This application is a national phase filing of international application no. PCT/FR2003/002635, filed Sep. 3, 2003, which claims priority to French patent application no. 02 11189, filed Sep. 10, 2002.
The present invention concerns a posterior vertebral support assembly.
In the case of degeneration of the intervertebral disc of two vertebrae and/or of ligament distension, it is known to place a wedge between the spinous processes of the two vertebrae concerned, making it possible to support the vertebrae. In this regard, reference may be made to French Patent Applications Nos. FR 94 03716 and FR 98 02300 filed in the name of the proprietor of the present application.
The wedges according to these earlier patent applications are connected to the spinous processes of the two treated vertebrae by two independent ligaments, each of the ligaments passing through the wedge and tightly surrounding the corresponding spinous process. In the case of flexion of the spinal column in a forward direction, the spinous processes move away from one another, thereby causing longitudinal stretching of the wedge.
A drawback of this longitudinal stretching is that of stressing the wedge in longitudinal traction. The conditions of exertion of this traction can however be perfected, in particular in order to obtain assisted and contained control of the movement of the vertebrae, inasmuch as the repetition of this traction threatens to affect the durability of the wedge.
The present invention aims to remedy this drawback.
The assembly which it concerns comprises, in a manner known per se, an interspinous wedge configured to be inserted between the spinous processes of two vertebrae to be treated, whereof at least the zone designed to be placed between the spinous processes of the vertebrae is made of an elastically deformable material.
According to the invention, the assembly further comprises:
The assembly according to the invention thus makes it possible to exert a progressive transverse compression on the wedge during the movement of flexion of the spinal column. This compression will reduce the shear stresses which are exerted on the wedge during intervertebral distancing combining tilting and forward sliding movements, owing to the containment of the displacements effected by the wedge.
The transverse compression of the wedge is preferable to pure longitudinal traction from the point of view of durability of the wedge, since it compensates the stressing of the wedge in the longitudinal direction.
The zone of the wedge designed to be placed between the spinous processes may be made of a material having limit of compressibility in the transverse direction of the wedge, and the assembly may then be configured such that this limit is reached when the treated vertebrae attain a predetermined tilted position.
It is also possible to configure the compressive lateral elements so that the elements have a limit of deformation in the transverse direction, this limit of deformation being reached when the treated vertebrae attain a predetermined tilted position.
The compressive lateral elements may be deformed nonelastically or elastically between said releasing and compressive positions. In the latter case, the return force of the elements to their neutral form contributes to the damping of the tilting movement of the treated vertebrae.
The compressive lateral elements may likewise be elastically deformable in the longitudinal direction of the compressive lateral elements, to the same end.
According to one embodiment of the invention, the compressive lateral elements are independent of one another, and each is connected to one of the treated vertebrae by one end and to the other treated vertebra by its other end. The connection of the ends of the compressive lateral elements to the vertebrae may in particular be effected at the pedicles of the vertebrae, by means of pedicular screws engaged in eyelets or anchorage pieces included in the compressive lateral elements.
The connection of the compressive lateral elements to the vertebrae may also be effected, in the case of the overlying vertebra, by means of the passage of the elements beneath the laminae of that vertebra. This sub-laminal passage makes it possible to preserve the pedicles and to be as central as possible in order, during the longitudinal elongation, to optimize the transverse thrust exerted on the wedge. In the case of the underlying vertebra, these same compressive lateral elements may also be connected to an interpedicular transverse connecting bar, placed in position especially in the case of laminectomy on this vertebra, thus making it possible to reduce the concentration of strains. Similarly, the compressive lateral elements may be connected to a connecting bar joined to a system of arthrodesis of the two underlying vertebrae.
According to another embodiment of the invention, the compressive lateral elements are formed by the two lateral portions of a circular strap engaged round the spinous processes of the two treated vertebrae.
The lateral transmission elements themselves may be constituted by small bars bearing on the one hand against the compressive lateral elements and on the other hand against the wedge, especially via small support plates.
These same lateral transmission elements may likewise be constituted by bosses connected either to the compressive lateral elements or to the wedge. In the latter case, the bosses may be integral with the wedge.
