WO2004078075A1 - Intervertebral disk prosthesis for the cervical spine - Google Patents

Intervertebral disk prosthesis for the cervical spine Download PDF

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Publication number
WO2004078075A1
WO2004078075A1 PCT/EP2004/002130 EP2004002130W WO2004078075A1 WO 2004078075 A1 WO2004078075 A1 WO 2004078075A1 EP 2004002130 W EP2004002130 W EP 2004002130W WO 2004078075 A1 WO2004078075 A1 WO 2004078075A1
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WO
WIPO (PCT)
Prior art keywords
intervertebral disc
disc prosthesis
prosthesis according
cranial
ventral
Prior art date
Application number
PCT/EP2004/002130
Other languages
German (de)
French (fr)
Inventor
Hans Jörg MEISEL
Guido Fehling
Original Assignee
Fehling Instruments Gmbh
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 Fehling Instruments Gmbh filed Critical Fehling Instruments Gmbh
Publication of WO2004078075A1 publication Critical patent/WO2004078075A1/en

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Classifications

    • 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
    • A61F2/44—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
    • A61F2/447—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 substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section
    • 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
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/442—Intervertebral or spinal discs, e.g. resilient
    • 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
    • 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
    • A61F2002/30112—Rounded shapes, e.g. with rounded corners
    • A61F2002/30133—Rounded shapes, e.g. with rounded corners kidney-shaped or bean-shaped
    • 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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • 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
    • A61F2002/30593—Special structural features of bone or joint prostheses not otherwise provided for hollow
    • 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
    • A61F2002/30772—Apertures or holes, e.g. of circular cross section
    • A61F2002/30774—Apertures or holes, e.g. of circular cross section internally-threaded
    • 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
    • A61F2002/30841—Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
    • A61F2002/30843—Pyramidally-shaped
    • 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
    • A61F2002/30841—Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
    • A61F2002/30845—Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes with cutting edges
    • 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
    • A61F2002/4629—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 connected to the endoprosthesis or implant via a threaded connection
    • 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
    • A61F2230/0015—Kidney-shaped, e.g. bean-shaped

