WO2006136937A2 - Dispositif de stabilisation spinale dynamique - Google Patents

Dispositif de stabilisation spinale dynamique Download PDF

Info

Publication number
WO2006136937A2
WO2006136937A2 PCT/IB2006/001713 IB2006001713W WO2006136937A2 WO 2006136937 A2 WO2006136937 A2 WO 2006136937A2 IB 2006001713 W IB2006001713 W IB 2006001713W WO 2006136937 A2 WO2006136937 A2 WO 2006136937A2
Authority
WO
WIPO (PCT)
Prior art keywords
screw
screw heads
tube
curved surfaces
nut
Prior art date
Application number
PCT/IB2006/001713
Other languages
English (en)
Other versions
WO2006136937A3 (fr
Inventor
Malan De Villiers
Original Assignee
Malan De Villiers
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 Malan De Villiers filed Critical Malan De Villiers
Publication of WO2006136937A2 publication Critical patent/WO2006136937A2/fr
Publication of WO2006136937A3 publication Critical patent/WO2006136937A3/fr

Links

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
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7019—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other
    • A61B17/7023—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other with a pivot joint
    • 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
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7004—Longitudinal elements, e.g. rods with a cross-section which varies along its length
    • A61B17/7008—Longitudinal elements, e.g. rods with a cross-section which varies along its length with parts of, or attached to, the longitudinal elements, bearing against an outside of the screw or hook heads, e.g. nuts on threaded rods
    • 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
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7014—Longitudinal elements, e.g. rods with means for adjusting the distance between two screws or hooks

