WO2006106246A2 - Implant chirurgical intervertébral formant rotule - Google Patents
Implant chirurgical intervertébral formant rotule Download PDFInfo
- Publication number
- WO2006106246A2 WO2006106246A2 PCT/FR2006/000791 FR2006000791W WO2006106246A2 WO 2006106246 A2 WO2006106246 A2 WO 2006106246A2 FR 2006000791 W FR2006000791 W FR 2006000791W WO 2006106246 A2 WO2006106246 A2 WO 2006106246A2
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- association
- surgical implant
- groove
- spinous process
- implant according
- Prior art date
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7053—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant with parts attached to bones or to each other by flexible wires, straps, sutures or cables
Definitions
- the invention relates to a surgical implant for maintaining and assisting the movement of two successive vertebrae together.
- EP-0 392 124 discloses a surgical implant for preventing mutual contact of the vertebrae, comprising an intervertebral spacer.
- the wedge comprises upper and lower grooves for receiving the spinous processes of the vertebrae disposed on either side of the wedge. Such a wedge makes it possible to prevent the contact of the vertebrae with each other while allowing the relative movement thereof.
- This surgical implant has several disadvantages. Indeed, the relative movement of the vertebrae is not assisted by the implant, the vertebrae can move relative to each other by providing a game in the maintenance of spinous processes in the throats. Such a game, however, does not ensure effective maintenance of the wedge between the vertebrae and a poor positioning of the apophyses in the grooves can then occur, thus reducing the effectiveness of the implant. In addition, such a game can also cause movements harmful to the logical operation of the spine.
- the invention aims to overcome these disadvantages by proposing a surgical implant intended to maintain and assist the movement of two successive vertebrae together, assisting the relative movement of the vertebrae together and thus allowing effective clamping of the implant around the spinous processes.
- vertebrae. successive to each other said implant comprising an upper part and a lower part intended to be each associated with the spinous process of one of said vertebrae, said parts each comprising a means of association with an apophysis and reciprocal means of association with rotation to the other part, said means forming a ball joint.
- the surgical implant also comprises a viscoelastic element interposed between the upper and lower parts and arranged to allow the absorption of the energy of the shocks and to allow relative movement between the vertebrae.
- This interposed intermediate element provided with a certain elasticity allows a compression deformation and distraction between the upper and lower parts.
- the viscoelastic element allows flexion, extension or even lateral inflection of the spine.
- the patella formed by the means of reciprocal association makes it possible to form a joint assisting the movement of the vertebrae between them, the vertebral column thus recovering a natural mobility without excessive movements, mobility identical to a healthy spine.
- the means of association with the apophyses have an anatomical form. Indeed, they are adapted to the shape of the spinous processes to which they are destined to be associated. Thus, a better stability of the means of association with the apophyses is ensured and the intervention to modify the shape of the spinous processes is less heavy.
- the invention in another aspect, relates to connecting device for associating at least two parts together, said parts being either an implant or a bone structure.
- the connecting device comprises a flexible band, at least one fastening element of the band for attaching said band surrounding all or part of said parts, said attachment member comprising a light arranged to be traversed by said band, and clamping means for adjusting the clamping of the band around said parts.
- the notching of the band and the projection of the fastening element are arranged to allow unidirectional sliding of the band in the fastening element as it passes through the light.
- the fastening element is provided at one end of the strip.
- the projection formed in the light extends towards the face of the strip opposite to the face bearing the notch.
- the connecting device comprises two fastening elements able to be traversed respectively by one of the ends of the strip, each fastener element being configured to slide unidirectionally on the strip, in the opposite direction to the end on which it is mounted.
- the band comprises on one of its faces two distinct notches, each notch being intended to cooperate with one of said fastening elements.
- said fastening elements are connected and arranged between them so as to form a means of association with one of the parts.
- they have a shape substantially complementary to that of the part of the room to which it is intended to be associated, in particular to ensure a better stability of the association means on the part with which it is in contact.
- FIG. 1 is a schematic perspective view of a surgical implant according to the invention.
- FIG. 2 is a schematic front view of the implant of FIG. 1.
- FIG. 3 is a schematic representation in partial section of the implant along the axis III-III of FIG. 1.
