DE4208115A1 - Bandscheibenendoprothese - Google Patents
BandscheibenendoprotheseInfo
- Publication number
- DE4208115A1 DE4208115A1 DE4208115A DE4208115A DE4208115A1 DE 4208115 A1 DE4208115 A1 DE 4208115A1 DE 4208115 A DE4208115 A DE 4208115A DE 4208115 A DE4208115 A DE 4208115A DE 4208115 A1 DE4208115 A1 DE 4208115A1
- Authority
- DE
- Germany
- Prior art keywords
- prosthesis
- intervertebral disc
- plate
- vertebral bodies
- screw
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Withdrawn
Links
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
- A61F2/442—Intervertebral or spinal discs, e.g. resilient
- A61F2/4425—Intervertebral or spinal discs, e.g. resilient made of articulated components
-
- 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
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
-
- 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
- A61F2002/30108—Shapes
- A61F2002/3011—Cross-sections or two-dimensional shapes
- A61F2002/30138—Convex polygonal shapes
- A61F2002/30156—Convex polygonal shapes triangular
-
- 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
- A61F2002/30576—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs
-
- 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
- A61F2002/30621—Features concerning the anatomical functioning or articulation of the prosthetic joint
- A61F2002/30639—Features concerning the anatomical functioning or articulation of the prosthetic joint having rolling elements between both articulating surfaces
- A61F2002/30642—Features concerning the anatomical functioning or articulation of the prosthetic joint having rolling elements between both articulating surfaces having a single rolling (or sliding) ball articulating between two cups
-
- 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
- A61F2002/30621—Features concerning the anatomical functioning or articulation of the prosthetic joint
- A61F2002/30649—Ball-and-socket joints
- A61F2002/30663—Ball-and-socket joints multiaxial, e.g. biaxial; multipolar, e.g. bipolar or having an intermediate shell articulating between the ball and the socket
-
- 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
- A61F2002/3082—Grooves
-
- 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
- A61F2002/30841—Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
-
- 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
- A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
- A61F2002/30891—Plurality of protrusions
- A61F2002/30892—Plurality of protrusions parallel
-
- 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
- A61F2/4425—Intervertebral or spinal discs, e.g. resilient made of articulated components
- A61F2002/443—Intervertebral or spinal discs, e.g. resilient made of articulated components having two transversal endplates and at least one intermediate component
-
- 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0017—Angular shapes
- A61F2230/0023—Angular shapes triangular
Landscapes
- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Neurology (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
Description
Die Erfindung betrifft eine Bandscheibenendoprothese, die eine
Grund- und eine Deckplatte umfaßt, die jeweils mit einem
Wirbelkörper zu verbinden sind.
Bei bekannten Bandscheibenendoprothesen dieser Art (EP-OS
01 76 728; Prospekt "LINK Zwischenwirbelendoprothese Modell
SB-Charit´" der Firma W. Link, 1988; FR-A-26 59 226), sind auf
den den Wirbeln zugewendeten Außenseiten der Platten Zähne
oder Vorsprünge vorgesehen, die in die Oberfläche der Wirbel
körper eindringen und dadurch die Prothese im Zwischenwirbel
raum festhalten. Dies reicht im allgemeinen selbst dann aus,
wenn die Zwischenwirbelräume sich in infolge einer vermehrten
Lordose nach vorne hin keilförmig verstärkt öffnen. Deshalb
ist eine zusätzlich Fixierung der Prothese an den zugehörigen
Wirbelkörpern bislang nicht für notwendig gehalten worden.
Jedoch hat die Erfindung erkannt, daß es Fälle gibt, in denen
die Wirksamkeit der Zähne beeinträchtigt ist, beispielsweise
wenn Welligkeit oder Krümmung der Wirbelkörperendplatten die
Zähne an hinreichendem Eindringen hindert.
Erfindungsgemäß wird die Haltesicherheit der Prothese dadurch
erhöht, daß die Grund- und/oder die Deckplatte der Prothese
mit Schraubbefestigungseinrichtungen versehen sind, die mit
dem jeweils zugehörigen Wirbelkörper zusammenwirken.
