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WO1998009576A1 - Osteosynthesis system for spinal column with stress distribution - Google Patents

Osteosynthesis system for spinal column with stress distribution Download PDF

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Publication number
WO1998009576A1
WO1998009576A1 PCT/FR1997/001557 FR9701557W WO9809576A1 WO 1998009576 A1 WO1998009576 A1 WO 1998009576A1 FR 9701557 W FR9701557 W FR 9701557W WO 9809576 A1 WO9809576 A1 WO 9809576A1
Authority
WO
WIPO (PCT)
Prior art keywords
anchoring member
osteosynthesis system
hooks
anchoring
osteosynthesis
Prior art date
Application number
PCT/FR1997/001557
Other languages
French (fr)
Inventor
Pierre Ange Moreno
Jacques Jean-Marie Boulot
Original Assignee
Stryker France S.A.
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
Family has litigation
First worldwide family litigation filed litigation Critical https://patents.darts-ip.com/?family=9495419&utm_source=google_patent&utm_medium=platform_link&utm_campaign=public_patent_search&patent=WO1998009576(A1) "Global patent litigation dataset” by Darts-ip is licensed under a Creative Commons Attribution 4.0 International License.
Application filed by Stryker France S.A. filed Critical Stryker France S.A.
Priority to BR9711652-1A priority Critical patent/BR9711652A/en
Priority to JP51230698A priority patent/JP2001504361A/en
Priority to AU41225/97A priority patent/AU4122597A/en
Priority to CA002266121A priority patent/CA2266121A1/en
Priority to EP97938979A priority patent/EP1009309A1/en
Publication of WO1998009576A1 publication Critical patent/WO1998009576A1/en

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers, e.g. stabilisers comprising fluid filler in an implant
    • 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
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7019—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other
    • A61B17/7022—Tethers, i.e. longitudinal elements capable of transmitting tension only, e.g. straps, sutures or cables
    • 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
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • 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
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7032—Screws or hooks with U-shaped head or back through which longitudinal rods pass

