WO2021092948A1 - Cages de fusion intersomatique - Google Patents

Cages de fusion intersomatique Download PDF

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Publication number
WO2021092948A1
WO2021092948A1 PCT/CN2019/118944 CN2019118944W WO2021092948A1 WO 2021092948 A1 WO2021092948 A1 WO 2021092948A1 CN 2019118944 W CN2019118944 W CN 2019118944W WO 2021092948 A1 WO2021092948 A1 WO 2021092948A1
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WO
WIPO (PCT)
Prior art keywords
shaft
slideway
fusion
fusion cage
cage according
Prior art date
Application number
PCT/CN2019/118944
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English (en)
Chinese (zh)
Inventor
邹丽敏
杨海东
孙君
李顺锋
李想
Original Assignee
邹丽敏
杨海东
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 邹丽敏, 杨海东 filed Critical 邹丽敏
Priority to PCT/CN2019/118944 priority Critical patent/WO2021092948A1/fr
Publication of WO2021092948A1 publication Critical patent/WO2021092948A1/fr

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    • 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

Definitions

  • the present invention relates to the field of medical equipment, in particular to an intervertebral fusion cage.
  • Lumbar degenerative diseases including lumbar spinal stenosis, lumbar spondylolisthesis, degenerative scoliosis, and intervertebral disc-derived diseases, etc.
  • Its treatment principle is to relieve nerve compression and rebuild the stability of the spine.
  • the use of intervertebral fusion cages implanted in the affected area of intervertebral disease to expand, compress and stabilize the diseased intervertebral space has gradually developed into a standard treatment for lumbar degenerative diseases.
  • an intervertebral fusion cage with a high degree of matching with the lumbar vertebral space and good fusion effect of the vertebral body space is provided.
  • An intervertebral fusion cage including:
  • the first expansion member is installed on the shaft body and can move along the axial direction of the shaft body.
  • the first expansion member has an inner end and an outer end distributed along the radial direction of the shaft body. The end is connected with the shaft body;
  • the fusion body is arranged in the circumferential direction of the shaft body and connected to the outer end of the first expansion member.
  • the inner wall of the fusion body is provided with a first slideway, and the extension direction of the first slideway is the same as
  • An included angle is arranged between the outer walls of the fusion body, and the outer end of the first spreading member is movably arranged in the first slideway.
  • Figure 1 is a schematic diagram of an embodiment of the intervertebral fusion cage
  • Fig. 2 is a schematic diagram of the structure of the first distractor in the intervertebral fusion cage shown in Fig. 1;
  • Fig. 3 is a schematic diagram of the structure of the fusion part in the intervertebral fusion cage shown in Fig. 1;
  • Figure 4 is an assembly diagram of the fusion part and the first distractor of the intervertebral fusion cage as shown in Figure 1
  • Figure 5 is a cross-sectional view of the fusion part in the intervertebral fusion cage shown in Figure 1
  • Figure 6 is a side view of the intervertebral fusion cage as shown in Figure 1 in a deployed state
  • Figure 7 is a side view of the closed state of the intervertebral fusion cage shown in Figure 1;
  • Fig. 8 is a schematic structural diagram of a second distracting member in the intervertebral fusion cage shown in Fig. 1;
  • Figure 9 is a side view of another embodiment of the intervertebral fusion cage in a deployed state
  • Fig. 10 is a schematic diagram of the structure of the fusion part in the intervertebral fusion cage shown in Fig. 1;
  • Fig. 11 is a schematic diagram of the working state of the intervertebral fusion cage shown in Fig. 1.
  • an intervertebral fusion cage 10 is used to expand, compress and stabilize the diseased intervertebral space.
  • the intervertebral fusion cage 10 includes a shaft body 100, a first expansion member 200 and a fusion body 300.
  • the first expansion member 200 is mounted on the shaft body 100, and the first expansion member 200 can move along the axial direction of the shaft body 100.
  • the first expansion member 200 has an inner end and an outer end distributed along the radial direction of the shaft body 100.
  • the fusion body 300 is arranged circumferentially around the shaft body 100 to surround the shaft body 100 and the first expansion member 200 and is connected to the outer end of the first expansion member 200.
  • the inner wall of the fusion body 300 close to the shaft 100 is provided with a first slideway 310, and an angle is formed between the extending direction of the first slideway 310 and the outer wall of the fusion body 300.
