ES2305761T3 - Implante de columna vertebral. - Google Patents

Implante de columna vertebral. Download PDF

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Publication number
ES2305761T3
ES2305761T3 ES04726859T ES04726859T ES2305761T3 ES 2305761 T3 ES2305761 T3 ES 2305761T3 ES 04726859 T ES04726859 T ES 04726859T ES 04726859 T ES04726859 T ES 04726859T ES 2305761 T3 ES2305761 T3 ES 2305761T3
Authority
ES
Spain
Prior art keywords
contact plate
support
contact
implant according
support arm
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
ES04726859T
Other languages
English (en)
Inventor
Stephan Lindner
Jorg Schumacher
Ulrich Kramer
Uwe Bader
Stefan Wallstein
Robert Schultz
Jens Beger
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.)
Aesculap AG
Original Assignee
Aesculap AG
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 Aesculap AG filed Critical Aesculap AG
Application granted granted Critical
Publication of ES2305761T3 publication Critical patent/ES2305761T3/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
    • 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
    • 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
    • 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
    • A61F2/48—Operating or control means, e.g. from outside the body, control of sphincters
    • A61F2/484—Fluid means, i.e. hydraulic or pneumatic
    • 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
    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30112—Rounded shapes, e.g. with rounded corners
    • A61F2002/30131—Rounded shapes, e.g. with rounded corners horseshoe- or crescent- or C-shaped or U-shaped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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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
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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
    • 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
    • A61F2002/30365—Rotation about the common longitudinal axis with additional means for limiting said rotation
    • 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
    • A61F2002/30362—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
    • A61F2002/3039—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 with possibility of relative movement of the rib within the groove
    • A61F2002/30392—Rotation
    • A61F2002/30395—Rotation with additional means for preventing or locking said rotation
    • 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
    • A61F2002/30405—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by screwing complementary threads machined on the parts themselves
    • 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
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30471—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements connected by a hinged linkage mechanism, e.g. of the single-bar or multi-bar linkage type
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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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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
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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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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
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    • A61F2002/30523—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements with possibility of relative movement between the prosthetic parts by means of meshing gear teeth
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    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
    • A61F2002/30538—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation
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    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
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    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30565—Special structural features of bone or joint prostheses not otherwise provided for having spring elements
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    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30579—Special structural features of bone or joint prostheses not otherwise provided for with mechanically expandable devices, e.g. fixation devices
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Abstract

Implante (1) de columna vertebral con una placa (42) de contacto que forma una superficie de contacto para apoyarse en un cuerpo vertebral, caracterizado porque presenta un rebaje (46), que aloja al menos un brazo (47) de apoyo, que está montado en la placa (42) de contacto de manera que puede pivotar alrededor de un eje (48) pivotante situado en perpendicular sobre la placa (42) de contacto, y porque el al menos un brazo (47) de apoyo pivotante puede pivotar entre un estado pivotado hacia dentro, en el que la placa (42) de contacto cubre completamente el al menos un brazo (47) de apoyo, y un estado pivotado hacia fuera, en el que el al menos un brazo (47) de apoyo sobresale por encima del contorno externo de la placa (42) de contacto.

