DE1807227A1 - prosthesis - Google Patents

Description

my sign o77o Pt

COLORADO STATE UNIVERSITY RESEARCH! FOUNDATION, Colorado State University, Fort Collins , County of Larimer, State of Colorado, United States of America.

prosthesis

The invention relates to a prosthesis, but in particular to a prosthesis in the form of an artificial vertebra the spine, this artificial vertebra on its own or in combination to bridge the remaining Space or gap in the spine is used when one or more natural vertebrae are then removed when these vertebrae are sick, broken, or misshapen.

It is or is common in the treatment of higher vertebrate beings, both human and animal it is desirable that one or possibly more vertebrae have to be removed from the spine. The removal of the sick Part of the spine may be required, for example

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den in order to prevent the spread of the disease to neighboring parts of the j control of the spine and the tissues surrounding it.

i Accidents and birth defects can in a similar way be the j require removal of part of the spine.

I.

; Notwithstanding this need for some form of prosthesis as a total or partial replacement of one or more vertebrae, such an expedition has not been available to this day. Accordingly, both the surgeon ^; and the veterinarian forced to leave a part of the natural, diseased or fractured spine in the patient's body ^ or sick animal with the purpose of a bridge or a joint between the adjacent healthy parts of the ^vertebra: provide. In many cases, however, this represents a highly unconfirmed; It is a peaceful solution and cannot prevent the disease from spreading and spreading to neighboring parts, especially if the bone has cancer or is otherwise ill.

The current state of the art is that very little can be done to correct this}, for example the vertebral body or part of the vertebra is replaced by a prosthesis, the latter to maintain continuity the spine is needed. All that can be done beyond that is a broken neural process to bridge the spine} in only rare cases is an arch made of metal, which bridges the natural neural processes, replaced by a full neural arch.

The invention relates, mutatis mutandis, to a prosthesis for insertion into after the removal of one or more natural ones Vertebrae of a higher vertebrate remaining gap in the vertebral column. The invention is characterized in that that each removed natural vertebra is replaced by a prosthetic limb, which has two interconnectable elements possesses, the one surface of the one element, which

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that touches a surface of the other element, a trough-shaped one Recess for receiving the spinal cord of the spine contains that one of these elements is a shaft-shaped part sits, which is connected to the neural process of the natural vertebra speaks that on the shaft-shaped part of the prosthetic limb or the end limb of a series of prosthetic limbs first Lanyard for establishing the connection with the adjacent! bare neural processes of the spine are attached that with; the other element of this prosthetic limb further connecting means for attachment to the vertebral body of the neighboring one natural vortex, and that these two

the bonding means work together in such a way that the adjacent natural vertebra is firmly connected to the prosthesis. j

The invention also relates to a prosthesis, for insertion into the vertebrae of a higher vertebrate after the removal of one or more natural vertebrae in the spine, remaining gap. The invention is further characterized by a prosthetic limb to replace any removed one natural vertebrae, the or each prosthetic limb J including an element having at least one relatively flat surface, ι which extends between the two ends of the link. One

each surface contains a longitudinally extending, substantially semi-cylindrical recess. It is also a essentially Y-shaped element with a shaft-shaped part provided, which for attachment to the surfaces of the element on opposite sides of the trough-shaped part on his one end engages in diverging leg-shaped parts such that, together with the element, a channel for receiving with Game of the spinal cord of the spine is formed. With the shaft-shaped part of the Y-shaped element or the end element a number of prosthetic limbs are connected to first connecting means with which the connection to the neural process of a neighboring natural vortex. With the element or with the end element of a series of prosthetic limbs further connecting means are connected, which the

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Establish connection with the vertebral body of the natural vertebra, these two connecting means cooperate in such a way that the adjacent natural vertebra is firmly connected to the prosthesis. is bound. ,

Some embodiments of the inventive pro ' these are explained in more detail below with the aid of the drawing

licher explained. In this show in a purely schematic way * j

1 shows a side view of a first embodiment of the prosthesis according to the invention
Spinal vertebrae of a higher vertebrate animal,
being this prosthesis between two natural ones

Vertebrae is attached j

ι Pig. 2 is a side view, partly in section, of the!

