The present patent claims the benefit of a corresponding French application FR 04 11314 filed Oct. 22, 2004, entitled Intervertebral Implant and Rachis Stabilization Device, the contents of which is hereby incorporated by reference.
The present invention relates to devices intended to be implanted between vertebrae, and, in some embodiments, more specifically to implants intended to replace damaged intervertebral disks.
Implants intended for the partial or total replacement of intervertebral disks are principally used in the cervical, thoracic, lumbar and lower dorsal regions of the rachis. Some of them comprise two plates, each coming into contact with a vertebral plate, and articulated one on another by a ball joint. This type of connection has the disadvantage of giving rise to relatively intense rubbing during relative movements of the vertebrae. There is therefore a high probability of wear of the implants, resulting in an emission of debris into the patient's body, which is clearly undesirable. To avoid this, materials have to be used which have the disadvantage of incompatibility with the performance of examination by scanning or by MRI. Furthermore, this connection by ball joint alone does not bring about the possibility of the implant returning to a nominal position after a movement, a possibility which would be analogous to the elastic behavior of a natural disk.
Several embodiments of an intervertebral implant and rachis stabilization device are disclosed. In one embodiment, an intervertebral implant includes two connected plates configured to contact with opposing vertebral plates. At least one of the plates has a cut-out delineating webs converging toward a zone where the plates are connected to one another. In some embodiments, the webs are not in mutual contact when the implant is ready for use.
In another embodiment, an intervertebral implant includes two connected plates configured to contact with opposing vertebral plates. Each plate has a cut-out delineating webs converging toward a zone where the plates are connected to one another, and a hub comprising a seat and an excrescence able to penetrate and be kept in the seat for fixing said plates to one another.
In yet another embodiment, an intervertebral implant includes two connected plates configured to contact with opposing vertebral plates. A plurality of webs are included, converging toward a zone where the plates are connected to one another. A cover is also included for each plate.
Additional embodiments are disclosed in the following discussion and the included drawings. Furthermore, the claims are directed broadly to the general invention therein defined, and should not be limited to any of the disclosed embodiments.
The invention will be better understood on reading the following description, given with reference to the following accompanying drawings.
The present disclosure relates generally to the field of orthopedic surgery, and in some embodiments, to intervertebral implants. For the purposes of promoting an understanding of the principles of the invention, reference will now be made to embodiments or examples illustrated in the drawings, and specific language will be used to describe the same. It will nevertheless be understood that no limitation of the scope of the invention is thereby intended. Any alteration and further modifications in the described embodiments, and any further applications of the principles of the invention as described herein are contemplated as would normally occur to one skilled in the art to which the invention relates. To facilitate the understanding of the invention, many of the drawings are out of scale, or include components that are out of scale. In addition, certain steps may not be shown in detail in the drawings, but are described below and are generally well known in the art. Furthermore, although reference numbers are repeated throughout the embodiments, this does not by itself dictate a relationship between the elements, but is instead provided for the sake of example.
A first example of an intervertebral implant according to one embodiment of the invention is shown in
The upper plate 1 has a circular perforation 5, within which elastic webs 6 with a substantially V-shaped cross section extend from its periphery to the center. These webs radially connect the periphery of the perforation 5 to a central hub 7 of the upper plate 1. This hub 7 is generally cylindrical in shape and has a seat 8 turned toward the lower face of the upper plate 1.
The lower plate 2 has a circular perforation 9, within which elastic webs 10 with a substantially inverted V-shaped cross section extend from its periphery to the center. These webs radially connect the periphery of the perforation 9 to a central hub 11 of the lower plate 2. This hub 11 is generally cylindrical in shape and is designed to be able to penetrate into the seat 8 of the hub 7 of the upper plate 1 with a tight fit ensuring fixing of the two pates 1, 2 to one another during the assembly of the implant before installation in a patient's intervertebral space. This tight fit may be completed or replaced by a laser weld or any other fixing mode. As may be seen in
The implant shown in
The implant shown in
The implant shown in
The implant shown in
The implant shown in
The implant shown in
The implant shown in
Generally, it should be understood that, in this class of alternatives, there is no obligation for the plates 1, 2 to have webs of similar configurations. If it is desired to confer different deformation characteristics on the plates 1, 2, webs of different conformations may be used, on condition, of course, that their geometries are compatible: the webs of a given plate should be able to be intercalated between the webs of the other plate without mutual contact. Similarly, the external faces of the plates 1, 2 may have different configurations.
