• 专利附录
  • 专利说明
  • 权利要求
  • 类似技术
  • 同族专利
  • 引用文献
  • 法律状态
  • 优先权
    • 专利摘要:
    The present invention relates to an expandable intravertebral implant system comprising an intravertebral implant (1) comprising an expandable anterior portion (11) in a vertebral body and a posterior portion (12); and a pedicle attachment (2) having at least one hollow receiving portion of the posterior portion (12). The present invention also relates to said expandable intravertebral implant system further comprising a posterior element (3), partially external to the vertebra and integral with the pedicle fixation (2), able to serve as anchoring point for at least one intervertebral bar or at least one artificial ligament system.
    公开号:FR3015221A1
    申请号:FR1363467
    申请日:2013-12-23
    公开日:2015-06-26
    发明作者:Jean Francois Oglaza；Yves Alain Ratron；Gianluca Maestretti
    申请人:Vexim SAS；
    IPC主号:
    专利说明:

    [0001] FIELD OF THE INVENTION The present invention relates to an expandable intravertebral implant system with posterior pedicle fixation. More particularly, the present invention relates to a system comprising an expandable intravertebral implant providing improved vertebral anchorage by adding a pedicle socket securely anchored in a vertebral pedicle. STATE OF THE ART Several vertebroplasty techniques are known to perform a vertebral straightening allowing to recover its shape or initial morphology to a deformed vertebra following bone compression, for example due to osteoporosis or trauma. For example, the kyphoplasty technique is known in which an inflatable balloon is introduced into a vertebra and then a pressurized fluid is forced into the balloon placed in the vertebra in order to force the cortical envelope of the vertebra, and in particular the lower vertebral endplates. higher to resume a shape rectified under the effect of pressure. Once the bone cortical envelope is straightened, the balloon is then deflated, then removed from the vertebra, so that a bone cement can be injected into the latter in order to give the straightened vertebra a stable mechanical resistance over time. It is also known, particularly through the international patent application WO / 2005/120400, an expandable implant comprising a first and a second opposite plates, able to form respectively a first and a second bearing surfaces in a vertebral body ; these two bearing surfaces being called to move away in one another according to a predefined expansion plane.
    [0002] The expandable implant is positioned in the vertebral body, and the trays are deployed in an expansion plane corresponding to the desired bone recovery plan. A bone cement is then injected to stabilize the bone recovery. The bone cement can be injected with a relatively low pressure thanks to the implant which remains in place in the vertebral body. In the case of the most severe trauma, the use of the above methods may be insufficient. The repair of vertebral fractures, and in particular compression vertebral fractures, is then preferentially effected by means of screws inserted in the pedicles of the vertebrae above and underlying the compressed vertebra, these screws being associated with posterior bars, thereby connecting mechanically the two vertebrae above and below to allow a vertebral consolidation. Pedicle screws are well known in the state of the art. Screws such as those described in US Pat. No. 5,209,753 are particularly known. The disadvantage of this technique lies in the fusion of two vertebral joint levels generated by the fixation of the posterior bars connecting the above and underlying vertebrae. In addition, these methods do not always allow bone recovery of the compressed vertebra but only the stabilization of three adjacent vertebrae and therefore the blocking of two articular levels. The surgical procedure associated with this procedure is also very invasive and requires access to at least two vertebrae.
    [0003] To overcome these drawbacks, it appears necessary to provide a device for the repair of vertebral fractures, including severe compressional vertebral fractures, avoiding fusion and allowing the consolidation, at the pedicle, of an expandable intravertebral implant located in the vertebral body. Thus, the object of the invention is to associate an expandable intravertebral implant, positioned in a vertebral body, with a pedicular attachment (for example a socket or sleeve) intended to be anchored in the pedicle. This pedicle fixation provides support and bone anchorage of high quality. Indeed, if the vertebral body consists of spongy bone, having a high porosity of 30 to 90%, the pedicle is made of cortical bone, having a porosity of 5 to 30%, thus providing a solid mechanical support for the intravertebral implant and to reconstruct vertebral fractures, including vertebral compression fractures, even the most severe. Advantageously, the pedicle fixation element is associated with a posterior element serving as a connection system, making it possible to add to the expandable intravertebral implant means completing bone rectification, for example by posterior bars or other systems intended to to further stabilize the fracture site. Thus the present invention provides vertebral straightening using an expandable intravertebral implantable system with posterior pedicle fixation.
