WO2015092270A1 - Spinal correction system - Google Patents

Spinal correction system Download PDF

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Publication number
WO2015092270A1
WO2015092270A1 PCT/FR2014/053384 FR2014053384W WO2015092270A1 WO 2015092270 A1 WO2015092270 A1 WO 2015092270A1 FR 2014053384 W FR2014053384 W FR 2014053384W WO 2015092270 A1 WO2015092270 A1 WO 2015092270A1
Authority
WO
WIPO (PCT)
Prior art keywords
axis
bone anchoring
spinal correction
distraction
stabilization system
Prior art date
Application number
PCT/FR2014/053384
Other languages
French (fr)
Inventor
Michel MASSENZIO
Sylvie RONEL
Vincent CUNIN
Yoann LAFON-JALBY
Margot ODET
Eric Jacquelin
Original Assignee
Universite Claude Bernard Lyon I
Institut Francais Des Sciences Et Technologies Des Transports, De L'amenagement Et Des Reseaux
Hospices Civils De Lyon
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Universite Claude Bernard Lyon I, Institut Francais Des Sciences Et Technologies Des Transports, De L'amenagement Et Des Reseaux, Hospices Civils De Lyon filed Critical Universite Claude Bernard Lyon I
Publication of WO2015092270A1 publication Critical patent/WO2015092270A1/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
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7004—Longitudinal elements, e.g. rods with a cross-section which varies along its length
    • A61B17/7007—Parts of the longitudinal elements, e.g. their ends, being specially adapted to fit around the screw or hook heads
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7041—Screws or hooks combined with longitudinal elements which do not contact vertebrae with single longitudinal rod offset laterally from single row of screws or hooks
    • 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
    • A61B17/7043—Screws or hooks combined with longitudinal elements which do not contact vertebrae with a longitudinal element fixed to one or more transverse elements which connect multiple screws or hooks
    • 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
    • A61B17/7049—Connectors, not bearing on the vertebrae, for linking longitudinal elements together
    • A61B17/7052—Connectors, not bearing on the vertebrae, for linking longitudinal elements together of variable angle or length

