WO2000074605A1 - Intervertebral implant and assembly for setting same - Google Patents
Intervertebral implant and assembly for setting same Download PDFInfo
- Publication number
- WO2000074605A1 WO2000074605A1 PCT/FR2000/001444 FR0001444W WO0074605A1 WO 2000074605 A1 WO2000074605 A1 WO 2000074605A1 FR 0001444 W FR0001444 W FR 0001444W WO 0074605 A1 WO0074605 A1 WO 0074605A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- implant
- shells
- core
- intermediate configuration
- interior volume
- Prior art date
Links
Classifications
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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
- 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
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2/4611—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
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- A61F2/02—Prostheses implantable into the body
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- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
- A61F2/446—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages having a circular or elliptical cross-section substantially parallel to the axis of the spine, e.g. cylinders or frustocones
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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
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
- A61F2002/30884—Fins or wings, e.g. longitudinal wings for preventing rotation within the bone cavity
-
- 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
- A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
- A61F2002/30891—Plurality of protrusions
- A61F2002/30892—Plurality of protrusions parallel
-
- 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
- A61F2/3094—Designing or manufacturing processes
- A61F2002/30975—Designing or manufacturing processes made of two halves
-
- 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
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2002/4625—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof with relative movement between parts of the instrument during use
- A61F2002/4627—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof with relative movement between parts of the instrument during use with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument
-
- 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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
-
- 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0004—Rounded shapes, e.g. with rounded corners
- A61F2230/0006—Rounded shapes, e.g. with rounded corners circular
-
- 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0017—Angular shapes
- A61F2230/0019—Angular shapes rectangular
-
- 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0017—Angular shapes
- A61F2230/0026—Angular shapes trapezoidal
-
- 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0063—Three-dimensional shapes
-
- 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0063—Three-dimensional shapes
- A61F2230/0069—Three-dimensional shapes cylindrical
-
- 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
Definitions
- the present invention relates to an intervertebral implant and a delivery assembly for such an implant.
- such an implant which may be partial or total, is intended to replace all or part of an intervertebral disc, when the latter has been destroyed by surgery or by disease.
- an intervertebral implant formed by a rigid body of frustoconical shape, the transverse dimensions of which increase towards the anterior part of the implant, with reference to the latter once placed between the vertebrae .
- This implant is provided with two threaded coatings, in the form of a circular arc, intended to come into contact with each of the vertebrae.
- the spacing between these two coatings that is to say the greatest distance separating them, in cross section, varies continuously from the rear of the implant, towards the front thereof.
- This known implant has drawbacks, however. Since, for anatomical reasons, its front longitudinal end has larger transverse dimensions, it is difficult to insert this implant from the back of the spine. Indeed, it is first of all necessary to provide, in the vertebral bone, a housing whose dimensions correspond to the maximum spacing between the coatings, at the level of the anterior part of the prosthesis. This is first of all at the origin of a destructive surgery, detrimental to the physical integrity of the patient. On the other hand, this implant has high risks of being ejected from the intervertebral space, insofar as, once placed, this implant is placed in a housing whose transverse dimensions are larger than those of the majority of the implant itself, particularly in the vicinity of the rear end of the latter. Such an implant can therefore only be placed, satisfactorily, from the front of the spine, which implies the implementation of surgery particularly delicate.
- the invention proposes to produce an intervertebral implant which, while having an advantageous conformation from a physiological point of view, can be introduced easily from behind 'a vertebra, by the implementation of a relatively little destructive surgery, and which has a satisfactory stability once established within the intervertebral space.
- an intervertebral implant intended to be inserted between two neighboring vertebrae, said implant comprising, on a part of its periphery, two rigid coatings intended to be in contact respectively with the two neighboring vertebrae, the vertical dimension implant implant increasing towards the anterior part of the implant and varying between a minimum dimension and a maximum dimension, characterized in that said implant also comprises a removable core, provided with two upper and lower peripheral zones of contact with each coating, the vertical distance separating the two peripheral zones increasing towards the anterior part of the implant, and in that the two coatings are shells suitable for adopting an intermediate configuration in which the vertical spacing between their external surfaces is substantially constant or decreasing towards the front, said shells forming, in said intermediate configuration, an interior volume adapted to receive said removable core.
