CA2510242A1 - Intervertebral implant with joint parts mounted on roller bodies - Google Patents

Intervertebral implant with joint parts mounted on roller bodies Download PDF

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Publication number
CA2510242A1
CA2510242A1 CA002510242A CA2510242A CA2510242A1 CA 2510242 A1 CA2510242 A1 CA 2510242A1 CA 002510242 A CA002510242 A CA 002510242A CA 2510242 A CA2510242 A CA 2510242A CA 2510242 A1 CA2510242 A1 CA 2510242A1
Authority
CA
Canada
Prior art keywords
intervertebral implant
joint
axle
intervertebral
sections
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
CA002510242A
Other languages
French (fr)
Inventor
Max Aebi
Dominique Burkard
Robert Frigg
Beat Lechmann
Robert Jun Mathys
Paul Pavlov
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.)
Synthes USA LLC
Original Assignee
Individual
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
Application filed by Individual filed Critical Individual
Publication of CA2510242A1 publication Critical patent/CA2510242A1/en
Abandoned legal-status Critical Current

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Classifications

    • AHUMAN NECESSITIES
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/442Intervertebral or spinal discs, e.g. resilient
    • A61F2/4425Intervertebral or spinal discs, e.g. resilient made of articulated components
    • AHUMAN NECESSITIES
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    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Pins or screws or threaded wires; nuts therefor
    • AHUMAN NECESSITIES
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    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Pins or screws or threaded wires; nuts therefor
    • A61B17/8625Shanks, i.e. parts contacting bone tissue
    • A61B17/863Shanks, i.e. parts contacting bone tissue with thread interrupted or changing its form along shank, other than constant taper
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    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
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    • A61F2002/30507Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a threaded locking member, e.g. a locking screw or a set screw
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30772Apertures or holes, e.g. of circular cross section
    • A61F2002/3079Stepped or enlarged apertures, e.g. having discrete diameter changes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30841Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
    • A61F2002/30843Pyramidally-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/442Intervertebral or spinal discs, e.g. resilient
    • A61F2/4425Intervertebral or spinal discs, e.g. resilient made of articulated components
    • A61F2002/443Intervertebral or spinal discs, e.g. resilient made of articulated components having two transversal endplates and at least one intermediate component
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4635Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit

Abstract

An intervertebral implant (1), especially an artificial intervertebral disc, comprising a central axis (2), an upper part (10) which can be arranged on the base plate of a vertebral body located thereabove, and a lower part (20) which can be arranged on the cover plate of a vertebral body located therebelow. A) The upper part (10) comprises a ventral side surface (11), a dorsal side surface (12), two lateral side surfaces (13,14), an upper apposition surface (15) and a lower surface (16).B) The lower part (20) comprises a ventral side surface (21), a dorsal side surface (22), two lateral side surfaces (23, 24), a lower apposition surface (25) and an upper surface (26). C) The two parts (10, 20) can be moved in relation to each other by means of two joints (38;
39) disposed between the two parts (10; 20). D) Each of the joints has an axis of rotation (3; 4) and the two axes of rotation (3; 4) are arranged crosswise in relation to each other. E) Each of the joints (38; 39) has at least one axis (34; 36) which is coaxial in relation to the respective axis of rotation (3; 4) and a bearing shell (35; 37) receiving the axis (34; 36). F) Roller bodies (70) are inserted between the axes (34; 36) and the bearing shells (35;
37).

