EP1572040A2 - Implant utilise pour des operations de rigidification de la colonne vertebrale - Google Patents

Implant utilise pour des operations de rigidification de la colonne vertebrale

Info

Publication number
EP1572040A2
EP1572040A2 EP03810989A EP03810989A EP1572040A2 EP 1572040 A2 EP1572040 A2 EP 1572040A2 EP 03810989 A EP03810989 A EP 03810989A EP 03810989 A EP03810989 A EP 03810989A EP 1572040 A2 EP1572040 A2 EP 1572040A2
Authority
EP
European Patent Office
Prior art keywords
hollow body
implant according
implant
elastomer
containers
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.)
Withdrawn
Application number
EP03810989A
Other languages
German (de)
English (en)
Inventor
Fritz Magerl
Roger Stadler
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Sepitec Foundation
Original Assignee
Sepitec Foundation
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
Priority claimed from DE2002153169 external-priority patent/DE10253169A1/de
Application filed by Sepitec Foundation filed Critical Sepitec Foundation
Publication of EP1572040A2 publication Critical patent/EP1572040A2/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • 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
    • A61F2/442—Intervertebral or spinal discs, e.g. resilient
    • 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
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
    • A61F2/4465—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages having a circular or kidney shaped cross-section substantially perpendicular to the axis of the spine
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    • 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 for implanting artificial joints
    • A61F2/4603—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4611—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
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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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    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
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    • A61F2/441—Joints for the spine, e.g. vertebrae, spinal discs made of inflatable pockets or chambers filled with fluid, e.g. with hydrogel
    • 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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    • A61F2/02—Prostheses implantable into the body
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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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    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30112—Rounded shapes, e.g. with rounded corners
    • A61F2002/30133—Rounded shapes, e.g. with rounded corners kidney-shaped or bean-shaped
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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
    • A61F2002/30426—Bayonet coupling
    • 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
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30507—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a threaded locking member, e.g. a locking screw or a set screw
    • 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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    • 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
    • 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
    • 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
    • A61F2230/0004—Rounded shapes, e.g. with rounded corners
    • A61F2230/0015—Kidney-shaped, e.g. bean-shaped

