DE19604246B4 - Distanzhaltendes Implantat zum Ersetzen von fehlenden Wirbelknochen - Google Patents
Distanzhaltendes Implantat zum Ersetzen von fehlenden Wirbelknochen Download PDFInfo
- Publication number
- DE19604246B4 DE19604246B4 DE19604246A DE19604246A DE19604246B4 DE 19604246 B4 DE19604246 B4 DE 19604246B4 DE 19604246 A DE19604246 A DE 19604246A DE 19604246 A DE19604246 A DE 19604246A DE 19604246 B4 DE19604246 B4 DE 19604246B4
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- Germany
- Prior art keywords
- elements
- implant
- implant according
- distance
- inner element
- Prior art date
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Classifications
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- 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
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- 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
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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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
-
- 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
Landscapes
- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Transplantation (AREA)
- Heart & Thoracic Surgery (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Cardiology (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)
- Physical Education & Sports Medicine (AREA)
- Prostheses (AREA)
- Surgical Instruments (AREA)
Abstract
Distanzhaltendes
Implantat zum Ersetzen von fehlenden Wirbelknochen, das Elemente
aufweist, die relativ zueinander axial bewegbar und festlegbar sind,
wobei die Elemente ineinander angeordnet werden können und
einander berührende
Flächen
tragen, die mit miteinander in Eingriff bringbaren Formgestaltungen
versehen sind, die derart zusammenwirken, daß ein Auseinanderziehen der
Elemente ermöglicht,
ihr Zusammenschieben dagegen verhindert wird, dadurch gekennzeichnet, daß das äußere Element
(1) und das innere Element (2) jeweils als Hohlzylinder ausgebildet
sind.
Description
- Die Erfindung betrifft ein distanzhaltendes Implantat zum Ersetzen von fehlenden Wirbelknochen, das Elemente aufweist, die relativ zueinander axial bewegbar und festlegbar sind, wobei die Elemente ineinander angeordnet werden können und einander berührende Flächen tragen, die mit miteinander in Eingriff bringbaren Formgestaltungen versehen sind, die derart zusammenwirken, daß ein Auseinanderziehen der Elemente ermöglicht, ihr Zusammenschieben dagegen verhindert.
- Es ist bekannt, daß die infolge von Verletzungen oder Entfernung von Geschwülsten entstehenden Knochenausfälle durch aus einem anderen Teil des Knochensystems entnommene körpereigene Knochen (Transplantat), Alloplastik und/oder distanzhaltende mechanische Elemente ersetzt werden können.
- Auch bei der Verwendung von körpereigener oder alloplastischer Materie ist ein Abstützen der die Knochenausfallstelle umgebenden Teile erforderlich, da die Eingliederung der autologen Transplantate eine längere Zeit beansprucht und deren sofortige Belastung nicht möglich ist.
- Zu diesem Zweck werden in bekannter Weise aus einem Titannetz gefertigte Zylinder verwendet, welche einerseits das zwischen die Wirbelknochen implantierte Material umgeben und gleichzeitig die benachbarten Wirbelknochen mechanisch abstützen. Derartige Zylinder aus Titannetz müssen jedoch gemein sam mit Knochenschrauben und Fixierstäben verwendet werden, wodurch ihre Anwendung außerordentlich kompliziert und zeitaufwendig wird.
- Gemäß einer anderen bekannten Lösung wird die Knochenfehlstelle durch distanzhaltende Elemente ersetzt, die eine einstellbare Länge aufweisen und mit Klauen versehen sind. Die Länge der distanzhaltenden Elemente kann mittels Schraubenbefestigung an beiden Seiten des Implantates eingestellt werden, was unter Operationsbedingungen äußerst schwierig ist.
- In der
DE 4012622 C1 ist ein gattungsgemäßes Wirbelkörperimplantat beschrieben mit zwei Teilen, von denen eines plattenförmig ausgebildet ist, während das andere einen Spalt zwischen zwei parallelen Wänden aufweist. Durch eine Zahnung wird sichergestellt, daß die Teile einander angenähert, nicht jedoch von einander entfernt werden können. Allerdings ist ein elastisches Polster notwendig, um die Zähne in Eingriff zu bringen. Außerdem können die gegeneinander verschiebbaren Teile mit umgebenden Gewebeteilen in Kontakt kommen, so daß eine Verletzung dieser Gewebeteile nicht ausgeschlossen werden kann. - Es ist Aufgabe der Erfindung, ein gattungsgemäßes Implantat so weiterzubilden, daß sich ein wesentlich einfacherer Aufbau ergibt und daß die Gefahr von Verletzungen herabgesetzt wird.
