DE102004007386B4 - Intervertebral implant - Google Patents

Abstract

Intervertebral implant with at least one hollow channel for receiving filler, especially a pasty one Mass of bone substance, for the connection of two adjacent in the spinal column Whirl, and with at least one support element for the filler within the at least one hollow channel, characterized in that the at least one holding element is one in the intervertebral implant (1) arranged groove (3, 3 ').

Description

The The invention relates to an intervertebral implant having at least one Hollow channel for receiving filler, especially a pasty one Mass of bone substance, for the connection of two adjacent in the spinal column Whirl, and with at least one support element for the filler within the at least one hollow channel according to the preamble of the claim 1.

From the EP 0 425 542 B1 For example, an intervertebral implant with multiple openings is known which can be filled with bone material and allows bone growth in the implant. The disadvantage here is the complicated filling of the implant by a removable lid.

In the published patent application DE 195 41 114 A1 describes a flange-type intervertebral implant with a central opening for a filler (bone or bone substitute material), support plates with anchoring elements and a spacer with openings for a good nutritional supply. In this implant, the maintenance of pasty fillers in the central opening is small, so that the filler can fall out during implantation.

From the EP 0 966 930 A1 For example, an implant is known that has a fillable hollow body and subsequent end caps lying flat on neighboring vertebral bodies. The implant can be easily filled with bone or bone substitute material. A disadvantage is the complex three-part design of the implant.

One Intervertebral implant, which has an axial through opening three lateral breakthroughs is known from the publication US 2003/0028249 A1. Again, the stop is for pasty fillers only insufficient and complicates the surgical technique.

Accordingly, lies The object of the present invention is to provide an intervertebral implant, that for fillers, especially pasty fillers, provides a sufficient grip.

These Task is performed by an intervertebral implant with the features of claim 1. Accordingly, FIG an intervertebral implant with a hollow channel of the aforementioned Genus at least one support element for filler within the at least a hollow channel, wherein the at least one support element is a groove disposed in the intermediate implant groove.

The Presence of a groove as at least one support element allows good adhesion of (pasty) fillers in said intervertebral implant and prevents the filler from falling out during implantation.

In an advantageous embodiment the invention, the hollow channel extends in the intended position of the intervertebral implant in a direction that is essentially parallel to that through the centers of the intervertebral implant adjacent vertebral bodies extending longitudinal axis The spine, within the intervertebral implant.

With a particular advantage is the support element in the intervertebral implant arranged groove at least partially as a hollow channel circumferential Groove designed. Furthermore, it is possible that the groove is the hollow channel thread-shaped circulates.

In another embodiment The invention is the at least one support member as a projection of the intervertebral implant vertebral implant in the direction of Center of the hollow channel formed. Also the arrangement of a row of protrusions in the hollow channel limiting wall of the intervertebral implant is advantageous. The result is a good hold of (pasty) fillers reached in the implant.

Of course it is it is also conceivable that the intervertebral implant according to the invention both at least one groove, as well as at least one projection having within the hollow channel as a support member. The common Use of grooves and protrusions can be especially cheap Effects on the adhesion of (pasty) fillers in the hollow channel of the Have implant.

The in the wall of the at least one hollow channel arranged mounting elements of the intervertebral implant are preferably substantially orthogonal arranged to a central axis of the hollow channel.

The in the wall of the at least one hollow channel arranged mounting elements can also lie on a plane that is substantially orthogonal to the Center axis of the hollow channel is arranged, wherein the central axis through the center of the hollow channel of the intervertebral implant runs. This too has favorable Effects on the adhesion of (pasty) fillers in the hollow channel.

Likewise, the arranged in the hollow channel Supporting element may be formed as a rough surface of the hollow channel forming wall of the intervertebral implant. Such a rough surface can, for. B. can be achieved by radiation with corundum. An average roughness value of R _a > 5 μm is advantageous.

