WO2004000176A1 - Reversible intersomatic cage and device for placement thereof between the vertebral bodies of a spinal column - Google Patents

Reversible intersomatic cage and device for placement thereof between the vertebral bodies of a spinal column Download PDF

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Publication number
WO2004000176A1
WO2004000176A1 PCT/FR2003/001947 FR0301947W WO2004000176A1 WO 2004000176 A1 WO2004000176 A1 WO 2004000176A1 FR 0301947 W FR0301947 W FR 0301947W WO 2004000176 A1 WO2004000176 A1 WO 2004000176A1
Authority
WO
WIPO (PCT)
Prior art keywords
intersomatic cage
intersomatic
rear face
cage
vertebral bodies
Prior art date
Application number
PCT/FR2003/001947
Other languages
French (fr)
Inventor
Olivier Gille
Guy Viart
Pascal Rokegem
Rodolphe Lourdel
Jean-Yves Leroy
Eric Leroy
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
Priority to AU2003263253A priority Critical patent/AU2003263253A1/en
Publication of WO2004000176A1 publication Critical patent/WO2004000176A1/en

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    • A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
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    • A61F2/4465—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages having a circular or kidney shaped cross-section substantially perpendicular to the axis of the spine
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    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0096—Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers
    • A61F2250/0098—Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers radio-opaque, e.g. radio-opaque markers

Definitions

  • the present invention relates to a reversible interbody cage and more particularly to a device for placing said cage between the vertebral bodies of a vertebral column.
  • the present invention relates to a follower rod allowing the location of the interbody cage during the surgical operation.
  • the reversible interbody cage for the fusion of vertebral bodies of the overlying and underlying vertebrae of a vertebral column comprises a body consisting of upper and lower edges provided with teeth, curved lateral faces of which at least one and more particularly that having the smallest radius of curvature of holes opening into an internal space for the placement of a bone graft, of a front face with rounded profile crossed in a vertical direction by a first marker and a flat rear face pierced with a bore intended to cooperate with a positioning tool, said rear face being traversed in a horizontal direction by a second marker.
  • the intersomatic cage according to the present invention comprises a body which is made of a radio translucent material.
  • the intersomatic cage according to the present invention comprises a body which is made of a radio translucent material such as PEEK.
  • the intersomatic cage according to the present invention comprises a body which comprises at the junction between the curved lateral faces with the rear face two notches.
  • the interbody cage according to the present invention comprises a first marker which is positioned vertically in front of the interbody cage and centered on the main axis of the latter.
  • the interbody cage according to the present invention comprises a second marker which is positioned in a horizontal direction and offset with respect to the main axes of the rear face of the interbody cage.
  • the interbody cage according to the present invention comprises markers which are formed in a cylindrical wire passing right through the interbody cage and which are made of a radio opaque material capable of being visible during an X-ray picture so as to allow display the position of the intersomatic cages with each other and with respect to the vertebral bodies of the vertebrae above and below a vertebral column.
  • the intersomatic cage according to the present invention has upper and lower edges which respectively comprise on either side of the internal space of the teeth with an inclined profile which are directed towards the rear face of the body.
  • the device for setting up an intersomatic cage comprises a tool which consists of a grip handle secured to a tube and assembly means for fixing a follower rod inside. of the tube.
  • the positioning device comprises assembly means which consist of a rod guided inside the bore of the tube, of a wheel allowing the rod to be driven in rotation, and a hexagonal profile provided in the bore of said tube for locking in rotation the follower rod inside the tube.
  • the positioning device according to the present invention comprises a handle comprising a housing inside which rotates the knob in order to drive the rod inside the tube bore, said housing being closed above the wheel by a plate forming a striking zone on the tool.
  • the positioning device according to the present invention comprises a follower rod comprising a threaded part and opposite to the latter a hexagonal profile or the like extending by a threaded end.
  • the positioning device comprises a tube comprising opposite the handle of the lugs.
  • the positioning device comprises a tube comprising in its internal part a first bore which is extended by a second bore whose internal diameter is less than that of the first.
  • Figure 1 is a perspective view illustrating the interbody cage according to the present invention.
  • Figure 2 is a view showing the vertebral bodies of the vertebrae above and below a vertebral column viewed from the front between which are introduced the intersomatic cages according to the present invention.
  • Figure 3 is a view showing the vertebral bodies of the vertebrae above and below a vertebral column viewed in profile between which are introduced the intersomatic cages according to the present invention.
  • Figure 4 is a perspective view showing the device or instrumentation for the establishment of the interbody cage.
  • Figure 5 is a perspective view showing a follower rod allowing the mechanical connection between the interbody cage and the positioning device according to the present invention.
  • Figure 6 is a sectional view illustrating the operating head of the positioning device according to the present invention.
  • Figure 7 is a sectional view showing the attachment of the follower rod at the end of the positioning device according to the present invention.
  • FIGS 8 and 9 are views showing the interbody cage mounted on the positioning device according to the present invention.
  • An intersomatic cage 1 has been shown in FIG. 1 having a curved profile to affect, for example, the shape of a half banana.
  • the intersomatic cage 1 consists of a body 2 made of a translucent radio material, that is to say, it is not visible during radiological shots.
  • the material used can be, for example, because of its technical and physical characteristics, a material sold under the name of PEEK.
  • the intersomatic cage 1 consists of a body 2 having in its middle a through space 3 intended to receive, for example, a bone graft not shown.
  • the body 2 has upper 4 and lower 5 edges, curved lateral faces 6, 7 joined together by a front face 8 with rounded profile and a flat rear face 9, the assembly delimiting the internal space 3.