- Diese Aufgabe wird bei einem distanzhaltenden Implantat der eingangs beschriebenen Art erfindungsgemäß dadurch gelöst, daß das äußere Element und das innere Element jeweils als Hohlzylinder ausgebildet sind.
- Günstig ist es dabei, wenn an der inneren Mantelfläche des äußeren Elementes sägezahnförmige Nuten ausgebildet sind und an der äußeren Mantelfläche des inneren Elementes sägezahnförmige Rippen, die eine an die Gestalt der Nuten angepaßte beziehungsweise diese ergänzende Form aufweisen.
- Bei einer weiteren vorteilhaften Ausführungsform der Erfindung weist die innere Mantelfläche des äußeren Elements mindestens eine axial ausgerichtete Rippe auf, wohingegen die Wand des inneren Elements mindestens einen axial ausgerichteten komplementären Schlitz aufweist, in den die Rippe eingreifen kann, so daß die beiden Elemente in ihrer Lage fixiert sind.
- Bei einer anderen Ausführungsform der Erfindung ist ein Ende des äußeren Elements mit einem Boden verschlossen, dessen Außenseite mit Eingriffsklauen versehen ist, und ein Ende des inneren Elements ist ebenfalls mit einem Boden verschlossen, dessen Außenseite mit Eingriffsklauen versehen ist. Es können jedoch auch solche Elemente verwendet werden, bei denen beide Enden offen sind, wobei an ihrem einen Ende jedoch ein mit Klauen oder einem Stützfuß versehener Pfropfen angeordnet ist.
- Bei einer bevorzugten Ausführungsform der Erfindung sind die Elemente zylinderförmig und weisen einen zylindrischen Hohlraum auf, während die sägezahnförmigen Nuten als Kreisnuten und die sägezahnförmigen Rippen als umlaufende Rippen ausgebildet sind.
- Weitere Ausgestaltungen und Details der Erfindung werden nachstehend anhand eines Ausführungsbeispiels in Verbindung mit den Zeichnung näher erläutert. In der Zeichnung zeigen:
-
1 ein äußeres Element eines erfindungsgemäßen Implantates in Schnittdarstellung, -
2 ein inneres Element eines erfindungsgemäßen Implantates in Halbschnittdarstellung, und -
3 ein erfindungsgemäßes Implantat in Schnittdarstellung. - Das in den Figuren dargestellte äußere Element
1 und das innere Element2 sind bei der gezeigten Ausführungsform aus den Zylindern3 bzw.4 ausgebildet. Die äußere Mantelfläche des äußeren Elementes1 ist zylindrisch, in seine innere, ebenfalls zylindrische Mantelfläche sind Nuten5 eingearbeitet. Die Nuten5 sind im Querschnitt sägezahnförmig ausgebildet, wobei die Tiefe der Nuten jeweils in Richtung auf das Ende, in das das innere Element2 eingeführt wird, abnimmt. Der Zylinder3 ist unten mit einem Boden6 abgeschlossen. Der Boden6 ist mit Klauen7 versehen. Auf der äußeren Mantelfläche des Zylinders3 sind einander gegenüberliegend zwei entlang von Mantellinien verlaufende Nuten8 ausgebildet, so daß auf der Innenseite zwei vorspringende Rippen8a geformt sind. - Aus
2 ist ersichtlich, daß der Hohlraum des Zylinders4 des inneren Elementes2 ebenfalls von einem Boden9 begrenzt ist, dessen Außenseite mit Klauen10 versehen ist. An dem unteren Teil der äußeren Mantelfläche des Zylinders4 sind Rippen11 angeordnet. Diese Rippen11 sind im Querschnitt ebenfalls sägezahnförmig und passen in die Nuten5 des äußeren Elementes1 . Der Zylinder4 des inneren Elementes2 weist eine dünnere Wand auf als der Zylinder3 des äußeren Elementes1 und an seiner Mantelfläche sind fast über die ganze Länge Schlitze12 ausgebildet. Die zusammen durch die dünne Wand des Zylinders4 und die Schlitze12 sichergestellte elastische Ausbildung ermöglicht es, wenn die Elemente einmal ineinander eingesetzt sind, daß das innere Element2 aus dem äußeren Element1 herausbewegbar ist, wobei die Rippen11 des inneren Elementes2 aus den Nuten5 des äußeren Elementes1 herausspringen und in die jeweils dahinterliegenden Nuten einrasten. Somit bilden das innere Element1 und das äußere Element2 ein längenveränderliches und -verstellbares distanzhaltendes Implantat, das gegen ein Zusammenschieben verriegelt ist, aber durch Verlagern des Elements2 stufenweise auseinandergezogen werden kann. - Dadurch, daß die Rippen
