DE4208116A1 - Bandscheibenendoprothese - Google Patents
BandscheibenendoprotheseInfo
- Publication number
- DE4208116A1 DE4208116A1 DE4208116A DE4208116A DE4208116A1 DE 4208116 A1 DE4208116 A1 DE 4208116A1 DE 4208116 A DE4208116 A DE 4208116A DE 4208116 A DE4208116 A DE 4208116A DE 4208116 A1 DE4208116 A1 DE 4208116A1
- Authority
- DE
- Germany
- Prior art keywords
- prosthesis
- intervertebral disc
- plates
- core
- section
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
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
- 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
- A61F2002/30112—Rounded shapes, e.g. with rounded corners
- A61F2002/30125—Rounded shapes, e.g. with rounded corners elliptical or oval
-
- 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
- A61F2002/30108—Shapes
- A61F2002/30199—Three-dimensional shapes
- A61F2002/30252—Three-dimensional shapes quadric-shaped
- A61F2002/30253—Three-dimensional shapes quadric-shaped ellipsoidal or ovoid
-
- 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
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30383—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
- A61F2002/3039—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove with possibility of relative movement of the rib within the groove
- A61F2002/30392—Rotation
- A61F2002/30393—Rotation with additional means for limiting said rotation
-
- 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
- A61F2002/30841—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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
-
- 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
- A61F2230/0004—Rounded shapes, e.g. with rounded corners
- A61F2230/0008—Rounded shapes, e.g. with rounded corners elliptical or oval
-
- 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
-
- 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
- A61F2230/0063—Three-dimensional shapes
- A61F2230/0073—Quadric-shaped
- A61F2230/0076—Quadric-shaped ellipsoidal or ovoid
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S606/00—Surgery
- Y10S606/907—Composed of particular material or coated
- Y10S606/91—Polymer
Description
Die Erfindung betrifft eine Bandscheibenendoprothese mit zwei
Abschlußplatten, die mit den Endplatten der zugehörigen
Wirbelkörper zu verbinden sind, und einem Prothesenkern, der
mit mindestens einer Abschlußplatte über eine eine Schwenk
bewegung gestattende Gelenkfläche zusammenwirkt.
Bei bekannten Bandscheibenendoprothesen dieser Art (EP-OS
01 76 728, FR-OS 26 59 226, DE-OS 28 04 936) ist die Gelenk
fläche sphärisch. Die durch die Prothese miteinander verbunde
nen Wirbelkörper können daher nicht nur Beugebewegungen in der
Medianebene und der Frontalebene, sondern auch Rotationsbewe
gungen um die Hochachse frei durchführen. Diese Rotationsbewe
gung wird auch nicht durch Anschläge von Abschlußplattenteilen
aneineinander gehindert. - Bei einer anderen bekannten Band
scheibenendoprothese (DE-PS 30 23 353) wird hingegen eine
Rotationsbewegung durch Abschlußplattenanschläge aneinander
unmöglich gemacht; eine Schwenkbewegung ist lediglich in der
Medianebene möglich. Dies hat nicht nur den Nachteil, daß an
den Abschlußplatten Teile aus gleichem Material mit entspre
chend hohem Abrieb und hoher Reibung aufeinander gleiten,
sondern daß auch bei einer Rotationsbewegung des Körpers auf
die Verankerung der Prothese an den zugehörigen Wirbelkörpern
hohe Kräfte wirken, die im Hinblick auf eine dauerhafte
Fixation der Prothesenteile an den Wirbelkörpern nachteilig
sind. Jedoch hat auch die freie Drehbeweglichkeit der zuvor
erwähnten Prothesen Nachteile in sofern, als der notwendige
Drehwiderstand, der von der natürlichen Bandscheibe dank deren
Faserbeschaffenheit und -anordnung geleistet werden kann,
mindestens bis zur Bildung ausreichenden Narbengewebes ent
fällt und daher die Wirbelbogengelenke überlastet werden
können, was zu Beschwerden führen kann.
