WO1995025486A1 - Height-adjustable body of a vertebra - Google Patents
Height-adjustable body of a vertebra Download PDFInfo
- Publication number
- WO1995025486A1 WO1995025486A1 PCT/EP1995/000744 EP9500744W WO9525486A1 WO 1995025486 A1 WO1995025486 A1 WO 1995025486A1 EP 9500744 W EP9500744 W EP 9500744W WO 9525486 A1 WO9525486 A1 WO 9525486A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- height
- vertebral body
- section
- body replacement
- replacement according
- Prior art date
Links
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2/00—Filters 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
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2/00—Filters 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
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2/4611—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters 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
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
- A61F2002/3006—Properties of materials and coating materials
- A61F2002/30062—(bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
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- A61F2/00—Filters 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
- A61F2/02—Prostheses implantable into the body
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- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30108—Shapes
- A61F2002/30199—Three-dimensional shapes
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- A61F2002/30235—Three-dimensional shapes cylindrical tubular, e.g. sleeves
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters 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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- A61F2002/30362—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit with possibility of relative movement between the protrusion and the recess
- A61F2002/30364—Rotation about the common longitudinal axis
- A61F2002/30367—Rotation about the common longitudinal axis with additional means for preventing said rotation
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- A—HUMAN NECESSITIES
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- A61F2002/30362—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit with possibility of relative movement between the protrusion and the recess
- A61F2002/3037—Translation along the common longitudinal axis, e.g. piston
- A61F2002/30372—Translation along the common longitudinal axis, e.g. piston with additional means for limiting said translation
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- A61F2/00—Filters 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
- A61F2/02—Prostheses implantable into the body
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- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30383—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
- A61F2002/3039—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove with possibility of relative movement of the rib within the groove
- A61F2002/30398—Sliding
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61F2/00—Filters 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
- A61F2/02—Prostheses implantable into the body
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- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30405—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by screwing complementary threads machined on the parts themselves
- A61F2002/30411—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by screwing complementary threads machined on the parts themselves having two threaded end parts connected by a threaded central part with opposite threads at its opposite ends, i.e. for adjusting the distance between both end parts by rotating the central part
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2/00—Filters 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
- A61F2/02—Prostheses implantable into the body
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- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters 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
- A61F2/02—Prostheses implantable into the body
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- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30561—Special structural features of bone or joint prostheses not otherwise provided for breakable or frangible
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters 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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- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters 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
- A61F2/02—Prostheses implantable into the body
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- A61F2/00—Filters 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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- A61F2/30—Joints
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- A61F2/30907—Nets or sleeves applied to surface of prostheses or in cement
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- A61F2/00—Filters 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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Definitions
- the invention relates to a height-adjustable vertebral body replacement.
- a height-adjustable vertebral body replacement is known from DE-GM 91 07 494.
- This has a threaded rod which has a right-hand thread at one end and a left-hand thread at its other end and a screw-nut-shaped profile in the middle for engaging and rotating the threaded rod.
- the threaded rod is connected at its two ends to stamps cooperating therewith, the free ends of which can be brought into engagement with opposing vertebral body surfaces.
- the punches are first screwed onto the threaded rod so far that the distance between the outer surfaces is smaller than the distance between the vertebrae to be supported.
- the two punches are held by hand at the opposite ends, while at the same time the threaded rod is rotated by engaging in the center until the punches come into engagement with the opposing vertebrae and by this engagement in a rotationally fixed position at the same time keep turning the threaded rod.
- the two opposite star On their surfaces which come into engagement with the vertebrae, pels have spikes which can be brought into engagement with the vertebral bodies.
- the object of the invention is to design a height-adjustable vertebral body replacement in such a way that it is easier to operate, since it is precisely the ease of use that plays an extremely large role in the field of use in vertebral surgery.
- Fig. Lb is a plan view of the device shown in Fig. La;
- FIG. 2a shows a side view of a first thread section and a profile axis
- FIG. 2b shows a view of the element shown in FIG. 2a from below;
- 3a shows a sectional view of the sleeve
- FIG. 3b is a top view of the sleeve;
- FIG. 4b is a plan view of the first Ge ⁇ threaded portion from below;
- FIG. 5a shows a corresponding sectional illustration of a second threaded section
- Fig. 5b threaded portion a top view of the second Ge ⁇ ;
- 6a is a side view of part of a profile section
- Fig. 6b is a top view of the element shown in Fig. 6a;
- Fig. 7b is a side view of the element shown in Figure 6a together ⁇ men massageden with the element.
- Fig. 8 is a side view in section.
- the height-adjustable vertebral body replacement has a zylinderför--shaped sleeve 1, as seen in the axial direction from a first ⁇ section 2 and a second portion. 3 Between these two sections, the cylinder jacket has recesses 4, 5. On the inside of the cylinder jacket is cut 2 and 3 hen on the opposite sides of each ⁇ wells a projecting into the interior of the cylinder stop 6 vorgese ⁇ between the two From ⁇ . Furthermore, the cylinder has guide grooves 7, 8 which extend parallel to the cylinder axis on two opposite sides.
- the vertebral body replacement has a first abutment body 9 and a second abutment body 10.
- Both abutment bodies are cylindrical and have an outer diameter which is so much smaller than the inner diameter of the cylindrical sleeve 1 that the abutment bodies can slide straight in the cylinder.