Definitions

  • the present invention relates to the field of positioning devices or stabilization of the spine, and eile more particularly a spinal correction system, comprising two bone anchoring devices, interconnected by a stabilization system.
  • the object of the invention finds particularly advantageous applications in the field of dynamic stabilization in the case for example of fractures or after correction of deformations to avoid functional farthrodesis.
  • the object of the invention finds a preferred application in the field of the correction of scoliosis and in particular scoliosis pathologies in children.
  • the patent application US 2013/0123851 discloses a spinal correction system comprising two bone anchoring devices, interconnected by a stabilizing rod on which transverse anchoring systems connected to a second rod are mounted. stabilization.
  • the bone anchors that are attached proximally and distally to two adjacent vertebrae are annularly connected to the shaft.
  • the angle between the rod and the vertebrae is limited after implantation, which reduces the margin of correction, that is to say does not allow the correction of large deformations.
  • the annular connection which allows the sliding of the rod relative to each anchoring device does not ensure a distraction, that is to say to provide a pushing effect of the joined parts of the spine forcing the recovery of the spine.
  • the patent application FR 2 781 359 describes a spinal osteosynthesis device comprising a plurality of bone anchoring devices interconnected by means of a vertical longitudinal rod.
  • Each bone anchoring device comprises two screws connected by a transverse bar equipped with a fastening connector for the longitudinal rod vertical.
  • the connector comprises a first piece fixed on the transverse bar and a second piece articulated on the first piece and on which is fixed the vertical longitudinal rod.
  • a nut makes it possible to secure the bar and the vertical rod together with the pieces one on the other.
  • US patent application 2010/0145388 discloses a rachidian correction system comprising bone anchoring devices connected by a connecting rod.
  • the connecting rod is connected to the bone anchoring device with a possibility of rotation.
  • the device described by this document requires fitting all the vertebrae involved in scoliosis. Moreover, such a device does not allow to resume significant correction efforts. By design, this device does not offer the possibility of implementing a distraction system.
  • the present invention therefore aims at remedying the drawbacks of the state of the art by proposing a rachidian correction system which makes it possible to correct large deformations of the vertebral column while enabling high forces to be transmitted and while maintaining mobility on the spine. .
  • the object of the invention is therefore a rachidian correction system, comprising a first and a second bone anchoring device, interconnected by a stabilization system.
  • the first bone anchoring device comprises two bone anchoring elements in two consecutive vertebrae, each element being composed of an anchoring body and a fixing head. It further comprises a support fixed on the fixing heads, defining between them a longitudinal axis.
  • the support includes a connecting element with the stabilization system, said connecting element extending along a first axis of rotation perpendicular to the longitudinal axis and being connected to the stabilization system so that the latter is deported beyond said heads of fixation.
  • the stabilization system is rotatably mounted on the connecting element of the first device all around at least a first axis of rotation by a mechanical connection ball joint and comprises a locking system in translation with respect to said connecting element made by a glue arranged on the stabilization system.
  • the second device is mounted free to rotate with the stabilization system along an axis parallel to said first axis of rotation,
  • such a system has one or more of the following additional features, or all of these characteristics:
  • the stabilization system is also rotatably mounted on the connecting element of the first bone anchoring device around a second axis of rotation orthogonal to both the first axis of rotation both at the longitudinal axis; ;
  • the second bone anchoring device is mounted free to rotate with the stabilizing system according to an axis parallel to said second axis of rotation;
  • the stabilization system is rotatably mounted on the connecting element by a mechanical connection ball joint;
  • the stabilization system comprises a collar, the connecting element of the first device comprising a ring adapted to cooperate within a spherical ring mounted in the collar of the stabilization system to form the mechanical connection ball joint, adapted to rotate around the first axis of rotation;
  • the second bone anchoring device is composed of a bone anchoring element of the tulip or hook screw type, anchored on a vertebra;
  • the second bone anchoring device is substantially identical to the first bone anchoring device;
  • the bone anchoring elements consist of tulip screws or hooks;
  • the stabilization system consists of a rod of predetermined length
  • the stabilization system consists of a coupie distraction rods interconnected by a connecting member provided with means for guiding each of the rods Tune relative to each other within said connecting member;
  • the connecting member is of the fixed manual distraction system type for fixing the two rods relative to each other, in order to regulate the distance between the two anchoring points of the device;
  • the connecting member is of the type comprising for each distraction rod, a blocking structure of the translational distraction rods in the connecting member, said structure being active only during efforts to compress the spine of a patient on the distraction rods so as to oppose said compressive forces and increase the comfort of the patient by avoiding arthrodesis of the vertebrae of the patient's spine;
  • the connecting member is of the type comprising for each distraction rod, at least one suspension member of the distraction rods capable of imparting flexibility and exert a longitudinal preload on the distraction rods, and
  • - ⁇ Binding member is of the type comprising for each distraction rod at least one suspension member of the distraction rods capable of imparting flexibility and exert a longitudinal preload on the distraction rods and a blocking structure of the translational distraction rods in the connecting member, said structure being active only during compression efforts of the spine of a patient on the distraction rods so as to oppose said compressive forces and increase the comfort of the patient by avoiding the arthrodesis of the vertebrae of the spine of said patient.
  • Figure 1 shows a perspective view of an embodiment of the spinal correction system according to the invention.
  • Figure 2 shows a three-dimensional exploded view of an embodiment of a bone anchoring device according to the invention.
  • Figure 3 is an elevational view of the bone anchor shown in FIG. 2.
  • Figure 4 is an elevational view of another embodiment of the spinal correction system according to the invention.
  • Figure 5 shows a perspective view of another embodiment of the spinal correction system according to the invention.
  • Figures 6 and 6A are schematic views of a correction system of the prior art, respectively before and after correction.
  • Figures 7 and 7A are schematic views of a correction system according to the invention, respectively before and after correction.
  • the present invention relates to a new spinal correction system 1, shown in FIG. 1 according to a first exemplary embodiment.
  • This spinal correction system i comprises a first bone anchoring device 2a, illustrated in detail in particular in FIG. 2.
  • This first bone anchoring device 2a is connected to a second bone anchoring device 2b by a stabilization system.
  • the first bone anchoring device 2a comprises two elements 4a, 4b of bone anchorage in two successive vertebrae VI, V2.
  • the advantage offered by this double bone anchorage lies in the stability of the first bone anchoring device 2a.
  • the positioning of the spinal correction system 1 is expressed in relation to the anatomical reference system, namely the frontal plane F, the sagittal plane S and the transverse plane T.
  • each bone anchoring element 4a, 4b is composed of an anchoring body 5 and a head 6.
  • the anchor body 5 is a hook or, as illustrated in the drawings, a tulip screw.
  • the first bone anchoring device 2a further comprises a support 7 fixed on its attachment heads 6 and defining a longitudinal axis X between the fixing heads 6,
  • the support 7 comprises a cylindrical shaft 7a of longitudinal axis X, adapted to be fixed on the fixing heads 6.
  • each fixing head 6 is constituted by two lateral branches 6a forming an open U and delimiting between they receive a housing 6b for the tree 7a.
  • the bottom of the housing 6b formed by the fixing head 6 is of radius substantially corresponding to that of the shaft 7a,
  • the locking screw 8 comprises in its center, a housing 8a. of hexagonal section to allow its gripping and its assembly or disassembly relative to the fixing head 6.
  • the support 7 further comprises a connecting element 7b with the stabilization system 3.
  • the connecting element 7b is made in the example illustrated in the form of a stud on either side of which extends cylindrical shaft 7a.
  • the connecting element 7b extends along a first axis of rotation A orthogonal to the longitudinal axis X, so that the stabilization system 3 is advantageously offset with respect to the fixing heads 6.
  • the stabilization system 3 is essentially rotatably mounted on the connecting element 7b at least all around the first axis of rotation A.
  • the stabilization system 3 extends above the fixing heads 6 allowing the rotation of the stabilization system 3 around the first axis A in an angular range of 360 ° if necessary.
  • the stabilization system 3 can move freely in a plane located above the fixing heads 6.
  • the stabilization system 3 is rotatably mounted on (the connecting element 7b according to a second axis of rotation B, this second axis B is both orthogonal to the first axis of rotation A and orthogonal to the longitudinal axis X.
  • the stabilization system 3 is mounted in connection with mechanical ball joint with the connecting element 7b, that is to say with three degrees of freedom in rotation, according to the first A and second axis B and a third axis of rotation C perpendicular to the first and second axes of rotation A, B.
