WO2009106733A2 - Pivoting connection device for spinal osteosynthesis screw - Google Patents

Pivoting connection device for spinal osteosynthesis screw Download PDF

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Publication number
WO2009106733A2
WO2009106733A2 PCT/FR2008/001790 FR2008001790W WO2009106733A2 WO 2009106733 A2 WO2009106733 A2 WO 2009106733A2 FR 2008001790 W FR2008001790 W FR 2008001790W WO 2009106733 A2 WO2009106733 A2 WO 2009106733A2
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WO
WIPO (PCT)
Prior art keywords
profile
spinal
connection device
connecting element
connecting rod
Prior art date
Application number
PCT/FR2008/001790
Other languages
French (fr)
Other versions
WO2009106733A3 (en
WO2009106733A8 (en
Inventor
Jean-Charles Le Huec
Original Assignee
Timoteo Michel
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 Timoteo Michel filed Critical Timoteo Michel
Publication of WO2009106733A2 publication Critical patent/WO2009106733A2/en
Publication of WO2009106733A8 publication Critical patent/WO2009106733A8/en
Publication of WO2009106733A3 publication Critical patent/WO2009106733A3/en

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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
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7032—Screws or hooks with U-shaped head or back through which longitudinal rods pass
    • 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
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7035—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • A61B17/704—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other the longitudinal element passing through a ball-joint in the screw head

Definitions

  • the present invention relates to a pivotal connection device for spinal osteosynthesis screw being fixed in the bone body of a vertebra of a spinal segment to instrument a spine.
  • French Patent No. FR 2,659,546 discloses a connection device for a pedicle screw comprising a connection head provided with two branches delimiting a U-shaped opening and receiving between them a connecting rod to be immobilized.
  • the connecting device comprises a split ring which is threaded on the connecting rod so as to be interposed between the bottom of the U-shaped opening of the pedicle screw and the clamping screw cooperating with a threaded section arranged on the inner and upper part of the vertical branches of the connection head.
  • the connection device is provided to ensure a certain angular displacement of the connecting rod relative to the axis of the pedicle screw.
  • the pivoting connection device aims to optimize the angular displacement of the connecting rod relative to the axis xx 'of the spinal screw while ensuring maximum stability and immobilization of said rod to the spindle. inside the connection head of said screw.
  • the pivotal connection device for spinal osteosynthesis screws comprises two connecting elements disposed inside the connection head of the spinal screw and cooperating respectively with the connecting rod, said lower and upper connecting elements being arranged relative to one another by means of a slotted connection so as to be able to pivot simultaneously around the same point C, C lying on the main axis xx 'of the spinal screw and below or above the longitudinal axis yy 'of the connecting rod and clamping means cooperating on the one hand with the threaded section of the connection head of the spinal screw and on the other hand by means of a sliding pivot connection with the second connecting element for immobilization in rotation, in translation and in a determined angular position of the connecting rod inside said spinal screw.
  • the pivotal connection device for spinal osteosynthesis screw shows a lower connecting element which comprises an outer surface with a spherical profile which is complementary to the internal one of a bowl formed in the bottom of the opening of the head. connection of the spinal screw.
  • the pivotal connection device for spinal osteosynthesis screw according to the present invention shows that the point C, C pivoting the lower connecting element inside the connection head is the center of the spherical profile outer face of said body.
  • the pivotal connection device for spinal osteosynthesis screw according to the present invention shows that the lower connecting element comprises in its middle and in a transverse direction a fingerprint intended to receive the connecting rod, and on each side of said fingerprint a lateral skirt each having a tip-shaped profile provided on its outer face with a lug for retaining the lower connecting element inside the connection head.
  • the pivotal connection device for spinal osteosynthesis screw shows that the upper connecting element comprises an outer face spherical profile and in its middle in a transverse direction a cavity for receiving the connecting rod.
  • the pivoting connection device for a spinal osteosynthesis screw shows that the upper connecting element comprises on each side of the cavity a lateral skirt having each a crenel-shaped profile delimiting between two points a space intended to receiving the tip-shaped profile of the side skirts of the lower link member.
  • the pivoting connection device for spinal osteosynthesis screw according to the present invention shows that the upper connecting element comprises in its thickness an oblong groove which opens on the one hand on the external face and on the other hand at the level of the transverse footprint.
  • the pivoting connection device for spinal osteosynthesis screw according to the present invention shows that the oblong groove has in its upper part a shoulder delimiting a reduction of the opening dimension of said oblong groove at the outer face.
  • the pivoting connection device for spinal osteosynthesis screw according to the present invention shows that the upper connecting element has in the upper part of its lateral skirt and from this latter another groove opening inside the oblong groove. .
  • the pivotal connection device for spinal osteosynthesis screw according to the present invention shows that the cylindrical finger in part and the head has in its middle a longitudinal slot providing a certain elasticity to said cylindrical finger and said head.
  • the pivoting connection device for spinal osteosynthesis screw according to the present invention shows that the impression has a planar profile provided at each end of at least one lug cooperating with the fluted profile of the connecting rod.
  • the pivoting connection device for spinal osteosynthesis screw shows that the upper connecting element consists of an H-shaped support having on its upper outer face a protuberance whose outer face has a convex spherical profile. and opposite its spherical profile and in a transverse direction a impression having on the inner part of each parallel branch of the H a first cylindrical profile whose diameter is complementary to that of the lower connecting element, in order to receive inside the spinal screw the connecting rod.
  • the pivoting connection device for spinal osteosynthesis screw shows that the imprint comprises on the inner part of the branch perpendicular to the first two of the H of the support a second planar profile provided with lugs or spikes allowing the assembly of the upper connecting element on the connecting rod.
  • the pivoting connection device for spinal osteosynthesis screw shows that the upper connecting element is pierced in its thickness with an oblong groove arranged in a circular arc profile so as to follow the spherical profile of the spine. upper outer face, and whose center of rotation of said arcuate profile is located in a spherical profile housing which opens on the one hand in the oblong groove and on the other hand between the lugs in the direction of the outside at the from the plane profile of the transverse footprint.
  • FIG. 1 is an exploded perspective view illustrating the various elements constituting the pivoting connection device for spinal osteosynthesis screw according to the present invention.
  • Figure 2 is a perspective view showing the two elements forming the pivotal connection of the connection device according to the present invention.
  • FIGS 3 to 5 are views showing the first element called “lower element” of the pivot connection of the connection device according to the present invention.
  • Figures 6 to 10 are views illustrating the second element called “upper element” of the pivot connection of the connection device according to the present invention.
  • Figure 11 is a perspective view showing the arrangement of the second so-called “upper element” of the pivotal connection with a clamping nut for immobilizing the connection device according to the present invention.
  • Figures 12 to 14 are views showing in detail the clamping nut of the connection device according to the present invention.
  • Figures 15 to 17 are views illustrating the assembly of the various elements constituting the pivotal connection device in the body of a spinal osteosynthesis screw according to the present invention.
  • Figures 18 and 19 are views showing a variant of the second element called "upper element" of the pivotal connection when the connecting rod is fluted type according to the present invention.
  • Figures 20 to 27 are views showing a variant of the pivotal connection device for spinal osteosynthesis screw according to the present invention.
  • FIG. 1 illustrates a pivoting connection device 1 enabling immobilization in translation and in rotation of a connecting rod 2 in the body of a spinal or pedicle screw 3 intended to be anchored in a vertebra of a segment spine to instrument a spine.
  • connection device 1 consists of two connecting elements 4 and 5 which are respectively arranged in the spinal screw 3 and more particularly inside a connection head 6 in the shape of a U.
  • each spinal screw 3 is formed mainly of a threaded portion 7 allowing it to anchor in the bone portion of the vertebra and a connecting head 6 located in the extension of said threaded portion and allowing the positioning and retaining the connecting rod 2.
  • connection head 6 consists of two vertical branches 8 and 9 delimiting an opening 10 in the shape of a U and whose bottom 11 comprises on the one hand in the middle a bowl 15 having an inner profile in sphere portion and other two inclined faces 26 bordering laterally said bowl.
  • the inner part of the vertical branches 8 and 9 of the connection head 6 comprises above the bottom 11 a threaded section 12 for clamping a clamping nut 13 for locking in translation and in rotation of the connecting rod 2 in each connection head 6.
  • the spinal screw 3 may present on the periphery of the external face of the connection head 6 and more particularly in the connection zone of the vertical branches 8 and 9 with the threaded portion 7 a series of milled teeth 14 intended to penetrate the part bone of the vertebra receiving said spinal screw 3.
  • FIGS. 2 to 10 show the two connection elements 4 and 5 of the connection device 1 intended to hold and immobilize the connecting rod 2 inside the connection head 6 of the corresponding spinal screw 3.
  • the first connecting element 4 called “lower element” comprises a body 40 having an outer face 47 with a spherical profile which is complementary to the internal one of the bowl 15 of the bottom 11 of the connection head 6 of the spinal screw 3.
  • the body 40 comprises at its center and in a transverse direction a cavity 41 with a cylindrical profile which is intended to receive during assembly of the connection device 1 the connecting rod 2.
  • the body 40 comprises on each side of the cavity 41 a lateral skirt 42, 43 that is elastically deformable and extends vertically above said cavity and each having a point-shaped profile 46.
  • each lateral skirt 42, 43 has on its outer face a lug 44 cooperating with a housing 16 of complementary shape formed above the bottom 11 and on each inner face of the opening 10 in the shape of a U in order to allow the snap and retain the body 40 in the bowl 15 of the spinal screw 3 corresponding.
  • the body 40 is pierced in the middle and in a vertical direction from its footprint 41 of a through bore 45 allowing the establishment of a suitable tool for handling and the introduction of the body 40 in the bowl 15 of the corresponding spinal screw 3.
  • the second connecting element 5 called “upper element” consists of a body 50 having an outer face 57 convex or convex spherical profile and in its middle in a transverse direction a cavity 51 with a cylindrical profile, complementary to that 41 of the first element 4, in order to receive during connection of the connection device 1 inside the spinal screw 3 the connection rod 2.
  • the body 50 comprises on each side of the cavity 51 a lateral skirt 52, 53 extending vertically above said cavity and each having a crenellated profile defining between two points 54, 55 a space 56 intended to receive when mounting the connecting device 1 the tip-shaped profile 46 of the side skirts 42, 43 of the first element 4.
  • the body 50 has in its thickness an oblong groove 58 which opens on the one hand on the outer face 57 and on the other hand at the level of the transverse impression 51.
  • the oblong groove 58 has in its upper part a shoulder 58a delimiting a reduction in the opening dimension of said oblong groove 58 at the outer face 57.
