WO2014029033A1 - Élément de serrage et dispositif de stabilisation d'os - Google Patents

Élément de serrage et dispositif de stabilisation d'os Download PDF

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Publication number
WO2014029033A1
WO2014029033A1 PCT/CH2012/000196 CH2012000196W WO2014029033A1 WO 2014029033 A1 WO2014029033 A1 WO 2014029033A1 CH 2012000196 W CH2012000196 W CH 2012000196W WO 2014029033 A1 WO2014029033 A1 WO 2014029033A1
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WO
WIPO (PCT)
Prior art keywords
bore
clamping element
channel
spring
screw
Prior art date
Application number
PCT/CH2012/000196
Other languages
German (de)
English (en)
Inventor
Lorraine MONTAVON
Original Assignee
Montavon Lorraine
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 Montavon Lorraine filed Critical Montavon Lorraine
Priority to PCT/CH2012/000196 priority Critical patent/WO2014029033A1/fr
Publication of WO2014029033A1 publication Critical patent/WO2014029033A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—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
    • A61B17/7011—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
    • 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
    • A61B17/7028—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 the flexible part being a coil spring
    • 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
    • A61B17/7041—Screws or hooks combined with longitudinal elements which do not contact vertebrae with single longitudinal rod offset laterally from single row of screws or hooks
    • 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
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8052—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded
    • 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
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8605—Heads, i.e. proximal ends projecting from bone

