WO2018127567A1 - Intersomatic implant with improved stability - Google Patents

Intersomatic implant with improved stability Download PDF

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Publication number
WO2018127567A1
WO2018127567A1 PCT/EP2018/050285 EP2018050285W WO2018127567A1 WO 2018127567 A1 WO2018127567 A1 WO 2018127567A1 EP 2018050285 W EP2018050285 W EP 2018050285W WO 2018127567 A1 WO2018127567 A1 WO 2018127567A1
Authority
WO
WIPO (PCT)
Prior art keywords
implant
face
vertebral element
axis
intersomatic
Prior art date
Application number
PCT/EP2018/050285
Other languages
French (fr)
Inventor
Clément CHAROSKY
Marc Bernard
Anne METZ
Christopher J. DEWALD
Poul Martin GEHRCHEN
Pierre Roussouly
Clément SILVESTRE
Original Assignee
Kisco 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 Kisco International filed Critical Kisco International
Publication of WO2018127567A1 publication Critical patent/WO2018127567A1/en

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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
    • 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
    • A61F2/4465—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 having a circular or kidney shaped cross-section substantially perpendicular to the axis of the spine
    • 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 or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4611—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
    • 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
    • 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
    • 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
    • A61F2002/30772—Apertures or holes, e.g. of circular cross section
    • A61F2002/30784—Plurality of holes
    • 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
    • A61F2/3094—Designing or manufacturing processes
    • A61F2/30942—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
    • A61F2002/30962—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques using stereolithography

Definitions

  • the present invention relates to an intersomatic implant for insertion into an intervertebral space delimited between an upper vertebral element and an adjacent lower vertebral element of a spine.
  • the implant is an intersomatic cage, in particular of the ALIF type (acronym for "Anterior Lumbar Interbody Fusion”).
  • Such an intersomatic cage usually comprises an interior space, intended to receive a graft, in particular autogenous bone, synthetic phospho-calcites, osteoinducers or other, intended to promote bone fusion between the upper vertebral element and the lower vertebral element.
  • a graft in particular autogenous bone, synthetic phospho-calcites, osteoinducers or other, intended to promote bone fusion between the upper vertebral element and the lower vertebral element.
  • the cage In order for the bone fusion to be performed optimally, the cage should preferably remain positioned with great stability in the intervertebral space.
  • the object of the invention is in particular to optimize this stability of the cage in a simple, reliable and efficient manner.
  • the subject of the invention is in particular an intersomatic implant intended to be inserted into an intervertebral space delimited between an upper vertebral element and an adjacent lower vertebral element of an extending spine extending along an rostro-caudal axis and perpendicular to a dorso-ventral axis
  • the implant comprising a body having an upper face and a lower face, and a rear face and a front face substantially perpendicular to a longitudinal axis intended to be substantially parallel to the dorso-ventral axis
  • the intersomatic implant comprises upper and lower fixation elements, extending the front face of the body in a vertical direction perpendicular to the longitudinal axis and intended to be parallel to the rostro axis -caudal, the upper fastening element having upper attachment means to the upper vertebral element and the lower fixation member having lower means for attachment to the lower vertebral element.
  • fixation elements extending the front face of the implant body, allow effective fixation on the upper and lower vertebral elements.
  • An intersomatic implant according to the invention may further comprise one or more of the following characteristics, taken alone or in any technically feasible combination:
  • the body and the upper and lower fasteners are made of material
  • the body and / or the upper and lower fastening elements are made by three-dimensional printing
  • each fastening element has a general shape of tongue;
  • the upper and lower fastening means each comprise a passage opening of a fastener, in particular a screw, formed in the corresponding upper or lower fastening element;
  • the upper and lower faces are inclined relative to each other, an angle between 8 and 30 °, preferably greater than 20 °;
  • the intersomatic implant is sized to be inserted into an intervertebral space delimited between a lower vertebral element formed by a sacrum and an upper vertebral element formed by a first vertebra adjacent to the sacrum, or in an intervertebral space delimited between a lower vertebral element formed by a first vertebra adjacent to the sacrum and an upper vertebral element formed by a second vertebra adjacent to the first vertebra;
  • the intersomatic implant comprises at least one upper opening formed in the upper face, at least one lower opening in the lower face, and an interior space extending between the lower and upper openings;
  • At least one of the upper or lower faces is rough, for example comprises a plurality of teeth or grooves, or is crosslinked.
  • FIG. 1 is a perspective view of an interbody implant according to an exemplary embodiment of the invention
  • FIG. 2 is a view from the front of the implant of FIG. 1, implanted between two vertebral elements.
  • FIG. 1 shows an intersomatic implant 10 according to an exemplary embodiment of the invention.
  • the implant 10 is a cage type ALIF (acronym for "Anterior Lumbar Interbody Fusion").
  • the implant 10 could be of another type.
