DE4213771C1 - Spinal disc endoprosthesis - has elastic core with rim beading between shaped cover plates with a screw bonding for implantation without adhesive - Google Patents
Spinal disc endoprosthesis - has elastic core with rim beading between shaped cover plates with a screw bonding for implantation without adhesiveInfo
- Publication number
- DE4213771C1 DE4213771C1 DE19924213771 DE4213771A DE4213771C1 DE 4213771 C1 DE4213771 C1 DE 4213771C1 DE 19924213771 DE19924213771 DE 19924213771 DE 4213771 A DE4213771 A DE 4213771A DE 4213771 C1 DE4213771 C1 DE 4213771C1
- Authority
- DE
- Germany
- Prior art keywords
- core
- cover plates
- intervertebral disc
- disc prosthesis
- implant
- 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.)
- Expired - Fee Related
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30907—Nets or sleeves applied to surface of prostheses or in cement
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/442—Intervertebral or spinal discs, e.g. resilient
-
- 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
- A61F2002/30016—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 hardness, e.g. Vickers, Shore, Brinell
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30108—Shapes
- A61F2002/3011—Cross-sections or two-dimensional shapes
- A61F2002/30112—Rounded shapes, e.g. with rounded corners
-
- 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
- A61F2002/30182—Other shapes
- A61F2002/30187—D-shaped or half-disc-shaped
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30433—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels, rivets or washers e.g. connecting screws
-
- 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
- A61F2002/30563—Special structural features of bone or joint prostheses not otherwise provided for having elastic means or damping means, different from springs, e.g. including an elastomeric core or shock absorbers
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30576—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/442—Intervertebral or spinal discs, e.g. resilient
- 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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- 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
- A61F2220/0041—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting screws
-
- 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
-
- 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
- A61F2230/0028—Shapes in the form of latin or greek characters
- A61F2230/0034—D-shaped
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0019—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in hardness, e.g. Vickers, Shore, Brinell
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- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Vascular Medicine (AREA)
- Transplantation (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Cardiology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Neurology (AREA)
- Prostheses (AREA)
Abstract
Description
Die Erfindung betrifft eine Bandscheibenendoprothese.The invention relates to a spinal disc endoprosthesis.
Grundsätzlich soll eine künstliche Bandscheibe sich verhalten wie eine natürliche Bandscheibe. Sie muß die Wirbelkörper voneinander beabstandet halten und jegliche Druckausübung auf Nerven oder das Rückenmark verhindern und eine Neigung innerhalb der Wirbelsäule um bis zu 5° abpuffern.Basically, an artificial intervertebral disc should be behave like a natural intervertebral disc. She must keep the vertebrae at a distance from each other and any pressure on nerves or that Prevent spinal cord and tilt within the Buffer the spine by up to 5 °.
Aus der EP-03 92 076 A1 ist eine Bandscheibenendoprothese bekannt, die aus zwei starren Deckplatten besteht, zwischen denen ein Kern aus einem Elastomer verklebt ist.From EP-03 92 076 A1 is one Intervertebral disc prosthesis known from two rigid cover plates, between which there is a core is glued from an elastomer.
Grundsätzlich kann eine derartige Bandscheibenendoprothese ihre Wirkung nur dann entfalten, wenn es nach der Primärfixation der Endoprothese durch ein regelrechtes Einklemmen zwischen zwei Wirbelkörpern zu einer Sekundärfixation kommt, das Implantat also einen innigen Verbund mit den benachbarten Wirbelkörpern eingeht. Wohl zu diesem Zwecke sind die erwähnten Deckplatten auf ihrer nach der Implantation den Wirbelkörpern zugewandten Außenseiten mit einer porösen Schicht versehen, in die Knochenmaterial einwachsen soll. Der elastische Kern bei der bekannten Endoprothese schließt an den Stirnflächen des Implantats bündig mit den Deckplatten ab. Basically, such Spinal disc endoprosthesis only works unfold if after the primary fixation of the Endoprosthesis by properly pinching it between two vertebrae to one Secondary fixation comes, so the implant one intimate bond with the neighboring vertebral bodies comes in. The above are probably for this purpose Cover plates on their after implantation Vertebral bodies facing outsides with a porous layer provided in the bone material should grow in. The elastic core at the known endoprosthesis closes on the end faces of the implant flush with the cover plates.