    [0004] SUMMARY The invention thus relates to an expandable intravertebral implant system comprising an intravertebral implant comprising an expandable anterior portion in a vertebral body and a posterior portion; and a pedicle attachment having at least a hollow receiving portion of the posterior portion of the intravertebral implant. According to one embodiment, the pedicle fixation comprises a threading ensuring the anchoring of said pedicle fixation in a vertebral pedicle. In one embodiment, the pedicle attachment includes a hollow posterior inner portion and a hollow anterior inner portion in which the posterior portion of the intravertebral implant is movable in at least one degree of freedom. According to one embodiment, the pedicle fixation comprises a main axis and the posterior portion of the intravertebral implant can move in translation and in rotation, along the main axis of the pedicle fixation, in the anterior inner portion of the fixation. pedicular. According to one embodiment, the anterior part of the intravertebral implant comprises a first and a second plate, able respectively to form a first and a second bearing surface in a vertebral body; these two surfaces can move away from one another according to a predefined expansion plan. According to one embodiment, the expansion direction of the expandable anterior portion of the intravertebral implant is independent of the position of the pedicle attachment in the vertebral pedicle. According to one embodiment, the anchoring of the pedicle fixation in a vertebral pedicle provides additional mechanical support for an intravertebral implant, able to remain in a vertebral body and repair a vertebral fracture. According to one embodiment, the expandable intravertebral implant system according to the present invention further comprises a posterior element, partially external to the vertebra and integral with the pedicle attachment. According to one embodiment, the posterior element is integral with the pedicle fixation by means of a threaded rod screwed into a tapping of the posterior internal portion. In one embodiment, the posterior member serves as an anchor for at least one intervertebral bar or at least one artificial ligament system. BRIEF DESCRIPTION OF THE FIGURES Other particularities and advantages will become clear from the description which is given below, by way of indication and in no way limitative, with reference to the appended drawings, in which: FIG. 1 is an exploded view of the system of FIG. implant according to one embodiment of the present invention. Figure 2 is a side view of the intravertebral implant according to an embodiment of the present invention. Figure 3A is a side view of the pedicle attachment according to an embodiment of the present invention.
    [0005] Figure 3B is a sectional view of the pedicle attachment according to an embodiment of the present invention. Figure 4 is a perspective view of the posterior element according to an embodiment of the present invention.
    [0006] Figure 5 is a side view of the implant system according to an embodiment of the present invention, mounted on an instrument adapted for insertion of the implant system. Figure 6A is a side view of the implant system, according to an embodiment of the present invention, placed in a vertebra; said vertebra is shown transparent, visible only by its contours. Figure 6B is a top view of the implant system, according to an embodiment of the present invention, placed in a vertebra; said vertebra is shown transparent, visible only by its contours. Figure 7A is a side view of the implant system according to an embodiment of the present invention, prior to expansion of the anterior portion of the implant. Figure 7B is a side view of the implant system according to an embodiment of the present invention, after expansion of the anterior portion of the implant. Figure 8A is a side view of the implant system according to an embodiment of the present invention placed in a vertebra; said vertebra is shown transparent, visible only by its contours. Figure 8B is a sectional view of the implant system according to one embodiment of the present invention placed in a vertebra; said vertebra is shown transparent, visible only by its contours. The drawings of the figures are not to scale. It goes without saying that the scope of the invention is not limited to the embodiments more specifically described and shown with reference to the accompanying drawings; on the contrary, it embraces all variants.
    [0007] REFERENCES 1 Intravertebral implant, 11 Anterior part of the intravertebral implant, 12 Posterior part of the intravertebral implant, 121 Shoulder, 122 Cylindrical recess, 13 Central traction tube, 2 Pedicle fixation, especially pedicle socket, 21 Thread, 22 Internal portion posterior, 221 Tapping, 23 Anterior Internal Portion, 24 Pedicle Attachment Rotating Device - Notch, 25 Input Chamfer, 3 Posterior Element, 31 Anterior Portion, 311 Thread, 32 Posterior Portion, 33 Support Surface , 4 Vertebra, 5 Insertion instrument, 51 Cannula in rotation with pedicle fixation, 52 Expansion tube.
