ES2293113T3 - Cuerpo intermedio para implante por fusion de la columna vertebral. - Google Patents

Cuerpo intermedio para implante por fusion de la columna vertebral. Download PDF

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Publication number
ES2293113T3
ES2293113T3 ES04007353T ES04007353T ES2293113T3 ES 2293113 T3 ES2293113 T3 ES 2293113T3 ES 04007353 T ES04007353 T ES 04007353T ES 04007353 T ES04007353 T ES 04007353T ES 2293113 T3 ES2293113 T3 ES 2293113T3
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Spain
Prior art keywords
implant
bone
spine
height
previous
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
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ES04007353T
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English (en)
Inventor
Gary Karlin Michelson
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Warsaw Orthopedic Inc
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Warsaw Orthopedic Inc
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    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
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Abstract

Implante troncocónico para la fusión interna de la columna vertebral, para su inserción en la altura corregida quirúrgicamente de un espacio discal entre cuerpos vertebrales adyacentes de una columna vertebral humana, cuyo implante comprende: un cuerpo (222'''')que tienen un eje longitudinal (L4, L5), un extremo de inserción (224''''), un extremo posterior (226''''), un tramo entre dichos extremos, una parte superior adaptada para su orientación hacia uno de los cuerpos vertebrales adyacentes, una parte inferior adaptada para su orientación hacia el otro de los cuerpos vertebrales adyacentes y una altura entre dicha parte superior y dicha parte inferior transversalmente a dicho tramo, siendo constante la altura de dichas partes superior e inferior a lo largo de una parte de la longitud de dicho implante y teniendo dichas partes superior e inferior como mínimo una obertura para permitir el crecimiento de hueso desde un cuerpo vertebral adyacente al cuerpo vertebral adyacente a través dedicho implante y medios (240'''') de acoplamiento con el hueso que se extienden como mínimo desde la parte de dichas zonas superior e inferior adaptadas para establecer contacto con dicho implante a los cuerpos vertebrales adyacentes de la columna vertebral una vez implantados en la columna vertebral, estando realizado dicho implante en un material apropiado para la implantación humana en el que dichos medios de acoplamiento con el hueso tienen una altura máxima más cerca de dicho extremo posterior que dicho extremo de inserción que aumenta desde dicho extremo de inserción al mencionado extremo posterior a lo largo de como mínimo una parte de la longitud de dicho cuerpo (222'''').

Description

Cuerpo intermedio para implante por fusión de la columna vertebral.
Antecedentes de la invención Solicitudes de patente relacionadas
La presente solicitud es una continuación en parte de la solicitud pendiente con la actual de Estados Unidos Nº de serie 08/396.414, presentada en 27 de febrero de 1995, que a su vez es continuación en parte de la solicitud de Estados Unidos Nº 08/074.781, presentada en 10 de Junio de 1993, que es continuación en parte de la solicitud de patente U.S.A. Nº de serie 07/698.674, presentada en 10 de Mayo de 1991, que es divisional de la solicitud de patente Nº de serie 07/205.935, presentada en 13 de Junio de 1988, en la actualidad patente U.S.A. Nº 5.015.247, todas las cuales se incorporan a la actual a título de referencia.
La presente solicitud es también una continuación en parte de la solicitud de patente U.S.A. Nº de serie 08/390.131, titulada "Cuerpos intermedios para implantes por fusión de la columna vertebral", presentada en 17 de Febrero de 1995.
Sector técnico de la invención
La presente invención se refiere de manera general a cuerpos intermedios para implantes por fusión de la columna vertebral, y en particular a implantes por fusión de la columna vertebral configurados para restablecer y mantener dos vértebras adyacentes de la columna vertebral en lordosis anatómica.