Das bekannte Implantat weist verschiedene Nachteile auf. Hervorgehoben an dieser Stelle werden die folgenden: Die Verklebung der Deckplatten mit dem elastischen Kern ist nicht unproblematisch im Hinblick auf eine zu fordernde Dauerbeständigkeit. So können Körperflüssigkeiten zu einem Anlösen der Klebverbindung zumindest im Bereich der Stirnseiten des Implantats führen. Darüber hinaus können Reste des Lösungsmittels des Klebers oder gar Kleberkomponenten in dem umgebenden Gewebe zu Unverträglichkeiten führen. Desweiteren sei hier der bündige Abschluß des elastischen Kerns mit den Deckplatten angesprochen. Kommt es nämlich zu den erwähnten Neigungen von bis zu 5°, so tritt das Material des Kerns im dorsalen Bereich aus den Konturen des Implantates aus in Folge einer Ausgleichsbewegung zu den dann wirkenden Kompressionskräften und kann dann unter Umständen zu einer höchst unerwünschten Druckbeaufschlagung des angrenzenden Spinalkanals führen.The known implant has several disadvantages on. At this point, the following: The gluing of the cover plates with the elastic core is not without problems in With regard to the required durability. So body fluids can cause the Adhesive connection at least in the area of the end faces of the implant. In addition, leftovers the solvent of the glue or even Adhesive components in the surrounding tissue too Lead intolerance. Furthermore, here is the flush termination of the elastic core with the Cover plates addressed. It comes to that inclinations of up to 5 ° mentioned, this occurs Material of the core in the dorsal area from the Contours of the implant in a row Compensatory movement to those then acting Compression forces and can then possibly a highly undesirable pressurization of the lead adjacent spinal canal.
Eine Bandscheibenendoprothese, die aus zwei sogenannten Abschlußplatten und einem dazwischen angeordneten Distanzstück besteht, ist bekannt geworden aus der DE 35 29 761 A1. Das Distanzstück besteht im wesentlichen aus einem konvexen Mittelteil mit planem ringförmigen Führungsrand und mit einem Ringwulst und kann beispielsweise aus Polyethylen oder aus Polyurethan bestehen. Wie diese Teile zu einer implantierbaren Einheit zusammengefügt sind, also beispielsweise durch ein Verkleben etc., läßt sich dieser Druckschrift nicht entnehmen. An intervertebral disc prosthesis consisting of two so-called end plates and one in between arranged spacer is known has become from DE 35 29 761 A1. The spacer consists essentially of a convex Middle part with a flat ring-shaped guide edge and with a ring bead and can, for example Polyethylene or polyurethane. Like these Parts into an implantable unit are joined together, for example by a This publication cannot be glued, etc. remove.
Zum technologischen Hintergrund seien noch die folgenden bekannt gewordenen Druckschriften genannt: DE 30 23 353 A1, DE 22 63 842 A1, EP 03 56 112 A1, EP 02 98 235 und EP 03 17 972.As far as the technological background is concerned mentioned the following known publications: DE 30 23 353 A1, DE 22 63 842 A1, EP 03 56 112 A1, EP 02 98 235 and EP 03 17 972.
Vor diesem Hintergrund ist es nun die Aufgabe der vorliegenden Erfindung, eine Bandscheibenendoprothese anzugeben, die ohne Verwendung eines Klebers zu einer kompakten implantierbaren Einheit zusammengefaßt ist, gleichwohl aber die Funktionen einer natürlichen Bandscheibe in guter Annäherung ausüben kann.Against this background, it is now the task of present invention, a Specify intervertebral disc prosthesis without Use an adhesive to make a compact implantable unit is summarized, but nevertheless the functions of a natural one Intervertebral disc can exercise in good approximation.
Gelöst wird diese Aufgabe durch eine aus zwei starren Deckplatten mit offenmaschiger Außenstruktur und einem zwischen diesen gelagerten Kern aus einem elastischen Material bestehenden Bandscheibenendoprothesen, bei welcher der Kern in seinem äußeren Randbereich einen umlaufenden Ringwulst aufweist, der in entsprechend ausgebildeten umlaufenden Mulden in den Deckplatten liegt, und bei welcher die Deckplatten und der Kern mittels einer Schraubverbindung miteinander verspannt sind.This task is solved by one out of two rigid cover plates with open-mesh outer structure and a core of one between them elastic material existing Intervertebral disc prostheses in which the core is in a peripheral around its outer edge Has annular bead, which in accordingly trained circumferential troughs in the cover plates lies, and in which the cover plates and the core by means of a screw connection are tense.
