WO1997047258A1 - Implantat zum einsetzen zwischen wirbelkörper als platzhalter - Google Patents

Implantat zum einsetzen zwischen wirbelkörper als platzhalter Download PDF

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Publication number
WO1997047258A1
WO1997047258A1 PCT/DE1997/001065 DE9701065W WO9747258A1 WO 1997047258 A1 WO1997047258 A1 WO 1997047258A1 DE 9701065 W DE9701065 W DE 9701065W WO 9747258 A1 WO9747258 A1 WO 9747258A1
Authority
WO
WIPO (PCT)
Prior art keywords
implant
terminal
sleeve
thread
implant part
Prior art date
Application number
PCT/DE1997/001065
Other languages
English (en)
French (fr)
Inventor
Helmut SCHÖNHÖFFER
Original Assignee
Ulrich, Heinrich
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Ulrich, Heinrich filed Critical Ulrich, Heinrich
Priority to EP97925873A priority Critical patent/EP0848603B1/de
Priority to JP50104098A priority patent/JP3826405B2/ja
Priority to DE59706670T priority patent/DE59706670D1/de
Priority to US09/011,418 priority patent/US6015436A/en
Priority to AT97925873T priority patent/ATE214578T1/de
Priority to CA002228812A priority patent/CA2228812C/en
Publication of WO1997047258A1 publication Critical patent/WO1997047258A1/de

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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
    • 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
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    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • 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
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    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4611—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
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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
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    • A61F2002/30362—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit with possibility of relative movement between the protrusion and the recess
    • A61F2002/3037—Translation along the common longitudinal axis, e.g. piston
    • A61F2002/30372—Translation along the common longitudinal axis, e.g. piston with additional means for limiting said translation
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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
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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
    • A61F2002/30772—Apertures or holes, e.g. of circular cross section
    • A61F2002/30777—Oblong apertures
    • 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
    • A61F2002/30772—Apertures or holes, e.g. of circular cross section
    • A61F2002/30784—Plurality of holes
    • A61F2002/30787—Plurality of holes inclined obliquely with respect to each other
    • 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
    • A61F2002/30795—Blind bores, e.g. of circular cross-section
    • 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
    • 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
    • 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
    • A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
    • 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
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0065—Three-dimensional shapes toroidal, e.g. ring-shaped, doughnut-shaped
    • 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
    • A61F2230/0069—Three-dimensional shapes cylindrical