- FIG. 4 is a schematic representation in partial section of the implant along the axis IV-IV of FIG. 2.
- FIG. 5 is a schematic representation in perspective of two successive implants according to the invention, said implants being associated with each other
- FIG. 6 is a diagrammatic representation in perspective of two successive implants according to the invention, said implants being integral with a rod piece.
- FIG. 7 is a schematic representation in perspective of two successive implants according to the invention, said implants being secured by an intermediate piece.
- FIG. 8 is a schematic perspective representation of an association device according to a first configuration of the invention.
- FIG. 9 is a diagrammatic representation in section of the association device along the axis IX-IX of FIG. 8.
- Figure 10 is a schematic sectional representation of the association device of Figure 9, in the attachment position.
- FIG. 11 is a schematic perspective representation of an association device according to a third configuration of the invention.
- FIG. 12 is a diagrammatic representation in section of the association device along the axis XII-XII of FIG. 11.
- Figure 13 is a schematic perspective representation of an association device according to a fourth configuration of the invention.
- FIG. 14 is a schematic representation in section of the association device along the axis XIV-XIV of FIG. 14.
- a surgical implant 1 comprising an upper part 2 and a lower part 3 intended to be each associated with the spinous process of two successive vertebrae arranged one above the other.
- the upper 2 and lower 3 parts are preferably made of a plastic material such as a solid polymer to ensure a certain rigidity of the implant.
- a material such as PEEK is used.
- the PEEK has the advantages of being close to the bone according to its mechanical characteristics, but it is quite possible to make these parts 2 and 3 in metallic materials such as titanium or stainless steel.
- Parts 2 and 3 each comprise a means of association, respectively 4 and 5, to an apophysis.
- the association means 4 and 5 each comprise a groove, respectively 6 and 7, and an attachment means, 8 and 9, respectively, for attachment to the spinous process of the vertebra to which the workpiece is intended to be associated.
- the attachment means are intended to surround the spinous process of the vertebra to which the part 2 or 3 is intended to be associated.
- the groove 6 of the upper part 2 has a shape substantially complementary to the lower part of the spinous process of the vertebra to which the part 2 is intended to be associated. As shown in FIG. 2, the groove 6 has a substantially U-shaped section. groove 6 is intended to receive the lower part of a spinous process, the latter being thicker than the upper part of this process, it is planned to adapt the shape of the groove 6 to that of the lower part of the apophysis to avoid major interventions on the process during implant placement. The U-shaped section allows such an adaptation.
- the groove 7 of the lower part 3 has a shape substantially complementary to the upper part of the spinous process of the vertebra to which the part 3 is intended to be associated. As shown in Figure 2, the groove 7 has a substantially V-shaped section. In fact, the groove 7 is intended to receive the upper part of a spinous process and, as indicated above, it is less thick than the lower part of this apophysis. It is therefore expected to adapt the shape of the groove 7 to that of the upper part of the process to, again, to avoid major interventions on the process during the installation of the implant.
- the V-shaped section allows such adaptation.
- the fastening means are clamps 8, 9.
- the clamps 8 and 9 may be identical for the upper 2 and lower parts 3, as shown in the figures. Therefore, only the collar 8 is now described.
- the collar 8 is associated with the upper part 2 on either side of the groove 6 and forms a loop with said groove.
- the collar 8 is secured to the rotating groove via fastening means 10.
- the fastening means 10 comprise a housing 11 disposed on one side of the groove 8 and secured thereto.
- the fastening means 10 further comprise a pivot 12 provided at an end portion of the clamping collar 8 and rotatably received in the housing 11.
- Other fastening means 10 could be envisaged, such as a pivot provided on one side of the groove 6 and passing through a hole provided in the end portion of the collar 8 or a pivot external passing through orifices provided on one side of the groove 6 and in the end portion of the collar 8.
- Any fastening means for securing the collar 8 to one side of the groove 6 can be used.
- clamping means 13 for adjusting the tightening of the collar 8 around the spinous process.
- These clamping means 13 may be of conventional type, for example by providing notches 14 on the collar 8 cooperating with a projection provided in a housing 15 on the other side of the groove 6 as shown in the figures.
- the collar 8 is secured to the groove by clamping means 13 disposed on both sides of said groove.
