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USRE42626E1 - Multidirectional adaptable vertebral osteosyntsis device with reduced space requirement - Google Patents

Multidirectional adaptable vertebral osteosyntsis device with reduced space requirement Download PDF

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Publication number
USRE42626E1
USRE42626E1 US10/629,788 US62978898A USRE42626E US RE42626 E1 USRE42626 E1 US RE42626E1 US 62978898 A US62978898 A US 62978898A US RE42626 E USRE42626 E US RE42626E
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United States
Prior art keywords
bone
threaded shank
head
shank
anchoring
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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
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US10/629,788
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English (en)
Inventor
Jean Taylor
Bernard Villaret
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Medicrea Technologies
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Medicrea Technologies
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    • 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
    • A61B17/7049—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
    • 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
    • A61B17/7001—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
    • 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
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/701—Longitudinal elements with a non-circular, e.g. rectangular, cross-section
    • 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
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7014—Longitudinal elements, e.g. rods with means for adjusting the distance between two screws or hooks
    • 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
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7035—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • A61B17/7037—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other wherein pivoting is blocked when the rod is clamped
    • 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
    • A61B17/7001—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
    • 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
    • A61B17/7047—Clamps comprising opposed elements which grasp one vertebra between them
    • 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
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8061—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones

Definitions

  • the subject of the present invention is a spinal, particularly dorso-lumbar, osteosynthesis device.
  • the invention is aimed at a device of the type comprising at least two bone-anchoring elements for anchoring into bone structures of the spine, a member for longitudinally connecting the bone-anchoring elements, and shackles for connecting the bone-anchoring elements and the members for connecting the screws; each bone-anchoring element comprises an anchor for anchoring into the bone, a head for grasping by a screwing tool, a threaded shank extending the head for grasping and a tightening element which can be mounted on this shank to lock together the connector, the longitudinal connecting member and the corresponding bone-anchoring element.
  • Multivertebral, particularly dorso-lumbar, osteosynthesis combines the use of screws or hooks connected together by plates or rods.
  • longitudinal connecting members such as rods for example also allows the bone-anchoring elements, for example screws, to slide along the principal axis of the longitudinal connecting member, and allows screws which diverge in the horizontal plane to be brought onto the same antero-posterior line, and this is by virtue of derotation effects imparted on the rods about an apicocaudal axis, that is to say in the horizontal plane.
  • the adjusting of the pedicle-screws/rod pair may lead to very high stresses in the system before it is definitely locked.
  • Pedicle screws in which the threaded shank is extended rearwards have also been developed, so that the descent of the rod as far as the vertebral implantation base of the screw can be guided, segment by segment.
  • Reduction of a deformation with a large radius, under such conditions, is in three planes, but is not in any way sequential, and can even less be said to be selective.
  • One vertebra which is off-set in isolation in the frontal sagittal and horizontal planes has to be brought into a condition such that it can undergo reduction in just one plane if necessary, or even with a view to be secured as it is to the adjacent segment under no stress other than the stress induced by neutralization.
  • the head of a screw may be capped by a U-shaped element thus dubbed a “tulip” which acquires mobility about the principal axis of the screw.
  • the surgeon is thus freed of this enormous burden and can implant the pedicle screws along the axis imposed by the topography of the pathological vertebra.
  • the threaded shank has a ball end for articulation in a housing of a spherical cup of the head for grasping, allowing the shank to be orientated in many directions, and allowing the connecting shackle to be positioned to suit the configuration of the vertebral segment receiving the bone-anchoring elements, and the ball and the cup have respective centres of rotation which are separated by a distance, giving the device, when tightened using the tightening element, by bearing against the upper part of the head for grasping, a function of returning the bone-anchoring element by transverse force, the connector shackle for this purpose having a spherical bearing surface articulated to a portion of the spherical surface of the cup of the head of the bone-anchoring element.
