EP1261302A1 - Prothese de disque intervertebral - Google Patents

Prothese de disque intervertebral

Info

Publication number
EP1261302A1
EP1261302A1 EP01911831A EP01911831A EP1261302A1 EP 1261302 A1 EP1261302 A1 EP 1261302A1 EP 01911831 A EP01911831 A EP 01911831A EP 01911831 A EP01911831 A EP 01911831A EP 1261302 A1 EP1261302 A1 EP 1261302A1
Authority
EP
European Patent Office
Prior art keywords
plate
disc prosthesis
intervertebral disc
core
upper plate
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.)
Withdrawn
Application number
EP01911831A
Other languages
German (de)
English (en)
Inventor
Guy Viart
Frédéric MARIN
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Eurosurgical SA
Original Assignee
Eurosurgical SA
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 Eurosurgical SA filed Critical Eurosurgical SA
Publication of EP1261302A1 publication Critical patent/EP1261302A1/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/442Intervertebral or spinal discs, e.g. resilient
    • A61F2/4425Intervertebral or spinal discs, e.g. resilient made of articulated components
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30721Accessories
    • A61F2/30742Bellows or hose-like seals; Sealing membranes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30003Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/3006Properties of materials and coating materials
    • A61F2002/30069Properties of materials and coating materials elastomeric
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/3011Cross-sections or two-dimensional shapes
    • A61F2002/30112Rounded shapes, e.g. with rounded corners
    • A61F2002/30125Rounded shapes, e.g. with rounded corners elliptical or oval
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/3011Cross-sections or two-dimensional shapes
    • A61F2002/30138Convex polygonal shapes
    • A61F2002/30156Convex polygonal shapes triangular
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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    • A61F2002/30199Three-dimensional shapes
    • A61F2002/302Three-dimensional shapes toroidal, e.g. rings
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    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30518Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements with possibility of relative movement between the prosthetic parts
    • A61F2002/30528Means for limiting said movement
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30563Special structural features of bone or joint prostheses not otherwise provided for having elastic means or damping means, different from springs, e.g. including an elastomeric core or shock absorbers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30589Sealing means
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30604Special structural features of bone or joint prostheses not otherwise provided for modular
    • A61F2002/30616Sets comprising a plurality of prosthetic parts of different sizes or orientations
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30621Features concerning the anatomical functioning or articulation of the prosthetic joint
    • A61F2002/30649Ball-and-socket joints
    • A61F2002/30662Ball-and-socket joints with rotation-limiting means
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30841Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
    • AHUMAN NECESSITIES
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    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30879Ribs
    • AHUMAN NECESSITIES
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    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30884Fins or wings, e.g. longitudinal wings for preventing rotation within the bone cavity
    • AHUMAN NECESSITIES
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    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30891Plurality of protrusions
    • A61F2002/30892Plurality of protrusions parallel
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    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
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    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/442Intervertebral or spinal discs, e.g. resilient
    • A61F2/4425Intervertebral or spinal discs, e.g. resilient made of articulated components
    • A61F2002/443Intervertebral or spinal discs, e.g. resilient made of articulated components having two transversal endplates and at least one intermediate component
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    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
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    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002Two-dimensional shapes, e.g. cross-sections
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    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063Three-dimensional shapes
    • A61F2230/0065Three-dimensional shapes toroidal, e.g. ring-shaped, doughnut-shaped
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    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00011Metals or alloys
    • A61F2310/00029Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium

