Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/30—Joints
  • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
  • A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
  • A61F2/447—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/30—Joints
  • A61F2/46—Special tools for implanting artificial joints
  • A61F2/4603—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof
  • A61F2/4611—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • 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 or setting implements
  • 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, e.g. stabilisers comprising fluid filler in an implant
  • A61B17/7059—Cortical plates
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/30—Joints
  • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
  • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
  • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
  • A61F2002/30383—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
  • A61F2002/30387—Dovetail connection
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/30—Joints
  • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
  • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
  • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
  • A61F2002/30383—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
  • A61F2002/3039—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove with possibility of relative movement of the rib within the groove
  • A61F2002/30397—Limited lateral translation of the rib within a larger groove
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/30—Joints
  • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
  • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
  • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
  • A61F2002/30383—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
  • A61F2002/3039—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove with possibility of relative movement of the rib within the groove
  • A61F2002/30398—Sliding
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/30—Joints
  • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
  • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
  • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
  • A61F2002/30576—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs
  • A61F2002/30578—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs having apertures, e.g. for receiving fixation screws
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/30—Joints
  • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
  • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
  • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
  • A61F2002/30593—Special structural features of bone or joint prostheses not otherwise provided for hollow
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/30—Joints
  • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
  • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
  • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
  • A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/30—Joints
  • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
  • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
  • A61F2002/3082—Grooves
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/30—Joints
  • A61F2/46—Special tools for implanting artificial joints
  • A61F2/4603—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof
  • A61F2002/4629—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof connected to the endoprosthesis or implant via a threaded connection
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
  • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements

Definitions

• the present invention relates to a cervical cage and plate system that can be positioned on two cervical vertebrae, in particular successive, and intended to promote the fusion of these vertebrae together (so-called interbody fusion).
• interbody fusion fusion of these vertebrae together
• Several such systems may in particular be superimposed on several levels of cervical vertebrae, including adjacent.
• Known systems of this kind comprise an intersomatic cage and a plate disposed substantially perpendicularly to the general plane of the cage and provided at these two free ends which project from the upper side and the lower side of the cage of respective fastening means to the one of the vertebrae, including fixing means in the form of a hole and a screw.
• the intersomatic cage is pierced centrally by opening on its upper face and on its lower face by two upper and lower openings. It is intended to receive cancellous bone and to be interposed between two vertebrae to allow the establishment of a bone graft or a material promoting fusion between the two vertebrae, the bone graft passing through the cage and merging with the two vertebrae on either side of the cage.
• the plate can be anchored to two upper and lower neighboring vertebrae only in a single relative position of the cage and the plate.
• Document US 2008/0051890 describes a cage-plate system in which the plate can be fixed to the cage in several relative positions. However, the plate can not slide relative to the cage between the positions while remaining attached to the cage.
• the present invention aims at overcoming the disadvantages of the devices of the prior art by proposing a system of the kind mentioned above with associated cage and plate which, although of very simple structure, also makes it possible to have a large number of possible positions of two successive plates without these being interfering with each other with respect to their anchoring to the same vertebra, this large number of anchoring positions of each plate vertebrae to choose a positioning of these anchors such as the maintenance of vertebrae relative to each other is made as stable as possible and in particular is much more stable than in the case of systems of the prior art.
• the present invention is a cage-plate system with several relative positions of the plate and the cage which is very easy to use, in particular to move from one relative position to another.
• a system for the compression and interbody fusion of the vertebrae is as defined in Claim 1. Improvements are defined in the subclaims.
• the plate is slidably mounted relative to the cage in the mediolateral direction.
• the plate is an oblong piece, in particular of rectangular shape and the longitudinal axis of the plate is perpendicular to the plane of the upper and / or lower faces of the cage.
• the plate is an oblong piece, in particular of rectangular shape and the longitudinal axis of the plate is inclined with respect to the plane of the upper and / or lower faces of the cage while being in the plane defined by the vertical axis and the medio-lateral axis.
• each free end of the plate there are provided means for anchoring the plate to a respective vertebra of the two vertebrae between which is intended to be arranged the cage, including a hole intended to cooperate with an associated screw.
• the plate is slidably mounted relative to the cage so that the two elements, the cage and the plate, are not detachable from one another.