Definitions

  • the invention relates to a clamping element for releasable fixation of a rod-shaped portion of a stabilizing element on a bone according to the preamble of patent claim 1, to a device for stabilizing bones according to the preamble of claim 22 and to a method for stabilizing a long-tubular bone, or the spine according to the preamble of claim 39.
  • a device for fixing a rod to a bone fixation element is known from the document EP 1 838 230.
  • This known device essentially comprises a three-dimensional body which serves as a connecting element between a longitudinal carrier and a bone fixation element and comprises a bore extending from the upper side to the lower side, which bore is suitable for receiving the bone fixation element. Furthermore, the three-dimensional body is penetrated by a channel open against the upper or lower side with a channel axis perpendicular to the bore axis, so that a longitudinal member orthogonal to the bone fixation element can be introduced into the channel.
  • the bore and the channel are arranged so that they do not intersect.
  • the body comprises a through two of the bore perpendicular to the channel axis in the body penetrating slots and limited by the bore and the channel, elastic element which is suitable for fixing the longitudinal member in the channel.
  • the elastic element is deformed by the conical head of the bone fixation element in such a way that the free end of the elastic element is pressed against the longitudinal support inserted into the channel so that it is rotationally and longitudinally fixed in the channel.
  • This known device is designed for the use of standardized head locking screws and comprises a bore with an upper and a lower conical portion, each with a conical internal thread.
  • a disadvantage of this known clamping device with the head locking screws is their complex and relatively expensive production.
  • the preamble of claim 1 is based on this disclosure.
  • the invention aims to remedy this situation.
  • the invention has for its object to provide a clamping element for releasable fixation of a rod-shaped portion of a stabilizing element on a bone, which has a total of a small volume and easy to produce means.
  • the invention solves the stated object with a clamping element, which has the features of claim 1, with a device for stabilizing bones, which has the features of claim 22, as well as with a method for stabilizing a long-tubular bone, or the spine, which features of patent claim 39.
  • the clamping element is easy to produce
  • the clamping element has small dimensions and thus is applicable to small animals
  • a usable with the clamping element bone screw can be formed as a cylindrical screw without a screw head, so that a simple cylindrical threaded rod can be screwed through the hole in the clamping element in a bone and separated after fixation of the device for stabilizing vertebral bodies just above the clamping element and as Output element can be used for more bone screws;
  • the bore can be unthreaded prior to screwing in the screw, so that when screwing the screw in the bore wall by material forming an internal thread is formed.
  • the bore may be provided with an internal thread prior to screwing in a screw, so that when screwing a screw with respect to the bore axis angled screw axis existing in the bore internal thread is formed, or the screw may be conical, so that the internal thread in the Bore deformed and the deformable area is pressed against the channel.
  • the clamping element additionally comprises a screw, wherein the clamping element is made of a softer material than the screw at least in a part surrounding the bore.
  • the portion of the clamping member made of a softer material than the screw additionally comprises the deformable portion bounded by the bore wall and the channel wall. The stiffness of the deformable region may be selected by the choice of material and / or the thickness between the bore and the channel in a suitable range.
  • the portion of the clamping element made of a softer material than the screw can alternatively also be designed as an insert.
  • the clamping member made of a biocompatible reinforced or unreinforced plastic, preferably from the group: polyetheretherketone (PEEK), polyacryletherketone (PEAK), polyoxymethylene (POM), polyphenylene sulfide (PPS), polysulfone or liquid-cristal Polymer (LCP).
  • PEEK polyetheretherketone
  • PEAK polyacryletherketone
  • POM polyoxymethylene
  • PPS polyphenylene sulfide
  • LCP liquid-cristal Polymer
  • the reinforcement of the plastic can be done by embedding metal, plastic or carbon fibers in the plastic matrix.
  • the clamping element can also be made of pure titanium. When screwing the bone screw made of titanium, a titanium alloy or a biocompatible steel can be formed by the thread in the bore wall in the clamping element, an internal thread.
  • the bore may have a bore diameter DB and the channel may have a channel diameter DK, and the ratio A / (DB / 2 + DK / 2) may be at most 1.3, and preferably at most 1.25.
  • the bore may have a bore diameter DB and the channel may have a channel diameter DK, wherein the ratio A / (DB / 2 + DK / 2) may be at least 1.05 and preferably at least 1.15. The condition applies here that the internal thread formed in the bore must not penetrate into the channel.
  • the bore may have an inner diameter DB and the thread of the screw may have an outer diameter DA> DB.
  • an internal thread can be formed on the bore wall, wherein in the case DA> DB the bone screw can be screwed coaxially to the bore axis in the clamping element.
  • the ratio DA: DB between the outer diameter DA of the screw and the bore diameter DB may be at least 1.05, and preferably at least 1.2.
  • the bore may be unthreaded prior to screwing in a screw.
  • the thread of the screw may have a core diameter, wherein the ratio between the core diameter and the bore diameter is a maximum of 1, and preferably a maximum of 0.9.
  • the screw may be formed as a threaded rod, which preferably comprises a tip at a first and a second end.
