ES2286891T3 - Protesis de disco en formacion individual o multiple, multidiscoidal, cilindrica y roscada. - Google Patents

Protesis de disco en formacion individual o multiple, multidiscoidal, cilindrica y roscada. Download PDF

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Publication number
ES2286891T3
ES2286891T3 ES99938781T ES99938781T ES2286891T3 ES 2286891 T3 ES2286891 T3 ES 2286891T3 ES 99938781 T ES99938781 T ES 99938781T ES 99938781 T ES99938781 T ES 99938781T ES 2286891 T3 ES2286891 T3 ES 2286891T3
Authority
ES
Spain
Prior art keywords
housing
disc prosthesis
accordance
cylindrical
vertebral
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Lifetime
Application number
ES99938781T
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English (en)
Inventor
Vincent Bryan
Alex Kunzler
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.)
Warsaw Orthopedic Inc
Original Assignee
Warsaw Orthopedic Inc
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 Warsaw Orthopedic Inc filed Critical Warsaw Orthopedic Inc
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Publication of ES2286891T3 publication Critical patent/ES2286891T3/es
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

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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
    • 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
    • A61F2/30721—Accessories
    • A61F2/30724—Spacers for centering an implant in a bone cavity, e.g. in a cement-receiving cavity
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30721—Accessories
    • A61F2/30742—Bellows or hose-like seals; Sealing membranes
    • 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
    • A61F2/441—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
    • 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
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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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    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/30252—Three-dimensional shapes quadric-shaped
    • A61F2002/30253—Three-dimensional shapes quadric-shaped ellipsoidal or ovoid
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30332—Conically- or frustoconically-shaped protrusion and recess
    • 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
    • A61F2002/30451—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements soldered or brazed or welded
    • 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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    • A61F2002/30316—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
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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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    • A61F2002/30316—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
    • A61F2002/30576—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs
    • A61F2002/30578—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs having apertures, e.g. for receiving fixation screws
    • A—HUMAN NECESSITIES
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    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
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    • 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
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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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    • 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
    • A61F2220/0058—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements soldered or brazed or welded
    • A—HUMAN NECESSITIES
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    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
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    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
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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
    • 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
    • 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
    • A61F2310/00179—Ceramics or ceramic-like structures

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  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
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  • Oral & Maxillofacial Surgery (AREA)
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  • Heart & Thoracic Surgery (AREA)
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  • General Health & Medical Sciences (AREA)
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Abstract

Una prótesis (10) de disco, que comprende, en combinación, un alojamiento cilíndrico (20), incluyendo el alojamiento una mitad superior (22) y una mitad inferior (24) caracterizada porque una pluralidad de discos elásticos, viscoelásticos (41, 42) están interpuestos entre el medio alojamiento superior y el medio alojamiento inferior para mantener los medios alojamientos separados uno de otro.