Definitions

  • Implant to be inserted between the vertebral body as a placeholder.
  • the invention relates to an implant for insertion between the vertebral body as a placeholder, consisting of two terminal implant parts intended for contact with the adjacent vertebrae and a central implant part located between them, which is connected to one of the terminal implant parts by a thread, the three implant parts and the Thread in
  • Longitudinal direction of the spine are arranged coaxially and the length of the implant can be changed overall by turning the central implant part, and the terminal implant parts form tubular sleeves with sleeve walls pierced by recesses.
  • Implants of this type are known from DE 44 23 257 AI and serve as placeholders for vertebrae or vertebral parts removed from the spine.
  • the two terminal implant parts are each connected to the central implant part by their own thread, the two threads being arranged coaxially in the longitudinal direction of the spine and having a thread direction opposite to one another.
  • a material to be introduced into the interior of the tubular sleeves, such as bone cement or bone pieces can be inserted through the cutouts in the implant parts, as a result of which a faster vessel connection with the implant is achieved. Therefore, the implant is well suited for induction of bone formation and stimulation of the bones and it can be easily and after the implantation grow in quickly.
  • the total axial length of these implants is at least as long as the total length of the two opposing threads, which means a restriction with regard to the smallest possible implant length, so that these known implants are not suitable as intervertebral spaceholders for intervertebral disc replacement.
  • the invention is based on the object of designing an implant of the type mentioned at the outset in such a way that it can be adjusted to a minimum length which, in addition to being a complete replacement of a vertebral body, in particular in the cervical vertebrae area, can also be used as an intervertebral space holder for intervertebral disc replacement, in particular in the lumbar area, enables.
  • the two terminal implant parts engage with one another axially with one another and are axially displaceably guided against one another on the sleeve walls and are secured against mutual rotation about the axis of the sleeve, that the thread between the middle implant part and the thread with it connected terminal implant part is provided on the sleeve and that the rotatable in the thread of this sleeve middle implant part is designed as an axial stop for the other terminal implant part.
  • the implant according to the invention has only a single thread, the minimum possible length to which the
  • Implant can be shortened by the thread length only this one thread is determined, because the two terminal implant parts can practically over the Entire length of their tubular sleeves are completely screwed into each other, which overall enables a very low axial design and thus the use of the implant as an intervertebral disc replacement. Nevertheless, the possibility of distraction of the implant is fully retained during the operation, since only the middle part of the implant needs to be twisted accordingly, so that the overall length of the implant changes as desired.
  • a particularly simple and therefore preferred embodiment of the implant according to the invention with regard to the manufacture, assembly and handling is characterized in that the sleeve of the terminal implant part, which is threadedly connected to the central implant part, carries the thread on its outer circumferential surface and both of the central implant part and of the sleeve of the other terminal implant part is encompassed radially on the outside.
  • the middle implant part is easily accessible for twisting and the thread of the end implant part guiding this middle implant part is axially overlapped on the outside by the sleeve of the other end implant part.
  • a further advantageous embodiment of the implant according to the invention is characterized in that the sleeve of one of the terminal implant parts in the overlap region of the sleeves of the two more terminal ones