  • the advantage of this embodiment is that the threaded rod can be cut off after being screwed into the bone above the top of the clamping element. The remnant can be reused so that two or more bone screws can be cut from a threaded rod, thereby allowing easy and inexpensive production of the bone screws.
  • the bore may comprise axially an upper enlargement widening towards the upper side and / or a lower extension flaring against the underside of the clamping element, wherein the upper and / or lower extension may preferably be conical.
  • the bone screw can be screwed angled relative to the bore axis in the clamping element.
  • the bore may have a length L between the upper and / or lower extension, wherein the ratio between this length L and the bore diameter DB, L / DB may be at least 15%, preferably at least 20%.
  • the advantage of this embodiment is that with a small ratio L / DB, the bone screw can be angled more strongly with respect to the bore axis.
  • the clamping element may have a height H between the top and the bottom, and the bore may have a length L between the top and / or bottom extensions, wherein the ratio of L / H may be at least 20%, preferably at least 25% , so that the screw can be angled away from the bore axis by a maximum of 30 °.
  • the ratio of L / H can be at most 80%, preferably at most 75%.
  • the thread of the screw may have a core diameter DK ⁇ DB.
  • the bone screw can be angled at a larger angle relative to the bore axis.
  • the difference between the outer diameter DA of the thread of the screw and the bore diameter DB may be at least 0.1 mm, preferably at least 0.15 mm and at most 0.4 mm, preferably at most 0.25 mm.
  • the channel may have a circumferentially closed channel wall.
  • the channel may have a channel wall open on the circumference against the bottom or the top of the clamping element, whereby the advantages are achievable
  • the spring can be previously introduced into the clamping element and preformed, while the bone screws must be set only if their position is known exactly;
  • the spring by means of another clamping element fixed to the spine must be, another clamping element without laboriously over the length to push the legs of the spring can be easily placed on this; and - the spring can be introduced into the human or animal body prior to setting the bone fixation elements, so that the positions of the bone fixation elements subsequently to be attached to the vertebral bodies are easy to determine for the surgeon.
  • the invention further relates to a device for stabilizing bones according to claim 22.
  • This device can be attached directly to bone by means of screws which can be introduced into the bores of the clamping elements and which are designed as bone screws.
  • the device can be fastened indirectly to bones, preferably to a first and second sleeve, which surround a body part of a patient comprising a bone to be treated.
  • the clamping elements can be attached to sleeves, which are made of gypsum, or to a fixator external.
  • the spring may be formed as a leg spring, which may comprise a spring coil with at least one turn and terminal a projecting beyond the periphery of the winding first and second legs.
  • the spring coil may have a variable pitch, which may preferably be realized in only one turn of the spring coil.
  • the spring may be made of a spring wire or ribbon wound around a central axis of the spring coil, and at least one leg may be convergent toward its free end with respect to a plane perpendicular to the central axis against the other leg. In this case, at least one leg can be angled with respect to a plane perpendicular to the central axis against the other leg.
  • variable pitch, one or both legs are arranged so that the straight end pieces come to lie substantially in a narrow axial region of the central axis of the spring coil.
  • the bone fixation means used for fastening the spring to bone can thereby be arranged in the immediate vicinity of a plane perpendicular to the central axis of the spring coil, so that the spring coil is subjected to bending only in the sense of a turn and unintentional deformation of the spring coil can be prevented.
  • Suitable materials for the spring are:
  • the spring may be made of a hollow spring wire or ribbon.
  • the central fibers of the spring wire contribute to the flexural rigidity no or only a small contribution, so that the bending stiffness is not reduced by the hollow design, but the net weight is reduced.
  • the spring may be made of a spring wire or ribbon with a flattened in the region of the spring coil, preferably rectangular cross-sectional area.
  • the advantage of this embodiment is the different bending stiffness of the spring wire in different directions.
  • the spring coil is designed as a conically wound spiral.
  • the spring is made of a spring wire with a wire axis and in the region of the first and second end piece of the first and second leg rectilinear portions of the wire axis close in a plane perpendicular to the central axis of the spring coil viewed an angle alpha, which in the unloaded Condition of the spring is between 135 ° and 225 °.
  • the advantage of this embodiment is that the end portions of the legs provided for attachment of the spring to the bone may be oriented in a position suitable for anatomy.
  • the leg spring is made of a spring wire with a diameter d between 2.0 mm and 4.0 mm, preferably between 3.3 mm and 3.7 mm.
  • the spring coil is made of a spring wire with a wire axis, wherein the wire axis of the spring wire in the spring coil with a diameter D winds around the central axis, which at least 12 mm, preferably at least 15 mm and typically 20 mm.
  • the spring coil is made of a spring wire with a wire axis, wherein the wire axis of the spring wire in the spring coil with a diameter D winds around the central axis, which is a maximum of 25 mm, preferably a maximum of 22 mm.
  • the spring coil comprises a plurality of spring coils. Due to the larger number of spring coils, the leg spring can allow an increased relative movement of the vertebral bodies for the same load.
  • the legs may comprise a three-dimensional structuring, preferably a laser texturing.
  • the device according to the invention can be used to treat a fractured bone or osteoarthritis or pseudoarthrosis, the spring being used for external fixation.
