The present invention relates to an implant assembly for bone fixation, and in particular to stabilize the vertebral column.
It is known, in bone surgery and in particular in surgery of the spinal column, to use plates provided with openings intended to receive anchoring elements, in particular screws that can be screwed into the bone parts one wishes to immobilize or stabilize relative to one another.
This type of application is in particular found in the field of vertebral column surgery, and more particularly in the cervical vertebrae zone.
In that zone, the stabilization plates are often implanted through the anterior route, i.e. through the front of the patient's body, such that the screws are also screwed from the front of the body.
If, for various reasons (degeneration of the vertebral bodies, poor application of the implant placement protocol, etc.), the screws are made to leave the openings of the plates, they can injure the adjacent organs, and in particular the patient's esophagus in the case of an anterior cervical implant.
It is therefore crucial to provide means making it possible to prevent the screws from spontaneously leaving the openings of the stabilization plate.
Many systems are found in the prior art that aim to resolve this problem: in Anglo-Saxon terminology, reference is commonly made to “anti-blackout” systems, i.e. systems making it possible to prevent the screws from coming out of the openings of the plates: systems exist with rings or elastic strips, springs, stop notches, heat-retractable inserts, bolts, etc.
Although they have a certain effectiveness relative to the problem to be resolved, these systems have in common that they are relatively complex to manufacture and/or implement.
The present invention therefore aims in particular to provide a plate-and-screw implant assembly that is very simple to manufacture and implement.
This aim of the invention is achieved with an implant assembly for bone fixation, and particularly for stabilizing the vertebral column, including a plate provided with at least two openings and at least two anchoring means that can be positioned in said openings and be attached to the bone portions to be stabilized, and blocking means for preventing said anchoring means from being accidentally released from said openings, remarkable in that blocking means include a shoulder arranged on each anchoring means on the one hand, and on the other hand an annular non-return lip which is arranged inside each opening, is integral with said plate, and can be deformed so as to be cleared by said shoulder during the positioning of the anchoring means, and then prevent the extraction of the anchoring means by forming an abutment against said shoulder.
Owing to this implant assembly according to the invention, the blocking means of the anchoring means (such as screws) in their openings are made in a single piece with the plate, and the blocking of those anchoring means in their openings is obtained due solely to the fixing of those anchoring means in the bone bodies, during which the shoulder of each anchoring means deforms and crosses the lip of the associated opening, then the lip is positioned abutting against said shoulder, preventing the anchoring means from being extracted.
According to other optional features of the implant according to the invention:
Other features and advantages of the present invention will appear in light of the following description, and upon examining the appended figures, in which:
In all of these figures, identical or similar references designate identical or similar members or sets of members.
As shown, the implant assembly according to the invention comprises a plate P on the one hand provided with a plurality of openings T1, T2 positioned opposite the vertebrae A and B, and on the other hand a plurality of anchoring means V intended to be fixed in the vertebrae A and B while passing through the openings T1 and T2 of the plate P.
In the following, these anchoring means will be presented as screws, but this is in no way limiting: these anchoring means could in fact be nails, staples, cables, with or without shape memory, and with or without glue. The plate P makes it possible to immobilize the two vertebrae A and B completely or partially for the fusion or mutual stabilization thereof.
In the example shown in
The material forming the plate P can be made from polymer. As shown in
A second reinforcing piece R2 is positioned symmetrically to the first reinforcing piece R1 and has the same structure as the piece R1, and the ends R21 and R22 thereof respectively surround the openings T2 and T3 of the plate P, on the two surfaces of that plate.
More specifically, as shown in
Also preferably (see
The material forming the reinforcing pieces R1, R2 can be chosen from amongst polymers, metal alloys, and ceramics, and is preferably harder than the material forming the plate P.
We will now refer to
As shown in these two figures, this screw comprises a head 1 provided with a cavity 3 adapted to receive a tool with a complementary shape, as well as a threaded shaft 5, adapted to cooperate with the vertebral bodies A and B.