Definitions

  • the invention relates to an implant for use in stiffening operations on the spine.
  • Such an implant is referred to in medical technology as a cage, which is used in stiffening operations on the spine after the intervertebral disc has been cleared into the intervertebral space.
  • the implant is filled with bone or bone replacement material taken from the patient.
  • hollow cages there are also a few full cages.
  • UP anterior lumbar interbody fusion
  • PLIF posterior lumbar interbody fusion
  • intervertebral discs are always removed. It is also not uncommon for vertebral bodies to be removed in whole or in part. The resilience of the vertebral body column must therefore be restored in any case. This can happen, for example, with pressure-resistant bone chips removed from the patient and clamped between the vertebral bodies. However, the load capacity of such chips is often uncertain. Because the availability of suitable bone chips is also limited and the morbidity caused by chip removal is considerable, place of autogenous bone chips increasingly made of metal or other materials flameproof implants. In technical terms, the implant is called a cage.
  • One or two implants are used per intervertebral disc space. If two implants are inserted from behind through two separate openings in the intervertebral disc ring, one speaks of a biportal implantation. With a uniportal implantation, the intervertebral disc ring is only opened at one point.
  • An intervertebral implant functions as a pressure-absorbing placeholder, which stabilizes the spinal fusion, ensures the position of the vertebral bodies relative to one another and ensures that a solid bone bridge can form between the vertebral bodies.
  • Bone or bone substitute material filled into and / or deposited around the implants forms the matrix for new bone formation.
  • the stability of the spinal fusion plays a crucial role in the ossification process. Movements occurring within the spinal fusion delay or prevent bony consolidation. Pedicle systems or translaminar screw connections are used for additional stabilization of the spondylodesis.
  • the distraction also has a mechanical meaning:
  • the accompanying stretching of the soft tissues generates a force that jams the intervertebral implants between the vertebral bodies. This prevents movement conditions within the spinal fusion and also reduces the risk of secondary implant dislocation, which can have serious consequences.
  • Cages can be implanted from the front in all areas of the spine (ALIF), and also from the back on the lumbar spine (PLIF).
  • ALIF lumbar spine
  • bone or bone substitute material is inserted between two or more vertebral bodies (interbody spondylodesis) or attached over the posterior vertebral elements of two or more vertebrae (dorsal spondylodesis). Over the course of several months, this creates a bony bridge that connects the vertebrae and thus eliminates the instability that causes pain.
  • the prerequisite for ossification is that the relevant section of the spine is immobilized until the bone bridge is sufficiently firm.
  • the reduced vertical distances between the vertebral bodies due to narrowing of the intervertebral discs must also be normalized and axis deviations of the spine eliminated. Since the increase in vertical vertebral body distance through instrumentally induced “distraction" has a strong decompressing effect on both the nerve structures and the intervertebral joints, distraction is always an essential part of the procedure.
  • a cage The purpose of a cage is to act as a pressure-absorbing placeholder, which ensures that the vertebral bodies grow together in the desired position. The latter happens through newly formed bones, which creates a bony bridge between the vertebral bodies. Bone or bone substitute material filled in and / or deposited around cages serves as a matrix for bone formation. The ossification process takes several months depending on various factors. The stability of the spinal fusion plays a crucial role because repetitive movements between the cage and the vertebral bodies can greatly delay or prevent the bony development of the spinal fusion. Surgical stiffening This section of the spine is called spinal fusion. Pain, spinal cord or nerve root compressions that cannot be influenced by conservative treatment measures as well as malpositions are indications for spondylodesis.
  • An essential requirement for the surgical technique is to normalize reduced distances between the vertebral bodies or to eliminate vertebral displacements.
  • increasing the intervertebral distance has a not insignificant mechanical meaning:
  • the tension in the paravertebral soft tissues associated with the spreading of the vertebral bodies generates a counterforce that presses the vertebral bodies onto the cage and clamps it between the vertebral bodies. This prevents harmful movements between the cage and the vertebral bodies and reduces the risk of secondary cage dislocation, which can have serious consequences.
  • the object of the invention is therefore to simplify the technique of cage implantation and thus, as well as to reduce the need for surgical trauma due to the simpler use of less invasive surgical techniques.
  • the implant is formed by a circumferentially closed hollow body made of at least two boxes, one inside the other, open towards one another and telescopically movable, which can be pressed apart by introducing filler material or by using a filling made of an elastomer. to expand the hollow body. cause.
  • An expandable hollow body (cage) has thus been created which, in a relatively small size, that is to say when the containers are pushed together, can be effortlessly inserted into the intervertebral space or other defect in the vertebral body column, where it can then be expanded to the required size.
  • only one can be implanted instead of the usual two cages. The previously otherwise necessary expansion process is thus carried out by the hollow body itself.
  • An elastic intervertebral implant has also been created by the invention in order to promote the bony development of the spinal fusion by reducing both the stress differences occurring in the contact zone of the bone and the formation of new bones by the elasticity or reduction of the stress shielding "is stimulated.
  • the implant also extends the vertical vertebral body distance.
  • the difference between the elasticity of the bone and that of the implant can play a significant role.
  • the bone of the vertebral body is elastically more deformable than the implants made of metal or polymer. For this reason, stress peaks occur in the contact zone of the bone among the thousands of daily changes in stress, which can cause microfractures in the bone of the contact zone as a result of material fatigue.
  • the damaged bone is then broken down and replaced with connective tissue. This replacement can be recognized radiologically from a more or less wide brightening hem surrounding the cage.
  • the replacement of the solid bone with soft connective tissue leads to loosening of the cage (implant) or to instability of the spinal fusion. As a result of the instability, the formation of the bony bridge between the vertebral bodies can also be omitted; H. Pseudarthrosis can occur. This is tantamount to treatment failure.
