CA2115637A1 - Extra-discal inter-vertebral prosthesis for controlling the variations of the inter-vertebral distance by means of a double damper - Google Patents

Extra-discal inter-vertebral prosthesis for controlling the variations of the inter-vertebral distance by means of a double damper

Info

Publication number
CA2115637A1
CA2115637A1 CA002115637A CA2115637A CA2115637A1 CA 2115637 A1 CA2115637 A1 CA 2115637A1 CA 002115637 A CA002115637 A CA 002115637A CA 2115637 A CA2115637 A CA 2115637A CA 2115637 A1 CA2115637 A1 CA 2115637A1
Authority
CA
Canada
Prior art keywords
damper
screw
sleeve
disc
sphere
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
CA002115637A
Other languages
French (fr)
Inventor
Fernand Navas
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
PSI
Original Assignee
Fernand Navas
Psi
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from FR9302184A external-priority patent/FR2701651B1/en
Application filed by Fernand Navas, Psi filed Critical Fernand Navas
Publication of CA2115637A1 publication Critical patent/CA2115637A1/en
Abandoned legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • 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, setting implements or the like
    • 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 ; Bone 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
    • A61B17/7004—Longitudinal elements, e.g. rods with a cross-section which varies along its length
    • A61B17/7007—Parts of the longitudinal elements, e.g. their ends, being specially adapted to fit around the screw or hook heads
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • 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, setting implements or the like
    • 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 ; Bone 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
    • A61B17/702—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other having a core or insert, and a sleeve, whereby a screw or hook can move along the core or in the sleeve
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • 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, setting implements or the like
    • 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 ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7046—Screws or hooks combined with longitudinal elements which do not contact vertebrae the screws or hooks being mobile in use relative to the longitudinal element
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • 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, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8685—Pins or screws or threaded wires; nuts therefor comprising multiple separate parts
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
    • Y10T403/00—Joints and connections
    • Y10T403/32—Articulated members
    • Y10T403/32606—Pivoted
    • Y10T403/32631—Universal ball and socket
    • Y10T403/32737—Universal ball and socket including liner, shim, or discrete seat
    • Y10T403/32754—Variably preloaded

Abstract

ABSTRACT OF THE DISCLOSURE

This invention relates to a prosthesis with double damper performing the function of intervertebral stabili-zer, wherein it comprises at least two identical elements assembled together and comprising means for regulating the bending-stretching movement between two vertebrae so as to approach as closely as possible the physiological course of a discal movement.

Description

-1- 21~37 FIELD OF rHE INVENTION
The present invention relates to a prosthesis with double damper, allowing the function of intervertebral stabilizer by controlling the interpedicular distance.
BACKGROUND ~F THE INVENTION
Dampers of this type are known, which are generall~
with single or double effect and which may progressively resist, in exponential manner, the advance of a piston, so that, after a certain stroke of the j?iston, the damper opposes any displacement of the piston beyond a determined value of this displacement. To that end, the damper con-tains on either side of the piston an elastic body whose , volume is smaller than that of the chamber determined i by the position of the piston in the free state with respect to the bottom of the cylinder.
i The variation of the volume of the chamber or of i,j the compartment brings about a deformation of the corres-ponding elastic body which is opposed by the non-deformabi-lity of the walls of the chamber, so that an antagonistic ~ 20 force progressively opposes the displacement of the piston ,l until it stops when this force becomes exponential.
The impro\~ements forming the subject matter of the present invention allow a damper to be produced, comprising two identical, separate elements assembled together and comprising means for regulating the bending-stretching movement between two vertebrae, by developing an exponen-tial curve in the two directions so as to approach as much as possible the physiological course of a discal ~! movement.
i 30 SUMMARY OF THE IN~ENTION
, Each element comprises a hollow cylinder pierced with an opening slot and of which one of the ends is closed by a bottom fast on its outer face with a tenon, whilst the other end receives a dlsc which, via an assembly ring, allows the connection with another element, a sleeve ', .i .

