WO2009013397A1 - Vertebral fastening device for a system for correcting the abnormal curvatures of the rachis - Google Patents

Vertebral fastening device for a system for correcting the abnormal curvatures of the rachis Download PDF

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Publication number
WO2009013397A1
WO2009013397A1 PCT/FR2007/001278 FR2007001278W WO2009013397A1 WO 2009013397 A1 WO2009013397 A1 WO 2009013397A1 FR 2007001278 W FR2007001278 W FR 2007001278W WO 2009013397 A1 WO2009013397 A1 WO 2009013397A1
Authority
WO
WIPO (PCT)
Prior art keywords
connecting piece
fixation device
rod
spinal fixation
flexible strip
Prior art date
Application number
PCT/FR2007/001278
Other languages
French (fr)
Inventor
David Attia
Original Assignee
Ros Guillen, Francisco
Schaumburg, Gérald
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 Ros Guillen, Francisco, Schaumburg, Gérald filed Critical Ros Guillen, Francisco
Priority to PCT/FR2007/001278 priority Critical patent/WO2009013397A1/en
Publication of WO2009013397A1 publication Critical patent/WO2009013397A1/en

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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, e.g. tourniquets
    • 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, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7053—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant with parts attached to bones or to each other by flexible wires, straps, sutures or cables
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • 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, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • 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, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • 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, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
    • A61B17/7064—Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor

Definitions

  • Vertebral fixation device for correction system of abnormal curvature of the spine.
  • the invention relates to a vertebral fixation system for attaching to the vertebrae a system for correcting abnormal curvatures or deformities of the spine such as, for example, scoliosis.
  • the spine is formed by the superposition of vertebrae normally aligned along a spinal axis.
  • Each of these vertebrae has a spinous process and transverse processes protruding at the level of its posterior and lateral edges respectively, the part separating these apophyses, called the blade is the posterior wall of the spinal canal, crossed by the spinal cord and its extension.
  • the narrow side edges are spaced apart or brought closer to each other and held in place by a system for correcting abnormal curvatures of the spine.
  • the vertebral fixation devices usually used include hooks or screws that are inserted into the vertebral pedicles.
  • Patent applications WO 022004/010881 and FR2890850 propose a vertebral fixation device capable of overcoming these disadvantages.
  • Such vertebral fixation devices comprise a connecting piece, a flexible link of elongated shape adapted to connect the connecting piece and a projecting portion of the vertebra and locking means integral with the connecting piece.
  • the present invention aims a vertebral fixation device for correction system abnormal curvature of the spine simple, easy and quick to implement and inexpensive.
  • a vertebral fixation device for a system for correcting abnormal curvatures of the spine, comprising a connecting piece adapted to engage a rod of said system, characterized in that said connecting piece is associated with at least one collar of clamping constituted by a flexible strip of biocompatible material adapted to pass through a light, a fastening element being adapted to cooperate with a notch of said strip in order to adjust the tightening of said collar.
  • the clamp may be passed around a transverse process, a blade and / or a spinous process, so as to secure the vertebra to the connecting piece.
  • said connecting piece is provided with at least one housing adapted to be traversed by said notched flexible strip.
  • said connecting piece is provided with at least two housings provided at two of its ends and aligned in a direction parallel to said rod.
  • said light and said hooking element are formed on a fastening element at the end of said notched flexible strip.
  • said light and said hooking element are formed in at least one housing adapted to be traversed by said flexible strip.
  • said connecting piece comprises at least two housings adapted to be traversed by said notched flexible strip and each comprising at least one hook-shaped projecting element adapted to cooperate with the notching of said band.
  • said connecting piece is associated with two clamps passing through respective housings formed on either side of said rod.
  • These necklaces can be passed around two different parts of the same vertebra. For example, one can be passed around the transverse process and the other around the blade or the spinous process of the same vertebra.
  • said connecting piece is associated with a clamp and a pedicle screw through respective housings formed on either side of said rod.
  • the tightening of the collar is done independently of the tightening of the connecting piece on the rod, so that the connecting piece can slide freely on the rod by holding the vertebra pressed against this rod, for example to maintain the correction and allow vertebral growth.
  • Clamps such as those that have just been defined are widely used outside the medical field, and widely distributed commercially, including for the general public. Therefore, the use of such collars is very inexpensive, since it is not necessary to provide a specific production.
  • said clamp is made of biocompatible plastic such as PEEK.
  • PEEK clamps are already manufactured, especially for the aeronautical industry. Therefore, the use of PEEK clamps is inexpensive, since it is not necessary to provide a specific production.
  • said clamp is made of bioabsorbable material such as PLLA.
  • said clamp may be manufactured in polyethylene used for the cups of hip prostheses or implantable nylon used for suture son.
