DE10309986A1 - Implant to be used for reconstruction of vertebral body, comprising multitude of small ball-shaped elements inserted with specific instrument - Google Patents
Implant to be used for reconstruction of vertebral body, comprising multitude of small ball-shaped elements inserted with specific instrument Download PDFInfo
- Publication number
- DE10309986A1 DE10309986A1 DE10309986A DE10309986A DE10309986A1 DE 10309986 A1 DE10309986 A1 DE 10309986A1 DE 10309986 A DE10309986 A DE 10309986A DE 10309986 A DE10309986 A DE 10309986A DE 10309986 A1 DE10309986 A1 DE 10309986A1
- Authority
- DE
- Germany
- Prior art keywords
- implant
- vertebral body
- elements
- interior
- insertion sleeve
- Prior art date
- Legal status (The legal status 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 status listed.)
- Granted
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7094—Solid vertebral fillers; devices for inserting such fillers
- A61B17/7095—Solid vertebral fillers; devices for inserting such fillers the filler comprising unlinked macroscopic particles
-
- 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
-
- 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
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4601—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for introducing bone substitute, for implanting bone graft implants or for compacting them in the bone cavity
-
- 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
- A61F2002/30108—Shapes
- A61F2002/30199—Three-dimensional shapes
- A61F2002/30224—Three-dimensional shapes cylindrical
- A61F2002/30235—Three-dimensional shapes cylindrical tubular, e.g. sleeves
-
- 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
- A61F2002/30108—Shapes
- A61F2002/30199—Three-dimensional shapes
- A61F2002/30242—Three-dimensional shapes spherical
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—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
- A61F2002/4625—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 with relative movement between parts of the instrument during use
- A61F2002/4627—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 with relative movement between parts of the instrument during use with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument
-
- 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
- A61F2002/4635—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using minimally invasive surgery
-
- 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0063—Three-dimensional shapes
- A61F2230/0069—Three-dimensional shapes cylindrical
-
- 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0063—Three-dimensional shapes
- A61F2230/0071—Three-dimensional shapes spherical
-
- 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
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00005—The prosthesis being constructed from a particular material
- A61F2310/00179—Ceramics or ceramic-like structures
- A61F2310/00293—Ceramics or ceramic-like structures containing a phosphorus-containing compound, e.g. apatite
-
- 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
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00005—The prosthesis being constructed from a particular material
- A61F2310/00353—Bone cement, e.g. polymethylmethacrylate or PMMA
Abstract
Description
Die Erfindung betrifft ein Implantat zum Wiederaufbau eines in seiner Tätigkeit eingeschränkten oder gebrochenen Wirbelkörpers einer menschlichen Wirbelsäule sowie ein Implantatsystem umfassend ein Implantat und eine Einsetzvorrichtung zum Einführen des Implantats in einen Innenraum des Wirbelkörpers.The invention relates to an implant to rebuild a restricted or broken vertebral body a human spine and an implant system comprising an implant and an insertion device to introduce of the implant in an interior of the vertebral body.
Ferner betrifft die Erfindung ein Verfahren zum Wiederaufbau eines in seiner Tätigkeit eingeschränkten oder gebrochenen Wirbelkörpers einer menschlichen Wirbelsäule.The invention further relates to a Procedure for the reconstruction of a restricted or broken vertebral body a human spine.
Ein Wirbelkörper der menschlichen Wirbelsäule kann in seiner Tragfähigkeit krankheitsbedingt eingeschränkt oder aufgrund eines Unfalls oder krankheitsbedingt gebrochen sein. Eine krankheitsbedingte Schädigung des Wirbelkörpers kann zum Beispiel durch Osteoporose verursacht sein.A vertebral body of the human spine can in its carrying capacity limited due to illness or broken due to an accident or illness. An illness-related injury of the vertebral body can be caused, for example, by osteoporosis.