"', i'. .'; , ' , ' ~ ' ` ' ' ., :
-2- 2~637 placed in the cylinder and of which one of the ends is closed by a bottom whilst the other receives a ~ace of the disc on which a boss is provided, a notch being made on the periphery of the sleeve, a screw whose spherical head is mounted to pivot between the disc and the bottom and an elastic body placed between the sleeve and the botto.~ of the cylinder so as to dampen the displacements thereof under the effect of the displacements of the screw.
~ variant embodiment consists in that, for each element, at least one cylinder is provided, of which one of the ends is closed by a bottom, whilst the other end comprises an assembly ring which allows connection with ~nother element, the median part of the cylinders being provid~d with a transverse hole for positioning a tubular sleeve provided to receive by force a sphere fast with a pedicular screw, and in that, between each ( sleeve and the bottom, there is placed an elastic body j whilst a~other elastic body is introduced between each sleeve and the assembly ring.
Moreover, each sleeve is elastically maintained in the axial direction of the cylinders, the displacements of the sleeve in one direction or in the o-her being !i effected against the reaction of the ccrresponding elastic ;~ 25 bodY-¦ BRIEF DESCRIPTION OF 'rHE DRAWINGS
~ The invention will be more readily understood on `, reading the following description with reference to the '''! accompanying drawings, in which:
i 30 Figure 1 is an exploded view in perspective showing ; an element of the damper according to the present invention.
I Figure 2 is a ~iew in perspective showing the elemen-t mounted, on wh1cn 1s cllpped the assembly ring for connec-tion with another element.
Figure 3 is a section showing the damper provided ,~, :,1 _3_ 2 ~1 ~ 63 7 with two elements of Figure 1 joined by means of an assem-bly ring to perform the function of intervertebral stabi-li~er.
Figure 4 is a view illustrating a first variant of the damper according to the invention.
Figure 5 is a view showing a second variant of the damper for positioning thereof on particular pedicular screws.
Figure 6 is a view illustrating a third variant of the damper according to the invention.
Figure 7 is a schematic view showing the positioning of a plurality of dampers shown in Figure 6.
Figure 8 is a view showing a variant assembly of the dampers shown in Figure 6.
Figure 9 is a curve showing the variations of the antagonistic force developed by the damper.
DESCRIPTION OF PREF~RRED EMBODIMENTS
Referring now to the drawings, Figure 1 firstly shows an isolated element 1 w'nich is to be assembled 20 with another, identical one, to constitute the interverte-bral damper a:cording to the invention.
!j Each element 1 comprises a hollow cylinder la of .~ which one of the ends is closed by a bottom 1_, whilst the other, which is provided to be open, is intende~' ~, 25 to receive a disc 2. The outer face of the bottom lb is machined to constitllte a T tenon lc which allows connec-tion with an assembly ring 3, as will be seen ~ore clearly hereinafter.
Cylinder la is pierced with a slot ~r longitudinal 30 notch ld which opens out ~oward, the end which is to ~ receive the disc 2. This latter comprise., on one of the aces a boss 2a whose centre is machined to constitute a hollow 2b of shape corresponding to part of a sphere, as shown in Figure 3. Disc 2 comprises on the face opposite 1 35 the one comprising the boss 2a, a projection 2c in the .'~
~,~
. .
,j ; ~, ~ . .

: .