Definitions

  • the present invention relates to an intervertebral disc prosthesis which is placed between the upper plate and the lower plate of the vertebral bodies of the vertebrae above and below a vertebral column.
  • German patent DE 2263842 an intervertebral disc prosthesis comprising an upper plate and a lower plate provided respectively on their internal face with an impression in portion of a sphere and with a spherical core placed between the plates which cooperates with footprints of the same profile.
  • the upper plate and the lower plate are connected together and around the spherical core by a peripheral element made of a flexible material such as plastic.
  • This disc prosthesis consists of a spherical element, forming a horizontal plate, which includes semi-spherical sectors projecting on either side of the horizontal surface of the element.
  • the spherical sectors are placed in the center of the plate at equal distance from the front, rear and side edges of the element.
  • the spherical element is placed between the upper plate and the lower plate of the vertebral bodies of the vertebrae above and below the vertebral column, so that the spherical sectors are directly in abutment against said plates of the vertebrae.
  • the spherical sectors of the element come to bear directly on the bone plates of the vertebral bodies resulting in penetration of the latter, due to the spherical shape, in the bone plates and an impossibility for the prosthesis to be able to function.
  • EP 0 176 728 discloses an intervertebral disc prosthesis comprising an upper plate and a lower plate provided respectively of a central part with concave profile intended to receive a bi-convex spacer of the same radius of curvature.
  • the spacer has a planar annular guide edge which is surrounded by an annular bead which prevents said part from slipping or sliding out of the end plates.
  • intervertebral disc prosthesis described in patent EP 0 176 728 has certain drawbacks with regard to the operation of the articular connection between the spacer and the concave middle parts of each upper and lower plate. Indeed, this articular connection is not protected from the fibrous tissues surrounding the prosthesis, which can penetrate inside the latter and come to be fixed on the moving parts hindering its proper functioning.
  • the intervertebral disc prosthesis comprises an upper plate and a lower plate which are anchored respectively on the upper plate and the lower plate of the vertebral bodies of the vertebrae above and underlying a vertebral column, a central core placed between the two plates which have an upper spherical cap and a lower spherical cap cooperating respectively with spherical impressions formed in said plates, upper and lower and an annular element made of a viscoelastic material which is centered around the core and which comes into contact with bosses provided on each internal face of the upper plate and the lower plate so as to limit and control the movements in bending, inclination and rotation of the upper plate and of the lower plate with respect to each other and around the core , to ensure the stability of the pos iteration of the core between the two plates, and to avoid fibrous deposits inside the prosthesis.
  • the intervertebral disc prosthesis according to the present invention comprises an upper plate and a lower plate which has an external face integral with teeth to allow respectively an anchoring of said plates in the upper plate and the lower plate of the vertebral bodies of the overlying and underlying vertebrae.
  • the intervertebral disc prosthesis according to the present invention comprises an internal face of the upper plate and the lower plate which has a spherical imprint delimited by a circular rim arranged in relief relative to the horizontal plane of the face.
  • the intervertebral disc prosthesis according to the present invention comprises an internal face which has, between the central impression with a spherical profile and the peripheral edge of each plate, bosses.
  • the intervertebral disc prosthesis according to the present invention comprises bosses which are arranged in an arc of a circle so as to be centered around the spherical impression.
  • the intervertebral disc prosthesis according to the present invention comprises a central core which comprises a peripheral crown arranged in a horizontal plane which cooperates with an internal groove formed in the annular element.
  • the intervertebral disc prosthesis according to the present invention comprises an annular element which has a central opening for the passage of the caps of the central core and an internal groove opening into the central opening in order to receive during the mounting of the disc prosthesis the peripheral crown of said nucleus.