Descripción de técnicas relacionadas
La fusión de la columna vertebral con cuerpos intermedios se refiere al método para conseguir un puente óseo entre vértebras adyacentes a través del espacio discal, espacio entre vértebras adyacentes normalmente ocupado por un disco vertebral. Se han descrito numerosos implantes para facilitar esta fusión por Cloward, Brantigan, y otros, que son conocidos por los técnicos en la materia. De manera general, los implantes cilíndricos ofrecen la ventaja de conformación a un orificio receptor preparado fácilmente que separa el espacio discal y que penetra dentro de cada una de las vértebras adyacentes. Este orificio puede ser creado mediante la utilización de un taladro. Es una realidad anatómica que tanto la columna vertebral cervical como la columna vertebral lumbar son lordóticas de manera normal, es decir, convexas hacia adelante. Esta alineación es importante para el funcionamiento apropiado de la columna vertebral. Habitualmente, los estados que requieren tratamiento por fusión de la columna vertebral son asociados a pérdida de la lordosis.
El documento WO 94/14459 da a conocer un conjunto de medios quirúrgicos para la estabilización de la columna vertebral con un implante. Este implante tiene una rosca en la superficie exterior del cilindro, en la que los hilos de la rosca tienen altura constante y solamente los dos primeros aumentan de altura. El implante tiene una serie de orificios utilizados para permitir el crecimiento del hueso desde el cuerpo vertebral adyacente al cuerpo vertebral adyacente a través de dicho implante.
El documento DE-A-4302397 da a conocer un implante con un cierto tipo de medios de acoplamiento del hueso que tienen una altura constante y están dispuestos en la superficie externa del cuerpo cilíndrico.
El documento U.S.A.-A-4878915 da a conocer un implante quirúrgico de avance transversal con nervios que tienen caras delanteras convexas y caras posteriores cóncavas.
Los implantes de fusión de la columna vertebral de la presente invención ofrecen ventajas significativas con respecto a los implantes anteriormente conocidos:
1. Dado que los implantes de fusión de la columna vertebral de la presente invención son, como mínimo parcialmente, troncocónicos en su forma, los que tienen conicidad desde el borde delantero al borde posterior son fáciles de introducir y fáciles de insertar por completo en el segmento de la columna vertebral a fusionar.
2. La forma de los implantes de la presente invención se corresponde con la forma del disco, al que los implantes sustituyen por lo menos en parte, de manera que la parte frontal del disco es normalmente más alta que la parte posterior del propio disco, lo que permite una lordosis normal. Los implantes de la presente invención son, de manera similar, más altos en la parte anterior que en la parte posterior.
3. Los implantes de fusión de la columna vertebral de la presente invención se adaptan a una forma geométrica, la cual se puede producir fácilmente en el lugar de la fusión, para recibir dichos implantes de fusión de la columna vertebral.
Los implantes de fusión de la columna vertebral, según la presente invención, pueden ser realizados en cualquier material apropiado para implantación humana, teniendo las características mecánicas suficientes para ser utilizados para el objetivo previsto de fusión de la columna vertebral, incluyendo varios metales tales como cobalto, cromo, acero inoxidable o titanio, incluyendo sus aleaciones y varios plásticos, incluyendo los que son bioabsorbibles, y diferentes cerámicas o combinaciones suficientes para el objetivo previsto. Además, los implantes de fusión de la columna vertebral según la presente invención pueden ser realizados a base del material sólido, un material poroso y/o el material puede comprender, de manera completa o en parte, materiales capaces de participar directamente en el proceso de fusión de la columna vertebral, o pueden ser dotados de una carga de sustancias químicas o pueden estar compuestos de dichas sustancias, tratados o recubiertos con las mismas, tales como hueso, proteínas morfogénicas, hidroxiapatita en cualquiera de sus formas y proteínas osteogénicas, para hacerlos bioactivos con el objetivo de estimular la fusión de la columna vertebral. Los implantes de la presente invención pueden ser bioabsorbibles de manera completa
o parcial.
Objetivos de la presente invención
Es un objetivo de la presente invención dar a conocer un implante de fusión de la columna vertebral que tiene conicidad en altura desde un extremo al otro, de forma adecuada con la conicidad de un disco vertebral normal, y es capaz de mantener alineación anatómica y lordosis de dos vértebras adyacentes durante el proceso de fusión de la columna vertebral, de manera que se consigue estabilidad simultáneamente entre vértebras adyacentes una vez insertado, y que es autoestabilizante dentro de la columna vertebral.