Description

Prótesis de disco en formación individual o múltiple, multidiscoidal, cilíndrica y roscada.
Este invento se refiere al diseño y uso de una prótesis de disco único para la espina cervical, torácica y lumbar.
La patente de EEUU 5.674.296 se incorpora como referencia.
Antecedentes del invento
La enfermedad de disco degenerativo que incluye hernia de disco puede producir síntomas discapacitantes con dolor local, radiculopathy o myelopathy en una espina por otro lado clínicamente estable, que demuestra no responder a tratamiento no quirúrgico. Hay disponibles varios tratamientos quirúrgicos para atender los síntomas de enfermedad de disco degenerativo cuando terapias no invasivas no son efectivas. Estos tratamientos quirúrgicos incluyen descompresión, disectomía y fusión. Estos tratamientos, y en particular los procedimientos de disectomía y fusión, proporcionan liberación de síntomas clínicos pero no restituyen el rango normal o casi normal de movimiento o amortiguamiento de la unidad espinal funcional afectada (FSU). Esto puede dar lugar a la aceleración del proceso degenerativo en los discos espinales adyacentes al lugar de la operación quirúrgica original. Este proceso degenerativo puede, a su vez, requerir intervención quirúrgica adicional.
Las técnicas endoscópicas y de cirugía abierta se usan a menudo para proporcionar acceso al espacio de disco intervertebral afectado. Las soluciones posterior, posterior-lateral y anterior permiten la colocación de instrumentación para facilitar la exposición del disco degenerado y la inserción de injertos de hueso o jaulas de fusión para conseguir la fusión ósea.
Debido a consideraciones de estructura anatómica y restricciones de tamaño del instrumental asociados con técnicas quirúrgicas mínimamente invasivas en la espina anterior, la inserción de una prótesis funcional de disco de igual tamaño que el disco natural crea riesgos debido a interferencias mecánicas con estructuras vasculares críticas y puede evitar la inserción segura de la prótesis.
El documento EP-A-566810 describe un miembro artificial de disco intervertebral que consiste en un apoyo superior e inferior que están sujetos en vértebras adyacentes. Un separador elástico está construido entre los apoyos.
Una prótesis funcional de disco que permite un rango completo de movimiento del FSU y almohadillado entre dos vértebras adyacentes a la vez que se mantiene la estabilidad, lordosis y separación del cuerpo intervertebral, si se desea, es más específicamente un objeto del invento proporcionar una prótesis de disco que tenga un perfil pequeño o estrecho. La nueva prótesis de ejemplo es de forma exterior cilíndrica, compuesta de dos mitades partidas longitudinalmente. Cada medio alojamiento está separado del otro en todo momento por cuerpos elásticos con forma de disco contenidos en ellos, y es suficiente fuerte para soportar las cargas a las que estará sometido durante las actividades de la vida diaria. El alojamiento contiene múltiples rebajes cóncavos de articulación capaces de emparejarse con los cuerpos elásticos discoides situados entre ellos. Los cuerpos discoides son de menor diámetro que el disco natural al que reemplazan, y están colocados en serie en las carcasas o rebajes de articulación contenidos en el interior del alojamiento cilíndrico. El alojamiento cilíndrico está roscado en su exterior para la introducción fácil y estabilidad mecánica en un espacio preparado en las vértebras opuestas del FSU. El alojamiento está configurado para corregir las restricciones impuestas por el espacio anatómico limitado disponible para la colocación quirúrgica del implante y es pequeño para utilizar procedimientos e instrumentación de implantación tal como los usados en un procedimiento endoscópico.
Es un objeto adicional del invento proporcionar alojamientos cilíndricos de tamaño diferente y cuerpos elásticos contenidos dentro, para que cuando las unidades de prótesis configuradas cilíndricamente se usan en paralelo, pueden facilitar la colocación apropiada de vértebras opuestas.
Otro objeto es obviar la necesidad de un segundo lugar quirúrgico para la recogida de injertos de huesos.