  • the upper 4 and lower 5 edges respectively comprise on each side of the internal space 3 teeth 10 with an inclined profile which are directed towards the rear face 9 of the body 2 of the cage 1.
  • the profile of the teeth 10 is provided to constitute a retaining element of the interbody cage 1 between the vertebral bodies of the above and underlying vertebrae VS, VI of a vertebral column.
  • the lateral face 6 forming the internal face with the radius of curvature of the body 2 in the form of a half banana is pierced with two holes 11 and 12 opening out inside the internal space 3.
  • the other lateral face 7 constitutes the external face to the radius of curvature of the body 2 in the form of a half banana.
  • the rear face 9 is pierced with a threaded bore 13 which is intended to cooperate with a tool 14 for the introduction and manipulation of the interbody cage 1 between the vertebral bodies of the above and underlying vertebrae VS, VI of a column spinal.
  • the threaded bore 13 is provided to open inside the internal space 3 of the body 2 of the interbody cage 1.
  • the body 2 comprises, at the junction between the lateral faces 6, 7 with the rear face 9 and on either side of the bore 13, two notches 15 and 16 opening out or not inside the internal space 3 of the body 2 of the interbody cage 1.
  • the body 2 of the interbody cage 1 comprises at at the front face 8 a first marker 17 arranged in a vertical direction and at the rear face 9 a second marker 18 placed in a horizontal direction and perpendicular to the first.
  • the first marker 17 is positioned at the front of the interbody cage 1 and centered on the main axis of the latter so that the distance between the internal and external faces is identical.
  • the second marker 18 is positioned in a horizontal direction which is offset from the main axes of the rear face 9 or of the threaded bore 13 of the interbody cage 1.
  • the offset of the second marker 18 on the rear face 9 allows the radiographic location between the right and left interbody cage during a front view of the spine of a patient ( Figure 2).
  • intersomatic cage 1 is reversible, that is to say, which is likely to be implanted between the vertebral bodies to the right and to the left of the vertical axis passing through the vertebrae of the spine.
  • the position of the markers 17 and 18 between the two intersomatic cages 1 implanted between the vertebral bodies VS, VI makes it possible to verify the respective penetration of the two cages between them (FIG. 3). Note that in the side view the intersomatic cage 1 on the right is the one with the marker 18 in the high position, while the intersomatic cage 1 on the left is identified by the marker 18 being in the lowest position.
  • the markers 17, 18 are made in a cylindrical wire or of another geometrical shape crossing right through the intersomatic cage 1.
  • the markers 17, 18 are made in a material likely to be visible during an X-ray photograph of so as to make it possible to visualize the position of the intersomatic cages 1 with one another and with respect to the vertebral bodies of the above and underlying vertebrae VS, VI of a vertebral column.
  • the intersomatic cage 1 called on the right is identified by the position of the markers 17, 18, the second of which 18 is located above the threaded bore 13 formed in the rear face 9 (FIG. 2).
  • the intersomatic cage 1 called on the left is identified by the position of the markers 17, 18, the second of which 18 is located below the threaded bore 13 formed in the rear face 9 (FIG. 2).
  • interbody cage 1 is reversible to be positioned either on the right or on the left and between the vertebral bodies of the above and underlying vertebrae VS, VI of a spine
  • FIG. 4 to 7 There is shown in Figures 4 to 7 a tool 14 for the establishment and introduction of the interbody cage 1 between the vertebral bodies of the vertebrae above and underlying VS, VI of a spine by means of a follower rod 21.
  • the tool 14 consists of a grip handle 19 integral with a tube 20 having in its internal part a first bore 31 which is extended by a second bore 32 whose internal diameter is less than that of the first.
  • the handle 19 has a housing 22 inside which rotates a thumb wheel 23 so as to drive inside the bore 31 of the tube 20 a rod 24.
  • the housing 22 is closed above the wheel 23 by a plate 25 forming a striking zone on the tool 14.
  • the tube 20 has, opposite the handle 19, lugs 26, while its internal bore 32 has a part 33 with a hexagonal profile or the like.
  • the rod 24 is fixed to the wheel 23 by means of a clamping screw 34, while it has, opposite the wheel 23, a threaded bore 27.
  • the follower rod 21 has a threaded part 28 and, opposite the latter, a hexagonal profile or the like 29 extending by a threaded end 30.
  • the follower rod 21 is assembled so that its threaded end 30 cooperates with the threaded bore 13 provided in the rear face 9 of the body 2.
  • the follower rod 21 is rotated by means of the hexagonal profile 29 so that the interbody cage 1 is perfectly maintained at the end of the latter.
  • the follower rod 21 is assembled to the tool 14 so that its threaded part 28 cooperates with the threaded bore 27 of the rod 24.
  • the fixation of the follower rod 21 is obtained by the rotary drive of the rod 24 by the wheel 23 located at the handle 19 of the tool 14.
  • the rotation of the rod 24 makes it possible to introduce the follower rod 21 inside the internal bore 32 of the tube 20 until the hexagonal profile 29 cooperates with the part with complementary profile 33 of said tube.
  • the translational movement of the follower rod 21 inside the tube 20 is carried out until the lugs 26 penetrate inside the notches 15 and 16 provided at the rear face 9 of the interbody cage 1 ( Figures 8, 9).
  • the surgeon can introduce between the vertebral bodies of the above and underlying vertebrae VS, VI of a spinal column the first interbody cage 1 using the tool 14.
  • This introduction can for example be formed by successive strikes made using a hammer on the plate 25 without risk of blocking the threaded parts of the tool 14 with the follower rod 21 and the latter with the interbody cage 1.
  • the surgeon withdraws the tool 14 by rotating the wheel 23 to release the blocked follower rod 21 in rotation by the complementary profiles 29, 33 of the rod 24 guided inside the tube 20.