Prosthesis according to the invention according to FIG. 1

3 is a vertical section along the line 3-3
in Fig. 1

4 shows a plan view of the prosthesis according to the invention

5 shows a side view, partially in section, of a somewhat modified embodiment of the prosthesis according to the invention, with one element
corresponds to that of FIGS. 1 to 4,
while two more, slightly modified
Elements bridge the gap remaining after removing three adjacent natural vertebrae

6 shows a bottom view, partly in section, of a somewhat modified embodiment of a part the prosthesis according to the invention

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7 shows one of the arrangement according to. Pig. 5 similar Dar- _; position, whereby all three prosthesis units of the prosthesis have been further modified, I so that the strong bridge by a resilient; Joint is replaced '

fig. 8 is a vertical section along line 8-8 in Fig. 7

Fig. 9 is a longitudinal section along the center line of the arrangement of Fig. 7, the Y-shaped Elements and connectors have been removed ^

In FIGS. 1 to 4, 1o is generally a. j Prosthesis referred to, which consists of a generally inverted ': Y-shaped element 12, which with a forming the body Element 14 is releasably connected. This element 14 has a cylindrical recess 16, which into the connection and Contact surface 18 is incorporated. If this connection and contact surface 18 against the outwardly diverging arms 2o is pressed, a cylindrical bore 22 is formed which is used to receive the spinal cord of the patient. As already As explained in more detail above, the outwardly diverging arms 2o of the Y-shaped element 12 work in a similar manner such as the heural arches 24 of the patient's vertebra, which vertebra is generally designated by the reference numeral 26. In contrast, the shaft-shaped part 28 of this member takes up the space of the neural process 3o of the spine. The element the prosthesis, on the other hand, replaces the vertebral body 32.

The elements 12 and 14 of the prosthesis are preferably made of certain types of plastics that are compatible with internal tissues and vertebral bones are compatible. Several plastics of this type are commercially available and are used to manufacture all kinds of prostheses. Of course, the material does not have to be toxic. be able to focus on the spine - 6 -

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acting compressive and bending forces without holding the brucfystand. In addition, this material must be easy to process, namely by metal-cutting deformation or by injection or Casting process so that a smooth surface is created, which is the spinal cord or the cartilage tissue that is separating from the neighboring vertebra is caused, not inflamed. For this purpose, thermoplastic vinylidene fluoride has proven particularly useful proven, which is traded under the name "Kynor", although other materials of this type may be suitable for this purpose.

In terms of total height, total width and total thickness, the prosthesis according to the invention essentially corresponds to the dimensions of vertebrae of a particular species of animal. It should be mentioned that these dimensions are for a certain species of animal remain essentially the same, so that standard sizes of these

; Prosthesis can be manufactured. The following in more detail!

The various screws, nuts and connecting brackets described can also be made of plastic, although

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For reasons of strength, metals are to be preferred as the material. Satisfactory for this particular purpose are ι stainless steels, although these elements are generally made from alloy steels including chromium, molybdenum and Contain nickel. These alloys are called;

"Vitalium" traded and used to manufacture spare parts of the human and animal bodies. j

The Y-shaped element 12 is connected to the element H via four screws 34 (FIG. 3) which are in the thread of the Blind bores 36 engage. These blind bores extend longitudinally from the arms 2o downward into the vertebral body of the spinal canal 22. The body must of course towards the patient's spinal cord in the remaining Space to be introduced in which the natural vertebra is removed before the arms of the Y-shaped element after passage a back cut suitable for this special purpose

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be screwed with it. In those cases in which the ' Vertebral body 32 remains intact and only the neural arch and neural process of the spine need to be replaced, can ! Y-shaped element 12 directly connected to the vertebral body

■ screwed after the latter separated from the neural arch

■ will.

