WO1998046173A1 - Teleskopierende wirbelprothese - Google Patents

Teleskopierende wirbelprothese Download PDF

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Publication number
WO1998046173A1
WO1998046173A1 PCT/CH1997/000151 CH9700151W WO9846173A1 WO 1998046173 A1 WO1998046173 A1 WO 1998046173A1 CH 9700151 W CH9700151 W CH 9700151W WO 9846173 A1 WO9846173 A1 WO 9846173A1
Authority
WO
WIPO (PCT)
Prior art keywords
hollow body
spring
central axis
grid
bodies
Prior art date
Application number
PCT/CH1997/000151
Other languages
English (en)
French (fr)
Inventor
Manuel SCHÄR
Alex Hatebur
Fridolin SCHLÄPFER
Original Assignee
Synthes Ag Chur
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 Synthes Ag Chur filed Critical Synthes Ag Chur
Priority to EP97915251A priority Critical patent/EP0975288B1/de
Priority to JP54333998A priority patent/JP3955883B2/ja
Priority to DE59708392T priority patent/DE59708392D1/de
Priority to AU22855/97A priority patent/AU723279B2/en
Priority to US09/402,995 priority patent/US6176881B1/en
Priority to AT97915251T priority patent/ATE225150T1/de
Priority to PCT/CH1997/000151 priority patent/WO1998046173A1/de
Priority to ES97915251T priority patent/ES2182055T3/es
Publication of WO1998046173A1 publication Critical patent/WO1998046173A1/de

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • 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
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30112—Rounded shapes, e.g. with rounded corners
    • A61F2002/30131—Rounded shapes, e.g. with rounded corners horseshoe- or crescent- or C-shaped or U-shaped
    • A—HUMAN NECESSITIES
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    • 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
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30138—Convex polygonal shapes
    • A61F2002/30153—Convex polygonal shapes rectangular
    • A—HUMAN NECESSITIES
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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
    • 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
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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
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30362—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit with possibility of relative movement between the protrusion and the recess
    • A61F2002/30364—Rotation about the common longitudinal axis
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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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    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30362—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit with possibility of relative movement between the protrusion and the recess
    • A61F2002/3037—Translation along the common longitudinal axis, e.g. piston
    • A—HUMAN NECESSITIES
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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
    • A61F2/02—Prostheses implantable into the body
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    • 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
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30362—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit with possibility of relative movement between the protrusion and the recess
    • A61F2002/3037—Translation along the common longitudinal axis, e.g. piston
    • A61F2002/30372—Translation along the common longitudinal axis, e.g. piston with additional means for limiting said translation
    • 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
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    • 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
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30383—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
    • A61F2002/30403—Longitudinally-oriented cooperating ribs and grooves on mating lateral surfaces of a mainly longitudinal connection
    • A—HUMAN NECESSITIES
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    • 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
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
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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
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30492—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a locking pin
    • A—HUMAN NECESSITIES
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    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30495—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a locking ring
    • A—HUMAN NECESSITIES
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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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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30507—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a threaded locking member, e.g. a locking screw or a set screw
    • A—HUMAN NECESSITIES
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    • A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
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    • 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
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    • A—HUMAN NECESSITIES
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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Neurology (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
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  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
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  • Prostheses (AREA)

Abstract

Vorrichtung zum Ersatz von Wirbelknochen, die einen inneren (1) und einen äusseren (2) Hohlkörper umfaßt, welche entlang einer Zentralachse (3) ineinander koaxial gleitbar und in Richtung dieser Zentralachse (3) relativ zueinander verschiebbar sind und der innere Hohlkörper (1) auf seiner äusseren Mantelfläche (4) mit einer Rasterung (5) versehen ist, dadurch gekennzeichnet, daß der äussere Hohlkörper (2) entlang der Zentralachse (3) durchgehend durchbohrt (10) ist; der äussere Hohlkörper (2) mindestens ein federndes Element (7) aufweist, das an seinem oberen Ende (9) in die Bohrung (10) hineinragt und den Durchmesser der Bohrung (10) so verringert, daß das federnde Element (7) in die Rasterung (5) des inneren Hohlkörpers (1) einklinkt und dadurch die Länge der Vorrichtung gegen Druckkräfte fixiert.

