WO2008049949A1

WO2008049949A1 - Intersomatic box, forceps for manipulating same and method for inserting the intersomatic box between vertebrae

Info

Publication number: WO2008049949A1
Application number: PCT/ES2007/000611
Authority: WO
Inventors: Lluis Marquez Alvarez
Original assignee: Traiber, S.A.
Priority date: 2006-10-27
Filing date: 2007-10-26
Publication date: 2008-05-02
Also published as: ES2328879B1; ES2328879A1

Abstract

The invention relates to an intersomatic box to be inserted between vertebrae and for fixing same, which, on its lateral face, has at least one orifice or depression via which it can be held via the gripping forceps, which forceps have individual articulated arms, and with the possibility of sliding between the two, said sliding being regulated from the rear part thereof, the forceps body including a copier device that, at all times, reproduces the positioning of the intersomatic box in precisely the way in which it is being held by the forceps, it being possible, at all times, to know its intervertebral location. The invention also relates to the method for placing intersomatic boxes between vertebrae.

Description

INTERSOMATIC CASE, CLAMP FOR HANDLING OF THE SAME AND INTRODUCTION PROCEDURE OF THE INTERSOMATIC CASE

BETWEEN VERTEBRAS

OBJECT OF THE INVENTION

The object of the invention refers to the field of intervertebral implants as a complement to carry out the immobilization between two adjacent vertebrae, by means of the introduction between them of an intersomatic box.

These implants are placed between vertebrae when the intervertebral disc has degenerated, with the consequent approach between vertebrae, the local compression of the spinal cord and the nerve roots that start from it.

BACKGROUND OF THE INVENTION

Intervertebral implants by means of an intersomatic cage are known in the state of the art, adopt various preferred forms and are an efficient method of achieving separation of the vertebrae when the intervertebral disc has degenerated.

This type of operations provides for the removal of the necessary part of the intervertebral disc and its replacement by a piece that is called the intersomatic cage, which maintains the intervertebral separation, thereby preventing the compression of the spinal cord and the nerves that leave the same.

In order to facilitate the grip of the intersomatic box to the vertebrae, said box is designed in such a way that it includes in its upper and lower faces, that is to say those that make contact with the vertebrae, a tooth that sticks on the vertebra itself and avoids the possible sliding between them and the intersomatic box.

It is known the Spanish patent ES-2,211,253 relating to an intersomatic box that has lateral windows that allow radiological control of bone growth and a vertical through window that form an interior hole where the bone insert is housed. Both superiorly and internally, it has saw teeth that increase the holding capacity between adjacent vertebrae. A problem with these boxes is due to their placement, since they are inserted between the vertebrae in a straight way so that the teeth prevent the easy entry of this box so that the same is done as it is said vulgarly with a hammer blow. the disorder that originates the patient with this so cumbersome inclusion technique.

Another problem added to the intersomatic boxes of the state of the art are derived from the assumption in which the position must be modified, in which case the modification is completely impossible since the system is irreversible.

Another problem added to the state of the art are the necessary and continuous exposures to X-rays to control at all times the placement of these intersomatic boxes.

DESCRIPTION OF THE INVENTION

The present invention aims and achieves, to eliminate all the problems indicated in the state of the art, for which a first objective of the invention is an improved intersomatic case. It is also the object of the invention the insertion clamps of this interbody fusion cage in the intervertebral cavity which, on the one hand, allow the box to be firmly held and cause a rotational movement of intervertebral introduction less invasive than the traditional one.

It is also the object of the invention to know at all times the position that the intersomatic box is adopting within the intervertebral cavity, without the need to use X-rays.

Lastly, it is the object of the invention to introduce the intersomatic box into its intervertebral space, controlling at all times the positioning and the support and even controlling the possibility of extraction, which allows a reversible movement. Said rotary movement of entry and exit does not perform any other current system.