  • the described process is intensified if the spondylodesis is not completely stable a priori, ie if movements between the vertebral bodies and the implant are possible from the start. If the vertebral body z. B. can move slightly away from the implant when tilted backwards, the tension in the bone drops to zero. Because in In such a case, the stresses can rise from zero to the maximum, the stress differences responsible for the fatigue fractures become particularly large.
  • the present invention now creates an elastic hollow body (HK) for restoring the spinal column (WS) stability, which can be used in the context of intercorporeal spondylodesis between the vertebral bodies in the intervertebral disc space or in defects of the vertebral body column (WkS).
  • the hollow body consists of two parts inserted into each other like a box and is filled with a tissue-compatible elastomer.
  • the hollow body (cage) according to the invention is thus designed in such a way that it meets the biomechanical requirements even when only one cage is implanted. This and the telescopic principle greatly simplify the technique of cage implantation, especially that of minimally invasive and uniportal.
  • the container can be connected to a feed hose. A proper supply of the filling material can thus be ensured as soon as the container is inserted. In addition, access is only required from one side (just from behind).
  • the supply hose can be connected at its other end to a device for generating the necessary filling pressure.
  • connection hole for the supply tube can also be used at the same time for the insertion of the hollow body, in order to thereby secure the implantation to accomplish.
  • an instrument for inserting the hollow body can be attached to the bore provided for connecting the feed hose.
  • the filling material is formed from a material that is compatible with the tissue, remains liquid or self-hardening after a liquid phase.
  • the pressure required for the expansion of the container can thus be exerted precisely with the material which is the best solution for the application.
  • the hollow body is structured or coated on a part or on its entire surface.
  • the containers forming the hollow body are sealed against one another, then filler material can be effectively prevented from escaping from the containers.
  • the containers forming the hollow body are mutually adjustable, this adjustment movement being limited to an area that always ensures mutual overlap of the containers. This also ensures that filling material can escape from the containers unintentionally.
  • the elastomer is filled into the inner part of the hollow body.
  • the elastomer thus has the purely the function of forming the desired elasticity, so that the elastomer never comes into direct contact with the area surrounding the implant.
  • the elastomer completely or partially fills the hollow body. Variations can also be created, including with different areas of different elasticity.
  • the elastomer should preferably Completely fill the interior of the implant with elastomer to prevent gas or liquid from being pressed out or drawn into the implant during loading and unloading.
  • the elastomer filled into the hollow body it is also possible for the elastomer filled into the hollow body to rest loosely or firmly and sealingly on the inner side walls of the hollow body.
  • a cavity is left between the elastomer and the lower wall of the container of the hollow body which is inserted into one another in a box-like manner.
  • a hermetically sealed gas bubble is incorporated in the elastomer. This means a very simple and also structurally very effective configuration for increasing the elasticity.
  • a device for example in the form of a clamping screw, be attached to the hollow body in order to allow the hollow body, which was compressed to a reduced height before the implantation, to expand after the implantation.
  • This facilitates the implantation and can also increase the vertical vertebral body distance (distraction).
  • the intervertebral implant receives a preload, which keeps the implant in constant contact with the vertebral body and reduces the harmful voltage differences.
  • a configuration is proposed in which the outer container of the box-like hollow body has a wedge-shaped insertion end. This can significantly improve the distracting effect.
  • the implant be made of metal, polymer or a composite material.
  • a constructive design of the implant according to the invention is per se possible in various ways.
  • An advantageous embodiment is given, however, when the pressure-absorbing parts of the hollow body have the shape of a low cylinder or prism, with flat or slightly curved base plates and cover plates which are parallel to one another or slightly inclined towards one another.
  • the implant can also be implanted in a simple manner, it is proposed that it be designed to attach an implantation instrument. This ensures that the implant itself is properly gripped and inserted.
  • An advantageous embodiment further provides that the surface of the implant is structured and / or coated. This also ensures optimal positional securing of the implant in the implanted position and better integration into the bony implant bed.
  • FIG. 1 shows a section through a section of a spine, the use of an implant in the form of an expandable hollow body (cage) being evident;
  • FIG. 2 shows a basic drawing of the pressure-resistant implant according to the invention
  • FIG. 3 shows a side view of the implant seen from the same side as in FIG. 2, the two containers of the implant designed as a hollow body being shown pulled apart;
  • FIG. 4 shows a view of the implant from above, a connection element for a supply line also being shown, as in FIG. 3;
  • FIG. 5 shows an oblique view of the implant with a connected insertion instrument
  • Fig. 6 is an oblique view of a special embodiment of the implant with a wedge-shaped introducer.
  • FIG. 7 shows a section of an intervertebral disc space with an inserted implant of another embodiment
  • FIG. 8 shows a section through the implant used according to FIG. 7 in a simplified representation
  • FIGS. 9 and 10 show sections through an implant in the simplified representation, the compressed position being shown once and the expanded position being shown once;
  • FIG. 11 and 12 show sections through an implant in a simplified representation, the compressed position being shown once and the expanded position being shown once, and a hermetically sealed gas bubble being provided as an additional elastic element;
  • FIG. 13 shows an oblique view of a special further embodiment of an implant.
  • An implant in the form of a flameproof hollow body 1 for use in stiffening operations on the spine 2 should, after the intervertebral disc (s) and / or after partial or total resection of vertebral bodies, be moved ventrally or dorsally into the ent existing defect can be used and expanded to the required size in the implanted position.
  • This hollow body 1 is formed from at least two boxes 3 and 4, which are inserted into one another in a box-like manner and face each other, and which fit exactly into one another, so that a corresponding pressure build-up in the hollow body is also possible in order to achieve the necessary expansion pressure.
