WO2005055843A1 - Clipping-type surgical instrument for spinal implant - Google Patents

Clipping-type surgical instrument for spinal implant Download PDF

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Publication number
WO2005055843A1
WO2005055843A1 PCT/FR2004/003093 FR2004003093W WO2005055843A1 WO 2005055843 A1 WO2005055843 A1 WO 2005055843A1 FR 2004003093 W FR2004003093 W FR 2004003093W WO 2005055843 A1 WO2005055843 A1 WO 2005055843A1
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WO
WIPO (PCT)
Prior art keywords
surgical instrument
tube
instrument according
plate
head
Prior art date
Application number
PCT/FR2004/003093
Other languages
French (fr)
Inventor
Tiphaine Leport
Jean-Yves Leroy
Pascal Rokegem
Guy Viart
Original Assignee
Eurosurgical
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 FR0314130A external-priority patent/FR2862863B1/en
Application filed by Eurosurgical filed Critical Eurosurgical
Publication of WO2005055843A1 publication Critical patent/WO2005055843A1/en

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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
    • A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • A61B17/7091—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for applying, tightening or removing longitudinal element-to-bone anchor locking elements, e.g. caps, set screws, nuts or wedges
    • 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
    • A61B17/7032—Screws or hooks with U-shaped head or back through which longitudinal rods pass

Definitions

  • the present invention relates to a surgical instrument of the clipping type allowing the introduction and the positioning of a blocking element in the head of a bone anchoring element belonging to a spinal implant.
  • a surgical instrument comprising means for immobilizing on the head of a bone anchoring element of a spinal implant and means for introducing a blocking element. in the U-shaped head of the bone anchoring element for fixing in rotation and in translation a connecting rod.
  • the blocking element consists of a threaded blocking screw cooperating by rotation with the threaded internal part of the U-shaped head of the bone anchoring element for pressure fixing of the connecting rod. in the bottom of said U-shaped head.
  • the blocking element consists of a first ring which snaps onto the external part of the U-shaped head of the bone anchoring element and a second ring cooperating on the one hand with the connecting rod and on the other hand by means of a threaded pin with the first ring to achieve the fixing in rotation and in translation of the connecting rod.
  • the surgical instrument according to the present invention is intended to improve and facilitate the introduction of each blocking element inside the U-shaped head of the corresponding bone anchoring element.
  • the surgical instrument according to the present invention is more particularly intended for spinal implants consisting of bone anchoring element comprising a U-shaped head intended to cooperate with a blocking element allowing via a clamping screw immobilization in translation and in rotation of a connecting rod connecting each bone anchoring element to each other.
  • the surgical instrument comprises a main body comprising a fixed handle, a movable handle and a drive device which consists of a first plate resiliently loaded by a spring, a cylindrical pusher and a second plate elastically loaded by a spring, said first plate being provided to come, under the effect of the spring, to bear against the profile of the movable handle allowing during actuation the latter the displacement in translation of the cylindrical pusher inside a tube thanks to the bracing of the first plate for the introduction under a thrust force F of a blocking element, previously positioned and guided at inside the tube, in the head of the bone anchor.
  • the surgical instrument according to the present invention comprises a movable handle which cooperates with the fixed handle by means of an axis of rotation and a leaf spring, making it possible to actuate the drive device under pressure. and to return to its rest position after release of the pressure force.
  • the surgical instrument according to the present invention comprises a movable handle which comprises above the axis of rotation a head having a convex profile.
  • the surgical instrument according to the present invention comprises a movable handle which comprises above the axis of rotation a head having a convex profile from which extends a fork, each of the branches of which has a free end with a rounded profile.
  • the surgical instrument comprises a frame which consists of two vertical and opposite walls connected to each other by upper and lower perforated walls, said vertical wall being integral with the horizontal tube having an internal bore opening out inside the frame. , while the opposite wall is pierced with a hole carried by the same main axes as that of the internal bore, said upper wall having a central recess of rectangular shape and an extension extending beyond the vertical wall and in which an oblong groove is pierced, while the lower wall has another recess disposed below it, said recess comprising at the level of the fixed handle internal shoulders intended to form a stop.
  • the surgical instrument according to the present invention comprises first and second plates which are guided and retained in the frame by means of a fixing screw cooperating with a horizontal hole provided with a threaded part pierced in the upper wall of said frame. .
  • the surgical instrument according to the present invention comprises a second plate which comprises an extension extending above the groove of the extension of the upper wall of the frame.
  • the surgical instrument according to the present invention comprises a second plate, the upper part of which is pierced with an oblong hole.
  • the surgical instrument according to the present invention comprises a second plate which comprises, opposite the extension, a profile in the shape of a beak forming a keeper.
  • the surgical instrument comprises a main body comprising a fixed handle, a movable handle acting on a device guided drive inside the main body and allowing, depending on the pressure force applied to the movable handle, on the one hand, the immobilization of the surgical instrument on the head of the bone anchoring element and d on the other hand the introduction under a thrust force F of a blocking element, previously positioned and guided inside a tube of the main body, in the head of the bone anchoring element.
  • the surgical instrument comprises a locking tube comprising at one of its ends fork-shaped branches each provided with notches so that the free ends of each branch of the movable handle cooperate respectively with said notches to allow under the action of the movable handle the sliding of the locking tube around the tube and at the opposite end a cylindrical sleeve extending by parallel tongues.
  • the surgical instrument according to the present invention comprises a locking tube comprising at one of its ends a cover having an ergonomic external profile ensuring perfect grip by the surgeon to allow him to move in translation the locking tube around the tube either towards the free end of said tube, or in a direction which moves away from said free end.
  • the surgical instrument according to the present invention comprises a cover which comprises, opposite the locking tube, and in its upper and internal part a groove cooperating, during the positioning of said cover on the frame, with the extension of the second stage of the drive device.
  • the surgical instrument according to the present invention comprises a cylindrical pusher which passes through the frame via the hole made in the vertical wall to slide in the internal bore of the tube.
  • the surgical instrument according to the present invention comprises a cylindrical pusher which comprises from its head a first cylindrical part which is extended by a second cylindrical part with an outside diameter smaller than that of the first part.
  • the surgical instrument comprises a drive device which consists of a first plate resiliently loaded by a spring and ' arranged inside the frame so as to cooperate with the recesses of the upper and lower walls and the cylindrical plunger and a second plate loaded elastically by a spring and disposed inside the groove of the extension of the upper wall so as to cooperate with the cylindrical pusher, said first plate being provided to come under the effect of spring, in abutment against the curved profile of the head of the movable handle allowing during actuation of the latter the displacement in translation of the cylindrical plunger inside the tube, thanks to the bracing of the first plate.
  • the surgical instrument according to the present invention comprises a tube which comprises an extension of the cylindrical internal bore and at its free end another internal bore whose internal profile is complementary to that of the external locking element in order to be able to receive and guide the latter before its introduction into the head of the bone anchoring element.
  • the surgical instrument comprises a cylindrical tube which is extended at its free end by a sleeve with a substantially rectangular profile, each parallel and opposite wall of which has a U-shaped notch intended to cooperate with the connecting rod. the spinal implant.
  • the surgical instrument according to the present invention comprises a cylindrical tube whose internal profile of the sleeve is in a direction, of dimensions slightly greater than those of the internal bore in order to conform, at the entry of the latter, shoulders forming a stop. .
  • the surgical instrument according to the present invention comprises a cylindrical tube which comprises on its external profile flats which extend on each wall of the sleeve, each flat being drilled at the level of the tube with first and second holes opening inside the bore and at the walls of the sleeve of a third through hole.
  • the surgical instrument according to the present invention comprises a cylindrical tube, each first hole of which has an internal thread making it possible to cooperate with a clamping screw for fixing in each flat part of two elastic strips.
  • the surgical instrument according to the present invention comprises a cylindrical tube, each elastic strip of which is integral with a finger cooperating with the corresponding second hole and inside the bore to allow the elements inside the latter to be retained. blocking.
  • the surgical instrument according to the present invention comprises a cylindrical tube, each elastic lamella of which is integral with a pin cooperating with the third hole of the sleeve so as to be able to penetrate inside the latter when the lamellae are deformed by a thrust force. external from the tabs of the locking tube in order to allow the surgical instrument to be fixed on the head of the bone anchoring element.
  • the surgical instrument according to the present invention comprises a cylindrical tube, the internal bore of which is designed to receive a certain number of locking elements.
  • Figure 1 is an exploded perspective view illustrating for example a bone anchoring element of a spinal implant for which the surgical instrument according to the present invention can be used.
  • Figure 2 is a view showing the surgical instrument according to the present invention.
  • FIG. 3 is a detail view showing the drive device of the surgical instrument according to the present invention.
  • Figure 4 is a perspective view illustrating the movable handle of the surgical instrument according to the present invention.
  • Figure 5 is a perspective view showing the frame of the main body of the surgical instrument according to the present invention.
  • Figure 6 is a view illustrating the cylindrical pusher of the surgical instrument according to the present invention.
  • FIGS 7 and 8 are detail views showing the free end of the main body coming to be fixed on that of the bone anchoring element.
  • Figures 9 and 10 are views showing the different stages of use of the surgical instrument according to the present invention.
  • Figure 11 is a view showing a variant of the surgical instrument according to the present invention.
  • Figures 12 to 14 are views illustrating the variant of Figure 11 of the surgical instrument according to the present invention.
  • Figure 15 is a view showing the second plate of the drive device of the variant of the surgical instrument according to the present invention.
  • FIG. 1 shows an exemplary embodiment of a spinal implant 1 comprising a bone anchoring element 2 for blocking the rotation and translation of a connecting rod 3 at each instrumented vertebra of a column spinal.
  • the bone anchoring element 2 cooperates with a blocking element 4 allowing, by means of a clamping screw 5, the fixing in rotation and in translation of the connecting rod 3.
  • the bone anchoring element 2 comprises an anchoring part 6 and a receiving part 7 which consists of a U-shaped head 8 open in its upper part to cooperate with the connecting rod 3 and the locking element 4.
  • the anchoring part 6 may have either the shape of a hook, or a threaded profile which may or may not be integral with the receiving part 7 so as to be fixed on / or in the vertebral body of the vertebra to be instrumented.
  • the head 8 has two vertical walls 9, 10 arranged one opposite the other and in parallel planes in order to delimit a first central opening 11 U-shaped carried by the axis XX 'of the connecting rod 3 and whose bottom 12 has a profile in the form of a cylinder.
  • Each vertical wall 9, 10 is separated, for example, from the bottom 12 of the central opening 11 by a vertical slot 13 giving a certain elasticity to each wall in the direction of the center of the head 8, along the geometric axis V V ".
  • the vertical walls 9, 10 respectively comprise at each end a hooking part 14, 15 arranged one opposite the other and on either side of the central opening 11.
  • Each vertical wall 9, 10 has on its internal face and between the hooking parts 14, 15 a vertical housing 16 having a profile in portion of cylinder provided on each side with a groove 17 for guiding the locking element 4 during its positioning by means of a surgical instrument 100 in the head 8 of the bone anchoring element 2.
  • Each vertical wall 9, 10 is pierced between the attachment parts 14, 15 with a hole 18 opening out inside the central opening 11 and intended to cooperate with the surgical instrument 100 during the introduction of the blocking element 4.
  • the locking element 4 has a substantially parallelepipedal external profile comprising in a direction parallel to the axis XX 'and in its lower part a housing 19 having a profile in the portion of a cylinder in order to receive and cooperate with the connecting rod 3.
  • the locking element 4 has in its middle a clamping screw 5 which opens inside the housing 19 to come into contact by pressure against the connecting rod 3 to allow its immobilization in rotation and in translation.
  • the locking element 4 comprises, in a plane parallel to the axis XX ', lugs 20, 21 in the form of a tooth separated by a vertical housing 22 bordered laterally by ribs 23 allowing the guidance of said locking element when it is introduced into the head 8 of the anchoring element 2.
  • FIGS. 2 and 3 show a surgical instrument 100 allowing the positioning and introduction of the blocking element 4 between the walls 9, 10 of the head 8 of the anchoring element 2.
  • the instrument 100 consists of a body 101 comprising a horizontal tube 102 extending from an openwork frame 103 integral in a direction parallel to the axis ZZ 'of a handle 104 called "fixed handle".
  • the fixed handle 104 cooperates with another handle 105 called a “movable handle” which is connected to the first by an axis of rotation 106 and a leaf spring 107 making it possible to actuate, under the force of a pressure, means of training 108.
  • FIG. 5 shows the frame 103 of the body 101 which is made up of two vertical and opposite walls 114 and 115 linked together by upper perforated walls 1 16 and lower 117.
  • the vertical wall 114 is integral with the horizontal tube 102 having an internal bore 118 emerging inside the frame 103, while the opposite wall 115 is pierced with a hole 119 carried by the same main axes as that of the internal bore 118.
  • the upper wall 116 has a central recess 120 of rectangular shape, while the lower wall 117 has another recess 121 arranged below that 120.
  • the recess 121 has, at the level of the fixed handle 104, internal shoulders 122 intended to form stubborn.