Description

Implante de columna vertebral.
La invención se refiere a un implante de columna vertebral con una placa de contacto que forma una superficie de contacto para apoyarse en un cuerpo vertebral.
Los implantes de columna vertebral pueden utilizarse en un espacio intervertebral para sustituir un disco intervertebral retirado y por consiguiente apoyar entre sí dos cuerpos vertebrales directamente contiguos, ya sea mediante una conexión rígida o mediante una conexión articulada. En este caso los implantes de columna vertebral están en contacto como implantes planos con sus superficies de contacto con las caras frontales de los cuerpos vertebrales contiguos.
Sin embargo, los implantes de columna vertebral de este tipo también se requieren como implantes sustitutivos de cuerpos vertebrales que deben puentear uno o varios cuerpos vertebrales ausentes. Los implantes de este tipo tienen entonces una altura considerable, ya que al menos deben ser igual de altos que un cuerpo vertebral, con esto los implantes sustitutivos de cuerpos vertebrales de este tipo se diferencian claramente de los implantes intervertebrales, que se insertan como sustitución de discos intervertebrales o como implante de fusión entre dos cuerpos vertebrales, que naturalmente son directamente adyacentes entre sí.
Para garantizar un apoyo fiable del implante de columna vertebral en los cuerpos vertebrales contiguos es favorable, tanto en el caso de implantes sustitutivos de cuerpos vertebrales como en el caso de implantes intervertebrales, usar superficies de contacto lo más grandes posible para que las fuerzas de compresión se distribuyan por una superficie grande y evitar picos de compresión. Las superficies de contacto corresponden por consiguiente a menudo a la superficie de las superficies finales de los cuerpos vertebrales, y por tanto puede ser difícil, introducir estos implantes de columna vertebral en el cuerpo. Para ello se necesitan accesos con un gran diámetro. Esto imposibilita accesos invasivos mínimos y dificulta también el guiado del implante entre las osteómeras del esqueleto, por ejemplo entre los arcos costales.
Se produce el mismo problema en el caso de implantes que si bien no deben sustituir un cuerpo vertebral completamente ausente, sí deben reforzar un cuerpo vertebral debilitado o parcialmente ausente, por ejemplo cuando este cuerpo vertebral muestra fracturas debido a osteoporosis. En estos casos los implantes de este tipo pueden introducirse lateralmente en las mismas a través de una abertura efectuada en el cuerpo vertebral y atraviesan entonces este cuerpo vertebral que ha de reforzarse, estando las superficies de contacto del implante tal como en el caso de un implante sustitutivo de cuerpos vertebrales en contacto con las superficies de contacto de los cuerpos vertebrales, que en ambas caras limitan con el cuerpo vertebral que ha de reforzarse. En este caso el implante es por tanto un implante de apoyo de cuerpos vertebrales aunque cuya longitud debe puentear naturalmente, igual que en el caso de un implante sustitutivo de cuerpos vertebrales, la distancia total entre los cuerpos vertebrales que por ambas caras limitan con el cuerpo vertebral debilitado y que ha de reforzarse. Por este motivo se usará en lo sucesivo para todos los implantes de este tipo la expresión común implante de columna vertebral, también cuando se trate en el caso particular de un implante que atraviesa un cuerpo vertebral aún presente y de este modo lo apoya.
En el documento US-B1-6.193.757 se describe un implante de columna vertebral, en el que puede modificarse la distancia entre superficies de apoyo en forma de alma mediante el pivotado de piezas de implante o mediante el desplazamiento de dos piezas de implante una respecto a otra, de modo que el implante de columna vertebral presenta para la introducción en el cuerpo un contorno menor que en el estado introducido, en el que las superficies de apoyo en forma de alma presentan una mayor distancia entre sí y por tanto pueden apoyar la superficie vertebral en zonas más externas, más estables. Sin embargo, el apoyo se efectúa a este respecto sólo en zonas en forma de alma, de modo que en ciertas circunstancias pueden aparecer puntas de compresión relativamente elevadas. Además este implante presenta bordes agudos que pueden hacer difícil su introducción.
El objetivo de la invención es configurar un implante de columna vertebral del tipo descrito al principio de modo que pueda introducirse en el cuerpo sin problemas también a través de accesos con un menor diámetro y que a pesar de ello exista la posibilidad de que el implante de columna vertebral apoye con una gran superficie un cuerpo vertebral adyacente.
Este objetivo se soluciona en el caso de un implante de columna vertebral del tipo descrito al principio según una primera forma de realización preferida según la invención porque la placa de contacto presenta un rebaje, que aloja al menos un brazo de apoyo, que está montado en la placa de contacto de manera que puede pivotar alrededor de un eje pivotante situado en perpendicular sobre la placa de contacto, y porque el al menos un brazo de apoyo pivotante puede pivotar entre un estado pivotado hacia dentro, en el que la placa de contacto cubre completamente el al menos un brazo de apoyo, y un estado pivotado hacia fuera, en el que el al menos un brazo de apoyo sobresale por encima del contorno externo de la placa de