  • the body 50 has in the upper part of its lateral skirt 52 and from this latter another groove 59 opening inside the oblong groove 58.
  • the groove 59 is intended to form an inlet which opens laterally inside.
  • the groove 59 may have a cylindrical profile extending outwardly and towards the outer face 57 by a rectilinear profile of smaller dimension than the cylindrical profile.
  • the groove 59 may be positioned at one end of the oblong groove 58 and in an axial direction which is inclined relative to the vertical and principal axis of the body 50.
  • the oblong groove 58 and the entrance groove 59 allow the establishment and the retention of the clamping nut 13 intended to cooperate with the threaded section 12 of the connection head 6 of the spinal screw 3.
  • the body 50 of the second connecting element 5, referred to as the "upper element” may have a recess 51 with a planar profile in order to allow the introduction and the retention of a connecting rod 2, the external face of which has a corrugated profile obtained by the intermediate longitudinal teeth 2a ( Figures 18 and 19).
  • the impression 51 comprises at each end of its plane profile lugs 51a intended during assembly of the second connecting element 5 to cooperate and penetrate between the longitudinal teeth 2a forming the corrugated profile of the connecting rod 2 in order to lock in place. rotation and in translation the latter between the first and second connecting elements 4, 5. With regard to the first connecting element 4, the latter has the same cavity 41 with a cylindrical profile regardless of the external profile of the connecting rod 2 .
  • FIGS. 11 to 14 show the clamping nut 13 which comprises a cylindrical body 17 having on its external face a thread 18 cooperating with the threaded section 12 of the connection head 6 of the spinal screw 3.
  • the cylindrical body 17 has a planar upper face 19 in which is formed in the middle of said body a recess 20 allowing the establishment of a tool, not shown, for the rotational drive of the clamping nut 13 to the
  • the cylindrical body 17 has, opposite the flat upper face 19, a lower face 21 having a concave spherical profile presenting in the middle a cylindrical finger 22 provided with a head 23 whose external diameter is greater than that of the cylindrical finger 22.
  • the tightening nut 13 is assembled with the body 50 of the second connecting element 5 by means of the cylindrical finger 22 which is introduced inside the oblong groove 58 by means of the inlet groove 59 whose internal profile is complementary to that of said finger.
  • the clamping nut 13 and the body 50 of the second connecting element 5 can freely move relative to each other along the profile of the oblong groove 58 to allow axial adjustment of said connecting element therein of the connection head 6 of the spinal screw 3 during the assembly of the connecting rod 2 inside the latter.
  • the lower face 21 having a concave spherical profile of said nut 13 is positioned above the outer face 57 with a convex spherical profile or convex of said body 50 to bear on the latter during the tightening of the nut in the connection head 6 of the spinal screw 3.
  • FIGS. 15 to 17 illustrate the assembly and fixation of the connecting rod 2 of a spinal osteosynthesis device inside the connection head 6 of the spinal screw 3 by means of the connecting device 1 according to the present invention.
  • connection head 6 receives in the first place the first connecting element 4 of the connection device 1 so that the latter cooperates freely with the bowl 15 formed in the bottom 11 of the opening 10.
  • the first connecting element 4 is on the one hand retained inside the connection head 6 by means of the lugs 44 of each lateral skirt 42, 43 which cooperate with the housings 16 provided for this purpose and other free portion in rotation around said lugs 44 to pivot relative to a center C lying below the longitudinal axis yy 'of the connecting rod 2 and on the main axis xx' passing through the threaded portion 7 of the spinal screw 3. It is noted that the pivot point C of the body 40 of the first connecting element 4 inside the connection head 6 is also the center of the outer face 47 with a spherical profile of said body 40.
  • the connecting rod 2 is placed after pivoting of the first connecting element 4 around the point C, inside the cavity 41 of the body 40.
  • connection head 6 of the spinal screw 3 is introduced into the connection head 6 of the spinal screw 3 by means of the clamping nut 13 which it is associated by means of the sliding pivot connection 22, 58.
  • the tightening nut 13 cooperates via its thread 18 with the threaded section 12 provided on each vertical branch 8, 9 of the connection head 6.
  • the convex spherical profile of the outer face 57 of the second connecting element 5 and the concave complementary spherical profile of the lower face 21 of the nut 13 allow the body 50 of said second connecting element 5 to tilt around said nut 13 held between the vertical branches 8, 9 to adapt to the position of the connecting rod 2.
  • the connecting element 5 and more particularly the gap 56 of the crenellated profile 54, 55 of the lateral skirts 52, 53 receives the point-shaped profile 46 of each lateral skirt 42, 43 of the first connecting element 4.
  • the connection by a slot connection 46, 54, 55 between the first connecting element 4 and the second connecting element 5 allows the latter to be in the same plane of inclination as that of said first connecting element 4 ensuring the first and second connecting elements 4, 5 pivoting about the same point C.
  • connection device 1 consists of the first and second connecting elements 4 and 5 and in particular the shift of the center of pivoting below the axis yy 'of the connecting rod 2 as well as the inclined faces 26 arranged in the bottom of the connection head 6 of the spinal screw
  • connection head 3 allow an increase in the angular pivoting of the connecting rod 2 relative to the spinal screw 3 facilitating its introduction and its introduction into said connection head.
  • FIGS. 20 to 27 show a variant of the connection device 1 enabling immobilization in translation and in rotation of a connecting rod 2 in the body of a spinal or pedicle screw 3 intended to be anchored in a vertebra d a spinal segment to instrument a spine.
  • the connecting device 1 is mainly modified in that the connecting elements 400 and 500 now allow an offset of the pivot center C above the axis yy 'of the connecting rod 2 of the spinal screw 3 in order to ensure on the one hand an increase in the angular pivoting of the connecting rod 2 relative to the spinal screw 3 and on the other hand the introduction and its introduction into the connection head 6.
  • connection device 1 namely the spinal screw 3 with its U-shaped connection head 6 into which the screw is screwed.
  • clamping nut 13 for locking in translation and in rotation of the connecting rod 2 remain unchanged and are similar to those described and referenced in Figures 1 to 19.
  • connection head 6 consists of two vertical branches 8 and 9 delimiting an opening 10 in the shape of a U and whose bottom 11 comprises on the one hand in its middle a bowl 15 having a spherical inner profile complementary to the external profile 470 curved or convex of the connecting element lower 400 and secondly two inclined faces 26 bordering laterally said bowl.
  • FIGS. 21 to 24 show the lower connecting element 400 which comprises at its center and in a transverse direction a cavity 410 with a cylindrical profile which is intended to receive, during assembly of the connection device 1, the connecting rod 2.
  • the lower connecting element 400 comprises on each side of the cavity 410 a lateral skirt 420, 430 elastically deformable and extending vertically above said cavity and each having a peak-shaped profile 460.
  • each lateral skirt 420, 430 comprises on its outer face a lug 440 cooperating with a housing 16 of complementary shape formed above the bottom 11 and on each inner face of the opening 10 in the shape of a U in order to allow the snap-fastening and retention of the lower connecting element 400 in the bowl 15 of the corresponding spinal screw 3.
  • the lower connecting element 400 is drilled in its middle and in a vertical direction from its footprint 410 of a through bore 450 allowing the passage of a guide pin on the occasion of the use of pedicle screws longitudinally breakthroughs.
  • FIGS. 25 and 26 illustrate the second connecting element 500, referred to as the "upper element", which consists of an H-shaped support 515 having on its upper external face a protuberance 570 whose external face has a convex spherical profile of complementary shape to that concave 21 of the clamping nut 13 of the connecting device 1.
  • the support 515 H-shaped upper connecting element 500 comprises, as an example embodiment, the opposite of its profile spherical 570 and in a transverse direction, a recess 510 having on the inner part of each parallel branch of the H a first cylindrical profile 511 whose diameter is complementary to that 410 of the lower connecting element 400, to receive during assembly of the connection device 1 inside the spinal screw 3 the connecting rod 2
  • the impression 510 has on the inner part of the branch perpendicular to the first two of the H of the support 515, a second planar profile 512 provided with pins or spikes 513 for assembling the upper connecting element 500 on the connecting rod 2. It may be according to another embodiment that the impression 510 has only a cylindrical profile 511 for receiving the connecting rod 2 without changing the object.
  • the upper connecting element 500 comprises on each side of the cavity 510 a lateral skirt 520, 530 extending vertically from each parallel branch of the support 515 in the shape of H.
  • Each lateral skirt 520, 530 has a slot-shaped profile delimiting between a pair of points 540, 550 a space 560 intended to receive, during assembly of the connection device 1, the point-shaped profile 460 of the side skirts 420, 430 of the lower link element 400.
  • the upper connecting element 500 is pierced in its thickness with an oblong groove 580 disposed in a circular arcuate profile so as to follow the spherical profile of the upper external face 570, and whose center of rotation of said arcuate profile circle is located in a housing 581 spherical profile which opens on the one hand in the oblong groove 580 and on the other hand between the lugs
  • the tightening nut 13 has on its outer face a thread 18 cooperating with the threaded section 12 of the connection head 6 of the spinal screw to allow the clamping of the latter resulting in the immobilization via the elements of lower link 400 and upper 500 of the connecting rod 2 in a determined angular position.
  • the clamping nut 13 has a flat upper face 19 in which is provided in the middle of said body a recess 20 allowing the introduction of a tool, not shown, for the rotational drive of the clamping nut 13 to inside the connection head 6.
  • the clamping nut 13 has opposite the flat upper face 19 the lower face 21 concave spherical profile having in the middle a cylindrical finger 22 provided with a head 23 whose outer diameter is greater than that of the cylindrical finger 22.
  • the cylindrical finger 22 in part and the head 23 comprises in the middle a longitudinal slot 24 providing a certain elasticity to said cylindrical finger 22 and said head 23.
  • clamping nut 13 is assembled with the upper connecting element 500 via the cylindrical finger 22 and the head 23 which are introduced respectively into the oblong groove 580 and the housing 581 after elastic deformation.
  • said cylindrical finger 22 and said head 23 ( Figure 27).
  • connection device 1 When the head 23 is housed inside the spherical housing 581, the clamping nut 13 and the upper connecting element 500 can move freely relative to each other in the arcuate profile. oblong groove 580 to allow axial adjustment of said upper link member within the connection head 6 of the spinal screw 3 during assembly of the connecting rod 2 within the latter ( Figure 27).
  • the assembly of the connection device 1 according to the present invention is similar to that described above for the first embodiment but allows in this case by means of the upper connecting elements 400 and lower 500 and the clamping screw 13 to position and immobilize the connecting rod 2 inside the connection head 6 of the spinal screw 3 in a determined angular position.