  • the upper wall 11 6 of the frame 103 has an extension 123 which extends beyond the vertical wall 115 and in which an oblong groove 124 is pierced.
  • the upper wall 1 16 of the frame 103 is traversed by a horizontal hole 155 comprising a threaded bore 156 for retaining a fixing screw 157.
  • the surgical instrument 100 comprises locking means which consist of a locking tube 125 comprising at one of its ends branches 127 in the form of a fork each provided with notches 126.
  • the tube 125 comprises at the opposite end of that in the form of a fork 127 a cylindrical sleeve 128 extended by parallel tongues 129 .
  • the locking tube 125 is arranged around the tube 102 so that the free ends 113 of each branch 112 of the movable handle 105 cooperate respectively with the notches 126 of each branch 127 to allow under the action of the movable handle 105 the sliding of the locking tube 125 around the tube 102.
  • the surgical instrument 100 comprises a cylindrical pusher 130 which passes through the frame 103 by means of the hole 119 made in the vertical wall 115 in order to slide in the internal bore 118 of the tube 102 (FIG. 6).
  • the cylindrical pusher 130 consists of a rod comprising at one of its ends a head 152 in the form of a curved disc allowing the surgeon to take said pusher.
  • the cylindrical pusher 130 has from its head 152 a first cylindrical part 153 which is extended by a second cylindrical part 154 with an outside diameter smaller than that of the first part.
  • the drive means of the instrument 100 are formed by a drive device 108 which consists of a first plate 131 arranged inside the frame 103 in a vertical direction parallel to the axis ZZ 'of so as to cooperate with the recesses 120 and 121 of the upper walls 116 and lower 117 to allow its lateral guidance during its movements.
  • the plate 131 is pierced in the middle of a through hole allowing the passage of the cylindrical plunger 130.
  • the drive device 108 comprises a compression spring 132 which arranged around the cylindrical plunger 130 so as to be in abutment against the plate 131 and the vertical wall 114 of the frame 103.
  • the drive device 108 of the surgical instrument 100 also consists of a second plate 133 which is positioned in a direction substantially parallel to the axis ZZ ′ in order to be guided and retained inside the groove 124 of the extension 123 of the upper wall 116 of the frame 103.
  • first and second plates 131 and 133 are pierced in their upper part with a hole, not shown, allowing the retention and guiding said plates in the frame 103 by means of the fixing screw 157 cooperating with the horizontal hole 155 and its threaded part 156 drilled in the upper wall e 116.
  • the second plate 133 is pierced in the middle with a through hole allowing the passage of the cylindrical pusher 130 so that the latter crosses, along a horizontal axis Y Y ′, the frame 103 of the surgical instrument 100.
  • the drive device 108 includes a compression spring 134 which is arranged around the cylindrical pusher 130 so as to bear against the plate 133 and the vertical wall 115 of the frame 103.
  • the first plate 131 is provided to come, under the effect of the spring 132, to bear against the convex profile 110 of the head 109 of the movable handle 105 allowing during actuation of the latter the displacement in translation of the cylindrical plunger 130 inside the tube 102 and the frame 103.
  • FIGS. 7 and 8 show the free end of the tube 102 lying opposite the frame 103 of the body 101 of the surgical instrument 100.
  • the cylindrical internal bore 118 of the tube 102 is extended at its free end by another bore 135 having in section a substantially rectangular profile and of shape complementary to that of the external locking element 4 of the spinal implant 1.
  • the internal bore 135 is designed to receive a certain number of locking elements 4, such as for example at least 10 locking elements 4, in order to be able to present them above each bone anchoring element 2 for their establishment.
  • the internal bore 135 comprises, on each parallel and opposite wall 136, a guide groove 137 provided for each receiving the ribs 23 of the corresponding locking element 4.
  • the cylindrical tube 102 is extended at its free end by a sleeve 138 with a substantially rectangular profile, each parallel and opposite wall 139 of which has a U-shaped notch 140 intended to cooperate with the connecting rod 3 of the spinal implant 1 .
  • the walls 139 of the sleeve 138 are arranged in planes perpendicular to those containing the walls 136 of the internal bore 135.
  • the internal profile of the sleeve 138 is in a direction of dimensions slightly greater than those of the internal bore 135 in order to conform to the entry of the latter of the shoulders 151 forming a stop.
  • the cylindrical tube 102 has, on its external profile and in planes parallel to those containing the walls 136 of the internal bore 135, flats 141 which extend on each wall 142 of the sleeve 138.
  • each flat 141 is pierced with a first hole 143 and a second hole 144 opening into the grooves 137 of the bore 135.
  • each flat 141 is pierced with a third through hole 145 which is carried by the same main axis as that of the first hole 143 and the second hole 144.
  • Each first hole 143 has an internal thread allowing to cooperate with a clamping screw 146 allowing the fixing in each flat 141 of two elastic strips 147 and 148.
  • Each elastic strip 147 is integral with a finger 149 cooperating with the second hole 144 and penetrating inside the bore 135 to allow the retention inside the latter of the locking elements 4.
  • Each elastic strip 148 is integral with a pin 150 cooperating with the third hole 145 of the sleeve 138 so as to be able to penetrate inside the latter when the strips 148 are deformed by an external thrust force.
  • the locking elements 4 are loaded inside the tube 102 and more particularly inside the bore 135.
  • the locking elements 4 are introduced through the lower end of the tube 102 at the sleeve 138.
  • the locking fingers 149 move apart thanks to the elasticity of the lamellae 147, thus allowing the introduction of at least ten locking elements 4 inside the bore 135 of tube 102.
  • the surgical instrument 100 is placed on the head 8 of the bone anchoring element 2 of the spinal implant 1 so that the head is positioned in the sleeve 138 and in abutment against the shoulders 151 forming a stop.
  • the orientation of the surgical instrument 100 is defined by the connecting rod 3 which must be introduced into the rod passage, formed by the notches 140. In this position, the pins 150 of the elastic strips 148 are positioned opposite the holes 18 made in the head 8 the bone anchoring element 2.
  • the surgical instrument 100 is actuated by acting by a pressure on the movable handle 105 allowing, through its branches 112, to move the tube 125 in translation towards the free end of the tube 102.
  • the tube 125 presses by means of the tongues 129 on the elastic strips 148, thus blocking the pins 150 in the lateral holes 18 formed in the head 8 the bone anchoring element 2.
  • This first movement of the handle 105 allows the fixation of the surgical instrument 100 on the bone anchoring element 2.
  • the insertion of the blocking element 4 is effected by a continuation of the pressure on the handle 105 extending its rotational movement and allowing on the one hand to release the ends of each branch 112 from the notches 126 of the tube 125 which puts an end to the translation of the tube 125 and on the other hand to come into contact via the convex profile 110 with the plate 131. Thanks to the thrust exerted on the lower end of the plate 131, the latter arcs - bottle on the cylindrical pusher 130.
  • the continuous movement of the handle 105 driving the plate 131 makes it possible by bracing of the latter to move in translation the cylindrical pusher 130 inside the tube 102.
  • the cylindrical pusher 130 comes to bear on the last blocking element 4 placed in the internal bore 135 applying to all of the blocking elements 4 contained in the bore 135, a thrust force F, allowing the expulsion of the blocking element 4 located directly above the head 8 of the bone anchoring element 2 and its introduction into said head 8.
  • the release of the surgical instrument 100 is obtained by the release of the pressure on the handle 105 which returns via the leaf spring 107 in its rest position. Returning to its rest position, the handle 105 drives the tube 125, thanks to the notches 126, thus releasing the lamellae 148 which, thanks to their elasticity, move away from the tube 102.
  • the pins 150 come out of the holes 18 thus releasing the instrument 100 of the head 8 of the bone anchoring element 2.
  • the plate 131 returns to its rest position, in abutment on the shoulders 122 of the recess 121 of the frame 103.
  • the cylindrical pusher 130 does not move back, thanks to the pressure exerted by the plate 133 braced thanks to spring 134.
  • the cylindrical pusher 130 and more particularly the first cylindrical part 153 has arrived at the end of the bore 118 of the tube 102, while the second cylindrical part 154 is for its part introduced into the bore 135 without penetrating inside the sleeve 138.
  • the cylindrical pusher 130 is released and can be reassembled. New blocking elements 4 can then be introduced as has been previously explained.
  • the surgical instrument 100 consists of a body 101 comprising a horizontal tube 102 extending from an openwork frame 103 integral in a direction parallel to the axis ZZ 'of a handle 104 called "handle fixed ”.
  • the fixed handle 104 cooperates with another handle 105 known as a “movable handle” which is connected to the first by an axis of rotation 106 and a leaf spring 107 making it possible to actuate, under the force of a pressure, the device d drive 108 described above.
  • the variant of the surgical instrument 100 will only be described with regard to the elements which have been modified, namely: the movable handle 105, the locking tube 125 and its drive around the tube 102, and the second plate 133 of the device 108 knowing that all the other parts have the same structure and function.
  • the movable handle 105 has been modified and no longer comprises a fork 11, but only the curved profile 110 which comes to bear on the first plate 131 of the drive device 108.
  • the second plate 133 of the drive device 108 is positioned in a direction substantially parallel to the axis ZZ ′ in order to be guided and retained inside the groove 124 of the extension 123 of the upper wall 116 of the frame 103. It is noted that the second plate 133 has an extension 158 extending above the groove 124 of the extension 123 of the upper wall 116 of the frame 103.
  • the upper part of the second plate 133 is pierced with an oblong hole 159 cooperating with the fixing screw 157 allowing, by an untightened fixing, the guidance and the retention of the first and second plates inside the frame 103, knowing that the first plate 131 is pierced with a hole not shown for the passage of the screw 157.
  • the oblong hole 159 allows the guide in translation of the plate 133 around the screw 157, when the cover 180 is dismantled.
  • the second plate 133 comprises, opposite the extension 158, a profile in the shape of a beak 160 forming a keeper for the translational movement of said second plate.
  • the locking tube 125 no longer comprises, opposite the tongues 129, branches 127 in the form of a fork each provided with notches 126.
  • the locking tube 125 has a cylindrical profile which is integral opposite the tongues 129 of a cover 180 having an ergonomic external profile ensuring perfect grip by the surgeon to allow him to move in translation the locking tube 125 around the tube 102, either in the direction of the free end of said tube 102, or in a direction which moves away from said free end.
  • the cover 180 comprises opposite the locking tube 125 and in its upper and internal part a groove 181 cooperating, during the positioning of said cover on the frame 103, with the extension 158 of the second plate 133 of the device d 'drive 108 ensuring the translational guidance of the cover 180.
  • the displacement in translation, by the surgeon by means of the cover 180, of the locking tube 125, in the direction of the free end of the tube 102, makes it possible to come to bear by means of the tongues 129 on the elastic strips 148 of the tube 102, thus blocking the pins 150 in the lateral holes 18 formed in the head 8 of the bone anchoring element 2.
  • This movement in translation of the tube 125 allows the surgical instrument 100 to be fixed on the element bone anchor 2.
  • the locking element 4 is introduced by pressing on the handle 105 making it possible to come into contact via the convex profile 110 with the plate 131. Thanks to the thrust exerted on the lower end of the plate 131, the latter is arched on the cylindrical pusher 130.
  • the continuous movement of the handle 105 driving the plate 131 makes it possible, by bracing the latter, to move the cylindrical pusher 130 in translation inside the tube 102.
  • the cylindrical pusher 130 comes to bear on the last blocking element 4 placed in the internal bore 135 applying to all of the blocking elements 4 contained in the bore 135, a thrust force F, allowing the expulsion of the blocking element 4 located directly above the head 8 of the bone anchoring element 2 and its introduction into said head 8.
  • the release of the surgical instrument 100 is obtained by the translational movement, by the surgeon by means of the cover 180, of the locking tube 125, in a direction which moves away from the free end of the tube 102 thus releasing the strips 148 which, thanks to their elasticity, move away from the tube 102.
  • the pins 150 come out of the holes 18 thus releasing the surgical instrument 1 00 from the head 8 of the bone anchoring element 2. It can be seen that the disassembly of the locking tube 125 is obtained when the pusher 130 is completely withdrawn from the surgical instrument 100. In fact, the withdrawal of the pusher 130 allows the displacement in translation of the second plate 133 by means of a pressure on the keeper 160 so that the extension 158 is released from the groove 181 of the cover 180.
  • the second plate 133 is displaced by the oblong hole 159 allowing the second plate 133 to guide in translation around the screw 157.