  • the mechanical connection ball between the stabilization system 3 and the connecting element 7b, comprises a spherical ring 9a mounted on one end 9 of the stabilization system 3 and intended to cooperate in
  • the spherical ring 10 is truncated on both sides to delimit bearing faces 10a into which a hole 10b opens for the passage of a mounting screw 11a. ring on the connecting element 7b.
  • the screw 11 is intended to cooperate with a tapping 7c of axis A arranged in the connecting element 7b and opening on a planar face 7d of the stud on which abuts a bearing face 10a of the spherical ring 10, the head 11 of the screw 11 coming into contact with the other bearing face of the spherical ring 10.
  • connection ball joint lies in the rotational flexibility of the spinal correction system object of the invention. Indeed, when it is fixed on the spine, it read gives a total freedom in rotation along the first axis of rotation A.
  • the stabilization system 3 comprises a system 12 ensuring its locking in translation relative to the connecting element 7b and at this connecting element.
  • the translation locking system 12 comprises a collar 12a arranged on the end 9 of the stabilization system 3 and in which is mounted the spherical ring 9a.
  • the collar 12a is fixed on the connecting element 7b by any appropriate means and preferably in the illustrated example, thanks to the mounting screw 11 passing through the shaft 12a and coming to anchor in the element. link 7b.
  • the collar I2a is integrated directly on the end 9 of the stabilizing device 3 or is reported in the form of a tip fixed by any appropriate means on the stabilizing device 3.
  • the second bone anchoring device 2b is rotatably mounted with the stabilization system 3 according to at least one axis and in the example illustrated in FIG. 4, an axis of rotation A which is parallel to the first axis of rotation A.
  • the second bone anchoring device 2b comprises an anchoring component 13 of the tulip screw or anchored hook type on one vertebra. This second bone anchoring device 2b is assembled with the stabilization system 3, in any appropriate manner, to allow rotation of the stabilization system 3 around the first axis of rotation A,
  • the second bone anchoring device 2b comprises a support 14 for receiving and mounting for the end of the stabilization system 3.
  • This support 14 is mounted with the possibility of rotation along the first axis A, with respect to the head 13a. of the bone anchoring component 13,
  • the support 14 has a reception U-shaped housing for the stabilization system 3, delimited by two threaded branches receiving a locking screw allowing a freedom of adaptation between the second bone anchoring device 2b and the stabilization system 3
  • the support 14 can be integrated directly in the stabilization system 3, in the same direction, it can be envisaged that the stabilization system 3 is also mounted free to rotate relative to the second bone anchoring device 2b along an axis parallel to the second axis of rotation 8.
  • the second bone anchoring device 2b consists of a bone anchoring device comprising two anchoring elements on two successive vertebrae.
  • the second bone anchoring device 2b is substantially identical to the first bone anchoring device 2a described above.
  • the spinal correction system 1 object of the invention comprises the first 2a and second 2b identical bone anchoring devices interconnected by a stabilization system 3.
  • Each bone anchoring device 2a, 2b comprises, as described in relation to Fia, 2, two bone anchoring elements 4a, 4b in two consecutive vertebrae V3, V4, each anchoring element 4a, 4b being composed of an anchoring body 5 and a head of
  • each bone anchoring device 2a, 2b comprises a support 7 on which the fastening heads 6 are fixed, defining between them a longitudinal axis X
  • This support 7 comprises a connecting element 7b with Se system of stabilization 3, said connecting element 7b extending along a first axis of rotation A orthogonal to longitudinal axis X and being connected to the stabilization system 3 so that the latter is offset beyond said fixing heads.
  • the stabilization system 3 is rotatably mounted on the connecting element 7b by a mechanical connection ball.
  • the stabilization system 3 may have various configurations depending on the pathology and purpose of the instrumentation (stabilization of the column, arthrodesis correction of deformation, etc.).
  • the stabilization system 3 consists of a rod 16 of predetermined length each end of which is connected to one of the bone anchoring devices 2a, 2b of the spinal correction system ( Figures 1 and 4).
  • This embodiment has the advantage of leaving its vertebrae, on which the first 2a and second 2b bone anchoring devices are fixed, fibers in rotation along at least one axis of rotation.
  • an embodiment of the invention shown in Figs. 5 comprises a stabilization system 3 which consists of a cut of distraction rods 16 connected between eiies by a connecting member 17.
  • Each rod 16 is connected at one of its ends to a bone anchoring device 2a and 2b, De in this way, each rod 16 is connected to only one bone anchoring device.
  • the connecting member 17 fixedly connects the two rods 16 between them.
  • the connecting member 17 comprises means for guiding in translation of each of the rods 16 relative to each other.
  • the connecting member 17 is a fixed manual distraction system for the two rods. This embodiment makes it possible in particular to adapt sequentially the distance between the first 2a and second 2b bone anchoring devices according to the growth of the child or adolescent.
  • the connecting member 17 is a self-adaptive distraction system comprising for each distraction rod 16, a biocage structure in translation of the distraction rods 16, in the body of This blocking structure is active only during compression efforts of the spine of a patient on the distraction rods 16 so as to oppose said compression forces.
  • a self-adaptive distraction system makes it possible to adapt in particular to the natural growth of the spine.
  • the connecting member 17 comprises for each distraction rod 16, at least one suspension member of the distraction rods capable of imparting flexibility and exerting a longitudinal precharge on the distraction rods 16
  • This embodiment allows the mobility of the spine and increase the comfort of the patient by avoiding the arthrodesis of the vertebrae of the patient's spine.
  • the connecting member 17 is a self-adaptive distraction system described by the application.
  • WO 2012/085405 comprises, for each distraction rod 16, at least one suspension member of the distraction rods capable of imparting flexibility and exert a longitudinal preload on the distraction rods.
  • the connecting member 17 comprises a biocage structure in translation of the distraction rods in the connecting member 17, said structure being active only during efforts to compress the spine of a patient on the distraction rods so as to oppose said compressive forces and increase patient comfort by avoiding arthrodesis of the spine vertebrae of said patient.
  • This mode of réaîsation allows in particular to reduce the number of surgical procedures and thus reduce the operational risk.
  • the spinal spinal correction system 1 has the advantage of allowing a progressive dynamic correction of scoliosis which avoids stiffening of the vertebrae.
  • the combination of the suspension member, the biocage structure, and at least one axis of rotation of the first 2a and second 2b bone anchoring devices relative to the stabilization system 3 allows both correct scoliosis and both to align all the vertebrae of the area to be corrected with the stabilization system 3.
  • the spinal correction system 1 allows the complete rotation of the stabilization system 3 around the first and second bone anchoring devices 2a, 2b, regardless of the anchoring element. to the vertebrae.
  • the correction system allows complete rotation in the front plane F of the stabilization system 3 since the first axis of rotation A extends substantially perpendicularly to the frontal plane F.
  • the first and second anchoring devices bone 2a, 2b f leave the stabilization system 3, a rotational movement, even during operation.
  • the stabilization system 3 is not completely rigid and thus leaves a flexibility in the area of the spine paired, This flexibility makes it possible to best preserve the vertebrae and the disks between the first and second anchoring devices 2a, 2b . Figs.
  • FIGS. 6 and 6A illustrate the advantages of the correction system i according to the invention with respect to the known correction devices, illustrated in FIGS. 6 and 6A, which show a stabilization system 3 'fixed distally and proximally with the aid of bone anchoring devices 2'a, 2'b.
  • the angle a between the stabilization system 3 'and its vertebrae being fixed after implantation, the correction margin is reduced. To minimize this effect, the bone anchors are moved out of the deformed area, thereby immobilizing the column in a larger portion.
  • the correction system I makes it possible, thanks to the unlimited frontal rotation of the stabilization system 3, to improve the correction both in terms of the amplitude of reduction of the deformation and on the reduction of the size of the paired area.
  • the angle ui between the stabilization system 3 and the vertebrae decreases after implantation to reach a value of 2 in order to adapt to the growth and straightening of the spine.
  • the immobilization length being reduced, the flexibility of the spine is preserved during the treatment, further increasing the efficiency of the distraction.
  • the correction system 1 also facilitates the implantation of various types of stabilization systems 3 by virtue of its mobility in rotation and typically along three orthogonal axes, with respect to the bone anchoring elements.
  • the stabilization system 3 is mounted mechanically connected with the connecting element 7b, that is to say with three degrees of freedom in rotation according to the first A, second B and third C axes of rotation, mounted on the spine, the first axis of rotation A is orthogonal to the frontal plane F, the second axis of rotation B is orthogonal to the sagittal plane S and the third axis C is orthogonal to the transverse plane T.
  • This mobility between the stabilization system 3 and the bone anchoring elements 4a, 4b allows easy mounting of the stabilization system 3 while adapting to the various constraints of implantation of the bone anchoring elements in the spine.