Die Schraubfixation von Prothesen am Knochen ist an sich
bekannt. Jedoch wird sie nur dann angewendet, wenn eine
Fixation auf andere Weise nicht möglich erscheint. Bei Band
scheibenendoprothesen schien die eingangs geschilderte Fixati
on aufgrund der herrschenden Annahme über die Form der Wirbel
körperendplatten auszureichen. Die Erfindung beruht demgemäß
auf der Erkenntnis, daß diese Annahme nicht immer zutrifft.
Zweckmäßigerweise sind die Schraubbefestigungseinrichtungen am
ventralen Rand der Prothese angeordnet. Zum einen ist dieser
am besten zugänglich. Zum anderen steht hier in vielen Fällen
mehr Platz für die Schraubenfixierung zur Verfügung, da man
häufig das Gelenkzentrum der Prothese aus dem Zentrum des Zwi
schenwirbelraums weiter nach hinten verlegt, um einen günsti
geren Kraftverlauf zu erzielen. Die Schraubfixation und die
Verschiebung des Gelenkzentrums nach hinten können auch
insofern im Sinne der Prothesenfixation zusammenwirken, als
die Lordosierung um so geringer ist, je weiter hinten das
Gelenkzentrum der Prothese liegt. Um so geringer sind auch die
Kräfte, die infolge keilförmiger Öffnung des Wirbelzwischen
raums die Prothese nach vorne drängen.
Meist genügt es, die Schraubfixierung lediglich bei der
Grundplatte oder der Deckplatte vorzunehmen.
Bei einer einfachen und deshalb zweckmäßigen Ausführungsform
der Erfindung bestehen die Schraubbefestigungseinrichtungen
aus wenigstens einer Bohrung zur Aufnahme einer Knochenschrau
be. Diese Bohrung kann am Rand der eigentlichen Grund- bzw.
Deckplatte angeordnet sein und demzufolge eine Richtung haben,
die quer, ggf. ein wenig schräg, zur Plattenebene verläuft.
Sie kann auch in einer laschenförmigen Verlängerung der Platte
angeordnet sein, wobei die Lasche in der Plattenebene liegt.
Mitunter genügt auch eine randoffene Ausnehmung an der Platte,
die mit der Befestigungsschraube zusammenwirkt, wobei die
Schraube im Zusammenwirken mit der Ausnehmung eine nach vorne
oder nach schräg vorne gerichtet Verlagerung der Prothese
verhindert. Eine Verlagerung nach hinten ist ohnehin in der
Regel nicht zu erwarten. Schließlich können die Befestigungs
einrichtungen auch von einer Lasche gebildet sein, die gegen
über der Plattenebene abgekantet ist und an die Vorderseite
des Wirbels angelegt wird, um eine von vorne nach hinten
gerichtet Knochenschraube aufzunehmen. Die Lasche kann auch in
die Vorderseite des Wirbel eingebettet sein, um eine etwaige
Gefährdung der unmittelbar vor den Wirbeln verlaufenden
Blutgefäße zu vermeiden.
Wenn in diesem Zusammenhang von der Schraubbefestigung, der
Bohrung oder der Lasche in der Einzahl gesprochen wird, so
bedeutet dies nicht, daß nur eine einzige Schraubbefestigung
angewendet werden soll. Es können auch mehrere Schraubbefe
stigungen, insbesondere in paarig symmetrischer Anordnung,
vorgesehen werden.
Die Erfindung wird im folgenden näher unter Bezugnahme auf die
Zeichnung erläutert, die vorteilhafte Ausführungsbeispiele
veranschaulicht. Es zeigt
Fig. 1 einen Medianschnitt einer ersten Ausführungs
form der Prothese zwischen zwei Wirbelkörpern,
Fig. 2 eine entsprechend Ansicht von vorne,
Fig. 3 eine Draufsicht auf die Deckplatte einer zweiten
Ausführungsform der Prothese am Wirbelkörper und
Fig. 4 eine Ansicht von vorne von derselben Anordnung,
Fig. 5 eine Draufsicht auf eine dritte Ausführungsform der
Prothesenplatte mit randoffenen Schraubenausneh
mungen, und
Fig. 6 eine vierte Ausführungsform, bei welcher die
Schrauböffnungen in Laschen angeordnet sind.