• the cage comprises at least one hollow guide groove in an upper and / or lower face of the cage, preferably two guide grooves respectively formed in the upper face of the cage and the lower face of the cage, and in which a guide pin respectively engages to allow the sliding of the plate relative to the cage.
• the cage comprises two lower and upper grooves which each extend between two end walls and the plate comprises a C-shaped hook each of which. free end is trapped in a respective groove, the sliding of the plate relative to the cage thus being between two extreme left and right positions without the plate can be detached from the cage.
• the cage comprises at least one groove in which is received a rib from the plate, the rib being slidably guided by the groove, in particular the cage has two upper and lower grooves and the plate has two ribs having a tenon-shaped end which are each received in one of the grooves.
• the two tenons and the part of the plate between the two ribs have the shape of a C-shaped clamp which clings to the cage by the two pins which penetrate into a respective groove and slide there.
• the system comprises an instrument shaft for placing it.
• the instrument stem comprises a cylindrical body at an upper or distal end which extend a complementary shaped stud of a through hole formed in the plate and at least one lug, preferably two pins arranged ( s) on either side of the stud, at a distance from it, protruding from the body of the rod of a greater height than the stud.
• the height of the lugs is greater than the height of the stud, so that the stud does not protrude from the plate and does not penetrate into the hole of the cage, while the lugs themselves penetrate between the two head plates, for thus prevent a rotation but allow however a mediolateral sliding.
• a flat head is formed at the upper end of the rod, the stud protruding from a central portion of the lateral surface of the head while the at least one pin, of preferably the two lugs, is projecting from a lateral portion of the lateral surface of the head, in particular the left and right lateral edges of the lateral surface of the head.
• two left and right rungs are formed on the upper surface of the head, so as to form a central open channel having a width corresponding substantially to the width of the plate, to thereby allow to the plate to be blocked in this channel when the stud has penetrated into the corresponding hole formed in the plate.
• at least the end of the stud comprises a thread and the associated through hole formed in the stud comprises a corresponding thread, so that by screwing the end of the stud into the hole of the plate, it ensures a bonding of the plate to the stem.
• the stud consists of a sub-rod which is received in a through shaft formed in the cylindrical body of the rod, the relative displacement of the sub-rod relative to the rod being done by screwing, in particular the inner wall. well being threaded and the sub-rod having an associated thread.
• the present invention also relates to an instrument rod for installing a cage-plate system according to the invention.
• Figure 1 is a perspective view of an intersomatic cage of a system according to the invention.
• Figure 2 is a top view of the cage of Figure 1;
• Figure 3 is a sectional view along the line III-III of Figure 2;
• Figure 4 is a perspective view of a plate of a cage system and plate according to the invention for cooperating with a cage as shown in Figures 1 to 3;
• Figure 5 is a top view of the plate of Figure 4;
• Figure 6 is a sectional view along the line VI-VI of Figure 5;
• Figure 7 is a perspective view of a cage and plate system, the plate being slidably mounted relative to the cage in a non-detachable manner;
• Figure 8 is a perspective view of the system of Figure 7, when it has been turned 180 ° to see its lower part which is here facing upwards;
• Figure 9 is a sectional perspective view of the cage and plate system of Figures 7 and 8, the sectional plane being the vertical anteroposterior plane;
• Figure 10 shows, seen from the posterior side, three cages and three plates arranged on the spine, four vertebrae are represented, a stack on three levels;
• Figure 11 shows in perspective the cage-plate assembly in which the plate has been shifted to the left by sliding relative to its central position shown in Figures 7 to 9;
• Figure 12 shows in perspective the cage-plate assembly in which the plate has been shifted to the right by sliding relative to its central position shown in Figures 7 to 9;
• Figure 13 shows the cage-plate assembly in perspective with the plate in its central position in which the holes 60 and 24 are in concordance;
• Figure 14 is a perspective view of an instrument rod for positioning the cage-plate assembly between two vertebrae
• Figure 15 is a front view of the instrument shaft of Figure 14;
• Figure 16 is a side view of the instrument shaft of Figures 14 and 15;
• Figure 17 is an enlarged view of an upper portion of the . Figure 16;
• Figure 18 is a sectional view following the line AA of Figure 17;
• Figure 19 is a side view substantially identical to Figure 15, but on a larger scale of an upper portion of the rod instrument;
• FIG. 20 is a view of a cage-plate assembly according to the invention and of an instrument rod in the position in which the cage-plate assembly can be inserted between two vertebrae using the instrument stem, the view being in perspective substantially from above;
• FIG. 21 is a perspective view of the assembly and the rod of Figure 20 according to another axis of view.