  • the pressure build-up is achieved by introducing filler material into the interior 13, whereby the two containers 3 and 4 are pressed apart and thus cause the hollow body 1 to expand in the vertical direction.
  • the hollow body 1 is used in the pushed-together state of the two containers 3 and 4, possibly with the aid of an instrument 5 connected to the cage opening for the feed.
  • the cage In the pushed-together state, the cage has relatively small dimensions.
  • the filling material is pressed from a vessel with a device for generating pressure through a removable feed hose 6 or another feed line with the required pressure into the hollow body 1.
  • the thus expanding hollow body 1 completely fills the defect, extends the distance between the vertebral bodies and generates the counterpressure required for jamming the cage.
  • the filling material must be perfectly compatible with the tissue and be so viscous that it flows well through the feed tube 6 but cannot escape from the cage.
  • Possible fillers are a tissue-compatible liquid medium or a tissue-compatible material that is cold-curing itself and after the liquid phase.
  • a non-return valve attached to the cage is required to prevent the filler from flowing back, as well as a sealing screw with which the feed opening on the gage can also be closed. If a self-curing material is used, the feed tube is twisted off the gage after the polymer has cured.
  • Part of the bone or bone replacement material is deposited in the defect before the cage is introduced, so that it finally comes to rest in front of the cage.
  • the other part is plugged next to and behind the cage after removing the supply hose. This ensures that a sufficiently strong bone bridge can form around the cage.
  • the feed hose 6 can be connected to the hollow body 1 in various ways. For example, it is possible to plug or screw on a connector 7 attached to the cage. A type of bayonet lock or direct connection or screwing of the connection to the cage would also be conceivable. When using a hardening material, it must be ensured that the feed hose 6 can be removed after the material has hardened.
  • the opening 8 of the cage for fastening the supply tube 6 can also be used to attach an instrument 5 which is suitable for inserting the cage into the defect.
  • the material from which the hollow body itself is formed can in principle be varied: metal, polymer or a composite material. It would also be conceivable to also manufacture the cage itself from bone substitute material or from a self-dissolving material, so that it is finally also replaced by bone. The latter assumes that a perfectly tissue-compatible and resorbable medium was used as the filling material.
  • the surface of the containers can be structured or coated in whole or in part.
  • a device which prevents the cage halves from being pressed apart too much.
  • This device can e.g. B. consist of a pin or a screw 9, which / which is fixed in the outer part of the cage and engages in a groove 9 'of the inner container 4. It would also be possible to have one or more sealing rings in the manner of piston seals that run parallel to the end plates of the cage and which, when the maximum permitted expansion is reached, abut against a strip or other elements of the inner surface of the outer container 3.
  • the essential features of the invention lie in particular in the design of a telescopically vertical, possibly also radially expandable cage consisting of at least two containers for stabilizing the vertebral body column.
  • the force required for expansion is generated by filling material pressed into the hollow body (cage).
  • the filling material is pressed into the cage from a pressure-generating device via a feed hose attached to the cage.
  • Tissue-compatible liquid and, after a liquid phase, self-hardening materials can be used as filling material. Suitable antibiotics can be added to the filling material to reduce the risk of infection.
  • the containers (cage parts) must fit exactly together or be sealed in such a way that no filling material can escape. Devices are provided which limit the expandability of the cage in such a way that the contact surfaces of the cage containers are always sufficiently large and in particular prevent the containers from being pushed apart completely.
  • An instrument 5 for inserting the cage into the defect can also be connected to the bore for the feed.
  • the surfaces of the cage containers can be structured or coated.
  • the cage after filling, does not contain any dead spaces in which bacteria could accumulate.
  • the cage can be implanted ventrally or dorsally into the defect in the area of the spinal column.
  • one or more uni or biportal cages can be used to stabilize the spine.
  • the cage (the hollow body) essentially has the following devices and features:
  • the implant is cylindrical or bean-shaped (see in particular FIGS. 4 to 6).
  • the upper and lower surfaces of the containers 3 and 4 are slightly curved both in the direction of the longer and in the direction of the shorter diameter.
  • the ends of the part with the longer diameter are each of the same height.
  • the front wall of the part is slightly lower than the rear wall.
  • a supplementary structural design can be equipped with a wedge-shaped insertion part 10 arranged at one end of the container 3. As a result, an effect that expands this space can be achieved even when it is introduced into the disc space.
  • the part of the implant opposite the insertion part 10 is rounded and has the bore 8 for receiving the instrument 5, which implantation of the cage can be used.
  • the following devices are provided to facilitate the rotation of the implant into the definitive transverse position: from the transition of the insertion part 10 into the container 3, the upper and lower front edges 11 of the implant are sharp-edged.
  • the front edges 12 are gradually rounded towards the end of the implant opposite the insertion part 10.
  • the implant therefore begins to rotate in the desired transverse direction as soon as it is inserted. Due to the rod-shaped insertion instrument 5 attached to its rear end, the implant is initially additionally steerable. The instrument 5 is removed as soon as it has reached the limit of the insertion opening and can no longer be pivoted further. The implant is then hammered in by a ram attached to its rear end and simultaneously rotated into the final position.
  • Such implants can basically be used in all areas of the spine: on the cervical, thoracic and lumbar spine from the front, and on the lumbar spine also uniportally or biportally from the rear, from the side or from the side.
  • a prerequisite for the applicability is that the shape of the two containers is specially designed according to the anatomical conditions of the intended implantation site (region of the spine) as well as the intended implantation technique.
  • the implant is designed as a hollow body 1 filled with an elastomer 12, the hollow body 1 consisting of at least two containers 3 and 4 which are inserted into one another in a box-like manner and telescopically movable in the longitudinal axis of the body.