21~37 form of a tenon identical to that, lc, provided on the bottom l_ of the cylinder la.
A tubular sleeve 4 is closed at one of its ends by a bottom 4a, whilst the other is provided to be open S in order to receive the boss 2a of the disc 2 when the element 1 is mounted. The periphery of the sleeve 4 is provided with a longitudinal notch 4b which opens out towards the end receiving the boss 2a. The inner part of the bottom 4a is machined to determine a hollow 4c of radius identical to that, 2b, provided in the boss 2a of disc 2. The element 1 further comprises a screw 5 of which one of the ends comprises a sphere 5_ whose radius corresponds to that of the hollows. The screw 5 comprises, opposite sphe-e 5a, a threaded part 5b which allows fixation thereof in a pedicular screw 6, as will be seen more clearly hereinafter. Between the threaded part 5b and the sphere Sa, the screw 5 is provided with a bearing surface 5c and with a smooth cylindrical part 5_ which is pierced right through with a transverse hole 5e. It will be observed that ,:he diameter of part 5d is smaller than that of the bearing surface 5c.
Between the bottom 4_ of the sleeve 4 and the bottom ~, lb of the cyllnder la, there is placed an elastic body i 7 such as a block of natural or synthetic rubber. The volume of the elastic body 7 in the free state is slightly smaller than that of the chamber in which it is placed which is determined by the inner volume of the cylinder ~ la defined between its bottom lb and the sleeve 4. The ;~ sleeve 4 is introduced in the cylinder la so that its notch 4b is placed opposite that, ld, of the cylinder.
The head 5a of the screw 5 is then introduced inside the sleeve 4 so that the smooth part 5cl passes through the notches ld and 4b.
The disc 2 which closes the sleeve and the element , 3 5 1 is welded on the periphery of the cylinder la sn that i;

2~ 5637 its boss 2a is placed inside the sleeve 4. It will be noted that the hollow 2_ of the boss 2a comes into abutment against the sphere 5a of i:he screw 5 to guide it angularly inside the sleeve 4.
S Figure 2 shows an element 1 completely mounted, on which is engaged the assembly ring 3. The latter makes it possible to join two identical elements 1 to constitute the damper according to the present invention. The ring 3 presents a hollow, cylindrical profile of which the ends are closed by parallel cheeks 3a and 3b which are each provided with a notch 3c whose diameter is slightly smaller than that of the tenons lc and 2c provided respec-tively ~3n the cylinder la and on the disc 2. The ring 3 may be totally rigid or supple or articulated so that the elements 1 may pivot with respect to one another.
Figure 3 shows two elements 1 described hereinabove and assembled with one another by means of the ring 3 wlth a view to constituting the damper. Each of the screws 5 is fixed in a pedicular screw 6 previously screwed ln the body of two vertebrae to be stabilized. Each pedicu-lar screw 6 presents at one of its ends a threaded tapped hole 6a in which is screwed the threaded part of the screws 5. The screws 5 may also be fixed by any other tneans inside the pedicu]ar screws 6. Around each screw 5 , there is provided a bellows 8 which surrounds the smooth part 5d and which abuts on the boss 5c and on the outer face of the cylinder la. The bellows are compres-sed at the moment of assembly so that the notches lb and 4b are never in contact with the parts such as blood or flesh, which would risk blocking the angular displace-meni-s of the damper.
It will be noted that the elements 1 are mounted in the same direction so that the ring 3 cooperates, on the one hand, with the Eirst element by means of the tenon 2c and, on the other hand, with the second element ... . . - . . , . ~ :
:; ~ . .: , . .
.,.~: ~ , , ~ : .

