MXPA04008099A - Implante intervertebral. - Google Patents
Implante intervertebral.Info
- Publication number
- MXPA04008099A MXPA04008099A MXPA04008099A MXPA04008099A MXPA04008099A MX PA04008099 A MXPA04008099 A MX PA04008099A MX PA04008099 A MXPA04008099 A MX PA04008099A MX PA04008099 A MXPA04008099 A MX PA04008099A MX PA04008099 A MXPA04008099 A MX PA04008099A
- Authority
- MX
- Mexico
- Prior art keywords
- intervertebral implant
- implant according
- perforations
- head
- longitudinal
- Prior art date
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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
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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
- A61F2/44—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
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/8052—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded
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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
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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
- A61F2/4455—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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- 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
- A61F2/44—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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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
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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
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
- A61F2002/30004—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis
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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
- 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
- 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
- A61F2002/30774—Apertures or holes, e.g. of circular cross section internally-threaded
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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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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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
- A61F2002/3079—Stepped or enlarged apertures, e.g. having discrete diameter changes
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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
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- A—HUMAN NECESSITIES
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- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
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- A—HUMAN NECESSITIES
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- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00005—The prosthesis being constructed from a particular material
- A61F2310/00011—Metals or alloys
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- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Neurology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- Heart & Thoracic Surgery (AREA)
- General Health & Medical Sciences (AREA)
- Cardiology (AREA)
- Vascular Medicine (AREA)
- Transplantation (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Prostheses (AREA)
Abstract
El invento es un implante intervertebral formado como un cuerpo tridimensional (10), que incluye: a) una cara superior (1) y una cara inferior (2) utilizado para su posicionamiento contra las placas terminales de dos cuerpos vertebrales adyacentes; b) una superficie lateral izquierda (3) y una superficie lateral derecha (4); c) una superficie frontal (5) y una superficie posterior (6); d) un plano central horizontal (7) localizado entre la cara superior (1) y la cara inferior (2); e) un plano central vertical (8) localizado entre la superficie lateral izquierda (3) y la superficie lateral derecha (4); y f) varias perforaciones (9) que penetran el cuerpo (10), las cuales reciben elementos de fijacion longitudinal (20) y los ejes (19) los cuales se intersecan con el plano central horizontal (7). Por lo menos una de dichas perforaciones (9) esta configurada de forma tal que un elemento de fijacion longitudinal (10) colocado en su interior pueda ser conectado de manera rigida al implante intervertebral. Este procedimiento se efectua efectivamente por medio de un tornillo o superficie coniforme correspondiente.
Description
IMPLANTE INTERVERTEBRAL DESCRIPCIÓN DE LA INVENCIÓN La presente invención se refiere a un implante intervertebral de acuerdo con el preámbulo de la reivindicación de patente 1. En el documento GB-A- 2 207 607 se revela un implante intervertebral de este tipo que presenta una configuración en forma de herradura con una pluralidad de orificios cilindricos. Los orificios tienen una terminación interior lisa y presentan meramente un tope para las cabezas de los tornillos osteológicos a ser introducidos en los mismos. Las desventajas de esta disposición consisten en el hecho que los tornillos de fijación introducidos en la misma pueden ser anclados en el hueso mediante sus vástagos solamente, sin que resulte una unión rígida con el implante intervertebral en forma de herradura. En cuanto se presenta un debilitamiento del anclado del vástago del tornillo en el hueso, el implante intervertebral adquiere la capacidad de moverse con respecto al tornillo, y existe el riesgo de una migración del tornillo osteológico, lo cual pone en peligro los vasos sanguíneos. Además, el aflojamiento del implante intervertebral puede ser causa de una seudoartrosis . La precedente exposición del estado actual de la técnica tiene por único objeto aclarar los alcances de la Invención y no implica que el estado actual mencionado de la técnica en momentos de la presentación de esta solicitud o su prioridad hayan sido de hecho publicados o sean públicamente conocidos. Y es aquí donde la invención pretende ofrecer una ayuda. La presente invención tiene por objeto crear un implante intervertebral que junto con los medios de fijación de los huesos puede asegurar una unión rígida de manera tal que también en el caso de un debilitamiento de la estructura ósea no se origine ningún aflojamiento entre el implante intervertebral y los medios de fijación osteológicos . La invención logra el objetivo planteado mediante un implante intervertebral que presenta las características de acuerdo con la reivindicación 1. Las ventajas logradas mediante la invención se deben esencialmente a la unión rígida, es decir, fija, entre el implante intervertebral y los elementos de fijación longitudinales. Esencialmente son posibles dos configuraciones distintas para implementar la unión rígida.
