WO2007011213A1 - Medical device for positioning bone elements - Google Patents

Medical device for positioning bone elements Download PDF

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Publication number
WO2007011213A1
WO2007011213A1 PCT/NL2006/000376 NL2006000376W WO2007011213A1 WO 2007011213 A1 WO2007011213 A1 WO 2007011213A1 NL 2006000376 W NL2006000376 W NL 2006000376W WO 2007011213 A1 WO2007011213 A1 WO 2007011213A1
Authority
WO
WIPO (PCT)
Prior art keywords
medical device
pins
vertebrae
intervertebral disc
elements
Prior art date
Application number
PCT/NL2006/000376
Other languages
French (fr)
Inventor
Gert Nijenbanning
Original Assignee
Axis Spine
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 Axis Spine filed Critical Axis Spine
Publication of WO2007011213A1 publication Critical patent/WO2007011213A1/en

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
    • A61B17/7011—Longitudinal element being non-straight, e.g. curved, angled or branched
    • 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
    • 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
    • A61B17/7022—Tethers, i.e. longitudinal elements capable of transmitting tension only, e.g. straps, sutures or cables
    • 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
    • A61B17/7026—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other with a part that is flexible due to its form
    • 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
    • A61B17/7032—Screws or hooks with U-shaped head or back through which longitudinal rods pass

Definitions

  • the invention relates to a medical device for positioning bone elements, in particular vertebrae, relative to each other, comprising at least one assembly built up of two or more anchoring elements, which can each be implanted in a bone element with a first end thereof, as well as an elongated connecting element, which can be connected to the other ends of the anchoring elements extending from the bone element in question.
  • Such medical devices are generally known, they are used for positioning or fixating adjacent vertebrae whose intervertebral disc is damaged and/or has lost its function relative to each other. Examples of such medical solutions are shown in WO 01/45576 and WO 02/102259.
  • the connecting elements used therein are made of a flexible material and they are implanted on either side of the vertebrae.
  • the object of the invention is to obviate the above drawbacks of a medical device as referred to in the introductory paragraph and to provide an improved version that makes it possible to position adjacent vertebrae relative to each other in such a manner that movement of the vertebrae towards each other is no longer possible and that thus the intervertebral disc is no longer loaded.
  • the connecting element is to that end built up of two straight pins, which pins are each connected to the anchoring element at spaced-apart positions with their ends.
  • a further constant position of the adjacent vertebrae relative to each other is achieved in particular if, according to a specific embodiment, the two straight pins extend parallel to each other.
  • the two straight pins lie in a plane posterior to the spine, as a result of which the implantation of the device into a patient's back can be carried out with a minimum burden for the patient.
  • a further immobilisation of the vertebrae and reduction of the load on the intervertebral disc can be realised in that in one embodiment at least one of said pins is rigid in longitudinal direction.
  • both pins are rigid in longitudinal direction, this in order to enhance the immobilisation of the vertebrae and the reduction of the load on the intervertebral disc.
  • the other pin is flexible in longitudinal direction.
  • the points of attachment of the two rigid pins are spaced the same distance apart, whilst in another functional embodiment the points of attachment of the two rigid pins are not spaced the same distance apart.
  • Figures 1a-1b show two embodiment is of a medical device according to the prior art.
  • Figure 2 shows an embodiment of a medical device according to the invention.
  • Figures 1a and 1b show two embodiments of a prior art medical device for positioning bone elements, in particular vertebrae, relative to each other.
  • two vertebrae are schematically indicated at 12 and 14, which vertebrae are separated by an intervertebral disc 16.
  • the intervertebral disc 16 In the situation in which the intervertebral disc 16 is damaged or otherwise affected it may be desirable to position the vertebrae 12 and 14 positioned thereabove and therebelow, respectively, relative to each other, to which end use is made in figure 1a of a medical device that is built up at least of an assembly comprising two anchoring elements 20, which can be placed in the vertebrae 12 and 14 with their distal ends 20a and 20b, respectively.
  • a connecting element 18 may be provided between the two adjacent anchoring elements 20 at the other ends 20c-20d of the anchoring elements 20, which connecting element can be attached with its ends 18b to the two other ends 20c-20d of the anchoring elements 20 that, extend from the bone elements.
  • the aim of the prior art embodiment as shown in figure 1a is to effect an adequate positioning or fixation of the two vertebrae 12-14 relative to each other, in order to reduce the load on the intervertebral disc 16, which is affected in many cases, the construction that is shown in figure 1a is often not satisfactory. This is caused by the use of a flexible or springing central part of 18a of the connecting element 18, which allows bending, turning or twisting movements of the spine and consequently of the two vertebrae 12-14 with respect to each other. This leads to an increased load on the intervertebral disc and the facet joints, which is unpleasant for the patient.
  • FIG. 1 b A similar prior art embodiment is shown in figure 1 b, which likewise employs connecting elements 18-18', which are similarly connected to anchoring elements 20, which are likewise placed in a vertebra 12, 14 with their first end 20b.
  • connecting elements 18-18' are used, so that a turning or twisting movement of the back is possible at all times, as a result of which the vertebrae 12-14 move relative to each other, in particular towards each other, and the intervertebral disc 16 can accordingly be loaded or compressed.
  • This known embodiment does not provide such a position or orientation of the vertebrae 12-14 disposed on either side of the affected intervertebral disc 16, either. In this case, too, the intervertebral disc 16 is still subjected to loads, with only adverse consequences for the patient.
  • Figure 2 shows an embodiment of the medical device according to the invention which employs two connecting elements 18-18' that are essentially rigid in longitudinal direction.
  • two assemblies each consisting of two connecting elements 18-18' (four in total), are used for thus realising a proper orientation or fixation or positioning of the two vertebrae 12-14 relative to each other.
  • the load on the intervertebral disc 16 is relieved in its entirety, thus enabling the intervertebral disc 16 to recover or preventing the intervertebral disc 16 from being further affected and making it possible to prepare the patient for, for example, an operation to replace the intervertebral disc 16 by an implant, for example.
  • the two straight anchoring elements or pins 18- 18' are provided in such a manner that they extend parallel to each other. More specifically, said straight anchoring elements 18-18' lie in a plane posterior to the spine 1. This makes it possible to carry out the surgical treatment, i.e. the implantation or removal of the medical device according to the invention, from the back side of the patient, thereby minimising the burden for the patient.
  • one anchoring element even more specifically both anchoring elements 18-18' are rigid in longitudinal direction. This makes it possible to realise a complete immobilisation of the two vertebrae 12-14, so that said vertebrae will function as one hinged bone element, as it were, and the load on the intervertebral disc 16 present therebetween is fully relieved and the intervertebral disc 16 will no longer be affected by any displacements or movements of the two vertebrae 12-14 relative to each other (and in particular towards each other).
  • a slight movement of the back may be rendered possible by making at least one of the pins 18-18' flexible in longitudinal direction.
  • the points of attachment between the connecting elements 18-18 ' and the anchoring elements 20 may or may not be spaced an even distance apart.
  • the rear connecting element 18' also restricts the extent of movement of the spine upon extension of the back.
  • the load on the intervertebral disc and the facet joints is reduced in that the vertebrae 12-14 can no longer move towards each other.
  • the patient's comfort is absolutely improved in this way.