  • the intervertebral disc prosthesis according to the present invention comprises an upper plate and a lower plate which are made of a cobalt chromium alloy.
  • the intervertebral disc prosthesis according to the present invention comprises a central core which is made of a plastic material having very good sliding characteristics, such as polyethylene.
  • the intervertebral disc prosthesis according to the present invention comprises an annular element which is made of a viscoelastic material such as, for example, biocompatible elastomer.
  • Figure 1 is an exploded perspective view illustrating the intervertebral disc prosthesis according to the present invention.
  • Figure 2 is a sectional view showing the intervertebral disc prosthesis according to the present invention.
  • Figure 3 is a view showing the intervertebral disc prosthesis in the assembled position.
  • FIGS. 1 to 3 show an intervertebral disc prosthesis 1 comprising two plates, an upper plate 2 and a lower plate 3, a central core 4 and an annular element 5, in order to be able to restore mobility between the levels above and below adjacent to two vertebrae adjacent to a spine.
  • Each upper 2 and lower 3 plate has an outer face 6 integral with teeth 7 to allow respectively an anchoring of said plates in the upper and lower plates of the vertebral bodies of the above and underlying vertebrae.
  • Each upper 2 and lower 3 plate has, opposite the external face 6, an internal face 8 comprising a spherical imprint 9 delimited by a circular rim 10 disposed in relief relative to the horizontal plane of the face 8.
  • the internal face 8 has, between the central imprint 9 with a spherical profile and the peripheral edge 11 of each plate 2, 3, bosses 12 arranged on either side of said imprint.
  • the bosses 12 are arranged in an arc of a circle so as to be centered around the spherical imprint 9.
  • the upper plate 2 and the lower plate 3 have an external profile in the shape of a "horseshoe", in order to best adapt to the profile of the vertebral plates of the above and underlying vertebrae.
  • the particular shape of the upper plate 2 and the lower plate 3 makes it possible to have the largest possible contact surface on the corresponding vertebra, in order to avoid the insertion of said plates into the body of the vertebra.
  • the upper plate 2 and the lower plate 3 are made of a cobalt chromium alloy.
  • the central core 4 comprises an upper spherical cap 13 and a lower spherical cap 14 which cooperate respectively with the imprints 9 of the same profile of each upper 2 and lower 3 plate.
  • the central core 4 has a peripheral ring 15 arranged in a horizontal plane and making it possible to limit the rotation of said core relative to the upper plate 2 and the lower plate 3.
  • the disc prosthesis 1 comprises an articular connection of spherical type due to the profile of the caps 13 and 14 of the central core 4 which cooperate with the imprints 9 of each upper 2 and lower 3 plate. It is noted that the spherical type articular connection of the disc prosthesis 1 constitutes a connection with 5 degrees of freedom between the upper plate 2 and the lower plate 3, namely:
  • the central core 4 is made of a plastic material having very good sliding characteristics, such as polyethylene.
  • the central core 4 comes from a set of core whose size varies according to the thickness of the peripheral crown 15.
  • the central core 4 is chosen according to the dimensions of the opening made by the surgeon between the upper plate and the lower plate of the vertebral bodies above and below, so that the intervertebral prosthesis adapts perfectly to the height of this opening.
  • the annular element 5 has a central opening 16 whose internal diameter is slightly greater than that of each cap 13, 14 of the central core 4 at the junction between said caps and the peripheral crown 15.
  • the annular element 5 has an internal groove 17 opening into the central opening 16 so as to receive, during assembly of the disc prosthesis 1, the peripheral crown 15 of the central core 4.
  • the annular element 5 is made of a visco-elastic material such as, for example, biocompatible elastomer.
  • this limitation and this control of the flexion, extension and lateral inclination movements of the disc prosthesis 1 is dependent on the height of the bosses produced on the internal faces 8 of the upper plate 2 and of the lower plate 3 of the prosthesis.
  • annular element makes it possible to prevent the fibrous tissues or of the fibro-pseudo-synovial gangue from being fixed on the mobile parts of the disc prosthesis 1, since it is included between the upper plate 2 and the bottom plate 3.
  • the central core 4 is linked to the annular element 5, and the element is pinched between the two plates 2 and 3, in order to ensure the stability of the positioning of the core between the two plates by the return action. of the annular element.