Abstract

The invention relates to a clipping-type surgical instrument for spinal implant. The inventive instrument consists of a main body (101) having a fixed handle (104), a mobile handle (105) and a drive device (108), said drive device comprising: a first plate (131) which is loaded elastically by a spring (132), a cylindrical push element (130) and a second plate (133) which is loaded elastically by a spring (134). According to the invention, under the effect of the spring (132), the aforementioned first plate (131) is designed to come into contact with and press against the profile of the mobile handle (105) such that, when said handle is actuated, the cylindrical push element (130) can move in translation inside a tube (102) owing to the butting of the first plate (131), in order for a blocking element (4) to be introduced into the head (8) of the bone-anchoring element (2) using a push force F, said blocking element having been pre-positioned and guided into the tube (102)

Description

INSTRUMENT CHIRURGICAL DE TYPE CLIPSEUSE POUR IMPLANT RACHIDIEN CLIPS-TYPE SURGICAL INSTRUMENT FOR A SPINAL IMPLANT
La présente invention est relative à un instrument chirurgical de type clipseuse permettant l'introduction et la mise en place d'un élément de blocage dans la tête d'un élément d'ancrage osseux appartenant à un implant rachidien. On connaît d'après le brevet US 6 648 888 un instrument chirurgical comportant des moyens d'immobilisation sur la tête d'un l'élément d'ancrage osseux d'un implant rachidien et des moyens d'introduction d'un élément de blocage dans la tête en forme de U de l'élément d'ancrage osseux pour la fixation en rotation et en translation d'une tige de liaison.The present invention relates to a surgical instrument of the clipping type allowing the introduction and the positioning of a blocking element in the head of a bone anchoring element belonging to a spinal implant. Known from US Pat. No. 6,648,888 is a surgical instrument comprising means for immobilizing on the head of a bone anchoring element of a spinal implant and means for introducing a blocking element. in the U-shaped head of the bone anchoring element for fixing in rotation and in translation a connecting rod.
On note que l'élément de blocage est constitué d'une vis de blocage filetée coopérant par rotation avec la partie interne filetée de la tête en forme de U de l'élément d'ancrage osseux pour la fixation par pression de la tige de liaison dans le fond de ladite tête en forme de U.Note that the blocking element consists of a threaded blocking screw cooperating by rotation with the threaded internal part of the U-shaped head of the bone anchoring element for pressure fixing of the connecting rod. in the bottom of said U-shaped head.
On connaît d'après le brevet US 6139 549 un instrument chirurgical comportant des moyens d'immobilisation sur la tête d'un l'élément d'ancrage osseux d'un implant rachidien et des moyens d'introduction d'un élément de blocage dans la tête en forme de U de élément d'ancrage osseux pour la fixation en rotation et en translation d'une tige de liaison.Known from US Pat. No. 6,139,549 is a surgical instrument comprising means for immobilizing on the head a bone anchoring element of a spinal implant and means for introducing a blocking element into the U-shaped head of bone anchoring element for fixing in rotation and in translation a connecting rod.
On note que l'élément de blocage est constitué d'une première bague qui vient s'encliqueter sur la partie externe de la tête en forme de U de l'élément d'ancrage osseux et d'une seconde bague coopérant d'une part avec la tige de liaison et d'autre part au moyen d'un axe fileté avec la première bague pour réaliser la fixation en rotation et en translation de la tige de liaison.Note that the blocking element consists of a first ring which snaps onto the external part of the U-shaped head of the bone anchoring element and a second ring cooperating on the one hand with the connecting rod and on the other hand by means of a threaded pin with the first ring to achieve the fixing in rotation and in translation of the connecting rod.
L'instrument chirurgical suivant la présente invention est prévu pour améliorer et faciliter l'introduction de chaque élément de blocage à l'intérieur de la tête en forme de U de l'élément d'ancrage osseux correspondant.The surgical instrument according to the present invention is intended to improve and facilitate the introduction of each blocking element inside the U-shaped head of the corresponding bone anchoring element.
L'instrument chirurgical suivant la présente invention est plus particulièrement destiné pour les implants rachidiens constitués d'élément d'ancrage osseux comportant une tête en forme de U prévue pour coopérer avec un élément de blocage permettant par l'intermédiaire d'une vis de serrage l'immobilisation en translation et en rotation d'une tige de liaison reliant chaque élément d'ancrage osseux entre eux.The surgical instrument according to the present invention is more particularly intended for spinal implants consisting of bone anchoring element comprising a U-shaped head intended to cooperate with a blocking element allowing via a clamping screw immobilization in translation and in rotation of a connecting rod connecting each bone anchoring element to each other.
L'instrument chirurgical suivant la présente invention comporte un corps principal comprenant une poignée fixe, une poignée mobile et un dispositif d'entraînement qui est constitué d'une première platine chargée élastiquement par un ressort, d'un poussoir cylindrique et d'une seconde platine chargée élastiquement par un ressort, ladite première platine étant prévue pour venir, sous l'effet du ressort, en appui contre le profil de la poignée mobile permettant lors de l'actionnement de cette dernière le déplacement en translation du poussoir cylindrique à l'intérieur d'un tube grâce à l'arc-boutement de la première platine pour l'introduction sous un effort de poussée F d'un élément de blocage, préalablement positionné et guidé à l'intérieur du tube, dans la tête de l'élément d'ancrage osseux.The surgical instrument according to the present invention comprises a main body comprising a fixed handle, a movable handle and a drive device which consists of a first plate resiliently loaded by a spring, a cylindrical pusher and a second plate elastically loaded by a spring, said first plate being provided to come, under the effect of the spring, to bear against the profile of the movable handle allowing during actuation the latter the displacement in translation of the cylindrical pusher inside a tube thanks to the bracing of the first plate for the introduction under a thrust force F of a blocking element, previously positioned and guided at inside the tube, in the head of the bone anchor.
L'instrument chirurgical suivant la présente invention comporte une poignée mobile qui coopère avec la poignée fixe par l'intermédiaire d'un axe de rotation et d'un ressort à lame, permettant d'actionner sous un effort de pression le dispositif d'entraînement et de revenir dans sa position de repos après relâchement de l'effort de pression.The surgical instrument according to the present invention comprises a movable handle which cooperates with the fixed handle by means of an axis of rotation and a leaf spring, making it possible to actuate the drive device under pressure. and to return to its rest position after release of the pressure force.
L'instrument chirurgical suivant la présente invention comporte une poignée mobile qui comporte au-dessus de l'axe de rotation une tête présentant un profil bombé.The surgical instrument according to the present invention comprises a movable handle which comprises above the axis of rotation a head having a convex profile.
L'instrument chirurgical suivant la présente invention comporte une poignée mobile qui comprend au-dessus de l'axe de rotation une tête présentant un profil bombé à partir duquel s'étend une fourche dont chacune des branches comporte une extrémité libre à profil arrondi.The surgical instrument according to the present invention comprises a movable handle which comprises above the axis of rotation a head having a convex profile from which extends a fork, each of the branches of which has a free end with a rounded profile.
L'instrument chirurgical suivant la présente invention comporte un cadre qui est constitué de deux parois verticales et opposées reliées entre elles par des parois ajourées supérieures et inférieures, ladite paroi verticale étant solidaire du tube horizontal présentant un alésage interne débouchant à l'intérieur du cadre, tandis que la paroi, opposée est percée d'un trou porté par les mêmes axes principaux que celui de l'alésage interne, ladite paroi supérieure présentant un évidemment central de forme rectangulaire et un prolongement s'étendant au-delà de la paroi verticale et dans lequel est percée une rainure oblongue, tandis que la paroi inférieure comporte un autre évidemment disposé en dessous de celui-ci, ledit évidemment comportant au niveau de la poignée fixe des épaulements internes destinés à former une butée.The surgical instrument according to the present invention comprises a frame which consists of two vertical and opposite walls connected to each other by upper and lower perforated walls, said vertical wall being integral with the horizontal tube having an internal bore opening out inside the frame. , while the opposite wall is pierced with a hole carried by the same main axes as that of the internal bore, said upper wall having a central recess of rectangular shape and an extension extending beyond the vertical wall and in which an oblong groove is pierced, while the lower wall has another recess disposed below it, said recess comprising at the level of the fixed handle internal shoulders intended to form a stop.
L'instrument chirurgical suivant la présente invention comporte des premières et secondes platines qui sont guidées et retenues dans le cadre par l'intermédiaire d'une vis de fixation coopérant avec un trou horizontal pourvu d'une partie filetée percée dans la paroi supérieure dudit cadre.The surgical instrument according to the present invention comprises first and second plates which are guided and retained in the frame by means of a fixing screw cooperating with a horizontal hole provided with a threaded part pierced in the upper wall of said frame. .
L'instrument chirurgical suivant la présente invention comporte une seconde platine qui comprend un prolongement s'étendant au-dessus de la rainure du prolongement de la paroi supérieure du cadre.The surgical instrument according to the present invention comprises a second plate which comprises an extension extending above the groove of the extension of the upper wall of the frame.
L'instrument chirurgical suivant la présente invention comporte une seconde platine dont la partie supérieure est percée d'un trou oblong. L'instrument chirurgical suivant la présente invention comporte une seconde platine qui comprend à l'opposé du prolongement un profil en forme de bec formant une gâche.The surgical instrument according to the present invention comprises a second plate, the upper part of which is pierced with an oblong hole. The surgical instrument according to the present invention comprises a second plate which comprises, opposite the extension, a profile in the shape of a beak forming a keeper.
L'instrument chirurgical suivant la présente invention comporte un corps principal comprenant une poignée fixe, une poignée mobile agissant sur un dispositif d'entraînement guidé à l'intérieur du corps principal et permettant suivant l'effort de pression appliqué sur la poignée mobile, d'une part l'immobilisation de l'instrument chirurgical sur la tête de l'élément d'ancrage osseux et d'autre part l'introduction sous un effort de poussée F d'un élément de blocage, préalablement positionné et guidé à l'intérieur d'un tube du corps principal, dans la tête de l'élément d'ancrage osseux.The surgical instrument according to the present invention comprises a main body comprising a fixed handle, a movable handle acting on a device guided drive inside the main body and allowing, depending on the pressure force applied to the movable handle, on the one hand, the immobilization of the surgical instrument on the head of the bone anchoring element and d on the other hand the introduction under a thrust force F of a blocking element, previously positioned and guided inside a tube of the main body, in the head of the bone anchoring element.
L'instrument chirurgical suivant la présente invention comporte un tube de verrouillage comprenant à l'une de ses extrémités des branches en forme de fourche pourvues chacune d'encoches de manière que les extrémités libres de chaque branche de la poignée mobile coopèrent respectivement avec lesdites encoches pour permettre sous l'action de la poignée mobile le coulissement du tube de verrouillage autour du tube et à l'extrémité opposée un manchon cylindrique se prolongeant par des languettes parallèles.The surgical instrument according to the present invention comprises a locking tube comprising at one of its ends fork-shaped branches each provided with notches so that the free ends of each branch of the movable handle cooperate respectively with said notches to allow under the action of the movable handle the sliding of the locking tube around the tube and at the opposite end a cylindrical sleeve extending by parallel tongues.
L'instrument chirurgical suivant la présente invention comporte un tube de verrouillage comprenant à l'une de ses extrémités un capot présentant un profil externe ergonomique assurant une parfaite préhension par le chirurgien pour lui permettre de déplacer en translation le tube de verrouillage autour du tube soit en direction de l'extrémité libre dudit tube, soit dans une direction qui s'éloigne de ladite extrémité libre.The surgical instrument according to the present invention comprises a locking tube comprising at one of its ends a cover having an ergonomic external profile ensuring perfect grip by the surgeon to allow him to move in translation the locking tube around the tube either towards the free end of said tube, or in a direction which moves away from said free end.
L'instrument chirurgical suivant la présente invention comporte un capot qui comprend, à l'opposé du tube de verrouillage, et dans sa partie supérieure et interne une rainure coopérant, lors de la mise en place dudit capot sur le cadre, avec le prolongement de la seconde platine du dispositif d'entraînement.The surgical instrument according to the present invention comprises a cover which comprises, opposite the locking tube, and in its upper and internal part a groove cooperating, during the positioning of said cover on the frame, with the extension of the second stage of the drive device.
L'instrument chirurgical suivant la présente invention comporte un poussoir cylindrique qui traverse le cadre par l'intermédiaire du trou ménagé dans la paroi verticale pour venir coulisser dans l'alésage interne du tube.The surgical instrument according to the present invention comprises a cylindrical pusher which passes through the frame via the hole made in the vertical wall to slide in the internal bore of the tube.
L'instrument chirurgical suivant la présente invention comporte un poussoir cylindrique qui comprend à partir de sa tête une première partie cylindrique qui se prolonge par une seconde partie cylindrique de diamètre extérieur inférieur à celui de la première partie.The surgical instrument according to the present invention comprises a cylindrical pusher which comprises from its head a first cylindrical part which is extended by a second cylindrical part with an outside diameter smaller than that of the first part.
L'instrument chirurgical suivant la présente invention comporte un dispositif d'entraînement qui est constitué d'une première platine chargée élastiquement par un ressort et' disposée à l'intérieur du cadre de manière à coopérer avec les evidements des parois supérieures et inférieures et le poussoir cylindrique et d'une seconde platine chargée élastiquement par un ressort et disposée à l'intérieur de la rainure du prolongement de la paroi supérieure de manière à coopérer avec le poussoir cylindrique, ladite première platine étant prévue pour venir, sous l'effet du ressort, en appui contre le profil bombé de la tête de la poignée mobile permettant lors de l'actionnement de cette dernière le déplacement en translation du poussoir cylindrique à l'intérieur du tube, grâce à l'arc-boutement de la première platine.The surgical instrument according to the present invention comprises a drive device which consists of a first plate resiliently loaded by a spring and ' arranged inside the frame so as to cooperate with the recesses of the upper and lower walls and the cylindrical plunger and a second plate loaded elastically by a spring and disposed inside the groove of the extension of the upper wall so as to cooperate with the cylindrical pusher, said first plate being provided to come under the effect of spring, in abutment against the curved profile of the head of the movable handle allowing during actuation of the latter the displacement in translation of the cylindrical plunger inside the tube, thanks to the bracing of the first plate.