contacto.
Se encarga por tanto de que si bien la superficie de contacto en la posición de contacto en la que está en contacto con la superficie final de los cuerpos vertebrales y en la que está implantada definitivamente presenta la extensión completa y con ello garantiza una buena distribución de la presión, sin embargo también se consigue mediante la modificación de la forma o de la disposición de esta superficie de contacto que para la introducción del implante en el cuerpo la extensión de la superficie de contacto en su plano sea menor que en la posición de contacto definitiva. De este modo se obtiene un implante completo con una menor dimensión y esto facilita la introducción en el cuerpo a través de un acceso con un menor diá-
metro.
A este respecto el eje pivotante del brazo de apoyo puede estar dispuesto en un borde longitudinal de la placa de contacto, especialmente en la zona en la zona del ángulo.
Es ventajoso que en los bordes laterales opuestos de la placa de contacto esté montado en cada caso un brazo de apoyo.
El brazo de apoyo en la posición pivotada hacia fuera puede estar fijado en esta posición por un elemento de bloqueo y de este modo estar asegurado contra un pivotado hacia dentro, por ejemplo el elemento de bloqueo puede ser un muelle de hojas que al pivotar hacia fuera se curva alejándose del brazo de apoyo.
En una segunda forma de realización se soluciona este objetivo en el caso de un implante de columna vertebral del tipo descrito al principio según la invención porque la placa de contacto presenta un rebaje, que aloja un cuerpo de apoyo que puede desplazarse paralelo consigo mismo en una guía, que puede desplazarse de una posición desplazada hacia dentro, en la que la placa de contacto cubre completamente el cuerpo de apoyo, a una posición desplazada hacia fuera, en la que el cuerpo de apoyo sobresale por encima del contorno externo de la placa de contacto.
Este cuerpo de apoyo puede estar configurado especialmente en forma de U y puede desplazarse en paralelo con respecto a sus lados.
También en este caso es ventajoso que el cuerpo de apoyo en la posición desplazada hacia fuera esté fijado en esta posición por un elemento de bloqueo y de este modo esté asegurado contra un desplazamiento hacia dentro.
La longitud de la placa de contacto puede ser aproximadamente el doble que su anchura, de modo que es posible una introducción especialmente favorable en el cuerpo.
La placa de contacto en su cara alejada del cuerpo vertebral puede estar apoyada de manera pivotante a través de una articulación en otra placa de contacto, siendo esto especialmente favorable en el caso de implantes que se utilizan como implante intervertebral.
A este respecto la articulación comprende según una forma de realización preferida superficies de apoyo abombadas de cerámica que actúan conjuntamente.
La siguiente descripción de una forma de realización preferida de la invención en relación con el dibujo sirve para una explicación más detallada. Muestran:
la figura 1: una vista en perspectiva de una placa de contacto de un implante intervertebral con brazos de apoyo pivotados hacia dentro;
la figura 2: una vista lateral de un implante intervertebral con dos placas de contacto;
la figura 3: una vista en corte a lo largo de la línea 3-3 en la figura 2;
la figura 4: una vista desde arriba de la placa de contacto de la figura 1 con un brazo de apoyo pivotado hacia dentro y con uno pivotado hacia fuera;
la figura 5: una vista similar a la figura 4 en otro ejemplo de realización preferido de una placa de contacto con un brazo de apoyo;
la figura 6: una vista lateral de un ejemplo de realización modificado de una placa de contacto de un implante intervertebral con un elemento de apoyo extraíble y
la figura 7: una vista desde arriba de la placa de contacto de la figura 6 con el elemento de apoyo en diferentes posiciones.
En el dibujo están representados implantes 41 intervertebrales que tras la retirada del disco intervertebral pueden introducirse en el espacio intervertebral entre dos cuerpos vertebrales contiguos.
El implante 41 intervertebral representado en las figuras 1 a 4 comprende una placa 42 de contacto longitudinal aproximadamente rectangular que es aproximadamente el doble de larga que ancha. A este respecto la longitud corresponde aproximadamente a la dimensión transversal de la superficie de apoyo del cuerpo vertebral, en perpendicular a esto la placa 42 de contacto es por el contrario sólo la mitad de ancha que la superficie de contacto del cuerpo vertebral. La forma en el ejemplo de realización representado se ha seleccionado fundamentalmente rectangular, pero también podría seleccionarse una forma arriñonada o curvada de otra manera que se adapte al contorno de la superficie del cuerpo vertebral.
En una cara la placa 42 de contacto lleva salientes 43 de anclaje que en el caso de contacto con un cuerpo vertebral penetran en el mismo e inmovilizan la placa 42 de contacto.
Dos placas 42 de contacto de este tipo forman conjuntamente un implante 41 intervertebral, para ello las dos placas 42 de contacto están dotadas en las caras orientadas una hacia la otra de superficies 44 articuladas abombadas, configuradas complementariamente una con la otra y en contacto entre sus superficies, que se forman por ejemplo por piezas de inserción cerámicas que están introducidas de manera fija en las entalladuras correspondientes de la placa 42 de contacto. De este modo ambas placas 42 de contacto se apoyan de manera pivotante entre sí y pueden pivotar una respecto a otra en ciertos límites.