Definitions

  • the invention relates to osteosynthesis systems for the spine.
  • Document FR-2 659 546 discloses an osteosynthesis system for a spine or spine, which comprises anchoring members intended to be fixed to a series of vertebrae of the column, and a rigid connecting rod intended to be received in the anchoring members and to connect the anchoring members together.
  • the rod allows a ball joint to be made with each of the anchoring members, and at the same time gives the system a small footprint.
  • An object of one present invention is to provide an osteosynthesis system 1 of this type avoiding, when the system involves at least two vertebrae connected rigidly, the occurrence of a sudden discontinuity in the distribution of stresses between the last vertebra of the series rigid and the first free vertebra, and on the contrary favoring a harmonious distribution of the stresses along the column.
  • an osteosynthesis system for the spine comprising first, second and third anchoring members adapted to be fixed to the vertebrae of the column, and a suitable rod to be received in the second and third anchoring members to connect them to each other, in which the system comprises at least one flexible link section adapted to exert traction between the first and second anchoring members.
  • the flexible link section resists all or part of the stresses tending to distance the first and second anchoring members from one another, without however opposing their approaching one from the other. Consequently, the system comprising at least three anchoring members, two of which are rigidly connected to each other by the rod and the first and second anchoring members are interconnected by the flexible link section located at one end of the series, a transition or stiffness gradient is formed between the rigid part of the column and its free part. A better distribution of the stresses is therefore obtained along the column and their increase is avoided at the level of the disc situated between the two aforementioned vertebrae.
  • the flexible link section can be attached to the second anchoring member in numerous ways.
  • the link section may be fixed to the rod, to a head of the second anchoring member, to the foot of the second anchoring member, or to an element attached to the rod or to the second anchoring member.
  • the system is adapted so that the link section and the rod extend to the same height in an axial direction of the second anchoring member.
  • this preferred characteristic of the invention leads to contrary to a balanced distribution of these constraints on the second anchoring member and the associated vertebra.
  • it gives the system reduced overall dimensions in the axial direction of the anchoring members.
  • the system is adapted to be fixed in the rear part of the column.
  • FIG. 1 is a partial elevational view of an osteosynthesis system according to a first embodiment of the invention, attached to vertebrae;
  • Figure 2 is a plan view of the system of Figure 1;
  • Figure 3 is an exploded elevation view of the second anchor member and the rigid connecting member of Figure 1;
  • FIG. 4 is a bottom view of the ring of Figure 3;
  • FIG. 5 is an elevational view partially in section of the first anchoring member of Figure 1;
  • FIG. 6 is a plan view of the member of Figure 5;
  • FIG. 7 is an exploded elevation view of a second embodiment of the osteosynthesis system showing the second anchor member;
  • FIG. 8 is a plan view of the ring of Figure 7;
  • Figure 9 is a plan view of the body of Figure 7;
  • FIG. 10 is an exploded view in elevation of a third embodiment of the osteosynthesis system, showing the second anchoring member
  • FIG. 11 is a plan view of the ring of Figure 10;
  • FIG. 12 is a front view of the bracket of Figure 10;
  • - Figure 13 is a plan view of the body of Figure 10; and - Figure 14 is an exploded elevation view of a fourth embodiment of the osteosynthesis system, showing the first anchoring member;
  • a first embodiment of the osteosynthesis system for a spinal column makes it possible to constitute the osteosynthesis device shown. It comprises several anchoring members or pedicle screws 2 adapted to be fixed to a series of respective vertebrae 4 of the spinal column of a patient, in particular in the posterior part of the column (posterior loading).
  • the system comprises a rigid connecting element 6 adapted to connect these anchoring members 2 to one another. Only the anchoring member 2 associated with the vertebra located at one end of the rigid series has been shown.
  • Each of these anchoring members 2 comprises an elongated body 8 of axis 10 having a threaded foot 12 of conical shape adapted to be anchored in the vertebra 4.
  • the body has a head axially opposite the foot 12 and intended to extend outside the vertebra.
  • the head has two legs 14 in the cylinder sector extending coaxially between the axis 10 opposite one another.
  • the tabs 14 have an internal face defining a thread 16 with an axis 10.
  • the rigid connecting element 6 comprises a cylindrical rod 18, and a ring 20 mounted on the rod and having a cylindrical internal face and a spherical external face 22.
  • the body 8 has between the legs 14 at the base thereof a cavity 24 constituting a housing for receiving the spherical ring 20.
  • Each anchoring member 2 further comprises an annular latch 26 having a cylindrical external face provided with a thread 28 adapted to cooperate with the thread 16 of the two tabs 14 for fixing the lock 26 to the body 8, the lock being in abutment against the spherical external face 22 of the ring 20.
  • the ring is thus immobilized in the housing 24 of the body, and the anchor member 2 is immobilized in rotation rigidly to the connecting element 6.
  • the anchor member 2 shown is adjacent to one end 29 of the rod 32.
  • the anchor members 2 and the el ment connection 6 of the system once assembled and mounted and constitute a rigid part of the device 1 osteosynthesis.
  • the foregoing characteristics are known and described in document FR-2 659 546.
  • the osteosynthesis system further comprises an additional anchoring member 30 and a flexible flexible connection element 32 adapted to connect the additional anchoring member 30 to the anchoring member 2 shown.
  • the first anchor member will designate the additional member 30, the second anchor member will designate the member 2 located at the end of the rod 18, and the third anchor member will designate the member d next anchor fixed to the rod 18.
  • the first anchor member 30 comprises a body 8 having a foot 12 identical to that of the second anchor member 2.
  • the head of the body 8 of the first anchoring member 30 is in the form of a hook 34 having a curved free end in the direction of the foot 12.
  • the second anchoring member 2 further comprises an annular ring 38 carrying two lateral hooks 40 adjacent to each other, oriented in the axial direction of the ring, and projecting from one edge of the ring in the axial direction .
  • the annular ring 38 has a smooth cylindrical internal face adapted to come into surface-to-surface contact with an external face of the two tabs 14 of the body 8 when the ring 38 is threaded on the two tabs before mounting of the bolt 26. The mounting then the tightening subsequent latch cause a slight spacing of the legs 14 from one another in the radial direction, which achieves the immobilization of the annular ring 38 by friction on the two legs.
  • the two hooks 40 extend parallel to the axis 10, on either side of the axis and on either side of the rod 18, and are oriented in the direction of the foot 12.