Abstract

The spinal correction system has two bone-anchoring devices (2a), (2b) connected to each other by a stabilization system (3). A bone-anchoring device (2a) comprises a support (7), on which are fixed the fixation heads (6) that define between them a longitudinal axis, said support (7) comprising a connector element (7b) for connection to the stabilization system (3), said connector element (7b) extending on a first axis of rotation orthogonal to the longitudinal axis and being connected to the stabilization system (3) in such a way that the latter is offset from said fixation heads (6). According to the invention, the stabilization system (3) is mounted freely in rotation on the connector element (7b) of the first device at least around the first axis of rotation and has a system for blocking in translation with respect to said connector element (7b).

Description

î  î
SYSTEME DE CORRECTION RACHIDIEN SPINAL CORRECTION SYSTEM
La présente invention concerne le domaine des dispositifs de mise en position ou de stabilisation de ia colonne vertébrale, et eile vise pius particulièrement un système de correction rachidien, comportant deux dispositifs d'ancrage osseux, reliés entre eux par un système de stabilisation.  The present invention relates to the field of positioning devices or stabilization of the spine, and eile more particularly a spinal correction system, comprising two bone anchoring devices, interconnected by a stabilization system.
L'objet de l'invention trouve des applications particulièrement avantageuses dans le domaine de ia stabilisation dynamique dans le cas par exemple de fractures ou après correction de déformations pour éviter farthrodèse fonctionnelle.  The object of the invention finds particularly advantageous applications in the field of dynamic stabilization in the case for example of fractures or after correction of deformations to avoid functional farthrodesis.
L'objet de l'invention trouve une application préférée dans te domaine de (a correction de la scoliose et notamment des pathoiogies scoliotîques chez l'enfant.  The object of the invention finds a preferred application in the field of the correction of scoliosis and in particular scoliosis pathologies in children.
Dans l'art antérieur, il a été proposé de nombreuses solutions pour corriger la déformation de la colonne vertébrale, comme notamment les scolioses. Par exemple, ia demande de brevet US 2013/0123851, présente un système de correction rachidien comportant deux dispositifs d'ancrage osseux, reliés entre eux par une tige de stabilisation sur laquelle sont montés des systèmes d'ancrage transversaux reliés à une seconde tige de stabilisation. Les dispositifs d'ancrage osseux qui sont fixés en proximal et en distal sur deux vertèbres adjacentes, sont en liaison annulaire avec la tige. L'angle entre la tige et les vertèbres est donc limité après implantation, ce qui réduit la marge de correction, c'est-à-dire ne permet pas la correction de grandes déformations. Par ailleurs, la liaison annulaire qui permet le glissement de ia tige par rapport à chaque dispositif d'ancrage, ne permet pas d'assurer une distraction, c'est-à-dire de procurer un effet de repoussement des parties jointes du rachis forçant au redressement du rachis.  In the prior art, numerous solutions have been proposed for correcting the deformation of the spine, such as scoliosis. For example, the patent application US 2013/0123851 discloses a spinal correction system comprising two bone anchoring devices, interconnected by a stabilizing rod on which transverse anchoring systems connected to a second rod are mounted. stabilization. The bone anchors that are attached proximally and distally to two adjacent vertebrae are annularly connected to the shaft. The angle between the rod and the vertebrae is limited after implantation, which reduces the margin of correction, that is to say does not allow the correction of large deformations. Furthermore, the annular connection which allows the sliding of the rod relative to each anchoring device, does not ensure a distraction, that is to say to provide a pushing effect of the joined parts of the spine forcing the recovery of the spine.
La demande de brevet FR 2 781 359 décrit un dispositif d'ostéosynthèse rachidienne comportant plusieurs dispositifs d'ancrage osseux reliés entre eux à l'aide d'une tige longitudinale verticale. Chaque dispositif d'ancrage osseux comprend deux vis reliées par une barre transversale équipée d'un connecteur de fixation pour la tige longitudinale verticale. Selon une forme de réalisation, ie connecteur comporte une première pièce fixée sur la barre transversale et une seconde pièce montée articulée sur la première pièce et sur laquelle est fixée la tige longitudinale verticale. Un écrou permet d'assurer ia solidarisation de la barre et de la tige verticale avec les pièces l'une sur l'autre. The patent application FR 2 781 359 describes a spinal osteosynthesis device comprising a plurality of bone anchoring devices interconnected by means of a vertical longitudinal rod. Each bone anchoring device comprises two screws connected by a transverse bar equipped with a fastening connector for the longitudinal rod vertical. According to one embodiment, the connector comprises a first piece fixed on the transverse bar and a second piece articulated on the first piece and on which is fixed the vertical longitudinal rod. A nut makes it possible to secure the bar and the vertical rod together with the pieces one on the other.
Il est clair que la tige longitudinale verticale est ainsi montée de manière fixe sur ie dispositif d'ancrage à la fin de l'intervention chirurgicale. Ainsi/ le rachis est contraint dans une position donnée à l'issue de l'opération. Un tel dispositif vise donc à provoquer à terme une arthrodèse de l'ensemble des segments vertébraux appareillés, empêchant ainsi de conserver une mobilité post-opératoire. It is clear that the vertical longitudinal rod is thus fixedly mounted on the anchoring device at the end of the surgical procedure. Thus / spine is forced in a given position after the operation. Such a device is therefore intended to eventually provoke arthrodesis of all vertebral segments matched, thus preventing a post-operative mobility.
La demande de brevet US 2010/0145388 décrit un système de correction rachîdien comportant des dispositifs d'ancrage osseux reliés par une tige de liaison. La tige de liaison est reliée au dispositif d'ancrage osseux avec une possibilité de rotation.  US patent application 2010/0145388 discloses a rachidian correction system comprising bone anchoring devices connected by a connecting rod. The connecting rod is connected to the bone anchoring device with a possibility of rotation.
Le dispositif décrit par ce document nécessite d'appareiller l'ensemble des vertèbres impliquées dans la scoliose. Par ailleurs, un tel dispositif ne permet pas de reprendre des efforts de correction important. De par sa conception, ce dispositif n'offre pas la possibilité d'implanter un système de distraction.  The device described by this document requires fitting all the vertebrae involved in scoliosis. Moreover, such a device does not allow to resume significant correction efforts. By design, this device does not offer the possibility of implementing a distraction system.
La présente invention vise donc à remédier aux inconvénients de l'état de la technique en proposant un système de correction rachîdien qui permet de corriger de grandes déformations de la colonne vertébrale tout en permettant de transmettre des efforts importants et tout en conservant une mobilité au rachis.  The present invention therefore aims at remedying the drawbacks of the state of the art by proposing a rachidian correction system which makes it possible to correct large deformations of the vertebral column while enabling high forces to be transmitted and while maintaining mobility on the spine. .
L'objet de l'invention est donc un système de correction rachîdien, comportant un premier et un second dispositif d'ancrage osseux, reliés entre eux par un système de stabilisation. Le premier dispositif d'ancrage osseux comprend deux éléments d'ancrage osseux dans deux vertèbres consécutives, chaque élément étant composé d'un corps d'ancrage et d'une tête de fixation. Il comprend en outre un support fixé sur les têtes de fixation, définissant entre elles un axe longitudinal. Le support comprend un élément de liaison avec le système de stabilisation, ledit élément de liaison s'étendant selon un premier axe de rotation perpendiculaire à l'axe longitudinal et étant relié au système de stabilisation de manière à ce que ce dernier se trouve déporté au-delà desdites têtes de fixation. Selon l'invention, le système de stabilisation est monté libre en rotation sur l'élément de liaison du premier dispositif tout autour d'au moins un premier axe de rotation par une liaison mécanique rotule et comporte un système de blocage en translation par rapport audit élément de liaison réalisé par un coller aménagé sur le système de stabilisation. De plus, le second dispositif est monté libre en rotation avec le système de stabilisation selon un axe parallèle audit premier axe de rotation, The object of the invention is therefore a rachidian correction system, comprising a first and a second bone anchoring device, interconnected by a stabilization system. The first bone anchoring device comprises two bone anchoring elements in two consecutive vertebrae, each element being composed of an anchoring body and a fixing head. It further comprises a support fixed on the fixing heads, defining between them a longitudinal axis. The support includes a connecting element with the stabilization system, said connecting element extending along a first axis of rotation perpendicular to the longitudinal axis and being connected to the stabilization system so that the latter is deported beyond said heads of fixation. According to the invention, the stabilization system is rotatably mounted on the connecting element of the first device all around at least a first axis of rotation by a mechanical connection ball joint and comprises a locking system in translation with respect to said connecting element made by a glue arranged on the stabilization system. In addition, the second device is mounted free to rotate with the stabilization system along an axis parallel to said first axis of rotation,
Selon des modes de réalisation particuliers, un tel système présente une ou plusieurs des caractéristiques additionnelles suivantes, voire toutes ces caractéristiques :  According to particular embodiments, such a system has one or more of the following additional features, or all of these characteristics:
- le système de stabilisation est en outre monté libre en rotation sur l'élément de liaison du premier dispositif d'ancrage osseux autour d'un deuxième axe de rotation orthogonal à la fois au premier axe de rotation à la fois à l'axe longitudinal ;  the stabilization system is also rotatably mounted on the connecting element of the first bone anchoring device around a second axis of rotation orthogonal to both the first axis of rotation both at the longitudinal axis; ;
- ie second dispositif d'ancrage osseux est monté libre en rotation avec Se système de stabilisation selon un axe parallèle audit deuxième axe de rotation ;  the second bone anchoring device is mounted free to rotate with the stabilizing system according to an axis parallel to said second axis of rotation;
- le système de stabilisation est monté libre en rotation sur l'élément de liaison par une liaison mécanique rotule ;  - The stabilization system is rotatably mounted on the connecting element by a mechanical connection ball joint;
- le système de stabilisation comporte un collier, l'élément de liaison du premier dispositif comportant une bague adaptée pour coopérer à l'intérieur d'un anneau sphérique monté dans le collier du système de stabilisation afin de former la liaison mécanique rotule, apte à tourner tout autour du premier axe de rotation ;  - The stabilization system comprises a collar, the connecting element of the first device comprising a ring adapted to cooperate within a spherical ring mounted in the collar of the stabilization system to form the mechanical connection ball joint, adapted to rotate around the first axis of rotation;
- le second dispositif d'ancrage osseux est composé d'un élément d'ancrage osseux du type à vis tulipe ou crochet, ancré sur une vertèbre ;  the second bone anchoring device is composed of a bone anchoring element of the tulip or hook screw type, anchored on a vertebra;
