FR3087334A1 - INTEROSSEUS CAGE - Google Patents
INTEROSSEUS CAGE Download PDFInfo
- Publication number
- FR3087334A1 FR3087334A1 FR1871205A FR1871205A FR3087334A1 FR 3087334 A1 FR3087334 A1 FR 3087334A1 FR 1871205 A FR1871205 A FR 1871205A FR 1871205 A FR1871205 A FR 1871205A FR 3087334 A1 FR3087334 A1 FR 3087334A1
- Authority
- FR
- France
- Prior art keywords
- insert
- cavity
- section
- cage according
- portions
- 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
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- 210000000988 bone and bone Anatomy 0.000 claims description 25
- 239000000463 material Substances 0.000 claims description 13
- 239000007787 solid Substances 0.000 claims description 5
- 238000004873 anchoring Methods 0.000 claims description 3
- 239000000316 bone substitute Substances 0.000 claims description 3
- 239000004696 Poly ether ether ketone Substances 0.000 description 6
- 229920002530 polyetherether ketone Polymers 0.000 description 6
- RTAQQCXQSZGOHL-UHFFFAOYSA-N Titanium Chemical compound [Ti] RTAQQCXQSZGOHL-UHFFFAOYSA-N 0.000 description 4
- 230000004927 fusion Effects 0.000 description 4
- 239000010936 titanium Substances 0.000 description 4
- 229910052719 titanium Inorganic materials 0.000 description 4
- 229910052751 metal Inorganic materials 0.000 description 2
- 239000002184 metal Substances 0.000 description 2
- 230000001225 therapeutic effect Effects 0.000 description 2
- 239000006096 absorbing agent Substances 0.000 description 1
- 230000008468 bone growth Effects 0.000 description 1
- 230000001788 irregular Effects 0.000 description 1
- 230000000399 orthopedic effect Effects 0.000 description 1
- 230000001737 promoting effect Effects 0.000 description 1
- 230000035939 shock Effects 0.000 description 1
- 239000002689 soil Substances 0.000 description 1
- 239000011343 solid material Substances 0.000 description 1
- 125000006850 spacer group Chemical group 0.000 description 1
Classifications
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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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- A61F2/30—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
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- 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
- A61F2/447—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 substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section
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- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
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- A61F2002/4495—Joints for the spine, e.g. vertebrae, spinal discs having a fabric structure, e.g. made from wires or fibres
Landscapes
- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Neurology (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
Description
Description Titre de l'invention : Cage interosseuse Domaine technique Description Title of the invention: Interosseous cage Technical field
[0001] La présente invention concerne les cages interosseuses, à savoir les cages aptes à être implantées entre deux portions d'os en vue de favoriser leur sol idarisation de façon ferme par ostéosynthèse, qui trouvent des applications particulièrement avantageuses, mais non exclusivement, comme cages intervertébrales. The present invention relates to interosseous cages, namely cages capable of being implanted between two portions of bone in order to promote their soil idarization firmly by osteosynthesis, which find particularly advantageous applications, but not exclusively, such as intervertebral cages.
[0002] On connaît déjà de nombreuses cages interosseuses de ce type.Many interosseous cages of this type are already known.
Elles sont essen- tiellement composées d'un corps solide, par exemple en métal, comportant une cavité traversante dans laquelle est placé un greffon osseux ou substitut osseux qui permet dc favoriser la croissance osseuse et donc la liaison entre les deux portions d'os par ostéosynthèse. They are essentially composed of a solid body, for example of metal, comprising a through cavity in which is placed a bone graft or bone substitute which makes it possible to promote bone growth and therefore the connection between the two portions of bone by osteosynthesis.
[0003] 11 existe aussi des cages interosseuses dans lesquelles le corps solide est en un matériau moins solide que le métal, par exemple comme celui qui est connu par les hommes dc l'art sous la dénomination PEEK (polyétheréthercétone).[0003] There are also interosseous cages in which the solid body is made of a material which is less solid than the metal, for example such as that which is known to those in the art under the name PEEK (polyetheretherketone).
Unc telle cage donne de bons résultats sur le plan thérapeutique orthopédique, mais peut présenter des inconvénients quand elle est intercalée entre deux portions d'os et qu'il se produit par exemple une fusion trop tardive entre ces deux portions d'os qui peuvent être soumises à des forces dc pression relativement importante.Such a cage gives good results on the orthopedic therapeutic plan, but can present drawbacks when it is interposed between two portions of bone and there occurs for example a too late fusion between these two portions of bone which may be. subjected to relatively large pressure forces.