Y es un objeto adicional del invento proporcionar una funda para rodear completamente y encerrar el espacio ocupado por los cuerpos elásticos entre las dos mitades cilíndricas de alojamiento.
Todavía otro objeto del invento es proporcionar una prótesis de disco que permitirá el movimiento entre los medios alojamientos.
Un objeto adicional del invento es proporcionar una prótesis de disco que proporcionará almuadillamiento adicional entre los medios alojamientos.
Todavía es un objeto adicional del invento proporcionar una prótesis de disco que puede ser usada sola o en una disposición en paralelo con prótesis similares.
Otros objetos y ventajas del invento se harán claros a los expertos en la técnica tras la lectura de la siguiente descripción detallada y tras referencia a los dibujos. Por los dibujos, números de referencia similares se refieren a piezas similares.
Descripción de los dibujos
La figura 1 es una vista isométrica de la nueva prótesis de disco.
La figura 2 es una vista en sección tomada substancialmente en el plano de la línea 2-2 de la figu-
ra 1.
La figura 3 es una vista en sección tomada substancialmente en el plano de la línea 3-3 de la fi-
gura 2.
La figura 4 es una vista isométrica similar a la figura 1 pero que muestra una realización alternativa del invento.
La figura 5 es una vista en sección tomada substancialmente en el plano de la línea 5-5 en la
figura 4.
La figura 6 es una vista en sección tomada substancialmente en el plano de la línea 6-6 de la figu-
ra 5.
La figura 7 es una vista isométrica de un medio alojamiento inferior del invento.
La figura 8 es una vista en planta superior del medio alojamiento inferior mostrado en la figura 7.
La figura 9 es una vista en sección tomada substancialmente en el plano de la línea 9-9 de la fi-
gura 8.
La figura 10 es una vista en sección tomada substancialmente en el plano de la línea 10-10 en la
figura 9.
La figura 11 es una vista en planta superior de un medio alojamiento inferior similar a la figura 8 pero que muestra una realización alternativa del inven-
to.
La figura 12 es una vista en sección similar a la figura 9 pero tomada substancialmente en el plano de la línea 12-12 de la figura 11.
La figura 13 es una vista isométrica del medio alojamiento inferior mostrado en las figuras 11 y 12.
La figura 14 es una vista en sección tomada substancialmente en el plano de la línea 14-14 de la figu-
ra 12.
Aunque el invento se describirá con relación a la una realización preferida, se entenderá que no se pretende limitar el invento a esta realización. Por el contrario, se pretende cubrir todas alternativas, modificaciones y equivalentes como puedan ser incluidos dentro del espíritu y alcance del invento como se define por las reivindicaciones adjuntas.
Para conseguir los objetivos establecidos antes, la nueva prótesis de disco a modo de ejemplo 10 incluye, como se muestra en las figuras 1 y 4, un alojamiento cilíndrico 20. El alojamiento 20 incluye un medio alojamiento superior 22 y un medio alojamiento inferior 24. En la realización mostrada en la figura 1, una aleta fijadora superior 26 está soldada o asociada de otra forma con el medio alojamiento superior 22, y una aleta fijadora inferior 28 está soldada similarmente o asociada de otra forma con el medio alojamiento inferior 24. Estas aletas 26, 28 pueden ser usadas para estabilizar la prótesis en el hueso, como se sugiere en la patente de EEUU 5.674.296. Las aletas 26, 28 pueden ser omitidas, como se sugiere en las figuras
4-14.
Como se muestra particularmente en las figuras 2, 3, 5 y 6, una pluralidad de discos viscoelásticos resistentes 41, 42 están interpuestos entre el medio alojamiento superior 22 y el medio alojamiento inferior 24 para mantener los medios alojamientos separados uno de otro y proporcionar un rango definido de movimiento. Alternativamente, los discos 41, 42 pueden estar hechos de un hidrogel adecuado. Si se desea, se pueden colocar protuberancias o postes 29 generalmente cónicos en los rebajes 33 formados en los discos 41, 42, para proporcionar estabilidad y limitación contra el movimiento excesivo.
