WO2004034935A1 - System von zwischenwirbelprothesen - Google Patents
System von zwischenwirbelprothesen Download PDFInfo
- Publication number
- WO2004034935A1 WO2004034935A1 PCT/EP2003/002555 EP0302555W WO2004034935A1 WO 2004034935 A1 WO2004034935 A1 WO 2004034935A1 EP 0302555 W EP0302555 W EP 0302555W WO 2004034935 A1 WO2004034935 A1 WO 2004034935A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- cover plate
- dorsal
- intervertebral prostheses
- prostheses according
- intervertebral
- Prior art date
Links
- 230000008719 thickening Effects 0.000 claims description 9
- 238000010079 rubber tapping Methods 0.000 claims description 3
- 210000000988 bone and bone Anatomy 0.000 description 36
- 230000013011 mating Effects 0.000 description 9
- 208000008558 Osteophyte Diseases 0.000 description 4
- 230000005540 biological transmission Effects 0.000 description 4
- 239000000126 substance Substances 0.000 description 3
- 208000007623 Lordosis Diseases 0.000 description 2
- 230000015572 biosynthetic process Effects 0.000 description 2
- 208000003618 Intervertebral Disc Displacement Diseases 0.000 description 1
- 206010050296 Intervertebral disc protrusion Diseases 0.000 description 1
- 230000006978 adaptation Effects 0.000 description 1
- 238000004873 anchoring Methods 0.000 description 1
- 230000037396 body weight Effects 0.000 description 1
- 239000002639 bone cement Substances 0.000 description 1
- 239000011248 coating agent Substances 0.000 description 1
- 238000000576 coating method Methods 0.000 description 1
- 230000000295 complement effect Effects 0.000 description 1
- 230000007850 degeneration Effects 0.000 description 1
- 201000010934 exostosis Diseases 0.000 description 1
- 238000003780 insertion Methods 0.000 description 1
- 230000037431 insertion Effects 0.000 description 1
- 238000009434 installation Methods 0.000 description 1
- 210000003041 ligament Anatomy 0.000 description 1
- 239000000463 material Substances 0.000 description 1
- 230000000149 penetrating effect Effects 0.000 description 1
- 230000002093 peripheral effect Effects 0.000 description 1
- 210000000278 spinal cord Anatomy 0.000 description 1
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
-
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- 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
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- 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
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- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
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- 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
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- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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- 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
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- 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
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- 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
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- 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
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- 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
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- 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
- A61F2002/30578—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs having apertures, e.g. for receiving fixation screws
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- A—HUMAN NECESSITIES
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- 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
- A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
- A61F2002/30616—Sets comprising a plurality of prosthetic parts of different sizes or orientations
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- 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
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- 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
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- 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
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- A61F2002/3065—Details of the ball-shaped head
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- 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
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- A61F2/30721—Accessories
- A61F2/30734—Modular inserts, sleeves or augments, e.g. placed on proximal part of stem for fixation purposes or wedges for bridging a bone defect
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- A—HUMAN NECESSITIES
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- 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
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- A—HUMAN NECESSITIES
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- 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
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- 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
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- 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
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- A—HUMAN NECESSITIES
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- 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
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Definitions
- the cover plates of the vertebral bodies, between which the intervertebral discs of the spine are located, are usually flat or slightly concave. Occasionally there is an increased concavity of the cover plates, especially in the area of the lower spine. This does not have to be, but it can be damage-related. For example, it happens that after a herniated disc the edge of a vertebral body hits the cover plate of the adjacent vertebral body and grinds out a depression there. However the increased concavity has arisen, it leads to inadequate support of the dorsal margin.
- a first object of the invention is to improve the dorsal support of the prosthesis. This is achieved by the correction cover plate specified in claim 1.
- a bone lip often remains behind the trough on the dorsal edge of the vertebral body. Protruding osteophytes can also form on the dorsal margin. So that this lip or osteophyte does not break off in an uncontrolled manner, they are often removed. This can result in the risk that the bone will weaken and collapse under the load on the prosthesis.