  • the two hooks 40 have a free end 42 folded radially in the direction of the axis of the ring, and of the axis 10 of the body after assembly.
  • the body 8 of the second anchoring member 2 has a relief 44 in the form of an annular bead extending projecting from the surface of the body and adapted to come into contact with the free end 42 of the hooks 40.
  • the second anchoring member 2 is fixed to the vertebra associated with the two hooks 40 opposite to the first anchoring member 30.
  • the latter is fixed to the vertebra associated with the hook 34 opposite to the second anchoring member 2.
  • the connecting element 32 is a flexible link, for example a flexible ligament made of biocompatible synthetic material, possibly provided with an internal reinforcement.
  • This ligament forms a loop around the first organ anchor 30, the middle part of the ligament being retained by the hook 34.
  • the ligament has two free ends 46 adjacent to the second anchor member 2. Each end 46 is folded back in a loop and fixed on itself by means a suitable seam or tie. Each loop is engaged on one of the hooks 40 of the second anchoring member 2 before mounting the ring.
  • the bead 44 and the folded end 42 of the hooks 40 in contact prevent the disengagement of the loops 46 of the hooks.
  • the second anchoring member 2 and the first anchoring member 30 are connected by two ligament sections 48 parallel to each other and extending on either side of a plane defined by the axial directions 10 of these two anchors.
  • the hooks 40 are arranged so that the ends 46 extend to the same height H (or level) as the rod 18 in the axial direction of the member 2. For example, this height H was measured from l 'lower end of the member 2 in Figure 1.
  • the hooks 34 and 40 are advantageously arranged so that the two sections 48 of the link 32 extend with the rod 18 in the same plane, this plane being perpendicular to the axial direction of the member 2 or strongly inclined relative to this direction.
  • the system is configured so that the ligament 32 is just stretched between the first anchor member 30 and the second anchor member 2.
  • FIG. 7 to 9 show a second embodiment of the osteosynthesis system for spine according to the invention. This system differs from that of the first mode only by the second anchoring member 2, the other parts being identical. The parts of this anchoring member specific to this second mode bear references increased by a hundred or starting with a hundred.
  • the body 8 of the second anchoring member 2 comprises as before a foot 12 and a head having two legs 14 and a housing 24 for receiving the spherical ring 20 of the connecting element 6.
  • the head of the body 8 carries two hooks 140 arranged in the vicinity of one another and oriented parallel to the axis 10 in the direction opposite to the foot 12, namely towards the legs 14, so that their free end 142 is turned upwards .
  • the hooks 140 extend from the base of the head to the appearance of the legs 14.
  • the second anchoring member 2 further comprises an annular ring 138 having a sector 143 enlarged in the radial direction outward by forming a pallet, the ring being intended as above to be immobilized by friction on the two legs 14 by means of the lock 26, with the enlarged sector 143 coming into contact with the free end 142 of the hooks 140.
  • the two loops 46 of the ligament 32 are first engaged on the hooks 140 of the body, then the annular ring 138 is engaged on the two tabs 14 and fixed to the body 8 by tightening the latch 26.
  • the contact of the annular ring with the free end 142 of the hooks prohibits disengagement of the loops 46 from the hooks.
  • the second anchor member 2 and the first member anchor 30 are arranged with the same positioning of the hooks as above.
  • the link extends at the same height as the rod in the axial direction of the member 2.
  • Figures 10 to 13 show a third embodiment of the osteosynthesis system for spine according to the invention. This system differs from that of the first mode only by the second anchoring member 2, the other parts being identical.
  • the parts of this anchoring member specific to this third mode bear references increased by two hundred or starting with two hundred.
  • the body 8 of the second anchoring member 2 comprises, as previously, a foot 12 and a head having two lugs 14 and a housing 24 for receiving the spherical ring 20 of the rigid connecting element.
  • the head of the body 8 has a lateral extension 250 extending projecting from one side of the body to the base of the head.
  • This extension has a rectilinear rib 252 with a rectangular profile located on the side of the head of the body 8.
  • the second anchoring member 2 further comprises an annular ring 238 having an enlarged sector in the radial direction towards the outside. On one side, this enlarged sector has a rectilinear rib 254 with a rectangular profile.
  • the ring 238 is adapted to be threaded onto the lugs 14 of the body, then immobilized by friction on the body when the lock 26 is tightened.
  • the annular ring is arranged so that the two ribs 252, 254 are parallel to each other and facing each other.
  • the second anchoring member 2 further comprises a stirrup 256 with four sides arranged in a rectangle, open on one side 257 to allow the lateral extension 250 to pass through this side.
  • the bracket is adapted to be arranged parallel to the axis 10 by being interposed and fixed between the lateral extension 250 and the annular ring 238 before immobilizing it.
  • the side 258 opposite the open side 257 of the stirrup is then received in the rib 252 of the lateral extension and in the rib 254 of the annular ring.
  • the other two sides 259 of the stirrup constitute two lateral portions forming hooks for receiving the loops 46 of the ligament.
  • the second anchoring member 2 and the first anchoring member 30 are arranged with the same positioning of the hooks as previously, the stirrup 256 being opposite to the first anchoring member 30.
  • the link extends at the same height as the rod in the axial direction of the member 2.
  • FIG. 14 shows a fourth embodiment of the osteosynthesis system for the spine according to the invention.
  • This system differs from that of the first mode only by the first anchoring member 30 and is compatible with the second and third embodiments described above.
  • the parts of the first anchoring member 30 specific to this fourth mode bear references increased by three hundred or starting with three hundred.
  • the first anchoring member 30 comprises a body 8 having a foot 12. It further comprises several heads 360, only one of which has been shown, having an end shaped as a hook 34 and adapted to be fixed to the body 8 removably to the by means of a screw-nut connection, the end of the hook 34 being oriented towards the foot.
  • the heads 360 have different axial lengths between them. Thus, after assembly, the distance between the hook 34 and the birth of the foot 12 is different for each head. It is thus possible to choose the height of the positioning of the loop of the ligament 32 relative to the foot 12 and to the vertebra 4.
  • the system will include two sets of anchoring members and connecting elements in order to constitute two symmetrical osteosynthesis devices. one from the other, on either side of the spine, each vertebra carrying an anchoring member of each device.
  • the second anchor member and the first anchor member may be configured so that the ligament forms a loop around the second anchor member 2, the ends of the ligament being adjacent to the first anchor member 30.