The wedge may be made entirely of an elastically deformable material such as a silicone; it may in particular comprise a core made of such a material and a textile envelope containing the core.
The wedge may also be formed by a band of resilient material, suitably curved.
The wedge may comprise a spring placed transversely at its zone designed to be placed between the spinous processes.
For greater understanding thereof, the invention is described again hereinafter with reference to the appended diagrammatic drawing representing, by way of non-limiting example, several possible embodiments of the assembly concerned.
The assembly 1 comprises an interspinous wedge 5, two compressive lateral elements 6 and two lateral transmission elements 7.
The wedge 5 is made of an elastically flexible material and comprises two curved recesses 8 allowing it to be inserted between the spinous processes 9 of the two vertebrae 2. It may in particular conform to the wedge according to French Patent Application No. FR 98 02300, that is to say:
The wedge 5 shown in
Each element 6 is formed by a lamina 15 made of elastically deformable synthetic material and by two eyelets 16 connected to the ends of the lamina 15. The latter is curved and comprises the element 7 at the median portion of its concave face, the concave face being designed to be turned towards the wedge 5.
The eyelets 16 are designed to receive pedicular screws permitting the anchorage of the elements 6 to the vertebrae 2.
Each element 7 is formed by a small rigid bar 20 fixed to an element 6, and is oriented substantially perpendicularly to the zone of the element 6 to which it is connected. The bar 20 is placed, after implantation, at the interspinous portion 10 of the wedge 5.
Each bar 20 is rigidly connected with a small plate 21 for bearing against the portion 10.
The assembly 1 according to the invention is in the position shown in
In the case of extension of the spinal column, the vertebrae 2 pivot in a direction in which the processes 9 are brought closer to one another, thereby leading to compression of the wedge 5 up to the limit of elasticity of the material constituting the core of the wedge. A damping of the pivoting movement of the vertebrae 2 is thus obtained as long as said limit of elasticity is not reached, then the arresting of that same movement is obtained when the limit of elasticity is reached. During this compression of the wedge 5, the elements 6 are deformed in the direction in which their curvature is increased, contributing to the damping of the movement of the vertebrae 2. The elements 6 likewise provide a perfect guarantee of maintenance of the position of the wedge 5 between the processes 9.
In the case of flexure of the spinal column, the vertebrae 2 pivot in a direction in which the processes 9 are spaced from each other, thereby leading to a reduction in the curvature of the elements 6. The elements 7 then press against the wedge 5 transversely, thereby also making it possible to dampen the movement of the vertebrae 2 then to arrest that movement when the limit of elasticity of the material forming the core of the wedge 5 is reached and/or when the elements come close to a substantially rectilinear form.
The strap 25 may be made of a slightly elastically stretchable material, and thus also contributes to the damping and then blocking of the pivoting movement of the vertebrae 2 in the case of flexion of the spinal column.
As it appears from the foregoing, the invention provides a decisive improvement on the prior art, by providing a posterior vertebral support assembly which does not stress the wedge in the longitudinal direction during the movement of flexion of the spinal column. Perfect control of the movement of the vertebrae is obtained by means of this assembly, and the durability of the wedge is not affected by the repeated movements of the vertebrae.
It is self-evident that the invention is not limited to the embodiment described above by way of example, but that on the contrary it encompasses all the variants of embodiment coming within the scope of protection defined by the appended claims.