Description

1 J. IG.GVVG

English translation of the International Patent Application No PCT/CH02/00704 "Zwischenwirbelimplantat mit auf Walzkorpern ctelagerten Gelenkteilen" im Namber der Mathys Medizinaltechnik AG
Intervertebral imulant with joint parts mounted on roller bodies The invention relates to an intervertebral implant according to the generic term of Patent Claim 1 and to a process for the replacement of a defect, natural intervertebral disk by an intervertebral implant according to Patent Claim 20.
After removal of a damaged, natural intervertebral disk or a damaged nucleus pulposus of an intervertebral disk, implants or prostheses are inserted into the intervertebral space of two neighbouring vertebral bodies. This suggests the idea of restoring the situation as much as possible to a natural state, i.e. specifically to restore the original height of the intervertebral disk and thus the original distance between the two neighbouring vertebral bodies. Furthermore, the patient should be able to carry out movements of the neighbouring vertebral bodies relative to each other in the natural way, thereby incurring as little obstruction as possible. This essential feature of this system is its ability to retain the freedom of movement in forward/reverse inclination, i.e.
flexion and extension of the vertebral bodies, and in lateral bending of the vertebral bodies within the natural limits. The natural sinews and muscles along the spinal column are in general left intact so that they further stabilise the movements of a mechanical intervertebral disk prosthesis.
A characteristic intervertebral disk endoprosthesis is state of the art from 761 BUTTNER. This known intervertebral disk endoprosthesis basically consists of two symmetric closing plates with concave sliding surfaces facing each other, and each having an external surface for laying on the base plate, or the cover plate of the adjoining vertebral body, and a distance piece positioned between the closing plates with convex sliding surfaces arranged complementary to the concave sliding surfaces on the closing plates. The sliding surfaces are designed in one embodiment as section surfaces of a cylinder coat area, wherein the sliding surfaces arranged on the two closing plates are provided complementary to each of the adjoining sliding surfaces at the distance piece, and two complementary sliding surfaces form the articulation surfaces, which can be moved towards each other, of a joint element rotating around a swivel axle. The joint comprises an upper and a lower joint element, each of which has one swivel axle. The two swivel axles are set at 90° to each other. The disadvantages of this known intervertebral disk endoprosthesis is that a) the arrangement of an intervertebral disk endoprosthesis with only one fulcrum does not take sufficient account of the overlaying swivel movements transferred by the natural intervertebral disk, specifically in the case of anterior-posterior and in lateral flexion, which in the natural intervertebral disk are independent of each other;
b) the verterbral joint is put under strain by swivel movements, specifically with translation in the anterior-posterior direction (face joint), which could cause pain for the patient;
c) disadvantageous friction forces are generated by two articulating surfaces sliding on each other. This also leads to wear on the surfaces, including also abrasion and resistance in movement of the joint elements. There is also the risk of the "stick slip»
effect;
d) a mechanical intervertebral disk prosthesis can scarcely prevent the further degeneration of the affected movement segments. Restoration of the original freedom of movement significantly reduces pain, with the resulting improvement to the patient's quality of life. A review of treatment will, however, have to be undertaken if pain recommences. This will normally involve complete removal of an intervertebral disk prosthesis of the standard model and a stiffening of the movement segment.
This operation represents extreme discomfort and strain on the patient; and e) the form of contact areas to the neighbouring vertebral bodies is generally not taken into account. The conventional types of intervertebral disk prosthesis implants have flat contact areas, which are often supplemented with keel-type elevations.
The invention is intended to remedy this situation. The invention is based on the task of creating an intervertebral implant that comprises a joint, the axles of which are provided with bearings with minimum friction.
The invention solves the task with an intervertebral implant that has the features of Claim 1 and with a process for replacing a defect, natural intervertebral disk by an intervertebral implant, comprising the steps of Claim 20.
The advantages achieved by the invention can generally be seen in that with the intervertebral implant according to the invention - the swivel movements in anterior-posterior and lateral direction are independent of each other;
- no translation movements of the vertebral bodies adjoining the implant are permitted, which relieves strain on the face joints;
- the friction surface is reduced to a minimum by roll bodies rolling on surfaces; and - the rolling movements of the roll bodies instead of the sliding movements of the articulation areas reduce the friction forces in the joint and as a result relative movement among the vertebral bodies, specifically lateral bending and flexion extension movement of the spinal column is not impaired.