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Abstract

The osteosynthesis system for spinal column comprises first (30), second (2) and third anchoring elements adapted for being fixed to the column vertebrae (4), and a rod (18) adapted for being received in the second and third anchoring elements (2) to be connected with each other. The system comprises a section of flexible linkage (32) adapted for exerting traction between the first and second anchoring elements (30, 2).

Description

«SYSTEME D'OSTEOSYNTHESE POUR COLONNE VERTEBRALE, A REPARTITION DE CONTRAINTES » "OSTEOSYNTHESIS SYSTEM FOR SPINE, WITH DISTRIBUTION OF CONSTRAINTS"
L'invention concerne les systèmes d' ostéosynthèse pour colonne vertébrale.The invention relates to osteosynthesis systems for the spine.
On connaît d'après le document FR-2 659 546 un système d' ostéosynthèse pour colonne vertébrale ou rachis, qui comporte des organes d'ancrage destinés à être fixés à une série de vertèbres de la colonne, et une tige de liaison rigide destinée à être reçue dans les organes d'ancrage et à relier les organes d'ancrage entre eux. La tige permet de réaliser une liaison rotule avec chacun des organes d'ancrage, et tout à la fois donne au système un faible encombrement . Après que le système a été fixé à une série de vertèbres et assemblé, il constitue un dispositif rigide immobilisant ces vertèbres entre elles. Cette rigidité permet au dispositif d'encaisser tout ou partie des contraintes à la place de la série de vertèbres concernée. Toutefois, la première vertèbre adjacente à la série est totalement libre de se déplacer par rapport à la série de vertèbres rigidifiée. Il peut alors apparaître entre la dernière vertèbre de la série et la première vertèbre libre une discontinuité brutale dans la répartition des contraintes le long de la colonne. Par conséquent, le disque interposé entre ces deux vertèbres est très sollicité, et on constate même une augmentation anormale des contraintes au niveau du disque. Il s'ensuit très souvent une accélération de la dégénérescence de ce disque. On parle alors d'un syndrome de néo-charnière.Document FR-2 659 546 discloses an osteosynthesis system for a spine or spine, which comprises anchoring members intended to be fixed to a series of vertebrae of the column, and a rigid connecting rod intended to be received in the anchoring members and to connect the anchoring members together. The rod allows a ball joint to be made with each of the anchoring members, and at the same time gives the system a small footprint. After the system has been attached to a series of vertebrae and assembled, it constitutes a rigid device immobilizing these vertebrae together. This rigidity allows the device to collect all or part of the stresses in place of the series of vertebrae concerned. However, the first vertebra adjacent to the series is completely free to move relative to the rigidified series of vertebrae. It can then appear between the last vertebra of the series and the first free vertebra a sudden discontinuity in the distribution of the stresses along the column. Consequently, the disc interposed between these two vertebrae is very stressed, and there is even an abnormal increase in stresses at the disc. It very often follows an acceleration of the degeneration of this disc. We then speak of a neo-hinge syndrome.
Un but de 1 ' invention est de fournir un système d1 ostéosynthèse de ce type évitant, lorsque le système concerne au moins deux vertèbres reliées rigidement, l'apparition d'une discontinuité brutale dans la répartition des contraintes entre la dernière vertèbre de la série rigide et la première vertèbre libre, et favorisant au contraire une répartition harmonieuse des contraintes le long de la colonne.An object of one present invention is to provide an osteosynthesis system 1 of this type avoiding, when the system involves at least two vertebrae connected rigidly, the occurrence of a sudden discontinuity in the distribution of stresses between the last vertebra of the series rigid and the first free vertebra, and on the contrary favoring a harmonious distribution of the stresses along the column.
En vue de la réalisation de ce but, on prévoit selon l'invention un système d ' ostéosynthèse pour colonne vertébrale, comportant des premier, deuxième et troisième organes d'ancrage adaptés à être fixés à des vertèbres de la colonne, et une tige adaptée à être reçue dans les deuxième et troisième organes d'ancrage pour les relier l'un à l'autre, dans lequel le système comporte au moins un tronçon de lien souple adapté à exercer une traction entre les premier et deuxième organes d'ancrage.In order to achieve this goal, there is provided according to the invention an osteosynthesis system for the spine, comprising first, second and third anchoring members adapted to be fixed to the vertebrae of the column, and a suitable rod to be received in the second and third anchoring members to connect them to each other, in which the system comprises at least one flexible link section adapted to exert traction between the first and second anchoring members.
Ainsi, le tronçon de lien souple résiste à tout ou partie des contraintes tendant à éloigner les premier et deuxième organes d'ancrage l'un de l'autre, sans toutefois s'opposer à leur rapprochement l'un de l'autre. Par conséquent, le système comportant au moins trois organes d'ancrage, dont deux sont rigidement reliés l'un à l'autre par la tige et les premier et deuxième organes d'ancrage sont reliés entre eux par le tronçon de lien souple se trouvant à une extrémité de la série, on constitue une transition ou gradient de rigidité entre la partie rigide de la colonne et sa partie libre. On obtient par conséquent une meilleure répartition des contraintes le long de la colonne et on évite leur augmentation au niveau du disque situé entre les deux vertèbres précitées.Thus, the flexible link section resists all or part of the stresses tending to distance the first and second anchoring members from one another, without however opposing their approaching one from the other. Consequently, the system comprising at least three anchoring members, two of which are rigidly connected to each other by the rod and the first and second anchoring members are interconnected by the flexible link section located at one end of the series, a transition or stiffness gradient is formed between the rigid part of the column and its free part. A better distribution of the stresses is therefore obtained along the column and their increase is avoided at the level of the disc situated between the two aforementioned vertebrae.
La fixation du tronçon de lien souple au deuxième organe d'ancrage pourra être effectuée de nombreuses façons. Par exemple, on pourra fixer le tronçon de lien à la tige, à une tête du deuxième organe d'ancrage, au pied du deuxième organe d'ancrage, ou encore à un élément rapporté sur la tige ou sur le deuxième organe d'ancrage. Avantageusement, le système est adapté de sorte que le tronçon de lien et la tige s'étendent à une même hauteur suivant une direction axiale du deuxième organe d ' ancrage .The flexible link section can be attached to the second anchoring member in numerous ways. For example, the link section may be fixed to the rod, to a head of the second anchoring member, to the foot of the second anchoring member, or to an element attached to the rod or to the second anchoring member. . Advantageously, the system is adapted so that the link section and the rod extend to the same height in an axial direction of the second anchoring member.
Ainsi, alors qu'une différence de hauteur conduisant à un déséquilibre dans les contraintes exercées par le lien souple et la tige génère un couple de rotation sur le deuxième organe d'ancrage et la vertèbre associée, cette caractéristique préférentielle de l'invention conduit au contraire à une répartition équilibrée de ces contraintes sur le deuxième organe d'ancrage et la vertèbre associée. De plus, elle donne au système un encombrement réduit suivant la direction axiale des organes d'ancrage.Thus, while a difference in height leading to an imbalance in the stresses exerted by the flexible link and the rod generates a torque on the second anchoring member and the associated vertebra, this preferred characteristic of the invention leads to contrary to a balanced distribution of these constraints on the second anchoring member and the associated vertebra. In addition, it gives the system reduced overall dimensions in the axial direction of the anchoring members.
Avantageusement, le système est adapté à être fixé en partie postérieure de la colonne.Advantageously, the system is adapted to be fixed in the rear part of the column.
D'autres caractéristiques et avantages deOther features and benefits of
1 ' invention apparaîtront encore à la lecture de la description suivante de quatre modes de réalisation préférés données à titre d'exemples non-limitatifs. Aux dessins annexés:1 the invention will appear further on reading the following description of four preferred embodiments given by way of non-limiting examples. In the accompanying drawings:
