WO2011098634A1

WO2011098634A1 - Device for the treatment of spine pathologies

Info

Publication number: WO2011098634A1
Application number: PCT/ES2010/070558
Authority: WO
Inventors: Antonio Magín ALONSO ABAJO; Pedro Hector Alonso Abajo
Original assignee: Alonso Abajo Antonio Magin; Pedro Hector Alonso Abajo
Priority date: 2010-02-12
Filing date: 2010-08-17
Publication date: 2011-08-18

Abstract

The present application relates to a device for the treatment of spine pathologies and belongs to the field of the systems that are used for instrumentation, fixation and prosthesis of the spine. The device (1) comprises a set of pieces such as they make it possible to realize the surgery using a post-bilateral percutaneous surgical approach. It is not a system thought to be used with an open operation, although it is also possible to implant it using an open operation.

Description

DEVICE FOR THE TREAT ENT OF SPINE PATHOLOGIES

OBJECT OF THE INVENTION

The present invention is directed to a device for the treatment of pathology in the spine and is in the field of systems that are used for instrumentation, fixation and prosthesis of the spine.

The present invention comprises a set of pieces that allow a posterobilateral percutaneous approach. It is not a system designed to be used through open surgery, although it could also be implanted with open surgery.

BACKGROUND OF THE INVENTION

There are currently instrumentation devices or systems for the spine. All these instrumentation systems have been created and designed to treat spinal pathologies. Pathologies may have an origin:

• Traumatic (fractures, dislocations, herniated discs).

• Congenital (deformities of the type of scoliosis, kyphosis).

• Degenerative (when a vertebral segment is unable to maintain vertebral stability, chronic degenerative changes in the joints of the vertebral segment originate giving rise to what is called osteoarthritis of the spine. If the situation is not corrected the spine ends up deforming .

• Infectious (discitis and spondylitis).

· Tumor.

All these pathologies cause spinal pain, which is the most important cause of work losses and disabilities in the western world. The origin of pain in the vast majority of cases comes from the incompetent intervertebral disc, so many instruments and devices have been developed that They try to correct the above problems to relieve pain.

Most of these systems are intended to fix the diseased or damaged vertebral segment, preventing movement of the disc space and thereby relieving pain in the dorsal or lumbar cervical spine. These fixation systems are made in most cases with open surgery, exposing an area of the vertebral segment to be treated.

In this way, the anterior, lateral or posterior side of the column is exposed to open sky and once exposed the device is placed. This is the case of the patent with publication number US4834757 of Brantigan or, of the patent with publication number US5015247 of Michelson.

Along with these devices that are used to fix the vertebral segment, other devices have been invented, which once placed by open surgery, can allow some mobility of the vertebral segment. These devices are the so-called intervertebral disc prostheses. This is the case of Spanish patents with publication number ES2310255T3 and ES2177578T3. The placement in the human body of the devices can be performed by three different surgical techniques: a) Open surgery, which can be by different routes: anterior, anterolateral, posterolateral or posterior. With open surgery, the practical totality of disc prostheses or intersomatic fixators (boxes, screws, plates, bars, etc.) can be placed. To apply this type of surgery, the vertebrae must be exposed on the desired face and the device is placed with visual control. b) Minimally invasive surgery. It is an open surgery that uses small, less aggressive incisions and exposures. With this type of surgery, disc prostheses, intersomatic screws and transpedicular posterior fixations are also placed. c) Percutaneous surgery. With this technique, the disc and vertebrae are not directly exposed. The position of the instruments inside the body is determined X-ray mine, is a closed surgery. With percutaneous surgery, a needle is inserted into a vertebra or into the disc. A trocar and dilators can be inserted through the needle and screws and different devices can be placed through the dilators.

At present, transpedicular posterior instrumentation systems can be placed with percutaneous surgery, the screws are introduced into the vertebrae through the pedicles posteriorly and then joined with vertical bars. Intervertebral discs can be removed, (percutaneous nucleotomy), or other types of interventions on the disc, (radiofrequency nucleoplasty etc.). Punctures of the vertebrae may also be done to biopsy or cement into the vertebrae (vertebroplasties and kyphoplasty). So far, it is not known that prostheses or intersomatic fixation systems have been placed with percutaneous surgery, posterolaterally.