- the abutment bodies both have projections 11, 12 which project outwards at the locations corresponding to the grooves 7 and 8 and are dimensioned such that they can slide in the grooves 7, 8.
- the first abutment body 9 has a left-hand thread on the inside, while the second abutment body has a right-hand thread with a corresponding pitch on its inside.
- the abutment bodies 9, 10 have on the outer edge surfaces 13, 14, which cooperate with the vertebral bodies to be supported, and outwardly projecting tines 28, 29 which come into engagement with the associated vertebral bodies.
- the area of the protruding prongs forms a jacket whose wall thickness is thinner than that of the abutment body 9, 10 and which preferably has a wall thickness of approximately 1 mm.
- the jacket-shaped wall has recesses 30, 31 between the teeth and the edge surfaces 13, 14.
- the tines themselves have protruding sections 32, 33 for cutting off. This makes it possible for the surgeon to cut on site, for example by cutting off the sections 32, 33 indicated in FIG. 8, wedge-shaped end faces of the prongs so that the end faces formed by the prongs run at an angle to one another.
- the recesses 30, 31 are preferably designed as triangles extending in the axial direction or as diamonds.
- a threaded device 15 is provided in the interior of the two abutment bodies. This includes at one end a first Ge ⁇ threaded portion 16. This is cylindrical and has an external thread, which is formed into the internal thread of the first Wi ⁇ derlager stresses 9 appropriately.
- the threaded section is formed in one piece with a coaxially extending profile axis 17. The profile has the shape shown in FIG. 2b.
- the length of the thread device corresponds to the length of the sleeve 1. Die
- the length of the first threaded section 16 corresponds to the length of the first abutment body 9.
- the thread device 15 further comprises the second threaded section 18 shown in FIG. 7a.
- This is designed as a cylindrical section and has a thread on its outer cylindrical surface which corresponds to the internal thread of the two ⁇ th abutment body 2 corresponds.
- the length of the second threaded section corresponds to the length of the second abutment body 10.
- the second threaded section has a concentric recess 19, the cross section of which corresponds to the cross section of the profile axis 17.
- the vertebral body replacement has a profile section 19.
- the profile section 19 comprises a plate-shaped section 20. This has a first section 21, the outer diameter of which is smaller than the remaining clear diameter between the stop parts 6 projecting into the cylinder interior. Adjoining this is a second section 22 which is circular and the diameter of which is greater than the distance between the two stop parts 6 and smaller than the inner diameter of the cylindrical sleeve 1.
- the plate-shaped section 22 has a coaxial recess 23, the cross section of which corresponds to the outer cross section of the profile axis 17.
- the first section 21 has recesses 24 which extend in the radial direction and are angularly offset relative to one another and which serve for engagement by means of a rod-shaped tool 25.
- the profile section 19 comprises a cylindrical plate 26 corresponding to the second section, the outer diameter of which corresponds to the outer diameter of the second section and which in the same way has a coaxial recess 27, the cross section of which corresponds to the cross section of the prof axis 17.
- the parts are composed as follows:
- the plate-shaped section 20 is pushed onto the profile axis in such a way that the second section rests on the lower surface of the first threaded section. Furthermore, the first threaded section The first abutment body 9 is completely screwed on. The part thus pre-assembled is inserted from above into the first section of the sleeve 1 until the second section rests on the stops 6 with its protruding edge. From the other side of the sleeve, the plate 26 is pushed up to the stop on the underside of the second section or the stop parts 6 through the second section.
- the second abutment body 10 is completely screwed onto the second threaded section 18, and these two parts are then fully inserted into the second section 3 of the sleeve 1 when the lugs 11, 12 engage the grooves 7, 8 and the profile section 19 with the profile axis 17 -
- the dimensioning of the profile section 19 is chosen so that there is a sufficient frictional connection between part 18 and profile axis 17.
- the vertebral body replacement assembled in this way has its smallest extension in the axial direction.
- the operator grasps the device by gripping the sleeve with one hand and engages with a rod-shaped tool 25 in the recesses 24 and rotates the thread device 15 over the first section 21 and as a result shifts the two abutment bodies 9, 10 so far outwards, until the distance between the oppositely directed edge surfaces 13, 14 or the prongs 28, 29 protruding therefrom is so large that the vertebral bodies are adequately supported.
- the edges with the prongs 28, 29 projecting outward from the abutment bodies 9, 10 have diamond-shaped recesses 30, 31, which are diamond-shaped or triangular in the form of diamond sections.
- the tines protruding from these recesses each have an essentially identical length.
- the prongs protruding from the recesses 30, 31 are so long that the sections 32, 33 indicated by the dash-dotted lines in FIG. 8 can be separated, so that, if desired, a vertebral body replacement in cross-section is possible create. Titanium material or a body-absorbable plastic material is chosen in particular as the material for the vertebral body replacement.
- the space surrounded by the thinner sheath carrying the teeth 28, 29 is filled with the body's own or foreign bone material.
- the protruding prongs 28, 29 engage in the adjacent vertebral body cover plate. There is then an overgrowth between the adjacent vertebral bodies or vertebral body cover plates and the implant, so that anchoring takes place which makes it possible to use the height-adjustable vertebral body replacement according to the invention as a long-term implant.