- le second dispositif d'ancrage osseux est sensiblement identique au premier dispositif d'ancrage osseux ; - les éléments d'ancrage osseux consistent en des vis tulipe ou des crochets ; the second bone anchoring device is substantially identical to the first bone anchoring device; the bone anchoring elements consist of tulip screws or hooks;
- ie système de stabilisation est constitué d'une tige de longueur prédéterminée ;  the stabilization system consists of a rod of predetermined length;
- le système de stabilisation consiste en un coupie de tiges de distraction reliées entre elles par un organe de liaison muni de moyens de guidage de chacune des tiges Tune par rapport à l'autre à l'intérieur dudit organe de liaison ;  - The stabilization system consists of a coupie distraction rods interconnected by a connecting member provided with means for guiding each of the rods Tune relative to each other within said connecting member;
- l'organe de liaison est du type système de distraction manuelle fixe pour fixer les deux tiges l'une par rapport à l'autre, afin de régier la distance entre les deux points d'ancrage du dispositif ;  the connecting member is of the fixed manual distraction system type for fixing the two rods relative to each other, in order to regulate the distance between the two anchoring points of the device;
- l'organe de liaison est du type comportant pour chaque tige de distraction, une structure de blocage des tiges de distraction en translation dans l'organe de liaison, ladite structure étant active uniquement lors d'efforts de compression du rachis d'un patient sur les tiges de distraction de façon à s'opposer aux dits efforts de compression et augmenter le confort du patient en évitant l'arthrodèse des vertèbres du rachis dudit patient ;  - The connecting member is of the type comprising for each distraction rod, a blocking structure of the translational distraction rods in the connecting member, said structure being active only during efforts to compress the spine of a patient on the distraction rods so as to oppose said compressive forces and increase the comfort of the patient by avoiding arthrodesis of the vertebrae of the patient's spine;
- l'organe de liaison est du type comportant pour chaque tige de distraction, au moins un organe de suspension des tiges de distraction apte à conférer une souplesse et exercer une précharge longitudinale sur les tiges de distraction, et  - The connecting member is of the type comprising for each distraction rod, at least one suspension member of the distraction rods capable of imparting flexibility and exert a longitudinal preload on the distraction rods, and
- { Organe de liaison est du type comportant pour chaque tige de distraction au moins un organe de suspension des tiges de distraction apte à conférer une souplesse et exercer une précharge longitudinale sur les tiges de distraction et une structure de blocage des tiges de distraction en translation dans l'organe de liaison, ladite structure étant active uniquement iors d'efforts de compression du rachis d'un patient sur les tiges de distraction de façon à s'opposer aux dits efforts de compression et augmenter îe confort du patient en évitant l'arthrodèse des vertèbres du rachis dudit patient. Diverses autres caractéristiques ressortant de ia description faite ci- dessous en référence aux dessins annexés qui montrent, à titre d'exemples non limitatifs, des formes de réalisation de l'objet de l'invention. - {Binding member is of the type comprising for each distraction rod at least one suspension member of the distraction rods capable of imparting flexibility and exert a longitudinal preload on the distraction rods and a blocking structure of the translational distraction rods in the connecting member, said structure being active only during compression efforts of the spine of a patient on the distraction rods so as to oppose said compressive forces and increase the comfort of the patient by avoiding the arthrodesis of the vertebrae of the spine of said patient. Various other features appearing from the description given below with reference to the accompanying drawings which show, by way of non-limiting examples, embodiments of the object of the invention.
La Figure 1 représente une vue en perspective d'un mode de réalisation du système de correction rachidien selon l'invention.  Figure 1 shows a perspective view of an embodiment of the spinal correction system according to the invention.
La Figure 2 représente une vue éclatée tridimensionnelle d'un mode de réalisation d'un dispositif d'ancrage osseux selon l'invention.  Figure 2 shows a three-dimensional exploded view of an embodiment of a bone anchoring device according to the invention.
La Figure 3 est une vue en élévation du dispositif d'ancrage osseux représenté à la Fig. 2.  Figure 3 is an elevational view of the bone anchor shown in FIG. 2.
La Figure 4 est une vue en élévation d'un autre mode de réalisation du système de correction rachidien selon l'invention.  Figure 4 is an elevational view of another embodiment of the spinal correction system according to the invention.
La figure 5 représente une vue en perspective d'un autre mode de réalisation du système de correction rachidien seion l'invention.  Figure 5 shows a perspective view of another embodiment of the spinal correction system according to the invention.
Les Figures 6 et 6A sont des vues schématiques d'un système de correction de l'art antérieur, respectivement avant et après correction.  Figures 6 and 6A are schematic views of a correction system of the prior art, respectively before and after correction.
Les Figures 7 et 7A sont des vues schématiques d'un système de correction conforme à l'invention, respectivement avant et après correction.  Figures 7 and 7A are schematic views of a correction system according to the invention, respectively before and after correction.
La présente invention concerne un nouveau système de correction rachidien 1, représenté à la Fig. 1 selon un premier exemple de réalisation. Ce système de correction rachidien i comporte un premier dispositif d'ancrage osseux 2a, illustré en détail notamment à la Fig, 2. Ce premier dispositif d'ancrage osseux 2a est relié à un second dispositif d'ancrage osseux 2b par un système de stabilisation rachidien 3. Le premier dispositif d'ancrage osseux 2a comprend deux éléments 4a, 4b d'ancrage osseux dans deux vertèbres successives VI, V2. L'avantage offert par ce double ancrage osseux réside dans la stabilité du premier dispositif d'ancrage osseux 2a. D'une manière classique, le positionnement du système de correction rachidien 1 est exprimé en relation du système de référence anatomique, à savoir le plan frontal F, le plan sagittal S et le plan transversai T.  The present invention relates to a new spinal correction system 1, shown in FIG. 1 according to a first exemplary embodiment. This spinal correction system i comprises a first bone anchoring device 2a, illustrated in detail in particular in FIG. 2. This first bone anchoring device 2a is connected to a second bone anchoring device 2b by a stabilization system. 3. The first bone anchoring device 2a comprises two elements 4a, 4b of bone anchorage in two successive vertebrae VI, V2. The advantage offered by this double bone anchorage lies in the stability of the first bone anchoring device 2a. In a conventional manner, the positioning of the spinal correction system 1 is expressed in relation to the anatomical reference system, namely the frontal plane F, the sagittal plane S and the transverse plane T.
Tel que cela ressort plus précisément des Fig. 2 et 3, chaque élément d'ancrage osseux 4a , 4b est composé d'un corps d'ancrage 5 et d'une tête de fixation 6. Typiquement, le corps d'ancrage 5 est un crochet ou, comme illustré sur les dessins, une vis tulipe. Le premier dispositif d'ancrage osseux 2a comporte, en outre, un support 7 fixé sur fes têtes de fixation 6, et qui définit entre les têtes de fixation 6 un axe longitudinal X, As is more particularly apparent from Figs. 2 and 3, each bone anchoring element 4a, 4b is composed of an anchoring body 5 and a head 6. Typically, the anchor body 5 is a hook or, as illustrated in the drawings, a tulip screw. The first bone anchoring device 2a further comprises a support 7 fixed on its attachment heads 6 and defining a longitudinal axis X between the fixing heads 6,
Avantageusement, le support 7 comprend un arbre cylindrique 7a d'axe longitudinal X, adapté pour être fixé sur les têtes de fixation 6. A cet effet, chaque tête de fixation 6 est constituée par deux branches latérales 6a formant un U ouvert et délimitant entre elles un logement 6b de réception pour i'arbre 7a. A cet effet, le fond du logement 6b formé par la tête de fixation 6 est de rayon sensiblement correspondant à celui de l'arbre 7a, Advantageously, the support 7 comprises a cylindrical shaft 7a of longitudinal axis X, adapted to be fixed on the fixing heads 6. For this purpose, each fixing head 6 is constituted by two lateral branches 6a forming an open U and delimiting between they receive a housing 6b for the tree 7a. For this purpose, the bottom of the housing 6b formed by the fixing head 6 is of radius substantially corresponding to that of the shaft 7a,
Les faces internes des branches 6a s'inscrivent dans un cylindre et sont taraudées pour coopérer avec une vis 8 de blocage de l'arbre 7a sur la tête de fixation 6. Classiquement, la vis de blocage 8 comporte en son centre, un logement 8a de section hexagonale pour permettre sa préhension et son montage ou démontage par rapport à la tête de fixation 6. The inner faces of the branches 6a fit into a cylinder and are threaded to cooperate with a screw 8 for locking the shaft 7a on the fixing head 6. Conventionally, the locking screw 8 comprises in its center, a housing 8a. of hexagonal section to allow its gripping and its assembly or disassembly relative to the fixing head 6.
Le support 7 comprend en outre, un élément de liaison 7b avec le système de stabilisation 3. L'élément de liaison 7b est réalisé dans l'exemple illustré sous ia forme d'un plot de part et d'autre duquel s'étend l'arbre cylindrique 7a. L'élément de liaison 7b s'étend selon un premier axe de rotation A orthogonal à l'axe longitudinal X, de sorte que le système de stabilisation 3 se trouve avantageusement déporté par rapport aux têtes de fixation 6.  The support 7 further comprises a connecting element 7b with the stabilization system 3. The connecting element 7b is made in the example illustrated in the form of a stud on either side of which extends cylindrical shaft 7a. The connecting element 7b extends along a first axis of rotation A orthogonal to the longitudinal axis X, so that the stabilization system 3 is advantageously offset with respect to the fixing heads 6.
Le système de stabilisation 3 est essentiellement monté libre en rotation sur l'élément de liaison 7b au moins tout autour du premier axe de rotation A. Ainsi, tel que ceia ressort plus précisément de la Fig. 3, !e système de stabilisation 3 s'étend au-dessus des têtes de fixation 6 autorisant la rotation du système de stabilisation 3 autour du premier axe A selon une plage angulaire de 360° si besoin. Ainsi, le système de stabilisation 3 peut évoluer librement dans un plan situé au-dessus des têtes de fixation 6.  The stabilization system 3 is essentially rotatably mounted on the connecting element 7b at least all around the first axis of rotation A. Thus, as is more particularly apparent from FIG. 3, the stabilization system 3 extends above the fixing heads 6 allowing the rotation of the stabilization system 3 around the first axis A in an angular range of 360 ° if necessary. Thus, the stabilization system 3 can move freely in a plane located above the fixing heads 6.
Selon un mode avantageux de réalisation de l'invention, le système de stabilisation 3 est monté libre en rotation sur ('élément de liaison 7b selon un deuxième axe de rotation B, Ce deuxième axe B est à îa fois orthogonal au premier axe de rotation A et orthogonal à l'axe iongitudinai X. Selon un mode préféré de réalisation de l'Invention, le système de stabilisation 3 est monté en liaison mécanique rotule avec l'élément de liaison 7b, c'est-à-dire avec trois degrés de liberté en rotation, selon les premier A et deuxième axe B et un troisième axe de rotation C perpendiculaire aux premier et deuxième axes de rotation A, B. According to an advantageous embodiment of the invention, the stabilization system 3 is rotatably mounted on (the connecting element 7b according to a second axis of rotation B, this second axis B is both orthogonal to the first axis of rotation A and orthogonal to the longitudinal axis X. According to a preferred embodiment of the invention, the stabilization system 3 is mounted in connection with mechanical ball joint with the connecting element 7b, that is to say with three degrees of freedom in rotation, according to the first A and second axis B and a third axis of rotation C perpendicular to the first and second axes of rotation A, B.