- la figure 1 est une vue partielle en élévation d'un système d' ostéosynthèse selon un premier mode de réalisation de l'invention, fixé à des vertèbres;- Figure 1 is a partial elevational view of an osteosynthesis system according to a first embodiment of the invention, attached to vertebrae;
- la figure 2 est une vue en plan du système de la figure 1; la figure 3 est une vue éclatée en élévation du deuxième organe d'ancrage et de l'élément de liaison rigide de la figure 1;- Figure 2 is a plan view of the system of Figure 1; Figure 3 is an exploded elevation view of the second anchor member and the rigid connecting member of Figure 1;
- la figure 4 est une vue de dessous de la bague de la figure 3;- Figure 4 is a bottom view of the ring of Figure 3;
- la figure 5 est une vue en élévation partiellement en coupe du premier organe d'ancrage de la figure 1 ;- Figure 5 is an elevational view partially in section of the first anchoring member of Figure 1;
- la figure 6 est une vue en plan de l'organe de la figure 5; - la figure 7 est une vue éclatée en élévation d'un deuxième mode de réalisation du système d' ostéosynthèse montrant le deuxième organe d'ancrage;- Figure 6 is a plan view of the member of Figure 5; - Figure 7 is an exploded elevation view of a second embodiment of the osteosynthesis system showing the second anchor member;
- la figure 8 est une vue en plan de la bague de la figure 7;- Figure 8 is a plan view of the ring of Figure 7;
- la figure 9 est une vue en plan du corps de la figure 7;- Figure 9 is a plan view of the body of Figure 7;
- la figure 10 est une vue éclatée en élévation d'un troisième mode de réalisation du système d' ostéosynthèse, montrant le deuxième organe d'ancrage;- Figure 10 is an exploded view in elevation of a third embodiment of the osteosynthesis system, showing the second anchoring member;
- la figure 11 est une vue en plan de la bague de la figure 10;- Figure 11 is a plan view of the ring of Figure 10;
- la figure 12 est une vue de face de 1 ' étrier de la figure 10;- Figure 12 is a front view of the bracket of Figure 10;
- la figure 13 est une vue en plan du corps de la figure 10; et - la figure 14 est une vue éclatée en élévation d'un quatrième mode de réalisation du système d ' ostéosynthèse, montrant le premier organe d'ancrage;- Figure 13 is a plan view of the body of Figure 10; and - Figure 14 is an exploded elevation view of a fourth embodiment of the osteosynthesis system, showing the first anchoring member;
En référence aux figures 1 à 6, un premier mode de réalisation du système d' ostéosynthèse pour colonne vertébrale selon l'invention permet de constituer le dispositif d' ostéosynthèse représenté. Il comporte plusieurs organes d'ancrage ou vis pédiculaires 2 adaptés à être fixés à une série de vertèbres respectives 4 de la colonne vertébrale d'un patient, notamment en partie postérieure de la colonne (chargement postérieur) . Le système comporte un élément de liaison rigide 6 adapté à relier ces organes d'ancrage 2 entre eux. Seul l'organe d'ancrage 2 associé à la vertèbre située à une extrémité de la série rigide a été représenté.With reference to FIGS. 1 to 6, a first embodiment of the osteosynthesis system for a spinal column according to the invention makes it possible to constitute the osteosynthesis device shown. It comprises several anchoring members or pedicle screws 2 adapted to be fixed to a series of respective vertebrae 4 of the spinal column of a patient, in particular in the posterior part of the column (posterior loading). The system comprises a rigid connecting element 6 adapted to connect these anchoring members 2 to one another. Only the anchoring member 2 associated with the vertebra located at one end of the rigid series has been shown.
Chacun de ces organes d'ancrage 2 comporte un corps allongé 8 d'axe 10 présentant un pied fileté 12 de forme conique adapté à être ancré dans la vertèbre 4. Le corps présente une tête opposée axialement au pied 12 et destinée à s'étendre à l'extérieur de la vertèbre. La tête présente deux pattes 14 en secteur de cylindre s 'étendant coaxiale ent à l'axe 10 en regard l'une de l'autre. Les pattes 14 présentent une face interne définissant un taraudage 16 d'axe 10. L'élément de liaison rigide 6 comporte une tige cylindrique 18, et une bague 20 montée sur la tige et présentant une face interne cylindrique et une face externe sphérique 22. Le corps 8 présente entre les pattes 14 à la base de celles-ci une cavité 24 constituant un logement de réception de la bague sphérique 20. Chaque organe d'ancrage 2 comporte en outre un verrou annulaire 26 présentant une face externe cylindrique pourvue d'un filetage 28 adapté à coopérer avec le taraudage 16 des deux pattes 14 pour la fixation du verrou 26 au corps 8, le verrou étant en appui contre la face externe sphérique 22 de la bague 20. La bague est ainsi immobilisée dans le logement 24 du corps, et l'organe d'ancrage 2 est immobilisé en rotation de façon rigide à l'élément de liaison 6. L'organe d'ancrage 2 représenté est adjacent à une extrémité 29 de la tige 32. Les organes d'ancrage 2 et l'élément de liaison 6 du système une fois assemblés et montés constituent ainsi une partie rigide du dispositif d1 ostéosynthèse . Les caractéristiques qui précèdent sont connues et décrites dans le document FR-2 659 546. Le système d Ostéosynthèse comporte en outre un organe d'ancrage supplémentaire 30 et un élément de liaison souple flexible 32 adapté à relier l'organe d'ancrage supplémentaire 30 à l'organe d'ancrage 2 représenté . Dans la suite, le premier organe d'ancrage désignera l'organe supplémentaire 30, le deuxième organe d'ancrage désignera l'organe 2 situé à l'extrémité de la tige 18, et le troisième organe d'ancrage désignera l'organe d'ancrage suivant fixé à la tige 18. Le premier organe d'ancrage 30 comporte un corps 8 présentant un pied 12 identique à celui du deuxième organe d'ancrage 2. La tête du corps 8 du premier organe d'ancrage 30 est conformée en un crochet 34 présentant une extrémité libre recourbée en direction du pied 12.Each of these anchoring members 2 comprises an elongated body 8 of axis 10 having a threaded foot 12 of conical shape adapted to be anchored in the vertebra 4. The body has a head axially opposite the foot 12 and intended to extend outside the vertebra. The head has two legs 14 in the cylinder sector extending coaxially between the axis 10 opposite one another. The tabs 14 have an internal face defining a thread 16 with an axis 10. The rigid connecting element 6 comprises a cylindrical rod 18, and a ring 20 mounted on the rod and having a cylindrical internal face and a spherical external face 22. The body 8 has between the legs 14 at the base thereof a cavity 24 constituting a housing for receiving the spherical ring 20. Each anchoring member 2 further comprises an annular latch 26 having a cylindrical external face provided with a thread 28 adapted to cooperate with the thread 16 of the two tabs 14 for fixing the lock 26 to the body 8, the lock being in abutment against the spherical external face 22 of the ring 20. The ring is thus immobilized in the housing 24 of the body, and the anchor member 2 is immobilized in rotation rigidly to the connecting element 6. The anchor member 2 shown is adjacent to one end 29 of the rod 32. The anchor members 2 and the el ment connection 6 of the system once assembled and mounted and constitute a rigid part of the device 1 osteosynthesis. The foregoing characteristics are known and described in document FR-2 659 546. The osteosynthesis system further comprises an additional anchoring member 30 and a flexible flexible connection element 32 adapted to connect the additional anchoring member 30 to the anchoring member 2 shown. In the following, the first anchor member will designate the additional member 30, the second anchor member will designate the member 2 located at the end of the rod 18, and the third anchor member will designate the member d next anchor fixed to the rod 18. The first anchor member 30 comprises a body 8 having a foot 12 identical to that of the second anchor member 2. The head of the body 8 of the first anchoring member 30 is in the form of a hook 34 having a curved free end in the direction of the foot 12.
