• 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:
    It is a vertebral anchoring system comprising two anchoring pieces (1) each having a pedicle element (2) adapted to be engaged in a vertebra pedicle and connected to one another by an element link. The connecting element is a flexible band (6), the pedicular elements are screws, and each anchoring piece comprises a fastening head (3) on a rod (4) integral with means (5) of adjustable locking of the flexible band in tension with respect to the head.
    公开号:FR3034978A1
    申请号:FR1553424
    申请日:2015-04-17
    公开日:2016-10-21
    发明作者:Couëdic Regis Le；Denis Pasquet
    申请人:Implanet SA；
    IPC主号:
    专利说明:

    [0001] SYSTEM, PIECE AND METHOD FOR VERTEBRAL ANCHORAGE. The present invention relates to a vertebral anchoring system comprising two anchoring pieces each having a pedicle element adapted to be engaged in a vertebra pedicle and connected to one another by a connecting element. It also relates to the anchoring parts themselves and a vertebral anchoring method 10 for securing two vertebrae adjacent to each other. It finds a particularly important, though not exclusive, application in the field of spinal consolidation in case of lesion, and more particularly when one of the vertebrae is of poor quality, for example due to osteoporosis or to a spinal cord. accident. Intervertebral discs are known to be subject to compaction, disc herniation, or intervertebral osteoarthritic degeneration. To relieve patients, there are then techniques requiring surgery. A first technique is to replace the damaged disc with an intervertebral disk prosthesis. Such a replacement is difficult to perform by the surgeon and presents a risk of uncoupling under the effect of significant shear forces that are exerted especially when the prosthesis is in the maximum bending position.
    [0002] A second technique consists in performing an intervertebral arthrodesis, an operation for fusing the two vertebrae adjacent to the damaged disc. There is then blockage of the degradation due to the removal of any mobility between the two vertebrae concerned. It is an improvement of this technique which is the subject of the present invention. It is known that such a technique involves the use of a device for stabilizing the two vertebrae comprising screws intended to be screwed into the vertebrae and secured together by a rigid connecting member. It is thus possible to avoid excessive mechanical stresses being applied to the intervertebral disc. But this technique has disadvantages requiring in particular to screw in the vertebrae which is an operation sometimes impossible if the latter are in poor condition and / or insufficiently large at the fixation. Anchoring devices are known (FR 2 913 330) made by assembling two anchoring parts each comprising a pedicle nail and 25 interconnected by a rigid connection. Such a system which provides good stability in the degraded bone, however, has the disadvantage of complicated assembly, the pedicle nails may further have inclinations incompatible because of the configuration of the vertebra.
    [0003] The present invention aims to overcome these drawbacks and to provide a system, a piece and a method of vertebral anchoring better than those previously known to the requirements of the practice, in particular in that it allows greater flexibility, in that it avoids any intrusive element in a weakened vertebra bone provided that a solid vertebra exists next to the damaged vertebra, and in that it has a good solidity 10 and this for a low cost and / or less than with the devices of the prior art. It also has the advantage of easy handling for easy installation by the surgeon.
    [0004] For this purpose the invention proposes in particular a vertebral anchoring system comprising two anchoring pieces each comprising a pedicular element adapted to be engaged in a vertebral pedicle and connected to one another by a connecting element, Characterized in that the connecting element is a flexible band, in that the pedicle elements are screws, in that each anchoring piece comprises a fixing head on a rod integral with means of adjustable locking of the band flexible in tension relative to the head and in that it comprises two rods corresponding to said fixing heads. The idea of the system is to control the movements of the degraded vertebra with respect to the more solid adjacent vertebra, by binding to the spinous vertebrae above or below (on its 3034978 4 process) through a in tension on both sides of the band. Here the jamming of the braid or band by the blocking means will be able to allow the longitudinal path of the latter by reproducing what the ligaments of the column do naturally. The amplitude of the movements will thus be able to be limited without being completely blocked, which in part avoids postponing all efforts on the free disk adjacent to the locked vertebrae moving between them, which otherwise generates the well-known phenomenon of effect. hinge ", risking this time to damage the adjacent disk still in good condition. With the invention we will also create a return force on the screws, force that brings them back into their housing and thus avoids the disadvantages of consolidating cements generally used with the screws of the prior art. Such cements pose temperature problems (necessary for good polymerization of the cement) and also cause an impossibility of re-intervention on the screw once locked in the mass. In advantageous embodiments, one or more of the following provisions are also and / or in