Tel est le cas qui peut se produire sur une cage intercalée entre deux vertèbres pour remplacer un disque intervertébral endommagé de la colonne vertébrale d'un Patient qui est encore relativement jeune et fort physiquement. Such is the case that can occur on a cage sandwiched between two vertebrae to replace a damaged intervertebral disc in the spine of a Patient who is still relatively young and physically strong.
[0004] En effet, le PEEK, défini ci-dessus, est un matériau qui a la particularité de pouvoir fusionner plus ou moins vite avec un milieu osseux, mais qui n'est pas assez solide pour résister à des efforts de pression importants. [0004] In fact, PEEK, defined above, is a material which has the particularity of being able to merge more or less quickly with a bone medium, but which is not strong enough to withstand significant pressure forces.
[0005] La cage peut dans ce cas ne pas être fixée parfaitement et peut même parfois s'enfoncer au moins partiellement dans l'os et ne plus jouer son rôle de cale, c'est-à-dire d'entretoise, pour maintenir les deux portions d'os à la bonne distance souhaitée par le Praticien. [0005] In this case, the cage may not be fixed perfectly and may even sometimes sink at least partially into the bone and no longer play its role of a wedge, that is to say a spacer, to maintain the two bone portions at the correct distance desired by the Practitioner.
[0006] Aussi, la présente invention a-t-elle pour but de réaliser une cage interosseuse qui, bien que présentant une structure simple et peu onéreuse tout en favorisant le travail des Praticiens qui opèrent, pallie les inconvénients mentionnés ci-dessus des cages similaires de l'art antérieur, notamment en maintenant parfaitement les deux portions d'os, par exemple deux vertèbres, à la bonne distance souhaitée, en évitant ainsi au patient de souffrir, par exemple, d'un affaissement de ces deux vertèbres.[0006] Also, the present invention aims to achieve an interosseous cage which, although having a simple and inexpensive structure while promoting the work of practitioners who operate, overcomes the aforementioned drawbacks of cages similar to the prior art, in particular by keeping the two bone portions, for example two vertebrae, perfectly at the desired distance, thus preventing the patient from suffering, for example, from a collapse of these two vertebrae.
Définition de l'invention Definition of invention
[0007] Plus précisément, la présente invention a pour objet une cage interosseuse apte à être I intercalée entre deux portions d'os en vue de leur réunion par ostéosynthèse, comportant au moins : - un corps délimité par deux faces opposées définies dans deux plans sensiblement parallèles entre eux, - une cavité traversante réalisée dans le corps et débouchant sur les deux faces opposées du dit corps, et - un insert défini entre deux faces d'extrémités et ayant. une section transversale au plus égale à la section transversale de ladite cavité traversante définie dans un plan sensiblement parallèle aux faces opposées du corps, de façon que ledit insert soit apte à glisser dans la cavité, caractérisée par le fait que ledit insert est constitué d'au moins deux portions d'insert et. qu'elle comporte en outre des moyens pour commander les déplacements des deux portions d'insert l'une par rapport à l'autre selon une direction sensiblement. perpendiculaire aux deux faces opposées.[0007] More specifically, the present invention relates to an interosseous cage capable of being interposed between two portions of bone with a view to their joining by osteosynthesis, comprising at least: - a body delimited by two opposite faces defined in two planes substantially parallel to each other, - a through cavity made in the body and opening onto the two opposite faces of said body, and - an insert defined between two end faces and having. a cross section at most equal to the cross section of said through cavity defined in a plane substantially parallel to the opposite faces of the body, so that said insert is able to slide in the cavity, characterized in that said insert consists of at least two insert portions and. that it further comprises means for controlling the movements of the two insert portions relative to each other in a substantially direction. perpendicular to the two opposite faces.