  • the spring may be attached to a plaster or attached to the bone externally by means of bone fixation elements in the form of an external fixator.
  • the device according to the invention can serve for the stabilization of vertebral bodies or for the temporary stabilization of a joint.
  • a joint on which partial or complete abrasion of the colateral ligaments has taken place can be temporarily stabilized.
  • Another application for temporary stabilization of a joint is in the case of bone defects that result from the removal of a tumor.
  • the inventive device can be further used for the treatment of a fractured bone or for the treatment of arthrosis or pseudoarthrosis.
  • the device according to the invention can preferably be used on the knee joint or on finger joints.
  • the invention also relates to a method for stabilizing a long-boned or spinal column comprising the steps of:
  • step i) involves the following additional steps:
  • a device according to the invention can be implanted.
  • Show it: 1 shows a longitudinal section through an embodiment of the inventive clamping member.
  • FIG. 2 shows a side view of an embodiment of the device according to the invention after its implantation on a spinal column
  • FIG. 3 shows a plan view of the embodiment of the device according to the invention shown in FIG. 2;
  • FIG. 4 shows a side view of a spring according to an embodiment of the device according to the invention
  • FIG. 5 shows a plan view of the spring according to the embodiment of the device according to the invention shown in FIG. 4;
  • FIG. 6 shows a longitudinal section through another embodiment of the clamping element according to the invention.
  • FIG. 7 shows a plan view of the embodiment of the inventive clamping mechanism according to FIG. 6;
  • FIG. 8 is a plan view of a spring according to another embodiment of the device according to the invention.
  • FIG. 9 shows a side view of a further embodiment of the device according to the invention after its implantation on a spinal column.
  • FIG. 10 shows a longitudinal section through a further embodiment of the clamping element according to the invention.
  • Fig. 1 shows an embodiment of the inventive clamping member 1 with a three-dimensional body 12 and a screw 3, which may be formed as a bone screw.
  • the three-dimensional body 12 is exemplified as a cuboid body with a top 4, a bottom 5 and four side surfaces.
  • the clamping element 1 comprises a three-dimensional body 12 penetrating bore 7 with a bore wall 13 and a bore axis 8 and a three-dimensional body 12 also penetrating channel 10 with a bore axis 8 skewed channel axis 11 and a channel wall 17.
  • the channel 10 is for receiving a rod-shaped portion of a stabilizing element, eg a spring 20 suitable and in this embodiment comprises a circumferentially closed channel wall 17th
  • the bore axis 8 and the channel axis 11 have a shortest distance A to each other, which is so dimensioned that the bore 7 and the channel 10 does not penetrate. Further, between the bore 7 and the channel 10 a through the bore wall 13 and the channel wall 17 limited, deformable region 14 of the clamping element 1 is formed.
  • material deformation through which an internal thread 18 is formed in the bore 7 and the deformable portion 14 against the channel (10) is pressed such that the channel 10 narrows and a rod-shaped portion of a spring 20 introduced into the channel 10 is rotatable and longitudinally clampable.
  • the screw 3 is formed as a threaded rod and comprises a shaft 15 with a thread 16.
  • the screw 3 may be made of titanium, a titanium alloy, a reinforced or unreinforced plastic (e.g., PEEK), a ceramic material, or a biocompatible steel.
  • the clamping element 1 may be made of PEEK, ie made of a softer material than the screw 3, so that by screwing the screw 3 into the bore 7 in the bore wall, an internal thread 18 is formed and at the same time the deformable portion 14 in the region of the channel 10th is pressed.
  • the bore 7 may be provided prior to screwing the screw 3 with an internal thread, so that when screwing the screw 3 with respect to the bore axis 8 angled longitudinal axis 29 of the screw in the bore 7 existing internal thread is formed.
  • the screw 3 may be conical, so that the internal thread is deformed in the bore 7 and the deformable portion 14 is pressed against the channel 10.
  • the clamping element 1 may comprise only one insert 7 enclosing the bore 7 and comprising the deformable region 14 comprising PEEK, while the area of the clamping element 1 surrounding the insert is made of titanium, a titanium alloy or a body-compatible steel.
  • the bore 7 has a bore diameter DB and the channel 10 a channel diameter DK, wherein the ratio of the shortest distance A to the sum of the radii of the bore 7 and the channel 10, A / (DB / 2 + DK / 2) a maximum of about 1, 25 and at least about 1.05.
  • the bore 7 is unthreaded before screwing the screw 3.
  • the thread 16 of the screw 3 has an outer diameter DA> DB, so that when screwing the screw 3 into the bore 7 in the clamping element 1 in the bore wall 13, an internal thread 18 is formed.
  • the screw 3 with its longitudinal axis 29 with respect to the bore axis 8 coaxially or angled be screwed into the bore 7.
  • the difference between the outer diameter DA of the thread 16 of the screw 3 and the bore diameter DB is at least 0.1 mm, typically 0.25 mm and a maximum of 0.4 mm.
  • the screw 3 can be screwed with a larger angle to the bore axis 8 in the bore 7, the ratio between the core diameter of the thread 16 of the screw 3 and the bore diameter DB is less than 1, and preferably not more than 0.9.
  • the deformable region 14 between the bore 7 and the channel 10 has at the narrowest point a wall thickness of at least 0.15 mm, preferably of at least 0.2 mm.
  • the wall thickness at the narrowest point is a maximum of 0.3 mm, preferably a maximum of 0.25 mm.
  • the distance A is approximately 3.1 mm. This results for the deformable region in the non-deformed state before screwing the screw 3 between the bore 7 and the channel 10 has a minimum wall thickness of about 0.225 mm.
