WO2018127574A1 - Intervertebral implant with graft retention - Google Patents

Intervertebral implant with graft retention Download PDF

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Publication number
WO2018127574A1
WO2018127574A1 PCT/EP2018/050297 EP2018050297W WO2018127574A1 WO 2018127574 A1 WO2018127574 A1 WO 2018127574A1 EP 2018050297 W EP2018050297 W EP 2018050297W WO 2018127574 A1 WO2018127574 A1 WO 2018127574A1
Authority
WO
WIPO (PCT)
Prior art keywords
implant
opening
permeable wall
face
intersomatic
Prior art date
Application number
PCT/EP2018/050297
Other languages
French (fr)
Inventor
Clément SILVESTRE
Marc Bernard
Sébastien CHAROSKY
Christopher J. DEWALD
Poul Martin GEHRCHEN
Pierre Roussouly
Original Assignee
Kisco International
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 Kisco International filed Critical Kisco International
Publication of WO2018127574A1 publication Critical patent/WO2018127574A1/en

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Classifications

    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
    • A61F2/4465—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages having a circular or kidney shaped cross-section substantially perpendicular to the axis of the spine
    • A—HUMAN NECESSITIES
    • 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
    • A61F2/30721—Accessories
    • A61F2/30744—End caps, e.g. for closing an endoprosthetic cavity
    • 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
    • A61F2002/30011—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 differing in porosity
    • 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
    • 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
    • A61F2002/30784—Plurality of holes
    • 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
    • A61F2002/30836—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves knurled
    • 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
    • A61F2002/4495—Joints for the spine, e.g. vertebrae, spinal discs having a fabric structure, e.g. made from wires or fibres
    • 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
    • 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
    • A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys

Definitions

  • the present invention relates to an intersomatic implant, intended to be inserted into an intervertebral space delimited between two adjacent vertebrae of a vertebral column, for the purpose of stabilizing these vertebrae in a normal anatomical position, after removal of a defective intervertebral disc.
  • an implant is also called intervertebral implant.
  • an intersomatic implant of the type comprising a body having an upper face, a lower face, and a circumferential lateral face connecting the upper and lower faces, the body comprising at least one opening in the upper or lower face. , and an interior space opening to said opening.
  • a hollow implant is also called "intersomatic cage”.
  • the interior space is intended to receive a graft, including autogenous bone, synthetic phospho-calcites, osteoinductors or other, intended to promote bone fusion between the trays of adjacent vertebrae.
  • a graft including autogenous bone, synthetic phospho-calcites, osteoinductors or other, intended to promote bone fusion between the trays of adjacent vertebrae.
  • the implant containing the graft, is manipulated to be inserted between two vertebrae during a surgical procedure. During this procedure, it is necessary to ensure that the graft remains maintained in the interior space, which implies a complexity of the intervention and / or a need to deliver graft into the implant after insertion of this implant between the vertebrae.
  • the object of the invention is notably to remedy this disadvantage by proposing an intersomatic implant that promotes the retention of the graft in place during the manipulation of this implant.
  • the subject of the invention is in particular an intersomatic implant, comprising a body having an upper face, a lower face, and a circumferential lateral face connecting the upper and lower faces, the body comprising at least one opening provided in at least one one of the upper and lower faces and an interior space opening to said opening, characterized in that it comprises at least one permeable wall, in particular porous or crosslinked, at least partially covering said opening.
  • the permeable wall holds the graft in place, preventing it from escaping through the opening as it is being handled during a surgical procedure.
  • a wall is called “permeable” when it ensures the maintenance of the graft, while allowing bone fusion through this wall.
  • the permeable wall is porous, or reticulated.
  • the permeable wall comprises for example a plurality of orifices, the dimensions of which are chosen to ensure the maintenance of the graft while allowing bone fusion through these orifices.
  • An implant according to the invention may further comprise one or more of the following characteristics, taken alone or in any technically feasible combination:
  • the body comprises an upper opening formed in the upper face, and a lower opening formed in the lower face, the inner space extending between the upper and lower openings, at least one of these lower and upper openings being at less partly covered with a permeable wall;
  • each of the upper and lower openings is covered, at least partially, by a respective permeable wall;
  • the permeable wall is formed by a net
  • the permeable wall is integral with the body
  • the body and the permeable wall are made by three-dimensional printing
  • the permeable wall completely covers the corresponding opening
  • the permeable wall covers only a peripheral portion of the corresponding opening
  • the circumferential lateral face comprises at least one lateral opening, opening into the interior space
  • the body and the permeable wall are made of a biocompatible material, including titanium;
  • the body one or each of the upper and lower faces is provided with a rough surface
  • the body has a central portion and two end portions forming additional bearing surfaces on the cortical bone;
  • one or each of the upper and lower faces is provided with a rough surface on the central part and with a smooth surface on one or each of the end portions;
  • the end portions extend in the continuity of the central portion, the lateral face being non-angular at the junction between the central portion and each end portion, or projecting from the central portion; lateral face forming a non-zero angle at the junction between the central portion and each end portion; - At least one end portion is provided with at least one notch for receiving a gripping tool and / or a threaded hole for assembly of the implant with the gripping tool.
  • FIG. 1 represents a perspective view of an interbody implant according to an exemplary embodiment of the invention.
  • Figures 2 and 3 show perspective views of intersomatic implants according to other exemplary embodiments.
  • intersomatic implant 10 there is shown in the figure an intersomatic implant 10.
  • the implant 10 is a cage of the ALIF (Acronym for "Anterior Lumbar Interbody Fusion"), OLIF (acronym for "Oblique Lumbar Interbody Fusion"), TLIF ("Transforaminal Lumbar Interbody Fusion"), PLIF ( “Posterior Lumbar Interbody Fusion”) or XLIF ("Lateral Lumbar Interbody Fusion”).
  • the implant 10 could be a cage of another type.
  • the implant 10 is conventionally intended to be inserted into an intervertebral space delimited between two adjacent vertebrae, called upper vertebra and lower vertebra.
  • the implant 10 comprises a body 12 having an upper face 14 intended to be arranged facing the upper vertebra when the implant 10 is implanted, and a lower face 16 intended to be arranged facing the lower vertebra when the implant 10 is implanted.
  • the upper 14 and lower 16 faces are generally substantially parallel to each other, but may alternatively be slightly inclined with respect to each other.
  • the implant 10 has a lordosis less than or equal to 18 °.
  • the body 12 furthermore comprises a circumferential lateral face 18, extending in height between the top 14 and lower 16 faces.
  • the circumferential lateral face 18 advantageously has a plurality of lateral openings 19, allowing the body 12 to be gripped by a tool adapted during implantation of the implant 10.
  • the lateral openings 19 are formed by threaded orifices.
  • the general shape and dimensions of the body 12 are conventional, and chosen according to the vertebrae between which the implant 10 is intended to be implanted.
  • the body 12 comprises at least one opening in at least one of the upper and lower faces, and an interior space opening to said opening.
  • the upper face 14 comprises at least one upper opening 20
  • the lower face 16 has at least one lower opening 22
  • the body 12 has at least one interior space 24 extending between the upper openings 20 and lower 22.
  • the body 12 has two interior spaces 24 separated by a central intermediate wall 26, and for each interior space 24, a respective upper opening 20 and lower opening 22.
  • the upper face 14 has an upper surface of contact with the upper vertebra, framing the upper openings 20. More particularly, the upper contact surface extends circumferentially around the upper openings 20 and above the central wall 26 .
