WO2009069025A2 - Dispositif d'ostéosynthèse vertébrale - Google Patents

Dispositif d'ostéosynthèse vertébrale Download PDF

Info

Publication number
WO2009069025A2
WO2009069025A2 PCT/IB2008/054605 IB2008054605W WO2009069025A2 WO 2009069025 A2 WO2009069025 A2 WO 2009069025A2 IB 2008054605 W IB2008054605 W IB 2008054605W WO 2009069025 A2 WO2009069025 A2 WO 2009069025A2
Authority
WO
WIPO (PCT)
Prior art keywords
stop means
flexible cord
bone anchoring
anchoring member
members
Prior art date
Application number
PCT/IB2008/054605
Other languages
English (en)
Other versions
WO2009069025A3 (fr
Inventor
Denys Sournac
David Ryan
Original Assignee
Medicrea International
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 Medicrea International filed Critical Medicrea International
Publication of WO2009069025A2 publication Critical patent/WO2009069025A2/fr
Publication of WO2009069025A3 publication Critical patent/WO2009069025A3/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
    • A61B17/7035—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • A61B17/7037—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other wherein pivoting is blocked when the rod is clamped
    • 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
    • A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • A61B17/7083—Tools for guidance or insertion of tethers, rod-to-anchor connectors, rod-to-rod connectors, or longitudinal elements

Definitions

  • the present invention concerns a vertebral osteosynthesis material. It also concerns an assembly comprising this vertebral osteosynthesis material and advancement means, in particular in the form of an instrument, making it possible to advance the stop means comprised by the material.
  • the invention also concerns a vertebral osteosynthesis method using said vertebral osteosynthesis material or said assembly.
  • connection members comprise in particular yokes intended to be engaged on the connecting bars and on threaded proximal slugs comprised by the screws.
  • proximal slugs can be fixed in relation to the bodies of the screws (screws then called “monoaxial”), or can be articulated in relation to these screw bodies (screws then called “polyaxial”).
  • Document WO 98/55038 illustrates one example of vertebral osteosynthesis material of this type.
  • a vertebral osteosynthesis material comprising at least one screw whereof the proximal part is connected to a flexible cord having a length such that it is able to extend, from the implantation site, to a location outside this implantation site.
  • This flexible cord serves to guide other members in the direction of the screw, in particular to guide a connection yoke allowing the connection of the screw to a connecting rod of several members anchoring bones to each other.
  • the progressive nature of the assembly of the yokes and nuts on the threaded proximal slugs is limited to the length of these threaded proximal slugs, which can hinder the placement of the material or make it difficult in certain cases, in particular given the correction of the spinal cord to be done.
  • the stop means comprise at least one piece defining a passage for its engagement on the flexible cord and teeth, claws, sharp protrusions or similar not presenting an obstacle to the movement of the piece along the flexible cord in the direction coming closer to the bone anchoring member, and penetrating into the material of the flexible cord when the stop means tend to be moved along the flexible cord in the direction of separation of the bone anchoring member.
  • the stop means comprise a piece comprising a passage for its engagement on the flexible cord and at least one mobile jaw, movable between a withdrawn position, in which this mobile jaw does not present an obstacle to the progress of the stop means along the flexible cord, and an active position, in which this mobile jaw grips the flexible cord between it and a wall located across from it, and thus prevents the sliding of the stop means in the direction of separation from the bone anchoring member.
  • the stop means comprise two mobile jaws arranged on both sides of the passage receiving the flexible cord.
  • the end of the flexible cord opposite that connected to said bone anchoring element can comprise a rigid member, such as a needle, facilitating the engagement of said other members on the flexible cord.
  • the invention also relates to a vertebral osteosynthesis method using said vertebral osteosynthesis material or said assembly.
  • This method is essentially characterized by the following steps: - implant, into a vertebra, at least one bone anchoring member which comprises the vertebral osteosynthesis material;
  • the method comprises a step consisting of using advancement means to advance said respective stop means or groups of stop means along the respective flexible cord(s).
  • Figure 1 is a cross-sectional view of various members comprised by this material according to one embodiment
  • figure 2 is a partial view, from the side, of a screw which is part of these members
  • figure 3 illustrates a vertebra on which are implanted, in the left part of the figure, a material according to the prior art, and in the right part of the figure, members of the material according to the invention
  • figure 4 is a side view of a bone anchoring member comprised by the material, according to another embodiment
  • figure 5 is a cross-sectional view of the screw comprising the bone anchoring member shown in figure 4
  • figure 6 is a view similar to figure 5 of a screw according to still another embodiment
  • figure 7 is a view of a stop means comprised by this material, according to another embodiment
  • figures 8 and 9 are partial views of an instrument which may be comprised by the material.
  • Figure 1 illustrates a set 1 of different members comprised by a vertebral osteosynthesis material, namely a pedicular screw 2, a connecting bar 3, a yoke 4 for connection of this bar 3 and this screw 2, a nut 5 for assembling the yoke 4 on the screw 2 and a stop piece 6.
  • a vertebral osteosynthesis material namely a pedicular screw 2, a connecting bar 3, a yoke 4 for connection of this bar 3 and this screw 2, a nut 5 for assembling the yoke 4 on the screw 2 and a stop piece 6.
  • the yoke 4 comprises a rounded part for receiving the bar 3 and two branches pierced with holes for its sliding engagement on the cord 15. It is intended to rest against the wall 11 , being gripped against said wall by the nut 5, intended to be screwed on the slug 10.
  • the stop piece 6 is, in the embodiment shown in figure 1 , made up by a single piece in the form of a sphere, pieced all the way through by a hole allowing the straight engagement of this piece 6 on the cord 15.
  • the piece 6 comprises, at this hole, teeth, claws, sharp projections 20 or similar, not presenting an obstacle to the movement of the piece 6 along the cord 15 in the direction of the slug 10 and penetrating into the material of the cord 15 when the piece 6 tends to be moved along this cord 15 in the direction opposite the slug 10.
  • the piece 6 is able to be engaged against the nut 5 when the yoke 4 and said nut 5 are engaged on the cord 15, and to make it possible to progressively bring said yoke 4 and said nut 5 closer to said slug 10, without possibility of withdrawal of the yoke 4 and the nut 5 in relation to the slug 10.
  • the cords 15 of the screws 2 according to the invention make it possible to secure the introduction of yokes 4 and nuts 5 as well as the extension rods 5OA but, thanks to their substantially non-elastic transverse deformability, can be moved in the operating field, in order to free a particular zone thereof. They can in particular be pressed against the tissue 101 as illustrated.
  • the material according to the invention comprises an instrument making it possible to advance a stop piece 6 as shown in figure 1 along the cord 15.
  • This instrument is in the form of a clamp with two pivoting branches 27, each equipped with a stop assembly 6a, 6b as shown in figure 7; the pivoting of the branches 27 in the direction bringing the two stop assemblies 6a, 6b closer toward each other (cf. figure 8) leads a first stop assembly 6a to be immobilized relative to the cord 15 and the second stop assembly 6b to advance along the cord 15; the consecutive pivoting of these branches 27 in the direction distancing the two stop assemblies 6a, 6b (cf. figure 9) leads to immobilizing said second stop assembly 6b relative to the cord 15 and allows said first stop assembly 6a to advance along the cord 15.
  • flexible cord must be understood in the broadest possible sense, covering any suitable threadlike flexible cord, able to have a braided structure as described above but also a single-thread structure, or able to be a cable.

Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Neurology (AREA)
  • Life Sciences & Earth Sciences (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 qui comprend au moins un élément d'ancrage à l'os (2) dont une partie proximale (10) est connectée à un cordon flexible (15) qui sert de guide à d'autres éléments (4, 5), en particulier pour guider un raccord de connexion qui permet de relier l'élément d'ancrage à l'os (2) à une tige reliant les uns aux autres plusieurs éléments d'ancrage à l'os. Selon l'invention, le dispositif comprend un arrêtoir (6) qui peut s'appliquer contre l'un desdits autres éléments (4, 5) lorsque ces autres éléments (4, 5) sont engagés sur le cordon flexible (15), ces arrêtoirs (6) étant équipés d'un dispositif anti-retour (20) formant un obstacle à leur mouvement le long du cordon flexible (15) dans la direction opposée à l'élément d'ancrage à l'os (2).
PCT/IB2008/054605 2007-11-30 2008-11-05 Dispositif d'ostéosynthèse vertébrale WO2009069025A2 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
FR0708366 2007-11-30
FR0708366A FR2924326B1 (fr) 2007-11-30 2007-11-30 Materiel chirurgical, notamment materiel d'osteosynthese vertebrale

Publications (2)

Publication Number Publication Date
WO2009069025A2 true WO2009069025A2 (fr) 2009-06-04
WO2009069025A3 WO2009069025A3 (fr) 2009-07-16

Family

ID=39591081

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IB2008/054605 WO2009069025A2 (fr) 2007-11-30 2008-11-05 Dispositif d'ostéosynthèse vertébrale

Country Status (2)

Country Link
FR (2) FR2924326B1 (fr)
WO (1) WO2009069025A2 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8540719B2 (en) 2010-02-09 2013-09-24 Aesculap Implant Systems, Llc Percutaneous rod insertion system and method

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20210220025A1 (en) * 2016-01-18 2021-07-22 Premia Spine Ltd. Fusion rod insertion in percutaneous fusion surgery