  • Implant parts has at least one radial threaded bore, in which a clamping screw that is clamped against the sleeve of the other terminal implant part is guided.
  • one or both of the terminal implant parts can be provided with an annular end plate at the end facing away from the middle implant part and this end plate can be provided on its end face with cutting edges or tips intended for penetration into the adjacent vertebrae.
  • the clear cross-section represented by the recesses as a whole should be as large as possible, on the other hand, the recesses must not unduly weaken the thread area, so that the strength of the thread connection between the one terminal implant part and the threaded middle implant part is not impaired. In general, you will see the recesses as in
  • FIG. 1 An implant according to the invention in one
  • FIG. 2 shows the subject of FIG. 1, but in the state in which the implant is set to its greatest possible length
  • FIGS. 1 and 2 shows the implant according to FIGS. 1 and 2 in the axially pulled apart state of the implant parts
  • FIG. 8 shows the section VIII - VIII in FIG. 4.
  • the implant shown in the drawing serves as a placeholder for insertion between vertebrae not shown in the drawing itself, depending on the length setting of the implant, for intervertebral disc replacement or for vertebrae removed from the spine or
  • the implant consists of two terminal implant parts 1, 2 intended for contact with the adjacent vertebrae and one in between middle implant part 3.
  • the middle implant part 3 is connected to one of the two terminal implant parts, in the drawing each with the upper terminal implant part 1, by a thread 4.
  • the three implant parts 1 to 3 and the thread 4 are in
  • the terminal implant parts 1, 2 form tubular sleeves 5 ', 5 "with sleeve walls pierced by recesses 6, these recesses 6 allowing the implant to rapidly grow into the surrounding tissue.
  • the two terminal implant parts 1, 2 grip with their sleeves 5', 5 "axially into each other. They are guided axially displaceably on the sleeve walls and secured against mutual rotation about the sleeve axis in a manner to be explained.
  • the thread 4 between the middle implant part 3 and the terminal part connected to it by thread, that is to say in the drawing the upper implant part 1, is provided on its sleeve 5 '.
  • the middle implant part 3, which can be rotated in the thread 4 of this sleeve 5 ', is designed as an axial stop for the sleeve 5 "of the other, lower end implant part 2 in the drawing.
  • an axially extending guide slot 7 is provided in the sleeve wall of the upper terminal implant part 1 in the drawing, and a guide projection 8 engaging in the guide slot 7 is provided on the sleeve wall of the other implant part 2, which is lower in the drawing.
  • the guide projection 8 is formed by a pin 8 'inserted radially into the sleeve wall.
  • the length of the guide slot 7 determines the extent by which the two terminal implant parts 1, 2 can be axially displaced relative to one another. Furthermore, the sleeve 5 "of the lower terminal implant part 2 has at least one radial threaded bore 9 in the area of overlap with the sleeve 5 'of the upper terminal implant part 1, in which a bore hole 5' of the upper terminal implant part only shown in FIGS.
  • clampable clamping screw 10 is guided so that the two terminal implant parts 1, 2 cannot be pulled apart axially when the clamping screw 10 is tightened, furthermore the upper terminal implant part 1 is at the middle End facing away from implant part 3 is provided with an annular end plate 11 projecting radially outward beyond the thread diameter, on the end face of which certain cutting edges or tips 12 'are provided for penetration into the adjacent vertebrae. Corresponding cutting edges or tips 12 "are located on the axially opposite end face of the lower end of the implant part 2.
  • the middle implant part 3 is provided on its outer circumferential surface with recesses 13 distributed over the circumference, which serve as key openings for inserting one for rotating the middle implant part 3 serving, not shown key are trained.

