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ES2253221T3 - Jaula de fusion de perfil bajo y el conjunto de insercion. - Google Patents

Jaula de fusion de perfil bajo y el conjunto de insercion.

Info

Publication number
ES2253221T3
ES2253221T3 ES00925908T ES00925908T ES2253221T3 ES 2253221 T3 ES2253221 T3 ES 2253221T3 ES 00925908 T ES00925908 T ES 00925908T ES 00925908 T ES00925908 T ES 00925908T ES 2253221 T3 ES2253221 T3 ES 2253221T3
Authority
ES
Spain
Prior art keywords
fusion
cage
distal
separator
fusion implant
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Lifetime
Application number
ES00925908T
Other languages
English (en)
Inventor
Salvatore Castro
Christopher Mcdonnell
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Howmedica Osteonics Corp
Original Assignee
Howmedica Osteonics Corp
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 Howmedica Osteonics Corp filed Critical Howmedica Osteonics Corp
Application granted granted Critical
Publication of ES2253221T3 publication Critical patent/ES2253221T3/es
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

Links

Classifications

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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
    • A61F2/446—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages having a circular or elliptical cross-section substantially parallel to the axis of the spine, e.g. cylinders or frustocones
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    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
    • A61B17/1757—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the spine
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    • A61F2/4603—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4611—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0069—Three-dimensional shapes cylindrical
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/006—Additional features; Implant or prostheses properties not otherwise provided for modular
    • A61F2250/0063—Nested prosthetic parts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00017—Iron- or Fe-based alloys, e.g. stainless steel
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00179—Ceramics or ceramic-like structures

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Abstract

Dispositivo de implante de fusión para huesos (200), que comprende: un cuerpo rígido que presenta un extremo distal (206), un extremo proximal (204) y un eje longitudinal que se extiende entre dichos extremos distal y proximal, presentando dicho cuerpo una cámara interna hueca formada en el mismo para admitir la fusión ósea; caracterizado porque un canal cóncavo (202) está formado en dicho cuerpo entre dichos extremos distal y proximal (206, 204), estando dispuesto dicho canal cóncavo (202) alrededor de un eje, que se extiende en una dirección substancialmente perpendicular a dicho eje longitudinal de dicho cuerpo.