Die Osteoporose ist eine Krankheit des Gesamtskeletts, die sich durch eine niedrige Knochenmasse und eine Beeinträchtigung der Mikroarchitektur des Knochengewebes auszeichnet und zu einer erhöhten Knochenbrüchigkeit führt. Die Behandlung osteoporotischer Wirbelkörperfrakturen erweist sich als außerordentlich schwierig. Eine bekannte Therapiemöglichkeit stellt die perkutane Vertebroplastik dar. Bei diesem Verfahren wird der frakturierte Wirbelkörper mit flüssigem Knochenzement aufgefüllt und so in seiner Stabilität verstärkt. Die Operation erfolgt über eine perkutan eingebrachte Hohlkanüle, die transpedikulär in dem Wirbelkörper plaziert wird. Verwendet wird entweder ein ste riler Knochenzement, der relativ lange dünnflüssig bleibt oder injektionsfähiges biodegradibles Calzium-Phosphat. Voraussetzung für eine solche Operation ist, daß die Hinterkante des zu behandelnden Wirbelkörpers intakt ist, um so ein Eindringen des Knochenzements in den Spinalkanal der Wirbelsäule zu vermeiden.Osteoporosis is an illness of the total skeleton, which is characterized by a low bone mass and an impairment the microarchitecture of the bone tissue and increased bone fragility leads. The treatment of osteoporotic vertebral body fractures proves to be extraordinarily difficult. Percutaneous therapy is a well-known therapy Vertebroplasty. In this procedure, the fractured vertebra with liquid Bone cement filled up and so in its stability strengthened. The operation is done via a percutaneously inserted hollow cannula, which is transpedicular in the vertebra is placed. Either a sterile bone cement is used, that remains fluid for a relatively long time or injectable biodegradable calcium phosphate. The prerequisite for such an operation is that the trailing edge of the vertebral body to be treated is intact, so as to prevent bone cement from penetrating the spinal canal The spine to avoid.
Problematisch bei der perkutanen Vertebroplastik ist, daß der Knochenzement in flüssiger Form unter Druck injiziert werden muß. Dies birgt die Gefahr von Embolien. Um dies zu vermeiden, kann der Knochenzement auch in eine vor der Injektion in den Wirbelkörper eingebrachte Hülle injiziert werden, aus welcher er nicht austreten kann.Problematic with the percutaneous Vertebroplastik is that the Bone cement in liquid Mold must be injected under pressure. This carries the risk of Embolisms. To avoid this, the bone cement can also be placed in a before injection into the vertebral body inserted casing injected, from which it can not escape.
Ein weiteres Verfahren wird in der WO 02/47563 A1 beschrieben, bei der ein Füllmaterial in eine in den Wirbelkörper eingebrachte expandierbare Tasche eingefüllt wird.Another method is in the WO 02/47563 A1, in which a filler material is introduced into the vertebral body filled expandable bag becomes.
Es ist daher Aufgabe der vorliegenden Erfindung, ein Implantat, ein Implantatsystem und ein Verfahren der eingangs beschriebenen Art so zu verbessern, daß der chirurgische Eingriff zum Einsetzen des Implantats einfach und sicher durchgeführt werden kann.It is therefore the task of the present Invention, an implant, an implant system and a method to improve the type described above so that the surgical Intervention to insert the implant can be carried out easily and safely.
Diese Aufgabe wird bei einem Implantat der eingangs beschriebenen Art erfindungsgemäß dadurch gelöst, daß das Implantat aus einer Vielzahl körperverträglicher, kantenfreier, einzeln in einen Innenraum des Wirbelkörpers einführbarer Implantatelemente besteht.This task is done with an implant of the type described in the introduction solved according to the invention in that the implant from a variety of body-friendly, edge-free, individually insertable into an interior of the vertebral body There are implant elements.
Das erfindungsgemäße Implantat hat gegenüber dem Injizieren von flüssigem Knochenzement in den Wirbelkörper den Vorteil, daß es zu keinerlei Embolien kommen kann. Darüberhinaus wird der Eingriff vereinfacht, da eine Implantationszeit nicht durch eine Aushärtzeit des Knochenzements begrenzt wird, denn die zu implantierenden Implantatelemente des vorliegenden Implantats werden bereits in ihrer endgültigen Form in den Wirbelkörper eingeführt. Weiterhin kann auch auf eine zusätzliche Hülle zum Aufnehmen der Implantatelemente im Wirbelkörper verzichtet werden. Dies verkürzt einerseits die Operationszeit und ermöglicht andererseits die Verwendung eines besonders einfachen Einsetzinstruments.The implant according to the invention has Inject liquid Bone cement in the vertebral body the advantage that it no embolism can occur. In addition, the intervention is simplified, since an implantation time is not limited by the hardening time of the bone cement, because the implant elements of the present implant to be implanted are already in their final Shape in the vertebral body introduced. Farther can also on an additional Cover for taking up of the implant elements in the vertebral body become. This shortens on the one hand the operating time and on the other hand it enables use a particularly simple insertion instrument.