  • the elastomer 12 is filled into the inner container of the implant, this elastomer 12 completely or partially filling the hollow body 1.
  • the elastomer 12 lies loosely or firmly and sealingly on the inner side walls of the container 4 of the hollow body 1.
  • the inner surfaces of the upper wall 16 and the lower wall 15 of the containers 3 and 4 of the implant are designed in such a way that they can penetrate into the elastomer 12 when loaded.
  • a cavity can either be left under the elastomer 12, ie between the elastomer 12 and the lower wall 15 of the implant, or, as can be seen in the embodiment according to FIGS. 11 and 12, a hermetically sealed gas bubble 17 can be inserted into it Elastomer 12 can be incorporated.
  • a device is attached to the implant, e.g. B. in the form of a clamping screw 18, which makes it possible for the implant compressed to a reduced height before the implantation to expand only after the implantation, that is to say after the clamping screw 18 has been loosened. So that the area of expansion cannot lead too far, the end of the clamping screw 18 engages in a slot 19 (see FIG. 13), so that the pushing of the container 4 out of the container 3 of the hollow body 1 is limited to a certain extent.
  • the outer container 3 of the implant can have a wedge-shaped insertion part 10.
  • such an intervertebral implant with a wedge end consists of two parts. This is shown by way of example in FIG. 8.
  • the two parts are the container 3 with the wedge-shaped insertion part 10 and the container 4 of the implant.
  • the shape of the two containers depends on the area of the spine and the technique with which the implant is to be used.
  • the containers have the following basic shape: it is a blunt, wedge-shaped insertion part 10, which has its base continuously attached to that side of the container 3 with which the implant is inserted into the intervertebral disc space.
  • the upper and lower surface of the insertion part 10 are flat and inclined in such a way that the wedge height decreases from the wedge base to the wedge end.
  • the end of the wedge opposite the wedge base is vertical in the side view and rounded in the top view.
  • the pressure-receiving containers 3 and 4 can have the shape of a low cylinder or prism, with flat or slightly curved, parallel or parallel Base and cover plates slightly inclined towards each other.
  • the implants can have a device for attaching an implantation instrument.
  • the surfaces of the implants can be structured and / or coated.
  • the elastic intervertebral implants can consist of metal, polymer or composite material.
  • radiological shading elements or materials are incorporated into the implants.
  • the hollow body 1 it is possible to form the hollow body 1 from more than two boxes 3 and 4 inserted one into the other in a box-like manner. It would be conceivable, e.g. to form the container 4 from a plurality of subareas which can be moved separately and elastically relative to the container 3. It would then also be possible to completely or partially fill the different partial areas with elastomers of different elasticity.
  • the implant according to the invention After possibly extending the intervertebral disc space or the defect with a suitable instrument (for example, a pair of spreading pliers), the height of the vertical vertebral body distance is measured and the implant selected that is compressed (reduced in height) Condition is still insertable into the disc space.
  • the implant is pressed or hammered into the intervertebral disc space, possibly with the help of an implantation instrument attached to it.
  • the clamping screw 18 is loosened so that the implant can expand in the vertical direction.
  • the implants In the case of uniportal dorsal or dorsolateral application technology, the implants must be rotated from the initial sagittal or oblique implantation direction to the frontal direction during the implantation, in particular if only one implant is inserted into the intervertebral disc space.
  • the desired jamming of the implant can be extremely difficult or impossible to rotate.
  • the uniportal intervertebral implant essentially has the following devices and features:
  • the implant has a bean shape (see in particular FIG. 13).
  • the top and The bottom surface of the containers 3 and 4 are slightly curved both in the direction of the longer and in the direction of the shorter diameter.
  • the longer diameter ends of the container are each of the same height.
  • the front wall of the container is slightly lower than the rear wall.
  • the section of the implant opposite the insertion part 10 is rounded and can have a device for receiving an instrument, which can be used for clamping and implantation.
  • the following devices are provided to facilitate the rotation of the implant: From the transition of the insertion part 10 into the container 3, the upper and lower front edges of the implant are sharp-edged. The front edges are gradually rounded towards the end of the implant opposite the insertion part 10. On the upper and lower surface of the container 3, incisions running parallel to the front edges can be made against the part 10, the rear surface of which is perpendicular to the respective surface and the front surface of which runs flat against the surface of the implant. These cuts act as guide grooves.
  • the implant therefore begins to rotate in the desired direction as soon as it is inserted.
  • the implant is initially additionally steerable by means of a rod-shaped insertion instrument attached to its rear end, which can also function as a clamping screw 18.
  • the instrument is removed as soon as it has reached the limit of the insertion opening and can no longer be pivoted.
  • the implant is then hammered in by a ram attached to its rear end and simultaneously rotated into the final position.
  • Such intervertebral implants can basically be used in all areas of the spine: on the cervical, thoracic and lumbar spine from the front, and on the lumbar spine additionally uni- or biportally from behind, from the side or from the side behind.
  • the prerequisite for the applicability is that the shape of the two implant parts corresponds to the anatomical conditions of the intended implantation site (region the spine) as well as the intended implantation technique.
  • a further spring element could be provided in a cavity between the lower wall 15 of the container 3 and the inserted and filled container 4 filled with elastomer 12 in order to increase the elasticity of the entire implant increase.
  • a spring element in the form of a spiral, helical or leaf spring is possible, or a further insert in the form of an elastomer could be provided, which possibly has a different elasticity than the elastomer 12 in the container 4.
  • the elastomer 12 itself has the effect of a spring, it would in principle also be possible, and to be classified under the term elastomer, to design this elastomer itself as a spring, so that instead of a filling made of an elastomeric filler, one or more spiral, helical or leaf springs (s) can be used.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Neurology (AREA)
  • Transplantation (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Cardiology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Prostheses (AREA)