Entering the description of the intersomatic box, we must firstly point out that on the lateral side of the same at least one hole or groove is made that can be through or blind and in which at least two holes or grooves are preferably located on said side face of the box, whose mission is to serve as a point or grip points of the positioning clips that will be described in more detail later.

These holes or grooves are rounded or circular in shape and the prominent ends of the clamps fit into them. These holes or slits may have external frustoconical areas that facilitate movement between the arms of the clamp and the intersomatic box.

With the incorporation of these holes, the clamps will grip the intersomatic box in its introduction towards the vertebrae, thereby eliminating possible risks that the box can be released. Likewise, the interbody frames have both straight and parallel curved teeth on their upper and lower faces that will achieve the grip of the box on the vertebrae, having that curved the mission that the teeth when the movement introduces the box into the intervertebral space occurs which is intended to be carried out, provided that this curved profile of the teeth facilitates the introduction by turning the interbody frames. In this case, the profile of the teeth is made without flattening the ridges of the teeth and defining tooth profiles in which on both sides they are similar on both flanks, since this will not prevent the recoil of the intersomatic box since turning the it follows the normal profile of the teeth, but it will prevent in a great way that there is displacement of the united vertebrae.

A second object of the invention is found in the clamps for fastening and introducing the interbody fusion cages in the intervertebral space. These tweezers are constituted by two arms articulated together in a central point, a joint that has the possibility of relative sliding between both arms. This relative displacement between the arms of

The clamp allows, when holding the intersomatic box with the movable ends of the clamp, the mentioned box rotates on the clamping axis of

The same and with that rotating movement the same is positioned in the intervertebral space

The rear ends of the clamp have a device for regulating the movement of the clamp arms. This device essentially consists of a threaded torm on one of the arms of the clamp, a drive control of said screw set in contrast and a lowered intermediate area where the other arm of the other clamp is introduced, which has the form of a channel that fits in the recessed portion of the drive device. Therefore, a turn in one direction or another of the regulating device would achieve a sliding of both arms of the caliper body.

The clamp is completed with the inclusion of a copying element that reproduces the shape and holding position of the intersomatic box by the clamps. This copying element is attached in its central position and rotatably to one of the arms of the clip, while on the periphery of the copying element an arm is attached articulated to the other arm of the clip, reproducing in the element Copier a turn identical to that produced by the intersomatic box held by the ends of the clip. At the moment that the arms of the clamp slide between them, the rotation of the intersomatic box is produced and therefore of the copying element, reproducing externally and so that the operating doctor sees it, the situation in which the intersomatic box is located between the vertebrae, which will be hidden from the view of the doctor who is operating. This device is extremely useful since it will not be necessary to perform multiple radiographs of the area to see the placement of the box with the danger of exposure to X-rays.

The method of fastening the intersomatic box is also the subject of the invention and includes the following operations

adjustment of the terminal ends of the clip on the corresponding hole (s) or recesses provided by the intersomatic box. - Tighten the arms of the clamp and firm hold of the intersomatic box

Approach of the ends of the clamp until its placement between the vertebrae where the intersomatic box is inserted

Sliding each other of the arms of the clamp by means of a rear actuator with the consequent articulated rotation of the box intersomatic and rotation of the copying element reproducing the rotation of the intersomatic box.

Placement within the intervertebral cavity of the intersomatic box Opening and removal of the clamps

BRIEF DESCRIPTION OF THE DRAWINGS

To complete the description that is being made and in order to help a better understanding of the characteristics of the invention, this descriptive report is attached, as an integral part thereof, a set of drawings where illustrative and not The following has been represented as limiting:

Figure 1 represents a perspective view from several angles of an interbody cage that includes the improvements of the invention

Figure 2 represents four views of a top view of the clamps of the invention with the sequence of the operation. Between the arms of the clamp, the intersomatic box is taken and the arms of the clamp are squeezed until it clicks, at this moment the intersomatic box has been completely pinched so that, even leaving the clamp, it is still making the grip force on the intersomatic box. That is, it takes the intersomatic box and maintains it.