    [0008] DETAILED DESCRIPTION The present invention relates to an expandable intravertebral implant system with posterior pedicle fixation.
    [0009] According to a first embodiment, the implant system comprises an intravertebral implant associated with pedicle fixation providing additional anchoring at the vertebral pedicle. According to a second embodiment, as shown in FIG. implant comprises an intravertebral implant 1 associated with pedicle fixation 2 and a posterior element 3 making it possible to connect, posteriorly to the vertebra, any device intended to stabilize, strengthen or repair the vertebral fracture, in particular vertebral fracture by compression. Intravertebral Implant 10 As shown in Figure 2, the intravertebral implant 1 according to the present invention comprises an anterior portion 11 and a posterior portion 12. According to one embodiment, the anterior portion 11 corresponds to an intravertebral implant 1 deformable and expandable such that the SpineJack® implant marketed by the company VEXIM, known to those skilled in the art and also described in the patent application EP 1 778 136-. It is specified that the skilled person, upon reading said patent application can easily find the characteristics necessary for the realization of the present invention. In particular, the anterior portion 11 of the intravertebral implant 1 of the present invention consists of an expandable portion allowing bone rectification and comprising: a determined single expansion plane, intrinsic to said anterior portion 11, a first and a second opposed plateaux, respectively capable of forming a first and a second bearing surface in a vertebral body for moving away from each other following said single expansion plane during expansion of the implant, a first and a second support for each of said first and second trays, located under the latter respectively, and means for adjusting a determined expansion value, comprising a web of material disposed between each support and a corresponding plate, said web having a determined thickness which makes it possible to control the expansion of the implant. According to one embodiment, said front portion 11 also comprises a central traction tube 13 for controlling the expansion of the first and second plates. According to an alternative embodiment, the anterior portion 11 of the intravertebral implant 1 corresponds to any intravertebral implant known to those skilled in the art which is deformable, expandable and able to remain in the vertebral body after expansion. According to one embodiment, the posterior portion 12 is a hollow cylindrical body connected, at its forward end, to the posterior end of the anterior portion 11 by a shoulder 121. Said posterior portion 12 comprises a cylindrical recess 122 through which can sliding a central pulling tube 13, initially located in the front portion 11. By pulling on the central pulling tube 13, the central pulling tube 13 slides in the cylindrical recess 122 of the posterior portion 12 and the anterior and posterior ends of the anterior portion 11 is brought about causing the expansion of the first and second trays of the anterior portion 11 of the intravertebral implant 1. The central traction tube 13 makes it possible to control the deployment of the expandable deformable anterior portion 11. Once the pulling tube 13 pulled inside the recess 122, the tube can not return to its original position ial, which maintains the expansion of the anterior portion 11, pending the injection of cement or bone substitute. According to one embodiment, the central traction tube 13 is perforated to allow the insertion of cement or bone substitute through said tube. Pedicle fixation As shown in FIG. 3A, the pedicle attachment 2 according to the present invention comprises a threading 21 able to provide a bone anchorage in the pedicle.
    [0010] The anchoring of the pedicle fixation 2 in a vertebral pedicle provides additional mechanical support to the intravertebral implant 1, and in particular to the expandable anterior portion 11 of said implant 1. The insertion of the pedicle fixation 2 into the bone tissue is facilitated by a chamfer 25 located at the anterior end of the pedicle fixation 2.