Erwünscht ist deshalb
eine Bandscheibenendoprothese, die der Verdrehung um die
Hochachse einen Widerstand entgegensetzt, ohne daß dies durch
Anschläge an den Abschlußplatten erzielt wird.
Die erfindungsgemäße Lösung besteht darin, daß die Gelenkflä
che im Sagittalschnitt und im Frontalschnitt Krümmungsbögen
von unterschiedlichem mittlerem Radius bildet. Vorzugsweise
sind die Krümmungsradien im Sagittalschnitt kleiner als im
Frontalschnitt. Die Krümmungsradien in den zueinander quer
stehenden Hauptrichtungen unterscheiden sich zweckmäßigerweise
um den Faktor 1,2 bis 2,5, vorzugsweise 1,5 bis 2. Sie sind
zweckmäßigerweise in den Hauptschnittebenen Kreisbögen oder
der Kreisbogenform angenähert.
Die Wirkung dieser Maßnahme besteht darin, daß eine Rotation
der Prothesenteile um die Hochachse zwar möglich ist, daß aber
die Prothese dabei infolge des Aufgleitens der seitlichen
schrägen Flanken der Gleitflächen aufeinander auseinanderge
spreizt wird, wodurch aufgrund der Gewichtsbelastung ein
rückführendes Moment entsteht. Umgekehrt könnte man auch
sagen, daß die Rotationsbewegung der Prothese um die Hochachse
sanft gebremst wird und die Prothese eine Tendenz hat, zur
neutralen Stellung zurückzukehren.
In manchen Fällen kann es trotz des erfindungsgemäß erzeugten
Widerstands gegen eine Rotation der Prothese um die Hochachse
zweckmäßig sein, den maximal verfügbaren Rotationswinkel durch
Anschläge zu begrenzen, die zwischen den Prothesenplatten oder
besser zwischen dem Prothesenkern und den damit über Gelenk
flächen zusammenwirkenden Prothesenplatten wirken können.
Diese Anschläge werden so angeordnet, daß sie im allgemeinen
nicht in Funktion treten, weil innerhalb des normalen Rotati
onsbereichs der durch die erfindungsgemäße Formgebung der
Gleitflächen erzeugte Rotationswiderstand ausreicht. Sie
sollen lediglich eine Rotation solchen Ausmaßes ausschließen,
daß dadurch Schäden am Wirbelapparat oder an der Prothese
verursacht werden könnten. Im allgemeinen vermeidet man
Anschläge zwischen Prothesenteilen, weil bei heftigem Anschlag
unter Körperschwung Kräfte entstehen können, die den Verbund
zwischen dem Prothesenteil und dem Knochen gefährden können.
Diese Gefahr besteht im vorliegenden Fall nicht, weil der
Körperschwung durch den Rotationswiderstand der Gleitflächen
hinreichend geschwächt worden ist, bevor die Anschläge er
reicht werden.
Bei einer bevorzugten Ausführungsform werden die Anschläge in
die Gleitflächen des Prothesenkerns und der damit zusammenwir
kenden Prothesenplatte(n) eingearbeitet. Diese können zweckmä
ßigerweise die Form einer Nut in der einen Fläche und einer
Feder in der anderen Fläche annehmen, wobei deren Kontur so
gewählt ist, daß der gewünschte Rotationsbereich ebenso
gewährleistet ist wie eine hinreichende Beugung nach vorne und
zu beiden Seiten. Zwar ist es bekannt (US-PS 47 59 766), die
Prothesenplatten und den Prothesenkern mit zusammenwirkenden
Vorsprüngen und Nuten zu versehen. Jedoch ist deren Form nicht
zur Bildung eines Anschlags gegen Rotationsbewegung geeignet;
dies ist auch nicht erforderlich, weil die Gelenkflächen
zylindrisch sind und keine Rotationsmöglichkeit bieten.