  • the implant 10 is conventionally intended to be inserted into an intervertebral space delimited between two adjacent vertebral elements of a vertebral column, said upper and lower vertebral elements.
  • the lower vertebral element is a sacrum S1 and the upper vertebral element is a first vertebra L5 adjacent to the sacrum S1.
  • the lower vertebral element is a first L5 vertebra adjacent to the S1 sacrum
  • the upper vertebral element is a second L4 vertebra adjacent to the first L5 vertebra.
  • the implant 10 is sized to be inserted into the corresponding intervertebral space.
  • the implant 10 comprises a body 12 having an upper face 14 intended to be arranged facing the upper vertebral element when the implant 10 is implanted in the intervertebral space, and a lower face 16 intended to be arranged in view of the lower vertebral element when implant 10 is implanted.
  • the upper 14 and lower 16 faces are inclined relative to each other.
  • the upper 14 and lower faces 16 advantageously form between them an angle of between 8 and 30 °, preferably greater than 20 °.
  • the body 12 comprises at least one upper opening 18 formed in the upper face 14, at least one lower opening 20 formed in the lower face 16.
  • the body 12 also comprises an interior space 22 extending between the upper 18 and lower 20 openings.
  • the body 12 has two interior spaces 22 separated by a central intermediate wall 24, and for each interior space 22, an upper opening 18 and a lower opening 20 respectively.
  • Each interior space 22 is intended to receive a graft, in particular autogenous bone, synthetic phospho-calcites, osteoinducers or other, intended to promote bone fusion between the trays of adjacent vertebrae.
  • a graft in particular autogenous bone, synthetic phospho-calcites, osteoinducers or other, intended to promote bone fusion between the trays of adjacent vertebrae.
  • Such a hollow implant is also called "intersomatic cage”.
  • the upper face 14 has an upper surface of contact with the upper vertebral element, flanking the upper openings 18. More particularly, the upper contact surface extends circumferentially around the upper openings 18, and above the wall Central 24.
  • the lower face 16 has a lower contact surface with the lower vertebral element, framing the lower openings 20. More particularly, the lower contact surface extends circumferentially around the lower openings 20, and below the central wall 24.
  • Each of the upper 14 and lower 16 faces is rough to allow good support with the corresponding upper or lower vertebral element.
  • the upper faces 14 and lower 16 are toothed, ridged or crosslinked.
  • the body 12 also has a rear face 26 and a front face 28, extending in height between the upper 14 and lower faces 16.
  • the rear faces 26 and front 28 are generally substantially perpendicular to a longitudinal axis X.
  • the longitudinal axis X is substantially parallel to a dorso-ventral axis of the patient, the dorso-ventral axis being conventionally defined by the direction of the succession back belly.
  • the rear face 26 Due to the inclination of the upper 14 and lower 16 faces, the rear face 26 has a rear height, considered parallel to a vertical axis Z perpendicular to the longitudinal axis X, which is less than a front height of the front face 28 , parallel to the same vertical axis Z.
  • This vertical axis Z is intended to be substantially parallel to a rostro-caudal axis RC of the spine when the implant 10 is implanted.
  • the front face 28 comprises at least one notch 29, intended to cooperate with a suitable handling tool, for the handling of the implant 10 during its implantation.
  • the body 12 also has side faces 30, each connecting the rear faces 26 and front 28.
  • Each side face 30 advantageously comprises an opening 32, for example through and opening into the corresponding interior space 22.
  • the general shape and dimensions of the body 12 are conventional, and chosen according to the intervertebral space in which the implant 10 is intended to be implanted.
  • the implant 10 according to the invention furthermore comprises upper and lower fastening elements 34, extending the front face 28 of the body 12 in the vertical direction Z.
  • the upper fixation element 34 having upper means 38 for attachment to the upper vertebral element L5, and the lower fixation element having lower means 40 for attachment to the lower vertebral element S1.
  • the upper fastening elements 34 and lower 36 extend sufficiently in the vertical direction Z so that the upper means 38 and the lower fastening means 40 are opposite the upper vertebral element L5 or lower S1 corresponding when the implant 10 is implanted.
  • each upper attachment member 34 or lower 36 has a general tab shape.
  • each fastening element 34, 36 has a length of between 10 and 15 mm, for example substantially equal to 12.5 mm, taken in the direction of the vertical axis Z, from the junction between this fastener 34, 36 and the corresponding upper face 14 or lower 16.
  • the upper fixing means 38 comprise an upper orifice for the passage of an upper fastening member, in particular a screw.
  • This upper passage opening is opposite the upper vertebral element L5 when the implant 10 is implanted, as can be seen in FIG. 2.
  • the lower fastening means 38 comprise a lower passage opening of a lower fastening member, in particular a screw. This lower passage opening is opposite the lower vertebral element S1 when the implant 10 is implanted, as can be seen in FIG. 2.
  • the body 12 and the fixing elements 34, 36 are integral.
  • the implant 10, thus monobloc, has no discontinuity material.