Abstract

La présente invention concerne un implant se présentant sous la forme d'un corps creux (1) résistant à la compression, utilisé pour des opérations de rigidification de la colonne vertébrale (2). Le corps creux (1) est constitué de deux réservoirs ouverts (3, 4) dirigés l'un vers l'autre qui s'emboîtent et forment le véritable implant (boîtier). Les deux réservoirs (3, 4) peuvent être séparés par compression grâce à l'introduction de matière de remplissage, et ainsi produire une expansion du corps creux (1) après son implantation.
EP03810989A 2002-11-14 2003-11-14 Implant utilise pour des operations de rigidification de la colonne vertebrale Withdrawn EP1572040A2 (fr)

Applications Claiming Priority (5)

Application Number Priority Date Filing Date Title
DE2002153169 DE10253169A1 (de) 2002-11-14 2002-11-14 Implantat zum Einsatz bei Versteifungsoperationen an der Wirbelsäule
DE10253170A DE10253170A1 (de) 2002-11-14 2002-11-14 Druckfester Hohlkörper zum Einsatz bei Versteifungsoperationen an der Wirbelsäule
DE10253170 2002-11-14
DE10253169 2002-11-14
PCT/EP2003/012762 WO2004043304A2 (fr) 2002-11-14 2003-11-14 Implant utilise pour des operations de rigidification de la colonne vertebrale

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EP1572040A2 true EP1572040A2 (fr) 2005-09-14

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EP03810989A Withdrawn EP1572040A2 (fr) 2002-11-14 2003-11-14 Implant utilise pour des operations de rigidification de la colonne vertebrale

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US (1) US20060116767A1 (fr)
EP (1) EP1572040A2 (fr)
JP (1) JP2006506116A (fr)
AU (1) AU2003301949A1 (fr)
CA (1) CA2505926A1 (fr)
DE (1) DE10253170A1 (fr)
WO (1) WO2004043304A2 (fr)

