WO2002051326A1 - Implant intervertebral a cale deformable - Google Patents
Implant intervertebral a cale deformable Download PDFInfo
- Publication number
- WO2002051326A1 WO2002051326A1 PCT/FR2001/004094 FR0104094W WO02051326A1 WO 2002051326 A1 WO2002051326 A1 WO 2002051326A1 FR 0104094 W FR0104094 W FR 0104094W WO 02051326 A1 WO02051326 A1 WO 02051326A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- wedge
- grooves
- intervertebral implant
- strip
- fixing means
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S606/00—Surgery
- Y10S606/907—Composed of particular material or coated
- Y10S606/91—Polymer
Definitions
- the present invention relates to an intervertebral implant comprising a wedge intended to be applied between two spinous processes, said wedge having two opposite grooves each defined by two wings, the axes of said two grooves being substantially parallel to each other and said spinous processes coming to bear in said two grooves.
- Intervertebral implants comprising a wedge capable of being inserted between the spinous processes, which extend the posterior part of the vertebrae, to limit the bringing together of two consecutive vertebrae with respect to one another are well known.
- At least one wedge is fixed between the spinous processes of the two consecutive vertebrae, with suitable fixing means, capable of coming into contact during the movement of the spine. In this way, the wedge blocks the movement of the vertebrae when they approach each other, in particular during the extension of the spine.
- These wedges are made of a rigid biocompatible alloy, generally based on titanium, and are non-deformable under the action of the forces exerted on them unlike the normally formed intervertebral disc which is elastically deformable within certain limits.
- these wedges make it possible to avoid contact between two vertebrae, but they provide an incomplete supplement to the intervertebral disc which allows relative mobility of the vertebrae.
- the invention aims to propose an intervertebral implant comprising a deformable wedge made of a rigid material obtained by polymerization.
- the wedge has at least one central recess between said two grooves, said central recess crossing said wedge right through along an axis substantially parallel to said axes of said grooves, and the volume of said obviously central relative to the total volume of said wedge is between 0.1 and 0.3 whereby said wedge is elastically deformable.
- a characteristic of the invention resides in the production of a central recess in a relatively stable non-deformable block so as to obtain walls which are movable relative to each other so that the block can deform elastically without being weakened. too important.
- the wall is capable of deforming elastically under stress, in particular when the spinous processes approach each other, since the space between said walls is free.
- the wedge constitutes an obstacle to bringing the vertebrae closer to one another.
- the forces exerted by the wedge on the spinous processes are proportional to the relative displacements of the two vertebrae, since the wedge is elastically deformable, which makes it possible to recreate normal or almost normal physiological conditions of the relative displacement of the vertebrae.
- the recess has a substantially rectangular parallelepiped shape, two parallel faces of which are perpendicular to an axis perpendicularly cutting the axes of said grooves.
- the bottom of the two grooves is constituted by a wall, the two walls of the two grooves being substantially parallel to each other and perpendicular to the main direction of approach of the two vertebrae.
- the wedge has a large amplitude of deformation, in compression in particular.
- the wedge comprises two recesses superimposed between said two grooves, the axes of said recesses and the axes of said two grooves being substantially parallel to one another.
- the two recesses make it possible to obtain three partitions capable of deforming elastically under the effect of a stress normal to said partitions.
- the intervertebral implant further comprises, at least one fixing strip capable of holding said wedge between said processes and said wedge has: fixing means for connecting said strip to said wedge; and, means self-locking fastening formed in its side walls, said self-locking fastening means being adapted to receive said fixing strip to block it relative to said wedge.
- the fixing band is mounted beforehand on the wedge before the surgical intervention and the operator can insert the wedge between the spinous processes, then secure it to these processes by pulling at the free end of the band which gets stuck in the self-locking fastening means.
- the fixing means are formed in said wedge by at least one lateral drilling of one of said wings opening into one of said grooves.
- the end of the strip opposite to said free end is connected to said shim by forming a loop passing through the lateral bore.
- the strip is fixed on itself with staple means.
- the lateral drilling is only intended to fix the end of the strip and it is distinct from said central obviously which is exclusively intended to give the wedge its deformability.
- the self-locking fastening means are formed in said wedge by at least two separate blind side holes having an intersection and a longitudinal bore passing through the wing opposite the wing having a side bore and opening into said intersection, said bore. longitudinal and said lateral bores being able to receive said fixing strip to form a loop.