• the cage 1 is generally parallelepipedal in shape having an anterior lateral external face 2, a posterior lateral external face 3, two lateral external faces 4 and 5 right and left, an upper outer face 7 and a lower outer face.
• the cage is pierced centrally with a hole 9 of substantially circular section which opens to the upper and lower faces by two upper and lower openings.
• the cage thus defines around the hole 9 an annular shape consisting of an anterior section 10, a rear section 11 and two sections 12 and 13 right and left.
• Bone material or bone substitute can thus pass through the cage through the hole 9 to promote fusion between the two vertebrae between which the cage has been inserted.
• These two plates are spaced from each other in the vertical direction (the direction of the spine). They are furthermore also each slightly recessed with respect to the upper and lower faces, respectively.
• a longitudinal groove 16 is formed in the mediolateral direction and in the lower face of the lower plate 15, a longitudinal groove 17 is formed in the mediolateral direction.
• Each of these grooves is delimited by a longitudinal wall 18, by the rear face 3 of the cage and two walls 19 and 20 left and right end.
• the system also comprises a plate 27 shown in isolation in FIGS. 4 to 6.
• This plate 27 has an elongated, substantially rectangular shape having a width dimension (in the direction perpendicular to the plane of FIG. 6) and a length dimension (in the vertical direction in Figure 6).
• the plate has at its two free ends holes 28 for allowing the passage of screws (not shown in the figures), for screwing. from each end of the plate to an associated vertebra.
• the hole at the upper end in FIGS. 5 or 6 is intended to assist in anchoring the plate to a vertebra lying above the cage 1, while the hole 28 in the lower end in FIG. 6 is intended to allow anchoring of the plate to the lower vertebra which is below the cage 1.
• ribs 30 and 31 From one of the faces of the plate (the anterior face), project two ribs 30 and 31 which extend over the entire width of the plate. These two ribs 30 and 31 are spaced from each other and have at their respective free end two pins 40, 41 which project laterally ribs. The two pins 40 and 41 are directed towards each other, so that the distance from which they are separated is less than the greatest distance (measured in the direction perpendicular to the ribs) between the ribs.
• the two ribs and the portion of the plate that extends between them have the shape of a C (reversed in Figure 6).
• the distance between the two plates 14 and 15 promontories is substantially equal (while being however slightly lower) to the distance between the two inner faces of the two ribs 30 and 31.
• the two ribs 30 and 31 thus surround the two plates and the two end tenons 40 and 41 of the ribs are received in the respective grooves 16 and 17 and thus prevent the detachment of the plate from the cage.
• the two pins can slide in the grooves to thereby allow sliding of the plate relative to the cage in the mediolateral direction. This sliding is limited to left and right by the two end walls 19 and 20.
• recesses 50 are formed which enlarge the width dimension of each groove at the ends and which make it possible, by a tilting action in connection with the elasticity of the material (generally thermoplastic or biocompatible metal) forming the ribs, to secure the plate to the cage or remove it.
• the material generally thermoplastic or biocompatible metal
• Two semi-circular cutouts are formed in the upper surface of the lower plate and in the lower surface of the top plate to form a kind of virtual hole in which is received a circular sleeve 60 for receiving a tool for laying the cage.
• the sleeve 60 comprises in particular a tapping or milling.
• the plate 17 has at its center, between the two ribs 30 and 31, a hole 24 intended to correspond with the virtual hole, to allow the passage of a set tool assembly.
• FIG. 9 a sectional view is taken at the level of the plane defined by the anteroposterior axis and the vertical axis and in perspective the assembly consisting of cage 1 and a plate 27 as shown in FIGS. and 8.
• the upper face 62 of the upper rib 30, when the pin 40 is received in the groove 16, is substantially flush with the upper outer face 7 of the cage, while the face 61 bottom of the lower rib 31, when the pin 41 is received in the groove 17, is substantially flush with the outer face 8 of the lower cage.
• these two faces 62 and 61 do not exceed, respectively upwardly and downwardly, respectively upper 7 and lower 8 faces of the cage.