Definitions

  • the invention relates to an intervertebral disc prosthesis for the cervical spine according to the preamble of claim 1.
  • intervertebral discs e.g. B. herniated disc
  • the damaged intervertebral disc is removed and replaced with an implanted intervertebral disc prosthesis.
  • an intervertebral disc prosthesis for the cervical spine is e.g. B. known from WO 98/58604.
  • This intervertebral disc prosthesis consists of a metallic circular cylindrical body which is inserted between the vertebral bodies. The cranial surface and the caudal lower surface of the body are serrated for anchoring in the vertebral bodies.
  • intervertebral disc prostheses from a biocompatible plastic, e.g. B. from polyether ether ketone (PEEK).
  • PEEK polyether ether ketone
  • the invention has for its object to provide an intervertebral disc prosthesis for the cervical spine that anatomically replaces the natural intervertebral disc as well as possible and ensures high positional stability.
  • the intervertebral disc prosthesis for the cervical spine has an approximately rectangular outer contour with approximately parallel lateral outer surfaces and approximately parallel ventral and dorsal outer surfaces.
  • the lateral outer surfaces and the ventral outer surface are preferably slightly convexly curved outwards.
  • the dorsal outer surface is concavely curved inwards, so that there is sufficient space for the dural sac running in the spinal canal. A collision of the intervertebral disc prosthesis with the dural sac and a possible Damage to the dural sac is therefore excluded with a high degree of certainty.
  • the cranial surface of the body of the intervertebral disc prosthesis is convexly curved, so that this surface adapts optimally to the concave arched cover plate of the vertebral body.
  • the lower surface of the body is preferably also slightly convex, the bulging of the surface having a greater curvature, i. H. a smaller radius of curvature than the lower surface.
  • the surface and the lower surface of the body have teeth, which is preferably formed with pyramidal teeth.
  • the contour of the free inner cutout of the body essentially follows the outer contour of the body, so that the surface and the lower surface each run with an approximately constant width over the entire circumference.
  • This design of the intervertebral disc prosthesis optimally adapts the disc-shaped body to the anatomical shape of the vertebral body.
  • the surface and the lower surface that support the vertebral bodies run close to the outer circumference of the vertebrae. cover plates, so that the vertebrae are supported in the area in which the bone substance of the vertebral body has the highest stability.
  • the body of the intervertebral disc prosthesis is recessed by the inner cutout. This saves material in the inner area, which cannot make a significant contribution to the support, so that the weight of the intervertebral disc prosthesis remains as low as possible.
  • the intervertebral disc prosthesis supports the vertebrae evenly over the circumference in their load-bearing bone area.
  • the rectangular shape of the outer contour and the inner contour together with the toothing result in a high degree of security against rotation.
  • the intervertebral disc prosthesis is preferably manufactured in two versions.
  • the surface and the lower surface run essentially parallel to one another, while in the other embodiment the surface and the lower surface run in a wedge shape with one another, the distance from the surface and lower surface increasing from dorsal to ventral.
  • the intervertebral disc prosthesis is preferably made from a biocompatible plastic with suitable mechanical properties, polyether ether ketone (PEEK) being particularly suitable.
  • PEEK polyether ether ketone
  • Show it 1 is an axial plan view of the intervertebral disc prosthesis
  • FIG. 3 is a ventral side view of the intervertebral disc prosthesis
  • Fig. 5 is a perspective view of the intervertebral disc prosthesis
  • FIG. 6 a section corresponding to FIG. 4 of a wedge-shaped embodiment of the intervertebral disk prosthesis.
  • the intervertebral disc prosthesis consists of a flat disc-shaped body 10, which is preferably made of PEEK.
  • the body 10 has approximately the shape of a rectangle with rounded corners in the axial projection.
  • the dorsal-ventral dimension is slightly larger than the lateral dimension.
  • the lateral outer surfaces 12 do not run exactly parallel, but at a small angle, so that the distance between the lateral outer surfaces 12 on the dorsal side is somewhat less than on the ventral side. In the axial projection shown in FIG. 1, the lateral outer surfaces 12 are curved slightly convexly outwards.
  • the ventral outer surface 14 is also slightly convexly curved outwards.
  • the dorsal outer surface 16 is concavely curved inwards in the axial projection, the radius of curvature of the curvature of the dorsal outer surface 16 being smaller than the radius of curvature of the ventral outer surface 14, ie the dorsal outer surface 16 is more curved.
  • the cranial surface 18 and the caudal lower surface 20 of the body 10 are each convexly curved. The axial height of the body 10 thus decreases against the lateral wheels 12, the ventral edge 14 and the dorsal edge 16.
  • the cranial surface 18 is bulged more than the caudal lower surface 20, so it has a smaller radius of curvature.
  • the body 10 has an inner cutout 22 which is axially continuous.
  • the cutout 22 follows in its circumferential contour the outer circumferential contour of the body 10, as a result of which the cranial.
  • Surface 18 and the caudal lower surface 20 have the shape of a circumferential strip of constant width, as can be seen in FIG. 1.
  • the cranial surface 18 and the caudal lower surface 20 each have a toothed structure, which is formed by pyramidal teeth 24.
  • a threaded bore 26 is provided in the center of the ventral outer surface 14 and leads from this outer surface 14 perpendicularly through the body 10 into the cutout 22.
  • a positioning instrument can be inserted into the threaded bore 26, which is used to handle the intervertebral disc prosthesis during implantation.
  • the cranial surface 18 and the caudal lower surface 20 run essentially parallel to one another (apart from the surface curvature), as is shown in FIGS. 2 and 3.
  • the cranial surface 18 and the caudal lower surface 20 run in a wedge shape at an angle to one another, the distance the surface 18 and the lower surface 20 is largest on the ventral side and decreases in the dorsal direction.
  • the intervertebral disc prosthesis has the following dimensions:
  • Radius of curvature of the ventral outer surface approx. 24 mm Radius of curvature of the dorsal outer surface: approx. 18 mm
  • Axial height of the body approx. 3-5 mm
  • Width of the cranial surface and the caudal lower surface between the outer contour and the inner contour of the cutout approx. 3 mm

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Neurology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (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)
  • Prostheses (AREA)

Abstract

The invention relates to an intervertebral disk prosthesis for the cervical spine, consisting of a disk-type body (10) with a hole (22). Said body (10) has an approximately rectangular shape. The lateral outer surfaces (12) and the ventral outer surface (14) are curved in a convex manner, while the dorsal outer surface (16) is curved in a concave manner. The cranial surface (18) and the caudal lower surface (20) are curved in a convex manner and have pyramidal teeth (24).