The described and shown examples are not limitative, either, as for the number of webs 6, 10 of each plate. It can be higher or lower than what is shown on the drawings.
In the embodiment shown on
The preceding examples of implants are characterized by the fact that the two plates, upper 1 and lower 2, are originally separate parts, which are assembled at the level of their hubs 7, 11. In the following examples, the two plates become integral and are joined at the level of a socket. But all the functionalities described for the preceding examples are found, or may be found, in the examples which follow.
The example of an implant shown in
The example of an implant shown in
The implant shown in
Because of the rearward offset of the socket 33 with respect to the center of the implant, a better reproduction is attained of the natural division of forces undergone and exerted by the disk during the patient's movements. In particular, the implant is endowed with the possibility of a deformation of greater amplitude when the rachis works in flexion (when the patient leans forward) than when the rachis works in extension (when the patient leans backward).
A forward offset of the socket 33 can also be considered, for cases where one would wish, for example, to favor a possibility of extension movements at the concerned level of the rachis. Generally, the location of the socket 33 can be optimally chosen according to the patient's morphology and weight, and also according to the level of the rachis where the implant is to be inserted.
The implant shown in
It is also seen that, differing from the configuration of
Preferably, as shown in
The implant shown in
In this example, the portions of the plates 31, 32 of the preceding examples which come into contact with the vertebral plates are each reduced to three bearings (53, 54, 55; 56, 57, 58) connected to the socket 33 (which has a truncated circular cross section here; it could have a rectangular cross section) by webs (59, 60, 61; 62, 63, 64). In fact, this comes to having extended the cutouts 34 of the preceding examples so as to have them include the edges of the plates 31, 32.
Two bearings (53, 54; 58, 57) are placed at the two extremities of the rear edge of each plate 31, 32, and the portions of the webs (59, 60; 62, 63) which connect them to the socket 33 have in the shown example a shape approximately of a quarter circle or of a quarter ellipse. The other bearing 55, 58 of each plate 31, 32 is placed at the middle of the front edge of the corresponding plate 31, 32 and is connected to the socket 33 by a web 61, 64 which substantially follows the longitudinal axis of the plate 31, 32.
The implant is completed by two covers 65, 66 which are each placed on an upper or lower face of one of the plates 31, 32. The internal faces 67, 68 of the covers 65, 66 bear grooves 69, 70, 71 into which the webs (59, 60, 61; 62, 63, 64) are inserted without any contact. The covers 65, 66 also have indentations (74, 75, 76; 77, 78, 78′) on the periphery of their external face 72, 73, enabling the bearings (53, 54, 55; 56, 57, 58) to be brought level, that is to themselves form portions of the external surfaces of the implant once assembled, being located in the exact prolongation of the external faces 72, 73 of the covers 65, 66.
Preferably, the external faces 72, 73 of the covers 65, 66 bear excrescences 29, 30 ensuring the anchoring of the implant to the vertebral plates. These excrescences 29, 30 may take various forms, particularly those described and shown for other examples of implants.
The covers 65, 66 also preferably have orifices 79, 80, 81 for the insertion of gripping instruments facilitating the insertion of the implant. Such orifices 79, 80, 81 may be found in the other examples of implants which have been described.
Preferably, shoulders 82, 83, 84, 85 are provided on the webs (59, 60, 61; 62, 63, 64) near the bearings (53, 54, 55; 56, 57, 58), so as to ensure a limitation of the penetration of the webs (59, 60, 61; 62, 63, 64) in the grooves 69, 70, 71 of the covers 65, 66. One is, so, more secure that contacts between the webs (59, 60, 61; 62, 63, 64) and the walls of the grooves 69, 70, 71 will be avoided.