Definitions

  • THIS invention relates to a posterior dynamic spinal stabilisation device.
  • Devices of the type with which the present invention is concerned are used to re-stabilise a spinal joint, typically in the lumbar region, without involving intervertebral discs or facet joints.
  • a typical example of a known device is that available under the trade mark Dynesys ® This known device makes use of pedicle screws, one or more spacers and a flexible cord. The pedicle screws are engaged in spaced apart holes formed in neighbouring lumbar vertebrae. One or more tubular spacers are located between the outer ends of the pedicle screws with the bore(s) of the spacer(s) aligned with eyes at those outer ends.
  • the cord is passed through the eyes and through the bore(s) of the spacer(s) and is anchored to the heads of the screws by clamping fasteners screwed into bores intersecting the eyes so as to clamp the cord. Such clamping is carried out after the cord has been appropriately tensioned using a separate tensioning tool. Ends of the cord which extend beyond the pedicle screws are trimmed off and the surgical wound is closed and allowed to heal.
  • the above procedure serves to stabilise the spinal segment under consideration while the flexibility of the cord and limited flexibility of the spacer(s) still allow some motion to take place.
  • the cord being anchored to the vertebrae, acts in the manner of a stabilising ligament.
  • the procedure can distract the spinal segment in order to decompress the spinal disc(s), inter alia in the treatment of indications such as degenerative disc disease, disc herniation and spinal stenosis.
  • the level of distraction is a function inter alia of the length of the spacer(s) between the pedicle screws.
  • cords because of the material of which they are made, can be a potential cause of infection at the stabilisation site.
  • the present invention seeks to provide an alternative posterior dynamic spinal stabilisation device.
  • a posterior dynamic spinal stabilisation device comprising pedicle screws engagable with respective spinal vertebrae, tie means for connecting protruding heads of the screws to one another and spacing means, located between the screw heads, for setting the distance between the screw heads, the spacing means being of adjustable length for selective setting of the distance between the screw heads.
  • the spacing means is conveniently telescopically adjustable in length. It may for instance include an externally threaded tube through which the tie means extends and at least one nut threadable on one end of the tube to define, in combination with the tube, a spacing means of telescopic construction and adjustable length. There may be a single nut threadable on one end of the tube and arranged to bear on one of the screw heads and a fixed abutment at the other end of the tube and arranged to bear on the other of the screw heads. To facilitate rotational movement in the device, the screw heads will typically have curved surfaces and the nut and abutment have correspondingly curved surfaces arranged to bear on the curved surfaces of the screw heads.
  • rotational movement is facilitated by the fact that the screw heads have curved surfaces and the washers have correspondingly curved surfaces arranged to bear on the curved surfaces of the screw heads, and the fact that the nut and the abutment have curved surfaces arranged to bear on correspondingly curved surfaces of the washers.
  • each screw has an outer end, a hollow screw head which has a curved external surface and which locates on the outer end and transverse, alignable passages through the screw head and outer end to receive the tie means.
  • Figure 1 shows a perspective view of a posterior dynamic spinal stabilisation device according to the present invention
  • Figure 2 shows a cross-sectional view of the device seen in Figure 1 ;
  • Figure 3 shows a perspective view of another embodiment of posterior dynamic spinal stabilisation device according to the invention;
  • Figure 4 shows a cross-sectional view of the device seen in Figure 3.
  • Figure 5 illustrates the manner in which the device of Figure 4 is installed in a spinal segment in use.
  • a first embodiment of posterior dynamic spinal stabilisation device 10 is illustrated in Figures 1 and 2.
  • the device 10 includes first and second, identical pedicle screws 12, a tie means 14 and a spacing structure 16.
  • the tie means 14 may be in the form of a cable as illustrated or, for instance, in the form of a slender, resilient rod.
  • the pedicle screws 12 have threaded screw portions 18 which can be screwed into holes 20 reamed posteriorly in respective spinal vertebrae 22 in a spinal segment 24 requiring stabilisation, as shown in Figure 5.
  • Each screw 12 also has a hollow, generally spherical head 26 which locates, through a Morse taper configuration, on the outer end 27of the screw 12 such that passages 28 and 29 extending through the head 26 and end 27 are in diametrical alignment with one another.
  • a threaded hole 30 intersects each passage 29 as illustrated.
  • the mouth of the hole is located centrally along a slot 32 in the end 27 which can be engaged by a screwdriver or other appropriate tool for the purposes of screwing the screw 12 into a hole 20.
  • the cable 14 in the illustrated embodiment is of twisted strand type and is made of stainless steel or other appropriate non-allergenic and corrosion- proof material. As illustrated, the cable passes through the passages 28 and 29 and can be clamped relative to the screw heads 26 by grub screws 34 screwed into the holes 30 so as to press against the cable inside the passages 29.
  • the spacing structure 16 includes an externally threaded tube 36 which is located between the screw heads 26.
  • the cable 14 passes through the tube.
  • the tube has a length less than the desired spacing of the screw heads 26 and carries an abutment 38 and an internally threaded, elongate nut 40. End surfaces 42, 44 of the abutment and nut are spherically concave with each surface having a curvature matching the curvature of a screw head 26.
  • the abutment 38 is positioned at the end of the tube 36 such that its end surface 42 can bear against the surface of the relevant screw head 26.
  • the nut 40 is threaded along the tube in a direction away from the abutment 38, such that the end surface 44 is located beyond the other end of the tube and bears against the other screw head 26.
  • the threaded nature of the connection between the nut and the tube provides a substantial mechanical advantage to facilitate the distraction of the vertebrae.
  • the abutment 38 and nut 40 have portions 46, 48 which are hexagonal in cross-section for engagement by a spanner or the like to facilitate rotation and the distraction process.
  • a locking nut 49 may be provided on the tube 36, inwardly of the nut 40, to lock that nut at the correct longitudinal position on the tube.
  • the cable 14 may be anchored to the respective pedicle screws by tightening down the grub screws 34, as described above, before the length of the spacing structure 16 is set. Accordingly as the length of the spacing structure is increased to the desired value the cord is placed under tension. It will however be understood that it would also be possible to set the desired length of the spacing structure before anchoring the cord.
  • the interaction of the end surfaces 42, 44 of the abutment 38 and nut 40 with the spherical surfaces of the screw heads 26 allows for some rotational movement in the spinal segment 24 while the device as a whole provides stabilisation to that segment even though the spacing structure 16 is itself rigid after installation.
  • FIGS 3 and 4 illustrate another embodiment of the invention which allows for some rotational movement in the spinal segment.
  • components corresponding to components seen in Figures 1 and 2 are designated by the same reference numerals.
  • Figures 3 and 4 differs from that of Figures 1 and 2 primarily in the inclusion of pairs of annular, spherically domed washers 50. These are located on the cable 14 beyond the ends of the tube 36, i.e. between the abutment 38 and nut 40 and the respective screw heads 26. Thus the abutment 38 and nut 40 do not bear directly on the screw heads as in the first embodiment. A limited degree of rotational movement is allowed by the interactions between the abutment, associated washer 50 and associated screw head 26 on the one hand and between the nut, associated washer 50 and associated screw head 26 on the other hand.
  • the washers 50, abutment 38 and nut 40 are formed with laterally projecting flanges 52 which, by abutment with one another, limit the amount of articulation which take place.
  • the outer surfaces of the abutment 38 and nut 40 have concave curvatures matching the convex curvatures on the inner surfaces of the washers 50. This facilitates rotational movement of the abutment, nut and washers relative to one another.
  • Both of the embodiments described above have a single threaded nut which is adjustable on the tube 36, but it will be understood that suitable telescopic adjustability of the length of the structure 16 could be obtained in each case with two nuts, one at each end of the tube. So 1 for instance, in the embodiment of Figures 1 and 2, the abutment 38 could be replaced by a threaded nut which will bear against the adjacent screw head 26. Both this nut and the nut 40 may then be adjusted rotationally on the tube 36 in order to adjust the overall length of the structure 16 and accordingly the degree to which the vertebrae are distracted.