Vorzugsweise sind die Implantatelemente im wesentlichen inelastisch. Nach dem Einführen der Implantatelemente in den Wirbelkörper stützen sich diese gegenseitig aneinander ab und halten so den wieder aufgerichteten Wirbelkörper in einer gewünschten, im wesentlichen seiner ursprünglichen natürlichen Gestalt entsprechenden Form.The implant elements are preferably essentially inelastic. After inserting the implant elements in the vertebral body support these mutually depend on each other and thus keep the erect again vertebra in a desired, essentially its original natural Shape corresponding shape.
Besonders einfach lassen sich die Implantatelemente einbringen, wenn sie im wesentlichen die Form einer Kugel aufweisen, da sie sich aufgrund dieser Form praktisch nicht verkanten können. Zudem ist ein optimiertes Durchwachsen des eingebrachten Implantats mit natürlicher Knochensubstanz möglich, da selbst bei einer dichtesten Kugelpackung noch Zwischenräume verbleiben.They are particularly easy Introduce implant elements when they are essentially the shape have a ball because they are practical due to this shape cannot tilt. In addition, there is an optimized growth of the inserted implant with natural Bone substance possible, because even with the densest spherical packing there are still gaps.
Eine besonders hohe Stabilität wird erreicht, wenn die Implantatelemente einen Durchmesser im Bereich von 3 bis 8 mm aufweisen. Dies verhindert zudem, daß Implantatelemente aus dem aufgrund einer Fraktur nicht mehr vollständig geschlossenen Wirbelkörper austreten können.Particularly high stability is achieved if the implant elements have a diameter in the range from 3 to 8 mm exhibit. This also prevents implant elements from the emerge from a vertebral body that is no longer completely closed due to a fracture can.
Günstig ist es, wenn die Implantatelemente aus einem ausgehärteten Knochenzement hergestellt sind. Bei Verwendung von ausgehärtetem Knochenzement kann es in der Regel zu keinen Abstoßungsreaktionen des Körpers kommen.Cheap It is when the implant elements are made from a hardened bone cement are made. When using hardened bone cement it can usually no rejection reactions of the body come.
Gemäß einer bevorzugten Ausführungsform der Erfindung kann vorgesehen sein, daß der Knochenzement Calzium-Phosphat (CaP) enthält. Dies ermöglicht die Verwendung bereits bekannter und in der Praxis bewährter Knochenzemente.According to a preferred embodiment of the Invention can be provided that the bone cement calcium phosphate (CaP) contains. this makes possible the use of already known and proven bone cements in practice.
Die eingangs gestellte Aufgabe wird ferner bei einem Implantatsystem der eingangs beschriebenen Art erfindungsgemäß dadurch gelöst, daß das Implantat eines der oben beschriebenen Implantate ist, daß die Einsetzvorrichtung eine in den Wirbelkörper einführbare Einführhülse umfaßt und daß die Einführhülse einen Innenquerschnitt aufweist, der im wesentlichen den äußeren Abmessungen eines Implantatelements entspricht.The object set forth is further achieved according to the invention in an implant system of the type described at the outset in that the implant is one of the implants described above, in that the insertion device comprises an insertion sleeve which can be inserted into the vertebral body and that the insertion sleeve has an internal cross section which is in the essentially corresponds to the external dimensions of an implant element.
Mit einem derartigen Implantatsystem lassen sich auf einfache Weise Implantatelemente einzeln, das heißt insbesondere nacheinander, in den Wirbelkörper einführen. Damit läßt sich der Wirbelkörper mit dem Implantat kontrolliert füllen.With such an implant system can be easily, that is, in particular implant elements individually successively, in the vertebral body introduce. So that can the vertebral body fill with the implant in a controlled manner.