2 ~ 3 7 via the tenon lc. This particular arrangement makes it possible to stabilize and dampen the displacements of the vertebrae either in traction o~- in compression.
Figure 4 shows a first variant of the damper according to the invention which comprises two identical elements 10 assembled together.
Each elemeni- col~prises a cylinder 11 open at its tw~ ends and of which one of them is closed by a bot~om 20, preferably screwed, but which may be fixed b~ any 1 10 other means.
The inedian part of the cylinder 10 is provided with a transverse through hole 12 in which is engaged a tubular sleeve 30 or piston. The tublllar sleeve 30 is made either of metal or of an appropriate plastics material such as polyethylene. It presents a b~re 31 comprising in its median part a hollow 32 whose shape corresponds to a part of a sphere. In this hollow 32 is engaged a sphere 40 whose radius may correspond to or be more widened I than that of said hollow.
; 20 The two cylinders 11 are assembled by means oE a , ring 50 constituted by a cylindrical collar 51 whose ;l ends are respectlvely screwed on the two opposite, adjacent ends of the two cylinders 11. It will be observed that the ring 50 is provided with a median transverse wall 52 whose thickness may vary depending on the use of the damper and which constitutes a partition separating the cylinders 11. This partition 11 may also be either articula-ted or flexible.
j Between each sleeve 30 and the bottom 20 of the corresponding cylinder is placed an elastic body 60 such as a block of natural or synthetic r~bber. The volume of the elastic body 60 in the fre? state is slightly smaller than that of the chamber in whlcn it is ~laced and which is determined by the inner volume of the cylinder ¦ 35 11 defined between its bottom 20 and the sleeve 30. Another 21~637 elastic body 70, identical to body 60, is placed betweei.
each sleeve 30 an~ the separating partition 52 of the assembly ring 50.
In this way, ea~h sleeve 30 is maintained elastically 5 in the axial direction of the cylinder 11, the displace-ments of the sleeve in one direction or in the other being effec-ted ~gainst the elastic reaction of the corres-ponding body.
With a view to the application of the damper described 10 hereinabove to the stabilization ~f two adjacent vertebrae of a spine, it is provided to pierce in each sphere 40 a radial hole 42 in ~hich is introduced a cylindrical end 82 of a pedicular screw 80. In fact, the pedicular screw 80 is anchored i.n the ar,ophysisof a vertebra by 15 its threaded end 81, whils~: its other cylindrical end 1 82 is assoc;.ated with the bore 41 of the sphere 40 via Z a screw 90. The screw 90 comprises a head which presents a larger diameter than that of the _ylindrical part 82, so as to constitute a sJ.:op preventing separation of the ~ 20 sphere 40 and the screw 80, whilst allowing the latter ¦ tn move longitudinally in the bore ~1.
Of course, it is thanks to ~he transverse hole 12 of each cylinder 11 that the ped.icular s,rew 80 may be associated with the corresponding sphere 40.
Il 25 Figure 5 shoi~s a second variant of the damper so '! that i.t may be ~ounted on particular pedicular screws :1 ~0'.
The damper comprises two identical elements 10' ' ea~h p.ovided with a cylinder 11' open at its two end., . 30 and of which o,.le is closed by a bot~om (not sho~n), i~enti-cal to the one referenced 20 (~igure 4).
In the median part of the cylinder 11' is pierced ~ a transverse, non-opening hole 12'. In the cylinde^ 11' .1 there is engaged a tubular s~.eeve 30' which is made of j 35 an appropriate plastics material su~h as polyethylene.
.~ .
l, y 2~1~6~7 The sleeve 30' comprises a bore 31' of conical profile whose wider base is turned towards the outside of said sleeve. The bore 31' opens out in a cavity 32' in the form of a sphere.
On either side of the sleeve 30' are provided two elastic blocks 60' and 70', identica~ to those described in the damper of Figure 4. The pedicular screw 80' compri-ses a threaded part 81' which allows anchoring thereof in the apophysis of a vertebra. The wider base of the threaded part 81' is fast with a hexagonal profile 82' which is extended along the major axis of the screw 80' by a spherical head 83' whose radius corresponds to that of the cavity 32' of the sleeve 30'.
Tne hexagonal profile 82' enables the operator -to screw the pedicular screw 80' in the apophysis of the vertebra to be stabilized. Once the pedicular screw 80' is anchored in the apophysis, its spherical head 83' is engaged by force in the cavity 32' of the sleeve 30'.
It will be observed -that, prior to positioning the damper on the spherical head 83' of the pedicular screw 80', lt is provided to place around the latter a bellows 90' which surrounds the he~agonal part 82' ancl which abuts on the outer ace oE the c~linder 11'. The bellows 90' is compre~sed at the moment of assembly so that the bore 12' is never in contact with the parts such as blood or flesh which would risk blocking the angular displace-ments of the d~mper.
Functioning is as follows: two pedicular screws 6 or 80 or 80' being anchored ln two adjacent vertebrae whose common disc is damaged, there is obtained thanks to the damper ac,_orcling to the invention, a dai~ping of the relative movement of -the two ve-tebrae in e~tension an~ in bending.
In fact, if the two pedicular screws 6 or 80 or 80' tend to move apart, which provokes a spacing apart ; .::