  • the connecting shackle Depending on the physical characteristics of the connecting shackle, either the surface contact immobilizes the bone-anchoring element and allows the orientation of the bone-anchoring element to be maintained, or the connecting shackle bears against the upper part of the head for grasping, giving the device, upon tightening of the element, a transverse return function.
  • the device according to the invention allows the implant to be orientated in many directions using a system which requires a very small amount of space, and allows the bone-anchoring elements to be used either with rods or with plates.
  • the threaded shank and the connecting shackle are equipped with means for immobilizing the shank and its ball in terms of rotation once the threaded shank has been introduced into the corresponding through-hole through the shackle.
  • the said means comprise at least one rotation-stopping geometry formed between the ball and the contiguous end of the threaded shank, and a second rotation-stopping geometry formed on the interior edge of the hole in the shackle, this second geometry being designed to press against the first geometry once the connecting shackle has been slid along the threaded shank.
  • the device also comprises at least one bone-anchoring element comprising an anchoring shape, a head with a transverse collar and a shape for grasping, for screwing and a threaded shank extending the head, the assembly being all of one piece.
  • FIG. 1 is a partial perspective view prior to assembly, on an enlarged scale, of a first embodiment of the spinal osteosynthesis device according to the invention.
  • FIG. 2 is a partial perspective view of the device of FIG. 1 , showing, on an enlarged scale, a bone-anchoring element with two screw threads and a corresponding shackle for connection to a vertebral rod, not depicted, it being possible for this bone-anchoring element to be, in particular, a screw or a hook.
  • FIG. 3 is a perspective view on an enlarged scale of the device of FIGS. 1 and 2 assembled and fitted to a vertebral segment.
  • FIG. 4 is an anterolateral elevation view of a dorsolumbar segment with an osteosynthesis device according to the invention, during fitting, some of the connecting shackles with which a vertebral rod is equipped being slipped over the threaded shanks of the corresponding bone-anchoring elements which have already been anchored in the vertebral bony structures.
  • FIG. 5 is a posterior view of the dorso-lumbar segment of FIG. 4 and of the corresponding device, installed.
  • FIG. 6 is anterolateral view of the device of FIG. 5 , showing the lumbar lordosis provided by bending the vertebral rod.
  • FIG. 7 is a plan view of a one-piece bone-anchoring element without ball, with which the osteosynthesis device according to the invention may be equipped.
  • FIG. 8 is a view in elevation from behind of a device with a plate for connecting the bone-anchoring elements and mounted on a dorso-lumbar segment.
  • FIG. 9 is a view in elevation in a sagittal plane of the device with a plate of FIG. 8 , comprising a bone-anchoring element like the one in FIG. 6 .
  • FIG. 10 is a view partly in elevation and partly in section on an enlarged scale of the assembly of a bone-anchoring element, a connecting shackle and a tightening element according to the embodiment of FIGS. 1 to 4 , for returning the bone-anchoring element to the axis of the tightening element.
  • FIG. 11 is a diagrammatic view in elevation on a smaller scale than FIG. 10 , of the whole of the corresponding device, illustrating the angular return of the bone-anchoring element to the axis of the tightening element and of the threaded rod during tightening.
  • FIG. 12 is a part view similar to FIG. 10 of an alternative form of the device, which is modified so as practically not to provide any appreciable angular return of the bone-anchoring element during tightening.
  • FIG. 13 is a perspective view on an enlarged scale, of a second embodiment of the connecting shackle of FIG. 2 .
  • FIG. 14 is a view in elevation on an enlarged scale of a second embodiment of a bone-anchoring element of the device.
  • FIG. 15 is a view partly in elevation and partly in section of one embodiment of a system for transversely connecting two bone-anchoring elements, with which the device of FIGS. 1 to 14 may be equipped.
  • FIG. 16 is a view from above of the transverse connecting system of FIG. 15 .
  • the spinal osteosynthesis device illustrated in FIGS. 1 to 6 comprises several bone-anchoring elements, consisting, in the example described, of elements 1 for anchoring into the bone of the respective vertebrae, a member for longitudinally connecting the bone-anchoring elements 1 , which member consists of a vertebral rod 2 , and shackles 3 for connecting the bone-anchoring elements 1 to the vertebral rods 2 , there being one shackle 3 per bone-anchoring element 1 .
  • Each element 1 comprises a tapered bone-anchoring threaded shank 4 , a head 5 for grasping with a screwing tool 6 , a mechanical threaded shank 7 extending the head 5 .
  • the device is supplemented by a nut 8 which can be screwed onto the threaded shank 7 to lock together the connecting shackle 3 , the vertebral rod 2 and the corresponding bone-anchoring element 1 .
  • the head 5 for grasping has a shape which can cooperate with a screwing tool 6 , for example a hexagonal outline as depicted, designed to cooperate with a female hexagonal cavity 9 of the tool 6 .