Zusätzlich zu oder statt der Nut-Feder-Verbindung kann die
Rotationsbegrenzung auch bewirkt werden durch einen vorzugs
weise umlaufenden Kragen an einem der beiden Teile und einen
damit zusammenwirkenden Rand am anderen Teil. Solche zusammen
wirkenden Kragen und Ränder an dem Prothesenkern und den
Prothesenplatten sind bei kreisrund begrenzten Prothesenteile
an sich bekannt (EP-A 01 76 728, Fig. 1 bis 3), um die Teile
gegenüber seitlicher Relativbewegung zusammenzuhalten. Bei
ovaler Grundform der Teile vermögen sie auch deren Rotation um
die Hochachse zu begrenzen.
Die Erfindung wird im folgenden näher unter Bezugnahme auf die
Zeichnung erläutert, die vorteilhafte Ausführungsbeispiele
veranschaulicht. Darin zeigt
Fig. 1 einen mittleren Frontalschnitt durch die
Prothese in deren Neutralstellung,
Fig. 2 einen der Fig. 1 entsprechenden Schnitt bei
seitlicher Beugung,
Fig. 3 einen Medianschnitt durch die Prothese,
Fig. 4 eine der Fig. 3 entsprechende Darstellung bei
Beugung nach vorne,
Fig. 5 eine Draufsicht auf die Außenfläche der
Prothesenplatten,
Fig. 6 eine Draufsicht auf den Prothesenkern,
Fig. 7 eine Draufsicht auf die Innenseite der
Prothesenplatten, jeweils von einer ersten
Ausführungsform der Erfindung,
Fig. 8 bis 11 Darstellungen entsprechend den Fig. 1, 3, 6
und 7 einer zweiten Ausführungsform,
Fig. 12 und 13 Darstellung entsprechend den Fig. 1 und 3
einer dritten Ausführungsform,
Fig. 14 und 15 zwei der Fig. 1 entsprechende Darstellungen
einer vierten und einer fünften Ausführungs
form der Erfindung.
Die dargestellte Bandscheibenendoprothese besteht aus den
Prothesenplatten, nämlich der Grundplatte 1 und der Deckplatte
2, und dem Prothesenkern 3. Die Prothesenplatten bestehen aus
Metall. Ihre Deckflächen 4, die sich an die ihnen zugewendeten
Deckflächen der Wirbelkörper anlegen, sind mit Zähnen 5
versehen, die in die Wirbelkörper eindringen und dadurch eine
Fixation der Prothese gegenüber den Wirbelkörpern bewirken.
Der Prothesenkern 3 besteht aus Kunststoff mit guten Gleitei
genschaften, insbesondere hochdichtem Polyethylen. Die Prothe
senplatten und der Prothesenkern bilden Gelenkflächen 6, die
im Neutralzustand (Fig. 1 und 3) kongruent sind. Im mittigen
Frontalschnitt (Fig. 1) stellen sie ebenso Kreisbögen dar wie
im Medianschnitt (Fig. 3). In allen sonstigen Sagittal- und
Frontalschnitten bilden sie vorzugsweise Kreisbögen oder sind
sie Kreisbögen angenähert. Dadurch ergeben sich die in Fig. 2
und 4 veranschaulichten Möglichkeiten einer seitlichen und
frontalen Beugebewegung, die bei schräger Beugung auch kombi
niert auftreten können. Der Prothesenkern 3 ist mit einem
Kragen 7 versehen, der mit dem Rand 8 der Prothesenplatten 1,
2 zusammenwirkt, um die seitliche Relativbewegung des Prothe
senkerns gegenüber den Prothesenplatten zu beschränken, wie
man in Fig. 2, rechte Seite, gut erkennt. Insoweit kann die
Prothese als bekannt betrachtet werden.