Die Teile der Endoprothese werden also durch eine Schraubverbindung zu einer kompakten Einheit zusammengefügt. Die äußere Formgebung des Implantats ist in bekannter Weise in etwa nierenförmig oder gerundet dreieckig ausgeführt. Etwa im Zentrum dieser Form ist die Schraubverbindung zwischen den Teilen vorgesehen, wozu in den Deckplatten jeweils eine Bohrung vorgesehen ist, durch die die Schraube geführt werden kann, welche durch den Kern durch eine an der entsprechenden Stelle vorgesehenen Durchbohrung greift. Die Schraubverbindung wird so fest angezogen, daß ein gewisser Kompressionsdruck auf den Kern ausgeübt wird. Ohne weitere Maßnahme bestünde - wie leicht einzusehen ist - die Gefahr, daß trotz der Vorspannung der Kern um die Achse der Schraubverbindung verdreht werden könnte. Um dies zu vermeiden, ist die Ausgestaltung der umlaufende Ringwulst im äußeren Randbereich des Kerns vorgesehen. Dieser liegt in den erwähnten umlaufenden Mulden in den Deckplatten. Diese Maßnahme bietet also die Gewähr einer Eigenzentrierung des elastischen Kerns. Dieser besteht vorzugsweise aus Silikon. Der Elastizitätsmodul von Silikon ist nämlich vergleichbar zu jenem des natürlichen Knorpels einer natürlichen Bandscheibe.The parts of the endoprosthesis are replaced by a Screw connection to a compact unit put together. The external shape of the implant is in a known manner approximately kidney-shaped or rounded triangular design. About in the center this form is the screw connection between the Parts provided for what in the cover plates a hole is provided through which the screw which can be performed through the core one provided at the appropriate place Perforation engages. The screw connection is like this tight that a certain compression pressure is exercised on the core. Without further action there is - as is easy to see - the danger that despite the bias the core around the axis of the Screw connection could be twisted. To do this avoid, the design is the circumferential Ring bead in the outer edge area of the core intended. This is in the mentioned circumferential troughs in the cover plates. These Measure therefore offers a guarantee Self-centering of the elastic core. This is preferably made of silicone. The The modulus of elasticity of silicone is namely comparable to that of natural cartilage one natural intervertebral disc.
Vorzugsweise ist der Kern so dimensioniert, daß er nicht ganz bündig an den Stirnflächen des Implantats mit den Deckplatten abschließt, damit unter Belastung ein Heraustreten des Kernmaterials aus den Konturen des Implantats unmöglich ist. Aber selbst wenn ein bündiger Abschluß vorliegt, ist gemäß einer vorteilhaften Weiterbildung des Implantats vorgesehen, daß der Kern dorsal gesehen in seiner Stirnfläche eine nutförmige Materialaussparung aufweist. Im Querschnitt bietet der Kern dann an seiner dorsalen Stirnfläche das Bild einer lippenförmigen Ausbildung, die Ausgleichsbewegungen des Materials unter Belastung zuläßt, ohne daß Kernmaterial die Konturen des Implantats verläßt, so daß die befürchtete Druckbeaufschlagung des Spinalkanals nicht auftreten kann. Um die dynamischen Eigenschaften des Implantats jenem einer natürlichen Bandscheibe noch weiter anzunähern, ist die Schraubverbindung gemäß einer vorteilhaften Ausführungsform speziell ausgebildet. So ist vorgesehen, daß die Schraubverbindung hergestellt ist durch eine Gewindeschraube und eine Gewindehülse mit jeweils einem halbkugelförmigen Kopf, wobei die Köpfe in pfannenartige Aufnahmen aufweisenden Einsätzen in den Deckplatten greifen. Neigungswinkel bis zu 5° unter Belastung sind dabei ohne weiteres möglich. Damit es aufgrund von Mikrobewegungen des Schrauben- bzw. Mutterkopfes in der jeweiligen pfannenartigen Aufnahme nicht zu bedenklichen Materialabtragungen kommen kann, bestehen die erwähnten Einsätze vorzugsweise aus abriebsarmem und reibungsarmem Material, beispielsweise Polyethylen.The core is preferably dimensioned such that it not completely flush with the face of the implant with the cover plates, so that under Loading a emergence of the core material from the Contours of the implant is impossible. But yourself if there is a flush conclusion, according to a advantageous development of the implant provided that the nucleus is seen in its dorsal direction End face a groove-shaped material cut-out having. The cross section then offers the core its dorsal face the image of a lip-shaped training, the compensatory movements of the material under load without Core material leaves the contours of the implant, see above that the feared pressurization of the Spinal canal cannot occur. To the dynamic properties of the implant that one is closer to the natural intervertebral disc the screw connection according to an advantageous Embodiment specially trained. So is provided that the screw connection is made is by a threaded screw and a threaded sleeve each with a hemispherical head, the Heads in pan-like receptacles Grip inserts in the cover plates. Angle of inclination up to 5 ° under load are easy possible. So that it is due to micro movements of the Screw or nut head in the respective pan-like intake not to be questioned Material removals can occur, which exist Inserts mentioned preferably from low abrasion and low-friction material, such as polyethylene.