Number | Date | Country | Kind |
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02 11189 | Sep 2002 | FR | national |
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/FR03/02635 | 9/3/2003 | WO | 00 | 3/9/2005 |
Publishing Document | Publishing Date | Country | Kind |
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WO2004/024010 | 3/25/2004 | WO | A |
Number | Name | Date | Kind |
---|---|---|---|
2077804 | Morrison | Apr 1937 | A |
2677369 | Knowles | May 1954 | A |
3426364 | Lumb | Feb 1969 | A |
3648691 | Lumb et al. | Mar 1972 | A |
3779239 | Fischer et al. | Dec 1973 | A |
4011602 | Rybicki et al. | Mar 1977 | A |
4237875 | Termanini | Dec 1980 | A |
4257409 | Bacal et al. | Mar 1981 | A |
4289123 | Dunn | Sep 1981 | A |
4401112 | Rezaian | Aug 1983 | A |
4553273 | Wu | Nov 1985 | A |
4554914 | Kapp et al. | Nov 1985 | A |
4573454 | Hoffman | Mar 1986 | A |
4599086 | Doty | Jul 1986 | A |
4604995 | Stephens et al. | Aug 1986 | A |
4611582 | Duff | Sep 1986 | A |
4632101 | Freedland | Dec 1986 | A |
4636217 | Ogilvie et al. | Jan 1987 | A |
4657550 | Daher | Apr 1987 | A |
4686970 | Dove et al. | Aug 1987 | A |
4759769 | Hedman et al. | Jul 1988 | A |
4827918 | Olerud | May 1989 | A |
4863476 | Shepperd | Sep 1989 | A |
4886405 | Blomberg | Dec 1989 | A |
4892545 | Day et al. | Jan 1990 | A |
4913144 | Del Medico | Apr 1990 | A |
4931055 | Bumpus et al. | Jun 1990 | A |
4932975 | Main et al. | Jun 1990 | A |
4969887 | Sodhi | Nov 1990 | A |
5011484 | Breard | Apr 1991 | A |
5047055 | Bao et al. | Sep 1991 | A |
5059193 | Kuslich | Oct 1991 | A |
5092866 | Breard et al. | Mar 1992 | A |
5098433 | Freedland | Mar 1992 | A |
5171278 | Pisharodi | Dec 1992 | A |
5201734 | Cozad et al. | Apr 1993 | A |
5290312 | Kojimoto et al. | Mar 1994 | A |
5306275 | Bryan | Apr 1994 | A |
5306297 | Rheinish et al. | Apr 1994 | A |
5306310 | Siebels | Apr 1994 | A |
5312405 | Korotko et al. | May 1994 | A |
5360430 | Lin | Nov 1994 | A |
5366455 | Dove | Nov 1994 | A |
5390683 | Pisharodi | Feb 1995 | A |
5395370 | Muller et al. | Mar 1995 | A |
5403316 | Ashman | Apr 1995 | A |
5415661 | Holmes | May 1995 | A |
5437672 | Alleyne | Aug 1995 | A |
5437674 | Worcel et al. | Aug 1995 | A |
5454812 | Lin | Oct 1995 | A |
5458641 | Ramirez | Oct 1995 | A |
5496318 | Howland et al. | Mar 1996 | A |
5518498 | Lindenberg et al. | May 1996 | A |
5540688 | Navas | Jul 1996 | A |
5554191 | Lahille et al. | Sep 1996 | A |
5562662 | Brumfield et al. | Oct 1996 | A |
5562735 | Margulies | Oct 1996 | A |
5609634 | Voydeville | Mar 1997 | A |
5609635 | Michelson | Mar 1997 | A |
5628756 | Barker, Jr. et al. | May 1997 | A |
5630816 | Kambin | May 1997 | A |
5645599 | Samani | Jul 1997 | A |
5653762 | Pisharodi | Aug 1997 | A |
5653763 | Errico et al. | Aug 1997 | A |
5658335 | Allen | Aug 1997 | A |
5665122 | Kambin | Sep 1997 | A |
5674295 | Ray et al. | Oct 1997 | A |