  • the body 12 and / or the fastening elements 34, 36 are made by three-dimensional printing.
  • the body 12 and the fixing elements 34, 36 are made of a biocompatible material, for example titanium.
  • the body 12 and the fasteners 34, 36 are made of any suitable material, for example stainless steel, polymer, etc.
  • the fasteners 34, 36 according to the invention allow a reliable and stable attachment of the implant 10 in the intersomatic space.
  • This reliable and stable fastening allows in particular the use of a body 12 whose angle between the upper 14 and lower 16 faces is particularly important (especially greater than 20 ° for example).
  • the fixing elements 34, 36 according to the invention make it possible to avoid an expulsion of the implant 10, even in the case of a large angle.

Abstract

The intersomatic implant (10) is intended to be inserted into an intervertebral space delimited between an upper vertebral element (L5) and a lower vertebral element (S1) adjacent thereto of a spinal column extending along a rostro-caudal axis (R-C) and perpendicular to a dorso-ventral axis (D-V). The implant (10) comprises a body (12) that has an upper face and a lower face, and a rear face (26) and a front face (28) substantially perpendicular to a longitudinal axis (X) intended to be substantially parallel to the dorso-ventral axis (D-V). The implant (10) comprises upper (34) and lower (36) attachment elements that extend the front face (28) of the body (12) in a vertical direction (Z) perpendicular to the longitudinal axis (X) and intended to be parallel to the rostro-caudal axis (R-C). The upper attachment element (34) comprises upper means (38) for attachment to the upper vertebral element (L5), and the lower attachment element (36) comprises lower means (40) for attachment to the lower vertebral element (S1).

Description

Implant intersomatique à stabilité améliorée  Interbody Stability Enhanced Implant
La présente invention concerne un implant intersomatique destiné à être inséré dans un espace intervertébral délimité entre un élément vertébral supérieur et un élément vertébral inférieur adjacents d'une colonne vertébrale. The present invention relates to an intersomatic implant for insertion into an intervertebral space delimited between an upper vertebral element and an adjacent lower vertebral element of a spine.
Par exemple, l'implant est une cage intersomatique, notamment de type ALIF (acronyme anglais pour « Anterior Lumbar Interbody Fusion »).  For example, the implant is an intersomatic cage, in particular of the ALIF type (acronym for "Anterior Lumbar Interbody Fusion").
Une telle cage intersomatique comporte habituellement un espace intérieur, destiné à recevoir un greffon, notamment de l'os autogène, des phospho-calcites de synthèse, des ostéo-inducteurs ou autre, destiné à favoriser une fusion osseuse entre l'élément vertébral supérieur et l'élément vertébral inférieur.  Such an intersomatic cage usually comprises an interior space, intended to receive a graft, in particular autogenous bone, synthetic phospho-calcites, osteoinducers or other, intended to promote bone fusion between the upper vertebral element and the lower vertebral element.
Afin que la fusion osseuse soit effectuée de manière optimale, la cage doit préférablement rester positionnée avec une grande stabilité dans l'espace intervertébral.  In order for the bone fusion to be performed optimally, the cage should preferably remain positioned with great stability in the intervertebral space.
L'invention a notamment pour but d'optimiser cette stabilité de la cage, de manière simple, fiable et efficace.  The object of the invention is in particular to optimize this stability of the cage in a simple, reliable and efficient manner.
A cet effet, l'invention a notamment pour objet un implant intersomatique destiné à être inséré dans un espace intervertébral délimité entre un élément vertébral supérieur et un élément vertébral inférieur adjacents d'une colonne vertébrale s'étendant s'étendant le long d'un axe rostro-caudal et perpendiculairement à un axe dorso-ventral, l'implant comportant un corps présentant une face supérieure et une face inférieure, ainsi qu'une face arrière et une face avant sensiblement perpendiculaires à un axe longitudinal destiné à être sensiblement parallèle à l'axe dorso-ventral, caractérisé en ce que l'implant intersomatique comporte des éléments de fixation supérieur et inférieur, prolongeant la face avant du corps dans une direction verticale perpendiculaire à l'axe longitudinal et destinée à être parallèle à l'axe rostro-caudal, l'élément de fixation supérieur comportant des moyens supérieurs de fixation à l'élément vertébral supérieur, et l'élément de fixation inférieur comportant des moyens inférieurs de fixation à l'élément vertébral inférieur.  For this purpose, the subject of the invention is in particular an intersomatic implant intended to be inserted into an intervertebral space delimited between an upper vertebral element and an adjacent lower vertebral element of an extending spine extending along an rostro-caudal axis and perpendicular to a dorso-ventral axis, the implant comprising a body having an upper face and a lower face, and a rear face and a front face substantially perpendicular to a longitudinal axis intended to be substantially parallel to the dorso-ventral axis, characterized in that the intersomatic implant comprises upper and lower fixation elements, extending the front face of the body in a vertical direction perpendicular to the longitudinal axis and intended to be parallel to the rostro axis -caudal, the upper fastening element having upper attachment means to the upper vertebral element and the lower fixation member having lower means for attachment to the lower vertebral element.
