FR2722980A1 - Implant vertebral inter-epineux - Google Patents
Implant vertebral inter-epineux Download PDFInfo
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- FR2722980A1 FR2722980A1 FR9409493A FR9409493A FR2722980A1 FR 2722980 A1 FR2722980 A1 FR 2722980A1 FR 9409493 A FR9409493 A FR 9409493A FR 9409493 A FR9409493 A FR 9409493A FR 2722980 A1 FR2722980 A1 FR 2722980A1
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- 239000007943 implant Substances 0.000 title claims abstract description 40
- RTAQQCXQSZGOHL-UHFFFAOYSA-N Titanium Chemical compound [Ti] RTAQQCXQSZGOHL-UHFFFAOYSA-N 0.000 claims abstract description 6
- 239000010936 titanium Substances 0.000 claims abstract description 6
- 229910052719 titanium Inorganic materials 0.000 claims abstract description 6
- 238000000034 method Methods 0.000 claims description 40
- 210000005069 ears Anatomy 0.000 claims description 21
- 239000013013 elastic material Substances 0.000 claims description 3
- 239000004744 fabric Substances 0.000 claims description 3
- 229920002994 synthetic fiber Polymers 0.000 claims description 3
- 239000007769 metal material Substances 0.000 claims description 2
- 210000000988 bone and bone Anatomy 0.000 abstract description 4
- 230000002452 interceptive effect Effects 0.000 abstract 1
- 210000003041 ligament Anatomy 0.000 description 9
- 208000003618 Intervertebral Disc Displacement Diseases 0.000 description 3
- 206010050296 Intervertebral disc protrusion Diseases 0.000 description 3
- 238000002513 implantation Methods 0.000 description 3
- 239000000463 material Substances 0.000 description 3
- 206010019909 Hernia Diseases 0.000 description 2
- 208000007623 Lordosis Diseases 0.000 description 2
- 238000005481 NMR spectroscopy Methods 0.000 description 2
- 210000003484 anatomy Anatomy 0.000 description 2
- 238000013016 damping Methods 0.000 description 2
- 238000009434 installation Methods 0.000 description 2
- 230000007935 neutral effect Effects 0.000 description 2
- 239000004753 textile Substances 0.000 description 2
- 230000003313 weakening effect Effects 0.000 description 2
- 230000002159 abnormal effect Effects 0.000 description 1
- 238000004026 adhesive bonding Methods 0.000 description 1
- 238000004873 anchoring Methods 0.000 description 1
- 230000015556 catabolic process Effects 0.000 description 1
- 238000006731 degradation reaction Methods 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 238000012423 maintenance Methods 0.000 description 1
- 239000002184 metal Substances 0.000 description 1
- 229910052751 metal Inorganic materials 0.000 description 1
- 201000008482 osteoarthritis Diseases 0.000 description 1
- 230000007170 pathology Effects 0.000 description 1
- 230000002980 postoperative effect Effects 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers, e.g. stabilisers comprising fluid filler in an implant
- A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
-
- 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
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30565—Special structural features of bone or joint prostheses not otherwise provided for having spring elements
- A61F2002/30571—Leaf springs
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30576—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
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30772—Apertures or holes, e.g. of circular cross section
- A61F2002/30784—Plurality of holes
- A61F2002/30785—Plurality of holes parallel
-
- 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
- A61F2002/449—Joints for the spine, e.g. vertebrae, spinal discs comprising multiple spinal implants located in different intervertebral spaces or in different vertebrae
-
- 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0004—Rounded shapes, e.g. with rounded corners
- A61F2230/0013—Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00005—The prosthesis being constructed from a particular material
- A61F2310/00011—Metals or alloys
- A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S606/00—Surgery
- Y10S606/907—Composed of particular material or coated
Landscapes
- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Neurology (AREA)
- Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
Abstract
Cet implant (1) comprend un corps (5) sensiblement en forme de U présentant une souplesse élastique au niveau de sa partie centrale (5a), et deux paires d'oreilles (6) faisant saillie de la face extérieure des deux branches (5b) du corps (5), ces oreilles (6) délimitant des chapes (7) de réception des apophyses épineuses des vertèbres et comprenant des moyens (8) permettant d'assurer leur fixation aux apophyses (2).
