FR2724554A1 - Dispositif de fixation d'une prothese ligamentaire - Google Patents
Dispositif de fixation d'une prothese ligamentaire Download PDFInfo
- Publication number
- FR2724554A1 FR2724554A1 FR9411534A FR9411534A FR2724554A1 FR 2724554 A1 FR2724554 A1 FR 2724554A1 FR 9411534 A FR9411534 A FR 9411534A FR 9411534 A FR9411534 A FR 9411534A FR 2724554 A1 FR2724554 A1 FR 2724554A1
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- FR
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- Prior art keywords
- ligaments
- parts
- eyelets
- bodies
- passage
- Prior art date
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Links
- 210000003041 ligament Anatomy 0.000 title claims abstract description 31
- 238000000034 method Methods 0.000 claims description 9
- 230000000295 complement effect Effects 0.000 claims description 3
- 230000001815 facial effect Effects 0.000 claims description 3
- 238000013016 damping Methods 0.000 claims description 2
- 230000000712 assembly Effects 0.000 description 1
- 238000000429 assembly Methods 0.000 description 1
- 230000000903 blocking effect Effects 0.000 description 1
- 230000006835 compression Effects 0.000 description 1
- 238000007906 compression Methods 0.000 description 1
- 238000009434 installation Methods 0.000 description 1
- 230000001575 pathological effect Effects 0.000 description 1
- 230000035939 shock Effects 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/08—Muscles; Tendons; Ligaments
- A61F2/0811—Fixation devices for tendons or ligaments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- 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 or setting implements
- 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, e.g. stabilisers comprising fluid filler in an implant
- A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/08—Muscles; Tendons; Ligaments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/08—Muscles; Tendons; Ligaments
- A61F2/0811—Fixation devices for tendons or ligaments
- A61F2002/0817—Structure of the anchor
- A61F2002/0823—Modular anchors comprising a plurality of separate parts
- A61F2002/0829—Modular anchors comprising a plurality of separate parts without deformation of anchor parts, e.g. fixation screws on bone surface, extending barbs, cams, butterflies, spring-loaded pins
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/08—Muscles; Tendons; Ligaments
- A61F2/0811—Fixation devices for tendons or ligaments
- A61F2002/0847—Mode of fixation of anchor to tendon or ligament
- A61F2002/0864—Fixation of tendon or ligament between anchor elements, e.g. by additional screws in the anchor, anchor crimped around tendon
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/08—Muscles; Tendons; Ligaments
- A61F2/0811—Fixation devices for tendons or ligaments
- A61F2002/0876—Position of anchor in respect to the bone
- A61F2002/0888—Anchor in or on a blind hole or on the bone surface without formation of a tunnel
Landscapes
- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Vascular Medicine (AREA)
- Transplantation (AREA)
- Cardiology (AREA)
- Rheumatology (AREA)
- Rehabilitation Therapy (AREA)
- Neurology (AREA)
- Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Prostheses (AREA)
Abstract
Ce dispositif comprend des moyens (3) et (4) aptes à être engagés et positionnés dans des trous formés dans l'épaisseur des apophyses épineuses (E1) (E2), lesdits moyens (3) et (4) étant conformés pour le passage d'organes de fixation (6) coopérant avec des agencements (5) que présentent les extrémités libres desdits ligaments (2).
Description
DlsDosItlf de fixation d'une prothèse liaamentaire.
L'invention se rattache au secteur technique des prothèses intervertébrales.
II est connu d'utiliser, pour assurer une contention intervertébrale des prothèses associant des ligaments à des cales rigides ou souples, généralement disposés entre les apophyses épineuses des vertèbres. Ce type de prothèses à pour but de stabiliser la flexion - extension et la rotation. Généralement, les extrémités des ligaments sont cousus en huit, entre les apophyses épineuses.
A partir de cette conception de base, le problème que se propose de résoudre l'invention, est d'améliorer la fixation des ligaments, au niveau des épineuses.
Pour résoudre un tel problème, il a été conçu et mis au point un dispositif de fixation d'une prothèse ligamentaire comprenant un élément amortisseur placé entre deux épineuses, ledit élément étant conformé pour le pasage de ligaments artificiels.
