EP2091471A2 - Prothese zum ersetzen eines zellkerns oder einer bandscheibe - Google Patents

Prothese zum ersetzen eines zellkerns oder einer bandscheibe

Info

Publication number
EP2091471A2
EP2091471A2 EP07871852A EP07871852A EP2091471A2 EP 2091471 A2 EP2091471 A2 EP 2091471A2 EP 07871852 A EP07871852 A EP 07871852A EP 07871852 A EP07871852 A EP 07871852A EP 2091471 A2 EP2091471 A2 EP 2091471A2
Authority
EP
European Patent Office
Prior art keywords
interface
nucleus
hand
plane
replacement prosthesis
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Withdrawn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
EP07871852A
Other languages
English (en)
French (fr)
Inventor
Lionel Simon
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.)
Spineway SA
Original Assignee
Spineway SA
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 Spineway SA filed Critical Spineway SA
Publication of EP2091471A2 publication Critical patent/EP2091471A2/de
Withdrawn legal-status Critical Current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
    • A61F2/4425—Intervertebral or spinal discs, e.g. resilient made of articulated components
    • 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
    • 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
    • A61F2002/30362—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
    • 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
    • A61F2002/30331—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
    • A61F2002/30364—Rotation about the common longitudinal axis
    • 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
    • A61F2002/30331—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
    • A61F2002/30369—Limited lateral translation of the protrusion within a larger recess
    • 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
    • A61F2002/30383—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
    • A61F2002/30387—Dovetail connection
    • 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
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30563—Special structural features of bone or joint prostheses not otherwise provided for having elastic means or damping means, different from springs, e.g. including an elastomeric core or shock absorbers
    • 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
    • A61F2002/30621—Features concerning the anatomical functioning or articulation of the prosthetic joint
    • A61F2002/30649—Ball-and-socket joints
    • A61F2002/3065—Details of the ball-shaped head
    • 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
    • A61F2002/30621—Features concerning the anatomical functioning or articulation of the prosthetic joint
    • A61F2002/30649—Ball-and-socket joints
    • A61F2002/30654—Details of the concave socket
    • 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
    • A61F2002/30621—Features concerning the anatomical functioning or articulation of the prosthetic joint
    • A61F2002/30649—Ball-and-socket joints
    • A61F2002/30662—Ball-and-socket joints with rotation-limiting means
    • 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
    • A61F2002/30621—Features concerning the anatomical functioning or articulation of the prosthetic joint
    • A61F2002/30649—Ball-and-socket joints
    • A61F2002/30663—Ball-and-socket joints multiaxial, e.g. biaxial; multipolar, e.g. bipolar or having an intermediate shell articulating between the ball and the socket
    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30841—Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
    • 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
    • A61F2/4425—Intervertebral or spinal discs, e.g. resilient made of articulated components
    • A61F2002/443—Intervertebral or spinal discs, e.g. resilient made of articulated components having two transversal endplates and at least one intermediate component
    • 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
    • A61F2002/444—Intervertebral or spinal discs, e.g. resilient for replacing the nucleus pulposus
    • 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
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00029—Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
    • 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
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00389—The prosthesis being coated or covered with a particular material
    • A61F2310/00395—Coating or prosthesis-covering structure made of metals or of alloys
    • A61F2310/00407—Coating made of titanium or of Ti-based alloys