The device of the present invention has been designed to be placed by percutaneous surgery, guided by x-rays, using a new surgical technique, with appropriate instrumentation for placement, and would be included within the vertebral intersomatic fixation systems using a pathway. Percutaneous and posterolateral approach. This involves the stabilization of the two vertebrae without having to make a direct exposure of them. At present there is no system with these characteristics, which allows the operation of placing a device that directly stabilizes the bodies of two adjacent vertebrae percutaneously without the need for open surgery.

This difference solves an important technical problem in the pathology of the intervertebral discs, since the fixation device can be placed by percutaneous approach, only producing small incisions that are usually between 12 and 15 mm in length in the patient's skin.

DESCRIPTION OF THE INVENTION

The invention relates to a device for the treatment of pathology in the spine such as instability between two or more vertebrae of the spine or an alteration of the intervertebral disc, these pathologies being congenital, traumatic, degenerative, infectious or tumor origin.

The device comprises two rod-shaped elements that are inserted between the two vertebrae to be stabilized and that join together to give rise to a stable fixation between vertebrae. This device, unlike the devices of the prior art, allows the insertion piece by piece by percutaneous surgery and subsequently allows it to be mounted inside also with percutaneous surgery, not open, in the intervertebral space. Therefore, the insertion method is carried out with percutaneous, bilateral surgery to access the intervertebral space. That is, by means of surgical instruments, the posterolateral part of the disc or the vertebra is given with an orientation directed towards the center of the disc without the need to use open surgery.

The first tool used is a cannulated trocar that allows to reach the center of the disc from both sides. Through the cannulated trocar, a Kirschner needle is passed through the center of the intervertebral disc. This needle serves as a guide in the following actions and over it they are overlapping (following through its outer part) dilators of progressively larger diameters until a dilator with the appropriate diameter to the implant is placed. The implant will be constituted by the rod-shaped elements that give rise to the device of the invention and which are to be placed between the vertebrae. In this way, once the two definitive dilators are placed, one on each side, the disc is first removed by means of known techniques and then the two rod-shaped elements that are to be stabilized are introduced between the two vertebrae that are to be stabilized. It comprises the invention through dilators that now serve as a guide.

The device therefore comprises a first rod-shaped element that extends along a longitudinal axis and which comprises at one end means of linking with a tool to allow insertion and manipulation between vertebrae by percutaneous surgery.

This first rod-shaped element is introduced through one of the dilators. As at one of its ends it has some means of linking with the tool, making use of said tool it is possible to push, pull and manipulate the rod-shaped element until its final position is achieved.

The bar-shaped configuration that extends longitudinally is the one that allows insertion between vertebrae through the dilator given the tubular configuration of the latter.

In the description of the embodiments of the invention particular ways of linking between the tool and the bar-shaped element will be shown.

The invention also comprises a second rod-shaped element that extends along a longitudinal axis and which comprises at one end means of linking with a tool to allow insertion and manipulation between vertebrae by percutaneous surgery.

As with the first rod-shaped element, this second rod-shaped element is introduced through the other dilator that has been placed on the other side of the spine by percutaneous surgery. The second bar-shaped element also has means of linking with a tool that allows it to be inserted and placed until the final position, the position that facilitates the coupling and the final connection between both bar-shaped elements.

In the embodiments, different surface finishes are incorporated to facilitate insertion by an axial movement coinciding with the longitudinal axis of the rod-shaped element, or by a turning movement using an external thread that also facilitates the entry or exit.

Finally, the invention incorporates coupling means between the first rod-shaped element and the second rod-shaped element such that once both elements are coupled, their longitudinal axes have an angle such that it is possible to define a single plane parallel to one and another longitudinal axis. The configuration of devices according to the state of the art or not sufficiently stabilize the relative position between the two vertebrae, since by percutaneous surgery the most that has been achieved is to place a screw or an insulated box that gives little stability; or it requires open surgery because the greater stability is provided by a greater effective area of support between vertebrae and said greater area prevents insertion unless it is carried out by open surgery.

In the present invention, the use of two rod-shaped elements allows insertion by percutaneous surgery; and the subsequent assembly in the interior so that a certain angle is maintained, allows to define a plane which, from a mechanical point of view means that the kinematics between the two vertebrae and the two rod-shaped elements is constituted by a system hyperstatic preventing the relative movement between vertebrae even before the application of efforts between them. This stabilization effect is greater when the first bar-shaped element and the second bar-shaped element are coupled at an angle close to the right angle.