  • the lower face 16 has a lower contact surface with the lower vertebra, flanking the lower openings 22. More particularly, the lower contact surface extends circumferentially around the lower openings 22, and below the central wall. 26.
  • Each of the upper and lower surfaces is rough to allow proper support with the corresponding upper or lower vertebra.
  • the upper and lower surfaces are toothed, ridged or crosslinked.
  • lateral openings 19 advantageously open each into one of the interior spaces 24.
  • the implant 10 further comprises at least one permeable wall 28 covering at least in part at least one of the upper and lower openings 22. More particularly, the implant 10 comprises at least one permeable wall 28 for each space inside 24.
  • Each permeable wall 28 is for example a porous wall or a reticulated wall.
  • the lower openings 22 are each covered with a respective permeable wall 28.
  • Each permeable wall 28 has through orifices, the dimensions of which are chosen small enough to allow graft retention when the implant is manipulated during a surgical procedure, and large enough to allow bone fusion through these orifices.
  • Each permeable wall 28 is for example formed of a net.
  • each permeable wall 28 is integral with the body 12, that is to say formed integrally with the body 12, without discontinuity material.
  • the body 12, provided with permeable walls 28, is produced by three-dimensional printing.
  • the body 12 and the porous walls 28 are made of a biocompatible material, for example titanium.
  • the body 12 and the porous walls 28 are made of any suitable material, for example stainless steel, polymer, etc.
  • the intersomatic implant 10 illustrated in FIG. 2 differs from that of FIG. 1 in that the body 12 is of elongate overall shape elongated along a longitudinal direction L and has, in the longitudinal direction L, a central portion 30 on which the upper surface of the upper face 14 and the lower surface of the lower face 16 are rough, located between two end portions 32A, 32B on which the upper surface of the upper face 14 and the lower surface of the lower face 16 are smooth.
  • the upper surface of the upper face 14 and the lower surface of the lower face 16 each have a rough central region 34 located between two end regions 36 smooth.
  • the central region 34 is located on the central portion 30 and each end region 36 is located on a respective end portion 32A, 32B.
  • Each upper opening 20 and lower opening 22 is located in the central portion 30.
  • Each interior space 24 is delimited in the central portion 30.
  • the implant of FIG. 2 also differs from that of FIG. 1 in that it comprises a single interior space 24, opening on the upper face 14 and the lower face 16 through openings 20, 22 respective ones.
  • the implant 10 of FIG. 2 is therefore devoid of a central wall 26
  • end portions 32A, 32B are of different shapes.
  • a front end portion 32A has a profiled shape to facilitate the introduction of the implant 10 into the intervertebral space, while a rear end portion 32B is shaped to cooperate with a gripping tool.
  • the end portion 32A before is rounded.
  • the lateral face 18 of the body 12 is thus rounded on the end portion 32A.
  • the rear end portion 32B ends here perpendicular to the longitudinal direction L.
  • the side face 18 is perpendicular to the longitudinal direction at the free end of the rear end portion 32B.
  • the rear end portion 32B is provided with a grip notch 42 for receiving a grasping tool, for example for the installation of the implant 10 during the surgical procedure.
  • the rear end portion 32B is for example provided with two notches 42 located on either side of the end portion 32A.
  • the rear end portion 32B has a tapped hole (not visible) located between the two notches 42 for the assembly of the gripping tool with the implant 10 by screwing.
  • the threaded orifice extends in the longitudinal direction L.
  • another threaded orifice 44 is formed in the front end portion 32A in order to allow the removal of the implant 10.
  • the end portions 32A, 32B here extend substantially in the continuity of the central portion 30.
  • the body 12 as a whole ie by including the central portion 30 and the end portions 32A, 32B
  • has a tapered shape here with a rounded front end portion 32A and a rear end portion 32B truncated perpendicularly to the longitudinal direction.
  • the side face 18 does not form an angle at the junction between the central portion 30 and each end portion 32A, 32B.
  • the implant of FIG. 2 is for example an OLIF cage (acronym for
  • the implant of Figure 3 differs from that of Figure 2 in that the end portions 32 are in the form of protrusions extending longitudinally from the central portion 30.
  • the side face 18 forms a non-zero angle at the junction between the central portion 30 and each end portion 32A, 32B.
  • the central portion 30 has a generally tapered shape, each end portion 32A, 32B extending from one end of the central portion 30.
  • Each end portion 32A, 32B here has a parallelepipedal general shape with for example faces on the lateral face 18 of the body 12 which are substantially parallel to the longitudinal direction L.
  • the projecting end portions 32A, 32B form, for example, additional bearing surfaces on the cortical bone.
  • spacers form spacers at the lateral portions of the cortical bone of the vertebrae between which the implant 10 is implanted. Such spacers reduce scoliosis.
  • the body 12 has a length, considered along the longitudinal axis, greater than or equal to 40 mm, for example 43 mm or 47 mm.
  • the end portions 32A, 32B extend sufficiently to form satisfactory bearing surfaces on the cortical bone of the vertebrae when implant 10 is implanted.
  • the body 12 has, in a transverse direction perpendicular T to the longitudinal direction L, a width of between 15 and 21 mm.
  • the ratio of the length to the width is between 2 and 2.5.
  • each end portion 32A, 32B extends in the longitudinal direction L over a length of between 1/10 and 1/5 of the length of the implant 10 along the longitudinal direction L.
  • each end portion 32A, 32B extends in the longitudinal direction L over a length of between 3 and 7 mm, for example over a length substantially equal to 5.50 mm.
  • the implant of FIG. 3 is for example an OLIFAN cage (acronym for "Oblique Lumbar Interbody Fusion").
  • each of the upper and lower openings 22 is covered, at least partially, by a respective permeable wall.
  • the graft is introduced into the interior space 24 through the lateral openings 19.
  • each permeable wall 28 covers only a peripheral portion of the opening 20, 22 corresponding.
  • the permeable wall 28 leaves free a central passage for the introduction of the graft into the interior space 24.
  • This permeable peripheral wall 28 allows the graft to be held in the interior space.
  • each lower opening 22 is completely covered with a permeable wall 28, and each upper opening 20 is covered with a permeable wall only on its periphery.