- the invention therefore has the further aim of creating an intervertebral prosthesis which in such a case reduces the risk of burglary. This is achieved primarily through the features of claim 2.
- the prosthesis is implanted and, due to its inadequate support in the region of the depression, places too much stress on the vertebral body edge.
- the invention has the further aim of avoiding the breaking off of parts of the vertebral body in such cases. To solve this problem for the first time, the invention offers different possibilities, namely those according to claims 10, 12, 16 and 14.
- the intervertebral prostheses of the system according to the invention consist of two cover plates and a prosthesis core.
- the cover plates On their mutually facing inner side, the cover plates have mating surfaces which are designed as sliding-joint surfaces or holding surfaces complementary to surfaces of the prosthesis core.
- the cover plates On the outside, the cover plates form vertebrae connection surfaces which are intended to lie against the associated vertebral bodies and, if appropriate, to be fastened thereon.
- the system mainly consists of standard prostheses, the vertebral connection surfaces, which can be provided in different size classes, have a predetermined dimension in the antero-posterior direction. Also has the position of the ventral and dorsal edges of the vertebral mating surfaces Standard prostheses have a predetermined spatial relation to the position of the inner mating surfaces of the cover plates.
- Section B-B of EP-B-0 176 728 in which the cover plates are weakly wedge-shaped in the sagittal section.
- the thicker side of the wedge is generally on the ventral side to compensate for the lumbar lordosis, in which the intervertebral space widens on the ventral side.
- a case has already become known (public prior use by the applicant) in which such a known wedge-shaped plate with the thickened side was inserted dorsally. However, this results in incorrect positioning of the joint center and the power transmission.
- the correction cover plate according to the invention is characterized in that the vertebral connection surface is thickened in the sagittal section in comparison with the standard cover plates.
- the thickening completely or partially compensates for the loss of substance on the vertebral body.
- the correction cover plate is preferably extended dorsally in the AP direction beyond the AP dimension of the standard cover plates.
- the lengthening enlarges the vertebral connection surface dorsally, thereby reducing the load on the weakened bone area.
- the prosthesis core via which the force transmission takes place, lies further forward in relation to the dorsal edge and is more distant from the weakened bone area.
- the lengthening is anatomically possible because the bone surface, which has changed compared to the normal case, has increased in size dorsally.
- PCT / EP02 / 03132 WO 02/080818
- the thickening according to the invention is expediently wedge-shaped.
- the wedge shape can extend over the entire AP extension of the cover plate. In some cases, however, one can be content with having the wedge shape start at a distance from the valve edge, for example in the middle area of the cover plate.
- the thickening is then limited to an area that is not larger than the dorsal two thirds, preferably the dorsal half, of the AP dimension of the correction cover plate.
- the wedge angle of the cover plate is advantageously between 5 ° and 20 °.
- the inner surface of the part of the correction cover plate which forms the extension can drop towards the edge and towards the vertebrae connecting surface.
- This bevel can be straight or fluted.
- the groove can have an arcuate or stepped profile. It gives space for the edge of the sliding core or anatomically natural components that are in the vicinity.
- the dorsal teeth are expediently provided at a greater distance from the dorsal edge, namely preferably approximately where they are in relation to the mating surfaces in the standard cover plates.
- the reason for this measure is that when the correction cover plate is used, the bone substance in the vicinity of the dorsal edge of the prosthesis is often weakened as a result of wear, and it is therefore better to place the teeth in firmer bone substance lying further forward.
- the correction cover plate is designed in such a way that it does not lead to an uncontrolled breaking off of such parts.
- the first solution according to the invention to this problem consists in that the dorsal thickening of the correction cover plate has the shape of a protrusion, which lies in the bone cavity, on the one hand to find improved support for the prosthesis and on the other hand to protect the bone edge protruding next to the cavity or in adaptation to the natural shape of the vertebra, only slightly curved basic shape of the standard cover plate surface.