  • the outer end of the first spreading member 200 is movably arranged in the first slideway 310. Sliding the first spreading member 200 along the first slideway 310 can change the distance between the inner wall of the fusion body 300 and the shaft 100, thereby changing the distance between the inner wall of the fusion body 300 and the shaft 100.
  • the expansion range of the intervertebral fusion cage 10 can be adjusted according to the specific conditions of the intervertebral space, and the contact surface with the vertebral body space can be enlarged to better adapt and match the intervertebral space, and also maintain the vertebral space.
  • the height of the gap restores the physiological curvature of the lumbar spine.
  • the intervertebral fusion cage 10 is closed before implantation, and the overall volume is small, which can meet the requirements of different surgical approaches (anterior approach, posterior approach, transforaminal approach) for the volume of the intervertebral fusion cage 10 .
  • the fusion body 300 includes four fusion parts 320, the four fusion parts 320 are arranged at intervals around the shaft 100, and each fusion part 320 is provided with a first slide 310, and the first expansion The piece 200 extends into the four first slideways 310, and the fusion portion 320 and the shaft body 100 are connected by the first spreading piece 200.
  • the first spreading member 200 includes a first threaded ring 210 and four first supporting rods 220. The first threaded ring 210 is sleeved on the shaft body 100 and is threadedly connected with the shaft body 100.
  • the four first supporting rods 220 are circumferentially and evenly arranged around the first threaded ring 210 to form a cross shape.
  • the four first struts 220 and the four first slides 310 are arranged in one-to-one correspondence, so as to connect the fusion portion 320 with the shaft body 100.
  • the inner walls on both sides of the first slideway 310 are extended with first bending portions 330, and the two first bending portions 330 extend in a direction approaching each other, and the outer end of the first spreading member 200 It is clamped in the first chute 310 and abuts against the first bending part 330.
  • the first support rod 220 includes a first body 221 and a first shaft 222.
  • the cross section of the first slide 310 is a "T" shape, and the first shaft 222 is clamped in the first slide 310, respectively It abuts against the bottom wall of the first slideway 310 and the first bending portion 330.
  • the first body 221 is connected to the first shaft 222 and the first threaded ring 210.
  • the first shaft 222 is cylindrical and is fixedly connected to the end of the first body 221 away from the first threaded ring 210.
  • the fusion portion 320 can rotate around the first shaft 222, so that the fusion portion 320 is driven by the first spreading member 200 The bottom can be stretched.
  • the cross-shaped first spreader 200 is matched with the first slide 310.
  • the four fusion parts 320 have the same structure, and the adjacent or opposite fusion parts 320 of the four fusion parts 320 are all arranged symmetrically.
  • the expanded state of the four fusion portions 320 is more uniform, the space occupied after expansion is larger, and the supporting effect on the vertebral body is better.
  • the first body 221 is in an interference connection with the first slideway 310 and has a certain moving resistance to prevent the first spreading member 200 from sliding along the first slideway 310 under the action of gravity.
  • the material of the fusion body 300 can be titanium alloy or tantalum alloy or high molecular polyether ether ketone or the like.
  • matching first slide 310 and first support rod 220 may be provided.
  • the inner wall of the fusion portion 320 is further provided with an avoiding groove 340, the avoiding groove 340 is parallel to the shaft body 100, and a part of the shaft body 100 is accommodated in the avoiding groove 340.
  • the avoidance groove matching the shape of the shaft body 100 is set as an arc shape to reduce the rotation resistance.
  • the intervertebral fusion cage 10 further includes a second expansion member 400.
  • the second expansion member 400 and the first expansion member 200 are respectively screwed to two ends of the shaft body 100.
  • the shaft body 100 is matched with the first expansion member 200 and is provided with a first thread 110
  • the shaft body 100 is matched with the second expansion member 400 and is further provided with a second thread 120.
  • the first thread 110 and the second thread 120 are respectively arranged in The upper and lower ends of the shaft 100.