Erfindungsgemäß sind die Krümmungsradien der Gelenkflächen 6
im Sagittalschnitt und Frontalschnitt unterschiedlich, nämlich
im Sagittalschnitt (Fig. 3) kleiner als im Frontalschnitt
(Fig. 1). Während bei sphärischer Gestaltung der Gleitflächen
deren Kongruenz auch dann noch erhalten bleibt, wenn die
Prothesenplatten sich gegenüber dem Prothesenkern (im Sinne
des Pfeils 10) um die Hochachse 9 verdrehen, ist die Kongruenz
bei der erfindungsgemäßen Gelenkflächenkonfiguration in den
Schnittebenen, die von den Hauptebenen abweichen, nicht mehr
vorhanden. In diesen äußeren Schnittebenen steigt der Prothe
senkern bei der Rotation an den Flanken der Gelenkflächen der
Prothesenplatten hoch. Dadurch werden die Prothesenplatten
entgegen dem auf ihnen lastenden Körpergewicht schraubenförmig
auseinandergezwungen. Das Körpergewicht verursacht demzufolge
ein gegenwirkendes Moment, das die Prothesenplatten in die
Neutralstellung zurückzudrehen sucht. Der Verdrehung der
Prothesenplatten wirkt ein Widerstand entgegen, dessen Größe
durch die Steilheit der zusammenwirkenden Flanken der Gelenk
flächen der Prothesenplatten und des Prothesenkerns bestimmt
wird. Durch die Bemessung dieser Flanken lädt sich der
Widerstand somit in geeigneter Weise bemessen. Er wird zweck
mäßigerweise so bemessen, daß er keinesfalls die zwischen den
Prothesenplatten und den Wirbelkörpern übertragbaren Veranke
rungskräfte übersteigt.
Bei einem gewissen Verdrehwinkel kommt der Kragen 7 des
Prothesenkerns mit dem Rand 8 der Prothesenplatten auch dann
in Eingriff, wenn die Symmetrieachsen 9 sämtlicher Komponenten
miteinander fluchten. Dadurch ist ein Anschlag gegen eine zu
grobe Verdrehung gegeben. Durch die Bemessung des Abstands des
Kragens von den Gelenkflächen bzw. von dem Rand 8 der Neutral
stellung kann leicht der Verdrehwinkel bemessen werden, bei
welchem die Anschlagfunktion eintritt. In diesem Zusammenhang
sei vermerkt, daß der Verlauf des Kragens 7 bzw. des Randes 8
nicht unbedingt parallel sein muß zum Verlauf der äußeren
Begrenzung der Gelenkflächen 6.
Die zweite Ausführungsform gemäß Fig. 8 bis 11 stimmt mit der
ersten Ausführungsform überein, soweit nicht im folgenden
anders beschrieben.
Für den Fall, daß die durch den Kragen 7 und den Rand 8
gegebene Begrenzung der Rotationsbewegung 10 nicht ausreicht,
ist der Prothesenkern mit einer in der Medianebene verlaufen
den Rippe 11 versehen, die in eine entsprechend verlaufende
Nut 12 in der zugeordneten Gelenkfläche der Prothesenplatte(n)
eingreift. Die Umrisse der Rippe 11 und der Nut 12 in Drauf
sicht (Fig. 10 und 11) unterscheiden sich ein wenig. Nicht nur
ist die Rippe 11 im Medianschnitt und im Frontalschnitt ein
wenig kürzer als die Nutweite, damit die Beugungsbewegung
gemäß Fig. 2 und 4 durchgeführt werden können, sondern vor
allem auch ist die Rippe 11 an ihren Enden schmaler als im
Mittelbereich und als die Nut, so daß sie eine gewisse Drehbe
wegung innerhalb der Nut 12 durchführen kann. Diese Rotations
bewegung wird erst dann beendet, wenn die schmaleren Enden der
Rippe 11 an den Seitenwänden der Nute 12 anschlagen. Falls -
wie in den dargestellten Beispielen vorausgesetzt - die
Prothese mit paarigen Gleitflächen oberhalb und unterhalb des
Prothesenkerns versehen ist, müssen selbstverständlich zu
beiden Prothesenplatten hin Anschläge des Prothesenkerns
vorgesehen sein. Wenn der Prothesenkern hingegen mit einer
Prothesenplatte fest verbunden ist, genügen derartige Anschlä
ge an lediglich einer Seite.