Abstract
The invention concerns a height-adjustable replacement body of a vertebra having a sleeve (1) and, viewed in the axial direction, a first abutment member (9) and a second abutment member (10) provided respectively on each side of the sleeve, and are secured against rotation in the sleeve and displaceable in the axial direction. A threaded arrangement (15) is provided which engages with the abutment members (9, 10) in order to move them coaxially.
Description
Höhenverstellbarer Wirbelkörper Adjustable vertebral body
Die Erfindung betrifft einen höhenverstellbaren Wirbelkörper¬ ersatz.The invention relates to a height-adjustable vertebral body replacement.
Aus der DE-GM 91 07 494 ist ein höhenverstellbarer Wirbelkörper¬ ersatz bekannt. Dieser weist eine Gewindestange auf, die an ihrem einen Ende ein Rechtsgewinde und an ihrem anderen Ende ein Links¬ gewinde und in der Mitte eine schraubenmutterförmige Profilierung zum Eingreifen und Drehen der Gewindestange aufweist. Die Gewin¬ destange ist an ihren beiden Enden jeweils mit damit zusammenwir¬ kenden Stempeln verbunden, deren freie Enden mit einander gegen¬ überliegenden Wirbelkörperflächen in Eingriff bringbar sind. Zum Einsetzen werden die Stempel zunächst so weit auf die Gewin¬ destange aufgeschraubt, daß der Abstand der Außenflächen kleiner ist als der Abstand der abzustützenden Wirbel. Dann werden die beiden Stempel an den gegenüberliegenden Enden von Hand gehalten, während gleichzeitig durch Eingreifen in der Mitte die Gewin¬ destange so weit gedreht wird, bis die Stempel mit den gegenüber¬ liegenden Wirbeln in Eingriff gelangen und durch diesen Eingriff in einer drehfesten Stellung bei gleichzeitigem Weiterdrehen der Gewindestange gehalten werden. Die beiden gegenüberliegenden Stem-
pel weisen auf ihren mit den Wirbeln in Eingriff gelangenden Flä¬ chen mit den Wirbelkörpern in Eingriff bringbare Dorne auf.A height-adjustable vertebral body replacement is known from DE-GM 91 07 494. This has a threaded rod which has a right-hand thread at one end and a left-hand thread at its other end and a screw-nut-shaped profile in the middle for engaging and rotating the threaded rod. The threaded rod is connected at its two ends to stamps cooperating therewith, the free ends of which can be brought into engagement with opposing vertebral body surfaces. For insertion, the punches are first screwed onto the threaded rod so far that the distance between the outer surfaces is smaller than the distance between the vertebrae to be supported. Then the two punches are held by hand at the opposite ends, while at the same time the threaded rod is rotated by engaging in the center until the punches come into engagement with the opposing vertebrae and by this engagement in a rotationally fixed position at the same time keep turning the threaded rod. The two opposite star On their surfaces which come into engagement with the vertebrae, pels have spikes which can be brought into engagement with the vertebral bodies.
Aufgabe der Erfindung ist es, einen höhenverstellbaren Wirbelkör¬ perersatz so auszubilden, daß er einfacher bedienbar ist, denn ge¬ rade die einfache Bedienbarkeit spielt bei dem Einsatzgebiet in der Wirbelchirurgie eine außerordentlich große Rolle.The object of the invention is to design a height-adjustable vertebral body replacement in such a way that it is easier to operate, since it is precisely the ease of use that plays an extremely large role in the field of use in vertebral surgery.
Diese Aufgabe wird durch den in Anspruch 1 gekennzeichneten höhen¬ verstellbaren Wirbelkörperersatz gelöst. Es wird dadurch erreicht, daß der Operateur mit einer Hand einfach die Hülse erfaßt und mit der anderen Hand die Dreheinstellung vornimmt. Bei Ineingriffge¬ langen der Widerlagerkörper mit den Wirbelkörpern wirkt kein Dreh¬ moment zwischen den Widerlagerkörpern und den Wirbelkörpern, so daß auch Verletzungen der Wirbelkörperdeckplatte vermieden werden.This object is achieved by the height-adjustable vertebral body replacement characterized in claim 1. It is achieved in that the operator simply grips the sleeve with one hand and makes the rotary adjustment with the other hand. When the abutment bodies engage the vertebral bodies, no torque acts between the abutment bodies and the vertebral bodies, so that injuries to the vertebral body cover plate are also avoided.
Weiterbildungen der Erfindung sind in den Unteransprüchen gekenn¬ zeichnet.Further developments of the invention are characterized in the subclaims.