In a preferred embodiment of the intervertebral implant according to the invention, the roll bodies are balls. Instead of balls, other rotation bodies can also be inserted, specifically the roll bodies used in conventional roller bearings, for example rolls, cones or tubs.
The number of roll bodies can measure between 3 to 12, preferably 4, for each joint.
According to the size of the intervertebral implant, the diameter of the roll bodies, specifically the ball diameter will measure between 0.3 mm and 6 mm.
Due to the different positions of the natural swivel axles in the different intervertebral disk spaces along the spinal column the arrangement of the swivel axles can be warped or intersecting.
In another embodiment, the joint elements are designed in such a way that the central joint element coaxial to the swivel axle comprises at least one axle belonging to the lower joint and the lower joint element comprises at least one bearing shell receiving the axle, and the upper joint element coaxial to the swivel axle comprises at least one axle belonging to the upper joint, and the central joint element comprises at least one bearing shell receiving the axle. The configuration of the central joint elements with at least one axle on one of its surfaces and at least one bearing shell on the other of its surfaces allows the lowest possible design height of the intervertebral implant.
In a further embodiment of the intervertebral implant according to the invention, a means can be attached to the two sections from the ventral side areas which fixes the two sections ventral at a specific distance relative to each other. This measure provides the advantage that the two sections for insertion into the intervertebral space can be brought to a position with fixed height and can be moved around the joints after insertion into the intervertebral space and can be placed on the base or cover plate of the adjoining vertebral body.
In a further embodiment of the intervertebral implant according to the invention, the means allows temporary blocking of the mobility of the two sections around the joint.
This measure provides the advantage that the joints integrated in the intervertebral space can be blocked by a minimum invasive operation. This is particularly advantageous in cases where the patient suffers from post-operative pain, i.e.
where degeneration of the affected spinal column segment continues and the surgeon is considering a fusion of the affected vertebra. The means can preferably be attached to the two ventral side areas of the two sections. With this subsequent, secondary blocking of the mobility of the two sections around the joint, the intervertebral implant is stiffened and transferred to an arthrodesis implant (fusion cage).
In a further embodiment of the intervertebral implant according to the invention, the means comprises an insert, which can be placed into each depression on the surfaces of the upper and lower section opposite each other. These depressions are preferably provided as dovetail guides that are open on the ventral side areas, so that the ends of the insert arranged complementary to the dovetail guides can be inserted from ventral into the dovetail guides. This provides the advantage that the mobility of the two sections around the joints is blocked due to the positioning of the insert.
The rigidity of the blocking can be increased when the dovetail guides are designed so that they are reduced is size towards the central axis of the intervertebral implant, which creates additional wedging of the insert in the dovetail guides.
In a further embodiment of the intervertebral implant according to the invention, the two sections are provided with drill holes for receiving the bone fixation means, specifically bone screws, wherein the drill holes are provided with longitudinal axes that stand perpendicular to the central axis. Preferably two drill holes will pass through one of the two sections from the ventral side area to the apposition surface. The longitudinal axes, if only an axial fixing of the intervertebral implant is provided, will then be able to stand only perpendicular to the central axis from a lateral perspective, or, if fixing of the intervertebral implant with stable angle is provided, will also from a lateral perspective diverge from the inner surfaces of the two sections against the apposition surfaces.
In a further embodiment of the intervertebral implant according to the invention, the drill holes for receiving the bone fixation means are provided with internal threads, which allows additional, rigid fixing of the bone fixation means in the two sections. The drill holes preferably have a conical shape so that a stronger fixing of the bone fixation means to each of the two sections can be achieved by the resulting conical thread connections between the internal threads and the external threads on the heads of the bone fixation means.
The apposition surfaces are preferably of convex shape and provided with a three-dimensional structure, preferably in the form of pyramid elevations. This arrangement of the apposition surfaces takes account of the anatomy of the vertebral body end plates.
The process according to the invention is intended primarily for replacing a defect, natural intervertebral disk by an intervertebral implant and comprises the following steps:
A) blocking of the joints) of an intervertebral implant by means of a special device placed in a certain position of the joint(s);
B) insertion of the intervertebral implant into the intervertebral space to be treated;