Estos y otros objetivos de la presente invención quedarán evidentes de los dibujos adjuntos y descripción detallada de los mismos.
Breve descripción de los dibujos
La figura 1 es una vista, en alzado lateral, de un implante de fusión de la columna vertebral que tiene un cuerpo troncocónico y una configuración superficial que comprende perfiles anti-retroceso para el acoplamiento del hueso, con cavidades y canales para el crecimiento óseo.
La figura 1A es una vista parcial, a mayor escala, a lo largo de la línea -1A- de la figura 1, mostrando la configuración superficial del implante de la figura 1.
La figura 2 es una vista, en sección transversal, según la línea de corte -2-2- de la figura 1, mostrando los canales y cavidades del implante de la presente invención.
La figura 3 es una vista, en sección transversal, según la línea de corte -3-3- del implante de la figura 1, mostrando los canales y cavidades del implante de la presente invención.
La figura 3A es una vista, en alzado lateral, de un ejemplo alternativo del implante de fusión de la columna vertebral que tiene un cuerpo troncocónico y una serie de perfiles anti-retroceso que forman una configuración cilíndrica externa.
La figura 4 es una vista, en alzado lateral, de una realización de un implante de fusión de la columna vertebral según la presente invención, que tiene lados truncados formando una superficie plana paralela al eje longitudinal del implante y perfiles anti-retroceso que tienen un radio y altura no constantes.
La figura 5 es una vista en planta del implante de fusión de la columna vertebral mostrado en la figura 4.
La figura 6 es una vista, en alzado lateral, del implante para fusión de la columna vertebral que tiene un cuerpo realizado en un material fibroso en forma de mallas, con forma parcialmente troncocónica, con un lado truncado que se ha mostrado al lado de un segundo implante idéntico mostrado en líneas de trazos.
La figura 7 es una vista, en sección, según la línea de corte -7-7- de los implantes de la figura 6.
La figura 8 es una vista parcial, a mayor escala, según la línea -8- de la figura 6, mostrando la configuración superficial del implante de la figura 6.
La figura 9 es una vista parcial, a mayor escala, a lo largo de la línea -8- de la figura 6, mostrando una configuración superficial del implante realizado en un material combinado.
La figura 10 es una sección transversal, según la línea de corte -10-10- de la figura 9, mostrando la configuración superficial del implante realizado en un material combinado.
La figura 11 es una vista, en alzado lateral, en sección parcial, de un implante de fusión de la columna vertebral que tiene un cuerpo troncocónico y una configuración superficial que comprende una serie de salientes separados entre sí.
La figura 12 es una vista parcial, en sección, a mayor escala, según las líneas -12-12- de la figura 11, mostrando la configuración superficial del implante de la figura 11.
Descripción detallada de los dibujos
Haciendo referencia a la figura 1, se ha mostrado un implante de fusión de la columna vertebral indicado de manera general con el numeral (220). El implante (220) tiene un cuerpo troncocónico (222) y una estructura externa de forma general sustancialmente troncocónica a lo largo de la parte del implante (220) que se encuentra en contacto con las vértebras adyacentes de la columna vertebral. El implante (220) tiene una configuración superficial de perfiles anti-retroceso (240) dirigidos hacia adelante, adecuados para acoplarse al hueso de las vértebras adyacentes. Cada uno de la serie de perfiles anti-retroceso (240) tiene un borde (242) para establecer contacto con el hueso y una zona en forma de rampa (244). Los perfiles anti-retroceso (240) tienen un radio (R_{4}) medido desde el eje central longitudinal (L_{4}) del implante (220) que aumenta desde el extremo de inserción (224) al extremo posterior (226). La altura de los perfiles anti-retroceso (240) medida desde el cuerpo (222) es constante según la longitud del implante (220).
La orientación de los perfiles anti-retroceso (240) hace la inserción del implante (220) más fácil que su extracción, dado que las zonas en rampa (244) actúan como plano inclinado en la entrada, mientras que los bordes (242) de acoplamiento con el hueso resisten el movimiento en las direcciones opuestas. Estos perfiles anti-retroceso dirigidos hacia adelante (240) tienden a forzar al implante (220) hacia adelante, hasta que el hueso no eliminado de las vértebras bloquea la posibilidad de movimiento adicional resultando en una construcción muy estable de la columna vertebral y el implante.