  • Figure 1 is a perspective view of a spinal fixation device for abnormal curvature correction system of the spine according to the present invention
  • Figure 2 is a perspective view of the fixation device of Figure 1 connecting a bar of said correction system to a spinous process of a vertebra;
  • Figure 3 is a perspective view of a spinal fixation device according to a second embodiment of the present invention
  • Figure 4 is a perspective view of a vertebral fixation device according to a third embodiment of the present invention.
  • Figure 5 is a perspective view of a spinal fixation device according to a fourth embodiment of the present invention.
  • a spinal fixation device for a system for correcting abnormal curvatures of the spine is described.
  • such a device is adapted to fix a bar 40 of the correction system on a projecting portion of a vertebra, such as a spinous process.
  • This device comprises a connecting piece 1 consisting of two flanges 1A and 1B hinged at one end so as to form gripper, said flanges each comprising a curved portion outwardly along an arc adapted to the diameter of the circle. closed off.
  • the two flanges being close to one another, are adapted to grip the bar 40 in the housing formed by the inner surfaces of the curved parts arranged opposite one another.
  • a locking device 20 for example by screwing, is provided at the end of the connecting piece 1 opposite its hinge end.
  • a housing (not shown) is formed through the flanges so as to allow the passage of a clamping screw.
  • the locking device may be an interlocking locking device.
  • the connecting piece 1 comes in a single block, for example a plate pressed to form the curved parts, pierced so as to define the housing of the locking device and the clamp and folded so as to form the two flanges.
  • a clamp 10 is preferably made of a plastic material such as a solid polymer.
  • a material such as PEEK is used.
  • nylon nylon
  • PLLA bioabsorbable material
  • Said collar comprises a flexible band whose one end is provided with an attachment element 12 for assembling the band to form a connecting loop.
  • said attachment element comprises a light arranged to be traversed by said other end of said strip.
  • clamping means are constituted by a notching 11 provided on one of the faces of the band, which notch is intended to cooperate with at least one hook forming tooth provided in the light of the fastener.
  • the light may comprise several teeth cooperating with neighboring notches of the band. For example, these projections may be three in number.
  • FIG. 2 shows the use of the fixation device to link a bar 40 of a spinal correction system to the blade 30 of a vertebra.
  • the bar 40 is clamped between the two flanges 1A and 1B which are locked by screwing the locking device 20.
  • the clamping collar is introduced by its end comprising the notch 11 into one of the 3, wound around the blade and then passed into the other housing 3.
  • the notched end is then introduced into the fastening element 12.
  • the tightening of the collar is set to the desired force. As the collar according to the invention is not likely to break, it can be tightened as much as necessary. In addition, the tightening is very easy to adjust. Just pull on the free end of the band. The notch allows a very fine adjustment.
  • the connecting piece (10) is provided to be associated with two clamps (10, 60) passing through. respective housings (3, 63) formed on either side of said rod (40).
  • the connecting piece comprises two flanges extending on either side of the cylindrical portion forming a housing in which the rod 40 is gripped.
  • a first flange of generally rectangular shape, is provided at its end with two aligned housings 3. in a direction parallel to the rod 40.
  • a second wing extending in the same plane as the first generally in a direction inclined relative to the rod 40 of about 45 °, is provided at its ends with two housings 63 aligned according to a direction inclined about 45 ° relative to the rod 40.
  • the two wings can extend in different planes and / or have different inclinations.
  • the connecting piece (10) is intended to be associated with a clamp (10) and a pedicle screw (51) passing through respective housings (3). 52) formed on either side of said rod (40).
  • the connecting piece also comprises two wings extending on either side of the cylindrical part forming a housing in which the rod 40 is clamped.
  • a first wing similar to that of the preceding variant is provided at its ends with two housings 3 aligned in a direction parallel to the rod 40.
  • a second wing, extending in the same plane as the first is provided at its center with a housing 52.
  • the housing 3 allow the installation of a clamp 10 wound around a blade, while the housing 52 allows the installation of a pedicle screw 51 which can be screwed on said spinous process, the collar preventing tearing of the pedicle screw.
  • the attachment of the collar 10, which in this embodiment is in the form of a flexible strip 10 notched at each of its ends and devoid of fastener element, is directly at the housings 73 formed in the connecting piece 1 to be traversed by the flexible strip.
  • said housings 73 are each provided with teeth 73 forming hooks adapted to cooperate with the notch 71 of the flexible strip 10.
  • these hooks are three in number.
  • the notch of the band and the teeth of the fastener are arranged to allow unidirectional sliding of the band.

Abstract

The invention relates to a vertebral fastening device for a systeme 'for correcting the abnormal curvatures of the rachis. It comprises a linking part (1) adapted for engaging a rod (40) of said system. According to the invention, said linking part is associated with at least one tightening collar (10) including a flexible strip notched and made of a flexible material that is placed about a blade or apophasis of a vertebra. The collar is adapted to extend through a lumen (12) provided with a fastening member adapted for interacting with the notching of said strip in order to adjust the tightening of said collar.