C) release and removal of the device inserted into the intervertebral implant for blocking the joint(s). Blocking the joint provides the advantage that the moveable sections with the external apposition surfaces can be inserted more easily into the intervertebral space to be treated.
In a further application of the process according to the invention, this comprises the subsequent blocking of the joints) on the implanted intervertebral implant by means of the device intended for blocking the joint(s). This provides the advantage that if the patient should suffer from post-operative pains or in case of a further degeneration of the movement segment, the joints) on the intervertebral implant are blocked post-operative by the insertion of the means intended for this purpose. This subsequent blocking can be achieved with an minimally invasive, preferably a laprascopic operation.
The intervertebral implant then assumes the function of a cage, so that the affected movement segment of the spinal column can be stiffened.
The invention and refinements of the invention are described in more detail below on the basis of a partially schematic illustration of several embodiments.
Fig. 1 shows an explosion diagram of one embodiment of the intervertebral implant according to the invention;
Fig. 2 shows a perspective view of the embodiment of the intervertebral implant according to the invention shown in Fig. 1 in assembled state;
Fig. 3 shows a lateral view of a further embodiment of the intervertebral implant according to the invention; and Fig. 4 shows a perspective view of the embodiment according to Fig. 3.
Fig. 1 and Fig. 2 show an embodiment of the intervertebral implant 1 according to the invention, which comprises an upper section 10 with a top apposition surface arranged perpendicular to the central axis 2 for laying on the base plate of an adjoining vertebral body, a lower section 20 with a tower apposition surface 25 arranged perpendicular to the central axis 2 for laying on the cover plate of the adjoining vertebral body and two joints 38;39. The upper section 10 and the lower section 20 are connected with the joints 38;39 and moveable in relation to each other, whereby the mobility of the upper section 10 relative to the lower section 20 is restricted by a first swivel axle 3 arranged perpendicular to the central axis 2 within an angle range of +10°
to -6° and by a second swivel axle 4 arranged perpendicular to the central axis 2 and vertical to the first swivel axle 3 within an angle range of ~ 7°.
The two joints 38;39 are realised by three joint elements 31;32;33, of which the lower joint element 33 and the upper joint element 31 each form a joint 38;39 interacting with the central joint element 32. The joints 38;39 are each provided with a swivel axle 3;4, wherein the swivel axles stand vertical to each other and vertical to the central axis 2.
The lower joint 39 comprises a two-part axle 36 arranged on the central joint element 32 and coaxial to the first swivel axle 3, and two bearing shells 37 arranged on the lower joint element 33 to receive the axle 36. The upper joint 38 is made up of an axle 34 arranged on the upper joint element 31 an coaxial to the second swivel axle 4 and a bearing shell 35 arranged on the central joint element 32 and receiving the axle 34. The bearing shells 35;37 and the axles 34;36 are provided with grooves 71 that are arranged as circular arc in a cross section to the swivel axle 3;4 seen from an orthogonal perspective to the relevant swivel axle 3;4 and which serve to receive balls as roll bodies 70.
In addition, coaxial cams 90 are also attached to the axles 34;36 terminal to the swivel axles 3;4, which are fitted with sliding action in oblong hole guides 91 in the lower joint element and in the central joint element 32. Because of the cams 90 moving in the oblong hole guides 91, the swivel angles of the joint elements 31;32;33 around the swivel axles 3;4 are limited. In addition, the intenrertebral implant 1 is held together by the cams 90 positioned in the oblong hole guides 91.
The mobility of the two sections 10;20 relative to each other can be blocked by the means 40 in a way that allows release. The means 40 comprises in the embodiment described here an insert 41 that can be slid in from the ventral side areas 11;21 of the two sections 10;20 perpendicular to the central axis 2 and parallel to the lateral side areas 13;14;23;24 of the two sections 10;20. The insert 41 is slid in two depressions 42;43, provided in the form of dovetail guides. The insert 41 is inserted from the ventral side areas 11;21 of the two sections 10;20 into the depressions 42;43 composed as dovetail guides and fitted to the lower section 20 by means of a screw 44. The insert 41 is furthermore arranged in the terminal state complementary to the depressions 42;43, so that the two sections 10;20 with fitted insert 41 are fixed relative to each other parallel to the central axis 2.
Fig. 3 illustrates an embodiment of the intervertebral implant 1 according to the invention, which differs from the embodiment illustrated in Fig. 1 and Fig. 2 only in that the two sections 10;20 also comprise drill holes 80 for receiving the bone fixation means 81, whereby the bone fixation means 80 is provided in this case as bone screws. The drill holes 80 are provided with longitudinal axes 83 that form an angle y with the central axis 2. In addition, each two drill holes 80 (Fig. 4) run trough one of the two sections 10;20 from the ventral side area 11;21 to the apposition surface 15;25. The longitudinal axes 83 of the drill holes 80 are standing perpendicular to the central axis 2 from only a lateral perspective. The drill holes 80 are furthermore provided in conical design and tapering towards the apposition surfaces 15;25 and provided with internal threads 82 that are used for screwing reception of the screw heads 84 of the bone fixation device 81 realised here in the form of bone screws and provided with complementary external threads.
The embodiment of the intervertebral implant 1 according to the invention illustrated in Fig. 4 differs from the embodiment illustrated in Fig. 3 only in that the longitudinal axes 83 of the drill holes 80 also diverge from the ventral perspective from the inner surfaces 16;26 of the two sections 10;20 against the apposition surfaces 15;25.