Cada una de las dos placas 42 de contacto presenta a lo largo de un borde 45 longitudinal un rebaje 46 que aloja en cada caso dos brazos 47 de apoyo. En el ejemplo de realización representado en las figuras 1 a 4 ambos brazos 47 de apoyo están construidos con simetría de espejo entre sí, por tanto sólo se explica con más detalle uno de los brazos 47 de apoyo. El brazo de apoyo está montado de manera que puede pivotar alrededor de un eje pivotante situado en perpendicular sobre la placa 42 de contacto, el eje pivotante se encuentra en una zona de ángulo. En esta zona el brazo 47 de apoyo rodea el eje 48 pivotante en forma de ojal y se extiende con una pieza 49 de prolongación aproximadamente hasta la mitad de la placa 42 de contacto, cuando ambos brazos 47 de apoyo están pivotados hacia dentro en el rebaje 46 (figura 1). Las piezas 49 de prolongación se encuentran entonces en el centro de la placa 42 de contacto directamente una enfrente de la otra, a este respecto la placa 42 de contacto cubre completamente los brazos 47 de apoyo.
Ambos brazos 47 de apoyo pueden pivotarse hacia fuera desde esta situación, de modo que la pieza 49 de prolongación sobresale por encima del contorno externo de la placa 42 de contacto y de este modo se aumenta la superficie de contacto eficaz de la placa 42 de contacto (figura 3). En el brazo 47 de apoyo está colocado lateralmente un muelle 50 de hojas que al pivotar hacia fuera el brazo 47 de apoyo se desplaza elásticamente hacia fuera y entra en contacto con su extremo libre con un borde 51 del rebaje 46 de modo que el brazo 47 de apoyo ya no puede pivotar de vuelta a la posición pivotada hacia dentro. Se obtiene con esto una protección contra un pivotado hacia dentro no deseado del brazo 47 de apoyo.
En el ejemplo de realización de la figura 5, que está construido fundamentalmente igual y en el que por tanto las mismas piezas tienen los mismos números de referencia, únicamente están sustituidos los dos brazos 47 de apoyo por un único brazo 47 de apoyo que se extiende fundamentalmente por toda la longitud de la placa 42 de contacto. A este respecto la pieza 49 de prolongación está configurada en forma de arco, de modo que al pivotar hacia fuera el brazo 47 de apoyo se produce un aumento lo más grande posible de la superficie de contacto eficaz y la pieza 49 de prolongación se extiende en la medida de lo posible por encima de la zona de borde del cuerpo vertebral, que presenta una resistencia especialmente elevada. Esto es válido por lo demás también en el caso de los brazos 47 de apoyo en el ejemplo de realización de las figuras 1 a 4, también en este caso las piezas 49 de prolongación llegan a la zona de borde especialmente estable del cuerpo vertebral y apoyan por tanto la placa de contacto de manera especialmente eficaz sobre cuerpo vertebral.
Mientras que en los ejemplos de realización de las figuras 1 a 5 se usan brazos de apoyo pivotantes para el aumento de la superficie de contacto eficaz de la placa 42 de contacto, la placa 42 de contacto del ejemplo de realización de las figuras 6 y 7, que por lo demás está construido de manera similar y en el que las mismas piezas tienen los mismos números de referencia, presenta un elemento 52 de apoyo, que está configurado en forma de U y por tanto presenta dos lados 53 paralelos y un alma 54 curvada que los une. Este elemento 52 de apoyo está montado en paralelo con respecto a sus lados 53 de manera que puede desplazarse en el rebaje 46 y por consiguiente puede desplazarse de una posición desplazada hacia dentro, en la que la placa 42 de contacto cubre completamente el elemento 52 de apoyo (dibujado en la figura 7 con líneas continuas) a una posición desplazada hacia fuera (en la figura 7 en líneas discontinuas), en la que el alma 54 y las partes de los lados 53 sobresalen por encima del contorno de la placa 42 de contacto y por consiguiente aumentan su superficie de contacto eficaz. También en este caso puede estar previsto un elemento de bloqueo, por ejemplo usando un muelle de hojas, tal como se muestra en el ejemplo de la figura 4.
Mediante las dimensiones relativamente pequeñas de la placa 42 de contacto es posible introducir este implante intervertebral desde el lateral en el espacio intervertebral y no, tal como es habitual, de manera ventral, así también puede efectuarse un implante en los casos en los que debido a circunstancias anatómicas la introducción ventral ocasionaría dificultades o sería imposible. A pesar de ello, mediante el pivotado hacia fuera o la extracción de los brazos de apoyo o de los elementos de apoyo puede aumentarse tanto la superficie de contacto eficaz de la placa 42 de contacto que las fuerzas de apoyo se distribuyen por una superficie de contacto muy grande, de modo que no existe ningún riesgo de que las placas 42 de contacto penetren en los cuerpos vertebrales.
Las diferentes construcciones para el aumento de las superficies de contacto pueden intercambiarse opcionalmente entre los implantes sustitutivos de cuerpos vertebrales y los implantes intervertebrales, es decir las construcciones descritas en los ejemplos por medio de implantes intervertebrales e implantes sustitutivos de cuerpos vertebrales no se limitan únicamente a los mismos.