addition used: - the fastening head of the anchoring piece is integral with a ring which is provided with locking means; the fixing head comprises a cup-shaped body traversed laterally by the rod perpendicular to the pedicle screw and provided with an internal thread in its upper part, for fixing the stem by means of a screw of compression, and the ring comprises a first through-hole clipping by deformation on the upper periphery of the fastening head, a second through-hole passing through the band and a third insertion opening of the band locking means in the Ring ; the fixing head comprises a cylindrical upper portion or a cylindrical portion of a first diameter, the first orifice being cylindrical with a diameter complementary to the first diameter with which it is arranged to cooperate with friction before screwing the compression screw and with which it is arranged to lock when tightening said screw. This blockage results from the widening or removal of the walls of the internal thread of the upper part of the head due to the compression exerted by the head of the compression screw itself on its edges. As a result, compression of the outer wall of the head on the inner wall of the first port and consequent blockage in lateral compression; the head comprises an upper part provided with a groove or a retaining rib and the first through-orifice of the ring is provided with a rib or a groove of corresponding shape arranged to be embedded in force; in the other ; The locking means comprise a retaining piece insertable in the third orifice of the ring, the holding part being at least partly in the form of a crushable wedge, blocking the band 5 passing through the second orifice; the holding piece has a tuning fork-shaped cross-section whose branches comprise non-return outer teeth and whose handle has a rounded end, and the third orifice has lateral walls provided with non-return teeth complementary to that; the retaining piece and a bottom of complementary shape to that of the end of the handle, wedging the band between the two; - The pedicle screw has a round or oblong end rotatably mounted in rotation in the lower part of the head and the head has a connecting structure between the cylindrical wall of the rod and said screw end.
    [0005] The invention also relates to an anchoring piece as described above. It also relates to an anchoring method using a system as described above. It further relates to a vertebral anchoring method for securing two vertebrae adjacent to each other in which two pedicle screws are screwed into the pedicles opposite a vertebra, a rod is slipped through a fixation head of each screw on said rod, and a pressure screw is screwed on the rod through the upper part of the head, characterized in that 3034978 7 before screwing the pressure screw is clipped on the upper periphery of each head a ring comprising a first through hole clipping by deformation on said upper periphery and comprising a second lateral through-hole for passing a band and a third insertion orifice for locking the band on said fixing head, place the flexible band on the adjacent vertebra and in the locking means 10 of each fixing head, said band is blocked on a head and one begins to put said ban of flexible tension by pulling the other side, then we put all the tension before definitively block the band relative to the remaining head 15. This completely and gently secures the movement of the vertebra adjacent to that of the base vertebra, preventing bending of the one relative to the other, in the direction of operation of the spine. . The invention will be better understood on reading the following description of embodiments given below by way of non-limiting examples. The description refers to the accompanying drawings in which: Figure 1 is an axionometric perspective view of an anchor according to a first embodiment of the invention. FIG. 1A is a sectional view along line 'A -' A of FIG.
    [0006] FIG. 1B is a sectional view along IB - IB of FIG. 1. FIG. 1C is a partial sectional view of the type of the section along IB - IB of a variant of the part of FIG. FIG. 2 is a perspective view of the ring of the part of FIG. 1. FIG. 3 schematically illustrates, in plan view, the anchoring system using two anchoring parts according to FIG. 1, two rods and the flexible band in tension around the apophysis of a vertebra. FIG. 4 is a perspective view of a system comprising two anchoring parts according to the embodiment of the invention more particularly described here, in position on two adjacent vertebrae. It should be noted that here it has been shown that a pedicle fixation screw per rod, each rod must of course comprise several to block the movements of at least two adjacent vertebrae. Figure 1 shows an anchor 1 comprising a pedicle screw 2 adapted to be screwed into a vertebra pedicle (not shown).
    [0007] The part comprises a fastening head 3 on a rod 4 integral with means 5 of adjustable locking of a flexible band 6 in tension. The strip 6 is flat, for example braided polyester 1 to 3 mm thick and 6 mm wide.
    [0008] The blocking means 5 comprise a ring 7 secured to the head 3, which comprises a body 8 in the form of a recessed cup pierced at its bottom or bottom 9 to allow the pedicle screw 2 to pass, and comprises two lateral notches 10. open upwards, lateral passage of the rod 4 which is embedded therein. The body 8, for example titanium, is cylindrical and comprises a rounded bottom and a cylindrical inner recess 12 for passage and locking in the axial direction of the screw.