Weitere Merkmale und Zweckmäßigkeiten der Erfindung ergeben sich aus der Beschreibung eines Ausführungsbeispieles anhand der Figu¬ ren. Von den Figuren zeigen:Further features and advantages of the invention result from the description of an exemplary embodiment with reference to the figures. The figures show:
Fig. la einen Schnitt durch den Wirbelkörper¬ ersatz in axialer Richtung;F i g. la a section through the vertebral body replacement in the axial direction;
Fig. lb eine Draufsicht auf die in Fig. la gezeigte Vorrichtung;Fig. Lb is a plan view of the device shown in Fig. La;
Fig. 2a eine Seitenansicht eines ersten Ge¬ windeabschnittes und einer Profil¬ achse;2a shows a side view of a first thread section and a profile axis;
Fig. 2b eine Ansicht des in Fig. 2a gezeig¬ ten Elementes von unten;2b shows a view of the element shown in FIG. 2a from below;
Fig. 3a eine Schnittdarstellung der Hülse;3a shows a sectional view of the sleeve;
Fig. 3b eine Draufsicht auf die Hülse;
Fig . 4a einen mit dem abzustützenden Wir¬ belkörper in Eingriff bringbaren ersten Gewindeabschnitt;3b is a top view of the sleeve; Fig. 4a with a d em be supported We ¬ b k el örper eabschnitt win d engageable first Ge;
Fig. 4b eine Draufsicht auf den ersten Ge¬ windeabschnitt von unten;FIG. 4b is a plan view of the first Ge ¬ threaded portion from below;
Fig. 5a eine entsprechende Schnittdarstellung eines zweiten Gewindeabschnittes;5a shows a corresponding sectional illustration of a second threaded section;
Fig. 5b eine Draufsicht auf den zweiten Ge¬ windeabschnitt;Fig. 5b threaded portion a top view of the second Ge ¬;
Fig. 6a eine Seitenansicht eines Teiles eines Profilabschnittes;6a is a side view of part of a profile section;
Fig. 6b eine Draufsicht auf das in Fig. 6a gezeigte Element;Fig. 6b is a top view of the element shown in Fig. 6a;
Fig. 7a den zweiten Gewindeabschnitt in ge¬ schnittener Darstellung;7a shows the second threaded section in a sectional view ;
Fig. 7b eine Seitenansicht des mit dem in Fig. 6a gezeigten Elementes zusam¬ menwirkenden Elementes; und. Fig. 7b is a side view of the element shown in Figure 6a together ¬ menwirkenden with the element; and
Fig. 8 eine Seitenansicht im Schnitt.Fig. 8 is a side view in section.
Der höhenverstellbare Wirbelkörperersatz weist eine zylinderför- mige Hülse 1 auf, die in axialer Richtung gesehen einen ersten Ab¬ schnitt 2 und einen zweiten Abschnitt 3 aufweist. Zwischen diesen beiden Abschnitten weist der Zylindermantel Ausneh ungen 4, 5 auf. Auf der Innenseite des Zylindermantels ist zwischen den beiden Ab¬ schnitten 2 und 3 auf den einander gegenüberliegenden Seiten je¬ weils ein in das Zylinderinnere hineinragender Anschlag 6 vorgese¬ hen. Ferner weist der Zylinder auf zwei gegenüberliegenden Seiten sich parallel zur Zylinderachse erstreckende Führungsnuten 7, 8 auf.
Der Wirbelkörperersatz weist einen ersten Widerlagerkörper 9 und einen zweiten Widerlagerkörper 10 auf. Beide Widerlagerkorper sind zylinderförmig ausgebildet und weisen einen Außendurchmesser auf, der um soviel kleiner ist als der Innendurchmesser der zylinder- förmigen Hülse 1, daß die Widerlagerkorper gerade in dem Zylinder gleiten können. Auf ihrer Außenseite weisen die Widerlagerkörper beide an den den Nuten 7 und 8 entsprechenden Stellen nach außen hervorstehende Nasen 11, 12 auf, die so bemessen sind, daß sie in den Nuten 7, 8 gleiten können. Auf der Innenseite weist der erste Widerlagerkorper 9 ein Linksgewinde auf, während der zweite Wider¬ lagerkörper auf seiner Innenseite ein Rechtsgewinde mit entspre¬ chender Steigung aufweist. Die Widerlagerkörper 9, 10 weisen auf den jeweils mit den abzustützenden Wirbelkörpern zusammenwirkenden äußeren Randflächen 13, 14 nach außen hervorstehende Zacken 28, 29 auf, die mit den zugehörigen Wirbelkörpern in Eingriff gelangen.The height-adjustable vertebral body replacement has a zylinderför--shaped sleeve 1, as seen in the axial direction from a first ¬ section 2 and a second portion. 3 Between these two sections, the cylinder jacket has recesses 4, 5. On the inside of the cylinder jacket is cut 2 and 3 hen on the opposite sides of each ¬ weils a projecting into the interior of the cylinder stop 6 vorgese ¬ between the two From ¬. Furthermore, the cylinder has guide grooves 7, 8 which extend parallel to the cylinder axis on two opposite sides. The vertebral body replacement has a first abutment body 9 and a second abutment body 10. Both abutment bodies are cylindrical and have an outer diameter which is so much smaller than the inner diameter of the cylindrical sleeve 1 that the abutment bodies can slide straight in the cylinder. On their outside, the abutment bodies both have projections 11, 12 which project outwards at the locations corresponding to the grooves 7 and 8 and are dimensioned such that they can slide in the grooves 7, 8. The first abutment body 9 has a left-hand thread on the inside, while the second abutment body has a right-hand thread with a corresponding pitch on its inside. The abutment bodies 9, 10 have on the outer edge surfaces 13, 14, which cooperate with the vertebral bodies to be supported, and outwardly projecting tines 28, 29 which come into engagement with the associated vertebral bodies.