- the protrusion accordingly advantageously also has a smaller extent than the cover plate surface in the AP and / or LM direction. Namely, it is preferably closer to the dorsal edge of the cover plate surface than to its ventral edge. It goes without saying that the protrusion should be as close as possible to the vortex shape found in terms of height, extent and position. It generally proves to be expedient if the protrusion extends to the dorsal edge of the cover plate surface.
- the dorsal edge of the cover plate surface facing the vertebral body is chamfered or rounded. This ensures that the dorsal edge of the cover plates does not bend sharply and hard against the dorsal bone edge when the prosthesis is inserted, but slides along it. In addition, the bone edge is relieved of the power transmission at the expense of other, more stable areas.
- the prosthesis is mainly used when the trough is not strong and / or can be filled in with bone cement. It can be combined with the presence of the protrusion mentioned above. The protrusion then forms the bevel or rounding or merges into it.
- the teeth or projections provided on the cover plate of the prosthesis to penetrate and anchor in the bone can contribute to the damage to the weakened, dorsal vertebral body edge. They should therefore have a distance of at least 20% from the dorsal edge of the cover plate, preferred wise more than 30% of the largest dimension of the cover plate measured in the AP direction. If the teeth are self-tapping and planar, ie in the manner of platelets whose main plane is transverse to the bone surface, it can also be expedient if their main plane runs in the sagittal direction. This applies in particular to those teeth that are arranged close to the dorsal edge of the cover plate.
- the prostheses when they are inserted into the intervertebral space, they exert only slight dorsal forces on the bone and thereby protect the possibly weakened areas.
- the correction cover plates which have different sizes or shapes of bulging, beveling or rounding.
- the invention prefers to design at least the bulge, but if desired also the bevel or rounding, as a special attachment part, that with a suitable cover plate can be connected. It is then possible to provide a larger number of different attachment parts. Among these, the appropriate one can be selected and may also be connected to the cover plate in a different, selectable position.
- a collection of vertebral prostheses according to the invention can therefore provide a plurality of different attachment parts and at least one, but preferably a number of different cover plates which can be connected to them. Possibly. a cover plate with variable attachment options for the extension parts is also sufficient.
- 1 shows a sagittal section through a spinal column section
- 2 shows the conditions when inserting a conventional prosthesis between a pair of vertebral bodies
- FIG. 3 shows an intervertebral prosthesis equipped with a correction cover plate in a sagittal section in the installed state
- 5 and 6 are partial sections of alternative designs according to the circle indicated in FIG. 3; 7 shows a further alternative embodiment of the correction cover plate;
- 8 and 9 show two exemplary embodiments in which the thickening of the correction cover plate is designed as a bulge; 10 and 11 embodiments in which the correction cover plate is chamfered at the dorsal edge; 12 is a plan view of the outside of a correction cover plate and its tooth arrangement; and
- Fig. 13 is a side view of a correction cover plate with a modular bulge approach.
- the pair of vertebral bodies 1, 2 includes an intervertebral disc 3 between its facing cover plates.
- the upper vertebral body 1 contains a trough 4 near its dorsal edge in the surface of its lower cover plate. This can be a sign of degeneration or a natural formation.
- a bone edge 5 remains behind the trough 4, which is not supported in the normal manner due to the lack of bone material in the region of the trough and is therefore sensitive to breakage.
- a conventional intervertebral prosthesis 6 is inserted into the space between the spread apart vertebral bodies 1 and 2 in the direction of the arrow, it can happen that the sharp dorsal edge 7 of the prosthetic cover plate abuts the sensitive bone edge 5 and breaks it away wholly or partially towards the dorsal ,
- the first group of exemplary embodiments which is illustrated in FIGS. 3 to 7, presupposes that in order to avoid them
- Fig. 3 illustrates the use of the prosthesis between the fifth lumbar vertebra 12 and the sacrum 13.
- the prosthesis consists of a lower, standard cover plate 14, a prosthesis core 15 and a correction cover plate 16.
- Es is a design in which both cover plates 14, 16 interact via spherical sliding-joint surfaces 17 as mating surfaces with the prosthesis core 15. This has a collar 18 which prevents it from escaping from its installation space if the cover plates 14, 16 should open unusually wide on one side or the other during the flexion movement.
