FIG. 9 shows plates 32, 33 of which the surface 34 facing the vertebrae is knurled
  • FIG. 10 shows plates 35, 36 with corrugated surface 37
  • FIG. 11 shows plates 38, 39 comprising curved surfaces 41.
  • FIG. 12 shows plates 42, 43, the bearing surfaces 44 of which support the vertebral bodies have undergone a suitable treatment: fixing of a metallic fabric in a manner known per se, projection of a metal or a ceramic, or bonding coating. This surface treatment can, moreover, be combined with the variants of FIGS. 9 to 11 to be applied to surfaces 34, 37, 41.
  • the pins 17 can also be replaced by screws or studs.
  • fixing by cement methylmethacrylate is not possible, given the proximity of the nervous elements and the release of heat during polymerization.
  • the flexible ring 10 may not have the asymmetry described and therefore have a uniform thickness.
  • the disc prosthesis according to the invention does not have a free part, unlike certain known disc prostheses. This has the advantage of eliminating any risk of ejection of such a free part against the aorta or towards the spinal canal.

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  • Health & Medical Sciences (AREA)
  • Chemical & Material Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
  • Biomedical Technology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Dermatology (AREA)
  • Cardiology (AREA)
  • Epidemiology (AREA)
  • Medicinal Chemistry (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Inorganic Chemistry (AREA)
  • Neurology (AREA)
  • Ceramic Engineering (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Prostheses (AREA)
PCT/FR1993/000825 1992-08-24 1993-08-24 Prothese discale intervertebrale WO1994004100A1 (fr)

Priority Applications (1)

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

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
FR9210232A FR2694882B1 (fr) 1992-08-24 1992-08-24 Prothèse discale intervertébrale.
FR9210232 1992-08-24

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WO1994004100A1 true WO1994004100A1 (fr) 1994-03-03

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CN (1) CN1090485A (enrdf_load_stackoverflow)
AU (1) AU4964593A (enrdf_load_stackoverflow)
FR (1) FR2694882B1 (enrdf_load_stackoverflow)
MX (1) MX9305071A (enrdf_load_stackoverflow)
TR (1) TR26927A (enrdf_load_stackoverflow)
TW (1) TW280767B (enrdf_load_stackoverflow)
WO (1) WO1994004100A1 (enrdf_load_stackoverflow)
ZA (1) ZA936156B (enrdf_load_stackoverflow)

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CN1090485A (zh) 1994-08-10
MX9305071A (es) 1994-04-29
FR2694882A1 (fr) 1994-02-25
TW280767B (enrdf_load_stackoverflow) 1996-07-11
TR26927A (tr) 1994-08-24
FR2694882B1 (fr) 1994-10-21
AU4964593A (en) 1994-03-15

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