El implante (220) tiene una ranura rebajada (234) en su extremo posterior (226), destinada a recibir y a acoplarse con instrumentación de inserción para la inserción del implante (220). La ranura rebajada (234) tiene una abertura roscada (236) para el acoplamiento por rosca del implante (220) a la instrumentación utilizada para insertar el implante (220).
Los bordes (242) de acoplamiento al hueso de los perfiles anti-retroceso (240) tienen una altura en el punto más alto, medida desde el cuerpo (222) (diámetro de la base) del implante (220) con un valor de 0,25-2,0 mm, con una altura que es preferentemente de 0,4 mm para su utilización en la columna vertebral cervical y 1,25 mm para su utilización en la columna vertebral de la zona lumbar.
Haciendo referencia a las figuras 2 y 3 se han mostrado secciones transversales del implante (220). El implante (220) tiene canales (250) que atraviesan el implante (220) y cavidades (260) formadas en la superficie de dicho implante (220). Las cavidades (260) pueden comunicar o no con los canales (250). Los canales (250) tienen un diámetro comprendido entre 0,1 mm y 6 mm siendo un diámetro preferente 2-3 mm. Las cavidades (260) tienen un diámetro comprendido entre 0,1 mm y 6 mm siendo 1-3 mm las dimensiones de diámetro preferentes. Se apreciará que si bien los canales (250) y las cavidades (260) se han mostrado con una configuración general redondeada, dichos canales (250) y
cavidades (260) podrían tener cualquier forma, dimensión, configuración y distribución adecuadas al objetivo deseado.
Haciendo referencia a la figura 1A el implante (220) tiene una superficie externa (238) que es porosa, presentando una superficie irregular al hueso para favorecer el crecimiento del mismo. La superficie externa (238) es también capaz de retener materiales promotores de la fusión y proporciona un área superficial incrementada para el acoplamiento del hueso en el proceso de fusión y para proporcionar estabilidad adicional. Se apreciará que la superficie externa (238) y/o la totalidad del implante (220) puede comprender cualquier otro material poroso o superficie rugosa suficiente para retener sustancias promotoras de la fusión y/o para permitir el crecimiento óseo y/o establecer contacto con el hueso durante el proceso de fusión. El implante (220) puede estar dotado de más de un recubrimiento de sustancias bioactivas promotoras de la fusión incluyendo, sin que ello sirva de limitación, compuestos de hidroxiapatita, proteínas ostiogénicas y proteínas morfogénicas de hueso. El implante (220) se ha mostrado sólido si bien se apreciará que puede ser sustancialmente hueco o hueco en parte.
Si bien el implante (220) se ha mostrado macizo se observará que dicho implante (220) puede ser hueco por lo menos en parte para proporcionar una cámara interna para la retención del hueso o cualquier material promotor de fusión. Este implante podría tener oberturas para permitir que el hueso externo al implante creciera hacia dentro de la cámara interna. Esta estructura se da a conocer en detalle en la solicitud pendiente con el actual número de serie 08/390.131 y en la solicitud pendiente con el actual número de serie 08/074.781.
Haciendo referencia a la figura 3A se ha mostrado un ejemplo alternativo del implante (220) al que se hace referencia de modo general con el numeral (220'). El implante (220') es similar en configuración al implante (220) excepto que el cuerpo (222') del implante es troncocónico en su configuración y las salientes de retención (240') tienen un radio R_{3} medido desde el eje central longitudinal L_{4} que es constante en sus dimensiones desde el extremo de inserción (224') al extremo posterior (226'). Cada uno de los cuerpos de retención (240') tienen una altura medida desde el cuerpo (222') que no es constante en la totalidad de la longitud del implante (220') y que disminuye desde el extremo de inserción (224') al extremo posterior (226'). De esta manera los salientes de retención (240') forman una configuración externa del implante (220') que tiene una forma sustancialmente cilíndrica, mientras que el cuerpo (220') es troncocónico. El extremo de inserción del implante (220') puede tener una parte cónica (223') de menos diámetro para facilitar la inserción del implante (220').
