DE10127924C1 - Spinal vertebra replacement prosthetic has base body and distraction body provided with cooperating distraction threads for adjustment of relative spacing between their contact surfaces - Google Patents
Spinal vertebra replacement prosthetic has base body and distraction body provided with cooperating distraction threads for adjustment of relative spacing between their contact surfacesInfo
- Publication number
- DE10127924C1 DE10127924C1 DE10127924A DE10127924A DE10127924C1 DE 10127924 C1 DE10127924 C1 DE 10127924C1 DE 10127924 A DE10127924 A DE 10127924A DE 10127924 A DE10127924 A DE 10127924A DE 10127924 C1 DE10127924 C1 DE 10127924C1
- Authority
- DE
- Germany
- Prior art keywords
- distraction
- thread
- vertebral replacement
- drive
- body according
- Prior art date
- Legal status (The legal status 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 status listed.)
- Expired - Fee Related
Links
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30721—Accessories
- A61F2/30744—End caps, e.g. for closing an endoprosthetic cavity
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2/4611—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/28—Bones
- A61F2002/2835—Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30108—Shapes
- A61F2002/3011—Cross-sections or two-dimensional shapes
- A61F2002/30138—Convex polygonal shapes
- A61F2002/30143—Convex polygonal shapes hexagonal
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
- A61F2002/30354—Cylindrically-shaped protrusion and recess, e.g. cylinder of circular basis
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
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- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
- A61F2002/30362—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit with possibility of relative movement between the protrusion and the recess
- A61F2002/3037—Translation along the common longitudinal axis, e.g. piston
- A61F2002/30372—Translation along the common longitudinal axis, e.g. piston with additional means for limiting said translation
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30405—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by screwing complementary threads machined on the parts themselves
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30518—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements with possibility of relative movement between the prosthetic parts
- A61F2002/30523—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements with possibility of relative movement between the prosthetic parts by means of meshing gear teeth
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30518—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements with possibility of relative movement between the prosthetic parts
- A61F2002/30523—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements with possibility of relative movement between the prosthetic parts by means of meshing gear teeth
- A61F2002/30525—Worm gears
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
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- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
- A61F2002/3055—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting length
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
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- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30601—Special structural features of bone or joint prostheses not otherwise provided for telescopic
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- A—HUMAN NECESSITIES
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- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
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- A61F2002/30891—Plurality of protrusions
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4637—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for connecting or disconnecting two parts of a prosthesis
- A61F2002/4638—Tools for performing screwing, e.g. nut or screwdrivers, or particular adaptations therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0017—Angular shapes
Abstract
Description
Die Erfindung betrifft einen Wirbelersatzkörper mit ei nem eine erste Kontaktfläche zur Anlage an einen be nachbarten Wirbelkörper umfassenden Grundkörper und mit einem eine zweite Kontaktfläche zur Anlage an einen be nachbarten Wirbelkörper umfassenden Distraktionskörper, wobei der Grundkörper ein erstes Distraktionsgewinde und der Distraktionskörper ein zum ersten Distraktions gewinde korrespondierendes zweites Distraktionsgewinde zum Relativbewegen des Grundkörpers und des Distrakti onskörpers in einer Distraktionsrichtung umfaßt, wobei das erste Distraktionsgewinde am Grundkörper um eine zur Distraktionsrichtung parallele Distraktionsdrehach se rotierbar gelagert ist und wobei das zweite Distrak tionsgewinde drehfest am Distraktionskörper angeordnet ist.The invention relates to a vertebral replacement body with egg nem a first contact surface for contact with a be neighboring vertebral body and with a a second contact surface for contact with a be neighboring distraction body, the base body having a first distraction thread and the distraction body to the first distraction corresponding second distraction thread for the relative movement of the body and the distracti body in a distraction direction, wherein the first distraction thread on the body by one Distraction rotation parallel to the direction of distraction se is rotatably mounted and the second distrak tion thread rotatably arranged on the distraction body is.
In Folge einer Fraktur der Wirbelsäule oder zur Behand lung von Tumoren werden häufig ein oder mehrere Wirbel körper entfernt. Als Wirbelersatzkörper ausgebildete Implantate dienen dann dazu, den aufgrund der Entfer nung entstandenen Substanzverlust im wesentlichen aus zugleichen und die ursprüngliche axiale Stabilität der Wirbelsäule wiederherzustellen. As a result of a spinal fracture or for treatment Tumors often become one or more vertebrae body removed. Trained as a vertebral replacement body Implants are then used because of the distance loss of substance essentially arises equalize and the original axial stability of the To restore spine.