Description

Dispositif de fixation vertébrale pour système de correction des courbures anormales du rachis. Vertebral fixation device for correction system of abnormal curvature of the spine.
L'invention concerne un système de fixation vertébrale permettant l'accrochage aux vertèbres d'un système de correction des courbures anormales ou déformations du rachis telles que, par exemple, les scolioses.The invention relates to a vertebral fixation system for attaching to the vertebrae a system for correcting abnormal curvatures or deformities of the spine such as, for example, scoliosis.
Le rachis est formé par la superposition de vertèbres normalement alignées selon un axe rachidien. Chacune de ces vertèbres présente une apophyse épineuse et des apophyses transverses faisant saillie au niveau respectivement de sa partie postérieure et de ses bords latéraux, la partie séparant ces apophyses, appelée lame constitue la paroi postérieure du canal rachidien, traversé par la moelle épinière et son prolongement.The spine is formed by the superposition of vertebrae normally aligned along a spinal axis. Each of these vertebrae has a spinous process and transverse processes protruding at the level of its posterior and lateral edges respectively, the part separating these apophyses, called the blade is the posterior wall of the spinal canal, crossed by the spinal cord and its extension.
Lorsque le rachis présente une courbure anormale, les vertèbres sont inclinées les unes par rapport aux autres, de sorte que les bords latéraux de deux vertèbres se trouvent rapprochés tandis que les bords latéraux opposés se trouvent éloignés. Une autre situation pathologique est constituée par l'accentuation des courbures naturelles, par l'affaissement ou le creusement de segments du rachis.When the spine presents an abnormal curvature, the vertebrae are inclined relative to each other, so that the lateral edges of two vertebrae are close together while the opposite lateral edges are distant. Another pathological situation is constituted by the accentuation of the natural curvatures, by the subsidence or the digging of segments of the rachis.
Afin de redresser la colonne vertébrale, les bords latéraux rapprochés sont écartés ou rapprochés l'un de l'autre et maintenus en place par un système de correction des courbures anormales du rachis.In order to straighten the spine, the narrow side edges are spaced apart or brought closer to each other and held in place by a system for correcting abnormal curvatures of the spine.
Généralement, il s'agit de deux tiges parallèles disposées de part et d'autre des apophyses épineuses pré-cintrées suivant la direction de l'axe rachidien physiologique et fixées aux vertèbres par un dispositif de fixation vertébrale.Generally, these are two parallel rods arranged on either side of the spinous processes pre-bent in the direction of the physiological spinal axis and attached to the vertebrae by a vertebral fixation device.
Les dispositifs de fixation vertébrales habituellement utilisés comprennent des crochets ou des vis que l'on insère dans les pédicules vertébraux.The vertebral fixation devices usually used include hooks or screws that are inserted into the vertebral pedicles.
Toutefois, dans de nombreux cas, l'utilisation de vis n'est pas possible, du fait du danger qu'elle présente ou de la trop faible taille et/ou de la détérioration des pédicules. L'utilisation de crochet est délicate, comporte des risques de blessures des structures nerveuses ou de leur enveloppe, et peuvent se mobiliser et se décrocher de leur site de fixation.However, in many cases, the use of screws is not possible because of the danger it presents or because of the small size and / or deterioration of the screws. pedicles. The use of hook is delicate, carries risks of injury to the nerve structures or their envelope, and can mobilize and unhook from their attachment site.
Les demandes de brevet WO 022004/010881 et FR2890850 proposent un dispositif de fixation vertébral susceptible de pallier à ces inconvénients.Patent applications WO 022004/010881 and FR2890850 propose a vertebral fixation device capable of overcoming these disadvantages.
De tels dispositifs de fixation vertébrale comprennent une pièce de liaison, un lien flexible de forme allongée propre à relier la pièce de liaison et une partie saillante de la vertèbre et des moyens de blocage solidaires de la pièce de liaison.Such vertebral fixation devices comprise a connecting piece, a flexible link of elongated shape adapted to connect the connecting piece and a projecting portion of the vertebra and locking means integral with the connecting piece.
Toutefois, de tels dispositifs sont relativement complexes à mettre en place et coûteux à fabriquer. En outre, il est difficile de contrôler le serrage, car le serrage du lien est solidaire et simultané de celui de la tige.However, such devices are relatively complex to implement and expensive to manufacture. In addition, it is difficult to control the tightening, because the tightening of the link is integral and simultaneous with that of the rod.
La présente invention vise un dispositif de fixation vertébrale pour système de correction des courbures anormales du rachis simple, facile et rapide à mettre en place et peu coûteux.The present invention aims a vertebral fixation device for correction system abnormal curvature of the spine simple, easy and quick to implement and inexpensive.