Description

Be s ehre ibung Be honored
Bandscheibenprothese für die Hals irbelsäuleIntervertebral disc prosthesis for the cervical spine
Die Erfindung betrifft eine Bandscheibenprothese für die Halswirbelsäule gemäß dem Oberbegriff des Anspruchs 1.The invention relates to an intervertebral disc prosthesis for the cervical spine according to the preamble of claim 1.
Bei Schädigungen der Bandscheiben, z. B. Bandscheibenvorfall, wird die schadhafte Bandscheibe entfernt und durch eine im- plantierte Bandscheibenprothese ersetzt. Eine solche Bandscheibenprothese für die Halswirbelsäule ist z. B. aus der WO 98/58604 bekannt. Diese Bandscheibenprothese besteht aus einem metallischen kreiszylindrischen Körper, der zwischen die Wirbelkörper eingesetzt wird. Zur Verankerung in den Wirbelkör- pern ist die kraniale Oberfläche und die kaudale Unterfläche des Körpers gezahnt.Damage to the intervertebral discs, e.g. B. herniated disc, the damaged intervertebral disc is removed and replaced with an implanted intervertebral disc prosthesis. Such an intervertebral disc prosthesis for the cervical spine is e.g. B. known from WO 98/58604. This intervertebral disc prosthesis consists of a metallic circular cylindrical body which is inserted between the vertebral bodies. The cranial surface and the caudal lower surface of the body are serrated for anchoring in the vertebral bodies.
Weiter ist es bekannt, Bandscheibenprothesen aus einem biokompatiblen Kunststoff zu fertigen, z. B. aus Polyetheretherketon (PEEK) .It is also known to manufacture intervertebral disc prostheses from a biocompatible plastic, e.g. B. from polyether ether ketone (PEEK).
Der Erfindung liegt die Aufgabe zugrunde, eine Bandscheibenprothese für die Halswirbelsäule zu schaffen, die die natürliche Bandscheibe anatomisch möglichst gut ersetzt und eine hohe Positionsstabilität gewährleistet.The invention has for its object to provide an intervertebral disc prosthesis for the cervical spine that anatomically replaces the natural intervertebral disc as well as possible and ensures high positional stability.
Diese Aufgabe wird erfindungsgemäß gelöst durch eine Bandscheibenprothese mit den Merkmalen des Anspruchs 1.This object is achieved according to the invention by an intervertebral disc prosthesis with the features of claim 1.
Vorteilhafte Ausführungen der Erfindung sind in den Unteransprüchen angegeben. Die erfindungsgemäße Bandscheibenprothese für die Halswirbelsäule weist eine in etwa rechteckige Außenkontur auf mit etwa parallel verlaufenden lateralen Außenflächen und etwa parallel verlaufender ventraler und dorsaler Außenfläche. Die lateralen Außenflächen und die ventrale Außenfläche sind vorzugsweise leicht konvex nach außen gewölbt. Die dorsale Außenfläche ist konkav nach innen gewölbt, sodass ein ausreichender Freiraum für den im Wirbelkanal verlaufenden Duralsack gewährleistet ist. Eine Kollision der Bandscheibenprothese mit dem Duralsack und eine evt . Schädigung des Duralsacks ist dadurch mit hoher Sicherheit ausgeschlossen.Advantageous embodiments of the invention are specified in the subclaims. The intervertebral disc prosthesis for the cervical spine has an approximately rectangular outer contour with approximately parallel lateral outer surfaces and approximately parallel ventral and dorsal outer surfaces. The lateral outer surfaces and the ventral outer surface are preferably slightly convexly curved outwards. The dorsal outer surface is concavely curved inwards, so that there is sufficient space for the dural sac running in the spinal canal. A collision of the intervertebral disc prosthesis with the dural sac and a possible Damage to the dural sac is therefore excluded with a high degree of certainty.
Die kraniale Oberfläche des Körpers der Bandscheibenprothese ist konvex ausgewölbt, sodass sich diese Oberfläche optimal der konkav gewölbten Deckplatte des Wirbelkörpers anpasst. Die Unterfläche des Körpers ist vorzugsweise ebenfalls leicht konvex ausgewölbt, wobei die Auswölbung der Oberfläche eine stärkere Krümmung, d. h. einen kleineren Krümmungsradius, als die Unterfläche aufweist.The cranial surface of the body of the intervertebral disc prosthesis is convexly curved, so that this surface adapts optimally to the concave arched cover plate of the vertebral body. The lower surface of the body is preferably also slightly convex, the bulging of the surface having a greater curvature, i. H. a smaller radius of curvature than the lower surface.