Les éléments de fixation, prolongeant la face avant du corps de l'implant, permettent une fixation efficace sur les éléments vertébraux supérieur et inférieur.  The fixation elements, extending the front face of the implant body, allow effective fixation on the upper and lower vertebral elements.
Un implant intersomatique selon l'invention peut comporter en outre l'une ou plusieurs des caractéristiques suivantes, prises seules ou selon toutes combinaisons techniquement envisageables :  An intersomatic implant according to the invention may further comprise one or more of the following characteristics, taken alone or in any technically feasible combination:
- le corps et les éléments de fixation supérieur et inférieur sont venus de matière ; - The body and the upper and lower fasteners are made of material;
- le corps et/ou les éléments de fixation supérieur et inférieur sont réalisés par impression tridimensionnelle ; the body and / or the upper and lower fastening elements are made by three-dimensional printing;
- chaque élément de fixation présente une forme générale de languette ; - les moyens de fixation supérieur et inférieur comportent chacun un orifice de passage d'un organe de fixation, notamment d'une vis, ménagé dans l'élément de fixation supérieur ou inférieur correspondant ; each fastening element has a general shape of tongue; - The upper and lower fastening means each comprise a passage opening of a fastener, in particular a screw, formed in the corresponding upper or lower fastening element;
- les faces supérieure et inférieure sont inclinées l'une par rapport à l'autre, d'un angle compris entre 8 et 30°, de préférence supérieur à 20° ;  - The upper and lower faces are inclined relative to each other, an angle between 8 and 30 °, preferably greater than 20 °;
- l'implant intersomatique est dimensionné pour être inséré dans un espace intervertébral délimité entre un élément vertébral inférieur formé par un sacrum et un élément vertébral supérieur formé par une première vertèbre adjacente au sacrum, ou dans un espace intervertébral délimité entre un élément vertébral inférieur formé par une première vertèbre adjacente au sacrum et un élément vertébral supérieur formé par une seconde vertèbre adjacente à la première vertèbre ;  the intersomatic implant is sized to be inserted into an intervertebral space delimited between a lower vertebral element formed by a sacrum and an upper vertebral element formed by a first vertebra adjacent to the sacrum, or in an intervertebral space delimited between a lower vertebral element formed by a first vertebra adjacent to the sacrum and an upper vertebral element formed by a second vertebra adjacent to the first vertebra;
- l'implant intersomatique comprend au moins une ouverture supérieure ménagée dans la face supérieure, au moins une ouverture inférieure ménagée dans la face inférieure, et un espace intérieur s'étendant entre les ouvertures inférieure et supérieure ;  the intersomatic implant comprises at least one upper opening formed in the upper face, at least one lower opening in the lower face, and an interior space extending between the lower and upper openings;
- au moins l'une des faces supérieure ou inférieure est rugueuse, par exemple comprend une pluralité de dents ou de rainures, ou est réticulée.  at least one of the upper or lower faces is rough, for example comprises a plurality of teeth or grooves, or is crosslinked.
L'invention sera mieux comprise à la lecture de la description qui va suivre, donnée uniquement à titre d'exemple et faite en se référant aux figures annexées, parmi lesquelles :  The invention will be better understood on reading the description which follows, given solely by way of example and with reference to the appended figures, among which:
- La figure 1 est une vue en perspective d'un implant intersomatique selon un exemple de mode de réalisation de l'invention ;  FIG. 1 is a perspective view of an interbody implant according to an exemplary embodiment of the invention;
- La figure 2 est une vue de l'avant de l'implant de la figure 1 , implanté entre deux élément vertébraux.  FIG. 2 is a view from the front of the implant of FIG. 1, implanted between two vertebral elements.
On a représenté, sur la figure 1 , un implant intersomatique 10 selon un exemple de mode de réalisation de l'invention.  FIG. 1 shows an intersomatic implant 10 according to an exemplary embodiment of the invention.
Par exemple, l'implant 10 est une cage de type ALIF (acronyme anglais pour « Anterior Lumbar Interbody Fusion »).  For example, the implant 10 is a cage type ALIF (acronym for "Anterior Lumbar Interbody Fusion").
Toutefois, en variante, l'implant 10 pourrait être d'un autre type.  However, alternatively, the implant 10 could be of another type.
L'implant 10 est destiné de manière classique à être inséré dans un espace intervertébral délimité entre deux éléments vertébraux adjacents d'une colonne vertébrale, dits éléments vertébraux supérieur et inférieur.  The implant 10 is conventionally intended to be inserted into an intervertebral space delimited between two adjacent vertebral elements of a vertebral column, said upper and lower vertebral elements.