The Intervertebral implant according to the invention has two substantially parallel sagittal limbs on, each by an anterior, so ventral running and a posterior, ie dorsally extending transversal limb connected to each other. The designations refer to this the leg of the intervertebral implant according to the invention to which, when used as intended of the implant resulting position of the intervertebral implant in body a patient.

from that shows that the intervertebral implant according to the invention a substantially annular Structure has. This will provide optimal support for the adjacent vertebrae of the spine reached through the implant.

In An advantageous embodiment of the invention comprises the intervertebral implant according to the invention two each in a transverse plane extending bone support surfaces. These bone support surfaces, on which after insertion of the implant into the body of a Each patient to one of two vertebra adjacent in the spine lying comes from each of the sagittal and transversal limbs of the implant, in each case of the substantially in a transverse plane running sides of this sagittal and Transversalschenkel. Due to the bone support surfaces, a good distribution of forces guaranteed.

Around the adhesion of the intervertebral implant to the neighboring, at least to improve vertebral spinal cord connectivity one of the bone support surfaces a profiling on. For the same purpose is on at least one the bone support surfaces at least one connecting element, for example in the form of a Thorn, arranged.

Around the surgeon the introduction of the intervertebral implant according to the invention between allowing two adjacent vertebral bodies of the spine, the intervertebral implant has a coupling element in the form of a Drilled hole on the insertion of the intervertebral implant serves. The hole runs in a proper position of the intervertebral implant along a sagittal axis, wherein this hole with particular advantage in the middle in the anterior transverse limb of the intervertebral implant is arranged.

With Help of an insertion tool, which has a holding means, for. B. in the form of an extension, has, that introduced into the hole can be, the surgeon, the intervertebral implant according to the invention in its intended location between two vertebral bodies bring.

Further Advantages of the invention will become apparent in the following description an embodiment be clear from the figures.

It demonstrate:

1A a perspective top view of an intervertebral implant;

1B another perspective top view of an intervertebral implant;

2A a plan view of an intervertebral implant;

2 B a cross-sectional view of in 2A shown intervertebral implant, the section was guided along the frontal plane AA;

2C a cross-sectional view of in 2A shown intervertebral implant, the section was guided along the median plane BB;

3A a plan view of another embodiment of an intervertebral implant;

3B a cross-sectional view of in 3A shown intervertebral implant, the section was guided along the frontal plane AA;

3C a cross-sectional view of in 3A shown intervertebral implant, the section was guided along the median plane BB;

4A a plan view of another embodiment of an intervertebral implant;

4B a cross-sectional view of in 4A shown intervertebral implant, the section was guided along the frontal plane AA;

4C a cross-sectional view of in 4A shown intervertebral implant, wherein the section along the median plane BB out has been;

5A a plan view of another embodiment of an intervertebral implant;

5B a cross-sectional view of in 4A shown intervertebral implant, the section was guided along the frontal plane AA;

5C a cross-sectional view of in 4A shown intervertebral implant, wherein the section along the median plane BB was performed.

The 1A and 1B show the same cervical intervertebral implant 1 from opposite perspectives. The following description therefore assumes both the 1A as well as on the 1B Reference.

The spatial orientation of the shown intervertebral implant 1 results from the coordinate system shown.

The intervertebral implant 1 has two substantially parallel sagittal limbs 4 . 5 on, each by an anterior transverse limb 6 and a posterior transverse limb 7 connected to each other. The intervertebral implant 1 thus has a substantially annular structure.

In particular, in the intervertebral implant shown here forms 1 the first sagittal thigh 4 together with the posterior transverse limb 7 and the second sagittal thigh 5 a horseshoe-shaped structure passing through the anterior transverse limb 6 closed to a ring. As in 1A is recognizable, run the side surfaces of the posterior transverse limb 7 flattened to the rear, so that these surfaces meet and a posterior edge is formed.