Die Oberfläche und die Unterfläche des Körpers weisen eine Zahnung auf, wobei diese vorzugsweise mit pyramidenförmigen Zähnen ausgebildet ist.The surface and the lower surface of the body have teeth, which is preferably formed with pyramidal teeth.
Der freie innere Ausschnitt des Körpers folgt in seiner Kontur im Wesentlichen der Außenkontur des Körpers, sodass die Oberfläche und die Unterfläche jeweils mit in etwa konstanter Breite über den gesamten Umfang verlaufen.The contour of the free inner cutout of the body essentially follows the outer contour of the body, so that the surface and the lower surface each run with an approximately constant width over the entire circumference.
Durch diese Gestaltung der Bandscheibenprothese passt sich der scheibenförmige Körper optimal der anatomischen Form der Wirbelkörper an. Die Oberfläche und die Unterfläche, welche die Wirbelkörper abstützen, verlaufen nahe am Außenumfang der Wir- beldeckplatten, sodass die Wirbel in dem Bereich abgestützt werden, in welchem die Knochensubstanz des Wirbelkörpers die höchste Stabilität aufweist. Im Bereich des spongiosen inneren Knochenbereichs der Wirbeldeckplatte, der eine geringere Sta- bilität und Tragfähigkeit aufweist, ist der Körper der Bandscheibenprothese durch den inneren Ausschnitt ausgespart . Dadurch wird in dem inneren Bereich, der zur Abstützung nicht wesentlich beitragen kann, Material eingespart, sodass das Gewicht der Bandscheibenprothese möglichst gering bleibt. Die Bandscheibenprothese bewirkt eine gleichmäßig über den Umfang verteilte Abstützung der Wirbel in deren tragfähigem Knochenbereich. Die rechteckige Form der Außenkontur und der Innenkontur ergeben zusammen mit der Zahnung eine hohe Verdrehsicherheit .This design of the intervertebral disc prosthesis optimally adapts the disc-shaped body to the anatomical shape of the vertebral body. The surface and the lower surface that support the vertebral bodies run close to the outer circumference of the vertebrae. cover plates, so that the vertebrae are supported in the area in which the bone substance of the vertebral body has the highest stability. In the area of the cancellous inner bone area of the vertebral cover plate, which has a lower stability and load-bearing capacity, the body of the intervertebral disc prosthesis is recessed by the inner cutout. This saves material in the inner area, which cannot make a significant contribution to the support, so that the weight of the intervertebral disc prosthesis remains as low as possible. The intervertebral disc prosthesis supports the vertebrae evenly over the circumference in their load-bearing bone area. The rectangular shape of the outer contour and the inner contour together with the toothing result in a high degree of security against rotation.
Die Bandscheibenprothese wird vorzugsweise in zwei Ausführungen hergestellt. In einer Ausführung verlaufen die Oberfläche und die Unterfläche im Wesentlichen parallel zueinander, während in der anderen Ausführung die Oberfläche und die Unter- fläche keilförmig zueinander verlaufen, wobei sich der Abstand von Oberfläche und Unterfläche von dorsal nach ventral vergrößert. Durch diese beiden Ausführungen ist eine optimale Anpassung an die anatomischen Gegebenheiten der zu ersetzenden Bandscheibe möglich.The intervertebral disc prosthesis is preferably manufactured in two versions. In one embodiment, the surface and the lower surface run essentially parallel to one another, while in the other embodiment the surface and the lower surface run in a wedge shape with one another, the distance from the surface and lower surface increasing from dorsal to ventral. These two designs allow optimal adaptation to the anatomical conditions of the intervertebral disc to be replaced.
Die Bandscheibenprothese wird vorzugsweise aus einem biokompatiblen Kunststoff mit geeigneten mechanischen Eigenschaften gefertigt, wobei sich Polyetheretherketon (PEEK) besonders eignet .The intervertebral disc prosthesis is preferably made from a biocompatible plastic with suitable mechanical properties, polyether ether ketone (PEEK) being particularly suitable.