Dans l'exemple décrit, comme cela est représenté sur la figure 2, l'élément vertébral inférieur est un sacrum S1 et l'élément vertébral supérieur est une première vertèbre L5 adjacente au sacrum S1 . En variante, l'élément vertébral inférieur est une première vertèbre L5 adjacente au sacrum S1 , et l'élément vertébral supérieur est une seconde vertèbre L4 adjacente à la première vertèbre L5. In the example described, as shown in FIG. 2, the lower vertebral element is a sacrum S1 and the upper vertebral element is a first vertebra L5 adjacent to the sacrum S1. Alternatively, the lower vertebral element is a first L5 vertebra adjacent to the S1 sacrum, and the upper vertebral element is a second L4 vertebra adjacent to the first L5 vertebra.
Dans les deux cas, l'implant 10 est dimensionné pour être inséré dans l'espace intervertébral correspondant.  In both cases, the implant 10 is sized to be inserted into the corresponding intervertebral space.
L'implant 10 comporte un corps 12 présentant une face supérieure 14 destinée à être agencée en regard de l'élément vertébral supérieur lorsque l'implant 10 est implanté dans l'espace intervertébral, et une face inférieure 16 destinée à être à être agencée en regard de l'élément vertébral inférieur lorsque l'implant 10 est implanté.  The implant 10 comprises a body 12 having an upper face 14 intended to be arranged facing the upper vertebral element when the implant 10 is implanted in the intervertebral space, and a lower face 16 intended to be arranged in view of the lower vertebral element when implant 10 is implanted.
Les faces supérieure 14 et inférieure 16 sont inclinées l'une par rapport à l'autre. The upper 14 and lower 16 faces are inclined relative to each other.
Plus particulièrement, les faces supérieure 14 et inférieure 16 forment avantageusement entre elles un angle compris entre 8 et 30°, de préférence supérieur à 20°. More particularly, the upper 14 and lower faces 16 advantageously form between them an angle of between 8 and 30 °, preferably greater than 20 °.
Conformément au mode de réalisation décrit, le corps 12 comprend au moins une ouverture supérieure 18 ménagée dans la face supérieure 14, au moins une ouverture inférieure 20 ménagée dans la face inférieure 16. Le corps 12 comporte également un espace intérieur 22 s'étendant entre les ouvertures supérieure 18 et inférieure 20.  According to the embodiment described, the body 12 comprises at least one upper opening 18 formed in the upper face 14, at least one lower opening 20 formed in the lower face 16. The body 12 also comprises an interior space 22 extending between the upper 18 and lower 20 openings.
Plus particulièrement, le corps 12 comporte deux espaces intérieurs 22 séparés par une paroi intermédiaire centrale 24, et pour chaque espace intérieur 22, une ouverture supérieure 18 et une ouverture inférieure 20 respectives.  More particularly, the body 12 has two interior spaces 22 separated by a central intermediate wall 24, and for each interior space 22, an upper opening 18 and a lower opening 20 respectively.
Chaque espace intérieur 22 est destiné à recevoir un greffon, notamment de l'os autogène, des phospho-calcites de synthèse, des ostéo-inducteurs ou autre, destiné à favoriser une fusion osseuse entre les plateaux des vertèbres adjacentes. Un tel implant creux est également appelé « cage intersomatique ».  Each interior space 22 is intended to receive a graft, in particular autogenous bone, synthetic phospho-calcites, osteoinducers or other, intended to promote bone fusion between the trays of adjacent vertebrae. Such a hollow implant is also called "intersomatic cage".
Ainsi, la face supérieure 14 présente une surface supérieure de contact avec l'élément vertébral supérieur, encadrant les ouvertures supérieures 18. Plus particulièrement, la surface supérieure de contact s'étend circonférentiellement autour des ouvertures supérieures 18, et au-dessus de la paroi centrale 24.  Thus, the upper face 14 has an upper surface of contact with the upper vertebral element, flanking the upper openings 18. More particularly, the upper contact surface extends circumferentially around the upper openings 18, and above the wall Central 24.
De même, la face inférieure 16 présente une surface inférieure de contact avec l'élément vertébral inférieur, encadrant les ouvertures inférieure 20. Plus particulièrement, la surface inférieure de contact s'étend circonférentiellement autour des ouvertures inférieures 20, et en-dessous de la paroi centrale 24.  Similarly, the lower face 16 has a lower contact surface with the lower vertebral element, framing the lower openings 20. More particularly, the lower contact surface extends circumferentially around the lower openings 20, and below the central wall 24.
Chacune des faces supérieure 14 et inférieure 16 est rugueuse pour permettre un bon maintien avec l'élément vertébral supérieur ou inférieur correspondant. Par exemple, les faces supérieures 14 et inférieures 16 sont dentées, striées ou réticulées. Le corps 12 comporte par ailleurs une face arrière 26 et une face avant 28, s'étendant en hauteur entre les faces supérieure 14 et inférieure 16. Les faces arrière 26 et avant 28 sont généralement sensiblement perpendiculaires à un axe longitudinal X. Each of the upper 14 and lower 16 faces is rough to allow good support with the corresponding upper or lower vertebral element. For example, the upper faces 14 and lower 16 are toothed, ridged or crosslinked. The body 12 also has a rear face 26 and a front face 28, extending in height between the upper 14 and lower faces 16. The rear faces 26 and front 28 are generally substantially perpendicular to a longitudinal axis X.