  • the follower rod 21 remains assembled with the first interbody cage 1.
  • the surgeon can visually identify the position of the interbody cage 1 between the vertebral bodies of the above and underlying vertebrae VS , VI of a vertebral column thanks to the follower rod which leaves the operating field.
  • the surgeon can act on the follower rod 21 to change the position of the interbody cage 1 between the vertebral bodies of the above and underlying vertebrae VS, VI of a vertebral column thanks to the follower rod which leaves the operating field.
  • the follower rod 21 is removed from the interbody cage 1 by means of its hexagonal profile 29 which allows it to be driven in rotation by any tool.

Abstract

The invention relates to a reversible intersomatic cage for the fusion of vertebral bodies of vertically adjacent vertebrae (VS, VI) in a spinal column, comprising a body (2) with upper (4) and lower (5) surfaces provided with teeth (10), curved lateral faces (6, 7), of which one at least and more particularly that having the smallest radius of curvature, has holes (11, 12) opening into the interior of an internal space (3) for the placement of a bony graft, a front face (8) with a rounded profile, crossed by a first marker (17) in a vertical direction and a rear planar face (9), provided with a drilling (13) for cooperation with a placement tool (14), said rear face (9) being crossed by a second marker (18) in a horizontal direction.

Description

CAGE INTERSOMATIQUE REVERSIBLE ET SON DISPOSITIF DE MISE EN PLACE ENTRE LES CORPS VERTEBRAUX D'UNE COLONNE REVERSIBLE INTERSOMATIC CAGE AND ITS DEVICE FOR PLACEMENT BETWEEN THE VERTEBRAL BODIES OF A COLUMN
VERTEBRALESPINAL
La présente invention est relative à une cage intersomatique réversible et plus particulièrement à un dispositif de mise en place de ladite cage entre les corps vertébraux d'une colonne vertébrale.The present invention relates to a reversible interbody cage and more particularly to a device for placing said cage between the vertebral bodies of a vertebral column.
Egalement, la présente invention est relative à une tige suiveuse permettant le repérage de la cage intersomatique pendant l'opération chirurgicale.Also, the present invention relates to a follower rod allowing the location of the interbody cage during the surgical operation.
La cage intersomatique réversible pour la fusion de corps vertébraux des vertèbres sus et sous jacentes d'une colonne vertébrale suivant la présente invention comporte un corps constitué de bords supérieurs et inférieurs pourvus de dents, de faces latérales courbes dont l'une au moins et plus particulièrement celle présentant le plus petit rayon de courbure de trous débouchant à l'intérieur d'un espace interne pour la mise en place d'un greffon osseux, d'une face avant à profil arrondi traversée suivant une direction verticale par un premier marqueur et d'une face arrière plane percée d'un alésage destiné à coopérer avec un outil de mise en place, ladite face arrière étant traversée suivant une direction horizontale par un second marqueur. La cage intersomatique suivant la présente invention comporte un corps qui est réalisé dans un matériau radio translucide.The reversible interbody cage for the fusion of vertebral bodies of the overlying and underlying vertebrae of a vertebral column according to the present invention comprises a body consisting of upper and lower edges provided with teeth, curved lateral faces of which at least one and more particularly that having the smallest radius of curvature of holes opening into an internal space for the placement of a bone graft, of a front face with rounded profile crossed in a vertical direction by a first marker and a flat rear face pierced with a bore intended to cooperate with a positioning tool, said rear face being traversed in a horizontal direction by a second marker. The intersomatic cage according to the present invention comprises a body which is made of a radio translucent material.
La cage intersomatique suivant la présente invention comporte un corps qui est réalisé dans un matériau radio translucide tel que du PEEK.The intersomatic cage according to the present invention comprises a body which is made of a radio translucent material such as PEEK.
La cage intersomatique suivant la présente invention comporte un corps qui comprend au niveau de la jonction entre les faces latérales courbes avec la face arrière deux encoches. La cage intersomatique suivant la présente invention comporte un premier marqueur qui est positionné verticalement à l'avant de la cage intersomatique et centré sur l'axe principal de cette dernière.The intersomatic cage according to the present invention comprises a body which comprises at the junction between the curved lateral faces with the rear face two notches. The interbody cage according to the present invention comprises a first marker which is positioned vertically in front of the interbody cage and centered on the main axis of the latter.
La cage intersomatique suivant la présente invention comporte un second marqueur qui est positionné suivant une direction horizontale et décalé par rapport aux axes principaux de la face arrière de la cage intersomatique.The interbody cage according to the present invention comprises a second marker which is positioned in a horizontal direction and offset with respect to the main axes of the rear face of the interbody cage.
La cage intersomatique suivant la présente invention comporte des marqueurs qui sont formés dans un fil cylindrique traversant de part en part la cage intersomatique et qui sont réalisés dans un matériau radio opaque susceptible d'être visible lors d'un cliché radiographique de manière à permettre de visualiser la position des cages intersomatiques entre elles et par rapport aux corps vertébraux des vertèbres sus et sous jacentes d'une colonne vertébrale.The interbody cage according to the present invention comprises markers which are formed in a cylindrical wire passing right through the interbody cage and which are made of a radio opaque material capable of being visible during an X-ray picture so as to allow display the position of the intersomatic cages with each other and with respect to the vertebral bodies of the vertebrae above and below a vertebral column.
La cage intersomatique suivant la présente invention comporte des bords supérieurs et inférieurs qui comprennent respectivement de part et d'autre de l'espace interne des dents à profil incliné qui sont dirigées vers la face arrière du corps.The intersomatic cage according to the present invention has upper and lower edges which respectively comprise on either side of the internal space of the teeth with an inclined profile which are directed towards the rear face of the body.