Abstract

Das Implantat besteht aus zwei endständigen, zur Anlage an den agrenzenden Wirbeln bestimmten Implantatteilen (1, 2) und einem dazwischen befindlichen mittleren Implantatteil (3), das mit einem der endständigen Implantatteile durch ein Gewinde (4) verbunden ist, wobei durch Verdrehen des mittleren Implantatteils (3) die Länge des Implantats insgesamt veränderbar ist. Die endständigen Implantatteile (1, 2) bilden rohrförmige Hülsen (5', 5'') mit von Aussparungen (6) durchbrochenen Hülsenwänden und greifen mit ihren Hülsen (5', 5'') axial ineinander, wobei sie an den Hülsenwänden axial gegeneinander verschieblich geführt sowie gegen gegenseitiges Verdrehen um die Hülsenachse gesichert sind. Das Gewinde (4) ist zwischen dem mittleren Implantatteil (3) und dem mit ihm gewindemäßig verbundenen endständigen Implantatteil (1) vorgesehen und das im Gewinde (4) verdrehbare mittlere Implantatteil (3) ist als axialer Anschlag für das andere endständige Implantatteil (2) ausgebildet.

Description

Implantat zum Einsetzen zwischen Wirbelkörper als Platzhalter.
Die Erfindung betrifft ein Implantat zum Einsetzen zwischen Wirbelkörper als Platzhalter, bestehend aus zwei endständigen, zur Anlage an den angrenzenden Wirbeln bestimmten Implantatteilen und einem dazwischen befindlichen mittleren Implantatteil, das mit einem der endständigen Inplantatteile durch ein Gewinde verbunden ist, wobei die drei Implantatteile und das Gewinde in
Längsrichtung der Wirbelsäule koaxial angeordnet sind und durch Verdrehen des mittleren Implantatteils die Länge des Implantats insgesamt veränderbar ist, und wobei die endständigen Implantatteile rohrformige Hülsen mit von Aussparungen durchbrochenen Hülsenwänden bilden.
Implantate dieser Art sind aus DE 44 23 257 AI bekannt und dienen als Platzhalter für aus der Wirbelsäule entfernte Wirbel oder Wirbelteile. Die Implantate ermöglichen durch Verdrehen des mittleren Implantatteils eine Distraktion des das Implantat enthaltenden Wirbelsäulenbereichε. Dabei sind beide endständigen Implantatteile mit dem mittleren Implantatteil durch je ein eigenes Gewinde verbunden, wobei die beiden Gewinde in Längsrichtung der Wirbelsäule koaxial angeordnet sind und zueinander gegenläufigen Gewindesinn besitzen. Durch die Aussparungen in den Implantatteilen kann gewünschtenfalls ein in das Innere der rohrförmigen Hülsen einzubringendes Material, wie Knochenzement oder Knochenstücke, eingefügt werden, wodurch ein schnellerer Gefäßanschluß mit dem Implantat erreicht wird. Daher ist das Implantat für die Induktion der Knochenbildung und Stimulation der Knochen gut geeignet und es kann nach, der Implantation leicht und schnell einwachsen. Allerdings ist bei diesen Implantaten die axiale Gesamtlänge mindestens so groß wie die Gesamtlänge der beiden gegensinnigen Gewinde, was eine Beschränkung hinsichtlich der kleinstmöglichen Implantatlänge bedeutet, so daß diese bekannten Implantate nicht als Zwischenwirbelplatzhalter zum Bandscheibenersatz geeignet sind.
Der Erfindung liegt die Aufgabe zu Grunde, ein Implantat der eingangs genannten Art so auszubilden, daß es auf eine Mindestlänge einstellbar ist, die seine Verwendung außer als kompletter Ersatz eines Wirbelkorpers, insbesondere im Halswirbelbereich, auch als Zwischenwirbelplatzhalter zum Bandscheibenersatz, insbesondere im lumbalen Bereich, ermöglicht.
Diese Aufgabe wird nach der Erfindung dadurch gelöst, daß die beiden endständigen Implantatteile mit ihren Hülsen axial ineinander greifen und an den Hülsenwänden axial gegeneinander verschieblich geführt sowie gegen gegenseitiges Verdrehen um die Hülsenachse gesichert sind, daß das Gewinde zwischen dem mittleren Implantatteil und dem mit ihm gewindemäßig verbundenen endständigen Implantatteil an dessen Hülse vorgesehen ist und daß das im Gewinde dieser Hülse verdrehbare mittlere Implantatteil als axialer Anschlag für das andere endständige Implantatteil ausgebildet ist.
Da das erfindungsgemäße Implantat nur ein einziges Gewinde besitzt, ist die mögliche Mindestlänge, auf die das