Wie insbesondere aus den Figuren la und 8 ersichtlich ist, bildet der Bereich der hervorstehenden Zacken einen Mantel, dessen Wand¬ stärke dünner ist als der der Widerlagerkorper 9, 10, und der vor¬ zugsweise eine Wandstärke von etwa 1 mm besitzt. Die mantelförmige Wandung weist zwischen den Zacken und den Randflächen 13, 14 Aus- nehmungen 30, 31 auf. Die Zacken selbst weisen, wie am besten aus Fig. 8 ersichtlich ist, überstehende Abschnitte 32, 33 zum Ab¬ schneiden auf. Dadurch ist es möglich, daß der Operateur vor Ort zum Beispiel durch Abtrennen der in Fig. 8 angedeuteten Abschnitte 32, 33 keilförmig zueinander verlaufende Endflächen der Zacken anschneidet, so daß die durch die Zacken gebildeten Endflächen un¬ ter einem Winkel zueinander verlaufen. Die Ausnehmungen 30, 31 sind vorzugsweise als sich in Axialrichtung erstreckende Dreiecke oder als Rauten ausgebildet.As can be seen in particular from FIGS. 1 a and 8, the area of the protruding prongs forms a jacket whose wall thickness is thinner than that of the abutment body 9, 10 and which preferably has a wall thickness of approximately 1 mm. The jacket-shaped wall has recesses 30, 31 between the teeth and the edge surfaces 13, 14. As can best be seen from FIG. 8, the tines themselves have protruding sections 32, 33 for cutting off. This makes it possible for the surgeon to cut on site, for example by cutting off the sections 32, 33 indicated in FIG. 8, wedge-shaped end faces of the prongs so that the end faces formed by the prongs run at an angle to one another. The recesses 30, 31 are preferably designed as triangles extending in the axial direction or as diamonds.
Im Inneren der beiden Widerlagerkörper ist eine Gewindeeinrichtung 15 vorgesehen. Diese umfaßt an ihrem einen Ende einen ersten Ge¬ windeabschnitt 16. Dieser ist zylinderförmig ausgebildet und weist ein Außengewinde auf, welches zu dem Innengewinde des ersten Wi¬ derlagerkörpers 9 passend ausgebildet ist. Der Gewindeabschnitt ist einstückig mit einer sich koaxial erstreckenden Profilachse 17 ausgebildet. Das Profil hat die aus Fig. 2b ersichtliche Form. Die Länge der Gewindeeinrichtung entspricht der Länge der Hülse 1. Die
Länge des ersten Gewindeabschnittes 16 entspricht der Länge des ersten Widerlagerkörpers 9. Die Gewindeeinrichtung 15 umfaßt fer¬ ner den in Fig. 7a gezeigten zweiten Gewindeabschnitt 18. Dieser ist als Zylinderabschnitt ausgebildet und weist auf seiner äußeren Zylinderfläche ein Gewinde auf, welches dem Innengewinde des zwei¬ ten Widerlagerkörpers 2 entspricht. Die Länge des zweiten Gewinde¬ abschnittes entspricht der Länge des zweiten Widerlagerkörpers 10. Der zweite Gewindeabschnitt weist eine konzentrische Ausnehmung 19 auf, deren Querschnitt dem Querschnitt der Profilachse 17 ent¬ spricht.A threaded device 15 is provided in the interior of the two abutment bodies. This includes at one end a first Ge ¬ threaded portion 16. This is cylindrical and has an external thread, which is formed into the internal thread of the first Wi ¬ derlagerkörpers 9 appropriately. The threaded section is formed in one piece with a coaxially extending profile axis 17. The profile has the shape shown in FIG. 2b. The length of the thread device corresponds to the length of the sleeve 1. Die The length of the first threaded section 16 corresponds to the length of the first abutment body 9. The thread device 15 further comprises the second threaded section 18 shown in FIG. 7a. This is designed as a cylindrical section and has a thread on its outer cylindrical surface which corresponds to the internal thread of the two ¬ th abutment body 2 corresponds. The length of the second threaded section corresponds to the length of the second abutment body 10. The second threaded section has a concentric recess 19, the cross section of which corresponds to the cross section of the profile axis 17.
Schließlich weist der Wirbelkörperersatz einen Profilabschnitt 19 auf. Der Profilabschnitt 19 umfaßt einen plattenförmigen Abschnitt 20. Dieser weist einen ersten Abschnitt 21 auf, dessen äußerer Durchmesser kleiner ist als der verbleibende lichte Durchmesser zwischen den in das Zylinderinnere hineinstehenden Anschlagteilen 6. Daran angrenzend ist ein zweiter Abschnitt 22 vorgesehen, der kreisförmig ausgebildet ist und dessen Durchmesser größer ist als der Abstand der beiden Anεchlagteile 6 und kleiner ist als der In¬ nendurchmesser der zylinderförmigen Hülse 1. Der plattenfδr ige Abschnitt 22 weist eine koaxial ausgebildete Ausnehmung 23 auf, deren Querschnitt dem äußeren Querschnitt der Profilachse 17 ent¬ spricht. Darüber hinaus weist der erste Abschnitt 21 sich in radi¬ aler Richtung erstreckende und gegeneinander winkelmäßig versetzte Ausnehmungen 24 auf, die zum Eingreifen mittels eines stabförmigen Werkzeuges 25 dienen. Ferner umfaßt der Profilabschnitt 19 eine dem zweiten Abschnitt entsprechende zylinderförmige Platte 26, de¬ ren Außendurchmesser dem Außendurchmesser des zweiten Abschnittes entspricht und die in gleicher Weise eine koaxiale Ausnehmung 27 aufweist, deren Querschnitt dem Querschnitt der ProfHachse 17 entspricht.Finally, the vertebral body replacement has a profile section 19. The profile section 19 comprises a plate-shaped section 20. This has a first section 21, the outer diameter of which is smaller than the remaining clear diameter between the stop parts 6 projecting into the cylinder interior. Adjoining this is a second section 22 which is circular and the diameter of which is greater than the distance between the two stop parts 6 and smaller than the inner diameter of the cylindrical sleeve 1. The plate-shaped section 22 has a coaxial recess 23, the cross section of which corresponds to the outer cross section of the profile axis 17. In addition, the first section 21 has recesses 24 which extend in the radial direction and are angularly offset relative to one another and which serve for engagement by means of a rod-shaped tool 25. Furthermore, the profile section 19 comprises a cylindrical plate 26 corresponding to the second section, the outer diameter of which corresponds to the outer diameter of the second section and which in the same way has a coaxial recess 27, the cross section of which corresponds to the cross section of the prof axis 17.