  • This angular position of the connecting rod 2 relative to the spinal screw 3 is obtained by the tilting of the upper connecting elements 400 and lower 500 about a center of rotation C which is positioned on the one hand on the vertical axis xx 'of the spinal screw 3 and secondly above the longitudinal axis yy' of the connecting rod 2.

Abstract

The pivoting connection device for a spinal osteosynthesis screw according to the present invention comprises two linking elements (4, 5; 400, 500) arranged inside the connection head (6) of the spinal screw (3) and cooperating respectively with the linking rod (2), said lower (4; 400) and upper (5; 500) linking elements being arranged in relation to one another by means of a notched connector (46, 54, 55; 460, 540, 550) so as to be able to pivot simultaneously about the same point C, which point C is situated on the main axis xx' of the spinal screw (3) and below or above the longitudinal axis yy' of the linking rod (2), and clamping means (13) that cooperate, on the one hand, with the threaded section (12) of the connection head (6) of the spinal screw (3) and, on the other hand, by means of a sliding pivot connector (22, 58; 580), with the second linking element (5; 500) for immobilization of the linking rod (2) in rotation, in translation and in a defined angular position inside said spinal screw (3).

Description

DISPOSITIF DE CONNEXION PIVOTANT POUR VIS DOSTEOSYNTHESE RACHIDIENNE SWIVEL CONNECTING DEVICE FOR SPINAL DOSTEOSYNTHESIS SCREW
La présente invention est relative à un dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne venant se fixer dans le corps osseux d'une vertèbre d'un segment rachidien à instrumenter d'une colonne vertébrale.The present invention relates to a pivotal connection device for spinal osteosynthesis screw being fixed in the bone body of a vertebra of a spinal segment to instrument a spine.
On connaît d'après le brevet français FR 2 659 546 un dispositif de connexion pour une vis pédiculaire comprenant une tête de connexion pourvue de deux branches délimitant une ouverture en forme de U et recevant entre elles une tige de liaison à immobiliser. Le dispositif de connexion comprend une bague fendue qui est enfilée sur la tige de liaison de manière à être interposée entre le fond de l'ouverture en forme de U de la vis pédiculaire et la vis de serrage venant coopérer avec une section filetée aménagée sur la partie interne et supérieure des branches verticales de la tête de connexion. Le dispositif de connexion est prévu pour assurer un certain débattement angulaire de la tige de liaison par rapport à l'axe de la vis pédiculaire. Le dispositif de connexion pivotant suivant la présente invention a pour but d'optimiser le débattement angulaire de la tige de liaison par rapport à l'axe xx' de la vis rachidienne tout en assurant une stabilité et une immobilisation maximum de ladite tige à l'intérieur de la tête de connexion de ladite vis. Le dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne suivant la présente invention comprend deux éléments de liaison disposés à l'intérieur de la tête de connexion de la vis rachidienne et coopérant respectivement avec la tige de liaison, lesdits éléments de liaison inférieurs et supérieurs étant agencés l'un par rapport à l'autre au moyen d'une liaison à créneaux pour pouvoir pivoter simultanément autour d'un même point C, C se trouvant sur l'axe principal xx' de la vis rachidienne et en dessous ou au-dessus de l'axe longitudinal yy' de la tige de liaison et des moyens de serrage coopérant d'une part avec la section filetée de la tête de connexion de la vis rachidienne et d'autre part au moyen d'une liaison pivot glissant avec le second élément de liaison pour l'immobilisation en rotation, en translation et dans une position angulaire déterminée de la tige de liaison à l'intérieur de ladite vis rachidienne.French Patent No. FR 2,659,546 discloses a connection device for a pedicle screw comprising a connection head provided with two branches delimiting a U-shaped opening and receiving between them a connecting rod to be immobilized. The connecting device comprises a split ring which is threaded on the connecting rod so as to be interposed between the bottom of the U-shaped opening of the pedicle screw and the clamping screw cooperating with a threaded section arranged on the inner and upper part of the vertical branches of the connection head. The connection device is provided to ensure a certain angular displacement of the connecting rod relative to the axis of the pedicle screw. The pivoting connection device according to the present invention aims to optimize the angular displacement of the connecting rod relative to the axis xx 'of the spinal screw while ensuring maximum stability and immobilization of said rod to the spindle. inside the connection head of said screw. The pivotal connection device for spinal osteosynthesis screws according to the present invention comprises two connecting elements disposed inside the connection head of the spinal screw and cooperating respectively with the connecting rod, said lower and upper connecting elements being arranged relative to one another by means of a slotted connection so as to be able to pivot simultaneously around the same point C, C lying on the main axis xx 'of the spinal screw and below or above the longitudinal axis yy 'of the connecting rod and clamping means cooperating on the one hand with the threaded section of the connection head of the spinal screw and on the other hand by means of a sliding pivot connection with the second connecting element for immobilization in rotation, in translation and in a determined angular position of the connecting rod inside said spinal screw.
Le dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne suivant la présente invention montre un élément de liaison inférieur qui comporte une face externe à profil sphérique qui est complémentaire à celui interne d'une cuvette ménagée dans le fond de l'ouverture de la tête de connexion de la vis rachidienne.The pivotal connection device for spinal osteosynthesis screw according to the present invention shows a lower connecting element which comprises an outer surface with a spherical profile which is complementary to the internal one of a bowl formed in the bottom of the opening of the head. connection of the spinal screw.
Le dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne suivant la présente invention montre que le point C, C de pivotement l'élément de liaison inférieur à l'intérieur de la tête de connexion est le centre de la face externe à profil sphérique dudit corps. Le dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne suivant la présente invention montre que l'élément de liaison inférieur comporte en son milieu et suivant une direction transversale une empreinte destinée à recevoir la tige de liaison, et de chaque coté de ladite empreinte une jupe latérale présentant chacune un profil en forme de pointe pourvu sur sa face externe d'un ergot permettant la retenue de l'élément de liaison inférieur à l'intérieur de la tête de connexion.The pivotal connection device for spinal osteosynthesis screw according to the present invention shows that the point C, C pivoting the lower connecting element inside the connection head is the center of the spherical profile outer face of said body. The pivotal connection device for spinal osteosynthesis screw according to the present invention shows that the lower connecting element comprises in its middle and in a transverse direction a fingerprint intended to receive the connecting rod, and on each side of said fingerprint a lateral skirt each having a tip-shaped profile provided on its outer face with a lug for retaining the lower connecting element inside the connection head.
Le dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne suivant la présente invention montre que l'élément de liaison supérieur comporte une face externe à profil sphérique et en son milieu suivant une direction transversale une empreinte permettant de recevoir la tige de liaison.The pivotal connection device for spinal osteosynthesis screw according to the present invention shows that the upper connecting element comprises an outer face spherical profile and in its middle in a transverse direction a cavity for receiving the connecting rod.
Le dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne suivant la présente invention montre que l'élément de liaison supérieur comporte de chaque coté de l'empreinte une jupe latérale présentant -chacune un profil en forme de créneau délimitant entre deux pointes un espace destiné à recevoir le profil en forme de pointe des jupes latérales de l'élément de liaison inférieur. Le dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne suivant la présente invention montre que l'élément de liaison supérieur comporte dans son épaisseur une rainure oblongue qui débouche d'une part sur la face externe et d'autre part au niveau de l'empreinte transversale. Le dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne suivant la présente invention montre que la rainure oblongue comporte dans sa partie supérieure un épaulement délimitant une réduction de la dimension d'ouverture de ladite rainure oblongue au niveau de la face externe. Le dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne suivant la présente invention montre que l'élément de liaison supérieur comporte dans la partie supérieure de sa jupe latérale et à partir de cette dernière une autre rainure débouchant à l'intérieur de la rainure oblongue. Le dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne suivant la présente invention montre que le doigt cylindrique en partie et la tête comporte en leur milieu une fente longitudinale assurant une certaine élasticité audit doigt cylindrique et à la dite tête. Le dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne suivant la présente invention montre que l'empreinte présente un profil plan pourvu à chaque extrémité d'au moins un ergot coopérant avec le profil cannelé de la tige de liaison. Le dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne suivant la présente invention montre que l'élément de liaison supérieur est constitué d'un support en forme de H comportant sur sa face externe supérieure une protubérance dont la face externe présente un profil sphérique convexe et à l'opposé de son profil sphérique et suivant une direction transversale une empreinte présentant sur la partie interne de chaque branche parallèle du H un premier profil cylindrique dont le diamètre est complémentaire à celui de l'élément de liaison inférieur, afin de recevoir à l'intérieur de la vis rachidienne la tige de liaison.The pivoting connection device for a spinal osteosynthesis screw according to the present invention shows that the upper connecting element comprises on each side of the cavity a lateral skirt having each a crenel-shaped profile delimiting between two points a space intended to receiving the tip-shaped profile of the side skirts of the lower link member. The pivoting connection device for spinal osteosynthesis screw according to the present invention shows that the upper connecting element comprises in its thickness an oblong groove which opens on the one hand on the external face and on the other hand at the level of the transverse footprint. The pivoting connection device for spinal osteosynthesis screw according to the present invention shows that the oblong groove has in its upper part a shoulder delimiting a reduction of the opening dimension of said oblong groove at the outer face. The pivoting connection device for spinal osteosynthesis screw according to the present invention shows that the upper connecting element has in the upper part of its lateral skirt and from this latter another groove opening inside the oblong groove. . The pivotal connection device for spinal osteosynthesis screw according to the present invention shows that the cylindrical finger in part and the head has in its middle a longitudinal slot providing a certain elasticity to said cylindrical finger and said head. The pivoting connection device for spinal osteosynthesis screw according to the present invention shows that the impression has a planar profile provided at each end of at least one lug cooperating with the fluted profile of the connecting rod. The pivoting connection device for spinal osteosynthesis screw according to the present invention shows that the upper connecting element consists of an H-shaped support having on its upper outer face a protuberance whose outer face has a convex spherical profile. and opposite its spherical profile and in a transverse direction a impression having on the inner part of each parallel branch of the H a first cylindrical profile whose diameter is complementary to that of the lower connecting element, in order to receive inside the spinal screw the connecting rod.
Le dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne suivant la présente invention montre que l'empreinte comporte sur la partie interne de la branche perpendiculaire aux deux premières du H du support un second profil plan pourvu d'ergots ou de pointes permettant l'assemblage de l'élément de liaison supérieur sur la tige de liaison.The pivoting connection device for spinal osteosynthesis screw according to the present invention shows that the imprint comprises on the inner part of the branch perpendicular to the first two of the H of the support a second planar profile provided with lugs or spikes allowing the assembly of the upper connecting element on the connecting rod.