    [0011] As shown in FIG. 3B, the pedicle attachment 2 is a hollow cylindrical pedicle socket or sleeve comprising a posterior inner portion 22 and an anterior inner portion 23. According to one embodiment, the posterior inner portion 22 includes a tapping 221 or any other means within the reach of those skilled in the art for connecting the attachment 2 to a posterior element 3. According to one embodiment, the inner anterior portion 23 comprises a bore defining a hollow receiving portion of the rear portion 12 of the intravertebral implant 1. According to one embodiment, the intravertebral implant 1, and in particular the posterior portion 12, does not cross the entirety of the hollow pedicle fixation 2. According to one embodiment, the posterior portion 12 serves as a guide for the pedicle fixation 2. The shoulder 121 thus serves as a guide stop for fixing 2. According to one embodiment, the party The posterior e 12 of the intravertebral implant 1 can move in at least one degree of freedom, preferably 2 degrees of freedom in the anterior inner portion 23 of the pedicular attachment 2. According to one embodiment, the pedicular attachment 2, particularly the pedicle socket, defines a main axis. According to this embodiment, the posterior portion 12 of the intravertebral implant 1 can move in rotation and in translation along said main axis in the anterior inner portion 23 of the pedicle fixation 2. According to one embodiment, the pedicle fixation 2 comprises at least one notch 24, or any other means within the reach of those skilled in the art, for rotating the pedicle fixation 2, with the aid of an insertion instrument 5. Posterior element As shown 4, the posterior element 3 according to the present invention comprises an anterior portion 31 consisting of a rod, preferably a threaded rod 311 cooperating with the tapping 221 of the pedicle fixation 2, thus allowing the fixation of the posterior element 3 to the pedicle fixation 2. The posterior element 3 also comprises a posterior portion 32, external to the vertebra 4, whose geometry makes it possible to ensure assembly anointments with complementary posterior fixation elements and known to those skilled in the art such as artificial bars or ligaments. Any other assembly configuration to other systems known to those skilled in the art may be considered. The posterior element 3 also comprises a bearing surface 33 against the bone tissue or against the posterior portion of the pedicle fixation 2, according to the choice made by the operator and / or the depression of the pedicle fixation 2 in the pedicular bone.
    [0012] Operation After the creation of an approach path and the boring of the vertebral pedicle, the implant system comprising the pedicle fixation 2 and the vertebral implant 1 whose posterior portion 12 is inserted into the anterior inner portion 23 of the Pedicle fixation 2 is inserted and then screwed into the pedicle using an insertion instrument 5, as shown in FIG. 5. Said insertion instrument 5 comprises a working cannula 51 integral in rotation with the pedicle fixation. 2 through the notches 24 for screwing the pedicle fixation 2 in the pedicle. Said insertion instrument 5 also comprises an expansion tube 52 integral with the intravertebral implant 1, and in particular integral with the central traction tube 13 of the intravertebral implant 1. The depth of insertion of the implant system is controlled. by the operator by screwing the thread 21 of the pedicle fixation 2 into the bone tissue, in order to position the intravertebral implant 1 optimally in the vertebral body. The positioning of the intravertebral implant 1 in axial rotation is controlled by the operator independently of the insertion of the pedicle fixation 2, using the tube 52 so as to maintain a cranio-caudal expansion plane of the intravertebral implant 1 regardless of the screwing angle obtained during the insertion of the pedicle fixation 2. As shown in FIGS. 6A, 6B, 8A and 8B, the intravertebral implant system according to the present invention is inserted through a vertebral pedicle, the intravertebral implant 1 then being located in the vertebral body and the pedicle fixation being anchored in the pedicle. According to one embodiment, after insertion, the pedicle fixation 2 is firmly fixed in the pedicle and the intravertebral implant 1 is secured to the pedicle fixation 2 by its cylindrical posterior portion 12. The pedicle fixation 2 then abuts on the pedicle shoulder 121. Thus the intravertebral implant 1 has an additional point of support in the pedicle. As shown in FIGS. 7A and 7B, the expansion of the intravertebral implant 1 is performed by pulling on the central traction tube 13, through the tube 52 of the insertion instrument 5 (not shown in the figures) . The central traction tube 13 can slide unidirectionally in the posterior portion 12 of the implant 1 to allow deployment while preventing withdrawal. As shown in FIG. 7B, the posterior portion 12 can slide freely in the anterior internal portion 23, without however leaving it in order to ensure a permanent additional support, so as not to constrain the deployment of the intravertebral implant in a position dependent on the location of pedicle fixation 2 in the pedicle. According to this embodiment, the intravertebral implant 1 is free in axial rotation and in anterior translation relative to the pedicle fixation 2. The deployment of the intravertebral implant 1 thus occurs solely according to the intravertebral bone environment. According to one embodiment, the intravertebral implant, and in particular its posterior portion 12, can move in one, two, three, four, five degrees of freedom, preferably two degrees of freedom, more preferably a degree of freedom in rotation. and a degree of freedom in translation, in the inner anterior portion 23.