- the vertebral body 12 is heavily removed and / or processed in its dorsal, caudal area 19. As a result, its surface facing the prosthesis appears dorsally elongated.
- the correction cover plate 16 is wedge-shaped with a greater thickness towards the dorsal side. It also has a part 20 which is extended dorsally beyond the dorsal border of the standard plates. In the embodiment shown in FIGS. 3 and 4, the inside 21 of this extension part 20 runs obliquely, so that its inner edge does not protrude too far dorsally and thus the dorsal collar 18 of the prosthesis core finds sufficient space during flexion movement. According to the examples given in FIGS. 5 and 6, the inner surface 21 can also be stepped or rounded. It is important that the dorsal length of the part 20 leads to the formation of a support surface which is elongated compared to the normal case, through which the force transmission is distributed over a larger surface and the dorsally weakened bone is protected.
- Fig. 4 illustrates the difference between a correction cover plate and a standard cover plate, the outline of which is indicated by dash-dotted lines. It can be seen that the wedge shape according to the invention extends with the wedge angle ⁇ over the entire AP extension of the plate. Since the semicolon tiert, fictitious course of the standard surface on the correction cover plate is not immediately recognizable, the wedge angle ⁇ in the representation between the main direction of the mating surfaces 17 (or their edge) on the one hand and the main direction of the vortex connection surface 22 on the other hand. In the case shown, it is approximately 8 °. It can also be a little bigger or smaller. The main direction of the sliding joint surfaces 17 is determined in this case on the basis of their peripheral edge. It coincides with the main direction of the vortex connection surface 22 in parallel. If the latter is curved, its central direction is the main direction.
- the correction cover plates for determining the difference according to the invention can also be compared with these weakly wedge-shaped standard cover plates , The difference is then evident from a larger wedge angle of the correction cover plates and, if appropriate, from the presence of a dorsal extension part 20.
- FIG. 7 An example of this is shown in FIG. 7.
- the vertebral connection surface which is partly dash-dotted and partly with a solid line, is wedge-shaped in relation to the main direction of the mating surfaces 17.
- This example further shows that the wedge shape of the correction cover plates does not extend over the entire AP extension needs to stretch. Rather, it is limited to the dorsal half (based on the standard cover plate). 3 that the teeth 23, 24 are arranged near the ventral or dorsal edge in the standard cover plate 14. These are teeth which, due to their sharpness, penetrate the surface of the bone when the prosthesis is inserted between the spread vertebral bodies 12, 13
- the dorsal teeth 26 of the correction cover plate are not arranged near the dorsal edge of the vertebral connection surface 22, but rather approximately where they are (in relation to the mating surfaces 17) also with the standard cover plate 14 are located. This is based on the assumption that they will find more resistant bone at this location than near the ventral cover plate edge.
- the cover plate 31 is provided near its dorsal edge with a bulge 32, which was selected so that it corresponds approximately to the shape of the trough 4.
- its dorsal edge 33 is not sharp, but bevelled or rounded.
- the bevel or rounding merges monotonously into the surface of the bulge 32.
- the cover plate 31 slides along the surface of the vertebral body, there is no danger that the preceding, dorsal edge 33 of the cover plate 31 will bend on the bone edge 5. Rather, it will glide along it gently without exerting any dangerous force on it.
- the bevel or rounding of the edge 33 ensures that no excessive forces are transmitted in the region of the bone edge 5. Rather, the cover plate 31 is supported thanks to its bulge 32 in the depth of the trough 4.
- the bulge 32 can also be provided if the design is based on the weakly wedge-shaped basic shape of a standard cover plate.
- FIG. 10 shows an example in which the cover plate 34 of the prosthesis 35 has no bulge, but only a bevel 36 on its dorsal edge.
- the bevel ensures that the rear edge of the cover plate 34 glides smoothly along the bone edge 5, if it touches it at all.
- Figure 11 shows that in the assembled state, the bevel 36 avoids the direct contact of the cover plate 34 with the bone edge 5 and thereby excludes its risk.