Selon l'invention, le dispositif comprend des moyens aptes à être engagés et positionnés dans des trous formés dans l'épaisseur des apophyses épineuses, lesdits moyens étant conformés pour le passage d'organes de fixation coopérant avec des agencements que présentent les extrémités libres des ligaments.
Pour résoudre le problème posé d'assurer la fixation des ligaments au niveau des épineuses, les moyens sont constitués par deux parties complémentaires emboitables.
Chaque partie présente un corps cylindrique creux, les corps des deux parties étant emboitables, I'une des extrémités des corps étant prolongée par une collerette d'appui faciale sur une partie correspondante de l'apophyse épineuse.
Pour résoudre le problème posé d'assurer la fixation des ligaments, les agencements de ces derniers sont constitués par des oeillets sertis en bout desdits ligaments.
Les organes d'assemblage sont constitués par un système qui comprend un boulon, deux écrous et une goupille.
L'invention est exposée, ci-après plus en détail à l'aide des dessins annexés, dans lesquels:
La figure 1 est une vue en perspective des éléments engagés dans les épineuses pour la fixation des ligaments.
La figure 1 est une vue en perspective des éléments engagés dans les épineuses pour la fixation des ligaments.
La figure 2 est une vue en plan d'un ligament équipé des agencements de fixation.
La figure 3 est une vue en coupe longitudinale montrant la mise en place du dispositif selon l'invention.
La figure 4 est une vue en plan correspondant à la figure 3.
D'une manière connue, I'élément prothétique comprend un élément amortisseur (1), constituant une cale apte à être disposée entre deux apophyses épineuses (El) et (E2). La cale (1) est conformée pour le pasage dans des conditions déterminées de ligaments artificiels (2). Plus particulièrement, la cale (1) est réalisée dans une matière semi rigide, sous forme, par exemple, d'un corps cylindrique. La cale (1) est percée de part en part pour le passage des ligaments (2).
Avantageusement, la cale est percée pour le passage, d'une manière croisée, de deux ligaments. Cette cale (2) peut, de manière connue, présenter différentes hauteurs pour caler les vertèbres, en distraction réduite.
Selon l'invention, le dispositif, apte à assurer la fixation des ligaments (2), présente des moyens conformés pour être engagés et positionnés dans des trous (T) formés dans l'épaisseur des épineuses.
Comme le montre la figure 1, ces moyens sont constitués par deux parties complémentaires (3) et (4). Chaque partie présente un corps cylindrique creux (3a) (4a), lesquels corps étant emboitables.
En outre, I'une des extrémités de chacun des corps (3a) et (4a) est prolongée par une colerette d'appui faciale (3b) et (4b), de manière à assurer un centrage de l'ensemble des deux parties (3) et (4), après emboitement dans le trou correspondant de l'apophyse épineuse. Après emboitement, les deux parties (3) et (4) constituent un élément ayant très sensiblement la forme d'un diabolo.
Ces dispositions permettent donc d'enserrrer la section des épineuses.
Selon une autre caractéristique, après introduction des ligaments (2) dans la cale (1), les extrémités (2a) et (2b) de chacun des ligaments, sont équipées d'oeillets (5) qui, avantageusement, sont sertis en bout desdites extrémités.
La fixation des ligaments par rapport aux épineuses s'effectue au moyen d'organes d'assemblage, coopérant avec les oeillets (5) et engagés dans les corps creux (3a) et (4a) des parties (3) et (4). Ces organes d'assemblage sont constitués par un système comprenant un boulon (6), deux écrous (7) (8) et une goupille (9).
II convient d'analyser la technique opératoire, en fonction de la mise en oeuvre du dispositif selon l'invention.
L'opérateur perce, dans un premier temps, les épineuses très sensiblement dans leur partie médiane. II est alors possible d'engager, dans les trous (T) effectués, les parties (3) et (4) qui sont emboitées au niveau de leur corps creux (3a) et (4a). Les colerettes (3b) et (4b) sont en appui sur les faces correspondantes des épineuses (El) et (E2).
L'opérateur met ensuite en place la cale amortisseur (1), entre les épineuses considérées (El) et (E2) et engage les ligaments d'essai dans la cale (1), pour mesurer leur longueur.