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  • 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)

Abstract

The invention relates to an intervertebral implant (10) comprising a body (12) having an upper face (14), a lower face (16), and a circumferential side face (18) connecting the upper (14) and lower (16) faces. The body (12) comprises at least one opening (20, 22) in at least either the upper face (14) and/or the lower face (16), and an interior space (24) that opens at the opening (20, 22). The implant (10) comprises at least one permeable wall (28) covering at least part of the opening (20, 22).

Description

Implant intersomatique avec rétention de greffon  Intersomatic implant with graft retention
La présente invention concerne un implant intersomatique, destiné à être inséré dans un espace intervertébral délimité entre deux vertèbres adjacentes d'une colonne vertébrale, dans le but de stabiliser ces vertèbres dans une position anatomique normale, après ablation d'un disque intervertébral défectueux. Un tel implant est également appelé implant intervertébral. The present invention relates to an intersomatic implant, intended to be inserted into an intervertebral space delimited between two adjacent vertebrae of a vertebral column, for the purpose of stabilizing these vertebrae in a normal anatomical position, after removal of a defective intervertebral disc. Such an implant is also called intervertebral implant.
Plus particulièrement, l'invention concerne un implant intersomatique du type comportant un corps présentant une face supérieure, une face inférieure, et une face latérale circonférentielle reliant les faces supérieure et inférieure, le corps comprenant au moins une ouverture ménagée dans la face supérieure ou inférieure, et un espace intérieur débouchant à ladite ouverture. Un tel implant creux est également appelé « cage intersomatique ».  More particularly, the invention relates to an intersomatic implant of the type comprising a body having an upper face, a lower face, and a circumferential lateral face connecting the upper and lower faces, the body comprising at least one opening in the upper or lower face. , and an interior space opening to said opening. Such a hollow implant is also called "intersomatic cage".
L'espace intérieur est destiné à recevoir un greffon, notamment de l'os autogène, des phospho-calcites de synthèse, des ostéro-inducteurs ou autre, destiné à favoriser une fusion osseuse entre les plateaux des vertèbres adjacentes.  The interior space is intended to receive a graft, including autogenous bone, synthetic phospho-calcites, osteoinductors or other, intended to promote bone fusion between the trays of adjacent vertebrae.
L'implant, contenant le greffon, est manipulé pour être inséré entre deux vertèbres au cours d'une intervention chirurgicale. Au cours de cette intervention, il est nécessaire de s'assurer que le greffon reste maintenu dans l'espace intérieur, ce qui implique une complexification de l'intervention et/ou une nécessité de remettre du greffon dans l'implant après insertion de cet implant entre les vertèbres.  The implant, containing the graft, is manipulated to be inserted between two vertebrae during a surgical procedure. During this procedure, it is necessary to ensure that the graft remains maintained in the interior space, which implies a complexity of the intervention and / or a need to deliver graft into the implant after insertion of this implant between the vertebrae.
L'invention a notamment pour but de remédier à cet inconvénient, en proposant un implant intersomatique favorisant le maintien du greffon en place lors de la manipulation de cet implant.  The object of the invention is notably to remedy this disadvantage by proposing an intersomatic implant that promotes the retention of the graft in place during the manipulation of this implant.
A cet effet, l'invention a notamment pour objet un implant intersomatique, comportant un corps présentant une face supérieure, une face inférieure, et une face latérale circonférentielle reliant les faces supérieure et inférieure, le corps comprenant au moins une ouverture ménagée dans au moins l'une des faces supérieure et inférieure et un espace intérieur débouchant à ladite ouverture, caractérisé en ce qu'il comporte au moins une paroi perméable, notamment poreuse ou réticulée, recouvrant au moins en partie ladite ouverture.  For this purpose, the subject of the invention is in particular an intersomatic implant, comprising a body having an upper face, a lower face, and a circumferential lateral face connecting the upper and lower faces, the body comprising at least one opening provided in at least one one of the upper and lower faces and an interior space opening to said opening, characterized in that it comprises at least one permeable wall, in particular porous or crosslinked, at least partially covering said opening.
La paroi perméable permet de maintenir le greffon en place, en l'empêchant de s'échapper par l'ouverture lors de sa manipulation au cours d'une intervention chirurgicale.  The permeable wall holds the graft in place, preventing it from escaping through the opening as it is being handled during a surgical procedure.
Dans la présente description, une paroi est dite « perméable » lorsqu'elle assure le maintien du greffon, tout en autorisant la fusion osseuse à travers cette paroi. Par exemple, la paroi perméable est poreuse, ou réticulée. La paroi perméable comporte par exemple une pluralité d'orifices, dont les dimensions sont choisies pour assurer le maintien du greffon tout en autorisant la fusion osseuse à travers ces orifices. In the present description, a wall is called "permeable" when it ensures the maintenance of the graft, while allowing bone fusion through this wall. For example, the permeable wall is porous, or reticulated. The permeable wall comprises for example a plurality of orifices, the dimensions of which are chosen to ensure the maintenance of the graft while allowing bone fusion through these orifices.
Ainsi, lors d'une intervention chirurgicale, il est possible d'insérer le greffon dans l'implant, puis de manipuler l'implant, en limitant le risque de perte de greffon.  Thus, during a surgical procedure, it is possible to insert the graft into the implant, then manipulate the implant, limiting the risk of graft loss.
Un implant selon l'invention peut comporter en outre l'une ou plusieurs des caractéristiques suivantes, prises seules ou selon toutes combinaisons techniquement envisageables :  An implant according to the invention may further comprise one or more of the following characteristics, taken alone or in any technically feasible combination:
- le corps comprend une ouverture supérieure ménagée dans la face supérieure, et une ouverture inférieure ménagée dans la face inférieure, l'espace intérieur s'étendant entre les ouvertures supérieure et inférieure, au moins l'une de ces ouvertures inférieure et supérieure étant au moins en partie recouverte d'une paroi perméable ;  the body comprises an upper opening formed in the upper face, and a lower opening formed in the lower face, the inner space extending between the upper and lower openings, at least one of these lower and upper openings being at less partly covered with a permeable wall;
- chacune des ouvertures supérieure et inférieure est recouverte, au moins partiellement, par une paroi perméable respective ;  each of the upper and lower openings is covered, at least partially, by a respective permeable wall;
- la paroi perméable est formée par un filet ;  the permeable wall is formed by a net;
- la paroi perméable est venue de matière avec le corps ;  - the permeable wall is integral with the body;
- le corps et la paroi perméable sont réalisés par impression tridimensionnelle ; the body and the permeable wall are made by three-dimensional printing;
- la paroi perméable recouvre intégralement l'ouverture correspondante ; the permeable wall completely covers the corresponding opening;
- la paroi perméable recouvre uniquement une partie périphérique de l'ouverture correspondante ;  the permeable wall covers only a peripheral portion of the corresponding opening;