Claims (11)

1. Implante (1) de columna vertebral con una placa (42) de contacto que forma una superficie de contacto para apoyarse en un cuerpo vertebral, caracterizado porque presenta un rebaje (46), que aloja al menos un brazo (47) de apoyo, que está montado en la placa (42) de contacto de manera que puede pivotar alrededor de un eje (48) pivotante situado en perpendicular sobre la placa (42) de contacto, y porque el al menos un brazo (47) de apoyo pivotante puede pivotar entre un estado pivotado hacia dentro, en el que la placa (42) de contacto cubre completamente el al menos un brazo (47) de apoyo, y un estado pivotado hacia fuera, en el que el al menos un brazo (47) de apoyo sobresale por encima del contorno externo de la placa (42) de contacto.
2. Implante de columna vertebral según la reivindicación 1, caracterizado porque el eje (48) pivotante del brazo (47) de apoyo está dispuesto en un borde (45) longitudinal de la placa (42) de contacto.
3. Implante de columna vertebral según la reivindicación 1 ó 2, caracterizado porque en bordes laterales opuestos de la placa (42) de contacto está montado en cada caso un brazo (47) de apoyo.
4. Implante de columna vertebral según una de las reivindicaciones anteriores, caracterizado porque el brazo (47) de apoyo en la posición pivotada hacia fuera está fijado en esta posición por un elemento (50) de bloqueo y de este modo está asegurado contra un pivotado hacia dentro.
5. Implante de columna vertebral según la reivindicación 4, caracterizado porque el elemento de bloqueo es un muelle (50) de hojas que al pivotarse hacia fuera se curva alejándose del brazo (47) de apoyo.
6. Implante de columna vertebral con una placa (42) de contacto que forma una superficie de contacto para apoyarse en un cuerpo vertebral, caracterizado porque presenta un rebaje (46), que aloja un cuerpo (52) de apoyo que puede desplazarse paralelo consigo mismo en una guía, que puede desplazarse de una posición desplazada hacia dentro, en la que la placa (42) de contacto cubre completamente el cuerpo (52) de apoyo, a una posición desplazada hacia fuera, en la que el cuerpo (52) de apoyo sobresale por encima del contorno externo de la placa (42) de contacto.
7. Implante de columna vertebral según la reivindicación 6, caracterizado porque el cuerpo (52) de apoyo está configurado en forma de U y puede desplazarse en paralelo con respecto a sus lados (53).
8. Implante de columna vertebral según la reivindicación 6 ó 7, caracterizado porque el cuerpo (52) de apoyo en la posición desplazada hacia fuera está fijado en esta posición por un elemento de bloqueo y de este modo está asegurado contra un desplazamiento hacia dentro.
9. Implante de columna vertebral según una de las reivindicaciones anteriores, caracterizado porque la longitud de la placa (42) de contacto es aproximadamente el doble que su anchura.
10. Implante de columna vertebral según una de las reivindicaciones anteriores, caracterizado porque la placa (42) de contacto en su cara alejada del cuerpo vertebral está apoyada de manera pivotante a través de una articulación (44) en otra placa (42) de contacto.
11. Implante de columna vertebral según la reivindicación 10, caracterizado porque la articulación comprende superficies (44) de apoyo abombadas de cerámica que actúan conjuntamente.
ES04726859T 2003-05-21 2004-04-10 Implante de columna vertebral. Expired - Lifetime ES2305761T3 (es)

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DE20311400U DE20311400U1 (de) 2003-05-21 2003-07-24 Wirbelsäulenimplantat
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EP1624830A2 (de) 2006-02-15
DE20311400U1 (de) 2003-10-02
DE502004007288D1 (de) 2008-07-10
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DE20308171U1 (de) 2003-07-31
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US20050060036A1 (en) 2005-03-17
EP1624830B1 (de) 2008-05-28

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