The invention relates to an adjustable distraction and support device implanted on the trunk of a child incorporating a combination of several devices used to straighten, support and cushion the mechanical stresses and which can be readjusted according to the growth of the child, these functions not being attainable through the use of each device separately.
Patent Fr 9907034, directed toward a chest wall distractor, describes and claims a mechanical device that can monitor the growth of the bones in incorrect formation while correcting the deformities of the trunk without prohibiting or obstructing the patient's growth, but it is limited in its application to a deformity at the level of the thorax; it cannot be applied to a deformity involving the lumbar spine of the child since his or her growth could be impaired by placing the device directly on the vertebrae.
Patent Fr 109628000, entitled Flexible vertebral linking device consisting of elements that allow the overcoming of a spinal deformity, is largely a cushioning device comprised of rigid components holding visco-elastic means that can cushion the mechanical stresses in the preferred directions.
This device was designed to offset the stresses sustained by the vertebrae of the human body in a multi-axial fashion; it was not intended to be lengthened during displacements by stretching as is the case of the device described in the previous patent.
The device of the present invention allows the steadying of the thorax while allowing the lungs to develop, the straightening of the spine completely during growth without blocking the vertebrae, the cushioning of the external mechanical stresses, the use of an adjustment system that can be accessed easily and does not require a extensive or invasive surgical procedure.
The anchoring devices of the first device resulting from the first invention (patent Fr 9907034) are formed through the use of anchoring brackets surrounding the bones; this first device lending itself perfectly to the fasteners of the thorax would however exert considerable stress on the fasteners used to secure the lumbar vertebrae, which would lead to a risk of rupture in particular for the anchoring screw, which is, of course, unacceptable.
The present invention solves this problem because of its capacity to resolve the difficulties stemming from large deformities by including the lumbar spine.
In the search report for the French patent application (filing 0210248), three prior documents are compared. In U.S. Pat. No. 6,402,750 B1, the only comparable device is the piston, which in this invention can only move axially, it being unable to follow a curvilinear path in phase with the shape of the spine. For an adjustment, this device has to be completely dismantled, which requires a major surgical procedure. In no way is this the case for our invention, which requires only a minor surgical procedure under local anesthesia in order to adjust a central means, the access to which requires only a small incision made under the skin.
Patents FR 2794357 and FR 2814936, dealing firstly with two devices designed independently and that could not be combined without being modified, demonstrates to a person skilled in the art the non-obviousness of this combination, and therefore constitutes a proof of inventiveness. The result that was obtained was not guaranteed in any way. It was made possible as a result of the creation and implantation of new means such as toothed rods, which can be bent as needed and one of the ends of which is shaped like a piston. The unexpected result was the smooth operation of the device, showing that the implementation of this invention combining two prior devices was carried out following numerous tests performed with various radii of rod curvature, characteristics that are distinguished from the prior art.
The following drawings may aid a better understanding of the invention:
Device 2, combining devices 3 and 1, consists of a device 3 called the distraction device intended for children's bones and of a device 1 called device for cushioning the mechanical stresses.
The device 2 (
This invention can be better understood if we recall briefly the means used in devices 3 and 1.
Device 3 allows the monitoring of the course of the deformity of a child's trunk; it can be implanted in the human body easily, due to its small size.
Two toothed rods 35 and 36 mounted on a central means 300 equipped with a hole 312 through which a tool can be inserted to adjust the distance from the anchoring devices 231 to the bones; the device is locked in place in a position determined by tightening the two screws 341 and 342 located on the central means 300.
As shown in the prior art, rods 35 and 36 were rectilinear and could have curved ends to ease placement of the anchoring devices, while the present device 2 may include arched or curved rods 35c and 37c, along their entire length. In this case, test results have shown a normal operation of the device. The advantage gained from this improvement is that damage to the surrounding tissues can be avoided by lengthen the anchoring distances by carefully following a curvature chosen at the beginning by the operator. Moreover, this curvature may be adjusted due to the malleability of the material constituting the rods, which, after testing, can be deformed by the operator.
The flexible intervertebral linking device 1 is itself comprised of two sets of means a first set of means 11 comprised of rigid means 110, 130, and 37 made of biocompatible material assuring a good mechanical bond of the device by transmitting the stresses completely without being deformed, and second set of means 12 made of flexible and cushioning means 121 and 122 made of biocompatible visco-elastic material, accepting repeated elastic deformations, the combination of both sets of means allowing the withstanding and cushioning of the mechanical stresses to which it will be subjected, in order to overcome any dysfunction in the spinal linkage.
Each of devices 3 and 1 have means which are compatible by their design and main functions to which are added new means allowing them to be combined.