Da die Rippe 11 im Zusammenwirken mit der Nut 12 nicht nur die
Rotationsbewegung, sondern auch die Beugebewegungen der
Prothese begrenzt, ist der Kragen 7 am Prothesenkern nicht
erforderlich, wie die Ausführung gemäß Fig. 12 und 13 zeigt,
die ansonsten mit derjenigen gemäß Fig. 8 bis 11 überein
stimmt.
Während in der zweiten und dritten Ausführung (Fig. 8 bis 13)
die Rippe am Prothesenkern und die damit zusammenwirkende Nut
an den Prothesenplatten vorgesehen war, sind die Verhältnisse
bei der Ausführungsform gemäß Fig. 14 umgekehrt; die Rippe 13
an den Prothesenplatten ragt jeweils in eine Nut 14 am Prothe
senkern. Auch in diesem Fall hat die Rippe 13 die in Fig. 10
dargestellte, nach den Enden zu sich verjüngende Form, während
die Nut 14 parallelflankig ist.
Die Ausführung gemäß Fig. 14 läßt sich sowohl ohne als auch
mit Kragen am Prothesenkern benutzen. Während die Ausführung
gemäß Fig. 14 die Version ohne Kragen darstellt, veranschau
licht Fig. 15 die Alternative mit Kragen 7 am Prothesenkern 3.
Claims (8)
1. Bandscheibenendoprothese mit zwei Prothesenplatten (1, 2),
die mit den Endplatten der zugehörigen Wirbelkörper zu
verbinden sind, und einem Prothesenkern (3), der mit
mindestens einer Prothesenplatte (1, 2) über eine eine
Rotationsbewegung (10) um die Hochachse (9) gestattende
Gelenkfläche (6) zusammenwirkt, dadurch gekennzeichnet,
daß die Gelenkfläche (6) im Medianschnitt und im Frontal
schnitt Krümmungsbögen von unterschiedlichem mittlerem
Radius bildet.
2. Bandscheibenendoprothese nach Anspruch 1, dadurch gekenn
zeichnet, daß der Krümmungsradius im Medianschnitt (Fig. 3)
kleiner als im Frontalschnitt (Fig. 1) ist.
3. Bandscheibenendoprothese nach Anspruch 1 oder 2, dadurch
gekennzeichnet, daß der mittlere Krümmungsradius in der
einen Hauptrichtung um den Faktor 1,2 bis 2,5 (vorzugswei
se 1,5 bis 2) größer ist als in der quer dazu verlaufenden
Hauptrichtung.
4. Bandscheibenendoprothese nach einem der Ansprüche 1 bis 3,
dadurch gekennzeichnet, daß die Krümmungsbögen der Gelenk
fläche (6) sowohl im Medianschnitt als auch im Frontal
schnitt im wesentlichen Kreisbögen sind.
5. Bandscheibenendoprothese nach einem der Ansprüche 1 bis 4,
dadurch gekennzeichnet, daß der Prothesenkern (3) und die
damit über eine Gelenkfläche (6) verbundene(n) Prothesen
platte(n) mit zusammenwirkenden Anschlägen zur Begrenzung
der Schwenkbewegung versehen sind.
6. Bandscheibenendoprothese nach Anspruch 5, dadurch gekenn
zeichnet, daß der Prothesenkern (3) und die Prothesenplat
te(n) (1, 2) mit wenigstens einer Nut (12, 14) und einer
darin geführten Feder (Rippe 11, 13) versehen sind, die in
der Hauptbewegungsrichtung verlaufen und mit Rotations
spiel zueinander ausgerüstet sind.