Lorsque l'implant 10 est implanté dans l'espace intervertébral, l'axe longitudinal X est sensiblement parallèle à un axe dorso-ventral du patient, l'axe dorso-ventral étant classiquement définit par la direction de la succession dos, ventre.  When the implant 10 is implanted in the intervertebral space, the longitudinal axis X is substantially parallel to a dorso-ventral axis of the patient, the dorso-ventral axis being conventionally defined by the direction of the succession back belly.
Du fait de l'inclinaison des faces supérieure 14 et inférieure 16, la face arrière 26 présente une hauteur arrière, considérée parallèlement à un axe vertical Z perpendiculaire à l'axe longitudinal X, qui est inférieure à une hauteur avant de la face avant 28, considérée parallèlement à ce même axe vertical Z. Cet axe vertical Z est destiné à être sensiblement parallèle à un axe rostro-caudal R-C de la colonne vertébrale lorsque l'implant 10 est implanté.  Due to the inclination of the upper 14 and lower 16 faces, the rear face 26 has a rear height, considered parallel to a vertical axis Z perpendicular to the longitudinal axis X, which is less than a front height of the front face 28 , parallel to the same vertical axis Z. This vertical axis Z is intended to be substantially parallel to a rostro-caudal axis RC of the spine when the implant 10 is implanted.
Avantageusement, la face avant 28 comporte au moins une encoche 29, destinée à coopérer avec un outil de manipulation adapté, pour la manipulation de l'implant 10 lors de son implantation.  Advantageously, the front face 28 comprises at least one notch 29, intended to cooperate with a suitable handling tool, for the handling of the implant 10 during its implantation.
Le corps 12 comporte par ailleurs des faces latérales 30, reliant chacune les faces arrière 26 et avant 28.  The body 12 also has side faces 30, each connecting the rear faces 26 and front 28.
Chaque face latérale 30 comporte avantageusement une ouverture 32, par exemple traversante et débouchant dans l'espace intérieur 22 correspondant.  Each side face 30 advantageously comprises an opening 32, for example through and opening into the corresponding interior space 22.
La forme générale et les dimensions du corps 12 sont classiques, et choisies en fonction de l'espace intervertébral dans lequel l'implant 10 est destiné à être implanté.  The general shape and dimensions of the body 12 are conventional, and chosen according to the intervertebral space in which the implant 10 is intended to be implanted.
L'implant 10 selon l'invention comporte par ailleurs des éléments de fixation supérieur 34 et inférieur 36, prolongeant la face avant 28 du corps 12 dans la direction verticale Z.  The implant 10 according to the invention furthermore comprises upper and lower fastening elements 34, extending the front face 28 of the body 12 in the vertical direction Z.
L'élément de fixation supérieur 34 comportant des moyens supérieurs 38 de fixation à l'élément vertébral supérieur L5, et l'élément de fixation inférieur comportant des moyens inférieurs 40 de fixation à l'élément vertébral inférieur S1 . Ainsi, les éléments de fixation supérieur 34 et inférieur 36 s'étendent suffisamment dans la direction verticale Z pour que les moyens supérieur 38 et inférieur 40 de fixation se trouvent en regard de l'élément vertébral supérieur L5 ou inférieur S1 correspondant lorsque l'implant 10 est implanté.  The upper fixation element 34 having upper means 38 for attachment to the upper vertebral element L5, and the lower fixation element having lower means 40 for attachment to the lower vertebral element S1. Thus, the upper fastening elements 34 and lower 36 extend sufficiently in the vertical direction Z so that the upper means 38 and the lower fastening means 40 are opposite the upper vertebral element L5 or lower S1 corresponding when the implant 10 is implanted.
Par exemple, chaque élément de fixation supérieur 34 ou inférieur 36 présente une forme générale de languette.  For example, each upper attachment member 34 or lower 36 has a general tab shape.
De préférence, chaque élément de fixation 34, 36 présente une longueur comprise entre 10 et 15 mm, par exemple sensiblement égale à 12,5 mm, prise dans la direction de l'axe vertical Z, depuis la jonction entre cet élément de fixation 34, 36 et la face supérieure 14 ou inférieure 16 correspondante. Preferably, each fastening element 34, 36 has a length of between 10 and 15 mm, for example substantially equal to 12.5 mm, taken in the direction of the vertical axis Z, from the junction between this fastener 34, 36 and the corresponding upper face 14 or lower 16.