Besonders sicher lassen sich die Implantatelemente in den Wirbelkörper injizieren, wenn die Einführhülse einen kreisförmigen Innenquerschnitt aufweist und wenn der Innenquerschnitt maximal 10 % größer ist als ein Außendurchmesser eines einzelnen Implantatelements. Eine Einführhülse mit einem der artigen Innenquerschnitt ermöglicht es, ohne ein Blockieren der Implantatelemente in der Einführhülse, diese einzeln und nacheinander in den Wirbelkörper einzubringen.They are particularly safe Implant elements in the vertebral body inject when the introducer sleeve circular Has internal cross section and if the internal cross section is maximum Is 10% larger as an outside diameter of a single implant element. An insertion sleeve with an internal cross-section of this type allows it, without blocking the implant elements in the insertion sleeve to be introduced individually and one after the other into the vertebral body.
Grundsätzlich wäre es denkbar, das Implantat in Längsrichtung der Einführhülse aus dieser herauszuführen. Günstig ist es jedoch, wenn die Einführhülse an einem distalen Ende mindestens eine in radialer Richtung weisende Austrittsöffnung aufweist. Ein seitliches Austreten des Implantats aus der Einführhülse hat den Vorteil, daß das Implantat optimal in dem Innenraum des Wirbelkörpers verteilt wird. Ferner läßt sich verhindern, daß das Implantat aus dem Wirbelkörper herausgedrückt wird. Denkbar wäre es beispielsweise, auch zwei radial nach außen weisende, diametral gegenüberliegende Schlitze an der Einführhülse vorzusehen.In principle, it would be conceivable for the implant longitudinal the insertion sleeve to bring this out. Cheap it is, however, if the insertion sleeve on one distal end has at least one outlet opening pointing in the radial direction. On lateral exit of the implant from the insertion sleeve has the advantage that the implant is optimally distributed in the interior of the vertebral body. Further let yourself prevent that Implant from the vertebral body forced out becomes. Would be conceivable it, for example, also two diametrically opposite, facing radially outwards Provide slots on the insertion sleeve.
Außerdem wird die eingangs gestellte Aufgabe erfindungsgemäß bei einem Verfahren der eingangs beschriebenen Art dadurch gelöst, indem ein Einführinstrument in Form einer Einführhülse in einen Innenraum des Wirbelkörpers eingeführt wird und indem ein Implantat der oben beschriebenen Art in den unpräparierten Wirbelkörper injiziert wird, und zwar indem nacheinander Implantatelemente in den Wirbelkörper eingeschoben werden.In addition, the above is posed Task according to the invention Process of the type described in the introduction solved by an introducer in the form of an insertion sleeve in an interior of the vertebral body introduced and by placing an implant of the type described above in the unprepared vertebra is injected, in that by successively implant elements in the vertebral body be inserted.
Dieses Verfahren ermöglicht den Wiederaufbau eines geschädigten, beispielsweise osteoporotischen Wirbelkörpers auf einfachste Weise. Der Wirbelkörper muß vor dem Einbringen des Implantats nicht präpariert werden, das heißt, die Implantatelemente werden direkt in den Wirbelkörper eingeführt. Dies bedeutet auch, daß gerade kein zusätzliches Behältnis zunächst in den Wirbelkörper eingeführt werden muß, in welchen bei bekannten Verfahren das Implantat eingebracht wird. Es lassen sich auf diese Weise Operationszeiten verkürzen. Ferner adaptiert sich das Implantat beim erfindungsgemäßen Verfahren in optimaler Weise an den wieder aufzubauenden Wirbelkörper.This procedure enables the Reconstruction of a damaged, for example, the easiest way to do an osteoporotic vertebral body. The vertebral body must before the preparation of the implant are not prepared, that is, the Implant elements are inserted directly into the vertebral body. This also means that straight no additional container initially in the vertebral body be introduced must, in which in known methods the implant is inserted. In this way, operating times can be shortened. Further the implant adapts itself optimally in the method according to the invention Way to the vertebral body to be rebuilt.
Um das Einsetzen des Implantats zu vereinfachen, kann es von Vorteil sein, wenn die Wirbelsäule vor und während des Einsetzens des Implantats gestreckt wird. Auf diese Weise werden nur relativ geringe Vorschubkräfte zum Einbringen der Implantatelemente in den Wirbelkörper benötigt.To insert the implant too Simplify it can be beneficial if the spine is in front and during the insertion of the implant is stretched. That way only relatively low feed forces needed to insert the implant elements into the vertebral body.