    [0009] Its upper part 13 comprises an internal thread 14 for fixing the rod, introduced into the lateral notches 10, by a compression screw 15 which thus compresses the rod on the head 16 of the pedicle screw 2.
    [0010] This comprises a screw body 17 provided with a screw thread known per se. The head 16 of the screw (see Figure 1B) is provided with a notch 18 for screwing by a tool. It is partially spherical and abuts on the bottom 11 of the cup of the body 8 of the attachment head 3 with which it cooperates with friction by rotation and in longitudinal abutment. After screwing the screw 2 previously introduced into the anchor 1, and after introduction of the rod 4, is placed in place the ring 7, and this after introduction above the screw head of a piece 19 junction / guide / support shaped half-cylinder on one side (rod) and ring on the other (screw head).
    [0011] The ring 7 (see also FIG. 2) is a piece, for example made of titanium, with a keyhole-shaped cross section, with a first cylindrical portion and a second parallelepipedal portion 21 of smaller width than the diameter. , or substantially parallelepipedic.
    [0012] The first cylindrical (or substantially cylindrical) portion is provided with an internal cylindrical bore 22 or first orifice comprising a tapered upper portion 23 forming a locking angle in axial displacement with the top 24 of the attachment head. The internal bore 22 cooperates frictionally in cylinder / cylinder contact with the outer surface of the cylindrical upper portion 13 of the body 8. Once the ring is inserted on this upper portion in friction, the compression clamping screw 15 is screwed on. By this screwing, the head of the screw 15 being designed to, one carries out a slight expansion of the volume which it occupies during the tightening, for example of the order of 0.2 mm, which deforms in lateral compression the bore of the fastener, which blocks any movement of the ring relative to the fastener. Figure 1C shows another embodiment where the first hole 22 of the ring comprises a rib forcefully snapped into a corresponding groove or groove. The ring 7 comprises a second orifice 25, lateral, through, through which the strip 6 (in the form of a vertical slot of width and thickness a little larger (for example with a clearance of 1 mm) 3034978 11 than those of the The ring 7 further comprises a third orifice 26 passing through the portion 21 perpendicularly with respect to the second orifice 25. The portion 21 comprises a first parallelepipedal portion 27 (see FIG. anti return 28 on two of its internal side faces 29 opposite (for example three teeth), for example on the 10 side faces located in planes parallel to the axis of the screw 2 and, on the other side of the through orifice 25 with respect to this first portion 27, a second portion 30, parallelepiped of smaller width, but of the same height as the first portion 27 of orifice, for example opening on the periphery of the face e 31 of the upper part of the fastener 3. The means 5 for blocking the band 6 also comprise a retaining piece 32 in the form of a tuning fork whose branches are crushable and / or insertable by deforming in the third orifice 26. More precisely, the piece 32 comprises a cross section (cf. FIG. 1A) in the form of a tuning fork 25 comprising two limbs 33 and 34 separated by a recess 35, themselves provided on their outer faces facing the internal lateral faces 29 of complementary anti-return teeth 36 of the teeth 28 with which they will snap into place by progressive snapping when the part 32 is forcibly inserted in the first part 27.
    [0013] The piece 32 also comprises a protruding tongue forming an end sleeve 37 of the tuning fork which is inserted into the second part 30 of the orifice in order to wedge the band 6 between it and the lateral edges 38 and the bottom 39 of said second part when the piece 32 is completely embedded in the third orifice 26. To do this a slight clearance will be left between the walls of the handle and that of the second portion 10 of orifice, to allow sufficient crushing of the band and its locking in position with a dimensioning calculated within the reach of the skilled person. Figures 3 and 4 illustrate the anchoring system 15 according to the embodiment of the invention more particularly described here, using two anchors 1, 1 'in the two opposite pedicles 40 and 41 of the vertebra 42, each the piece being provided with screws 2, 2 'and fixed on the rods 4, 4' by means of the compression screws 15, 15 '. The band 6 is blocked on both sides by the locking means 5, 5 'and is embedded in 43 on the epiphysis 44 of the vertebra 45 (see Figure 4). The implementation of the anchoring with the system according to the embodiment of the invention will now be described more particularly described herein with reference to FIGS. 1A and 4. The surgeon who wants to relieve the intervertebral disk 47 between the vertebra 42 (solid) and the vertebra 45 (fragile) begins by fixing the pedicle screws previously provided with their fixation head in the pedicles 40 and 41 of the vertebra 42, and this in a manner known in itself, by screwing said screws through the heads, by means of a screwdriver or tool that attacks the notch 18.