Description
La présente invention concerne un implant vertébral inter- épineux,
c'est-à-dire un implant destiné à être inséré entre les apophyses épineuses de deux
vertèbres adjacentes.
La dégradation d'un disque inter-vertébral peut amener à un jeu anormal des vertèbres attenantes à ce disque. Ce jeu soumet les apophyses articulaires postérieures à des contraintes importantes, générant une usure très douloureuse de ces apophyses et une instabilité
générale du rachis.
Une telle instabilité peut également résulter d'une intervention sur une hernie discale, ayant conduit à un abord du disque, donc à un affaiblissement du système ligamentaire de l'articulation, ou de certains cas d'arthrose soumettant également les articulations postérieures à des contraintes importantes et douloureuses. Pour remédier à cette instabilité, il est connu d'implanter des dispositifs d'étayage du rachis, comprenant des éléments rigides reliés à des moyens
d'ancrage osseux.
Les éléments rigides sont fréquemment constitués par des tiges métalliques qui sont implantées le long de plusieurs vertèbres, de part et d'autre des apophyses épineuses. Les moyens d'ancrage osseux sont généralement constitués par des vis, dites "pédiculaires", car
implantées au niveau des pédicules vertébrales.
Ces dispositifs présentent l'inconvénient d'être difficiles à implanter, en nécessitant notamment un travail de mise en place important et complexe. De plus et surtout, ils immobilisent un segment vertébral relativement long, ce qui réduit notablement la mobilité du patient et peut soumettre les articulations situées de part et d'autre de ce segment rigide à des contraintes
importantes, susceptibles de générer de nouvelles pathologies.
Il est connu de remédier à une instabilité du rachis par la mise en place d'une cale insérée entre les
apophyses épineuses.
Une telle cale peut notamment être implantée à une extrémité du segment du rachis rigidifié par un dispositif d'ostéosynthèse tel que précité, afin d'assurer un maintien relatif des vertèbres et de limiter les
contraintes qu'elles subissent.
Une cale existante comprend un coussinet inter-épineux dont la fixation au rachis est assurée par
un ligament textile venant entourer les apophyses.
Lors de l'extension du rachis, le coussinet permet de maintenir un écart minimum entre les apophyses des deux vertèbres et de soulager ainsi le disque inter-vertébral ainsi que les articulations postérieures. Lors de la flexion du rachis, le ligament limite l'écartement des
deux apophyses.
Ce coussinet, également réalisé en matière textile, présente l'inconvénient d'être relativement rigide et donc de maintenir les vertèbres dans une position déterminée, guère confortable pour le patient. En outre, il a tendance à s'user sous l'exercice des
contraintes répétées qu'il subit.
La nécessité de faire passer le ligament autour des apophyses implique d'intervenir au niveau de zones anatomiques saines pour aménager un passage, et d'affaiblir les ligaments naturels. De plus, il est difficile de déterminer la tension adéquate à donner au ligament pour régler la possibilité de jeu des apophyses par rapport au coussinet. En outre, le ligament s'use sous l'effet des sollicitations répétées que les apophyses exercent sur lui et a également tendance à se distendre, ce qui favorise cette usure et réduit la limitation du
mouvement des vertèbres lors de la flexion du rachis.
La présente invention vise à remédier à l'ensemble de ces inconvénients, en fournissant un implant inter-épineux assurant un positionnement souple des vertèbres l'une par rapport à l'autre, agissant de manière anatomique et confortable pour le patient, qui ne soit pas sujet à une usure même sous l'exercice de contraintes répétées, et dont la pose soit simple, facile et rapide à réaliser, sans nécessiter d'intervenir au niveau de zones
anatomiques saines.