Die Teile sind wie folgt zusammengesetzt:The parts are composed as follows:
Vom freien Ende der Profilachse 17 her wird der plattenförmige Ab¬ schnitt 20 auf die Profilachse so aufgeschoben, daß er mit dem zweiten Abschnitt an der unteren Fläche des ersten Gewindeab¬ schnittes anliegt. Ferner wird auf den ersten Gewindeabschnitt der
erste Widerlagerkorper 9 vollständig aufgeschraubt- Der so vormon¬ tierte Teil wird von oben in den ersten Abschnitt der Hülse 1 so weit eingeschoben, bis der zweite Abschnitt mit seinem hervorste¬ henden Rand auf den Anschlägen 6 aufliegt. Von der anderen Seite der Hülse her wird durch den zweiten Abschnitt die Platte 26 bis zum Anschlag an die Unterseite des zweiten Abschnittes bzw. der Anschlagteile 6 aufgeschoben. Der zweite Widerlagerkorper 10 wird auf den zweiten Gewindeabschnitt 18 vollständig aufgeschraubt, und diese beiden Teile werden dann bei Eingriff der Nasen 11, 12 in die Nuten 7, 8 und des Profilabschnittes 19 mit der Profilachse 17 vollständig in den zweiten Abschnitt 3 der Hülse 1 eingeschoben- Die Bemessung des Profilabschnittes 19 ist so gewählt, daß eine ausreichende Reibverbindung zwischen Teil 18 und Profilachse 17 vorhanden ist.From the free end of the profile axis 17, the plate-shaped section 20 is pushed onto the profile axis in such a way that the second section rests on the lower surface of the first threaded section. Furthermore, the first threaded section The first abutment body 9 is completely screwed on. The part thus pre-assembled is inserted from above into the first section of the sleeve 1 until the second section rests on the stops 6 with its protruding edge. From the other side of the sleeve, the plate 26 is pushed up to the stop on the underside of the second section or the stop parts 6 through the second section. The second abutment body 10 is completely screwed onto the second threaded section 18, and these two parts are then fully inserted into the second section 3 of the sleeve 1 when the lugs 11, 12 engage the grooves 7, 8 and the profile section 19 with the profile axis 17 - The dimensioning of the profile section 19 is chosen so that there is a sufficient frictional connection between part 18 and profile axis 17.
Im Betrieb hat der so zusammengesetzte Wirbelkörperersatz seine kleinste Ausdehnung in axialer Richtung. Der Operateur erfaßt die Vorrichtung durch Ergreifen der Hülse mit einer Hand und greift mit einem stangenförmigen Werkzeug 25 in die Ausnehmungen 24 ein und dreht über den ersten Abschnitt 21 die Gewindeeinrichtung 15 und verschiebt als Folge davon die beiden Widerlagerkorper 9, 10 so weit nach außen, bis der Abstand der entgegengesetzt gerichte¬ ten Randflächen 13, 14 bzw. der von diesen hervorstehenden Zacken 28, 29 so groß ist, daß die Wirbelkörper ausreichend abgestützt werden.In operation, the vertebral body replacement assembled in this way has its smallest extension in the axial direction. The operator grasps the device by gripping the sleeve with one hand and engages with a rod-shaped tool 25 in the recesses 24 and rotates the thread device 15 over the first section 21 and as a result shifts the two abutment bodies 9, 10 so far outwards, until the distance between the oppositely directed edge surfaces 13, 14 or the prongs 28, 29 protruding therefrom is so large that the vertebral bodies are adequately supported.