Abstract

A medical device for positioning bone elements, in particular vertebrae (12,14), relative to each other, comprising at least one assembly built up of two or more anchoring elements (20), which can each be implanted in a bone element with a first end thereof, as well as an elongated connecting element, which can be connected to the other ends of the anchoring elements extending from the bone element in question, wherein the connecting element is built up of two straight pins (18,18'), which pins are each connected by their ends to the anchoring elements (20) at spaced-apart positions.

Description

MEDICAL DEVICE FOR POSITIONING BONE ELEMENTS
DESCRIPTION
The invention relates to a medical device for positioning bone elements, in particular vertebrae, relative to each other, comprising at least one assembly built up of two or more anchoring elements, which can each be implanted in a bone element with a first end thereof, as well as an elongated connecting element, which can be connected to the other ends of the anchoring elements extending from the bone element in question.
Such medical devices are generally known, they are used for positioning or fixating adjacent vertebrae whose intervertebral disc is damaged and/or has lost its function relative to each other. Examples of such medical solutions are shown in WO 01/45576 and WO 02/102259. The connecting elements used therein are made of a flexible material and they are implanted on either side of the vertebrae.
These known implant constructions still allow movement of the vertebrae relative to each other, however, to the extent even the affected intervertebral disc is subjected to a load. The flexible connecting element in particular allows movement of the vertebrae in a direction towards each other, which may cause the vertebrae to sag, as a result of which the intervertebral disc and the facet joints are excessively loaded. The latter (sagging of the intervertebral disc) is undesirable in many cases.
The object of the invention is to obviate the above drawbacks of a medical device as referred to in the introductory paragraph and to provide an improved version that makes it possible to position adjacent vertebrae relative to each other in such a manner that movement of the vertebrae towards each other is no longer possible and that thus the intervertebral disc is no longer loaded.
According to the invention, the connecting element is to that end built up of two straight pins, which pins are each connected to the anchoring element at spaced-apart positions with their ends. In this way a radical fixation of the adjacent vertebrae relative to each other is obtained, and further loads on the intervertebral disc are prevented by preventing the vertebrae from sagging (or moving) in a direction towards each other.
A further constant position of the adjacent vertebrae relative to each other is achieved in particular if, according to a specific embodiment, the two straight pins extend parallel to each other.
More in particular, the two straight pins lie in a plane posterior to the spine, as a result of which the implantation of the device into a patient's back can be carried out with a minimum burden for the patient.
A further immobilisation of the vertebrae and reduction of the load on the intervertebral disc can be realised in that in one embodiment at least one of said pins is rigid in longitudinal direction.
More specifically, both pins are rigid in longitudinal direction, this in order to enhance the immobilisation of the vertebrae and the reduction of the load on the intervertebral disc.
On the other hand, a slight movement in one direction can be allowed if according to the invention the other pin is flexible in longitudinal direction.
In a preferred embodiment, the points of attachment of the two rigid pins are spaced the same distance apart, whilst in another functional embodiment the points of attachment of the two rigid pins are not spaced the same distance apart.
The invention will not be explained in more detail with reference to a drawing, in which:
Figures 1a-1b show two embodiment is of a medical device according to the prior art; and
Figure 2 shows an embodiment of a medical device according to the invention.
For a better understanding of the invention, like parts will be indicated by identical numerals in the description below.
Figures 1a and 1b show two embodiments of a prior art medical device for positioning bone elements, in particular vertebrae, relative to each other.
In figure 1a, two vertebrae are schematically indicated at 12 and 14, which vertebrae are separated by an intervertebral disc 16. In the situation in which the intervertebral disc 16 is damaged or otherwise affected it may be desirable to position the vertebrae 12 and 14 positioned thereabove and therebelow, respectively, relative to each other, to which end use is made in figure 1a of a medical device that is built up at least of an assembly comprising two anchoring elements 20, which can be placed in the vertebrae 12 and 14 with their distal ends 20a and 20b, respectively. A connecting element 18 may be provided between the two adjacent anchoring elements 20 at the other ends 20c-20d of the anchoring elements 20, which connecting element can be attached with its ends 18b to the two other ends 20c-20d of the anchoring elements 20 that, extend from the bone elements.