8a des äußeren Elementes1 und die Schlitze12 des inneren Elementes2 miteinander in Deckung gebracht werden, kann das Implantat in der gewünschten Lage fixiert werden, ohne daß zusätzliche Befestigungsmittel erforderlich sind. - Das Einsetzen kann im konkreten Fall so erfolgen, daß das Implantat in vollkommen zusammengeschobenem Zustand des äußeren und inneren Elementes an die Stelle der Knochenfehlstelle zwischen die nächst benachbarten Wirbelknochen eingefügt wird und die Elemente mittels einer Zange so weit auseinandergezogen werden, bis die benachbarten Wirbelknochen in die gewünschte Position gelangen. Das Einsetzen besteht somit praktisch nur aus zwei einfachen Arbeitsschritten, welche auch unter Operationsbedingungen einfach und sicher durchgeführt werden können. Erforderlichenfalls können die Elemente gegeneinander in der oben erwähnten Weise unter Zusammenwirken der Rippen
8a und der Schlitze12 verkeilt werden. - Im Vergleich mit den bekannten Implantaten vereinfacht die erfindungsgemäße Lösung in außerordentlicher Weise die Durchführung der erforderlichen Arbeitsabläufe beim Einsetzen des Implantates dadurch, daß zur Festlegung der relativ zueinander bewegbaren Elemente kein gesonderter Arbeitsschritt erforderlich ist und der einmal eingestellte Abstand sich durch eine falsche Bewegung oder aus sonstigen Gründen nicht verändern kann.
- Natürlich kann das Implantat in zahlreichen Varianten ausgebildet sein, z.B. auf die Weise, daß anstelle der Klauen andere Stützelemente z.B. Stützfüße verwendet werden. Die die Elemente bildenden rohrförmigen Körper können an beiden Seiten offen sein, in diesem Fall können die Stützflächen oder Klauen pfropfenartig in das eine Ende der Elemente eingefügt werden.
Claims (5)
- Distanzhaltendes Implantat zum Ersetzen von fehlenden Wirbelknochen, das Elemente aufweist, die relativ zueinander axial bewegbar und festlegbar sind, wobei die Elemente ineinander angeordnet werden können und einander berührende Flächen tragen, die mit miteinander in Eingriff bringbaren Formgestaltungen versehen sind, die derart zusammenwirken, daß ein Auseinanderziehen der Elemente ermöglicht, ihr Zusammenschieben dagegen verhindert wird, dadurch gekennzeichnet, daß das äußere Element (
1 ) und das innere Element (2 ) jeweils als Hohlzylinder ausgebildet sind. - Implantat nach Anspruch 1, dadurch gekennzeichnet, daß an der inneren Mantelfläche des äußeren Elements (
1 ) sägezahnförmige Nuten (5 ) ausgebildet sind und an der äußeren Mantelfläche des inneren Elements (2 ) sägezahnförmige Rippen (11 ) ausgebildet sind, die eine an die Gestalt der Nuteln (5 ) angepaßte bzw. diese ergänzende Form aufweisen. - Implantat nach Anspruch 1 oder 2, dadurch gekennzeichnet, daß auf der inneren Mantelfläche des äußeren Elements (
1 ) mindestens eine axiale Rippe (8a ) ausgebildet ist und daß die wand des inneren Elements (2 ) mindestens einen axialen Schlitz (12 ) aufweist, in den die Rippe (8a ) eingreifen kann, so daß die Lage der beiden Elemente zueinander fixiert ist. - Implantat nach einem der Ansprüche 1 bis 3, dadurch gekennzeichnet, daß beide Enden wenigstens eines der Elemente (