Selon un mode préféré de réalisation de l'invention, la liaison mécanique rotule, entre le système de stabilisation 3 et l'élément de liaison 7b, comporte un anneau sphérique 9a monté sur une extrémité 9 du système de stabilisation 3 et destiné à coopérer en liaison mécanique rotule avec une bague sphérique 10. Pius précisément, îa bague sphérique 10 est tronquée de part et d'autre pour délimiter des faces d'appui 10a dans lesquelles débouche un trou 10b pour le passage d'une vis 11 de montage de îa bague sur i'élément de liaison 7b. La vis 11 est destinée à coopérer avec un taraudage 7c d'axe A aménagé dans l'élément de liaison 7b et débouchant sur une face plane 7d du plot sur laquelle vient en appui une face d'appui 10a de la bague sphérique 10, la tête lia de îa vis 11 venant en contact sur l'autre face d'appui de la bague sphérique 10.  According to a preferred embodiment of the invention, the mechanical connection ball, between the stabilization system 3 and the connecting element 7b, comprises a spherical ring 9a mounted on one end 9 of the stabilization system 3 and intended to cooperate in The spherical ring 10 is truncated on both sides to delimit bearing faces 10a into which a hole 10b opens for the passage of a mounting screw 11a. ring on the connecting element 7b. The screw 11 is intended to cooperate with a tapping 7c of axis A arranged in the connecting element 7b and opening on a planar face 7d of the stud on which abuts a bearing face 10a of the spherical ring 10, the head 11 of the screw 11 coming into contact with the other bearing face of the spherical ring 10.
L'avantage offert par îa liaison mécanique rotule réside dans la souplesse en rotation du système de correction rachidien objet de l'invention. En effet, lorsque celui-ci est fixé sur le rachis, il lus donne une totale liberté en rotation selon ie premier axe de rotation A.  The advantage offered by the mechanical connection ball joint lies in the rotational flexibility of the spinal correction system object of the invention. Indeed, when it is fixed on the spine, it read gives a total freedom in rotation along the first axis of rotation A.
Selon une autre caractéristique de l'invention, ie système de stabilisation 3 comporte un système 12 assurant son blocage en translation par rapport à l'élément de liaison 7b et au niveau de cet élément de liaison . Selon une variante préférée de réalisation, ie système de blocage en translation 12 comporte un collier 12a aménagé sur l'extrémité 9 du système de stabilisation 3 et dans lequel est monté l'anneau sphérique 9a. Le collier 12a est fixé sur l'élément de liaison 7b par tous moyens appropriés et de préférence dans l'exemple iîlustré, grâce à la vis de montage 11 passant à travers le coiiier 12a et venant s'ancrer dans l'élément de liaison 7b. Le collier I2a est intégré directement sur l'extrémité 9 du dispositif de stabilisation 3 ou se trouve rapporté sous la forme d'un embout fixé par tous moyens appropriés sur le dispositif de stabilisation 3. According to another characteristic of the invention, the stabilization system 3 comprises a system 12 ensuring its locking in translation relative to the connecting element 7b and at this connecting element. According to a preferred embodiment, the translation locking system 12 comprises a collar 12a arranged on the end 9 of the stabilization system 3 and in which is mounted the spherical ring 9a. The collar 12a is fixed on the connecting element 7b by any appropriate means and preferably in the illustrated example, thanks to the mounting screw 11 passing through the shaft 12a and coming to anchor in the element. link 7b. The collar I2a is integrated directly on the end 9 of the stabilizing device 3 or is reported in the form of a tip fixed by any appropriate means on the stabilizing device 3.
Seion une caractéristique essentielle de l'invention, le second dispositif d'ancrage osseux 2b est monté libre en rotation avec le système de stabilisation 3 selon au moins un axe et dans l'exemple illustré à la Fig. 4, un axe de rotation A qui est parallèle au premier axe de rotation A. Selon un mode avantageux de réalisation de l'invention, le second dispositif d'ancrage osseux 2b comporte un composant d'ancrage 13 du type vis tulipe ou crochet ancré sur une seule vertèbre. Ce second dispositif d'ancrage osseux 2b est assemblé avec le système de stabilisation 3, de toute manière appropriée, pour permettre une rotation du système de stabilisation 3 autour du premier axe de rotation A,  Seion an essential characteristic of the invention, the second bone anchoring device 2b is rotatably mounted with the stabilization system 3 according to at least one axis and in the example illustrated in FIG. 4, an axis of rotation A which is parallel to the first axis of rotation A. According to an advantageous embodiment of the invention, the second bone anchoring device 2b comprises an anchoring component 13 of the tulip screw or anchored hook type on one vertebra. This second bone anchoring device 2b is assembled with the stabilization system 3, in any appropriate manner, to allow rotation of the stabilization system 3 around the first axis of rotation A,
Dans l'exemple illustré à la Fig. 4, le second dispositif d'ancrage osseux 2b comporte un support 14 de réception et de montage pour l'extrémité du système de stabilisation 3. Ce support 14 est monté avec possibilité de rotation selon le premier axe A, par rapport à la tête 13a du composant d'ancrage osseux 13, Dans l'exemple illustré à ia Fig. 4, le support 14 présente un logement en U de réception pour le système de stabilisation 3, délimité par deux branches taraudées recevant une vis de blocage autorisant une liberté d'adaptation entre le second dispositif d'ancrage osseux 2b et le système de stabilisation 3. Il est à noter que le support 14 peut être intégré directement au système de stabilisation 3, Dans le même sens, il peut être envisagé que le système de stabilisation 3 soit également monté libre en rotation par rapport au second dispositif d'ancrage osseux 2b, selon un axe parallèle au deuxième axe de rotation 8.  In the example illustrated in FIG. 4, the second bone anchoring device 2b comprises a support 14 for receiving and mounting for the end of the stabilization system 3. This support 14 is mounted with the possibility of rotation along the first axis A, with respect to the head 13a. of the bone anchoring component 13, In the example illustrated in FIG. 4, the support 14 has a reception U-shaped housing for the stabilization system 3, delimited by two threaded branches receiving a locking screw allowing a freedom of adaptation between the second bone anchoring device 2b and the stabilization system 3 It should be noted that the support 14 can be integrated directly in the stabilization system 3, in the same direction, it can be envisaged that the stabilization system 3 is also mounted free to rotate relative to the second bone anchoring device 2b along an axis parallel to the second axis of rotation 8.
Seion un autre mode avantageux de réalisation de l'invention, le second dispositif d'ancrage osseux 2b consiste en un dispositif d'ancrage osseux comportant deux éléments d'ancrage sur deux vertèbres successives. Selon un mode préféré de réalisation de l'invention, le second dispositif d'ancrage osseux 2b est sensiblement identique au premier dispositif d'ancrage osseux 2a décrit plus haut Ainsi, se!on un mode particulier de réalisation de l'invention illustré notamment aux Fig. 1 et 5, le système de correction rachidien 1 objet de l'invention comporte les premier 2a et second 2b dispositifs d'ancrage osseux identiques reliés entre eux par un système de stabilisation 3. Chaque dispositif d'ancrage osseux 2a, 2b comporte, comme décrit en relation de ia Fïg, 2, deux éléments d'ancrage osseux 4a, 4b dans deux vertèbres consécutives V3, V4, chaque élément d'ancrage 4a, 4b étant composé d'un corps d'ancrage 5 et d'une tête de fixation 6. De plus, chaque dispositif d'ancrage osseux 2a, 2b comporte un support 7 sur lequel sont fixées les têtes de fixation 6, définissant entre elles un axe longitudinal X, Ce support 7 comprend un élément de liaison 7b avec Se système de stabilisation 3, ledit élément de liaison 7b s'étendant selon un premier axe de rotation A orthogonal à Taxe longitudinal X et étant relié au système de stabilisation 3 de manière à ce que ce dernier se trouve déporté au-delà desdites têtes de fixation. En outre, le système de stabilisation 3 est monté libre en rotation sur l'élément de liaison 7b par une liaison mécanique rotule. According to another advantageous embodiment of the invention, the second bone anchoring device 2b consists of a bone anchoring device comprising two anchoring elements on two successive vertebrae. According to a preferred embodiment of the invention, the second bone anchoring device 2b is substantially identical to the first bone anchoring device 2a described above. Thus, there is a particular embodiment of the invention illustrated in particular in FIGS. 1 and 5, the spinal correction system 1 object of the invention comprises the first 2a and second 2b identical bone anchoring devices interconnected by a stabilization system 3. Each bone anchoring device 2a, 2b comprises, as described in relation to Fia, 2, two bone anchoring elements 4a, 4b in two consecutive vertebrae V3, V4, each anchoring element 4a, 4b being composed of an anchoring body 5 and a head of In addition, each bone anchoring device 2a, 2b comprises a support 7 on which the fastening heads 6 are fixed, defining between them a longitudinal axis X, This support 7 comprises a connecting element 7b with Se system of stabilization 3, said connecting element 7b extending along a first axis of rotation A orthogonal to longitudinal axis X and being connected to the stabilization system 3 so that the latter is offset beyond said fixing heads. In addition, the stabilization system 3 is rotatably mounted on the connecting element 7b by a mechanical connection ball.
Pour l'ensemble des modes de réalisation de l'invention décrits ci-dessus, Sa distance entre les premier 2a et second 2b dispositifs d'ancrage est choisie en fonction de la correction du rachis à réaliser, De même, le système de stabilisation 3 peut présenter diverses configurations selon la pathologie et le but de l'instrumentation (stabilisation de la colonne, arthrodèse correction de déformation, etc.).  For all the embodiments of the invention described above, its distance between the first 2a and second 2b anchoring devices is chosen according to the correction of the spine to be performed, Similarly, the stabilization system 3 may have various configurations depending on the pathology and purpose of the instrumentation (stabilization of the column, arthrodesis correction of deformation, etc.).
Ainsi, dans le cas de l'utilisation du système de stabilisation 3 comme un stabilisateur dynamique dans le cas par exemple de fractures ou après correction de déformations pour éviter l'arthrodèse fonctionnelle, le système de stabilisation 3 consiste en une tige 16 de longueur prédéterminée, dont chacune des extrémités est reliée à l'un des dispositifs d'ancrage osseux 2a, 2b du système de correction rachidien (Fig. 1 et 4). Ce mode de réalisation offre l'avantage de laisser Ses vertèbres, sur lesquelles les premier 2a et second 2b dispositifs d'ancrage osseux sont fixés, fibres en rotation selon au moins un axe de rotation. Dans le cas d'une correction de scoliose, un mode de réalisation de l'invention représenté à la Fîg. 5, comprend un système de stabilisation 3 qui consiste en un coupie de tiges 16 de distraction reliées entre eiies par un organe de liaison 17. Chaque tige 16 est reliée à une de ses extrémités à un dispositif d'ancrage osseux 2a et 2b, De cette manière, chaque tige 16 n'est reliée qu'à un seul dispositif d'ancrage osseux. Selon un exemple de réalisation, l'organe de liaison 17 relie de manière fixe, les deux tiges 16 entre elles. Un tel système de correction peut être utilisé lors de la mise en place d'implants pour la scoliose, Thus, in the case of the use of the stabilization system 3 as a dynamic stabilizer in the case for example of fractures or after correction of deformations to avoid functional arthrodesis, the stabilization system 3 consists of a rod 16 of predetermined length each end of which is connected to one of the bone anchoring devices 2a, 2b of the spinal correction system (Figures 1 and 4). This embodiment has the advantage of leaving its vertebrae, on which the first 2a and second 2b bone anchoring devices are fixed, fibers in rotation along at least one axis of rotation. In the case of a scoliosis correction, an embodiment of the invention shown in Figs. 5, comprises a stabilization system 3 which consists of a cut of distraction rods 16 connected between eiies by a connecting member 17. Each rod 16 is connected at one of its ends to a bone anchoring device 2a and 2b, De in this way, each rod 16 is connected to only one bone anchoring device. According to an exemplary embodiment, the connecting member 17 fixedly connects the two rods 16 between them. Such a correction system can be used during the placement of implants for scoliosis,