Vorteilhaft kann es sein, wenn das Implantat durch einen Pedikelkanal hindurch eingesetzt wird. Durch einen Pedikel läßt sich auf einfache Weise ein Zugang zum Innenraum des Wirbelkörpers ausbilden.It can be advantageous if that Implant is inserted through a pedicle channel. By a pedicle can be form an access to the interior of the vertebral body in a simple manner.
Günstig ist es, wenn ein Zugang zum Innenraum des Wirbelkörpers nach dem Einsetzen des Implantats verschlossen wird. Auf diese Weise wird vermieden, daß das Implantat durch den Zugang wieder austreten kann, wenn beispielsweise Kräfte auf den Wirbelkörper und damit auf das eingebrachte Implantat ausgeübt werden.Cheap it is when access to the interior of the vertebral body after is closed when inserting the implant. In this way it is avoided that Implant can exit again through the access if, for example personnel on the vertebral body and thus be exerted on the inserted implant.
Auf besonders einfache Weise kann ein Austreten des Implantats aus dem Wirbelkörper verhindert werden, wenn der Zugang mit einem Stopfen oder mit Knochenzement verschlossen ist.In a particularly simple way the implant can be prevented from escaping from the vertebral body if access closed with a stopper or with bone cement is.
Günstig ist es, wenn das Implantat radial aus der Einführhülse herausgeschoben wird. Auf diese Weise kann es besonders gut und gleichmäßig im Innenraum des Wirbelkörpers verteilt werden. Ferner wird eine Gefahr minimiert, daß das Implantat direkt nach dem Einführen wieder aus dem Wirbelkörper herausgedrückt wird, beispielsweise durch eine aufgrund einer Fraktur offene Stelle oder durch eine geschwächte Wand des Wirbelkörpers.Cheap it is when the implant is pushed radially out of the insertion sleeve. On in this way it can be distributed particularly well and evenly in the interior of the vertebral body become. Furthermore, a risk is minimized that the implant is directly after the introduction is pushed out of the vertebral body again, for example due to a vacancy due to a fracture or through a weakened Wall of the vertebral body.
Die nachfolgende Beschreibung einer bevorzugten Ausführungsform des Implantats, des Implantatsystems und eines Verfahrens zum Wiederaufbau eines osteoporotischen Wirbelkörpers dient im Zusammenhang mit der Zeichnung der näheren Erläuterung. Es zeigen:The following description of a preferred embodiment of the implant, the implant system and a method for the reconstruction of a osteoporotic vertebral body serves in connection with the drawing for further explanation. Show it:
In
Zum Wiederaufbau des Wirbelkörpers
Das Injizieren oder Einführen des
Implantats besteht darin, die Kügelchen
Nach Abschluß der Implantation füllt das
Implantat
Die Kanüle
Claims (15)
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE10309986A DE10309986B4 (en) | 2003-02-28 | 2003-02-28 | Implant, implant system for rebuilding a vertebral body |
DE20303642U DE20303642U1 (en) | 2003-02-28 | 2003-02-28 | Implant for reconstruction of human vertebra which has lost some of its load-carrying capacity or is broken consists of edgeless implant elements introduced singly |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE10309986A DE10309986B4 (en) | 2003-02-28 | 2003-02-28 | Implant, implant system for rebuilding a vertebral body |
DE20303642U DE20303642U1 (en) | 2003-02-28 | 2003-02-28 | Implant for reconstruction of human vertebra which has lost some of its load-carrying capacity or is broken consists of edgeless implant elements introduced singly |
Publications (2)
Publication Number | Publication Date |
---|---|
DE10309986A1 true DE10309986A1 (en) | 2004-09-23 |
DE10309986B4 DE10309986B4 (en) | 2005-03-17 |
Family
ID=39643967
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE10309986A Expired - Fee Related DE10309986B4 (en) | 2003-02-28 | 2003-02-28 | Implant, implant system for rebuilding a vertebral body |