Landscapes

  • 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)
  • Surgical Instruments (AREA)
  • Prostheses (AREA)

Abstract

L'invention concerne un dispositif de stabilisation (10) spinale postérieure dynamique pouvant être utilisé pour stabiliser une partie spinale, en général, une région lombaire. Ledit dispositif comprend des vis pédiculaires (12) pouvant être vissées dans des trous alésés dans des vertèbres respectives. Un câble souple (14) connecte les têtes saillantes (26) des vis les unes aux autres, une structure d'espacement (16) étant placée entre lesdites têtes de vis. Cette structure d'espacement est utilisée pour régler la distance entre les têtes de vis et présente une longueur, de préférence, télescopiquement réglable.
PCT/IB2006/001713 2005-06-24 2006-06-23 Dispositif de stabilisation spinale dynamique WO2006136937A2 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
ZA2005/05133 2005-06-24
ZA200505133 2005-06-24

Publications (2)

Publication Number Publication Date
WO2006136937A2 true WO2006136937A2 (fr) 2006-12-28
WO2006136937A3 WO2006136937A3 (fr) 2007-03-22

Family

ID=37027847

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IB2006/001713 WO2006136937A2 (fr) 2005-06-24 2006-06-23 Dispositif de stabilisation spinale dynamique

Country Status (1)

Country Link
WO (1) WO2006136937A2 (fr)

Cited By (15)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2010075400A1 (fr) * 2008-12-22 2010-07-01 Synthes Usa, Llc Tige de fixation de la colonne vertébrale à tension variable
US8034085B2 (en) 2004-05-28 2011-10-11 Depuy Spine, Inc. Non-fusion spinal correction systems and methods
US8357182B2 (en) 2009-03-26 2013-01-22 Kspine, Inc. Alignment system with longitudinal support features
US8920472B2 (en) 2011-11-16 2014-12-30 Kspine, Inc. Spinal correction and secondary stabilization
US9011491B2 (en) 2004-08-03 2015-04-21 K Spine, Inc. Facet device and method
US9333009B2 (en) 2011-06-03 2016-05-10 K2M, Inc. Spinal correction system actuators
US9451987B2 (en) 2011-11-16 2016-09-27 K2M, Inc. System and method for spinal correction
US9468468B2 (en) 2011-11-16 2016-10-18 K2M, Inc. Transverse connector for spinal stabilization system
US9468471B2 (en) 2013-09-17 2016-10-18 K2M, Inc. Transverse coupler adjuster spinal correction systems and methods
US9468469B2 (en) 2011-11-16 2016-10-18 K2M, Inc. Transverse coupler adjuster spinal correction systems and methods
US9510865B2 (en) 2008-11-11 2016-12-06 K2M, Inc. Growth directed vertebral fixation system with distractible connector(s) and apical control
US9827022B2 (en) 2009-09-15 2017-11-28 K2M, Llc Growth modulation system
US10603091B2 (en) 2014-02-24 2020-03-31 Curtin University Of Technology Fastener
US10702311B2 (en) 2011-11-16 2020-07-07 K2M, Inc. Spinal correction and secondary stabilization
US10729480B2 (en) 2016-03-18 2020-08-04 Curtin University Expandable fastener for orthopaedic applications

