WO2009041923A1 - Plaque dynamique pour la région occipito-cervicale - Google Patents

Plaque dynamique pour la région occipito-cervicale Download PDF

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Publication number
WO2009041923A1
WO2009041923A1 PCT/TR2007/000099 TR2007000099W WO2009041923A1 WO 2009041923 A1 WO2009041923 A1 WO 2009041923A1 TR 2007000099 W TR2007000099 W TR 2007000099W WO 2009041923 A1 WO2009041923 A1 WO 2009041923A1
Authority
WO
WIPO (PCT)
Prior art keywords
plaque
occipital
mentioned
rods
region
Prior art date
Application number
PCT/TR2007/000099
Other languages
English (en)
Inventor
Ugur Tabuktekin
Y. Sukru Caglar
Original Assignee
Medikon Medikal Malzemeler Dagitim Ve Pazarlama Limited Sirketi
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Medikon Medikal Malzemeler Dagitim Ve Pazarlama Limited Sirketi filed Critical Medikon Medikal Malzemeler Dagitim Ve Pazarlama Limited Sirketi
Priority to PCT/TR2007/000099 priority Critical patent/WO2009041923A1/fr
Publication of WO2009041923A1 publication Critical patent/WO2009041923A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7055—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant connected to sacrum, pelvis or skull
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7049—Connectors, not bearing on the vertebrae, for linking longitudinal elements together
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8061—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones

Definitions

  • Our invention involves the dynamic plaques which have been developed to use in the posterior ' dynamic * stabilization operations, starting from occiput down to C1-2-3 and more in cervical spine surgeries.
  • the invention involves particularly occipito cervical dynamic plaques which are used by fixing to a construction of pedicle screws, rods, and/or transverse connectors in the posterior cervical system, in order to maintaining the ability of motion, not to stop losing the ability of motion by using fusion instead in the occiput region.
  • a method of pin fixation in which the pin is passed through the occipital external protuberance and the ends of the pin are used as fixation points for rods or wires, has also been described. Wires or rods attached to the free ends of the pin and the cervical spine secure the suboccipital bone to the cervical spine. This treatment has been successful in patients who have upper cervical instability due to cancer metastasis.
  • An inverted Y-shaped screw plate which also has been described, is used to secure the occipitocervical junction. Using this technique the plate is secured to C1-2 with transarticular screws and to the suboccipital bone with paramedian screws. The suboccipital bone varies in thickness, with a mean thickness of 14 mm. Screws must be carefully selected to provide adequate purchase, yet avoid cerebellar injury.
  • Utilizing the maximum screw length possible is critical because shorter screws do have decreased resistance to pullout. If stabilization is required below the C1-2 level, then lateral mass screws can be placed through additional holes in a longer plate to include these levels as well. A bone graft is again added to promote fusion.
  • the guidewire was directed medially 10 to 20° across the occipital condyle. This was monitored on the anteroposterior fluoroscopic image. A pilot hole, 30 mm deep, was then created by using a 2.7-mm cannulated bit. The hole in the C-1 portion and the proximal portion of the condyle was widened using a 4-mm drill. A lag screw was then placed. By using a lag screw, the occipitocervical gap could be reduced. Although this was an in vitro biomechanical study, the authors do report the successful treatment of one 17- year-old patient and provide 7 months of follow-up data in that case.
  • the implantable connector has two elongated coupling plates (2,3) each formed with a vertebral section (2A 1 B) extending longitudinally at each side of the spine (A-E) and fixed by pedicular screws (4) extending thorough longitudinal openings (5) in the plates.
  • the vertebral section is extended at its upper end by an occipital section (OA.B) following the form and angle of the occiput (o).
  • the vertebral section is flat and has rectangular openings (5) of a length (L) corresponding to a distance equal to that (P) separating at least two vertebrae and of a width superior to the shanks (e) of the screws.
  • the stated invention as seen in figure 6, has a rigid structure which consists of two long plaques that connect occipital and cervical regions without giving any ability of motion. There is no application of a joint around neck area. After the implementation, the patient cannot move his head and must stay immobile during all recovery period. It is not advantageous because it has a structure that prevents the motion.
  • the occipital clamp assembly comprises a lower occipital plate for attachment to the skull of a patient, wherein the lower occipital plate includes grooves in its upper surface.
  • An occipital plate stud mounted in the lower occipital plate and upper occipital plates, having a groove in each of their lower surfaces, mounted on the occipital plate stud wherein the grooves of the lower occipital plate mate with the grooves of the upper occipital plates to thereby form rod receiving apertures.
  • the stated invention has a rigid structure which connects the occipital region and cervical region. Yet this implementation does not give any freedom of mobility to the patient, because it does not have any joint around the neck area. Therefore, it is hard to use for patients.
  • one objective of the invention is to give an ability of action, and not to prevent the moving of patient's neck after surgery.
  • Another objective of the invention is to provide sharing of load by the normal cervical axis by an ability of action.
  • Another objective of the invention is that it protects the part which also gives ability of action; by connecting the occiput plaque to the occiput region.
  • Another objective of the invention is to prevent the friction of metal-to-metal by means of a lining made of polyethylene (UHMWPE) material, and placed between the plaque and the joint.
  • UHMWPE polyethylene
  • Another objective of the invention is to provide a fixation of rods and the sphere head which gives an ability of action to the system by a joint.
  • Another objective of the invention is to provide a protection to the plaque and the head of the joint which gains the ability of action by the capsule.
  • Another objective of the invention is to secure the connection of cervical and occiput constructions to each other via set screws, by locking the rods of stabilization in the cervical area to the connector.
  • Another objective of the invention is to connect the construction in the cervical area to the construction in the occiput area by a connector.
  • Another objective of the invention is to unite the capsule and the connector by a Coupling part . Another objective of the invention is to obtain the construction in the cervical area by a rod.
  • Other preferred alternative structures of the invention are:
  • the shape of the dynamic segment can be changed; in other words, a hinge system can be obtained, which would allow only fro-back flexion-extension, aside a top-socket system.
  • the proposed system essentially consists of rigid rods. It requires making of a second product that will be combined with spiral (flexible) ropes.
  • This second product that is planned to be made of Titanium, can be also made of materials such as peek, carbon reinforced peek, nitinol, derlyn, high molecule polyethylene, polyethylene, or by making some parts (i.e., dynamic surfaces, assuming that minimum friction will be obtained) of these materials, alternatives can be achieved. Particularly, those made of 30% carbon reinforced PEEK can be advantageous, because they can give good results with MRI.
  • rods which are implemented to connect the relevant regions to each other; structuring the occipital plaque containing Coupling parts; a neck part that helps to the ability of action by angling the plaque which unites the occipital area to the cervical area that is connected to the rods.
  • Structuring the occipital plaque involves a dynamic occipital plaque to be joined to the occipital region.
  • Structuring the occipital plaque involves arms to be joined to the occipital region.
  • the plaque For the connection of neck part, the plaque has a ring. It has a joint allowing the neck part for moving and angling. For the rotation of joint, it has a round element.
  • Figure 2 The free upward motion of the invention.
  • Figure 3 The free downward motion of the invention.
  • Figure 4 The free leftward motion of the invention.
  • Figure 5 The free rightward motion of the invention.
  • Figure 6 The look of the region with the previous technique and implementation.
  • the invention involves occipito cervical dynamic plaques (1 ) which are used by fixing to a construction that is constituted by pedicle screws, rods, and/or transverse connectors in the posterior cervical system in order to maintain the ability of action, not to stop losing it by a fusion in the occipital region (O).
  • Figure 1 a dismantled perspective of the invention is shown. According to the drawing, the occiput plaque (1 ) is seemingly the same as of the ones in the rigid systems. In the same way, it is united to the occipital area (O) with bone screws. The difference is that the part called 'neck' (B) is in the lower part.
  • the joint (3) in the lower part of the neck is in contact with a lining (2) made of polyethylene material providing to eliminate an erosion to be caused by the plausible friction of metal-to-metal.
  • the lining (2) has been built to fit into the occiput plaque (1) and, its inner surface (2.1 ) has been carved in a concave form enabling the round element (3.1 ) of the joint (3) to move in all directions freely.
  • the round element (3.1 ), the head part of the joint (3), has been formed in a spherical shape in order to that the occiput plaque (1) can move in all directions.
  • the two sides (3.2) of its lower part have been flattened, enabling it to hold to the connector (6) perfectly, and at the same time, it has grooves to prevent its upward movement in case of the connector (6) forces.
  • the capsule (4) has been put together by locking the occiput plaque (1) to it, in a way that the joint (3), the round element (3.1 ) and the lining (2), all together have been encased in the capsule. In this way, a joint has been obtained in the system.
  • the system that its imaginary motions are as shown in Figures 2, 3, 4 and 5, has a feature of free action ability via this joint.
  • the ability of the joint has been limited by that the joint (3) of the capsule (4) touches to the round element (3.1).
  • this constructed joint it is adaptable to the angle between cervical (S) and occiput (O) regions, which varies for each patient according to his/her anatomic structure.
  • the connector (6) is united to the joint (3) by a Coupling part (7).
  • the connector (6) secures the occiput dynamic plaque (1 ) via rods (8) coming from the stabilization in the cervical area.
  • a set screw (5) is used to join the rods (8) to the connector (6).
  • the rods (8) are fixed to the connector this way.
  • the invention is mantled on the construction after the cervical region (S) is stabilized. As seen in Figures 2, 3, 4 and 5, our invention is connected to the rods (8). It is fixed to the occipital region (O) with a suitable angle according to the anatomic structure via bone screws. With this, the implementation is completed.

Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgery (AREA)
  • Neurology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Neurosurgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

L'invention porte sur une structure de plaque occipitale, qui donne une capacité de déplacement dans n'importe quelle direction avec l'action libre de la région occipitale (O) et de sa plaque occipitale de connexion (1), tandis que le connecteur (6) et les tiges (8) qui sont connectées à la région cervicale (S) restent stables, et qui présente une partie de col (B) qui donne une capacité d'action par inclinaison de la plaque (1) avec les parties de couplage, et qui est connectée à la région occipitale mentionnée (O) et à la région cervicale (S) où les tiges (8) sont connectées, et avec les tiges mentionnées (8) qui sont introduites pour relier la région occipitale (O) à la région cervicale (S) lors de blessures de ces régions mentionnées.
PCT/TR2007/000099 2007-09-27 2007-09-27 Plaque dynamique pour la région occipito-cervicale WO2009041923A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/TR2007/000099 WO2009041923A1 (fr) 2007-09-27 2007-09-27 Plaque dynamique pour la région occipito-cervicale

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/TR2007/000099 WO2009041923A1 (fr) 2007-09-27 2007-09-27 Plaque dynamique pour la région occipito-cervicale

Publications (1)

Publication Number Publication Date
WO2009041923A1 true WO2009041923A1 (fr) 2009-04-02

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/TR2007/000099 WO2009041923A1 (fr) 2007-09-27 2007-09-27 Plaque dynamique pour la région occipito-cervicale

Country Status (1)

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WO (1) WO2009041923A1 (fr)

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9387013B1 (en) 2011-03-01 2016-07-12 Nuvasive, Inc. Posterior cervical fixation system
CN107496019A (zh) * 2017-09-21 2017-12-22 北京爱康宜诚医疗器材有限公司 钢板结构
CN109464181A (zh) * 2018-12-20 2019-03-15 天衍医疗器材有限公司 枕颈固定装置

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2212211A (en) * 1987-12-23 1989-07-19 Dana Corp Preloaded steering ball joint
JP2944997B1 (ja) * 1998-07-22 1999-09-06 株式会社ロバート・リード商会 頭蓋支持装置
US6296644B1 (en) * 1998-08-26 2001-10-02 Jean Saurat Spinal instrumentation system with articulated modules
EP1600112A1 (fr) * 2004-05-26 2005-11-30 SDGI Holdings, Inc. Implants pour un dispositif d'ostéosynthèse rachidienne et ensemble comprenant ces implants
WO2006096756A2 (fr) * 2005-03-07 2006-09-14 Abdou M Samy Systeme de fixation occipitale et procede d'utilisation
WO2007044716A1 (fr) * 2005-10-07 2007-04-19 Alphatec Spine, Inc. Plaque occipitale reglable

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2212211A (en) * 1987-12-23 1989-07-19 Dana Corp Preloaded steering ball joint
JP2944997B1 (ja) * 1998-07-22 1999-09-06 株式会社ロバート・リード商会 頭蓋支持装置
US6296644B1 (en) * 1998-08-26 2001-10-02 Jean Saurat Spinal instrumentation system with articulated modules
EP1600112A1 (fr) * 2004-05-26 2005-11-30 SDGI Holdings, Inc. Implants pour un dispositif d'ostéosynthèse rachidienne et ensemble comprenant ces implants
WO2006096756A2 (fr) * 2005-03-07 2006-09-14 Abdou M Samy Systeme de fixation occipitale et procede d'utilisation
WO2007044716A1 (fr) * 2005-10-07 2007-04-19 Alphatec Spine, Inc. Plaque occipitale reglable

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9387013B1 (en) 2011-03-01 2016-07-12 Nuvasive, Inc. Posterior cervical fixation system
US9956009B1 (en) 2011-03-01 2018-05-01 Nuvasive, Inc. Posterior cervical fixation system
US10368918B2 (en) 2011-03-01 2019-08-06 Nuvasive, Inc. Posterior cervical fixation system
US11123110B2 (en) 2011-03-01 2021-09-21 Nuvasive, Inc. Posterior cervical fixation system
CN107496019A (zh) * 2017-09-21 2017-12-22 北京爱康宜诚医疗器材有限公司 钢板结构
CN109464181A (zh) * 2018-12-20 2019-03-15 天衍医疗器材有限公司 枕颈固定装置

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