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WO2024108277A1 - Vis de limitation pour bloquer la migration d'une prothèse lombaire - Google Patents

Vis de limitation pour bloquer la migration d'une prothèse lombaire Download PDF

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Publication number
WO2024108277A1
WO2024108277A1 PCT/BR2022/050456 BR2022050456W WO2024108277A1 WO 2024108277 A1 WO2024108277 A1 WO 2024108277A1 BR 2022050456 W BR2022050456 W BR 2022050456W WO 2024108277 A1 WO2024108277 A1 WO 2024108277A1
Authority
WO
WIPO (PCT)
Prior art keywords
screw
limiting screw
prosthesis
bone
migration
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.)
Ceased
Application number
PCT/BR2022/050456
Other languages
English (en)
Portuguese (pt)
Inventor
Osvaldo Piovezani FILHO
André Evaristo Marcondes CESAR
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.)
Individual
Original Assignee
Individual
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 Individual filed Critical Individual
Priority to PCT/BR2022/050456 priority Critical patent/WO2024108277A1/fr
Publication of WO2024108277A1 publication Critical patent/WO2024108277A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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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
    • 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

Definitions

  • disc degeneration can lead to dehydration and collapse of the intervertebral disc, herniated disc, lumbar stenosis ⁇ narrowing of the spinal canal in addition to muscle and ligament injuries of the spine.
  • the main treatment for degenerative disc disease is clinical treatment that includes physiotherapy, medications, weight loss, postural control and lifestyle changes. However, if this treatment fails, it is possible to perform infiltration, decompressive surgery, arthrodesis and lumbar arthroplasty.
  • Lumbar arthroplasty consists of replacing the intervertebral disc with a prosthesis with intrinsic mobility. In this way, spinal movement is preserved, avoiding overload on the rest of the spine, as happens in arthrodesis surgery. [004] As examples of solutions relating to the subject discussed above, the following prior documents can be cited, which represent the applied state of the art:
  • BR 1 120150229085 entitled “PROSTHETIC DEVICES TO IMPROVE JOINT MECHANICS IN ARTHROPLASTY”, which claims a kit that includes a humerus stem with a central longitudinal axis, configured to attach to a resected bone; a first tuberosity component; a second tuberosity component; and at least one proximal segment configured to engage the tuberosity components;
  • arthrodesis surgery does not normally cause major complications, however it is known that non-union between the vertebrae due to constant and improper displacement of the prostheses can affect up to 5% of operated patients.
  • a posterior approach becomes necessary when stabilizing these prostheses is necessary, as this procedure is invasive and not always effective.
  • the screw in question is self-drilling, of the cancellous type, and adopts a low-profile thrust washer to work as a stop in stabilizing the prosthesis.
  • Figure 1 isometric view of the limiting screw
  • Figure 2 side view of the screw from its head and side view of the screw from its tip, respectively;
  • FIG. 3 front and rear views of the limiting screw, respectively.
  • Enlarged detail A shows its tip with grooves and oblong cuts;
  • Figure 5 - illustrates the vertebral bodies of the lumbar spine intermediated by the vertebral discs.
  • one of the vertebral discs were replaced by a lumbar disc prosthesis (represented in light gray), where the lower vertebral body at the prosthesis site receives the bone tunnel for implantation of the limiting screw;
  • FIG. 6 Figure 6 - figure in accordance with the previous figure, illustrating that the bone tunnel received the limiting screw, which has its washer positioned as a stop to limit the movement of the prosthesis, as seen in enlarged detail B.
  • the “LIMITING SCREW FOR BLOCKING MIGRATION OF LUMBAR PROSTHESIS”, reason for this present patent application, forms a bone insertion screw (1) to be implanted close to the vertebral plateau in order to prevent anterior migration of intervertebral disc prostheses or double-lock ALIF type.
  • the limiting screw (1) is of the spongy type, preferably manufactured in Titanium ASTM F-136, formed by a cylindrical body 4mm in diameter equipped with spongy threads (2) measuring 6.5mm throughout its entire length. Its low-profile head (3) adopts a hexagonal wrench fitting (4) and thrust washer (5), also low-profile, with approximately twice the diameter of the body.
  • the screw (1) receives a pair of opposing grooves (6), formed by chamfered cutouts whose ends form cutting edges, with sharp vertices, with the face of each groove (6) interrupted by an oblong cutout ( 7) that leaks its end, thus forming a self-drilling screw body.
  • the screw (1) is limited by its main configurations, but these do not restrict small variations in its shape, which can be applied without distorting the invention, such as, for example, different measurements and angles of the threads (2); different angle or size of the grooves (6); different diameters of the screw body (1) and its head (3), etc.
  • the limiting screw (1) this will be used after intervertebral disc prosthesis implantation surgery, in the case of Lumbar Arthroplasty, or ALIF Stand Alone double lock in order to limit the anterior migration of these prostheses, stabilizing them on site and avoiding post-surgical complications.
  • a bone tunnel (8) is created with a 3.2mm drill or Stillman wire in the anterior center from the apex (center of the upper front edge) of the lower vertebral plateau (9) of the instrumented level, heading in an antero-superior direction to the monocortical posteroinferior region of said vertebral plateau (9).
  • the procedure must be entirely monitored by fluoroscopy.
  • the “C” arm of radioscopy directed in profile is used to assist in the depth of insertion of the drill with the aim of not invading the opposite cortex, as well as the end plate.
  • the screw (1) is measured with a conventional large fragment box gauge, which varies between 25mm and 40mm.
  • the tunnel can be tapped bone (8) with a 6.5mm male, which reduces insertion torque and improves bone-implant contact.
  • the limiting screw (1) is inserted until its thrust washer (5) covers the edge of the bone tunnel (8) and is positioned so as to partially cover the prosthesis (P ).
  • the washer (5) of the limiting screw (1) will block the movement of the prosthesis (P) in the location of its abutment face, thus preventing the migration of the instrumented material and ensuring its stability.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgery (AREA)
  • Biomedical Technology (AREA)
  • Engineering & Computer Science (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