Im Folgenden wird die Erfindung anhand eines in der Zeichnung dargestellten Ausführungsbeispieles näher erläutert. Es zeigen Fig. 1 eine axiale Draufsicht auf die Bandscheibenprothese,The invention is explained in more detail below on the basis of an exemplary embodiment shown in the drawing. Show it 1 is an axial plan view of the intervertebral disc prosthesis,
Fig. 2 eine laterale Seitenansicht der Bandscheibenprothese,2 shows a lateral side view of the intervertebral disc prosthesis,
Fig. 3 eine ventrale Seitenansicht der Bandscheibenprothese,3 is a ventral side view of the intervertebral disc prosthesis,
Fig. 4 einen Schnitt längs der Linie B-B in Fig. 3,4 shows a section along the line B-B in FIG. 3,
Fig. 5 eine perspektivische Ansicht der Bandscheibenprothese undFig. 5 is a perspective view of the intervertebral disc prosthesis and
Fig. 6 einen Fig. 4 entsprechenden Schnitt einer keilförmigen Ausführung der Bandscheibenprothese.6 a section corresponding to FIG. 4 of a wedge-shaped embodiment of the intervertebral disk prosthesis.
Die Bandscheibenprothese besteht aus einem flachen scheibenförmigen Körper 10, der vorzugsweise aus PEEK gefertigt ist. Der Körper 10 hat in der axialen Projektion etwa die Form eines Rechtecks mit abgerundeten Ecken. Die dorsal-ventrale Abmessung ist dabei etwas größer als die laterale Abmessung. Die lateralen Außenflächen 12 verlaufen dabei nicht exakt parallel, sondern unter einem kleinen Winkel, sodass der Abstand der lateralen Außenflächen 12 an der dorsalen Seite etwas geringer ist als an der ventralen Seite. Die lateralen Außenflächen 12 sind in der in Fig. 1 gezeigten axialen Projektion leicht konvex nach außen gewölbt.The intervertebral disc prosthesis consists of a flat disc-shaped body 10, which is preferably made of PEEK. The body 10 has approximately the shape of a rectangle with rounded corners in the axial projection. The dorsal-ventral dimension is slightly larger than the lateral dimension. The lateral outer surfaces 12 do not run exactly parallel, but at a small angle, so that the distance between the lateral outer surfaces 12 on the dorsal side is somewhat less than on the ventral side. In the axial projection shown in FIG. 1, the lateral outer surfaces 12 are curved slightly convexly outwards.
Ebenso ist die ventrale Außenfläche 14 leicht konvex nach außen gewölbt. Die dorsale Außenfläche 16 ist dagegen in der a- xialen Projektion konkav nach innen gewölbt, wobei der Krüm- mungsradius der Wölbung der dorsalen Außenfläche 16 kleiner ist als der Krümmungsradius der ventralen Außenfläche 14, d. h. die dorsale Außenfläche 16 ist stärker gekrümmt. Die kraniale Oberfläche 18 und die kaudale Unterfläche 20 des Körpers 10 sind jeweils konvex ausgewölbt. Die axiale Höhe des Körpers 10 nimmt somit gegen die lateralen Räder 12, den ventralen Rand 14 und den dorsalen Rand 16 ab. Dabei ist die kraniale Oberfläche 18 stärker ausgewölbt als die kaudale Unterfläche 20, weist also einen kleineren Krümmungsradius auf.The ventral outer surface 14 is also slightly convexly curved outwards. In contrast, the dorsal outer surface 16 is concavely curved inwards in the axial projection, the radius of curvature of the curvature of the dorsal outer surface 16 being smaller than the radius of curvature of the ventral outer surface 14, ie the dorsal outer surface 16 is more curved. The cranial surface 18 and the caudal lower surface 20 of the body 10 are each convexly curved. The axial height of the body 10 thus decreases against the lateral wheels 12, the ventral edge 14 and the dorsal edge 16. The cranial surface 18 is bulged more than the caudal lower surface 20, so it has a smaller radius of curvature.
Der Körper 10 weist einen inneren Ausschnitt 22 auf, der axial durchgehend ausgebildet ist. Der Ausschnitt 22 folgt in seiner Ümfangskontur der Außenumfangskontur des Körpers 10, wodurch die kraniale. Oberfläche 18 und die kaudale Unterfläche 20 die Form eines umlaufenden Streifens konstanter Breite haben, wie dies in Fig. 1 zu sehen ist.The body 10 has an inner cutout 22 which is axially continuous. The cutout 22 follows in its circumferential contour the outer circumferential contour of the body 10, as a result of which the cranial. Surface 18 and the caudal lower surface 20 have the shape of a circumferential strip of constant width, as can be seen in FIG. 1.