~ 't ~, 2 ~ 3 7 't _ g _ '1 of the two spheres 5a or 40 or 83', the block 7 of the element 1 being located in the lower part of the damper or the two blocks 60 and 60 are compressed and are de-formed. However, the deforlnation is countered by the rigidity of the walls of each cylinder la or 11 or ll' so that the elastic block opposes the displacement of he sleeve 4 or 30 or 30' with an increasing reaction.
When the sleeve 4 or 30 or 30' occupies the wh~le volume `~' of the chamber in which it is disposed, the reaction developed by this block becomes exponential and at the limit, forms a ,top preventing any subsequent displacement of the sleeve 4 or 30 or 30'. Consequently, the in-ter-! vertebral displacement is limited.
`l The same applies ~hen the two spheres 5a or 40 or :`I 15 83' tend to approach one anoth~r. At that moment, the same phenomenon is produced as the one described llerein-above, but which is compensated tllanks to the block 7 of the element 1 located in the upper part of the damper j or to the two blocks 70 or 7~J'.
Figures 6 and 7 show a third variant of the damper . according to the invention which comprises an element , 1' mounted on pedicular screws 8' previously anchored ln the vertebrae.
j Element 1' comprises a hollow cylinder l'a of which ~i 25 one oE the en~is is closed by a bottom l'b, whilst the other, which is provided to be open, is intended to receive , a disc 2' fast with a fixing lug 2'a which is pi.erced at its free end with a hole 2'd. The lug 2'a is provided ~;~ to be laterally offset with respect to the middle of the disc 2' in order to be in a plane parallel to the ,!', one passing through -the vertical axis of the element .. ,, 1' ! ' ~
~ The cylinder l'a is pierced with a l~ngitudinal i slot or notch l'd which opens out towards the end which ~i 35 is to receive the disc 2'. 'rhe latter comprises a skirt . .1 ''j~l .,~