Gemäß einem weiteren Aspekt der Erfindung ist in vorteilhafter Weiterbildung vorgesehen, daß die Außenseite jeder Deckplatte zur Horizontalebene des Kerns zu dessen dorsalen Stirnseite hin in einem Winkel im Bereich zwischen 2° und 4° geneigt sind. Hierdurch nimmt das Implantat eine leicht keilförmige Gestalt an, so daß es bei der Implantation leichter in ventraler Richtung zwischen zwei Wirbelkörper eingesetzt werden kann.According to a further aspect of the invention, in advantageous further training provided that the Outside of each cover plate to the horizontal plane of the Kerns to its dorsal end face in one Angles in the range between 2 ° and 4 ° are inclined. This makes the implant easy wedge-shaped shape, so that it is in the Implantation easier in the ventral direction between two vertebral bodies can be used.
Die Erfindung wird anhand eines Ausführungsbeispiels anhand der Zeichnungen näher erläutert. Hierbei zeigt: The invention is based on an embodiment explained in more detail with reference to the drawings. Here shows:
Fig. 1 eine Aufsicht auf die Banscheiben endoprothese, Fig. 1 is a plan view of the endoprosthesis Banscheiben,
Fig. 2 eine Schnittansicht des Implantats aus Fig. 1. FIG. 2 shows a sectional view of the implant from FIG. 1.
In Fig. 1 ist eine Aufsicht auf die erfindungsgemäße Bandscheibenendoprothese 1 dargestellt. Wie hieraus ersichtlich, weist das Implantat eine in etwa nierenförmige Gestalt auf. Aus Fig. 1 ist die eine starre Deckplatte 2 erkennbar, die eine offenmaschige Außenstruktur 4 aufweist. Diese dient zur Sekundärfixation des Implantats dadurch, daß Knochenmaterial der nach der Implantation an ihr anliegenden Wirbelkörper die Außenstruktur durchwachsen kann. Etwa mittig durchgreift eine Gewindehülse die Deckplatte. Von dieser Gewindehülse ist in Fig. 1 lediglich der Kopf 8 erkennbar. Zwei Anschlagsbolzen 14 sind vorgesehen, um eine definierte Stellung des Implantats in der Wirbelsäule zu erzielen.In Fig. 1 is a plan view displayed on the intervertebral disc prosthesis according to the invention 1. As can be seen from this, the implant has an approximately kidney-shaped shape. From Fig. 1, a rigid cover plate 2 is seen to comprise an open-mesh outer structure 4. This serves for the secondary fixation of the implant in that bone material of the vertebral body lying against it after the implantation can grow through the outer structure. A threaded sleeve extends through the middle of the cover plate. Only the head 8 of this threaded sleeve can be seen in FIG. 1. Two stop bolts 14 are provided in order to achieve a defined position of the implant in the spine.
Aus der Schnittansicht gemäß Fig. 2 wird deutlich, wie die beiden Deckplatten 2 und 3 den elastischen Kern 5 einfassen. Der Kern 5 weist einen umlaufenden Ringwulst 6 auf, der in entsprechend ausgeformte umlaufende Mulden 11 und 12 in der Deckplatte 2 bzw. 3 liegt. In der Fig. 2 ist die besonders bevorzugte Schraubverbindung dargestellt, die durch die Gewindeschraube 20 und die Gewindehülse 21 hergestellt ist. Die Gewindeschraube 20 und die Gewinderhülse 21 weisen jeweils einen halbkugelförmigen Kopf 7 bzw. 8 auf. In die Deckplatten 2 und 3 ist jeweils ein Einsatz 9 bzw. 10 gesetzt, in denen jeweils eine pfannenartige Aufnahme 15 bzw. 16 vorgesehen ist. Die pfannenartigen Aufnahmen 15 und 16 sind so dimensioniert, daß die halbkugelförmigen Köpfe 7 und 8 in ihnen eine Schwenkbewegung in allen Richtungen ausführen können. Die Gewindehülse 21 greift im dargestellten Ausführungsbeispiel durch die Bohrung 23 im Kern 5.From the sectional view according to FIG. 2 it is clear how the two cover plates 2 and 3 enclose the elastic core 5 . The core 5 has a circumferential annular bead 6 which lies in appropriately shaped circumferential troughs 11 and 12 in the cover plate 2 and 3, respectively. FIG. 2 shows the particularly preferred screw connection which is produced by the threaded screw 20 and the threaded sleeve 21 . The threaded screw 20 and the threaded sleeve 21 each have a hemispherical head 7 and 8, respectively. In the cover plates 2 and 3 , an insert 9 or 10 is placed, in each of which a pan-like receptacle 15 or 16 is provided. The pan-like receptacles 15 and 16 are dimensioned such that the hemispherical heads 7 and 8 can perform a pivoting movement in them in all directions. In the exemplary embodiment shown, the threaded sleeve 21 engages through the bore 23 in the core 5 .