Le dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne suivant la présente invention montre que l'élément de liaison supérieur est percé dans son épaisseur d'une rainure oblongue disposée suivant un profil en arc de cercle de manière à suivre le profil sphérique de la face externe supérieure, et dont le centre de rotation dudit profil en arc de cercle est situé dans un logement à profil sphérique qui débouche d'une part dans la rainure oblongue et d'autre part entre les ergots en direction de l'extérieur au niveau du profil plan de l'empreinte transversale.The pivoting connection device for spinal osteosynthesis screw according to the present invention shows that the upper connecting element is pierced in its thickness with an oblong groove arranged in a circular arc profile so as to follow the spherical profile of the spine. upper outer face, and whose center of rotation of said arcuate profile is located in a spherical profile housing which opens on the one hand in the oblong groove and on the other hand between the lugs in the direction of the outside at the from the plane profile of the transverse footprint.
Les dessins annexés, donnés à titre d'exemple, permettront de mieux comprendre l'invention, les caractéristiques qu'elle présente et les avantages qu'elle est susceptible de procurer : Figure 1 est une vue en perspective éclatée illustrant les différents éléments constituant le dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne suivant la présente invention.The accompanying drawings, given by way of example, will provide a better understanding of the invention, the characteristics it has and the advantages that it is likely to provide: FIG. 1 is an exploded perspective view illustrating the various elements constituting the pivoting connection device for spinal osteosynthesis screw according to the present invention.
Figure 2 est une vue en perspective montrant les deux éléments formant la liaison pivotante du dispositif de connexion suivant la présente invention.Figure 2 is a perspective view showing the two elements forming the pivotal connection of the connection device according to the present invention.
Figures 3 à 5 sont des vues représentant le premier élément dit « élément inférieur » de la liaison pivotante du dispositif de connexion suivant la présente invention.Figures 3 to 5 are views showing the first element called "lower element" of the pivot connection of the connection device according to the present invention.
Figures 6 à 10 sont des vues illustrant le second élément dit « élément supérieur » de la liaison pivotante du dispositif de connexion suivant la présente invention. Figure 11 est une vue en perspective montrant l'agencement du second élément dit « élément supérieur » de la liaison pivotante avec un écrou de serrage pour l'immobilisation du dispositif de connexion suivant la présente invention.Figures 6 to 10 are views illustrating the second element called "upper element" of the pivot connection of the connection device according to the present invention. Figure 11 is a perspective view showing the arrangement of the second so-called "upper element" of the pivotal connection with a clamping nut for immobilizing the connection device according to the present invention.
Figures 12 à 14 sont de vues représentant en détail l'écrou de serrage du dispositif de connexion suivant la présente invention.Figures 12 to 14 are views showing in detail the clamping nut of the connection device according to the present invention.
Figures 15 à 17 sont des vues illustrant l'assemblage des différents éléments constituant le dispositif de connexion pivotant dans le corps d'une vis d'ostéosynthèse rachidienne suivant la présente invention. Figures 18 et 19 sont des vues représentant une variante du second élément dit « élément supérieur » de la liaison pivotante lorsque la tige de liaison est de type cannelé suivant la présente invention.Figures 15 to 17 are views illustrating the assembly of the various elements constituting the pivotal connection device in the body of a spinal osteosynthesis screw according to the present invention. Figures 18 and 19 are views showing a variant of the second element called "upper element" of the pivotal connection when the connecting rod is fluted type according to the present invention.
Figures 20 à 27 sont des vues montrant une variante du dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne suivant la présente invention.Figures 20 to 27 are views showing a variant of the pivotal connection device for spinal osteosynthesis screw according to the present invention.
On a illustré en figure 1 un dispositif de connexion pivotant 1 permettant l'immobilisation en translation et en rotation d'une tige de liaison 2 dans le corps d'une vis rachidienne ou pédiculaire 3 destinée à être ancrée dans une vertèbre d'un segment rachidien à instrumenter d'une colonne vertébrale.FIG. 1 illustrates a pivoting connection device 1 enabling immobilization in translation and in rotation of a connecting rod 2 in the body of a spinal or pedicle screw 3 intended to be anchored in a vertebra of a segment spine to instrument a spine.
Le dispositif de connexion 1 est constitué de deux éléments de liaison 4 et 5 qui sont respectivement disposés dans la vis rachidienne 3 et plus particulièrement à l'intérieur d'une tête de connexion 6 en forme de U.The connection device 1 consists of two connecting elements 4 and 5 which are respectively arranged in the spinal screw 3 and more particularly inside a connection head 6 in the shape of a U.
Ainsi, chaque vis rachidienne 3 est formée principalement d'une partie filetée 7 permettant son ancrage dans la partie osseuse de la vertèbre et d'une tête de connexion 6 se trouvant dans le prolongement de ladite partie filetée et permettant la mise en place et la retenue de la tige de liaison 2.Thus, each spinal screw 3 is formed mainly of a threaded portion 7 allowing it to anchor in the bone portion of the vertebra and a connecting head 6 located in the extension of said threaded portion and allowing the positioning and retaining the connecting rod 2.
La tête de connexion 6 est constituée de deux branches verticales 8 et 9 délimitant une ouverture 10 en forme de U et dont le fond 11 comporte d'une part en son milieu une cuvette 15 présentant un profil interne en portion de sphère et d'autre part deux pans inclinés 26 bordant latéralement ladite cuvette.The connection head 6 consists of two vertical branches 8 and 9 delimiting an opening 10 in the shape of a U and whose bottom 11 comprises on the one hand in the middle a bowl 15 having an inner profile in sphere portion and other two inclined faces 26 bordering laterally said bowl.
La partie interne des branches verticales 8 et 9 de la tête de connexion 6 comporte au-dessus du fond 11 une section filetée 12 permettant le serrage d'un écrou de serrage 13 pour le blocage en translation et en rotation de la tige de liaison 2 dans chaque tête de connexion 6.The inner part of the vertical branches 8 and 9 of the connection head 6 comprises above the bottom 11 a threaded section 12 for clamping a clamping nut 13 for locking in translation and in rotation of the connecting rod 2 in each connection head 6.
La vis rachidienne 3 peut présenter sur le pourtour de la face externe de la tête de connexion 6 et plus particulièrement dans la zone de raccordement des branches verticales 8 et 9 avec la partie filetée 7 une série de dents fraisées 14 destinées à pénétrer dans la partie osseuse de la vertèbre recevant ladite vis rachidienne 3.The spinal screw 3 may present on the periphery of the external face of the connection head 6 and more particularly in the connection zone of the vertical branches 8 and 9 with the threaded portion 7 a series of milled teeth 14 intended to penetrate the part bone of the vertebra receiving said spinal screw 3.
On a montré en figures 2 à 10 les deux éléments de liaison 4 et 5 du dispositif de connexion 1 destinés à maintenir et à immobiliser la tige de liaison 2 à l'intérieur de la tête de connexion 6 de la vis rachidienne 3 correspondante.FIGS. 2 to 10 show the two connection elements 4 and 5 of the connection device 1 intended to hold and immobilize the connecting rod 2 inside the connection head 6 of the corresponding spinal screw 3.
Le premier élément de liaison 4 dit « élément inférieur » comporte un corps 40 présentant une face externe 47 à profil sphérique qui est complémentaire à celui interne de la cuvette 15 du fond 11 de la tête de connexion 6 de la vis rachidienne 3.The first connecting element 4 called "lower element" comprises a body 40 having an outer face 47 with a spherical profile which is complementary to the internal one of the bowl 15 of the bottom 11 of the connection head 6 of the spinal screw 3.
Le corps 40 comporte en son milieu et suivant une direction transversale une empreinte 41 à profil cylindrique qui est destinée à recevoir lors du montage du dispositif de connexion 1 la tige de liaison 2. Le corps 40 comprend de chaque coté de l'empreinte 41 une jupe latérale 42, 43 élastiquement déformable et s'étendant verticalement au-dessus de ladite empreinte et présentant chacune un profil en forme de pointe 46.The body 40 comprises at its center and in a transverse direction a cavity 41 with a cylindrical profile which is intended to receive during assembly of the connection device 1 the connecting rod 2. The body 40 comprises on each side of the cavity 41 a lateral skirt 42, 43 that is elastically deformable and extends vertically above said cavity and each having a point-shaped profile 46.
L'extrémité pointue de chaque jupe latérale 42, 43 comporte sur sa face externe un ergot 44 coopérant avec un logement 16 de forme complémentaire ménagé au-dessus du fond 11 et sur chaque face interne de l'ouverture 10 en forme de U afin de permettre l'encliquetage et la retenue du corps 40 dans la cuvette 15 de la vis rachidienne 3 correspondante.The pointed end of each lateral skirt 42, 43 has on its outer face a lug 44 cooperating with a housing 16 of complementary shape formed above the bottom 11 and on each inner face of the opening 10 in the shape of a U in order to allow the snap and retain the body 40 in the bowl 15 of the spinal screw 3 corresponding.
Le corps 40 est percé en son milieu et suivant une direction verticale à partir de son empreinte 41 d'un alésage débouchant 45 permettant la mise en place d'un outil adapté pour la manipulation et l'introduction du corps 40 dans la cuvette 15 de la vis rachidienne 3 correspondante.The body 40 is pierced in the middle and in a vertical direction from its footprint 41 of a through bore 45 allowing the establishment of a suitable tool for handling and the introduction of the body 40 in the bowl 15 of the corresponding spinal screw 3.
Lorsque le corps 40 à profil sphérique est engagé dans la cuvette 15 de la vis rachidienne 3 ce dernier peut librement pivoter autour des ergots 44 de chaque jupe latérale 42, 43.When the body 40 with a spherical profile is engaged in the bowl 15 of the spinal screw 3, the latter can freely pivot around the lugs 44 of each lateral skirt 42, 43.
Le second élément de liaison 5 dit « élément supérieur » est constitué d'un corps 50 comportant une face externe 57 à profil sphérique bombé ou convexe et en son milieu suivant une direction transversale une empreinte 51 à profil cylindrique, complémentaire à celle 41 du premier élément 4, afin de recevoir lors du montage du dispositif de connexion 1 à l'intérieur de la vis rachidienne 3 la tige de liaison 2.The second connecting element 5 called "upper element" consists of a body 50 having an outer face 57 convex or convex spherical profile and in its middle in a transverse direction a cavity 51 with a cylindrical profile, complementary to that 41 of the first element 4, in order to receive during connection of the connection device 1 inside the spinal screw 3 the connection rod 2.