Although the aim of the prior art embodiment as shown in figure 1a is to effect an adequate positioning or fixation of the two vertebrae 12-14 relative to each other, in order to reduce the load on the intervertebral disc 16, which is affected in many cases, the construction that is shown in figure 1a is often not satisfactory. This is caused by the use of a flexible or springing central part of 18a of the connecting element 18, which allows bending, turning or twisting movements of the spine and consequently of the two vertebrae 12-14 with respect to each other. This leads to an increased load on the intervertebral disc and the facet joints, which is unpleasant for the patient.
The above degrees of freedom of movement make it possible for the vertebrae to move towards each other ("sag"), thus increasing the load on the intervertebral disc 16, which may be a painful experience for the patient in question.
A similar prior art embodiment is shown in figure 1 b, which likewise employs connecting elements 18-18', which are similarly connected to anchoring elements 20, which are likewise placed in a vertebra 12, 14 with their first end 20b. In this embodiment, too, flexible connecting elements 18-18' are used, so that a turning or twisting movement of the back is possible at all times, as a result of which the vertebrae 12-14 move relative to each other, in particular towards each other, and the intervertebral disc 16 can accordingly be loaded or compressed.
Upon extension of the wearer's back, the restraining function of the rear connecting element 18 ' in figure 1 b is lost. This, too, causes the load on the intervertebral disc and the facet joints to increase, with the attendant unpleasant side-effects for the patient.
This known embodiment does not provide such a position or orientation of the vertebrae 12-14 disposed on either side of the affected intervertebral disc 16, either. In this case, too, the intervertebral disc 16 is still subjected to loads, with only adverse consequences for the patient.
Figure 2 shows an embodiment of the medical device according to the invention which employs two connecting elements 18-18' that are essentially rigid in longitudinal direction. Preferably, two assemblies, each consisting of two connecting elements 18-18' (four in total), are used for thus realising a proper orientation or fixation or positioning of the two vertebrae 12-14 relative to each other. As a result, the load on the intervertebral disc 16 is relieved in its entirety, thus enabling the intervertebral disc 16 to recover or preventing the intervertebral disc 16 from being further affected and making it possible to prepare the patient for, for example, an operation to replace the intervertebral disc 16 by an implant, for example.
To immobilise the two vertebrae 12-14 relative to each other and relative to the intervertebral disc 16, the two straight anchoring elements or pins 18- 18' are provided in such a manner that they extend parallel to each other. More specifically, said straight anchoring elements 18-18' lie in a plane posterior to the spine 1. This makes it possible to carry out the surgical treatment, i.e. the implantation or removal of the medical device according to the invention, from the back side of the patient, thereby minimising the burden for the patient.
More specifically, one anchoring element, even more specifically both anchoring elements 18-18' are rigid in longitudinal direction. This makes it possible to realise a complete immobilisation of the two vertebrae 12-14, so that said vertebrae will function as one hinged bone element, as it were, and the load on the intervertebral disc 16 present therebetween is fully relieved and the intervertebral disc 16 will no longer be affected by any displacements or movements of the two vertebrae 12-14 relative to each other (and in particular towards each other).
A slight movement of the back (without the intervertebral disc 16 being loaded thereby) may be rendered possible by making at least one of the pins 18-18' flexible in longitudinal direction. Depending on the position at which the medical device is implanted in the patient's back, the points of attachment between the connecting elements 18-18 ' and the anchoring elements 20 may or may not be spaced an even distance apart.
In contrast to the flexible prior art implants (as shown in figure 1b), the rear connecting element 18' also restricts the extent of movement of the spine upon extension of the back. Thus the load on the intervertebral disc and the facet joints is reduced in that the vertebrae 12-14 can no longer move towards each other. The patient's comfort is absolutely improved in this way.