Le deuxième organe d'ancrage 2 comporte en outre une bague annulaire 38 portant deux crochets latéraux 40 voisins l'un de l'autre, orientés suivant la direction axiale de la bague, et dépassant d'un bord de la bague suivant la direction axiale. La bague annulaire 38 présente une face interne cylindrique lisse adaptée à venir en contact surface contre surface avec une face externe des deux pattes 14 du corps 8 lorsque la bague 38 est enfilée sur les deux pattes avant montage du verrou 26. Le montage puis le serrage ultérieur du verrou entraînent un léger écartement des pattes 14 l'une de l'autre suivant la direction radiale, ce qui réalise l'immobilisation de la bague annulaire 38 par friction sur les deux pattes. Dans cette position de montage de la bague, les deux crochets 40 s'étendent parallèlement à l'axe 10, de part et d'autre de l'axe et de part et d'autre de la tige 18, et sont orientés en direction du pied 12. Les deux crochets 40 présentent une extrémité libre 42 repliée radialement en direction de l'axe de la bague, et de l'axe 10 du corps après montage. Le corps 8 du deuxième organe d'ancrage 2 présente un relief 44 ayant la forme d'un bourrelet annulaire s 'étendant en saillie de la surface du corps et adapté à venir en contact avec l'extrémité libre 42 des crochets 40. Le deuxième organe d'ancrage 2 est fixé à la vertèbre associée avec les deux crochets 40 opposés au premier organe d'ancrage 30. Ce dernier est fixé à la vertèbre associée avec le crochet 34 opposé au deuxième organe d ' ancrage 2.The second anchoring member 2 further comprises an annular ring 38 carrying two lateral hooks 40 adjacent to each other, oriented in the axial direction of the ring, and projecting from one edge of the ring in the axial direction . The annular ring 38 has a smooth cylindrical internal face adapted to come into surface-to-surface contact with an external face of the two tabs 14 of the body 8 when the ring 38 is threaded on the two tabs before mounting of the bolt 26. The mounting then the tightening subsequent latch cause a slight spacing of the legs 14 from one another in the radial direction, which achieves the immobilization of the annular ring 38 by friction on the two legs. In this mounting position of the ring, the two hooks 40 extend parallel to the axis 10, on either side of the axis and on either side of the rod 18, and are oriented in the direction of the foot 12. The two hooks 40 have a free end 42 folded radially in the direction of the axis of the ring, and of the axis 10 of the body after assembly. The body 8 of the second anchoring member 2 has a relief 44 in the form of an annular bead extending projecting from the surface of the body and adapted to come into contact with the free end 42 of the hooks 40. The second anchoring member 2 is fixed to the vertebra associated with the two hooks 40 opposite to the first anchoring member 30. The latter is fixed to the vertebra associated with the hook 34 opposite to the second anchoring member 2.
L'élément de liaison 32 est un lien souple, par exemple un ligament souple en matériau synthétique biocompatible, éventuellement muni d'un renfort interne. Ce ligament forme une boucle autour du premier organe d'ancrage 30, la partie médiane du ligament étant retenue par le crochet 34. Le ligament présente deux extrémités libres 46 adjacentes au deuxième organe d'ancrage 2. Chaque extrémité 46 est repliée en formant une boucle et fixée sur elle-même au moyen d'une couture ou d'une attache adaptée. Chaque boucle est engagée sur l'un des crochets 40 du deuxième organe d'ancrage 2 avant le montage de la bague. Le bourrelet 44 et l'extrémité repliée 42 des crochets 40 en contact interdisent le désengagement des boucles 46 des crochets. Ainsi, le deuxième organe d'ancrage 2 et le premier organe d'ancrage 30 sont reliés par deux tronçons de ligament 48 parallèles entre eux et s 'étendant de part et d'autre d'un plan défini par les directions axiales 10 de ces deux organes d'ancrage. Les crochets 40 sont disposés de sorte que les extrémités 46 s'étendent à une même hauteur H (ou niveau) que la tige 18 suivant la direction axiale de l'organe 2. Par exemple, cette hauteur H a été mesurée à partir de l'extrémité inférieure de l'organe 2 sur la figure 1. De plus, les crochets 34 et 40 sont avantageusement disposés de sorte que les deux tronçons 48 du lien 32 s'étendent avec la tige 18 dans un même plan, ce plan étant perpendiculaire à la direction axiale de l'organe 2 ou fortement incliné par rapport à cette direction. Le système est configuré de sorte que le ligament 32 est tout juste tendu entre le premier organe d'ancrage 30 et le deuxième organe d'ancrage 2. Ces deux organes d'ancrage 2 , 30 et le ligament 32 qui les relie constituent une partie flexible du dispositif d ' ostéosynthèse. Cette partie crée une transition dans la répartition des contraintes le long de la colonne, entre la partie rigide précitée du dispositif et la partie de la colonne non reliée au dispositif d Ostéosynthèse . Les boucles d'extrémité 46 du ligament restent libres d'effectuer des mouvements de faible amplitude autour des crochets. Tous les organes d'ancrage 2, 30, l'élément de liaison rigide 6 et le ligament 32 s'étendent à l'intérieur du corps du patient . Les figures 7 à 9 présentent un deuxième mode de réalisation du système d' ostéosynthèse pour colonne vertébrale selon l'invention. Ce système diffère de celui du premier mode seulement par le deuxième organe d'ancrage 2, les autres pièces étant identiques. Les parties de cet organe d'ancrage propres à ce deuxième mode portent des références augmentées de cent ou commençant par cent . Le corps 8 du deuxième organe d'ancrage 2 comporte comme précédemment un pied 12 et une tête présentant deux pattes 14 et un logement 24 pour la réception de la bague sphérique 20 de l'élément de liaison 6. Cette fois, la tête du corps 8 porte deux crochets 140 disposés au voisinage l'un de l'autre et orientés parallèlement à l'axe 10 dans la direction opposée au pied 12, à savoir vers les pattes 14, de sorte que leur extrémité libre 142 est tournée vers le haut. Les crochets 140 s'étendent depuis la base de la tête jusqu'en regard de la naissance des pattes 14. Le deuxième organe d'ancrage 2 comporte en outre une bague annulaire 138 présentant un secteur 143 élargi suivant la direction radiale vers l'extérieur en formant une palette, la bague étant destinée comme précédemment à être immobilisée par friction sur les deux pattes 14 au moyen du verrou 26, avec le secteur élargi 143 venant en contact avec l'extrémité libre 142 des crochets 140. Les deux boucles 46 du ligament 32 sont d'abord engagées sur les crochets 140 du corps, puis la bague annulaire 138 est engagée sur les deux pattes 14 et fixée au corps 8 par serrage du verrou 26. Le contact de la bague annulaire avec l'extrémité libre 142 des crochets interdit le désengagement des boucles 46 des crochets. Le deuxième organe d'ancrage 2 et le premier organe d'ancrage 30 sont disposés avec le même positionnement des crochets que précédemment . De même que dans le premier mode, le lien s'étend à la même hauteur que la tige suivant la direction axiale de l'organe 2. Les figures 10 à 13 présentent un troisième mode de réalisation du système d' ostéosynthèse pour colonne vertébrale selon l'invention. Ce système diffère de celui du premier mode seulement par le deuxième organe d'ancrage 2, les autres pièces étant identiques. Les parties de cet organe d'ancrage propres à ce troisième mode portent des références augmentées de deux cents ou commençant par deux cents. Le corps 8 du deuxième organe d'ancrage 2 comporte comme précédemment un pied 12 et une tête présentant deux pattes 14 et un logement 24 pour la réception de la bague sphérique 20 de l'élément de liaison rigide. Cette fois, la tête du corps 8 comporte une extension latérale 250 s 'étendant en saillie d'un côté du corps à la base de la tête. Cette extension présente une nervure rectiligne 252 à profil rectangulaire située du côté de la tête du corps 8. Le deuxième organe d'ancrage 2 comporte en outre une bague annulaire 238 présentant un secteur élargi suivant la direction radiale vers l'extérieur. Sur un côté, ce secteur élargi présente une nervure rectiligne 254 à profil rectangulaire. Comme précédemment, la bague 238 est adaptée à être enfilée sur les pattes 14 du corps, puis immobilisée par friction sur le corps lors du serrage du verrou 26. La bague annulaire est disposée de sorte que les deux nervures 252, 254 soient parallèles entre elles et en regard l'une de l'autre. Le deuxième organe d'ancrage 2 comporte en outre un étrier 256 à quatre côtés disposés en rectangle, ouvert sur un côté 257 pour permettre à l'extension latérale 250 de traverser ce côté. L' étrier est adapté à être disposé parallèlement à l'axe 10 en étant interposé et fixé entre l'extension latérale 250 et la bague annulaire 238 avant immobilisation de celle-ci. Le côté 258 opposé au côté ouvert 257 de l' étrier est alors reçu dans la nervure 252 de l'extension latérale et dans la nervure 254 de la bague annulaire. Les deux autres côtés 259 de 1' étrier constituent deux portions latérales formant des crochets de réception des boucles 46 du ligament. Le deuxième organe d'ancrage 2 et le premier organe d'ancrage 30 sont disposés avec le même positionnement des crochets que précédemment, l' étrier 256 étant opposé au premier organe d'ancrage 30. De même que dans le premier mode, le lien s'étend à la même hauteur que la tige suivant la direction axiale de l'organe 2.The connecting element 32 is a flexible link, for example a flexible ligament made of biocompatible synthetic material, possibly provided with an internal reinforcement. This ligament forms a loop around the first organ anchor 30, the middle part of the ligament being retained by the hook 34. The ligament