DE20303642U Expired - Lifetime DE20303642U1 (en) | 2003-02-28 | 2003-02-28 | Implant for reconstruction of human vertebra which has lost some of its load-carrying capacity or is broken consists of edgeless implant elements introduced singly |
Family Applications After (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE20303642U Expired - Lifetime DE20303642U1 (en) | 2003-02-28 | 2003-02-28 | Implant for reconstruction of human vertebra which has lost some of its load-carrying capacity or is broken consists of edgeless implant elements introduced singly |
Country Status (1)
Country | Link |
---|---|
DE (2) | DE10309986B4 (en) |
Cited By (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8357169B2 (en) | 2006-01-27 | 2013-01-22 | Spinal Ventures, Llc | System and method for delivering an agglomeration of solid beads and cement to the interior of a bone in order to form an implant within the bone |
US8673010B2 (en) | 2007-06-29 | 2014-03-18 | DePuy Synthes Products, LLC | Flexible chain implants and instrumentation |
US9289240B2 (en) | 2005-12-23 | 2016-03-22 | DePuy Synthes Products, Inc. | Flexible elongated chain implant and method of supporting body tissue with same |
Families Citing this family (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
FR2871366A1 (en) | 2004-06-09 | 2005-12-16 | Ceravic Soc Par Actions Simpli | PROSTHETIC EXPANSIBLE BONE IMPLANT |
FR3015221B1 (en) | 2013-12-23 | 2017-09-01 | Vexim | EXPANSIBLE INTRAVERTEBRAL IMPLANT SYSTEM WITH POSTERIOR PEDICULAR FIXATION |
Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5549679A (en) * | 1994-05-20 | 1996-08-27 | Kuslich; Stephen D. | Expandable fabric implant for stabilizing the spinal motion segment |
WO1999008616A1 (en) * | 1997-08-13 | 1999-02-25 | Kyphon Inc. | Systems and methods for injecting flowable materials into bones |
US6379385B1 (en) * | 2000-01-06 | 2002-04-30 | Tutogen Medical Gmbh | Implant of bone matter |
WO2002047563A1 (en) * | 2000-12-15 | 2002-06-20 | The Spineology Group, Llc. | Tool to direct bond replacement material |
DE10154163A1 (en) * | 2001-11-03 | 2003-05-22 | Advanced Med Tech | Device for straightening and stabilizing the spine |
-
2003
- 2003-02-28 DE DE10309986A patent/DE10309986B4/en not_active Expired - Fee Related
- 2003-02-28 DE DE20303642U patent/DE20303642U1/en not_active Expired - Lifetime
Patent Citations (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5549679A (en) * | 1994-05-20 | 1996-08-27 | Kuslich; Stephen D. | Expandable fabric implant for stabilizing the spinal motion segment |
US5571189A (en) * | 1994-05-20 | 1996-11-05 | Kuslich; Stephen D. | Expandable fabric implant for stabilizing the spinal motion segment |
WO1999008616A1 (en) * | 1997-08-13 | 1999-02-25 | Kyphon Inc. | Systems and methods for injecting flowable materials into bones |
US6379385B1 (en) * | 2000-01-06 | 2002-04-30 | Tutogen Medical Gmbh | Implant of bone matter |
WO2002047563A1 (en) * | 2000-12-15 | 2002-06-20 | The Spineology Group, Llc. | Tool to direct bond replacement material |
DE10154163A1 (en) * | 2001-11-03 | 2003-05-22 | Advanced Med Tech | Device for straightening and stabilizing the spine |
Cited By (11)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US9289240B2 (en) | 2005-12-23 | 2016-03-22 | DePuy Synthes Products, Inc. | Flexible elongated chain implant and method of supporting body tissue with same |
US9956085B2 (en) | 2005-12-23 | 2018-05-01 | DePuy Synthes Products, Inc. | Flexible elongated chain implant and method of supporting body tissue with same |
US10881520B2 (en) | 2005-12-23 | 2021-01-05 | DePuy Synthes Products, Inc. | Flexible elongated chain implant and method of supporting body tissue with same |
US11406508B2 (en) | 2005-12-23 | 2022-08-09 | DePuy Synthes Products, Inc. | Flexible elongated chain implant and method of supporting body tissue with same |
