• 专利附录
  • 专利说明
  • 权利要求
  • 类似技术
  • 同族专利
  • 引用文献
  • 法律状态
  • 优先权
    • 专利摘要:
    An intervertebral cage comprising two pieces, namely an annular inner male piece (1) having two small sides and two long sides, an upper surface and a lower surface and an outer annular female piece (2) having two small sides and two large sides sides, an upper surface and a lower surface, the upper surface of the annular inner male piece and the lower surface of the annular outer female piece forming external surfaces determining the height of the cage, said annular inner male piece (1) is fitted into the annular outer female piece (2), each of these two parts having a generally parallelepipedal shape and therefore a longitudinal axis, the annular inner male piece (1) being slidable with respect to the annular outer female piece (2) and comprising a device for blocking a longitudinal displacement of the annular inner male part (1) vis-à-vis the part f annular external emel (2), the intervertebral cage being provided with a device for adjusting the height of the cage acting individually on one end and the other end of the longitudinal axis of the annular inner male piece (1), a small side of the annular inner male piece and a corresponding small side of the annular outer female piece each being provided with a slot for insertion of an adjusting tool passing through the annular outer female piece to actuate the annular inner male piece.
    公开号:FR3033247A1
    申请号:FR1551917
    申请日:2015-03-06
    公开日:2016-09-09
    发明作者:Jerome Levieux
    申请人:Spineart SA；
    IPC主号:
    专利说明:

    [0001] 1 Intervertebral cages and their applications.
    [0002] The present invention relates to intervertebral cages, also called intersomatic cages, and their applications. In humans, the degeneration of the intervertebral disc tends to reduce the intradiscal space and to narrow the foramens through which the nerve roots leave the spinal canal. As a reminder, the intervertebral discs are located in the spine between two consecutive vertebrae. An intervertebral disc includes a cartilage ring with a gelatinous core at its center. The intervertebral discs are elastic and thus contribute to the damping of the shocks suffered by a spine. The surgical treatment of this type of pathology of the spine may require the fusion of one or more vertebral segments in the best possible anatomical position. The technique requires to revitalize the vertebral endplates and to use a bone graft to promote fusion of the vertebrae. In order to restore the normal space and sagittal anatomical angle of the segment (lordosis), intersomatic cages are implanted between the vertebrae, bone graft can be installed in the cage and sometimes around in order to achieve the fusion. The intersomatic cages are generally conceived as a box having two lights, one on the lower face and one on the posterior face, the lateral faces being able also to be perforated. Sometimes these cages are not hollow but full, in this case no graft will be placed inside. In what follows, "height" of a cage means the dimension measured in the direction corresponding to the thickness (or height) of an intervertebral disc. Recently, expansive cages and 30 cages called "lordosantes" have been found on the market. For example, the Latis® or Caliber® cages from Globus for expanding cages. There may be mentioned, for example, Varlock0 cages from the Kisco company for lording cages. The disadvantages of these cages are of several types: The technology used to enable their operation is expensive because it is complex and often has several small parts, which leads to expensive implants in the manufacture, and thus limits their production. market accessibility. None of these cages are both lordful and expansive. The surgeon wishes to restore both the normal space and the anatomical sagittal angle of the segment (lordosis). Their complex technology due to the presence of screws with very small diameters and sliding parts increases the risk of malfunction and therefore increases the risks for the patient. Their complex technology does not allow enough space inside the cage to place a sufficient amount of bone graft. It would therefore be desirable to have intervertebral cages - very simple, therefore inexpensive to manufacture and more reliable than complex cages, 15 - capable of simultaneously producing lordosis and enhancement, - with a large volume available for receive bone graft. The applicant has designed intervertebral cages giving complete satisfaction with the aforementioned criteria.