- the cover plate the normal dorsal limitation of which is indicated by line 44 in FIG. 12, can also be shortened or straightened dorsally according to line 45. This embodiment of the invention can be seen in comparison with the standard cover plates of the same size level, which are provided for normal applications.
- FIGS. 11 and 12 show that the cover plates of the prosthesis 35 are provided with teeth 37, 38 which have the shape of triangular plates, the plane of which is perpendicular to the cover plate plane. They are so sharply designed that they self-tapping sink into the surface of the bone when the spreading of the vertebral bodies is reversed after the prosthesis has been inserted. It is known to arrange such teeth parallel to the edge (EP-A-1 057 462). For the teeth 38, which are arranged along the ventral edge of the cover plate 34, this also applies to the present exemplary embodiment.
- the teeth 37 arranged closer to the dorsal edge 36 are, however, firstly arranged at a large distance from this edge and secondly oriented in the AP direction, so that they neither when inserted into a narrow intervertebral space nor when they sink into the bone surface nor later during the normal function of the Prosthesis can exert a harmful, dorsally directed force on the bone. Moreover, their height may be less than that of teeth 38.
- FIG. 13 illustrates the possibility of providing a cover plate 39 with differently shaped protrusions 40.
- Interacting fastening means are provided for this purpose, which in the simplest case can consist of screws or pins. In the example shown, they comprise dovetail-shaped strips or grooves 41.
- the prosthesis cover plates are intended for a firm connection to the vertebral cover plates. Suitable connecting means can be provided for this.
- the cover plates 16, 31, 34 can be equipped with ventral flanges 48 which can be used in a known manner for screw fastening to the bone and, moreover, prevent the intervertebral space from penetrating too far.
- Another example of means for connecting the prosthesis to the bone is a biological coating on the prosthesis.
- the application of the invention is not limited to the type of prosthesis shown.
- it can also be used in the case of a prosthesis with a differently designed or differently held prosthesis core, for example when sliding joint surfaces are only provided on one cover plate, while on the other cover plate there are only holding members for the prosthesis core 15.
- it can also be used when both cover plates are firmly connected to the prosthesis core 15 and the joint movement within the prosthesis core 15 is ensured. Otherwise, the explanation of the prosthesis core has been omitted, since it is known in different forms.
Abstract
Description
Claims
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
AU2003222758A AU2003222758A1 (en) | 2002-10-14 | 2003-03-12 | System of intervertebral prostheses |
Applications Claiming Priority (5)
Application Number | Priority Date | Filing Date | Title |
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DE10247762.0 | 2002-10-14 | ||
DE10247762A DE10247762A1 (de) | 2002-10-14 | 2002-10-14 | Zwischenwirbelprothese |
EPPCT/EP03/00372 | 2003-01-15 | ||
PCT/EP2003/000372 WO2004034936A1 (de) | 2002-10-14 | 2003-01-15 | Zwischenwirbelprothese |
US10/358,387 | 2003-02-05 |
Publications (1)
Publication Number | Publication Date |
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WO2004034935A1 true WO2004034935A1 (de) | 2004-04-29 |
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PCT/EP2003/000372 WO2004034936A1 (de) | 2002-10-14 | 2003-01-15 | Zwischenwirbelprothese |
PCT/EP2003/002555 WO2004034935A1 (de) | 2002-10-14 | 2003-03-12 | System von zwischenwirbelprothesen |
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PCT/EP2003/000372 WO2004034936A1 (de) | 2002-10-14 | 2003-01-15 | Zwischenwirbelprothese |
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US (2) | US20040073307A1 (de) |
AU (1) | AU2003301233A1 (de) |
DE (1) | DE10247762A1 (de) |
WO (2) | WO2004034936A1 (de) |
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Also Published As
Publication number | Publication date |
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US20040073313A1 (en) | 2004-04-15 |
DE10247762A1 (de) | 2004-04-22 |
AU2003301233A1 (en) | 2004-05-04 |
US7311732B2 (en) | 2007-12-25 |
WO2004034936A1 (de) | 2004-04-29 |
US20040073307A1 (en) | 2004-04-15 |
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