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5330474A (en) * 1991-09-23 1994-07-19 Lin Chih I Vertebral locking and retrieving system
US5413602A (en) * 1991-09-30 1995-05-09 Howmedica Gmbh Vertebral body spacer device
FR2794357A1 (fr) * 1999-06-01 2000-12-08 Frederic Fortin Dispositif de distraction pour les os d'enfants possedant des moyens d'accrochage et de reglage permettant de suivre leur croissance
US20050085815A1 (en) * 2003-10-17 2005-04-21 Biedermann Motech Gmbh Rod-shaped implant element for application in spine surgery or trauma surgery, stabilization apparatus comprising said rod-shaped implant element, and production method for the rod-shaped implant element

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5330474A (en) * 1991-09-23 1994-07-19 Lin Chih I Vertebral locking and retrieving system
US5413602A (en) * 1991-09-30 1995-05-09 Howmedica Gmbh Vertebral body spacer device
FR2794357A1 (fr) * 1999-06-01 2000-12-08 Frederic Fortin Dispositif de distraction pour les os d'enfants possedant des moyens d'accrochage et de reglage permettant de suivre leur croissance
US20050085815A1 (en) * 2003-10-17 2005-04-21 Biedermann Motech Gmbh Rod-shaped implant element for application in spine surgery or trauma surgery, stabilization apparatus comprising said rod-shaped implant element, and production method for the rod-shaped implant element