    [0003] This is why the present application relates to a two-piece intervertebral cage, namely an annular inner male piece having two small sides and two long sides and thus four outer and four inner faces, one upper surface and one inner surface. lower surface and - an annular outer female piece also having two short sides and two long sides and thus four outer faces and four inner faces, an upper surface and a lower surface, the upper surface of the annular inner male piece and the lower surface 30 the annular outer female piece forming external surfaces determining the height of the cage, said annular inner male piece fitting and preferably wedging in the annular outer female piece, each of these two pieces having a generally parallelepipedal shape and therefore an axis longitudinal, the male part 3033247 3 internal annular being sliding against the annular outer female piece and comprising a device for blocking a longitudinal displacement of the annular inner male piece vis-à-vis the annular outer female piece, the intervertebral cage being provided with a device for adjusting the height of the cage acting individually on one end and the other end of the longitudinal axis of the annular inner male part, a small side of the annular inner male part and a corresponding small side of the external female part each annular being each provided with a slot for insertion of an adjusting tool passing through the annular outer female piece to actuate the annular inner male piece, whereby it is possible to increase the height of the cage and change the angle between the outer surfaces. Under preferred conditions of implementation of the invention, one or more sides, preferably one side, of the annular outer female piece is provided with a lumen to enable the annular inner male piece to be moved in order to increase the height of the cage and change the angle between the outer surfaces. The light is preferably provided in a small side of the annular outer female piece.
    [0004] Advantageously, the annular inner male piece is also provided on one or more sides, preferably only one side, with a light also usable for this purpose. For this, one can advantageously use a suitable tool. A suitable tool is, for example, a screwdriver or wrench acting directly or indirectly on the annular inner male piece, for example (indirect action) on a cage height adjusting device comprising two elongated rotary shafts with concentric axes, each shaft having a segment cam flattened and rotatable independently of the other. By turning one and the other one can increase the height of the cage equally along the longitudinal axis. By turning one of the two, one increases the height only on the side along the longitudinal axis where the cam acts and can thus obtain a lordosis. By turning one more than the other, one can both increase the height of the cage and produce a lordosis.
    [0005] 3033247 4 The inner male piece and the outer female piece are annular and therefore open. The opening of the outer female part allows the insertion of the inner male part. Each of these two pieces has a general parallelepiped ring shape.
    [0006] In horizontal section, if one considers the cages installed in the intervertebral space of an individual in standing position, the cages have a generally rectangular shape. They also have an upper surface and a lower surface. The upper surface of one and the lower surface of the other forming outer surfaces determine the height of the cage.
    [0007] In the cages of the invention having a parallelepipedal general shape, it is therefore possible to distinguish as in any rectangle two small sides and two long sides. The annular nature of the pieces leads to distinguish four external faces and four internal faces. As seen above, the annular inner male piece is provided to fit into the annular outer female piece. The annular inner male piece is slidable with respect to the annular outer female piece and comprises a device for blocking the longitudinal displacement of the annular inner male piece vis-à-vis the annular outer female piece. For this purpose, for example the outer face of the small sides of the inner male piece is curved and bears on the inner side of the short sides of the annular outer female piece. As the short sides of the inner male piece are bulged, the inner male piece can be moved in pitching movements. This curved shape can come from a dome shape, for example hemispherical, said small sides. It can also come from a semi-cylindrical surface, that is to say a half-round gutter shape (like a classic gutter of a house). In the latter case, the gutter is installed horizontally. When the short sides of the annular inner male piece have the shape of a semi-cylindrical surface, then the inner surfaces of the small sides of the annular outer female piece 2 are planar faces as shown in Fig. 6 below. When the short sides of the annular inner male piece are dome-shaped, in this case the inner surface of the short sides of the outer female piece is in the form of half-rounded vertical gutters as shown in FIGS. 5. To schematize, it can be said that the outer face of the short sides of the inner male piece is supported on the inner face of the short sides 5 of the annular outer female piece and that the short sides of the inner male piece are able to describe a circle of radius (R) while remaining in contact with the inner surface of the short sides of the outer female piece. This configuration allows the assembly to withstand shear forces when opening the cage or lordosis. Expressed very simply, it can be said that arcs