Pour cela elle propose un dispositif de fixation vertébrale pour système de correction des courbures anormales du rachis comprenant une pièce de liaison adaptée à venir en prise avec une tige dudit système, caractérisé en ce que ladite pièce de liaison est associée à au moins un collier de serrage constitué par une bande souple crantée en matériau biocompatible adapté à traverser une une lumière, un élément d'accrochage étant adapté à coopérer avec un crantage de ladite bande afin d'ajuster le serrage dudit collier.For this purpose, it proposes a vertebral fixation device for a system for correcting abnormal curvatures of the spine, comprising a connecting piece adapted to engage a rod of said system, characterized in that said connecting piece is associated with at least one collar of clamping constituted by a flexible strip of biocompatible material adapted to pass through a light, a fastening element being adapted to cooperate with a notch of said strip in order to adjust the tightening of said collar.
Le collier de serrage peut être passé autour d'une apophyse transverse, d'une lame et/ou d'une apophyse épineuse, de manière à solidariser la vertèbre à la pièce de liaison.The clamp may be passed around a transverse process, a blade and / or a spinous process, so as to secure the vertebra to the connecting piece.
Selon un aspect de la présente invention, ladite pièce de liaison est pourvue d'au moins un logement adapté à être traversé par ladite bande souple crantée. Avantageusement, ladite pièce de liaison est pourvue d'au moins deux logements ménagés au niveau de deux de ses extrémités et alignés suivant une direction parallèle à ladite tige.According to one aspect of the present invention, said connecting piece is provided with at least one housing adapted to be traversed by said notched flexible strip. Advantageously, said connecting piece is provided with at least two housings provided at two of its ends and aligned in a direction parallel to said rod.
Selon un aspect de la présente invention, ladite lumière et ledit élément d'accrochage sont ménagés sur un élément d'attache à l'extrémité de ladite bande souple crantée.According to one aspect of the present invention, said light and said hooking element are formed on a fastening element at the end of said notched flexible strip.
Selon un autre aspect de la présente invention, ladite lumière et ledit élément d'accrochage sont ménagés dans au moins un logement adapté à être traversé par ladite bande souple crantée.According to another aspect of the present invention, said light and said hooking element are formed in at least one housing adapted to be traversed by said flexible strip.
Avantageusement, ladite pièce de liaison comprend au moins deux logements adaptés à être traversés par ladite bande souple crantée et comprenant chacun au moins un élément en saillie formant crochet adapté à coopérer avec le crantage de ladite bande.Advantageously, said connecting piece comprises at least two housings adapted to be traversed by said notched flexible strip and each comprising at least one hook-shaped projecting element adapted to cooperate with the notching of said band.
Selon un autre mode de réalisation alternatif, ladite pièce de liaison est associée à deux colliers de serrage traversant des logements respectifs ménagés de part et d'autre de ladite tige.According to another alternative embodiment, said connecting piece is associated with two clamps passing through respective housings formed on either side of said rod.
Ces colliers peuvent être passés autours de deux parties différentes de la même vertèbre. Par exemple, l'un peut être passé autour de l'apophyse transverse et l'autre autour de la lame ou l'apophyse épineuse de la même vertèbre.These necklaces can be passed around two different parts of the same vertebra. For example, one can be passed around the transverse process and the other around the blade or the spinous process of the same vertebra.
Selon un autre mode de réalisation alternatif, ladite pièce de liaison est associée à un collier de serrage et à une vis pédiculaire traversant des logements respectifs ménagés de part et d'autre de ladite tige.According to another alternative embodiment, said connecting piece is associated with a clamp and a pedicle screw through respective housings formed on either side of said rod.
Le serrage du collier se fait indépendamment du serrage de la pièce de liaison sur la tige, de sorte qu'on peut laisser la pièce de liaison coulisser librement sur la tige en maintenant la vertèbre plaquée contre cette tige, par exemple pour maintenir la correction et permettre la croissance vertébrale. Des colliers de serrage tels que ceux qui viennent d'être définis sont largement utilisés hors du domaine médical, et largement distribués dans le commerce, y compris à destination du grand public. De ce fait, l'utilisation de tels colliers est très peu coûteuse, puisqu'il n'est pas nécessaire de prévoir une production spécifique.The tightening of the collar is done independently of the tightening of the connecting piece on the rod, so that the connecting piece can slide freely on the rod by holding the vertebra pressed against this rod, for example to maintain the correction and allow vertebral growth. Clamps such as those that have just been defined are widely used outside the medical field, and widely distributed commercially, including for the general public. Therefore, the use of such collars is very inexpensive, since it is not necessary to provide a specific production.
Avantageusement, ledit collier de serrage est en matière plastique biocompatible telle que PEEK.Advantageously, said clamp is made of biocompatible plastic such as PEEK.