Description

Jaula de fusión de perfil bajo y el conjunto de inserción.
Antecedentes de la técnica
Los implantes espinales conocidos, tales como los utilizados para la fusión vertebral, se suelen utilizar en pares para proporcionar un soporte adecuado, uniformemente distribuido así como una inducción a la fusión. Debido al espacio limitado para la implantación y para las manipulaciones quirúrgicas, a veces resulta difícil o inviable realizar un par de implantes que presenten las dimensiones y los atributos deseables. Algunos diseños de implantes ya existentes están configurados para la colocación próxima contigua a otros implantes, pero ninguno consigue un rendimiento óptimo, versatilidad ni facilidad de inserción.
El documento EP-A-0 732 093 (Sofomor Danek Group, Inc.) da a conocer implantes de fusión espinal con, al menos en parte, forma cilíndrica. Las partes laterales de los implantes pueden presentar lados cóncavos y convexos correspondientes para reducir el perfil global cuando dos o más implantes se aplican en posiciones contiguas.
Sumario de la invención
Un objetivo de la presente invención es proporcionar un diseño de implante que presente configuraciones óptimas para la colocación de implantes contiguos en estrecha proximidad con un rendimiento óptimo. Estos y otros objetivos se alcanzan mediante la configuración de implantes según la presente invención. La invención proporciona un dispositivo según la reivindicación 1.
Un implante de fusión según la presente invención está provisto de una zona cortada cóncava en una superficie circunferencial de un implante alargado. La parte cóncava se adapta al contorno exterior de un implante colocado en una posición contigua, que presenta una superficie convexa correspondiente. Una herramienta separadora dual puede estar provista de dos configuraciones de sección transversal solapadas para facilitar la inserción y colocación próxima de implantes según la presente invención.
Breve descripción de los dibujos
A continuación se describen unas formas de realización preferidas de la presente invención haciendo referencia a los dibujos adjuntos, en los que:
la Fig. 1 es una vista en perspectiva de una jaula de fusión de perfil bajo;
la Fig. 2 es una vista lateral de la jaula de fusión que se ilustra en la Fig. 1;
la Fig. 3a es una vista en sección transversal de la jaula de fusión tomada a lo largo de la línea B-B de la Fig. 1;
la Fig. 3b es una vista en sección transversal de la jaula de fusión ilustrada en la Fig. 3a, con una jaula de implante convencional de vista similar colocado en una posición adyacente;
la Fig. 4 es una vista en perspectiva de un separador de espigas.
la Fig. 5 es una vista en perspectiva de la guía descrita en la presente invención;
la Fig. 6 es una vista en perspectiva que ilustra la unión de la guía al separador;
la Fig. 7a es una vista del impactor;
la Fig. 7b es una vista en perspectiva de la placa del impactor; y
la Fig. 8 es una vista en perspectiva frontal de una forma de realización según la presente invención.
Descripción detallada de la forma de realización preferida
Las Figuras 1 a 3a ilustran una vista en perspectiva y unas vistas extremas de una jaula de fusión de perfil bajo. La jaula (10) es del tipo conocido comercialmente como RAY TFC^{TM} Fusion Cage que actualmente se comercializa por Surgical Dynamics, Inc. En la patente US nº 4.961.740 da a conocer la jaula de fusión Ray TFC^{TM}.
La jaula de fusión (10) se puede colocar junto con otra jaula para reducir la cantidad de espacio total ocupado por dos jaulas de fusión convencionales colocadas próximas entre sí. La jaula de fusión (10) presenta un roscado helicoidal (14) para facilitar la inserción y la fijación de la jaula (10) en un espacio de disco vertebral. El roscado (14) está entallado para formar unas partes cóncavas (16, 17) y reducir así el perfil del roscado.
Según la presente invención, se proporciona un implante de fusión ósea que comprende:
un cuerpo rígido que presenta un extremo distal (206), un extremo proximal (204) y un eje longitudinal que se extiende entre dichos extremos distal y proximal.
presentando dicho cuerpo una cámara interna hueca formada para alojar la fusión ósea;
caracterizado porque
está formado un canal cóncavo (202), en dicho cuerpo, entre los extremos distal y proximal (206, 204), estando dispuesto dicho canal cóncavo (202) alrededor de un eje que se extiende en una dirección substancialmente perpendicular a dicho eje longitudinal de dicho cuerpo.
Si así se desea, solamente es necesaria una parte cóncava para realizar la presente invención. Además, es posible proporcionar más de dos partes cóncavas si así se requiere. Las partes cóncavas permiten colocar juntas dos o más jaulas puesto que la parte convexa de una jaula está dispuesta dentro de la parte cóncava de una jaula adyacente. Como puede apreciarse, la anchura combinada (espacio transversal) de las dos jaulas de perfil bajo colocadas de esta manera es inferior a la anchura combinada de dos implantes convencionales.
Las Figs. 4 a 7b ilustran un conjunto de instrumentos de inserción para jaulas de fusión. El conjunto de instrumentos comprende un separador de espigas (20), una guía (30) y un impactor (40) así como una placa de impactor (41). El separador (20) comprende un par de espigas espaciadas (21) que están dimensionadas y configuradas como cuñas en el extremo distal para su inserción en el espacio de disco y para su separación del mismo.
El separador de espigas (20) comprende un par de lengüetas ranuradas (22) que se extienden de modo proximal para el montaje de las lengüetas (42) de la placa del impactor (41), cuando la placa del impactor (41) está montada en el extremo proximal del separador (20). Las lengüetas (42) se insertan en las ranuras (23) de las lengüetas (22) para el montaje de la placa del impactor (41) y del impactor integral alargado (40), que está unido a la placa del impactor (41) mediante unos roscados (43, 45), en el separador de espigas (20). A continuación, el impactor (40) puede impactarse o golpearse en su extremo proximal (47) con una herramienta adecuada, tal como un martillo, para insertar la espiga (21) en un espacio vertebral. Después de la inserción, las lengüetas (42) se desacoplan de las ranuras (23) para separar y retirar el impactor (40) y la placa del impactor (41), dejando el separador de espigas (20) en su lugar con las espigas (21) insertadas en el espacio vertebral.
A continuación, la guía (30) se une al separador (20) insertando el pasador extremo distal (32) en la ranura longitudinal (25) del separador (20). El pasador del extremo distal se asienta dentro de la ranura (25) de tal modo que la guía (30) se pueda pivotar, alrededor del pasador (32), con respecto al separador fijo (20), entre la alineación con cada una de las dos aberturas (26, 27) del separador (20) respectivamente. Cada una de las aberturas (26, 27) está configurada para recibir una jaula de fusión junto con una herramienta de inserción de implante convencional (no ilustrada). Se hace girar la guía (30) alrededor del pasador (32) de tal modo que su perforación axial (34) quede alineada con una de las aberturas (26, 27) del separador (20) durante la preparación del orificio a través de una de las aberturas respectivas. Se insertan unas herramientas adecuadas a través de la perforación (34) para preparar el espacio para la inserción de la jaula de fusión. Las jaulas de fusión, tales como las jaulas del tipo según la presente invención, se insertan mediante una herramienta de inserción alargada a través de la perforación (34) y la abertura del separador (26, 27) respectiva, para colocación dentro del espacio vertebral. Cada jaula se coloca de modo que una de las partes cóncavas (16, 17) quede frente a la abertura contigua o perforación en el espacio vertebral. Se hace girar la guía (30) posteriormente de modo que la perforación axial (34) quede alineada con la otra abertura (26, 27) en el separador (20). Otra jaula de fusión, con o sin partes cóncavas, se inserta de una manera similar a la descrita anteriormente, de tal modo que su parte circunferencial exterior encaje dentro de la parte cóncava de la jaula de fusión insertada en primer lugar.
Se considera la posibilidad de prever un dispositivo de enclavamiento (33) para detener la guía (30) en cada una de sus dos posiciones alineadas en relación con el separador de espigas (20) durante la preparación del lugar del implante y la inserción de un implante de fusión a través de dicho lugar.
Se puede apreciar que el separador de espigas (20), que presenta una longitud aproximadamente igual a su anchura, aumenta la visibilidad así como permite al usuario retirar con mayor facilidad el tejido de disco extraño debido a la creciente movilidad de los instrumentos, por ejemplo pinzas gubias, que se insertan a través del separador (20). Aunque ésta es la forma de realización preferida, se puede modificar la longitud del separador (20) según se requiera para conseguir ventajas diferentes.
Aunque se ha descrito en la presente memoria descriptiva una forma de realización preferida, se entiende y se considera que se pueden aportar modificaciones y variantes sin apartarse por ello del alcance de la presente invención.