Figure 3 represents three sequential views of the movement of the tip of

The clamp and the displacement of the intersomatic box.

Figure 4 represents a perspective view of the clip holding an intersomatic box. DESCRIPTION OF A PREFERRED EMBODIMENT OF THE INVENTION

Figure 1 shows a perspective view of an intersomatic box (1) that includes the improvements of the invention. This box, in this example, has a lobular shape with a central hollow (2) and both on the upper and lower face that are those that make contact with the vertebrae have straight or curved teeth (3) in the form of a tooth of saw that will be embedded in the vertebrae preventing the movement of the vertebrae with each other.

In an area of the side wall and can take it in the opposite position another similar way, a hole or recess (4) is made that can be through to the central hollow area (2), which can be limited externally by a conical frustoconical recess (5 ) as observed in the sequential figures of Figure 3 where the relative position occupied by the ends of the clamps and the intersomatic box makes this truncated cone (5) necessary to allow free movement of the intersomatic box.

In figure 2, the relative movement between the arms of the clamp (6) (7), arms that are centrally coupled in the sliding coupling (8) formed by a sliding axis in a skewed groove is represented in four sequences. , each of these elements belonging to each of the arms of the clamp, so that a displacement between the two causes a sliding between the arms of

The clamp.

The front end (9) of the tips of the clip is adapted to be inserted in the holes or recesses (4). The rear end of the clamp arms are arched at a steep angle to define two ends

(10) and (11). At the end (10) it is threaded into (14) a regulating shaft of the axial sliding between arms (12), finished at its end in the drive wheel (13), while intermediate this regulating axis has a recess (15) inside which the end of the arm (11) is held that has a ribbed shape . This ribbed shape of the end of the clamp arm (11) allows the free movement of opening and closing of the clamps, while the axial sliding between its arms will be conditioned by the positioning of the screw (12).

The copying device (16) is incorporated on one of the arms of the clip (6) and rotatably held through the axis (17), while at the periphery of the copying device (16) it is attached to a cam ( 18) which is held on the other arm of the clip (7). The sliding between the arms of the clip will cause the copying device to rotate, which by having a representation similar to the placement of the intersomatic box between the ends of the clip, the operating doctor will at all times have exact information on the This position occupies that box between the vertebrae, avoiding the continuous exposure to X-rays that traditional interventions require since they do not know the placement of the intersomatic box at all times.

The copying device (16) has regulation (not shown in the figures) by means of a screw, which allows the variation of this device to be placed in the same position in which the intersomatic box is held. The cam (18) is also constituted as a displacement element of the copying device in a spring opening and closing element of the clamp.

The flexion of the tweezers causes the clamping to be maintained on the intersomatic box, although the pressure normally exerted on the arms of the clamp is released. The design of the clamp is such that it allows the total disassembly thereof, without the need for tools, in order to achieve a better cleaning thereof.

Finally, say that the system allows the replacement of the intersomatic box at any time during the process of implementing the box itself.

Figure 3 shows three representations of how the sliding between the ends (9) of the arms of the clamp (6) (7), causes the rotation of the intersomatic box (1), for that such ends of the clamps will have some recesses (19) where the sides of the boxes fit and define extreme seating positions of the said interbody compartment.

Figure 4 represents a perspective view of the clip (20) holding the intersomatic box (1). This figure allows the arms (6) and (7) to be observed, holding the intersomatic box through the ends (9) and how the joint axis between the arms (6) and (7) constitutes a sliding coupling (8) . It should be noted from this figure the copying device (16) that carries the upper form (21) with the similar placement of the intersomatic box and how this copying device (16) is guided by the action of a cam (18).

Claims

1.- Intersomatic box for intervertebral implantation as a complement to immobilize the vertebrae between which it is placed, which comprises at least one hole or recess made in the extreme lateral portion of the box for its subjection by a grip and placement of Ia same.

