EP1868509A1 - Instrument permettant de redresser un corps vertebral tasse - Google Patents

Instrument permettant de redresser un corps vertebral tasse

Info

Publication number
EP1868509A1
EP1868509A1 EP06724317A EP06724317A EP1868509A1 EP 1868509 A1 EP1868509 A1 EP 1868509A1 EP 06724317 A EP06724317 A EP 06724317A EP 06724317 A EP06724317 A EP 06724317A EP 1868509 A1 EP1868509 A1 EP 1868509A1
Authority
EP
European Patent Office
Prior art keywords
instrument
vertebral body
adjusting
lever
adjustable
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Withdrawn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
EP06724317A
Other languages
German (de)
English (en)
Inventor
Claudio Lamartina
Dirk Weidmann
Mathias Heller
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.)
Zimmer GmbH
Original Assignee
Zimmer GmbH
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Zimmer GmbH filed Critical Zimmer GmbH
Priority to EP06724317A priority Critical patent/EP1868509A1/fr
Publication of EP1868509A1 publication Critical patent/EP1868509A1/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/02—Surgical instruments, devices or methods for holding wounds open, e.g. retractors; Tractors
    • A61B17/025—Joint distractors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers, e.g. stabilisers comprising fluid filler in an implant
    • A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • A61B17/7076—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation
    • A61B17/7077—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation for moving bone anchors attached to vertebrae, thereby displacing the vertebrae
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/02—Surgical instruments, devices or methods for holding wounds open, e.g. retractors; Tractors
    • A61B17/025—Joint distractors
    • A61B2017/0256—Joint distractors for the spine