A cette fin, l'implant qu'elle concerne comprend un corps sensiblement en forme de U présentant une souplesse élastique au niveau de sa partie centrale, et deux paires d'oreilles faisant saillie de la face extérieure des deux branches du corps, ces oreilles délimitant des chapes de réception des apophyses épineuses des vertèbres et comprenant des moyens permettant
d'assurer leur fixation aux apophyses.
Cet implant est destiné à être inséré dans l'espace inter- épineux, avec venue de ladite partie centrale au niveau des apophyses articulaires postérieures, avec venue desdites branches latérales contre les apophyses épineuses, et avec engagement de
chaque paire d'oreilles autour d'une apophyse épineuse.
Grace à la souplesse de la partie centrale de son corps, l'implant assure un positionnement souple des vertèbres l'une par rapport à l'autre. Il permet une flexion et une extension du rachis de part et d'autre d'une position neutre correspondant à la position sensiblement parallèle des deux branches latérales de son corps en U. La limite élastique de cette partie centrale permet d'éviter une lordose excessive, et évite donc que des contraintes importantes soient exercées sur les articulations postérieures, sans pour autant empêcher tout mouvement d'extension du rachis. Cette limite élastique permet également de limiter la flexion du rachis, sans
recours à un ligament.
L'implant selon l'invention agit ainsi de manière
anatomique et est confortable pour le patient.
Il est réalisé en matériau résistant et ne subit
aucune usure sous l'exercice de contraintes répétées.
En outre, grâce à sa forme spécifique et à ses oreilles de fixation, il peut être mis en place par simple engagement dans l'espace inter-épineux, sans nécessiter de
travail particulier au niveau du site qui le reçoit.
Notamment, dans le cas d'une hernie discale, l'espace inter-épineux a souvent été préparé lors de l'intervention sur la hernie. Une fois cette préparation effectuée, il suffit d'écarter légèrement les apophyses épineuses des deux vertèbres concernées, d'engager l'implant entre elles en insérant les apophyses épineuses entre les paires
d'oreilles précitées, et de fixer l'implant aux apophyses.
Ainsi, l'implant n'oblige pas à intervenir au niveau de
zones anatomiques saines.
Un coussinet en matériau élastique approprié, soit en tissu, soit en matière synthétique, peut être mis en place entre les branches latérales du corps en U, afin de limiter le rapprochement de ces deux branches et d'assurer un amortissement supplémentaire des vertèbres, si cela
s'avère nécessaire.
Cet implant est de préférence réalisé en matériau métallique forgé en une seule pièce. Avantageusement, il est en titane. Outre ses caractéristiques mécaniques appropriées, ce matériau permet l'utilisation post-opératoire de techniques radiographiques comme le scanner ou la résonnance magnétique nucléaire, dont il ne
trouble pas les images.
Suivant une forme de réalisation préférée de l'invention, les paires d'oreilles sont décalées l'une par rapport à l'autre le long des branches du corps, de manière à ce que plusieurs implants successifs puissent être mis en place sur plusieurs vertèbres consécutives. Ce décalage permet en effet d'engager les oreilles de deux
implants adjacents sur la même apophyse épineuse.
De préférence, les moyens de fixation de l'implant aux apophyses épineuses des vertèbres sont constitués par des trous de réception de vis ou de picots sertis engagés
dans les apophyses.
Pour sa bonne compréhension, l'invention est & nouveau décrite ci- dessous en référence au dessin schématique annexé représentant, à titre d'exemple non limitatif, une forme de réalisation préférée de l'implant
inter-épineux qu'elle concerne.
La figure i en est une vue en perspective; la figure 2 en est une vue de profil, après implantation; la figure 3 en est une vue de l'arrière, après implantation; la figure 4 est une vue de profil de deux cales destinées à être implantées sur trois vertèbres consécutives et la figure 5 en est une vue de profil, après
implantation, selon une variante de réalisation.