2 ~ 3 7 2'b exten,ling vert~cally so ~s to guide the hollow cylinder l'a axially. Between the w~lls of the skirt 2'_ there is provided a bearing surface 2'c of cylindrical orm and whose diameter is substantially equivalent to the inLernal diameter of the cylinder l'a. The skirt 2'b and the bearing surface 2'b define a notch 2'e in which is introduced the open end of the hol.low cylinder l'a with a view to co~perating ~ith the disc 2'.
The pedicular screws 8' anchored in the vertebrae 10 "f the spine comprise a self-tapping threaded part 8'a and a cylindrical head 8'b. The latter is pierced ~t its centre ~ith a blind hole 8'c allowing the positioning either of a cylindrical rod 8'd provided at one of its ends with a spherical head 8'e, or with a cylindrical 15 finger 8'f comprising at one of its ends a stop 8'q.
The cylindrical rod 8'd and the finger 8'f are maintained inside each corresponding blind hole 8'c via a press screw 8'h or any other like means.
On the base l'b of the element 1' is placed an elastic 1 20 body 3' such as a block of natural or synthetic rubber.
! The rod 8'd is introduced via the notch l'd inside the I hollow cylinder l'a so -that its spherical head 8'e co.~es ¦ into abutment agains~.: the elastic body 3'. Prior to the I positioning oE the rod 8'd, there is placed around the ¦ 25 spherical head 8'e a ring 8'l of which the inner and outer Eaces take the profile of a portion of sphere with the same diameter as that of said head 8'e. The ring 8'l is made of a material such as metal or TEFLON. Another elastic body 4' identical to the one ,-eferenced 3' is placed inside the hollow cylinder l'a to come into abutment ag~inst the ring 8'l fast with the sphere 8'e. The end opposite that, l'b, of the hollow cylinder l'a is then ,l -losed by the disc 2' for its surface 2'c to abut agalns~
the elastic body 4'.
In place o~ ring 8'l, there may be provided a cup ::,: - --ll- 21~637 of the same profile which is placed on either side of the spherical head 8'e in o~der that the latter does not abut directly on the elastic bodies.
It will be noted that the cylindrical rod 8'd compri-sing the spherical head 8'e associated with its ring8'i is mounted to pivot between two elastic bodies 3' and 4' in order to dampen its displacements when the vertebrae are subjected to efforts of traction/compression.
The elastic bodies 3' and 4' may fo~ example present a conical profile of which the less wide base is in abut-ment respectively against the bottom l'b of the element 1' and tl~e surface 2'c of the disc 2'.
Depending on the number of discs to be relie~ed, the surgeon will proceed with different assembli s of the elements 1' such as for example those shown in E'igures 6 and 7.
In fact, when one disc only is to be relieved, tlle surgeon will previously fix two screws 8' in each of the vertebrae lying above and below said disc. He intro-duces in the first screw 8', i.e. -the one lying above the disc to be relieved, a rod 8'd fast with the element 1' so that the free end of the lug 2'a of the disc 2' and more particularly its hole 2'd cooperates with a ~' certain clearance with the finger 8'f which is placed inside the second screw 8' disposed in the vertebra lying below the disc (Figure 6). This particular assembly will thus make it possible, during displacement of the verte-brae, to relieve and dampen the efforts of compression and of traction to which the disc is subjected.
On the other hand, when several discs are to be relieved, the surgeon proceeds with the assembly as shown ¦ in Figure 7. It is possible to mount a plurality of ele-ments 1' one above the other so that each lug 2'a of the discs 2' cooperates with the rod 8'd of the element 1' lying directly thsrebelow. The first element 1' oE

211~637 the assembly abuts on a pedicular screw 8' associated with a finger 8'f fast with the stop 8'~ a, was described hereinabove in Figure 6. Such assembly may be repeated for several levels to be relieved.
Figure 8 shows a particular assembly of two identical elements 1' described hereinabove. Assembly is provided to relieve, for examplef a disc located between two verte-brae of the spine. The two elements 1' are joined via a cylindrical sleeve S'. The sleeve 5' is provided to replace the disc 2' described hereinbefore. The sleeve 5' comprises at each end a blind hole 5'a whose internal diameter is equivalent to the external dia!neter of the ~ cylinder l'a of each element 1' to be joined. In the ;~ bottom of each blind hole S'a is provided a bearing surface 5'c identical to that, referensed 2'c and of diameter equivalent to th~ internal diameter of the cylin~er l'a so as to determine a cylindrical notch 5'e for fixing the elements 1'. The blind hole 5'a defines on its peri-phery a skirt 5'b which axially guides the cylinder l'a and maintains it vertically. The bearlng surface 5'c `~ is provided to receive one of the ends of the elastic bodies 3' or 4' of each element 1' to be joined. Such assembly makes it possible, in the same manner as previous-ly, to dampen the efforts of traction and compression in order to relieve the damaged discs.
Of course, a bellows which has not been shown but which is identical to those referenced 8, 90', surrounds ~`1 the rod 8'd fast with the pedicular screws 8' in order to protect the internal part of the elements 1'.
Figure 9 shows the curve which illustrates the varia tion of the force oE resistance of the damper according to the p-esent inve~tion. The left-hand part of the curve corresponds to an efEort of compression applied on the damper and which in fact presents a negative displacement illustrated from the origin. The reaction N increases ...

. ., ~ .