Claims

1. A medical device for positioning bone elements, in particular vertebrae, relative to each other, comprising at least one assembly built up of two or more anchoring elements, which can each be implanted in a bone element with a first end thereof, as well as an elongated connecting element, which can be connected to the other ends of the anchoring elements extending from the bone element in question, characterised in that the connecting element is to that end built up of two straight pins, which pins are each connected to the anchoring element at spaced-apart positions with their ends.
2. A medical device according to claim 1 , characterised in that the two straight pins extend parallel to each other.
3. A medical device according to claim 2, characterised in that the two straight pins lie in a plane posterior to the spine.
4. A medical device according to any one of the claims 1-3, characterised in that at least one of said pins is rigid in longitudinal direction.
5. A medical device according to claim 4, characterised in that both pins are rigid in longitudinal direction.
6. A medical device according to claim 4, characterised in that the other pin is flexible in longitudinal direction.
7. A medical device according to any one of the claims 1-6, characterised in that the points of attachment of the two rigid pins are spaced the same distance apart.
8. A medical device according to any one of the claims 1-6, characterised in that the points of attachment of the two rigid pins are not spaced the same distance apart.
PCT/NL2006/000376 2005-07-20 2006-07-19 Medical device for positioning bone elements WO2007011213A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
NL1029568A NL1029568C2 (en) 2005-07-20 2005-07-20 Medical device for positioning bone parts, in particular vertebrae, relative to each other.
NL1029568 2005-07-20

Publications (1)

Publication Number Publication Date
WO2007011213A1 true WO2007011213A1 (en) 2007-01-25

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PCT/NL2006/000376 WO2007011213A1 (en) 2005-07-20 2006-07-19 Medical device for positioning bone elements

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WO (1) WO2007011213A1 (en)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8758347B2 (en) 2010-03-19 2014-06-24 Nextremity Solutions, Inc. Dynamic bone plate

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
NL1033910C1 (en) 2007-05-31 2008-12-02 Baat Holding B V Medical device for positioning bone parts, in particular spine, relative to each other, as well as a tool for fitting such a medical device component by component.

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0838196A2 (en) * 1997-11-30 1998-04-29 Daniel Spitzer Clamping connector for medical tools and apparatus
DE10124994A1 (en) * 2001-05-22 2002-12-12 Hans-Georg Gradl Fractured bone fixture especially on wrist has first and further supports, fixture elements, and adjustable fixture element
WO2004052217A2 (en) * 2002-12-06 2004-06-24 Sdgi Holdings, Inc. Multi-rod bone attachment
WO2005072631A1 (en) * 2004-01-30 2005-08-11 Sanatmetal Kft. Set of surgical equipment for the fixing of bone pieces

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
PT1239785E (en) 1999-12-20 2005-01-31 Synthes Ag DEVICE FOR THE STABILIZATION OF TWO ADDITIONAL VERTEBRAL BODIES OF THE VERTEBRAL COLUMN
GB0114783D0 (en) 2001-06-16 2001-08-08 Sengupta Dilip K A assembly for the stabilisation of vertebral bodies of the spine

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0838196A2 (en) * 1997-11-30 1998-04-29 Daniel Spitzer Clamping connector for medical tools and apparatus
DE10124994A1 (en) * 2001-05-22 2002-12-12 Hans-Georg Gradl Fractured bone fixture especially on wrist has first and further supports, fixture elements, and adjustable fixture element
WO2004052217A2 (en) * 2002-12-06 2004-06-24 Sdgi Holdings, Inc. Multi-rod bone attachment
WO2005072631A1 (en) * 2004-01-30 2005-08-11 Sanatmetal Kft. Set of surgical equipment for the fixing of bone pieces

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8758347B2 (en) 2010-03-19 2014-06-24 Nextremity Solutions, Inc. Dynamic bone plate

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