DE10035182A1 - Instrument for inserting intervertebral implant has stop on forward thrust element, with protuberance, cavity , guide track with two arms - Google Patents
Instrument for inserting intervertebral implant has stop on forward thrust element, with protuberance, cavity , guide track with two armsInfo
- Publication number
- DE10035182A1 DE10035182A1 DE10035182A DE10035182A DE10035182A1 DE 10035182 A1 DE10035182 A1 DE 10035182A1 DE 10035182 A DE10035182 A DE 10035182A DE 10035182 A DE10035182 A DE 10035182A DE 10035182 A1 DE10035182 A1 DE 10035182A1
- Authority
- DE
- Germany
- Prior art keywords
- instrument according
- feed element
- intervertebral implant
- stop
- arms
- Prior art date
- Legal status (The legal status 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 status listed.)
- Granted
Links
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/442—Intervertebral or spinal discs, e.g. resilient
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/025—Joint distractors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
- A61F2/4465—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages having a circular or kidney shaped cross-section substantially perpendicular to the axis of the spine
-
- A—HUMAN NECESSITIES
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- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2/4611—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
-
- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/025—Joint distractors
- A61B2017/0256—Joint distractors for the spine
-
- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30108—Shapes
- A61F2002/3011—Cross-sections or two-dimensional shapes
- A61F2002/30138—Convex polygonal shapes
- A61F2002/30158—Convex polygonal shapes trapezoidal
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30108—Shapes
- A61F2002/30199—Three-dimensional shapes
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
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- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30593—Special structural features of bone or joint prostheses not otherwise provided for hollow
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30772—Apertures or holes, e.g. of circular cross section
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30772—Apertures or holes, e.g. of circular cross section
- A61F2002/30777—Oblong apertures
-
- A—HUMAN NECESSITIES
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- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30772—Apertures or holes, e.g. of circular cross section
- A61F2002/30784—Plurality of holes
- A61F2002/30785—Plurality of holes parallel
-
- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/3082—Grooves
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- A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
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- A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
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Abstract
Description
Die Erfindung betrifft ein Einsetzinstrument für ein Zwischenwirbelimplantat mit einer zwischen zwei benach barte Wirbel einsetzbaren Führungsbahn für das Zwi schenwirbelimplantat und mit einem das Zwischenwirbel implantat längs der Führungsbahn vorschiebenden, sich an der Führungsbahn abstützenden Vorschubelement.The invention relates to an insertion instrument for a Intervertebral implant with one between two adj beard swirl usable guideway for the Zwi intervertebral implant and the intervertebral implant advancing along the guideway feed element supporting the guideway.
Ein solches Einsetzinstrument ist beispielsweise aus dem deutschen Gebrauchsmuster 299 16 079 bekannt.Such an insertion instrument is, for example, from the German utility model 299 16 079 known.
Der Erfindung liegt die Aufgabe zugrunde, ein Ein setzinstrument der eingangs beschriebenen Art so zu verbessern, daß der Einsetzvorgang des Zwischenwirbel implantates weiter erleichtert wird.The invention has for its object a setting instrument of the type described at the beginning improve that the insertion process of the intervertebral implant is further facilitated.
Diese Aufgabe wird bei einem Einsetzinstrument der ein gangs beschriebenen Art erfindungsgemäß dadurch gelöst, daß an dem Vorschubelement ein Anschlag vorgesehen ist, der sich beim Erreichen der gewünschten Endposition des Zwischenwirbelimplantates im Zwischenwirbelraum von zwei benachbarten Wirbelkörpern an einen Wirbelkörper anlegt, und daß das Vorschubelement relativ zur Füh rungsbahn auch nach Anlage des Anschlages an einem Wir belkörper weiter vorschiebbar ist.This task is the one with an insertion instrument type described above solved according to the invention that a stop is provided on the feed element, which changes when the desired end position of the Intervertebral implant in the intervertebral space of two adjacent vertebral bodies to one vertebral body applies, and that the feed element relative to the Füh train even after the attack on a we the body can be advanced further.
Auf diese Weise stützt sich das Vorschubelement beim Vorschieben des Zwischenwirbelimplantates in den Zwi schenwirbelraum an einem Wirbelkörper ab, sobald die gewünschte Eintauchtiefe des Zwischenwirbelimplantates in den Zwischenwirbelraum erreicht ist. Ein weiteres Vorschieben des Vorschubelementes in Richtung auf den Zwischenwirbelraum wird dadurch ausgeschlossen, das heißt der Anschlag wirkt als Eintauchentiefenbegren zung.In this way, the feed element is based on Advancing the intervertebral implant into the Zwi vertebral space on a vertebral body as soon as the Desired immersion depth of the intervertebral implant reached in the intervertebral space. Another one Pushing the feed element towards the Intervertebral space is excluded by that the stop acts as an immersion depth limit Zung.