- the free end of the fixing strip is the approach inserted into the first longitudinal bore to open out into said intersection, passes through one of the two bores to come out of the hold and be reinserted to open out again into said intersection, then comes out in the opposite direction through said longitudinal bore so as to come into friction against the portion of strip already introduced. In this way, the strip is immobilized relative to the wedge.
- the implant according to the invention comprises a single fixing strip, the first end of which is connected to the said wedge by the said fixing means and the second end of which is connected to the said wedge by the fixing means self-locking provided in one of its side walls; and said wedge has, in the side wall opposite said side wall having the self-locking fixing means, guide means in which said fixing strip is able to slide so that said strip is able to surround said spinous processes and said wedge.
- the first end of the strip is connected to the wedge at the level of the lateral drilling then surrounds the spinous process which is inserted into the first groove and joins the side wall presenting the guide means.
- the band surrounds the spinous process which is inserted into the second groove and joins the self-locking fixing means so as to be immobilized relative to the wedge.
- the shim is produced by molding in one piece in a material obtained by polymerization.
- the shims according to the invention are capable of being produced at advantageous costs with regard to the shims obtained by machining.
- the wedge is made of polyether-ether-ketone.
- FIG. 1 is a schematic perspective view showing the wedge, according to a first particular embodiment, inserted between the spinous processes of two consecutive vertebrae;
- FIG. 2 is a schematic view along a vertical section of the wedge in accordance with Figure 1; and, - Figure 3 is a schematic perspective view showing the wedge, according to a second particular embodiment, inserted between the two spinous processes of two consecutive vertebrae.
- FIG. 1 shows two consecutive vertebrae V1 and V2 respectively extended, in their posterior part, by their spinous process A1 and A2.
- a wedge 10, having an upper groove 12 and a lower groove 14 is inserted between the spinous processes A1 and A2 so that the process A1 is in support in the groove 12 and that the process A2 is supported in the throat 14
- the upper grooves 12 and lower ⁇ respectively have an axis Agi and Ag2 substantially parallel to each other.
- the wedge 10 has a central recess 16 located between the two grooves 12 and 14, having a substantially rectangular parallelepiped shape and passing through said wedge 10 right through. For practical reasons of making said wedge 10 the corners 18 of the recess form a rounded shape over the entire thickness of the wedge.
- the central recess has an axis Ac substantially parallel to the two axes Agi and Ag2 of the two upper 12 and lower 14 grooves.
- the central recess 16 has an upper face 20 parallel to a lower face 22 opposite, said faces 20, 22 being substantially perpendicular to an axis Ap perpendicularly cutting the axes Agi and Ag2 of said grooves 12 and 14, and the axis Ac of the central recess.
- Figure 2 illustrates the wedge 10 in rear view, in which there is the axis Ap and the upper 20 and lower 22 faces which are perpendicular thereto.
- the wedge 10 is produced by molding in a material of the polymer type. However, it could be obtained by machining starting from a block of said material.
- the materials used to make the shims according to the invention are biocompatible.
- the wedge 10 according to the invention is produced in polyether-ether-ketone. This material intrinsically has a low stress strain coefficient and therefore a high elastic modulus of the order of 3.5 GPa. However, when the wedge 10 is made of this material and a central recess is made, it deforms more easily.
- the recess represents between 10 and 30% of the volume of the hold.
- the width of the central recess 16 represents 38% of the total width of the wedge 10 and its height represents 40% of the total height of the wedge 10.
- the recess 16 represents 30% of the volume of the wedge 10 , it deforms significantly when a force is applied to it without its mechanical resistance being compromised.
- the recess 16 represents 10% of the volume of the shim 10, it deforms little but with a greater amplitude than a shim having no recess.
- the shim 10 is divided into two portions, 24 and 26, the two portions being connected by an upper wall 28 and a lower wall 30.
- the upper walls 28 and lower 30 respectively constitute the bottom of the two grooves 12 and 14. It is understood that these walls 28, 30 are thin relative to the wedge portion 10 which separates the two grooves 12 and 14 when the wedge 10 does not have a recess 16 and that they are likely to be flexible with respect to said portions 24 and 26.
- the spinous processes A1 and A2 when they approach one another, during the extension of the spine, tend to compress the two walls 28 and 30 and also to drive them one towards the other.