Definitions

  • the invention relates to an instrument and a method for erecting a buried vertebral body.
  • a vertebral body fracture is a fracture of a vertebral body of the spine. Such a fracture may, for example, be the result of an accident (traumatic vertebral body fracture) or osteoporosis-related.
  • traumatic vertebral body fracture traumatic vertebral body fracture
  • osteoporosis-related Several methods are known from the prior art for rebuilding a broken-in vertebral body.
  • vertebroplasty the patient, who is lying on the abdomen, is inserted into the affected vertebral body via a percutaneous transpedicular cannulation under X-ray control. To erect and stabilize the vertebral body, bone cement is then injected via the cannula. In this method, however, the buried vertebral body is usually not completely erected. In vertebroplasty, it may further be found that greater pressure is required on the bone cement, and consequently the injected one
  • Bone cement can escape through the fractured surfaces or the venous blood vessel system again.
  • kyphoplasty the patient lying on the abdomen undergoes a x-ray control and uses a cannula to insert a balloon catheter into the affected vertebral body via a percutaneous transpedicular cannulation.
  • a percutaneous transpedicular cannulation To erect the vertebral body of the balloon catheter is inflated with an X-ray contrast liquid. After draining the contrast fluid, the balloon catheter is removed.
  • the balloon catheter In which of the balloon Catheter-left cavity is then injected via the cannula bone cement to stabilize the vertebral body.
  • the broken-down vertebral body, to which the two adjacent vertebral bodies press is usually also not completely erected.
  • the balloon catheters required for kyphoplasty are also expensive.
  • lordoplasty has recently become more popular. This is a method which is shown in FIG. 6 and in which in the cranial and caudally adjacent vertebral bodies 73, 77 of the vertebral body to be treated 75 lever elements 63, 67 - in this example cannulas - are inserted and in particular cemented, which are used as lever arms to relieve them before injecting bone cement into the broken vertebral body 75.
  • lever elements 63, 67 - in this example cannulas - are inserted and in particular cemented, which are used as lever arms to relieve them before injecting bone cement into the broken vertebral body 75.
  • the original vertebral body height and spinal curvature can be restored at least approximately.
  • a balloon catheter is not necessary for this.
  • the needles bend comparatively strongly when levered, ie when compressed relative to one another, so that often the desired lever effect can at least not be achieved completely.
  • the cannulas can already touch each other without the desired relief for the buried vertebral body is reached.
  • the involved vertebral bodies are pressed together posteriorly and thus exposed there to an increased pressure, whereby bone pieces can be pressed into the nerve canal.
  • the surgeon's hands holding the lever arms or cannulae are held and in position, loaded with high radiation doses, since the operation takes place at least partially under X-ray control.
  • the lever elements can be cannulas, for example biopsy needles. Therefore, the lever elements are also referred to below as cannulas, the stated properties and advantages Ie principle for any type of lever elements applies.
  • the abutments can be arranged adjacent to the underside of the adjustable device. Furthermore, the abutments can protrude laterally from the adjustable device.
  • the spacer may comprise in one embodiment a base member and an adjustable relative to the base member adjustment, wherein at least one abutment with the base member and at least one abutment is connected to the Ver adjusting element.
  • the effective length of the spacer can be adapted to the mutual distance of the cannulas, in particular at the entry or exit points into and out of the skin.
  • the spacer can fix a mutual minimum distance between the cannulas.
  • the abutments provided for fixing the mutual spacing of the cannulas are also referred to below as distance holding means.
  • the spacer means of the base member may be associated with both the cranial cannula and the caudal cannula. The spacer means of the adjustment is then assigned according to the cannula of the other direction.
  • the spacer means may protrude to the left and / or right, in particular symmetrically from a center plane of the spacer of the base member and the adjusting element.
  • a distance-holding means can be provided in each case, which is designed as a continuous rod or the like and at the same time projects to the left and to the right.
  • two or more distance-retaining means may also be provided, of which at least one distance-retaining means projects to the left and at least one distance-retaining means projects to the right.
  • Spacer devices that protrude to the left and to the right are particularly suitable in cases where two lever elements, eg cannulas, are set for each adjacent vertebral body.
  • the adaptation to the mutual distance of the cannulas takes place in particular with non-actuated cannulas, i. before the cranial cannula and the caudal cannula are compressed relative to each other.