En una primera configuración, por lo menos una de las perforaciones presenta un roscado interior. En este caso, un tornillo osteológico correspondiente provisto con una cabeza roscada puede ser atornillado de manera rígida junto con el implante.
En una segunda configuración, en la cara anterior del cuerpo tridimensional se ha aplicado una placa frontal dispuesta verticalmente con respecto al plano medio horizontal del implante intervertebral, a través de la cual placa frontal pueden pasar las perforaciones y en la cual pueden ser anclados los elementos de fijación longitudinales. Frente a los implantes de dos partes del estado actual de la técnica, en el cual en un paso operativo especial se implanta una placa frontal, tiene esto la ventaja que la implantación del implante intervertebral puede ser llevada a cabo en un solo paso y con ello de una manera mas sencilla y rápida. Otra ventaja es la que se debe al hecho que con ello la fijación del implante intervertebral tiene lugar en todo lo posible frontalmente en el cuerpo de la vértebra, es decir, alLí donde por lo general se dispone de un buen material óseo. El resultado es una limitación anterior de los movimientos, sin que por ello se origine un mayor riesgo para las estructuras circundantes en comparación con el caso de un implante intervertebral de acuerdo con el estado actual de la técnica. Bajo compresión, la carga es todavía absorbida por el implante intervertebral y no por la placa frontal ni por los tornillos de fijación. En otra forma de realización más, la placa frontal en el cuerpo tridimensional está dispuesta de manera deslizable, de manera tal que puede desplazarse con respecto al cuerpo tridimensional en la dirección vertical. Con ello se logra un "stress shielding" (una protección o una neutralización de las tensiones mecánicas) , que permite una adaptación gradual de las placas terminales al implante intervertebral durante el proceso de la curación. En otra forma de realización, la placa frontal está hecha de un material distinto del cuerpo tridimensional. Y en otra forma de realización, por lo menos una de las perforaciones se ahusa en dirección del lado interior, en forma de cono, de manera tal que es posible anclar en ella rígidamente un , tornillo osteológico con su correspondiente cabeza cónica. La perforación cónica tiene preferentemente un ángulo cónico que es mas pequeño que el ángulo de fricción resultante. Es conveniente que la conicidad de la perforación cónica sea de 1:3,75 a 1. 20,00, preferentemente de 1:5 a 1: 15. En otra forma de realización, las áreas laterales del implante intervertebral están configuradas, esencialmente todas ellas, en forma convexa. Es conveniente que el lado superior y/o el lado inferior, del implante intervertebral, no tengan una configuración plana; es conveniente que tenga una configuración convexa. Con ello es posible lograr una mejor adaptación en las placas terminales de los cuerpos vertebrales adyacentes. Es preferible que las perforaciones no atraviesen las áreas laterales izquierda y derecha del implante intervertebral. También es ventajoso que el área anterior no sea atravesada por las perforaciones. En otra forma de realización preferida mas, por lo menos dos de las perforaciones se extienden paralelamente entre si. Con ello se facilita la introducción del implante intervertebral durante la implantación. En otra forma de realización preferida mas, por lo menos dos de las perforaciones se desarrollan divergentemente, visto desde el lado anterior. Con ello se llega con los tornillos osteológicos, a una zona del cuerpo de la vértebra que en comparación con su centro presenta una mejor calidad ósea. Es conveniente que los ejes de las perforaciones presenten con respecto al plano medio horizontal un ángulo en un intervalo de 25 a 70 grados, preferentemente de 35 a 55 grados. Con ello se logra una mejor accesibilidad durante la introducción del tornillo. Y en otra forma de realización más, el plano medio horizontal no es atravesado por las perforaciones. En función de cada caso puede haber dos, tres, cuatro, o mas, elementos de fijación longitudinales unidos de manera rígida con el implante intervertebral; es conveniente que haya por lo menos un elemento de fijación que atraviese el lado superior y por lo menos un elemento de