Un tel matériau résiste bien à la fatigue. En outre, des colliers de serrage en PEEK sont déjà manufacturés, notamment pour l'industrie aéronautique. De ce fait, l'utilisation de colliers de serrage en PEEK est peu coûteuse, puisqu'il n'est pas nécessaire de prévoir une production spécifique.Such a material is resistant to fatigue. In addition, PEEK clamps are already manufactured, especially for the aeronautical industry. Therefore, the use of PEEK clamps is inexpensive, since it is not necessary to provide a specific production.
Avantageusement, ledit collier de serrage est en matière biorésorbable telle que PLLA.Advantageously, said clamp is made of bioabsorbable material such as PLLA.
Alternativement, ledit collier de serrage peut être manufacturé en polyéthylène utilisé pour les cupules des prothèses de hanche ou en nylon implantable utilisé pour les fils de suture.Alternatively, said clamp may be manufactured in polyethylene used for the cups of hip prostheses or implantable nylon used for suture son.
D'autres particularités et avantages de l'invention apparaîtront dans la description qui suit, faite en référence aux figures suivantes dans lesquelles :Other features and advantages of the invention will appear in the description which follows, made with reference to the following figures in which:
La figure 1 est une vue en perspective d'un dispositif de fixation vertébrale pour système de correction des courbures anormales du rachis selon la présente invention ;Figure 1 is a perspective view of a spinal fixation device for abnormal curvature correction system of the spine according to the present invention;
la figure 2 est une vue en perspective du dispositif de fixation de la figure 1 raccordant une barre dudit système de correction à une apophyse épineuse d'une vertèbre ;Figure 2 is a perspective view of the fixation device of Figure 1 connecting a bar of said correction system to a spinous process of a vertebra;
la figure 3 est une vue en perspective d'un dispositif de fixation vertébrale selon un deuxième mode de réalisation de la présente invention ; la figure 4 est une vue en perspective d'un dispositif de fixation vertébrale selon un troisième mode de fixation de la présente invention ;Figure 3 is a perspective view of a spinal fixation device according to a second embodiment of the present invention; Figure 4 is a perspective view of a vertebral fixation device according to a third embodiment of the present invention;
la figure 5 est une vue en perspective d'un dispositif de fixation vertébrale selon un quatrième mode de réalisation de la présente invention.Figure 5 is a perspective view of a spinal fixation device according to a fourth embodiment of the present invention.
En référence à la figure 1 , on décrit un dispositif de fixation vertébrale pour système de correction des courbures anormales du rachis. En référence à la figure 2, un tel dispositif est adapté à fixer une barre 40 du système de correction sur une partie en saillie d'une vertèbre, telle qu'une apophyse épineuse.With reference to FIG. 1, a spinal fixation device for a system for correcting abnormal curvatures of the spine is described. With reference to FIG. 2, such a device is adapted to fix a bar 40 of the correction system on a projecting portion of a vertebra, such as a spinous process.
Ce dispositif comprend une pièce de liaison 1 constituée de deux flasques 1 A et 1B articulées au niveau d'une extrémité de manière à former pince, lesdites flasques comprenant chacune une partie courbée vers l'extérieur suivant un arc de cercle adapté au diamètre de la barre.This device comprises a connecting piece 1 consisting of two flanges 1A and 1B hinged at one end so as to form gripper, said flanges each comprising a curved portion outwardly along an arc adapted to the diameter of the circle. closed off.
De la sorte les deux flasques, en étant rapprochées l'une de l'autre, sont adaptées à venir enserrer la barre 40 dans le logement formé par les surfaces intérieures des parties courbées disposées en regard l'une de l'autre.In this way the two flanges, being close to one another, are adapted to grip the bar 40 in the housing formed by the inner surfaces of the curved parts arranged opposite one another.
Un dispositif de verrouillage 20, par exemple par vissage, est ménagé au niveau de l'extrémité de la pièce de liaison 1 opposée à son extrémité d'articulation. Un logement (non représenté) est ménagé à travers les flasques de manière à permettre le passage d'une vis de serrage. Alternativement, le dispositif de verrouillage peut être un dispositif de verrouillage par enclipsage.A locking device 20, for example by screwing, is provided at the end of the connecting piece 1 opposite its hinge end. A housing (not shown) is formed through the flanges so as to allow the passage of a clamping screw. Alternatively, the locking device may be an interlocking locking device.