Les figures représentent sous différents angles un implant vertébral inter-épineux 1, c'est-à-dire un implant destiné à être inséré entre les apophyses épineuses 2 de
deux vertèbres adjacentes 3.
L'implant 1 comprend un corps 5 sensiblement en forme de U présentant une souplesse élastique au niveau de sa partie centrale 5a, et deux paires d'oreilles 6 faisant saillie de la face extérieure des deux branches 5b du
corps 5.
L'implant 1 est réalisé en titane et est forgé en une seule pièce.
Comme cela apparaît sur les figures, chaque paire d'oreilles 6 délimite des chapes 7 de réception des apophyses épineuses 2. La figure 3 montre plus particulièrement que les deux oreilles 6 de la branche 5b supérieure convergent l'une vers l'autre en direction de leur extrémité libre tandis que les deux oreilles 6 de la branche 5b inférieure convergent dans un premier temps l'une vers l'autre puis divergent en direction de leur extrémité libre. Cette forme spécifique des oreilles 6 leur permet de s'adapter à la forme anatomique des
apophyses épineuses 2 insérées entre elles.
En outre, chaque oreille 6 comprend des trous 8 destinés à recevoir des vis osseuses 9, ou des picots engagés dans les apophyses et sertis dans ces trous 8, permettant d'assurer la fixation des oreilles 6 aux
apophyses épineuses 2.
Ainsi que le montrent plus particulièrement les figures 2 et 5, l'implant 1 est destiné à être inséré dans l'espace inter-épineux, avec venue de ladite partie centrale 5a du corps 5 au niveau des apophyses articulaires postérieures 10, avec venue desdites branches latérales 5b contre les apophyses épineuses 2, et avec engagement de chaque paire d'oreilles 6 autour de l'une
des apophyses épineuses 2.
Grace à la souplesse de la partie centrale 5a, l'implant assure un positionnement souple des vertèbres 3 l'une par rapport à l'autre. Il permet une flexion et une extension du rachis de part et d'autre d'une position neutre représentée aux figures 2 et 3, correspondant à la position sensiblement parallèle des deux branches
latérales 5b.
La limite élastique de la partie centrale 5a permet d'éviter une lordose excessive, et évite donc que des contraintes importantes soient exercées sur les articulations postérieures 10, sans pour autant empêcher tout mouvement d'extension du rachis. Cette limite élastique permet également de limiter la flexion du rachis, sans recours à un ligament prothétique engagé
autour des apophyses épineuses 2.
L'implant 1 agit ainsi de manière anatomique et
confortable pour le patient.
Grâce à sa forme spécifique et à ses oreilles de fixation 6, il peut être mis en place par simple engagement dans l'espace inter-épineux, en ne nécessitant
qu'un travail limité au niveau du site qui le reçoit.
Notamment, dans le cas d'une intervention sur une hernie discale, l'espace inter-épineux a souvent été préparé lors de l'intervention sur la hernie, afin de permettre l'abord du disque. Une fois cette préparation effectuée, il suffit d'écarter légèrement les apophyses épineuses 2 l'une de l'autre, d'engager l'implant 1 entre elles en insérant les apophyses 2 dans les chapes 7, et de fixer l'implant aux
apophyses 2 par les vis 9 ou picots précités.
L'implant est de préférence réalisé en titane. Il ne subit aucune usure sous l'exercice des contraintes répétées qu'il subit. Le titane permet, outre ses caractéristiques mécaniques appropriées, d'utiliser des techniques radiographiques comme le scanner ou la résonnance magnétique nucléaire après l'intervention. Il
ne trouble en effet pas les images obtenues.
La figure 4 montre que les paires d'oreilles 6 sont décalées l'une par rapport à l'autre le long des branches 5b du corps 5, de manière à ce que plusieurs implants successifs 1 puissent être mis en place sur plusieurs vertèbres consécutives du rachis. Ce décalage permet d'engager les oreilles 6 de deux implants 1 adjacents sur la même apophyse épineuse 2. L'implant selon l'invention peut ainsi être utilisé, en remplacement des dispositifs classiques, pour étayer un segment du rachis,
sans que ce segment soit rendu complètement rigide.