5676702 | Ratron | Oct 1997 | A |
5690649 | Li | Nov 1997 | A |
5693100 | Pisharodi | Dec 1997 | A |
5702395 | Hopf | Dec 1997 | A |
5702452 | Argenson et al. | Dec 1997 | A |
5702455 | Saggar | Dec 1997 | A |
5707390 | Bonutti | Jan 1998 | A |
5716416 | Lin | Feb 1998 | A |
5723013 | Jeanson et al. | Mar 1998 | A |
5746762 | Bass | May 1998 | A |
5755797 | Baumgartner | May 1998 | A |
5800547 | Schafer et al. | Sep 1998 | A |
5810815 | Morales | Sep 1998 | A |
5836948 | Zucherman et al. | Nov 1998 | A |
5849004 | Bramlet | Dec 1998 | A |
5860977 | Zucherman et al. | Jan 1999 | A |
5888196 | Bonutti | Mar 1999 | A |
5976186 | Bao et al. | Nov 1999 | A |
6022376 | Assell et al. | Feb 2000 | A |
6048342 | Zucherman et al. | Apr 2000 | A |
6068630 | Zucherman et al. | May 2000 | A |
6126689 | Brett | Oct 2000 | A |
6126691 | Kasra et al. | Oct 2000 | A |
6127597 | Beyar et al. | Oct 2000 | A |
6132464 | Martin | Oct 2000 | A |
6152959 | Portney | Nov 2000 | A |
6190413 | Sutcliffe | Feb 2001 | B1 |
6190414 | Young | Feb 2001 | B1 |
6214050 | Huene | Apr 2001 | B1 |
6293949 | Justis et al. | Sep 2001 | B1 |
6336930 | Stalcup et al. | Jan 2002 | B1 |
6348053 | Cachia | Feb 2002 | B1 |
6352537 | Strnad | Mar 2002 | B1 |
6364883 | Santilli | Apr 2002 | B1 |
6371987 | Weiland et al. | Apr 2002 | B1 |
6375682 | Fleischmann et al. | Apr 2002 | B1 |
6402750 | Atkinson et al. | Jun 2002 | B1 |
6402751 | Hoeck et al. | Jun 2002 | B1 |
6419704 | Ferree | Jul 2002 | B1 |
6440169 | Elberg et al. | Aug 2002 | B1 |
6447513 | Griggs | Sep 2002 | B1 |
6451019 | Zucherman et al. | Sep 2002 | B1 |
6500178 | Zucherman et al. | Dec 2002 | B2 |
6514256 | Zucherman et al. | Feb 2003 | B2 |
6520991 | Huene | Feb 2003 | B2 |
6554833 | Levy et al. | Apr 2003 | B2 |
6582433 | Yun | Jun 2003 | B2 |
6582467 | Teitelbaum et al. | Jun 2003 | B1 |
6592585 | Lee et al. | Jul 2003 | B2 |
6626944 | Taylor | Sep 2003 | B1 |
6645207 | Dixon et al. | Nov 2003 | B2 |
6685742 | Jackson | Feb 2004 | B1 |
6695842 | Zucherman et al. | Feb 2004 | B2 |
6709435 | Lin | Mar 2004 | B2 |
6723126 | Berry | Apr 2004 | B1 |
6730126 | Boehm, Jr. et al. | May 2004 | B2 |
6733534 | Sherman | May 2004 | B2 |
6736818 | Perren et al. | May 2004 | B2 |
6758863 | Estes et al. | Jul 2004 | B2 |
6761720 | Senegas | Jul 2004 | B1 |
6770096 | Bolger et al. | Aug 2004 | B2 |
6783530 | Levy | Aug 2004 | B1 |
6835205 | Atkinson et al. | Dec 2004 | B2 |
6905512 | Paes et al. | Jun 2005 | B2 |
6946000 | Senegas et al. | Sep 2005 | B2 |
6981975 | Michelson | Jan 2006 | B2 |
7011685 | Arnin et al. | Mar 2006 | B2 |
7041136 | Goble et al. | May 2006 | B2 |
7048736 | Robinson et al. | May 2006 | B2 |
7081120 | Li et al. | Jul 2006 | B2 |
7087083 | Pasquet et al. | Aug 2006 | B2 |
7097648 | Globerman et al. | Aug 2006 | B1 |
7101375 | Zucherman et al. | Sep 2006 | B2 |
7163558 | Senegas et al. | Jan 2007 | B2 |