- the clamps are made of polymer and more particularly of nylon.
- the attachment means 8, 9 are not limited to clamps. Indeed, attachment means, known to those skilled in the art, such as ligaments, fixation screws or osteo-inductive or osteo-conductive coating can also be used.
- the clamps allow effective maintenance with the spinous process that does not degrade over time.
- the implant 1 may comprise a means of association with another implant 1.
- the means of association between the upper part 2 of one implant and the lower part 3 of the other implant also forms means of association with a spinous process.
- This means of association is for example formed by a clamping collar 8 forming association means for the upper part 2 of an implant and for the lower part 3 of the other implant.
- the space created between the two implants allows to receive a spinous process of a vertebra.
- three vertebrae are connected by means of surgical implants 1 according to the invention.
- association means between the upper part 2 of one implant and the lower part 3 of the other implant is a connecting rod 21.
- the means of association between the implants does not require to have a space to receive a spinous process.
- the means of association between the upper part 2 of one implant and the lower part 3 of the other implant is an intermediate piece of solid type 22 made integral with the upper part 2 of an implant and the lower part 3 of the other implant via one or more means (s) 8, 9.
- Parts 2 and 3 furthermore comprise mutually reciprocating association means 16 to the other part. As shown in the figures, these means 16 form a ball joint.
- the reciprocal association means 16 comprise a housing 17 provided on the upper part 2 and arranged to receive in rotation a protuberance 18 of the lower part 3.
- the housing 17 could be provided on the lower part 3 and the protuberance 18 on the upper part 2.
- the associating means 16 further comprises a viscoelastic element 19 interposed between the upper and lower parts 2 and 3 arranged to absorb the energy of shocks and movements between vertebrae.
- the viscoelastic element 19 is, for example, made of a polymeric material such as polyurethane (PU) or polycarbonate urethane (PCU).
- the reciprocal means 16 are arranged so that the rotation is only in the direction of movement of the vertebrae between them.
- the housing 17 has a substantially ovoidal section and comprises a slot
- the viscoelastic member 19 surrounds the protuberance 18 and presents a substantially complementary shape of the housing 17, as can be seen in Figures 3 and 4.
- the viscoelastic element 19 is for example fitted around the protrusion 18.
- the viscoelastic element 19 "fills" the housing 17, allows absorb the energy that could be transmitted from the upper part 2 to the lower part 3 both compression and distraction during an impact between two consecutive vertebrae and allows relative movement between the vertebrae.
- the housing 17 is open on one side to allow the mounting of the protuberance 18 and the viscoelastic element 19 inside the housing 17.
- the shape of the opening of the housing and the one of the housing 17 are arranged so that the introduction of the protrusion 18 and the viscoelastic element 19 in the housing is done by a slight rotation and not in translation.
- Such an assembly makes it possible to prevent the lower part 3 from coming out of the upper part 2 by translation once the implant 1 has been mounted. This ensures good maintenance of the parts relative to each other once the implant has been placed.
- the mounting of the parts 2 and 3 and the viscoelastic element 19 can also be made integrally during manufacture, and thus prevent any inadvertent disassembly parts.
- FIGS. 8 to 14 embodiments of a device for connecting at least two parts to each other are described, said parts being, or a surgical implant, or a bone structure. It is therefore, with the connecting device according to the invention:
- said bone structures may be optionally interspersed by one or more implants.
- Figures 8 to 10 illustrate a first configuration of such a connecting device.
- Said connecting device 30 comprises a flexible strap, preferably in the form of a strip 31, one end of which is provided with an attachment element 32 for assembling the strip 31 to form a connecting loop 40.
- said attachment member 32 comprises a slot 33 arranged to be traversed by said strip 31 at its other end.
- Said connecting device 30 further comprises clamping means for adjusting the clamping of the band 31 when it is arranged around the parts to be connected.
- These clamping means may be of conventional type. Thus, they may include a notch 34 provided on one side of the strip, which notch is intended to cooperate with at least one projection 35 provided in the light 33. In the embodiment described, the light 33 comprises three projections successive.
- the light 33 of the fastening element 32 is delimited by two walls 41, 42, the wall 41 being arranged in the extension of the strip 31.