Cited By (32)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8506602B2 (en) 2004-05-28 2013-08-13 DePuy Synthes Products, LLC Non-fusion spinal correction systems and methods
US8034085B2 (en) 2004-05-28 2011-10-11 Depuy Spine, Inc. Non-fusion spinal correction systems and methods
US9011491B2 (en) 2004-08-03 2015-04-21 K Spine, Inc. Facet device and method
US9451997B2 (en) 2004-08-03 2016-09-27 K2M, Inc. Facet device and method
US9510865B2 (en) 2008-11-11 2016-12-06 K2M, Inc. Growth directed vertebral fixation system with distractible connector(s) and apical control
US10842536B2 (en) 2008-11-11 2020-11-24 K2M, Inc. Growth directed vertebral fixation system with distractible connector(s) and apical control
WO2010075400A1 (fr) * 2008-12-22 2010-07-01 Synthes Usa, Llc Tige de fixation de la colonne vertébrale à tension variable
US8845690B2 (en) 2008-12-22 2014-09-30 DePuy Synthes Products, LLC Variable tension spine fixation rod
US9173681B2 (en) 2009-03-26 2015-11-03 K2M, Inc. Alignment system with longitudinal support features
US11154329B2 (en) 2009-03-26 2021-10-26 K2M, Inc. Semi-constrained anchoring system
US8357183B2 (en) 2009-03-26 2013-01-22 Kspine, Inc. Semi-constrained anchoring system
US9358044B2 (en) 2009-03-26 2016-06-07 K2M, Inc. Semi-constrained anchoring system
US8357182B2 (en) 2009-03-26 2013-01-22 Kspine, Inc. Alignment system with longitudinal support features
US9827022B2 (en) 2009-09-15 2017-11-28 K2M, Llc Growth modulation system
US10736669B2 (en) 2009-09-15 2020-08-11 K2M, Inc. Growth modulation system
US9408638B2 (en) 2011-06-03 2016-08-09 K2M, Inc. Spinal correction system actuators
US10675062B2 (en) 2011-06-03 2020-06-09 K2M, Inc. Spinal correction system actuators
US9333009B2 (en) 2011-06-03 2016-05-10 K2M, Inc. Spinal correction system actuators
US9895168B2 (en) 2011-06-03 2018-02-20 K2M, Inc. Spinal correction system actuators
US9468469B2 (en) 2011-11-16 2016-10-18 K2M, Inc. Transverse coupler adjuster spinal correction systems and methods
US9757157B2 (en) 2011-11-16 2017-09-12 K2M, Inc. System and method for spinal correction
US9827017B2 (en) 2011-11-16 2017-11-28 K2M, Inc. Spinal correction and secondary stabilization
US8920472B2 (en) 2011-11-16 2014-12-30 Kspine, Inc. Spinal correction and secondary stabilization
US9451987B2 (en) 2011-11-16 2016-09-27 K2M, Inc. System and method for spinal correction
US10342581B2 (en) 2011-11-16 2019-07-09 K2M, Inc. System and method for spinal correction
US9113959B2 (en) 2011-11-16 2015-08-25 K2M, Inc. Spinal correction and secondary stabilization
US10702311B2 (en) 2011-11-16 2020-07-07 K2M, Inc. Spinal correction and secondary stabilization
US11013538B2 (en) 2011-11-16 2021-05-25 K2M, Inc. System and method for spinal correction
US9468468B2 (en) 2011-11-16 2016-10-18 K2M, Inc. Transverse connector for spinal stabilization system
US9468471B2 (en) 2013-09-17 2016-10-18 K2M, Inc. Transverse coupler adjuster spinal correction systems and methods
US10603091B2 (en) 2014-02-24 2020-03-31 Curtin University Of Technology Fastener
US10729480B2 (en) 2016-03-18 2020-08-04 Curtin University Expandable fastener for orthopaedic applications

Also Published As

Publication number Publication date
WO2006136937A3 (fr) 2007-03-22

Similar Documents

Publication Publication Date Title
WO2006136937A2 (fr) Dispositif de stabilisation spinale dynamique
US6802844B2 (en) Spinal alignment apparatus and methods
US8088149B2 (en) Dynamic intervertebral stabilization system
US8414618B2 (en) Elastic stabilization system for vertebral columns
US5196013A (en) Pedicel screw and correcting and supporting apparatus comprising such screw
US5468241A (en) Support device for the human vertebral column
US7682379B2 (en) Device for osteosynthesis
US7658754B2 (en) Method for the correction of spinal deformities using a rod-plate anterior system
US7914536B2 (en) Bone repair device and method
US8979902B2 (en) Dynamic stabilization device for bones or vertebrae
US6709434B1 (en) Spinal osteosynthesis device
AU687698B2 (en) Spinal fixation system
KR960004979B1 (ko) 척추골 유지 장치
US20140031868A1 (en) Flexible stabilization device for dynamic stabilization of bones or vertebrae
US20100286730A1 (en) Implant for correction of spinal deformity
US20110144692A1 (en) Interspinous spacer assembly
US20070270860A1 (en) Dynamic stabilization connecting member with slitted core and outer sleeve
AU2002252625A1 (en) Spinal alignment apparatus and methods
EP0506420A1 (fr) Dispositif de fixation osseuse
JPH03500259A (ja) 特定的には脊柱のための、矯正および支持装置
EP0999795A1 (fr) Dispositif pour le raidissement ou la correction de la colonne vertebrale ou autre
EP1682016A2 (fr) Systeme de fixation pour os comprenant un element d'attache a faible encombrement

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application
NENP Non-entry into the national phase in:

Ref country code: DE

WWW Wipo information: withdrawn in national office

Country of ref document: DE

122 Ep: pct application non-entry in european phase

Ref document number: 06755962

Country of ref document: EP

Kind code of ref document: A2