disposed on each side of the cage substantially describe the same theoretical circle. In order to block the longitudinal displacement of the inner male annular piece vis-à-vis the annular outer female part, it can also provide the installation of studs preferably installed in the middle position, in the long sides of the room internal male, these studs can cooperate with an oblong hole through each of the long sides of the outer female part. According to the present invention, the intervertebral cage is provided with a cage height adjusting device acting individually on one end and the other end of the longitudinal axis of the annular inner male piece. This device can take various forms. In one embodiment of a cage height adjusting device acting individually on one end and the other end of the longitudinal axis of the annular inner male piece where the adjustment is reversible, a system of the The invention comprises a device comprising two elongate rotary shafts with concentric and independent axes, each shaft having a segmented cam that is flattened and can be rotated independently of the other. The flattened segments of the cam are progressively more and more distant from the axis. Blocking occurs every 30 times that a flattened segment bears against the annular inner male part. The flats serve both to adjust the height and to maintain the cage in the desired position by choosing a front and rear flat. By turning one shaft and the other, the height of the cage can be increased equally along the longitudinal axis. By turning one of the two only, the height is increased only on the side along the longitudinal axis in which the cam acts and thus a lordosis can be obtained. By turning one more than the other, one can both increase the height of the cage and produce a lordosis. In an embodiment where the adjustment is irreversible, the outer faces of the long sides of the annular inner male piece or the internal faces of the long sides of the annular outer female piece or all these faces are each provided with two or more devices constituting each a system of elastic casing. An irreversible elastic casing system is an assembly mode where one or both of the assembly members are deformed upon insertion. After the introduction, the elements can not be separated. According to the invention, this system is provided with multiple positions (or notches, thus several adjustments are possible, and for each adjustment, a backwards step is no longer possible.The presence of these systems makes it possible to irreversibly vary the The height of the cage and the angle between the external surfaces, for example two devices on each of the long sides, spaced from one another, for example each device is preferably installed near a small side. In this embodiment, for example, the outer faces of the long sides of the annular inner male piece are provided with a pair of flexible tabs each provided with a protruding lamella by means of a flanged fastener. relative to the outer general surface of said long sides, such a conformation allows the relative retention of the two parts by wedging, without it being necessary to provide notches in the inner surface of the long sides of the outer annular female piece, as shown in Figure 7 for example. Such a device comprises according to another embodiment for example a series of notches formed of several inclined slats installed parallel to each other. The system is rendered irreversible by using a surface perpendicular to the direction of movement in the disassembly direction while keeping a contact surface inclined in the direction of insertion.
    [0008] Such devices are preferably arranged to allow adjustment in height in steps of 0.3 to 3 millimeters, preferably from 0.5 to 2.5 millimeters, particularly from 1 to 2 millimeters. There is thus both a fine adjustment of the height and sufficient strength.
    [0009] On each long side, there are two or more devices facing each other, each constituting an elastic casing system. There are, for example, four devices per side, but preferably three or more devices per side as shown in FIG. 2. In a system of the invention, the devices are obviously installed in a face-to-face pair to form the control system. irreversible interlocking. In such a casing system, at least one and preferably only one of the two devices installed face-to-face is elastic. For this purpose, this device is advantageously mounted on an elastic tab. One can also have on one side a tooth and opposite a series of notches, or two sets of notches facing each other. Depending on the height of the notch or notches in which the notch or the opposing notches are installed, it is possible to irreversibly vary the height of the cage and the angle between the outer surfaces.
    [0010] It should be noted that the first cage height adjustment embodiment, using 2 sets of flats, is compatible with the other control systems discussed above and can therefore be used together. An expandable cage of the invention may be made of any biocompatible material and corresponding to this type of implants. For example, it may be made of titanium, titanium alloy, Peek, stainless steel, cobalt chromium alloy, tantalum, etc. Moreover, the upper and lower surfaces, intended to be in contact Bones of adjacent vertebral endplates may be coated with bone-facilitating materials such as porous titanium or hydroxyapatite. They can also be made with technologies to obtain a so-called "trabecular" surface, that is to say that this surface is porous and with characteristics close to the human bone (pore diameters and porosity).