- the projections 35 are arranged on the inside face of the wall 42, facing the wall 41.
- the notch 34 of the band 31 and the projections 35 of the fastening element 32 are arranged to allow unidirectional sliding of the band 31 in the fastening element 32. when it passes through the light 33.
- the clamping means thus form irreversible locking means. This locking is all the more reliable as the fastener element is provided with several projections.
- the notch 34 is formed on the half of the band 31 corresponding to the half nearest the free end (opposite end to said attachment means 32).
- Maintaining the pieces together is obtained by forming the connecting loop 40 around said parts and exerting a sliding clamping of the band in the light 33.
- the connecting device 30 comprises two attachment elements 32, 36 able to be traversed respectively by one of the ends 43, 44 of the band 31.
- each attachment member 32, 36 is configured to slide unidirectionally on the strip, in the opposite direction to the end of which it is mounted.
- the strip 31 comprises a non-toothed portion 46.
- said strip advantageously comprises three parts: two end portions 45, 47 respectively carrying, on the same face, a partial latch 34, 37, said end portions 45, 47 being spaced apart by the notched portion 46, not serrated.
- Each notch 34, 37 is intended to cooperate with one of said fastening elements 32, 36.
- This second configuration of the fixing device 30 requires that at least one of the parts comprises two through slots through which are intended to pass the ends of the band 31.
- the band 31 is disposed on the apophysis, the faces with the notches 34 and 37 being turned outward (as opposed to the inside of the connecting loop 40).
- the ends 43 and 44 of the band 31 are then each passed through a slot of the implant.
- the ends 43, 44 are then passed respectively through one of the fastening elements 32, 36.
- the fastening elements 32, 36 are in turn slid along the band 31 to abut against the implant, against the opening of the slot through which said band 31 exits.
- a tension force is then exerted jointly on each of the strands of the band 31 obtained at the outlet of the implant, and the respective fastening element, so as to exert a firm hold of the implant against the spinous process.
- the fastening elements 32, 36 are connected and arranged between them so as to form an association means 38 to one of the pieces.
- the association means 38 comprises a groove 39 of substantially complementary shape of the part of the part to which it is intended to be associated.
- the groove 39 has a substantially U-shaped section.
- the invention is not limited to such a configuration of the groove, and that any other shape having a conformation complementary to the room with which it is associated falls within the scope of this application.
- association means having a U-shaped groove, the surrounding loop, for example, the upper part of the spinous process of one of the upper vertebrae or an implant disposed between said vertebrae.
- the fixing device 30 is made of polymer, and more particularly nylon.
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Neurology (AREA)
- Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
- Materials For Medical Uses (AREA)
- Surgical Instruments (AREA)
Abstract
Description
Claims
Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP06743671A EP1865864A2 (fr) | 2005-04-08 | 2006-04-10 | Implant chirurgical intervertébral formant rotule |
JP2008504810A JP2008534199A (ja) | 2005-04-08 | 2006-04-10 | スイベル関節を形成する医療用椎間インプラント |
US11/887,970 US20090270918A1 (en) | 2005-04-08 | 2006-04-10 | Surgical Intervertebral Implant Forming a Swivel Joint |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
FR0503524 | 2005-04-08 | ||
FR0503524A FR2884136B1 (fr) | 2005-04-08 | 2005-04-08 | Implant chirurgical intervertebral formant rotule |
Publications (2)
Publication Number | Publication Date |
---|---|
WO2006106246A2 true WO2006106246A2 (fr) | 2006-10-12 |
WO2006106246A3 WO2006106246A3 (fr) | 2007-01-25 |
Family
ID=35124669