Los ejemplos según las figuras 1-3A no son parte de la invención pero a pesar de ello dan a conocer algunas características reivindicadas también por la presente invención tales como medios de contacto con el hueso, aberturas en el cuerpo, etc.
Haciendo referencia a las figuras 4 y 5 se ha mostrado una realización de un implante de acuerdo con la invención indicado de manera general con el numeral (220''). El implante (220'') es similar en su configuración al implante (220) y tiene salientes de retención anti retroceso (240'') con un radio R_{5} medido desde el eje central longitudinal L_{5} que aumenta en dimensiones desde el extremo de inserción (224'') hasta el extremo posterior (226''). Los salientes anti retroceso (240'') tienen una altura medida desde el cuerpo (222'') que no es constante en toda la longitud del implante (220''). En la realización precedente el radio de la retención R_{5} y la altura de la misma aumenta en sus dimensiones desde el extremo de inserción (224'') al extremo posterior (226'').
Tal y como se ha mostrado en la figura 5 el implante (220'') tiene lados truncados (270) y (272) que forman dos superficies planas que son diametralmente opuestas y paralelas al eje longitudinal L_{4}. De esta manera se pueden colocar dos implantes (220'') lado a lado con uno de los lados (270) (272) de cada implante en contacto de manera que el área de contacto del hueso con las vértebras adyacentes y los salientes anti retroceso (240'') se hace máximo. De manera alternativa, el implante (220'') puede tener un lado truncado.
Con respecto a otras características referentes a los salientes anti retroceso (240''), la superficie externa, etc, se hará referencia a los implantes previamente descritos.
Los ejemplos de las siguientes figuras no forman parte de la presente invención.
Haciendo referencia a las figuras 6 y 8 se ha mostrado otro implante de fusión de la columna vertebral al que se ha hecho una experiencia de modo general con el numeral (320a). El implante (320a) se ha mostrado adyacente a un segundo implante idéntico (320b) mostrado en líneas de trazo. El implante (320a) tiene un cuerpo (322) realizado en un material en forma de malla que comprende hilos que pueden ser realizados en un metal, que son prensados entre sí moldeados formando una configuración parcialmente troncocónica sustancialmente a lo largo de la parte del implante (320a) en contacto con las vértebras adyacentes de la columna vertebral. El implante (320a) tiene un extremo de inserción (324) y un extremo posterior (326) y puede ser realizado de manera completa o parcialmente en un material sólido y/o un material poroso y/o un material en forma de malla. El implante (320a) puede tener una superficie que comprende un material poroso, un material en forma de malla o puede tener una superficie rugosa. Se observará que el implante (320a) puede ser macizo o puede ser parcialmente hueco y puede incluir como mínimo una cámara interna. Tal y como se ha mostrado en la figura 8 el material en forma de malla comprende hilos formados y prensados conjuntamente de manera que se generan unos intersticios (339) capaces de retener material promotor de la fusión y para permitir crecimiento óseo, entre los hilos como mínimo la superficie externa (338) del implante (320a).
Haciendo referencia a las figuras 9 y 10 alternativamente al implante (320a) puede estar realizado en un material (350) dotado de cavidades similares en configuración a los huesos humanos celulares o porosos con intersticios (352) de manera que la superficie externa (338) tenga un configuración tal y como se ha mostrado en las figuras 9 y 10. Dado que el implante (320a) puede estar realizado de manera completa o en parte del material poroso (350) los intersticios (352) pueden encontrarse presentes en la superficie externa (338) y/o dentro del implante completo (320a) para favorecer el crecimiento óseo y retener los materiales promotores de la fusión ósea.
Haciendo referencia nuevamente a la figura 7 el implante (320a) es parcialmente troncocónico, similar en su forma al implante (20) pero teniendo como mínimo un lado truncado (340) que forma una superficie plana paralela al eje central longitudinal del implante (320). El lado truncado (340) permite la colocación de dos implantes 320a y 320b más próximos entre sí cuando se colocan lado a lado entre dos vértebras adyacentes tal como se ha indicado en la solicitud de patente USA número de serie 08/390.131. El implante (320a) puede ser parcialmente roscado o de otro modo puede parecerse a cualesquiera de las realizaciones que se han descrito o que son funcionalmente equivalentes.