Abstract

La prothèse de disque intervertébral suivant la présente invention comprend une plaque supérieure (2) et une plaque inférieure (3) qui sont ancrées respectivement sur le plateau supérieur et le plateau inférieur des corps vertébraux des vertèbres sus et sous jacentes d'une colonne vertébrale, un noyau central (4) placé entre les deux plaques (2, 3) qui présente une calotte sphérique supéerieure (13) et une calotte sphérique inférieure (14) coopérant respectivement avec des empreintes sphériques (9) ménagées dans lesdites plaques, supérieure et inférieure, et un élément annulaire (5) réalisé dans un matériau viscoélastique qui est centré autour du noyau (4) et qui vient en contact avec des bossages (12) prévus sur chaque face interne (8) de la plaque supérieure (2) et dela plaque inférieure (3) de manière à limiter et contrôler les mouvements en flexion, inclinaison et rotation de la plaque supérieure (2) et de la plaque inférieure (3) l'une par rapport à l'autre et autour du noyau (4), à assurer la stabilité du positionnement du noyau (4) entre les deux plaques (2, 3), et à éviter les dépôts fibreux à l'intérieur de la prothèse (1).

Description

PROTHESE DE DISQUE INTERVERTEBRAL
La présente invention est relative à une prothèse de disque intervertébral venant se placer entre le plateau supérieur et le plateau inférieur des corps vertébraux des vertèbres sus et sous jacentes d'une colonne vertébrale.
On connaît d'après le brevet allemand DE 2263842 une prothèse de disque intervertébral comportant une plaque supérieure et une plaque inférieure pourvues respectivement sur leur face interne d'une empreinte en portion de sphère et d'un noyau sphérique placé entre les plaques qui coopère avec les empreintes de même profil.
La plaque supérieure et la plaque inférieure sont reliées entres elles et autour du noyau sphérique par un élément périphérique réalisé dans une matière souple telle que du plastique.
On connaît d'après le brevet français FR 76 37174 (2 372 622) une prothèse de disque intervertébral destinée à toutes les affections discales découlant de l'écrasement, des déplacements ou détériorations de toutes sortes de corps vertébraux.
Cette prothèse de disque est constituée d'un élément sphérique, formant un plateau horizontal, qui comporte des secteurs semi-sphériques débordant de part et d'autre de la surface horizontale de l'élément.
Les secteurs sphériques sont placés au centre du plateau à égale distance des bords antérieurs, postérieurs et latéraux de l'élément.
L'élément sphérique est placé entre le plateau supérieur et le plateau inférieur des corps vertébraux des vertèbres sus et sous jacentes de la colonne vertébrale, de manière à ce que les secteurs sphériques soient directement en appui contre lesdits plateaux des vertèbres.
On note que la prothèse décrite dans le brevet FR 76 37174 comporte certains inconvénients en ce qui concerne la surface d'appui de l'élément sphérique contre le plateau supérieur et le plateau inférieur des corps vertébraux.
En effet, les secteurs sphériques de l'élément viennent prendre directement appui sur les plateaux osseux des corps vertébraux entraînant une pénétration de ces derniers, du fait de la forme sphérique, dans les plateaux osseux et une impossibilité à la prothèse de pouvoir fonctionner.
On connaît d'après le brevet EP 0 176 728 une prothèse de disque intervertébral comportant une plaque supérieure et une plaque inférieure munies respectivement d'une partie médiane à profil concave destinée à recevoir une pièce d'écartement bi-convexe de même rayon de courbure.
La pièce d'écartement comporte un bord de guidage annulaire plan qui est entouré d'un bourrelet annulaire qui empêche ladite pièce de déraper ou de glisser hors des plaques terminales.
On note que la prothèse de disque intervertébral décrite dans le brevet EP 0 176 728 comporte certains inconvénients en ce qui concerne le fonctionnement de la liaison articulaire entre la pièce d'écartement et les parties médianes concaves de chaque plaque supérieure et inférieure. En effet, cette liaison articulaire n'est pas protégée des tissus fibreux entourant la prothèse, qui peuvent pénétrer à l'intérieur de cette dernière et venir se fixer sur les parties mobiles entravant son bon fonctionnement.
La prothèse de disque intervertébral suivant la présente invention a pour fonction principale :
• de restaurer la mobilité entre les niveaux sus et sous jacents des vertèbres d'une colonne vertébrale par une liaison bi-rotule ou bi-concave, • de présenter une limitation et un contrôle des mouvements en flexion, inclinaison et rotation de la plaque supérieure et de la plaque inférieure l'une par rapport à l'autre, et autour de la pièce d'écartement ou noyau,
• d'empêcher les tissus fibreux ou de la gangue fibro-pseudo-synoviale de venir se fixer sur les parties mobiles.