  • the distance between the cannulas, in particular on the skin or in the vicinity of the skin which is present when the cannulas are not actuated, can also be maintained by the spacer, even when the cannulas are actuated, i. in a state where the cannulas are compressed relative to each other. In this way it can be prevented that the involved vertebral bodies are pressed against each other posteriorly and each exposed to an increased pressure.
  • the instrument system disclosed herein comprises an instrument of the type specified herein as well as lever members, e.g. Cannulas, which can be introduced into the vertebral body and are provided for the distraction of the vertebral body which is cranially and caudally adjacent to a broken-in vertebral body.
  • lever members e.g. Cannulas
  • a method in which the instrument or instrument system specified here is used comprises introducing at least one device for introducing bone cement into the buried vertebral body and in each case at least one cranial and one caudal lever element in the cranially and caudally adjacent the fractured vertebral body Vortex bodies, the positioning of the instrument between the cranial lever element and the caudal lever element on the skin, whereby in the region of the abutment of the instrument, the mutual minimum distance of the lever elements is fixed, the compression of the lever elements relative to each other on the skin protruding areas, whereby a distraction of the cranial and causing caudal adjacent vertebral body and the buried vertebral body is relieved, and the introduction of bone cement into the buried vertebral body by the device for introducing bone cement.
  • the position of the adjusting element on the base element is aretrable.
  • the base element may have at least one longitudinally oriented longitudinal beam.
  • At least a portion of the base member may be formed in the manner of a frame having two side members arranged as side members. Due to the at least partial embodiment of the base element as a frame material and weight can be saved. In addition, can Space for the adjustment and / or the adjustment mechanism are created to allow a particularly compact design of the instrument.
  • elongated holes can be formed in the longitudinal members or side parts of the frame, in which the adjusting element is adjustably mounted.
  • At least one of the slots may have a plurality of locking positions.
  • the locking positions may be formed in the form of circular arc-shaped depressions in the longitudinal sides of the slot. In such a depression, a cross-sectionally at least partially circular executed element of the adjusting element can be stored stationary and immovable.
  • the adjusting element comprises an adjusting part and an operating part connected to the adjusting part, which is switchable between a release position and a blocking position relative to the adjusting part, wherein in particular the adjusting part and the operating part are hinged together.
  • the spacer In the release position of the control element, the spacer can be adjusted in its effective length along the adjusting device and then by transferring be locked in the blocking position with the set length.
  • the adjusting part In an articulated connection between the adjusting part and the operating part, it is possible that when the operating part is switched over, the adjusting part can remain stationary in its position.
  • the operating part can protrude through a frame slot formed in a frame of the base element between longitudinal members.
  • the operating part of the frame is bordered so to speak, so that a particularly compact design is possible.
  • the particular arcuate control panel can be rotationally rigidly connected to an axle mounted on the base element of the adjusting element.
  • the switching movement of the operating part between a release position and a blocking position can thus be a rotary movement. Since the axis is rotationally rigidly connected to the control panel, both the axis mounted on the base member and the control panel is rotated in a switching movement of the control panel.
  • At least one abutment or distance-holding means can be formed on the adjusting part, wherein the adjusting part is articulated to an axis of the adjusting element mounted on the base element, which corresponds in particular to the axis rotationally rigidly connected to the operating part.
  • the adjusting part can remain stationary in its position since the adjusting part is pivotally connected to the axle.
  • the axis is adjustably mounted in oblong holes, in particular in oblong holes of side parts or side rails of a frame of the base member.
  • the axis can be adjusted along the elongated holes.
  • the axle allows at least a portion of the Adjustment, in particular the operating part, is rotatable relative to the base member.
  • the axis can be flattened on two opposite sides, wherein it can be provided that the diameter of the axis substantially corresponds to the diameter of arcuate recesses in the longitudinal sides of a slot.
  • the flattened axis and thus the adjusting element can be fixedly locked to the base element and / or the lock can be released.
  • a stop element can be assigned to the abutment, which abutment is arranged adjacent to the upper side of the adjustable device, wherein the abutment elements in the longitudinal direction of the adjustable device at least in a locked position of an adjusting element of the adjustable device are arranged on the outside than the Abutment, such that the distance in the longitudinal direction between two abutments is smaller than that between two associated stop elements.