    [0011] The thickness (or height) of a cage according to the invention may, with reference to the end notches, be from 4 to 16 mm, preferably from 5 to 14 mm, in particular from 6 to 12 mm. . The expansion of a cage according to the invention may be 0 to 8 mm, preferably 0 to 4 mm, preferably 0 to 2 mm In the anteroposterior direction of the human body, the size of the cage may be 10 mm at 50 mm, preferably from 12 to 45 mm, most preferably from 14 to 40 mm. In the transverse direction (from left to right) of the human body, the size of the cage may range from 5 mm to 25 mm, preferably from 7 to 20 mm, most preferably from 8 to 12 mm. The surfaces of contact with the vertebrae may be left-shaped, for example dome-shaped or tile-shaped, and preferably flat. With the design of the present invention, the outer surfaces may be angled relative to each other. The angle between the contact surfaces imparted by the use of the extreme settings can range from 0 to 25 degrees, preferably from 0 to 20 degrees, particularly from 0 to 12 degrees. It should be remembered that the contact surfaces of the intervertebral cages are usually provided with asperities to allow attachment of the implant. Moreover, these surfaces intended to be in contact with the bone of the adjacent vertebral endplates may be coated with materials facilitating bone grip such as porous titanium or hydroxyapatite. They can also be made with technologies 25 to obtain a so-called "trabecular" surface, that is to say that this surface is porous and with characteristics close to the human bone (pore diameters and porosity). The intervertebral cages object of the present invention have very interesting qualities. In particular, they are able, like conventional intervertebral cages, to restore the normal space between the vertebrae and to use a bone graft to promote the fusion of the vertebrae, but also - to restore the normal space by easily and exactly adjusting the height of the cage, and 3033247 9 - to restore the sagittal anatomical angle of the segment (lordosis), They are of simple structure since in some embodiments achievable in 2 pieces only while both they are expandable and allow lordosis, and furthermore, they provide a large volume for placing a sufficient amount of bone graft for fusion. These properties are illustrated below in the description of the figures. They justify the use of the cages described above, in the replacement of an intervertebral disk subject to degeneration following trauma, disease or old age. They also justify the use of intervertebral cages described above in a method of fusion between two vertebrae. They also justify the use of intervertebral cages described above in a method of restoring the anatomical sagittal angle of an intervertebral segment. They also justify the use of the intervertebral cages described above in a method of restoring the intervertebral space. Therefore, the present application also relates to a method of replacing an intervertebral disk, for example subject to degeneration following trauma, disease or old age, in which two pieces are implanted between two adjacent vertebrae. of a prosthesis above in unexpanded position, then using a suitable adjustment tool inserted into the cage through the lights we adjust the chosen height or lordosis or both. The present application also relates to a method of fusion between two adjacent vertebrae in which is implanted between two adjacent vertebrae at least one cage above (a cervical or lumbar cage for anterior approach and two lumbar cages for posterior approach) and installs a bone graft in a free volume of the cage accessible from the outside. The above methods include the steps of: - removing an intervertebral disk between two adjacent vertebrae, for example through the back or belly - filling the empty space created by removal of the intervertebral disk, by installing a intervertebral cage of the invention, 3033247 10 - make the necessary adjustment or adjustments of height or lordosis or both parameters with a suitable auxiliary instrument, - optionally install a bone graft. The adapted accessory instrument may be for example a simple cylindrical bar preferably comprising a handle, or a more complex device as described above, which can be actuated by tools such as a flat screwdriver, cruciform or an Allen key. The preferred conditions of implementation of the intervertebral cages 10 described above also apply to the other objects of the invention referred to above, for example to the replacement methods of an intervertebral disc. The invention will be better understood with reference to the accompanying drawings in which - Figure 1 shows a schematic perspective view from above of a cage according to the invention, wherein the inner part is inserted into the room Figure 2 shows a view comparable to that of Figure 1, in which the inner part has not yet been inserted into the outer part, and where the parts have been rotated 180 times. 3 represents a view comparable to that of FIG. 1, in which the inner part has been raised to increase the height of the assembly, FIG. 4 represents a view comparable to that of FIG. the height of the inner part has been increased differentially to provide lordosis; FIG. 5 shows a longitudinal sectional view of an intervertebral cage shown in FIG. 4; FIG. seen from longitudinal sectional section of an intervertebral cage of the invention, of the type where the short sides of the inner annular male piece have the shape of a semi-cylindrical surface, then the inner surfaces of the short sides of the outer annular female piece 2 are flat faces. FIG. 7 is a cross-sectional view of an annular inner male piece and a cross-sectional view in which the annular inner male piece is installed in an annular outer female piece, FIG. at the top a perspective view of an annular external female piece, and at bottom a perspective view of an annular internal male piece; FIG. 9 is a cross-sectional view in which the annular internal male piece of FIG. 8 is a view similar to that of FIG. 4; FIG. 11 is an exploded view of a cage of the invention in which a Figure 12 is a perspective view of the adjusting device of Figure 11. In Figure 1, the cage is shown in the position where it is installed in the housing. intervertebral space of an individual while standing.