The element 14 in the form shown in FIGS. 1 to 4 has a pair of lugs 38 which protrude in the longitudinal and ί transverse directions from both ends and are shaped so that they the vertebral body 32 of the adjacent natural * vertebra with which they are connected by screws 4o, ™ overlap. As can be clearly seen from FIGS. 2 and 4, the opposing inner surfaces of the lugs 38 are curved so that they are adapted to the shape of the natural vertebral body to which they are connected.

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j The shaft-shaped part 28 of the Y-shaped element 12 i ^! has a ^τ Urtical longitudinal slot 42 which is designed so that it receives a screw-clamp connection 44 which; by means of brackets 46 connects the opposite sides with one another. 46 as seen in FIG. 1 have the clips a plurality of recesses 48 for receiving \ screws 44 and are somewhat curved. In the embodiment shown in Fig. 1 of the j drawing, in which the Proi thesis is used to bridge the gap after removing only a single natural vertebra, the brackets are with the opposite sides of the shaft-shaped part 28, approximately in the middle , tied together. The outer ends of the same protrude in the longitudinal direction and extend beyond the shaft-shaped part into a position in which: · the neighboring neural process 3o of the natural vertebra in! is overlapped in the same way as the lugs 38 of the element 14, which overlap the vertebral body. These outer ends are connected to the spinous processes by means of screws 50, these screws being passed through bores in the spinous processes.

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Like from Pig. 1 of the drawing appears, is on ^; joint formed in this way quite vigorously. Moreover, I falls any pivoting movement or articulated rotary movement between j

ι see the artificial vertebra and the neighboring natural one:

.Whirl. The slit 42 makes only one raising and lowering! Of the clamps 46 is possible so that the outer ends of which are connected to the adjacent spinous processes thereof are [properly. The resulting firm and strong

Connection is the same as when two or more natural The patient's vertebrae merge with one another by fusing; be tied, which can only be achieved by surgical intervention Back injury is possible.

Reference is now made to FIGS. 5 and 6 of the drawing Reference, which represent a modification of the inventive concept. In this case, two or more will be missing natural vertebrae replaced by artificial vertebrae. The prosthesis 1o shown on the left in the drawing corresponds to essential to the prosthesis shown with the reference number 1o in FIGS. 1 to 4. That the shape of someone standing upside down Element 12 having Y is essentially the same except that it has slightly different dimensions. The bracket 46a is straight and slightly shorter, but has the same function as the bracket 46. This function is to see that the device 10a is firmly connected to the adjacent natural vertebra 26. That the body forming element Ha has a slight deviation in that the lugs 38c of the right end, which with the second of the three prostheses 1ob are connected in a straight line and are parallel to each other (Fig. 6), and are by no means arched in order to adapt to the vertebral body, as shown on the lugs 38 at the left end of the device 1oc applies.

The middle unit of the three units 1ob has again on the Y-shaped element 28, but has a further, modified base surface 14b or base. The modified

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! guide form differs by nothing other than the absence of the lugs 38 of the device 1oc. For this reason, bearings 52 are provided which are designed in such a way that they receive the parallel lugs 38e and permit a limited pivoting movement about helical swivel joints 4o of the same. ^!