- la face latérale circonférentielle comporte au moins une ouverture latérale, débouchant dans l'espace intérieur ;  the circumferential lateral face comprises at least one lateral opening, opening into the interior space;
- le corps et la paroi perméable sont réalisés en un matériau biocompatible, notamment en titane ;  - The body and the permeable wall are made of a biocompatible material, including titanium;
- le corps une ou chacune des faces supérieure et inférieure est munie d'une surface rugueuse ;  the body one or each of the upper and lower faces is provided with a rough surface;
- le corps possède une portion centrale et deux portions d'extrémité formant des surfaces d'appuis supplémentaires sur l'os cortical ;  the body has a central portion and two end portions forming additional bearing surfaces on the cortical bone;
- une ou chacune des faces supérieure et inférieure est munie d'une surface rugueuse sur la partie centrale et d'une surface lisse sur une ou chacune des portions d'extrémité ;  one or each of the upper and lower faces is provided with a rough surface on the central part and with a smooth surface on one or each of the end portions;
- les portions d'extrémité s'étendent dans la continuité de la portion centrale, la face latérale ne faisant pas d'angle à la jonction entre la portion centrale et chaque partie d'extrémité ou font saillie par rapport à la portion centrale, la face latérale faisant un angle non nul à la jonction entre la portion centrale et chaque partie d'extrémité ; - au moins une portion d'extrémité est munie d'au moins une encoche pour recevoir un outil de préhension et/ou d'un orifice taraudé pour l'assemblage de l'implant avec l'outil de préhension. the end portions extend in the continuity of the central portion, the lateral face being non-angular at the junction between the central portion and each end portion, or projecting from the central portion; lateral face forming a non-zero angle at the junction between the central portion and each end portion; - At least one end portion is provided with at least one notch for receiving a gripping tool and / or a threaded hole for assembly of the implant with the gripping tool.
L'invention sera mieux comprise à la lecture de la description qui va suivre, donnée uniquement à titre d'exemple et faite en se référant aux dessins annexés, sur lesquels  The invention will be better understood on reading the description which follows, given solely by way of example and with reference to the appended drawings, in which:
- la figure 1 représente une vue en perspective d'un implant intersomatique selon un exemple de mode de réalisation de l'invention ; et  FIG. 1 represents a perspective view of an interbody implant according to an exemplary embodiment of the invention; and
- les figures 2 et 3 représentent des vues en perspective d'implants intersomatiques selon d'autres exemples de mode de réalisation.  Figures 2 and 3 show perspective views of intersomatic implants according to other exemplary embodiments.
On a représenté sur la figure un implant intersomatique 10.  There is shown in the figure an intersomatic implant 10.
Par exemple, l'implant 10 est une cage de type ALIF (acronyme anglais pour « Anterior Lumbar Interbody Fusion »), OLIF (acronyme anglais pour « Oblique Lumbar Interbody Fusion »), TLIF (« Transforaminal Lumbar Interbody Fusion »), PLIF (« Posterior Lumbar Interbody Fusion ») ou XLIF (« Latéral Lumbar Interbody Fusion »).  For example, the implant 10 is a cage of the ALIF (Acronym for "Anterior Lumbar Interbody Fusion"), OLIF (acronym for "Oblique Lumbar Interbody Fusion"), TLIF ("Transforaminal Lumbar Interbody Fusion"), PLIF ( "Posterior Lumbar Interbody Fusion") or XLIF ("Lateral Lumbar Interbody Fusion").
Toutefois, en variante, l'implant 10 pourrait être une cage d'un autre type.  However, alternatively, the implant 10 could be a cage of another type.
L'implant 10 est destiné de manière classique à être inséré dans un espace intervertébral délimité entre deux vertèbres adjacentes, dites vertèbre supérieure et vertèbre inférieure.  The implant 10 is conventionally intended to be inserted into an intervertebral space delimited between two adjacent vertebrae, called upper vertebra and lower vertebra.
L'implant 10 comporte un corps 12 présentant une face supérieure 14 destinée à être agencée en regard de la vertèbre supérieure lorsque l'implant 10 est implanté, et une face inférieure 16 destinée à être à être agencée en regard de la vertèbre inférieure lorsque l'implant 10 est implanté.  The implant 10 comprises a body 12 having an upper face 14 intended to be arranged facing the upper vertebra when the implant 10 is implanted, and a lower face 16 intended to be arranged facing the lower vertebra when the implant 10 is implanted.
Les faces supérieure 14 et inférieure 16 sont généralement sensiblement parallèles entre elles, mais peuvent être en variante légèrement inclinées l'une par rapport à l'autre. Par exemple, l'implant 10 présente une lordose inférieure ou égale à 18°.  The upper 14 and lower 16 faces are generally substantially parallel to each other, but may alternatively be slightly inclined with respect to each other. For example, the implant 10 has a lordosis less than or equal to 18 °.
Le corps 12 comporte par ailleurs une face latérale circonférentielle 18, s'étendant en hauteur entre les faces supérieure 14 et inférieure 16.  The body 12 furthermore comprises a circumferential lateral face 18, extending in height between the top 14 and lower 16 faces.
La face latérale circonférentielle 18 présente avantageusement une pluralité d'ouvertures latérales 19, permettant la préhension du corps 12 par un outil adapté lors de l'implantation de l'implant 10. En variante, les ouvertures latérales 19 sont formées par des orifices taraudés.  The circumferential lateral face 18 advantageously has a plurality of lateral openings 19, allowing the body 12 to be gripped by a tool adapted during implantation of the implant 10. In a variant, the lateral openings 19 are formed by threaded orifices.
La forme générale et les dimensions du corps 12 sont classiques, et choisies en fonction des vertèbres entre lesquelles l'implant 10 est destiné à être implanté.  The general shape and dimensions of the body 12 are conventional, and chosen according to the vertebrae between which the implant 10 is intended to be implanted.
Le corps 12 comprend au moins une ouverture ménagée dans au moins l'une des faces supérieure et inférieure, et un espace intérieur débouchant à ladite ouverture. Conformément au mode de réalisation décrit, la face supérieure 14 comporte au moins une ouverture supérieure 20, la face inférieure 16 comporte au moins une ouverture inférieure 22, et le corps 12 comporte au moins un espace intérieur 24 s'étendant entre les ouvertures supérieure 20 et inférieure 22. The body 12 comprises at least one opening in at least one of the upper and lower faces, and an interior space opening to said opening. According to the embodiment described, the upper face 14 comprises at least one upper opening 20, the lower face 16 has at least one lower opening 22, and the body 12 has at least one interior space 24 extending between the upper openings 20 and lower 22.
Plus particulièrement, le corps 12 comporte deux espaces intérieurs 24 séparés par une paroi intermédiaire centrale 26, et pour chaque espace intérieur 24, une ouverture supérieure 20 et une ouverture inférieure 22 respectives.  More particularly, the body 12 has two interior spaces 24 separated by a central intermediate wall 26, and for each interior space 24, a respective upper opening 20 and lower opening 22.
Ainsi, la face supérieure 14 présente une surface supérieure de contact avec la vertèbre supérieure, encadrant les ouvertures supérieures 20. Plus particulièrement, la surface supérieure de contact s'étend circonférentiellement autour des ouvertures supérieures 20, et au-dessus de la paroi centrale 26.  Thus, the upper face 14 has an upper surface of contact with the upper vertebra, framing the upper openings 20. More particularly, the upper contact surface extends circumferentially around the upper openings 20 and above the central wall 26 .