Deux logements 3 adaptés à être traversés par un collier de serrage 10 sont ménagés au niveau de l'une et l'autre extrémité de la pièce de liaison, à proximité de son extrémité d'articulation. Ces deux logements sont alignés suivant une direction parallèle à la tige 40. Avantageusement, la pièce de liaison 1 vient en un seul bloc, par exemple une plaque emboutie de manière à former les parties courbées, percée de manière à définir les logements du dispositif de verrouillage et du collier de serrage et pliée de manière à former les deux flasques.Two housings 3 adapted to be traversed by a clamp 10 are provided at one and the other end of the connecting piece, near its articulation end. These two housings are aligned in a direction parallel to the rod 40. Advantageously, the connecting piece 1 comes in a single block, for example a plate pressed to form the curved parts, pierced so as to define the housing of the locking device and the clamp and folded so as to form the two flanges.
Un collier de serrage 10 est réalisé de préférence en un matériau plastique tel qu'un polymère solide. On utilise par exemple un matériau tel que du PEEK.A clamp 10 is preferably made of a plastic material such as a solid polymer. For example, a material such as PEEK is used.
De tels colliers existent déjà et sont utilisés dans des domaines autres que le domaine médical.Such collars already exist and are used in fields other than the medical field.
On pourra également utiliser un matériau biocompatible ayant une certaine élasticité (nylon) ou un matériau biorésorbable (PLLA).It is also possible to use a biocompatible material having a certain elasticity (nylon) or a bioabsorbable material (PLLA).
Ledit collier comprend une bande souple dont l'une des extrémités est pourvue d'un élément d'attache 12 permettant d'assembler la bande pour former une boucle de liaison.Said collar comprises a flexible band whose one end is provided with an attachment element 12 for assembling the band to form a connecting loop.
Pour ce faire, ledit élément d'attache comprend une lumière agencée pour être traversée de ladite bande par son autre extrémité. De manière bien connue dans les domaines techniques dans lesquels de tels colliers sont utilisés, des moyens de serrage sont constitués par un crantage 11 prévu sur l'une des faces de la bande, lequel crantage est destiné à coopérer avec au moins une dent formant crochet prévue dans la lumière de l'élément d'attache. La lumière peut comprendre plusieurs dents coopérant avec des crans voisins de la bande. Par exemple, ces saillies peuvent être au nombre de trois.To do this, said attachment element comprises a light arranged to be traversed by said other end of said strip. In a manner well known in the technical fields in which such collars are used, clamping means are constituted by a notching 11 provided on one of the faces of the band, which notch is intended to cooperate with at least one hook forming tooth provided in the light of the fastener. The light may comprise several teeth cooperating with neighboring notches of the band. For example, these projections may be three in number.
Ainsi qu'il est également connu dans les domaines techniques dans lesquels de tels colliers sont utilisés, le crantage de la bande et les dents de l'élément d'attache sont agencés pour permettre un coulissement unidirectionnel de la bande dans l'élément d'attache lors de sa traversée dans la lumière. Les moyens de serrage forment ainsi des moyens de verrouillage irréversibles. Ce verrouillage est d'autant plus fiabilisé que l'élément d'attache est pourvu de plusieurs saillies. La figure 2 représente l'utilisation du dispositif de fixation pour lier une barre 40 d'un système de correction rachidien à la lame 30 d'une vertèbre.As is also known in the technical fields in which such collars are used, the notching of the band and the teeth of the fastener element are arranged to allow a unidirectional sliding of the band in the element of tie when crossing in the light. The clamping means thus form irreversible locking means. This locking is all the more reliable as the fastener element is provided with several projections. Figure 2 shows the use of the fixation device to link a bar 40 of a spinal correction system to the blade 30 of a vertebra.
La barre 40 est serrée entre les deux flasques 1A et 1B qui sont verrouillées par vissage du dispositif de verrouillage 20. Une fois la pièce de liaison approchée de la lame, le collier de serrage est introduit par son extrémité comprenant le crantage 11 dans un des logements 3, enroulé autour de la lame puis passé dans l'autre logement 3. L'extrémité crantée est ensuite introduite dans l'élément d'attache 12. Le serrage du collier est réglé à la force désirée. Comme le collier selon l'invention ne risque pas de rompre, on peut le serrer autant qu'il le faut. En outre, le serrage est très facile à régler. Il suffit de tirer sur l'extrémité libre de la bande. Le crantage permet un réglage très fin.The bar 40 is clamped between the two flanges 1A and 1B which are locked by screwing the locking device 20. Once the connecting piece is approaching the blade, the clamping collar is introduced by its end comprising the notch 11 into one of the 3, wound around the blade and then passed into the other housing 3. The notched end is then introduced into the fastening element 12. The tightening of the collar is set to the desired force. As the collar according to the invention is not likely to break, it can be tightened as much as necessary. In addition, the tightening is very easy to adjust. Just pull on the free end of the band. The notch allows a very fine adjustment.
