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ES2745732T3 - Implante intervertebral con forma mejorada de la placa de fijación - Google Patents

Implante intervertebral con forma mejorada de la placa de fijación Download PDF

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Publication number
ES2745732T3
ES2745732T3 ES14707244T ES14707244T ES2745732T3 ES 2745732 T3 ES2745732 T3 ES 2745732T3 ES 14707244 T ES14707244 T ES 14707244T ES 14707244 T ES14707244 T ES 14707244T ES 2745732 T3 ES2745732 T3 ES 2745732T3
Authority
ES
Spain
Prior art keywords
intervertebral implant
fusion cage
passages
fixation plate
plane
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.)
Active
Application number
ES14707244T
Other languages
English (en)
Inventor
Meinrad Fiechter
Marco Riva
Francesco Siccardi
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.)
Medacta International SA
Original Assignee
Medacta International SA
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 Medacta International SA filed Critical Medacta International SA
Priority claimed from PCT/IB2014/058961 external-priority patent/WO2014125428A1/en
Application granted granted Critical
Publication of ES2745732T3 publication Critical patent/ES2745732T3/es
Active legal-status Critical Current
Anticipated expiration legal-status Critical

Links

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
    • A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
    • 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
    • A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
    • A61F2/4465—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages having a circular or kidney shaped cross-section substantially perpendicular to the axis of the spine
    • 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
    • A61B17/7059—Cortical plates
    • 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
    • A61F2/3094—Designing or manufacturing processes
    • A61F2/30965—Reinforcing the prosthesis by embedding particles or fibres during moulding or dipping
    • 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
    • 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
    • A61F2/28—Bones
    • A61F2002/2835—Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
    • 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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    • A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/3006—Properties of materials and coating materials
    • A61F2002/3008—Properties of materials and coating materials radio-opaque, e.g. radio-opaque markers
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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
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    • 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
    • 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
    • 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
    • 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
    • A61F2002/30331—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
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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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    • A61F2002/30383—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
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Abstract

Un implante (100) intervertebral para la fusión entre dos cuerpos vertebrales de una columna vertebral que comprende: - una jaula (1) de fusión, que se extiende desde un lado posterior a un lado anterior, adaptada para interponerse entre dos cuerpos vertebrales adyacentes de un paciente; - una placa (2) de fijación, unida a la jaula (1) de fusión en un lado anterior y/o anterolateral, que tiene una porción (21) lateral ampliada que sobresale en ambas direcciones caudal y craneal con respecto a la altura de la jaula (1) de fusión y que tiene una pluralidad de pasajes (16, 17) para la inserción de tornillos para huesos; un plano (y) medio del implante (100) intervertebral que divide la jaula de fusión en dos mitades sustancialmente simétricas y la placa (2) de fijación en dos mitades asimétricas, dichos pasajes (16; 17) se proporcionan solo en una de dichas mitades asimétricas en dicha porción (21) lateral ampliada, caracterizada porque dicha porción (21) lateral ampliada provista de dichos pasajes (16, 17) está inclinada hacia el plano (y) medio en la dirección postero anterior formando un ángulo con el plano (y) medio comprendida entre 30° y 60°.