Le corps 50 comprend de chaque coté de l'empreinte 51 une jupe latérale 52, 53 s'étendant verticalement au-dessus de ladite empreinte et présentant chacune un profil en forme de créneau délimitant entre deux pointes 54, 55 un espace 56 destiné à recevoir lors du montage du dispositif de connexion 1 le profil en forme de pointe 46 des jupes latérales 42, 43 du premier élément 4.The body 50 comprises on each side of the cavity 51 a lateral skirt 52, 53 extending vertically above said cavity and each having a crenellated profile defining between two points 54, 55 a space 56 intended to receive when mounting the connecting device 1 the tip-shaped profile 46 of the side skirts 42, 43 of the first element 4.
Le corps 50 comporte dans son épaisseur une rainure oblongue 58 qui débouche d'une part sur la face externe 57 et d'autre part au niveau de l'empreinte transversale 51.The body 50 has in its thickness an oblong groove 58 which opens on the one hand on the outer face 57 and on the other hand at the level of the transverse impression 51.
La rainure oblongue 58 comporte dans sa partie supérieure un épaulement 58a délimitant une réduction de la dimension d'ouverture de ladite rainure oblongue 58 au niveau de Ia face externe 57.The oblong groove 58 has in its upper part a shoulder 58a delimiting a reduction in the opening dimension of said oblong groove 58 at the outer face 57.
Le corps 50 comporte dans la partie supérieure de sa jupe latérale 52 et à partir de cette dernière une autre rainure 59 débouchant à l'intérieur de la rainure oblongue 58. La rainure 59 est destinée à former une entrée qui débouche latéralement à l'intérieur de la rainure oblongue 58. La rainure 59 peut présenter un profil cylindrique se prolongeant vers l'extérieur et en direction de la face externe 57 par un profil rectiligne de dimension inférieure à celle du profil cylindrique. Egalement, la rainure 59 peut être positionnée à l'une des extrémités de la rainure oblongue 58 et suivant une direction axiale qui est inclinée par rapport à l'axe vertical et principal du corps 50. La rainure oblongue 58 et la rainure d'entrée 59 permettent la mise en place et la retenue de l'écrou de serrage 13 destiné à coopérer avec la section filetée 12 de la tête de connexion 6 de la vis rachidienne 3.The body 50 has in the upper part of its lateral skirt 52 and from this latter another groove 59 opening inside the oblong groove 58. The groove 59 is intended to form an inlet which opens laterally inside. the groove 59 may have a cylindrical profile extending outwardly and towards the outer face 57 by a rectilinear profile of smaller dimension than the cylindrical profile. Also, the groove 59 may be positioned at one end of the oblong groove 58 and in an axial direction which is inclined relative to the vertical and principal axis of the body 50. The oblong groove 58 and the entrance groove 59 allow the establishment and the retention of the clamping nut 13 intended to cooperate with the threaded section 12 of the connection head 6 of the spinal screw 3.
Le corps 50 du second élément de liaison 5 dit « élément supérieur » peut présenter une empreinte 51 à profil plan afin de permettre la mise en place et la retenue d'une tige de liaison 2 dont la face externe présente un profil cannelé obtenu par l'intermédiaire de dents longitudinales 2a (figures 18 et 19).The body 50 of the second connecting element 5, referred to as the "upper element", may have a recess 51 with a planar profile in order to allow the introduction and the retention of a connecting rod 2, the external face of which has a corrugated profile obtained by the intermediate longitudinal teeth 2a (Figures 18 and 19).
L'empreinte 51 comporte à chaque extrémité de son profil plan des ergots 51a destinés lors de l'assemblage du second élément de liaison 5 de coopérer et pénétrer entre les dents longitudinales 2a formant le profil cannelé de la tige de liaison 2 afin de bloquer en rotation et en translation cette dernière entre les premiers et seconds éléments de liaison 4, 5. En ce qui concerne le premier élément de liaison 4 ce dernier présente la même empreinte 41 à profil cylindrique quel que soit le profil externe de la tige de liaison 2.The impression 51 comprises at each end of its plane profile lugs 51a intended during assembly of the second connecting element 5 to cooperate and penetrate between the longitudinal teeth 2a forming the corrugated profile of the connecting rod 2 in order to lock in place. rotation and in translation the latter between the first and second connecting elements 4, 5. With regard to the first connecting element 4, the latter has the same cavity 41 with a cylindrical profile regardless of the external profile of the connecting rod 2 .
On a représenté en figures 11 à 14 l'écrou de serrage 13 qui comprend un corps cylindrique 17 comportant sur sa face externe un filetage 18 venant coopérer avec la section filetée 12 de la tête de connexion 6 de la vis rachidienne 3.FIGS. 11 to 14 show the clamping nut 13 which comprises a cylindrical body 17 having on its external face a thread 18 cooperating with the threaded section 12 of the connection head 6 of the spinal screw 3.
Le corps cylindrique 17 comporte une face supérieure plane 19 dans laquelle est ménagée au milieu dudit corps une empreinte 20 permettant la mise en place d'un outil, non représenté, pour l'entraînement en rotation de l'écrou de serrage 13 à l'intérieur de la tête de connexion 6. Le corps cylindrique 17 comporte à l'opposé de la face supérieure plane 19 une face inférieure 21 à profil sphérique concave présentant en son milieu un doigt cylindrique 22 pourvu d'une tête 23 dont le diamètre externe est supérieur à celui du doigt cylindrique 22.The cylindrical body 17 has a planar upper face 19 in which is formed in the middle of said body a recess 20 allowing the establishment of a tool, not shown, for the rotational drive of the clamping nut 13 to the The cylindrical body 17 has, opposite the flat upper face 19, a lower face 21 having a concave spherical profile presenting in the middle a cylindrical finger 22 provided with a head 23 whose external diameter is greater than that of the cylindrical finger 22.
Ainsi l'écrou de serrage 13 est assemblé avec le corps 50 du second élément de liaison 5 par l'intermédiaire du doigt cylindrique 22 qui est introduit à l'intérieur de la rainure oblongue 58 au moyen de la rainure d'entrée 59 dont le profil interne est complémentaire à celui dudit doigt. *Thus, the tightening nut 13 is assembled with the body 50 of the second connecting element 5 by means of the cylindrical finger 22 which is introduced inside the oblong groove 58 by means of the inlet groove 59 whose internal profile is complementary to that of said finger. *
L'écrou de serrage 13 et le corps 50 du second élément de liaison 5 peuvent se déplacer librement l'un par rapport à l'autre suivant le profil de la rainure oblong 58 pour permettre un ajustement axial dudit élément de liaison à l'intérieur de la tête de connexion 6 de la vis rachidienne 3 lors de l'assemblage de la tige de liaison 2 à l'intérieur de cette dernière.The clamping nut 13 and the body 50 of the second connecting element 5 can freely move relative to each other along the profile of the oblong groove 58 to allow axial adjustment of said connecting element therein of the connection head 6 of the spinal screw 3 during the assembly of the connecting rod 2 inside the latter.
Lors de l'assemblage de l'écrou de serrage 13 avec le corps 50 du second élément de liaison 5 la face inférieure 21 à profil sphérique concave dudit écrou 13 est positionnée au-dessus de la face externe 57 à profil sphérique bombé ou convexe dudit corps 50 pour venir en appui sur cette dernière lors du serrage de l'écrou dans la tête de connexion 6 de la vis rachidienne 3.During the assembly of the clamping nut 13 with the body 50 of the second connecting element 5, the lower face 21 having a concave spherical profile of said nut 13 is positioned above the outer face 57 with a convex spherical profile or convex of said body 50 to bear on the latter during the tightening of the nut in the connection head 6 of the spinal screw 3.
A cet effet, on a illustré en figures 15 à 17 l'assemblage et la fixation de la tige de liaison 2 d'un dispositif d'ostéosynthèse rachidienne à l'intérieur de la tête de connexion 6 de la vis rachidienne 3 au moyen du dispositif de connexion 1 suivant la présente invention.For this purpose, FIGS. 15 to 17 illustrate the assembly and fixation of the connecting rod 2 of a spinal osteosynthesis device inside the connection head 6 of the spinal screw 3 by means of the connecting device 1 according to the present invention.
La tête de connexion 6 reçoit en premier lieu le premier élément de liaison 4 du dispositif de connexion 1 de manière à ce que ce dernier coopère librement avec la cuvette 15 ménagée dans le fond 11 de l'ouverture 10.The connection head 6 receives in the first place the first connecting element 4 of the connection device 1 so that the latter cooperates freely with the bowl 15 formed in the bottom 11 of the opening 10.
Le premier élément de liaison 4 est d'une part retenu à l'intérieur de la tête de connexion 6 par l'intermédiaire des ergots 44 de chaque jupe latérale 42, 43 qui coopèrent avec les logements 16 prévus à cet effet et d'autre part libre en rotation autour desdits ergots 44 pour pouvoir pivoter par rapport à un centre C se trouvant en dessous de l'axe longitudinal yy' de la tige de liaison 2 et sur l'axe principal xx' passant par la partie filetée 7 de la vis rachidienne 3. On note que le point C de pivotement du corps 40 du premier élément de liaison 4 à l'intérieur de la tête de connexion 6 est également le centre de la face externe 47 à profil sphérique dudit corps 40.The first connecting element 4 is on the one hand retained inside the connection head 6 by means of the lugs 44 of each lateral skirt 42, 43 which cooperate with the housings 16 provided for this purpose and other free portion in rotation around said lugs 44 to pivot relative to a center C lying below the longitudinal axis yy 'of the connecting rod 2 and on the main axis xx' passing through the threaded portion 7 of the spinal screw 3. It is noted that the pivot point C of the body 40 of the first connecting element 4 inside the connection head 6 is also the center of the outer face 47 with a spherical profile of said body 40.
Enfin, on remarque que le point C est placé au milieu et sur la face de l'empreinte 41 recevant la tige de liaison 2 à immobiliser.Finally, it is noted that the point C is placed in the middle and on the face of the cavity 41 receiving the connecting rod 2 to immobilize.
En fonction de la position d'ancrage de la vis rachidienne 3 dans le corps de la vertèbre à instrumenter et de la position axiale de la tige de liaison 2 par rapport à la position de ladite vis, la tige de liaison 2 est placée, après pivotement du premier élément de liaison 4 autour du point C, à l'intérieur de l'empreinte 41 du corps 40.Depending on the anchoring position of the spinal screw 3 in the body of the vertebra to be instrumented and the axial position of the connecting rod 2 relative to the position of said screw, the connecting rod 2 is placed after pivoting of the first connecting element 4 around the point C, inside the cavity 41 of the body 40.