  • the rotation directions of the first thread 110 and the second thread 120 are opposite, the first thread 110 is a right-hand thread, and the second thread 120 is a left-hand thread.
  • the pitch of the first thread 110 is greater than the pitch of the second thread 120.
  • the fusion portion 320 is further provided with a second slideway 350, and the end of the second spreading member 400 away from the shaft body 100 is provided in the second slideway 350.
  • the first chute 310 and the second chute 350 are respectively provided at both ends of the fusion part 320.
  • An angle is set between the extension line of the second chute 350 and the shaft body 100.
  • the first chute 310 has an angle along the shaft body 100.
  • the first slide 310 gradually inclined to the shaft body 100 to approach the shaft body 100, along the axis From the top of the body 100 to the center line of the shaft body 100, the distance from the inner wall of the first slide 310 to the shaft body 100 gradually decreases.
  • the second slideway 350 has an inner end and an outer end distributed along the longitudinal direction of the shaft body 100.
  • the second slideway 350 gradually Incline to the shaft body 100 to approach the shaft body 100, and along the direction from the bottom of the shaft body 100 to the center line of the shaft body 100, the distance from the inner wall of the second slideway 350 to the shaft body 100 gradually decreases.
  • the shaft 100 is rotated to perform the expansion operation on the intervertebral fusion cage 10, and the first expansion member 200 and the second expansion member 400 simultaneously move from both ends of the shaft 100 toward the midline of the shaft 100 to align the vertebral body.
  • the two ends of the intermediate cage 10 are expanded.
  • the pitch of the first thread 110 is greater than the pitch of the second thread 120, the moving speed of the first spreading member 200 will be faster and the moving distance will be greater, so that the first support
  • the degree to which the opening 200 stretches the top of the intervertebral fusion cage 10 is greater than the degree to which the second expansion member 400 stretches the bottom of the intervertebral fusion cage 10.
  • the size of the top spread of the intervertebral fusion cage 10 is the fusion
  • the side view of the intervertebral fusion cage 10 after unfolding is trapezoidal.
  • the normal lumbar intervertebral space is wide anteriorly and narrowly rearward.
  • the intervertebral fusion cage 10 in the state where both ends are stretched can match the normal vertebral body space after implantation, thereby restoring the original position at the implantation site.
  • Physiological curvature of the lumbar spine is Physiological curvature of the lumbar spine.
  • the second spreading member 400 includes a second threaded ring 410 and four second supporting rods 420.
  • the second threaded ring 410 is sleeved on the shaft body 100 and is threadedly connected with the shaft body 100.
  • the four second supporting rods 420 are circumferentially and evenly arranged around the second threaded ring 410 to form a cross shape.
  • the second support rod 420 includes a second body 421 and a second shaft 422.
  • the cross section of the second slideway 350 is a "T" shape.
  • the second shaft 422 is clamped in the second slideway 350 and is respectively connected to the second slideway 350.
  • the bottom wall of the channel 350 abuts against the second bending part 430.
  • the second body 421 is connected to the second shaft 422 and the second threaded ring 410.
  • the second shaft 100 is cylindrical, and is fixedly connected to the end of the second body 421 away from the second threaded ring 410.
  • the fusion portion 320 can rotate around the second shaft 422, so that the fusion portion 320 is driven by the second spreading member 400 The bottom can be stretched.
  • the four second supporting rods 420 and the four second sliding rails 350 are arranged in one-to-one correspondence to connect the fusion portion 320 and the shaft body 100.
  • the pitch of the second threaded ring 410 is smaller than the pitch of the first threaded ring 210, and the second threaded ring 410 is adapted to the second thread 120 to ensure that the moving distances of the first spreader 200 and the second spreader 400 are different. It should be noted that, referring again to FIG.
  • the end of the shaft body 100 is provided with an operating hole 130.
  • the operating hole 130 is cross-shaped and can be rotated by a workpiece matching the shape of the operating hole 130.
  • the operating hole 130 may also have a regular hexagonal shape, a plum blossom shape, or the like.
