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WO1997000054A1 - Dispositif d'espacement reglable et methode de reglage de la distance entre deux vertebres a l'aide dudit espaceur dans les interventions chirurgicales sur la moelle epiniere - Google Patents

Dispositif d'espacement reglable et methode de reglage de la distance entre deux vertebres a l'aide dudit espaceur dans les interventions chirurgicales sur la moelle epiniere Download PDF

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Publication number
WO1997000054A1
WO1997000054A1 PCT/SE1996/000797 SE9600797W WO9700054A1 WO 1997000054 A1 WO1997000054 A1 WO 1997000054A1 SE 9600797 W SE9600797 W SE 9600797W WO 9700054 A1 WO9700054 A1 WO 9700054A1
Authority
WO
WIPO (PCT)
Prior art keywords
plates
vertebrae
centre
towards
implant
Prior art date
Application number
PCT/SE1996/000797
Other languages
English (en)
Inventor
Sven Olerud
Original Assignee
Sven Olerud
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
Priority claimed from SE9502224A external-priority patent/SE9502224L/xx
Priority claimed from SE9503191A external-priority patent/SE9503191L/xx
Application filed by Sven Olerud filed Critical Sven Olerud
Priority to AU61444/96A priority Critical patent/AU6144496A/en
Publication of WO1997000054A1 publication Critical patent/WO1997000054A1/fr

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    • A—HUMAN NECESSITIES
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    • 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
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0041—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting 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
    • 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
    • A61F2230/0017—Angular shapes
    • A61F2230/0019—Angular shapes rectangular
    • 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
    • A61F2230/0017—Angular shapes
    • A61F2230/0026—Angular shapes trapezoidal
    • 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
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0082—Three-dimensional shapes parallelepipedal
    • 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
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0004—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof adjustable
    • A61F2250/0006—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof adjustable for adjusting angular orientation
    • 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
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0004—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof adjustable
    • A61F2250/0009—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof adjustable for adjusting thickness