Le dispositif de mise en place d'une cage intersomatique suivant la présente invention comporte un outil qui est constitué d'une poignée de préhension solidaire d'un tube et des moyens d'assemblage pour la fixation d'une tige suiveuse à l'intérieur du tube.The device for setting up an intersomatic cage according to the present invention comprises a tool which consists of a grip handle secured to a tube and assembly means for fixing a follower rod inside. of the tube.
Le dispositif de mise en place suivant la présente invention comporte des moyens d'assemblage qui sont constitués d'une tige guidée à l'intérieur de l'alésage du tube, d'une molette permettant l'entraînement en rotation de la tige, et d'un profil hexagonal prévu dans l'alésage dudit tube pour le blocage en rotation de la tige suiveuse à l'intérieur du tube. Le dispositif de mise en place suivant la présente invention comporte une poignée comprenant un logement à l'intérieur duquel tourne en rotation la molette afin d'entraîner à l'intérieur de l'alésage du tube la tige, ledit logement étant fermé au dessus de la molette par une platine formant une zone de frappe sur l'outil. Le dispositif de mise en place suivant la présente invention comporte une tige suiveuse comprenant une partie filetée et à l'opposé de cette dernière un profil hexagonal ou analogue se prolongeant par une extrémité filetée.The positioning device according to the present invention comprises assembly means which consist of a rod guided inside the bore of the tube, of a wheel allowing the rod to be driven in rotation, and a hexagonal profile provided in the bore of said tube for locking in rotation the follower rod inside the tube. The positioning device according to the present invention comprises a handle comprising a housing inside which rotates the knob in order to drive the rod inside the tube bore, said housing being closed above the wheel by a plate forming a striking zone on the tool. The positioning device according to the present invention comprises a follower rod comprising a threaded part and opposite to the latter a hexagonal profile or the like extending by a threaded end.
Le dispositif de mise en place suivant la présente invention comporte un tube comprenant à l'opposé de la poignée des ergots.The positioning device according to the present invention comprises a tube comprising opposite the handle of the lugs.
Le dispositif de mise en place suivant la présente invention comporte un tube comprenant dans sa partie interne un premier alésage qui se prolonge par un second alésage dont le diamètre interne est inférieur à celui du premier.The positioning device according to the present invention comprises a tube comprising in its internal part a first bore which is extended by a second bore whose internal diameter is less than that of the first.
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 :The description which follows with reference to the appended drawings, given by way of nonlimiting examples, will make it possible to better understand the invention, the characteristics which it presents and the advantages which it is capable of providing:
Figure 1 est une vue en perspective illustrant la cage intersomatique suivant la présente invention.Figure 1 is a perspective view illustrating the interbody cage according to the present invention.
Figure 2 est une vue représentant les corps vertébraux des vertèbres sus et sous jacentes d'une colonne vertébrale vue de face entre lesquels sont introduit les cages intersomatiques suivant la présente invention. Figure 3 est une vue représentant les corps vertébraux des vertèbres sus et sous jacentes d'une colonne vertébrale vue de profil entre lesquels sont introduites les cages intersomatiques suivant la présente invention. Figure 4 est une vue en perspective montrant le dispositif ou l'instrumentation pour la mise en place de la cage intersomatique.Figure 2 is a view showing the vertebral bodies of the vertebrae above and below a vertebral column viewed from the front between which are introduced the intersomatic cages according to the present invention. Figure 3 is a view showing the vertebral bodies of the vertebrae above and below a vertebral column viewed in profile between which are introduced the intersomatic cages according to the present invention. Figure 4 is a perspective view showing the device or instrumentation for the establishment of the interbody cage.
Figure 5 est une vue en perspective représentant une tige suiveuse permettant la liaison mécanique entre la cage intersomatique et le dispositif de mise en place suivant la présente invention.Figure 5 is a perspective view showing a follower rod allowing the mechanical connection between the interbody cage and the positioning device according to the present invention.
Figure 6 est une vue en coupe illustrant la tête de manœuvre du dispositif de mise en place suivant la présente invention. Figure 7 est une vue en coupe montrant la fixation de la tige suiveuse à l'extrémité du dispositif de mise en place suivant la présente invention.Figure 6 is a sectional view illustrating the operating head of the positioning device according to the present invention. Figure 7 is a sectional view showing the attachment of the follower rod at the end of the positioning device according to the present invention.
Figures 8 et 9 sont des vues représentant la cage intersomatique montée sur le dispositif de mise en place suivant la présente invention.Figures 8 and 9 are views showing the interbody cage mounted on the positioning device according to the present invention.
On a montré en figure 1 une cage intersomatique 1 présentant un profil courbé pour affecter par exemple la forme d'une demi banane.An intersomatic cage 1 has been shown in FIG. 1 having a curved profile to affect, for example, the shape of a half banana.
La cage intersomatique 1 est constituée d'un corps 2 réalisé dans un matériau radio translucide, c'est à dire, qu'elle n'est pas visible lors de prises de vue radiologique. Le matériau utilisé peut être, par exemple, du fait de ses caractéristiques techniques et physiques un matériau commercialisé sous le nom de PEEK. La cage intersomatique 1 est constituée d'un corps 2 présentant en son milieu un espace traversant 3 destiné à recevoir, par exemple, un greffon osseux non représenté.The intersomatic cage 1 consists of a body 2 made of a translucent radio material, that is to say, it is not visible during radiological shots. The material used can be, for example, because of its technical and physical characteristics, a material sold under the name of PEEK. The intersomatic cage 1 consists of a body 2 having in its middle a through space 3 intended to receive, for example, a bone graft not shown.