L'instrument chirurgical suivant la présente invention comporte un tube qui comprend dans le prolongement de l'alésage interne cylindrique et au niveau de son extrémité libre un autre alésage interne dont le profil interne est complémentaire à celui externe de l'élément de blocage afin de pouvoir recevoir et guider ce dernier avant son introduction dans la tête de l'élément d'ancrage osseux.The surgical instrument according to the present invention comprises a tube which comprises an extension of the cylindrical internal bore and at its free end another internal bore whose internal profile is complementary to that of the external locking element in order to be able to receive and guide the latter before its introduction into the head of the bone anchoring element.
L'instrument chirurgical suivant la présente invention comporte un tube cylindrique qui se prolonge au niveau de son extrémité libre par un manchon à profil sensiblement rectangulaire dont chaque paroi parallèle et opposée comporte une échancrure en forme de U destinée à coopérer avec la tige de liaison de l'implant rachidien.The surgical instrument according to the present invention comprises a cylindrical tube which is extended at its free end by a sleeve with a substantially rectangular profile, each parallel and opposite wall of which has a U-shaped notch intended to cooperate with the connecting rod. the spinal implant.
L'instrument chirurgical suivant la présente invention comporte un tube cylindrique dont le profil interne du manchon est suivant une direction, de dimensions légèrement supérieures à celles de l'alésage interne afin de conformer, à l'entrée de ce dernier, des épaulements formant butée.The surgical instrument according to the present invention comprises a cylindrical tube whose internal profile of the sleeve is in a direction, of dimensions slightly greater than those of the internal bore in order to conform, at the entry of the latter, shoulders forming a stop. .
L'instrument chirurgical suivant la présente invention comporte un tube cylindrique qui comprend sur son profil externe des méplats qui se prolongent sur chaque paroi du manchon, chaque méplat étant percé au niveau du tube de premier et second trous débouchant à l'intérieur de l'alésage et au niveau des parois du manchon d'un troisième trou débouchant.The surgical instrument according to the present invention comprises a cylindrical tube which comprises on its external profile flats which extend on each wall of the sleeve, each flat being drilled at the level of the tube with first and second holes opening inside the bore and at the walls of the sleeve of a third through hole.
L'instrument chirurgical suivant la présente invention comporte un tube cylindrique dont chaque premier trou présente un filetage interne permettant de coopérer avec une vis de serrage pour la fixation dans chaque méplat de deux lamelles élastiques.The surgical instrument according to the present invention comprises a cylindrical tube, each first hole of which has an internal thread making it possible to cooperate with a clamping screw for fixing in each flat part of two elastic strips.
L'instrument chirurgical suivant la présente invention comporte un tube cylindrique dont chaque lamelle élastique est solidaire d'un doigt coopérant avec le second trou correspondant et à l'intérieur de l'alésage pour permettre la retenue à l'intérieur de ce dernier des éléments de blocage.The surgical instrument according to the present invention comprises a cylindrical tube, each elastic strip of which is integral with a finger cooperating with the corresponding second hole and inside the bore to allow the elements inside the latter to be retained. blocking.
L'instrument chirurgical suivant la présente invention comporte un tube cylindrique dont chaque lamelle élastique est solidaire d'un pion coopérant avec le troisième trou du manchon afin de pouvoir pénétrer à l'intérieur de ce dernier lorsque les lamelles sont déformées par un effort de poussée externe provenant des languettes du tube de verrouillage afin de permettre la fixation de l'instrument chirurgical sur la tête de l'élément d'ancrage osseux.The surgical instrument according to the present invention comprises a cylindrical tube, each elastic lamella of which is integral with a pin cooperating with the third hole of the sleeve so as to be able to penetrate inside the latter when the lamellae are deformed by a thrust force. external from the tabs of the locking tube in order to allow the surgical instrument to be fixed on the head of the bone anchoring element.
L'instrument chirurgical suivant la présente invention comporte un tube cylindrique dont l'alésage interne est prévu pour recevoir un certain nombre d'éléments de blocage.The surgical instrument according to the present invention comprises a cylindrical tube, the internal bore of which is designed to receive a certain number of locking elements.
La description qui va suivre en regard des dessins annexés, donnés à titre d'exemples non limitatifs, permettra de mieux comprendre l'invention, les caractéristiques qu'elle présente et les avantages qu'elle est susceptible de procurer :The description which follows with reference to the appended drawings, given by way of nonlimiting examples, will allow a better understanding of the invention, the characteristics which it presents and the advantages which it is capable of providing:
Figure 1 est une vue en perspective éclatée illustrant par exemple un élément d'ancrage osseux d'un implant rachidien pour lequel l'instrument chirurgical suivant la présente invention peut être utilisé. Figure 2 est une vue représentant l'instrument chirurgical suivant la présente invention.Figure 1 is an exploded perspective view illustrating for example a bone anchoring element of a spinal implant for which the surgical instrument according to the present invention can be used. Figure 2 is a view showing the surgical instrument according to the present invention.
Figure 3 est une vue de détail montrant le dispositif d'entraînement de l'instrument chirurgical suivant la présente invention.Figure 3 is a detail view showing the drive device of the surgical instrument according to the present invention.
Figure 4 est une vue en perspective illustrant la poignée mobile de l'instrument chirurgical suivant la présente invention. Figure 5 est une vue en perspective montrant le cadre du corps principal de l'instrument chirurgical suivant la présente invention.Figure 4 is a perspective view illustrating the movable handle of the surgical instrument according to the present invention. Figure 5 is a perspective view showing the frame of the main body of the surgical instrument according to the present invention.
Figure 6 est une vue illustrant le poussoir cylindrique de l'instrument chirurgical suivant la présente invention.Figure 6 is a view illustrating the cylindrical pusher of the surgical instrument according to the present invention.
Figures 7 et 8 sont des vues de détail représentant l'extrémité libre du corps principal venant se fixer sur celle de l'élément d'ancrage osseux.Figures 7 and 8 are detail views showing the free end of the main body coming to be fixed on that of the bone anchoring element.
Figures 9 et 10 sont des vues montrant les différentes étapes d'utilisation de l'instrument chirurgical suivant la présente invention.Figures 9 and 10 are views showing the different stages of use of the surgical instrument according to the present invention.
Figure 11 est une vue représentant une variante de l'instrument chirurgical suivant la présente invention. Figures 12 à 14 sont des vues illustrant la variante de figure 11 de l'instrument chirurgical suivant la présente invention.Figure 11 is a view showing a variant of the surgical instrument according to the present invention. Figures 12 to 14 are views illustrating the variant of Figure 11 of the surgical instrument according to the present invention.
Figure 15 est une vue montrant la seconde platine du dispositif d'entraînement de la variante de l'instrument chirurgical suivant la présente invention.Figure 15 is a view showing the second plate of the drive device of the variant of the surgical instrument according to the present invention.
On a montré en figure 1 , un exemple de réalisation d'un implant rachidien 1 comportant un élément d'ancrage osseux 2 pour le blocage en rotation et en translation d'une tige de liaison 3 au niveau de chaque vertèbre instrumentée d'une colonne vertébrale.FIG. 1 shows an exemplary embodiment of a spinal implant 1 comprising a bone anchoring element 2 for blocking the rotation and translation of a connecting rod 3 at each instrumented vertebra of a column spinal.
L'élément d'ancrage osseux 2 coopère avec un élément de blocage 4 permettant par l'intermédiaire d'une vis de serrage 5 la fixation en rotation et en translation de la tige de liaison 3. L'élément d'ancrage osseux 2 comprend une partie d'ancrage 6 et une partie de réception 7 qui est constituée d'une tête 8 en forme de U ouverte dans sa partie supérieure pour coopérer avec la tige de liaison 3 et l'élément de blocage 4.The bone anchoring element 2 cooperates with a blocking element 4 allowing, by means of a clamping screw 5, the fixing in rotation and in translation of the connecting rod 3. The bone anchoring element 2 comprises an anchoring part 6 and a receiving part 7 which consists of a U-shaped head 8 open in its upper part to cooperate with the connecting rod 3 and the locking element 4.
La partie d'ancrage 6 peut présenter soit la forme d'un crochet, soit un profil fileté solidaire ou non de la partie de réception 7 pour venir se fixer sur/ou dans le corps vertébral de la vertèbre à instrumenter.The anchoring part 6 may have either the shape of a hook, or a threaded profile which may or may not be integral with the receiving part 7 so as to be fixed on / or in the vertebral body of the vertebra to be instrumented.
La tête 8 comporte deux parois verticales 9, 10 disposées l'une en face de l'autre et dans des plans parallèles afin de délimiter une première ouverture centrale 11 en forme de U portée par l'axe XX' de la tige de liaison 3 et dont le fond 12 présente un profil en portion de cylindre.The head 8 has two vertical walls 9, 10 arranged one opposite the other and in parallel planes in order to delimit a first central opening 11 U-shaped carried by the axis XX 'of the connecting rod 3 and whose bottom 12 has a profile in the form of a cylinder.
Chaque paroi verticale 9, 10 est séparée, par exemple, du fond 12 de l'ouverture centrale 11 par une fente verticale 13 donnant une certaine élasticité à chaque paroi en direction du centre de la tête 8, selon l'axe géométrique V V".Each vertical wall 9, 10 is separated, for example, from the bottom 12 of the central opening 11 by a vertical slot 13 giving a certain elasticity to each wall in the direction of the center of the head 8, along the geometric axis V V ".
Les parois verticales 9, 10 comportent respectivement à chaque extrémité une partie d'accrochage 14, 15 disposée l'une en face de l'autre et de part et d'autre de l'ouverture centrale 11.The vertical walls 9, 10 respectively comprise at each end a hooking part 14, 15 arranged one opposite the other and on either side of the central opening 11.
Chaque paroi verticale 9, 10 comporte sur sa face interne et entre les parties d'accrochage 14, 15 un logement vertical 16 présentant un profil en portion de cylindre pourvu de chaque côté d'une rainure 17 permettant de guider l'élément de blocage 4 lors de sa mise en place au moyen d'un instrument chirurgical 100 dans la tête 8 de l'élément d'ancrage osseux 2.Each vertical wall 9, 10 has on its internal face and between the hooking parts 14, 15 a vertical housing 16 having a profile in portion of cylinder provided on each side with a groove 17 for guiding the locking element 4 during its positioning by means of a surgical instrument 100 in the head 8 of the bone anchoring element 2.
Chaque paroi verticale 9, 10 est percée entre les parties d'accrochage 14, 15 d'un trou 18 débouchant à l'intérieur de l'ouverture centrale 11 et destiné à coopérer avec l'instrument chirurgical 100 lors de l'introduction de l'élément de blocage 4.Each vertical wall 9, 10 is pierced between the attachment parts 14, 15 with a hole 18 opening out inside the central opening 11 and intended to cooperate with the surgical instrument 100 during the introduction of the blocking element 4.
L'élément de blocage 4 présente un profil externe sensiblement parallélépipédique comportant suivant une direction parallèle à l'axe XX' et dans sa partie inférieure un logement 19 présentant un profil en portion de cylindre afin de recevoir et coopérer avec la tige de liaison 3.The locking element 4 has a substantially parallelepipedal external profile comprising in a direction parallel to the axis XX 'and in its lower part a housing 19 having a profile in the portion of a cylinder in order to receive and cooperate with the connecting rod 3.
L'élément de blocage 4 comporte en son milieu une vis de serrage 5 qui débouche à l'intérieur du logement 19 pour venir en contact par pression contre la tige de liaison 3 pour permettre son immobilisation en rotation et en translation.The locking element 4 has in its middle a clamping screw 5 which opens inside the housing 19 to come into contact by pressure against the connecting rod 3 to allow its immobilization in rotation and in translation.
L'élément de blocage 4 comporte dans un plan parallèle à l'axe XX' des ergots 20, 21 en forme de dent séparés par un logement vertical 22 bordé latéralement par des nervures 23 permettant le guidage dudit élément de blocage lors de son introduction dans la tête 8 de l'élément d'ancrage 2.The locking element 4 comprises, in a plane parallel to the axis XX ', lugs 20, 21 in the form of a tooth separated by a vertical housing 22 bordered laterally by ribs 23 allowing the guidance of said locking element when it is introduced into the head 8 of the anchoring element 2.