  • the base element has support means, which are arranged in particular at the same height as the support means of the adjustment.
  • the support means are provided for supporting the patch on the spacer handle parts, especially when a fixing device for fixing the distance between the handle parts is not yet mounted.
  • the operating part may comprise at least one support leg which is arranged outside a frame of the base element and which serves as a stop element.
  • the Abstützschenkel can be provided as a support point or support area for a handle part on the spacer can be placed and will be explained in more detail elsewhere.
  • the grip part is also referred to below as a guide part.
  • the adjusting part can be adjustable along a recess of the base element, which extends on the underside thereof. This may be advantageous, since the adjusting element is provided with a distance-retaining means, which is thereby positionable close to the skin and can fix the distance of the cannula directly at the point of entry into the skin. In particular, this makes it possible for the adjusting part to form part of the support surface of the spacer holder on the skin.
  • a handle part or guide part can be provided for a cranial and a caudal lever element, which can be placed on the adjustable device such that the guide part provides a contact surface for the respective lever element.
  • the guide parts can each be formed like a blade.
  • the gripping parts can each have a plate-like base section, which in particular slits centrally for placement on the spacer and / or for lateral guidance the lever element is provided with lateral abutment boundaries.
  • the central slot allows the base section to also extend in the attached state of the grip part to the left and to the right of the spacer, so that a contact surface is available to the lever element over as large a portion as possible.
  • the lateral restraints prevent the lever member from escaping to the left or right when levered to avoid the pressure of the handle portion or the base portion.
  • the handle parts may each have a particular S-shaped actuating portion, wherein in the mounted state, the actuating portions have a greater distance from one another than base portions of the handle parts.
  • the handle parts can be actuated via the operating sections.
  • the distance of the actuating portions may be greater than the distance of the base portions.
  • the handle parts can be connected to one another via an adjustable fixing device, in particular an adjusting screw and / or a nut.
  • an adjustable fixing device in particular an adjusting screw and / or a nut.
  • At least one grip part can have an insertion slot, through which the fixing device can be inserted into the grip part.
  • the adjusting screw in particular together with a nut, can be pivoted to a certain extent into this relative to the handle part.
  • the insertion slot may be partially formed in a base portion and partially in an actuation portion of the handle portion, wherein the formed in the operating portion of the insertion slot may allow the passage of the nut.
  • the method set forth herein may include, after positioning the instrument on the skin and before compressing the lever members, translating the effective length of the instrument to the distance between a cranial and a caudal lever member at the exit site from the skin an adjusting element is adjusted relative to a base element, and that a loading part of the adjusting element is switched from a release position to a locked position relative to an adjusting part of the adjusting element.
  • the method may comprise - after the positioning of the instrument on the skin - a guide part between the bone cement introduction device and a stop element assigned to the abutment of the instrument being introduced cranially and caudally, and the guide parts are placed on the adjustable device of the instrument are placed such that in each case the guide part provides a contact surface for the lever element. Further, the method may include compressing the guide members relative to one another to compress the portions of the lever members protruding from the skin relative to each other.
  • the method may comprise - after the compression of the lever elements - the distance between the guide parts is fixed by means of an adjustable fixing device.
  • the method may include providing means for introducing bone cement as lever elements and - before compressing - bone cement is introduced into the immediately cranially and caudally adjacent vertebral bodies by the corresponding means for introducing bone cement.
  • the introduction of bone cement can be done by injection.
  • FIG. 1 is a perspective view of a spacer of an instrument specified here
  • FIG. 2 shows perspective views of components of the spacer shown in FIG. 1 (adjustable device), FIG.
  • FIG. 3 perspective views of handle parts (guide parts) of an instrument specified here
  • 4 shows different views of an instrument specified here with the spacer (adjustable device) of FIG. 1 and the grip parts (guide parts) of FIG. 3, FIG.