- the invention also proposes to produce an installation assembly for the implant as defined above, which ensures easy implantation of the latter and which makes it possible to preserve the integrity of the various organs in the vicinity of which this assembly is moved during all the laying operations.
- the invention also relates to a fitting assembly for the implant as defined above, characterized in that it comprises means for forming a second interior volume, in communication with the interior volume formed by said shells, in said intermediate configuration.
- FIG. 1 is a perspective view of the various components of an implant according to a first embodiment of the invention
- FIG. 2 is an exploded perspective view of the various components of a delivery assembly for the implant of Figure 1;
- FIG 3 is a longitudinal sectional view of the two coatings of the prosthesis of Figure 1, secured with a fitting insert of Figure 2;
- FIG. 4 is a longitudinal sectional view illustrating the phase of insertion of the implant core into the interior volume defined by the two coatings of the implant of Figure 1;
- FIG. 1 represents, seen in perspective, an intervertebral implant in accordance with a first embodiment of the invention, generally designated by the reference 2.
- This implant comprises a core 4 made of a substantially rigid biocompatible material, such as a metal, for example titanium, or even a polymer.
- This core can also be made of a bone substitute material or even comprise a hollow metallic reinforcement, the surface of which is pierced with orifices.
- the cross section of the core 4 is composed of two end portions 6, the outer periphery of which describes an arc of a circle and which are connected by two flats 8 forming a middle portion 10.
- the transverse dimension, or width, of the portions end 6 is substantially constant throughout the implant 2, while the height of the flats 8 increases towards the front of the implant, with reference to the latter once placed in the intervertebral space .
- Each end portion 6 is hollowed out with two grooves
- the core 4 is also pierced with a central longitudinal orifice, which is through. The vertical spacing between the two end portions
- the implant 2 also comprises two coatings 16, 16 'forming shells, which are removable both relative to one another and relative to the core 4.
- Each shell 16, 16 ' comprises a central cap 18, 18' cylindrical, intended to come into contact with the core 4.
- This cap is connected to a peripheral cap 20, 20 'having, in cross section, an arc shape of circle.
- the outer surface of these caps is provided with a thread 22, 22 ', intended to facilitate the implantation of the prosthesis.
- connection zone between each cap 18, 18 ′ and its adjacent cap 20, 20 ′ is hollowed out with a longitudinal through opening 24, 24 ′, in the form of an arc of a circle, intended to accommodate the tongues of a set of pose, as will be explained in the following figures.
- Each shell, 16, 16 ' is provided with two radial notches 26, 26', projecting inwards, from the front end of each cap 18, 18 '. It should be noted that these notches extend only over a small part of the longitudinal dimension of the shells 16, 16 '. The respective positions of the notches 26, 26 'and the grooves 12 allows them to cooperate, by sliding of these notches within these grooves.
- Each shell 16, 16 ' is provided with two side skirts 28, 28', 30, 30 'extending in the direction of the shell opposite, from the ends of each cap 18, 18 ′, substantially perpendicular to the main axis of the prosthesis. These skirts, seen from the side, have an almost sinusoidal profile. Skirts 28, 30 or 28 ', 30' of the same shell 16, 16 'are arranged asymmetrically with respect to each other. On the other hand, the facing skirts 28, 28 ′ or 30, 30 ′ of the shells 16, 16 ′ have conjugate shapes, so that they are able to bear on one another, by their respective edges. To this end, the latter can be provided with male-female elements, not shown, for example of the mortise-tenon type, making it possible to avoid the relative translation of these two shells, in directions that are both longitudinal and transverse.
- Each shell is provided with a respective front flap 32, 32 '.