The third unit of the three units 10c at the right end of the overall arrangement differs somewhat in that the base Hc or base - instead of having parallel projections 38c like the middle element 10ob - has arched projections 38 which are adapted to the vertebral body of the natural vertebra. Otherwise, however, the units 10b and 10c are the same, whereby it must be taken into account that the unit mentioned last is connected to the neighboring natural vertebra via somewhat modified brackets 46a in the same way as the unit 10a, so that an extraordinarily powerful one Connection is formed. It is clear that one of these units, for example the unit 1oa, can be mounted at both outer ends of the overall arrangement, one of these units being able to take the position of the unit 1oc and the ends being reversed. This requires a slight modification of the shape of the average unit 1Ob, in which the lugs 38a by \ replaces the base 52 and the projections 38c are fitted into the unit 1oa. Obviously, the construction described above becomes simpler than the arrangement shown, since in this case only two instead of three different forms of unit are required. For other reasons, however, the embodiment according to FIG. 5 is to be given preference. However, this embodiment can be used in any case in which a chain of two or more natural vertebrae is required, while the above-described arrangement j is limited exclusively to the case of three artificial vertebrae. In the embodiment shown, the unit 1oa can be directly connected to the unit 1oc, the unit 10ob being able to be omitted in such a way that a chain consisting of two units is formed. On the other hand

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several units 1ob can become one unit 1oa and 1oc with one another be connected, ao that a longer chain is formed if necessary.

The remaining feature of the modification of the arrangement according to FIGS. 5 and 6 is the arc-shaped part 54. Two arc-shaped parts 54 are connected to one another in the middle, with longitudinal slots 56 and transverse slots 42 being provided in the shaft-shaped part 28 of the central unit 10b. The connection is made in the same Vfei.se as shown in Fig. 1 by means of restrain or W numbers 46. The outer ends of these sheets are connected in the same manner with the shaft-shaped parts of the units and 1oa 1oc, namely at opposite ends and by means of elongated end slots 58. Tightening the screw clamp connection 44 in the central slot 56 prevents any relative movement between the arches 54 and the central device. The fact that the through the end slots 58 passed

: Screws have a certain amount of play is limited Pivoting movement between the end units 1oa and 1oc together

j with the natural vertebrae firmly connected to them If all of these connections are made firmly and powerfully! would be led, then no less than five we- '

^ i at (two natural and three artificial vertebrae) to one one | ι

umpteen units to be connected, and possibly ι the patient's freedom of movement is unduly impaired.

Figs. 7> 8 and 9 show another, somewhat removed ' Modified embodiment of a three-part unit. The arches 54 have been omitted altogether; the base areas Hd, e and f of the modified units iodine, e and f are modified to include a provision for creaming a Spring member 6o is hit. With the exception that the units Iodine and 1of modified bases with a slightly conical shape have molded bearings 62 which are formed so that they the outer ends of the spring member 6o parallel and below

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^; hold the opening 22, these elements are identical to the elements 1oa and 1oc described above, in particular with regard to the manner of connection with the adjacent natural vertebra \ . Similarly, the middle unit 10 corresponds to a high degree to the unit 10 with the exception that the former has an opening 64 which receives the central part of the spring element 6o loosely, that is to say with play. The opening 64 has two opposing, conically shaped bores which intersect in the middle of the element He and widen outwards when they protrude from the ends and are aligned with the conical bearings 62.

The conical bearings and a conical bore opening load obliquely running conical surfaces in which the elements closest to the screws 4o are all collimated and tangential to the spring member 6o when the segments of the device are in the extended position (FIG. 9). Any inclination in a direction in which the hole 66 between the individual segments is widened immediately affects the spring element; . 6o counteracts and forces the individual segments \ into an aligned position in which they are therefore straight | ι side by side. place. If now the segments are bent in the opposite direction in which the hole 66 is closed \. is, the already mentioned, diametrically opposite surfaces assume a collinear position and are thus tangential to the spring element 6o. So is the latter type of A "ü3biegung independently of the FedeaLement 66 instead, which in no way counteracts such movement merely for ease of understanding, the inclinations of these conical surfaces are shown in Figure 9 over the top of the drawing somewhat as -.. As shown - with the V-shaped members in the upper part of the base the gap would close before the elements in the conical surfaces assume the colineal position.