Wenn das Vorschubelement relativ zur Führungsbahn wei ter nach vorne, das heißt in distaler Richtung, ver schoben wird, muß dies daher dazu führen, daß die Füh rungsbahn relativ zu dem am Wirbelkörper anschlagenden und dadurch festgehaltenen Vorschubelementes in der entgegengesetzten Richtung verschoben wird, also in proximaler Richtung, das heißt die Führungsbahn wird aus dem Zwischenwirbelraum herausgezogen. Dabei ver bleibt das Zwischenwirbelimplantat im Inneren des Zwi schenwirbelraumes, während das Einsetzinstrument dabei aus dem Zwischenwirbelraum entfernt wird. Man erhält also durch Vorschieben des Vorschubelementes relativ zur Führungsbahn zunächst ein Vorschieben des Zwischen wirbelimplantates bis zu der gewünschten Endposition im Zwischenwirbelraum und dann ohne Änderung des Vorschub vorganges selbst ein Abziehen des Einsetzinstrumentes vom eingesetzten Zwischenwirbelimplantat und eine Ent fernung des Einsetzinstrumentes aus dem Zwischenwirbel raum. Der Operateur muß beim Einsetzvorgang daher keine unterschiedlichen Handhabungsschritte vornehmen, son dern ein einziger Handhabungsschritt, nämlich das Vor schieben des Vorschubelementes relativ zur Führungs bahn, führt zwangsläufig zu den geschilderten Ergebnis sen. If the feed element knows relative to the guideway ter forward, that is, in the distal direction, ver is pushed, this must therefore lead to the fact that the trajectory relative to that striking the vertebral body and thereby held feed element in the is moved in the opposite direction, i.e. in proximal direction, that is the guideway pulled out of the intervertebral space. Ver the intervertebral implant remains inside the Zwi vertebral space while the insertion instrument is removed from the intervertebral space. You get thus by advancing the feed element relatively first push the intermediate to the guideway vertebral implants up to the desired end position in the Intervertebral space and then without changing the feed process itself a removal of the insertion instrument of the intervertebral implant used and an ent removal of the insertion instrument from the intervertebral vertebra room. The operator therefore does not have to do this during the insertion process carry out different handling steps, son a single handling step, namely the front push the feed element relative to the guide bahn, inevitably leads to the described result sen.
Es ist günstig, wenn das Vorschubelement in einer Füh rung in Richtung der Führungsbahn verschieblich gela gert ist, die ihrerseits an der Führungsbahn angeordnet ist.It is advantageous if the feed element is in a guide tion slidable in the direction of the guideway device, which in turn is arranged on the guideway is.
Besonders vorteilhaft ist es, wenn das Vorschubelement als Zahnstange ausgebildet ist, die mit einem an der Führungsbahn gelagerten, drehbaren Zahnrad kämmt.It is particularly advantageous if the feed element is designed as a rack that with one on the Guide track mounted, rotatable gear meshes.
Das Vorschubelement kann vorzugsweise an seinem dista len Ende stufig ausgebildet sein und mit einem vor springenden Teil in eine Ausnehmung des Zwischenwirbel implantates eintauchen, während ein zurückspringender Teil eine Anlagefläche für das Zwischenwirbelimplantat ausbildet. Damit wird das Vorschubelement gegen eine seitliche Verschiebung relativ zum Zwischenwirbelim plantat gesichert, kann aber ohne weiteres in Vor schubrichtung vom Zwischenwirbelimplantat abgezogen werden.The feed element can preferably at its dista len end be graduated and with a front jumping part into a recess of the intervertebral vertebra Immerse the implants while a recoil Part of a contact surface for the intervertebral implant formed. So that the feed element against a lateral displacement relative to the intervertebral limb Plantat secured, but can easily in advance direction of thrust deducted from the intervertebral implant become.
Der Anschlag an dem Vorschubelement kann beispielsweise durch einen quer abstehenden Zapfen gebildet werden.The stop on the feed element can for example be formed by a transversely projecting pin.
Bei einer besonders bevorzugten Ausführungsform ist vorgesehen, daß die Führungsbahn zwei im wesentlichen parallel zueinander verlaufende Arme aufweist, die das Zwischenwirbelimplantat zwischen sich führen.In a particularly preferred embodiment provided that the guideway two essentially has parallel arms that the Guide the intervertebral implant between them.
Dabei ist es vorteilhaft, wenn der gegenseitige Abstand der Arme veränderbar ist, so daß die Arme gleichzeitig als Spreizeinrichtung dienen, die bei Vergrößerung des gegenseitigen Abstandes in ihrem distalen, in den Zwi schenwirbelbereich eintauchenden Teil die Wirbelkörper voneinander entfernen und damit den Zwischenwirbelraum aufweiten.It is advantageous if the mutual distance the arms are changeable so that the arms at the same time serve as a spreading device, which when the mutual distance in their distal, in the Zwi the vertebral body separate from each other and thus the intervertebral space expand.
Insbesondere können die Arme an ihrem proximalen Ende um eine quer zu ihrer Längsrichtung verlaufende Achse verschwenkbar miteinander verbunden sein.In particular, the arms can be at their proximal end about an axis transverse to its longitudinal direction be pivotally connected.
Günstig ist es, wenn der Abstand der Arme am distalen Ende geringer ist als am proximalen Ende, dadurch wird es ermöglicht, daß allein durch das Vorschieben des Zwischenwirbelimplantates ein Auseinanderschwenken der Arme und dadurch ein Aufspreizen im distalen Endbereich der Arme erreicht wird.It is beneficial if the distance between the arms is at the distal End is less than at the proximal end, this will it allows that only by advancing the Intervertebral implant swings apart Arms and thereby spreading in the distal end area the poor is reached.