A distinction is made between the terms coupling and joining as distinct relationships between the first and second bar-shaped elements. The term coupling will be used to establish the link that two pieces maintain when they have seating surfaces intended to come into contact so that the seat defines a stable position between both pieces. However, decoupling is avoided if you have joining means. The union is the one that offers the resistance or impediment to disengage. In the present invention the first and second rod-shaped elements have coupling means. The posterior union is established either because there are some joining means (for example a screw) or because after a phase of ossification and generation of fibers, the two coupled parts form a single body.

The embodiments according to dependent claims 2 to 11 establish particular ways of configuring the elements in the form of a bar, of the linkage between both and other technical characteristics that solve various partial technical problems. All protection objects resulting from the different combinations of the dependent claims are incorporated by Reference to this description.

The use of a device according to any of claims 12 to 15 is also considered incorporated by reference to this description.

The method for treating a spinal pathology in a subject comprising the implantation of a device according to claims 1 to 12 is also considered incorporated by reference to this description.

Technical advantages of the invention:

The device, by its design, remains fixed in the position in which it is intended to be placed. It is almost impossible to migrate it in the plane of the disk by the way that two convergent arranged elements are provided in the joining means, for example with a cross arrangement, since it would have to drag all the structures with it, as well as by its system of anchorage in the bone. This positional stability means that future complications that require new interventions are not expected as with other methods.

With this new implant and applying the percutaneous surgical technique, without open surgery, all complications of open surgery are avoided, namely:

• It is not necessary to keep a wide incision open for hours, which prevents infections.

• It is not necessary to make large incisions, so bleeding is not abundant as in other techniques and does not require blood transfusion.

• There are no bruises in the surgical bed after the incision is sutured.

• There are no injuries to muscles and ligaments of the spine, as they do not have to be cut in order to achieve exposure of the disc and vertebrae. Likewise, the structure of muscles and ligaments will not be weakened, which are fundamental in the stability of the spine.

• Fibrosis and scars are not formed in the vicinity of nerve structures that in many cases are responsible for failed spinal surgeries in other techniques with open surgery.

In addition to the technical advantages, it is economically a reduction ¡Mportante of the costs for the health system and for the patient. When an open transpedicular fixation surgery is used, or for the placement of prostheses or intersomatic devices, the patient must remain admitted to the hospital for prolonged stays (7 days or more). With this method the patient's stay in the hospital is only 24 to 48 hours, with this the hospital saves stays for the care of that patient, in addition the patient saves time to live his normal life.

• It also has other benefits derived from the possibilities provided by the device, such as the absence of large scars, avoiding an aesthetic problem.

• The time that the patient has to rest until the wounds heal completely and can live a normal life is shorter and the work leave is shorter.

• The surgery time is approximately one hour, which saves operating room costs, since any open surgery of this type usually requires more than 2 hours.

· The placement of the system can be done with sedation, since it can be done in one hour and it is not excessively painful. No general anesthesia is necessary, thus avoiding the problems of intubation and the complications of general anesthesia.

• It is easier to remove the device, if necessary. With the current techniques, the patient must be reopened while with this system it is possible to perform, also percutaneously, a disassembly of the device inversely to its placement, and open surgery is not necessary either.

DESCRIPTION OF THE DRAWINGS

These and other features and advantages of the invention will become more clearly apparent from the detailed description that follows in a preferred embodiment, given only by way of illustrative and non-limiting example, with reference to the accompanying figures. .

Figure 1 This figure shows schematically and in perspective vertebrae and intervertebral spaces as well as an embodiment of the invention already incorporated in the intervertebral space. Figure 2 This figure shows in plan a vertebra on which they have represented superimposed auxiliary lines; thick lines indicate the position of the dilators and other fine dashed lines indicate the axes that correspond to the direction of insertion and placement of the bar-shaped elements.

Figure 3 This figure shows in exploded perspective a first embodiment where the rod-shaped elements have a cylindrical configuration and with threaded surfaces. Figure 4 This figure shows in perspective a second embodiment where the bar-shaped elements have an essentially square section and with a grooved surface. This exemplary embodiment requires axial displacement insertion. Figure 5 This figure shows in perspective one of the bar-shaped elements, of short length, and of cylindrical configuration and with threaded surface.

Figure 6 This figure shows in perspective one of the bar-shaped elements, of long length, of cylindrical configuration and with threaded surface, and with a central through hole to allow the union of two bar-shaped elements of short length.