De même, la face inférieure 16 présente une surface inférieure de contact avec la vertèbre inférieure, encadrant les ouvertures inférieure 22. Plus particulièrement, la surface inférieure de contact s'étend circonférentiellement autour des ouvertures inférieures 22, et en-dessous de la paroi centrale 26.  Similarly, the lower face 16 has a lower contact surface with the lower vertebra, flanking the lower openings 22. More particularly, the lower contact surface extends circumferentially around the lower openings 22, and below the central wall. 26.
Chacune des surfaces supérieure et inférieure est rugueuse pour permettre un bon maintien avec la vertèbre supérieure ou inférieure correspondante. Par exemple, les surfaces supérieures et inférieures sont dentées, striées ou réticulées.  Each of the upper and lower surfaces is rough to allow proper support with the corresponding upper or lower vertebra. For example, the upper and lower surfaces are toothed, ridged or crosslinked.
Il est à noter que les ouvertures latérales 19 débouchent avantageusement chacune dans l'un des espaces intérieurs 24.  It should be noted that the lateral openings 19 advantageously open each into one of the interior spaces 24.
L'implant 10 comporte par ailleurs au moins une paroi perméable 28 recouvrant, au moins en partie, au moins l'une des ouvertures supérieures 20 et inférieures 22. Plus particulièrement, l'implant 10 comporte au moins une paroi perméable 28 pour chaque espace intérieur 24.  The implant 10 further comprises at least one permeable wall 28 covering at least in part at least one of the upper and lower openings 22. More particularly, the implant 10 comprises at least one permeable wall 28 for each space inside 24.
Chaque paroi perméable 28 est par exemple une paroi poreuse ou une paroi réticulée.  Each permeable wall 28 is for example a porous wall or a reticulated wall.
Dans l'exemple décrit, les ouvertures inférieures 22 sont chacune recouverte d'une paroi perméable 28 respective.  In the example described, the lower openings 22 are each covered with a respective permeable wall 28.
Chaque paroi perméable 28 présente des orifices traversants, dont les dimensions sont choisies suffisamment petites pour permettre de retenir du greffon lorsque l'implant est manipulé au cours d'une intervention chirurgicale, et suffisamment grandes pour autoriser la fusion osseuse à travers ces orifices.  Each permeable wall 28 has through orifices, the dimensions of which are chosen small enough to allow graft retention when the implant is manipulated during a surgical procedure, and large enough to allow bone fusion through these orifices.
Chaque paroi perméable 28 est par exemple formée d'un filet.  Each permeable wall 28 is for example formed of a net.
Avantageusement, chaque paroi perméable 28 est venue de matière avec le corps 12, c'est-à-dire formée d'un seul bloc avec ce corps 12, sans discontinuité de matière. Par exemple, le corps 12, muni des parois perméables 28, est réalisé par impression tridimensionnelle. Advantageously, each permeable wall 28 is integral with the body 12, that is to say formed integrally with the body 12, without discontinuity material. For example, the body 12, provided with permeable walls 28, is produced by three-dimensional printing.
Le corps 12 et les parois poreuses 28 sont réalisés en un matériau biocompatible, par exemple en titane. En variante, le corps 12 et les parois poreuses 28 sont réalisés dans tout matériau adapté, par exemple en acier inoxydable, en polymère, etc.  The body 12 and the porous walls 28 are made of a biocompatible material, for example titanium. In a variant, the body 12 and the porous walls 28 are made of any suitable material, for example stainless steel, polymer, etc.
L'implant intersomatique 10 illustré sur la figure 2 diffère de celui de la figure 1 en ce que le corps 12 est de forme générale oblongue allongée suivant une direction longitudinale L et présente, suivant la direction longitudinale L, une portion centrale 30, sur laquelle la surface supérieure de la face supérieure 14 et la surface inférieure de la face inférieure 16 sont rugueuses, située entre deux portions d'extrémités 32A, 32B sur lesquelles la surface supérieure de la face supérieure 14 et la surface inférieure de la face inférieure 16 sont lisses.  The intersomatic implant 10 illustrated in FIG. 2 differs from that of FIG. 1 in that the body 12 is of elongate overall shape elongated along a longitudinal direction L and has, in the longitudinal direction L, a central portion 30 on which the upper surface of the upper face 14 and the lower surface of the lower face 16 are rough, located between two end portions 32A, 32B on which the upper surface of the upper face 14 and the lower surface of the lower face 16 are smooth.
Ainsi, la surface supérieure de la face supérieure 14 et la surface inférieure de la face inférieure 16 présente chacune une région centrale 34 rugueuse située entre deux régions d'extrémité 36 lisses. La région centrale 34 est située sur la portion centrale 30 et chaque région d'extrémité 36 est située sur une portion d'extrémité 32A, 32B respective.  Thus, the upper surface of the upper face 14 and the lower surface of the lower face 16 each have a rough central region 34 located between two end regions 36 smooth. The central region 34 is located on the central portion 30 and each end region 36 is located on a respective end portion 32A, 32B.
Chaque ouverture supérieure 20 et chaque ouverture inférieure 22 est située dans la portion centrale 30. Chaque espace intérieur 24 est délimité dans la portion centrale 30.  Each upper opening 20 and lower opening 22 is located in the central portion 30. Each interior space 24 is delimited in the central portion 30.
Dans l'exemple illustré, l'implant de la figure 2 diffère en outre de celui de la figure 1 en ce qu'il comprend un seul espace intérieur 24, débouchant sur la face supérieure 14 et la face inférieure 16 par des ouvertures 20, 22 respectives. L'implant 10 de la figure 2 est donc dépourvu de paroi centrale 26  In the example illustrated, the implant of FIG. 2 also differs from that of FIG. 1 in that it comprises a single interior space 24, opening on the upper face 14 and the lower face 16 through openings 20, 22 respective ones. The implant 10 of FIG. 2 is therefore devoid of a central wall 26
Dans l'exemple illustré, les portions d'extrémités 32A, 32B sont de formes différentes.  In the example shown, the end portions 32A, 32B are of different shapes.
En particulier, une portion d'extrémité 32A avant présente une forme profilée pour faciliter l'introduction de l'implant 10 dans l'espace intervertébral, alors qu'une portion d'extrémité 32B arrière est conformée pour coopérer avec un outil de préhension.  In particular, a front end portion 32A has a profiled shape to facilitate the introduction of the implant 10 into the intervertebral space, while a rear end portion 32B is shaped to cooperate with a gripping tool.
La portion d'extrémité 32A avant est arrondie. La face latérale 18 du corps 12 est ainsi arrondie sur la portion d'extrémité 32A.  The end portion 32A before is rounded. The lateral face 18 of the body 12 is thus rounded on the end portion 32A.
La portion d'extrémité 32B arrière se termine ici perpendiculairement à la direction longitudinale L. La face latérale 18 est perpendiculaire à la direction longitudinale à l'extrémité libre de la portion d'extrémité 32B arrière.  The rear end portion 32B ends here perpendicular to the longitudinal direction L. The side face 18 is perpendicular to the longitudinal direction at the free end of the rear end portion 32B.
La portion d'extrémité 32B arrière est munie d'une encoche 42 de préhension destinée à recevoir un outil de préhension, par exemple pour l'installation de l'implant 10 pendant l'opération chirurgicale. La portion d'extrémité 32B arrière est par exemple munie de deux encoches 42 situées de part et d'autre de la portion d'extrémité 32A. The rear end portion 32B is provided with a grip notch 42 for receiving a grasping tool, for example for the installation of the implant 10 during the surgical procedure. The rear end portion 32B is for example provided with two notches 42 located on either side of the end portion 32A.