Le corps 2 comporte des bords supérieurs 4 et inférieurs 5, des face latérales courbes 6, 7 réunies entre elles par une face avant 8 à profil arrondi et une face arrière 9 plane, l'ensemble délimitant l'espace interne 3.The body 2 has upper 4 and lower 5 edges, curved lateral faces 6, 7 joined together by a front face 8 with rounded profile and a flat rear face 9, the assembly delimiting the internal space 3.
Les bords supérieurs 4 et inférieurs 5 comportent respectivement de part et d'autre de l'espace interne 3 des dents 10 à profil incliné qui sont dirigées vers la face arrière 9 du corps 2 de la cage 1.The upper 4 and lower 5 edges respectively comprise on each side of the internal space 3 teeth 10 with an inclined profile which are directed towards the rear face 9 of the body 2 of the cage 1.
Le profil des dents 10 est prévu pour constituer un élément de retenue de la cage intersomatique 1 entre les corps vertébraux des vertèbres sus et sous jacentes VS, VI d'une colonne vertébrale.The profile of the teeth 10 is provided to constitute a retaining element of the interbody cage 1 between the vertebral bodies of the above and underlying vertebrae VS, VI of a vertebral column.
La face latérale 6 formant la face interne au rayon de courbure du corps 2 en forme de demi banane est percée de deux trous 11 et 12 débouchant à l'intérieur de l'espace interne 3. De fait, l'autre face latérale 7 constitue la face externe au rayon de courbure du corps 2 en forme de demi banane. La face arrière 9 est percée d'un alésage fileté 13 qui est destiné à coopérer avec un outil 14 pour l'introduction et la manipulation de la cage intersomatique 1 entre les corps vertébraux des vertèbres sus et sous jacentes VS, VI d'une colonne vertébrale.The lateral face 6 forming the internal face with the radius of curvature of the body 2 in the form of a half banana is pierced with two holes 11 and 12 opening out inside the internal space 3. In fact, the other lateral face 7 constitutes the external face to the radius of curvature of the body 2 in the form of a half banana. The rear face 9 is pierced with a threaded bore 13 which is intended to cooperate with a tool 14 for the introduction and manipulation of the interbody cage 1 between the vertebral bodies of the above and underlying vertebrae VS, VI of a column spinal.
L'alésage fileté 13 est prévu pour déboucher à l'intérieur de l'espace interne 3 du corps 2 de la cage intersomatique 1. Le corps 2 comporte, au niveau de la jonction entre les faces latérales 6, 7 avec la face arrière 9 et de part et d'autre de l'alésage 13, deux encoches 15 et 16 débouchant ou non à l'intérieur de l'espace interne 3 du corps 2 de la cage intersomatique 1. Le corps 2 de la cage intersomatique 1 comporte au niveau de la face avant 8 un premier marqueur 17 disposé suivant une direction verticale et au niveau de la face arrière 9 un second marqueur 18 placé suivant une direction horizontale et perpendiculaire au premier. Le premier marqueur 17 est positionné à l'avant de la cage intersomatique 1 et centré sur l'axe principal de cette dernière de manière que la distance entre les faces internes et externes soit identique.The threaded bore 13 is provided to open inside the internal space 3 of the body 2 of the interbody cage 1. The body 2 comprises, at the junction between the lateral faces 6, 7 with the rear face 9 and on either side of the bore 13, two notches 15 and 16 opening out or not inside the internal space 3 of the body 2 of the interbody cage 1. The body 2 of the interbody cage 1 comprises at at the front face 8 a first marker 17 arranged in a vertical direction and at the rear face 9 a second marker 18 placed in a horizontal direction and perpendicular to the first. The first marker 17 is positioned at the front of the interbody cage 1 and centered on the main axis of the latter so that the distance between the internal and external faces is identical.
Le second marqueur 18 est positionné suivant une direction horizontale qui est décalée par rapport aux axes principaux de la face arrière 9 ou de l'alésage fileté 13 de la cage intersomatique 1.The second marker 18 is positioned in a horizontal direction which is offset from the main axes of the rear face 9 or of the threaded bore 13 of the interbody cage 1.
Le décalage du second marqueur 18 sur la face arrière 9 permet le repérage radiographique entre la cage intersomatique droite et gauche lors d'une vue de face de la colonne vertébrale d'un patient (figure 2).The offset of the second marker 18 on the rear face 9 allows the radiographic location between the right and left interbody cage during a front view of the spine of a patient (Figure 2).
En effet la cage intersomatique 1 suivant la présente invention est réversible, c'est à dire, quelle est susceptible d'être implantée entre les corps vertébraux à droite et à gauche de l'axe vertical passant par les vertèbres de la colonne vertébrale.Indeed the intersomatic cage 1 according to the present invention is reversible, that is to say, which is likely to be implanted between the vertebral bodies to the right and to the left of the vertical axis passing through the vertebrae of the spine.
Egalement lors d'une vue de profil la position des marqueurs 17 et 18 entre les deux cages intersomatiques 1 implantés entre les corps vertébraux VS, VI permet de vérifier l'enfoncement respectif des deux cages entre elles (figure 3). On note que sur la vue de profil la cage intersomatique 1 de droite est celle présentant le marqueur 18 en position haute, tandis que la cage intersomatique 1 de gauche est repérée par le marqueur 18 se trouvant en position la plus basse.Also during a profile view, the position of the markers 17 and 18 between the two intersomatic cages 1 implanted between the vertebral bodies VS, VI makes it possible to verify the respective penetration of the two cages between them (FIG. 3). Note that in the side view the intersomatic cage 1 on the right is the one with the marker 18 in the high position, while the intersomatic cage 1 on the left is identified by the marker 18 being in the lowest position.