Claims (21)

Claims
1. Intervertebral implant (1), specifically an artificial intervertebral disk, with a central axis (2), an upper section (10), suitable for laying onto the base plate of a vertebral body lying above and a lower section (20) suitable for laying onto the cover plate of a vertebral body lying below, wherein A) the upper section (10) is provided with a ventral side area (11), a dorsal side area (12), two lateral side areas (13,14), a top apposition surface (15) and a bottom surface (16);
B) the lower section (20) is provided with a ventral side area (21), a dorsal side area (22), two lateral side areas (23,24); a bottom apposition surface (25) and a top surface (26);
C) the two sections (10,20) moveable in relation to each other by means of two joints (38;39) arranged between the two sections (10;20), wherein D) each of the joints (38;39) is provided with a swivel axle (3;4) and the two swivel axles (3;4) are arranged perpendicular to each other;
E) the two joints (38;39) are realised by means of an upper joint element (31) connected with the upper section (10), a central joint element (32) and a lower joint element (33) connected with the lower section (20);
F) each joint (38;39) comprises a first joint element (31;32;33) with at least one axle (34;36) coaxial to the swivel axle (3;4) and a second joint element (31;32;33) with at least one bearing shell (35;37) receiving the axle (34;36), characterised in that G) roll bodies (70) are inserted between the axles (34;36) and the bearing shells (35;37).
2. Intervertebral implant (1) according to Claim 1, characterised in that the central joint element (32) coaxial to the swivel axle (3) comprises at least one axle (36) belonging to the lower joint (39) and the lower joint element (33) comprises at least one bearing shell (37) receiving the axle (36).
3. Intervertebral implant (1) according to Claim 1 or Claim 2, characterised in that the upper joint element (31) coaxial to the swivel axle (4) comprises at least one axle (34) belonging to the upper joint (38) and the central joint element (32) comprises at least one bearing shell (35) receiving the axle (34).
4. Intervertebral implant (1) according to one of the claims 1 to 3, characterised in that the roll bodies (70) are rotation-symmetric bodies, preferably balls.
5. Intervertebral implant (1) according to one of the claims 1 to 4, characterised in that the bearing shells (35;37) are provided with grooves (71), in which the roll bodies (70) are conduced in axial direction.
6. Intervertebral implant (1) according to one of the claims 1 to 5, characterised in that the axles (34;36) are provided with grooves (71), in which the roll bodies (70) are conduced in axial direction.
7. Intervertebral implant (1) according to Claim 5 or Claim 6, characterised in that the grooves (71) in the cross-section area orthogonal to the swivel axle (3;4) are arranged in a circular arc with a sector angle between 0° and 180°.
8. Intervertebral implant (1) according to one of the claims 1 to 7, characterised in that a means (40) is provided that keeps the two sections (10;20), measured at their ventral side areas (11;21), at a fixed distance from each other.
9. Intervertebral implant (1) according to one of the claims 1 to 7, characterised in that a means (40) is provided that is suitable for causing temporary blocking of the mobility of the two sections (10,20) around the joints (38;39).
10. Intervertebral implant (1) according to Claim 8 or Claim 9, characterised in that the means (40) can be attached to the two ventral side areas (11,21) of the two sections (10;20).
11. Intervertebral implant (1) according to Claim 9 or Claim 10, characterised in that the means (40) comprises an insert (41) with a lower end (45) and an upper end (46) and a depression (42;43) in the surfaces (16;26) at each of the two sections (10;20), which are open on the ventral side areas (11;21), and that the insert (41) with its ends (45;46) can be inserted into each of the depressions (42;43).
12. Intervertebral implant (1) according to Claim 11, characterised in that the depressions (42;43) are dovetail guides and the ends (45;46) on the insert (41) are arranged complementary to these dovetail guides.
13. Intervertebral implant (1) according to Claim 12, characterised in that the dovetail guides are tapered from the ventral side areas (11;21) towards the dorsal side areas (12;22).
14. Intervertebral implant (1) according to one of the claims 1 to 13, characterised in that the upper and the lower sections (10;20) each comprises at least two drill holes (80) running through from the ventral side areas (11;21) to the apposition surfaces (15;25) with longitudinal axes (83) for receiving bone fixation devices (81).
15. Intervertebral implant (1) according to Claim 14, characterised in that the longitudinal axes (83) of the drill holes (80) make an angle .gamma. with the central axis (2).
16. Intervertebral implant (1) according to Claim 15, characterised in that the angle y lies in a range of between 20° and 65°.
17. Intervertebral implant (1) according to one of the claims 14 to 16, characterised in that the longitudinal axes (83) of the drill holes (80) as seen from the ventral side areas (11;21) diverge from the inner surfaces (16;26) against the apposition surfaces (15;25).
18. Intervertebral implant (1) according to one of the claims 14 to 17, characterised in that the drill holes (80) are conically tapered towards the apposition surfaces (15;25).
19. Intervertebral implant (1) according to one of the claims 14 to 18, characterised in that the drill holes (80) are provided with an internal thread (82).
20. Process for the replacement of a defect, natural intervertebral disk characterised by an intervertebral implant, with the steps:

A) blocking of the joint(s) (38;39) of an intervertebral implant (1) through the special means (40) in a certain position of the joint(s) (38;39);
B) insertion of the intervertebral implant (1) into the intervertebral space to be treated;
C) release and removal of the device (40) inserted into the intervertebral implant (1) for blocking the joint(s) (38;39).
21. Process according to Claim 20, characterised in that it additionally comprises the subsequent blocking of the joint(s) (38;39) on the implanted intervertebral implant (1) through the means (40).
CA002510242A 2002-12-17 2002-12-17 Intervertebral implant with joint parts mounted on roller bodies Abandoned CA2510242A1 (en)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/CH2002/000704 WO2004054475A1 (en) 2002-12-17 2002-12-17 Intervertebral implant with joint parts mounted on roller bodies

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CA2510242A1 true CA2510242A1 (en) 2004-07-01

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EP (1) EP1572036B1 (en)
JP (1) JP4210651B2 (en)
KR (1) KR101026936B1 (en)
CN (1) CN100400016C (en)
AR (1) AR042503A1 (en)
AT (1) ATE394084T1 (en)
AU (1) AU2002347116B2 (en)
BR (1) BR0215965B1 (en)
CA (1) CA2510242A1 (en)
DE (1) DE50212247D1 (en)
ES (1) ES2306797T3 (en)
HU (1) HUP0500850A2 (en)
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