En référence à la figure 3, suivant une variante de la présente invention, la pièce de liaison (10) est prévue pour être associée à deux colliers de serrage (10, 60) traversant des. logements respectifs (3, 63) ménagés de part et d'autre de ladite tige (40).Referring to Figure 3, according to a variant of the present invention, the connecting piece (10) is provided to be associated with two clamps (10, 60) passing through. respective housings (3, 63) formed on either side of said rod (40).
Pour cela la pièce de liaison comprend deux ailes s'étendant de part et d'autre de la partie cylindrique formant logement dans lequel est enserré la tige 40. Une première aile, de forme globalement rectangulaire est pourvue à ses extrémité de deux logements 3 alignés suivant une direction parallèle à la tige 40. Une seconde aile, s'étendant dans le même plan que la première globalement suivant une direction inclinée par rapport la tige 40 d'environ 45°, est pourvue à ses extrémités de deux logements 63 alignés suivant une direction inclinée d'environ 45° par rapport à la tige 40. Ces deux paires de logements 3 et 63 permettent l'installation de deux colliers de serrage 10 et 60 enroulés autour de parties respectives 67 et 66 d'une vertèbre.For this purpose, the connecting piece comprises two flanges extending on either side of the cylindrical portion forming a housing in which the rod 40 is gripped. A first flange, of generally rectangular shape, is provided at its end with two aligned housings 3. in a direction parallel to the rod 40. A second wing, extending in the same plane as the first generally in a direction inclined relative to the rod 40 of about 45 °, is provided at its ends with two housings 63 aligned according to a direction inclined about 45 ° relative to the rod 40. These two pairs of housings 3 and 63 allow the installation of two clamps 10 and 60 wrapped around respective parts 67 and 66 of a vertebra.
Alternativement, suivant les besoins de la fixation, les deux ailes peuvent s'étendre dans des plans différents et/ou avoir des inclinaisons différentes. En référence à la figure 4, suivant une autre variante de la présente invention, la pièce de liaison (10) est prévue pour être associée à un collier de serrage (10) et à une vis pédiculaire (51) traversant des logements respectifs (3, 52) ménagés de part et d'autre de ladite tige (40).Alternatively, depending on the needs of the attachment, the two wings can extend in different planes and / or have different inclinations. With reference to FIG. 4, according to another variant of the present invention, the connecting piece (10) is intended to be associated with a clamp (10) and a pedicle screw (51) passing through respective housings (3). 52) formed on either side of said rod (40).
Pour cela la pièce de liaison comprend également deux ailes s'étendant de part et d'autre de la partie cylindrique formant logement dans lequel est ensserré la tige 40. Une première aile similaire à celle de la variante précédente, est pourvue à ses extrémité de deux logements 3 alignés suivant une direction parallèle à la tige 40. Une seconde aile, s'étendant dans le même plan que la première est pourvue en son centre d'un logement 52. Comme précédemment, les logements 3 permettent l'installation d'un collier de serrage 10 enroulé autour d'une lame, tandis que le logement 52 permet l'installation d'une vis pédiculaire 51 qui peut être vissée sur ladite apophyse épineuse, le collier empêchant l'arrachement de la vis pédiculaire.For this purpose the connecting piece also comprises two wings extending on either side of the cylindrical part forming a housing in which the rod 40 is clamped. A first wing similar to that of the preceding variant is provided at its ends with two housings 3 aligned in a direction parallel to the rod 40. A second wing, extending in the same plane as the first is provided at its center with a housing 52. As previously, the housing 3 allow the installation of a clamp 10 wound around a blade, while the housing 52 allows the installation of a pedicle screw 51 which can be screwed on said spinous process, the collar preventing tearing of the pedicle screw.
En référence à la figure 5, suivant une autre variante de la présente invention, l'accrochage du collier 10, qui dans ce mode de réalisation se présente sous la forme d'une bande souple 10 crantée au niveau de chacun de ses extrémités et dépourvue d'élément d'attache, se fait directement au niveau des logements 73 ménagés dans la pièce de liaison 1 pour être traversés par la bande souple.Referring to Figure 5, according to another variant of the present invention, the attachment of the collar 10, which in this embodiment is in the form of a flexible strip 10 notched at each of its ends and devoid of fastener element, is directly at the housings 73 formed in the connecting piece 1 to be traversed by the flexible strip.
Pour cela, lesdits logements 73 sont pourvus chacun de dents 73 formant crochets adaptés à coopérer avec le crantage 71 de la bande souple 10. Avantageusement, ces crochets sont au nombre de trois. Comme précédemment, le crantage de la bande et les dents de l'élément d'attache sont agencés pour permettre un coulissement unidirectionnel de la bande. For this, said housings 73 are each provided with teeth 73 forming hooks adapted to cooperate with the notch 71 of the flexible strip 10. Advantageously, these hooks are three in number. As before, the notch of the band and the teeth of the fastener are arranged to allow unidirectional sliding of the band.