7. Bandscheibenendoprothese nach Anspruch 5, dadurch gekenn
zeichnet, daß der Prothesenkern (3) oder die Prothesen
platte(n) (1, 2) einen den Rand (8) des jeweils anderen
Teils mit Rotationsspiel umfassenden Kragen (7) aufweist
(aufweisen).
8. Bandscheibenendoprothese nach einem der Ansprüche 1 bis 5,
dadurch gekennzeichnet, daß die Prothesenplatten (1, 2)
mit zusammenwirkenden Anschlägen zur Begrenzung der
Schwenkbewegung versehen sind.
Priority Applications (7)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE4208116A DE4208116C2 (de) | 1992-03-13 | 1992-03-13 | Bandscheibenendoprothese |
EP93102993A EP0560141B1 (de) | 1992-03-13 | 1993-02-25 | Bandscheibenendoprothese |
DE59304327T DE59304327D1 (de) | 1992-03-13 | 1993-02-25 | Bandscheibenendoprothese |
AT93102993T ATE144695T1 (de) | 1992-03-13 | 1993-02-25 | Bandscheibenendoprothese |
ES93102993T ES2094393T3 (es) | 1992-03-13 | 1993-02-25 | Endoprotesis de disco intervertebral. |
US08/028,967 US5401269A (en) | 1992-03-13 | 1993-03-10 | Intervertebral disc endoprosthesis |
JP5052070A JP3017371B2 (ja) | 1992-03-13 | 1993-03-12 | 脊椎骨間円板用人工器官 |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE4208116A DE4208116C2 (de) | 1992-03-13 | 1992-03-13 | Bandscheibenendoprothese |
Publications (2)
Publication Number | Publication Date |
---|---|
DE4208116A1 true DE4208116A1 (de) | 1993-09-23 |
DE4208116C2 DE4208116C2 (de) | 1995-08-03 |
Family
ID=6454037
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE4208116A Expired - Fee Related DE4208116C2 (de) | 1992-03-13 | 1992-03-13 | Bandscheibenendoprothese |
DE59304327T Expired - Lifetime DE59304327D1 (de) | 1992-03-13 | 1993-02-25 | Bandscheibenendoprothese |
Family Applications After (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE59304327T Expired - Lifetime DE59304327D1 (de) | 1992-03-13 | 1993-02-25 | Bandscheibenendoprothese |
Country Status (6)
Country | Link |
---|---|
US (1) | US5401269A (de) |
EP (1) | EP0560141B1 (de) |
JP (1) | JP3017371B2 (de) |
AT (1) | ATE144695T1 (de) |
DE (2) | DE4208116C2 (de) |
ES (1) | ES2094393T3 (de) |
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DE3023353C2 (de) * | 1979-10-03 | 1982-04-22 | Gebrüder Sulzer AG, 8401 Winterthur | Zwischenwirbel-Totalprothese |
EP0176728A1 (de) * | 1984-09-04 | 1986-04-09 | Humboldt-Universität zu Berlin | Bandscheibenendoprothese |
DD239523A1 (de) * | 1985-07-19 | 1986-10-01 | Univ Berlin Humboldt | Bandscheibenendoprothese |
EP0317972A1 (de) * | 1987-11-24 | 1989-05-31 | Asahi Kogaku Kogyo Kabushiki Kaisha | Künstliche Zwischenwirbelscheibe |
FR2659226A1 (fr) * | 1990-03-07 | 1991-09-13 | Jbs Sa | Prothese pour disques intervertebraux et ses instruments d'implantation. |
Family Cites Families (2)
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CA1146301A (en) * | 1980-06-13 | 1983-05-17 | J. David Kuntz | Intervertebral disc prosthesis |
US5258031A (en) * | 1992-01-06 | 1993-11-02 | Danek Medical | Intervertebral disk arthroplasty |
-
1992
- 1992-03-13 DE DE4208116A patent/DE4208116C2/de not_active Expired - Fee Related
-
1993