    [0012] It can be observed that a spinal cage of the invention consists of an annular internal male piece 1 fitted into an annular outer female piece 2. The inner male piece 1 and the outer female piece 2 are annular and therefore open in their entirety. center. Each of these two pieces has a generally parallelepipedal ring shape and comprises two small sides 3, 4, 5, 6, and two long sides 7, 8, 9, 10, and thus four outer faces and four inner faces, one upper surface 11, 12 and a lower surface 13, 14 masked in this figure. The general shape of these pieces can also be described as short rolled cylinders. In the middle of these parts, there is therefore an opening 15, 16.
    [0013] The dimensions and shape of the opening 16 of the outer female part 2 have allowed the insertion of the inner male part 1. Due to their parallelepipedal overall shape, in horizontal section, the cages have a generally rectangular shape. They also have an upper surface and a lower surface. The upper surface of one and the lower surface 12 of the other, invisible in this figure, form external surfaces which determine the height of the cage. The inner surface of the short sides 4, 6 of the outer female piece is curved and forms a vertical gutter. The outer surface of the short sides 3, 5 of the inner male piece is domed domed. The outer face of the short sides 3, 5 of the inner male part 1 is supported on the inner face of the short sides 4, 6 of the outer annular female piece 2. One of the short sides 3 of the annular inner male piece 1 is provided with a light 17 opening into its opening 15. This light 17 is not visible in this figure. In the same way, one of the short sides 4 of the outer annular female piece 2 is provided with a lumen 18 opening into its opening 16. When a cage of the invention is implemented, the two lights are located in the same side of the cage.
    [0014] FIG. 2 represents a perspective view of a spinal cage of FIG. 1 in which the two separate parts have been represented before insertion and engagement of the annular internal male part 1 in the annular outer female part 2. This view makes it possible to distinguish other features of the cage.
    [0015] Each of the outer faces of the long sides of the annular inner male piece is provided with a pair of flexible tabs longitudinally spaced apart from each other, each provided with a protruding slat with respect to the outer general surface of said large ones. sides. Such a conformation allows the relative maintenance of the two parts by sintering, without it being necessary to provide notches in the inner surface of the long sides of the annular outer female part 2. The upper surface 11 of the annular inner male part 1 is provided with hooking reliefs. It is the same for the lower surface 14, invisible in this figure, of the outer annular female piece 2.
    [0016] Fig. 3 is a perspective view of a spinal cage of Fig. 1 in which the annular inner male piece 1 has been inserted further into the annular outer female piece 2. Therefore, it is possible to distinguish the light 17 formed in a small side 3 of the annular inner male part 1.
    [0017] FIG. 4 shows a cage according to the invention to which, thanks to the series of lamellae, a particular lordosis has been conferred (see angle α between the upper surface 11 of the annular inner male part 1 and the surfaces 12, 14 of the annular outer female part 2). FIG. 5 represents a longitudinal sectional view exploded in the length of a cage similar to that shown in FIG. 4. It makes it possible to better observe the conformation of the external surfaces of the short sides of the male part and the internal sides of the short sides of the annular outer female piece 10. The inner surfaces of the short sides of the outer annular female piece 2 are in the form of perpendicularly arranged gutters. For their part, the outer surfaces of the short sides of the annular inner male part 1 have a dome shape. While being wedged in horizontal translation between the inner surfaces of the short sides of the annular outer female part 2, the annular inner male part 1 can, however, be inclined as seen above. In this figure, it can also be observed that one of the short sides 4 of the outer annular female piece 2 is provided with a slot 18 and that it is likewise 17 for one of the short sides of the annular inner male piece 20 1. The two lights are located on the same side of the cage and are installed in coincidence with each other, which allows to insert a tool to spread the boxes relative to each other (movement H in Figure 3). The tool passes through the lumen 18 of the outer annular female piece 2 and can be deployed inside, which pushes the annular inner male piece 1 and thus separates the pieces to increase the height of the assembly (movement H , Figure 3). This makes it possible to give height to the set but also, in the case where one spreads more than one side than the other, to create the desired lordosis. (Angle a in Figure 4). When the desired lordosis and height have been obtained by the surgeon, the cages of the invention are able not only to maintain their structure, but also to withstand compressive but also shear loads (P forces and F forces). in Figure 3).