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Claims (1)

Claims Prosthesis for insertion into the after removal of one or more natural vertebrae of a higher vertebrate animal the spinal column remaining gap characterized in that each distant natural Vertebra is replaced by a prosthetic limb which has two interconnectable elements (12, 14), wherein the one surface of the one element which touches the one surface of the other element, a trough-shaped recess (22) for receiving the spinal cord of the spine contains that one of these elements has a shaft-shaped part (28) possesses, which corresponds to the neural process of the natural vertebra, that on the shaft-shaped part (28) of the prosthetic limb or first connecting means (46 or 46a) for manufacturing the end member of a series of prosthetic members the connection with the neighboring neural process of the spine is attached to that with the other element of this Prosthetic limb further connecting means for attachment to the vertebral body of the adjacent natural vertebra are connected, and that these two connecting means work together so that the adjacent natural Vertebra is firmly connected to the prosthesis. Prosthesis according to Claim 1, characterized in that the element (12) is essentially Is V-shaped and that its shaft-shaped part (28) for attachment to the surfaces of the element (14) opposite sides of the trough-shaped part (22) with its one outer end in diverging leg-shaped Parts engages. Prosthesis according to Claim 2, characterized that a single prosthetic limb is used for a length which is dimensioned to fit the limb in the gap remaining after the removal of a single natural vertebra fits so that the first lanyard to- - A2 - 009822/0187 BATH has at least one clamp (46) which, between its ends, is connected to the shaft-shaped part of the Y-shaped element (12) communicates, the outer ends of which extend longitudinally into one for connection with the neural processes of the adjacent, remaining natural vertebrae extend in a suitable position, and that the further connecting means have a pair of longitudinally extending, laterally spaced apart lugs (38), which on opposite ends of the element (14) protrude outwards and for receiving the adjacent one serve natural vertebrae along the vertebral body. 4. Prosthesis according to Claim 2, characterized in that that two prosthetic limbs are provided in a head-to-head arrangement, which in the after removal Gaps arising from two adjacent natural vertebrae are used, and that for articulating around a transverse axis Connection of the element (H) to the other element, a third connection means (38a) on one of the two elements (14) is attached. 5. Prosthesis according to claim 4, characterized that the first connecting means has a pair of sturdy brackets, which with the opposite Areas of the shaft-shaped part (28) are connected to at least one prosthetic limb, and which are connected to Distance and lying essentially parallel to each other in the longitudinal direction outwardly so that they are against create the neural process of the adjacent natural vertebra. 6. Prosthesis according to claim 1 or 2, with a plurality of prosthetic limbs, which in a head-to-head arrangement into those after removing a corresponding number of adjacent ones gap created by natural vertebrae can be used, characterized by a fourth connection - A3 - 009822/0187 BATH ORIGINAL means (54) which articulate the prosthetic limbs with one another connect such that a relative movement of the elements (Ha, b, c) around in the longitudinal direction, at a distance and substantially axes lying parallel to each other is possible. 7. Prosthesis according to claim 6, characterized in that the fourth connecting means have at least one clip (54) provided with longitudinal slots, which are located between the shaft-shaped parts of the Y-shaped element of the prosthetic limb, and to limit the relative pivoting movement of the two elements in these shaft-shaped parts arranged pins engage in these slots. β. Prosthesis according to Claim 6 or 7, characterized in that the elements are elongated bearings (62) which are in an aligned arrangement and parallel and at a distance from the trough-shaped part (22), and that in the bearings bridging the two elements a spring member (6o) is arranged, which normally this Pushes elements in the extended position. 9 · Prosthesis according to claim 8, characterized by characteristic; indicates that the third connection means the EIe-> Connect the elements with one another in such a way that a gap remains between these elements in the extended position, and that the bearings j (62) are designed so that they the spring member (6o) after the action of forces on the egg widening the gap ' Bend out elements immediately, while the gap without bend ι of the spring element (6o) can close. 009822 / 018T