Figure 7 This figure shows in perspective one of the elements in the form of a bar, of short length, and of configuration in essentially square section and with grooved surface.

Figure 8 This figure shows in perspective one of the bar-shaped elements, of long length, of essentially square section configuration and with grooved surface, and with a central through hole to allow the joining of two bar-shaped elements Short length

Figure 9 This figure shows a screw that allows it to be threaded into different internal threads of the bar-shaped elements. DETAILED EXHIBITION OF THE INVENTION

The present invention consists of a device for the treatment of pathology in the spine. This device solves the problem of getting an apparatus that is operatively arranged between two vertebrae and that can be inserted by percutaneous surgery. The device of the invention allows to solve this problem since it admits the insertion of the elements that form it through guides and also allows its subsequent coupling inside.

Figure 1 shows in perspective two vertebrae (V) between which there is a space (E) that is where the device (1) will be arranged after the intervention. This same figure shows an example of an embodiment consisting of three elements (1.1, 1.2, 1.3) in the form of a bar connected to each other, which are insertable by means of an axial displacement, and which once joined give rise to a cross or cross of perpendicular arms.

Figure 2 shows in plan a vertebra (V) where the base (V.l) of the vertebral disc is distinguished (not shown for clarity in the figure) which is where the device (1) is located once implanted. The implant is performed by accessing through the pedicles (V.2), in a posterolateral position and orientation, as indicated by the axes shown in dashed lines. Both axes converge at an interior point to the space (E) where the intervertebral disc is located before being removed. In this same figure, the transverse process (V.3), and the plates (V.4) that connect n with the spiny port (V.5) are identified in the vertebra (V). Likewise, at the end of the plates (V.4) and in symmetrical arrangement, the articular processes (V.7) are observed.

Continuing with figure 2, by thick lines the position of the dilators (D) that allow the insertion, by percutaneous surgery, of the components of the device (1) that is only shown schematically by rectangles is represented. The position and orientation of the dilators (D) is what is prolonged by the axes shown in broken lines.

The exemplary embodiment shown in figure 1 and corresponding to the pattern of figure 2 comprises 3 bar-shaped elements (1.1, 1.2, 1.3) that are ¡Nserted in a certain order and subsequently fixed to each other. It is in figure 4 where this same example of embodiment of the device is shown in greater detail and is the example that will be described first. First, a bar-shaped element is inserted which in this embodiment is short. We will call this element the second element (1.2) in the form of a bar. This second bar-shaped element (1.2) and the rest of the bar-shaped elements (1.1, 1.3) used in this exemplary embodiment are essentially square in section. On the upper and lower surfaces, those that in operating mode come into contact with the vertebrae (V), a set of projections are shown that give rise to a longitudinal groove (1.1.5, 1.2.5, 1.3.5). The grooving (1.1.5, 1.2.5,

1.3.5) longitudinal allows each element (1.1, 1.2, 1.3) to be stabilized in the form of a bar with respect to the surface of the vertebra (V) with which it is in contact in a direction transverse to the element (1.1, 1.2, 1.3) in bar shape The use of instruments that carve a complementary groove in the bone surface allows for better insertion and guidance of the position of each of the elements (1.1, 1.2, 1.3) in the form of a bar during placement. After placement, the coincidence of grooves in the vertebra (V) and in the bar-shaped elements (1.1, 1.2, 1.3) also stabilizes the position of the device (1).

Additionally, each of the elements (1.1, 1.2, 1.3) in the form of a bar, in this embodiment, also has a groove (1.1.6, 1.2.6,

1.3.6) transverse that when crossing with the grooving (1.1.5, 1.2.5, 1.3.5) longitudinal results in a set of rectangular floor projections. The height of each of these projections has been made variable and faceted to improve the union with the vertebra (V).

Once the second element (1.2) in the form of a bar is inserted, another element in the form of a bar is introduced, which we will call the first element (1.1) in the form of a bar and which in this embodiment is coincident with the longest element. This first bar-shaped element (1.1) has a central through hole (1.1.4) in its central part that allows the end of the second bar-shaped element (1.2) to be accessible to the first bar-shaped element (1.1) . Through this central hole (1.1.4), it is possible to set the pri- mer element (1.1) in the form of a bar with the second element (1.2) in the form of a bar, for example, by means of a screw that leaves the first element (1.1) in the form of a bar against the end of the second element (1.2) in the form of a bar that has the means of linking with the tool that has allowed its insertion and manipulation. In this case, the screw threads into a thread (1.2.2) inside the second element (1.2) in the form of a bar until the head imprisons a seat located in the central hole (1.1.4) through (the seat is not shown in the figure). In this way the first rod-shaped element (1.1) is caught between the screw head and the second rod-shaped element (1.2). The three elements (1.1, 1.2, 1.3) in the form of bar used have a thread (1.1.2, 1.2.2, 1.3.2) inside.