US11701233B2 (en) | 2005-12-23 | 2023-07-18 | DePuy Synthes Products, Inc. | Flexible elongated chain implant and method of supporting body tissue with same |
US8357169B2 (en) | 2006-01-27 | 2013-01-22 | Spinal Ventures, Llc | System and method for delivering an agglomeration of solid beads and cement to the interior of a bone in order to form an implant within the bone |
US9301792B2 (en) | 2006-01-27 | 2016-04-05 | Stryker Corporation | Low pressure delivery system and method for delivering a solid and liquid mixture into a target site for medical treatment |
US10426536B2 (en) | 2006-01-27 | 2019-10-01 | Stryker Corporation | Method of delivering a plurality of elements and fluent material into a vertebral body |
US8673010B2 (en) | 2007-06-29 | 2014-03-18 | DePuy Synthes Products, LLC | Flexible chain implants and instrumentation |
US9907667B2 (en) | 2007-06-29 | 2018-03-06 | DePuy Synthes Products, Inc. | Flexible chain implants and instrumentation |
US10716679B2 (en) | 2007-06-29 | 2020-07-21 | DePuy Synthes Products, Inc. | Flexible chain implants and instrumentation |
Also Published As
Publication number | Publication date |
---|---|
DE20303642U1 (en) | 2003-04-30 |
DE10309986B4 (en) | 2005-03-17 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
DE60128087T2 (en) | SYSTEMS FOR THE TREATMENT OF ANGLE BODIES | |
EP2124783B1 (en) | Implant for fracture care | |
DE60304127T2 (en) | Vertebral distractor | |
DE69822817T2 (en) | OPEN INTERMEDIATE DISTANCE PIECE | |
DE60220716T2 (en) | DEVICES FOR COMPRESSING SPONGIOSA BONES BY MEANS OF A EXPANDABLE BODY WITH INTERNAL RESTRAINT | |
DE60132304T2 (en) | DEVICE FOR CARRYING OUT THERAPEUTIC TREATMENTS IN THE SPINE | |
DE69729140T2 (en) | Instrumentation for the implantation of a surgical implant | |
DE69633778T2 (en) | INSTRUMENTARY FOR THE SURGICAL CORRECTION OF HUMAN SPINE IN LUMBAR AND BREEZE HEIGHT | |
DE60023284T2 (en) | INTERMEDIATE DISCUSPULPOSUS PROSTHESIS WITH SHAPE CHANGE PROPERTIES | |
AT507086B1 (en) | IMPLANT, IN PARTICULAR BRAND NAIL FOR THE TREATMENT OF A PROXIMAL HUMERUS FRACTURE | |
EP1771217B1 (en) | Filler and administration device for forming a supportive structure in a bone cavity | |
EP1749491A2 (en) | Device for treating vertebral bodies | |
EP1572040A2 (en) | Implant used in procedures for stiffening the vertebral column | |
WO2002043628A1 (en) | Method and device for expanding a body cavity | |
DE10219104A1 (en) | Spinal fusion implant | |
EP1339335A1 (en) | Device for fixing bones, particularly vertebral bodies, in relation to one another | |
EP2640289B1 (en) | Device for connecting bony structures | |
CH696926A5 (en) | Intervertebral or disk prosthesis manipulating and osteocementum supplying device for arthrodesis surgery, has tube coupled in rotationally fixed and sealed manner to prosthesis, and feeding unit to inject cementum into intervertebral area | |
WO2005082292A1 (en) | Intervertebral implant and surgical method for spondyilodesis of a lumbar vertebral column | |
DE202013012321U1 (en) | Arrangement, kit and vertebral implant for percutaneous disc recovery | |
WO2006108661A1 (en) | Instrument for disimpacting a damaged vertebral body | |
EP3923840A1 (en) | Bone-anchoring device for a pedicle access | |
DE10309986B4 (en) | Implant, implant system for rebuilding a vertebral body | |
DE60310218T2 (en) | Fillable implant and system for treating a deformed or pathologically altered spine | |
EP3478195A1 (en) | Expandable intervertebral implant |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
OP8 | Request for examination as to paragraph 44 patent law | ||
8364 | No opposition during term of opposition | ||
8327 | Change in the person/name/address of the patent owner |
Owner name: AESCULAP AG, 78532 TUTTLINGEN, DE |
|
R119 | Application deemed withdrawn, or ip right lapsed, due to non-payment of renewal fee | ||
R119 | Application deemed withdrawn, or ip right lapsed, due to non-payment of renewal fee |
Effective date: 20140902 |