The covers 65, 66 preferably have, as shown, a biconvex external surface 72, 73, and the bearings (53, 54, 55; 56, 57, 58) consequently have shapes which prolong those of the covers 65, 66.
The implant which has been described and shown in
This configuration shown in FIGS. 19 to 22 gives an excellent compromise between the deformation and strength properties of the implant and its manufacturing cost.
The different elements of the implants according to different embodiments of the invention may particularly be manufactured by electro-erosion, laser cutting or molding. They may particularly be made of titanium or carbon fibers.
The different implants which have been described and shown are non-limiting examples. A characteristic may be taken from one of the examples and transposed into another of the examples, in place of another functionally equivalent characteristic, or in addition to other described characteristics, if this appears possible to those skilled in the art, without departing from the scope of the invention.
Because of the absence of mechanical connecting parts with displacement, the implants according to some of the present embodiments do not generate debris which may become spread in the organism of the patient.
These implants can be used, for example, in two different ways. In a first way, they can be a total intervertebral disk prosthesis. The surgeon performs a total discectomy of the damaged disk, then an adequate preparation of the vertebral plates by conventional instruments and techniques. Then, the implant is placed in position by the anterior approach, again by conventional methods.
In a second way, they can be used as elements of a rachis stabilization device. To this end, they may replace only a part of the disk. They are, in a manner which is known as for intervertebral implants, associated with other rachis stabilizing elements attached to the vertebrae of the region to be stabilized. The main elements known to this end include one or several rods which longitudinally stretch along the rachis, and are attached to the vertebrae, for example by means of pedicle screws. In such an embodiment, one ore several implants of the type which has been described can be used, according to the number of intervertebral disks included in the region of the rachis to be stabilized.
In some embodiments of the stabilization device, it is possible to use intervertebral implants which may not be all identical, the main point being that one of them, at least, is of the type which has been described.
As will have been seen, in the implant of one or more embodiments of the invention, the two plates intended to be placed in contact with the vertebral plates are shaped so as to provide them with a significant capacity for elastic deformation and flexibility, as well as a mobile center of rotation. For this purpose, the plates have a cut-out which delineates elastic webs converging toward a solid zone where the plates are connected to one another. The deformations of the elastic webs make possible a great variety of relative movements between the vertebrae, namely:
In a first series of alternatives of the implant, the two plates are distinct in construction and nest one into the other at the level of their solid zones, for example by means of a connection by a tight fit and/or by means of cement and/or by welding (TIG or laser).
In a second series of alternatives of the implant, the two plates form a unit and are united at the level of a socket which may be located substantially in a central position or in an offset position toward the rear or front region on the longitudinal axis of the implant.
The webs may not be in mutual contact when the implant is ready for use. In particular, if the webs are not planar, the webs of the upper and lower plates have to be intercalated one between another to avoid such a contact which would prevent satisfactory functioning of the implant.
This implant can be used, for example, in two different ways. It can be used as a total intervertebral disk prosthesis. To this end, the surgeon performs a total discectomy, then inserts the implant of one or more embodiments of the invention between the involved vertebrae. It can also be used for replacing, possibly only partially, an intervertebral disk, in combination with a classical rachis stabilization device, in particular a device including longitudinal rods, attached to the vertebrae for example by means of pedicle screws. Other ways of use may also exist.
Although only a few exemplary embodiments of this invention have been described in detail above, those skilled in the art will readily appreciate that many modifications are possible in the exemplary embodiments without materially departing from the novel teachings and advantages of this invention. For example, although the teachings have been directed to the intervertebral space, other embodiments of the present invention can be directed to other areas, including the knee, the femur, and so forth. Accordingly, all such modifications are intended to be included within the scope of this invention as defined in the following claims.
Number | Date | Country | Kind |
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FR 04 11314 | Oct 2004 | FR | national |