Description

Teleskopierende Wirbelprothese
Die Erfindung bezieht sich auf eine Vorrichtung zum Ersatz von Wirbelkörpern aus der menschlichen Wirbelsäule gemass dem Oberbegriff des Patentanspruchs 1.
Wird ein Wirbelkörper krank oder erleidet einen Defekt muss dieser aus der Wirbelsäule entfernt werden. Aus dem Stand der Technik sind einige distanzhaltende Implantate zum Ersatz des fehlenden Wirbelkörpers bekannt. Das Implantat u fasst gegeneinander verschiebbare Teile, die unter anderem mittels Rasterungen eine Einstellung der Länge des Implantates gestatten, und zwei spezielle Endplatten, die zur Verankerung des Implantates in den anschliessenden intakten Wirbelkörpern dienen. Solche Wirbelprothesen oder Implantate sind beispielsweise aus der AT R 24426 RASHEED oder aus der DE 196 04 246 AI JEANSON bekannt.
Der Nachteil der bekannten Wirbelprothesen besteht darin, dass die beiden gegeneinander verschiebbaren Teile keine geschlossenen Hohlzylinder sind und daher die gesamte Wirbelprothese eine geringe Steifigkeit aufweist. Der Erfindung liegt die Aufgabe zugrunde, mit einer stabilen und längeneinstellbaren Wirbelprothese die biomechanischen und physiologischen Eigenschaften der Wirbelsäule trotz des entfernten Wirbelkörpers zu erhalten. Grosse Bedeutung gilt daneben auch der Handhabung des Wirbelsäulenimplantates im Lauf der Operation.
Die Erfindung löst die gestellte Aufgabe mit einer Vorrichtung, welche die Merkmale des Anspruchs 1 aufweist.
Eine Ausführung der erfindungsgemässen Vorrichtung umfasst zwei ineinander verschiebbare Hohlzylinder. Der innere Hohlzylinder ist am äusseren Umfang mit einer Rasterung versehen. Der äussere Hohlzylinder weist mindestens ein federndes Element auf, das in die Rasterung des inneren Hohlzylinders einklinkt und die Länge der Vorrichtung festlegt. Durch die Rasterung und das einklinkbare, federnde Element kann die erfindungsgemässe Vorrichtung verlängert werden und bei der Operation eingepasst werden.
Eine andere Ausführung der erfindungsgemässen Vorrichtung umfasst zwei ineinander koaxial angeordnete und entlang dieser Achse gegeneinander verschiebbare Hohlkörper, eine in einer im äusseren Hohlkörper angebrachten Nute gelagerten Feder und Endplatten, die zur Verankerung der Vorrichtung in den anschliessenden Wirbelkörpern dienen. Der innere Hohlkörper ist an seiner äusseren Mantelfläche mit einer Rasterung versehen. Die Feder weist an ihrer Innenfläche eine Rasterung auf, welche beim Einklinken in die Rasterung am inneren Hohlkörper diesen in axialer Richtung fixiert. Da die Feder von aussen durch eine Öffnung im äusseren Hohlkörper auch mit einem Hilfsinstrument gespreizt und aus der Rasterung gelöst werden kann, ist eine kontrollierte Kompression dieser Variante der erfindungsgemässen Vorrichtung im Bedarfsfall auch in situ möglich. Auch ist eine Ausführung mit drei ineinander verschiebbaren Hohlkörpern möglich, wobei die äusseren und inneren Zylinderflächen jeweils wie bei der beschriebenen, zweiteiligen Variante gestaltet sind.
Die durch diese Variante der Erfindung erreichten Vorteile sind im wesentlichen darin zu sehen, dass bei der erfindungsgemässen Vorrichtung eine Feder mit einer Rasterung zur Fixierung der Länge des Implantates eingebaut ist. Die Bauhöhe des Implantates kann somit verkleinert werden und bei kleinen Freiräumen zwischen den angrenzenden Wirbeln eingesetzt werden, was eine Anwendung der Prothese auch in der Nähe der Halswirbelsäule gestattet. Durch Spreizen der Feder kann die erfindungsgemässe Wirbelprothese wieder komprimiert und entfernt werden. Ausserdem können die beiden Hohlzylinder relativ dickwandig sein und somit eine sehr stabile Prothese bilden.
Die Erfindung und Weiterbildungen der Erfindung werden im folgenden anhand der teilweise schematischen Darstellungen mehrerer Ausführungsbeispiele noch näher erläutert.
Es zeigen: Fig. 1 einen Längsschnitt durch den inneren Hohlkörper 1 der erfindungsgemässen Vorrichtung;
Fig. 2 einen Längsschnitt durch den äusseren Hohlkörper 2 einer Variante der erfindungsgemässen Vorrichtung;
Fig. 3 einen Längsschnitt durch eine weitere Ausführung der erfindungsgemässen Vorrichtung;