- These flaps are offset longitudinally with respect to each other and, as shown in FIG. 3, extend along main dimensions such that they overlap, when the shells are in abutment against one another .
- the flap 32 'adjacent to the notches 26, 26' is further provided with a threaded through hole 34 ', intended to cooperate with a threaded rod, as will be explained in the following. Provision may be made for the other flap 32 to be provided with a similar hole.
- the shell 16 ' is further provided with a terminal lug 35 forming, with the flap 32', a housing 35 'in the form of a U in which the flap 32 is received.
- Each shell 16, 16 ' is pierced with a notch 36, 36' extending over part of the longitudinal dimension of the shell, at the level of the median radial part of the latter.
- An elastic tab 38, 38 ′ terminated, at its front part, by a point 40, 40 ′ projecting outwards, is articulated on the front wall of each notch 36, 36 ′.
- the dimensions of the tip 40, 40 ' are such that it does not protrude beyond the outer surface of the cap when the core 4 is not in contact with the latter ( Figure 4).
- each point 40, 40' protrudes by compared to the external surface of these shells, so as to constitute a means of anchoring the implant in the corresponding vertebra.
- FIG. 2 represents the various constituent elements of a set for placing the implant 2, designated as a whole by the reference 42.
- This set comprises an insert 44, which is made up, in cross section, of two end portions 46, the outer periphery of which describes an arc of a circle and which are connected by two flats 48 forming a middle part 50. It should be noted that the vertical spacing between these end portions is constant along this insert and is located substantially equal to the spacing of existing between the end portions 6 of the core 4, at the rear part of the latter.
- Each end portion 46 of the insert 44 is hollowed out with three longitudinal grooves, namely a central groove 52 and two external grooves 54. The depth of these grooves is substantially constant along the prosthesis.
- the outer grooves 54 are arranged in such a way that they cooperate, by sliding, with the notches 26, 26 'of the shells 16, 16'.
- the outer groove 54 is arranged in such a way that the insert 44, when it is secured to the shells 16, 16 ', as shown in FIG. 3, does not lead to the projecting of the legs 38, 38' relative to at the outer periphery of the shells 16, 16 '.
- the insert 44 is hollowed out with a central longitudinal orifice, which passes through. It should be noted that the longitudinal dimensions of this insert 44 are larger than those of the shells 16, 16 '.
- the installation assembly 42 also comprises a tool 58 comprising a handle 60 extended by two tongues 62, 62 'in the form of an arc of a circle.
- the latter have dimensions such that they are capable of penetrating into the openings 24, 24 'formed in the shells 16, 16'.
- Each tongue 62, 62 ' is provided with an internal radial recess 64, 64' defining a thinned distal portion 66, 66 'of this tongue.
- Each distal portion 66, 66 ' is further hollowed out with a longitudinal lumen 68, 68', which makes it possible to avoid any contact between the tongues 62, 62 'and the tips 40, 40', as shown in particular in Figure 3.
- the installation assembly 42 finally comprises a rod 70, one end 72 of which is threaded.
- the two shells 16, 16 ′ are first placed around the insert 44.
- the inner surface of the caps 18, 18 ′ is brought against the end portions 46 of this insert, the notches 26, 26 'penetrating into the outer grooves 54.
- One end of this insert is abutted against the flap 32', while the other end of this insert projects longitudinally relative to the corresponding end of the shells 16, 16 ' .
- the rod 70 is then threaded into the central orifice 56 of the insert 44, then the rod is secured to the shells, by cooperation of the threaded end 72 of this rod 70 with the tapped hole 34 'of the flap 32' .
- each tongue 62, 62' is then threaded into the openings 24, 24 ', until the recesses 64, 64' abut against the rear wall of the shells.
- the inner surface of the caps 18, 18 'and that of the tongues 62, 62' are continuous.
- the two shells 16, 16 ′ thus form an intermediate implant I, the transverse dimensions of which are substantially constant and are close to the smallest transverse dimension of the final implant.