Brève description des dessins Brief description of the drawings
[0008] D'autres caractéristiques et avantages de la présente invention apparaîtront au cours de la description suivante donnée en regard des dessins annexés à titre illustratif, mais nullement limitatif, dans lesquels : - Les figures 1 et 2 représentent deux vues en coupe d'un mode de réalisation très schématisé d'une cage interosseuse selon l'invention, la figure 2 étant une coupe référencée 1-1 sur la figure 2, et la figure 2 une coupe référencée 11-11 sur la figure 1, et - La figure 3 représente, vu en coupe et sous une forme très schématique, un autre mode de réalisation d'une cage interosseuse selon l'invention. [0008] Other characteristics and advantages of the present invention will become apparent from the following description given with reference to the accompanying drawings for illustrative purposes, but in no way limiting, in which: - Figures 1 and 2 show two sectional views of a very diagrammatic embodiment of an interosseous cage according to the invention, FIG. 2 being a section referenced 1-1 in FIG. 2, and FIG. 2 a section referenced 11-11 in FIG. 1, and - FIG. 3 shows, seen in section and in very schematic form, another embodiment of an interosseous cage according to the invention.
[0009] 11 est tout d'abord précisé que les figures représentent deux modes de réalisation de l'objet selon l'invention, mais qu'il peut en exister d'autres qui répondent à la définition de cette invention. [0009] It is first of all specified that the figures represent two embodiments of the object according to the invention, but that there may be others which meet the definition of this invention.
[0010] 11 est en outre précisé que, lorsque, selon la définition de l'invention, l'objet de l'invention comporte "au moins un" élément ayant une fonction donnée, le mode de réalisation décrit peut comporter plusieurs de ces éléments.[0010] It is also specified that, when, according to the definition of the invention, the object of the invention comprises "at least one" element having a given function, the embodiment described may include several of these elements. .
Réciproquement, si le mode de réalisation de l'objet selon l'invention tel qu'illustré comporte plusieurs éléments de fonction identique et si, dans la description, il n'est pas spécifié que l'objet selon cette invention doit obligatoirement comporter un nombre particulier de ces éléments, l'objet de l'invention pourra être défini comme comportant "au moins un" de ces éléments. Conversely, if the embodiment of the object according to the invention as illustrated comprises several elements of identical function and if, in the description, it is not specified that the object according to this invention must necessarily include a number particular of these elements, the object of the invention may be defined as comprising "at least one" of these elements.
[0011] Il est précisé que lorsque, dans la présente description, une expression définit à elle seule, sans mention particulière spécifique la concernant, un ensemble de caractéristiques structurelles, ces caractéristiques peuvent être prises, pour la définition de 3 l'objet de la protection demandée, quand cela est techniquement possible, soit séparément, soit en combinaison totale et/ou partielle. It is specified that when, in the present description, an expression defines on its own, without specific specific mention concerning it, a set of structural characteristics, these characteristics can be taken, for the definition of the object of the protection requested, when technically possible, either separately or in total and / or partial combination.
[0012] Il est de plus précisé que, dans la présente description, si l'adverbe "sensiblement" est associé à un qualificatif d'un moyen donné, ce qualificatif doit être compris au sens strict ou approché. It is further specified that, in the present description, if the adverb "substantially" is associated with a qualifier of a given means, this qualifier must be understood in the strict or approximate sense.
[0013] Il est enfin précisé que, au sens de la présente invention, par « matériau solide », il faut entendre un matériau qui présente une structure, une qualité qui lui permettent de bien résister à l'usure et/ou aux risques de bris et/ou de déchirure et/ou de rupture, etc. sous l'action de forces de pression d'une intensité donnée. [0013] It is finally specified that, within the meaning of the present invention, by "solid material" is meant a material which has a structure, a quality which allow it to withstand wear and / or the risks of breakage and / or tear and / or breakage, etc. under the action of pressure forces of a given intensity.
[0014] C'est ainsi que, pour la définition de la présente invention, il pourra être fait mention, dans la description et dans les revendications annexées, d'au moins un couple de matériau dont l'un est plus solide que l'autre selon la définition ci-dessus.Thus, for the definition of the present invention, mention may be made, in the description and in the appended claims, of at least one pair of material, one of which is more solid than the other as defined above.
Description d'un mode de réalisation préféré de l'objet de l'invention. Description of a preferred embodiment of the object of the invention.
[0015] En référence aux figures 1 et 2 annexées, la présente invention concerne un mode de réalisation possible d'une cage interosseuse apte à être intercalée entre deux portions d'os 01, 02 en vue de leur réunion notamment par ostéosynthèse. Referring to Figures 1 and 2 attached, the present invention relates to a possible embodiment of an interosseous cage capable of being interposed between two portions of bone 01, 02 for their reunion, in particular by osteosynthesis.