    [0018] The openings of the upper and lower faces of the cages of the invention make it possible to install bone graft to cause fusion. FIG. 6 shows a longitudinal sectional view in the length of a cage of the invention in which the inner and outer surfaces of the annular inner male piece 1 and the annular outer female piece 2 have a different conformation to that of the previous cage. 2-piece lights have not been shown To withstand the shear forces (F Fig. 3) the annular inner male piece 1 in profile view has both ends which describe a circle of radius (R) so that the contacts between the two rooms are always effective when opening the cage or lordosis. It can be said that the arcs arranged on each side of the cage describe substantially the same theoretical circle.
    [0019] To achieve this function, the short sides of the annular inner male part 1 may have a cylindrical shape, the axis of the cylinder being horizontal, and come into contact with flat faces constituting the inner surface of the short sides of the outer female piece. annular 2 as shown here in Figure 6.
    [0020] Preferably, the short sides of the annular inner male piece 1 are dome-shaped, for example hemispherical, and are in contact with half round gutter shaped surfaces constituting the inner surface of the short sides of the annular outer female piece 2 as shown in Figures 1 to 5.
    [0021] FIG. 7 also shows a cage of the same general structure, but in which the flexible lugs 21, carrying a single strip 20, are installed on the annular inner male part 1, whereas the surface of the female part The outer annular surface 2 facing it is smooth and thus a sliding in the direction of insertion and a jamming in the opposite direction is obtained. The flexible tabs 21 are not installed parallel to the wall of the long sides of the annular inner male part 1, but substantially perpendicular to it. In addition, they are slightly inclined downward if you look from the inside to the outside of the room. Thus, the introduction of the inner male piece into the outer female piece is facilitated, but the movement in the opposite and upset direction. As shown in the figure, a greater clearance of the part is possible in the direction of the introduction than in the direction of the outlet, where the flexible lug 21 quickly abuts against the rest of the annular inner male piece 1 This kind of tabs and more particularly designed to cooperate by jamming on an annular outer female part 2. When the locking is obtained by jamming, the annular outer female part 2 does not need to have series 19 of slats installed on the faces internal, and can therefore be internally smooth.
    [0022] In FIG. 8, it can be seen at the top that the internal faces of the long sides of the annular outer female piece 2 and the outer faces of the long sides of the annular internal male piece 1 are each provided with devices each constituting a system of FIG. irreversible elastic casing with multiple positions. For this purpose, the outer annular female piece 2 is provided on the inner faces of its long sides with two series 19 of parallel inclined lamellae such as louvers (which would not be perforated on the model shown but may be perforated) over practically all the length of the long sides. These inclined slats are also installed parallel to the upper surface 12 and to the lower surface 14 of the annular outer female part 2. In vertical section perpendicular to the surface of the long side on which they are installed, these series of slats have a structure as seen in FIG. 9. In a variant not shown, there are several opposite pairs of series 19 of lamellae installed on the internal faces of the long sides of the annular outer female part 2. To cooperate with these series 19 sloping lamellae, there are also on the outer faces of the inner male part 1 series 20 inclined slats, but of inverted conformation and independent of each other. These series of slats are installed on flexible tabs 21.
    [0023] The system is rendered irreversible by using a lamella surface perpendicular to the direction of movement in the disassembly direction while keeping a contact surface inclined in the direction of insertion of the inner female part 1 into the outer female part 2.