• FIGS 14 to 19 there is shown a rod-shaped laying instrument for coupling to the cage-plate assembly to allow 1 insertion between two vertebrae in particular.
• This instrument consists of a main body 100 in the form of a substantially circular cylinder at the upper end of which projects a head 101 of larger dimension in width.
• the upper surface of the head 101 has a central flat face 102 from which a circular cylindrical stud 103 of smaller dimension than that of the flat surface 102 projects.
• two shoulders 104 and 105, right and left, are formed on this surface. 102, the two shoulders 104 and 105 thus forming two steps or side steps on the right and left sides respectively.
• the instrument rod 100 is taken and the stud 103 is inserted into the hole 24 formed in the plate.
• the relative dimensions of the hole 24 and the stud 103 are such that the stud 103 can penetrate into the hole 24, preferably having substantially the same dimensions and in complementary form.
• the extension in length, that is to say in the longitudinal direction of the rod of the stud 103 is however such that it does not penetrate into the hole 60 of the cage so as not to prevent the plate from sliding in the direction of mediolateral sliding.
• the two lugs 106 and 107 penetrate them into the groove formed between the two plates 14 and 15 in the form of a promontory of the cage to thereby block any possibility of rotation of the rod. instrument and plate relative to the cage.
• the central stud 103 Once the central stud 103 inserted into the hole 60 and the lugs disposed within the groove formed between the two plates 14 and 15, it pushes with the rod the plate and cage together between the two vertebrae.
• the cooperation between the rod and the plate is such that the rod and the plate are secured in displacement, so that once the cage inserted between two vertebrae, can then by displacement of the rod slide the plate relative to the cage to place it exactly in the position in which one wishes to fix it to the vertebrae.
• the width dimension of the central face 102, between the two shoulders 104 and 105 corresponds substantially to the width of the plate or in any case is greater than the width of the plate so that it can be received between the plates. shoulders.
• the hole 24 in the plate 27 has a thread.
• the stud 103 consists of a sub-rod which can move inside a well 109 formed inside the rod 100.
• a distal end portion of the stud 103 is threaded so as to be screwed into the tapping of the hole 24 and thus secure the rod to the plate.
• the well 109 is threaded and at least one section of the sub-rod is threaded to allow movement by screwing the sub-rod relative to the rod. This threaded section is different from the threaded distal end portion.
• the shapes and dimensions of the stud, plate and cage and their corresponding thread and thread are made so that the free end of the stud 103 does not exceed the face of the plate on the side of the cage and in particular does not penetrate the hole 60 to not prevent the mediolateral sliding of the plate relative to the cage.
• the end of the stud 103 is flush with the face of the plate.
• other locking means can be envisaged and it is also possible, without departing from the scope of the present invention, not to provide such locking means. For example, one can predict that in his distal portion the stud or under rod is threaded only over a distance corresponding to the depth of the hole in the plate, a neighboring section of this distal portion of the sub-rod not being threaded.
• FIG. 10 three cage-plate systems identical to that of FIGS. 7 to 9 are shown.
• the cage-plate system of the top of the figure (between Vi and V 2 ) is anchored to Vi and V 2 in a first relative position of the cage and the. plate.
• the cage-plate system of the middle of the figure (between V 2 and V 3 ) is anchored to V 2 and V 3 in a second relative position of the cage and the plate different from the first position.
• the cage-plate system of the bottom of the figure (between V 3 and V 4 ) is anchored to V 3 and V 4 in a third relative position of the cage and the plate which is here identical to the first position, but could, if desired, be different from the first, for example be more shifted to the left.
• the plate can be slid relative to the cage between a plurality of different relative positions of the cage and plate in which the cage-plate system can be anchored to two upper and lower neighboring vertebrae by intermediate anchoring means (holes 28 and corresponding screws) carried by the plate.

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Cited By (20)

Citations (7)

• 2010
  • 2010-10-29 FR FR1004266A patent/FR2966720B1/fr not_active Expired - Fee Related
• 2011
  • 2011-10-04 BR BR112013010019A patent/BR112013010019A2/pt not_active IP Right Cessation
  • 2011-10-04 WO PCT/FR2011/000540 patent/WO2012056119A1/fr active Application Filing
  • 2011-10-04 EP EP11771215.8A patent/EP2632391A1/fr not_active Withdrawn

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