fijación que atraviese el lado inferior del implante intervertebral. Es preferible utilizar elementos de fijación longitudinales con una cabeza y un vástago, estando la cabeza provista por ejemplo con un roscado exterior que se corresponda con el roscado interior de la perforación del implante intervertebral En un segundo tipo posible de unión rígida es utilizar por ejemplo un tornillo osteológico en el cual la cabeza se ahusa cónicamente en dirección del vástago, correspondiendo la conicidad de la cabeza del tornillo con la conicidad de la perforación del implante intervertebral . En otra forma de realización, por lo menos dos elementos de fijación longitudinales atraviesan el lado superior y por lo menos dos elementos de fijación longitudinal atraviesan el lado inferior. Con ello se confiere al implante intervertebral un anclado óptimo en los cuerpos vertebrales adyacentes. Los elementos de fijación longitudinales configurados como tornillos osteológicos presentan preferentemente un roscado exterior auto-taladrante y auto-cortante. Los elementos de fijación longitudinales también pueden estar configurados como varillas cilindricas sin rosca, provistas con una punta taladro, preferentemente en forma de un trocar. Otra variante es la que consiste en que los elementos de fijación longitudinales están configurados como resortes en espiral, y finalmente, los elementos de fijación longitudinales también pueden estar configurados como hojas o láminas en espiral de varias alas. En otra forma de realización, la punta del elemento de fijación longitudinal puede ser anclada en el cuerpo del implante intervertebral, de manera tal que la cabeza del elemento de fijación longitudinal puede ser anclado en el cuerpo de vértebra mas vecino. En otra forma de realización más, la cabeza del elemento de fijación longitudinal presenta un diámetro ensanchado y además se ha previsto adicionalmente un disco de apoyo para dicha cabeza, que está destinado a servir de apoyo en el cuerpo de la vértebra. El implante intervertebral puede ser manufacturado de cualquier material compatible con el organismo, pero es conveniente que su cuerpo consista en un material sintético compatible con el organismo, preferentemente un material sintético no reforzado. La ventaja con respecto a los materiales sintéticos reforzados con fibras ya conocidos en la implantología consiste en que no se desprenden fibras de refuerzo, lo cual sería clínicamente perjudicial. En un cuerpo de esta naturaleza, consistente en un material sintético no reforzado, es ventajoso utilizar tornillos cuya rosca exterior presente un ángulo en el flanco de carga en el intervalo de 11 a 14 grados, preferentemente de 12 a 13 grados. La inclinación, comparativamente reducida, del flanco de carga tiene como efecto una elevada fuerza de apriete, con lo cual se reduce la dilatación radial y el peligro de la formación de fisuras en el material sintético. Es conveniente que el roscado exterior del tornillo osteológico presente un ángulo de paso en el intervalo de 6 a 10 grados, preferentemente de 7 a 9 grados. Este ángulo de paso especial genera una auto-inhibición en el roscado y asegura con ello el tornillo osteológico contra un aflojamiento auto-generado. A efectos de mejorar el anclado del tornillo osteológico en el cuerpo de material sintético, puede la perforación consiste en un manguito metálico con un roscado interior. El implante intervertebral también puede consistir solamente en forma parcial en un material sintético - en la zona de las perforaciones - en un metal. De esta manera se logra en conjunto un mejor guiado y anclado del tornillo osteológico en el implante intervertebral . En otra forma de realización mas, pueden las perforaciones presentar una pared interior lisa, en la cual puede ser tallada o conformada la cabeza roscada de un elemento de fijación longitudinal metálico. La invención, y los desarrollos ulteriores de la misma, son seguidamente objeto de una mayor aclaración en base a la representación, parcialmente esquemática, de dos formas de realización. En los dibujos: La Figura 1 es una vista en perspectiva, con un corte parcial, de un implante intervertebral con tornillos osteológicos instalados; La Figura 2 es una vista anterior del implante intervertebral de acuerdo con la Figura 1; La Figura 3 es una vista lateral del implante intervertebral de acuerdo con la Figura 1; La Figura 4 es una vista superior del implante intervertebral de acuerdo con la Figura 3; La Figura 5 es una vista anterior del implante intervertebral con un inserto anterior, en una representación en corte parcial; La Figura 6 es una corte longitudinal vertical a través del implante intervertebral de acuerdo con la Figura