Die Prothese besteht aus einer Deckplatte 1 und einer Grund
platte 2, die übereinstimmend spiegelbildlich ausgebildet sind
und aus Metall bestehen und zwischen sich einen Prothesenkern
3 aus Polyethylen einschließen. Die Prothesenplatten 1, 2 und
der Prothesenkern 3 wirken über sphärische Gelenkflächen 4
zusammen. Der Kern 3 weist einen Randwulst 5 auf, der seinen
Bewegungsspielraum eingrenzt und auch unter Extrembedingungen
für den Zusammenhalt der Prothese sorgt. Der Kern kann in
einer anderen Ausführung mit einer der Platten fest verbunden
sein.
Die etwa ebenen Endplatten 6 der Prothesenplatten 1, 2 liegen
auf den Endflächen der Wirbelkörper auf. Sie sind mit einer
Anzahl (beispielsweise sechs) Zähnen 7 versehen, die in die
Wirbelkörper unter Belastung eindringen und dadurch die
Prothese an Ort und Stelle sichern. Soweit kann die Prothese
als bekannt betrachtet werden.
In der ersten Ausführungsform gemäß Fig. 1 und 2 sind am
vorderen Rand 8 der Prothesenplatten 1, 2, der über die
Vorderkanten der Wirbelkörper hinwegragt, Laschen 9 angeord
net, die sich etwa parallel zur nach vorne gewendeten Wirbel
körperoberfläche winklig zur Prothesenplatte 1, 2 erstrecken
und an der Wirbelkörperoberfläche anliegen. Sie enthalten
Bohrungen 10 zur Aufnahme von Schrauben 11, die dank der
ventral offenen Lage der Laschen 9 leicht eingebracht werden
können und mit der harten, vorderen Knochenrinde der Wirbel
körper sicher zusammenwirken. Sie sind symmetrisch so angeord
net, daß der ventrale Mittelbereich frei bleibt, so daß sich
dort in der Nähe wichtiger Blutgefäße keine Schrauben befin
den. Die Schrauben 11 verlaufen mit überwiegend parallel zu
den Prothesenplatten 1, 2 verlaufender Hauptrichtung. Entspre
chend können auch die Bohrungen 10 in den Laschen 9 verlaufen.
In einer Abwandlung dieser Ausführungsform werden die Laschen
9 in die Wirbelkörper vorderseitig eingebettet, so daß sie
nicht vorstehen und weder ihre Kanten noch die Schraubenköpfe
die vor den Wirbelkörpern befindlichen Organe gefährden,
insbesondere die dort verlaufenden Blutgefäße.
Fig. 1 zeigt das Gelenkzentrum der Prothese etwa zentrisch im
Verhältnis zu den beiden angrenzenden Wirbelkörpern. Wird
dieselbe Prothese so implantiert, daß die Laschen 9 in die
Vorderseite der Wirbelkörper eingebettet sind, verlagert sich
das Bewegungszentrum ein wenig nach hinten, was im Sinne eines
günstigen Kraftverlaufs mitunter bevorzugt wird.
Diese Verlagerung des Gelenkzentrums nach hinten erkennt man
auch in der zweiten Ausführungsform der Darstellung der Fig. 3.
Dabei sind die Bohrungen 12 für die Knochenschrauben 11 im
Rand der Prothesenlatte 1, 2 untergebracht. Die Knochensch
rauben 11 verlaufen daher im wesentlichen quer zur Ebene der
Prothesenplatten.
In der Ausführung gemäß Fig. 5 sind die Bohrungen 13 für die
Knochenschrauben derart in den Randbereich der Prothesenplatte
1, 2 verlagert, daß sie randoffen sind. Dadurch wird im
Vergleich mit der Ausführung gemäß Fig. 3 Platz gespart, der
demzufolge für eine größere, kraftübertragende Gelenkfläche
zur Verfügung steht. Zur Fixation der Prothese reichen die
randoffenen Ausnehmungen in der Regel aus, da in der Regel
nicht mit Kräften zu rechnen ist, die die Prothese nach hinten
verlagern könnten.