  • the second slideway 350 and the first slideway 310 are arranged symmetrically with respect to the midpoint of the shaft body 100, so that the first spreading member 200 and the second spreading member 400 can be kept synchronized during movement. Performance and stability to ensure the expansion effect of the intervertebral fusion cage 10.
  • a limit section 140 is provided between the first thread 110 and the second thread 120 on the shaft body 100, and the limit section 140 is not provided with threads, the first spreading member 200 or the second When the expansion member 400 moves to the limit section 140, it cannot continue to move.
  • the limit section 140 can limit the movement stroke of the first expansion member 200 or the second expansion member 400, avoiding the first expansion member 200 and the second expansion member 200.
  • the two spreaders 400 collide.
  • the shaft 100 is set as a first shaft 150 and a second shaft 160 spaced apart, and the first shaft 150 and the second shaft 160 are arranged coaxially.
  • the first spreading member 200 is threadedly connected with the first shaft 150.
  • the first shaft 150 rotates to drive the first spreading member 200 to move along the first slide 310.
  • the downward movement of the opening 200 will propagate the upper end of the intervertebral fusion cage 10.
  • the second expansion member 400 is threadedly connected with the second shaft 160.
  • the rotation of the second shaft 160 drives the second expansion member 400 to move along the second slideway 350.
  • the upward movement of the second expansion member 400 will affect the intervertebral fusion cage.
  • the lower end of 10 is stretched.
  • the first shaft 150 is provided with a first operating hole (not shown), the first operating hole extends along the axial direction of the first shaft 150 and passes through the first shaft 150, and the second shaft 160 is provided with a second operating hole (Not shown in the figure), the second operating hole extends along the axial direction of the second shaft 160 and penetrates the second shaft 160, and the first operating hole and the second operating hole are arranged opposite to each other.
  • both the first operating hole and the second operating hole can be set in a cross shape, and the workpiece is rotated by matching the shape. When the movement of the first spreading member 200 needs to be driven, the workpiece is extended into the first operating hole It is sufficient to rotate the first shaft 150 in the middle.
  • the movable member When it is necessary to drive the movement of the second spreading member 400, the movable member can be extended into the first operating hole, and inserted into the second operating hole through the first operating hole to rotate the second shaft 160.
  • the material of the fusion body 300 should be a material with a certain deformability, such as a polyurethane material.
  • a finite section 140 is provided on the end of the first shaft 150 close to the second shaft 160.
  • a finite section 140 is provided on the end of the second shaft 160 close to the first shaft 150 to The strokes of the first expansion member 200 and the second expansion member 400 are respectively restricted.
  • two opposite surfaces of the fusion body 300 are provided with teeth 500.
  • the toothed portion 500 is provided on the end surface of the fusion portion 320 that is in contact with the vertebral body.
  • the toothed portion 500 may be in the shape of a saw tooth, which can increase the friction with the contact surface, thereby enhancing stability and avoiding implantation of the cage. Moved after entering.
  • the shape of the fusion portion 320 is a ladder, and the toothed portion 500 is provided on the slope of the ladder.
  • the shape of the fusion portion 320 may be a rectangular parallelepiped, a cylinder, etc., and the tooth-shaped portion 500 is correspondingly disposed on the surface that is in contact with the vertebral body.
  • the fusion part 320 has a hollow structure inside, and the hollow fusion part 320 can store more allogeneic bone powder.
  • a hollow layer 600 is provided in the fusion portion 320.
  • the hollow layer 600 includes a hollow surface 610 and a bottom surface (not shown) disposed oppositely.
  • the hollow surface 610 is provided on the outer wall of the fusion portion 320, and is provided on the outer wall of the fusion portion 320.
  • a plurality of hollow holes are formed to form a hollow surface 610.
  • the hollow surface 610 and the toothed portion 500 are spaced apart, and the bottom surface is opposite to the hollow surface 610.
  • a cavity 620 is provided between the hollow surface 610 and the bottom surface to ensure a greater degree of grasping.