La prothèse de disque intervertébral suivant la présente invention comprend une plaque supérieure et une plaque inférieure qui sont ancrées respectivement sur le plateau supérieur et le plateau inférieur des corps vertébraux des vertèbres sus et sous jacentes d'une colonne vertébrale, un noyau central placé entre les deux plaques qui présente une calotte sphérique supérieure et une calotte sphérique inférieure coopérant respectivement avec des empreintes sphériques ménagées dans lesdites plaques, supérieure et inférieure et un élément annulaire réalisé dans un matériau viscoélastique qui est centré autour du noyau et qui vient en contact avec des bossages prévus sur chaque face interne de la plaque supérieure et de la plaque inférieure de manière à limiter et contrôler les mouvements en flexion, inclinaison et rotation de la plaque supérieure et de la plaque inférieure l'une par rapport à l'autre et autour du noyau, à assurer la stabilité du positionnement du noyau entre les deux plaques, et à éviter les dépôts fibreux à l'intérieur de la prothèse.
La prothèse de disque intervertébral suivant la présente invention comprend une plaque supérieure et une plaque inférieure qui présente une face extérieure solidaire de dents pour permettre respectivement un ancrage desdites plaques dans le plateau supérieur et le plateau inférieur des corps vertébraux des vertèbres sus et sous jacentes. La prothèse de disque intervertébral suivant la présente invention comprend une face interne de la plaque supérieure et de la plaque inférieure qui comporte une empreinte sphérique délimitée par un rebord circulaire disposé en relief par rapport au plan horizontal de la face.
La prothèse de disque intervertébral suivant la présente invention comprend une face interne qui présente, entre l'empreinte centrale à profil sphérique et le bord périphérique de chaque plaque, des bossages.
La prothèse de disque intervertébral suivant la présente invention comprend des bossages qui sont disposés en arc de cercle de manière à être centrés autour de l'empreinte sphérique.
La prothèse de disque intervertébral suivant la présente invention comprend un noyau central qui comporte une couronne périphérique disposée dans un plan horizontal qui coopère avec une rainure interne ménagée dans l'élément annulaire.
La prothèse de disque intervertébral suivant la présente invention comprend un élément annulaire qui comporte une ouverture centrale pour le passage des calottes du noyau central et une rainure interne débouchant dans l'ouverture centrale afin de recevoir lors du montage de la prothèse de disque la couronne périphérique dudit noyau.
La prothèse de disque intervertébral suivant la présente invention comprend une plaque supérieure et une plaque inférieure qui sont réalisées dans un alliage de cobalt chrome.
La prothèse de disque intervertébral suivant la présente invention comprend un noyau central qui est réalisé dans une matière plastique ayant de très bonnes caractéristiques de glissement, telle que le polyéthylène.
La prothèse de disque intervertébral suivant la présente invention comprend un élément annulaire qui est réalisé dans un matériau viscoélastique tel que, par exemple, de l'élastomère biocompatible.
La description qui va suivre en regard des dessins annexés donnés à titre d'exemples non limitatifs, permettra de mieux comprendre l'invention, les caractéristiques qu'elle présente et les avantages qu'elle est susceptible de procurer :
Figure 1 est une vue en perspective éclatée illustrant la prothèse de disque intervertébral suivant la présente invention.
Figure 2 est une vue en coupe montrant la prothèse de disque intervertébral suivant la présente invention. Figure 3 est une vue représentant la prothèse de disque intervertébral en position assemblée.
On a représenté en figures 1 à 3 une prothèse de disque intervertébral 1 comportant deux plaques, une plaque supérieure 2 et une plaque inférieure 3, un noyau central 4 et un élément annulaire 5, afin de pouvoir restaurer la mobilité entre les niveaux sus et sous jacents de deux vertèbres voisines d'une colonne vertébrale.
Chaque plaque supérieure 2 et inférieure 3 présente une face extérieure 6 solidaire de dents 7 pour permettre respectivement un ancrage desdites plaques dans les plateaux supérieur et inférieur des corps vertébraux des vertèbres sus et sous jacentes.
Chaque plaque supérieure 2 et inférieure 3 présente à l'opposé de la face externe 6, une face interne 8 comportant une empreinte sphérique 9 délimitée par un rebord circulaire 10 disposé en relief par rapport au pian horizontal de la face 8.
La face interne 8 présente entre l'empreinte centrale 9 à profil sphérique et le bord périphérique 11 de chaque plaque 2, 3, des bossages 12 disposés de part et d'autre de ladite empreinte.