Definitions

  • the present invention relates to a prosthesis intended to completely replace a damaged intervertebral disc of the human spine, or to replace it partially, replacing only its "nucleus pulposus”. Its field of application is therefore orthopedic surgery.
  • each vertebra is separated from the adjacent vertebrae by a fibro-cartilaginous disk called an intervertebral disc.
  • intervertebral disc a fibro-cartilaginous disk
  • These discs have a role of forestay, articulation and damper between each vertebra.
  • Another need is the reduction of contact stresses in order to preserve joint surfaces. To do this, it is necessary to favor surface support and therefore a permanent congruence of the two articular surfaces during their relative movement, as well as the largest possible joint surfaces.
  • the simultaneous response to these two needs involves the production of at least one so-called articular interface materialized by two complementary surfaces of essentially spherical, rigid shape and with almost equal radii, and therefore the production of an implant composed of at least two elements.
  • the last basic need of a joint prosthesis is to have sufficient stability to prevent dislocation.
  • two vertebrae in relative motion define at each instant of movement an instantaneous center of rotation.
  • the instantaneous center of anatomical rotation between two vertebrae even if it is weakly mobile, has a known position, below the intervertebral space between the center and the posterior third of the vertebral trays. Respect for this position avoids the creation of non-anatomical movements that can damage the posterior joints of the spine.
  • the answer to this need can take two different forms. The first is to design an implant whose center of rotation is fixed and located in the appropriate space (see for example US2006229725 and WO01 01893). The second answer to this Need is to design an implant whose center of rotation is mobile, leaving free the posterior joints to constrain the relative movement of the two vertebrae adjacent to the implant. This last choice involves the realization of a second articular interface, and thus the realization of an implant composed of at least three elements (see for example EP1 532950 or FR2865629).
  • EP1 532950 discloses an implant which leaves free a large peripheral space, conducive to bone fusion. This space can not be filled by the nucleus since the radii of the articular surfaces, necessarily smaller than the height of the implant, limit its diameter in a plane perpendicular to its axis.
  • the document WO2005007040 describes an implant provided with a connecting element of the two trays that constitute it, said element necessarily crossing the articular surface. Thus, it unnecessarily increases the height of the implant.
  • the documents FR2856587 and US5683465 describe an implant in which the center of rotation is fixed and does not respect the anatomical center of rotation.
  • the radius of curvature of the articular surfaces is necessarily very short, to allow a proper clearance, which frees a large peripheral space, conducive to bone fusion, and therefore contrary to the desired result.
  • US5895428 discloses an implant, wherein the spherical articular surfaces are surmounted by a screw whose function is to hold together the various components. This configuration unnecessarily increases the implant height.
  • the implant does not respect the anatomical center of rotation, and further comprises peripheral spaces conducive to bone fusion.
  • the device according to the invention therefore aims to overcome the various deficiencies of the implants proposed by the prior art, simultaneously satisfying all the needs mentioned and making improvements both in terms of manufacturing and in terms of use, to know :
  • the device according to the invention consists of a replacement prosthesis of nucleus or intervertebral disc composed of at least two trays, respectively anchored in the adjacent vertebrae via anchoring surfaces, the said trays being movable relative to each other via at least one interface defined by two so-called articular surfaces, respectively a female surface and a male surface, which have a substantially spherical shape and substantially equal radii.
  • the two articular surfaces are respectively intersected by surfaces delimiting between them a space of relative mobility of the plates when the articular surfaces are coapted, the surface intersecting the female articular surface being contained in the volume defined firstly by the theoretical sphere of said female articular surface excluding a point which defines a pole, and secondly, by an equatorial plane of said sphere excluding said equatorial plane itself, the surface intersecting the surface male articular being flat or convex and being contained in a volume delimited on the one hand by the theoretical sphere of said male articular surface, on the other hand by the equatorial plane excluding it.
  • the surfaces that intersect the articular surfaces are located near the pole of the interface, said pole being defined with respect to an axis parallel to the approximate axis of revolution of the natural intervertebral disc.
  • At least one of the surfaces that intersect the articular surfaces is flat.
  • the two surfaces that intersect the articular surfaces are planar.