On a montré en figures 2 et 3 un instrument chirurgical 100 permettant la mise en place et l'introduction de l'élément de blocage 4 entre les parois 9, 10 de la tête 8 de l'élément d'ancrage 2. L'instrument chirurgical 100 est constitué d'un corps 101 comprenant un tube horizontal 102 s'étendant à partir d'un cadre ajouré 103 solidaire suivant une direction parallèle à l'axe Z Z' d'une poignée 104 dite « poignée fixe ».FIGS. 2 and 3 show a surgical instrument 100 allowing the positioning and introduction of the blocking element 4 between the walls 9, 10 of the head 8 of the anchoring element 2. The instrument 100 consists of a body 101 comprising a horizontal tube 102 extending from an openwork frame 103 integral in a direction parallel to the axis ZZ 'of a handle 104 called "fixed handle".
La poignée fixe 104 coopère avec une autre poignée 105 dite « poignée mobile » qui est reliée à la première par un axe de rotation 106 et un ressort à lame 107 permettant d'actionner, sous l'effort d'une pression, des moyens d'entraînement 108.The fixed handle 104 cooperates with another handle 105 called a “movable handle” which is connected to the first by an axis of rotation 106 and a leaf spring 107 making it possible to actuate, under the force of a pressure, means of training 108.
On a illustré en figure 4 la poignée mobile 105 comportant au-dessus de l'axe de rotation 1 06 une tête 109 présentant un profil bombé 110 à partir duquel s'étend une fourche 111 dont chacune des branches 112 comporte une extrémité libre 113 à profil arrondi.Illustrated in Figure 4 the movable handle 105 having above the axis of rotation 1 06 a head 109 having a curved profile 110 from which extends a fork 111 each of the branches 112 of which has a free end 113 with a rounded profile.
On a représenté en figure 5, le cadre 103 du corps 101 qui est constitué de deux parois verticales et opposées 114 et 115 reliées entre elles par des parois ajourées supérieures 1 16 et inférieures 117.FIG. 5 shows the frame 103 of the body 101 which is made up of two vertical and opposite walls 114 and 115 linked together by upper perforated walls 1 16 and lower 117.
La paroi verticale 114 est solidaire du tube horizontal 102 présentant un alésage interne 118 débouchant à l'intérieur du cadre 103, tandis que la paroi opposée 115 est percée d'un trou 119 porté par les mêmes axes principaux que celui de l'alésage interne 118.The vertical wall 114 is integral with the horizontal tube 102 having an internal bore 118 emerging inside the frame 103, while the opposite wall 115 is pierced with a hole 119 carried by the same main axes as that of the internal bore 118.
La paroi supérieure 116 présente un évidemment central 120 de forme rectangulaire, tandis que la paroi inférieure 117 comporte un autre évidemment 121 disposé en dessous de celui 120. L'évidemment 121 comporte au niveau de la poignée fixe 104 des épaulements internes 122 destinés à former une butée.The upper wall 116 has a central recess 120 of rectangular shape, while the lower wall 117 has another recess 121 arranged below that 120. The recess 121 has, at the level of the fixed handle 104, internal shoulders 122 intended to form stubborn.
La paroi supérieure 11 6 du cadre 103 comporte un prolongement 123 qui s'étend au-delà de la paroi verticale 115 et dans lequel est percée une rainure oblongue 124.The upper wall 11 6 of the frame 103 has an extension 123 which extends beyond the vertical wall 115 and in which an oblong groove 124 is pierced.
La paroi supérieure 1 16 du cadre 103 est traversée par un trou horizontal 155 comportant un alésage fileté 156 pour la retenue d'une vis de fixation 157. L'instrument chirurgical 100 comporte des moyens de verrouillage qui sont constitués d'un tube de verrouillage 125 comprenant à l'une de ses extrémités des branches 127 en forme de fourche pourvues chacune d'encoches 126. Le tube 125 comporte à l'extrémité opposée de celle en forme de fourche 127 un manchon cylindrique 128 se prolongeant par des languettes parallèles 129.The upper wall 1 16 of the frame 103 is traversed by a horizontal hole 155 comprising a threaded bore 156 for retaining a fixing screw 157. The surgical instrument 100 comprises locking means which consist of a locking tube 125 comprising at one of its ends branches 127 in the form of a fork each provided with notches 126. The tube 125 comprises at the opposite end of that in the form of a fork 127 a cylindrical sleeve 128 extended by parallel tongues 129 .
Le tube de verrouillage 125 est agencé autour du tube 102 de manière que les extrémités libres 113 de chaque branche 112 de la poignée mobile 105 coopèrent respectivement avec les encoches 126 de chaque branche 127 pour permettre sous l'action de la poignée mobile 105 le coulissement du tube de verrouillage 125 autour du tube 102.The locking tube 125 is arranged around the tube 102 so that the free ends 113 of each branch 112 of the movable handle 105 cooperate respectively with the notches 126 of each branch 127 to allow under the action of the movable handle 105 the sliding of the locking tube 125 around the tube 102.
L'instrument chirurgical 100 comporte un poussoir cylindrique 130 qui traverse le cadre 103 par l'intermédiaire du trou 119 ménagé dans la paroi verticale 115 pour venir coulisser dans l'alésage interne 118 du tube 102 (figure 6).The surgical instrument 100 comprises a cylindrical pusher 130 which passes through the frame 103 by means of the hole 119 made in the vertical wall 115 in order to slide in the internal bore 118 of the tube 102 (FIG. 6).
Le poussoir cylindrique 130 est constitué d'une tige comportant à l'une de ses extrémités une tête 152 en forme de disque bombé permettant la prise par le chirurgien dudit poussoir. Le poussoir cylindrique 130 compte à partir de sa tête 152 une première partie cylindrique 153 qui se prolonge par une seconde partie cylindrique 154 de diamètre extérieur inférieur à celui de la première partie.The cylindrical pusher 130 consists of a rod comprising at one of its ends a head 152 in the form of a curved disc allowing the surgeon to take said pusher. The cylindrical pusher 130 has from its head 152 a first cylindrical part 153 which is extended by a second cylindrical part 154 with an outside diameter smaller than that of the first part.
Les moyens d'entraînement de l'instrument 100 sont formés d'un dispositif d'entraînement 108 qui est constitué d'une première platine 131 disposée à l'intérieur du cadre 103 suivant une direction verticale parallèle à l'axe Z Z' de manière à coopérer avec les evidements 120 et 121 des parois supérieures 116 et inférieures 117 pour permettre son guidage latéral lors de ses déplacements.The drive means of the instrument 100 are formed by a drive device 108 which consists of a first plate 131 arranged inside the frame 103 in a vertical direction parallel to the axis ZZ 'of so as to cooperate with the recesses 120 and 121 of the upper walls 116 and lower 117 to allow its lateral guidance during its movements.
La platine 131 est percée en son milieu d'un trou débouchant permettant le passage du poussoir cylindrique 130. Le dispositif d'entraînement 108 comporte un ressort de compression 132 qui agencé autour du poussoir cylindrique 130 de manière à être en appui contre la platine 131 et la paroi verticale 114 du cadre 103. Le dispositif d'entraînement 108 de l'instrument chirurgical 100 est également constitué d'une seconde platine 133 qui est positionnée suivant une direction sensiblement parallèle à l'axe Z Z' afin d'être guidée et retenue à l'intérieur de la rainure 124 du prolongement 123 de la paroi supérieure 116 du cadre 103. On note que les premières et secondes platines 131 et 133 sont percées dans leur partie supérieure d'un trou, non représenté, permettant la retenue et le guidage desdites platines dans le cadre 103 par l'intermédiaire de la vis de fixation 157 coopérant avec le trou horizontal 155 et sa partie filetée 156 percés dans la paroi supérieure 116.The plate 131 is pierced in the middle of a through hole allowing the passage of the cylindrical plunger 130. The drive device 108 comprises a compression spring 132 which arranged around the cylindrical plunger 130 so as to be in abutment against the plate 131 and the vertical wall 114 of the frame 103. The drive device 108 of the surgical instrument 100 also consists of a second plate 133 which is positioned in a direction substantially parallel to the axis ZZ ′ in order to be guided and retained inside the groove 124 of the extension 123 of the upper wall 116 of the frame 103. It is noted that the first and second plates 131 and 133 are pierced in their upper part with a hole, not shown, allowing the retention and guiding said plates in the frame 103 by means of the fixing screw 157 cooperating with the horizontal hole 155 and its threaded part 156 drilled in the upper wall e 116.
La seconde platine 133 est percée en son milieu d'un trou débouchant permettant le passage du poussoir cylindrique 130 afin que ce dernier traverse, suivant un axe horizontal Y Y', le cadre 103 de l'instrument chirurgical 100. Le dispositif d'entraînement 108 comporte un ressort de compression 134 qui est agencé autour du poussoir cylindrique 130 de manière à être en appui contre la platine 133 et la paroi verticale 115 du cadre 103.The second plate 133 is pierced in the middle with a through hole allowing the passage of the cylindrical pusher 130 so that the latter crosses, along a horizontal axis Y Y ′, the frame 103 of the surgical instrument 100. The drive device 108 includes a compression spring 134 which is arranged around the cylindrical pusher 130 so as to bear against the plate 133 and the vertical wall 115 of the frame 103.
La première platine 131 est prévue pour venir, sous l'effet du ressort 132, en appui contre le profil bombé 110 de la tête 109 de la poignée mobile 105 permettant lors de l'actionnement de cette dernière le déplacement en translation du poussoir cylindrique 130 à l'intérieur du tube 102 et du cadre 103.The first plate 131 is provided to come, under the effect of the spring 132, to bear against the convex profile 110 of the head 109 of the movable handle 105 allowing during actuation of the latter the displacement in translation of the cylindrical plunger 130 inside the tube 102 and the frame 103.
On a montré en figures 7 et 8 l'extrémité libre du tube 102 se trouvant à l'opposé du cadre 103 du corps 101 de l'instrument chirurgical 100.FIGS. 7 and 8 show the free end of the tube 102 lying opposite the frame 103 of the body 101 of the surgical instrument 100.
L'alésage interne cylindrique 118 du tube 102 se prolonge au niveau de son extrémité libre par un autre alésage 135 présentant en section un profil sensiblement rectangulaire et de forme complémentaire à celui externe de l'élément de blocage 4 de l'implant rachidien 1.The cylindrical internal bore 118 of the tube 102 is extended at its free end by another bore 135 having in section a substantially rectangular profile and of shape complementary to that of the external locking element 4 of the spinal implant 1.
En effet, l'alésage interne 135 est prévu pour recevoir un certain nombre d'élément de blocage 4, comme par exemple au moins 10 éléments de blocage 4, afin de pouvoir les présenter au-dessus de chaque élément d'ancrage osseux 2 pour leur mise en place.In fact, the internal bore 135 is designed to receive a certain number of locking elements 4, such as for example at least 10 locking elements 4, in order to be able to present them above each bone anchoring element 2 for their establishment.
Ainsi, l'alésage interne 135 comporte, sur chaque paroi 136 parallèle et opposée, une rainure de guidage 137 prévue pour recevoir chacune les nervures 23 de l'élément de blocage 4, correspondant. Le tube cylindrique 102 se prolonge au niveau de son extrémité libre par un manchon 138 à profil sensiblement rectangulaire dont chaque paroi 139 parallèle et opposée comporte une échancrure 140 en forme de U destinée à coopérer avec la tige de liaison 3 de l'implant rachidien 1.Thus, the internal bore 135 comprises, on each parallel and opposite wall 136, a guide groove 137 provided for each receiving the ribs 23 of the corresponding locking element 4. The cylindrical tube 102 is extended at its free end by a sleeve 138 with a substantially rectangular profile, each parallel and opposite wall 139 of which has a U-shaped notch 140 intended to cooperate with the connecting rod 3 of the spinal implant 1 .
On note que les parois 139 du manchon 138 sont disposées dans des plans perpendiculaires à ceux contenant les parois 136 de l'alésage interne 135.It will be noted that the walls 139 of the sleeve 138 are arranged in planes perpendicular to those containing the walls 136 of the internal bore 135.
On constate que le profil interne du manchon 138 est suivant une direction de dimensions légèrement supérieures à celles de l'alésage interne 135 afin de conformer à l'entrée de ce dernier des épaulements 151 formant butée.It can be seen that the internal profile of the sleeve 138 is in a direction of dimensions slightly greater than those of the internal bore 135 in order to conform to the entry of the latter of the shoulders 151 forming a stop.
Le tube cylindrique 102 comporte sur son profil externe et dans des plans parallèles à ceux contenant les parois 136 de l'alésage interne 135 des méplats 141 qui se prolongent sur chaque paroi 142 du manchon 138.The cylindrical tube 102 has, on its external profile and in planes parallel to those containing the walls 136 of the internal bore 135, flats 141 which extend on each wall 142 of the sleeve 138.
Au niveau du tube cylindrique 102 chaque méplat 141 est percé d'un premier trou 143 et d'un second trou 144 débouchant à l'intérieur des rainures 137 de l'alésage 135.At the level of the cylindrical tube 102 each flat 141 is pierced with a first hole 143 and a second hole 144 opening into the grooves 137 of the bore 135.