Die von den Widerlagerkörpern 9, 10 nach außen hervorstehenden Ränder mit den Zacken 28, 29 weisen rautenförmige Ausnehmungen 30, 31 auf, die rautenförmig bzw. dreieckförmig als Rautenabschnitte ausgebildet sind. Die an diesen Ausnehmungen hervorstehenden Zacken weisen jeweils eine im wesentlichen gleiche Länge auf. Wie aus Fig. 8 ersichtlich ist, sind die über die Ausnehmungen 30, 31 hervorstehenden Zacken so lang ausgebildet, daß die in Figur 8 durch die strichpunktierten Linien angedeuteten Abschnitte 32, 33 abtrennbar sind, um so gewünschtenfalls einen im Querschnitt keil¬ förmigen Wirbelkörperersatz zu schaffen. Als Material für den Wir¬ belkörperersatz wird insbesondere Titanmaterial oder ein körperre- sorbierbares Kunststoffmaterial gewählt-
Bei der Operation wird der von dem die Zacken 28, 29 tragenden dünneren Mantel umgebene Raum mit körpereigenem oder fremdem Kno¬ chenmaterial gefüllt. Die hervorstehenden Zacken 28, 29 greifen in die benachbarte Wirbelkörperdeckplatte ein. Es erfolgt anschlie¬ ßend ein Verwachsen zwischen den benachbarten Wirbelkörpern bzw. Wirbelkörperdeckplatten und dem Implantat, so daß eine Verankerung erfolgt, die es ermöglicht, den höhenverstellbaren WirbelkÖrperer- satz nach der Erfindung als Langzeitimplantat zu verwenden.
The edges with the prongs 28, 29 projecting outward from the abutment bodies 9, 10 have diamond-shaped recesses 30, 31, which are diamond-shaped or triangular in the form of diamond sections. The tines protruding from these recesses each have an essentially identical length. As can be seen from FIG. 8, the prongs protruding from the recesses 30, 31 are so long that the sections 32, 33 indicated by the dash-dotted lines in FIG. 8 can be separated, so that, if desired, a vertebral body replacement in cross-section is possible create. Titanium material or a body-absorbable plastic material is chosen in particular as the material for the vertebral body replacement. During the operation, the space surrounded by the thinner sheath carrying the teeth 28, 29 is filled with the body's own or foreign bone material. The protruding prongs 28, 29 engage in the adjacent vertebral body cover plate. There is then an overgrowth between the adjacent vertebral bodies or vertebral body cover plates and the implant, so that anchoring takes place which makes it possible to use the height-adjustable vertebral body replacement according to the invention as a long-term implant.
Claims
1. Höhenverstellbarer Wirbelkörperersatz mit einer Hülse (1), einem in dieser in axialer Richtung gesehen an einer Hülsenseite vorgesehenen und in der Hülse drehfest und in axialer Richtung verschiebbaren ersten Widerlagerkorper (9) , einem in dieser in axialer Richtung gesehen an der entgegengesetz¬ ten Seite vorgesehenen und in der Hülse drehfest und in axialer Richtung verschiebbaren zweiten Widerlagerkorper (10) und einer mit den Widerlagerkörpern (9, 10) in Eingriff befindlichen Gewindeeinrichtung (15) zum Bewegen der Widerlagerkörper (9, 10) in jeweils zueinander entgegengesetzter axialer Richtung bei Ver¬ stellen der Gewindeeinrichtung (15) .1. Height-adjustable vertebral body replacement with a sleeve (1), provided in the axial direction on a sleeve side and rotatably and axially displaceable in the sleeve in the first abutment body (9), seen in this in the axial direction on the opposite side Side provided and in the sleeve rotatably and axially displaceable second abutment body (10) and a threaded device (15) in engagement with the abutment bodies (9, 10) for moving the abutment body (9, 10) in opposite axial directions Adjust the thread device (15).
2. Höhenverstellbarer Wirbelkörperersatz nach Anspruch 1, dadurch gekennzeichnet, daß die Widerlagerkörper (9, 10) jeweils zueinander entgegengesetzt gerichtete Gewinde aufweisen und die Gewindeeinrichtung (15) mit diesen jeweiligen Gewinden zusammen¬ wirkende Gewindeabschnitte (16, 18) aufweisen.2. Height-adjustable vertebral body replacement according to claim 1, characterized in that the abutment body (9, 10) each have oppositely directed threads and the thread device (15) with these respective threads cooperating thread sections (16, 18).
3. Höhenverstellbarer Wirbelkörperersatz nach Anspruch 1 oder 2, dadurch gekennzeichnet, daß die Gewindeeinrichtung 15 zwischen den Gewindeabschnitten (16, 18) einen Profilabschnitt (19) zum Bewegen der Gewindeeinrichtung (15) aufweist.3. Height-adjustable vertebral body replacement according to claim 1 or 2, characterized in that the threaded device 15 between the threaded sections (16, 18) has a profile section (19) for moving the threaded device (15).
. Höhenverstellbarer Wirbelkörperersatz nach einem der Ansprü¬ che 1 bis 3, dadurch gekennzeichnet, daß die Hülse (1) im Bereich zwischen den Widerlagerkörpern (9, 10) einen deren Axialbewegung aufeinander zu begrenzenden Anschlag (6) aufweist.. Height-adjustable vertebral body replacement according to one of claims 1 to 3, characterized in that the sleeve (1) in the area between the abutment bodies (9, 10) has a stop (6) which limits their axial movement to one another.
5. Höhenverstellbarer Wirbelkörperersatz nach Anspruch 4, dadurch gekennzeichnet, daß der Profilabschnitt (19) einen ersten auf einer Seite des Anschlages (6) anliegenden ersten Rand (22) und einen auf der entgegengesetzten Seite anliegenden zweiten Rand (26) aufweist. 5. Height-adjustable vertebral body replacement according to claim 4, characterized in that the profile section (19) has a first on one side of the stop (6) adjacent first edge (22) and a second edge (26) adjacent on the opposite side.