The intervertebral implant 1 has a hollow channel 2 for receiving filler, in particular for receiving a pasty mass of bone substance. The hollow channel 2 runs in the intended position of the intervertebral implant 1 parallel to the direction of the longitudinal axis of the spine, ie, substantially along the longitudinal axis of the body within the intervertebral implant 1 ,

Inside the hollow channel 2 is a support member in the form of a groove 3 arranged here as a the hollow channel 2 partially circumferential groove 3 is designed. The groove 3 can in particular by a bore or milling of the hollow channel 2 forming wall of the intervertebral implant 1 be formed. The groove shown 3 is as part of the hollow channel 2 circumferential groove formed as the groove 3 only through a center in the posterior transverse limb 7 arranged surface portion of the wall of the hollow channel 2 not going.

The holding element arranged in the hollow channel can also be designed as a roughened surface of at least one section of the hollow channel 2 forming wall of the intervertebral implant 1 be educated. Such roughening of portions of the wall of the hollow channel 2 may be due to roughness, z. B. by air pressure irradiation with corundum, a material obtained from bauxite, can be achieved. In this case, a mean roughness value of R _a > 5 μm of the wall of the hollow channel is preferred 2 wherein the roughened portion may have a geometrically indeterminate shape.

The illustrated intervertebral implant 1 has a first bone support surface 8th and a second bone support surface 9 on. These bone support surfaces extending essentially within a transverse plane 8th . 9 each of the Sagittal 4 . 5 and transverse legs 6 . 7 of the intervertebral implant 1 educated.

The bone support surfaces shown here 8th . 9 each have a profile that facilitates adhesion to the adjacent vertebral bodies within the spine. Only a posterior portion of the posterior transverse limb 7 has no profiling in the variant of the invention shown here.

Furthermore, the anchoring of the intervertebral implant 1 improved at the adjacent vertebrae by a connecting means, which in the embodiment shown here as a mandrel 10 is trained. The variant of the invention shown here has three spikes 10 on the first bone support surface 8th on, each with a thorn 10 at the lateral ends of the anterior transverse limb 6 is formed, and another thorn 10 centered on the posterior transverse limb 7 is arranged. A second arrangement of thorns corresponding to this first arrangement 10 can be found on the opposite, second bone support surface 9 ,

The intervertebral implant 1 has a coupling element in the form of a threaded hole 11 on, in the middle in the anterior transverse limb 6 is arranged and, starting from a proper position of the intervertebral implant 1 , along a sagittal axis. Lateral to the hole 11 is a circular excavation 12 in the front of the anterior transverse limb 6 arranged.

Both the hole 11 , as well as the circular cavity 12 serve the introduction of the intervertebral implant 1 by an operator in the intended position between two adjacent vertebrae of the spine of a patient. For this purpose, an inserting instrument, not shown here, is used, which has a holding means, which in the bore 11 of the intervertebral implant 1 is introduced. The excavation 12 serves for the spatial orientation of the implant in connection with the insertion instrument. This ensures correct position implantation.

The insertion instrument used by the surgeon has a holding means and a projection. The holding means may be in the form of a pin which has an external thread. About this external thread, the holding means of the insertion is in the coupling element in the form of a bore 10 screwed in with internal thread. A projection of the Einsetzinstrumentes engages in a circular cavity 12 of the intervertebral implant 1 to provide a spatial orientation of the implant 1 to allow and thus facilitate a correct position implantation by the surgeon.

The operative insertion of the intervertebral implant 1 into the body of a patient is done from ventrally after removal of the appropriate intervertebral disc. The intervertebral implant 1 stabilizes the vertebrae to each other, with the hollow channel 2 fills with bone after healing and bridges the vertebrae bony.

2A shows that in the 1A and 1B shown intervertebral implant 1 in a top view. So it is in the in the 1 and 2 Intervertebral implant to the same embodiment.