  • the shank 7 has a ball end 11 for articulation in a hemispherical housing 12 of the head 5 , in which housing this ball 11 can be held by various assembly techniques, particularly by crimping, welding, etc.
  • the approximately hemispherical housing 12 allows the ball 11 to turn and be mobile in all planes, thus allowing the threaded shank 7 to be orientated in many directions.
  • these means comprise at least one male rotation-stopping geometry 13 formed on a collar 14 arranged between the ball 11 and the contiguous end of the shank 7 , and at least one second, female, rotation-stopping geometry illustrated as a flat 15 formed on the interior edge of the hole 10 in the shackle 3 .
  • This second flat 15 is designed to press against the first flat 13 once the shackle 3 has been slid along the threaded shank 7 .
  • the collar 14 thus has two diametrically opposed rotation-stopping geometries 13 , just one of these geometries 13 being visible in the drawings.
  • the collar 14 thus equipped with the two geometries 13 can fit into the corresponding connecting shackle 3 if the fixture is being used with a vertebral rod 2 or into a plate 16 having similar rotation-stopping geometries (edges of the holes 38 , 41 , 43 in FIGS. 8 and 9 ) 13 ( FIGS. 8 and 9 ) if a plate 16 is being used in place of the rod 2 as a member for longitudinally connecting the screws 1 .
  • the shank 7 has a first cylindrical threaded portion 17 , a narrowed portion 18 constituting a break initiator, a second cylindrical threaded portion 19 extended by a plain end part 21 constituting a male shape with an appropriate profile, for example a half-moon profile with a rotation-stopping geometry, hereinafter known as the flat 22 ( FIG. 2 ).
  • This male shape 21 is designed to be able to cooperate with a complementary female shape 20 of the tool 6 formed in the end of a sleeve 24 mounted to slide axially inside a socket 25 at the end of which the hexagonal female cavity 9 is arranged ( FIG. 1 ).
  • the narrowed portion 18 preferably has a rotation-stopping geometry identical to the fiat 22 . This arrangement allows the ball 11 to be immobilized in terms of rotation during an operation of withdrawing the implant, using the tool 6 .
  • the shank 7 is broken into two parts so that the threaded portion 19 can be removed.
  • the second portion 19 having the function only of guiding the descent of the nut 8 as far as the shackle 3 ( FIG. 3 ).
  • the fact that the male 22 and female 23 flats of the sleeve 24 are fitted together immobilizes the ball 11 in its housing 12 in terms of rotation.
  • the connecting shackle 3 consists of two branches 26 , 27 bent one over onto the other and separated by a longitudinal slit 28 , the hole 10 for the passage of the shank 7 thus being formed in the branches 26 , 27 one on each side of the slit 28 .
  • the two branches 26 , 27 are connected by one or two rounded connecting pieces 29 which delimit one or two cylindrical housings 31 into which one or two cylindrical rods 2 can be introduced ( FIG. 13 ).
  • FIGS. 10 and 11 illustrate in greater detail the embodiment of the device which has just been described with reference to FIGS. 1 to 3 .
  • the sphere or ball 11 of the bone-anchoring element 1 and the spherical cup 57 have respective centres of rotation R 1 and R 2 which are distinct and separated by a distance S.
  • the surface of the cup 57 of the head 5 is hemispherical and interrupted in its polar region to receive the ball 11 , and the associated spherical surface 55 of the shackle 3 , with the same radius of curvature as the surface of the hemispherical cup 57 , completely covers the latter.
  • the pressing on the upper part of the head 5 for grasping gives the connecting shackle 3 /bone-anchoring element 1 system a function of returning the latter to the axis XX of the tightening nut 8 and of the threaded shank 7 during the tightening manoeuvre using the element 8 .
  • the element 8 nut for example
  • the skirt 8 a of which rests against the conical wall 56 of the recess in the nut 8 produces a tensile force F ( FIG. 10 ) which causes a torque C ( FIG. 11 ) which returns the bone-anchoring element 4 towards the longitudinal axis XX of the tightening element 8 and of the threaded shank 7 as the result of a force which is orthogonal to this axis.
  • the spherical surface 55 a only partially covers the spherical surface of the cup 57 because the spherical bearing surface 55 a is interrupted significantly before the equator of the cup 57 .
  • the tensile force F produced by tightening the nut 8 immobilizes the connecting shackle 3 by surface contact, while at the same time maintaining the orientation of the bone-anchoring element 1 .
  • FIG. 13 illustrates one embodiment of the connecting shackle 3 a in which this shackle comprises, on each side of the hole 10 , two rounded connecting pieces 29 , 29 a delimiting two respective housings 31 , 31 a designed to receive longitudinal connecting members such as vertebral rods.
  • FIG. 14 illustrates a second embodiment of the bone-anchoring element, here consisting of a blade-type hook 60 replacing the threaded shank 4 of the previous embodiment, the remainder of the device incidentally being similar to the one in FIGS. 1 and 2 , particularly the head 5 for grasping using a screwing tool 6 and the threaded shank 7 .
  • the blade-type hook 6 consists, in the way known per se, of two pincers 60 a, 60 b with curved ends and adjustable relative separation.