[0016] La cage comporte au moins un corps 10 délimité par deux faces opposées 11, 12, une cavité traversante 20 réalisée dans ce corps 10 et débouchant sur les deux faces opposées 11, 12, et un insert 30 défini entre deux faces d'extrémités 31, 32 et ayant une section transversale au plus égale à la section transversale de la cavité traversante 20 définie dans un plan sensiblement parallèle aux faces opposées 11, 12 du corps 10, de façon que l'insert 30 soit apte à glisser dans cette cavité. The cage comprises at least one body 10 delimited by two opposite faces 11, 12, a through cavity 20 made in this body 10 and opening onto the two opposite faces 11, 12, and an insert 30 defined between two faces of ends 31, 32 and having a cross section at most equal to the cross section of the through cavity 20 defined in a plane substantially parallel to the opposite faces 11, 12 of the body 10, so that the insert 30 is able to slide in this cavity.
[0017] Il est précisé que l'insert et la cavité traversante peuvent ne pas être strictement cy- lindriques, par exemple présenter une très légère conicité.[0017] It is specified that the insert and the through cavity may not be strictly cylindrical, for example have a very slight taper.
Cependant, dans ce dernier cas, au sens de la présente description, ils doivent être assimilés à des pièces cylindriques, ou sensiblement cylindriques, de façon que l'insert 30 soit apte à glisser ou coulisser dans la cavité sur au moins une certaine distance. However, in the latter case, within the meaning of the present description, they should be likened to cylindrical or substantially cylindrical parts, so that the insert 30 is able to slide or slide in the cavity over at least a certain distance.
[0018] Selon une première caractéristique essentielle de l'invention, figures 1 à 3, l'insert 30 est constitué d'au moins deux portions d'insert 30-1, 30-2. According to a first essential characteristic of the invention, Figures 1 to 3, the insert 30 consists of at least two insert portions 30-1, 30-2.
[0019] La cage comporte en outre des moyens 50 pour commander les déplacements de ces deux portions d'insert l'une par rapport à l'autre selon une direction sensiblement perpendiculaire aux deux faces opposées 11, 12, essentiellement pour pouvoir les éloigner l'une de l'autre, mais avantageusement aussi pour pouvoir, après les avoir éloignées, les rapprocher l'une de l'autre.The cage further comprises means 50 for controlling the movements of these two insert portions relative to each other in a direction substantially perpendicular to the two opposite faces 11, 12, essentially to be able to move them away. 'one from the other, but advantageously also to be able, after having moved them away, to bring them closer to one another.
Un exemple de ces moyens qui permettent de réaliser ces deux fonctions sera décrit ci-après, plus particulièrement en regard de la figure 3. An example of these means which make it possible to perform these two functions will be described below, more particularly with reference to FIG. 3.
[0020] Les moyens pour commander les déplacements des deux portions d'insert 30-1, 30-2 l'une par rapport à l'autre sont constitués par au moins l'un des éléments suivants : came, came 300 à section transversale de forme ovoïde, crémaillère, vérin, vissage 4 entre au moins une des portions d'insert et la paroi de la cavité, une combinaison d'au moins deux de ces éléments. The means for controlling the movements of the two insert portions 30-1, 30-2 relative to each other consist of at least one of the following elements: cam, cam 300 with cross section of ovoid shape, rack, jack, screwing 4 between at least one of the insert portions and the wall of the cavity, a combination of at least two of these elements.
[0021] La cage comporte en outre des moyens associés à ces éléments pour les commander en fonction de leur structure.The cage further comprises means associated with these elements to control them according to their structure.
Par exemple : dans le cas d'une came, les moyens pour la commander en rotation peuvent être constitués, comme illustré sur les figures, par un arbre apte à être pivoté par rapport au corps 10, à partir de l'extérieur à la cage. For example: in the case of a cam, the means for controlling it in rotation can be constituted, as illustrated in the figures, by a shaft capable of being pivoted with respect to the body 10, from outside the cage .
[0022] Selon un mode de réalisation possible, plus particulièrement dans le cas de la réa- lisation selon les figures 1 et 2, le corps 10 est réalisé en un premier matériau ayant une solidité donnée et l'insert est réalisé dans un second matériau plus solide que le premier matériau. [0022] According to one possible embodiment, more particularly in the case of the embodiment according to FIGS. 1 and 2, the body 10 is made of a first material having a given strength and the insert is made of a second material. stronger than the first material.