Implantat verkürzt werden kann, durch die Gewindelänge nur dieses einen Gewindes bestimmt, denn die beiden endständigen Implantatteile können praktisch über die gesamte Länge ihrer rohrförmigen Hülsen völlig ineinandergeschraubt werden, was insgesamt eine axial sehr niedrige Bauform und damit die Verwendung des Implantats als Bandscheibenersatz ermöglicht. Dennoch bleibt die Distraktionsmöglichkeit des Implantats während der Operation voll erhalten, da nur das mittlere Implantatteil im Gewinde entsprechend verdreht zu werden braucht, damit sich die Länge des Implantats insgesamt nach Wunsch ändert.
Eine im Hinblick auf die Herstellung, Montage und Handhabung besonders einfache und daher bevorzugte Ausführungsform des erfindungsgemäßen Implantats ist dadurch gekennzeichnet, daß die Hülse des mit dem mittleren Implantatteil gewindemäßig verbundenen endständigen Implantatteils das Gewinde auf seiner äußeren Umfangsflache trägt und sowohl vom mittleren Implantatteil als auch von der Hülse des anderen endständigen Implantatteils radial außen umfaßt ist. Dadurch ist das mittlere Implantatteil zum Verdrehen leicht zugänglich und das dieses mittlere Implantatteil führende Gewinde des endεtändigen Implantatteils durch die Hülse des anderen endεtändigen Implantatteils außenseitig axial übergriffen. Auch empfiehlt es sich, die Anordnung so zu treffen, daß zur gegenseitigen Verdrehungssicherung der beiden endständigen Inplantatteile in der Hülsenwand des einen Inplantateils ein axial verlaufender Führungsschlitz und an der Hülsenwand des anderen Inplantatteils ein in den Führungsschlitz eingreifender Führungsvorsprung vorgesehen ist. Führungsschlitz und Führungsvorsprung können zu mehreren verteilt über den Umfang der Hülsenwände angeordnet sein. Um die gegenseitige Stellung der beiden endständigen Implantatteile auch unabhängig von der Anschlagfunktion des mittleren Implantatteils fixieren zu können, ist eine weitere vorteilhafte Ausführungsform des erfindungsgemäßen Implantats dadurch gekennzeichnet, daß die Hülse eines der endständigen Implantatteile im Überlappungsbereich der Hülsen beider endständiger
Implantatteile mindestens eine radiale Gewindebohrung aufweist, in der eine gegen die Hülse des anderen endständigen Implantatteils verspannbare Klemmschraube geführt ist. In weiter bevorzugter Ausführungsform können eines oder beide der endständigen Implantatteile am jeweils vom mittleren Implantatteil abgewandten Ende mit einer ringförmigen Stirnplatte und diese Stirnplatte an ihrer Stirnfläche mit zum Eindringen in den angrenzenden Wirbel bestimmten Schneiden oder Spitzen versehen sein. Bezüglich der Ausbildung und Anordnung der Aussparungen in den Hülsenwänden der endständigen Implantatteile besteht im Rahmen der Erfindung eine gewisse Wahlfreiheit. Einerseits soll der von den Aussparungen insgesamt repräsentierte lichte Querschnitt möglichst groß sein, anderseits dürfen die Aussparungen den Gewindebereich nicht unzulässig schwächen, damit die Festigkeit der Gewindeverbindung zwischen dem einen endständigen Implantatteil und dem damit gewindemäßig verbundenen mittleren Implantatteil keine Beeinträchtigung erfährt. Im allgemeinen wird man dabei die Aussparungen als im
Querschnitt kreisförmige Bohrungen oder als Langlöcher ausbilden und gleichmäßig über den Hülsenumfang verteilt anordnen. Weitere Aussparungen sind vorzugsweise in der äußeren Umfangsflache des mittleren Implantatteils über den Umfang verteilt angeordnet und als Schlüsselöffnungen zum Einstecken eines zum Verdrehen des mittleren Implantatteiles dienenden Schlüssels ausgebildet. Im folgenden ist die Erfindung an einem in der Zeichnung dargestellten Ausführungsbeispiel näher erläutert; es zeigen:
Fig. 1 Ein Implantat nach der Erfindung in einer
Seitenansicht und in dem Zustand, in dem es auf seine kleinstmöglich axiale Länge eingestellt ist,
Fig. 2 den Gegenstand der Fig. 1, jedoch im Zustand, in dem das Implantat auf seine größtmögliche Länge eingestellt ist,
Fig. 3 eine Stirnansicht des Implantats,
Fig. 4 das Implantat nach den Fig.l und 2 in axial auseinandergezogenem Zustand der Implantatteile,
Fig. 5 den Schnitt V - V in Fig. 4,
Fig. 6 den Schnitt VI - VI in Fig. 4,
Fig. 7 den Schnitt VII - VII in Fig. 4 und
Fig. 8 den Schnitt VIII - VIII in Fig. 4.
Das in der Zeichnung dargestellte Implantat dient zum Einsetzen zwischen in der Zeichnung selbst nicht dargestellte Wirbel als Platzhalter, und zwar, je nach Längeneinstellung des Implantats, zum Bandscheibenersatz oder für aus der Wirbelsäule entfernte Wirbel oder