Definitions

  • the present inventions relates to an adjustable spacing device for insertion between two mutually adjacent vertebrae in spinal surgical operations so as to adjust and increase the distance therebetween, wherein there is formed a space in which a fibrocartilage disc is located and which space has diminished as a result of a pathological change.
  • the inven ⁇ tion also relates to a method for adjusting and increasing the distance between two vertebrae by means of the adjustable spacing device.
  • An intermediate disc a fibrocartilage disc
  • This disc may degenerate as a result of a disease process or pathological change, therewith reducing the distance between the vertebrae.
  • Such conditions are treated with the intention of restoring the distance between the vertebrae and of filling the resultant space with bone transplant so as to achieve bone healing, fusion, between the vertebrae and therewith establish normal vertebrae spacing and stability between the vertebrae.
  • One method of holding the vertebrae apart during a bone healing process is to replace part of the space with a fixed body of some kind or other, after the vertebrae have been indirectly brought to a normal position.
  • cortical bone has earlier been used in this regard.
  • "cages" i.e. hollow implants of different constructions which are filled with cancellous bone, so as to hold the vertebrae apart and also stimulate bone healing between the vertebrae at the same time. All of these solutions involve the insertion of a body which is unable to adapt to the specific shape or configura ⁇ tion that is ideal with respect to the particular individual conditions that prevail from case to case.
  • the object of the present invention is to eliminate the aforesaid drawbacks encountered in vertebrae surgical operations cf the aforesaid kind and to provide an implant which can be inserted surgically in between the vertebrae and wherein the distance therebetween can be adjusted in place, at both ends, independently of one another, and therewith achieve ideal conditions, i.e. the healthy and natural distances between respective vertebrae at their front and rear parts, which are determined and decided by the different lengths of the ligaments (band structures that surround the vertebrae) and suitably tension the same.
  • the distance between the rear part of the vertebra interspace shall be longer than the distance within the forward part.
  • an adjustable spacing device which comprises two mutually superposed elongated plates, wherein the plates are provided centrally thereof with a pivot which prevents mutual longitudinal movement of the plates but allows the plates to be positioned angularly in relation to one another and permits at least one of the plates to move at right angles to the common plane of said plates, wherein the distance of one plate from the other can be adjusted at each end, individually, by means of an adjuster having spacing means and disposed in a longitudinal ⁇ ly extending cavity defined by mutually corresponding cylindrical grooves milled in respective mutually facing surfaces of said plates, wherein said cavity also includes two circular recesses which extend obliquely from the short ends of the implant and in towards the centre thereof, wherein the deeper ends of the circular recesses either face away from each other and towards the short ends of the implant, and the shallower parts face towards each other in the centre of the implant, or one or both of the deeper ends are disposed in towards the centre on each side of a hole in the implant plates, said hole extending essentially at right angles
  • the invention also relates to a method for surgically adjusting the distance between two mutually adjacent verte- brae with the aid of an inventive spacing device, wherein one or more spacing devices are inserted into the space between two vertebrae, whereafter the person making the insertion adjusts from one side the distance between the two plates in one spacing device, by first adjusting from one and the same side the position of the most distal end of the implant, by moving a thickened end-part of the adjuster into the cavity and towards the centre or out towards the end-part of the implant, and thereafter adjusting the end of the implant lying most proximal to said person, by moving a second thickened end-part of the adjuster in towards the centre of the implant or out towards said end-part, wherewith both parts are moved away from each other to therewith separate the two vertebra as a result of the varying depth of the cavity.
  • the cavities thus formed by the side of and within the implant are then filled with an appropriate bone trans ⁇ plant material for subsequent bone healing between the vertebrae.
  • Fig. 1 is a perspective view of the implant seen obliquely from above.
  • Fig. 2a is a side view of one of the plates.
  • Fig. 2b is a sectional view of the plate taken on the line A-A in Figure 2a.
  • Fig. 3a shows one of the plates from above.
  • Fig. 3b is a sectional view of the plate in Figure 3a taken on the line B-B in Figure 3a.
  • Fig. 3c is a sectional view of the plate shown in Figure 3b, taken on the line C-C in Figure 3a.
  • Fig. 4 is a side view of an adjuster, seen without a centre pin.
  • Fig. 5 is an end view of the adjuster screw.
  • Fig. 6 is a side view of the centre pin.
  • Fig. 7 shows an assembled implant with the adjuster adjust ⁇ ed differently forwards and backwards as seen in a longitudinal sectional view in Figure 1 from one side.
  • Fig. 8 illustrates another embodiment of the invention and shows the implant when assembled and the adjuster adjusted differently forwards and backwards as seen in a longitudinal view in Figure 1 from one side.
  • the spacing device 1 includes two elongated plates 2, 3 each having an obliquely milled groove 4, 5, said grooves together forming a cavity
  • the plates can be manipulated with the aid of a wrench, key or like tool such that when fitting the implant 1 the upper plate 2 will be positioned above the lower plate, by first placing the upper plate at an angle of 90° in relation to the longitudinal axis of the lower plate 3 and then rotating said upper plate so that in use said plate will be parallel with the lower plate 3.
  • the adjuster means 7 is comprised of a threaded rod 11 on which the centre pin 9 is screwed to a position roughly in the centre of the threaded rod 11.
  • the rod 11 has a frusto- conical part 12 formed integrally with one end thereof and is provided with tool-coacting surfaces 13 on its other end.
  • a frustoconical nut 14 is screwed over the tool-coacting surfaces 13 on the rod 11.
  • FIGS 2a-3c illustrate the design of the plates.
  • the plates 2, 3 of the implant 1 are mutually identical.
  • the plates 2, 3 are provided with two oblique, cylindrical recesses 15, 16, e.g. milled recesses, one at each end, and a coaxially extending semi-circular groove 17 which extends in two opposite directions from the oval hole 8 in the centre of the plates 2, 3, out towards the deeper end of the semi-cylindri ⁇ cal recesses 15, 16 through a distance corresponding roughly to half the length of the semi-cylindrical recesses 15, 16 and with a slightly larger than the diameter of the threaded rod 11.
  • Figure 7 illustrates the mutual relationship of the plates 2, 3 when manipulating the adjuster means 7.
  • the reference h illustrates the height of the implant 1 at one end and the distance between the vertebrae at this end when using the implant in a spinal surgical operation, whereas the reference H indicates the height of the implant 1 at its other end, i.e. the distance between the vertebrae at said other end.
  • Figure 8 illustrates the mutual relationship of the plates 2, 3 when the adjuster means 7 is manipulated.
  • the reference h indicates the height of the implant 1 at one end thereof, i.e. the distance between the vertebrae at this end, and the reference H indicates the height of the implant at the other end, i.e. the distance between the vertebrae at said other end.
  • the adjuster means 7 is comprised of a threaded rod 11 onto which the centre rod 9 is screwed to a position roughly in the centre of the rod 11.
  • One end of the rod 11 has formed integrally therewith a frustoconical part 12 whose wider end faces inwards towards the centre of the implant, and the other end of the rod is provided with means for coaction with a wrench, key or like turning tool.
  • the plates 2, 3 of the implant 1 are mutually identical.
  • the longitudinally extending cavity 6 includes an oblique, cylindrical recess 15, 16 milled in each end of the plates 2, 3, of which recesses 15, 16 the first recess 15 has a deeper part which extends in towards the centre of the plates and a shallower part which extends towards the shorter ends of the plates (2, 3), whereas the other cylindrical recess 16 has a deeper part which extends towards the shorter ends of the plates (2, 3) and a shallower part which extends in towards the centre of the plates.
  • a coaxial semi-circular groove 17 which extends in two mutually opposite directions from the oval hole 8 in the centre of the plates 2, 3 outwardly towards the end parts through a distance corresponding roughly to half the length of the recesses 15, 16 and which has a diameter that is slightly larger than the diameter of the threaded rod 11.
  • An inventive adjustable spacing device is used in spinal surgery in the following manner:
  • the adjustable spacing device is preferably used in pairs, one on each side of the space between two mutually adjacent vertebrae.
  • the spacer device is inserted in between the vertebrae and the distance h between the rear parts of the implant plates 2, 3 is adjusted with the aid of a tool inserted into the tool-coacting part 13 through a centre hole in the frustoconical part 14.
  • the frustoconical part formed integral with the threaded rod 11 is caused to move in the cavity 6 in response to turning of the tool, by virtue of the centre pin 9 being screwed onto the rod 11- and also by virtue of the centre pin 9 being locked in the centre hole 8 of the plates 2, 3 and therewith prevented from moving in the longitudinal direction of the rod.
  • the plates are able to move perpendicularly to the longitudinal axis of the rod, i.e. the longitudinally extending sides can be moved in relation to each other so as to enable lh and LH to be varied, therewith enabling flexible adjustment of the distance between the vertebrae.
  • the distance between the front parts of respective plates 2, 3 is then adjusted by screwing-in the frustoconical nut 14 on the threaded rod 11 so as to be moved either into or out of the circular cavity 6 in the implant, therewith either increasing or decreasing the distance H between the front ends of the plates.
  • the cavity thus formed by the side of and within the implant is then filled with an appropriate bone transplant for subsequent bone healing between the vertebrae.
  • the implant plates can be mutually connected in a number of different ways, for instance by means of a spring device or the like disposed around the plates.