  • Fig. 5 shows a further embodiment of an instrument specified here, wherein additionally cannulas (lever elements) are shown, which are set in the broken and the immediately adjacent vertebral bodies, and
  • Fig. 6 is an illustration of a known from the prior art surgical procedure.
  • FIG. 1 shows a spacer 11 of an instrument or instrument system for erecting a buried vertebral body 75, which is shown in FIG. 6 only in connection with a surgical procedure known from the prior art.
  • the spacer comprises a base element 13, which is additionally shown in Fig. 2a, and a multi-part adjusting element 15, the individual parts 29, 31, 39 are additionally shown in Figs. 2c to 2d.
  • the adjusting element 15 is adjustable along an adjustment direction 71 on the base member 13 to the effective length between a rod-shaped spacer support shaft (abutment) 17 which is attached to a head portion of the base member 13, and a likewise rod-shaped spacer support shaft (abutment) 19, on the Adjustment element 15 is attached to adjust.
  • the spacer support shaft 17 and the spacer support shaft 19 each extend perpendicular to the adjustment direction 71 of the adjusting element 15 or to the longitudinal axis of the spacer 11, are each passed through a cylinder-shaped bore formed in the base member 13 and in the adjusting element 15 and are closed both sides, in particular symmetrically to a center plane of the spacer 11 from the base member 13 and the adjusting element 15 from.
  • the spacer 11 is provided between cannulas (lever members) 63, 67 shown only in connection with another embodiment of an instrument in FIG. 5 and in FIG. 6, on the skin 69 (FIG Operation is on the stomach, positionable.
  • the cannulas 63 and 67 are set in the immediately adjacent vertebral bodies 73, 77 (FIG. 6) of the buried vertebral body 75.
  • two cannulas 63, 65, 67 are placed on the left and right of the plane of symmetry of the vertebral bodies 73, 75, 77.
  • the effective length of the spacer 11 is adjusted such that the spacer support shafts 17, 19 abut the inside of the cannulas 63, 67 in order to fix the mutual distance of the cannulas 63, 67 at the entry points into the skin 69.
  • the base member 13 includes, in addition to the head portion, a portion formed like a frame 21.
  • a portion formed like a frame 21 In the two side parts 23 of the frame 21 each have a slot 25 is formed, in which a flattened on two opposite sides of the axis 29 is adjustably mounted.
  • Each of the two slots 25 has to set different relative positions between the adjusting element 15 and the base member 13 a plurality of locking positions, which are formed in the form of arcuate recesses 27 in the longitudinal sides of the slot 25.
  • the adjustment element 15 comprises an adjustment part 39 with a cylindrical bore, through which the distance support shaft 19 is inserted.
  • the adjusting part 39 has a hinge section 79, the same if a cylindrical bore has and through which the axis 29 extends in the assembled state of the adjusting element 15 as shown in FIG.
  • the adjusting part 39 and the axis 29 are hinged together, ie the axis 29 is freely rotatable within the cylinder bore of the joint portion 79 of the adjusting part 39.
  • the adjusting part 39, in particular the section 79, on which the spacer support shaft 19 is formed, is adjustable along a recess 41 on the underside of the base member 13. The spacer 11 is thus on the fixed head portion and the adjustable adjustment part 39 on the skin.
  • the adjusting element 15 further comprises an operating part 31.
  • the operating part 31 is arc-shaped and protrudes through a frame slot 33 formed in the frame 21 of the base element 13.
  • the control panel 31 also includes a hinge portion 81 in which a bore for the axis 29 is formed and which is arranged in the assembled state of the adjusting element 15 of FIG. 1 adjacent to the hinge portion 79 of the adjustment member 39 and at this.
  • the contour of the bore of the joint portion 81 of the base member 13 is adapted to the contour of the flattened axis 29, so that the operating part 31 is rotationally rigidly connected to the axis 29.
  • the operating part 31 is between a blocking position, in which the adjusting element 15 is locked in an undetachable manner to the base element 13 and which is shown in FIG. 1, and a release position in which the adjusting element 15 is adjustable along the adjustment direction 71 relative to the base element 13, switchable.
  • the locked position the non-flattened sides of the axis 29 engage in the circular-arc-shaped depressions 27 in the longitudinal sides of the oblong holes 25 positively and non-positively, so that an adjustability along the adjustment direction 71 is effectively prevented.
  • This is made possible in particular by the fact that the diameter the axis 29 substantially corresponds to the diameter of the circular-arc-shaped depressions 27 in the longitudinal sides of the elongated holes 25.
  • the release position is achieved in that the control unit 31 is pivoted about the axis 29, wherein due to the rigid connection between the operating part 31 and the axis 29 and the shaft 29 rotates.
  • the non-flattened sides of the axis 29 and the recesses 27 in the longitudinal sides of the elongated holes 25 are disengaged, so that the adjusting element 15 can be adjusted in the adjustment direction 71 relative to the base element 13.