-13- 2~1~637 for the majority of the displacement in relatively slight manner, i.e. it is approximately tangential to the X-axis representing the displacement. It then becomes exponential and is finally asymptotic with respect to a straight line (not shown) parallel to the axis of the forces N.
If, on the contrary, the displacement of the damper is positive (case of a traction), the curve illustrating the antagonistic resistance of the damper is symmetrical with res-~ect -to that corresponding to a compression, this part of the curve becoming asymptotic with respect to a straight line (not shown), but likewise parallel to the axis of the positive forces N.
A regulation of the bending-stretching movement between two vertebrae is therefore obtained, developing a cllrve of the forces N and exponential displacements X in the two directions, which correspo~ds to the physio-logical course of the discal movement.
When the different prostheses described above are functioning, it is noticed that they define an amplitude i 20 of b~nding-stretching whose limits correspond to 'he vertical zones of the curve shown in Figure 9. These vertical zones may be modified to control the sector i of mobility in bending-stretching.
I Of course, the curve is totally symmetrical if the elastic b-~dies 7 or 60, 70 or 60', 70' or 3', 4' present the same characteristics of volume and of flexibility and if the chambers which receive them are of the same volume. On the other hand, both the characteristics of the elastic blocks and the volumes of the chambers recei-ving them may be varied so as to obtain different effortsresistant to compression or to traction.
It will be noted that the dampers described herein-abov~ may be superposed with respect to the spine thanks to pedicular screws comprising a plurality of sphericai heads which are aligned alon~ ~he m~jor axis of said 211~63 1 :, il screw. It is observed that there is a link between each I vertebra, which is totally stabilized, whether it be ;' in traction or in compression via the damper. It is ascer-Z tained that the elastic bodies of each prosthesis described Z S hereinabove may each be associated with a spring to improve j their damping effort, whilst they may present any outer i profile.
i It will be noted that the dampers described create ;, ;, devices for intervertebral stabilization, but other medical applications may be envisaged. For example, such dampers ~ may be used in combination with any system of prosthesis `~ such as for example an osteosynthesis device in order ~, to create a combination of a fixed rachidian zone whose ends are mechanically assisted and supple.

Claims (26)