Schließlich können gemäß der Ausführungsform, die in Fig. 6
dargestellt ist, die Bohrungen 14 für die Knochenschrauben
auch in besonderen Laschen 15 vorgesehen sein, die in der
Ebene der Prothesenplatten 1, 2 nach vorne ragen. Diese
Anordnung bietet sich insbesondere in den Fällen an, in denen
eine starke Verlagerung des Gelenkzentrums 16 nach hinten
beabsichtigt ist.
Claims (6)
1. Bandscheibenendoprothese, die zwischen zwei Wirbelkörper
einzusetzen ist und eine Grundplatte (2) und eine Deck
platte (1) aufweist, dadurch gekennzeichnet, daß die
Grund- und/oder die Deckplatte der Prothese mit Schraubbe
festigungseinrichtungen (9 bis 15) versehen sind.
2. Bandscheibenendoprothese nach Anspruch 1, dadurch gekenn
zeichnet, daß die Schraubbefestigungseinrichtungen am
vorderen Rand an wenigstens einer der Platten (1, 2) der
Prothese angeordnet sind.
3. Bandscheibenendoprothese nach Anspruch 2, dadurch gekenn
zeichnet, daß das Gelenkzentrum der Prothese gegenüber dem
Zentrum der Wirbelkörperendplatten nach hinten verlagert
ist.
4. Bandscheibenendoprothese nach einem der Ansprüche 1 bis 3,
dadurch gekennzeichnet, daß die Schraubbefestigungsein
richtungen wenigstens eine Bohrung (10, 12, 13, 14) zur
Aufnahme einer Knochenschraube (11) umfassen.
5. Bandscheibenendoprothese nach Anspruch 4, dadurch gekenn
zeichnet, daß die Bohrung (12 bis 14) eine quer zur
Plattenebene verlaufende Richtung aufweist.
6. Bandscheibenendoprothese nach Anspruch 5, dadurch gekenn
zeichnet, daß die Bohrung (10) in einer Abkantung (9) der
Platte (1, 2) vorgesehen ist und ihre Richtung parallel
oder spitzwinklig zu der Plattenebene verläuft.
Priority Applications (7)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE4208115A DE4208115A1 (de) | 1992-03-13 | 1992-03-13 | Bandscheibenendoprothese |
AT93102992T ATE165726T1 (de) | 1992-03-13 | 1993-02-25 | Bandscheibenendoprothese |
ES93102992T ES2117064T3 (es) | 1992-03-13 | 1993-02-25 | Endoprotesis de disco intervertebral. |
EP93102992A EP0560140B1 (de) | 1992-03-13 | 1993-02-25 | Bandscheibenendoprothese |
DE59308489T DE59308489D1 (de) | 1992-03-13 | 1993-02-25 | Bandscheibenendoprothese |
JP05058393A JP3181131B2 (ja) | 1992-03-13 | 1993-03-11 | 椎間板内部補綴具 |
US08/287,701 US5556431A (en) | 1992-03-13 | 1994-08-09 | Intervertebral disc endoprosthesis |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
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DE4208115A DE4208115A1 (de) | 1992-03-13 | 1992-03-13 | Bandscheibenendoprothese |
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DE4208115A Withdrawn DE4208115A1 (de) | 1992-03-13 | 1992-03-13 | Bandscheibenendoprothese |
DE59308489T Expired - Lifetime DE59308489D1 (de) | 1992-03-13 | 1993-02-25 | Bandscheibenendoprothese |
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EP (1) | EP0560140B1 (de) |
JP (1) | JP3181131B2 (de) |
AT (1) | ATE165726T1 (de) |
DE (2) | DE4208115A1 (de) |
ES (1) | ES2117064T3 (de) |
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Also Published As
Publication number | Publication date |
---|---|
DE59308489D1 (de) | 1998-06-10 |
JP3181131B2 (ja) | 2001-07-03 |
ATE165726T1 (de) | 1998-05-15 |
JPH067390A (ja) | 1994-01-18 |
US5556431A (en) | 1996-09-17 |
ES2117064T3 (es) | 1998-08-01 |
EP0560140B1 (de) | 1998-05-06 |
EP0560140A1 (de) | 1993-09-15 |
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