Fig. 4 eine perspektivische Darstellung der ringförmigen Feder 13 gemass einer Ausführung der erfindungsgemässen Vorrichtung;
Fig. 5 eine perspektivische Darstellung der ringförmigen Feder (13) mit einem Ausschnitt aus dem äusseren Hohlkörper gemass einer Ausführung der erfindungsgemässen Vorrichtung;
Fig. 6 einen perspektivischen Ausschnitt der beiden Hohlkörper 1,2 und eines federnden Bügels 24 gemass einer Ausführung der erfindungsgemässen Vorrichtung; und
Fig. 7 eine weitere Ausführung des inneren Hohlkörpers 1 der erfindungsgemässen Vorrichtung. Fig. l zeigt den inneren Hohlzylinder 1 ge ass einer Ausführung der erfindungsgemässen Vorrichtung. Die Rasterung 5 auf der Mantelfläche ist nur auf einem Teil der Länge des inneren Hohlzylinders angebracht. Je nach Ausführungsart der erfindungsgemässen Vorrichtung ist der nicht mit der Rasterung 5 versehene Teil des inneren Hohlzylinders 1 mit radialen Durchgangsöffnungen 30 ausgestattet.
Der in Fig. 2 dargestellte äussere Hohlzylinder 2 entspricht einer Ausführung der erfindungsgemässen Vorrichtung, die als federndes Element 7 mehrere Zungen 19 aufweist, welche aus der Wand 6 des äusseren Hohlzylinders 2 ausgeschnitten sind und gegen die Zentralachse 3 hin eingebogen sind. Je nach Ausführungsart der erfindungsgemässen Vorrichtung ist der äussere Hohlzylinder 2 mit radialen Durchgangsöffnungen 30 ausgestattet.
Die in Fig. 3 dargestellte Variante der erfindungsgemässen Vorrichtung zeigt den äusseren Hohlkörper 2, der innen koaxial zur Zentralachse 3 mit einer zylindrischen Bohrung 10, einer ebenfalls zylindrischen Nute 12 und einer von dieser Nute 12 zur äusseren Mantelfläche des äusseren Hohlkörpers 2 durchgehenden Öffnung 17 versehen ist. Im äusseren Hohlkörper 2 gleitbar und entlang der Zentralachse 3 gegen diesen verschiebbar angeordnet ist der innere Hohlkörper 1, welcher an seiner Aussenflache mit einer Rasterung 5 versehen ist. In die Nute 12 ist eine Feder 13, die innen mit einer zur Rasterung 5 des inneren Hohlkörpers 1 formschlüssigen Rasterung 14 versehen ist, eingelegt. Wird die Feder 13 mit einem Hilfsmittel, das durch die Öffnung 17 im äusseren Hohlelement 2 in den Spalt 18 der Feder 13 bringbar ist, gespreizt, kann der innere Hohlkörper 1 relativ zum äusseren in beide Richtungen verschoben werden.
Eine weitere in Fig. 3 dargestellte Variante der erfindungsgemässen Vorrichtung ist im Bereich der Nute 12 mit einer den äusseren Hohlkörper 2 radial durchdringenden Verriegelungsschraube 35 zur Blockierung der beiden Hohlkörper 1,2 in Richtung der Zentralachse 3 ausgerüstet.
Ebenfalls in Fig. 3 enthalten sind Varianten der erfindungsgemässen Vorrichtung, die an den beiden freien Enden 36, 37 der Hohlkörper 1,2 mit Endplatten 38, 39, welche knochenseitig Dorne 40 aufweisen können, ausgerüstet.
Die ringförmige Feder 13 der in Fig. 3 dargestellten Ausführung der erfindungsgemässen Vorrichtung wird in Fig. 4 dargestellt. Durch einen Spalt 18 ist die Feder 13 am Umfang geöffnet. Eine Rasterung 14, die in die Rasterung 5 auf dem äusseren Umfang des inneren Hohlkörpers 1 einklinkbar ist, ist auf der inneren Mantelfläche der ringförmigen Feder 13 angebracht.
Fig. 5 zeigt eine weitere Ausführung der in Fig. 3 dargestellten Version der erfindungsgemässen Vorrichtung. Ein Stift 21 ist in eine radial durch den äusseren Hohlkörper 2 dringende Öffnung 23 eingesetzt, welcher in eine Kerbe 22 auf der oberen Stirnfläche 20 der Feder 13 einrastet und eine Verdrehung der Feder 13 um die Zentralachse 3 verhindert.
Fig. 6 zeigt eine weiter Ausführung der erfindungsgemässen Vorrichtung. Ein federnder Bügel 24 mit nach aussen gebogenen, freien Enden 25, 26 , die in Längsschlitze 27 am äusseren Hohlkörper 2 einrastbar sind, sichert die beiden Hohlkörper 1, 2 gegen Verdrehung.
In einer weiteren in Fig. 7 dargestellten Ausführung der in Fig. 3 dargestellten Version der erfindungsgemässen Vorrichtung ist der innere Hohlkörper 1 an seinem unteren Ende 16 mit einem Absatz 28 versehen, dessen Aussendurchmesser grösser als der Innendurchmesser der ungedehnten Feder 13 ist. Der Absatz 28 am unteren Ende 16 verhindert, dass der innere Hohlkörper 1 nach oben an der Feder 13 vorbeigleiten und aus dem äusseren Hohlkörper 2 herausrutschen kann.