Bei einer bevorzugten Ausführungsform ist vorgesehen, daß die Arme in zur Oberseite beziehungsweise zur Un terseite hin offene Längsnuten des Zwischenwirbelim plantates eintauchen. Zur Führung des Zwischenwirbelim plantates genügt es also, wenn in diesem auf gegenüber liegenden Seiten offene Längsnuten vorgesehen werden, die die Arme aufnehmen.In a preferred embodiment, that the arms in to the top or to the Un open longitudinal grooves of the intervertebral limb Immerse plantates. To guide the intervertebral limb It is therefore sufficient for plantates to face each other open longitudinal grooves are provided on the sides, that take up the arms.
Dabei ist es günstig, wenn die Arme nach oben bezie hungsweise unten aus den Längsnuten hervorstehen, ins besondere wenn die Arme nach oben beziehungsweise unten nur im distalen Teil des Zwischenwirbelimplantates aus den Längsnuten hervorstehen. It is beneficial if the arms are up protruding from the longitudinal grooves below, ins especially if the arms are up or down only in the distal part of the intervertebral implant protrude the longitudinal grooves.
Eine solche Ausgestaltung führt dazu, daß sich die Zwischenwirbelkörper beim Einschieben des Zwischenwir belimplantates auf den Armen abstützen, die aus den Längsnuten des Zwischenwirbelimplantates hervortreten, so daß das Zwischenwirbelimplantat ohne weiteres längs der Arme vorgeschoben werden kann, ohne mit den benach barten Wirbelkörpern in Kontakt zu kommen. Erst beim Herausziehen der Arme aus den Längsnuten und damit aus dem Zwischenwirbelraum senken sich die benachbarten Wirbelkörper auf das eingesetzte Zwischenwirbelimplan tat ab und ruhen dann auf diesem.Such an arrangement leads to the fact that Intervertebral body when inserting the intervertebral Support belimplantates on the arms that come from the Emerge longitudinal grooves of the intervertebral implant, so that the intervertebral implant easily along the arm can be advanced without having to move the neighboring beard vertebral bodies come into contact. Not until Pull the arms out of the longitudinal grooves and out in the intervertebral space the neighboring ones sink Vertebral body on the inserted intervertebral implant dismissed and then rest on this.
Es kann vorgesehen sein, daß der eine Arm zwei neben einander angeordnete Stege umfaßt, wobei vorzugsweise der andere Arm dem Zwischenraum zwischen den beiden Stegen gegenüberliegt.It can be provided that one arm two next to mutually arranged webs, preferably the other arm the space between the two Is opposite.
Auch die Stege können dabei jeweils in eine offene Längsnut des Zwischenwirbelimplantates eintauchen, bei einer solchen Konstruktion sind somit auf einer Seite des Zwischenwirbelimplantates zwei im Abstand zueinan der angeordnete Längsnuten angeordnet, auf der gegen überliegenden Seite jedoch nur eine, die vorzugsweise zwischen den beiden Längsnuten auf der gegenüberliegen den Seite liegt.The webs can also each be in an open Immerse the longitudinal groove of the intervertebral implant, at such a construction are thus on one side of the intervertebral implant two at a distance from each other the arranged longitudinal grooves arranged on the against overlying side however only one that is preferred between the two longitudinal grooves on the opposite the side.
Vorteilhaft ist es, wenn die Führung einen Anschlag trägt, der bei Anlage an einem Wirbelkörper die Ein tauchtiefe der Führungsbahn in den Zwischenwirbelraum begrenzt. Auch dies erleichtert das Einsetzen, da der Operateur beim Einschieben des Einsetzinstrumentes in den Zwischenwirbelraum diesen bis zu einer definierten Eintauchtiefe vorschieben kann.It is advantageous if the guide makes a stop carries the one when resting on a vertebral body immersion depth of the guideway in the intervertebral space limited. This also makes insertion easier, since the Operator inserting the insertion instrument into the intervertebral space this up to a defined one Can advance immersion depth.
Es ist dabei günstig, wenn das Vorschubelement Verbin dungsmittel trägt, mit denen eine entgegen der Ver schieberichtung zugfeste Verbindung zu dem Zwischenwir belimplantat herstellbar ist. Eine solche Verbindung ermöglicht es, das Vorschubelement und das Zwischenwir belimplantat so zu verbinden, daß mit dem Vorschubele ment das Zwischenwirbelimplantat aus dem Zwischenwir belraum herausgezogen werden kann. Dazu wird das Vor schubelement gegenüber der Führungsbahn zurückgezogen, diese stützt sich dann mit ihrem Anschlag an einem Wir belkörper ab und zieht dadurch das Vorschubelement re lativ zu dem Wirbelkörper und damit relativ zum Zwi schenwirbelraum zurück, das mit dem Vorschubelement zugfest verbundene Zwischenwirbelimplantat wird auf diese Weise mitgenommen. Das Einsetzinstrument über nimmt in diesem Falle die Funktion eines Ausziehinstru mentes.It is favorable if the feed element is connected bears with which one against the Ver slide-resistant connection to the intermediate wire bel implant is producible. Such a connection enables the feed element and the intermediate wire Belimplantat to connect so that with the feed ment the intervertebral implant from the interwir can be pulled out. This becomes the before retracted thrust element opposite the guideway, this then supports itself with its attack on a we the body and pulls the feed element right relative to the vertebral body and thus relative to the Zwi vortex space back, that with the feed element tensile intervertebral implant is on taken this way. The insertion tool about takes on the function of an extractor in this case mentes.