    [0024] As a result of this structure, it is possible to irreversibly vary the total height of the cage, and the front / rear and left / right angles between the outer surfaces 11/14. It can also be seen that the lumen 17 formed in a small side of the annular inner male piece 1 is elongated and open on the lower part of this piece. FIG. 9 which is a cross-sectional view of FIG. 8, except that the annular inner male part 1 has been introduced into the annular outer female part 2 from below, makes it possible to clearly observe the cooperation between the lamellae. 20 independent of the inner annular male part 1 and the series 19 of lamellae installed on the internal faces of the annular outer female part 2. FIG. 10, similar to that of FIG. 4, illustrates another embodiment of the blocking of the displacement. longitudinal of the annular inner male piece (1) vis-à-vis the outer annular female piece (2). In the embodiment shown here, where the height adjustment device is not shown, a stud 22 has been installed in the middle position vis-à-vis the length of the cage, in the long sides 7, 9 of the inner male piece 1. These studs can move in vertical translation in an oblong hole 23 traversing each of the long sides 8, 10 of the outer female part 2. In another embodiment, a single d-bolt a big side to side of the cage. Figure 11 illustrates another embodiment of a cage height adjusting device acting individually on one end and the other end of the longitudinal axis of the annular inner male piece (1). The device used here comprises two internal elongated shafts 31, external, rotary with concentric and independent axes, each shaft 30, 31 having a flattened segment cam 32, 33 and rotatable independently of the other. The inner elongated shaft 30 is housed at one of its ends in a blind bore 34 provided in the short side of the annular outer female part 2 opposite the lumens 17, 18. The cams 32, 33 bear against an inner upper surface 35 of the annular inner male part 1.
    [0025] In the perspective view of the shafts of FIG. 12, it can be seen that the flattened segments 36 of each cam 32, 33 are progressively further apart from the axis A-B. Locking occurs whenever a flattened segment 36 bears against an inner upper surface 35 of the annular inner male part. The inner shaft 30 is provided at its accessible end by the lumen 18 of the female part with a Torx® tip imprint as shown, Allen®, or the like to allow its rotation. For the same purpose, the outer shaft 31 is for its part provided with the same side of grooves 10 or grooves for the use of for example a flat screwdriver or cruciform. By turning one shaft and the other, the height of the cage can be increased equally along the longitudinal axis. Turning only one of the two shafts increases the height only to the side along the longitudinal axis in which the cam acts, and thus a lordosis can be obtained. By turning one tree more than the other, one can both increase the height of the cage and produce a lordosis.
    权利要求:
    Claims (8)
    [0001]
    REVENDICATIONS1. An intervertebral cage comprising two pieces, namely - an annular inner male piece (1) having two small sides (3,5) and two long sides (7,9) and thus four outer faces and four inner faces, a top surface (11) and a lower surface (13) and - an outer annular female piece (2) having two small sides (4,6) and two long sides (8,10) and thus four outer faces and four inner faces, one upper surface (12) and a lower surface (14), the upper surface (11) of the annular inner male piece and the lower surface (14) of the outer annular female piece forming external surfaces determining the height of the cage, said annular inner male part (1) fitting into the annular outer female part (2), each of these two parts having a generally parallelepipedic shape and therefore a longitudinal axis, the annular inner male part (1) being slidable screw-to -vis the annular outer female piece (2) and comprising a device for blocking a longitudinal displacement of the annular inner male piece (1) vis-à-vis the annular outer female piece (2), the intervertebral cage being provided with a cage height adjusting device acting individually on one end and the other end of the longitudinal axis of the annular inner male piece (1), a short side of the annular inner male piece and a corresponding small side of the annular outer female piece being each provided with a slot (17, 18) for insertion of an adjusting tool passing through the annular outer female piece to actuate the annular inner male piece, as a result of which it is possible to increase the height of the cage and change the angle between the outer surfaces (11,14).
    [0002]
    2. A cage according to claim 1, characterized in that the cage height adjusting device comprises two elongated shafts (30, 31) rotatable with concentric and independent axes, each shaft including a cam (32, 33) with flattened segments and can be turned independently of the other.
    [0003]
    3. A cage according to claim 1, characterized in that the outer faces of the long sides of the inner annular male piece are provided with a pair of flexible tabs (21) each provided with a slat (20) in protrusion relative to to the outer general surface of said long sides and cooperate by wedging with the inner surface of the long sides of the outer annular female piece.
    [0004]
    4. A cage according to claim 1, characterized in that the outer faces of the long sides of the annular inner male piece or the internal faces of the long sides of the annular outer female piece or all these faces are each provided with two or more devices. (19,20,21) each constituting an elastic casing system.
    [0005]
    5. A cage according to any one of claims 1 to 4, characterized in that the outer face of the short sides (3,5) of the inner male piece is domed and bears on the inner side of the short sides (4). 6) of the annular outer female piece.
    [0006]
    6. A cage according to any one of claims 1 to 5, characterized in that the short sides (3,5) of the inner annular male piece 20 have the shape of a semi-cylindrical surface, while the inner surfaces of the small sides (4,6) of the outer annular female piece 2 are planar faces.