[0023] Selon un autre mode de réalisation possible, l'insert 30 présente une structure poreuse, avantageusement une structure poreuse en nid d'abeille. According to another possible embodiment, the insert 30 has a porous structure, advantageously a porous honeycomb structure.
[0024] Selon un autre mode de réalisation possible, la section transversale des portions d'insert 30-1, 30-2 est inférieure à la section transversale de la cavité 20 de façon à laisser, entre elles et la paroi de la cavité, au moins un espace 40 déterminé pour leur permettre de glisser par rapport au corps selon une direction parallèle aux deux faces opposées 11, 12, du corps 10 pour par exemple casser les liens de fusion osseuse (trahéculaires) afin de libérer la cage de cette fusion osseuse, lors d'une éventuelle révision de la cage, s'il en était besoin. According to another possible embodiment, the cross section of the insert portions 30-1, 30-2 is less than the cross section of the cavity 20 so as to leave, between them and the wall of the cavity, at least one space 40 determined to allow them to slide relative to the body in a direction parallel to the two opposite faces 11, 12, of the body 10 for example to break the bone fusion links (trahecular) in order to free the cage from this fusion bone, during a possible revision of the cage, if necessary.
[0025] Ces espaces 40 peuvent aussi recevoir au moins l'un des éléments suivants : une lame d'ancrage 41 (figures 1 et 2), un greffon osseux, un substitut osseux, une combinaison d'au moins deux de ces éléments.These spaces 40 can also receive at least one of the following elements: an anchoring blade 41 (Figures 1 and 2), a bone graft, a bone substitute, a combination of at least two of these elements.
Tous ces éléments mentionnés ci-dessus sont bien connus en eux-mêmes. All of these elements mentioned above are well known in themselves.
[0026] Dans une réalisation avantageuse, le premier matériau est du PEEK et le second matériau est choisi parmi les produits suivants : titane, titane maillé, titane poreux, titane trabercularTM, une combinaison d'au moins deux de ces produits. In an advantageous embodiment, the first material is PEEK and the second material is chosen from the following products: titanium, mesh titanium, porous titanium, trabercularTM titanium, a combination of at least two of these products.
[0027] Dans les modes de réalisation décrits ci-dessus, les deux portions d'insert sont illustrées pour être aptes à être entièrement contenues dans la cavité 20 quand elles sont les plus proches l'une de l'autre de façon que, dans cette position, leurs faces d'extrémité les plus éloignées 31, 32 puissent être respectivement dans le plan des deux faces opposées 11, 12 du corps 10, et même dans certains cas légèrement en retrait. In the embodiments described above, the two insert portions are illustrated to be able to be entirely contained in the cavity 20 when they are closest to one another so that, in In this position, their most distant end faces 31, 32 can be respectively in the plane of the two opposite faces 11, 12 of the body 10, and even in some cases slightly recessed.
[0028] Le mode de réalisation de la cage interosseuse selon l'invention illustré sur la figure 3 peut, dans certains cas, être avantageux. The embodiment of the interosseous cage according to the invention illustrated in Figure 3 may, in some cases, be advantageous.
[0029] Dans ce mode de réalisation, la cage comporte toutes les caractéristiques définies en regard des figures 1 et 2, et en plus au moins une tête 36, 37 solidaire d'une des deux portions d'insert 30-1, 30-2. In this embodiment, the cage has all the characteristics defined with reference to Figures 1 and 2, and in addition at least one head 36, 37 integral with one of the two insert portions 30-1, 30- 2.
[0030] Cette tête 36, 37 peut présenter différentes structures.This head 36, 37 can have different structures.
Une première structure est celle par exemple de moyens d'ancrage de la portion d'insert avec l'os, par exemple une lame, des picots ou analogue. A first structure is that, for example, of means for anchoring the insert portion with the bone, for example a blade, pins or the like.
[0031] Selon un autre mode de réalisation, comme illustré sur la figure 3, la au moins une tête 36, 37 présente la structure d'une plaque d'appui de façon que cette plaque d'appui et la portion d'insert dont elle est solidaire forment ensemble un élément présentant une forme sensiblement en T, la barre verticale du T correspondant à la portion d'insert et la barre horizontale du T correspondant à la tête, la section de cette tête, définie dans un plan sensiblement parallèle à la face d'extrémité 11, 12 du corps 10 en regard de cette tête, étant supérieure à la section transversale de la cavité traversante définie dans ce même plan. According to another embodiment, as illustrated in Figure 3, the at least one head 36, 37 has the structure of a support plate so that this support plate and the insert portion of which it is integral together form an element having a shape substantially T, the vertical bar of the T corresponding to the insert portion and the horizontal bar of the T corresponding to the head, the section of this head, defined in a plane substantially parallel to the end face 11, 12 of the body 10 facing this head, being greater than the cross section of the through cavity defined in this same plane.