Bei einer weiteren bevorzugten Ausführungsform ist vor gesehen, daß der Anschlag am Vorschubelement in dessen Verschieberichtung in unterschiedlicher Position fest legbar ist. Damit kann die Einschubtiefe des Zwischen wirbelimplantates in den Zwischenwirbelraum variiert werden.In a further preferred embodiment is before seen that the stop on the feed element in the Movement direction fixed in different positions can be laid. This allows the insertion depth of the intermediate vertebral implant in the intervertebral space varies become.
Beispielsweise kann das Vorschubelement in Verschiebe richtung gegeneinander versetzt mehrere Einsetzöffnungen für den Anschlag aufweisen, in die dieser wahlweise eingesetzt wird.For example, the feed element can be moved Several insertion openings offset from one another for the stop, in which this is optional is used.
Bei einer anderen Ausführungsform ist vorgesehen, daß auf dem Vorschubelement in Verschieberichtung ver schiebbar ein den Anschlag tragender Anschlagkörper ge lagert ist, der in verschiedenen Positionen festlegbar ist.In another embodiment it is provided that ver on the feed element in the direction of displacement slidably a stop body carrying the stop ge is stored in different positions is.
Insbesondere kann der Anschlagkörper durch eine Raste festlegbar sein, die lösbar in Zähne des als Zahnstange ausgebildeten Vorschubelementes eingreift.In particular, the stop body can be locked be fixable, which can be detached in teeth of as a rack trained feed element engages.
Die nachfolgende Beschreibung bevorzugter Ausführungs formen der Erfindung dient im Zusammenhang mit der Zeichnung der näheren Erläuterung. Es zeigen:The following description of preferred embodiment forms of the invention is used in connection with the Drawing of the detailed explanation. Show it:
Fig. 1 eine Seitenansicht eines Zwischenwir belimplantates mit drei Längsnuten zur Führung der Arme eines Einsetzinstrumen tes in Richtung der Längsnuten; Figure 1 is a side view of an intervertebral implant with three longitudinal grooves for guiding the arms of an insertion instrument in the direction of the longitudinal grooves.
Fig. 2 eine Ansicht ähnlich Fig. 1 quer zur Richtung der Längsnuten; Fig. 2 is a view similar to Figure 1 transverse to the direction of the longitudinal grooves.
Firma 3 eine Draufsicht auf das Implantat der Fig. 1 und 2;Company 3 is a top view of the implant of FIGS. 1 and 2;
Fig. 4 eine perspektivische Ansicht des Implan tates der Fig. 1 bis 3; Fig. 4 is a perspective view of the implant gate of Figures 1 to 3.
Fig. 5 eine Ansicht des Implantates der Fig. 1 bis 4 mit einem daran angelegten Vor schubelement eines im übrigen nicht dar gestellten Einsetzinstrumentes; Fig. 5 is a view of the implant of Figures 1 to 4 with an attached before thrust element of an insertion instrument not otherwise shown;
Fig. 6 eine Ansicht des vollständigen Einsetzin strumentes für das Zwischenwirbelimplan tat der Fig. 1 bis 4 vor dem Einschie ben des Zwischenwirbelimplantates in den Zwischenwirbelraum zwischen zwei Wirbel körpern; Fig. 6 is a view of the complete insertion instrument for the intervertebral implant did the body of Figures 1 to 4 before inserting the intervertebral implant into the intervertebral space between two vertebrae;
Fig. 7 eine Ansicht des Einsetzinstrumentes in Fig. 6 in Richtung des Pfeiles A in Fig. 6; FIG. 7 is a view of the insertion instrument in FIG. 6 in the direction of arrow A in FIG. 6;
Fig. 8 eine Seitenansicht des Einsetzinstrumen tes der Fig. 6 nach dem Einschieben des Zwischenwirbelimplantates in den Zwi schenwirbelraum; FIG. 8 is a side view of the insertion instrument of FIG. 6 after the intervertebral implant has been inserted into the intervertebral space;
Fig. 9 eine vergrößerte Detailansicht des Berei ches B in Fig. 8; Fig. 9 is an enlarged detail view of the area B in Fig. 8;
Fig. 10 eine Ansicht ähnlich Fig. 8 mit gegen über der Führungsbahn des Einsetzinstru mentes weiter vorgeschobenem Vorschubele ment und nach Herausziehen der Führungs bahn des Einsetzinstrumentes aus dem Zwi schenwirbelraum der benachbarten Wirbel körper und Fig. 10 is a view similar to FIG. 8 with element advanced against the guideway of the inserting element and after pulling out the guideway of the inserting instrument from the intervertebral space of the adjacent vertebral body and
Fig. 11 eine perspektivische Ansicht eines Im plantates und des vorderen Teils eines Vorschubelementes mit einem längs des Vorschubelementes verschieblichen Vor schubkörper. Fig. 11 is a perspective view of an in plantates and the front part of a feed element with a longitudinally displaceable before the feed element thrust body.
Das in den Fig. 6 bis 10 dargestellte Einsetzinstru ment 1 dient zum Einsetzen eines Zwischenwirbelimplan tates 2 in den Zwischenwirbelraum 3 zwischen zwei be nachbarten Wirbelkörpern 4, wie es in den Fig. 1 bis 4 dargestellt ist.The Einsetzinstru to 10 shown in FIGS. 6 element 1 serves for inserting a Zwischenwirbelimplan tates 2 be in the intervertebral space 3 between two adjacent vertebral bodies 4, as shown in FIGS. 1 to 4.