The substantially annular structure of the intervertebral implant 1 gets through the first sagittal thigh 4 and the second sagittal thigh 5 formed, each by the anterior transverse limb 6 and the posterior transverse limb 7 be connected to each other. It can be seen that the first bone support surface 8th has a profiling, which is formed of parallel, transversely extending, pointed roof-like structures. Furthermore, there are three connecting elements in the form of thorns 10 on the first bone support surface 8th arranged.

The 2 B shows that in 2A shown intervertebral implant 1 which runs along the in 2A frontal plane AA was cut, in a plan view of the cut surface. The posterior transverse limb 7 is from the first sagittal thigh 4 and the second sagittal thigh 5 bounded laterally, wherein both Sagittalschenkel substantially perpendicular to the section plane.

In the posterior transverse limb 7 is a groove 3 Arranged through the hole 11 is interrupted. The hole 11 which, as described above, the introduction of the intervertebral implant 1 used by the operator by means of an insertion tool, runs along a sagittal axis.

Both the first bone support surface 8th , as well as the second bone support surface 9 each have thorns 10 for improved retention of the intervertebral implant 1 with the adjacent vertebral bodies.

In 2C is that in 2A illustrated intervertebral implant shown in a sectional view, wherein the cut entlag the median plane designated BB was performed. The first sagittal thigh 4 becomes from the anterior transverse limb 6 and the posterior transverse limb 7 limited, with the two transverse limbs 6 . 7 are shown cut. Inside the first sagittal thigh 4 of the intervertebral implant 1 runs a groove 3 for holding the (pasty) filling compound.

Further recognizable is the profiling of both the first bone support surface 8th , as well as the second bone support surface 9 , On both bone support surface 8th . 9 are thorns 10 arranged.

The cut through the intervertebral implant 1 passes through the middle of the hole 11 located in the posterior transverse limb 7 is arranged and which serves the introduction of the holding means. The holding means is part of the insertion tool available to the surgeon for insertion of the implant.

The 3 . 4 and 5 each show further embodiments of the Zwischenwirbelimplatates 1 , in particular by the formation of the support member 3 . 3 ' . 30 . 300 differ. Therefore, only the distinguishing features will be discussed below.

In the 3 to 5 is in each case in the figure designated A, a plan view of the intervertebral implant 1 on a first bone support surface 8th shown. In the figure designated as B is in each case a cross-sectional view of the intervertebral implant shown in the corresponding Figure A. 1 shown, wherein the section was guided along the frontal plane AA. Figure C shows a cross-sectional view of each corresponding figure A, wherein the respective shown intervertebral implant 1 was cut along the median plane BB.

In the in the 3A . 3B and 3C shown embodiment of an intervertebral implant 1 is the retaining means also as a groove 3 ' educated. However, the groove is 3 ' in this case the hollow channel 2 spirally arranged circumferentially, so that there is a thread-like structure.

In terms of in 3B shown intersection point S of the plane E and the central axis M extends the thread-shaped groove 3 ' mirror-symmetric within the hollow channel 2 adjacent wall. The plane E is equidistant from the bone support surfaces 8th . 9 at the same height through all four legs 4 . 5 . 6 . 7 , the intervertebral implant 1 , The central axis M extends within the hollow channel 2 perpendicular to the plane E. Here, the central axis M (in the case of a circular hollow channel 2 ) through its (geometric) center.

In contrast, in which in the 4A . 4B and 4C shown embodiment of an intervertebral implant 1 the holding means in the form of protrusions 30 formed. These projections 30 are essentially parallelepiped-shaped and also allow good adhesion of (pasty) fillers (eg bone or bone substitute material), within the intervertebral implant 1 ,

In the hollow channel 2 delimiting wall are several projections 30 arranged in a circumferential manner. Here are the projections 30 all within a plane E connecting them. This plane E is orthogonal to the central axis M of the hollow channel 2 , At the same time, the plane E can be a plane of symmetry of the intervertebral implant 1 be.