Families Citing this family (52)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CA2363254C (fr) 1999-03-07 2009-05-05 Discure Ltd. Procede et appareil de chirurgie informatisee
ATE489919T1 (de) * 2004-02-13 2010-12-15 Jun Franz Copf Zwischenwirbelimplantat zur spondylodese der lendenwirbelsäule
DE102004057977B3 (de) * 2004-11-30 2006-08-10 Mtm Medizin Technik Mauk Gmbh Implantat für die Endoprothetik
US8506629B2 (en) * 2005-01-28 2013-08-13 Advanced Medical Technologies Ag Implant for transforaminal interbody fusion
US20070050034A1 (en) * 2005-05-24 2007-03-01 Schwardt Jeffrey D Low-compliance expandable medical device
US7988735B2 (en) * 2005-06-15 2011-08-02 Matthew Yurek Mechanical apparatus and method for delivering materials into the inter-vertebral body space for nucleus replacement
US8070813B2 (en) 2005-09-26 2011-12-06 Coalign Innovations, Inc. Selectively expanding spine cage, hydraulically controllable in three dimensions for vertebral body replacement
US9028550B2 (en) 2005-09-26 2015-05-12 Coalign Innovations, Inc. Selectively expanding spine cage with enhanced bone graft infusion
US7985256B2 (en) * 2005-09-26 2011-07-26 Coalign Innovations, Inc. Selectively expanding spine cage, hydraulically controllable in three dimensions for enhanced spinal fusion
FR2894808B1 (fr) * 2005-12-20 2009-02-06 Spineart Sa Sa Espaceur discal anatomique et ses applications
US7794501B2 (en) * 2006-04-27 2010-09-14 Wasaw Orthopedic, Inc. Expandable intervertebral spacers and methods of use
US7731752B2 (en) * 2006-07-21 2010-06-08 Warsaw Orthopedic, Inc. Implant with nested members and methods of use
US20080058931A1 (en) * 2006-07-21 2008-03-06 John White Expandable vertebral implant and methods of use
US8715350B2 (en) 2006-09-15 2014-05-06 Pioneer Surgical Technology, Inc. Systems and methods for securing an implant in intervertebral space
EP2066267A4 (fr) * 2006-09-15 2013-03-06 Pioneer Surgical Technology Inc Systemes et procedes pour dimensionner, inserer et fixer un espace intervertebral d'un implant
US8377133B2 (en) * 2006-09-15 2013-02-19 Pioneer Surgical Technology, Inc. Systems and methods for sizing, inserting and securing an implant in intervertebral space
US7972382B2 (en) * 2006-12-26 2011-07-05 Warsaw Orthopedic, Inc. Minimally invasive spinal distraction devices and methods
US20080161928A1 (en) * 2006-12-27 2008-07-03 Warsaw Orthopedic, Inc. Compliant intervertebral prosthetic devices with motion constraining tethers
US20100087924A1 (en) * 2007-01-05 2010-04-08 University Of Virginia Patent Foundation Expandable Intervertebral Prosthesis Device for Posterior Implantation and Related Method Thereof
US20080183292A1 (en) * 2007-01-29 2008-07-31 Warsaw Orthopedic, Inc. Compliant intervertebral prosthetic devices employing composite elastic and textile structures
MX2009007197A (es) * 2007-03-07 2009-10-13 Ulrich Gmbh & Co Kg Implante intervertebral con componente elastico.
US8323345B2 (en) * 2008-02-14 2012-12-04 U.S. Spine, Inc. Anterior lumbar interbody fusion cage device and associated method
US8932355B2 (en) * 2008-02-22 2015-01-13 Coalign Innovations, Inc. Spinal implant with expandable fixation
US20100145455A1 (en) * 2008-12-10 2010-06-10 Innvotec Surgical, Inc. Lockable spinal implant
US12232975B2 (en) 2008-02-22 2025-02-25 Howmedica Osteonics Corp. Lockable spinal implant
US8696751B2 (en) * 2008-12-10 2014-04-15 Coalign Innovations, Inc. Adjustable distraction cage with linked locking mechanisms
US8992620B2 (en) 2008-12-10 2015-03-31 Coalign Innovations, Inc. Adjustable distraction cage with linked locking mechanisms
US8267939B2 (en) 2008-02-28 2012-09-18 Stryker Spine Tool for implanting expandable intervertebral implant
WO2009137506A1 (fr) * 2008-05-05 2009-11-12 Pioneer Surgical Technology, Inc Dispositif de disque intervertébral artificiel à conservation de mouvement
US9028553B2 (en) 2009-11-05 2015-05-12 DePuy Synthes Products, Inc. Self-pivoting spinal implant and associated instrumentation
EP2547292B1 (fr) 2010-03-16 2019-04-24 Pinnacle Spine Group, LLC Implants intervertébraux et systèmes d'implantation d'un greffon
US9320610B2 (en) 2011-08-16 2016-04-26 Stryker European Holdings I, Llc Expandable implant
US9380932B1 (en) 2011-11-02 2016-07-05 Pinnacle Spine Group, Llc Retractor devices for minimally invasive access to the spine
US10022245B2 (en) 2012-12-17 2018-07-17 DePuy Synthes Products, Inc. Polyaxial articulating instrument
US10342675B2 (en) 2013-03-11 2019-07-09 Stryker European Holdings I, Llc Expandable implant
AU2014201372B2 (en) * 2013-03-13 2018-07-19 Vb Spine Us Opco Llc Selectively expanding spine cage with enhanced bone graft infusion
WO2014159739A1 (fr) 2013-03-14 2014-10-02 Pinnacle Spine Group, Llc Implants intersomatiques et systèmes de pose de greffe
EP3073969B1 (fr) 2013-11-27 2023-08-16 Howmedica Osteonics Corp. Élément d'insertion de support structural pour cage de spondylodèse
US9486327B2 (en) 2014-05-15 2016-11-08 Globus Medical, Inc. Standalone interbody implants
US11160666B2 (en) 2014-05-15 2021-11-02 Globus Medical, Inc. Laterally insertable intervertebral spinal implant
US9968461B2 (en) 2014-05-15 2018-05-15 Globus Medical, Inc. Standalone interbody implants
US9545320B2 (en) 2014-05-15 2017-01-17 Globus Medical, Inc. Standalone interbody implants
US10548738B2 (en) 2016-04-07 2020-02-04 Howmedica Osteonics Corp. Expandable interbody implant
AU2017203369B2 (en) 2016-05-20 2022-04-28 Vb Spine Us Opco Llc Expandable interbody implant with lordosis correction
AU2017228529B2 (en) 2016-09-12 2022-03-10 Vb Spine Us Opco Llc Interbody implant with independent control of expansion at multiple locations
AU2017251734B2 (en) 2016-10-26 2022-10-20 Vb Spine Us Opco Llc Expandable interbody implant with lateral articulation
US10966843B2 (en) 2017-07-18 2021-04-06 DePuy Synthes Products, Inc. Implant inserters and related methods
US11045331B2 (en) 2017-08-14 2021-06-29 DePuy Synthes Products, Inc. Intervertebral implant inserters and related methods
JP7521152B2 (ja) 2017-09-08 2024-07-24 エクスタント メディカル ホールディングス，インコーポレイテッド． 椎間インプラント、器具、及び方法
EP3456294B1 (fr) 2017-09-15 2024-06-05 Stryker European Operations Holdings LLC Dispositif de fusion de corps intervertébraux expansé à l'aide d'un matériau durcissable
USD907771S1 (en) 2017-10-09 2021-01-12 Pioneer Surgical Technology, Inc. Intervertebral implant
CN116019538B (zh) * 2023-03-29 2023-06-23 中国人民解放军联勤保障部队第九二〇医院 一种高位胫骨截骨术用植入体