Claims

Patentansprüche
1. Vorrichtung zum Ersatz von Wirbelknochen, die einen inneren (1) und einen äusseren (2) Hohlkörper umfasst, welche entlang einer Zentralachse (3) ineinander koaxial gleitbar und in Richtung dieser Zentralachse (3) relativ zueinander verschiebbar sind und der innere Hohlkörper (1) auf seiner äusseren Mantelfläche (4) mit einer Rasterung (5) versehen ist, dadurch gekennzeichnet, dass
A) der äussere Hohlkörper (2) entlang der Zentralachse (3) durchgehend durchbohrt (10) ist;
B) der äussere Hohlkörper (2) mindestens ein federndes Element (7) aufweist, das in die Bohrung (10) hineinragt und den Durchmesser der Bohrung (10) so verringert, dass das federnde Element (7) in die Rasterung (5) am inneren Hohlkörper (1) einklinkt; und
C) der innere Hohlkörper (1) starr ist.
2. Vorrichtung nach Anspruch 1, dadurch gekennzeichnet, dass beide Hohlkörper (1,2) hohlzylindrisch sind.
3. Vorrichtung nach Anspruch 1 oder 2, dadurch gekennzeichnet, dass dieses mindestens eine federnde Element (7) als Zunge (19) aus der Wand (6) des äusseren Hohlkörpers (2) ausgeschnitten ist.
4. Vorrichtung nach Anspruch 1 oder 2, dadurch gekennzeichnet, dass als federndes Element (7) eine ringförmige, radial durch einen Spalt (18) geöffnete Feder (13), die mit einer Rasterung (14) am inneren Umfang (15) versehen ist und in einer an der inneren Mantelfläche (11) des äusseren Hohlkörpers (2) umlaufenden Nute (12) gelagert ist, in die Rasterung (5) am inneren Hohlkörper (1) einklinkt.
5. Vorrichtung nach Anspruch 4, dadurch gekennzeichnet, dass durch eine den äusseren Hohlkörper (2) radial durchdringende Öffnung (17) die Feder (13) mit einem Hilfsmittel, das durch die Öffnung (17) in den Spalt (18) der Feder (13) einbringbar ist, die Feder (13) gespreizt und damit die Rasterung (14) der Feder (13) aus der Rasterung (5) am inneren Hohlkörper (1) ausgeklinkt werden kann.
6. Vorrichtung nach einem der Ansprüche 4 oder 5, dadurch gekennzeichnet, dass die Feder (13) auf einer Stirnfläche (20) eine Kerbe (22) aufweist.
7. Vorrichtung nach einem der Ansprüche 4 bis 6, dadurch gekennzeichnet, dass ein Stift (21) in eine durch den äusseren Hohlkörper (2) dringende Öffnung (23) eingesetzt ist und dieser Stift (21) die Feder (13) durch Formschluss mit der Kerbe (22) gegen Drehung um die Zentralachse (3) sichert.
8. Vorrichtung nach einem der Ansprüche 1 bis 7, dadurch gekennzeichnet, dass ein federnder Bügel (24) mit nach aussen gebogenen, freie Enden (25,26) in Längsschlitzen (27) am äusseren Hohlkörper (2) einrastbar ist und ein Verdrehen der beiden Hohlkörper (1,2) verhindert.