Description

DESCRIPCIÓN
Implante intervertebral con forma mejorada de la placa de fijación
Campo técnico
La presente invención se refiere al campo general de los implantes quirúrgicos ortopédicos.
En particular, la invención se refiere a un implante intervertebral que permite la fusión entre dos cuerpos vertebrales de una columna vertebral, usado en el campo del tratamiento quirúrgico de la columna vertebral.
Más específicamente, el implante está destinado preferiblemente para ser utilizado como dispositivo de fusión de cuerpo intervertebral independiente para la Fusión Intercorporal Lumbar Anterior (ALIF).
Antecedentes de la técnica
La metodología ALIF es una técnica quirúrgica utilizada principalmente para operar un disco dañado en el área lumbar de la columna vertebral. La operación consiste en acercarse a la columna a través de una incisión en el abdomen, extraer el disco dañado y reemplazarlo con un implante intervertebral adecuado.
El implante intervertebral comprende principalmente una jaula hueca, que se inserta entre los dos cuerpos vertebrales y se llena con un injerto de hueso autógeno o similar con el fin de promover el crecimiento del hueso y la fusión eventual de los dos cuerpos.
Además, el implante comprende una placa de fijación firmemente unida a la jaula hueca. La placa de fijación puede sobresalir o no del espacio intervertebral y se fija a los lados anteriores de los dos cuerpos vertebrales adyacentes, generalmente por medio de dos o más tornillos para huesos. La función principal de la placa de fijación y los tornillos es la de mejorar la estabilidad primaria de todo el implante.
Un inconveniente de la metodología ALIF radica en el hecho de que, por encima de la quinta vértebra lumbar, los principales vasos sanguíneos se encuentran directamente en frente de la columna vertebral. Por lo tanto, el cirujano debe realizar una disección de los vasos para determinar un acceso quirúrgico para la inserción de la placa intervertebral. Esta operación preliminar lleva mucho tiempo y es un reto.
En vista de lo anterior, el problema técnico subyacente a la presente invención es proporcionar un implante intervertebral que se pueda insertar y fijar en la columna vertebral de un paciente por encima de la quinta vértebra lumbar, sin la necesidad de diseccionar los vasos sanguíneos. Algunos ejemplos de implantes intervertebrales conocidos se pueden encontrar en los documentos US2012/041559, EP 2628466 y WO2010/107692.
Divulgación de la invención.
El problema técnico mencionado anteriormente se resuelve mediante un implante intervertebral para la fusión entre dos cuerpos vertebrales de una columna vertebral que comprende:
- una jaula de fusión, que se extiende desde un lado posterior a un lado anterior, adaptada para interponerse entre dos cuerpos vertebrales adyacentes de un paciente; y
- una placa de fijación, unida a la jaula de fusión en un lado anterior y/o antero-lateral, que tiene una porción lateral ampliada que sobresale en ambas direcciones caudal y craneal con respecto a la altura de la jaula de fusión y que tiene una pluralidad de pasajes para la inserción de tornillos para huesos;
un plano medio del implante intervertebral que divide la jaula de fusión en dos mitades sustancialmente simétricas y la placa de fijación en dos mitades asimétricas, dichos pasajes se proporcionan solo en una de dichas mitades asimétricas en dicha porción lateral ampliada, por lo que dicha porción lateral ampliada provista de dichos pasajes está inclinada hacia el plano medio en la dirección postero-anterior formando un ángulo con el plano medio comprendido entre 30° y 60°.
Como puede reconocer fácilmente una persona experta en la técnica, la forma asimétrica del implante intervertebral hace posible que el cirujano adopte una nueva metodología quirúrgica. En efecto, el implante intervertebral puede insertarse en una dirección oblicua, por ejemplo, a 45° con respecto al plano medio-sagital, para que no se requiera una disección de los vasos delante de las vértebras. Además, todo el tornillo para hueso puede insertarse en los pasajes adoptando el mismo ángulo y metodología quirúrgica.
La placa de fijación puede presentar ventajosamente una porción en forma de cuña en el lado lateral opuesto al de la porción lateral ampliada.
Tal porción en forma de cuña está adaptada morfológicamente para ser insertada en el tejido del hueso del paciente, facilitando así la tarea del cirujano.
Las superficies anteriores de la porción en forma de cuña y de la porción lateral ampliada pueden converger ventajosamente en un borde anterior de la placa de fijación, dichas superficies anteriores se inclinan en una dirección posterior desde dicho borde anterior a sus bordes laterales.