Ein Wirbelersatzkörper der eingangs beschriebenen Art ist beispielsweise aus der DE 196 22 827 A1 bekannt. Er besteht aus einem hülsenförmigen Grundkörper, in dem längsverschieblich ein hülsenförmiger Distraktionskör per gelagert ist. Zum Erzeugen einer Relativbewegung ist ein Gewindering vorgesehen, der mit einem auf dem Distraktionskörper vorgesehenen Außengewinde ver schraubbar ist und gleichzeitig am Grundkörper anliegt. Zum Distrahieren wird der Gewindering gedreht.A vertebral replacement body of the type described in the introduction is known for example from DE 196 22 827 A1. He consists of a sleeve-shaped body in which a sleeve-shaped distraction body is stored by. To generate a relative movement a threaded ring is provided, which with a on the Distraction body provided external thread ver is screwable and at the same time abuts the base body. The threaded ring is turned for distraction.
Ein Nachteil dieses Wirbelersatzkörpers ist es, daß zum Drehen des Gewinderings ein relativ großer Operations zugang erforderlich ist, denn ein Operateur muß entwe der den Gewindering mit der Hand bewegen oder mit einem Werkzeug in dafür vorgesehene Werkzeugaufnahmen ein greifen, die in radialer Richtung des Gewinderings an geordnet sind.A disadvantage of this vertebral replacement body is that Turning the threaded ring is a relatively large operation Access is required because an operator must either who move the threaded ring by hand or with one A tool in the designated tool holders attack in the radial direction of the threaded ring are ordered.
Daher ist es Aufgabe der vorliegenden Erfindung, einen Wirbelersatzkörper der eingangs beschriebenen Art so zu verbessern, daß die beiden Kontaktflächen besonders einfach voneinander weg bewegt werden können.It is therefore an object of the present invention to Vertebral replacement bodies of the type described at the beginning improve that the two contact surfaces especially can be easily moved away from each other.
Diese Aufgabe wird erfindungsgemäß dadurch gelöst, daß eine Getriebeeinheit vorgesehen ist zum Antreiben einer Rotation des ersten Distraktionsgewindes.This object is achieved in that a gear unit is provided for driving a Rotation of the first distraction thread.
Mit einer solchen Getriebeeinheit ist es möglich, ein Antriebsdrehmoment auf das erste Distraktionsgewinde zu übertragen, und zwar, indem das Antriebsdrehmoment in beliebiger Richtung in das Getriebe eingeleitet wird. Auf diese Weise kann bei besonders kleinen Operations zugängen der Wirbelersatzkörper auf einfache Weise di strahiert werden. Darüber hinaus ist es möglich, bei Kenntnis des Über- oder Untersetzungsverhältnisses des Getriebes, eine Distraktionskraft zu ermitteln. Ferner besitzt ein solcher Wirbelersatzkörper gegenüber dem in der DE 196 22 827 A1 beschriebenen den Vorteil, daß ei ne Verringerung des Kontaktflächenabstandes gezielt durch eine gegenläufige Rotation des ersten Distrakti onsgewindes ermöglicht, und nicht nur allein durch auf die von den benachbarten Wirbelkörpern auf die Kontakt flächen ausgeübten Kräfte bewirkt wird.With such a gear unit, it is possible to Drive torque to the first distraction thread transmitted, by the drive torque in is initiated in any direction in the transmission. In this way, especially small operations access of the vertebral replacement body in a simple way di be extracted. In addition, it is possible to Knowledge of the gear ratio of the Gearbox to determine a distraction force. Further has such a vertebral replacement body compared to the in DE 196 22 827 A1 described the advantage that egg targeted reduction of the contact surface distance by counter-rotating the first distracti ons thread and not only by on that of the neighboring vertebral bodies on the contact forces exerted on surfaces.
Günstig ist es, wenn die Getriebeeinheit ein erstes, am Grundkörper um eine Antriebsachse rotierbar gelagertes Antriebselement zur Einleitung eines Antriebsdrehmo ments und ein zweites, mit dem ersten Distraktionsge winde drehfest verbundenes, um die Distraktionsdrehach se gelagertes, direkt oder indirekt vom ersten An triebselement angetriebenes Antriebselement umfaßt. Ei ne solche Ausgestaltung erleichtert das Einleiten eines Antriebsdrehmoments, beispielsweise über eine Antriebs element, die insbesondere bei minimalinvasiven chirur gischen Eingriffen vorzugsweise flexibel ausgestaltet ist, um insbesondere einen möglichst kleinen Operati onszugang zu eröffnen. Bei rotierenden Antriebselemen ten läßt sich darüber hinaus eine Distraktionskraft be sonders einfach berechnen.It is advantageous if the gear unit a first, on Base body mounted rotatably about a drive axis Drive element for initiating a drive torque and a second one, with the first distraction area winch rotatably connected to the distraction swivel se stored, directly or indirectly from the first drive element comprises driven drive element. egg Such an arrangement facilitates the initiation of a Drive torque, for example via a drive element, particularly in minimally invasive surgery Interventions preferably designed flexibly is, in particular, to operate as small as possible open access. With rotating drive elements A distraction force can also be used easy to calculate.