Wirbelteile. Das Implantat besteht aus zwei endständigen, zur Anlage an den jeweils angrenzenden Wirbeln bestimmten Implantteilen 1, 2 und einem dazwischen befindlichen mittleren Implantatteil 3. Das mittlere Implantatteil 3 ist mit einem der beiden endständigen Implantatteile, in der Zeichnung jeweils mit dem oberen endständigen Implantatteil 1, durch ein Gewinde 4 verbunden. Die drei Implantatteile 1 bis 3 und das Gewinde 4 sind in
Längsrichtung der Wirbelsäule koaxial angeordnet. Durch Verdrehen des mittleren Implantatteils 3 im Gewinde 4 ist die Länge des Implantats insgesamt zwischen den aus dem Vergleich der Fig. 1 und 2 ersichtlichen Grenzen veränderbar. Die endständigen Implantatteile 1, 2 bilden rohrformige Hülsen 5', 5" mit von Aussparungen 6 durchbrochenen Hülsenwänden, wobei diese Aussparungen 6 ein schnelles Einwachsen des Implantats im umgebenden Gewebe ermöglichen. Die beiden endständigen Implantatteile 1, 2 greifen mit ihren Hülsen 5', 5" axial ineinander. Sie sind an den Hülsenwänden axial gegeneinander verschieblich geführt sowie gegen gegenseitiges Verdrehen um die Hülsenachse in noch zu erläuternder Weise gesichert. Das Gewinde 4 zwischen dem mittleren Implantatteil 3 und dem mit ihm gewindemäßig verbundenen endständigen, in der Zeichnung also oberen Implantatteil 1 ist an dessen Hülse 5' vorgesehen. Das im Gewinde 4 dieser Hülse 5' verdrehbare mittlere Implantatteil 3 ist als axialer Anschlag für die Hülse 5" des anderen, in der Zeichnung unteren endständigen Implantatteils 2 ausgebildet. Durch Verdrehen des mittleren Implantatteils 3 im Gewinde 4 des oberen endständigen Implantatteils 1 ändert sich die axiale Lage des mittleren Implantatteils 3 auf dem oberen endständigen Implantatteil 1, so daß sich auch die axiale Lage der beiden endständigen Implantatteile 1 zueinander ändert, da die Lage des in der Zeichung unteren endständigen Implantatteils 2 gegenüber dem in der Zeichnung oberen endständigen Implantatteil 1 durch den Anschlag seiner Hülse 5" am mittleren Implantatteil 3 bestimmt ist. Die Hülse des mit dem mittleren Implantatteil 3 gewindemäßig verbundenen, also oberen endständigen Implantatteils 1 trägt das Gewinde 4 auf ihrer äußeren Umfangsflache. In dieses Gewinde 4 greift das die Hülse 5' radial an ihrer Außenseite umgebende mittlere Implantatteil 3 mit einem Muttergewinde 4'. Die Hülse 5' des mit dem mittleren Implantatteil 3 gewindemäßig verbundenen endständigen, also in der Zeichnung oberen Implantatteils 1 ist außer vom mittleren Implantatteil 3 auch von der Hülse 5" des anderen endständigen Implantatteils 2 radial außen umfaßt. Zur gegenseitigen Verdrehungssicherung der beiden endständigen Implantatteile 1, 2 ist in der Hülsenwand des in der Zeichnung oberen endständigen Implantatteils 1 ein axial verlaufender Führungsschlitz 7 und an der Hülsenwand des anderen, in der Zeichnung unteren Implantatteils 2 ein in den Führungsschlitz 7 eingreifender Führungsvorsprung 8 vorgesehen. Der Führungsvorsprung 8 ist durch einen radial in die Hülsenwand eingesetzten Stift 8' gebildet. Der
Führungsschlitz 7 bestimmt mit seiner Länge das Maß, um welches die beiden endständigen Implantatteile 1, 2 gegeneinander axial verschoben werden können. Weiter besitzt die Hülse 5" des unteren endständigen Implantatteils 2 im Überlappungsbereich mit der Hülse 5' des oberen endständigen Implantatteils 1 mindestens eine radiale Gewindebohrung 9, in der eine nur in Fig. 1 und 2 dargestellte, gegen die Hülse 5' des oberen endständigen Implantarteils 1 verspannbare Klemmschraube 10 geführt ist, so daß bei angezogener Klemmschraube 10 die beiden endständigen Implantatteile 1, 2 axial nicht auseinandergezogen werden können. Weiter ist das obere endständige Implantatteil 1 am vom mittleren Implantatteil 3 abgewandten Ende mit einer über den Gewindedurchmesser radial nach außen vorstehenden ringförmigen Stirnplatte 11 versehen, an deren Stirnfläche zum Eindringen in den angrenzenden Wirbel bestimmte Schneiden oder Spitzen 12' vorgesehen sind. Entsprechende Schneiden bzw. Spitzen 12" befinden sich am axial gegenüberliegenden stirnseitigen Hülsenrand des unteren endständigen Implantatteils 2. Das mittlere Implantatteil 3 ist an seiner äußeren Umfangsflache mit über den Umfahg verteilt angeordneten Aussparungen 13 versehen, die als Schlüsselöffnungen zum Einstecken eines zum Verdrehen des mittleren Implantatteiles 3 dienenden, selbst nicht dagestellten Schlüssels ausgebildet sind.