1 ,2 ) offen sind und an einem der Enden ein mit axialen Klauen (7 ) oder einem Stützfuß versehener Pfropfen (6 ) angeordnet ist. - Implantat nach einem der Ansprüche 1 bis 4, dadurch gekennzeichnet, daß wenigstens ein Ende eines Elements (
1 ,2 ) mit einem Boden (9 ) abgeschlossen und an seiner äußeren Seite mit Klauen (7 ) versehen ist.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE29623988U DE29623988U1 (de) | 1995-02-06 | 1996-02-06 | Distanzhaltendes Implantat zum Ersetzen von fehlenden Wirbelknochen |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
FR9501326A FR2730158B1 (fr) | 1995-02-06 | 1995-02-06 | Dispositif de maintien d'un ecartement normal entre les vertebres et destine au remplacement de vertebres manquantes |
FR9501326 | 1995-02-06 |
Publications (2)
Publication Number | Publication Date |
---|---|
DE19604246A1 DE19604246A1 (de) | 1996-08-08 |
DE19604246B4 true DE19604246B4 (de) | 2006-06-01 |
Family
ID=9475859
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE29623988U Expired - Lifetime DE29623988U1 (de) | 1995-02-06 | 1996-02-06 | Distanzhaltendes Implantat zum Ersetzen von fehlenden Wirbelknochen |
DE19604246A Expired - Fee Related DE19604246B4 (de) | 1995-02-06 | 1996-02-06 | Distanzhaltendes Implantat zum Ersetzen von fehlenden Wirbelknochen |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE29623988U Expired - Lifetime DE29623988U1 (de) | 1995-02-06 | 1996-02-06 | Distanzhaltendes Implantat zum Ersetzen von fehlenden Wirbelknochen |
Country Status (5)
Country | Link |
---|---|
US (1) | US5723013A (de) |
JP (1) | JPH08266564A (de) |
KR (1) | KR960030899A (de) |
DE (2) | DE29623988U1 (de) |
FR (1) | FR2730158B1 (de) |
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AU2017203369B2 (en) | 2016-05-20 | 2022-04-28 | Howmedica Osteonics Corp. | Expandable interbody implant with lordosis correction |
AU2017228529B2 (en) | 2016-09-12 | 2022-03-10 | Howmedica Osteonics Corp. | Interbody implant with independent control of expansion at multiple locations |
US10973648B1 (en) | 2016-10-25 | 2021-04-13 | Samy Abdou | Devices and methods for vertebral bone realignment |
US10744000B1 (en) | 2016-10-25 | 2020-08-18 | Samy Abdou | Devices and methods for vertebral bone realignment |
AU2017251734B2 (en) | 2016-10-26 | 2022-10-20 | Howmedica Osteonics Corp. | Expandable interbody implant with lateral articulation |
EP3456294A1 (de) | 2017-09-15 | 2019-03-20 | Stryker European Holdings I, LLC | Mit aushärtendem material expandierte zwischenwirbelkörperfusionsvorrichtung |
CN107550603B (zh) * | 2017-09-29 | 2024-01-23 | 辽宁禾润新材料科技有限公司 | 一种人工肋骨 |
US11179248B2 (en) | 2018-10-02 | 2021-11-23 | Samy Abdou | Devices and methods for spinal implantation |
US11219531B2 (en) | 2019-04-10 | 2022-01-11 | Wenzel Spine, Inc. | Rotatable intervertebral spacing implant |
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US4157715A (en) * | 1977-03-25 | 1979-06-12 | Erhard Westerhoff | Intracorporal drive to produce a continuous traction or pressure and method of operating the same |
DE4012622C1 (en) * | 1990-04-20 | 1991-07-18 | Eska Medical Luebeck Medizintechnik Gmbh & Co, 2400 Luebeck, De | Two-part metal vertebra implant - has parts locked by two toothed racks, pre-stressed by elastic cushion between both implant parts |
WO1995003745A1 (en) * | 1993-08-03 | 1995-02-09 | Howmedica Inc. | Ratcheting compression device |