Les bossages 12 sont disposés en arc de cercle de manière à être centrés autour de l'empreinte sphérique 9.
La plaque supérieure 2 et la plaque inférieure 3 présentent un profil extérieur en forme de " fer à cheval " , afin de s'adapter au mieux au profil des plateaux vertébraux des vertèbres sus et sous jacentes.
La forme particulière de la plaque supérieure 2 et la plaque inférieure 3 permet d'avoir une surface de contact sur la vertèbre correspondante la plus grande possible, pour éviter l'enfoncement desdites plaques dans le corps de la vertèbre.
La plaque supérieure 2 et la plaque inférieure 3 sont réalisées dans un alliage de cobalt chrome.
Le noyau central 4 comporte une calotte sphériques supérieure 13 et une calotte sphérique inférieure 14 qui coopèrent respectivement avec les empreintes 9 de même profil de chaque plaque supérieure 2 et inférieure 3.
Le noyau central 4 présente une couronne périphérique 15 disposée dans un plan horizontal et permettant de limiter la rotation dudit noyau par rapport à la plaque supérieure 2 et la plaque inférieure 3.
Ainsi, la prothèse de disque 1 comporte une liaison articulaire de type sphérique du fait du profil des calottes 13 et 14 du noyau central 4 qui coopèrent avec les empreintes 9 de chaque plaque supérieure 2 et inférieure 3. On note que la liaison articulaire de type sphérique de la prothèse de disque 1 constitue une liaison à 5 degrés de liberté entre la plaque supérieure 2 et la plaque inférieure 3, à savoir :
• 3 rotations,
• 2 translations.
Le noyau central 4 est réalisé dans une matière plastique ayant de très bonnes caractéristiques de glissement, telle que le polyéthylène.
On note que le noyau central 4 est issu d'un jeu de noyau dont la taille varie en fonction de l'épaisseur de la couronne périphérique 15. Le noyau central 4 est choisi en fonction des dimensions de l'ouverture réalisée par le chirurgien entre le plateau supérieur et le plateau inférieur des corps vertébraux sus et sous jacents, afin que la prothèse intervertébrale s'adapte parfaitement à la hauteur de cette ouverture.
L'élément annulaire 5 présente une ouverture centrale 16 dont le diamètre interne est légèrement supérieur à celui de chaque calotte 13, 14 du noyau central 4 au niveau de la jonction entre lesdites calottes et la couronne périphérique 15.
L'élément annulaire 5 comporte une rainure interne 17 débouchant dans l'ouverture centrale 16 afin de recevoir lors du montage de la prothèse de disque 1 la couronne périphérique 15 du noyau central 4.
L'élément annulaire 5 est réalisé dans un matériau visco-élastique tel que, par exemple, de l'élastomère biocompatible.
On constate, lors du montage de la prothèse de disque 1 , que l'élément annulaire 5 vient en contact avec la plaque supérieure 2 et la plaque inférieure 3 au niveau des bossages 12 prévus sur chaque face interne 8, tandis que les calottes sphériques 13 et 14 du noyau central 4 sont également en contact avec les empreintes 9 de chaque plaque.
On remarque que le contrôle et la limitation des mouvements de flexion, extension et inclinaison latérale de la prothèse de disque 1 est obtenue par la compression de l'élément annulaire 5 par la plaque supérieure 2 et la plaque inférieure 3 lorsqu'elles sont ancrées entre le plateau supérieur et le plateau inférieur des corps vertébraux sus et sous jacents d'une colonne vertébrale.
Ainsi, cette limitation et ce contrôle des mouvements de flexion, extension et inclinaison latérale de la prothèse de disque 1 est dépendante de la hauteur des bossages réalisés sur les faces internes 8 de la plaque supérieure 2 et de la plaque inférieure 3 de la prothèse.
En ce qui concerne le contrôle et la limitation en rotation axiale de la prothèse de disque 1 , celle-ci est obtenue par le frottement de l'élément annulaire 5 sur la plaque supérieure 2 et la plaque inférieure 3, et par obstacle de l'élément annulaire 5 sur les bossages 12 en arc de cercle prévus sur les faces internes 8 de chaque plaque.
On note que l'élément annulaire permet d'empêcher les tissus fibreux ou de la gangue fibro-pseudo-synoviale de venir se fixer sur les parties mobiles de la prothèse de disque 1 , étant donné qu'il est compris entre la plaque supérieure 2 et la plaque inférieure 3.
De plus, le noyau central 4 est lié à l'élément annulaire 5, et l'élément est pincé entre les deux plaques 2 et 3, afin d'assurer la stabilité du positionnement du noyau entre les deux plaques par l'action de rappel de l'élément annulaire.
Il doit d'ailleurs être entendu que la description qui précède n'a été donnée qu'à titre d'exemple, et quelle ne limite nullement le domaine de l'invention dont on ne sortirait pas en remplaçant les détails d'exécution décrits par tout autre équivalent.