As we have already mentioned, device 3 can receive rectilinear or curvilinear rods that are curved at various radii. A device 2 can be positioned consisting of a device 3 having a rectilinear rod 37 on one side, and a curved or arched rod 35c on the other side.
In this latter case, 35c is curved to avoid causing injury and to allow lengthening near the anatomic curve (
The distraction device 2 includes at least one rectilinear or curvilinear toothed rod 37 or 37c, one end of which includes a cylindrical plate 370 perfectly integrated into the visco-elastic means 121 and 122 and rigid means 130 of device 1, allowing the distraction device 2 to be cushioned and to cling to a vertebra even though beforehand it is out of alignment with the distraction device 3.
Thus, the trunk is straightened with the central means 300, which is locked into place with screws 341 and 342 using a small Allen wrench inserted in screw 312 through a small opening requiring only minor surgery. Device 2 can then perform its function of supporting the straightened trunk.
After growth, device 2 is examined and in particular the alignment of rod 37 with rod 110; the operator may then modify means 300 in an effort to straighten the trunk again. Following the straightening efforts, the cushioning device 1 that is part of device 2 is positioned slightly crosswise (
If both rods are aligned, it is again necessary to restore the tension to the device since the stresses applied to device 1 have decreased and the two rods are again on the same axis as a result of the elasticity of device 1 and of the growth of the child.
In addition to the limitations on the stresses exerted on the screws following the straightening of the trunk, device 1 cushions the exterior mechanical stresses and as a result its flexibility will not restrict vertebral mobility.
The various straightening and steadying maneuvers on a child's trunk can easily be repeated; consequently, device 2 may be adjusted as many times as is necessary through a highly localized procedure performed on means 300.
In addition, the multiple combinations of means 1 and 3 allow placing several devices 2 on the spine (
Number | Date | Country | Kind |
---|---|---|---|
02 10248 | Aug 2002 | FR | national |
Filing Document | Filing Date | Country | Kind | 371c Date |
---|---|---|---|---|
PCT/FR03/02435 | 7/31/2003 | WO | 00 | 3/3/2006 |
Publishing Document | Publishing Date | Country | Kind |
---|---|---|---|
WO2004/016185 | 2/26/2004 | WO | A |
Number | Name | Date | Kind |
---|---|---|---|
3900025 | Barnes, Jr. | Aug 1975 | A |
4386603 | Mayfield | Jun 1983 | A |
4445674 | Clayton, Jr. | May 1984 | A |
4611582 | Duff | Sep 1986 | A |
4658809 | Ulrich et al. | Apr 1987 | A |
4747394 | Watanabe | May 1988 | A |
4931055 | Bumpus et al. | Jun 1990 | A |
5129903 | Luhr et al. | Jul 1992 | A |
5130356 | Feuerherd et al. | Jul 1992 | A |
5261908 | Campbell, Jr. | Nov 1993 | A |
5375823 | Navas | Dec 1994 | A |
5395370 | Muller et al. | Mar 1995 | A |
5503413 | Belogour | Apr 1996 | A |
5672175 | Martin | Sep 1997 | A |
5700263 | Schendel | Dec 1997 | A |
5885283 | Gittleman | Mar 1999 | A |
6241730 | Alby | Jun 2001 | B1 |
6382602 | Morrow | May 2002 | B1 |
6402750 | Atkinson et al. | Jun 2002 | B1 |
7029472 | Fortin | Apr 2006 | B1 |
20020074881 | Imlach | Jun 2002 | A1 |
20020151978 | Zacouto et al. | Oct 2002 | A1 |
20040097938 | Alleyne | May 2004 | A1 |
20040153067 | Smith et al. | Aug 2004 | A1 |
20050056979 | Studer et al. | Mar 2005 | A1 |
20050165396 | Fortin et al. | Jul 2005 | A1 |
20050182401 | Timm et al. | Aug 2005 | A1 |
20050261685 | Fortin et al. | Nov 2005 | A1 |
Number | Date | Country |
---|---|---|
2 451 977 | Nov 1993 | CA |
24 37 752 | Feb 1976 | DE |
19500202 | Jul 1996 | DE |
0576379 | Dec 1993 | EP |
2692952 | Dec 1993 | FR |
2717370 | Sep 1995 | FR |
2730156 | Aug 1996 | FR |
2774581 | Aug 1999 | FR |
2 794 357 | Dec 2000 | FR |
2 814 936 | Apr 2002 | FR |
WO 9012553 | Nov 1990 | WO |
WO 9822033 | May 1998 | WO |
WO 0072768 | Dec 2000 | WO |
Number | Date | Country | |
---|---|---|---|
20070149909 A1 | Jun 2007 | US |