Claims

Patentansprüche:
1. Implantat zum Einsetzen zwischen Wirbelkörper als Platzhalter, bestehend aus zwei endständigen, zur Anlage an den angrenzenden Wirbeln bestimmten Implantatteilen (1, 2) und einem dazwischen befindlichen mittleren Implantatteil (3) , das mit einem der endständigen Implantatteile durch ein Gewinde (4) verbunden ist, wobei die drei
Implantatteile (1, 2, 3) und das Gewinde (4) in Längsrichtung der Wirbelsäule koaxial angeordnet sind und durch Verdrehen des mittleren Implantatteils (3) die Länge des Implantats insgesamt veränderbar ist, und wobei die endständigen Implantatteile (1, 2) rohrformige Hülsen (5', 5") mit von Aussparungen (6) durchbrochenen Hülsenwänden bilden, dadurch gekennzeichnet, daß die beiden endständigen Implantatteile (1,
2) mit ihren Hülsen (5', 5") axial ineinander greifen und an den Hülsenwänden axial gegeneinander verschieblich geführt sowie gegen gegenseitiges Verdrehen um die Hülsenachse gesichert sind, daß das Gewinde (4) zwischen dem mittleren Implantatteil (3) und dem mit ihm gewindemäßig verbundenen endständigen Implantatteil (1) an dessen Hülse (5') vorgesehen ist und daß das im Gewinde (4) dieser Hülse (5') verdrehbare mittlere Implantatteil (3) als axialer Anschlag für das andere endständige Implantatteil (2) ausgebildet ist.
Implantat nach Anspruch 1, dadurch gekennzeichnet, daß die Hülse (5') des mit dem mittleren Implantatteil (3) gewindemäßig verbundenen endständigen Implantatteils (1) das Gewinde (4) auf seiner äußeren Umfangsflache trägt und sowohl vom mittleren Implantatteil (3) als auch von der Hülse (5") des anderen endständigen Implantatteils (2) radial außen umfaßt ist.
3. Implantat nach Anspruch 1 oder 2, dadurch gekennzeichnet, daß zur gegenseitigen Verdrehungssicherung der beiden endständigen Implantatteile (1, 2) in der Hulsenwand des einen Implantateiis (1) ein axial verlaufender Führungsschlitz (7) und an der Hülsenwand des anderen Implantatteils (2) ein in den Führungsschlitz (7) eingreifender Führungsvorεprung (8) vorgesehen ist.
4. Implantat nach einem der Ansprüche 1 bis 3, dadurch gekennzeichnet, daß die Hülse (5") eines der endständigen Implantatteile (1, 2) im Überlappungsbereich der Hülsen (5', 5") beider endständiger Implantatteile (1, 2) mindestens eine radiale Gewindebohrung (9) aufweist, in der eine gegen die Hülse (5') des anderen endständigen Implantatteils (1) verspannbare Klemmschraube (10) geführt ist.
5. Implantat nach einem der Ansprüche 1 bis 4, dadurch gekennzeichnet, daß eines der beiden endständigen Implantatteile (l, 2) am vom mittleren Implantatteil (3) abgewandten Ende mit einer ringförmigen Stirnplatte (11) und diese
Stirnplatte (11) an ihrer Stirnfläche mit zum Eindringen in den angrenzenden Wirbel bestimmten Schneiden oder Spitzen (12', 12") versehen ist. Implantat nach einem der Ansprüche 1 bis 5, dadurch gekennzeichnet, daß das mittlere Implantatteil (3) an seiner äußeren Umfangsflache über den Umfang verteilt angeordnete Ausparungen (13) aufweist, die als Schlüsselöffnungen zum Einstecken eines zum Verdrehen des mittleren Implantatteils (3) dienenden Schlüssels ausgebildet sind.
PCT/DE1997/001065 1996-06-07 1997-05-22 Implantat zum einsetzen zwischen wirbelkörper als platzhalter WO1997047258A1 (de)

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EP97925873A EP0848603B1 (de) 1996-06-07 1997-05-22 Implantat zum einsetzen zwischen wirbelkörper als platzhalter
JP50104098A JP3826405B2 (ja) 1996-06-07 1997-05-22 スペース保持部材として脊柱の椎体間に挿入する生体埋め込み部材
DE59706670T DE59706670D1 (de) 1996-06-07 1997-05-22 Implantat zum einsetzen zwischen wirbelkörper als platzhalter
US09/011,418 US6015436A (en) 1996-06-07 1997-05-22 Implant for filling a space between vertebrae
AT97925873T ATE214578T1 (de) 1996-06-07 1997-05-22 Implantat zum einsetzen zwischen wirbelkörper als platzhalter
CA002228812A CA2228812C (en) 1996-06-07 1997-05-22 Implant for filling a space between vertebrae

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DE19622827A DE19622827B4 (de) 1996-06-07 1996-06-07 Implantat zum Einsetzen zwischen Wirbelkörper als Platzhalter
DE19622827.1 1996-06-07

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US6015436A (en) 2000-01-18
ATE214578T1 (de) 2002-04-15
ES2171947T3 (es) 2002-09-16
EP0848603B1 (de) 2002-03-20
JP3826405B2 (ja) 2006-09-27
EP0848603A1 (de) 1998-06-24
DE59706670D1 (de) 2002-04-25
CA2228812C (en) 2005-11-15
JPH11510720A (ja) 1999-09-21
DE19622827B4 (de) 2009-04-23
CA2228812A1 (en) 1997-12-18

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