Das Einsetzinstrument 1 umfaßt einen ersten Arm 5 mit zwei parallelen im Abstand zueinander verlaufenden, stabförmigen Stegen 6, 7, die an ihrem proximalen Ende über eine Brücke 8 miteinander verbunden sind und die beide einen rechteckigen Querschnitt aufweisen.The insertion instrument 1 comprises a first arm 5 with two parallel, spaced-apart, rod-shaped webs 6 , 7 which are connected to one another at their proximal end by a bridge 8 and which both have a rectangular cross section.
Die Brücke 8 steht aus der durch die beiden Stege 6 und 7 aufgespannten Ebene senkrecht hervor und bildet ein Schwenklager 9 für einen zweiten Arm 10, der in ähnli cher Weise wie die Stege 6 und 7 einen rechteckigen Querschnitt und dieselbe Länge aufweist. Die Schwenk achse 11 des Armes 10 verläuft quer zur Längsrichtung des Armes 10 und ist im Abstand von der von den Stegen 6 und 7 aufgespannten Ebene angeordnet, der Zwischen raum zwischen den Stegen 6 und 7 ist größer als die Breite des zweiten Armes 20. Dadurch kann der zweite Arm 10 mit seinem distalen Ende in den Zwischenraum zwischen den beiden Stegen 6 und 7 eintauchen.The bridge 8 protrudes perpendicularly from the plane spanned by the two webs 6 and 7 and forms a pivot bearing 9 for a second arm 10 which , in a manner similar to the webs 6 and 7, has a rectangular cross section and the same length. The pivot axis 11 of the arm 10 extends transversely to the longitudinal direction of the arm 10 and is arranged at a distance from the plane spanned by the webs 6 and 7 , the space between the webs 6 and 7 is larger than the width of the second arm 20th As a result, the distal end of the second arm 10 can dip into the space between the two webs 6 and 7 .
Im Bereich zwischen den Stegen 6 und 7 einerseits und dem Schwenklager 9 für den zweiten Arm 10 andererseits ist an der Brücke 8 eine Führungshülse 12 gehalten, in welcher ein stabförmiges Vorschubelement 13 längsver schieblich gelagert ist, die Verschieberichtung ver läuft dabei parallel zur Längserstreckung der Stege 6 und 7. Das Vorschubelement 13 ist in seinem proximalen Teil als Zahnstange 14 ausgebildet, mit der ein Zahnrad 15 kämmt, welches an der Brücke 8 um eine Drehachse verdrehbar gelagert ist, die parallel zur Schwenkachse 11 verläuft. Das Zahnrad 15 ist mit einem Griff 16 ver bunden, durch den das Zahnrad 15 verdreht werden kann. Bei dieser Verdrehung wird das Vorschubelement 13 in der Führungshülse 12 verschoben.In the area between the webs 6 and 7, on the one hand, and the pivot bearing 9 for the second arm 10, on the other hand, a guide sleeve 12 is held on the bridge 8 , in which a rod-shaped feed element 13 is mounted in a longitudinally displaceable manner, the direction of displacement running parallel to the longitudinal extension of the webs 6 and 7 . In its proximal part, the feed element 13 is designed as a toothed rack 14 , with which a toothed wheel 15 meshes, which is rotatably mounted on the bridge 8 about an axis of rotation which runs parallel to the pivot axis 11 . The gear 15 is connected to a handle 16 , through which the gear 15 can be rotated. During this rotation, the feed element 13 is displaced in the guide sleeve 12 .
Sowohl an den Stegen 6 und 7 als auch an dem Arm 10 sind in einigem Abstand von deren distalem Ende nach außen quer abstehende Zapfen 17, 18 angeordnet, die Anschläge für die Wirbelkörper 4 ausbilden, wenn das Einsetzinstrument 1 mit den distalen Endabschnitten der Stege 6 und 7 und des Armes 10 in den Zwischenwirbel raum 3 eingeschoben wird (Fig. 6), so daß durch diese Anschläge eine Eintauchtiefenbegrenzung erfolgt.Both on the webs 6 and 7 and on the arm 10 are arranged at a certain distance from their distal end outwardly projecting pins 17 , 18 which form the stops for the vertebral bodies 4 when the insertion instrument 1 with the distal end portions of the webs 6 and 7 and the arm 10 is inserted into the intervertebral space 3 ( Fig. 6), so that an immersion depth limitation is carried out by these stops.
Das in den Fig. 1 bis 4 dargestellte Zwischenwir belimplantat 2 hat im wesentlichen die Form eines fla chen Ringes mit einer oberen Stützfläche 19 und einer unteren Stützfläche 20, die jeweils mit spitzen Vorsprüngen 21 versehen sind. In diesen Ringkörper des Zwischenwirbelimplantates 2 ist eine zentrale, nach oben offene Längsnut 22 eingearbeitet, außerdem befin den sich in diesem Ringkörper zwei parallel zur Längs nut 22 verlaufende, nach unten offene, zu beiden Seiten der Längsnut 22 angeordnete weitere Längsnuten 23 und 24.The 1 to 4 shown in Fig. Zwischenwir Belimplantat 2 has essentially the shape of a fla chen ring with an upper support surface 19 and a lower support surface 20 , which are each provided with pointed projections 21 . In this ring body of the intervertebral implant 2 is a central, incorporated upwardly open longitudinal groove 22, also befin the parallel in this ring body has two to the longitudinal groove 22 extending, downwardly open, to both sides of the longitudinal groove 22 disposed more longitudinal grooves 23 and 24th
Die Breite dieser Längsnuten 22, 23 und 24 entspricht der Breite des Armes 10 beziehungsweise der Stege 6, 7, die Tiefe der Längsnuten 22, 23 und 24 ist dabei so ausgebildet, daß die Stege beziehungsweise der Arm zu mindest teilweise aus der Längsnut hervorstehen, wenn die Stege und der Arm am Boden der Längsnuten anliegen.The width of these longitudinal grooves 22 , 23 and 24 corresponds to the width of the arm 10 or the webs 6 , 7 , the depth of the longitudinal grooves 22 , 23 and 24 is designed so that the webs or the arm at least partially protrude from the longitudinal groove, when the webs and the arm lie against the bottom of the longitudinal grooves.