6. Höhenverstellbarer Wirbelkörperersatz nach Anspruch 4 oder 5, dadurch gekennzeichnet, daß die Gewindeeinrichtung (15) in einer Stellung mit ihrem ersten Gewindeabschnitt (16) an dem Anschlag (6) bzw. dem Profilabschnitt (19) anliegt und eine durch den Pro¬ filabschnitt (19) hindurchgeführten und mit ihm drehtest verbun¬ dene Profilachse (17) aufweist und der zweite Gewindeabschnitt (18) auf dem Profilabschnitt (19) von der gegenüberliegenden Seite des Profilabschnittes (19) her auf die Profilachse (17) aufgescho¬ ben ist und in der ersten Stellung auf der gegenüberliegenden Seite am Anschlag (6) bzw. dem Profilabschnitt (19) anliegt.6. Height-adjustable vertebral body replacement according to claim 4 or 5, characterized in that the threaded device (15) bears in one position with its first threaded section (16) on the stop (6) or the profile section (19) and one through the profile section (19) passed through and rotated with it connected profile axis (17) and the second threaded portion (18) on the profile portion (19) from the opposite side of the profile portion (19) is pushed onto the profile axis (17) and in the first position on the opposite side against the stop (6) or the profile section (19).
7. Höhenverstellbarer Wirbelkörperersatz nach einem der Ansprü¬ che 1 bis 5, dadurch gekennzeichnet, daß der jeweilige äußere Rand der Widerlagerkörper (9, 10) jeweils eine Mehrzahl von nach außen hervorstehenden Zacken (28, 29) aufweist.7. Height-adjustable vertebral body replacement according to one of Ansprü¬ che 1 to 5, characterized in that the respective outer edge of the abutment body (9, 10) each has a plurality of outwardly projecting teeth (28, 29).
8. Höhenverstellbarer Wirbelkörperersatz nach einem der Ansprü¬ che 1 bis 7, dadurch gekennzeichnet, daß die mantelförmige Wandung wenigstens in den einander gegenüberliegenden Endbereichen Ausneh¬ mungen (30, 31) aufweisen.8. Height-adjustable vertebral body replacement according to one of claims 1 to 7, characterized in that the jacket-shaped wall has recesses (30, 31) at least in the opposite end regions.
9. Höhenverstellbarer Wirbelkörperersatz nach Anspruch 7 oder 8, dadurch gekennzeichnet, daß die Zacken (28, 29) abtrennbare Ab¬ schnitte (32, 33) aufweisen.9. Height-adjustable vertebral body replacement according to claim 7 or 8, characterized in that the teeth (28, 29) have separable sections (32, 33).
10. Höhenverstellbarer Wirbelkörperersatz nach Anspruch 9, da¬ durch gekennzeichnet, daß die beiden einander gegenüberliegenden Ränder so gegeneinander geneigt sind, daß der Wirbelkörperersatz einen keilförmigen Querschnitt aufweist.10. Height-adjustable vertebral body replacement according to claim 9, characterized in that the two opposite edges are inclined so that the vertebral body replacement has a wedge-shaped cross section.
11. Höhenverstellbarer Wirbelkörperersatz nach Anspruch 9, da¬ durch gekennzeichnet, daß die Ausnehmungen (30, 31) als sich im wesentlichen in Axialrichtung erstreckende Vierecke bzw. Rauten ausgebildet sind. 11. Height-adjustable vertebral body replacement according to claim 9, characterized by the fact that the recesses (30, 31) are designed as quadrangles or diamonds extending essentially in the axial direction.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE19944409392 DE4409392A1 (en) | 1994-03-18 | 1994-03-18 | Adjustable vertebral body |
DEP4409392.6 | 1994-03-18 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO1995025486A1 true WO1995025486A1 (en) | 1995-09-28 |
Family
ID=6513227
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/EP1995/000744 WO1995025486A1 (en) | 1994-03-18 | 1995-03-01 | Height-adjustable body of a vertebra |
Country Status (3)
Country | Link |
---|---|
DE (1) | DE4409392A1 (en) |
TW (1) | TW294971U (en) |
WO (1) | WO1995025486A1 (en) |
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US6783547B2 (en) * | 2002-04-05 | 2004-08-31 | Howmedica Corp. | Apparatus for fusing adjacent bone structures |
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US8292963B2 (en) | 2009-04-23 | 2012-10-23 | Warsaw Orthopedic, Inc. | Expandable implant for supporting skeletal structures |
US8690950B2 (en) | 2007-10-30 | 2014-04-08 | Aesculap Implant Systems, Llc | Vertebral body replacement device and method for use to maintain a space between two vertebral bodies within a spine |
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DE19519101B4 (en) * | 1995-05-24 | 2009-04-23 | Harms, Jürgen, Prof. Dr. | Height adjustable vertebral body replacement |
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DK1267755T3 (en) | 2000-03-31 | 2006-09-25 | Koenigsee Implantate & Instr | Height-adjustable vertebral implant and operating set for this |
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Also Published As
Publication number | Publication date |
---|---|
DE4409392A1 (en) | 1995-09-21 |
TW294971U (en) | 1997-01-01 |
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