[0032] Sur la figure 3, la cage est représentée avec deux têtes respectivement solidaires des deux portions d'insert 30-1, 30-2.In Figure 3, the cage is shown with two heads respectively secured to the two insert portions 30-1, 30-2.
Mais, comme défini ci-dessus, il peut être très avantageux qu'elle n'en comporte qu'une, de façon que le corps 10 vienne, par une de ses faces opposées 11, 12, directement au contact de l'un des deux os 01, 02, comme cela est possible dans le cas de la réalisation selon les figures 1 et 2.But, as defined above, it can be very advantageous for it to include only one, so that the body 10 comes, through one of its opposite faces 11, 12, directly in contact with one of the two bones 01, 02, as is possible in the case of the embodiment according to Figures 1 and 2.
Bien que, dans le cas de la réalisation selon les figures 1 et 2, les deux faces opposées 11, 12 du corps 10 peuvent venir respectivement au contact des deux 01, 02. Although, in the case of the embodiment according to Figures 1 and 2, the two opposite faces 11, 12 of the body 10 may come into contact with the two 01, 02 respectively.
[0033] Selon une réalisation préférentielle, la tête 36, 37 et la portion d'insert 30-1, 30-2 dont elle est solidaire sont réalisées d'une seule pièce. According to a preferred embodiment, the head 36, 37 and the insert portion 30-1, 30-2 which it is integral with are made in one piece.
[0034] Dans le cas évoqué ci-dessus, le corps 10 peut donc être réalisé avantageusement avec un matériau comme du PEEK, exactement de la même façon que selon les modes de réalisation illustrés sur les figures 1 et 2, pour favoriser l'ostéosynthèse. In the case mentioned above, the body 10 can therefore be made advantageously with a material such as PEEK, exactly in the same way as according to the embodiments illustrated in Figures 1 and 2, to promote osteosynthesis .
[0035] Il a été mentionné auparavant que la cage interosseuse selon l'invention comporte des moyens 50 pour commander les déplacements des deux portions d'insert 30-1, 30-2 l'une par rapport à l'autre selon une direction sensiblement perpendiculaire aux deux faces opposées 11, 12 du corps 10, essentiellement pour pouvoir les éloigner l'une de l'autre, mais aussi pour pouvoir, après les avoir éloignées, les rapprocher, pour des nécessités thérapeutiques voulues par le Praticien. It was mentioned before that the interosseous cage according to the invention comprises means 50 for controlling the movements of the two insert portions 30-1, 30-2 relative to each other in a substantially direction perpendicular to the two opposite faces 11, 12 of the body 10, essentially to be able to move them away from one another, but also to be able, after having moved them away, to bring them together, for therapeutic needs desired by the practitioner.
[0036] Ces moyens comme mentionnés ci-avant sont constitués par une came 300 à section transversale de forme ovoïde.These means as mentioned above are constituted by a cam 300 with a cross section of ovoid shape.
Une telle came permet d'éloigner les deux portions 30-1 et 30-2 l'une de l'autre, mais pas de les rapprocher. Such a cam makes it possible to move the two portions 30-1 and 30-2 away from one another, but not to bring them together.
[0037] En conséquence, un autre mode de réalisation de ces moyens pour rapprocher les deux portions d'insert l'une de l'autre est illustré sur la figure 3.[0037] Consequently, another embodiment of these means for bringing the two insert portions closer to one another is illustrated in FIG. 3.
Ces moyens comportent, dans ce mode de réalisation, au moins un crochet 301, 302 monté solidaire sur la came 300, et une goupille 303, 304 montée par exemple dans un logement en creux réalisé dans la portion d'insert qui doit pouvoir être éloignée ou rapprochée de l'autre portion d'insert, par exemple la portion 30-1, de façon que, lors de la rotation de la came 300 dans le sens senestrorsum, le crochet 301 s'éloigne de façon relative de la 6 goupille 303 (ou monte avec elle) et la came 300 permet donc de faire monter cette portion 30-1 vers le haut par référence à cette figure 3.These means comprise, in this embodiment, at least one hook 301, 302 mounted integrally on the cam 300, and a pin 303, 304 mounted for example in a recessed housing made in the insert portion which must be able to be removed. or brought closer to the other insert portion, for example the portion 30-1, so that, during the rotation of the cam 300 in the senestorsum direction, the hook 301 moves away relatively from the pin 303 (or rises with it) and the cam 300 therefore makes it possible to raise this portion 30-1 upwards with reference to this figure 3.