El alojamiento 20 tiene una superficie exterior 30 que tiene una forma 31 de rosca de tornillo. Esta forma 31 de rosca de tornillo es continua y es contigua desde el medio alojamiento 22 al medio alojamiento 24 de manera que la prótesis de disco puede ser enroscada en un agujero de espacio intervertebral prerroscado formado entre dos vértebras adyacentes como, por ejemplo, en la espina dorsal humana. Si se desea, los rebajes 35 pueden estar formados para permitir el crecimiento hacia dentro del hueso y la estabilización adicional del dispositivo. La forma del alojamiento 20 puede ser la de un cilindro recto o puede ser cónica.
De acuerdo con un aspecto del invento, esta prótesis 10 de perfil delgado o pequeño puede ser creada colocando más de uno de los discos elásticos ovoides 41, 42 de prótesis, dentro de un alojamiento cilíndrico 20 de metal, cerámico o material polimérico (habiendo sido separado el alojamiento 20 en dos mitades longitudinalmente 22, 24). Este pequeño dispositivo 10 puede ser implantado en la espina dorsal a través de una apertura quirúrgica. Se puede usar un dispositivo 20 que contiene dos o más discos 41, 42, o colocando dos de tales dispositivos 20 en paralelo, cada uno conteniendo uno o más discos ovoides en serie, se puede conseguir un rango completo de movimiento de la unidad funcional espinal (FSU). Si el material discoide posee propiedades resistentes y viscoelásticas, estando partido el alojamiento o abierto de otra forma en sus lados, los discos ovoides colocados internamente manteniendo la separación de los miembros de alojamiento superior e inferior, también se puede realizar un efecto de almohadillado. Si se desea, se puede añadir una funda o retén en los medios alojamientos, como una banda o cable de retención, como se sugiere en la patente de EEUU 5.674.296.
Como se sugiere en las figuras 7 - 10, cada disco ovoide 41, 42 puede estar rodeado por una superficie cóncava 51, 52 formada o contenida dentro del alojamiento, y perfilada para aceptar la forma de superficie superior e inferior de cada uno de los discos ovoides 41, 42 de manera que el alojamiento 20 que comprende las dos o más mitades o carcasas emparejadas 23, 24 pueda deslizarse y/o girar por la superficie de los discos 41, 42 para proporcionar movimiento y separación de espacio de unión.
Como se sugiere en las figuras 11-14, puede haber provisto un solo rebaje 61 para acomodar ambos discos 41,42. Si se desea, los postes 29 puede estar dispuestos para limitar el movimiento relativo de medio alojamiento - con disco.
Como se ha anotado antes, la superficie exterior del alojamiento partido 20 tiene una formación roscada de manera que puede ser roscado en un agujero prerroscado de tamaño apropiado en un espacio de disco intervertebral. Cuando se enrosca apropiadamente en su sitio, la mitad superior del alojamiento roscado se acopla a la placa inferior de extremo de hueso vertebral cefalad y la otra mitad 24 del alojamiento roscado se acopla a la placa de extremo superior opuesta del hueso vertebral caudal cuando está completamente insertado. Los discos ovoides 41, 42 y sus respectivas cóncavas superficies en cualquier unidad de alojamiento puede ser de tamaño diferente para permitir la apropiada curvatura de columna espinal, especialmente cuando es insertado en la dirección anterior/posterior, o pueden ser del mismo tamaño en un alojamiento pero diferir de tamaño de los discos en el segundo alojamiento colocado en paralelo cuando es insertado desde una dirección lateral.
El dispositivo puede ser insertado por medio de técnicas mínimamente invasivas o abiertas incluyendo endoscopio, o por una variedad de soluciones quirúrgicas conocidas en las que hay disponible espacio anatómico adecuado. Aunque la prótesis es insertada como una única unidad cilíndrica roscada, su posición final es tal que una mitad del alojamiento es dejada exclusivamente en contacto con la placa de extremo de un cuerpo vertebral y el otro en el contacto exclusivo de la placa de extremo de cuerpo vertebral opuesto. Los cuerpos vertebrales discoides entre los medios alojamientos cilíndricos contienen dos o más superficies cóncavas, permiten el movimiento al proporcionar deslizamiento y rotación en múltiples direcciones y almohadillado como respuesta a cargas fisiológicas situada en ellos. Cuando se usan en paralelo cilíndros de tamaño diferente, se puede variar la separación intervertebral para conseguir la relación posicional entre vértebras deseada.