    [0014] 5 It then fits the rods 4, 4 'on the heads, then snap the rings 7, 7' on the upper periphery of each head. Before or after, while the rings still retain a certain degree of freedom in rotation relative to the corresponding fixing head, it slides into the third orifice, the end portions 6 'and 6 "respectively of the strip 6. It then places the central portion 6 "'of the band on the pineal edge 44 of the adjacent vertebra 45. Then, on the one hand it blocks the head 3 on the rod 4 by screwing the compression screw 15 and on the other hand it blocks the end portion 6 'of the band with the locking means 8, inserting in all the retaining piece 32 in the third hole of the corresponding ring, the teeth 28 of the opening cooperating in gradually becoming embedded and by deformation and then resumed their location in the teeth 36 of the tuning fork, because of the elasticity relative branches of said tuning fork. The dimensions of the elements are designed to wedge the band in the recess formed by the second portion of the third orifice immovably and calculated to the scope of the skilled person.
    [0015] The surgeon then stretches with a tool of known type the band 6 by pulling on the end portion 6 "through the still unrestrained blocking means 8 ', the fastening head 3' having for its part been blocked. on the rod 41 by screwing the compression screw 15 ', then once the tension on the required edge 44 has been obtained (for example by means of a dynamometric tensor) the end 6 "is definitely locked with respect to 7. As is obvious and as also follows from the foregoing, the present invention is not limited to the embodiments more particularly described. On the contrary, it encompasses all the variants and in particular those in which the locking means are different, those where the pedicle screws are double-threaded or those where the rings are snapped onto the fixing head by means of cone / cone contact. for example 20 with a taper angle of the Morse taper type and with a deformable locking tongue at the bottom.
    权利要求:
    Claims (8)
    [0001]
    REVENDICATIONS1. A vertebral anchoring system comprising two anchoring pieces (1) each having a pedicle element (2) adapted to be engaged in a vertebral pedicle and connected to one another by a connecting element, characterized in that that the connecting element is a flexible band (6), in that the pedicle elements (2) are screws, in that each anchoring piece (1) comprises a fixing head (3) on a rod (4) integral with means (5) of adjustable locking of the flexible band in tension relative to the head (3) and in that it comprises two rods (4, 4 ') corresponding to said fixing heads.
    [0002]
    2. System according to claim 1, characterized in that the fixing head (3) of the anchor (1) is integral with a ring (7) which is provided with said means (5) for locking. 20
    [0003]
    3. System according to claim 2, characterized in that the fixing head (3) comprises a body (8) in the form of a cup traversed laterally by the rod (4) perpendicular to the pedicle screw (2) and provided with a internal tapping (14) in its upper part (13), securing the rod by means of a screw (15) of compression, and in that the ring (7) comprises a first orifice (22) crossing clipable by deformation on the upper periphery (13) of the fastening head, a second through-hole (25) passing through the strip (6) and a third hole (26) for insertion of the locking means band (6) in the ring (7).
    [0004]
    4. System according to any one of claims 2 and 3, characterized in that the fixing head (3) comprises a cylindrical upper portion or cylindrical portion of a first diameter, the first orifice (22) is cylindrical of complementary diameter to the first diameter with which it is arranged to cooperate frictionally before screwing the screw (15) of compression and with which it is arranged to lock during tightening.
    [0005]
    5. System according to any one of claims 2 and 3, characterized in that the fixing head (3) comprises an upper part provided with a groove or a retaining rib and in that the first orifice ( 22) passing through the ring is provided with a rib or groove of corresponding shape arranged to be embedded in force one in the other. 20
    [0006]
    6. System according to any one of claims 2 to 5, characterized in that the means (5) for locking comprises a holding piece (32) insertable in the third hole (26) of the ring, the holding part being at least 25 partly in the form of crushable wedge, blocking the band (6) passing through the second orifice (25).
    [0007]
    7. System according to any one of claims 2 to 6, characterized in that the retaining piece (32) has a diaphragm-shaped cross section whose branches (33, 34) comprise teeth (36) external anti -return and 3034978 17 whose handle (37) has a rounded end, and in that the third orifice (26) has side walls provided with teeth (28) non-return complementary to those of the holding piece (32) and a bottom of complementary shape to that of the end of the handle, wedging the band (6) between the two.
    [0008]
    8. System according to any one of the preceding claims, characterized in that the pedicle screw (2) has a end (16) round or oblong rotatably mounted in rotation in the lower part of the fixing head and in that the head fastener comprises a structure (19) connecting the cylindrical wall of the rod and said screw end.