Claims

REVENDICATIONS
1. Prothèse de disque intervertébral comprenant une plaque supérieure (2) et une plaque inférieure (3) qui sont ancrées respectivement sur le plateau supérieur et le plateau inférieur des corps vertébraux des vertèbres sus et sous jacentes d'une colonne vertébrale et un noyau central (4) placé entre les deux plaques (2, 3) qui présente une calotte sphérique supérieure (13) et une calotte sphérique inférieure (14) coopérant respectivement avec des empreintes sphériques (9) ménagées dans lesdites plaques, supérieure et inférieure, caractérisée en ce qu'elle comprend un élément annulaire (5) réalisé dans un matériau viscoélastique qui est centré autour du noyau (4) et qui vient en contact avec des bossages (12) prévus sur chaque face interne (8) de la plaque supérieure (2) et de la plaque inférieure (3) de manière à limiter et contrôler les mouvements en flexion, inclinaison et rotation de la plaque supérieure (2) et de la plaque inférieure (3) l'une par rapport à l'autre et autour du noyau (4), à assurer la stabilité du positionnement du noyau (4) entre les deux plaques (2, 3), et à éviter les dépôts fibreux à l'intérieur de la prothèse (1 ).
2. Prothèse de disque intervertébral suivant la revendication 1 , caractérisée en ce que chaque plaque, la plaque supérieure (2) et la plaque inférieure (3) présente une face extérieure (6) solidaire de dents (7) pour permettre respectivement un ancrage desdites plaques dans le plateau supérieur et le plateau inférieur des corps vertébraux des vertèbres sus et sous jacentes.
3. Prothèse de disque intervertébral suivant la revendication 1 , caractérisée en ce que la face interne (8) de la plaque supérieure (2) et la plaque inférieure (3) comporte une empreinte sphérique (9) délimitée par un rebord circulaire (10) disposé en relief par rapport au plan horizontal de la face (8).
4. Prothèse de disque intervertébral suivant la revendication 1 , caractérisée en ce que la face interne (8) présente entre l'empreinte centrale (9) à profil sphérique et le bord périphérique (11 ) de chaque plaque (2, 3), des bossages
(12).
5. Prothèse de disque intervertébral suivant la revendication 1 , caractérisée en ce que les bossages (12) sont disposés en arc de cercle de manière à être centrés autour de l'empreinte sphérique (9).
6. Prothèse de disque intervertébral suivant la revendication 1 , caractérisée en ce que le noyau central (4) comporte une couronne périphérique (15) disposée dans un plan horizontal qui coopère avec une rainure interne (17) ménagée dans l'élément annulaire (5).
7. Prothèse de disque intervertébral suivant la revendication 1 , caractérisée en ce que l'élément annulaire (5) comporte une ouverture centrale (16) pour le passage des calottes (13, 14) du noyau central (4) et une rainure interne (17) débouchant dans l'ouverture centrale (16) afin de recevoir lors du montage de la prothèse de disque (1 ) la couronne périphérique (15) dudit noyau.
8. Prothèse de disque intervertébral suivant la revendication 1 , caractérisée en ce que la plaque supérieure (2) et la plaque inférieure (3) sont réalisées dans un alliage de cobalt chrome.
9. Prothèse de disque intervertébral suivant la revendication 1 , caractérisée en ce que le noyau central (4) est réalisé dans une matière plastique ayant de très bonnes caractéristiques de glissement, telle que le polyéthylène.
10. Prothèse de disque intervertébral suivant la revendication 1 , caractérisée en ce que l'élément annulaire (5) est réalisé dans un matériau viscoélastique tel que, par exemple, de l'élastomère biocompatible.
EP01911831A 2000-03-10 2001-03-02 Prothese de disque intervertebral Withdrawn EP1261302A1 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
FR0003069A FR2805985B1 (fr) 2000-03-10 2000-03-10 Prothese de disque intervertebral
FR0003069 2000-03-10
PCT/FR2001/000626 WO2001068003A1 (fr) 2000-03-10 2001-03-02 Prothese de disque intervertebral

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EP1261302A1 true EP1261302A1 (fr) 2002-12-04

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JP (1) JP2003526456A (fr)
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WO (1) WO2001068003A1 (fr)

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JP2003526456A (ja) 2003-09-09
FR2805985B1 (fr) 2003-02-07
WO2001068003A1 (fr) 2001-09-20
FR2805985A1 (fr) 2001-09-14
US6682562B2 (en) 2004-01-27

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