Haciendo referencia a la figura 11 una vista lateral en alzado parcialmente seccionada de otro implante se ha mostrado y se ha indicado de manera general con el numeral (420). El implante (420) tiene un cuerpo (422) troncocónico sustancialmente a lo largo de la parte del implante (420) que se encuentra en contacto con las vértebras adyacentes de la columna vertebral y tiene un extremo de inserción (424) y un extremo posterior (426). El implante (420) tiene una superficie externa (438) que es capaz de recibir y retener hueso u otros materiales capaces de participar en el proceso de fusión y/o capaces de promover el crecimiento óseo. La superficie (438) comprende una serie de salientes (440) que están separados entre sí para proporcionar una serie de intersticios (442) que son cavidades parciales con paredes incompletas capaces de soportar y retener material fresado del hueso o cualquier otro material artificial promotor del crecimiento óseo. El implante (420) puede ser preparado para implantación mediante una lechada o por recubrimiento de la superficie (438) con las sustancias de promoción de fusión apropiadas.
Haciendo referencia a la figura 12 se ha mostrado una vista ampliada de la superficie (438) del implante (420). Los salientes (440) tienen una parte (444) de la cabeza con mayor diámetro que el resto de dichos salientes (440) y cada uno de los intersticios (442) tiene la configuración inversa a la de los salientes (444), teniendo un fondo (446) más ancho que la entrada (448) de los intersticios (442). Esta configuración de los salientes (440) y de los intersticios (442) ayuda a la retención de material óseo en la superficie (438) del implante (420) y además ayuda en el bloqueo del implante (420) en la masa de fusión ósea creada a partir del crecimiento óseo. Dado que el crecimiento óseo en el fondo (466) de los intersticios (442) es más ancho que en la entrada (448), el crecimiento óseo no puede salir de las entradas (448) y está bloqueado dentro del intersticio (442). La superficie (438) del implante (420) proporciona una mejora de la cantidad de área superficial disponible que puede ser incrementada adicionalmente por acabado grosero, flocado o produciendo de otro modo una superficie que no es lisa.
Los salientes (440) pueden tener un diámetro máximo dentro de una gama aproximada de 0,1-2 mm y una altura aproximada de 0,1-2 mm y están separados entre sí por una distancia aproximada de 0,1-2 mm de forma tal que los intersticios (442) tienen una anchura comprendida aproximadamente entre 0,1-2 mm. Las dimensiones, formas y distribuciones de dichos salientes se podrán variar dentro del mismo implante.
Si bien la presente invención ha sido descrita en detalle con respecto a las realizaciones preferentes, se observará que se pueden diseñar otras variantes de la presente invención sin salir del ámbito de las siguientes reivindicaciones.

Claims (14)

1. Implante troncocónico para la fusión interna de la columna vertebral, para su inserción en la altura corregida quirúrgicamente de un espacio discal entre cuerpos vertebrales adyacentes de una columna vertebral humana, cuyo implante comprende:
un cuerpo (222'')que tienen un eje longitudinal (L_{4}, L_{5}), un extremo de inserción (224''), un extremo posterior (226''), un tramo entre dichos extremos, una parte superior adaptada para su orientación hacia uno de los cuerpos vertebrales adyacentes, una parte inferior adaptada para su orientación hacia el otro de los cuerpos vertebrales adyacentes y una altura entre dicha parte superior y dicha parte inferior transversalmente a dicho tramo, siendo constante la altura de dichas partes superior e inferior a lo largo de una parte de la longitud de dicho implante y teniendo dichas partes superior e inferior como mínimo una obertura para permitir el crecimiento de hueso desde un cuerpo vertebral adyacente al cuerpo vertebral adyacente a través de dicho implante y
medios (240'') de acoplamiento con el hueso que se extienden como mínimo desde la parte de dichas zonas superior e inferior adaptadas para establecer contacto con dicho implante a los cuerpos vertebrales adyacentes de la columna vertebral una vez implantados en la columna vertebral, estando realizado dicho implante en un material apropiado para la implantación humana en el que
dichos medios de acoplamiento con el hueso tienen una altura máxima más cerca de dicho extremo posterior que dicho extremo de inserción que aumenta desde dicho extremo de inserción al mencionado extremo posterior a lo largo de como mínimo una parte de la longitud de dicho cuerpo (222'').