- the establishment of the intermediate implant which is generally cylindrical, in the intervertebral space, consists first of all in providing, in the latter, a housing whose transverse dimensions correspond to those of this intermediate implant. Then, this implant is introduced by screwing, by means of the handle 60 of the setting tool 58.
- the threads 22, 22 ′ with which the shells are provided are advantageous with regard to this operation.
- the outer surface of the tongues 62, 62 ′ is preferably smooth, which allows easy removal of these tongues once the intermediate implant has been put in place.
- the handle 60 is removed from the tool 58, which is removable relative to the tongues 62, 62 ′, the distal portion of which 66, 66 'remains in place in the openings 24, 24'.
- the insert 44 is then removed from the interior volume V of the shells 16, 16 ', taking advantage of the fact that this insert 44 has large longitudinal dimensions.
- the core 4 is introduced into the interior volume V of the tongues 62, 62 '.
- the core 4 is introduced by its front end, of larger dimension, which has the effect of spreading the tongues mutually, as well as the facing edges of the skirts 28, 30 and 28 ', 30' of the shells.
- the flap 32 ' has a certain elasticity, in order to compensate for this separation.
- the core 4 is advanced towards the interior volume V of the shells 16, 16 '.
- a plate 74 hollowed out from a central hole 76 is threaded with respect to the tongues 62, 62 ′.
- a tubular member 78 disposed around the threaded rod 70 and the outer surface of which is threaded.
- One of the ends of this tubular member 78 is provided with an operating button 80, while its opposite end receives, with ball joint, a discoidal piston bearing against the rear face of the core 4.
- the tubular member moves, relative to the plate 74, in the direction of the shells 16, 16 ', which has the effect of bringing the core 4 closer to the latter.
- the notches 26, 26 ′ of the shells 16, 16 ′ penetrate into the longitudinal grooves 12 of the core 4. It is then possible to separate the threaded rod 70 relative to the flaps 32, 32 ', then remove this rod from the interior volumes of the shells 16, 16' and the tabs 62, 62 '.
- the rod can also be removed threaded 70 at the same time as the insert 44, taking advantage of the fact that the caps cannot move longitudinally relative to each other, the flap 32 being received in the housing 35 'in a U shape. '' actuate the operating button 80, the core
- the front wall of the core 4 bears against the flap 32', while the notches 26, 26 'bear against the rear face of this core 4. Since the grooves 12 have zero depth in the vicinity of this rear end, the notches 26, 26 'prevent any longitudinal movement of the core 4 relative to the shells 16, 16' in a first direction, such longitudinal movement being prevented, in the other direction, due the presence of the rear flap 32 '.
- the opposite skirts 28, 30 'and 28', 30 of the caps namely a skirt of a cap and the skirt of the other cap, generally symmetrical of this first skirt with respect to the longitudinal axis of the implant have, in cross section, a covering zone. This reduces the lateral shear to which the implant is subjected.
- the height, or vertical dimension of the implant, once placed, increases from a value d at the back of the implant, to a value D at the front of it.
- FIG. 6 represents the various constituent elements of an implant according to a second embodiment of the invention, designated as a whole by the reference 102.
- This implant comprises a core 104, the cross section of which consists of two end portions 106, connected by two walls 108, perpendicular to these end portions 106, so as to form a middle portion 110.
- the transverse dimension, or width, of this core 104 is substantially constant all along the latter, while the height, or vertical dimension, of this core increases towards the front thereof, with reference to the implant. once placed in the intervertebral space.
- the core 104 is hollowed out by four lateral grooves 112, namely two pairs of respectively upper and lower grooves extending parallel to the end portion 106 of which they are adjacent.
- the core 104 is also pierced with a central longitudinal orifice 114, which is through.
- the implant 102 also comprises two shells 116, 116 ′, which are removable both with respect to each other and with respect to the core 104.