Grundsätzlich kann vorgesehen sein, daß die Getriebe einheit ein Winkelgetriebe umfaßt und daß die Antriebs achse und die Distraktionsdrehachse einen von 0 oder 180 Grad abweichenden Winkel einschließen. Mit einer derartigen Getriebeeinheit kann das Antriebsdrehmoment quasi um die Ecke herum gelenkt werden. Dies ermöglicht das Einleiten eines Antriebsdrehmoments unter einem be liebigen Winkel bezogen auf eine Längsachse des Wirbel ersatzkörpers.Basically, it can be provided that the gear Unit includes an angular gear and that the drive axis and the distraction axis of rotation one of 0 or Include an angle of 180 degrees. With a Such a gear unit can drive torque be directed around the corner. this makes possible the initiation of a drive torque under a be arbitrary angle related to a longitudinal axis of the vertebra spare body.
Vorzugsweise weist der eingeschlossene Winkel einen Wert von 90 Grad auf. Das erforderliche Antriebsdrehmo ment kann somit senkrecht zur Distraktionsrichtung ein geleitet werden. Dadurch ist für einen späteren Distraktions- oder aber auch Entnahmevorgang des Wir belersatzkörpers lediglich ein sehr kleiner Operations zugang erforderlich, um eine Antriebswelle einzuführen.The included angle preferably has a Value of 90 degrees. The required drive torque can therefore be perpendicular to the direction of distraction be directed. This is for a later one Distraction or removal process of the we only a very small operation access required to insert a drive shaft.
Vorteilhafterweise umfaßt das erste Antriebselement ei ne Antriebsschnecke und das zweite Antriebselement ein an die Antriebsschnecke angepaßtes Schneckenzahnrad. Durch ein solches Schneckengetriebe kann insbesondere bei Vorsehung einer Gewindespindel zwischen dem Grund körper und dem Distraktionskörper, eine sehr hohe Un tersetzung erreicht werden, so daß durch geringe An triebsdrehmomente hohe Distraktionskräfte erzielt wer den können.The first drive element advantageously comprises egg ne drive screw and the second drive element worm gear adapted to the drive worm. Such a worm gear can in particular if a threaded spindle is provided between the bottom body and the distraction body, a very high Un translation can be achieved so that by low An driving torques high distraction forces achieved that can.
Gemäß einer bevorzugten Ausführungsform der Erfindung kann vorgesehen sein, daß die Getriebeeinheit zwischen dem ersten und dem zweiten Antriebselement untersetzt ist. Auf diese Weise können durch geringe Antriebs drehmomente große Distraktionskräfte übertragen werden.According to a preferred embodiment of the invention can be provided that the gear unit between the first and the second drive element is. In this way, by low drive large distraction forces are transmitted.
Günstig ist es, wenn das erste Antriebselement eine in Richtung der Antriebsachse weisende Antriebswellenauf nahme aufweist. Damit lassen sich Antriebsdrehmomente direkt in Richtung der Antriebsachse in die Getriebe einheit einleiten. It is expedient if the first drive element has an in Drive shafts pointing in the direction of the drive axis shows. This allows drive torques directly in the direction of the drive axis in the gearbox initiate unit.
Grundsätzlich kann die Antriebswellenaufnahme beliebig ausgebildet sein, beispielsweise auch durch einen Vor sprung. Günstig ist es jedoch, wenn die Antriebswellen aufnahme einen Innensechskant umfaßt. Somit kann auch mit einem herkömmlichen Sechskantschlüssel die Getrie beeinheit angetrieben werden.Basically, the drive shaft holder can be any be formed, for example by a pre Leap. However, it is favorable if the drive shafts Includes a hexagon socket. So can also the gearbox with a conventional hexagon wrench be unit driven.