Avantageusement, les moyens supérieurs de fixation 38 comportent un orifice supérieur de passage d'un organe supérieur de fixation, notamment d'une vis. Cet orifice supérieur de passage se trouve en regard de l'élément vertébral supérieur L5 lorsque l'implant 10 est implanté, comme cela est visible sur la figure 2.  Advantageously, the upper fixing means 38 comprise an upper orifice for the passage of an upper fastening member, in particular a screw. This upper passage opening is opposite the upper vertebral element L5 when the implant 10 is implanted, as can be seen in FIG. 2.
De même, les moyens inférieurs de fixation 38 comportent un orifice inférieur de passage d'un organe inférieur de fixation, notamment d'une vis. Cet orifice inférieur de passage se trouve en regard de l'élément vertébral inférieur S1 lorsque l'implant 10 est implanté, comme cela est visible sur la figure 2.  Similarly, the lower fastening means 38 comprise a lower passage opening of a lower fastening member, in particular a screw. This lower passage opening is opposite the lower vertebral element S1 when the implant 10 is implanted, as can be seen in FIG. 2.
Avantageusement, le corps 12 et les éléments de fixation 34, 36 sont venus de matière. L'implant 10, ainsi monobloc, ne présente aucune discontinuité de matière.  Advantageously, the body 12 and the fixing elements 34, 36 are integral. The implant 10, thus monobloc, has no discontinuity material.
De préférence, le corps 12 et/ou les éléments de fixation 34, 36 sont réalisés par impression tridimensionnelle.  Preferably, the body 12 and / or the fastening elements 34, 36 are made by three-dimensional printing.
Le corps 12 et les éléments de fixation 34, 36 sont réalisés en un matériau biocompatible, par exemple en titane. En variante, le corps 12 et les éléments de fixation 34, 36 sont réalisés dans tout matériau adapté, par exemple en acier inoxydable, en polymère, etc.  The body 12 and the fixing elements 34, 36 are made of a biocompatible material, for example titanium. Alternatively, the body 12 and the fasteners 34, 36 are made of any suitable material, for example stainless steel, polymer, etc.
On notera que les éléments de fixation 34, 36 selon l'invention permettent une fixation fiable et stable de l'implant 10 dans l'espace intersomatique. Cette fixation fiable et stable permet notamment l'utilisation d'un corps 12 dont l'angle entre les faces supérieure 14 et inférieure 16 est particulièrement important (notamment supérieur à 20° par exemple). Les éléments de fixation 34, 36 selon l'invention permettent d'éviter une expulsion de l'implant 10, même dans le cas d'un angle important.  Note that the fasteners 34, 36 according to the invention allow a reliable and stable attachment of the implant 10 in the intersomatic space. This reliable and stable fastening allows in particular the use of a body 12 whose angle between the upper 14 and lower 16 faces is particularly important (especially greater than 20 ° for example). The fixing elements 34, 36 according to the invention make it possible to avoid an expulsion of the implant 10, even in the case of a large angle.
On notera que l'invention n'est pas limitée au mode de réalisation précédemment décrit, et pourrait présenter diverses variantes.  Note that the invention is not limited to the embodiment described above, and could have various variants.

Claims

REVENDICATIONS
1 . Implant intersomatique (10) destiné à être inséré dans un espace intervertébral délimité entre un élément vertébral supérieur (L5) et un élément vertébral inférieur (S1 ) adjacents d'une colonne vertébrale s'étendant s'étendant le long d'un axe rostro-caudal (R-C) et perpendiculairement à un axe dorso-ventral (D-V), l'implant (10) comportant un corps (12) présentant une face supérieure (14) et une face inférieure (16), ainsi qu'une face arrière (26) et une face avant (28) sensiblement perpendiculaires à un axe longitudinal (X) destiné à être sensiblement parallèle à l'axe dorso-ventral (D-V), caractérisé en ce que l'implant intersomatique (10) comporte des éléments de fixation supérieur (34) et inférieur (36), prolongeant la face avant (28) du corps (12) dans une direction verticale (Z) perpendiculaire à l'axe longitudinal (X) et destinée à être parallèle à l'axe rostro-caudal (R-C), l'élément de fixation supérieur (34) comportant des moyens supérieurs (38) de fixation à l'élément vertébral supérieur (L5), et l'élément de fixation inférieur (36) comportant des moyens inférieurs (40) de fixation à l'élément vertébral inférieur (S1 ). 1. An intersomatic implant (10) for insertion into an intervertebral space delimited between an upper vertebral element (L5) and an adjacent lower vertebral element (S1) of an extending spine extending along a rostrum axis. caudal (RC) and perpendicularly to a dorso-ventral axis (DV), the implant (10) comprising a body (12) having an upper face (14) and a lower face (16), and a rear face ( 26) and a front face (28) substantially perpendicular to a longitudinal axis (X) intended to be substantially parallel to the dorso-ventral axis (DV), characterized in that the intersomatic implant (10) comprises fixing elements upper (34) and lower (36), extending the front face (28) of the body (12) in a vertical direction (Z) perpendicular to the longitudinal axis (X) and intended to be parallel to the rostro-caudal axis (RC), the upper fastening element (34) comprising means upper attaching members (38) to the upper vertebral element (L5), and the lower fixation member (36) having lower means (40) for attachment to the lower vertebral element (S1).