Con el fin de minimizar el volumen del implante, la porción en forma de cuña puede tener la misma altura que la jaula de fusión.
Los pasajes pueden comprender al menos un pasaje superior y al menos un pasaje inferior, dispuestos simétricamente con respecto a un plano transversal.
En particular, los pasajes pueden comprender dos pasajes superiores y dos pasajes inferiores. Alternativamente, los pasajes pueden comprender un solo pasaje superior y un solo pasaje inferior.
En una realización del implante intervertebral de acuerdo con la presente invención, la placa de fijación puede formarse integralmente con la jaula de fusión.
Alternativamente, el implante intervertebral puede comprender un mecanismo de sujeción para sujetar la placa de fijación en la jaula de fusión.
El mecanismo de sujeción puede comprender alternativamente: un pasador de centrado que coopera con un orificio de centrado junto con protuberancias que cooperan con una guía deslizante; protuberancias que cooperan con una guía deslizante vertical; protuberancias que cooperan con una guía deslizante horizontal; o una pluralidad de pasadores de centrado que cooperan con los orificios de centrado y un solo tornillo de sujeción para sujetar la jaula de fusión y la placa de fijación.
Las características y ventajas adicionales del implante intervertebral de acuerdo con la invención se aclararán mediante la descripción que se proporciona a continuación en el presente documento, de varias realizaciones descritas a modo de ejemplos no limitativos con referencia a los dibujos adjuntos.
Breve descripción de los dibujos.
- La figura 1 muestra una vista en perspectiva de una primera realización de un implante intervertebral de acuerdo con la invención;
- La figura 2 muestra una vista en perspectiva del implante intervertebral de la figura 1 con su placa de fijación y su jaula de fusión desprendidas;
- La figura 3 muestra una vista en perspectiva del implante intervertebral de la figura 1 en una configuración de montaje intermedia;
- La figura 4 muestra una vista en perspectiva de una segunda realización de un implante intervertebral de acuerdo con la invención;
- La figura 5 muestra una vista en perspectiva del implante intervertebral de la figura 4 con su placa de fijación y su jaula de fusión desprendidas;
- La figura 6 muestra una vista en perspectiva de una tercera realización de un implante intervertebral de acuerdo con la invención;
- La figura 7 muestra una vista en perspectiva del implante intervertebral de la figura 6 con su placa de fijación y su jaula de fusión desprendidas.
- La figura 8 muestra una vista en perspectiva de una cuarta realización de un implante intervertebral de acuerdo con la invención;
- La figura 9 muestra una vista en perspectiva del implante intervertebral de la figura 8 con su placa de fijación y su jaula de fusión desprendidas;
- La figura 10 muestra una vista en perspectiva diferente del implante intervertebral de la figura 8;
- La figura 11 muestra una vista en perspectiva de una quinta realización de un implante intervertebral de acuerdo con la invención;
- La figura 12 muestra una vista en perspectiva de una sexta realización de un implante intervertebral de acuerdo con la invención;
- La figura 13 muestra una vista en perspectiva de una séptima realización de un implante intervertebral de acuerdo con la invención.
Descripción detallada de realizaciones preferidas de la invención.
Con referencia a las figuras 1-13, con 100 se muestra globalmente un implante intervertebral, de acuerdo con varias realizaciones de la presente invención.
Debe observarse que se han usado los mismos números de referencia para identificar los elementos y partes que son similares o idénticas, ya sea en forma o función, en las diferentes realizaciones de la invención.
Una primera realización del implante 100 intervertebral, que se muestra en las figuras 1-3, comprende una jaula 1 de fusión acoplada a una placa 2 de fijación por medio de un mecanismo de sujeción globalmente denominado 3.
La jaula 1 de fusión, destinada a ser insertada dentro del espacio intervertebral de un paciente, presenta cuatro paredes de altura uniforme que se elevan desde una base sustancialmente rectangular y que encierran un orificio 6 central.
El lado posterior de la jaula 1 de fusión, que es el lado insertado entre los cuerpos vertebrales, presenta bordes redondeados, mientras que el lado anterior, que tiene que estar acoplado con la placa 2 de fijación, tiene bordes rectos.
El orificio 6 central, que se extiende en la dirección caudal-craneal, está destinado a rellenarse con material para la promoción del crecimiento del hueso, tal como un injerto de hueso autógeno. La superficie de la jaula caudal y craneal está ventajosamente cubierta por un patrón dentado para mejorar la estabilidad primaria.