9. Vorrichtung nach einem der Ansprüche 4 bis 8, dadurch gekennzeichnet, dass der innere Hohlkörper (1) an seinem unteren Ende (16) mit einem Absatz (28) versehen ist, dessen Aussendurchmesser grösser als der Innendurchmesser der ungedehnten Feder (13) ist und der verhindert, dass der innere Hohlkörper (1) nach oben an der Feder (13) vorbeigleiten und aus dem äusseren Hohlkörper (2) herausrutschen kann.
10. Vorrichtung nach einem der Ansprüche 1 bis 9, dadurch gekennzeichnet, dass beide Hohlkörper (1, 2) radial zur Zentralachse (3) Durchgangsöffnungen (30) aufweisen.
11. Vorrichtung nach einem der Ansprüche 4 bis 10, dadurch gekennzeichnet, dass die Nut (12) und die Feder (13) gegen die Berührungsfläche (31) hin sich verjüngend konisch gestaltet sind.
12. Vorrichtung nach einem der Ansprüche 1 bis 11, dadurch gekennzeichnet, dass einer oder beide der Hohlkörper (1,2) entlang der Zentralachse (3) abgekröpft ist oder sind.
13. Vorrichtung nach einem der Ansprüche 1 bis 12, dadurch gekennzeichnet, dass die beiden Hohlkörper (1, 2) einen nicht kreisförmigen Querschnitt haben.
14. Vorrichtung nach einem der Ansprüche 1 bis 13, dadurch gekennzeichnet, dass an den beiden freien Enden (36, 37) der beiden Hohlkörper (1, 2) Endplatten (38, 39) angebracht werden.
15. Vorrichtung gemass Anspruch 14, dadurch gekennzeichnet, dass knochenseitig an den Endplatten (38, 39) Dorne (40) angebracht sind.
16. Vorrichtung nach einem der Ansprüche 1 bis 15, dadurch gekennzeichnet, dass im äusseren Hohlkörper (2) eine Verriegelungsschraube (35) eingeschraubt wird.
17. Vorrichtung nach einem der Ansprüche 4 bis 16, dadurch gekennzeichnet, dass die Rasterung (5; 14) sowohl am inneren Hohlkörper (1) als auch an der Feder (13) auf der druckbelasteten Seite in Richtung des oberen Endes (37) hinterschnitten ist.
PCT/CH1997/000151 1997-04-15 1997-04-15 Teleskopierende wirbelprothese WO1998046173A1 (de)

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EP97915251A EP0975288B1 (de) 1997-04-15 1997-04-15 Teleskopierende wirbelprothese
JP54333998A JP3955883B2 (ja) 1997-04-15 1997-04-15 伸縮式椎体プロテーゼ
DE59708392T DE59708392D1 (de) 1997-04-15 1997-04-15 Teleskopierende wirbelprothese
AU22855/97A AU723279B2 (en) 1997-04-15 1997-04-15 Telescopic vertebral prosthesis
US09/402,995 US6176881B1 (en) 1997-04-15 1997-04-15 Telescopic vertebral prosthesis
AT97915251T ATE225150T1 (de) 1997-04-15 1997-04-15 Teleskopierende wirbelprothese
PCT/CH1997/000151 WO1998046173A1 (de) 1997-04-15 1997-04-15 Teleskopierende wirbelprothese
ES97915251T ES2182055T3 (es) 1997-04-15 1997-04-15 Protesis de vertebra telescopica.

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EP0975288B1 (de) 2002-10-02
DE59708392D1 (de) 2002-11-07
US6176881B1 (en) 2001-01-23
ATE225150T1 (de) 2002-10-15
JP3955883B2 (ja) 2007-08-08
AU723279B2 (en) 2000-08-24
EP0975288A1 (de) 2000-02-02
AU2285597A (en) 1998-11-11
ES2182055T3 (es) 2003-03-01

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