La figure 5 montre qu'un coussinet 15 en matériau élastique approprié, soit en tissu, soit en matière synthétique, peut être mis en place entre les branches latérales 5b du corps 5 et être fixé à elles par tout moyen approprié, par exemple par collage. Ce coussinet 15 permet de limiter le rapprochement des deux branches latérales 5b et d'assurer un amortissement supplémentaire
des vertèbres 3, si cela s'avère nécessaire.
Claims (6)
1 - Implant vertébral inter-épineux, caractérisé en ce qu'il comprend un corps (5) sensiblement en forme de U présentant une souplesse élastique au niveau de sa partie centrale (5a), et deux paires d'oreilles (6) faisant saillie de la face extérieure des deux branches (5b) du corps (5), ces oreilles (6) délimitant des chapes (7) de réception des apophyses épineuses (2) des vertèbres (3) et comprenant des moyens (8,9) permettant d'assurer
leur fixation aux apophyses (2).
2 - Implant selon la revendication 1, caractérisé en ce qu'un coussinet (15) en matériau élastique approprié, soit en tissu, soit en matière synthétique, est mis en place entre les branches latérales (5b) du corps en
U (5).
3 - Implant selon la revendication 1 ou la revendication 2, caractérisé en ce qu'il est réalisé en
matériau métallique forgé en une seule pièce.
4 - Implant selon la revendication 3, caractérisé
en ce qu'il est réalisé en titane.
S - Implant selon l'une des revendications i à 4,
caractérisé en ce que les paires d'oreilles (6) sont décalées l'une par rapport à l'autre le long des branches (5b) du corps (5), de manière à ce que plusieurs implants successifs puissent être mis en place sur plusieurs
vertèbres consécutives.
6 - Implant selon l'une des revendications i à 5,
caractérisé en ce que ses moyens de fixation aux apophyses épineuses (2) des vertèbres (3) sont constitués par des trous (8) de réception de vis (9) ou de picots sertis
engagés dans les apophyses (2).
7 - Implant selon l'une des revendications i à 6,
caractérisé en ce que les deux oreilles (6) de la branche (5b) supérieure convergent l'une vers l'autre en direction de leur extrémité libre tandis que les deux oreilles (6) de la branche (5b) inférieure convergent dans un premier temps l'une vers l'autre puis divergent en direction de
leur extrémité libre.
Priority Applications (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| FR9409493A FR2722980B1 (fr) | 1994-07-26 | 1994-07-26 | Implant vertebral inter-epineux |
| JP18943395A JP3631293B2 (ja) | 1994-07-26 | 1995-07-25 | 椎骨の棘間インプラント |
| US08/635,735 US5645599A (en) | 1994-07-26 | 1996-04-22 | Interspinal vertebral implant |
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| FR9409493A FR2722980B1 (fr) | 1994-07-26 | 1994-07-26 | Implant vertebral inter-epineux |
| US08/635,735 US5645599A (en) | 1994-07-26 | 1996-04-22 | Interspinal vertebral implant |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| FR2722980A1 true FR2722980A1 (fr) | 1996-02-02 |
| FR2722980B1 FR2722980B1 (fr) | 1996-09-27 |
Family
ID=26231335
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| FR9409493A Expired - Lifetime FR2722980B1 (fr) | 1994-07-26 | 1994-07-26 | Implant vertebral inter-epineux |
Country Status (3)
| Country | Link |
|---|---|
| US (1) | US5645599A (fr) |
| JP (1) | JP3631293B2 (fr) |
| FR (1) | FR2722980B1 (fr) |
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Also Published As
| Publication number | Publication date |
|---|---|
| JPH0852166A (ja) | 1996-02-27 |
| JP3631293B2 (ja) | 2005-03-23 |
| US5645599A (en) | 1997-07-08 |
| FR2722980B1 (fr) | 1996-09-27 |
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