Claims (14)

1. Una prótesis (10) de disco, que comprende, en combinación, un alojamiento cilíndrico (20), incluyendo el alojamiento una mitad superior (22) y una mitad inferior (24) caracterizada porque una pluralidad de discos elásticos, viscoelásticos (41, 42) están interpuestos entre el medio alojamiento superior y el medio alojamiento inferior para mantener los medios alojamientos separados uno de otro.
2. Una prótesis de disco (10) acorde con la reivindicación 1, en la que dichos discos (41, 42) son de forma ovoide.
3. Una prótesis de disco (10) acorde con la reivindicación 1, en la que cada disco (41, 42) está parcialmente rodeado por una superficie cóncava (51) formada dentro de dicho alojamiento (20).
4. Una prótesis de disco (10) acorde con la reivindicación 1, en al que dicho alojamiento (20) tiene una superficie exterior roscada que tiene una forma (31) de rosca de tornillo.
5. Una prótesis de disco (10) acorde con la reivindicación 4, en la que dicha rosca (31) de tornillo es continua, y es contigua desde medio alojamiento (22) hasta medio alojamiento (24) de manera que la prótesis de disco pueda ser enroscada en un agujero de espacio intervertebral prerroscado.
6. Una prótesis de disco (10) acorde con la reivindicación 1, en la que hay definidos unos rebajes (35) en dicho alojamiento (20) para permitir crecimiento hacia dentro del hueso.
7. Una prótesis de disco (10) acorde con la reivindicación 1, que incluye un miembro (26, 28) de aleta sujeto a cada uno de los miembros (22, 24) de medio alojamiento superior e inferior, permitiendo las aletas que los medios alojamientos sean fijados a las vértebras espinales.
8. Una prótesis de disco (10) acorde con la reivindicación 1, en la que la mitad superior (22) y mitad inferior (24) cada una incluye una superficie externa semicilíndrica para acoplarse con placas de extremo vertebrales opuestas.
9. Una prótesis de disco (10) acorde con la reivindicación 4, en la que el alojamiento cilíndrico (20) está adaptado para ser enroscado entre cuerpos vertebrales adyacentes de manera que las dos mitades (22, 24) se acoplarán individualmente con placas opuestas de extremo de los cuerpos vertebrales adyacentes.
10. Una prótesis de disco (10) acorde con la reivindicación 1, en la que el alojamiento cilíndrico (20) está adaptado de manera que cuando es insertado entre cuerpos vertebrales adyacentes, un eje longitudinal del alojamiento cilíndrico reposa dentro de un plano axial de los cuerpos vertebrales.
11. Una prótesis de disco (10) acorde con la reivindicación 1, en la que el alojamiento (20) tiene una superficie exterior que define una formación de rosca (31) generalmente continua.
12. Una prótesis de disco (10) acorde con la reivindicación 1, en la que la rosca (31) de alojamiento está adaptada para acoplarse con el hueso de cuerpos vertebrales adyacentes.
13. Una prótesis de disco (10) acorde con la reivindicación 1, que incluye una funda sujeta a dichos medios alojamientos (22, 24).
14. Una prótesis de disco (10) acorde con la reivindicación 1, que incluye una pluralidad de discos de diferentes tamaños.
ES99938781T 1998-07-22 1999-07-22 Protesis de disco en formacion individual o multiple, multidiscoidal, cilindrica y roscada. Expired - Lifetime ES2286891T3 (es)

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EP (1) EP1100416B1 (es)
JP (1) JP2002521090A (es)
AT (1) ATE363877T1 (es)
AU (1) AU748746B2 (es)
CA (1) CA2338379A1 (es)
DE (1) DE69936263T2 (es)
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AU748746B2 (en) 2002-06-13
DE69936263D1 (de) 2007-07-19
WO2000004851A1 (en) 2000-02-03
US7147665B1 (en) 2006-12-12
CA2338379A1 (en) 2000-02-03
JP2002521090A (ja) 2002-07-16
AU5319399A (en) 2000-02-14
EP1100416A1 (en) 2001-05-23
ATE363877T1 (de) 2007-06-15
EP1100416A4 (en) 2001-11-14
EP1100416B1 (en) 2007-06-06
DE69936263T2 (de) 2007-10-04

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