  • the operating part 31 has a support leg 35 on both the left and the right, which extends laterally of the side parts 23 of the frame 21 outside the frame 21 of the base element 13 ,
  • a projection (stop member) 37 is formed, which is directed in the adjustment direction 71 and in analogy to a support shaft (stop member) 61 which is attached via a cylinder bore to the head portion of the base member 13 and symmetrically to the left and right of the spacer 11 projects, serves as a support means for handle parts (guide parts) 43, 45, which are shown in Fig. 3.
  • the grip parts 43, 45 each of which has the shape of a blade, can be placed on the spacer 11 in a cranial and caudal manner such that the grip parts 43, 45 provide a contact surface 47 for the cranial and caudal needles 63, 67.
  • the handle parts 43, 45 each have a plate-like base portion 49 which is slotted centrally for placement on the spacer 11.
  • the base portion 49 is provided with lateral abutments 51 for guiding the cannulas 63, 67 so that they can not escape to the left or right upon actuation of the handle parts 43, 45.
  • the grip parts 43, 45 each have an actuating portion 53 which is designed in the shape of an S and connects directly to the base portions 49. In the state attached to the spacer 11 (FIG. 4), the actuating sections 53 are at a greater distance from each other than the base sections 49.
  • the instrument for erecting a broken-in vertebral body 75 comprises an adjustable fixing device 55, shown in FIG. 4, via which the two gripping parts 43, 45 are connected to one another in a state placed on the spacer 11.
  • the fixing device 55 in this case comprises an adjusting screw 57 which is guided through or guided through a circular opening formed in the grip part 45 and an insertion slot 83 formed in the grip part 43, with a nut 59 on the end of the adjusting screw 57 emerging from the insertion slot 83 is screwed to fix the mutual position of the two handle parts 43, 45.
  • FIG. 5 Another, second embodiment of an instrument for erecting a collapsed vertebral body 75 is shown in Fig. 5, wherein the same or corresponding parts are denoted by the same reference numerals, so that only the deviations of the second embodiment with respect to those shown in Figs first embodiment will be explained.
  • a support shaft 37 which projects to the left and to the right of the spacer 11, is attached to the upper end of the operating part 31.
  • the support shaft 37 assumes the function of the projections 37 of the first embodiment.
  • the second embodiment differs from the first embodiment in that the support means 61 assigned to the base element 13 are not arranged at the same height as the support means 37 associated with the adjustment element 15.
  • the distance-adjustable spacer 11 is positioned on the skin 69 of a patient such that the mutual spacing of the cranial and caudal cannulas 63, 67 is fixed at the sites of entry into the skin.
  • the effective length of the spacer 11 is set such that the distance-holding shaft 17 and the distance-holding shaft 19 are in each case on the inner sides of the cranial or caudal cannulas 63, 67. If this is achieved, the control panel 31 is switched from the release position to the blocking position to lock the length of the spacer 11 at the appropriate distance.
  • the two grip parts 43, 45 are inserted between the cranial and caudal cannulas 63, 67 and the spacer support shafts 17, 19 of the spacer 11 and placed on the spacer 11 such that the grip parts 43, 45 form a contact surface 47 for the cannulas 63, 67 provide.
  • the adjustment direction 71 - in each case from outside to inside - thus the following sequence is present (FIG. 5): support shaft 61 or 37 - grip part 43 or 45 - cannula 63 or 67 - distance support shaft 17 or 19.
  • the gripping members 43, 45 are compressed relative to each other so that the portions of the cannulas 63, 67 protruding from the body of the patient are also compressed relative to each other. This ensures that the collapsed vertebral body 75 is relieved.
  • the two distance holding shafts (abutments) 17 and 19 act as fulcrum or "break point" for the cranial and caudal needles 63, 67.
  • the areas of the cannulas 63, 67 that are acted upon by the base sections 49 of the grip parts 43, 45 are not bent.
  • the distance between the handle parts 43, 45 is fixed by means of the fixing device 55. This is achieved in particular by tightening the nut 59 until it touches the grip part 43. In principle, it is also possible for the fixing device 55 to be used for compressing the two grip parts 43, 45 relative to one another per se. Finally, bone cement is injected into the buried vertebral body 75 via the cannulas 65 in order to stabilize the buried vertebral body 75.
  • the instrument and the cannulas 63, 65, 67 set in the involved vertebral bodies 73, 75, 77 can be removed.
  • the surgical procedure takes place at least partially under X-ray control.
  • Vertebral body 75 which comprises at least the above-described spacer 11 and in particular also the two handle parts 43, 45 and the fixing device 55 explained above, makes it possible to improve all previously known surgical techniques described in connection with the prior art. In particular, a better supply of broken-in vertebral bodies can be ensured by the instrument or method specified here.
  • vertebral bodies 75 fractured vertebral bodies to be erected