2. Implante, según la reivindicación 1, en el que dichos medios de acoplamiento con el hueso incluyen una serie de salientes anti retroceso (240'').
3. Implante, según la reivindicación 2, en el que dichos salientes anti retroceso (240'') están dirigidos hacia adelante.
4. Implante, según la reivindicación 1, en la que dichos medios de acoplamiento con el hueso comprenden moleteado.
5. Implante, según cualquiera de las reivindicaciones anteriores, en el que dichos medios de acoplamiento con el hueso tienen una parte externa y forma una configuración sustancialmente troncocónica.
6. Implante según, cualquiera de las reivindicaciones anteriores, en el que dicho cuerpo (222'') comprende una cámara interna en comunicación con una o varias de dichas aberturas.
7. Implante, según cualquiera de las reivindicaciones anteriores, en el que dicho cuerpo (222'') tiene como mínimo un lado truncado (270, 272) que forma una superficie plana con respecto al eje longitudinal medio.
8. Implante, según cualquiera de las reivindicaciones anteriores, en el que dicho implante se ha configurado para situación con gran proximidad en una alineación lado a lado con respecto a un segundo implante de fusión de la columna vertebral, teniendo dichos primer y segundo implantes una vez colocados conjuntamente una anchura combinada general que es menor que la suma de las anchuras individuales máximas de cada uno de dichos primer y segundo implantes.
9. Implante, según cualquiera de las reivindicaciones anteriores, en que dichos implantes están realizados en un material más resistente que el hueso.
10. Implante, según cualquiera de las reivindicaciones anteriores, en que dicho implante está realizado en un material artificial distinto del hueso.
11. Implante, según la reivindicación 10, en que dicho material es poroso.
12. Implante, según cualquiera de las reivindicaciones anteriores, en que dicho implante es como mínimo bioabsorbible.
13. Implante, según cualquiera de las reivindicaciones anteriores, en combinación con un material promotor de la fusión.
14. Implante, según la reivindicación 13, en que dicho material promotor de la fusión es como mínimo uno de: hueso, proteína morfogénica de hueso e hidroxiapatita.
ES04007353T 1995-06-07 1996-06-06 Cuerpo intermedio para implante por fusion de la columna vertebral. Expired - Lifetime ES2293113T3 (es)

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EP0836457B1 (en) 2004-09-01
DE69637271T2 (de) 2008-01-24
US20050165489A1 (en) 2005-07-28
EP0836457A1 (en) 1998-04-22
US7942933B2 (en) 2011-05-17
US20100217394A1 (en) 2010-08-26
EP1442732B1 (en) 2007-09-26
CN1190881A (zh) 1998-08-19
ATE373999T1 (de) 2007-10-15
EP1442732A1 (en) 2004-08-04
CA2224249C (en) 2007-11-27
US8409292B2 (en) 2013-04-02
DE29623360U1 (de) 1998-03-19
CA2224249A1 (en) 1996-12-19
US6923810B1 (en) 2005-08-02
KR19990022610A (ko) 1999-03-25
ATE274889T1 (de) 2004-09-15
US20050165399A1 (en) 2005-07-28
US20110224795A1 (en) 2011-09-15
JP2006061708A (ja) 2006-03-09
DE69633287T2 (de) 2005-01-13
US7691148B2 (en) 2010-04-06
JP4005613B2 (ja) 2007-11-07
JPH11506656A (ja) 1999-06-15
JP4011616B2 (ja) 2007-11-21
EP0836457A4 (en) 1999-09-15
DE69633287D1 (de) 2004-10-07
DE69637271D1 (de) 2007-11-08
WO1996040019A1 (en) 1996-12-19
AU6036096A (en) 1996-12-30
CN1149059C (zh) 2004-05-12

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