L'invention concerne une vis de limitation (1) d'insertion osseuse pour empêcher la migration de prothèses du disque vertébral. Ladite vis (1) est formée d'un corps cylindrique pourvu de filets de filetage spongieux (2), dont la tête (3) de profil bas est pourvu d'un encastrement de clé mâle à six pans (4) et comprend une rondelle de butée (5), également de profil bas, avec approxativement le double du diamètre du corps. La pointe de la vis (1) loge une paire de rainures opposées (6), de sommets aigus interrompus respectivement par une découpe oblongue (7). Ainsi, après une chirurgie d'implantation de prothèse du disque intervertébral ou après le placement de la prothèse du disque lombaire (P) ou de la cage intersomatique, est réalisé un tunnel osseux (8) avec une mèche ou un fil de Stillman au centre de la pointe (centre du bord supérieur avant) du plateau vertébral inférieur (9) du niveau à instrument, suivant la direction antéro-supérieure vers la région postéro-inférieure monocorticale dudit plateau vertébral (9), lequel reçoit le forage pour que la vis de limitation (1) soit insérée jusqu'à ce que sa rondelle de butée (5) couvre le bord du tunnel osseux (8) et soit positionnée de manière à recouvrir partiellement la prothèse, servant de butée.
PCT/BR2022/050456 2022-11-21 2022-11-21 Vis de limitation pour bloquer la migration d'une prothèse lombaire Ceased WO2024108277A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/BR2022/050456 WO2024108277A1 (fr) 2022-11-21 2022-11-21 Vis de limitation pour bloquer la migration d'une prothèse lombaire

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/BR2022/050456 WO2024108277A1 (fr) 2022-11-21 2022-11-21 Vis de limitation pour bloquer la migration d'une prothèse lombaire

Publications (1)

Publication Number Publication Date
WO2024108277A1 true WO2024108277A1 (fr) 2024-05-30

Family

ID=91194801

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/BR2022/050456 Ceased WO2024108277A1 (fr) 2022-11-21 2022-11-21 Vis de limitation pour bloquer la migration d'une prothèse lombaire

Country Status (1)

Country Link
WO (1) WO2024108277A1 (fr)

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5868749A (en) * 1996-04-05 1999-02-09 Reed; Thomas M. Fixation devices
US20020016595A1 (en) * 1999-05-05 2002-02-07 Gary K. Michelson Screws of cortical bone and method of manufacture thereof
FR2840799A1 (fr) * 2002-06-17 2003-12-19 Fixano Vis d'osteosynthese
CA2539391A1 (fr) * 2003-09-17 2005-04-21 Depuy Spine, Inc. Systeme de fixation d'os
EP2018827B1 (fr) * 2007-07-26 2012-05-02 BIEDERMANN MOTECH GmbH Dispositif de fixation pour os
EP2683337B1 (fr) * 2011-03-10 2017-08-16 Synthes GmbH Éléments de fixation à vis allen et systèmes associés
US11076902B2 (en) * 2018-02-22 2021-08-03 Phoenix Spine Holdings, Inc. Locking screw assembly for facilitating direct lateral interbody fusion procedures

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5868749A (en) * 1996-04-05 1999-02-09 Reed; Thomas M. Fixation devices
US20020016595A1 (en) * 1999-05-05 2002-02-07 Gary K. Michelson Screws of cortical bone and method of manufacture thereof
FR2840799A1 (fr) * 2002-06-17 2003-12-19 Fixano Vis d'osteosynthese
CA2539391A1 (fr) * 2003-09-17 2005-04-21 Depuy Spine, Inc. Systeme de fixation d'os
EP2018827B1 (fr) * 2007-07-26 2012-05-02 BIEDERMANN MOTECH GmbH Dispositif de fixation pour os
EP2683337B1 (fr) * 2011-03-10 2017-08-16 Synthes GmbH Éléments de fixation à vis allen et systèmes associés
US11076902B2 (en) * 2018-02-22 2021-08-03 Phoenix Spine Holdings, Inc. Locking screw assembly for facilitating direct lateral interbody fusion procedures

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