5; y La Figura 7 es un corte transversal horizontal a traces de un implante intervertebral de acuerdo con la Figura 5. El implante intervertebral representado en las Figuras 1 a 4 consiste en un cuerpo tridimensional 10 con un lado superior con un abombado convexo 1 y un lado inferior 3 también con un abombado convexo, que están destinados para el apoyo en las placas terminales de dos cuerpos vertebrales adyacentes. Para un mejor anclado pueden el lado superior 1 y el lado inferior 2 estar estructurados y presentar estrías, nervios o dientes, o también pueden simplemente presentar una superficie provista con cierta rugosidad. El cuerpo tridimensional presenta además un área lateral izquierda 3 y un área lateral derecha 4, como también una área anterior 5 y un área posterior 5. El cuerpo 10 también puede ser configurado hueco, y el área de su manto o envoltura puede estar provista con perforaciones. El cuerpo 10 está provisto con una pluralidad de perforaciones 9 que atraviesan el cuerpo 10, que son adecuadas para alojar los elementos de fijación longitudinales 20. Es preferible que haya cuatro de estas perforaciones 9. Los ejes 19 de las perforaciones 8 cortan el plano medio horizontal, que está dispuesto entre el lado superior 1 y el lado inferior 2. Por lo menos una de las perforaciones 9 está configurada de manera tal que un elemento de fijación longitudinal, 10, alojado en la misma, puede ser unido de manera rígida con el implante intervertebral . A tal efecto las perforaciones 9 están configuradas cónicamente. Los elementos de fijación 20 consisten preferentemente en tornillos osteológicos con una cabeza 21 y una punta 22. La cabeza 21 se ahusa cónicamente hacia el vástago 23, correspondiendo la conicidad de la cabeza a la conicidad de la perforación 9. Las cuatro perforaciones 9 pueden además presentar un roscado interior. En el caso de la variante de las Figuras 5 -7 posee el cuerpo tridimensional 10 en su área anterior 5 un inserto o suplemento 8 preferentemente metálico, en el cual puede ser anclado el elemento de fijación 20. En este caso, el inserto o suplemento 8 está dispuesto de manera de poder deslizarse verticalmente en el cuerpo tridimensional 10.
Claims (1)
12 R E I V I N D I C A C I O N E S 1. - Implante intervertebral en forma de un cuerpo tridimensional, con: a) .- un lado superior y un lado inferior, que son adecuados para el apoyo en las placas terminales de dos cuerpos vertebrales adyacentes; b) . - un área lateral izquierda y un área lateral derecha; c) .- un área anterior y un área posterior; d) . - un plano medio horizontal situado entre el lado superior y el área inferior; como también e) .- una pluralidad de perforaciones que atraviesan el cuerpo, que son adecuadas para alojar elementos de fijación longitudinales y cuyos ejes cortan el plano medio horizontal; siendo que f) .- por lo menos una de las perforaciones está configurada de manera tal que un elemento de fijación longitudinal alojado en la misma puede ser unido de manera rígida con el implante intervertebral , caracterizado porque g) un cuerpo tridimensional comprende en su cara frontal una placa frontal configurada como pieza suplementaria dispuesta verticalmente con respecto al plano central horizontal, a través de la cual pasan las perforaciones y en la cual se pueden anclar los elementos de fijación. 13 2. - Implante intervertebral de acuerdo con la reivindicación 2, caracterizado porque la placa frontal está dispuesta en el cuerpo tridimensional desplazable verticalmente con respecto al plano medio. 3.- Implante intervertebral de acuerdo con la reivindicación 2 ó 3, caracterizado porque la placa frontal está hecha de un material distinto del cuerpo tridimensional . 4. - Implante intervertebral de acuerdo con la reivindicación 3, caracterizado porque la placa frontal es metálica . 