  • the developed mobility space is filled at least partially by a deformable body.
  • the implant comprises a third element acting as a mobile core, defining two interfaces with the plates, on the one hand the interface between the core and one of the two plates, and on the other hand, the interface between the kernel and the other tray.
  • the two interfaces are essentially spherical, oriented in the same direction, and one of the two interfaces being included in the sphere defined by the other.
  • one of the two interfaces is flat, the other is concave.
  • the joint prosthesis according to the invention makes it possible to establish the best compromise between the following needs: position of the center or centers of rotation of one or both articular interfaces, area of the contact surface to reduce wear, thickness implant, mobility required by the implant, inclination of the interfaces to prevent the expulsion of the nucleus if there is dislocation or dislocation of the prosthesis, and filling free spaces, conducive to fusion.
  • Figure 1 shows a section of a healthy natural disc between two vertebrae, place of implantation of the prosthesis.
  • Figures 2 to 8 show implants having only an articular interface. These implants can still be made in a number of components greater than two, but assembled in a fixed manner to finally leave only two moving solids relative to each other.
  • Figures 9 to 13 show implants having two articular surfaces.
  • Figure 14 is a block diagram.
  • FIG. 1 represents a healthy natural disk separating two vertebrae (7) and (8), composed of its nucleus pulposus (NP) and its annulus (AN).
  • NP nucleus pulposus
  • AN annulus
  • Figure 2 shows a replacement implant of the nucleus according to the invention. Its size is reduced compared to a total prosthesis, so as to retain part of the annulus.
  • Figure 3a shows a total disc prosthesis according to the invention, in place between the vertebrae (7) and (8).
  • the surfaces that intersect the articular surfaces are flat and located approximately in the vicinity of the pole of the joint, and the instantaneous center of rotation (C) is located below the intervertebral space.
  • FIG. 3b represents a total disk prosthesis according to the invention, almost identical to that of FIG. 3a, but for which it has been chosen to position the instantaneous center of rotation (C) above the intervertebral space.
  • This configuration does not respect the center of anatomical rotation and can thus cause pain for the patient, but can technically be considered.
  • the plates (1) and (2) can each be made of a single block of chromium-cobalt-based alloy, which is particularly advantageous for its tribological properties. and be able to rub against each other.
  • one of the trays (1) and (2) can be made in two parts, one in cobalt-chromium, the other in polyethylene, the two parts being then assembled in a fixed manner to form said tray, the other plate being made of a cobalt-chrome block, for example, the chromium-cobalt-polyethylene friction couple being widely used in arthroplasty of the spine, hip or knee.
  • the anchoring surfaces (3) and (4) of the trays (1) and (2) on the vertebral plates (5) and (6) adjacent can be curved to best fit their anatomy, and covered with a coating suitable for recolonization by bone, a coating of pure titanium deposited by plasma spraying is often used.
  • the polyethylene part is fixedly positioned in the lower plate (2) of which it becomes an integral part, the plate being itself anchored to the lower vertebra not shown, and the plate (1) upper, anchored in the upper vertebra not shown is movable relative to the plate (2).
  • the disc prosthesis thus produced allows the restoration of the disc space and the mobility between the vertebrae.
  • Figures 4a and 4b show the general principle of the invention, namely two trays (1) and (2) respectively comprising spherical articular surfaces (11) and (12) of approximately equal radii. Each of these articular surfaces (11, 12) is intersected by a surface (13) and (14).
  • This embodiment represents an arbitrary surface (13) and a convex surface (14). This figure is intended to demonstrate certain interests that the invention brings simultaneously. ' , In the first place, no free space suitable for the intrusion of scar tissue remains, whatever the relative position of the trays (1) and (2).
  • the center of prosthetic rotation (O) respects the anatomical center.
  • the inclination of the articular surfaces is greater than in the case of a polar contact, which provides greater stability.
  • pole (P) of the joint or bottom of the theoretical female sphere, generally having a turning defect is not a point of contact, which facilitates the realization of the implant since it no longer need to deal with this problem.
  • the implant is composed of only two components, which facilitates its handling and therefore its use.
  • FIG. 4c is intended to explain that the designation, on a sphere, for example that defined by the articular surface (11), of a particular point as pole (P) naturally entails the definition of:
  • equatorial plane passing by definition by the center (O) of sphere, and having an orientation close to that of the plane (AA).
  • BB equatorial plane