DE29623360U1 (de) * | 1995-06-07 | 1998-03-19 | Michelson Gary K | Sich verjüngende Zwischenkörper-Wirbelsäulenversteifungsimplantate mit bogenförmigen Teilen |
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US4567884A (en) * | 1982-12-01 | 1986-02-04 | Edwards Charles C | Spinal hook |
FR2575059B1 (fr) * | 1984-12-21 | 1988-11-10 | Daher Youssef | Dispositif d'etaiement utilisable dans une prothese vertebrale |
US4892545A (en) * | 1988-07-14 | 1990-01-09 | Ohio Medical Instrument Company, Inc. | Vertebral lock |
US4870957A (en) * | 1988-12-27 | 1989-10-03 | Marlowe Goble E | Ligament anchor system |
US5059193A (en) * | 1989-11-20 | 1991-10-22 | Spine-Tech, Inc. | Expandable spinal implant and surgical method |
US5290312A (en) * | 1991-09-03 | 1994-03-01 | Alphatec | Artificial vertebral body |
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- 1995-02-06 FR FR9501326A patent/FR2730158B1/fr not_active Expired - Fee Related
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1996
- 1996-02-05 JP JP8018968A patent/JPH08266564A/ja active Pending
- 1996-02-06 DE DE29623988U patent/DE29623988U1/de not_active Expired - Lifetime
- 1996-02-06 US US08/595,955 patent/US5723013A/en not_active Expired - Fee Related
- 1996-02-06 DE DE19604246A patent/DE19604246B4/de not_active Expired - Fee Related
- 1996-02-06 KR KR1019960002823A patent/KR960030899A/ko not_active Application Discontinuation
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US4157715A (en) * | 1977-03-25 | 1979-06-12 | Erhard Westerhoff | Intracorporal drive to produce a continuous traction or pressure and method of operating the same |
DE4012622C1 (en) * | 1990-04-20 | 1991-07-18 | Eska Medical Luebeck Medizintechnik Gmbh & Co, 2400 Luebeck, De | Two-part metal vertebra implant - has parts locked by two toothed racks, pre-stressed by elastic cushion between both implant parts |
WO1995003745A1 (en) * | 1993-08-03 | 1995-02-09 | Howmedica Inc. | Ratcheting compression device |
DE29623360U1 (de) * | 1995-06-07 | 1998-03-19 | Michelson Gary K | Sich verjüngende Zwischenkörper-Wirbelsäulenversteifungsimplantate mit bogenförmigen Teilen |
Cited By (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US7918876B2 (en) | 2003-03-24 | 2011-04-05 | Theken Spine, Llc | Spinal implant adjustment device |
US8337559B2 (en) | 2005-04-21 | 2012-12-25 | Globus Medical, Inc. | Expandable vertebral prosthesis |
DE102008010607A1 (de) * | 2008-02-22 | 2009-08-27 | Heinrich Dr. Böhm | Implantatvorrichtung für die Wirbelsäule |
DE102008010607B4 (de) * | 2008-02-22 | 2016-03-24 | Heinrich Böhm | Implantatvorrichtung für die Wirbelsäule |
DE102010047901A1 (de) | 2010-10-11 | 2012-04-12 | Heinrich Böhm | Implantat für die Wirbelsäule und Betätigungsinstrument |
WO2012048920A1 (de) | 2010-10-11 | 2012-04-19 | Boehm Heinrich | Implantat für die wirbelsäule und betätigungsinstrument |
US9308098B2 (en) | 2010-10-11 | 2016-04-12 | Heinrich Boehm | Implant for the spinal column and actuating instrument |
DE102010047901B4 (de) | 2010-10-11 | 2019-01-10 | Heinrich Böhm | Implantat für die Wirbelsäule und Betätigungsinstrument |
Also Published As
Publication number | Publication date |
---|---|
KR960030899A (ko) | 1996-09-17 |
DE29623988U1 (de) | 2001-03-08 |
DE19604246A1 (de) | 1996-08-08 |
JPH08266564A (ja) | 1996-10-15 |
FR2730158B1 (fr) | 1999-11-26 |
FR2730158A1 (fr) | 1996-08-09 |
US5723013A (en) | 1998-03-03 |
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