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5258015A (en) * 1991-05-03 1993-11-02 American Cyanamid Company Locking filament caps
WO1998055038A1 (fr) * 1997-06-03 1998-12-10 Jean Taylor Dispositif d'osteosynthese vertebrale pluridirectionnelle et modulable, a encombrement reduit
US6475230B1 (en) * 1997-08-01 2002-11-05 Peter M. Bonutti Method and apparatus for securing a suture
US20040147928A1 (en) * 2002-10-30 2004-07-29 Landry Michael E. Spinal stabilization system using flexible members
US20050043742A1 (en) * 2003-08-21 2005-02-24 Aurelian Bruneau Systems and methods for positioning implants relative to bone anchors in surgical approaches to the spine
WO2005072632A1 (fr) * 2004-01-27 2005-08-11 Medicrea International Materiel d'osteosynthese vertebrale

Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5312410A (en) * 1992-12-07 1994-05-17 Danek Medical, Inc. Surgical cable tensioner
DE19627864C2 (de) * 1996-07-11 2003-05-08 Aesculap Ag & Co Kg Chirurgische Spannvorrichtung
US5782831A (en) * 1996-11-06 1998-07-21 Sdgi Holdings, Inc. Method an device for spinal deformity reduction using a cable and a cable tensioning system
FR2777449B1 (fr) * 1998-04-17 2000-09-15 Sulzer Orthopedics Limited Dispositif de tension pour la pose d'un systeme de stabilisation du rachis

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5258015A (en) * 1991-05-03 1993-11-02 American Cyanamid Company Locking filament caps
WO1998055038A1 (fr) * 1997-06-03 1998-12-10 Jean Taylor Dispositif d'osteosynthese vertebrale pluridirectionnelle et modulable, a encombrement reduit
US6475230B1 (en) * 1997-08-01 2002-11-05 Peter M. Bonutti Method and apparatus for securing a suture
US20040147928A1 (en) * 2002-10-30 2004-07-29 Landry Michael E. Spinal stabilization system using flexible members
US20050043742A1 (en) * 2003-08-21 2005-02-24 Aurelian Bruneau Systems and methods for positioning implants relative to bone anchors in surgical approaches to the spine
WO2005072632A1 (fr) * 2004-01-27 2005-08-11 Medicrea International Materiel d'osteosynthese vertebrale

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8540719B2 (en) 2010-02-09 2013-09-24 Aesculap Implant Systems, Llc Percutaneous rod insertion system and method

Also Published As

Publication number Publication date
FR2924326A1 (fr) 2009-06-05
FR2940041A1 (fr) 2010-06-25
FR2940041B1 (fr) 2013-08-02
WO2009069025A3 (fr) 2009-07-16
FR2924326B1 (fr) 2010-12-10

Similar Documents

Publication Publication Date Title
US20230404628A1 (en) Soft stabilization assemblies with pretensioned cords
US11707298B2 (en) Dynamic spinal stabilization assembly with elastic bumpers and locking limited travel closure mechanisms
US8911477B2 (en) Dynamic stabilization member with end plate support and cable core extension
US8603146B2 (en) System and method for insertion of flexible spinal stabilization element
EP1981420B1 (fr) Ensembles ancrages vertébraux ayant des récepteurs étendus
EP2278930B1 (fr) Equipement d ostéosynthèse vertébrale
US8603143B2 (en) Spinous process fixation apparatus
EP3131485B1 (fr) Materiel d'osteosynthese vertebrale permettant de realiser l'ancrage iliaque d'une barre vertebrale
CA2690038C (fr) Element de raccord a stabilisation dynamique avec noyau solide precontraint
US10258382B2 (en) Rod-cord dynamic connection assemblies with slidable bone anchor attachment members along the cord
US20090105764A1 (en) Dynamic stabilization member with fin support and solid core extension
US20080147122A1 (en) Dynamic stabilization connecting member with molded inner segment and surrounding external elastomer
EP1674042A1 (fr) Connecteur à décalage latéral réglable pour fixation osseuse
US11786279B2 (en) Modular spinal fixation device
CA2689669A1 (fr) Instruments et techniques associee pour l'installation minimalement invasive d'une structure rachidienne
US20090171357A1 (en) Collet fixation system
WO2008088866A2 (fr) Élément de liaison de stabilisation dynamique avec connexion de cordon
US20140277151A1 (en) Fulcrum Cap for Spinal Constructs
WO2009069025A2 (fr) Dispositif d'ostéosynthèse vertébrale
US20100217330A1 (en) Bone fixation devices and methods

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 08853225

Country of ref document: EP

Kind code of ref document: A2

NENP Non-entry into the national phase in:

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 08853225

Country of ref document: EP

Kind code of ref document: A2