- the two walls 28 and 30 are able to move elastically towards each other and therefore to induce a greater amplitude of movement of the two processes A1 and A2 with respect to each other.
- This mechanical force which is exerted in compression on the shim causes the deformation of the recess so as to bring the two walls 28 and 30 towards each other.
- the deformation of the spine can also be done in other directions as will be described in more detail in the following description.
- the intervertebral implant according to the invention and according to this particular embodiment comprises a single fixing strip 32 which makes it possible to secure the wedge 10 and the spinous processes A1 and A2.
- the first end 34 of the strip 32 is connected to the first wing 36 of the upper groove 12 by means of a lateral bore 38 which is formed in the wing 36 and which opens into the upper groove 12.
- the first end 34 of the strip 32 is inserted into the bore 38 so as to form a loop around the upper portion of the wing 36 and is fixed on itself with stapling means.
- the strip 32 is securely connected to the wedge 10 so as to allow the tensioning of the strip 32 without degradation of this connection.
- Band 32 surrounds the spinous processes A1 and A2 and the wedge
- the strip 32 and guide it on the wedge 10 has self-locking fastening means 40 formed in a side wall and a longitudinal bore 41 as well as guide means 42 formed in the opposite side wall.
- the self-locking fixing means 40 are formed by a first lateral bore 44 and a second lateral bore 46, which meets in an intersection 47 located in the thickness of the wedge.
- a longitudinal bore 41 crosses the wing of the groove and opens into said intersection 47.
- the wedge portion 48 separating the two lateral bores 44 and 46 has a projecting transverse edge 50 capable of constituting friction means and band locking 32.
- the strip 32 the first end 34 of which is connected to the wing 36 bears on the upper part of the spinous process A1 then on the end of the second wing 52 of the upper groove 12 and is inserted in the guide means 42 located on the side wall of the wedge 10.
- the strip 32 then rests on the spinous process A2 and on the ends of the two wings of the lower groove 14.
- the free end 54 of the strip 32 is inserted into the longitudinal bore 41 and crosses said intersection 47 to come out of the wedge through the second bore 46, then the strip is inserted into the first bore 44, crosses again said intersection 47 to come out through the longitudinal bore 41.
- the strip 32 is capable of being blocked in translation by friction on itself in the longitudinal bore 41 when it is tensioned.
- the projecting edge 50 of the wedge portion 48 allows the band 32 to be blocked.
- the wedge 10 is able to be secured to the spinous processes A1 and A2 by tensioning the band 32 which is blocked relative to the wedge 10 in the self-locking means 40.
- the movement of the processes prickles A1 and A2 relative to each other, respectively trapped in gorges 12 and 14, causes an elastic deformation of the wedge 10 whatever the direction of movement.
- the wedge 60 has two superimposed recesses 66 and 68 of respective axes Ad and Ac2 substantially parallel to each other and to the axes Agi and
- the superimposed recesses 66 and 68 have a shape comprising two superposed faces parallel to each other and two curved facing walls.
- the wedge 60 is divided into two parts interconnected by three partitions 70, 72 and 74 capable of being deformed when an effort is exerted on the wedge 60.
- the deformation capacities of the wedge 60 are less significant than that of the wedge 10 shown in Figures 1 and 2 taking into account that the two parts of the wedge 10 are connected by only two partitions. This is only true if the partitions 70, 72, 74 and 28, 30 are substantially the same size.
- the self-locking means are also produced by making two holes in the thickness of the side wall of the wedge 60, which meet in an intersection, and a longitudinal drilling made in the wing which opens into said intersection.
- intervertebral implants comprising wedges with mechanical properties, in particular of deformations, adapted to the reactions that one wishes to exercise on the spinous processes when the latter move relative to each other.
- the invention is not limited to the preceding embodiments, but extends to the shims having at least one recess in their central part whatever the shape of said recess.
- the recess is likely to have a circular shape.