This embodiment is not the one shown in the figure, that of the figure incorporates an element (1.3) in the form of an additional bar. The internal threading (1.2.2) of the second rod-shaped element (1.2) in this case is also the means by which the insertion manipulation tool allows the traction to extract the rod-shaped element (1.2). This is the solution used in all the elements (1.1, 1.2, 1.3) in the form of a bar. The additional presence of a crenellated (1.1.3, 1.2.3, 1.3.3) makes it possible with the tool to apply a torque that facilitates certain maneuvers. In this particular case, the crenellation (1.1.3, 1.2.3, 1.3.3) of the elements (1.1, 1.2, 1.3) in the form of a bar and its internal threads (1.1.2, 1.2.2, 1.3.2 ) form the means of linking with the tool that allows the insertion and manipulation of such elements during percutaneous surgery.

In this same embodiment, the one shown in Figure 4, a third element (1.3) in the form of a bar is also introduced, also short. In the example shown in Figure 4, instead of fixing the first and second element (1.1, 1.2) in the form of a bar by means of a screw as described above, the screw leaves the three elements (1.1, 1.2) , 1.3) in the form of a bar. In this case, the screw that is not represented graphically, threads into the second element (1.2) in the form of a bar (short length), and leaves the third element (1.3) in the form of a bar per passage through its cavity longitudinal interior (in this case shown with thread (1.3.2) although the screw does not thread because the diameter of the internal thread (1.3.2) is larger than that of the screw). The screw also leaves tight The first element (1.1) in the form of a bar is crossed as it crosses its central transverse perforation (1.1.4).

Both bar-shaped elements (1.1, 1.3) are pressed because the screw head seats at the end of the third bar-shaped element (1.3). Additionally, in this position it is accessible through the dilator (D).

The screw can be replaced, for example, by the third rod-shaped element (1.3) when it, instead of having a square section, has a cylindrical section. In the embodiments of the invention shown in figures such as Figures 3, 5 and 6, the bar-shaped elements (1.1, 1.2, 1.3) have a cylindrical configuration with circular section and show a thread (1.1.1, 1.2 .1, 1.3.1) outside. This external thread (1.3.1) facilitates the insertion by turning and therefore its function is to favor the advance during the insertion operation; and subsequent fixation with the vertebrae (V).

In turn, if at the end there is an additional thread that is capable of threading into the internal thread (1.2.2) of the second bar-shaped element (1.2), the first bar-shaped element (1.1) is caught.

In any of these described embodiments, the first bar-shaped element (1.1) and the second bar-shaped element (1.2) end up coupled and also joined.

It is also possible that they are only coupled and the union is carried out by the healing and ossification process. In this case, stability is achieved after a longer period of time.

Ossification fixation is favored when any of the elements (1.1, 1.2, 1.3) in the form of a bar has perforations (1.1.7, 1.2.7, 1.3.7) that communicate the internal cavity with the external surface. Through these perforations (1.1.7, 1.2.7, 1.3.7), the creation of fibers and bone causes the internal cavity to fill and bind with the bone of the vertebrae (V) that are in contact and they want to stabilize resulting in a stronger structural assembly. Therefore, the internal cavities shown in the elements (1.1, 1.2, 1.3) in the form of a bar are optional and can be filled by the ossification process or by internal screws (2) as shown in Figure 9 that facilitate the connection between elements (1.1, 1.2, 1.3) in the form of a bar.

In all the examples the elements (1.1, 1.2, 1.3) in the form of a bar have an internal hollow that extends along its entire length and has an internal thread (1.1.2, 1.2.2, 1.3.2); however, this internal gap may only partially extend and not necessarily be threaded.