Bei der in der Zeichnung dargestellten Ausführungsform sind die Stützflächen 19 und 20 geringfügig gegeneinan der geneigt, so daß der Abstand der Stützflächen 19 und 20 am distalen Ende des Implantates geringer ist als am proximalen Ende (Fig. 2), so daß die Tiefe der Längs nuten 22, 23 und 24 am proximalen Ende größer ist als am distalen Ende. Dies kann dazu führen, daß die Stege 6, 7 und der Arm 10 nur am distalen Ende aus den Längs nuten hervorstehen, nicht dagegen am proximalen Ende.In the embodiment shown in the drawing, the support surfaces 19 and 20 are slightly inclined towards each other, so that the distance between the support surfaces 19 and 20 at the distal end of the implant is less than at the proximal end ( FIG. 2), so that the depth of the longitudinal grooves 22 , 23 and 24 is larger at the proximal end than at the distal end. This can lead to the fact that the webs 6 , 7 and the arm 10 only protrude from the longitudinal grooves at the distal end, but not at the proximal end.
Zum Einsetzen des Zwischenwirbelimplantates 2 in einen Zwischenwirbelraum 3 wird zunächst der zweite Arm 10 so von den Stegen 6 und 7 weggeschwenkt, daß diese von oben her frei zugänglich sind. Das Zwischenwirbelim plantat 2 wird auf die Stege 6 und 7 so aufgesetzt, daß diese in die Längsnuten 23 und 24 eintauchen, und zwar in einem Bereich, der zwischen dem proximalen Ende des Einsetzinstrumentes 1 und dem distalen Ende liegt (Fig. 6).To insert the intervertebral implant 2 into an intervertebral space 3 , the second arm 10 is first pivoted away from the webs 6 and 7 in such a way that they are freely accessible from above. The intervertebral implant 2 is placed on the webs 6 and 7 so that they dip into the longitudinal grooves 23 and 24 , in a region which lies between the proximal end of the insertion instrument 1 and the distal end ( Fig. 6).
Anschließend wird der zweite Arm 10 so gegen die Stege 6 und 7 geschwenkt, daß er in die Längsnut 22 ein taucht. Das Zwischenwirbelimplantat 2 ist dadurch zwi schen den Stegen 6, 7 einerseits und dem Arm 10 ande rerseits in Längsrichtung am Einsetzinstrument 1 ge führt, die Stege 6 und 7 bilden gemeinsam mit dem Arm 10 eine Führungsbahn für das Zwischenwirbelimplantat 2 aus.Then the second arm 10 is pivoted against the webs 6 and 7 that it dips into the longitudinal groove 22 . The intervertebral implant 2 is thereby between the webs 6 , 7 on the one hand and the arm 10 on the other hand leads in the longitudinal direction on the insertion instrument 1 , the webs 6 and 7 together with the arm 10 form a guideway for the intervertebral implant 2 .
Das Einsetzinstrument wird daraufhin mit den distalen Enden der Stege 6 und 7 und des Armes 10 in den Zwi schenwirbelraum 3 eingeschoben, bis die Zapfen 17, 18 an den Wirbelkörpern 4 anliegen, wie dies beispielswei se aus Fig. 6 deutlich wird.The insertion instrument is then inserted with the distal ends of the webs 6 and 7 and the arm 10 in the inter mediate vertebral space 3 until the pins 17 , 18 rest against the vertebral bodies 4 , as is evident, for example, from FIG. 6.
Mittels des Griffes 16 wird das Vorschubelement 13 so weit in distaler Richtung verschoben, bis das distale Ende des Vorschubelementes 13 an dem Zwischenwirbelim plantat 2 anliegt. Dabei kann das distale Ende des Vor schubelementes 13 stufig ausgebildet sein, so daß ein vorspringender Teil in die Längsnut 22 eintaucht, wäh rend der rückspringende Teil an der Außenseite des Zwi schenwirbelimplantates 2 anliegt. Dadurch wird das Vor schubelement 13 in Querrichtung relativ zum Zwischen wirbelimplantat 2 festgelegt. By means of the handle 16 , the feed element 13 is displaced in the distal direction until the distal end of the feed element 13 lies against the intervertebral implant 2 . The distal end of the thrust element 13 can be designed in stages so that a projecting part dips into the longitudinal groove 22 , while the recessed part rests against the outside of the intervertebral implant 2 . As a result, the thrust element 13 is fixed in the transverse direction relative to the intervertebral implant 2 .