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/FR2006/000791 WO2006106246A2 (fr) | 2005-04-08 | 2006-04-10 | Implant chirurgical intervertébral formant rotule |
Country Status (5)
Country | Link |
---|---|
US (1) | US20090270918A1 (fr) |
EP (1) | EP1865864A2 (fr) |
JP (1) | JP2008534199A (fr) |
FR (1) | FR2884136B1 (fr) |
WO (1) | WO2006106246A2 (fr) |
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WO2007010140A1 (fr) * | 2005-07-21 | 2007-01-25 | Charles Khalife | Dispositif inter epineux rotatoire |
WO2007090009A1 (fr) * | 2006-01-27 | 2007-08-09 | Warsaw Orthopedic, Inc. | Dispositifs interepineux et procedes d'utilisation |
WO2008051802A2 (fr) | 2006-10-19 | 2008-05-02 | Simpirica Spine, Inc. | Procédés et systèmes de contrainte de segments spinaux multiples |
FR2908035A1 (fr) * | 2006-11-08 | 2008-05-09 | Jean Taylor | Implant interepineux |
WO2008073866A1 (fr) * | 2006-12-08 | 2008-06-19 | Warsaw Orthopedic, Inc. | Implants rachidiens de stockage d'énergie et procédés d'utilisation |
DE102006059395A1 (de) * | 2006-12-08 | 2008-06-19 | Aesculap Ag & Co. Kg | Implantat und Implantatsystem |
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US20100036424A1 (en) * | 2007-06-22 | 2010-02-11 | Simpirica Spine, Inc. | Methods and systems for increasing the bending stiffness and constraining the spreading of a spinal segment |
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US9717536B2 (en) | 2005-09-20 | 2017-08-01 | Zimmer Spine S.A.S. | Vertebral fixing system |
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US8162946B2 (en) | 2005-09-21 | 2012-04-24 | Zimmer Spine S.A.S. | Instrument for tensioning a flexible tie |
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WO2007090009A1 (fr) * | 2006-01-27 | 2007-08-09 | Warsaw Orthopedic, Inc. | Dispositifs interepineux et procedes d'utilisation |
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JP2010506694A (ja) * | 2006-10-19 | 2010-03-04 | シンピライカ スパイン, インコーポレイテッド | 複数の脊椎分節拘束用の方法およびシステム |
WO2008051802A2 (fr) | 2006-10-19 | 2008-05-02 | Simpirica Spine, Inc. | Procédés et systèmes de contrainte de segments spinaux multiples |
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JP2010508934A (ja) * | 2006-11-08 | 2010-03-25 | ジャン・テイラー | 棘状突起間移植片 |
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WO2008056237A3 (fr) * | 2006-11-08 | 2008-09-04 | Jean Taylor | Implant inter-épineux |
FR2908035A1 (fr) * | 2006-11-08 | 2008-05-09 | Jean Taylor | Implant interepineux |
JP2013135925A (ja) * | 2006-11-08 | 2013-07-11 | Jean Taylor | 棘状突起間移植片 |
DE102006059395A1 (de) * | 2006-12-08 | 2008-06-19 | Aesculap Ag & Co. Kg | Implantat und Implantatsystem |
US8313513B2 (en) | 2006-12-08 | 2012-11-20 | Aesculap Ag | Implant and implant system |
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US20100036424A1 (en) * | 2007-06-22 | 2010-02-11 | Simpirica Spine, Inc. | Methods and systems for increasing the bending stiffness and constraining the spreading of a spinal segment |
US8221464B2 (en) | 2007-09-25 | 2012-07-17 | Zimmer Spine, S.A.S. | Device for clamping two portions of a braid and an intervertebral implant comprising a spacer, a braid, and such a clamping device |
US8128635B2 (en) | 2007-10-23 | 2012-03-06 | Zimmer Spine S.A.S. | Bone fixation tensioning tool and method |
EP2098183A1 (fr) * | 2008-01-30 | 2009-09-09 | ARCA-MEDICA GmbH | Implant inter-épineux destiné à être implanté entre les apophyses épineuses de deux vertrèbres adjacentes |
US8845689B2 (en) | 2008-04-24 | 2014-09-30 | Zimmer Spine S.A.S. | System for stabilizing at least a portion of the spine |
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US8663283B2 (en) | 2008-05-20 | 2014-03-04 | Zimmer Spine S.A.S. | System for stabilizing at least two vertebrae |
Also Published As
Publication number | Publication date |
---|---|
FR2884136A1 (fr) | 2006-10-13 |
EP1865864A2 (fr) | 2007-12-19 |
FR2884136B1 (fr) | 2008-02-22 |
US20090270918A1 (en) | 2009-10-29 |
JP2008534199A (ja) | 2008-08-28 |
WO2006106246A3 (fr) | 2007-01-25 |
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