Abstract
Description
Claims
Priority Applications (8)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
KR1020037007554A KR100848206B1 (ko) | 2000-12-22 | 2001-12-20 | 변형 가능한 웨지를 갖는 척주간 임플란트 |
AT01994926T ATE275879T1 (de) | 2000-12-22 | 2001-12-20 | Zwischenwirbelimplantat mit verformbarem keil |
JP2002552475A JP4109990B2 (ja) | 2000-12-22 | 2001-12-20 | 変形可能なウェッジを含む椎間インプラント |
AU2002225119A AU2002225119B8 (en) | 2000-12-22 | 2001-12-20 | Intervertebral Implant with Deformable Wedge |
DE60105639T DE60105639T2 (de) | 2000-12-22 | 2001-12-20 | Zwischenwirbelimplantat mit verformbarem keil |
EP01994926A EP1343424B1 (fr) | 2000-12-22 | 2001-12-20 | Implant intervertebral a cale deformable |
DK01994926T DK1343424T3 (da) | 2000-12-22 | 2001-12-20 | Intervertebralt implantat med deformerbar kile |
US10/332,798 US6946000B2 (en) | 2000-12-22 | 2001-12-20 | Intervertebral implant with deformable wedge |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
FR0016857A FR2818530B1 (fr) | 2000-12-22 | 2000-12-22 | Implant intervertebral a cale deformable |
FR00/16857 | 2000-12-22 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2002051326A1 true WO2002051326A1 (fr) | 2002-07-04 |
Family
ID=8858067
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/FR2001/004094 WO2002051326A1 (fr) | 2000-12-22 | 2001-12-20 | Implant intervertebral a cale deformable |
Country Status (16)
Country | Link |
---|---|
US (1) | US6946000B2 (fr) |
EP (1) | EP1343424B1 (fr) |
JP (1) | JP4109990B2 (fr) |
KR (1) | KR100848206B1 (fr) |
AR (1) | AR032030A1 (fr) |
AT (1) | ATE275879T1 (fr) |
AU (1) | AU2002225119B8 (fr) |
DE (1) | DE60105639T2 (fr) |
DK (1) | DK1343424T3 (fr) |
ES (1) | ES2225642T3 (fr) |
FR (1) | FR2818530B1 (fr) |
PT (1) | PT1343424E (fr) |
TW (1) | TW520986B (fr) |
UY (1) | UY27066A1 (fr) |
WO (1) | WO2002051326A1 (fr) |
ZA (1) | ZA200304208B (fr) |
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WO2006107539A1 (fr) * | 2005-03-31 | 2006-10-12 | Warsaw Orthopedic, Inc. | Appareil intervertébral pour stabilisation vertébrale et méthode pour l’implanter |
WO2006136938A1 (fr) * | 2005-06-24 | 2006-12-28 | Malan De Villiers | Dispositif de stabilisation interepineux |
JP2007501076A (ja) * | 2003-08-06 | 2007-01-25 | ウォーソー・オーソペディック・インコーポレーテッド | 人工器官 |
WO2007075843A2 (fr) * | 2005-12-19 | 2007-07-05 | Abdou M S | Dispositifs et procédés de mise en place d'un dispositif orthopédique intervertébral |
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CN100353919C (zh) * | 2003-02-19 | 2007-12-12 | 华沙整形外科公司 | 用于阻止两个连续的脊椎骨移动的棘突间器械 |
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Also Published As
Publication number | Publication date |
---|---|
EP1343424A1 (fr) | 2003-09-17 |
AU2002225119B8 (en) | 2006-05-18 |
US6946000B2 (en) | 2005-09-20 |
KR20030068168A (ko) | 2003-08-19 |
JP4109990B2 (ja) | 2008-07-02 |
ATE275879T1 (de) | 2004-10-15 |
DE60105639T2 (de) | 2005-09-29 |
ZA200304208B (en) | 2004-06-25 |
UY27066A1 (es) | 2002-01-31 |
KR100848206B1 (ko) | 2008-07-24 |
FR2818530A1 (fr) | 2002-06-28 |
AU2002225119B2 (en) | 2006-04-06 |
TW520986B (en) | 2003-02-21 |
DK1343424T3 (da) | 2005-01-24 |
JP2004516094A (ja) | 2004-06-03 |
DE60105639D1 (de) | 2004-10-21 |
US20040024458A1 (en) | 2004-02-05 |
FR2818530B1 (fr) | 2003-10-31 |
ES2225642T3 (es) | 2005-03-16 |
EP1343424B1 (fr) | 2004-09-15 |
AR032030A1 (es) | 2003-10-22 |
PT1343424E (pt) | 2005-01-31 |
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