  • the core diameter of the thread 16 of the screw 3 may for example be 2.0 mm and the outer diameter of the thread 16 of the screw 3 may be, for example, 2.5 mm.
  • the bore axis 8 can have an angle of at least 5 °, preferably of at least 10 ° and of not more than 25 °, preferably of not more than 20 °, with respect to the underside 5 of the clamping element 1.
  • each device 40 for stabilizing the last lumbar vertebral body 41 relative to the sacrum 42, e.g. a dog is shown, wherein each device 40 is disposed on one side of the spinous processes of the vertebral body.
  • Each of the two devices 40 comprises three clamping bodies 1, and a spring 20, which is designed as a leg spring and terminally comprises a first and a second leg 25a, 25b.
  • the first and second legs 25a, 25b each form a cylindrical portion of the spring 20, which is inserted into a channel 10 in one of the clamping elements 1 and is fixed when tightening the screws 3 in the channels 10, so that the entire device 40 to the Vertebral bodies is attached.
  • Two clamping elements 1 are fixed with one screw 3 on the sacrum 42 and two clamping elements 1 are fastened with one screw 3 to the last lumbar vertebral body 41.
  • the degree and type of compression of the spinal cord are diagnosed by an imaging examination.
  • the maximum extension and flexion of the vertebral column segment to be treated can subsequently be determined.
  • the dorsal, respectively posterior access is used for the insertion, positioning and fixation of the device.
  • a bilateral preparation of the epaxial musculature and a surgical preparation of the bony attachment sites are performed beforehand.
  • the lateral retraction of the Muscle masses are produced by self-retaining retractors.
  • the pedicles, transverse processes and spinous processes are now exposed, allowing the fixation of the implant with bone fixation elements, preferably with bone screws of the necessary different angles relative to the device. Surgical decompression within the spinal canal is also possible. After fixation of the implant, the incision is closed again.
  • the spring 20 is formed as a Schenkeifeder and comprises a central axis 30, a first end 23 and a second end 24.
  • the spring 20 is made of a spring wire 22 and includes a spring coil 21 and a respective end disposed straight leg 25a, 25b.
  • the spring coil 21 includes, for example, a spring coil.
  • the spring wire 22 may be circular cylindrical and have a diameter d.
  • the longitudinal axis 26 of the spring wire 22 is helically wound around the central axis 30 of the spring 20 by a diameter D of the spring coil 21 of the spring 20 and passes tangentially at the transitions to the legs 25a, 25b into a respective straight section in the region of the legs 25a. 25b over.
  • the projections of the sections of the longitudinal axis 26 of the spring wire 22 which are rectilinear in the region of the legs 25a, 25b into a plane perpendicular to the central axis 30 of the spring 20, e.g. in the plane of drawing include an angle alpha, which may be in the unloaded state of the spring 20 between about 135 ° and about 225 ° and in the present embodiment, for example, about 165 °.
  • the legs 25a, 25b thus form levers which can be rotated against the elastic resistance of the spring 20 relative to each other, so that the angle alpha is increased or decreased.
  • the spring wire 22 is moved in the area of the spring coil 21, i.
  • the spring 20 may be made of a titanium alloy, preferably of TiAINb, a plastic, a ceramic material or Nitinol. Furthermore, the legs 25a, 25b comprise a three-dimensional structuring 27 in the form of a laser texturing, so that the legs 25a, 25b of the spring 20 can be fixed in a rigid manner in the channels 10 of the clamping elements 1.
  • the spring coil 21 has a variable pitch, so that at the first and second ends 23, 24 of the spring 20, the longitudinal axis 26 of the spring wire 22 substantially in lie to the central axis 30 of the spring coil 21 perpendicular plane. It can thus be achieved that the first and second legs 25a, 25b come to lie substantially in a narrow axial area of the central axis 30 of the spring coil 21.
  • the spring wire 22 may have a polygonal cross-sectional area in the area of the spring coil 21 and / or on the legs 25a, 25b.
  • the embodiment of the clamping element 1 shown in FIGS. 6 and 7 differs from the embodiment shown in FIG. 1 only in that the bore 7 axially has an upper extension 6 which widens against the upper side 4 and a lower extension 5 of the clamping element 1 widening lower extension 19 includes, wherein the upper and lower extension 6, 19 are conical.
  • the screw 3 can be screwed angled relative to the bore axis 8 into the clamping element 1.
  • the extending against the top and bottom 4, 5 sections of the bore 7 are conical and have a maximum cone angle beta of 60 °.
  • the bore 7 has between the upper and lower extension 6, 19 has a length L, wherein the ratio between this length L and the bore diameter DB, L / DB is at least 15%, preferably at least 20%.
  • the clamping element 1 has measured between the top 4 and the bottom 5 of the three-dimensional body 12 has a height H, wherein the ratio of L / H is at least 20%, preferably at least 25%, so that the screw 3 relative to the bore axis 8 to a Angle gamma of a maximum of 30 ° can be angled.
  • the ratio of L / H is at most 80%, preferably at most 75%.
  • the embodiment of the spring 20 shown in FIG. 8 differs from the embodiment shown in FIGS. 4 and 5 only in that the spring 20 comprises a plurality of spring coils.
  • FIG. 9 shows an embodiment of the device 40 according to the invention, which is arranged on the ventral side of the vertebral bodies.
  • 10 shows a further embodiment of the clamping element 1, which differs from the embodiment illustrated in FIGS. 6 and 7 only in that the channel 10 has a channel wall 17 which is open on the circumference against the underside 5 of the clamping element 1.
  • the channel 10 narrows against the underside 5 of the clamping element 1 such that a leg 25a, 25b of a spring 20 can be snapped into the channel 10 from the underside 5 of the clamping element 1.