Family Cites Families (32)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CH640131A5 (en) * 1979-10-03 1983-12-30 Sulzer Ag Complete intervertebral prosthesis
CA1146301A (fr) * 1980-06-13 1983-05-17 J. David Kuntz Disque intervertebral prosthetique
US4309777A (en) * 1980-11-13 1982-01-12 Patil Arun A Artificial intervertebral disc
US4517844A (en) * 1983-06-03 1985-05-21 Steven Powell Fluid damping device for a compliant system
CH671691A5 (fr) * 1987-01-08 1989-09-29 Sulzer Ag
JPH01136655A (ja) * 1987-11-24 1989-05-29 Asahi Optical Co Ltd 人工椎間板
DE8807485U1 (de) * 1988-06-06 1989-08-10 Mecron Medizinische Produkte Gmbh, 1000 Berlin Endoprothese der Zwischenwirbelscheibe
US5545229A (en) * 1988-08-18 1996-08-13 University Of Medicine And Dentistry Of Nj Functional and biocompatible intervertebral disc spacer containing elastomeric material of varying hardness
DE3922203C1 (de) * 1989-07-06 1990-10-25 Martin Nolde Chirurgisches Instrument zur Implantation einer Bandscheibenkernprothese
US5236460A (en) * 1990-02-12 1993-08-17 Midas Rex Pneumatic Tools, Inc. Vertebral body prosthesis
DE4417629B4 (de) * 1993-06-24 2006-03-16 SDGI Holdings, Inc., Wilmington Implantat für den Ersatz von Wirbelkörpern
US5514180A (en) * 1994-01-14 1996-05-07 Heggeness; Michael H. Prosthetic intervertebral devices
EP0975288B1 (fr) * 1997-04-15 2002-10-02 Synthes AG Chur Prothese de vertebre telescopique
US6258126B1 (en) * 1997-09-09 2001-07-10 Depuy Orthopaedics, Inc. Cushioned joint prosthesis
US5980570A (en) * 1998-03-27 1999-11-09 Sulzer Carbomedics Inc. System and method for implanting an expandable medical device into a body
ATE268579T1 (de) * 1998-10-15 2004-06-15 Synthes Ag Teleskopierende wirbelprothese
US6193757B1 (en) * 1998-10-29 2001-02-27 Sdgi Holdings, Inc. Expandable intervertebral spacers
DE19856013A1 (de) * 1998-12-04 2000-06-08 Wittenstein Gmbh & Co Kg Distraktionsvorrichtung
FR2787018B1 (fr) * 1998-12-11 2001-03-02 Dimso Sa Prothese de disque intervertebral a enceinte de liquide
DE19902481A1 (de) * 1999-01-22 2000-07-27 Signus Medizintechnik Gmbh Wirbelsäulenersatzkörper
US6342074B1 (en) * 1999-04-30 2002-01-29 Nathan S. Simpson Anterior lumbar interbody fusion implant and method for fusing adjacent vertebrae
US6419704B1 (en) * 1999-10-08 2002-07-16 Bret Ferree Artificial intervertebral disc replacement methods and apparatus
JP2003501142A (ja) * 1999-06-04 2003-01-14 エスディージーアイ・ホールディングス・インコーポレーテッド 椎間板用人工移植部材
AU5701200A (en) * 1999-07-02 2001-01-22 Petrus Besselink Reinforced expandable cage
FR2797179B1 (fr) * 1999-08-03 2002-03-08 Michel Gau Prothese nucleaire intervertebrale et son procede chirurgical d'implantation
WO2002054978A2 (fr) * 1999-08-18 2002-07-18 Intrinsic Orthopedics Inc Dispositifs et procede permettant d'augmenter ou de conserver un noyau gelatineux
US6296665B1 (en) * 2000-03-20 2001-10-02 Electro-Biology, Inc. Method and apparatus for spinal fixation
AR027685A1 (es) * 2000-03-22 2003-04-09 Synthes Ag Forma de tejido y metodo para realizarlo
DE20017962U1 (de) * 2000-10-20 2001-01-04 Aesculap AG & Co. KG, 78532 Tuttlingen Wirbelersatzkörper
US7153304B2 (en) * 2000-12-29 2006-12-26 Zimmer Trabecular Metal Technology, Inc. Instrument system for preparing a disc space between adjacent vertebral bodies to receive a repair device
US6572619B2 (en) * 2001-02-23 2003-06-03 Albert N. Santilli Cage plate for spinal fusion and method of operation
DE10116412C1 (de) * 2001-04-02 2003-01-16 Ulrich Gmbh & Co Kg Implantat zum Einsetzen zwischen Wirbelkörper der Wirbelsäule

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See references of WO2004043304A2 *

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CA2505926A1 (fr) 2004-05-27
WO2004043304A3 (fr) 2004-07-08
WO2004043304A2 (fr) 2004-05-27
AU2003301949A8 (en) 2004-06-03
DE10253170A1 (de) 2004-06-03
US20060116767A1 (en) 2006-06-01
AU2003301949A1 (en) 2004-06-03
JP2006506116A (ja) 2006-02-23

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