In the in the 5A . 5B and 5C shown embodiment of an intervertebral implant 1 is the holding means as a pin 300 educated. Whereas the in 4 shown projection 30 with its longest side along the wall of the hollow channel 2 extends, a pin extends 300 with its longest side substantially perpendicular to the wall of the hollow channel 2 , so with its longest side in the direction of the through the hollow channel 2 extending center axis M.

Unless these cones 300 have a radiopaque material or consist of a radiopaque material, they can simultaneously as X-ray marker for determining the position of the intervertebral implant 1 serve.

Of course, it is also possible, at least two of the said support elements, ie groove 3 , Thread 3 ' , Head Start 30 , Cones 300 or rough surface to combine with each other and in the hollow channel 2 to arrange.

Claims (15)

Intervertebral implant having at least one hollow channel for receiving filler, in particular a pasty mass of bone substance, for connecting two adjacent vertebrae in the vertebra, and at least one support member for the filler within the at least one hollow channel, characterized in that the at least one support member in the Intervertebral implant ( 1 ) groove ( 3 . 3 ' ). Intervertebral implant according to claim 1, characterized in that the at least one hollow channel ( 2 ) in the intended position of the intervertebral implant ( 1 ) in one direction within the intervertebral implant ( 1 ) substantially parallel to that through the centers of the intervertebral implant ( 1 ) adjacent vertebral body extending longitudinal axis of the spine extends. Intervertebral implant according to claim 1 or 2, characterized in that the groove ( 3 ) at least partially as one in the wall of the at least one hollow channel ( 2 ) circumferential groove ( 3 . 3 ' ) is configured. Intervertebral implant according to one of the preceding claims, characterized in that the groove ( 3 ' ) in the wall of the at least one hollow channel ( 2 ) rotates thread-shaped. Intervertebral implant according to one of the preceding claims, characterized in that at least one further retaining element has a projection ( 30 ) and / or a pin ( 300 ) of the intervertebral implant ( 1 ). Intervertebral implant according to one of the preceding claims, characterized in that in the wall of the at least one hollow channel ( 2 ) arranged holding elements ( 3 . 30 . 300 ) substantially orthogonal to a central axis (M) of the hollow channel ( 2 ) is arranged. An intervertebral implant according to any one of the preceding claims, characterized in that the at least one holding element is one in the wall of the at least one hollow channel ( 2 ), wherein this section has an average roughness of greater than 5 μm (R _a > 5 μm). Intervertebral implant according to one of the preceding claims, characterized in that the intervertebral implant ( 1 ) with respect to its intended position two substantially parallel to each other Sagittalschenkel ( 4 . 5 ), each by an anterior transverse limb ( 6 ) and a posterior transverse limb ( 7 ) are interconnected. Intervertebral implant according to one of the preceding claims, characterized in that the intervertebral implant ( 1 ) is formed substantially annular. Intervertebral implant according to one of the preceding claims, characterized in that the intervertebral implant ( 1 ) two each in a transverse plane extending bone support surfaces ( 8th . 9 ) having. Intervertebral implant according to claim 10, characterized in that the bone support surfaces ( 8th . 9 ) each of the sagittal ( 4 . 5 ) and transversal legs ( 6 . 7 ) be formed. Intervertebral implant according to claim 10 or 11, characterized in that at least one of the bone support surfaces ( 8th . 9 ) has a profiling. Intervertebral implant according to one of the preceding claims 9 to 12, characterized in that on at least one of the bone support surfaces ( 8th . 9 ) at least one connecting element ( 10 ) is arranged for connection to at least one adjacent vertebral body in the intended position. Intervertebral implant according to one of the preceding claims, characterized in that the intervertebral implant ( 1 ) a coupling element, in particular in the form of a threaded hole ( 11 ) as an aid for insertion of the intervertebral implant, which in an intended position of the intervertebral implant ( 1 ) runs along a sagittal axis. Intervertebral implant according to claim 14, characterized in that the coupling element ( 11 ) in the center of the anterior transverse limb ( 6 ) is arranged.