1. A damper of the type comprising an elastic body of which the volume is smaller than that of the chamber determined by the position, in the free state, of the piston with respect to the bottom of the cylinder, wherein it is constituted by elements comprising means for regulating the bending-stretching movement between two vertebrae so as to approach as closely as possible the physiological course of a discal movement.
2. The damper of Claim 1, wherein each element comprises a hollow cylinder pierced with a opening slot of which one of the ends is closed by a bottom fast on its outer face with a tenon whilst the other end receives a disc which, via an assembly ring, allows connection with another element, a sleeve placed in the cylinder and of which one of the ends is closed by a bottom whilst the other receives a face of the disc on which is provided a boss, a notch being made on the periphery of the sleeve and a screw whose spherical head is mounted to pivot between the disc and the bottom and an elastic body placed between the sleeve and the bottom of the cylinder so as to dampen the displacements thereof under the effect of the displace-ments of the screw.
3. The damper of Claim 1, wherein each element comprises a hollow cylinder of which one of the ends is closed by a bottom whilst the other end comprises an assembly ring which allows connection with another cylinder, the median part of the cylinders being provided with a trans-verse hole for positioning a tubular sleeve which is provided to receive by force a sphere fast with a pedicular screw, and between each sleeve and the bottom there is placed an elastic body whilst another body is introduced between each sleeve and the assembly ring.
4. The damper of Claim 1, wherein each element comprises a hollow cylinder pierced with an opening slot and of which one of the ends is closed by a bottom whilst the other end receives a disc fast with an assembly lug allo-wing connection either with another element or with a finger fast with a pedicular screw, and a cylindrical rod whose spherical head associated with a ring is mounted to pivot between two elastic bodies respectively placed in abutment against the bottom and the disc of the element.
5. The damper of Claim 2, wherein the disc comprises on the face opposite the one comprising the boss, a projec-tion in the form of a tenon allowing connection with the assembly ring.
6. The damper of Claim 2, wherein the boss of the disc comprises a hollow adapted to receive the sphere of the screw.
7. The damper of Claim 2, wherein the assembly ring presents a hollow cylindrical profile of which the parallel ends are provided with a notch, which cooperate upon assembly of the damper with the tenons of each element.
8. The damper of Claim 7, wherein the ring is rigid or supple or articulated.
9. The damper of Claim 2, wherein the sleeve presents in its internal part a hollow whose radius is identical to that of the hollow of the disc in order to receive in rotation the sphere of the screw.
10. The damper of Claim 2, wherein the screw presents at the end opposite the sphere a threaded part which cooperates with a tapped hole of a pedicular screw.
11. The damper of Claim 10, wherein the screw comprises between the threaded part and the sphere a bearing surface and a smooth cylindrical part which is pierced right through with a transverse hole to allow the screw to be tightened in the pedicular screw.
12. The damper of Claim 3, wherein the tubular sleeve is provided with a bore comprising in its median part a hollow whose radius is identical to that of the sphere.
13. The damper of Claim 3, wherein the two cylinders are assembled by means of a ring which is constituted by a cylindrical collar, of which the ends screw respective-ly on the two opposite, adjacent ends of the two cylinders.
14. The damper of Claim 3, wherein the ring is provided with a median transverse wall of variable thickness which constitutes a partition separating the two cylinders.
15. The damper of Claim 3, wherein each sphere comprises a radial hole in which is introduced a cylindrical end of the pedicular screw which is immobilized via a screw whose head presents a diameter larger than that of said cylindrical end.
16. The damper of Claim 3, wherein the sleeve comprises a bore which opens out in a cavity in the form of a sphere.
17. The damper of Claim 3, wherein the pedicular screw comprises a threaded part which is fast with a hexagonal profile, extended by a spherical head whose radius is identical to that of the cavity.
18. The damper of Claim 1, wherein a bellows surrounds the screws or the pedicular screws in order to protect the sleeve.
19. The damper of Claim 4, wherein the lug of the disc is offset laterally with respect to the major axis of the element in order to lie in a plane parallel to the latter, whilst its free end is pierced with a hole.
20. The damper of Claim 4, wherein the disc is replaced by a sleeve for joining two identical elements.
21. The damper of Claim 20, wherein each end of the sleeve is pierced with a blind hole to cooperate with the hollow cylinder whilst its bottom comprises a bearing surface which is in contact with the elastic body of each element to be joined.
22. The damper according to Claim 4, wherein the rod and the finger are respectively retained inside a blind hole in the corresponding pedicular screw via a press screw.
23. The damper of Claim 4, wherein the ring is made of a material such as TEFLON or metal.
24. The damper of Claim 4, wherein the elastic bodies are of conical shape, of which the less wide base faces towards the spherical head of the rod.
25. The damper of Claim 1, wherein the elastic bodies are each associated with a spring in order to improve their damping effect.
26. The damper of Claim 1, wherein the elements are joined to a rigid osteosynthesis system to constitute an association comprising a fixed rachidian zone whose ends are mechanically assisted and supple.
CA002115637A 1993-02-17 1994-02-14 Extra-discal inter-vertebral prosthesis for controlling the variations of the inter-vertebral distance by means of a double damper Abandoned CA2115637A1 (en)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
FR9302184A FR2701651B1 (en) 1993-02-17 1993-02-17 Double shock absorber for intervertebral stabilization.
FR9302184 1993-02-17
FR9306174A FR2701650B1 (en) 1993-02-17 1993-05-17 Double shock absorber for intervertebral stabilization.
FR9306174 1993-05-17

Publications (1)

Publication Number Publication Date
CA2115637A1 true CA2115637A1 (en) 1994-08-18

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CA002115637A Abandoned CA2115637A1 (en) 1993-02-17 1994-02-14 Extra-discal inter-vertebral prosthesis for controlling the variations of the inter-vertebral distance by means of a double damper

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US (1) US5480401A (en)
EP (1) EP0611554A1 (en)
JP (1) JP3594643B2 (en)
AU (1) AU5515594A (en)
CA (1) CA2115637A1 (en)
FR (1) FR2701650B1 (en)

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US5480401A (en) 1996-01-02
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