7201751 | Zucherman et al. | Apr 2007 | B2 |
7217293 | Branch, Jr. | May 2007 | B2 |
7238204 | Le Couedic et al. | Jul 2007 | B2 |
7306628 | Zucherman et al. | Dec 2007 | B2 |
7377942 | Berry | May 2008 | B2 |
7442208 | Mathieu et al. | Oct 2008 | B2 |
7445637 | Taylor | Nov 2008 | B2 |
7458981 | Fielding et al. | Dec 2008 | B2 |
7582106 | Teitelbaum et al. | Sep 2009 | B2 |
7611316 | Panasik et al. | Nov 2009 | B2 |
20010016743 | Zucherman et al. | Aug 2001 | A1 |
20020143331 | Zucherman et al. | Oct 2002 | A1 |
20030045940 | Eberlein et al. | Mar 2003 | A1 |
20030109880 | Shirado et al. | Jun 2003 | A1 |
20030153915 | Nekozuka et al. | Aug 2003 | A1 |
20030220643 | Ferree | Nov 2003 | A1 |
20040024458 | Senegas et al. | Feb 2004 | A1 |
20040097931 | Mitchell | May 2004 | A1 |
20040106995 | Le Couedic et al. | Jun 2004 | A1 |
20040117017 | Pasquet et al. | Jun 2004 | A1 |
20040133204 | Davies | Jul 2004 | A1 |
20040167625 | Beyar et al. | Aug 2004 | A1 |
20040199255 | Mathieu et al. | Oct 2004 | A1 |
20040260397 | Lambrecht et al. | Dec 2004 | A1 |
20050010293 | Zucherman et al. | Jan 2005 | A1 |
20050033434 | Berry | Feb 2005 | A1 |
20050049708 | Atkinson et al. | Mar 2005 | A1 |
20050165398 | Reiley | Jul 2005 | A1 |
20050203512 | Hawkins et al. | Sep 2005 | A1 |
20050203624 | Serhan et al. | Sep 2005 | A1 |
20050228391 | Levy et al. | Oct 2005 | A1 |
20050245929 | Winslow et al. | Nov 2005 | A1 |
20050245937 | Winslow | Nov 2005 | A1 |
20050261768 | Trieu | Nov 2005 | A1 |
20050288672 | Feree | Dec 2005 | A1 |
20060004447 | Mastrorio et al. | Jan 2006 | A1 |
20060004455 | Leonard et al. | Jan 2006 | A1 |
20060015181 | Elberg | Jan 2006 | A1 |
20060064165 | Zucherman et al. | Mar 2006 | A1 |
20060084983 | Kim | Apr 2006 | A1 |
20060084985 | Kim | Apr 2006 | A1 |
20060084987 | Kim | Apr 2006 | A1 |
20060084988 | Kim | Apr 2006 | A1 |
20060085069 | Kim | Apr 2006 | A1 |
20060085070 | Kim | Apr 2006 | A1 |
20060085074 | Raiszadeh | Apr 2006 | A1 |
20060089654 | Lins et al. | Apr 2006 | A1 |
20060089719 | Trieu | Apr 2006 | A1 |
20060095136 | McLuen | May 2006 | A1 |
20060106381 | Ferree et al. | May 2006 | A1 |
20060106397 | Lins | May 2006 | A1 |
20060111728 | Abdou | May 2006 | A1 |
20060116690 | Pagano | Jun 2006 | A1 |
20060122620 | Kim | Jun 2006 | A1 |
20060129239 | Kwak | Jun 2006 | A1 |
20060136060 | Taylor | Jun 2006 | A1 |
20060184247 | Edidin et al. | Aug 2006 | A1 |
20060184248 | Edidin et al. | Aug 2006 | A1 |
20060195102 | Malandain | Aug 2006 | A1 |
20060217726 | Maxy et al. | Sep 2006 | A1 |
20060235387 | Peterman | Oct 2006 | A1 |
20060235532 | Meunier et al. | Oct 2006 | A1 |
20060241601 | Trautwein et al. | Oct 2006 | A1 |
20060241613 | Bruneau et al. | Oct 2006 | A1 |
20060247623 | Anderson et al. | Nov 2006 | A1 |
20060247640 | Blackwell et al. | Nov 2006 | A1 |
20060264938 | Zucherman et al. | Nov 2006 | A1 |