Claims

1. - Device for the treatment of pathology in the spine characterized in that it comprises:

• a first element (1.1) in the form of a bar that extends along a longitudinal axis and that comprises at one end connection means (1.1.2, 1.1.3) with a tool to allow insertion and manipulation between vertebrae by percutaneous surgery ;

• a second rod-shaped element (1.2) that extends along a longitudinal axis and that comprises at one end means of connection (1.2.2, 1.2.3) with a tool to allow insertion and manipulation between vertebrae by percutaneous surgery ;

• coupling means between the first rod-shaped element (1.1) and the second rod-shaped element (1.2) such that once both elements are coupled together their longitudinal axes present an angle such that it is possible define a single plane parallel to one and another longitudinal axis.

2. - Device according to claim 1 characterized in that the first bar-shaped element (1.1), the second bar-shaped element (1.2), or both, comprise a threaded outer surface (1.1.1 , 1.2.1) which facilitates the insertion between vertebrae by rotation.

3. - Device according to claim 1 characterized by the first element (1.1) in the form of a bar, the second element (1.2) in the form of a bar, or both elements (1.1, 1.2) in the form of a bar , they comprise an outer surface with longitudinal grooves (1.1.5, 1.2.5) for percutaneous insertion by axial displacement.

4. - Device according to any of the preceding claims characterized in that the first element (1.1) in the form of a bar, the second element (1.2) in the form of a bar or both elements (1.1, 1.2) in the form of a bar have on its outer surface of grooves (1.1.6, 1.2.6) additional transverse to prevent sliding with the support surfaces of the vertebra (V) with which they are in contact once implanted.

5. - Device according to any of the preceding claims. curled because the first element (1.1) in the form of a bar, the second element (1.2) in the form of a bar or both elements (1.1, 1.2) in the form of a bar have a gap that extends totally or partially along its length length.

6. Device according to claim 5 characterized in that any of the elements (1.1, 1.2, 1.3) in the form of a bar comprises transverse perforations (1.1.7, 1.2.7, 1.3.7) that allow communication between the inner hollow and the outside to favor healing fixation and bone formation through these perforations.

7. Device according to claim 5 characterized in that the hollow that extends totally or partially along the length of any of the elements (1.1, 1.2, 1.3) in the form of a bar is threaded (1.1.2, 1.2.2 , 1.3.2).

8. Device according to any of the preceding claims characterized in that the coupling means between two elements (1.1, 1.2) in the form of a bar comprise fixing means according to two complementary threads.

9. - Device according to claims 1 and 7 characterized in that · the second rod-shaped element (1.2) has a threaded recess (1.2.2) that extends at least partially at the end of its length where the means of linkage with the tool that allows insertion and manipulation between vertebrae by percutaneous surgery,

• the first bar-shaped element (1.1) has a transverse through hole (1.1.4) where the coupling with the second bar-shaped element (1.2) occurs,

• comprises a screw capable of passing through the transverse perforation (1.1.4) of the first rod-shaped element (1.1), reaching the second rod-shaped element (1.2) by tapping into its threaded hole (1.2); and, trapping the first rod-shaped element (1.1) between the screw and the second rod-shaped element (1.2).

10. - Device according to claim 9 characterized in that the screw is a third rod-shaped element (1.3) comprising a threaded outer surface (1.3.1) that facilitates its insertion between vertebrae (V) by turning giving rise to a configuration of the device (1) in blade.

11. - Device according to any of the preceding claims characterized in that the means of linking between a rod-shaped element (1.1, 1.2, 1.3) and the tool that allows insertion and manipulation between vertebrae (V) by percutaneous surgery comprises a crenellated crown (1.1.3, 1.2.3, 1.3.3) and an internal thread (1.1.2, 1.2.2, 1.3.2) that allows the insertion / extraction tool to be attached to the element (1.1, 1.2, 1.3) in the form of a bar.

12. - Device according to any of claims 1 to 11 for use in the treatment of a pathology in the spine.

13. - Device according to claim 12 wherein the pathology is an instability between two or more vertebrae of the spine or an alteration of the intervertebral disc, these pathologies being of congenital, traumatic, degenerative, infectious or tumor origin.

14. - Use of a device according to any of claims 1 to 11 for the preparation of a medicament for the treatment of a pathology in the spine.

15. Use according to claim 14 wherein the pathology is an instability between two or more vertebrae of the spine or an alteration of the intervertebral disc, these pathologies being of congenital, traumatic, degenerative, infectious or tumor origin.

16. Method for the treatment of a spinal pathology in a subject comprising the implantation of a device according to claims 1 to 12.