La jaula 1 de fusión está hecha de material biocompatible, por ejemplo, PEEK, CFRP o titanio, con o sin recubrimiento, por ejemplo, se podría proporcionar un recubrimiento de titanio o hidroxiapatita incluso si se puede usar otro recubrimiento.
La placa 2 de fijación tiene una estructura asimétrica. Para describir su estructura, se deben introducir dos planos perpendiculares: un plano medio y que divide el implante 100 intervertebral en dos mitades asimétricas laterales, y un plano z transversal que divide el implante en mitades craneales y caudales aproximadamente simétricas.
De hecho, la placa de fijación presenta una porción 21 lateral ampliada que sobresale en ambas direcciones caudal, craneal y lateral con respecto a la altura y anchura de la jaula 1 de fusión.
Dicha porción 21 ampliada tiene cuatro pasajes 16, 17 para alojar tornillos para huesos. Dos pasajes 16 superiores están posicionados en el lado superior, es decir, el lado que sobresale en dirección craneal, de la porción 21 ampliada; dos pasajes 17 inferiores están colocados simétricamente en el lado inferior.
Debe observarse que todos los pasajes 16, 17 convergen hacia el plano medio del implante 100 intervertebral.
La porción ampliada en sí misma es básicamente una pestaña plana inclinada con respecto al lado frontal de la jaula 1 de fusión. En particular, la porción 21 ampliada se inclina desde su borde 25 lateral, sobresaliendo con respecto al lado lateral de la jaula 1 de fusión, hacia un borde 23 anterior de la placa 2 de fijación.
En el lado opuesto con respecto a la porción 21 lateral ampliada, la placa 2 de fijación presenta una porción 22 en forma de cuña que tiene la misma altura de la jaula 1 de fusión y que se inclina desde el borde 23 anterior hacia el borde 24 lateral de la placa 2 de fijación. Este borde 24 lateral no sobresale con respecto al lado lateral de la jaula 1 de fusión.
La placa 2 de fijación se realiza convenientemente con un material biocompatible, por ejemplo, PEEK, CFRP, titanio o con otro material alternativo adecuado para dispositivos médicos implantables.
El mecanismo 3 de sujeción previsto para sujetar la placa 2 de fijación a la jaula 1 de fusión comprende un orificio 30 de centrado de la jaula de fusión y un pasador de centrado de la placa 2 de fijación que encaja en la misma. La cooperación de las dos características promueve una rotación de la placa 2 de fijación en la jaula 1 de fusión; el acoplamiento de las protuberancias 31 en forma basculante de la placa 2 de fijación en una guía 32 deslizante giratoria definida en la jaula de fusión proporciona una guía deslizante adicional y un tope para dicho montaje giratorio.
Una segunda realización, representada en las figuras 4-5, comparte básicamente las mismas características de la realización descrita anteriormente.
Sin embargo, el mecanismo 3 de sujeción difiere del anterior en que una guía 33 deslizante giratoria sustituye a la guía 32 deslizante giratoria; el orificio 30 de centrado y el pasador ya no son necesarios.
Una tercera realización, representada en las figuras 6-7, comparte básicamente las mismas características de las realizaciones descritas anteriormente.
Aquí, nuevamente, la única diferencia radica en el mecanismo de sujeción, que emplea una guía 34 deslizante horizontal.
Una cuarta realización, representada en las figuras 8-10, comparte básicamente las mismas características de las realizaciones descritas anteriormente.
Aquí nuevamente, se propone un mecanismo 3 de sujeción diferente. El mecanismo de sujeción comprende dos pasadores 35 de centrado alojados en los orificios 36 de centrado, mientras que un solo tornillo 37 de sujeción atraviesa las placas 2 de fijación y se acopla en la jaula 1 de fusión.
Una quinta realización, representada en la figura 11, es sustancialmente similar a las descritas previamente, pero difiere en que la placa 2 de fijación y la jaula 1 de fusión están preensambladas. Por lo tanto, no se proporciona ningún mecanismo 3 de sujeción.
Una sexta realización, representada en la figura 12, presenta una ligera variación en la placa 2 de fijación, que está provista de un único pasaje 16 superior y un único pasaje 17 inferior.
Una séptima realización, representada en la figura 13, presenta un implante 100 intervertebral en donde la placa 2 de fijación está formada monolíticamente con la jaula 1 de fusión. Por lo tanto, los dos elementos están, hechos del mismo material. A
Obviamente, una persona experta en la técnica, para satisfacer necesidades específicas, reconocerá fácilmente la posibilidad de cambios y variaciones en el implante intervertebral descrito anteriormente, todo comprendido dentro del alcance de protección definido por las siguientes reivindicaciones.