- 1993-02-25 ES ES93102993T patent/ES2094393T3/es not_active Expired - Lifetime
- 1993-02-25 DE DE59304327T patent/DE59304327D1/de not_active Expired - Lifetime
- 1993-02-25 EP EP93102993A patent/EP0560141B1/de not_active Expired - Lifetime
- 1993-02-25 AT AT93102993T patent/ATE144695T1/de active
- 1993-03-10 US US08/028,967 patent/US5401269A/en not_active Expired - Lifetime
- 1993-03-12 JP JP5052070A patent/JP3017371B2/ja not_active Expired - Fee Related
Patent Citations (8)
Publication number | Priority date | Publication date | Assignee | Title |
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DE2804936A1 (de) * | 1978-02-01 | 1979-08-02 | Sulzer Ag | Zwischenwirbel-prothese |
DE3023353C2 (de) * | 1979-10-03 | 1982-04-22 | Gebrüder Sulzer AG, 8401 Winterthur | Zwischenwirbel-Totalprothese |
EP0176728A1 (de) * | 1984-09-04 | 1986-04-09 | Humboldt-Universität zu Berlin | Bandscheibenendoprothese |
DE3529761A1 (de) * | 1984-09-04 | 1986-07-03 | Humboldt-Universität zu Berlin, DDR 1080 Berlin | Bandscheibenendoprothese |
US4759766A (en) * | 1984-09-04 | 1988-07-26 | Humboldt-Universitaet Zu Berlin | Intervertebral disc endoprosthesis |
DD239523A1 (de) * | 1985-07-19 | 1986-10-01 | Univ Berlin Humboldt | Bandscheibenendoprothese |
EP0317972A1 (de) * | 1987-11-24 | 1989-05-31 | Asahi Kogaku Kogyo Kabushiki Kaisha | Künstliche Zwischenwirbelscheibe |
FR2659226A1 (fr) * | 1990-03-07 | 1991-09-13 | Jbs Sa | Prothese pour disques intervertebraux et ses instruments d'implantation. |
Cited By (9)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP1405615A1 (de) * | 2002-09-12 | 2004-04-07 | BIEDERMANN MOTECH GmbH | Bandscheibenprothese |
US7828846B2 (en) | 2002-09-12 | 2010-11-09 | Biedermann Motech Gmbh | Space keeper for vertebrae or intervertebral disks |
US7963994B2 (en) | 2002-09-12 | 2011-06-21 | Biedermann Motech Gmbh | Intervertebral disk prosthesis |
US8613768B2 (en) | 2002-09-12 | 2013-12-24 | Biedermann Technologies Gmbh & Co. Kg | Space keeper for vertebrae or intervertebral disks |
US8821576B2 (en) | 2002-09-12 | 2014-09-02 | Biedermann Technologies Gmbh & Co. Kg | Intervertebral disk prosthesis |
US8187333B2 (en) | 2008-09-18 | 2012-05-29 | Mayer Peter L | Intervertebral disc prosthesis and method for implanting and explanting |
US8814937B2 (en) | 2008-09-18 | 2014-08-26 | Peter L. Mayer | Intervertebral disc prosthesis, method for assembling, method for implanting prosthesis, and method for explanting |
US9393126B2 (en) | 2012-04-20 | 2016-07-19 | Peter L. Mayer | Bilaterally placed disc prosthesis for spinal implant and method of bilateral placement |
US9364339B2 (en) | 2012-04-30 | 2016-06-14 | Peter L. Mayer | Unilaterally placed expansile spinal prosthesis |
Also Published As
Publication number | Publication date |
---|---|
JPH067391A (ja) | 1994-01-18 |
US5401269A (en) | 1995-03-28 |
EP0560141A1 (de) | 1993-09-15 |
ES2094393T3 (es) | 1997-01-16 |
DE4208116C2 (de) | 1995-08-03 |
EP0560141B1 (de) | 1996-10-30 |
ATE144695T1 (de) | 1996-11-15 |
JP3017371B2 (ja) | 2000-03-06 |
DE59304327D1 (de) | 1996-12-05 |
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