Die kraniale Oberfläche 18 und die kaudale Unterfläche 20 weisen jeweils ein gezahnte Struktur auf, die durch pyramidenförmige Zähne 24 gebildet ist.The cranial surface 18 and the caudal lower surface 20 each have a toothed structure, which is formed by pyramidal teeth 24.
Mittig in der ventralen Außenfläche 14 ist eine Gewindebohrung 26 vorgesehen, die von dieser Außenfläche 14 senkrecht durch den Körper 10 bis in den Ausschnitt 22 führt. In die Gewindebohrung 26 kann ein Positionierinstrument eingesetzt werden, welches der Handhabung der Bandscheibenprothese bei der Implantation dient.A threaded bore 26 is provided in the center of the ventral outer surface 14 and leads from this outer surface 14 perpendicularly through the body 10 into the cutout 22. A positioning instrument can be inserted into the threaded bore 26, which is used to handle the intervertebral disc prosthesis during implantation.
In einer Ausführung der Bandscheibenprothese verlaufen die kraniale Oberfläche 18 und die kaudale Unterfläche 20 im Wesentlichen parallel zueinander (abgesehen von der Oberflächenkrümmung) , wie dies in den Figuren 2 und 3 gezeigt ist.In one embodiment of the intervertebral disc prosthesis, the cranial surface 18 and the caudal lower surface 20 run essentially parallel to one another (apart from the surface curvature), as is shown in FIGS. 2 and 3.
In einer zweiten Ausführung, die in Fig. 6 gezeigt ist, verlaufen die kraniale Oberfläche 18 und die kaudale Unterfläche 20 keilförmig unter einem Winkel zueinander, wobei der Abstand der Oberfläche 18 und der Unterfläche 20 auf der ventralen Seite am größten ist und in dorsaler Richtung abnimmt.In a second embodiment, which is shown in FIG. 6, the cranial surface 18 and the caudal lower surface 20 run in a wedge shape at an angle to one another, the distance the surface 18 and the lower surface 20 is largest on the ventral side and decreases in the dorsal direction.
In einer beispielhaften Ausführung weist die Bandscheibenpro- these folgende Abmessungen auf:In an exemplary embodiment, the intervertebral disc prosthesis has the following dimensions:
Außenabmessung in ventral-dorsaler Richtung: ca. 14 mmExternal dimension in the ventral-dorsal direction: approx. 14 mm
Außenabmessung in lateraler Richtung: ca. 12 mmExternal dimension in the lateral direction: approx. 12 mm
Krümmungsradius der ventralen Außenfläche: ca. 24 mm Krümmungsradius der dorsalen Außenfläche: ca. 18 mmRadius of curvature of the ventral outer surface: approx. 24 mm Radius of curvature of the dorsal outer surface: approx. 18 mm
Krümmungsradius der lateralen Außenflächen: ca. 25 mmRadius of curvature of the lateral outer surfaces: approx. 25 mm
Axiale Höhe des Körpers: ca. 3-5 mmAxial height of the body: approx. 3-5 mm
Krümmungsradius der kranialen Oberfläche: ca. 30 mmRadius of curvature of the cranial surface: approx. 30 mm
Krümmungsradius der kaudalen Unterfläche: ca. 60 mmRadius of curvature of the caudal lower surface: approx. 60 mm
Breite der kranialen Oberfläche und der kaudalen Unterfläche zwischen Außenkontur und Innenkontur des Ausschnitts: ca. 3 mmWidth of the cranial surface and the caudal lower surface between the outer contour and the inner contour of the cutout: approx. 3 mm
Höhe der pyramidenförmigen Zähne: ca. 1 mmHeight of the pyramid-shaped teeth: approx. 1 mm
Flankenwinkel der Zähne: ca. 45° Winkel zwischen Oberfläche und Unterfläche bei der keilförmigen Ausbildung: ca. 15°Flank angle of the teeth: approx. 45 ° Angle between surface and bottom surface in the wedge-shaped configuration: approx. 15 °
Diese Abmessungen stellen nur bevorzugte Werte dar und sollen die Erfindung nicht einschränken. BezugszeichenlisteThese dimensions are only preferred values and are not intended to limit the invention. LIST OF REFERENCE NUMBERS
10 Körper10 bodies
12 laterale Außenflächen 14 ventrale Außenfläche12 lateral outer surfaces 14 ventral outer surfaces
16 dorsale Außenfläche16 dorsal outer surface
18 kraniale Oberfläche18 cranial surface
20 kaudale Unterfläche20 caudal sub-surface
22 Ausschnitt 24 Zähne22 cutout 24 teeth
26 Gewindebohrung 26 threaded hole