Claims

REVENDICATIONS
1. Dispositif de fixation vertébrale pour système de correction des courbures anormales du rachis comprenant une pièce de liaison (1) adaptée à venir en prise avec une tige (40) dudit système, caractérisé en ce que ladite pièce de liaison est associée à au moins un collier de serrage (10 ; 60) constitué par une bande souple crantée en matériau biocompatible adapté à traverser une lumière (12 ; 73) pourvue d'un élément d'accrochage (72) adapté à coopérer avec un crantage (71) de ladite bande afin d'ajuster le serrage dudit collier.1. Spinal fixation device for abnormal bending of the spine correction system comprising a connecting piece (1) adapted to engage a rod (40) of said system, characterized in that said connecting piece is associated with at least a clamping collar (10; 60) constituted by a flexible strip of biocompatible material adapted to pass through a slot (12; 73) provided with a hooking element (72) adapted to cooperate with a notch (71) of said tape to adjust the tightening of said collar.
2. Dispositif de fixation vertébrale selon la revendication 1 , caractérisé en ce que ladite pièce de liaison (1) est pourvue d'au moins un logement (3, 63, 73) adapté à être traversé par ladite bande souple crantée.2. A spinal fixation device according to claim 1, characterized in that said connecting piece (1) is provided with at least one housing (3, 63, 73) adapted to be traversed by said flexible strip.
3. Dispositif de fixation vertébrale selon la revendication 2, caractérisé en ce que ladite pièce de liaison (1) est pourvue d'au moins deux logements (3, 63, 73) ménagés au niveau de deux de ses extrémités et alignés suivant une direction parallèle à ladite tige (40).3. A spinal fixation device according to claim 2, characterized in that said connecting piece (1) is provided with at least two housings (3, 63, 73) formed at two of its ends and aligned in one direction. parallel to said rod (40).
4. Dispositif de fixation vertébrale selon l'une quelconque des revendications précédentes, caractérisé en ce qu'un élément d'attache (12) comprenant ladite lumière et ledit élément d'accrochage est ménagé à l'extrémité de ladite bande souple crantée (10).4. A spinal fixation device according to any one of the preceding claims, characterized in that a fastening element (12) comprising said light and said hooking element is provided at the end of said notched flexible strip (10). ).
5. Dispositif de fixation vertébrale selon l'une quelconque des revendications 1 à 3, caractérisé en ce que ladite lumière et ledit élément d'accrochage (72) sont ménagés dans au moins un logement (73) adapté à être traversé par ladite bande souple crantée (10).5. A vertebral fixation device according to any one of claims 1 to 3, characterized in that said light and said hooking element (72) are formed in at least one housing (73) adapted to be traversed by said flexible strip. notched (10).
6. Dispositif de fixation vertébrale selon la revendication 5, caractérisé en ce que ladite pièce de liaison (1) comprend au moins deux logements (73) adaptés à être traversés par ladite bande souple crantée (10) et comprenant chacun au moins un élément en saillie (72) formant crochet adapté à coopérer avec le crantage (71) de ladite bande. 6. A spinal fixation device according to claim 5, characterized in that said connecting piece (1) comprises at least two housings (73) adapted to be traversed by said flexible strip (10) and each comprising at least one element protrusion (72) forming a hook adapted to cooperate with the notching (71) of said band.
7. Dispositif de fixation vertébrale selon l'une quelconque des revendications précédentes, caractérisé en ce que ladite pièce de liaison (10) est associée à deux colliers de serrage (10, 60) traversant des logements respectifs (3, 63) ménagés de part et d'autre de ladite tige (40).7. A spinal fixation device according to any one of the preceding claims, characterized in that said connecting piece (10) is associated with two clamps (10, 60) passing through respective housings (3, 63) provided by and other of said rod (40).
8. Dispositif de fixation vertébrale selon l'une quelconque des revendications 1 à 7, caractérisé en ce que ladite pièce de liaison est associée à un collier de serrage (10) et à une vis pédiculaire (51) traversant des logements respectifs (3, 52) ménagés de part et d'autre de ladite tige (40).8. A spinal fixation device according to any one of claims 1 to 7, characterized in that said connecting piece is associated with a clamp (10) and a pedicle screw (51) passing through respective housings (3, 52) formed on either side of said rod (40).
9. Dispositif de fixation vertébrale selon l'une quelconque des revendications précédentes, caractérisé en ce que ledit collier de serrage (10) est en matière plastique biocompatible telle que PEEK ou en matière biorésorbable telle que PLLA. 9. A spinal fixation device according to any one of the preceding claims, characterized in that said clamp (10) is biocompatible plastic such as PEEK or bioabsorbable material such as PLLA.
PCT/FR2007/001278 2007-07-25 2007-07-25 Vertebral fastening device for a system for correcting the abnormal curvatures of the rachis WO2009013397A1 (en)

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