  • FIGS. 15 and 16 illustrate one possible embodiment of a system for transversely connecting the bone-anchoring elements ( 1 or 31 or 60 ).
  • This connecting system is formed of a pair of flared dished elements 58 , 59 , the bottoms of which are pierced with an opening 66 for the passage of the threaded shank 7 .
  • Each dished element 58 , 59 is made of one piece with a respective transverse tab 61 , 62 , the relative position and therefore the separation between the dished elements being adjustable. Adjustment may be achieved for example by means of a screw/nut assembly 63 , 64 passing through an elongate slot 65 in one tab 61 and a tapped hole in the other tab 62 .
  • Each dished element 58 , 59 is interposed between a connecting shackle 3 (or 3 a) and a corresponding tightening element 8 which screws into the dished part, resting against its conical wall 67 , 68 via its conical skirt 8 a.
  • the ability to orientate the bone-anchoring element 1 with respect to the axis XX, with return ( FIGS. 10 , 11 ) or without angular return ( FIG. 12 ) can also be achieved with a similar geometrically complex cavity made in a plate such as 16 ( FIGS. 8 and 9 , orifice 41 , 43 ).
  • the shank 7 is orientated towards the corresponding connector 3 already mounted on a vertebral rod 2 .
  • the tool 6 Allows the shank 7 to be immobilized in terms of rotation using the sleeve 24 while the outer socket 25 allows the tightening element 8 to be screwed as far as its position which immobilizes the assembly, the rotation stopping geometry or geometries 13 of the collar 14 pressing against the corresponding rotation-stopping geometry or geometries 15 of the shackle 3 .
  • FIG. 4 illustrates a reduction manoeuvre.
  • the vertebral rod 2 has been bent in the sagittal plane to reproduce the curvature of the lordosis that it is desired to re-establish.
  • the connecting shackles 3 are slipped onto the rod 2 which, via the shackles 3 , is guided step by step but without effort, because the ball 11 of each bone-anchoring element 1 allows the extra-pedicle threaded shank 7 to be directed towards the shackle 3 before the rod 2 starts to be brought into contact with the spinal column—namely in the example depicted a dorso-lumbar segment: sacrum S and lumbar vertebrae L 5 , L 4 , L 3 , L 2 .
  • the shackle 3 via its underside meets the appropriately orientated collar 14 , the two rotation-stopping geometries 22 (flats) 23 meeting, thus immobilizing the ball 11 .
  • the collar 14 can no longer turn about its axis.
  • the implant has become a single-axis implant.
  • FIG. 7 illustrates a second bone-anchoring element 31 (in this example, a screw) which can be used in a device which is not an embodiment according to the invention when this device comprises a plate 16 ( FIGS. 8 and 9 ) or connecting shackles 3 .
  • a second bone-anchoring element 31 in this example, a screw
  • the bone-anchoring element 31 comprises a threaded anchoring rod 32 , a head 33 which has no ball thus making the screw a one-piece screw.
  • the head 33 consists of a transverse collar 34 and a shape 35 for grasping for screwing with an appropriate tool, for example a hexagonal shape.
  • a threaded shank 7 similar to the one of the bone-anchoring element 1 extends the head 33 , the assembly being of one piece.
  • the plate 16 Facing the sacrum S the plate 16 has an end part with a circular hole for the passage of a single bone-anchoring element 31 , and then, in the region of L 5 , has a second elongate portion 39 in which there is formed an oblong hole 41 which allows the position of a bone-anchoring element 31 to be adjusted correspondingly between two positions; finally, the plate 16 has a third part 42 of elongate shape in which there is made an oblong passage 43 delimiting three possible positions for the bone-anchoring element 1 depending on the adjustment needed, by virtue of three cut-outs formed on the edges of the passage 43 .
  • the plate 16 which is intended for three spinal segments or stages, S, L 5 , L 4 , for example, may be replaced with a plate suited to a different number of stages.
  • just one bone-anchoring element is multiaxial, and therefore has a ball 11 , the other bone-anchoring elements 31 being monoaxial.
  • Each hole ( 41 . . . ) in the plate 16 may have the same profile as the hole 10 in the connecting shackle 3 for the passage of the bone-anchoring element ( FIG. 10 ).
  • This profile makes it possible to fulfil a function of returning the bone element towards the longitudinal axis of the tightening element and of the threaded shank 7 by means of a force orthogonal to this axis.
  • the collar 34 located in the extension of the intra-pedicle portion of the bone-anchoring element 1 is stationary ( FIGS. 8 and 9 ). It may beneficially provide good support against the vertebra using a so-called “bracket” effect, whereas a bone-anchoring element 1 can beneficially be used to reduce, at segment level, an angle between two contiguous boney structures of the spine.
  • the multi-axis screw 1 is left free to move at the beginning of the fitting of the tightening element 8 along the threaded shank 7 .
  • the sleeve 24 with its half-moon shape 23 immobilizes the ball 11 .
  • the bone-anchoring element 1 is thus positioned in one of the three orifices of the oblong hole 43 .
  • the prebending of the plate 16 allows the vertebra L 4 to reposition itself in lordosis with respect to the underlying vertebra, without compromising the locking of the plate 16 /bone-anchoring element 1 pair, because of the tolerance afforded by the ball 11 .
  • the spinal osteosynthesis device according to the invention exhibits the following advantages:

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US10/629,788 1997-06-03 1998-06-03 Multidirectional adaptable vertebral osteosyntsis device with reduced space requirement Expired - Lifetime USRE42626E1 (en)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
IES970411 1997-06-03
IE970411A IES970411A2 (en) 1997-06-03 1997-06-03 Pluridirectional and modulable vertebral osteosynthesis device of small overall size
PCT/FR1998/001119 WO1998055038A1 (fr) 1997-06-03 1998-06-03 Dispositif d'osteosynthese vertebrale pluridirectionnelle et modulable, a encombrement reduit

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US09/445,176 Ceased US6267765B1 (en) 1997-06-03 1998-06-03 Multidirectional adaptable vertebral osteosyntsis device with reduced space requirement
US10/629,788 Expired - Lifetime USRE42626E1 (en) 1997-06-03 1998-06-03 Multidirectional adaptable vertebral osteosyntsis device with reduced space requirement

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EP (3) EP1415602B1 (fr)
JP (1) JP4399554B2 (fr)
CA (1) CA2292748C (fr)
DE (3) DE69839406T2 (fr)
ES (3) ES2229509T3 (fr)
IE (1) IES970411A2 (fr)
PT (3) PT1415602E (fr)
WO (1) WO1998055038A1 (fr)

Cited By (13)

* Cited by examiner, † Cited by third party
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JP2002510998A (ja) 2002-04-09
US6267765B1 (en) 2001-07-31
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IES77331B2 (en) 1997-12-03
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DE69839406T2 (de) 2009-05-20
PT1415603E (pt) 2008-06-09
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DE69838626T2 (de) 2008-08-28
CA2292748A1 (fr) 1998-12-10
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JP4399554B2 (ja) 2010-01-20
DE69826999D1 (de) 2004-11-18
ES2295496T3 (es) 2008-04-16
DE69826999T2 (de) 2005-10-13
EP1415603B1 (fr) 2008-04-23
EP1415603A2 (fr) 2004-05-06
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DE69839406D1 (de) 2008-06-05
EP0986339A1 (fr) 2000-03-22
PT1415602E (pt) 2008-01-30
DE69838626D1 (de) 2007-12-06
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ES2304482T3 (es) 2008-10-16
PT986339E (pt) 2005-01-31

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