Ensuite, le second élément de liaison 5 est introduit dans la tête de connexion 6 de la vis rachidienne 3 au moyen de l'écrou de serrage 13 dont il est associé au moyen de la liaison pivot glissant 22, 58. L'écrou de serrage 13 coopère par l'intermédiaire de son filetage 18 avec la section filetée 12 prévue sur chaque branche verticale 8, 9 de la tête de connexion 6.Then, the second connecting element 5 is introduced into the connection head 6 of the spinal screw 3 by means of the clamping nut 13 which it is associated by means of the sliding pivot connection 22, 58. The tightening nut 13 cooperates via its thread 18 with the threaded section 12 provided on each vertical branch 8, 9 of the connection head 6.
Le profil sphérique convexe de la face externe 57 du second élément de liaison 5 et le profil sphérique complémentaire concave de la face inférieure 21 de l'écrou 13 permettent au corps 50 dudit second élément de liaison 5 de basculer autour dudit écrou 13 maintenu entre les branches verticales 8, 9 afin de s'adapter à la position de la tige de liaison 2. Lors de la mise en place de l'écrou serrage 13 entre les branches verticales 8, 9 de la tête de connexion 6 l'élément de liaison 5, et plus particulièrement l'espace 56 du profil en créneau 54, 55 des jupes latérales 52,53 reçoit le profil en forme de pointe 46 de chaque jupe latérale 42, 43 du premier élément de liaison 4. La connexion par une liaison à créneaux 46, 54, 55 entre le premier élément de liaison 4 et le second élément de liaison 5 permet à ce dernier de se présenter dans le même plan d'inclinaison que celui dudit premier élément de liaison 4 assurant aux premiers et seconds éléments de liaison 4, 5 un pivotement autour du même point C.The convex spherical profile of the outer face 57 of the second connecting element 5 and the concave complementary spherical profile of the lower face 21 of the nut 13 allow the body 50 of said second connecting element 5 to tilt around said nut 13 held between the vertical branches 8, 9 to adapt to the position of the connecting rod 2. When placing the clamping nut 13 between the vertical branches 8, 9 of the connection head 6 the connecting element 5, and more particularly the gap 56 of the crenellated profile 54, 55 of the lateral skirts 52, 53 receives the point-shaped profile 46 of each lateral skirt 42, 43 of the first connecting element 4. The connection by a slot connection 46, 54, 55 between the first connecting element 4 and the second connecting element 5 allows the latter to be in the same plane of inclination as that of said first connecting element 4 ensuring the first and second connecting elements 4, 5 pivoting about the same point C.
Lors du serrage de l'écrou 13 dans la tête de connexion 6 la face inférieure 21 à profil sphérique concave vient en appui sur la face externe 57 à profil sphérique convexe du corps 50 du second élément de liaison 5 permettant d'immobiliser en rotation et translation la tige de liaison 2 à l'intérieur des empreintes 41 , 51 du premier et second élément de liaison 4, 5.When tightening the nut 13 in the connection head 6, the lower face 21 with a concave spherical profile bears on the outer face 57 with a convex spherical profile of the body 50 of the second connecting element 5, which makes it possible to immobilize in rotation and translating the connecting rod 2 into the indentations 41, 51 of the first and second connecting elements 4, 5.
On note que les surfaces de contact entre l'écrou de serrage 13 et le corps 50 de l'élément de liaison 5 et entre l'empreinte 51 et la tige de liaison 2 étant optimisées, ces dernières permettent d'assurer et augmenter l'efficacité du blocage de la tige de liaison 2 à l'intérieur de la tête de connexion 6 de la vis rachidienne 3.It is noted that the contact surfaces between the clamping nut 13 and the body 50 of the connecting element 5 and between the cavity 51 and the connecting rod 2 being optimized, the latter make it possible to ensure and increase the effective locking of the connecting rod 2 inside the connection head 6 of the spinal screw 3.
On constate que le profil du dispositif de connexion 1 constitué des premiers et seconds éléments de liaison 4 et 5 et notamment du décalage du centre C de pivotement en dessous de l'axe yy' de la tige de liaison 2 ainsi que les pans inclinés 26 aménagés dans le fond de la tête de connexion 6 de la vis rachidienneIt can be seen that the profile of the connection device 1 consists of the first and second connecting elements 4 and 5 and in particular the shift of the center of pivoting below the axis yy 'of the connecting rod 2 as well as the inclined faces 26 arranged in the bottom of the connection head 6 of the spinal screw
3 permettent une augmentation du pivotement angulaire de la tige de liaison 2 par rapport à la vis rachidienne 3 facilitant sa mise en place et son introduction dans ladite tête de connexion.3 allow an increase in the angular pivoting of the connecting rod 2 relative to the spinal screw 3 facilitating its introduction and its introduction into said connection head.
On a représenté en figures 20 à 27 une variante du dispositif de connexion 1 permettant l'immobilisation en translation et en rotation d'une tige de liaison 2 dans le corps d'une vis rachidienne ou pédiculaire 3 destinée à être ancrée dans une vertèbre d'un segment rachidien à instrumenter d'une colonne vertébrale.FIGS. 20 to 27 show a variant of the connection device 1 enabling immobilization in translation and in rotation of a connecting rod 2 in the body of a spinal or pedicle screw 3 intended to be anchored in a vertebra d a spinal segment to instrument a spine.
Le dispositif de connexion 1 est principalement modifié en ce que les éléments de liaison 400 et 500 permettent désormais un décalage du centre de pivotement C au-dessus de l'axe yy' de la tige de liaison 2 de la vis rachidienne 3 afin d'assurer d'une part une augmentation du pivotement angulaire de la tige de liaison 2 par rapport à la vis rachidienne 3 et d'autre part la mise en place et son introduction dans la tête de connexion 6.The connecting device 1 is mainly modified in that the connecting elements 400 and 500 now allow an offset of the pivot center C above the axis yy 'of the connecting rod 2 of the spinal screw 3 in order to ensure on the one hand an increase in the angular pivoting of the connecting rod 2 relative to the spinal screw 3 and on the other hand the introduction and its introduction into the connection head 6.
En effet, seuls les éléments de liaison inférieurs 400 et supérieurs 500, sont modifiés tandis que les autres éléments constituant le dispositif de connexion 1 , à savoir la vis rachidienne 3 avec sa tête de connexion 6 en forme de U dans laquelle est vissé l'écrou de serrage 13 pour le blocage en translation et en rotation de la tige de liaison 2, restent inchangés et sont semblables à ceux décrits et référencés en figures 1 à 19.Indeed, only the lower link elements 400 and 500 are modified, while the other elements constituting the connection device 1, namely the spinal screw 3 with its U-shaped connection head 6 into which the screw is screwed. clamping nut 13 for locking in translation and in rotation of the connecting rod 2, remain unchanged and are similar to those described and referenced in Figures 1 to 19.
La tête de connexion 6 est constituée de deux branches verticales 8 et 9 délimitant une ouverture 10 en forme de U et dont le fond 11 comporte d'une part en son milieu une cuvette 15 présentant un profil interne sphérique de profil complémentaire à celle externe 470 bombée ou convexe de l'élément de liaison inférieur 400 et d'autre part deux pans inclinés 26 bordant latéralement ladite cuvette.The connection head 6 consists of two vertical branches 8 and 9 delimiting an opening 10 in the shape of a U and whose bottom 11 comprises on the one hand in its middle a bowl 15 having a spherical inner profile complementary to the external profile 470 curved or convex of the connecting element lower 400 and secondly two inclined faces 26 bordering laterally said bowl.
On a montré en figures 21 à 24 l'élément de liaison inférieur 400 qui comporte en son milieu et suivant une direction transversale une empreinte 410 à profil cylindrique qui est destinée à recevoir lors du montage du dispositif de connexion 1 la tige de liaison 2.FIGS. 21 to 24 show the lower connecting element 400 which comprises at its center and in a transverse direction a cavity 410 with a cylindrical profile which is intended to receive, during assembly of the connection device 1, the connecting rod 2.
L'élément de liaison inférieur 400 comprend de chaque coté de l'empreinte 410 une jupe latérale 420, 430 élastiquement déformable et s'étendant verticalement au-dessus de ladite empreinte et présentant chacune un profil en forme de pointe 460.The lower connecting element 400 comprises on each side of the cavity 410 a lateral skirt 420, 430 elastically deformable and extending vertically above said cavity and each having a peak-shaped profile 460.
L'extrémité pointue de chaque jupe latérale 420, 430 comporte sur sa face externe un ergot 440 coopérant avec un logement 16 de forme complémentaire ménagé au-dessus du fond 11 et sur chaque face interne de l'ouverture 10 en forme de U afin de permettre l'encliquetage et la retenue de l'élément de liaison inférieur 400 dans la cuvette 15 de la vis rachidienne 3 correspondante. L'élément de liaison inférieur 400 est percé en son milieu et suivant une direction verticale à partir de son empreinte 410 d'un alésage débouchant 450 permettant le passage d'une broche-guide à l'occasion de l'utilisation de vis pédiculaires longitudinalement percées. Lorsque l'élément de liaison inférieur 400 à profil sphérique est engagé dans la cuvette 15 de la vis rachidienne 3, ce dernier peut librement pivoter autour des ergots 440 de chaque jupe latérale 420, 430.The pointed end of each lateral skirt 420, 430 comprises on its outer face a lug 440 cooperating with a housing 16 of complementary shape formed above the bottom 11 and on each inner face of the opening 10 in the shape of a U in order to allow the snap-fastening and retention of the lower connecting element 400 in the bowl 15 of the corresponding spinal screw 3. The lower connecting element 400 is drilled in its middle and in a vertical direction from its footprint 410 of a through bore 450 allowing the passage of a guide pin on the occasion of the use of pedicle screws longitudinally breakthroughs. When the lower link member 400 with spherical profile is engaged in the bowl 15 of the spinal screw 3, the latter can freely pivot around the lugs 440 of each lateral skirt 420, 430.