Between the head 1 and the threaded screw 5 of the screw V is an annular shoulder 7, the diameter D1 of which is slightly smaller than the smallest diameter of the openings T1 to T4 formed in the ends R11, R12, R21 and R22 of the reinforcing pieces R1 and R2, and larger than the smallest diameter of the lip L formed in the plate P in each of the openings T1 to T4.
The largest diameter D2 of the head 1 of the screw V is adapted to allow said screw head 1 to rest on the edge B1 of each opening T formed in the reinforcing pieces R1 and R2, so that the edge B1 constitutes the seat of that screw head.
More specifically, one can see that the shoulder 7 is connected to the threaded shaft 5 by a conical part 9, and to the screw head 1 by a hollow doughnut-shaped part 11.
The screw V can be formed from any material commonly used in the field of plate-and-screw implants, such as titanium-based metal alloys, for example.
The usage mode and the advantages of the implant assembly just described will be particularly clear in light of the description of
When one wishes to fix this implant assembly on vertebral bodies A and B (see
These screws are therefore screwed using suitable tools and cooperating with the cavities 3 of the heads 1 of those screws, owing to which said screws rotate and are pushed into the associated vertebral bodies.
Due to the pushing in, there comes a moment where the conical part 9 of the shoulder 7 of each screw comes into contact with the slightly inclined edge L1 of the lip L of the concerned opening T.
When one continues to screw, the conical part 9 of the shoulder 7 deforms the lip L so as to push it radially back toward the outside of the opening T.
The cylindrical part of the shoulder 7 then moves along the slightly inclined part L1 of the lip L, until said cylindrical part has passed the connecting line between the slightly inclined edge L1 and the greatly inclined edge L2 of the lip L: at that stage, under the effect of the relative elasticity of the material forming the plate P, the lip L regains its initial shape and is housed inside the substantially doughnut-shaped part 11 separating the shoulder 7 from the screw head 1.
The greatly inclined edge L2 of the lip L is thus positioned abutting against the corresponding annular edge 13 of the shoulder 7.
One thus arrives at the situation of
Of course, by exerting substantial force, it remains possible to perform such an extraction, by going against the retaining force exerted by the lip L.
But it must be understood that such an extraction force requires a special tool, and that the aim of the invention is thus achieved, which is to prevent screws from leaving their openings spontaneously, when they are in use in a patient's body.
It will be noted that the cooperation of the head 1 of each screw V with the part forming the spherical seat B1 of each associated opening T, makes it possible to impart two degrees of freedom (ball joint-type connection) of that screw relative to the plate T, and thus to tilt said screws as needed as a function of the configuration of the vertebral bodies to be treated.
Advantageously, choosing a relatively flexible material for the plate P makes it possible to give the latter a certain deformability allowing a small relative movement of the vertebral bodies A and B, and using a relatively hard material for the reinforcing pieces R1 and R2 makes it possible to give sufficient strength to the seats of the screws V.
It will be noted that providing that the lips L are formed in the plate P itself constitutes a considerable simplification of the plate according to the invention, and that the relative flexibility of the material forming the plate P makes it possible to give those lips L the deformability necessary to allow the passage of each screw V and the subsequent blocking of the axial movement of that screw V in its associated opening T, owing to the repositioning of the associated lip L abutting against the shoulder 7 of that screw.
Of course, the present invention is in no way limited to the embodiment described and shown.
Thus the invention also covers a plate P without a reinforcing piece R1 and R2, i.e. formed in a rigid enough material to be able to constitute the seats of the heads of the screws V, and at the same time flexible enough to allow the deformation of the lips L associated with those openings.
The invention thus also extends to any plate with a shape different from that shown, and comprising a larger or smaller number of openings than those of that plate.
Number | Date | Country | Kind |
---|---|---|---|
09/04153 | Sep 2009 | FR | national |
Filing Document | Filing Date | Country | Kind | 371c Date |
---|---|---|---|---|
PCT/FR10/51793 | 8/27/2010 | WO | 00 | 3/2/2012 |