Claims

Patentansprüche claims
1. Bandscheibenprothese für die Halswirbelsäule, bestehend aus einem scheibenförmigen Körper (10) mit einem inneren Ausschnitt (22) und gezahnter Oberfläche (18) und Unterfläche (20), d a d u r c h g e k e n n z e i c h n e t, dass der Körper (10) aus einem biokompatiblen Kunststoff besteht, dass der Körper (10) etwa parallele laterale Außenflächen (12) und etwa parallele ventrale Außenfläche (14) und dorsale Außenfläche (16) aufweist, dass die dorsale Außenfläche (16) in axialer Projektion konkav nach innen gewölbt ist und dass die kraniale Oberfläche (18) konvex ausgewölbt ist .1. Intervertebral disc prosthesis for the cervical spine, consisting of a disc-shaped body (10) with an inner cutout (22) and toothed surface (18) and bottom surface (20), characterized in that the body (10) consists of a biocompatible plastic that Body (10) has approximately parallel lateral outer surfaces (12) and approximately parallel ventral outer surface (14) and dorsal outer surface (16), that the dorsal outer surface (16) is concavely curved inwards in axial projection and that the cranial surface (18) is convex.
Bandscheibenprothese nach Anspruch 1, d a d u r c h g e k e n n z e i c h n e t, dass die Innenkontur des Ausschnittes (22) im Wesentlichen der Außenkontur des Körpers (10) radial beabstandet folgt.Intervertebral disc prosthesis according to claim 1, so that the inner contour of the cutout (22) essentially follows the outer contour of the body (10) in a radially spaced manner.
Bandscheibenprothese nach Anspruch 1 oder 2, d a d u r c h g e k e n n z e i c h n e t, dass die ventrale Außenfläche (14) des Körpers (10) in axialer Projektion konvex nach außen gewölbt ist.Intervertebral disc prosthesis according to claim 1 or 2, so that the ventral outer surface (14) of the body (10) is convexly curved outwards in axial projection.
4. Bandscheibenprothese nach einem der vorhergehenden Ansprüche, d a d u r c h g e k e n n z e i c h n e t, dass die lateralen Außenflächen (12) in axialer Projektion konvex nach außen gewölbt sind.4. Intervertebral disc prosthesis according to one of the preceding claims, that the lateral outer surfaces (12) are convexly curved in an axial projection to the outside.
5. Bandscheibenprothese nach einem der vorhergehenden Ansprüche, d a d u r c h g e k e n n z e i c h n e t, dass die kaudale Unterfläche (20) konvex ausgewölbt ist.5. Intervertebral disc prosthesis according to one of the preceding claims, characterized in that the caudal lower surface (20) is convex.
6. Bandscheibenprothese nach Anspruch 5, d a d u r c h g e e n n z e i c h n e t, dass die Aus- wölbung der kranialen Oberfläche (18) stärker gekrümmt ist als die Auswölbung der kaudalen Unterfläche (29) .6. Intervertebral disc prosthesis according to claim 5, that the curvature of the cranial surface (18) is more curved than the curvature of the caudal lower surface (29).
7. Bandscheibenprothese nach einem der vorhergehenden Ansprü- ehe, d a d u r c h g e k e n n z e i c h n e t, dass die lateralen Außenflächen (12) von dorsal nach ventral leicht divergierend auseinanderlaufen.7. Intervertebral disc prosthesis according to one of the preceding claims, so that the lateral outer surfaces (12) diverge slightly from dorsal to ventral.