has two free ends 46 adjacent to the second anchor member 2. Each end 46 is folded back in a loop and fixed on itself by means a suitable seam or tie. Each loop is engaged on one of the hooks 40 of the second anchoring member 2 before mounting the ring. The bead 44 and the folded end 42 of the hooks 40 in contact prevent the disengagement of the loops 46 of the hooks. Thus, the second anchoring member 2 and the first anchoring member 30 are connected by two ligament sections 48 parallel to each other and extending on either side of a plane defined by the axial directions 10 of these two anchors. The hooks 40 are arranged so that the ends 46 extend to the same height H (or level) as the rod 18 in the axial direction of the member 2. For example, this height H was measured from l 'lower end of the member 2 in Figure 1. In addition, the hooks 34 and 40 are advantageously arranged so that the two sections 48 of the link 32 extend with the rod 18 in the same plane, this plane being perpendicular to the axial direction of the member 2 or strongly inclined relative to this direction. The system is configured so that the ligament 32 is just stretched between the first anchor member 30 and the second anchor member 2. These two anchor members 2, 30 and the ligament 32 which connects them constitute a part flexible osteosynthesis device. This part creates a transition in the distribution of stresses along the column, between the aforementioned rigid part of the device and the part of the column not connected to the Osteosynthesis device. The end loops 46 of the ligament remain free to perform small movements amplitude around the hooks. All the anchoring members 2, 30, the rigid connecting element 6 and the ligament 32 extend inside the patient's body. Figures 7 to 9 show a second embodiment of the osteosynthesis system for spine according to the invention. This system differs from that of the first mode only by the second anchoring member 2, the other parts being identical. The parts of this anchoring member specific to this second mode bear references increased by a hundred or starting with a hundred. The body 8 of the second anchoring member 2 comprises as before a foot 12 and a head having two legs 14 and a housing 24 for receiving the spherical ring 20 of the connecting element 6. This time, the head of the body 8 carries two hooks 140 arranged in the vicinity of one another and oriented parallel to the axis 10 in the direction opposite to the foot 12, namely towards the legs 14, so that their free end 142 is turned upwards . The hooks 140 extend from the base of the head to the appearance of the legs 14. The second anchoring member 2 further comprises an annular ring 138 having a sector 143 enlarged in the radial direction outward by forming a pallet, the ring being intended as above to be immobilized by friction on the two legs 14 by means of the lock 26, with the enlarged sector 143 coming into contact with the free end 142 of the hooks 140. The two loops 46 of the ligament 32 are first engaged on the hooks 140 of the body, then the annular ring 138 is engaged on the two tabs 14 and fixed to the body 8 by tightening the latch 26. The contact of the annular ring with the free end 142 of the hooks prohibits disengagement of the loops 46 from the hooks. The second anchor member 2 and the first member anchor 30 are arranged with the same positioning of the hooks as above. As in the first mode, the link extends at the same height as the rod in the axial direction of the member 2. Figures 10 to 13 show a third embodiment of the osteosynthesis system for spine according to the invention. This system differs from that of the first mode only by the second anchoring member 2, the other parts being identical. The parts of this anchoring member specific to this third mode bear references increased by two hundred or starting with two hundred. The body 8 of the second anchoring member 2 comprises, as previously, a foot 12 and a head having two lugs 14 and a housing 24 for receiving the spherical ring 20 of the rigid connecting element. This time, the head of the body 8 has a lateral extension 250 extending projecting from one side of the body to the base of the head. This extension has a rectilinear rib 252 with a rectangular profile located on the side of the head of the body 8. The second anchoring member 2 further comprises an annular ring 238 having an enlarged sector in the radial direction towards the outside. On one side, this enlarged sector has a rectilinear rib 254 with a rectangular profile. As before, the ring 238 is adapted to be threaded onto the lugs 14 of the body, then immobilized by friction on the body when the lock 26 is tightened. The annular ring is arranged so that the two ribs 252, 254 are parallel to each other and facing each other. The second anchoring member 2 further comprises a stirrup 256 with four sides arranged in a rectangle, open on one side 257 to allow the lateral extension 250 to pass through this side. The bracket is adapted to be arranged parallel to the axis 10 by being interposed and fixed between the lateral extension 250 and the annular ring 238 before immobilizing it. The side 258 opposite the open side 257 of the stirrup is then received in the rib 252 of the lateral extension and in the rib 254 of the annular ring. The other two sides 259 of the stirrup constitute two lateral portions forming hooks for receiving the loops 46 of the ligament. The second anchoring member 2 and the first anchoring member 30 are arranged with the same positioning of the hooks as previously, the stirrup 256 being opposite to the first anchoring member 30. As in the first mode, the link extends at the same height as the rod in the axial direction of the member 2.
La figure 14 présente un quatrième mode de réalisation du système d Ostéosynthèse pour colonne vertébrale selon l'invention. Ce système diffère de celui du premier mode seulement par le premier organe d'ancrage 30 et est compatible avec les deuxième et troisième modes de réalisation décrits plus haut. Les parties du premier organe d'ancrage 30 propres à ce quatrième mode portent des références augmentées de trois cents ou commençant par trois cents. Le premier organe d'ancrage 30 comporte un corps 8 présentant un pied 12. Il comporte en outre plusieurs têtes 360, dont une seule a été représentée, ayant une extrémité conformée en crochet 34 et adaptée à être fixée au corps 8 de façon amovible au moyen d'une liaison vis-écrou, l'extrémité du crochet 34 étant orientée vers le pied. Les têtes 360 présentent des longueurs axiales différentes entre elles. Ainsi, après montage, la distance entre le crochet 34 et la naissance du pied 12 est différente pour chaque tête. On peut ainsi choisir la hauteur du positionnement de la boucle du ligament 32 par rapport au pied 12 et à la vertèbre 4.FIG. 14 shows a fourth embodiment of the osteosynthesis system for the spine according to the invention. This system differs from that of the first mode only by the first anchoring member 30 and is compatible with the second and third embodiments described above. The parts of the first anchoring member 30 specific to this fourth mode bear references increased by three hundred or starting with three hundred. The first anchoring member 30 comprises a body 8 having a foot 12. It further comprises several heads 360, only one of which has been shown, having an end shaped as a hook 34 and adapted to be fixed to the body 8 removably to the by means of a screw-nut connection, the end of the hook 34 being oriented towards the foot. The heads 360 have different axial lengths between them. Thus, after assembly, the distance between the hook 34 and the birth of the foot 12 is different for each head. It is thus possible to choose the height of the positioning of the loop of the ligament 32 relative to the foot 12 and to the vertebra 4.
Au besoin, le système comportera deux jeux d'organes d'ancrage et d'éléments de liaison en vue de constituer deux dispositifs d ' ostéosynthèse symétriques l'un de l'autre, de part et d'autre de la colonne vertébrale, chaque vertèbre portant un organe d'ancrage de chaque dispositif.If necessary, the system will include two sets of anchoring members and connecting elements in order to constitute two symmetrical osteosynthesis devices. one from the other, on either side of the spine, each vertebra carrying an anchoring member of each device.
Bien entendu, on pourra apporter à l'invention de nombreuses modifications sans sortir du cadre de celle-ci .Of course, many modifications can be made to the invention without departing from the scope thereof.
Le deuxième organe d'ancrage et le premier organe d'ancrage pourront être configurés de sorte que le ligament forme une boucle autour du deuxième organe d'ancrage 2, les extrémités du ligament étant adjacentes au premier organe d'ancrage 30. The second anchor member and the first anchor member may be configured so that the ligament forms a loop around the second anchor member 2, the ends of the ligament being adjacent to the first anchor member 30.