5. - Implante intervertebral de acuerdo con una cualquiera de las reivindicaciones 1 a 4, caracterizado porque por lo menos una de las perforaciones presenta un roscado interior. 6. - Implante intervertebral de acuerdo con una cualquiera de las reivindicaciones 1 a 5, caracterizado porque la por lo menos una perforación se ahusa cónicamente hacia el lado inferior. 7.- Implante intervertebral de acuerdo con la reivindicación 6, caracterizado porque la perforación cónica tiene un ángulo de conicidad, que es más pequeño que el ángulo de rozamiento resultante. 8. - Implante intervertebral de acuerdo con la reivindicación 7, caracterizado porque la conicidad de la 14 perforación cónica se halla en el intervalo de 1 :3,75 a 1: 20,00, preferiblemente en el intervalo de 1 :5 a 1 : 15. 9. - Implante intervertebral de acuerdo con una cualquiera de las reivindicaciones 1 a 8, caracterizado porque sus áreas laterales están configuradas, esencialmente todas ellas, en forma convexa. 10. - Implante intervertebral de acuerdo con una cualquiera de las reivindicaciones 1 a 9, caracterizado porque el lado superior y/o el lado inferior no es plano y está configurado preferentemente en forma convexa. 11. - Implante intervertebral de acuerdo con una cualquiera de las reivindicaciones 1 a 10, caracterizado porque las perforaciones no atraviesan el área lateral izquierda ni el área lateral derecha. 12.- Implante intervertebral de acuerdo con una cualquiera de las reivindicaciones 1 a 11, caracterizado porque las perforaciones no atraviesan el área anterior. 13. - Implante intervertebral de acuerdo con una cualquiera de las reivindicaciones l a 12, caracterizado porque por lo menos dos de las perforaciones se extienden paralelas entre si . 14. - Implante intervertebral de acuerdo con una cualquiera de las reivindicaciones 1 a 13, caracterizado porque por lo menos dos de las perforaciones, vistas desde el lado anterior, se extienden en forma divergente. 15 15. - Implante intervertebral de acuerdo con una cualquiera de las reivindicaciones 1 a 14 , caracterizado porque los ejes de las perforaciones con respecto al plano medio horizontal abarcan un ángulo en el intervalo de 25 a 70 grados, preferiblemente de 35 a 55 grados. 16. - Implante intervertebral de acuerdo con una cualquiera de las reivindicaciones 1 a 15, caracterizado porque las perforaciones no atraviesan el plano medio horizontal . 17.- Implante intervertebral de acuerdo con una cualquiera de las reivindicaciones 1 a 16, con por lo menos dos elementos de fijación longitudinales introducidos en las perforaciones con una cabeza y una punta, caracterizado porque por lo menos un elemento de fijación longitudinal atraviesa el lado superior y por lo menos un elemento de fijación longitudinal atraviesa el lado inferior. 18. - Implante intervertebral de acuerdo con la reivindicación 17, caracterizado porque los elementos de fijación longitudinales están configurados con una cabeza y con un vástago. 19. - Implante intervertebral de acuerdo con la reivindicación 18, caracterizado porque la cabeza está provista con un roscado exterior, que se corresponde al roscado interior de la perforación. 20.- Implante intervertebral de acuerdo con la reivindicación 18 ó 19, caracterizado porque la cabeza se ahusa cónicamente hacia el vástago, siendo preferible que la conicidad de la cabeza coincida con la conicidad de la perforación. 21.- Implante intervertebral de acuerdo con una cualquiera de las reivindicaciones 17 a 20, caracterizado porque que por lo menos dos elementos de fijación longitudinal atraviesan el lado superior y por lo menos dos elementos de fijación longitudinales atraviesan el lado inferior. 22. - Implante intervertebral de acuerdo con una cualquiera de las reivindicaciones 17 a 21, caracterizado porque los elementos de fijación longitudinales están configurados como tornillos osteológicos, cuyo vástago está provisto con un roscado exterior que es preferentemente autotaladrante y autocortante. 23. - Implante intervertebral de acuerdo con una cualquiera de las reivindicaciones 17 a 22, caracterizado porque los elementos de fijación longitudinales, están configurados como varillas cilindricas sin rosca con una punta taladro, preferentemente en forma de un trocar. 2 . - Implante intervertebral de acuerdo con una cualquiera de las reivindicaciones 17 a 22, caracterizado porque los elementos de fijación longitudinal están configurados como resortes en espiral. 