Durch weiteres Verdrehen des Zahnrades 15 über den Griff 16 kann das Vorschubelement 13 in distaler Rich tung vorgeschoben werden und schiebt dabei das Zwi schenwirbelimplantat 2 ebenfalls in distaler Richtung längs der Stege 6, 7 und des Armas 10 in Richtung auf den Zwischenwirbelraum 3 vor. Dies führt zu einer Ver schwenkung des Armes 10 relativ zu den Stegen 6 und 7, so daß der Abstand zwischen den Stegen 6, 7 einerseits und dem Arm 10 andererseits im distalen Endbereich ver größert wird, dadurch werden die Wirbelkörper 4 vonein ander entfernt, das heißt der Zwischenwirbelraum 3 wird aufgeweitet. Das Einsetzinstrument wirkt also durch das Vorschieben des Zwischenwirbelimplantates 2 in distaler Richtung als Spreizinstrument.By further turning the gear 15 via the handle 16 , the feed element 13 can be advanced in the distal direction and thereby pushes the intervertebral implant 2 also in the distal direction along the webs 6 , 7 and the arm 10 in the direction of the intervertebral space 3 . This leads to a Ver pivoting of the arm 10 relative to the webs 6 and 7 , so that the distance between the webs 6 , 7 on the one hand and the arm 10 on the other hand is enlarged ver in the distal end region, thereby the vertebral bodies 4 are removed from each other, the the intervertebral space 3 is widened. The insertion instrument thus acts as a spreading instrument by advancing the intervertebral implant 2 in the distal direction.
Die Vorschubbewegung des Zwischenwirbelimplantates 2 wird weitergeführt, bis dieses in die gewünschte Lage im Zwischenwirbelraum 3 vorgeschoben ist.The advancing movement of the intervertebral implant 2 is continued until it is advanced into the desired position in the intervertebral space 3 .
Wenn diese gewünschte Lage erreicht ist, legt sich ein Anschlag in Form eines vom Vorschubelement 13 abstehen den Zapfens 25 an den Wirbelkörper 4 an und verhindert, daß das Vorschubelement 13 relativ zum Wirbelkörper 4 weiter vorgeschoben werden kann (Fig. 8 und 9). Die Vorschubbewegung des Zwischenwirbelimplantates 2 wird dadurch begrenzt, das heißt es wird gewährleistet, daß das Zwischenwirbelimplantat 2 genau die gewünschte Ein schubtiefe erreicht.When this desired position is reached, a stop in the form of a pin 25 projecting from the feed element 13 rests against the vertebral body 4 and prevents the feed element 13 from being able to be advanced further relative to the vertebral body 4 ( FIGS. 8 and 9). The feed movement of the intervertebral implant 2 is limited, that is, it is ensured that the intervertebral implant 2 reaches exactly the desired insertion depth.
Beim weiteren Verdrehen des Zahnrades 15 mittels des Griffes 16 in derselben Richtung wird zwar das Vorschubelement 13 relativ zum übrigen Einsetzinstrument 1 weiter in distaler Richtung vorgeschoben, wird aber durch den Zapfen 25 am Wirbelkörper 4 abgestützt, so daß die Relativbewegung zwischen Vorschubelement 13 ei nerseits und dem aus den Stegen 6, 7 und dem Arm 10 ge bildeten übrigen Einsetzinstrument 1 andererseits dazu führt, daß dieses übrige Einsetzinstrument 1 in proxi maler Richtung vom Wirbelkörper 4 entfernt wird, das heißt die distalen Endabschnitte der Stege 6 und 7 und des Armes 10 werden aus den Längsnuten 22, 23 und 24 und damit aus dem Zwischenwirbelraum 3 herausgezogen. Dabei setzen sich die benachbarten Wirbelkörper 4 auf die Stützflächen 19 und 20 auf.With further rotation of the gear 15 by means of the handle 16 in the same direction, the feed element 13 is advanced further in the distal direction relative to the rest of the insertion instrument 1 , but is supported by the pin 25 on the vertebral body 4 , so that the relative movement between the feed element 13 is on the one hand and the ge from the webs 6 , 7 and the arm 10 formed other insertion instrument 1 on the other hand leads to the fact that this remaining insertion instrument 1 is removed in the proximal direction from the vertebral body 4 , that is, the distal end portions of the webs 6 and 7 and the arm 10 pulled out of the longitudinal grooves 22 , 23 and 24 and thus out of the intervertebral space 3 . The adjacent vertebrae 4 sit on the support surfaces 19 and 20 .
Sobald die distalen Endabschnitte der Stege 6 und 7 so wie des Armes 10 aus dem Zwischenwirbelraum 3 herausge zogen sind (Fig. 10), kann das Einsetzinstrument 1 in proximaler Richtung abgezogen werden, das Zwischenwir belimplantat 2 verbleibt dann zwischen den beiden Wir belkörpern 4 in der gewünschten Stellung.As soon as the distal end sections of the webs 6 and 7 as well as the arm 10 are pulled out of the intervertebral space 3 ( FIG. 10), the insertion instrument 1 can be removed in the proximal direction, the intervertebral implant 2 then remains between the two vertebrae 4 in the desired position.
Bei den Ausführungsbeispielen der Fig. 5 bis 10 wird der Anschlag, mit dem das Vorschubelement 13 an einem Wirbelkörper 4 anliegt, durch einen festen Zapfen 25 gebildet. Dieser kann beispielsweise in das Vorschube lement eingeschraubt sein.In the exemplary embodiments in FIGS. 5 to 10, the stop with which the feed element 13 bears against a vertebral body 4 is formed by a fixed pin 25 . This can be screwed into the feed element, for example.