Claims

REVENDICATIONS
1. Système d' ostéosynthèse pour colonne vertébrale, comportant des premier (30) , deuxième (2) et troisième organes d'ancrage adaptés à être fixés à des vertèbres (4) de la colonne, et une tige (18) adaptée à être reçue dans les deuxième et troisième organes d'ancrage (2) pour les relier l'un à l'autre, caractérisé en ce qu'il comporte au moins un tronçon (48) de lien souple (32) adapté à exercer une traction entre les premier et deuxième organes d'ancrage (30, 2) .1. Osteosynthesis system for vertebral column, comprising first (30), second (2) and third anchoring members adapted to be fixed to vertebrae (4) of the column, and a rod (18) adapted to be received in the second and third anchoring members (2) to connect them to each other, characterized in that it comprises at least one section (48) of flexible link (32) adapted to exert traction between the first and second anchoring members (30, 2).
2. Système d Ostéosynthèse selon la revendication 1, caractérisé en ce que le système est adapté de sorte que le tronçon (48) de lien (32) et la tige (18) s'étendent à une même hauteur (H) suivant une direction axiale du deuxième organe d'ancrage (2).2. Osteosynthesis system according to claim 1, characterized in that the system is adapted so that the section (48) of link (32) and the rod (18) extend at the same height (H) in a direction axial of the second anchoring member (2).
3. Système d ' ostéosynthèse selon l'une quelconque des revendications 1 ou 2 , caractérisé en ce que l'élément de liaison (32) comporte deux tronçons de lien souple adaptés chacun à relier les premier et deuxième organes d'ancrage (2, 30) l'un à l'autre, le lien (32) formant une boucle autour de l'un (30) de ces deux organes d'ancrage, le lien ayant des extrémités3. Osteosynthesis system according to any one of claims 1 or 2, characterized in that the connecting element (32) comprises two flexible link sections each adapted to connect the first and second anchoring members (2, 30) to each other, the link (32) forming a loop around one (30) of these two anchoring members, the link having ends
(46) adjacentes à l'autre organe d'ancrage (2) . (46) adjacent to the other anchoring member (2).
4. Système d ' ostéosynthèse selon la revendication 3, caractérisé en ce que le lien présente deux tronçons d'extrémités (46) formant chacun une boucle, l'organe d'ancrage (2) associé aux extrémités comportant au moins un crochet (40; 140; 259) de réception des boucles.4. osteosynthesis system according to claim 3, characterized in that the link has two sections of ends (46) each forming a loop, the anchoring member (2) associated with the ends comprising at least one hook (40 ; 140; 259) receiving loops.
5. Système d ' ostéosynthèse selon la revendication 4, caractérisé en ce que le crochet (40; 140; 259) s'étend parallèlement à un axe (10) de 1 ' organe d ' ancrage . 5. osteosynthesis system according to claim 4, characterized in that the hook (40; 140; 259) extends parallel to an axis (10) of one anchoring member.
6. Système d' ostéosynthèse selon la revendication 5, caractérisé en ce que l'organe d'ancrage (2) associé aux extrémités comporte deux crochets latéraux (40; 140; 259).6. Osteosynthesis system according to claim 5, characterized in that the organ anchor (2) associated with the ends comprises two lateral hooks (40; 140; 259).
7. Système d Ostéosynthèse selon l'une quelconque des revendications 1 à 6, caractérisé en ce que le système comporte en outre une bague (20) à face externe sphérique (22) montée sur la tige, le deuxième organe d'ancrage (2) comportant un corps (8) présentant un logement (24) de réception de la bague sphérique, et un verrou (26) pour immobiliser la bague sphérique dans le logement.7. Osteosynthesis system according to any one of claims 1 to 6, characterized in that the system further comprises a ring (20) with a spherical external face (22) mounted on the rod, the second anchoring member (2 ) comprising a body (8) having a housing (24) for receiving the spherical ring, and a latch (26) for immobilizing the spherical ring in the housing.
8. Système d' ostéosynthèse selon la revendication 7, caractérisé en ce que le corps présente un taraudage (16) et le verrou présente un filetage (28) adapté à coopérer avec le taraudage du corps pour la fixation du verrou au corps.8. Osteosynthesis system according to claim 7, characterized in that the body has a thread (16) and the lock has a thread (28) adapted to cooperate with the thread of the body for fixing the lock to the body.
9. Système d' ostéosynthèse selon les revendications 6 et 8 , caractérisé en ce que le corps comporte deux pattes (14) définissant le taraudage (16) , et le deuxième organe d'ancrage (2) comporte une bague annulaire (38) portant les crochets (40) et adaptée à être enfilée sur les pattes et à être immobilisée par friction sur les pattes lors du serrage du verrou (26) .9. osteosynthesis system according to claims 6 and 8, characterized in that the body has two legs (14) defining the thread (16), and the second anchoring member (2) has an annular ring (38) bearing the hooks (40) and adapted to be threaded on the legs and to be immobilized by friction on the legs when tightening the lock (26).
10. Système d Ostéosynthèse selon la revendication 9, caractérisé en ce que les crochets (40) présentent une extrémité libre (42) repliée en direction d'un axe (10) de la bague, et le corps présente un relief (44) adapté à venir en contact avec l'extrémité libre des crochets.10. Osteosynthesis system according to claim 9, characterized in that the hooks (40) have a free end (42) folded in the direction of an axis (10) of the ring, and the body has a relief (44) adapted to come into contact with the free end of the hooks.
11. Système d' ostéosynthèse selon la revendication 9 ou 10, caractérisé en ce que la bague11. Osteosynthesis system according to claim 9 or 10, characterized in that the ring
(38) est fixée au corps de sorte que les crochets (40) sont orientés en direction opposée aux pattes (14) .(38) is fixed to the body so that the hooks (40) are oriented in the opposite direction to the legs (14).
12. Système d' ostéosynthèse selon les revendications 6 et 8 , caractérisé en ce que le corps comporte deux pattes (14) définissant le taraudage et porte les crochets (140) , les crochets étant orientés dans la direction des -pattes, le deuxième organe d'ancrage (2) comportant une bague annulaire (138) adaptée à être enfilée sur les pattes et à être immobilisée par friction sur les pattes lors du serrage du verrou (26) en étant contact avec une extrémité libre (142) des crochets.12. Osteosynthesis system according to claims 6 and 8, characterized in that the body has two tabs (14) defining the thread and carries the hooks (140), the hooks being oriented in the direction of the legs, the second anchoring member (2) comprising an annular ring (138) adapted to be threaded on the legs and to be immobilized by friction on the legs when tightening the lock (26) by being in contact with a free end (142) of the hooks.
13. Système d Ostéosynthèse selon les revendications 6 et 8, caractérisé en ce que le corps (8) comporte deux pattes (14) définissant le taraudage et présente une nervure (252) , le deuxième organe d'ancrage (2) comportant une bague annulaire (238) présentant une nervure (254) , les deux nervures étant adaptées à s'étendre en regard l'une de l'autre, le deuxième organe d'ancrage (2) comportant un étrier (256) présentant un côté (258) adapté à être reçu dans les nervures et deux côtés latéraux (259) formant les crochets .13. Osteosynthesis system according to claims 6 and 8, characterized in that the body (8) has two tabs (14) defining the thread and has a rib (252), the second anchoring member (2) comprising a ring annular (238) having a rib (254), the two ribs being adapted to extend opposite one another, the second anchoring member (2) comprising a stirrup (256) having a side (258 ) adapted to be received in the ribs and two lateral sides (259) forming the hooks.
14. Système d' ostéosynthèse selon l'une quelconque des revendications 3 à 13, caractérisé en ce que le premier organe d'ancrage (30) comporte un corps (8) adapté à être inséré dans une vertèbre et présentant une extrémité conformée en crochet (34).14. osteosynthesis system according to any one of claims 3 to 13, characterized in that the first anchoring member (30) comprises a body (8) adapted to be inserted into a vertebra and having a hook shaped end (34).
15. Système d ' ostéosynthèse selon l'une quelconque des revendications 3 à 13, caractérisé en ce que le premier organe d'ancrage (30) comporte un corps15. Osteosynthesis system according to any one of claims 3 to 13, characterized in that the first anchoring member (30) comprises a body
(8) adapté à être inséré dans une vertèbre, et une tête(8) adapted to be inserted into a vertebra, and a head
(360) adaptée à être fixée au corps de façon amovible, une extrémité de la tête étant conformée en crochet(360) adapted to be removably fixed to the body, one end of the head being shaped as a hook
(34) . (34).
16. Système d' ostéosynthèse selon la revendication 15, caractérisé en ce que le système comporte plusieurs têtes (360) présentant des longueurs axiales différentes entre elles et adaptées à être fixées au corps du premier organe d'ancrage. 16. Osteosynthesis system according to claim 15, characterized in that the system comprises several heads (360) having different axial lengths between them and adapted to be fixed to the body of the first anchoring member.
17. Système d' ostéosynthèse selon l'une quelconque des revendications 1 à 16, caractérisé en ce que le système est adapté à être fixé en partie postérieure de la colonne. 17. Osteosynthesis system according to any one of claims 1 to 16, characterized in that the system is adapted to be fixed in the posterior part of the column.
PCT/FR1997/001557 1996-09-04 1997-09-04 Osteosynthesis system for spinal column with stress distribution WO1998009576A1 (en)

Priority Applications (5)

Application Number Priority Date Filing Date Title
BR9711652-1A BR9711652A (en) 1996-09-04 1997-09-04 Spinal osteosynthesis system
JP51230698A JP2001504361A (en) 1996-09-04 1997-09-04 Spine osteosynthesis system with stress distribution
AU41225/97A AU4122597A (en) 1996-09-04 1997-09-04 Osteosynthesis system for spinal column with stress distribution
CA002266121A CA2266121A1 (en) 1996-09-04 1997-09-04 Osteosynthesis system for spinal column with stress distribution
EP97938979A EP1009309A1 (en) 1996-09-04 1997-09-04 Osteosynthesis system for spinal column with stress distribution

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
FR96/10767 1996-09-04
FR9610767A FR2752719B1 (en) 1996-09-04 1996-09-04 OSTEOSYNTHESIS SYSTEM FOR SPINE, WITH STRESS DISTRIBUTION

Publications (1)

Publication Number Publication Date
WO1998009576A1 true WO1998009576A1 (en) 1998-03-12

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JP (1) JP2001504361A (en)
KR (1) KR20010029473A (en)
AU (1) AU4122597A (en)
BR (1) BR9711652A (en)
CA (1) CA2266121A1 (en)
FR (1) FR2752719B1 (en)
WO (1) WO1998009576A1 (en)

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JP2001314416A (en) * 2000-05-10 2001-11-13 Showa Ika Kohgyo Co Ltd Rod for bone connector
JP4755782B2 (en) * 2001-08-01 2011-08-24 昭和医科工業株式会社 Bone implant implant
JP2003038507A (en) * 2001-08-01 2003-02-12 Showa Ika Kohgyo Co Ltd Implant for bone joining implement
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FR2659546A1 (en) * 1990-03-19 1991-09-20 Lapresle Philippe Device for adjustable fixation of spinal osteosynthesis rods
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Publication number Publication date
AU4122597A (en) 1998-03-26
JP2001504361A (en) 2001-04-03
KR20010029473A (en) 2001-04-06
FR2752719A1 (en) 1998-03-06
EP1009309A1 (en) 2000-06-21
CA2266121A1 (en) 1998-03-12
BR9711652A (en) 2000-10-31
FR2752719B1 (en) 1998-12-18

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