25.- Implante intervertebral de acuerdo con una cualquiera de las reivindicaciones 17 a 22, caracterizado porque los elementos de fijación longitudinales están configurados en forma de paletas u hojas de varias alas. 26.- Implante intervertebral de acuerdo con una cualquiera de las reivindicaciones 17 a 25, caracterizado porque la punta del elemento de fijación longitudinal puede ser anclado en el cuerpo, de manera tal que la cabeza del elemento de fijación longitudinal puede ser anclado en el cuerpo vertebral adyacente. 27. - Implante intervertebral de acuerdo con la reivindicación 26, caracterizado porque la cabeza del elemento de fijación longitudinal presenta un diámetro ensanchado, y porque adicionalmente se ha previsto un inserto o suplemento para esta cabeza, que es adecuado para el apoyo en el cuerpo vertebral . 28. - Implante intervertebral de acuerdo con una cualquiera de las reivindicaciones 17 a 27, caracterizado porque el cuerpo es de un material sintético, preferentemente un material sintético no reforzado. 29. - Implante intervertebral de acuerdo con la reivindicación 28, caracterizado porque el roscado exterior del tornillo osteológico tiene un ángulo de flanco de carga en el intervalo de 11 a 14 grados, preferentemente de 12 a 13 grados. 30. - Implante intervertebral de acuerdo con una cualquiera de las reivindicaciones 17 a 29, caracterizado porque el roscado exterior de los tornillos osteológicos presenta un ángulo de paso en el intervalo de 6 a 10 grados, preferentemente de 7 a 9 grados. 31. - Implante intervertebral de acuerdo con una cualquiera de las reivindicaciones 1 a 30, caracterizado porque la perforación presenta un manguito metálico con un roscado interior. 32.- Implante intervertebral de acuerdo con una cualquiera de las reivindicaciones 1 a 31, caracterizado porque consiste parcialmente en material sintético y - en la zona de las perforaciones -, en metal. 33. - Implante intervertebral de acuerdo con una cualquiera de las reivindicaciones 28 a 32, caracterizado porque las perforaciones presentan una pared interior lisa, en la cual puede ser tallada o conformada la cabeza roscada de un elemento de fijación longitudinal metálico. 34. - Implante intervertebral de acuerdo con una cualquiera de las reivindicaciones 1 a 33, caracterizado porque su lado superior y lado inferior están provistos con una estructuración, preferentemente en forma de dientes. 35. - Implante intervertebral de acuerdo con una cualquiera de las reivindicaciones 1 a 34, caracterizado porque está configurado como cuerpo hueco el área de cuyo 19 manto o envoltura está preferentemente provisto con perforaciones .
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- 2002-02-19 WO PCT/CH2002/000099 patent/WO2003070128A1/de active IP Right Grant
- 2002-02-19 CN CNB028282159A patent/CN100400014C/zh not_active Expired - Lifetime
- 2002-02-19 EP EP02710746A patent/EP1476098B1/de not_active Expired - Lifetime
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2004
- 2004-08-19 US US10/923,534 patent/US7232464B2/en not_active Expired - Lifetime
- 2004-09-17 NO NO20043905A patent/NO20043905L/no unknown
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2007
- 2007-05-22 US US11/751,757 patent/US7618456B2/en not_active Expired - Lifetime
-
2009
- 2009-10-06 US US12/574,222 patent/US7875076B2/en not_active Expired - Fee Related
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2011
- 2011-01-24 US US13/012,626 patent/US20110118843A1/en not_active Abandoned
- 2011-10-28 US US13/284,747 patent/US9572681B2/en not_active Expired - Lifetime
- 2011-10-28 US US13/284,731 patent/US20120109310A1/en not_active Abandoned
- 2011-10-28 US US13/284,726 patent/US20120109309A1/en not_active Abandoned
- 2011-10-28 US US13/284,742 patent/US20120101581A1/en not_active Abandoned
- 2011-10-28 US US13/284,762 patent/US20120109313A1/en not_active Abandoned
- 2011-10-28 US US13/284,755 patent/US20120109312A1/en not_active Abandoned
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2017
- 2017-01-09 US US15/401,713 patent/US10492922B2/en not_active Expired - Lifetime
-
2019
- 2019-11-04 US US16/672,620 patent/US20200060844A1/en active Pending
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