    类似技术:
    公开号 | 公开日 | 专利标题
    FR3034978A1|2016-10-21|SYSTEM, PART AND METHOD FOR VERTEBRAL ANCHORING.
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    EP1011504B1|2005-06-08|Apparatus for osteosynthesis comprising a connector of the spinal pin and the anchoring elements
    EP2164412B1|2014-09-03|Inter-spine vertebral implant
    EP0645986B1|1997-03-26|Spinal therapy apparatus
    EP1080692A1|2001-03-07|Flexible connection for bone anchor means
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    WO2006003316A1|2006-01-12|Pin for attaching a support member to a bone
    CA2979795A1|2016-10-20|Device and system for fixing a spinal vertebra to a rod
    EP2833808A1|2015-02-11|Spinal osteosynthesis instrument kit
    EP2862529B1|2016-04-06|Vertebral fixation device and system and method for blocking a loop with such a device
    FR2959113A1|2011-10-28|POLAR PEDICULAR SCREW AND PEDICULAR FIXING DEVICE FOR APPLYING FOR VERTEBRAL OSTEOSYNTHESIS
    EP1571971A2|2005-09-14|Device for solidly connecting a part to a support and method of fitting one such device
    EP3082630B1|2018-03-28|Vertebral fixation device with double fastening, system for blocking a loop with such a device
    EP1361827B1|2007-08-08|Fixing screw
    FR3076199A1|2019-07-05|SYSTEM FOR CONNECTING TWO PORTIONS OF BONES BETWEEN THEM WHEN ONE MUST MOVE IN RELATION TO THE OTHER
    WO2015173104A1|2015-11-19|Assembly for osteosynthesis formed by a plate and at least one screw
    EP3402423A1|2018-11-21|Implant device
    EP2858584B1|2016-03-30|Iliosacral implant for connection to a spinal osteosynthesis system
    WO2015092270A1|2015-06-25|Spinal correction system
    FR3106968A1|2021-08-13|System for connecting at least two portions of bone
    同族专利:
    公开号 | 公开日
    KR20170138422A|2017-12-15|
    CN107530113B|2020-02-28|
    US20180078286A1|2018-03-22|
    CN107530113A|2018-01-02|
    AU2016250056A1|2017-10-05|
    CA2979956A1|2016-10-20|
    EP3282980A1|2018-02-21|
    AU2016250056B2|2021-01-21|
    US10420590B2|2019-09-24|
    JP2018511433A|2018-04-26|
    WO2016166448A1|2016-10-20|
    FR3034978B1|2017-04-07|
    HK1243301A1|2018-07-13|
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    法律状态:
    2016-04-27| PLFP| Fee payment|Year of fee payment: 2 |
    2016-10-21| PLSC| Search report ready|Effective date: 20161021 |
    2017-04-13| PLFP| Fee payment|Year of fee payment: 3 |
    2018-04-04| PLFP| Fee payment|Year of fee payment: 4 |
    2020-03-24| PLFP| Fee payment|Year of fee payment: 6 |
    2021-03-16| PLFP| Fee payment|Year of fee payment: 7 |
    优先权:
    申请号 | 申请日 | 专利标题
    FR1553424A|FR3034978B1|2015-04-17|2015-04-17|SYSTEM, PART AND METHOD FOR VERTEBRAL ANCHORING.|FR1553424A| FR3034978B1|2015-04-17|2015-04-17|SYSTEM, PART AND METHOD FOR VERTEBRAL ANCHORING.|
    EP16718436.5A| EP3282980A1|2015-04-17|2016-04-07|Vertebral fixation device|
    US15/565,733| US10420590B2|2015-04-17|2016-04-07|Vertebral fixation device|
    CA2979956A| CA2979956A1|2015-04-17|2016-04-07|Vertebral fixation device|
    CN201680022270.XA| CN107530113B|2015-04-17|2016-04-07|Vertebral anchor system and components|
    PCT/FR2016/050799| WO2016166448A1|2015-04-17|2016-04-07|Vertebral fixation device|
    KR1020177029183A| KR20170138422A|2015-04-17|2016-04-07|Vertebra fixation device|
    JP2017554081A| JP2018511433A|2015-04-17|2016-04-07|Vertebral fixation device|
    AU2016250056A| AU2016250056B2|2015-04-17|2016-04-07|Vertebral fixation device|
    HK18102840.8A| HK1243301A1|2015-04-17|2018-02-27|Vertebral fixation device|
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