Bei einer bevorzugten Ausführungsform ist es möglich, diesen Zapfen 25 in Vorschubrichtung in unterschiedli chen Positionen am Vorschubelement 13 festzulegen, bei spielsweise dadurch, daß eine größere Anzahl von Einschraublöchern für den Zapfen 25 vorgesehen sind. Da durch kann die Einschubtiefe für das Zwischenwirbelim plantat variiert werden.In a preferred embodiment, it is possible to fix this pin 25 in the feed direction in various positions on the feed element 13 , for example in that a larger number of screw holes are provided for the pin 25 . As a result, the insertion depth for the intervertebral implant can be varied.
In Fig. 11 ist eine weitere bevorzugte Ausführungsform eines Vorschubelementes 13 dargestellt, bei welcher der Anschlag nicht durch einen Zapfen gebildet wird, son dern durch einen Anschlagkörper 26, der das Vorschube lement 13 hülsenförmig umgebend auf diesem längsver schieblich gelagert ist und dessen distale, dem Zwi schenwirbelimplantat zugewandte Stirnseite 27 einen die Eintauchtiefe begrenzenden Anschlag ausbildet. Der An schlagkörper 26 trägt eine Raste 28, die in die Zähne der Zahnstange 14 eingreift und somit den Anschlagkör per 26 in Verschieberichtung am Vorschubelement 13 in der gewünschten Position festlegt. Die Raste 28 kann durch in der Zeichnung nur schematisch dargestellte Be tätigungsmittel 29 so gelöst werden, daß der Anschlag körper 26 längs des Vorschubelementes 13 in eine andere Position verschoben wird, in der er dann durch Eingrei fen der Raste 28 in die Zahnstange 14 wieder festgelegt wird.In Fig. 11, a further preferred embodiment of a feed element 13 is shown, in which the stop is not formed by a pin, but son by a stop body 26 , the feed element 13 sleeve-shaped surrounding this is longitudinally displaceably mounted and its distal, the Intermediate vertebra implant face 27 forms a stop limiting the immersion depth. At the impact body 26 carries a detent 28 which engages in the teeth of the rack 14 and thus sets the stop body by 26 in the direction of displacement on the feed element 13 in the desired position. The detent 28 can be solved by actuation means 29 shown only schematically in the drawing so that the stop body 26 is moved along the feed element 13 to a different position, in which it is then fixed by engaging the detent 28 in the rack 14 again becomes.
Am Vorschubelement 13 können an dessen distalem Ende Befestigungsmittel vorgesehen werden, die es ermögli chen, das Vorschubelement 13 und das Zwischenwirbelim plantat 2 zugfest miteinander zu verbinden, so daß bei einem Zurückziehen des Vorschubelementes 13 eine das Zwischenwirbelimplantat 2 aus dem Zwischenwirbelraum 3 herausziehende Kraft auf das Zwischenwirbelimplantat 2 übertragen werden kann. At the feed element 13 attachment means may be provided at its distal end, which ermögli chen, the feed element 13 and the Zwischenwirbelim Plantat 2 tensile strength with each other to be connected, so that when the retraction of the feed element 13, the intervertebral implant 2 pull-out from the intervertebral space 3 force to the Intervertebral implant 2 can be transferred.
Das beschriebene Einsetzinstrument kann bei einer sol chen Ausgestaltung auch als Ausziehinstrument benutzt werden. Wenn nämlich das Vorschubelement 13 in der be schriebenen Weise zugfest mit dem Zwischenwirbelimplan tat 2 verbunden wird und wenn das Vorschubelement 13 gegenüber dem Arm 5 zurückgezogen wird, dann stützt sich der Arm 5 über die Zapfen 17, 18 an den Wirbelkör pern 4 ab und ermöglicht so das Aufbringen einer Zug kraft auf das Zwischenwirbelimplantat 2, durch welches dieses aus dem Zwischenwirbelraum 3 herausgezogen wer den kann.The insertion instrument described can also be used as a pull-out instrument in such a configuration. If namely the feed element 13 in the manner described be tensile to the intervertebral implant did 2 and if the feed element 13 is retracted relative to the arm 5 , then the arm 5 is supported by the pins 17 , 18 on the Wirbelkör 4 and allows so the application of a pull force on the intervertebral implant 2 , through which this is pulled out of the intervertebral space 3 who can.
Claims (21)
Priority Applications (2)
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DE10035182A DE10035182C2 (en) | 2000-07-20 | 2000-07-20 | Insertion tool for an intervertebral implant |
DE20012549U DE20012549U1 (en) | 2000-07-20 | 2000-07-20 | Insertion tool for an intervertebral implant |
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DE10035182A DE10035182C2 (en) | 2000-07-20 | 2000-07-20 | Insertion tool for an intervertebral implant |
DE20012549U DE20012549U1 (en) | 2000-07-20 | 2000-07-20 | Insertion tool for an intervertebral implant |
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DE10035182A1 true DE10035182A1 (en) | 2002-02-07 |
DE10035182C2 DE10035182C2 (en) | 2002-07-11 |
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DE20012549U Expired - Lifetime DE20012549U1 (en) | 2000-07-20 | 2000-07-20 | Insertion tool for an intervertebral implant |
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