Cette mise en place à droite et gauche de la cage intersomatique 1 est obtenue par une simple rotation de cette dernière autour de son axe longitudinal afin que chaque face interne 6 de plus petit rayon de courbure soit toujours disposée l'une en face de l'autre. Les marqueurs 17, 18 sont réalisés dans un fil cylindrique ou d'une autre forme géométrique traversant de part en part la cage intersomatique 1. Les marqueurs 17, 18 sont réalisés dans un matériau susceptible d'être visible lors d'un cliché radiographique de manière à permettre de visualiser la position des cages intersomatiques 1 entre elles et par rapport aux corps vertébraux des vertèbres sus et sous jacentes VS, VI d'une colonne vertébrale. En effet, il est généralement introduit entre les corps vertébraux des vertèbres sus et sous jacentes VS, VI d'une colonne vertébrale deux cages intersomatiques 1 qui sont positionnées l'une par rapport à l'autre de manière que les faces latérales internes 6 soient disposées l'une en face de l'autre. Ainsi, les marqueurs 17 et 18 permettent de vérifier la position des deux cages l'une par rapport à l'autre et de repérer la cage droite de la cage gauche lorsqu'elles sont introduites entre les corps vertébraux des vertèbres sus et sous jacentes VS, VI d'une colonne vertébrale (figures 2, 3). On constate que lors d'une vue de face de la colonne vertébrale il est placée entre les corps vertébraux des vertèbres sus et sous jacentes VS, VI une cage 1 à droite et une cage à gauche de l'axe vertical de ladite colonne vertébrale.This positioning on the right and left of the intersomatic cage 1 is obtained by a simple rotation of the latter around its longitudinal axis so that each internal face 6 of smaller radius of curvature is always arranged one opposite the other. The markers 17, 18 are made in a cylindrical wire or of another geometrical shape crossing right through the intersomatic cage 1. The markers 17, 18 are made in a material likely to be visible during an X-ray photograph of so as to make it possible to visualize the position of the intersomatic cages 1 with one another and with respect to the vertebral bodies of the above and underlying vertebrae VS, VI of a vertebral column. Indeed, it is generally introduced between the vertebral bodies of the above and underlying vertebrae VS, VI of a vertebral column two intersomatic cages 1 which are positioned relative to each other so that the internal lateral faces 6 are arranged one opposite the other. Thus, the markers 17 and 18 make it possible to check the position of the two cages with respect to each other and to locate the right cage of the left cage when they are introduced between the vertebral bodies of the above and underlying vertebrae VS , VI of a spine (Figures 2, 3). It is noted that during a front view of the spine it is placed between the vertebral bodies of the vertebrae above and below VS, VI a cage 1 to the right and a cage to the left of the vertical axis of said spine.
Ainsi, la cage intersomatique 1 dite à droite est repérée grâce à la position des marqueurs 17, 18 dont le second 18 se trouve au dessus de l'alésage fileté 13 ménagé dans la face arrière 9 (figure 2).Thus, the intersomatic cage 1 called on the right is identified by the position of the markers 17, 18, the second of which 18 is located above the threaded bore 13 formed in the rear face 9 (FIG. 2).
La cage intersomatique 1 dite à gauche est repérée grâce à la position des marqueurs 17, 18 dont le second 18 se trouve au dessous de l'alésage fileté 13 ménagé dans la face arrière 9 (figure 2).The intersomatic cage 1 called on the left is identified by the position of the markers 17, 18, the second of which 18 is located below the threaded bore 13 formed in the rear face 9 (FIG. 2).
Ainsi, on constate que la cage intersomatique 1 est réversible pour être positionnée soit à droite soit à gauche et entre les corps vertébraux des vertèbres sus et sous jacentes VS, VI d'une colonne vertébraleThus, we see that the interbody cage 1 is reversible to be positioned either on the right or on the left and between the vertebral bodies of the above and underlying vertebrae VS, VI of a spine
On a représenté en figures 4 à 7 un outil 14 permettant la mise en place et l'introduction de la cage intersomatique 1 entre les corps vertébraux des vertèbres sus et sous jacentes VS, VI d'une colonne vertébrale au moyen d'une tige suiveuse 21.There is shown in Figures 4 to 7 a tool 14 for the establishment and introduction of the interbody cage 1 between the vertebral bodies of the vertebrae above and underlying VS, VI of a spine by means of a follower rod 21.
L'outil 14 est constitué d'une poignée de préhension 19 solidaire d'un tube 20 comportant dans sa partie interne un premier alésage 31 qui se prolonge par un second alésage 32 dont le diamètre interne est inférieur à celui du premier. La poignée 19 comporte un logement 22 à l'intérieur duquel tourne en rotation une molette 23 afin d'entraîner à l'intérieur de l'alésage 31 du tube 20 une tige 24.The tool 14 consists of a grip handle 19 integral with a tube 20 having in its internal part a first bore 31 which is extended by a second bore 32 whose internal diameter is less than that of the first. The handle 19 has a housing 22 inside which rotates a thumb wheel 23 so as to drive inside the bore 31 of the tube 20 a rod 24.
Le logement 22 est fermé au dessus de la molette 23 par une platine 25 formant une zone de frappe sur l'outil 14. Le tube 20 comporte à l'opposé de la poignée 19 des ergots 26, tandis que son alésage interne 32 présente une partie 33 à profil hexagonal ou analogue.The housing 22 is closed above the wheel 23 by a plate 25 forming a striking zone on the tool 14. The tube 20 has, opposite the handle 19, lugs 26, while its internal bore 32 has a part 33 with a hexagonal profile or the like.
La tige 24 est fixée à la molette 23 par l'intermédiaire d'une vis de serrage 34, tandis qu'elle comporte à l'opposé de la molette 23 un alésage fileté 27.The rod 24 is fixed to the wheel 23 by means of a clamping screw 34, while it has, opposite the wheel 23, a threaded bore 27.