    [0013] According to one embodiment, once the intravertebral implant 1 has been deployed and stabilized, if necessary by means of the injection of cement or of a specially adapted bone substitute, it is then possible to join the entire pedicle fixation 2 - intravertebral implant. 1 the posterior element 3 by simple screwing and tightening of the latter in the posterior internal portion 22 of the pedicle fixation 2. In this embodiment, the posterior element 3 is at least partially external to the vertebra 4 and is then capable of to receive posterior fixation elements such as bars or artificial ligament systems or any other means of stabilizing the vertebral fracture known to those skilled in the art.
    权利要求:
    Claims (9)
    [0001]
    REVENDICATIONS1. An expandable intravertebral implant system comprising an intravertebral implant (1) comprising an expandable anterior portion (11) in a vertebral body and a posterior portion (12); and a pedicle attachment (2) having at least one hollow receiving portion of the posterior portion (12).
    [0002]
    An expandable intravertebral implant system according to claim 1, wherein the pedicle attachment (2) comprises a thread (21) for anchoring said pedicle attachment in a vertebral pedicle.
    [0003]
    An expandable intravertebral implant system according to claim 1 or claim 2, wherein the pedicle attachment (2) comprises a posterior inner portion (22) and an anterior inner portion (23) in which the posterior portion (12) of the intravertebral implant (1) can move in at least one degree of freedom.
    [0004]
    An expandable intravertebral implant system according to claim 3, wherein the pedicle attachment (2) comprises a main axis and the posterior portion (12) of the intravertebral implant (1) is translatable and rotatable according to the main axis of the pedicle fixation (2), in the anterior inner portion (23) of the pedicle fixation (2).
    [0005]
    An expandable intravertebral implant system according to any one of claims 3 or 4, wherein the anterior portion (11) of the intravertebral implant (1) comprises first and second trays, respectively capable of forming a first and a second a second bearing surface in a vertebral body; these two bearing surfaces being called to move away in one another according to a predefined expansion plane.
    [0006]
    An expandable intravertebral implant system according to any one of claims 1 to 5, wherein the expansion direction of the anterior portion (11) of the intravertebral implant (1) is independent of the position of the pedicle attachment. (2) in the vertebral pedicle.
    [0007]
    An expandable intravertebral implant system according to any of claims 1 to 6, further comprising a posterior member (3), partially external to the vertebra and integral with the pedicle attachment (2).
    [0008]
    8. An expandable intravertebral implant system according to claim 7, wherein the posterior element (3) is integral with the pedicle fixation (2) via a threaded rod (311) screwed into a tapping (221). the posterior inner portion (22).
    [0009]
    An expandable intravertebral implant system according to any of claims 7 or 8, wherein the posterior element (3) comprises a posterior portion (32) for assembly with complementary posterior fixation elements such as bars or artificial ligaments.
    类似技术:
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    法律状态:
    2015-12-21| PLFP| Fee payment|Year of fee payment: 3 |
    2016-12-22| PLFP| Fee payment|Year of fee payment: 4 |
    2017-12-21| PLFP| Fee payment|Year of fee payment: 5 |
    2019-11-15| PLFP| Fee payment|Year of fee payment: 7 |
    2020-11-12| PLFP| Fee payment|Year of fee payment: 8 |
    2021-11-15| PLFP| Fee payment|Year of fee payment: 9 |
    优先权:
    申请号 | 申请日 | 专利标题
    FR1363467A|FR3015221B1|2013-12-23|2013-12-23|EXPANSIBLE INTRAVERTEBRAL IMPLANT SYSTEM WITH POSTERIOR PEDICULAR FIXATION|FR1363467A| FR3015221B1|2013-12-23|2013-12-23|EXPANSIBLE INTRAVERTEBRAL IMPLANT SYSTEM WITH POSTERIOR PEDICULAR FIXATION|
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