20060271044 | Petrini et al. | Nov 2006 | A1 |
20060271049 | Zucherman et al. | Nov 2006 | A1 |
20060293662 | Boyer, II et al. | Dec 2006 | A1 |
20060293663 | Walkenhorst et al. | Dec 2006 | A1 |
20070043362 | Malandain et al. | Feb 2007 | A1 |
20070142915 | Altarac et al. | Jun 2007 | A1 |
20070151116 | Malandain | Jul 2007 | A1 |
20070162000 | Perkins | Jul 2007 | A1 |
20070191838 | Bruneau et al. | Aug 2007 | A1 |
20070198091 | Boyer et al. | Aug 2007 | A1 |
20070225807 | Phan et al. | Sep 2007 | A1 |
20070233068 | Bruneau et al. | Oct 2007 | A1 |
20070233081 | Pasquet et al. | Oct 2007 | A1 |
20070233089 | DiPoto et al. | Oct 2007 | A1 |
20070270834 | Bruneau et al. | Nov 2007 | A1 |
20070276369 | Allard et al. | Nov 2007 | A1 |
20070276493 | Malandain et al. | Nov 2007 | A1 |
20070282443 | Globerman et al. | Dec 2007 | A1 |
20080021457 | Anderson et al. | Jan 2008 | A1 |
20080058934 | Malandain et al. | Mar 2008 | A1 |
20080161818 | Kloss et al. | Jul 2008 | A1 |
20080221685 | Altarac et al. | Sep 2008 | A9 |
20080262617 | Froehlich et al. | Oct 2008 | A1 |
20090234389 | Chuang et al. | Sep 2009 | A1 |
20090270918 | Attia et al. | Oct 2009 | A1 |
Number | Date | Country |
---|---|---|
2821678 | Nov 1979 | DE |
3922044 | Feb 1991 | DE |
4012622 | Jul 1991 | DE |
0322334 | Feb 1992 | EP |
0767636 | Jan 1999 | EP |
1004276 | May 2000 | EP |
1138268 | Oct 2001 | EP |
1138268 | Oct 2001 | EP |
1302169 | Apr 2003 | EP |
1330987 | Jul 2003 | EP |
1982664 | Oct 2008 | EP |
2623085 | May 1989 | FR |
2625097 | Jun 1989 | FR |
2681525 | Mar 1993 | FR |
2700941 | Aug 1994 | FR |
2703239 | Oct 1994 | FR |
2707864 | Jan 1995 | FR |
2717675 | Sep 1995 | FR |
2 722 088 | Jan 1996 | FR |
2722087 | Jan 1996 | FR |
2722088 | Jan 1996 | FR |
2724554 | Mar 1996 | FR |
2725892 | Apr 1996 | FR |
2730156 | Aug 1996 | FR |
2731643 | Sep 1996 | FR |
2775183 | Aug 1999 | FR |
2799948 | Apr 2001 | FR |
2799948 | Apr 2001 | FR |
2816197 | May 2002 | FR |
02-224660 | Sep 1990 | JP |
09-075381 | Mar 1997 | JP |
988281 | Jan 1983 | SU |
1484348 | Jun 1989 | SU |
WO 9426192 | Nov 1994 | WO |
WO 9426195 | Nov 1994 | WO |
9718769 | May 1997 | WO |
WO 9820939 | May 1998 | WO |
WO 9926562 | Jun 1999 | WO |
WO 0044319 | Aug 2000 | WO |
WO 0154598 | Aug 2001 | WO |
WO 0203882 | Jan 2002 | WO |
WO 03057055 | Jul 2003 | WO |
2004024010 | Mar 2004 | WO |
WO 2004047689 | Jun 2004 | WO |
WO 2004047691 | Jun 2004 | WO |
2004084768 | Oct 2004 | WO |
WO 2005009300 | Feb 2005 | WO |
WO 2005011507 | Feb 2005 | WO |
WO 2005009300 | Feb 2005 | WO |
WO 2005044118 | May 2005 | WO |
WO 2005048856 | Jun 2005 | WO |
WO 2005110258 | Nov 2005 | WO |
2006064356 | Jun 2006 | WO |
WO 2007034516 | Mar 2007 | WO |
2007052975 | May 2007 | WO |
2009083276 | Jul 2009 | WO |
2009083583 | Jul 2009 | WO |
2009098536 | Aug 2009 | WO |
Number | Date | Country | |
---|---|---|---|
20060136060 A1 | Jun 2006 | US |