Selon un autre mode de réalisation, l'organe de liaison 17 comporte des moyens de guidage en translation de chacune des tiges 16 l'une par rapport à l'autre. Selon ce mode avantageux de réalisation, l'organe de liaison 17 est un système de distraction manuelle fixe pour les deux tiges. Ce mode de réalisation permet en particulier d'adapter séquentiellement la distance entre les premier 2a et second 2b dispositifs d'ancrage osseux en fonction de la croissance de l'enfant ou de l'adolescent.  According to another embodiment, the connecting member 17 comprises means for guiding in translation of each of the rods 16 relative to each other. According to this advantageous embodiment, the connecting member 17 is a fixed manual distraction system for the two rods. This embodiment makes it possible in particular to adapt sequentially the distance between the first 2a and second 2b bone anchoring devices according to the growth of the child or adolescent.
Selon un autre mode de réalisation de l'invention, l'organe de liaison 17 est un système de distraction auto-adaptatif comportant pour chaque tige de distraction 16, une structure de biocage en translation des tiges de distraction 16, dans l'organe de liaison 17. Cette structure de blocage est active uniquement lors d'efforts de compression du rachis d'un patient sur les tiges de distraction 16 de façon à s'opposer aux dits efforts de compression. Un tel système de distraction auto-adaptatif permet de s'adapter en particulier à la croissance naturelle du rachis.  According to another embodiment of the invention, the connecting member 17 is a self-adaptive distraction system comprising for each distraction rod 16, a biocage structure in translation of the distraction rods 16, in the body of This blocking structure is active only during compression efforts of the spine of a patient on the distraction rods 16 so as to oppose said compression forces. Such a self-adaptive distraction system makes it possible to adapt in particular to the natural growth of the spine.
Selon un autre mode de réalisation de (Invention, l'organe de liaison 17 comporte pour chaque tige de distraction 16, au moins un organe de suspension des tiges de distraction apte è conférer une souplesse et exercer une précharg longitudinale sur les tiges de distraction 16, Ce mode de réalisation permet la mobilité du rachis et d'augmenter le confort du patient en évitant l'arthrodèse des vertèbres du rachis dudit patient.  According to another embodiment of (Invention, the connecting member 17 comprises for each distraction rod 16, at least one suspension member of the distraction rods capable of imparting flexibility and exerting a longitudinal precharge on the distraction rods 16 This embodiment allows the mobility of the spine and increase the comfort of the patient by avoiding the arthrodesis of the vertebrae of the patient's spine.
Selon un mode préféré de réalisation de l'invention, l'organe de liaison 17 est un système de distraction auto-adaptatif décrit par la demande il de brevet: WO 2012/085405 et comporte, pour chaque tige de distraction 16, au moins un organe de suspension des tiges de distraction apte à conférer une souplesse et exercer une précharge longitudinale sur les tiges de distraction. De plus, i'organe de liaison 17 comporte une structure de biocage en translation des tiges de distraction dans l'organe de liaison 17, iadite structure étant active uniquement lors d'efforts de compression du rachis d'un patient sur les tiges de distraction de façon à s'opposer aux dits efforts de compression et augmenter ie confort du patient en évitant l'arthrodèse des vertèbres du rachis dudit patient. Ce mode de réaiîsation permet en particulier de diminuer ie nombre d'interventions chirurgicales et donc de diminuer le risque opératoire. According to a preferred embodiment of the invention, the connecting member 17 is a self-adaptive distraction system described by the application. he patent: WO 2012/085405 and comprises, for each distraction rod 16, at least one suspension member of the distraction rods capable of imparting flexibility and exert a longitudinal preload on the distraction rods. In addition, the connecting member 17 comprises a biocage structure in translation of the distraction rods in the connecting member 17, said structure being active only during efforts to compress the spine of a patient on the distraction rods so as to oppose said compressive forces and increase patient comfort by avoiding arthrodesis of the spine vertebrae of said patient. This mode of réaîsation allows in particular to reduce the number of surgical procedures and thus reduce the operational risk.
Ainsi, ie système de correction rachidien 1 d'une scoliose offre l'avantage de permettre une correction dynamique e progressive de la scoliose qui évite un enraidissement des vertèbres. En effet, ia combinaison de l'organe de suspension, de ia structure de biocage, et d'au moins un axe de rotation des premier 2a et second 2b dispositifs d'ancrage osseux par rapport au système de stabilisation 3 permet à la fois de corriger la scoliose et à Sa fois d'aligner toutes les vertèbres de la zone à corriger avec ie système de stabilisation 3.  Thus, the spinal spinal correction system 1 has the advantage of allowing a progressive dynamic correction of scoliosis which avoids stiffening of the vertebrae. Indeed, the combination of the suspension member, the biocage structure, and at least one axis of rotation of the first 2a and second 2b bone anchoring devices relative to the stabilization system 3 allows both correct scoliosis and both to align all the vertebrae of the area to be corrected with the stabilization system 3.
II ressort de ia description qui précède que ie système de correction rachidien 1 seion l'invention permet la rotation complète du système de stabilisation 3 autour des premier et second dispositifs d'ancrage osseux 2a, 2b, quel que soit l'élément d'ancrage aux vertèbres. Typiquement, le système de correction permet la rotation complète dans Se pian frontal F, du système de stabilisation 3 dans la mesure où ie premier axe de rotation A s'étend sensiblement perpendtcuiai rement au plan frontal F. Les premier et second dispositifs d'ancrage osseux 2a, 2bf laissent au système de stabilisation 3, une mobilité en rotation, même en fonctionnement. Le système de stabilisation 3 n'est pas totalement rigide et laisse de ce fait une souplesse à ia zone du rachis appareillée, Cette souplesse permet de préserver au mieux les vertèbres et les disques compris entre les premier et second dispositifs d'ancrage 2a, 2b. Les Fig. 7 et 7A permettent d'illustrer les avantages du système de correction i selon l'invention par rapport aux dispositifs de correction connus, illustrés aux Fig. 6 et 6A, qui montrent un système de stabilisation 3' fixé en distai et proximal à l'aide de dispositifs d'ancrage osseux 2'a, 2'b. L'angle a entre le système de stabilisation 3' et Ses vertèbres étant figé après implantation, la marge de correction est réduite. Pour minimiser cet effet, tes dispositifs d'ancrage osseux sont déplacés en dehors de fa zone déformée, ce qui immobilise ia colonne selon une plus grande partie. It follows from the above description that the spinal correction system 1 according to the invention allows the complete rotation of the stabilization system 3 around the first and second bone anchoring devices 2a, 2b, regardless of the anchoring element. to the vertebrae. Typically, the correction system allows complete rotation in the front plane F of the stabilization system 3 since the first axis of rotation A extends substantially perpendicularly to the frontal plane F. The first and second anchoring devices bone 2a, 2b f leave the stabilization system 3, a rotational movement, even during operation. The stabilization system 3 is not completely rigid and thus leaves a flexibility in the area of the spine paired, This flexibility makes it possible to best preserve the vertebrae and the disks between the first and second anchoring devices 2a, 2b . Figs. 7 and 7A illustrate the advantages of the correction system i according to the invention with respect to the known correction devices, illustrated in FIGS. 6 and 6A, which show a stabilization system 3 'fixed distally and proximally with the aid of bone anchoring devices 2'a, 2'b. The angle a between the stabilization system 3 'and its vertebrae being fixed after implantation, the correction margin is reduced. To minimize this effect, the bone anchors are moved out of the deformed area, thereby immobilizing the column in a larger portion.
Tel que cela ressort des Fîg. 7 et 7A, le système de correction I selon 1 Invention permet, grâce à la rotation frontale non limitée du système de stabilisation 3, d'améliorer la correction tant sur le plan de l'amplitude de réduction de la déformation que sur la réduction de la taille de la zone appareillée. L'angle uî entre le système de stabilisation 3 et les vertèbres diminue après implantation pour atteindre une valeur «2 afin de s'adapter à la croissance et au redressement du rachis. La longueur d'immobilisation étant réduite, la souplesse de ia colonne vertébrale est préservée pendant le traitement, augmentant encore l'efficacité de la distraction.  As it appears from the Fîg. 7 and 7A, the correction system I according to the invention makes it possible, thanks to the unlimited frontal rotation of the stabilization system 3, to improve the correction both in terms of the amplitude of reduction of the deformation and on the reduction of the size of the paired area. The angle ui between the stabilization system 3 and the vertebrae decreases after implantation to reach a value of 2 in order to adapt to the growth and straightening of the spine. The immobilization length being reduced, the flexibility of the spine is preserved during the treatment, further increasing the efficiency of the distraction.
Le système de correction 1 selon l'invention facilite également l'implantation de divers types de systèmes de stabilisation 3 grâce à sa mobilité en rotation et typiquement selon trois axes orthogonaux, par rapport aux éléments d'ancrage osseux. En effet, selon un exemple préféré de réalisation illustré en particulier à la Fig. 5, le système de stabilisation 3 est monté en liaison mécanique rotuie avec l'élément de liaison 7b, c'est-à-dire avec trois degrés de liberté en rotation selon les premier A, deuxième B et troisième C axes de rotation, En position montée sur le rachis, le premier axe de rotation A est orthogonal au plan frontal F, le deuxième axe de rotation B est orthogonal au plan sagittal S et le troisième axe C est orthogonal au plan transversal T. Cette mobilité entre le système de stabilisation 3 et les éléments d'ancrage osseux 4a, 4b, permet un montage facile du système de stabilisation 3 tout en s'adaptant aux diverses contraintes d'implantation des éléments d'ancrage osseux dans Se rachis.  The correction system 1 according to the invention also facilitates the implantation of various types of stabilization systems 3 by virtue of its mobility in rotation and typically along three orthogonal axes, with respect to the bone anchoring elements. Indeed, according to a preferred embodiment illustrated in particular in FIG. 5, the stabilization system 3 is mounted mechanically connected with the connecting element 7b, that is to say with three degrees of freedom in rotation according to the first A, second B and third C axes of rotation, mounted on the spine, the first axis of rotation A is orthogonal to the frontal plane F, the second axis of rotation B is orthogonal to the sagittal plane S and the third axis C is orthogonal to the transverse plane T. This mobility between the stabilization system 3 and the bone anchoring elements 4a, 4b, allows easy mounting of the stabilization system 3 while adapting to the various constraints of implantation of the bone anchoring elements in the spine.