Denkbar wäre es, das erste Distraktionsgewinde in Form eines Innengewindes und das zweite Distraktionsgewinde in Form eines Außengewindes auszubilden. Vorteilhaft ist es jedoch, wenn ein Spindelantrieb mit einer Gewin despindel und mit einer Gewindehülse vorgesehen ist und wenn die Gewindespindel das erste Distraktionsgewinde in Form eines Außengewindes und wenn die Gewindehülse das zweite Distraktionsgewinde in Form eines Innenge windes umfaßt. Diese Anordnung macht es möglich, daß die beiden Kontaktflächen bei einer Relativbewegung in Distraktionsrichtung nicht gegeneinander verdreht wer den. Eine solche Anordnung ist der oben beschriebenen kinematischen Umkehrlösung mit einer angetriebenen Ge windehülse gegenüber gleichwertig.It would be conceivable to shape the first distraction thread an internal thread and the second distraction thread to form in the form of an external thread. Advantageous it is, however, when a spindle drive with a win despindel and is provided with a threaded sleeve and if the lead screw is the first distraction thread in the form of an external thread and if the threaded sleeve the second distraction thread in the form of an internal thread includes winds. This arrangement makes it possible for the two contact surfaces during a relative movement in Distraction direction not twisted against each other the. Such an arrangement is that described above kinematic reversal solution with a driven Ge equivalent to wind sleeve.
Grundsätzlich kann es vorteilhaft sein, wenn mindestens ein Sicherungselement zum Fixieren einer Relativpositi on zwischen dem Grundkörper und dem Distraktionskörper vorgesehen ist. Damit kann ein vom Operateur einge stellter Abstand zwischen den beiden Kontaktflächen ge gen ein unerwünschtes Zusammenschieben oder Auseinan derziehen gesichert werden.In principle, it can be advantageous if at least a securing element for fixing a relative position on between the base body and the distraction body is provided. This can be used by the surgeon distance between the two contact surfaces an undesirable pushing together or apart be secured.
Vorzugsweise wird das mindestens eine Sicherungselement durch eine Klemmschraube zum Sichern der beiden Di straktionsgewinde gebildet. Damit läßt sich eine Rela tivposition der beiden Distraktionsgewinde direkt si chern.The at least one securing element is preferably with a clamping screw to secure the two di traction thread formed. With this a Rela tive position of the two distraction threads directly si manuals.
Bei einer anderen bevorzugten Ausführungsform kann vor gesehen sein, daß das mindestens eine Sicherungselement durch einen Deckel zum Fixieren des ersten Antriebsele ments gebildet wird. Diese indirekte Sicherung hat zu sätzlich den Vorteil, daß auch das Antriebselement ge schützt und je nach Ausgestaltung der Getriebeeinheit, verschlossen werden kann.In another preferred embodiment, before be seen that the at least one securing element through a cover for fixing the first drive element is formed. This indirect backup has too additional the advantage that the drive element ge protects and, depending on the design of the gear unit, can be locked.
Um einen optimalen Heilungsprozeß zu gewährleisten, ist es günstig, wenn die Kontaktflächen jeweils eine im we sentlichen anatomisch angepaßte, konvex gewölbte Form aufweisen.To ensure an optimal healing process is it is favorable if the contact surfaces each one in the we considerable anatomically adapted, convex shape exhibit.
Um ein Verwachsen der Kontaktflächen mit den benachbar ten Wirbelkörpern zu verbessern und ein seitliches Aus treten des Wirbelersatzkörpers aus der Wirbelsäule zu verhindern, ist es günstig, wenn die Kontaktflächen im wesentlichen in Distraktionsrichtung abstehende Fixie rungsvorsprünge aufweisen.In order for the contact surfaces to grow together with the neighboring ones ten vertebral bodies to improve and a lateral extension the vertebral replacement body comes out of the spine prevent it is favorable if the contact surfaces in the Fixie protruding essentially in the direction of distraction have projections.
Gemäß einer weiteren bevorzugten Ausführungsform der Erfindung kann vorgesehen sein, daß am Grundkörper min destens ein Führungselement und am Distraktionskörper mindestens ein korrespondierendes Führungsglied vorge sehen sind, die eine Bewegung des Distraktionskörpers relativ zum Grundkörper in Distraktionsrichtung führen. Dadurch wird die Stabilität des Wirbelersatzkörpers insgesamt erhöht, insbesondere eine Rotation des Di straktionskörpers relativ zum Grundkörper kann auf die se Weise verhindert werden.According to a further preferred embodiment of the Invention can be provided that min preferably a guide element and on the distraction body featured at least one corresponding leader are seeing a movement of the distraction body lead relative to the base body in the direction of distraction. This improves the stability of the vertebral body overall increased, especially a rotation of the Di traction body relative to the base body can on the be prevented.