  • the allogeneic bone meal promotes the induction of bone tissue to grow into the pores, promotes the fusion of the vertebral bodies, and enhances the mechanical locking of the intervertebral fusion cage 10, thereby obtaining a better long-term fixation effect.
  • the bottom surface and the inner wall of the fusion part 320 have a predetermined distance to avoid the hollow structure of the inner walls of the first slide 310 and the second slide 350, and to ensure that the first spreader 200 slides on the first slide 310 and the second spreader The stability of 400 when sliding on the second slide 350.
  • the tooth-shaped part 500 can also be circumferentially arranged on the fusion part 320, so that when the intervertebral fusion cage 10 is implanted, the angle of the tooth-shaped part 500 is opposite to the vertebral body. It is more flexible, and at the same time, in order to accommodate the allogeneic bone powder, a toothed portion and a hollow surface 610 are provided on the end surface of the fusion portion 320 at the same time.
  • the internal structure of the intervertebral fusion cage 10 of this embodiment is simple. By replacing the different shafts 100, the first distracting member 200, and the second distracting member 400, it is possible to meet the needs of patients with different degrees of disease and different intervertebral spaces. The individual needs of different heights or different angles in the area have greatly improved the scope of application.
  • the intervertebral fusion cage 10 is implanted in the intervertebral space 11, the initial contact between the vertebral body 12 and the intervertebral fusion cage 10 will compress the intervertebral fusion cage 10. Then, the intervertebral fusion cage 10 is properly deployed according to the size of the intervertebral space 11. Due to the force of the vertebral body 12 on the intervertebral fusion cage 10, when the workpiece rotates the shaft 100, the first distractor 200 and the second distractor 400 will move on the shaft 100. Specifically, the workpiece rotates the proximal end of the shaft body 100.
  • the first spreading member 200 and the second spreading member 400 will approach the middle of the shaft body 100 along the shaft body 100.
  • the expansion member 200 moves faster, and the expanded size of the proximal end of the intervertebral fusion cage 10 is larger to match the normal lumbar intervertebral space 11 that is wide in the front and narrow in the back, so as to expand, compress and stabilize the damaged intervertebral space 11.
  • first and second are only used for descriptive purposes, and cannot be understood as indicating or implying relative importance or implicitly indicating the number of indicated technical features. Therefore, the features defined with “first” and “second” may explicitly or implicitly include at least one of the features. In the description of the present invention, “plurality” means at least two, such as two, three, etc., unless otherwise specifically defined.
  • the terms “installed”, “connected”, “connected”, “fixed” and other terms should be understood in a broad sense, for example, it can be a fixed connection or a detachable connection. , Or integrated; it can be mechanically connected or electrically connected; it can be directly connected or indirectly connected through an intermediary, it can be the internal connection of two components or the interaction relationship between two components, unless otherwise specified The limit.
  • installed can be a fixed connection or a detachable connection. , Or integrated; it can be mechanically connected or electrically connected; it can be directly connected or indirectly connected through an intermediary, it can be the internal connection of two components or the interaction relationship between two components, unless otherwise specified The limit.
  • the specific meanings of the above-mentioned terms in the present invention can be understood according to specific situations.
  • the first feature “on” or “under” the second feature may be in direct contact with the first and second features, or the first and second features may be indirectly through an intermediary. contact.
  • the "above”, “above” and “above” of the first feature on the second feature may mean that the first feature is directly above or diagonally above the second feature, or it simply means that the level of the first feature is higher than the second feature.
  • the “below”, “below” and “below” of the second feature of the first feature may be that the first feature is directly below or obliquely below the second feature, or it simply means that the level of the first feature is smaller than the second feature.