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  • Orthopedic Medicine & Surgery (AREA)
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  • Prostheses (AREA)

Abstract

L'invention concerne un élément de serrage (1) pour la fixation libérable d'une section, en forme de tige, d'un élément de stabilisation sur un os, comprenant : un corps tridimensionnel (12); un orifice (7) traversant le corps tridimensionnel, cet orifice étant destiné à recevoir la vis (3) et étant doté d'un axe d'orifice (8) et d'une paroi d'orifice (13), et un canal (10) traversant le corps tridimensionnel, ce canal étant doté d'une paroi canal (17) et d'un axe canal (11), et étant de disposition gauche par rapport à l'axe d'orifice ; l'axe d'orifice et l'axe de canal présentant une distance la plus courte A, laquelle est dimensionnée de telle façon que l'orifice et le canal ne présentent pas d'intersection ; une zone (14) déformable de l'élément de serrage, délimitée par la paroi d'orifice et la paroi de canal, se formant entre l'orifice et le canal ; et le vissage d'une vis dans l'orifice provoquant une déformation de la matière de la paroi d'orifice, ce qui entraîne la formation d'un taraudage (18) dans l'orifice et la pression de la zone déformable contre le canal, de sorte que le canal se rétrécit et qu'une section, en forme de tige, d'un élément de stabilisation, puisse être immobilisée en rotation et en longueur par insertion dans le canal.
PCT/CH2012/000196 2012-08-21 2012-08-21 Élément de serrage et dispositif de stabilisation d'os WO2014029033A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/CH2012/000196 WO2014029033A1 (fr) 2012-08-21 2012-08-21 Élément de serrage et dispositif de stabilisation d'os

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/CH2012/000196 WO2014029033A1 (fr) 2012-08-21 2012-08-21 Élément de serrage et dispositif de stabilisation d'os

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WO2014029033A1 true WO2014029033A1 (fr) 2014-02-27

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Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0360139A2 (fr) * 1988-09-17 1990-03-28 Boehringer Ingelheim Kg Dispositif d'ostéosynthèse et son procédé de fabrication
US20030078580A1 (en) * 2000-04-28 2003-04-24 Hideo Shitoto Spinal-rod connecting apparatus and a connector thereof
EP1838230A2 (fr) 2005-01-18 2007-10-03 Synthes GmbH Dispositif a stabilite angulaire pour fixation mutuelle d'un support longitudinal a un element de fixation d'os
US20090222049A1 (en) * 2005-11-16 2009-09-03 Robert Frigg Device for Bone Fixation with at least one Through Hole
US20110022173A1 (en) * 2009-07-24 2011-01-27 Warsaw Orthopedic, Inc. Implant with an interference fit fastener

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0360139A2 (fr) * 1988-09-17 1990-03-28 Boehringer Ingelheim Kg Dispositif d'ostéosynthèse et son procédé de fabrication
US20030078580A1 (en) * 2000-04-28 2003-04-24 Hideo Shitoto Spinal-rod connecting apparatus and a connector thereof
EP1838230A2 (fr) 2005-01-18 2007-10-03 Synthes GmbH Dispositif a stabilite angulaire pour fixation mutuelle d'un support longitudinal a un element de fixation d'os
EP1838230B1 (fr) * 2005-01-18 2008-03-05 Synthes GmbH Dispositif a stabilite angulaire pour fixation mutuelle d'un support longitudinal a un element de fixation d'os
US20090222049A1 (en) * 2005-11-16 2009-09-03 Robert Frigg Device for Bone Fixation with at least one Through Hole
US20110022173A1 (en) * 2009-07-24 2011-01-27 Warsaw Orthopedic, Inc. Implant with an interference fit fastener

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