Die Einsätze 9 und 10 bestehen vorteilhafter Weise aus einem abriebsarmen und reibungsarmen Material, wie beispielsweise Polyethylen.The inserts 9 and 10 advantageously consist of a low-abrasion and low-friction material, such as polyethylene.
Der Kern 5 ist im dargestellten Fall so dimensioniert, daß er nicht über die Stirnkanten der Deckplatten 2 und 3 hinausragt. Auch eine zusätzliche Sicherheit gegen eine eingangs erwähnte Druckbeaufschlagung des Spinalkanals, weist der Kern 5 dorsal gesehen in seiner Stirnfläche eine nutförmige Materialaussparung 13 auf, so daß sich auf dieser Seite eine etwa lippenartige Gestalt darbietet.The core 5 is dimensioned in the case shown that it does not protrude beyond the end edges of the cover plates 2 and 3 . Also an additional security against the above-mentioned pressurization of the spinal canal, the core 5 , seen dorsally, has a groove-shaped material recess 13 in its end face, so that an approximately lip-like shape is presented on this side.
Aus Fig. 2 wird darüber hinaus die Position der Anschlagsbolzen 14 auf jeder Deckplatte 2 und 3 ersichtlich. Diese legen sich nach der Implantation an den betreffenden Wirbelkörper an und verleihen dem Implantat eine definierte Lage.About the position of the stop pin 14 on each top plate 2 and 3 it can be seen also from FIG. 2. These attach themselves to the vertebral body after implantation and give the implant a defined position.
Die dargestellte und besonders bevorzugte Ausführungsform des Implantates gestattet es, daß die Deckplatten 2 und 3 sich zueinander in allen Richtungen bewegen können.The illustrated and particularly preferred embodiment of the implant allows the cover plates 2 and 3 to move to one another in all directions.
Gemäß einem weiteren Aspekt sind die Außenseiten der Deckplatten 2 und 3 zur Horizontalebene H des Kerns 5 zu dessen dorsalen Stirnseite 22 hin geneigt, und zwar in einem Winkel α, der im Bereich von 2° bis 4° liegt.According to a further aspect, the outer sides of the cover plates 2 and 3 are inclined towards the horizontal plane H of the core 5 towards its dorsal end face 22 , namely at an angle α which is in the range from 2 ° to 4 °.
Die Deckplatten 2 und 3 bestehen vorzugsweise aus körperverträglichem Metall, wie es aus der Endoprothetik bekannt ist.The cover plates 2 and 3 are preferably made of body-compatible metal, as is known from endoprosthetics.
Claims (6)
Priority Applications (1)
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DE19924213771 DE4213771C1 (en) | 1992-04-27 | 1992-04-27 | Spinal disc endoprosthesis - has elastic core with rim beading between shaped cover plates with a screw bonding for implantation without adhesive |
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DE19924213771 DE4213771C1 (en) | 1992-04-27 | 1992-04-27 | Spinal disc endoprosthesis - has elastic core with rim beading between shaped cover plates with a screw bonding for implantation without adhesive |
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WO2005094734A1 (en) | 2004-03-30 | 2005-10-13 | Hjs Gelenk System Gmbh | Artificial intervertebral disk |
US6981989B1 (en) | 2003-04-22 | 2006-01-03 | X-Pantu-Flex Drd Limited Liability Company | Rotatable and reversibly expandable spinal hydraulic prosthetic device |
EP1610740A2 (en) * | 2003-04-04 | 2006-01-04 | Theken Disc, LLC | Artificial disc prosthesis |
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WO2005094734A1 (en) | 2004-03-30 | 2005-10-13 | Hjs Gelenk System Gmbh | Artificial intervertebral disk |
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US8480742B2 (en) * | 2005-08-02 | 2013-07-09 | Perumala Corporation | Total artificial disc |
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