Dabei ist es günstig, wenn das mindestens eine Füh rungselement eine im wesentlichen zylindrische Hülse und wenn das mindestens eine Führungsglied eine im we sentlichen zylindrische Säule umfaßt, wobei der Innen durchmesser der Hülse und der Außendurchmesser der Säu le so gewählt sind, daß eine im wesentlichen spielfreie und reibungsfreie Translationsbewegung in Distsrakti onsrichtung ermöglicht wird. Eine zylindrische Säule und eine korrespondierende Hülse lassen sich besonders einfach herstellen und verringern gleichzeitig die Ge fahr eines Verkantens von Führungselement und Führungs glied.It is beneficial if at least one foot tion element a substantially cylindrical sleeve and if the at least one leader is one in the we substantial cylindrical column, the inside diameter of the sleeve and the outer diameter of the column le are chosen so that an essentially backlash-free and smooth translation movement in Distsrakti direction is made possible. A cylindrical column and a corresponding sleeve can be special easy to manufacture and at the same time reduce the Ge driving a tilting of the guide element and guide element.
Nachfolgende Beschreibung dient im Zusammenhang mit der Zeichnung der näheren Erläuterung. Es zeigen:The following description serves in connection with the Drawing of the detailed explanation. Show it:
Fig. 1 eine Explosionsdarstellung eines Wirbeler satzkörpers; Figure 1 is an exploded view of a vortex set body.
Fig. 2 eine Seitenansicht des in Fig. 1 dargestell ten Wirbelersatzkörpers; Fig. 2 is a side view of the vertebra replacement body shown in Fig. 1;
Fig. 3 eine weitere Seitenansicht des in Fig. 1 dargestellten Wirbelersatzkörpers mit teil weiser Querschnittsansicht; und . Fig. 3 is a further side view of the vertebral replacement body shown in Figure 1 with part wise cross-sectional view; and
Fig. 4 eine Querschnittsansicht längs Linie 4-4 in Fig. 2. Fig. 4 is a cross sectional view taken along line 4-4 in Fig. 2.
In den Fig. 1 bis 4 ist ein insgesamt mit dem Be zugszeichen 10 versehenes Implantat dargestellt, das als Wirbelersatzkörper zwischen zwei benachbarte Wir belkörper 12 und 14 eingesetzt werden kann. Es besteht im wesentlichen aus zwei Teilen, nämlich einem Grund körper 16 und einem Distraktionselement 18, die jeweils ein Anlageelement 20 beziehungsweise 22 aufweisen, wel che voneinander weg weisend eine gewölbte, im wesentli chen durch einen Zylinderoberflächenausschnitt gebilde te Kontaktflächen 24 beziehungsweise 26 aufweisen, die mit einer Vielzahl aneinander angrenzender Vorsprünge in Form von quadratischen Pyramiden 28 bedeckt sind.In FIGS. 1 to 4, a total of reference symbols with the Be implant 10 provided is illustrated as adjacent vertebral replacement body between two We can be used belkörper 12 and 14. It consists essentially of two parts, namely a base body 16 and a distraction element 18 , each having an abutment element 20 or 22 , which face away from each other an arched, essentially by a cylinder surface cutout te contact surfaces 24 and 26 , respectively are covered with a plurality of adjacent projections in the form of square pyramids 28 .
Am Anlageelement 20 des Grundkörpers 16 ist eine eine Rotationsachse senkrecht zur Kontaktfläche 24 aufwei sende Spindelhülse 30 angeordnet, in der eine Gewinde spindel 32 rotierbar, aber in Längsrichtung derselben unverschieblich, gelagert ist. Die Rotationsachse defi niert dabei die Distraktionsrichtung. An ihrem dem An lageelement 20 zugewandten Ende ist an der Gewindespin del 32 ein Schneckenrad 34 drehfest angeordnet. An die ses schließt sich ein glatter zylindrischer Schaftab schnitt 36 an, dessen äußerer Durchmesser kleiner ist als der Außendurchmesser des Schneckenrads 34. Auf etwa zwei Drittel ihrer Gesamtlänge ist die Gewindespindel 32 an den Schaftabschnitt 36 anschließend mit einem Au ßengewinde 38 versehen, das zu einem Innengewinde 40 einer senkrecht vom Anlageelement 22 abstehenden Di straktionshülse 42 korrespondiert. Der Außendurchmesser der Distraktionshülse 42 ist unwesentlich kleiner als der Innendurchmesser der Spindelhülse 30, so daß die beiden Hülsen 30 und 42 gegenseitig eine Führung in Richtung ihrer Symmetrieachsen bilden, die im wesentli chen senkrecht zu den Kontaktflächen 24 und 26 orien tiert sind.On the contact element 20 of the base body 16 is a rotational axis perpendicular to the contact surface 24 aufwei sending spindle sleeve 30 is arranged, in which a threaded spindle 32 is rotatable, but is non-displaceable in the longitudinal direction thereof. The axis of rotation defines the direction of distraction. At its end facing element 20, a worm wheel 34 is arranged in a rotationally fixed manner on the threaded spindle del 32 . A smooth cylindrical shaft section 36 adjoins this, the outer diameter of which is smaller than the outer diameter of the worm wheel 34 . On about two thirds of its total length, the threaded spindle 32 on the shaft portion 36 is then provided with an external thread 38 which corresponds to an internal thread 40 of a vertical protruding sleeve 42 projecting from the contact element 22 . The outer diameter of the distraction sleeve 42 is insignificantly smaller than the inner diameter of the spindle sleeve 30 , so that the two sleeves 30 and 42 mutually form a guide in the direction of their axes of symmetry, which are oriented essentially perpendicular to the contact surfaces 24 and 26 .