    [0007]
    7. A cage according to any one of claims 1 to 5, characterized in that the short sides (3,5) of the annular inner male piece 25 are dome-shaped, and the inner surface of the short sides (4, 6) of the outer female piece has a form of half-round gutters installed vertically.
    [0008]
    8. A cage according to any one of claims 1 to 7, characterized in that studs (22) are installed in the long sides of the inner male piece, these studs (22) cooperate with an oblong hole (23). crossing each of the long sides (8, 10) of the outer female piece.
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    同族专利:
    公开号 | 公开日
    WO2016142282A1|2016-09-15|
    EP3265032A1|2018-01-10|
    CN107427370A|2017-12-01|
    US20180036137A1|2018-02-08|
    FR3033247B1|2017-03-24|
    引用文献:
    公开号 | 申请日 | 公开日 | 申请人 | 专利标题
    WO2000035389A1|1998-12-16|2000-06-22|Loubert Suddaby|Expandable intervertebral fusion implant and applicator|
    WO2004019829A1|2002-08-28|2004-03-11|Sdgi Holdings, Inc.|Minimally invasive expanding spacer and method|
    WO2011011609A2|2009-07-22|2011-01-27|Spinex Tec, Llc.|Methods and apparatuses for vertebral body distraction and fusion employing a coaxial screw gear sleeve mechanism|
    US20130274883A1|2012-04-13|2013-10-17|Gary R. McLuen|Bone fusion device|
    WO2013158294A1|2012-04-16|2013-10-24|Biospine, Llc|Multiple spindle adjustable interbody fusion devices and methods of use|
    US20140094917A1|2012-10-02|2014-04-03|Anthony A. Salerni|Expandable fusion cage with cam adjuster|
    US8696751B2|2008-12-10|2014-04-15|Coalign Innovations, Inc.|Adjustable distraction cage with linked locking mechanisms|
    US9050194B2|2009-05-06|2015-06-09|Stryker Spine|Expandable spinal implant apparatus and method of use|
    US9463099B2|2013-03-15|2016-10-11|Expanding Orthopedics Inc.|Orthopedic expandable devices|
    US9668876B2|2013-12-05|2017-06-06|Spinal Elements, Inc.|Expandable interbody device|US10500061B2|2015-08-13|2019-12-10|K2M, Inc.|Adjustable spinal implant|
    WO2018015964A1|2016-07-21|2018-01-25|Nlt Spine Ltd.|Expandable implant|
    TR201620372A3|2016-12-30|2018-08-27|Tobb Ekonomi Ve Teknoloji Ueniversitesi|AN EXTENDABLE CAGE|
    TR201620379A2|2016-12-30|2018-07-23|Tobb Ekonomi Ve Teknoloji Ueniversitesi|AN OPENING APPARATUS|
    法律状态:
    2016-03-29| PLFP| Fee payment|Year of fee payment: 2 |
    2016-09-09| PLSC| Search report ready|Effective date: 20160909 |
    2017-03-27| PLFP| Fee payment|Year of fee payment: 3 |
    2018-03-27| PLFP| Fee payment|Year of fee payment: 4 |
    2019-03-27| PLFP| Fee payment|Year of fee payment: 5 |
    2020-03-24| PLFP| Fee payment|Year of fee payment: 6 |
    2021-03-25| PLFP| Fee payment|Year of fee payment: 7 |
    优先权:
    申请号 | 申请日 | 专利标题
    FR1551917A|FR3033247B1|2015-03-06|2015-03-06|INTERVERTEBRAL CAGES AND THEIR APPLICATIONS|FR1551917A| FR3033247B1|2015-03-06|2015-03-06|INTERVERTEBRAL CAGES AND THEIR APPLICATIONS|
    US15/554,665| US20180036137A1|2015-03-06|2016-03-04|Intervertebral cages and their uses|
    CN201680013179.1A| CN107427370A|2015-03-06|2016-03-04|Invasive lumbar fusion device and application thereof|
    PCT/EP2016/054625| WO2016142282A1|2015-03-06|2016-03-04|Intervertebral cages and their uses|
    EP16709313.7A| EP3265032A1|2015-03-06|2016-03-04|Intervertebral cages and their uses|
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