2. Implant intersomatique (10) selon la revendication 1 , dans lequel le corps (12) et les éléments de fixation supérieur (34) et inférieur (36) sont venus de matière. The interbody implant (10) of claim 1, wherein the body (12) and the upper (34) and lower (36) fasteners are integral.
3. Implant intersomatique (10) selon la revendication 2, dans lequel le corps (12) et/ou les éléments de fixation supérieur (34) et inférieur (36) sont réalisés par impression tridimensionnelle. The interbody implant (10) of claim 2, wherein the body (12) and / or the upper (34) and lower (36) fasteners are made by three-dimensional printing.
4. Implant intersomatique (10) selon l'une quelconque des revendications précédentes, dans lequel chaque élément de fixation (34, 36) présente une forme générale de languette. The intersomatic implant (10) according to any one of the preceding claims, wherein each fastener (34, 36) has a generally tongue shape.
5. Implant intersomatique (10) selon l'une quelconque des revendications précédentes, dans lequel les moyens de fixation supérieur (38) et inférieur (40) comportent chacun un orifice de passage d'un organe de fixation, notamment d'une vis, ménagé dans l'élément de fixation supérieur (34) ou inférieur (36) correspondant. An intersomatic implant (10) according to any one of the preceding claims, wherein the upper (38) and lower (40) attachment means each comprise a passage opening of a fastener, in particular a screw, formed in the corresponding upper fastening element (34) or lower (36).
6. Implant intersomatique (10) selon l'une quelconque des revendications précédentes, dans lequel les faces supérieure (14) et inférieure (16) sont inclinées l'une par rapport à l'autre, d'un angle compris entre 8 et 30°, de préférence supérieur à 20°. The intersomatic implant (10) according to any one of the preceding claims, wherein the upper (14) and lower (16) faces are inclined relative to each other by an angle of between 8 and 30. °, preferably greater than 20 °.
7. Implant intersomatique (10) selon l'une quelconque des revendications précédentes, dimensionné pour être inséré dans un espace intervertébral délimité entre un élément vertébral inférieur formé par un sacrum (S1 ) et un élément vertébral supérieur formé par une première vertèbre (L5) adjacente au sacrum (S1 ), ou dans un espace intervertébral délimité entre un élément vertébral inférieur formé par une première vertèbre (L5) adjacente au sacrum (S1 ) et un élément vertébral supérieur formé par une seconde vertèbre (L4) adjacente à la première vertèbre (L5). The intersomatic implant (10) according to any one of the preceding claims, sized to be inserted into an intervertebral space delimited between a lower vertebral element formed by a sacrum (S1) and an upper vertebral element formed by a first vertebra (L5). adjacent to the sacrum (S1), or in an intervertebral space delimited between a lower vertebral element formed by a first vertebra (L5) adjacent to the sacrum (S1) and an upper vertebral element formed by a second vertebra (L4) adjacent to the first vertebra (L5).
8. Implant intersomatique (10) selon l'une quelconque des revendications précédentes, comprenant au moins une ouverture supérieure (18) ménagée dans la face supérieure (14), au moins une ouverture inférieure (20) ménagée dans la face inférieure (16), et un espace intérieur (22) s'étendant entre les ouvertures inférieure (18) et supérieure (20). 8. intersomatic implant (10) according to any one of the preceding claims, comprising at least one upper opening (18) formed in the upper face (14), at least one lower opening (20) formed in the lower face (16). , and an interior space (22) extending between the lower (18) and upper (20) openings.
9. Implant intersomatique (10) selon l'une quelconque des revendications précédentes, dans lequel au moins l'une des faces supérieure (14) ou inférieure (16) est rugueuse, par exemple comprend une pluralité de dents ou de rainures, ou est réticulée. The interbody implant (10) according to any one of the preceding claims, wherein at least one of the upper (14) or lower (16) faces is rough, for example comprises a plurality of teeth or grooves, or is crosslinked.
PCT/EP2018/050285 2017-01-06 2018-01-05 Intersomatic implant with improved stability WO2018127567A1 (en)

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US5713899A (en) * 1995-04-27 1998-02-03 Societe Jbs Sa Cervical cage designed for the performance of intersomatic arthrodesis
FR2747034A1 (en) * 1996-04-03 1997-10-10 Scient X INTERSOMATIC CONTAINMENT AND MERGER SYSTEM
US20110282392A1 (en) * 2006-10-30 2011-11-17 Tissue Regeneration Systems, Inc. Degradable cage for bone fusion
US8287579B2 (en) * 2007-09-17 2012-10-16 Thermage, Inc. Method of using cryogenic compositions for cooling heated skin
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