Au niveau des parois 142 du manchon 138, chaque méplat 141 est percé d'un troisième trou débouchant 145 qui est porté par le même axe principal que celui du premier trou 143 et du second trou 144. Chaque premier trou 143 présente un filetage interne permettant de coopérer avec une vis de serrage 146 permettant la fixation dans chaque méplat 141 de deux lamelles élastiques 147 et 148.At the walls 142 of the sleeve 138, each flat 141 is pierced with a third through hole 145 which is carried by the same main axis as that of the first hole 143 and the second hole 144. Each first hole 143 has an internal thread allowing to cooperate with a clamping screw 146 allowing the fixing in each flat 141 of two elastic strips 147 and 148.
Chaque lamelle élastique 147 est solidaire d'un doigt 149 coopérant avec le second trou 144 et pénétrant à l'intérieur de l'alésage 135 pour permettre la retenue à l'intérieur de ce dernier des éléments de blocage 4.Each elastic strip 147 is integral with a finger 149 cooperating with the second hole 144 and penetrating inside the bore 135 to allow the retention inside the latter of the locking elements 4.
Chaque lamelle élastique 148 est solidaire d'un pion 150 coopérant avec le troisième trou 145 du manchon 138 afin de pouvoir pénétrer à l'intérieur de ce dernier lorsque les lamelles 148 sont déformées par un effort de poussée externe.Each elastic strip 148 is integral with a pin 150 cooperating with the third hole 145 of the sleeve 138 so as to be able to penetrate inside the latter when the strips 148 are deformed by an external thrust force.
On comprend aisément de la description ci-dessus et des figures 8 et 9 que le fonctionnement du premier mode de réalisation de l'instrument chirurgical 100 est le suivant :It is easily understood from the above description and from FIGS. 8 and 9 that the operation of the first embodiment of the surgical instrument 100 is as follows:
On procède au chargement des éléments de blocage 4 à l'intérieur du tube 102 et plus particulièrement à l'intérieur de l'alésage 135. Les éléments de blocage 4 sont introduits par l'extrémité inférieure du tube 102 au niveau du manchon 138. Lors du passage de chaque élément de biocage 4, les doigts de blocage 149 s'écartent grâce à l'élasticité des lamelles 147, permettant ainsi l'introduction d'au moins dix éléments de blocage 4 à l'intérieur de l'alésage 135 du tube 102.The locking elements 4 are loaded inside the tube 102 and more particularly inside the bore 135. The locking elements 4 are introduced through the lower end of the tube 102 at the sleeve 138. During the passage of each biocage element 4, the locking fingers 149 move apart thanks to the elasticity of the lamellae 147, thus allowing the introduction of at least ten locking elements 4 inside the bore 135 of tube 102.
On procède à la mise en place de l'instrument chirurgical 100 sur la tête 8 de l'élément d'ancrage osseux 2 de l'implant rachidien 1 de sorte que la tête soit positionnée dans le manchon 138 et en appui contre les épaulements 151 formant butée. L'orientation de l'instrument chirurgical 100 est définie par la tige de liaison 3 qui doit être introduite dans le passage de tige, constitué par les échancrures 140. Dans cette position, les pions 150 des lamelles élastiques 148 viennent se positionner en face des trous 18 ménagés dans la tête 8 l'élément d'ancrage osseux 2.The surgical instrument 100 is placed on the head 8 of the bone anchoring element 2 of the spinal implant 1 so that the head is positioned in the sleeve 138 and in abutment against the shoulders 151 forming a stop. The orientation of the surgical instrument 100 is defined by the connecting rod 3 which must be introduced into the rod passage, formed by the notches 140. In this position, the pins 150 of the elastic strips 148 are positioned opposite the holes 18 made in the head 8 the bone anchoring element 2.
On actionne l'instrument chirurgical 100 en agissant par une pression sur la poignée mobile 105 permettant par l'intermédiaire de ses branches 112 de déplacer en translation le tube 125 en direction de l'extrémité libre du tube 102. Lors de ce déplacement en translation, le tube 125 vient appuyer au moyen des languettes 129 sur les lamelles élastiques 148, bloquant ainsi les pions 150 dans les trous latéraux 18 ménagés dans la tête 8 l'élément d'ancrage osseux 2. Ce premier mouvement de la poignée 105 permet la fixation de l'instrument chirurgical 100 sur l'élément d'ancrage osseux 2.The surgical instrument 100 is actuated by acting by a pressure on the movable handle 105 allowing, through its branches 112, to move the tube 125 in translation towards the free end of the tube 102. During this movement in translation , the tube 125 presses by means of the tongues 129 on the elastic strips 148, thus blocking the pins 150 in the lateral holes 18 formed in the head 8 the bone anchoring element 2. This first movement of the handle 105 allows the fixation of the surgical instrument 100 on the bone anchoring element 2.
L'introduction de l'élément de blocage 4 s'effectue par une continuation de la pression sur la poignée 105 prolongeant son mouvement de rotation et permettant d'une part de dégager les extrémités de chaque branche 112 des encoches 126 du tube 125 ce qui met fin à la translation du tube 125 et d'autre part de venir en contact par l'intermédiaire du profil bombé 110 avec la platine 131. Grâce à la poussée exercée sur l'extrémité inférieure de la platine 131 , cette dernière s'arc- boute sur le poussoir cylindrique 130. Le mouvement continu de la poignée 105 entraînant la platine 131 permet par arc-boutement de cette dernière de déplacer en translation le poussoir cylindrique 130 à l'intérieur du tube 102.The insertion of the blocking element 4 is effected by a continuation of the pressure on the handle 105 extending its rotational movement and allowing on the one hand to release the ends of each branch 112 from the notches 126 of the tube 125 which puts an end to the translation of the tube 125 and on the other hand to come into contact via the convex profile 110 with the plate 131. Thanks to the thrust exerted on the lower end of the plate 131, the latter arcs - bottle on the cylindrical pusher 130. The continuous movement of the handle 105 driving the plate 131 makes it possible by bracing of the latter to move in translation the cylindrical pusher 130 inside the tube 102.
Le poussoir cylindrique 130 vient en appui sur le dernier élément de blocage 4 placé dans l'alésage interne 135 appliquant sur l'ensemble des éléments de blocage 4 contenus dans l'alésage 135, un effort de poussée F, permettant l'expulsion de l'élément de blocage 4 se trouvant directement au-dessus de la tête 8 de l'élément d'ancrage osseux 2 et son introduction dans ladite tête 8. La libération de l'instrument chirurgical 100 est obtenue par le relâchement de la pression sur la poignée 105 qui revient par l'intermédiaire du ressort à lame 107 dans sa position de repos. En revenant à sa position de repos, la poignée 105 entraîne le tube 125, grâce aux encoches 126, libérant ainsi les lamelles 148 qui grâce à leur élasticité s'écartent du tube 102. Les pions 150 sortent des trous 18 libérant ainsi l'instrument chirurgical 100 de la tête 8 de l'élément d'ancrage osseux 2.The cylindrical pusher 130 comes to bear on the last blocking element 4 placed in the internal bore 135 applying to all of the blocking elements 4 contained in the bore 135, a thrust force F, allowing the expulsion of the blocking element 4 located directly above the head 8 of the bone anchoring element 2 and its introduction into said head 8. The release of the surgical instrument 100 is obtained by the release of the pressure on the handle 105 which returns via the leaf spring 107 in its rest position. Returning to its rest position, the handle 105 drives the tube 125, thanks to the notches 126, thus releasing the lamellae 148 which, thanks to their elasticity, move away from the tube 102. The pins 150 come out of the holes 18 thus releasing the instrument 100 of the head 8 of the bone anchoring element 2.
Grâce au ressort 132, la platine 131 revient dans sa position de repos, en butée sur les épaulements 122 de l'évidemment 121 du cadre 103. Le poussoir cylindrique 130 ne recule pas, grâce à la pression exercée par la platine 133 arc- boutée grâce au ressort 134.Thanks to the spring 132, the plate 131 returns to its rest position, in abutment on the shoulders 122 of the recess 121 of the frame 103. The cylindrical pusher 130 does not move back, thanks to the pressure exerted by the plate 133 braced thanks to spring 134.
Lorsque le dernier élément de blocage 4 a été introduit, le poussoir cylindriqueWhen the last blocking element 4 has been introduced, the cylindrical pusher
130 et plus particulièrement la première partie cylindrique 153 est arrivée au bout de l'alésage 118 du tube 102, tandis que la seconde partie cylindrique 154 est pour sa part introduite dans l'alésage 135 sans pénétrer à l'intérieur du manchon 138. En appuyant sur la platine 133, le poussoir cylindrique 130 est libéré et peut être remonté. De nouveaux éléments de blocage 4 peuvent alors être introduits comme cela a été précédemment expliqué.130 and more particularly the first cylindrical part 153 has arrived at the end of the bore 118 of the tube 102, while the second cylindrical part 154 is for its part introduced into the bore 135 without penetrating inside the sleeve 138. By pressing on the plate 133, the cylindrical pusher 130 is released and can be reassembled. New blocking elements 4 can then be introduced as has been previously explained.
On a montré en figures 11 à 15 une variante de l'instrument chirurgical 100 décrit précédemment permettant la mise en place et l'introduction de l'élément de blocage 4 entre les parois 9, 10 de la tête 8 de l'élément d'ancrage 2. L'instrument chirurgical 100 est constitué d'un corps 101 comprenant un tube horizontal 102 s'étendant à partir d'un cadre ajouré 103 solidaire suivant une direction parallèle à l'axe Z Z' d'une poignée 104 dite « poignée fixe ».There is shown in Figures 11 to 15 a variant of the surgical instrument 100 described above allowing the establishment and introduction of the locking element 4 between the walls 9, 10 of the head 8 of the element anchoring 2. The surgical instrument 100 consists of a body 101 comprising a horizontal tube 102 extending from an openwork frame 103 integral in a direction parallel to the axis ZZ 'of a handle 104 called "handle fixed ”.
La poignée fixe 104 coopère avec une autre poignée 105 dite « poignée mobile » qui est reliée à la première par un axe de rotation 106 et un ressort à lame 107 permettant d'actionner, sous l'effort d'une pression, le dispositif d'entraînement 108 décrit précédemment.The fixed handle 104 cooperates with another handle 105 known as a “movable handle” which is connected to the first by an axis of rotation 106 and a leaf spring 107 making it possible to actuate, under the force of a pressure, the device d drive 108 described above.
La variante de l'instrument chirurgical 100 sera uniquement décrite en ce qui concerne les éléments qui ont été modifiés, à savoir : la poignée mobile 105, le tube de verrouillage 125 et son entraînement autour du tube 102, et la seconde platine 133 du dispositif d'entraînement 108 sachant que toutes les autres pièces sont de structure et de fonction identiques. La poignée mobile 105 a été modifiée et ne comporte plus de fourche 1 11 , mais uniquement le profil bombé 110 qui vient en appui sur la première platine 131 du dispositif d'entraînement 108.The variant of the surgical instrument 100 will only be described with regard to the elements which have been modified, namely: the movable handle 105, the locking tube 125 and its drive around the tube 102, and the second plate 133 of the device 108 knowing that all the other parts have the same structure and function. The movable handle 105 has been modified and no longer comprises a fork 11, but only the curved profile 110 which comes to bear on the first plate 131 of the drive device 108.
En ce qui concerne la seconde platine 133 du dispositif d'entraînement 108, cette dernière est positionnée suivant une direction sensiblement parallèle à l'axe Z Z' afin d'être guidée et retenue à l'intérieur de la rainure 124 du prolongement 123 de la paroi supérieure 116 du cadre 103. On note que la seconde platine 133 présente un prolongement 158 s'étendant au dessus de la rainure 124 du prolongement 123 de la paroi supérieure 116 du cadre 103.As regards the second plate 133 of the drive device 108, the latter is positioned in a direction substantially parallel to the axis ZZ ′ in order to be guided and retained inside the groove 124 of the extension 123 of the upper wall 116 of the frame 103. It is noted that the second plate 133 has an extension 158 extending above the groove 124 of the extension 123 of the upper wall 116 of the frame 103.
La partie supérieure de la seconde platine 133 est percée d'un trou oblong 159 coopérant avec la vis de fixation 157 permettant, par une fixation non serrée, le guidage et la retenue des premières et secondes platines à l'intérieur du cadre 103, sachant que la première platine 131 est percée d'un trou non représenté pour le passage de la vis 157. Le trou oblong 159 permet le guidage en translation de la platine 133 autour de la vis 157, lors du démontage du capot 180.The upper part of the second plate 133 is pierced with an oblong hole 159 cooperating with the fixing screw 157 allowing, by an untightened fixing, the guidance and the retention of the first and second plates inside the frame 103, knowing that the first plate 131 is pierced with a hole not shown for the passage of the screw 157. The oblong hole 159 allows the guide in translation of the plate 133 around the screw 157, when the cover 180 is dismantled.
La seconde platine 133 comporte à l'opposé du prolongement 158 un profil en forme de bec 160 formant une gâche pour le déplacement en translation de ladite seconde platine.The second plate 133 comprises, opposite the extension 158, a profile in the shape of a beak 160 forming a keeper for the translational movement of said second plate.