En option, la portion d'extrémité 32B arrière possède un orifice taraudé (non visible) situé entre les deux encoches 42 pour l'assemblage de l'outil de préhension avec l'implant 10 par vissage. L'orifice taraudé s'étend suivant la direction longitudinale L.  Optionally, the rear end portion 32B has a tapped hole (not visible) located between the two notches 42 for the assembly of the gripping tool with the implant 10 by screwing. The threaded orifice extends in the longitudinal direction L.
Avantageusement, en option, un autre orifice taraudé 44 est ménagé dans la portion d'extrémité 32A avant, afin de permettre le retrait de l'implant 10.  Advantageously, as an option, another threaded orifice 44 is formed in the front end portion 32A in order to allow the removal of the implant 10.
Les portions d'extrémité 32A, 32B s'étendent ici sensiblement dans la continuité de la portion centrale 30. Le corps 12 dans son ensemble (i.e. en incluant la portion centrale 30 et les portions d'extrémité 32A, 32B) présente une forme fuselée, avec ici une portion d'extrémité 32A avant arrondie et une portion d'extrémité arrière 32B tronquée perpendiculairement à la direction longitudinale.  The end portions 32A, 32B here extend substantially in the continuity of the central portion 30. The body 12 as a whole (ie by including the central portion 30 and the end portions 32A, 32B) has a tapered shape , here with a rounded front end portion 32A and a rear end portion 32B truncated perpendicularly to the longitudinal direction.
La face latérale 18 ne forme pas d'angle à la jonction entre la portion centrale 30 et chaque portion d'extrémité 32A, 32B.  The side face 18 does not form an angle at the junction between the central portion 30 and each end portion 32A, 32B.
L'implant de la figure 2 est par exemple une cage OLIF (acronyme anglais pour The implant of FIG. 2 is for example an OLIF cage (acronym for
« Oblique Lumbar Interbody Fusion »). "Oblique Lumbar Interbody Fusion").
L'implant de la figure 3 diffère de celui de la figure 2 en ce que les portions d'extrémité 32 se présentent sous la forme de saillies s'étendant longitudinalement à partir de la portion centrale 30.  The implant of Figure 3 differs from that of Figure 2 in that the end portions 32 are in the form of protrusions extending longitudinally from the central portion 30.
La face latérale 18 forme un angle non nul à la jonction entre la portion centrale 30 et chaque portion d'extrémité 32A, 32B.  The side face 18 forms a non-zero angle at the junction between the central portion 30 and each end portion 32A, 32B.
Dans l'exemple illustré, la portion centrale 30 présente une forme générale fuselée, chaque portion d'extrémité 32A, 32B s'étendant à partir d'une extrémité de la portion centrale 30.  In the example shown, the central portion 30 has a generally tapered shape, each end portion 32A, 32B extending from one end of the central portion 30.
Chaque portion d'extrémité 32A, 32B présente ici une forme générale parallélépipédique avec par exemple des faces situées sur la face latérale 18 du corps 12 qui sont sensiblement parallèles à la direction longitudinale L.  Each end portion 32A, 32B here has a parallelepipedal general shape with for example faces on the lateral face 18 of the body 12 which are substantially parallel to the longitudinal direction L.
Les portions d'extrémité 32A, 32B saillantes forment par exemple des surfaces d'appui supplémentaires sur l'os cortical.  The projecting end portions 32A, 32B form, for example, additional bearing surfaces on the cortical bone.
Elles forment des cales d'espacement au niveau des parties latérales de l'os cortical des vertèbres entre lesquelles l'implant 10 est implanté. De telles cales d'espacement permettent de réduire une scoliose.  They form spacers at the lateral portions of the cortical bone of the vertebrae between which the implant 10 is implanted. Such spacers reduce scoliosis.
Avantageusement, le corps 12 présente une longueur, considérée selon l'axe longitudinal, supérieure ou égale à 40 mm, par exemple 43 mm ou 47 mm. Ainsi, les portions d'extrémité 32A, 32B s'étendent suffisamment pour former des surfaces d'appui satisfaisantes sur l'os cortical des vertèbres lorsque l'implant 10 est implanté. Advantageously, the body 12 has a length, considered along the longitudinal axis, greater than or equal to 40 mm, for example 43 mm or 47 mm. Thus, the end portions 32A, 32B extend sufficiently to form satisfactory bearing surfaces on the cortical bone of the vertebrae when implant 10 is implanted.
Avantageusement, le corps 12 présente, suivant une direction transversale perpendiculaire T à la direction longitudinale L, une largeur comprise entre 15 et 21 mm. Par exemple, le rapport de la longueur sur la largeur est compris entre 2 et 2,5.  Advantageously, the body 12 has, in a transverse direction perpendicular T to the longitudinal direction L, a width of between 15 and 21 mm. For example, the ratio of the length to the width is between 2 and 2.5.
Avantageusement, chaque portion d'extrémité 32A, 32B s'étend suivant la direction longitudinal L sur une longueur comprise entre 1 /10 et 1 /5 de la longueur de l'implant 10 suivant la direction longitudinal L.  Advantageously, each end portion 32A, 32B extends in the longitudinal direction L over a length of between 1/10 and 1/5 of the length of the implant 10 along the longitudinal direction L.
Par exemple, chaque portion d'extrémité 32A, 32B s'étend suivant la direction longitudinal L sur une longueur comprise entre 3 et 7 mm, par exemple sur une longueur sensiblement égale à 5,50 mm.  For example, each end portion 32A, 32B extends in the longitudinal direction L over a length of between 3 and 7 mm, for example over a length substantially equal to 5.50 mm.
L'implant de la figure 3 est par exemple une cage OLIFAN (acronyme anglais pour « Oblique Lumbar Interbody Fusion).  The implant of FIG. 3 is for example an OLIFAN cage (acronym for "Oblique Lumbar Interbody Fusion").
On notera que l'invention n'est pas limitée aux modes de réalisation précédemment décrits, et pourrait présenter diverses variantes.  Note that the invention is not limited to the embodiments described above, and could have various variants.
Conformément à une première variante, chacune des ouvertures supérieures 20 et inférieures 22 est recouverte, au moins partiellement, par une paroi perméable respective.  According to a first variant, each of the upper and lower openings 22 is covered, at least partially, by a respective permeable wall.
Dans ce cas, le greffon est introduit dans l'espace intérieur 24 à travers les ouvertures latérales 19.  In this case, the graft is introduced into the interior space 24 through the lateral openings 19.
Conformément à une autre variante, chaque paroi perméable 28 recouvre uniquement une partie périphérique de l'ouverture 20, 22 correspondante. Dans ce cas, la paroi perméable 28 laisse libre un passage central servant à l'introduction du greffon dans l'espace intérieur 24. Cette paroi perméable périphérique 28 permet toutefois un maintien du greffon dans l'espace intérieur.  According to another variant, each permeable wall 28 covers only a peripheral portion of the opening 20, 22 corresponding. In this case, the permeable wall 28 leaves free a central passage for the introduction of the graft into the interior space 24. This permeable peripheral wall 28, however, allows the graft to be held in the interior space.
Conformément à une autre variante, chaque ouverture inférieure 22 est recouverte intégralement d'une paroi perméable 28, et chaque ouverture supérieure 20 est recouverte d'une paroi perméable uniquement sur sa périphérie.  According to another variant, each lower opening 22 is completely covered with a permeable wall 28, and each upper opening 20 is covered with a permeable wall only on its periphery.
Toute autre variante est envisageable dans le cadre des revendications.  Any other variant is conceivable within the scope of the claims.