8. Bandscheibenprothese nach einem der Ansprüche 1-7, d a d u r c h g e k e n n z e i c h n e t, dass die kraniale Oberfläche (18) und die kaudale Unterfläche (20) des Körpers (10) im Wesentlichen parallel zueinander verlaufen.8. Intervertebral disc prosthesis according to one of claims 1-7, that the cranial surface (18) and the caudal lower surface (20) of the body (10) run essentially parallel to one another.
9. Bandscheibenprothese nach einem der Ansprüche 1-7, d a d u r c h g e k e n n z e i c h n e t, dass die kraniale Oberfläche (18) und die kaudale Unterfläche (20) des Körpers (10) unter einem sich von dorsal nach ventral er- weiternden Winkel keilförmig zueinander verlaufen.9. Intervertebral disc prosthesis according to any one of claims 1-7, that the cranial surface (18) and the caudal lower surface (20) of the body (10) run in a wedge shape with respect to one another at an angle widening from dorsally to ventrally.
10. Bandscheibenprothese nach einem der vorhergehenden Ansprüche, d a d u r c h g e k e n n z e i c h n e t, dass die kra- niale Oberfläche (18) und/oder die kaudale Unterfläche (20) pyramidenförmige Zähne (24) aufweisen. 10. Intervertebral disc prosthesis according to one of the preceding claims, characterized in that the cranial surface (18) and / or the caudal lower surface (20) have pyramidal teeth (24).
11. Bandscheibenprothese nach Anspruch 10, d a d u r c h g e k e n n z e i c h n e t, dass die Zähne (24) eine Höhe von ca. 1 mm und einen Flankenwinkel von ca. 45° aufweisen.11. Intervertebral disc prosthesis according to claim 10, that the teeth (24) have a height of approximately 1 mm and a flank angle of approximately 45 °.
12. Bandscheibenprothese nach einem der vorhergehenden Ansprüche, d a d u r c h g e k e n n z e i c h n e t, dass die radiale Breite der kranialen Oberfläche (18) und der kauda- len Unterfläche (20) zwischen dem inneren Ausschnitt (22) und den lateralen Außenflächen (12) bzw. der ventralen Außenfläche (14) und der dorsalen Außenfläche (16) etwa 3 mm beträgt.12. Intervertebral disc prosthesis according to one of the preceding claims, characterized in that the radial width of the cranial surface (18) and the caudal lower surface (20) between the inner cutout (22) and the lateral outer surfaces (12) or the ventral outer surface ( 14) and the dorsal outer surface (16) is approximately 3 mm.
13. Bandscheibenprothese nach einem der vorhergehenden Ansprüche, d a d u r c h g e k e n n z e i c h n e t, dass der Körper (10) aus Polyetheretherketon (PEEK) , besteht. 13. Intervertebral disc prosthesis according to one of the preceding claims, that the body (10) consists of polyether ether ketone (PEEK).
PCT/EP2004/002130 2003-03-06 2004-03-03 Intervertebral disk prosthesis for the cervical spine WO2004078075A1 (en)

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DE10309702A DE10309702A1 (en) 2003-03-06 2003-03-06 Intervertebral disc prosthesis for the cervical spine
DE10309702.3 2003-03-06

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US9132021B2 (en) 2011-10-07 2015-09-15 Pioneer Surgical Technology, Inc. Intervertebral implant
US11147682B2 (en) 2017-09-08 2021-10-19 Pioneer Surgical Technology, Inc. Intervertebral implants, instruments, and methods
USD907771S1 (en) 2017-10-09 2021-01-12 Pioneer Surgical Technology, Inc. Intervertebral implant

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