Landscapes

  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Neurology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Cardiology (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

L'invention se rapporte à un dispositif d'espacement réglable destiné à être inséré entre les vertèbres lors d'interventions chirurgicales sur la moelle épinière et qui permet de régler la distance entre deux vertèbres où se trouve un disque de cartilage fibreux. Ce dispositif (1) comprend deux plaques allongées superposées (2, 3) qui sont dotées au centre d'un pivot servant à empêcher le déplacement des plaques (2, 3) dans le sens de la longueur mais qui permet aux plaques (2, 3) de se déplacer en angle l'une par rapport à l'autre et au moins à une des plaques de se déplacer perpendiculairement au plan commun des deux plaques (2, 3). La distance séparant les deux plaques (2, 3) peut se régler à chaque extrémité, séparément, à l'aide d'un dispositif de réglage (7) pourvu de deux éléments espaceurs (12, 14) montés dans une cavité s'étendant longitudinalement (6) définie par des cannelures (4, 5) qui s'étendent le long du côté de chaque plaque faisant face à l'autre plaque. Les cannelures (4, 5) coïncident de manière à pouvoir recevoir le dispositif de réglage. L'invention porte également sur une méthode permettant de régler la distance entre deux vertèbres à l'aide dudit espaceur lors d'interventions chirurgicales sur la moelle épinière.
PCT/SE1996/000797 1995-06-19 1996-06-18 Dispositif d'espacement reglable et methode de reglage de la distance entre deux vertebres a l'aide dudit espaceur dans les interventions chirurgicales sur la moelle epiniere WO1997000054A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU61444/96A AU6144496A (en) 1995-06-19 1996-06-18 An adjustable spacing device and a method of adjusting the distance between two vertebrae with the aid of said spacing device in spinal surgical operations

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
SE9502224A SE9502224L (sv) 1995-06-19 1995-06-19 Variabel distanskropp samt förfarande för justering av avståndet mellan två kotor medelst denna distanskropp vid ryggoperationer
SE9502224-0 1995-06-19
SE9503191-0 1995-09-14
SE9503191A SE9503191L (sv) 1995-09-14 1995-09-14 Variabel distanskropp samt förfarande för justering av avståndet mellan två kotor medelst denna distanskropp vid ryggoperationer

Publications (1)

Publication Number Publication Date
WO1997000054A1 true WO1997000054A1 (fr) 1997-01-03

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Country Status (2)

Country Link
AU (1) AU6144496A (fr)
WO (1) WO1997000054A1 (fr)

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