2.- Intersomatic box for intervertebral implantation according to claim 1, characterized in that it has two holes or recesses made in the extreme lateral portion of the box for its subjection by a gripper and placement thereof.

3. Intersomatic box for intervertebral implantation according to claim 2, characterized in that the holes or recesses are placed on opposite sides of the box for fastening by a gripper and placement thereof.

4. Intersomatic box for intervertebral implantation according to claims 1 to 3 characterized in that the holes or recesses have circular or rounded section

5. Intersomatic box for intervertebral implantation according to claims 1 to 4, characterized in that the holes or recesses have a truncated conical external section that facilitates the relative movement between clamps and interbody fusion box.

6. Intersomatic box for intervertebral implantation according to claim 1, characterized in that the teeth of the faces facing the vertebrae are performed with a curved and parallel shape on both sides.

7. Intersomatic box for intervertebral implantation according to claim 1, characterized in that the teeth of the faces facing the vertebrae are performed with a straight and parallel shape on both sides.

8.- Clamp for manipulation of an intersomatic box comprising

two arms articulated with each other in a central area, a joint that has the possibility of relative sliding between the arms, a subsequent fixation of the articulated arms that allows the free movement of opening or closing and the regulated movement of the arms sliding an anterior end of the clamp arms adapted to the hole or recesses of the interbody compartment.

9. - Clamp for manipulation of an interbody compartment according to claim 7, characterized in that it has a copying element that reproduces the shape and holding position of the intersomatic box by the tweezers, this copying element is located centrally and rotating to one of the arms of the clamp, while on the periphery of the copied element a cam is fixedly connected to the other arm of the clamp, reproducing in the copying element a rotation identical to that produced by the box intersomatic held by the ends of the clamp.

10. Clamp for manipulation of an intersomatic box according to claims 7 and 8, characterized in that the relative sliding between the arms of the clamp entails the positional rotation of the intersomatic box held by the clamp.

11. Clamp for manipulation of an intersomatic box according to claim 7 characterized in that the regulating element of sliding between the arms of the clamp is achieved by means of a threaded shaft on one of the ends of the clamp, which at its opposite end has the actuation and actuation zone on the sliding mechanism, while in an intermediate position It finds a lowered area where an arm attached to the other arm of the clamp is attached, an arm that has a torn shape that facilitates the opening and closing of the arms of the clamp but nevertheless maintains the interconnection with the sliding control of the arms of the arm. gripper.

12. Clamp for manipulation of an intersomatic box, according to claims 8 and 9, characterized in that the copying device has regulation of the position through the screw that adjusts its position to the fixing of the intersomatic box.

13. Clamp for manipulation of an entomatic box, according to claims 8 and 9, characterized in that the cam that displaces the copying element is also constituted as an opening and closing spring of the clamp.

14. Clamp for manipulation of an intersomatic box, according to claims 8 to 13, characterized in that the flexion of the clamps causes the clamping on the intersomatic box to be maintained, although the pressure exerted manually on the arms of the clamp is released.

15. Clamp for manipulation of an intersomatic box, according to claims 8 to 14, characterized in that the design of the clamp allows the disassembly of the main elements, without the need for tools, facilitating greater cleaning thereof.

16.- Clamp for manipulation of an entomatic box, according to claims 8 to 15, characterized in that the system allows Ia replacement of the intersomatic box at any time during the implementation process of the box itself.

17.- Procedure for securing the intersomatic box comprising

adjustment of the terminal ends of the clip on the corresponding hole (s) or recesses provided by the intersomatic box.

Squeeze the arms of the clamp and firm hold of the intersomatic box - Sliding each other of the arms of the clamp by means of a rear actuator with the consequent articulated rotation of the intersomatic box and rotation of the copying element reproducing the rotation of the intersomatic box.