  • FIG. 4d is intended to explain the possible presence of the intersection surface (14) of the male articular surface (12), here convex and contained in a volume delimited on the one hand by the theoretical sphere of said surface (12), and secondly, by the equatorial plane (BB) defined previously excluding it.
  • BB equatorial plane
  • FIG. 5 is intended to illustrate the choice of a pole (P) defined by an axis (XX) parallel to the approximate axis (YY) of revolution of the intervertebral disk.
  • the two intersection surfaces (13) and (14) are planar.
  • Figures 6a and 6b illustrate the possibility offered by the invention to provide an internal angular abutment system.
  • intersection surface (13) is flat, and the intersection surface (14) is essentially conical and adapted in that it allows contact along a line (L) when the plate (1) reaches the maximum travel chosen.
  • Figure 6b shows the plate (1) inclined and close to the abutment along a line (L) between the substantially conical surface (13) and the plane surface (14).
  • FIG. 7a represents a particular embodiment of the invention for which it is considered that the axis (YY) of revolution of the intervertebral disk is an approximation of the axes of revolution (ZZ) and (WW) of each of the vertebral plates (5). ) and (6).
  • the pole (P) is approximately defined.
  • FIG. 7b represents the same implant as FIG. 7a, in limit of displacement.
  • FIG. 8 represents an embodiment of the implant in which part of the mobility space (20) is filled by a deformable body (21), for example made of silicone or polyurethane, in order, for example, to produce a progressive stop system which allows a more homogeneous distribution of mobility between the prosthesis stage and the other natural stages of the spine.
  • a deformable body for example made of silicone or polyurethane
  • This imbalance can lead at least temporarily to a hyper mobility of the prosthesis level which causes a local deformation of the spine, for example a cervical kyphosis, or an exaggerated stress on the posterior joints on the one hand, and in return for a reduction of the mobility of healthy adjacent floors that can lead to their stiffening.
  • Figure 9 is intended to illustrate an implant consisting of two trays (1) and (2) and a core (40).
  • This embodiment has the particularity of having two articular interfaces (10) and (30) of the same orientation, one (10), called internal, being inside the other (30), said external.
  • the center (C) of the internal interface (10) is between the external interface (30) and its own center (D).
  • the advantage of this particular arrangement is to define a stable position of the plate (1) relative to the core (40). Indeed, if the plate (1) moves from this position relative to the core (40), the distance between the plate (1) and the plate (2) increases, which has the effect of removing one of the other vertebrae (7) and (8) not shown. The anatomical forces exerted on the implant therefore have the effect of returning the plate (1) to its stable position relative to the core (40) . so that the implant height becomes minimum again.
  • Figure 10a is to illustrate an implant consisting of two trays (1) and (2) and a core (40). This embodiment has the particularity of having a flat articular interface (30) as well as an internal device limiting displacement in translation.
  • FIG. 10b is intended to illustrate a particular embodiment having a plane articular interface (30) as well as an external device limiting the translational movement.
  • Figure 1 i is intended to illustrate a particular embodiment having a substantially spherical articular interface (30) and an external device limiting its movement.
  • FIGS 12 and 13 show further embodiments of the interfaces (10) and (30).
  • FIG. 14 shows a block diagram which represents the possible location of the interface (10) whose center (C) is located on a radius of the interface (30), and the interface (10) is - even located between the interface (30) and a plane passing through its own center (C) and approximately perpendicular to the line joining the centers (C) of the interface (10) and (D) of the interface (30) ).

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Neurology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Cardiology (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)
EP07871852A 2006-12-13 2007-12-13 Prothese zum ersetzen eines zellkerns oder einer bandscheibe Withdrawn EP2091471A2 (de)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
FR0610852A FR2909859B1 (fr) 2006-12-13 2006-12-13 Prothese articulaire de disque intervertebral
FR0702659A FR2909860B3 (fr) 2006-12-13 2007-04-12 Prothese articulaire de disque intervertebral partielle ou totale
PCT/FR2007/002060 WO2008087291A2 (fr) 2006-12-13 2007-12-13 Prothèse de remplacement de nucléus ou de disque intervertébral

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EP2091471A2 true EP2091471A2 (de) 2009-08-26

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US (1) US20100030338A1 (de)
EP (1) EP2091471A2 (de)
FR (2) FR2909859B1 (de)
WO (1) WO2008087291A2 (de)

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Also Published As

Publication number Publication date
FR2909859B1 (fr) 2011-02-11
WO2008087291A3 (fr) 2008-10-09
US20100030338A1 (en) 2010-02-04
FR2909860B3 (fr) 2009-02-27
FR2909860A1 (fr) 2008-06-20
WO2008087291A2 (fr) 2008-07-24
FR2909859A1 (fr) 2008-06-20

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