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Neurology (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

La présente invention concerne une cage de fusion intersomatique (10) comprenant un arbre (100), un premier élément d'expansion (200), et un corps de fusion (300). Le premier élément d'expansion (200) est monté sur l'arbre (100) et peut se déplacer dans la direction axiale de l'arbre (100) ; le premier élément d'expansion (200) comprend des extrémités internes et externes réparties dans la direction radiale de l'arbre (100) ; les extrémités internes sont reliées à l'arbre (100) ; le corps de fusion (300) est disposé de manière circonférentielle autour de l'arbre (100), et est relié aux extrémités externes du premier élément d'expansion (200) ; des premières voies de coulissement (310) sont disposées sur les parois internes du corps de fusion (300) ; des angles inclus sont formés entre les directions d'extension des premières voies de coulissement (310) et les parois externes du corps de fusion (300) ; les extrémités externes du premier élément d'expansion (200) sont disposées de façon mobile dans les premières voies de coulissement (310).
PCT/CN2019/118944 2019-11-15 2019-11-15 Cages de fusion intersomatique WO2021092948A1 (fr)

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PCT/CN2019/118944 WO2021092948A1 (fr) 2019-11-15 2019-11-15 Cages de fusion intersomatique

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PCT/CN2019/118944 WO2021092948A1 (fr) 2019-11-15 2019-11-15 Cages de fusion intersomatique

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Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN105769391A (zh) * 2016-04-05 2016-07-20 广州爱锘德医疗器械有限公司 椎体融合器
CN206239558U (zh) * 2016-08-26 2017-06-13 张衣北 一种可调节椎间固定融合器
US20170231780A1 (en) * 2014-08-05 2017-08-17 Paul S. D'Urso Expandable fusion cage
CN107405204A (zh) * 2014-11-12 2017-11-28 爱整形外科公司 通用扩张融合器
CN107427371A (zh) * 2015-01-20 2017-12-01 整体植入有限公司 稳定的椎间的支架系统
CN208243665U (zh) * 2017-07-17 2018-12-18 博能华医疗器械（北京）有限公司 一种可撑开型椎间融合器
CN208464353U (zh) * 2018-02-12 2019-02-05 博能华医疗器械（北京）有限公司 一种四面可撑开型椎间融合器
CN109820626A (zh) * 2019-03-15 2019-05-31 博能华医疗器械（北京）有限公司 一种四向展开的椎间融合器
CN110402124A (zh) * 2017-01-10 2019-11-01 整体植入有限公司 可扩张的椎间融合装置

Patent Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20170231780A1 (en) * 2014-08-05 2017-08-17 Paul S. D'Urso Expandable fusion cage
CN107405204A (zh) * 2014-11-12 2017-11-28 爱整形外科公司 通用扩张融合器
CN107427371A (zh) * 2015-01-20 2017-12-01 整体植入有限公司 稳定的椎间的支架系统
CN105769391A (zh) * 2016-04-05 2016-07-20 广州爱锘德医疗器械有限公司 椎体融合器
CN206239558U (zh) * 2016-08-26 2017-06-13 张衣北 一种可调节椎间固定融合器
CN110402124A (zh) * 2017-01-10 2019-11-01 整体植入有限公司 可扩张的椎间融合装置
CN208243665U (zh) * 2017-07-17 2018-12-18 博能华医疗器械（北京）有限公司 一种可撑开型椎间融合器
CN208464353U (zh) * 2018-02-12 2019-02-05 博能华医疗器械（北京）有限公司 一种四面可撑开型椎间融合器
CN109820626A (zh) * 2019-03-15 2019-05-31 博能华医疗器械（北京）有限公司 一种四向展开的椎间融合器

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