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)
  • Surgical Instruments (AREA)

Abstract

Instrument permettant de redresser un corps vertébral tassé, qui comporte un dispositif réglable (11) dans un sens longitudinal sur sa longueur effective, pouvant être positionné sur la peau (69) de manière que sa face interne se trouve au-dessus d'un corps vertébral tassé. Des butées réglables (17, 19) l'une par rapport à l'autre sont placées sur le dispositif réglable, et l'écart entre les faces externes opposées l'une à l'autre de deux butées définit dans le sens longitudinal la longueur efficace du dispositif réglable. La zone de réglage de la longueur efficace est mesurée de manière telle que les butées peuvent être positionnées entre des éléments leviers (63, 67) qui sont destinés à la distraction des corps vertébraux voisins, dans la direction crânienne et caudale, du corps vertébral tassé, les butées servant au maintien de l'écart entre les éléments leviers.
EP06724317A 2005-04-14 2006-04-13 Instrument permettant de redresser un corps vertebral tasse Withdrawn EP1868509A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP06724317A EP1868509A1 (fr) 2005-04-14 2006-04-13 Instrument permettant de redresser un corps vertebral tasse

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
EP05008186A EP1712185A1 (fr) 2005-04-14 2005-04-14 Dispositif pour la correction d'une vertèbre fracturée
EP06724317A EP1868509A1 (fr) 2005-04-14 2006-04-13 Instrument permettant de redresser un corps vertebral tasse
PCT/EP2006/003426 WO2006108661A1 (fr) 2005-04-14 2006-04-13 Instrument permettant de redresser un corps vertebral tasse

Publications (1)

Publication Number Publication Date
EP1868509A1 true EP1868509A1 (fr) 2007-12-26

Family

ID=34978988

Family Applications (2)

Application Number Title Priority Date Filing Date
EP05008186A Withdrawn EP1712185A1 (fr) 2005-04-14 2005-04-14 Dispositif pour la correction d'une vertèbre fracturée
EP06724317A Withdrawn EP1868509A1 (fr) 2005-04-14 2006-04-13 Instrument permettant de redresser un corps vertebral tasse

Family Applications Before (1)

Application Number Title Priority Date Filing Date
EP05008186A Withdrawn EP1712185A1 (fr) 2005-04-14 2005-04-14 Dispositif pour la correction d'une vertèbre fracturée

Country Status (3)

Country Link
US (1) US20090076515A1 (fr)
EP (2) EP1712185A1 (fr)
WO (1) WO2006108661A1 (fr)

Families Citing this family (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2008106478A1 (fr) * 2007-02-27 2008-09-04 Lanx, Llc Compositions et procédés pour la modification de cellules cibles et leurs utilisations
US20100150881A1 (en) * 2007-06-01 2010-06-17 Lanx, Inc. Compositions and Methods for Use of Scar Tissue in Repair of Weight Bearing Surfaces
US8821502B2 (en) * 2007-10-23 2014-09-02 Alphatec Spine, Inc. Instrument and method for spinal compression and distraction
WO2009105606A1 (fr) * 2008-02-21 2009-08-27 Lanx, Llc Compositions et procédés pour utiliser un tissu cicatriciel dans une réparation de surfaces supportant un poids
US9149319B2 (en) * 2008-09-23 2015-10-06 Lanx, Llc Methods and compositions for stabilization of a vertebra
US9907582B1 (en) 2011-04-25 2018-03-06 Nuvasive, Inc. Minimally invasive spinal fixation system and related methods
US9480504B1 (en) 2013-03-15 2016-11-01 Nuvasive, Inc. Spinal alignment frame
US10194960B1 (en) 2015-12-03 2019-02-05 Nuvasive, Inc. Spinal compression instrument and related methods
CN109788975A (zh) 2016-07-01 2019-05-21 纽文思公司 脊柱损伤矫正和固定
DE102018116177A1 (de) * 2018-07-04 2020-01-09 Silony Medical International AG Vorrichtung zur Korrektur einer Knochenfraktur
CN115040179B (zh) * 2022-07-01 2024-11-12 重庆市人民医院 一种acdf手术用拉钩防护装置及其使用方法

Family Cites Families (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3709219A (en) * 1970-11-27 1973-01-09 W Halloran Bone compression device
FR2757761B1 (fr) * 1996-12-27 1999-08-20 Stryker France Sa Systeme d'oteosynthese du rachis avec reglage en position
US5944658A (en) * 1997-09-23 1999-08-31 Koros; Tibor B. Lumbar spinal fusion retractor and distractor system
DE19836498A1 (de) * 1998-08-12 2000-02-17 Medinorm Ag Spreizvorrichtung
US6174311B1 (en) * 1998-10-28 2001-01-16 Sdgi Holdings, Inc. Interbody fusion grafts and instrumentation
US6648891B2 (en) * 2001-09-14 2003-11-18 The Regents Of The University Of California System and method for fusing spinal vertebrae
US20040116777A1 (en) * 2002-12-13 2004-06-17 Jeffrey Larson Guided retractor and methods of use
US7250055B1 (en) * 2003-08-26 2007-07-31 Biomet Manufacturing Corp. Method and apparatus for cement delivering buttress pin

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See references of WO2006108661A1 *

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WO2006108661A1 (fr) 2006-10-19
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