En revanche, en faisant tourner la came 300 dans le sens opposé, à savoir dans le sens dextrorsum, le crochet revient au contact de la gouille 303 et fait redescendre ccttc même portion d'insert vers le bas, toujours par référence à la figure 3. On the other hand, by rotating the cam 300 in the opposite direction, namely in the dextrorsum direction, the hook comes back into contact with the pin 303 and causes the same portion of the insert to descend downwards, again with reference to FIG. 3 .
[0038] Ainsi avec ces moyens 50, 300, 301, 302, 303 et 304 il est possible de déplacer les deux portions d'insert l'une par rapport à l'autre, pour les éloigner dans le but par exemple de réaliser une distraction entre les deux os 01, 02, niais aussi pour les rapprocher, à n'importe quel moment décidé par le Praticien, par exemple pour repositionner cette cage en la dégagent partiellement des deux os et, après l'avoir repositionnée, pour effectuer une nouvelle distraction qui réponde mieux aux souhaits du Praticien. Thus with these means 50, 300, 301, 302, 303 and 304 it is possible to move the two insert portions relative to each other, to move them away with the aim for example of achieving a distraction between the two bones 01, 02, but also to bring them closer, at any time decided by the practitioner, for example to reposition this cage by partially disengaging it from the two bones and, after having repositioned it, to perform a new distraction that better meets the wishes of the Practitioner.
[0039] Il est enfin précisé que d'autres moyens peuvent être associés à au moins l'une des deux portions d'insert 30-1, 30-2, parfois avantageusement aux deux, par exemple des cliquets pour les monter en coopération plus étroite avec le corps, le bruit que peuvent faire les cliquets permettant en outre d'indiquer au Praticien que la cage est en position.Finally, it is specified that other means can be associated with at least one of the two insert portions 30-1, 30-2, sometimes advantageously both, for example pawls to mount them in cooperation more close with the body, the noise that the pawls can make also allow the practitioner to indicate that the cage is in position.
Il est aussi possible de donner aux portions d'insert d'autres formes que celles illustrées.It is also possible to give the insert portions other shapes than those illustrated.
Ces portions d'insert peuvent comporter par exemple des moyens équivalents à des amortisseurs de tous types pour notamment s'adapter à la forme irrégulière des os 01 et/ou 02 ou absorber des contraintes trop élevées qui seraient appliquées aux deux os 01, 02, ce qui peut être possible dans le cas où ces deux os sont des vertèbres. These insert portions may for example comprise means equivalent to shock absorbers of all types in order in particular to adapt to the irregular shape of the bones 01 and / or 02 or to absorb excessively high stresses which would be applied to the two bones 01, 02, which may be possible in the case where these two bones are vertebrae.
[0040] A la lecture de la description ci-dessus, il apparaît clairement que la cage selon l'invention comportant un insert tel que décrit permet de respecter et maintenir la distance entre deux os voulue par le Praticien, même au cours de la fusion du PEEK avec au moins l'un des deux os.On reading the above description, it is clear that the cage according to the invention comprising an insert as described makes it possible to respect and maintain the distance between two bones desired by the practitioner, even during the fusion PEEK with at least one of the two bones.
7 [Revendication 1] [Revendication 2] [Revendication 3] [Revendication 4] [Revendication 5] [Revendication 6]7 [Claim 1] [Claim 2] [Claim 3] [Claim 4] [Claim 5] [Claim 6]
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US20140236296A1 (en) * | 2013-02-20 | 2014-08-21 | Erik Wagner | Expandable fusion device for positioning between adjacent vertebral bodies |
FR3006168A1 (en) * | 2013-06-03 | 2014-12-05 | Hassan Razian | BONE SEAL DISTRATENT |
US20150100124A1 (en) * | 2013-10-03 | 2015-04-09 | Amendia, Inc. | Expandable spinal implant |
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FR3087334B1 (en) | 2021-11-05 |
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