On note que le tube de verrouillage 125 ne comporte plus à l'opposé des languettes 129 des branches 127 en forme de fourche pourvues chacune d'encoches 126. Le tube de verrouillage 125 présente un profil cylindrique qui est solidaire à l'opposé des languettes 129 d'un capot 180 présentant un profil externe ergonomique assurant une parfaite préhension par le chirurgien pour lui permettre de déplacer en translation le tube de verrouillage 125 autour du tube 102, soit en direction de l'extrémité libre dudit tube 102, soit dans une direction qui s'éloigne de ladite extrémité libre.It will be noted that the locking tube 125 no longer comprises, opposite the tongues 129, branches 127 in the form of a fork each provided with notches 126. The locking tube 125 has a cylindrical profile which is integral opposite the tongues 129 of a cover 180 having an ergonomic external profile ensuring perfect grip by the surgeon to allow him to move in translation the locking tube 125 around the tube 102, either in the direction of the free end of said tube 102, or in a direction which moves away from said free end.
Le capot 180 comprend à l'opposé du tube de verrouillage 125 et dans sa partie supérieure et interne une rainure 181 coopérant, lors de la mise en place dudit capot sur le cadre 103, avec le prolongement 158 de la seconde platine 133 du dispositif d'entraînement 108 assurant le guidage en translation du capot 180.The cover 180 comprises opposite the locking tube 125 and in its upper and internal part a groove 181 cooperating, during the positioning of said cover on the frame 103, with the extension 158 of the second plate 133 of the device d 'drive 108 ensuring the translational guidance of the cover 180.
Egalement la coopération du prolongement 1 58 dans la rainure 181 permet de limiter la course de déplacement du capot 180 et donc du tube de verrouillage 125 par rapport au tube 102.Also the cooperation of the extension 1 58 in the groove 181 makes it possible to limit the displacement stroke of the cover 180 and therefore of the locking tube 125 relative to the tube 102.
On comprend aisément de la description ci-dessus et des figures 11 à 15 que le fonctionnement du second mode de réalisation de l'instrument chirurgical 100 est le suivant :It is easily understood from the above description and from FIGS. 11 to 15 that the operation of the second embodiment of the surgical instrument 100 is as follows:
A cet effet, le déplacement en translation, par le chirurgien au moyen du capot 180, du tube de verrouillage 125, en direction de l'extrémité libre du tube 102, permet de venir appuyer au moyen des languettes 129 sur les lamelles élastiques 148 du tube 102, bloquant ainsi les pions 150 dans les trous latéraux 18 ménagés dans la tête 8 de l'élément d'ancrage osseux 2. Ce mouvement en translation du tube 125 permet la fixation de l'instrument chirurgical 100 sur l'élément d'ancrage osseux 2.For this purpose, the displacement in translation, by the surgeon by means of the cover 180, of the locking tube 125, in the direction of the free end of the tube 102, makes it possible to come to bear by means of the tongues 129 on the elastic strips 148 of the tube 102, thus blocking the pins 150 in the lateral holes 18 formed in the head 8 of the bone anchoring element 2. This movement in translation of the tube 125 allows the surgical instrument 100 to be fixed on the element bone anchor 2.
L'introduction de l'élément de blocage 4 s'effectue par une pression sur la poignée 105 permettant de venir en contact par l'intermédiaire du profil bombé 110 avec la platine 131. Grâce à la poussée exercée sur l'extrémité inférieure de la platine 131 , cette dernière s'arc-boute sur le poussoir cylindrique 130.The locking element 4 is introduced by pressing on the handle 105 making it possible to come into contact via the convex profile 110 with the plate 131. Thanks to the thrust exerted on the lower end of the plate 131, the latter is arched on the cylindrical pusher 130.
Le mouvement continu de la poignée 105 entraînant la platine 131 permet par arc-boutement de cette dernière de déplacer en translation le poussoir cylindrique 130 à l'intérieur du tube 102.The continuous movement of the handle 105 driving the plate 131 makes it possible, by bracing the latter, to move the cylindrical pusher 130 in translation inside the tube 102.
Le poussoir cylindrique 130 vient en appui sur le dernier élément de blocage 4 placé dans l'alésage interne 135 appliquant sur l'ensemble des éléments de blocage 4 contenus dans l'alésage 135, un effort de poussée F, permettant l'expulsion de l'élément de blocage 4 se trouvant directement au-dessus de la tête 8 de l'élément d'ancrage osseux 2 et son introduction dans ladite tête 8.The cylindrical pusher 130 comes to bear on the last blocking element 4 placed in the internal bore 135 applying to all of the blocking elements 4 contained in the bore 135, a thrust force F, allowing the expulsion of the blocking element 4 located directly above the head 8 of the bone anchoring element 2 and its introduction into said head 8.
Egalement, la libération de l'instrument chirurgical 100 est obtenue par le déplacement en translation, par le chirurgien au moyen du capot 180, du tube de verrouillage 125, dans une direction qui s'éloigne de l'extrémité libre du tube 102 libérant ainsi les lamelles 148 qui grâce à leur élasticité s'écartent du tube 102.Also, the release of the surgical instrument 100 is obtained by the translational movement, by the surgeon by means of the cover 180, of the locking tube 125, in a direction which moves away from the free end of the tube 102 thus releasing the strips 148 which, thanks to their elasticity, move away from the tube 102.
Les pions 150 sortent des trous 18 libérant ainsi l'instrument chirurgical 1 00 de la tête 8 de l'élément d'ancrage osseux 2. On constate que le démontage du tube de verrouillage 125 est obtenu lorsque le poussoir 130 est complètement retiré de l'instrument chirurgical 100. En effet, le retrait du poussoir 130 permet le déplacement en translation de la seconde platine 133 au moyen d'une pression sur la gâche 160 afin que le prolongement 158 soit dégagé de la rainure 181 du capot 180.The pins 150 come out of the holes 18 thus releasing the surgical instrument 1 00 from the head 8 of the bone anchoring element 2. It can be seen that the disassembly of the locking tube 125 is obtained when the pusher 130 is completely withdrawn from the surgical instrument 100. In fact, the withdrawal of the pusher 130 allows the displacement in translation of the second plate 133 by means of a pressure on the keeper 160 so that the extension 158 is released from the groove 181 of the cover 180.
Le déplacement de la seconde platine 133 est assuré par le trou oblong 159 permettant le guidage en translation de la seconde platine 133 autour de la vis 157.The second plate 133 is displaced by the oblong hole 159 allowing the second plate 133 to guide in translation around the screw 157.
Il doit d'ailleurs être entendu que la description qui précède n'a été donnée qu'a titre d'exemple et qu'elle ne limite nullement le domaine de l'invention dont on ne sortirait pas en remplaçant les détails d'exécutions décrits par tout autre équivalent. It should moreover be understood that the foregoing description has been given only by way of example and that it in no way limits the field of the invention from which one would not depart by replacing the details of executions described by any other equivalent.

Claims

REVENDICATIONS
1. Instrument chirurgical comportant des moyens d'immobilisation (125) sur la tête (8) d'un l'élément d'ancrage osseux (2) d'un implant rachidien (1 ) et des moyens d'entraînement (108) pour l'introduction d'un élément de blocage (4) dans la tête (8) en forme de U de l'élément d'ancrage osseux (2) pour la fixation en rotation et en translation d'une tige de liaison (3), caractérisé en ce qu'il comporte un corps principal (101 ) comprenant une poignée fixe (104), une poignée mobile (105) et un dispositif d'entraînement (108) qui est constitué d'une première platine (131 ) chargée élastiquement par un ressort (132), d'un poussoir cylindrique (130) et d'une seconde platine (133) chargée élastiquement par un ressort (134), ladite première platine (131) étant prévue pour venir, sous l'effet du ressort (132), en appui contre le profil de la poignée mobile (105) permettant lors de l'actionnement de cette dernière le déplacement en translation du poussoir cylindrique (130) à l'intérieur d'un tube (102) grâce à l'arc-boutement de la première platine ( 131 ) pour l'introduction sous un effort de poussée F d'un élément de blocage (4), préalablement positionné et guidé à l'intérieur du tube (102), dans la tête (8) de l'élément d'ancrage osseux (2).1. Surgical instrument comprising immobilization means (125) on the head (8) of a bone anchoring element (2) of a spinal implant (1) and drive means (108) for the introduction of a blocking element (4) into the U-shaped head (8) of the bone anchoring element (2) for fixing in rotation and in translation a connecting rod (3) , characterized in that it comprises a main body (101) comprising a fixed handle (104), a movable handle (105) and a drive device (108) which consists of a first plate (131) loaded elastically by a spring (132), a cylindrical pusher (130) and a second plate (133) loaded elastically by a spring (134), said first plate (131) being provided to come, under the effect of the spring (132), pressing against the profile of the movable handle (105) allowing during actuation of the latter the displacement in translation of the cylindrical plunger (130) inside a tube (102) thanks to the bracing of the first plate (131) for the introduction under a pushing force F of a blocking element (4), previously positioned and guided inside the tube (102), in the head (8) of the bone anchoring element (2).
2. Instrument chirurgical suivant la revendication 1 , caractérisé en ce que la poignée mobile (105) coopère avec la poignée fixe (104) par l'intermédiaire d'un axe de rotation (106) et d'un ressort à lame (107) permettant d'actionner sous un effort de pression le dispositif d'entraînement ( 108) et de revenir dans sa position de repos après relâchement de l'effort de pression.2. Surgical instrument according to claim 1, characterized in that the movable handle (105) cooperates with the fixed handle (104) via a rotation axis (106) and a leaf spring (107) allowing the drive device (108) to be actuated under pressure force and to return to its rest position after the pressure force has been released.
3. Instrument chirurgical suivant la revendication 2, caractérisé en ce que la poignée mobile (105) comporte au-dessus de l'axe de rotation (106) une tête (109) présentant un profil bombé (110).3. Surgical instrument according to claim 2, characterized in that the movable handle (105) comprises above the axis of rotation (106) a head (109) having a curved profile (110).
4. Instrument chirurgical suivant la revendication 2, caractérisé en ce que la poignée mobile (105) comporte au-dessus de l'axe de rotation (106) une tête (109) présentant un profil bombé (110) à partir duquel s'étend une fourche (111 ) dont chacune des branches (112) comporte une extrémité libre (113) à profil arrondi.4. Surgical instrument according to claim 2, characterized in that the movable handle (105) comprises above the axis of rotation (106) a head (109) having a curved profile (110) from which extends a fork (111), each of the branches (112) of which has a free end (113) with a rounded profile.
5. Instrument chirurgical suivant la revendication 1 , caractérisé en ce que le cadre (103) est constitué de deux parois verticales et opposées (1 14, 115) reliées entre elles par des parois ajourées supérieures (116) et inférieures (117), ladite paroi verticale (114) étant solidaire du tube horizontal (102) présentant un alésage interne (118) débouchant à l'intérieur du cadre (103), tandis que la paroi opposée (115) est percée d'un trou (119) porté par les mêmes axes principaux que celui de l'alésage interne (118), ladite paroi supérieure (116) présentant un évidemment central (120) de forme rectangulaire et un prolongement (123) s'étendant au-delà de la paroi verticale (115) et dans lequel est percée une rainure oblongue (1 24), tandis que la paroi inférieure (117) comporte un autre évidemment (121 ) disposé en dessous de celui (120), ledit évidemment (121 ) comportant au niveau de la poignée fixe (104) des épaulements internes (122) destinés à former une butée.5. Surgical instrument according to claim 1, characterized in that the frame (103) consists of two vertical and opposite walls (1 14, 115) interconnected by upper perforated walls (116) and lower (117), said vertical wall (114) being integral with the horizontal tube (102) having an internal bore (118) opening inside the frame (103), while the opposite wall (115) is pierced with a hole (119) carried by the same main axes as that of the internal bore (118), said upper wall (116) having a central recess (120) of rectangular shape and an extension (123) extending beyond the vertical wall (115) and in which an oblong groove (1 24) is pierced, while the lower wall (117) has another recess (121) arranged below that (120), said obviously (121) comprising at the level of the fixed handle (104) internal shoulders (122) intended to form a stop.
6. Instrument chirurgical suivant la revendication 1 , caractérisé en ce que les premières et secondes platines (131 , 133) sont guidées et retenues dans le cadre (103) par l'intermédiaire d'une vis de fixation (157) coopérant avec un trou horizontal (155) pourvu d'une partie filetée (156) percés dans la paroi supérieure (116) dudit cadre. 6. Surgical instrument according to claim 1, characterized in that the first and second plates (131, 133) are guided and retained in the frame (103) by means of a fixing screw (157) cooperating with a hole horizontal (155) provided with a threaded part (156) drilled in the upper wall (116) of said frame.
7. Instrument chirurgical suivant la revendication 1 , caractérisé en ce que la seconde platine (133) comporte une prolongement (158) s'étendant au dessus de la rainure (124) du prolongement (123) de la paroi supérieure (116) du cadre (103). 7. Surgical instrument according to claim 1, characterized in that the second plate (133) has an extension (158) extending above the groove (124) of the extension (123) of the upper wall (116) of the frame (103).