Parallel zur Distraktionshülse 42 sind am Distraktions element 18 symmetrisch Zylinderstäbe 44 und 46 angeord net, und zwar derart, daß sie jeweils in eine Führungs hülse 48 beziehungsweise 50 des Grundkörpers 16 eintau chen können. Die beiden Führungshülsen 48 und 50 gren zen mit ihren Außenflächen an die Spindelhülse 30 an. Im Verbindungsbereich ist quer zu den Symmetrieachsen der Führungshülsen 48 und 50 zwischen diesen und der Spindelhülse jeweils ein langlochförmiger Schlitz 52 beziehungsweise 54 angeordnet. Durch diesen kann bei eingesetztem Implantat 10 Spongiosagewebe hindurchwach sen und eine knöcherne Verwachsung des Implantats 10 mit den benachbarten Wirbelkörpern bilden.Parallel to the distraction sleeve 42 are on the distraction element 18 symmetrical cylinder rods 44 and 46 angeord net, in such a way that they can each dive into a guide sleeve 48 or 50 of the base body 16 . The two guide sleeves 48 and 50 limit the outer surfaces of the spindle sleeve 30 . In the connection area, an elongated slot-shaped slot 52 and 54 is arranged transversely to the axes of symmetry of the guide sleeves 48 and 50 between them and the spindle sleeve. With this implant, 10 cancellous tissue can pass through when the implant is inserted and form a bony overgrowth of the implant 10 with the adjacent vertebral bodies.
Um das Einwachsen des Implantats 10 zusätzlich zu ver bessern, ist das Anlageelement 20 mit die Spindelhülse 30 halbkreisförmig umgebenden Durchgangsbohrungen 68 versehen.In order to improve the ingrowth of the implant 10 in addition to ver, the contact element 20 is provided with the spindle sleeve 30 semicircular surrounding bores 68 .
Die Führungshülsen 48 und 50 gehen in Richtung auf das Anlageelement 20 hin in eine quer zu deren Längsachse verlaufenden Getriebekasten 56 über, der eine im we sentlichen halbzylindrische Außenfläche aufweist. Im Getriebekasten 56 ist frei rotierbar eine Gewinde schnecke 58 gelagert, die auf nahezu ihrer gesamten Länge mit einem an das Schneckenrad 34 angepaßten Schneckengewinde 60 versehen ist. Der in seinem Inneren hohlzylindrisch ausgeformte Getriebekasten 56 weist ein offenes Ende 62 auf, über das ein mit einem Innensechs kant 64 versehener Kopf 66 der Gewindeschnecke 58 zu gänglich ist.The guide sleeves 48 and 50 merge in the direction of the contact element 20 into a gear box 56 which runs transversely to the longitudinal axis thereof and which has an essentially semicylindrical outer surface. In the gear box 56 is free to rotate a threaded screw 58 which is provided on almost its entire length with an adapted to the worm wheel 34 worm thread 60th The gearbox 56 , which is hollow-cylindrical in its interior, has an open end 62 , via which a head 66 of the screw worm 58 provided with a hexagon socket 64 is accessible.
Das freie Ende 62 des Getriebekastens 56 kann mit einem nicht dargestellten Deckel verschlossen werden, der in den Innensechskant 64 der Gewindeschnecke 58 eingreift und diese blockiert.The free end 62 of the gearbox 56 can be closed with a cover, not shown, which engages in the hexagon socket 64 of the threaded screw 58 and blocks it.