Claims

REVENDICATIONS
1 . Implant intersomatique (10), comportant un corps (12) présentant une face supérieure (14), une face inférieure (16), et une face latérale circonférentielle (18) reliant les faces supérieure (14) et inférieure (16), le corps (12) comprenant au moins une ouverture (20, 22) ménagée dans au moins l'une des faces supérieure (14) et inférieure (16) et un espace intérieur (24) débouchant à ladite ouverture (20, 22), caractérisé en ce qu'il comporte au moins une paroi perméable (28), notamment poreuse ou réticulée, recouvrant au moins en partie ladite ouverture (20, 22). 1. An intersomatic implant (10) having a body (12) having an upper face (14), a lower face (16), and a circumferential side face (18) connecting the upper (14) and lower (16) faces, the body (12) comprising at least one opening (20, 22) in at least one of the upper (14) and lower (16) faces and an interior space (24) opening to said opening (20, 22), characterized in that it comprises at least one permeable wall (28), in particular porous or crosslinked, at least partially covering said opening (20, 22).
2. Implant intersomatique (10) selon la revendication 1 , dans lequel le corps (12) comprend une ouverture supérieure (20) ménagée dans la face supérieure (14), et une ouverture inférieure (22) ménagée dans la face inférieure (16), l'espace intérieur (24) s'étendant entre les ouvertures supérieure (20) et inférieure (24), au moins l'une de ces ouvertures inférieure (22) et supérieure (20) étant au moins en partie recouverte d'une paroi perméable (28). The intersomatic implant (10) according to claim 1, wherein the body (12) comprises an upper opening (20) in the upper face (14), and a lower opening (22) in the lower face (16). , the interior space (24) extending between the upper (20) and lower (24) openings, at least one of which (22) and upper (20) openings is at least partially covered by a permeable wall (28).
3. Implant intersomatique (10) selon la revendication 2, dans lequel chacune des ouvertures supérieure (20) et inférieure (22) est recouverte, au moins partiellement, par une paroi perméable (28) respective. The interbody implant (10) of claim 2, wherein each of the upper (20) and lower (22) openings is at least partially covered by a respective permeable wall (28).
4. Implant intersomatique (10) selon l'une quelconque des revendications précédentes, dans lequel la paroi perméable (28) est formée par un filet. The intersomatic implant (10) according to any one of the preceding claims, wherein the permeable wall (28) is formed by a net.
5. Implant intersomatique (10) selon l'une quelconque des revendications précédentes, dans lequel la paroi perméable (28) est venue de matière avec le corps (12). The intersomatic implant (10) according to any one of the preceding claims, wherein the permeable wall (28) is integral with the body (12).
6. Implant intersomatique (10) selon la revendication 5, dans lequel le corps (12) et la paroi perméable (28) sont réalisés par impression tridimensionnelle. The intersomatic implant (10) of claim 5, wherein the body (12) and the permeable wall (28) are made by three-dimensional printing.
7. Implant intersomatique (10) selon l'une quelconque des revendications 1 à 6, dans lequel la paroi perméable (28) recouvre intégralement l'ouverture (20, 22) correspondante. The intersomatic implant (10) according to any one of claims 1 to 6, wherein the permeable wall (28) completely covers the corresponding opening (20, 22).
8. Implant intersomatique (10) selon l'une quelconque des revendications 1 à 6, dans lequel la paroi perméable (28) recouvre uniquement une partie périphérique de l'ouverture (20, 22) correspondante. The intersomatic implant (10) according to any one of claims 1 to 6, wherein the permeable wall (28) covers only a peripheral portion of the corresponding opening (20, 22).
9. Implant intersomatique (10) selon l'une quelconque des revendications précédentes, dans lequel la face latérale circonférentielle (18) comporte au moins une ouverture latérale (19), débouchant dans l'espace intérieur (24). 9. intersomatic implant (10) according to any one of the preceding claims, wherein the circumferential side face (18) comprises at least one lateral opening (19), opening into the interior space (24).
10. Implant intersomatique (10) selon l'une quelconque des revendications précédentes, dans lequel le corps (12) et la paroi perméable (28) sont réalisés en un matériau biocompatible, notamment en titane. The intersomatic implant (10) according to any one of the preceding claims, wherein the body (12) and the permeable wall (28) are made of a biocompatible material, especially titanium.
1 1 . Implant intersomatique (10) selon l'une quelconque des revendications précédentes, dans lequel le corps (12) une ou chacune des faces supérieure et inférieure (14, 16) est munie d'une surface rugueuse. 1 1. An interbody implant (10) as claimed in any one of the preceding claims, wherein the body (12) has one or each of the upper and lower faces (14,16) provided with a rough surface.
12. Implant intersomatique (10) selon l'une quelconque des revendications précédentes, dans lequel le corps (12) possède une portion centrale et deux portions d'extrémité formant des surfaces d'appuis supplémentaires sur l'os cortical. The intersomatic implant (10) according to any of the preceding claims, wherein the body (12) has a central portion and two end portions forming additional bearing surfaces on the cortical bone.
13. Implant intersomatique (10) selon la revendication 12, dans lequel une ou chacune des faces supérieure et inférieure (14, 16) est munie d'une surface rugueuse sur la partie centrale et d'une surface lisse sur une ou chacune des portions d'extrémité. The intersomatic implant (10) according to claim 12, wherein one or each of the upper and lower faces (14,16) is provided with a rough surface on the central portion and a smooth surface on one or each of the portions. end.
14. Implant intersomatique (10) selon la revendication 12 ou 13, dans lequel les portions d'extrémité (32A, 32B) s'étendent dans la continuité de la portion centrale (30), la face latérale (18) ne faisant pas d'angle à la jonction entre la portion centrale (30) et chaque partie d'extrémité (32A, 32B) ou font saillie par rapport à la portion centrale (30), la face latérale (18) faisant un angle non nul à la jonction entre la portion centrale (30) et chaque partie d'extrémité (32A, 32B). 14. intersomatic implant (10) according to claim 12 or 13, wherein the end portions (32A, 32B) extend in the continuity of the central portion (30), the lateral face (18) not making angle at the junction between the central portion (30) and each end portion (32A, 32B) or protrude from the central portion (30), the side face (18) forming a non-zero angle at the junction between the central portion (30) and each end portion (32A, 32B).
15.- Implant intersomatique (10) selon l'une quelconque des revendications 12 à 14, dans lequel au moins une portion d'extrémité (32A, 32B) est munie d'au moins une encoche pour recevoir un outil de préhension et/ou d'un orifice taraudé pour l'assemblage de l'implant (10) avec l'outil de préhension. 15. The intersomatic implant (10) according to any one of claims 12 to 14, wherein at least one end portion (32A, 32B) is provided with at least one notch for receiving a gripping tool and / or a threaded orifice for the assembly of the implant (10) with the gripping tool.
PCT/EP2018/050297 2017-01-06 2018-01-05 Intervertebral implant with graft retention WO2018127574A1 (en)

Applications Claiming Priority (2)

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FR1750155A FR3061650B1 (en) 2017-01-06 2017-01-06 INTERSOMATIC IMPLANT WITH GRAFT RETENTION
FR1750155 2017-01-06

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11173043B1 (en) 2019-05-17 2021-11-16 Joseph T. Robbins Spinal interbody implants

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2003068111A1 (en) * 2002-02-13 2003-08-21 Danfoss A/S Implant for spine and method for manufacturing same
US20040249461A1 (en) * 1999-08-13 2004-12-09 Ferree Bret A. Coupled artificial disc replacements methods and apparatus
US20110054408A1 (en) * 2007-07-10 2011-03-03 Guobao Wei Delivery systems, devices, tools, and methods of use
US20130110238A1 (en) * 2011-10-26 2013-05-02 Warsaw Orthopedic, Inc. Interbody implant
US20150250607A1 (en) * 2014-03-10 2015-09-10 Warsaw Orthopedic, Inc. Interbody implant system and method
US20160270920A1 (en) * 2014-10-23 2016-09-22 Spinesmith Partners, L.P. Treatment of skeletal voids with implantable substrate hydrated with bone marrow concentrate

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20040249461A1 (en) * 1999-08-13 2004-12-09 Ferree Bret A. Coupled artificial disc replacements methods and apparatus
WO2003068111A1 (en) * 2002-02-13 2003-08-21 Danfoss A/S Implant for spine and method for manufacturing same
US20110054408A1 (en) * 2007-07-10 2011-03-03 Guobao Wei Delivery systems, devices, tools, and methods of use
US20130110238A1 (en) * 2011-10-26 2013-05-02 Warsaw Orthopedic, Inc. Interbody implant
US20150250607A1 (en) * 2014-03-10 2015-09-10 Warsaw Orthopedic, Inc. Interbody implant system and method
US20160270920A1 (en) * 2014-10-23 2016-09-22 Spinesmith Partners, L.P. Treatment of skeletal voids with implantable substrate hydrated with bone marrow concentrate

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11173043B1 (en) 2019-05-17 2021-11-16 Joseph T. Robbins Spinal interbody implants

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FR3061650B1 (en) 2020-10-02

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