La tige suiveuse 21 comporte une partie filetée 28 et à l'opposé de cette dernière un profil hexagonale ou analogue 29 se prolongeant par une extrémité filetée 30.The follower rod 21 has a threaded part 28 and, opposite the latter, a hexagonal profile or the like 29 extending by a threaded end 30.
On a montré en figures 6 à 7 l'outil 14 qui porte à l'extrémité opposée à celle de la poignée 19 une cage intersomatique 1.The tools 14 which have at the end opposite to that of the handle 19 an intersomatic cage 1 have been shown in FIGS. 6 to 7.
La tige suiveuse 21 est assemblée de manière que son extrémité filetée 30 coopère avec l'alésage fileté 13 prévu dans la face arrière 9 du corps 2.The follower rod 21 is assembled so that its threaded end 30 cooperates with the threaded bore 13 provided in the rear face 9 of the body 2.
La tige suiveuse 21 est entraînée en rotation au moyen du profil hexagonal 29 afin que la cage intersomatique 1 soit parfaitement maintenue au bout de cette dernière.The follower rod 21 is rotated by means of the hexagonal profile 29 so that the interbody cage 1 is perfectly maintained at the end of the latter.
Ensuite la tige suiveuse 21 est assemblée à l'outil 14 de manière que sa partie filetée 28 coopère avec l'alésage fileté 27 de la tige 24. La fixation de la tige suiveuse 21 est obtenue par l'entraînement en rotation de la tige 24 par la molette 23 située au niveau de la poignée 19 de l'outil 14.Then the follower rod 21 is assembled to the tool 14 so that its threaded part 28 cooperates with the threaded bore 27 of the rod 24. The fixation of the follower rod 21 is obtained by the rotary drive of the rod 24 by the wheel 23 located at the handle 19 of the tool 14.
La rotation de la tige 24 permet d'introduire la tige suiveuse 21 à l'intérieur de l'alésage interne 32 du tube 20 jusqu'à ce que le profil hexagonal 29 coopère avec la partie à profil complémentaire 33 dudit tube. Le déplacement en translation de la tige suiveuse 21 à l'intérieur du tube 20 est effectué jusqu'à ce que les ergots 26 pénètrent à l'intérieur des encoches 15 et 16 prévues au niveau de la face arrière 9 de la cage intersomatique 1 (figures 8, 9).The rotation of the rod 24 makes it possible to introduce the follower rod 21 inside the internal bore 32 of the tube 20 until the hexagonal profile 29 cooperates with the part with complementary profile 33 of said tube. The translational movement of the follower rod 21 inside the tube 20 is carried out until the lugs 26 penetrate inside the notches 15 and 16 provided at the rear face 9 of the interbody cage 1 ( Figures 8, 9).
La coopération des ergots 26 du tube 20 avec les encoches 15, 16 de la cage intersomatique 1 permet le blocage en rotation de la tige suiveuse 21 à l'intérieur dudit tube.The cooperation of the pins 26 of the tube 20 with the notches 15, 16 of the interbody cage 1 allows the locking in rotation of the follower rod 21 inside said tube.
Ainsi, le chirurgien peut introduire entre les corps vertébraux des vertèbres sus et sous jacentes VS, VI d'une colonne vertébrale la première cage intersomatique 1 à l'aide de l'outil 14.Thus, the surgeon can introduce between the vertebral bodies of the above and underlying vertebrae VS, VI of a spinal column the first interbody cage 1 using the tool 14.
Cette introduction peut être par exemple formée par des frappes successives réalisées à l'aide d'un marteau sur la platine 25 sans risque de blocage des parties filetées de l'outil 14 avec la tige suiveuse 21 et cette dernière avec la cage intersomatique 1.This introduction can for example be formed by successive strikes made using a hammer on the plate 25 without risk of blocking the threaded parts of the tool 14 with the follower rod 21 and the latter with the interbody cage 1.
Dès que la première cage intersomatique 1 est introduite, le chirurgien retire l'outil 14 en entraînant en rotation la molette 23 pour libérer la tige suiveuse 21 bloquée en rotation par les profils complémentaires 29, 33de la tige 24 guidée à l'intérieur du tube 20.As soon as the first intersomatic cage 1 is introduced, the surgeon withdraws the tool 14 by rotating the wheel 23 to release the blocked follower rod 21 in rotation by the complementary profiles 29, 33 of the rod 24 guided inside the tube 20.
Après le retrait de l'outil 14, on constate que la tige suiveuse 21 reste assemblée avec la première cage intersomatique 1. Ainsi, le chirurgien peut repérer visuellement la position de la cage intersomatique 1 entre les corps vertébraux des vertèbres sus et sous jacentes VS, VI d'une colonne vertébrale grâce à la tige suiveuse qui sort du champ opératoire. Egalement, le chirurgien peut agir sur la tige suiveuse 21 pour changer la position de la cage intersomatique 1 entre les corps vertébraux des vertèbres sus et sous jacentes VS, VI d'une colonne vertébrale grâce à la tige suiveuse qui sort du champ opératoire. La tige suiveuse 21 est retirée de la cage intersomatique 1 au moyen de son profil hexagonal 29 qui permet son entraînement en rotation par un outil quelconque.After removing the tool 14, it can be seen that the follower rod 21 remains assembled with the first interbody cage 1. Thus, the surgeon can visually identify the position of the interbody cage 1 between the vertebral bodies of the above and underlying vertebrae VS , VI of a vertebral column thanks to the follower rod which leaves the operating field. Also, the surgeon can act on the follower rod 21 to change the position of the interbody cage 1 between the vertebral bodies of the above and underlying vertebrae VS, VI of a vertebral column thanks to the follower rod which leaves the operating field. The follower rod 21 is removed from the interbody cage 1 by means of its hexagonal profile 29 which allows it to be driven in rotation by any tool.