On a illustré en figures 25 et 26 le second élément de liaison 500 dit « élément supérieur » qui est constitué d'un support 515 en forme de H comportant sur sa face externe supérieure une protubérance 570 dont la face externe présente un profil sphérique convexe de forme complémentaire à celle concave 21 de l'écrou de serrage 13 du dispositif de connexion 1. Le support 515 en forme de H de l'élément de liaison supérieur 500 comporte à titre d'exemple de réalisation, à l'opposé de son profil sphérique 570 et suivant une direction transversale, une empreinte 510 présentant sur la partie interne de chaque branche parallèle du H un premier profil cylindrique 511 dont le diamètre est complémentaire à celui 410 de l'élément de liaison inférieur 400, afin de recevoir lors du montage du dispositif de connexion 1 à l'intérieur de la vis rachidienne 3 la tige de liaison 2FIGS. 25 and 26 illustrate the second connecting element 500, referred to as the "upper element", which consists of an H-shaped support 515 having on its upper external face a protuberance 570 whose external face has a convex spherical profile of complementary shape to that concave 21 of the clamping nut 13 of the connecting device 1. The support 515 H-shaped upper connecting element 500 comprises, as an example embodiment, the opposite of its profile spherical 570 and in a transverse direction, a recess 510 having on the inner part of each parallel branch of the H a first cylindrical profile 511 whose diameter is complementary to that 410 of the lower connecting element 400, to receive during assembly of the connection device 1 inside the spinal screw 3 the connecting rod 2
Egalement, l'empreinte 510 comporte sur la partie interne de la branche perpendiculaire aux deux premières du H du support 515, un second profil plan 512 pourvu d'ergots ou de pointes 513 permettant l'assemblage de l'élément de liaison supérieur 500 sur la tige de liaison 2. II peut être selon une autre réalisation que l'empreinte 510 présente uniquement un profil cylindrique 511 pour la réception de la tige de liaison 2 sans pour cela changer l'objet. L'élément de liaison supérieur 500 comprend de chaque coté de l'empreinte 510 une jupe latérale 520, 530 s'étendant verticalement à partir de chaque branche parallèle du support 515 en forme de H.Also, the impression 510 has on the inner part of the branch perpendicular to the first two of the H of the support 515, a second planar profile 512 provided with pins or spikes 513 for assembling the upper connecting element 500 on the connecting rod 2. It may be according to another embodiment that the impression 510 has only a cylindrical profile 511 for receiving the connecting rod 2 without changing the object. The upper connecting element 500 comprises on each side of the cavity 510 a lateral skirt 520, 530 extending vertically from each parallel branch of the support 515 in the shape of H.
Chaque jupe latérale 520, 530 présente un profil en forme de créneau délimitant entre deux pointes 540, 550 un espace 560 destiné à recevoir lors du montage du dispositif de connexion 1 le profil en forme de pointe 460 des jupes latérales 420, 430 de l'élément de liaison inférieur 400.Each lateral skirt 520, 530 has a slot-shaped profile delimiting between a pair of points 540, 550 a space 560 intended to receive, during assembly of the connection device 1, the point-shaped profile 460 of the side skirts 420, 430 of the lower link element 400.
L'élément de liaison supérieur 500 est percé dans son épaisseur d'une rainure oblongue 580 disposée suivant un profil en arc de cercle de manière à suivre le profil sphérique de la face externe supérieure 570, et dont le centre de rotation dudit profil en arc de cercle est situé dans un logement 581 à profil sphérique qui débouche, d'une part dans la rainure oblongue 580 et d'autre part entre les ergotsThe upper connecting element 500 is pierced in its thickness with an oblong groove 580 disposed in a circular arcuate profile so as to follow the spherical profile of the upper external face 570, and whose center of rotation of said arcuate profile circle is located in a housing 581 spherical profile which opens on the one hand in the oblong groove 580 and on the other hand between the lugs
513 en direction de l'extérieur au niveau du profil plan 512 de l'empreinte transversale 510.513 towards the outside at the plane profile 512 of the transverse footprint 510.
L'écrou de serrage 13 comporte sur sa face externe un filetage 18 venant coopérer avec la section filetée 12 de la tête de connexion 6 de la vis rachidienne afin de permettre le serrage de ce dernier entraînant l'immobilisation par l'intermédiaire des éléments de liaison inférieurs 400 et supérieurs 500 de la tige de liaison 2 dans une position angulaire déterminée.The tightening nut 13 has on its outer face a thread 18 cooperating with the threaded section 12 of the connection head 6 of the spinal screw to allow the clamping of the latter resulting in the immobilization via the elements of lower link 400 and upper 500 of the connecting rod 2 in a determined angular position.
L'écrou de serrage 13 comporte une face supérieure plane 19 dans laquelle est ménagée au milieu dudit corps une empreinte 20 permettant la mise en place d'un outil, non représenté, pour l'entraînement en rotation de l'écrou de serrage 13 à l'intérieur de la tête de connexion 6.The clamping nut 13 has a flat upper face 19 in which is provided in the middle of said body a recess 20 allowing the introduction of a tool, not shown, for the rotational drive of the clamping nut 13 to inside the connection head 6.
L'écrou de serrage 13 comporte à l'opposé de la face supérieure plane 19 la face inférieure 21 à profil sphérique concave présentant en son milieu un doigt cylindrique 22 pourvu d'une tête 23 dont le diamètre externe est supérieur à celui du doigt cylindrique 22.The clamping nut 13 has opposite the flat upper face 19 the lower face 21 concave spherical profile having in the middle a cylindrical finger 22 provided with a head 23 whose outer diameter is greater than that of the cylindrical finger 22.
Le doigt cylindrique 22 en partie et la tête 23 comporte en leur milieu une fente longitudinale 24 assurant une certaine élasticité audit doigt cylindrique 22 et à Ia dite tête 23.The cylindrical finger 22 in part and the head 23 comprises in the middle a longitudinal slot 24 providing a certain elasticity to said cylindrical finger 22 and said head 23.
Ainsi l'écrou de serrage 13 est assemblé avec l'élément de liaison supérieur 500 par l'intermédiaire du doigt cylindrique 22 et de la tête 23 qui sont introduits respectivement à l'intérieur de la rainure oblongue 580 et du logement 581 après déformation élastique dudit doigt cylindrique 22 et de ladite tête 23 (Figure 27).Thus the clamping nut 13 is assembled with the upper connecting element 500 via the cylindrical finger 22 and the head 23 which are introduced respectively into the oblong groove 580 and the housing 581 after elastic deformation. said cylindrical finger 22 and said head 23 (Figure 27).
Lorsque que la tête 23 est logée à l'intérieur du logement sphérique 581 , l'écrou de serrage 13 et l'élément de liaison supérieur 500 peuvent se déplacer librement l'un par rapport à l'autre suivant le profil en arc de cercle de la rainure oblongue 580 pour permettre un ajustement axial dudit élément de liaison supérieur à l'intérieur de la tête de connexion 6 de la vis rachidienne 3 lors de l'assemblage de la tige de liaison 2 à l'intérieur de cette dernière (Figure 27). A cet effet, l'assemblage du dispositif de connexion 1 suivant la présente invention est semblable à celui décrit précédemment pour le premier exemple de réalisation mais permet dans ce cas au moyen des éléments de liaison supérieurs 400 et inférieurs 500 et de la vis de serrage 13 de positionner et d'immobiliser la tige de liaison 2 à l'intérieur de la tête de connexion 6 de la vis rachidienne 3 dans une position angulaire déterminé.When the head 23 is housed inside the spherical housing 581, the clamping nut 13 and the upper connecting element 500 can move freely relative to each other in the arcuate profile. oblong groove 580 to allow axial adjustment of said upper link member within the connection head 6 of the spinal screw 3 during assembly of the connecting rod 2 within the latter (Figure 27). For this purpose, the assembly of the connection device 1 according to the present invention is similar to that described above for the first embodiment but allows in this case by means of the upper connecting elements 400 and lower 500 and the clamping screw 13 to position and immobilize the connecting rod 2 inside the connection head 6 of the spinal screw 3 in a determined angular position.
Cette position angulaire de la tige de liaison 2 par rapport à la vis rachidienne 3 est obtenue par le basculement des éléments de liaison supérieurs 400 et inférieurs 500 autour d'un centre de rotation C qui est positionné d'une part sur l'axe vertical xx' de la vis rachidienne 3 et d'autre part au-dessus de l'axe longitudinal yy' de la tige de liaison 2.This angular position of the connecting rod 2 relative to the spinal screw 3 is obtained by the tilting of the upper connecting elements 400 and lower 500 about a center of rotation C which is positioned on the one hand on the vertical axis xx 'of the spinal screw 3 and secondly above the longitudinal axis yy' of the connecting rod 2.
Il doit d'ailleurs être entendu que la description qui précède n'a été donnée qu'a titre d'exemple et qu'elle ne limite nullement le domaine de l'invention dont on ne sortirait pas en remplaçant les détails d'exécution décrits par tous autres équivalents. It must also be understood that the foregoing description has been given by way of example only and that it in no way limits the scope of the invention which could not be overcome by replacing the execution details described. by all other equivalents.

Claims

REVENDICATIONS
1. Dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne (3) comprenant une tête de connexion (6) pourvue d'une ouverture (10) en forme de U permettant la mise en place d'une tige de liaison (2) et une partie filetée (7) permettant son ancrage dans la partie osseuse d'une vertèbre à instrumenter, caractérisé en ce qu'il comprend deux éléments de liaison (4, 5 ; 400, 500) disposés à l'intérieur de la tête de connexion (6) de la vis rachidienne (3) et coopérant respectivement avec la tige de liaison (2), lesdits éléments de liaison inférieurs (4 ; 400) et supérieurs (5 ; 500) étant agencés l'un par rapport à l'autre au moyen d'une liaison à créneaux (46, 54, 55 ; 460, 540, 550) pour pouvoir pivoter simultanément autour d'un même point C, C se trouvant sur l'axe principal xx' de la vis rachidienne (3) et en dessous ou au- dessus de l'axe longitudinal yy' de la tige de liaison (2) et des moyens de serrage (13) coopérant d'une part avec la section filetée (12) de la tête de connexion (6) de la vis rachidienne (3) et d'autre part au moyen d'une liaison pivot glissant (22, 58 ; 580) avec le second élément de liaison (5 ; 500) pour l'immobilisation en rotation, en translation et dans une position angulaire déterminée de la tige de liaison (2) à l'intérieur de ladite vis rachidienne (3).Pivoting connection device for a spinal osteosynthesis screw (3) comprising a connection head (6) provided with a U-shaped opening (10) for the insertion of a connecting rod (2) and a threaded part (7) allowing it to be anchored in the bone part of a vertebra to be instrumented, characterized in that it comprises two connecting elements (4, 5; 400, 500) arranged inside the connection head (6) of the spinal screw (3) and cooperating respectively with the connecting rod (2), said lower (4; 400) and upper (5; 500) connecting elements being arranged with respect to each other by means of a slotted connection (46, 54, 55; 460, 540, 550) to be able to pivot simultaneously about the same point C, C being on the main axis xx 'of the spinal screw (3) and below or above the longitudinal axis yy 'of the connecting rod (2) and clamping means (13) cooperating on the one hand with the section threaded (12) of the connection head (6) of the spinal screw (3) and secondly by means of a sliding pivot connection (22, 58; 580) with the second connecting element (5; 500) for immobilization in rotation, in translation and in a determined angular position of the connecting rod (2) within said spinal screw (3).
2. Dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne suivant la revendication 1 , caractérisé en ce que l'élément de liaison inférieur (4 ; 400) comporte une face externe (47 ; 470) à profil sphérique qui est complémentaire à celui interne d'une cuvette (15) ménagée dans le fond (11 ) de l'ouverture (10) de la tête de connexion (6) de la vis rachidienne (3).2. Swivel connection device for spinal osteosynthesis screw according to claim 1, characterized in that the lower connecting element (4; 400) has an outer face (47; 470) spherical profile which is complementary to the internal one a bowl (15) formed in the bottom (11) of the opening (10) of the connection head (6) of the spinal screw (3).
3. Dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne suivant la revendication 1 , caractérisé en ce que le point C, C de pivotement de l'élément de liaison inférieur (4 ; 400) à l'intérieur de la tête de connexion (6) est le centre de la face externe (47 ; 470) à profil sphérique.Pivoting connection device for a spinal osteosynthesis screw according to claim 1, characterized in that the point C, C of pivoting of the lower connecting element (4, 400) inside the connection head ( 6) is the center of the outer face (47; 470) with a spherical profile.
4. Dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne suivant la revendication 2, caractérisé en ce que l'élément de liaison inférieur (4 ;4. Swivel connection device for spinal osteosynthesis screw according to claim 2, characterized in that the lower connecting element (4;
400) comporte en son milieu et suivant une direction transversale une empreinte (41 ; 410) destinée à recevoir la tige de liaison (2), et de chaque coté de ladite empreinte (41 ; 410) une jupe latérale (42, 43 ; 420, 430) présentant chacune un profil en forme de pointe (46 ; 460) pourvu sur sa face externe d'un ergot (44 ; 440) permettant la retenue de l'élément de liaison inférieur (4 ; 400) à l'intérieur de la tête de connexion (6).400) comprises at its center and in a transverse direction a recess (41; 410) intended to receive the connecting rod (2), and on each side of said recess (41; 410) a lateral skirt (42, 43; , 430) each having a tip-like profile (46; 460) provided on its outer face with a pin (44; 440) for retaining the lower link member (4; 400) within the the connection head (6).
5. Dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne suivant la revendication 1 , caractérisé en ce que l'élément de liaison supérieur (5 ; 500) comporte une face externe (57 ; 570) à profil sphérique et en son milieu suivant une direction transversale une empreinte (51 ; 510) permettant de recevoir la tige de liaison (2). 5. Swivel connection device for spinal osteosynthesis screw according to claim 1, characterized in that the upper connecting element (5; 500) comprises an outer face (57; 570) with a spherical profile and in its middle according to a transverse direction a recess (51; 510) for receiving the connecting rod (2).
6. Dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne suivant la revendication 5, caractérisé en ce que l'élément de liaison supérieur (5 ; 500) comporte de chaque coté de l'empreinte (51 ; 510) une jupe latérale (52, 53 ; 520, 530) présentant chacune un profil en forme de créneau délimitant entre deux pointes (54, 55 ; 540, 550) un espace (56 ; 560) destiné à recevoir le profil en forme de pointe (46 ; 460) des jupes latérales (42, 43 ; 420, 430) de l'élément de liaison inférieur (4 ; 400). 6. Swivel connection device for spinal osteosynthesis screw according to claim 5, characterized in that the upper connecting element (5; 500) comprises on each side of the cavity (51; 510) a lateral skirt (52). , 53, 520, 530) each having a slot-like profile defining between a pair of peaks (54, 55, 540, 550) a gap (56, 560) for receiving the peak-shaped profile (46; side skirts (42,43,420,430) of the lower link (4; 400).
7. Dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne suivant la revendication 5, caractérisé en ce que l'élément de liaison supérieur (5 ; 500) comporte dans son épaisseur une rainure oblongue (58 ; 580) qui débouche d'une part sur la face externe (57; 570) et d'autre part au niveau de l'empreinte transversale (51 ; 510).7. Swivel connection device for spinal osteosynthesis screw according to claim 5, characterized in that the upper connecting element (5; 500) comprises in its thickness an oblong groove (58; 580) which opens on the one hand on the outer face (57; 570) and on the other side at the transverse footprint (51; 510).
8. Dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne suivant la revendication 7, caractérisé en ce que la rainure oblongue (58) comporte dans sa partie supérieure un épaulement (58a) délimitant une réduction de la dimension d'ouverture de ladite rainure oblongue (58) au niveau de la face externe (57).8. Swivel connection device for spinal osteosynthesis screw according to claim 7, characterized in that the oblong groove (58) has in its upper part a shoulder (58a) defining a reduction of the opening dimension of said oblong groove. (58) at the outer face (57).
9. Dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne suivant la revendication 7, caractérisé en ce que l'élément de liaison supérieur (5) comporte dans la partie supérieure de sa jupe latérale (52) et à partir de cette dernière une autre rainure (59) débouchant à l'intérieur de la rainure oblongue9. pivoting connection device for spinal osteosynthesis screw according to claim 7, characterized in that the upper connecting element (5) comprises in the upper part of its lateral skirt (52) and from this latter another groove (59) opening into the oblong groove
(58).(58).
10. Dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne suivant la revendication 1 , caractérisé en ce que les moyens de serrage (13) sont constitués d'un écrou comprenant un corps cylindrique (17) comportant sur sa face externe un filetage (18) venant coopérer avec la section filetée (12) de la tête de connexion (6) de la vis rachidienne (3), ledit corps cylindrique (17) comprenant une face inférieure (21 ) à profil sphérique concave présentant en son milieu un doigt cylindrique (22) pourvu d'une tête (23).10. Swivel connection device for spinal osteosynthesis screw according to claim 1, characterized in that the clamping means (13) consist of a nut comprising a cylindrical body (17) having on its outer face a thread (18). ) cooperating with the threaded section (12) of the connection head (6) of the spinal screw (3), said cylindrical body (17) comprising a lower face (21) concave spherical profile having in the middle a cylindrical finger (22) provided with a head (23).
11. Dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne suivant la revendication 10, caractérisé en ce que le doigt cylindrique (22) en partie et la tête (23) comporte en leur milieu une fente longitudinale (24) assurant une certaine élasticité audit doigt cylindrique (22) et à la dite tête (23).11. Swivel connection device for spinal osteosynthesis screw according to claim 10, characterized in that the cylindrical finger (22) in part and the head (23) has in their middle a longitudinal slot (24) providing a certain elasticity auditing cylindrical finger (22) and said head (23).
12. Dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne suivant la revendication 5, caractérisé en ce que l'empreinte (51 ) présente un profil plan pourvu à chaque extrémité d'au moins un ergot (51a) coopérant avec le profil cannelé de la tige de liaison (2).12. pivoting connection device for spinal osteosynthesis screw according to claim 5, characterized in that the cavity (51) has a planar profile provided at each end of at least one lug (51a) cooperating with the fluted profile of the connecting rod (2).
13. Dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne suivant la revendication 5, caractérisé en ce que l'élément de liaison supérieur (500) est constitué d'un support (515) en forme de H comportant sur sa face externe supérieure une protubérance (570) dont la face externe présente un profil sphérique convexe et à l'opposé de son profil sphérique (570) et suivant une direction transversale une empreinte (510) présentant sur la partie interne de chaque branche parallèle du H un premier profil cylindrique (511 ) dont le diamètre est complémentaire à celui (410) de l'élément de liaison inférieur (400), afin de recevoir à l'intérieur de la vis rachidienne (3) la tige de liaison (2).13. Swiveling connection device for spinal osteosynthesis screw according to claim 5, characterized in that the upper connecting element (500) consists of an H-shaped support (515) comprising on its upper outer face a protuberance (570) whose external face has a profile spherical convex and opposite its spherical profile (570) and in a transverse direction an impression (510) having on the inner part of each parallel branch of H a first cylindrical profile (511) whose diameter is complementary to that ( 410) of the lower connecting element (400), to receive inside the spinal screw (3) the connecting rod (2).
14. Dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne suivant la revendication 13, caractérisé en ce que l'empreinte (510) comporte sur la partie interne de la branche perpendiculaire aux deux premières du H du support (515) un second profil plan (512) pourvu d'ergots ou de pointes (513) permettant l'assemblage de l'élément de liaison supérieur (500) sur la tige de liaison (2).14. Swivel connection device for spinal osteosynthesis screw according to claim 13, characterized in that the recess (510) has on the inner part of the branch perpendicular to the first two of the H of the support (515) a second planar profile. (512) provided with pins or spikes (513) for assembling the upper connecting element (500) on the connecting rod (2).
15. Dispositif de connexion pivotant pour vis d'ostéosynthèse rachidienne suivant la revendication 13, caractérisé en ce que l'élément de liaison supérieur (500) est percé dans son épaisseur d'une rainure oblongue (580) disposée suivant un profil en arc de cercle de manière à suivre le profil sphérique de la face externe supérieure (570), et dont le centre de rotation dudit profil en arc de cercle est situé dans un logement (581 ) à profil sphérique qui débouche d'une part dans la rainure oblongue (580) et d'autre part entre les ergots (513) en direction de l'extérieur au niveau du profil plan (512) de l'empreinte transversale (510). 15. A pivoting connection device for a spinal osteosynthesis screw according to claim 13, characterized in that the upper connecting element (500) is pierced in its thickness by an oblong groove (580) arranged in an arcuate profile. circle so as to follow the spherical profile of the upper outer face (570), and whose center of rotation of said arcuate profile is located in a housing (581) with a spherical profile which opens on the one hand into the oblong groove (580) and on the other hand between the lugs (513) towards the outside at the plane profile (512) of the transverse footprint (510).
PCT/FR2008/001790 2007-12-21 2008-12-19 Pivoting connection device for spinal osteosynthesis screw WO2009106733A2 (en)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
FR0708975A FR2925288B1 (en) 2007-12-21 2007-12-21 SWIVEL CONNECTING DEVICE FOR SPINAL OSTEOSYNTHESIS SCREW
FR07/08975 2007-12-21
US2197608P 2008-01-18 2008-01-18
US61/021,976 2008-01-18

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Also Published As

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FR2925288A1 (en) 2009-06-26
WO2009106733A3 (en) 2009-11-26
WO2009106733A8 (en) 2009-10-08
FR2925288B1 (en) 2010-01-15

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