Claims (13)

REIVINDICACIONES
1. Un implante (100) intervertebral para la fusión entre dos cuerpos vertebrales de una columna vertebral que comprende:
- una jaula (1) de fusión, que se extiende desde un lado posterior a un lado anterior, adaptada para interponerse entre dos cuerpos vertebrales adyacentes de un paciente;
- una placa (2) de fijación, unida a la jaula (1) de fusión en un lado anterior y/o anterolateral, que tiene una porción (21) lateral ampliada que sobresale en ambas direcciones caudal y craneal con respecto a la altura de la jaula (1) de fusión y que tiene una pluralidad de pasajes (16, 17) para la inserción de tornillos para huesos;
un plano (y) medio del implante (100) intervertebral que divide la jaula de fusión en dos mitades sustancialmente simétricas y la placa (2) de fijación en dos mitades asimétricas, dichos pasajes (16; 17) se proporcionan solo en una de dichas mitades asimétricas en dicha porción (21) lateral ampliada, caracterizada porque dicha porción (21) lateral ampliada provista de dichos pasajes (16, 17) está inclinada hacia el plano (y) medio en la dirección postero anterior formando un ángulo con el plano (y) medio comprendida entre 30° y 60°.
2. El implante (100) intervertebral de acuerdo con la reivindicación 1, en donde la placa de fijación tiene una porción (22) en forma de cuña en el lado lateral opuesto al de la porción (21) lateral ampliada.
3. El implante (100) intervertebral de acuerdo con una de las reivindicaciones 1 o 2, en donde dichos pasajes (16; 17) comprenden al menos un pasaje (16) superior y al menos un pasaje (17) inferior, dispuestos simétricamente con respecto a un plano (z) transversal.
4. El implante (100) intervertebral de acuerdo con la reivindicación 3, en donde dichos pasajes (16; 17) comprenden dos pasajes (16) superiores y dos pasajes (17) inferiores.
5. El implante (100) intervertebral de acuerdo con la reivindicación 3, en donde dichos pasajes (16; 17) comprenden solo un único pasaje (16) superior y solo un solo pasaje (17) inferior.
6. El implante (100) intervertebral de acuerdo con una de las reivindicaciones anteriores, en donde la placa (2) de fijación está formada integralmente con la jaula (1) de fusión.
7. El implante (100) intervertebral de acuerdo con la reivindicación 6, en donde la placa (2) de fijación está formada como un único componente con la jaula (1) de fusión.
8. El implante (100) intervertebral de acuerdo con una de las reivindicaciones 1-5, que comprende un mecanismo (3) de sujeción para sujetar la placa (2) de fijación en la jaula (1) de fusión.
9. El implante (100) intervertebral de acuerdo con la reivindicación 8, en donde dicho mecanismo (3) de sujeción comprende un pasador de centrado que coopera con un orificio (30) de centrado, y protuberancias (31) que cooperan con una guía (32) deslizante giratoria.
10. El implante (100) intervertebral de acuerdo con la reivindicación 8, en donde dicho mecanismo (3) de sujeción comprende protuberancias (31) que cooperan con una guía (33) deslizante vertical.
11. El implante (100) intervertebral de acuerdo con la reivindicación 8, en donde dicho mecanismo (3) de sujeción comprende protuberancias (31) que cooperan con una guía (34) deslizante horizontal.
12. El implante (100) intervertebral de acuerdo con la reivindicación 8, en donde dicho mecanismo (3) de sujeción comprende al menos un tornillo (37) de sujeción para sujetar la jaula (1) de fusión y la placa (2) de fijación juntas.
13. El implante (100) intervertebral de acuerdo con la reivindicación 12, en donde el mecanismo (3) de sujeción comprende un solo tornillo (37) de sujeción y además comprende una pluralidad de pasadores (35) de centrado que cooperan con los orificios (36) de centrado.
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CN103251465B (zh) 2017-03-01
EP2628467B1 (en) 2017-04-26
ES2628444T3 (es) 2017-08-02
EP2628466A1 (en) 2013-08-21
JP6009961B2 (ja) 2016-10-19
AU2013200734B2 (en) 2015-09-24
JP2013169465A (ja) 2013-09-02
US10052212B2 (en) 2018-08-21
ES2633197T3 (es) 2017-09-19
US20130218276A1 (en) 2013-08-22
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CN103251465A (zh) 2013-08-21
EP2628466B1 (en) 2017-04-05

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