- Each shell has a U shape and has a core 118, 118 ', intended to come into contact with the end portions 106, as well as two wings 120, 120' intended to bear against the flats 108.
- the core 118, 118 ' is pierced with a longitudinal opening 124, 124 ', as well as a notch 136, 136', the walls of which receive a tab, not shown, similar to that 38, 38 'described with reference to the preceding figures.
- the outer surface of the core is further provided with pins 137, 137 'intended to penetrate a corresponding vertebra.
- the inner wall of the wings 120, 120 ' is provided with longitudinal ribs 138, 138' adapted to cooperate with the grooves 112 of the core 104.
- Each shell is provided, at its front end, with flaps, of which only the one 132 'is shown, similar to those described with reference to FIGS. 3 to 5.
- the positioning of this implant 102 is carried out by means of a fitting assembly comprising an insert 144, of rectangular cross section, constant all along this insert.
- the latter is provided with six grooves, namely two grooves 152, 152 ', respectively upper and lower, as well as four lateral grooves 154, intended to cooperate with the ribs 138, 138'.
- the grooves 152, 152 ' allow the free passage of the elastic anchoring tab in the vertebra.
- the implant 102 is placed in the following manner.
- the insert 144 is first secured to the shells 116, 116 ', by cooperation of the ribs 138, 138' with the lateral grooves 154.
- the two shells are then secured by means of a threaded rod, not shown, of analogously to what has been described with reference to the previous embodiment.
- the wings 120, 120 ′ facing the two shells are in mutual support.
- An intermediate implant is thus formed which is introduced into the intervertebral space by impaction.
- tongues similar to those 62, 62 ′, are placed in the openings 124, 124 ′ of the shells 116, 116 ′.
- the core 104 is introduced into the interior volume defined by these tabs which are not shown, then this core 104 is introduced into the interior volume of the shells 116, 116 ′, by impaction, by means of a tool which is not shown.
- the operations for removing the insert 144, the threaded rod and the tongues, not shown, operate in a similar manner to what has been described with reference to the preceding figures.
- the invention makes it possible to achieve the objectives mentioned above.
- the two shells, removable with respect to the core, which is provided with the implant of the invention allow the production of an intermediate implant of small transverse dimension, capable of being introduced into the intervertebral space by providing a housing for limited dimensions, which is advantageous for the physical integrity of the patient.
- This intermediate implant has good stability with respect to the vertebral bones and constitutes a lever arm for the insertion of the core into the interior volume of the shells.
- the final implant has a very satisfactory stability, once in place.
- the implant of the invention is also advantageous, in that it allows the carrying out of preliminary tests, by only partially introducing the core into the interior volume of the cap. In this way, it is possible to remove this core, in the case where its conformation is not favorable to the patient, so as to replace it with another core, of appropriate profile.
Landscapes
- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Neurology (AREA)
- Transplantation (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Cardiology (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Physical Education & Sports Medicine (AREA)
- Prostheses (AREA)
Abstract
Description
Claims
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
AU52264/00A AU5226400A (en) | 1999-06-02 | 2000-05-26 | Intervertebral implant and assembly for setting same |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
FR9907123A FR2794362B1 (en) | 1999-06-02 | 1999-06-02 | INTERVERTEBRAL IMPLANT AND POSITIONING ASSEMBLY OF SUCH AN IMPLANT |
FR99/07123 | 1999-06-02 |
Publications (1)
Publication Number | Publication Date |
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WO2000074605A1 true WO2000074605A1 (en) | 2000-12-14 |
Family
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Family Applications (1)
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PCT/FR2000/001444 WO2000074605A1 (en) | 1999-06-02 | 2000-05-26 | Intervertebral implant and assembly for setting same |
Country Status (3)
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---|---|
AU (1) | AU5226400A (en) |
FR (1) | FR2794362B1 (en) |
WO (1) | WO2000074605A1 (en) |
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AU5226400A (en) | 2000-12-28 |
FR2794362B1 (en) | 2001-09-21 |
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