Zum Einsetzen des Implantats 10 wird dieses zunächst so vorbereitet, daß die beiden Kontaktflächen 24 und 26 den geringsten Abstand voneinander aufweisen. Bei einem minimal invasiven Eingriff reicht zum Einführen des Im plantats 10 ein Operationszugang, der im wesentlichen dem Außendurchmesser einer der Kontaktflächen 24 oder 26 entspricht. Das Implantat 10 wird zwischen zwei Wir belkörper 12 und 14 eingesetzt, und über eine in den Innensechskant 64 eingesetzte Antriebswelle 70 wird die Gewindeschnecke angetrieben. Dadurch wird die Gewinde spindel 32 in Drehung versetzt, was zu einer Translati onsbewegung des Distraktionselements 18 relativ zum Grundkörper 16 in Distraktionsrichtung führt. Die An triebswelle 70 kann von Hand oder motorisch angetrieben werden, sie kann insbesondere auch flexibel ausgestal tet sein.To insert the implant 10 , it is first prepared in such a way that the two contact surfaces 24 and 26 are at the smallest distance from one another. In the case of a minimally invasive intervention, an operation access that essentially corresponds to the outer diameter of one of the contact surfaces 24 or 26 is sufficient to insert the implant 10 . The implant 10 is inserted between two belbodies 12 and 14 , and the threaded screw is driven via a drive shaft 70 inserted into the hexagon socket 64 . As a result, the threaded spindle 32 is set in rotation, which leads to a translational movement of the distraction element 18 relative to the base body 16 in the distraction direction. At the drive shaft 70 can be driven by hand or by motor, it can in particular also be flexibly designed.
Sind die beiden Wirbelkörper 12 und 14 in der gewünsch ten Weise mittels des Implantats 10 voneinander distra hiert, wird der Getriebekasten 56 mit einem Deckel ver schlossen und so die Relativposition zwischen den Anla geelementen 20 und 22 fixiert. Are the two vertebral bodies 12 and 14 distra hated from each other in the desired manner by means of the implant 10 , the gearbox 56 is closed with a cover ver and so the relative position between the Anla geelemente 20 and 22 fixed.
Die Schlitze 52 und 54 werden mit Spongiosagewebe durchfüttert, ebenso freie Abschnitte zwischen den Zy linderstäben 44, 46 und der Distraktionshülse 42.The slots 52 and 54 are lined with cancellous tissue, as well as free sections between the cylinder rods 44 , 46 and the distraction sleeve 42nd
Über eine Messung des angeleiteten Antriebsdrehmoments, beispielsweise über einen Drehmomentschlüssel, läßt sich direkt bei Kenntnis des Untersetzungsverhältnisses von Gewindeschnecke 58, Schneckenrad 34 und Gewinde spindel 32 eine Distraktionskraft ermitteln.By measuring the guided drive torque, for example using a torque wrench, a distraction force can be determined directly with knowledge of the reduction ratio of the screw worm 58 , worm wheel 34 and threaded spindle 32 .
Claims (16)
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
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DE10127924A DE10127924C1 (en) | 2001-06-08 | 2001-06-08 | Spinal vertebra replacement prosthetic has base body and distraction body provided with cooperating distraction threads for adjustment of relative spacing between their contact surfaces |
DE20109599U DE20109599U1 (en) | 2001-06-08 | 2001-06-08 | Spine replacement body |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
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DE10127924A DE10127924C1 (en) | 2001-06-08 | 2001-06-08 | Spinal vertebra replacement prosthetic has base body and distraction body provided with cooperating distraction threads for adjustment of relative spacing between their contact surfaces |
DE20109599U DE20109599U1 (en) | 2001-06-08 | 2001-06-08 | Spine replacement body |
Publications (1)
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DE10127924C1 true DE10127924C1 (en) | 2002-12-19 |
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DE20109599U Expired - Lifetime DE20109599U1 (en) | 2001-06-08 | 2001-06-08 | Spine replacement body |
DE10127924A Expired - Fee Related DE10127924C1 (en) | 2001-06-08 | 2001-06-08 | Spinal vertebra replacement prosthetic has base body and distraction body provided with cooperating distraction threads for adjustment of relative spacing between their contact surfaces |
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Cited By (10)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP1459710A2 (en) * | 2003-03-15 | 2004-09-22 | Ulrich GmbH & Co. KG | Implant for insertion between two vertebral bodies of the spine |
WO2004100837A1 (en) * | 2003-05-14 | 2004-11-25 | Kilian Kraus | Height-adjustable implant to be inserted between vertebral bodies and corresponding handling tool |