Claims (4)

1. Dispositivo de implante de fusión para huesos (200), que comprende:
un cuerpo rígido que presenta un extremo distal (206), un extremo proximal (204) y un eje longitudinal que se extiende entre dichos extremos distal y proximal,
presentando dicho cuerpo una cámara interna hueca formada en el mismo para admitir la fusión ósea; caracterizado porque
un canal cóncavo (202) está formado en dicho cuerpo entre dichos extremos distal y proximal (206, 204), estando dispuesto dicho canal cóncavo (202) alrededor de un eje, que se extiende en una dirección substancialmente perpendicular a dicho eje longitudinal de dicho cuerpo.
2. Dispositivo de implante de fusión según la reivindicación 1, en el que dicha cámara interna hueca es generalmente cilíndrica.
3. Dispositivo de implante de fusión según la reivindicación 1 ó 2, en el que dicha superficie exterior está roscada para facilitar la inserción y la fijación dentro de un espacio vertebral.
4. Implante de fusión según cualquiera de las reivindicaciones anteriores, en el que dicho cuerpo presenta unas aberturas en extremos opuestos (204, 206), estando dichas aberturas en comunicación con dicha cámara interna hueca.
ES00925908T 1999-04-07 2000-04-07 Jaula de fusion de perfil bajo y el conjunto de insercion. Expired - Lifetime ES2253221T3 (es)

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US20050228499A1 (en) 2005-10-13
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CA2366824C (en) 2008-03-18
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EP1164979A1 (en) 2002-01-02
US7070621B2 (en) 2006-07-04
WO2000059413A1 (en) 2000-10-12
CA2366824A1 (en) 2000-10-12
US20030097181A1 (en) 2003-05-22
US6783545B2 (en) 2004-08-31
DE60024979D1 (de) 2006-01-26
AU762689B2 (en) 2003-07-03
JP2002540845A (ja) 2002-12-03
US7105025B2 (en) 2006-09-12
DE60024979T2 (de) 2006-08-24
US20030018389A1 (en) 2003-01-23

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