Après avoir pris ces mesures, les ligaments définitifs (2) sont introduits dans la cale (1) et équipés en bout des oeillets (5). Il suffit alors d'engager le boulon (6) au travers des oeillets et des parties emboitées (3) et (4), et d'assurer l'assemblage au moyen des écrou et contre-écrou (7) et (8). La goupille (9) assure le blocage en translation du système écrou contre-écrou en cas de blocage accidentel.
Bien évidemment, le dispositif de fixation tel que décrit, peut etre répété sur plusieurs étages, par exemple, pour trois épineuses. Dans ce cas, le même système de boulon est utilisé pour deux montages successifs. Le boulon reçoit, en superposition, les extrémités des ligaments consécutifs.
La forme de réalisation de la cale amortisseur et des ligaments n'est pas décrite en détail car parfaitement connue pour un homme du métier, en étant susceptible, par ailleurs, de faire l'objet de différentes variantes d'exécution, en fonction du cas pathologique à traiter.
Les avantages ressortent bien de la description, en particulier on souligne et on rappelle le meilleur contrôle de la rotation axiale.
Claims (6)
- -1- Dispositif de fixation d'une prothèse ligamentaire comprenant un élément amortisseur (1) placé entre deux épineuses (El) (E2), ledit élément (1) étant conformé pour le passage de ligaments artificiels (2), caractérisé en ce qu'il comprend des moyens (3) et (4) aptes à être engagés et positionnés dans des trous formés dans l'épaisseur des apophyses épineuses (El) (E2), lesdits moyens (3) et (4) étant conformés pour le passage d'organes de fixation (6) coopérant avec des agencements (5) que présentent les extrémités libres desdits ligaments (2).
- -2- Dispositif selon la revendication 1, caractérisé en ce que les moyens sont constitués par deux parties complémentaires emboitables (3) et (4).
- -3- Dispositif selon la revendication 2, caractérisé en ce que chaque partie (3) et (4) présente un corps cylindrique creux (3a) et (4a), les corps des deux parties étant emboitables, I'une des extrémités des corps (3a) et (4a) étant prolongée par une colerette d'appui faciale (3b) (4b) sur une partie correspondante de l'apophyse épineuse.
- -4- Dispositif selon la revendication 1, caractérisé en ce que les agencements des ligaments (2) sont constitués par des oeillets (5) sertis en bout desdits ligaments.
- -5- Dispositif selon la revendication 1, caractérisé en ce que les organes d'assemblage sont constitués par un système qui comprend un boulon (6), deux écrous (7) et (8) et une goupille (9).
- -6- Dispositif selon la revendication 1, caractérisé en ce que l'élément amortisseur (1) est un cylindre en matière semi-rigide.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| FR9411534A FR2724554B1 (fr) | 1994-09-16 | 1994-09-16 | Dispositif de fixation d'une prothese ligamentaire |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| FR9411534A FR2724554B1 (fr) | 1994-09-16 | 1994-09-16 | Dispositif de fixation d'une prothese ligamentaire |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| FR2724554A1 true FR2724554A1 (fr) | 1996-03-22 |
| FR2724554B1 FR2724554B1 (fr) | 1997-01-24 |
Family
ID=9467325
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| FR9411534A Expired - Fee Related FR2724554B1 (fr) | 1994-09-16 | 1994-09-16 | Dispositif de fixation d'une prothese ligamentaire |
Country Status (1)
| Country | Link |
|---|---|
| FR (1) | FR2724554B1 (fr) |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| EP1027004A4 (fr) * | 1997-10-27 | 2004-10-13 | St Francis Medical Tech Inc | Implant de distraction vertebrale |
| EP1030615A4 (fr) * | 1997-10-27 | 2004-10-13 | St Francis Medical Tech Inc | Implant de distraction vertebrale |
| CN100345522C (zh) * | 1997-10-27 | 2007-10-31 | 圣弗朗西斯医疗技术公司 | 脊椎分离嵌入物 |
| US7585316B2 (en) | 2004-05-21 | 2009-09-08 | Warsaw Orthopedic, Inc. | Interspinous spacer |
| US7588592B2 (en) | 2003-02-12 | 2009-09-15 | Kyphon Sarl | System and method for immobilizing adjacent spinous processes |
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