8. Instrument chirurgical suivant la revendication 7, caractérisé en ce que la seconde platine (133) est percée d'un trou oblong (159).8. Surgical instrument according to claim 7, characterized in that the second plate (133) is pierced with an oblong hole (159).
9. Instrument chirurgical suivant la revendication 7, caractérisé en ce que la seconde platine (133) comporte à l'opposé du prolongement (158) un profil en forme de bec (160) formant une gâche.9. Surgical instrument according to claim 7, characterized in that the second plate (133) comprises opposite the extension (158) a profile in the form of a beak (160) forming a keeper.
10. Instrument chirurgical suivant la revendication 1 , caractérisé en ce qu'il comporte un corps principal (101 ) comprenant une poignée fixe (104), une poignée mobile (105) agissant sur un dispositif d'entraînement (108) guidé à l'intérieur du corps principal (101 ) et permettant suivant l'effort de pression appliqué sur la poignée mobile (105) d'une part l'immobilisation de l'instrument chirurgical (100) sur la tête (8) de l'élément d'ancrage osseux (2) et d'autre part l'introduction sous un effort de poussée F d'un élément de blocage (104), préalablement positionné et guidé à l'intérieur d'un tube (102) du corps principal (101 ), dans la tête (8) de l'élément d'ancrage osseux (2).10. Surgical instrument according to claim 1, characterized in that it comprises a main body (101) comprising a fixed handle (104), a movable handle (105) acting on a drive device (108) guided by the inside the main body (101) and allowing, depending on the pressure force applied to the movable handle (105) on the one hand, the immobilization of the surgical instrument (100) on the head (8) of the element bone anchoring (2) and on the other hand the introduction under a pushing force F of a blocking element (104), previously positioned and guided inside a tube (102) of the main body (101) , in the head (8) of the bone anchoring element (2).
11. Instrument chirurgical suivant la revendication 10, caractérisé en ce que les moyens de verrouillage sont constitués d'un tube de verrouillage (125) comprenant à l'une de ses extrémités des branches (127) en forme de fourche pourvues chacune d'encoches (126) de manière que les extrémités libres (113) de chaque branche (112) de la poignée mobile (105) coopèrent respectivement avec lesdites encoches (126) pour permettre sous l'action de la poignée mobile (105) le coulissement du tube de verrouillage (125) autour du tube (102) et à l'extrémité opposée un manchon cylindrique (128) se prolongeant par des languettes parallèles (129).11. Surgical instrument according to claim 10, characterized in that the locking means consist of a locking tube (125) comprising at one of its ends branches (127) in the form of a fork each provided with notches (126) so that the free ends (113) of each branch (112) of the movable handle (105) cooperate respectively with said notches (126) to allow under the action of the movable handle (105) the sliding of the tube locking (125) around the tube (102) and at the opposite end a cylindrical sleeve (128) extended by parallel tongues (129).
12. Instrument chirurgical suivant la revendication 1 , caractérisé en ce que les moyens de verrouillage sont constitués d'un tube de verrouillage (125) comprenant à l'une de ses extrémités un capot (1 80) présentant un profil externe ergonomique assurant une parfaite préhension par le chirurgien pour lui permettre de déplacer en translation le tube de verrouillage (125) autour du tube (102) soit en direction de l'extrémité libre dudit tube (102), soit dans une direction qui s'éloigne de ladite extrémité libre. 12. Surgical instrument according to claim 1, characterized in that the locking means consist of a locking tube (125) comprising at one of its ends a cover (1 80) having an external ergonomic profile ensuring perfect gripping by the surgeon to allow him to move in translation the locking tube (125) around the tube (102) either in the direction of the free end of said tube (102), or in a direction which moves away from said free end .
13. Instrument chirurgical suivant la revendication 12, caractérisé en ce que le capot (180) comprend, à l'opposé du tube de verrouillage (125), et dans sa partie supérieure et interne une rainure (181 ) coopérant, lors de la mise en place dudit capot sur le cadre (103), avec le prolongement (158) de la seconde platine (133) du dispositif d'entraînement (108).13. Surgical instrument according to claim 12, characterized in that the cover (180) comprises, opposite the locking tube (125), and in its upper and internal part a groove (181) cooperating, when putting in place of said cover on the frame (103), with the extension (158) of the second plate (133) of the drive device (108).
14. Instrument chirurgical suivant la revendication 1 , caractérisé en ce qu'il comporte un poussoir cylindrique (130) qui traverse le cadre (103) par l'intermédiaire du trou (119) ménagé dans la paroi verticale (115) pour venir coulisser dans l'alésage interne (118) du tube (102).14. Surgical instrument according to claim 1, characterized in that it comprises a cylindrical pusher (130) which passes through the frame (103) via the hole (119) made in the vertical wall (115) to slide in the internal bore (118) of the tube (102).
15. Instrument chirurgical suivant la revendication 14, caractérisé en ce que le poussoir cylindrique (130) comporte à partir de sa tête (152) une première partie cylindrique (153) qui se prolonge par une seconde partie cylindrique (154) de diamètre extérieur inférieur à celui de la première partie.15. Surgical instrument according to claim 14, characterized in that the cylindrical pusher (130) comprises from its head (152) a first cylindrical part (153) which is extended by a second cylindrical part (154) of smaller outside diameter to that of the first part.
16. Instrument chirurgical suivant la revendication 1 , caractérisé en ce que le dispositif d'entraînement (108) est constitué d'une première platine (131 ) chargée élastiquement par un ressort (132) et disposée à l'intérieur du cadre (103) de manière à coopérer avec les evidements (120, 121) des parois supérieures (116) et inférieures (117) et le poussoir cylindrique (130) et d'une seconde platine (133) chargée élastiquement par un ressort (134) et disposée à l'intérieur de la rainure (124) du prolongement (123) de la paroi supérieure (116) de manière à coopérer avec le poussoir cylindrique (13O), ladite première platine (131 ) étant prévue pour venir, sous l'effet du ressort (132), en appui contre le profil bombé (110) de la tête (109) de la poignée mobile (105) permettant lors de l'actionnement de cette dernière le déplacement en translation du poussoir cylindrique (130) à l'intérieur du tube (102) grâce à l'arc-boutement de la première platine (131).16. Surgical instrument according to claim 1, characterized in that the drive device (108) consists of a first plate (131) loaded elastically by a spring (132) and disposed inside the frame (103) so as to cooperate with the recesses (120, 121) of the upper (116) and lower (117) walls and the cylindrical pusher (130) and of a second plate (133) loaded elastically by a spring (134) and arranged at the interior of the groove (124) of the extension (123) of the upper wall (116) so as to cooperate with the cylindrical plunger (130), said first plate (131) being provided to come, under the effect of the spring (132), bearing against the curved profile (110) of the head (109) of the movable handle (105) allowing, when the latter is actuated, the displacement in translation of the cylindrical plunger (130) inside the tube (102) thanks to the bracing of the first plate ( 131).
17. Instrument chirurgical suivant la revendication 5, caractérisé en ce que le tube (102) comporte dans le prolongement de l'alésage interne cylindrique (118) et au niveau de son extrémité libre un autre alésage interne (135) dont le profil interne est complémentaire à celui externe de l'élément de blocage (4) afin de pouvoir recevoir et guider ce dernier avant son introduction dans la tête (8) de l'élément d'ancrage osseux (2).17. Surgical instrument according to claim 5, characterized in that the tube (102) comprises in the extension of the cylindrical internal bore (118) and at its free end another internal bore (135) whose internal profile is complementary to that of the external locking element (4) in order to be able to receive and guide the latter before its introduction into the head (8) of the bone anchoring element (2).
18. Instrument chirurgical suivant la revendication 17, caractérisé en ce que le tube cylindrique (102) se prolonge au niveau de son extrémité libre par un manchon (138) à profil sensiblement rectangulaire dont chaque paroi (139) parallèle et opposée comporte une échancrure (140) en forme de U destinée à coopérer avec la tige de liaison (3) de l'implant rachidien (1 ).18. Surgical instrument according to claim 17, characterized in that the cylindrical tube (102) is extended at its free end by a sleeve (138) with a substantially rectangular profile, each parallel and opposite wall (139) of which has a notch ( 140) in the form of a U intended to cooperate with the connecting rod (3) of the spinal implant (1).
19. Instrument chirurgical suivant la revendication 18, caractérisé en ce que le profil interne du manchon (138) est suivant une direction, de dimensions légèrement supérieures à celles de l'alésage interne (135) afin de conformer à l'entrée de ce dernier des épaulements (151) formant butée.19. Surgical instrument according to claim 18, characterized in that the internal profile of the sleeve (138) is in a direction, of dimensions slightly greater than those of the internal bore (135) in order to conform to the entry of the latter. shoulders (151) forming a stop.
20. Instrument chirurgical suivant la revendication 19, caractérisé en ce que le tube cylindrique (102) comporte sur son profil externe des méplats (141 ) qui se prolongent sur chaque paroi (142) du manchon (138), chaque méplat (141 ) étant percé au niveau du tube (102) de premier et second trous (143, 144) débouchant à l'intérieur de l'alésage (135) et au niveau des parois ( 142) du manchon (138) d'un troisième trou débouchant (145).20. Surgical instrument according to claim 19, characterized in that the cylindrical tube (102) has on its external profile flats (141) which are extend on each wall (142) of the sleeve (138), each flat (141) being drilled at the level of the tube (102) of first and second holes (143, 144) opening into the interior of the bore (135) and at the walls (142) of the sleeve (138) of a third through hole (145).
21. Instrument chirurgical suivant la revendication 20, caractérisé en ce que chaque premier trou (143) présente un filetage interne permettant de coopérer avec une vis de serrage (146) pour la fixation dans chaque méplat ( 141 ) de deux lamelles élastiques (147, 148).21. Surgical instrument according to claim 20, characterized in that each first hole (143) has an internal thread making it possible to cooperate with a clamping screw (146) for fixing in each flat part (141) two elastic lamellae (147, 148).
22. Instrument chirurgical suivant la revendication 21 , caractérisé en ce que chaque lamelle élastique (147) est solidaire d'un doigt (149) coopérant avec le second trou (144) correspondant et à l'intérieur de l'alésage (135) pour permettre la retenue à l'intérieur de ce dernier des éléments de blocage (4).22. Surgical instrument according to claim 21, characterized in that each elastic strip (147) is integral with a finger (149) cooperating with the corresponding second hole (144) and inside the bore (135) for allow the locking elements (4) to be retained inside the latter.
23. Instrument chirurgical suivant la revendication 21 , caractérisé en ce que chaque lamelle élastique (148) est solidaire d'un pion (150) coopérant avec le troisième trou (145) du manchon (138) afin de pouvoir pénétrer à l'intérieur de ce dernier lorsque les lamelles (148) sont déformées par un effort de poussée externe provenant des languettes (129) du tube de déverrouillage (125) afin de permettre la fixation de l'instrument chirurgical (100) sur la tête (8) de l'élément d'ancrage osseux (2).23. Surgical instrument according to claim 21, characterized in that each elastic strip (148) is integral with a pin (150) cooperating with the third hole (145) of the sleeve (138) so as to be able to penetrate inside the latter when the lamellae (148) are deformed by an external thrust force coming from the tabs (129) of the release tube (125) in order to allow the surgical instrument (100) to be fixed on the head (8) of the bone anchoring element (2).
24. Instrument chirurgical suivant la revendication 17, caractérisé en ce que l'alésage interne (135) du tube (102) est prévu pour recevoir un certain nombre d'élément de blocage (4). 24. Surgical instrument according to claim 17, characterized in that the internal bore (135) of the tube (102) is designed to receive a certain number of locking element (4).
PCT/FR2004/003093 2003-12-02 2004-12-02 Clipping-type surgical instrument for spinal implant WO2005055843A1 (en)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
FR0314130A FR2862863B1 (en) 2003-12-02 2003-12-02 CLIPSEUSE-TYPE SURGICAL INSTRUMENT FOR SPINAL IMPLANT
FR0314130 2003-12-02
US10/898,320 US20050119667A1 (en) 2003-12-02 2004-07-26 Clip-type surgical instrument for spinal implant
US10/898,320 2004-07-26

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US9486256B1 (en) 2013-03-15 2016-11-08 Nuvasive, Inc. Rod reduction assemblies and related methods
US10136927B1 (en) 2013-03-15 2018-11-27 Nuvasive, Inc. Rod reduction assemblies and related methods
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EP1942814A2 (en) * 2005-09-29 2008-07-16 K2M, Inc. Single action anti-torque rod reducer
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US9486256B1 (en) 2013-03-15 2016-11-08 Nuvasive, Inc. Rod reduction assemblies and related methods
US10136927B1 (en) 2013-03-15 2018-11-27 Nuvasive, Inc. Rod reduction assemblies and related methods
US10898241B2 (en) 2013-03-15 2021-01-26 Nuvasive, Inc. Rod reduction assemblies and related methods
US11660128B2 (en) 2013-03-15 2023-05-30 Nuvasive, Inc. Rod reduction assemblies and related methods
US11051861B2 (en) 2018-06-13 2021-07-06 Nuvasive, Inc. Rod reduction assemblies and related methods

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