EP1491165A1 (en) * | 2003-06-23 | 2004-12-29 | Franz Rennebaum | Vertebral prosthesis |
DE10324108B3 (en) * | 2003-05-21 | 2005-01-27 | Aesculap Ag & Co. Kg | Backbone implant is inserted with contracted contact disc which is expanded to optimum area following insertion |
WO2005055887A3 (en) * | 2003-12-11 | 2005-08-25 | Deltacor Gmbh | Length-adjustable implant for the vertebral column |
WO2010120782A2 (en) * | 2009-04-13 | 2010-10-21 | Biospine, Llc | Variable height intervertebral devices and methods for use |
US8292963B2 (en) | 2009-04-23 | 2012-10-23 | Warsaw Orthopedic, Inc. | Expandable implant for supporting skeletal structures |
US8992617B2 (en) | 2007-03-13 | 2015-03-31 | DePuy Synthes Products, LLC | Adjustable intervertebral implant |
US9700425B1 (en) | 2011-03-20 | 2017-07-11 | Nuvasive, Inc. | Vertebral body replacement and insertion methods |
US9808354B2 (en) | 2014-01-17 | 2017-11-07 | Stryker European Holdings I, Llc | Implant insertion tool |
Families Citing this family (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US7018415B1 (en) * | 2002-09-23 | 2006-03-28 | Sdgi Holdings, Inc. | Expandable spinal fusion device and methods of promoting spinal fusion |
CA2508666C (en) * | 2002-12-06 | 2011-02-15 | Synthes (U.S.A.) | Intervertebral implant |
DE10361166A1 (en) * | 2003-12-22 | 2005-07-28 | Meisel, Jörg, Dr. | Component for a prosthesis, especially a cervica vertebra, comprises two base parts coupled together by a hinge |
Citations (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE19622827A1 (en) * | 1996-06-07 | 1997-12-11 | Ulrich Heinrich | Implant to be inserted between the vertebral body as a placeholder |
-
2001
- 2001-06-08 DE DE20109599U patent/DE20109599U1/en not_active Expired - Lifetime
- 2001-06-08 DE DE10127924A patent/DE10127924C1/en not_active Expired - Fee Related
Patent Citations (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE19622827A1 (en) * | 1996-06-07 | 1997-12-11 | Ulrich Heinrich | Implant to be inserted between the vertebral body as a placeholder |
Cited By (19)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP1459710A2 (en) * | 2003-03-15 | 2004-09-22 | Ulrich GmbH & Co. KG | Implant for insertion between two vertebral bodies of the spine |
EP1459710A3 (en) * | 2003-03-15 | 2004-12-29 | Ulrich GmbH & Co. KG | Implant for insertion between two vertebral bodies of the spine |
WO2004100837A1 (en) * | 2003-05-14 | 2004-11-25 | Kilian Kraus | Height-adjustable implant to be inserted between vertebral bodies and corresponding handling tool |
US8568482B2 (en) | 2003-05-14 | 2013-10-29 | Kilian Kraus | Height-adjustable implant to be inserted between vertebral bodies and corresponding handling tool |
DE10324108B3 (en) * | 2003-05-21 | 2005-01-27 | Aesculap Ag & Co. Kg | Backbone implant is inserted with contracted contact disc which is expanded to optimum area following insertion |
EP1491165A1 (en) * | 2003-06-23 | 2004-12-29 | Franz Rennebaum | Vertebral prosthesis |
US7909870B2 (en) | 2003-12-11 | 2011-03-22 | Tpl - Kilian Kraus | Height-adjustable spinal implant and operating instrument for the implant |
US8267998B2 (en) | 2003-12-11 | 2012-09-18 | Kilian Kraus | Operating instrument for a height-adjustable spinal implant |
WO2005055887A3 (en) * | 2003-12-11 | 2005-08-25 | Deltacor Gmbh | Length-adjustable implant for the vertebral column |
US8992617B2 (en) | 2007-03-13 | 2015-03-31 | DePuy Synthes Products, LLC | Adjustable intervertebral implant |
WO2010120782A3 (en) * | 2009-04-13 | 2010-12-23 | Biospine, Llc | Variable height intervertebral devices and methods for use |
WO2010120782A2 (en) * | 2009-04-13 | 2010-10-21 | Biospine, Llc | Variable height intervertebral devices and methods for use |
US8840669B2 (en) | 2009-04-13 | 2014-09-23 | Biomet Spine, Llc | Variable height intervertebral devices and methods for use |
US8292963B2 (en) | 2009-04-23 | 2012-10-23 | Warsaw Orthopedic, Inc. | Expandable implant for supporting skeletal structures |
US9700425B1 (en) | 2011-03-20 | 2017-07-11 | Nuvasive, Inc. | Vertebral body replacement and insertion methods |
US10485672B2 (en) | 2011-03-20 | 2019-11-26 | Nuvasive, Inc. | Vertebral body replacement and insertion methods |
US11389301B2 (en) | 2011-03-20 | 2022-07-19 | Nuvasive, Inc. | Vertebral body replacement and insertion methods |
US9808354B2 (en) | 2014-01-17 | 2017-11-07 | Stryker European Holdings I, Llc | Implant insertion tool |
US10433982B2 (en) | 2014-01-17 | 2019-10-08 | Stryker European Holdings I, Llc | Implant insertion tool |
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