Claims

REVENDICATIONS
1 - Système de correction rachidien (1), comportant un premier (2a) et un second (2b) dispositif d'ancrage osseux, reliés entre eux par un système de stabilisation (3), le premier dispositif d'ancrage (2a) osseux comprenant :  1 - spinal correction system (1), comprising a first (2a) and a second (2b) bone anchoring device, connected together by a stabilization system (3), the first bone anchoring device (2a) comprising:
- deux éléments d'ancrage osseux (4a, 4b) dans deux vertèbres consécutives (VI) et (V2), chaque élément (4a, 4b) étant composé d'un corps d'ancrage (5) et d'une tête de fixation (6) ;  - two bone anchoring elements (4a, 4b) in two consecutive vertebrae (VI) and (V2), each element (4a, 4b) being composed of an anchoring body (5) and a fixing head (6);
- un support (7) fixé sur ies têtes de fixation (6) et définissant entre elles un axe longitudinal (X), ledit support (7) comprenant un élément de liaison (7b) avec le système de stabilisation (3), ledit élément de liaison (7b) s'étendant selon un premier axe de rotation (A) orthogonal à l'axe longitudinal (X) et étant relié au système de stabilisation (3) de manière à ce que ce dernier se trouve déporté au-delà desdites têtes de fixation (6), caractérisé en ce que :  a support (7) fixed on the fixing heads (6) and defining between them a longitudinal axis (X), said support (7) comprising a connecting element (7b) with the stabilization system (3), said element link (7b) extending along a first axis of rotation (A) orthogonal to the longitudinal axis (X) and being connected to the stabilization system (3) so that the latter is deported beyond said fixing heads (6), characterized in that:
- le système de stabilisation (3) est monté libre en rotation sur l'élément de liaison (7b) du premier dispositif (2a) au moins tout autour du premier axe de rotation (A) par une liaison mécanique rotule et comporte un système (12) de blocage en translation par rapport audit élément de liaison (7b) réalisé par un collier (12a) aménagé sur l'extrémité (9) du système de stabilisation (3) et fixé sur l'élément de liaison (7b), et  - the stabilization system (3) is rotatably mounted on the connecting element (7b) of the first device (2a) at least all around the first axis of rotation (A) by a mechanical connection ball joint and comprises a system ( 12) translational lock with respect to said connecting element (7b) formed by a collar (12a) arranged on the end (9) of the stabilization system (3) and fixed on the connecting element (7b), and
- en ce que le second dispositif (2b) est monté libre en rotation avec le système de stabilisation (3) seion un axe parallèle audit premier axe de rotation (A),  in that the second device (2b) is mounted free to rotate with the stabilization system (3) between an axis parallel to said first axis of rotation (A),
2 - Système de correction rachidien (1) selon la revendication 1, caractérisé en ce que Se système de stabilisation (3) est en outre monté libre en rotation sur l'élément de liaison (7b) du premier dispositif d'ancrage osseux (2a) autour d'un deuxième axe de rotation (B) orthogonal à la fois au premier axe de rotation (A) à la fois à l'axe longitudinal (X).  2 - spinal correction system (1) according to claim 1, characterized in that Se stabilization system (3) is further mounted free to rotate on the connecting element (7b) of the first bone anchoring device (2a ) about a second axis of rotation (B) orthogonal to both the first axis of rotation (A) at both the longitudinal axis (X).
3 - Système de correction rachidien (1) selon la revendication 2, caractérisé en ce que le second dispositif d'ancrage osseux (2b) est monté libre en rotation avec le système de stabilisation se!on un axe parallèle audit deuxième axe de rotation (B). 4 - Système de correction rachidien (I) seion l'une des revendications 1, à 3, caractérisé en ce que l'élément de liaison (7b) du premier dispositif comporte une bague (10) adaptée pour coopérer à l'intérieur d'un anneau sphérique (9a) monté dans ie collier (12a) du système de stabilisation (3) afin de former la iiaison mécanique rotule, apte à tourner tout autour du premier axe de rotation (A). 3 - spinal correction system (1) according to claim 2, characterized in that the second bone anchoring device (2b) is mounted free to rotate with the stabilization system is an axis parallel to said second axis of rotation ( B). 4 - spinal correction system (I) according to one of claims 1 to 3, characterized in that the connecting element (7b) of the first device comprises a ring (10) adapted to cooperate inside of a spherical ring (9a) mounted in the collar (12a) of the stabilizing system (3) to form the mechanical ball joint, rotatable about the first axis of rotation (A).
5 - Système de correction rachidien (1) selon la revendication 4, caractérisé en ce que ia bague (10) comporte un trou de passage pour une vis (11) de montage de la bague sur l'élément de liaison (7b).  5 - spinal correction system (1) according to claim 4, characterized in that the ring (10) has a through hole for a screw (11) for mounting the ring on the connecting element (7b).
6 - Système de correction rachidien (1) selon Tune des revendications 1 à 5, caractérisé en ce que le second dispositif d'ancrage (2b) osseux est composé d'un élément d'ancrage osseux du type à vis tulipe ou crochet, ancré sur une vertèbre.  6 - spinal correction system (1) according to one of claims 1 to 5, characterized in that the second bone anchoring device (2b) is composed of a bone anchoring element of the tulip or hook screw type, anchored on a vertebra.
7 - Système de correction rachidien (1) selon l'une des revendications 1 à 5, caractérisé en ce que le second dispositif d'ancrage osseux (2b) est sensiblement identique au premier dispositif d'ancrage osseux (2a).  7 - spinal correction system (1) according to one of claims 1 to 5, characterized in that the second bone anchoring device (2b) is substantially identical to the first bone anchoring device (2a).
8 - Système de correction rachidien (1) selon l'une des revendications 1 à 8 - spinal correction system (1) according to one of claims 1 to
7, caractérisé en ce que les éléments d'ancrage osseux (4a, 4b) consistent en des vis tulipe ou des crochets. 7, characterized in that the bone anchoring elements (4a, 4b) consist of tulip screws or hooks.
9 - Système de correction rachidien (1) selon l'une des revendications 1 à 9 - spinal correction system (1) according to one of claims 1 to
8, caractérisé en ce que le système de stabilisation (3) est constitué d'une tige de longueur prédéterminée. 8, characterized in that the stabilization system (3) consists of a rod of predetermined length.
10 - Système de correction rachidien (1) selon l'une des revendications 1 à 9, caractérisé en ce que 1e système de stabilisation (3) consiste en un couple de tiges (16) de distraction reliées entre elles par un organe de liaison (17) muni de moyens de guidage de chacune des tiges (16) l'une par rapport à l'autre à l'intérieur dudit organe de liaison (17).  10 - spinal correction system (1) according to one of claims 1 to 9, characterized in that the stabilization system (3) consists of a pair of distraction rods (16) interconnected by a connecting member ( 17) provided with means for guiding each of the rods (16) relative to each other within said connecting member (17).
11 - Système de correction rachidien (1) selon la revendication 10, caractérisé en ce que l'organe de liaison (17) est du type système de distraction manuelle fixe pour fixer les deux tiges (16) l'une par rapport à l'autre, afin de régler ia distance entre les deux points d'ancrage du dispositif (2a, 2b). 12 - Système de correction rachidien (1) selon fa revendication 10, caractérisé en ce que l'organe de liaison (17) est du type comportant pour chaque tige (16) de distraction, une structure de blocage des tiges de distraction (16) en translation dans l'organe de liaison, ladite structure étant active uniquement Sors d'efforts de compression du rachis d'un patient sur les tiges de distraction de façon à s'opposer aux dits efforts de compression et augmenter le confort du patient en évitant l'arthrodèse des vertèbres du rachis dudît patient 11 - spinal correction system (1) according to claim 10, characterized in that the connecting member (17) is of the fixed manual distraction system type to fix the two rods (16) with respect to the other, to adjust the distance between the two anchor points of the device (2a, 2b). 12 - spinal correction system (1) according to claim 10, characterized in that the connecting member (17) is of the type comprising for each rod (16) of distraction, a blocking structure of the distraction rods (16) in translation in the connecting member, said structure being active only Comes from compressive forces of the spine of a patient on the distraction rods so as to oppose said compressive forces and increase the comfort of the patient by avoiding arthrodesis of vertebrae of the spine of this patient
13 - Système de correction rachidien (1) selon la revendication 10, caractérisé en ce que l'organe de liaison (17) est du type comportant pour chaque tige de distraction, au moins un organe de suspension des tiges de distraction apte à conférer une souplesse et exercer une précharge longitudinale sur les tiges de distraction (16),  13 - spinal correction system (1) according to claim 10, characterized in that the connecting member (17) is of the type comprising for each distraction rod, at least one suspension member of the distraction rods capable of imparting a flexibility and exert a longitudinal preload on the distraction rods (16),
14 - Système de correction rachidien (1) selon la revendication 10, caractérisé en ce que l'organe de liaison (17) est du type comportant pour chaque tige (16) de distraction :  14 - spinal correction system (1) according to claim 10, characterized in that the connecting member (17) is of the type comprising for each rod (16) of distraction:
- au moins un organe de suspension des tiges de distraction apte à conférer une souplesse et exercer une précharge longitudinale sur les tiges (16) de distraction et ;  at least one suspension member of the distraction rods capable of imparting flexibility and exerting a longitudinal preload on the distraction rods (16) and;
- une structure de blocage des tiges de distraction (16) en translation dans l'organe de liaison, ladite structure étant active uniquement lors d'efforts de compression du rachis d'un patient sur les tiges de distraction de façon à s'opposer aux dits efforts de compression et augmenter le confort du patient en évitant l'arthrodèse des vertèbres du rachis dudit patient  a structure for locking the distraction rods (16) in translation in the connecting member, said structure being active only during compression efforts of the spine of a patient on the distraction rods so as to oppose the said compressive forces and increase the comfort of the patient by avoiding the arthrodesis of the vertebrae of the patient's spine
PCT/FR2014/053384 2013-12-17 2014-12-17 Spinal correction system WO2015092270A1 (en)

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN113613574A (en) * 2019-03-22 2021-11-05 德克萨斯苏格兰礼仪儿童医院 Hinge-connector spinal correction device and method
CN113613574B (en) * 2019-03-22 2024-04-16 德克萨斯苏格兰礼仪儿童医院 Hinge-connector spinal correction device and method

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2781359A1 (en) 1998-07-21 2000-01-28 Pierre Boccara Osteosynthesis frame for spinal surgery has rod with clamps to hold cross bars with anchor screws
US20100145388A1 (en) 2008-12-03 2010-06-10 Spartek Medical, Inc. Low profile spinal prosthesis incorporating a bone anchor having a deflectable post and a compound spinal rod
WO2012085405A1 (en) 2010-12-23 2012-06-28 Universite Claude Bernard Lyon I Device for correcting scoliosis and controlling vertebral arthrodesis
US8430916B1 (en) * 2012-02-07 2013-04-30 Spartek Medical, Inc. Spinal rod connectors, methods of use, and spinal prosthesis incorporating spinal rod connectors
US20130123851A1 (en) 2011-11-16 2013-05-16 Kspine, Inc. Transverse connector for spinal stabilization system

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2781359A1 (en) 1998-07-21 2000-01-28 Pierre Boccara Osteosynthesis frame for spinal surgery has rod with clamps to hold cross bars with anchor screws
US20100145388A1 (en) 2008-12-03 2010-06-10 Spartek Medical, Inc. Low profile spinal prosthesis incorporating a bone anchor having a deflectable post and a compound spinal rod
WO2012085405A1 (en) 2010-12-23 2012-06-28 Universite Claude Bernard Lyon I Device for correcting scoliosis and controlling vertebral arthrodesis
US20130123851A1 (en) 2011-11-16 2013-05-16 Kspine, Inc. Transverse connector for spinal stabilization system
US8430916B1 (en) * 2012-02-07 2013-04-30 Spartek Medical, Inc. Spinal rod connectors, methods of use, and spinal prosthesis incorporating spinal rod connectors

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN113613574A (en) * 2019-03-22 2021-11-05 德克萨斯苏格兰礼仪儿童医院 Hinge-connector spinal correction device and method
CN113613574B (en) * 2019-03-22 2024-04-16 德克萨斯苏格兰礼仪儿童医院 Hinge-connector spinal correction device and method

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