Il doit d'ailleurs être entendu que la description qui précède n'a été donnée qu'à titre d'exemple et qu'elle ne limite nullement le domaine de l'invention dont on ne sortirait pas en remplaçant les détails d'exécutions décrits par tout autre équivalent. It should also be understood that the foregoing description has been given only by way of example and that it in no way limits the field of the invention from which one would not depart by replacing the details of embodiments described by any other equivalent.

Claims

REVENDICATIONS
1. Cage intersomatique réversible pour la fusion de corps vertébraux des vertèbres sus et sous jacentes (VS, VI) d'une colonne vertébrale, caractérisée en ce qu'elle comporte un corps (2) constitué de bords supérieurs (4) et inférieurs (5) pourvus de dents (10), de faces latérales courbes (6, 7) dont l'une au moins et plus particulièrement celle présentant le plus petit rayon de courbure, de trous (11 , 12) débouchant à l'intérieur d'un espace interne (3) pour la mise en place d'un greffon osseux, d'une face avant (8) à profil arrondi traversée suivant une direction verticale par un premier marqueur (17) et d'une face arrière (9) plane percée d'un alésage (13), ladite face arrière (9) étant traversée suivant une direction horizontale par un second marqueur (18) qui est décalé par rapport aux axes principaux de la face arrière (9) de la cage intersomatique (1).1. Reversible intersomatic cage for the fusion of vertebral bodies of the overlying and underlying vertebrae (VS, VI) of a vertebral column, characterized in that it comprises a body (2) consisting of upper (4) and lower edges ( 5) provided with teeth (10), with curved lateral faces (6, 7) at least one of which and more particularly that having the smallest radius of curvature, with holes (11, 12) opening out inside an internal space (3) for the establishment of a bone graft, a front face (8) with rounded profile crossed in a vertical direction by a first marker (17) and a rear face (9) planar pierced with a bore (13), said rear face (9) being traversed in a horizontal direction by a second marker (18) which is offset with respect to the main axes of the rear face (9) of the interbody cage (1) .
2. Cage intersomatique suivant la revendication 1 , caractérisée en ce que le corps (2) est réalisé dans un matériau radio translucide.2. intersomatic cage according to claim 1, characterized in that the body (2) is made of a radio translucent material.
3. Cage intersomatique suivant la revendication 1 , caractérisée en ce que le corps (2) est réalisé dans un matériau radio translucide tel que du PEEK.3. intersomatic cage according to claim 1, characterized in that the body (2) is made of a radio translucent material such as PEEK.
4. Cage intersomatique suivant la revendication 1 , caractérisée en ce que le corps (2) comporte, au niveau de la jonction entre les faces latérales courbes4. intersomatic cage according to claim 1, characterized in that the body (2) comprises, at the junction between the curved lateral faces
(6, 7) avec la face arrière (9), deux encoches (15, 16).(6, 7) with the rear face (9), two notches (15, 16).
5. Cage intersomatique suivant la revendication 1 , caractérisée en ce que le premier marqueur (17) est positionné verticalement à l'avant de la cage intersomatique (1) et centré sur l'axe principal de cette dernière.5. intersomatic cage according to claim 1, characterized in that the first marker (17) is positioned vertically in front of the intersomatic cage (1) and centered on the main axis of the latter.
6. Cage intersomatique suivant la revendication 1 , caractérisée en ce que les marqueurs (17, 18) sont formés dans un fil cylindrique traversant de part en part la cage intersomatique et qui est réalisé dans un matériau radio opaque susceptible d'être visible lors d'un cliché radiographique de manière à permettre de visualiser la position des cages intersomatiques (1) entre elles et par rapport aux corps vertébraux des vertèbres sus et sous jacentes (VS, VI) d'une colonne vertébrale. 6. intersomatic cage according to claim 1, characterized in that the markers (17, 18) are formed in a cylindrical wire passing right through the intersomatic cage and which is made of a radio opaque material capable of being visible during 'an X-ray image in order to visualize the position of the intersomatic cages (1) between them and in relation to the vertebral bodies of the overlying and underlying vertebrae (VS, VI) of a vertebral column.
7. Cage intersomatique suivant la revendication 1 , caractérisée en ce que les bords supérieurs (4) et inférieurs (5) comportent respectivement, de part et d'autre de l'espace interne (3), des dents (10) à profil incliné qui sont dirigées vers la face arrière (9) du corps (2). 7. intersomatic cage according to claim 1, characterized in that the upper (4) and lower (5) edges respectively comprise, on either side of the internal space (3), teeth (10) with inclined profile which are directed towards the rear face (9) of the body (2).
PCT/FR2003/001947 2002-06-25 2003-06-25 Reversible intersomatic cage and device for placement thereof between the vertebral bodies of a spinal column WO2004000176A1 (en)

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FR0207840A FR2841124B1 (en) 2002-06-25 2002-06-25 REVERSIBLE INTERSOMATIC CAGE AND DEVICE FOR PLACING IT BETWEEN THE VERTEBRAL BODY OF A VERTEBRAL COLUMN

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AU2003263253A1 (en) 2004-01-06
FR2841124B1 (en) 2007-04-13
WO2004000177A8 (en) 2004-02-19
AU2003263254A1 (en) 2004-01-06
AU2003263254A8 (en) 2004-01-06
WO2004000177A1 (en) 2003-12-31
FR2841124A1 (en) 2003-12-26
FR2841125A1 (en) 2003-12-26

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