Plate and system for making vertebral column osteosynthesis

FIELD: medicine; medical engineering.

SUBSTANCE: device is rectangular and has four or more slits for fixing means to pass through each of them. Two slits have exit to lateral side of plate to enable one to set the plate at required position and fix it without preliminarily removing the instrument for correcting orientation relative to vertebral column. Lateral plate surface runs from edge pointing the same direction with longitudinal plate direction. The latter exactly coincides with the vertebral column direction. The system comprises several vertebral column osteosynthesis plates to keep orientation correction relative to the vertebral column unchanged. Correction is carried out by means of the instrument for correcting orientation.

EFFECT: less number of holes to be drilled for mounting the device.

11 cl, 10 dwg

 

The present invention relates to the field of surgery to repair a broken spine (osteosynthesis). More precisely, it refers to the plate for osteosynthesis of the spine, designed for installation without the possibility of displacement of one relative to the other, at least two adjacent vertebrae.

Such plates are usually cut from a biocompatible material, in particular made of metal, such as titanium, rigid or flexible. They (plates) are round or oblong holes for the passage of fixing screws or vertebral implant formed by parts with thread.

As an example, let's specify the links in French patents FR 2763828 or FR 276353 describing system osteosynthesis of the spine with the use of plates known from the prior art.

Also known reference to the French patent FR 2737402, which describes a device for anterior stabilization of the cervical spine, intended for fixation of vertebrae and restore normal vnutrisosudistogo space. The device includes a plate of double curvature with oval holes, screws for mounting in the body and closing the tube with thread intended for installation in a hole with internal thread, made in the upper part of the anchor screws.

These records for osteo is Intesa, known prior art, it is difficult to establish. Indeed, the surgeon starts with the correct placing of the spine with a tool for time correction, representing the adjustment rods designed for fixing in the vertebrae, which prevent the establishment of a plate and its fixing. If the correction tool withdrawn before final fixation plate, it is necessary to align the invoice before final fixation plate.

To remedy this inconvenience has been proposed in German patent application No. DE 4201043 plate in a generally rectangular shape for osteosynthesis of the spine, having at least four holes for the passage of fixing, as well as two longitudinal slots, open to the transverse sides of the plate in order to make it possible to the final installation on the spot and the fixation plate without removing the front of this instrument for the correction of orientation relative to the vertebrae.

The main disadvantage of this plate is that the surgeon must make six holes: two holes to allow installation tool for the correction of orientation relative to the vertebrae and four holes for fixing the plate for osteosynthesis of the spine.

In addition, the presence of longitudinal slits increases the width p of the plates for osteosynthesis.

The purpose of the present invention is to create a plate that is free from these inconveniences. To accomplish this, the present invention relates to a plate for osteosynthesis of the spine to maintain the correct orientation relative to the vertebrae using the tool for the correction, and the above-mentioned plate for osteosynthesis of the spine has a generally rectangular shape and includes at least four slots for passage through each fixation means. Plate for osteosynthesis according to the invention is remarkable in its broadest sense, that at least two slots are connected on the side of the above-mentioned plate for osteosynthesis in order to make possible the installation place and the fixation plate without prior removal tool to correct orientation relative to the vertebrae.

Lateral edge of the plate comes from the region lying in the same direction as the longitudinal direction of the plate, wherein the longitudinal direction of the plate strictly coincides with the direction of the spine, where the operation is carried out osteosynthesis. Lateral edge forms an angle formed at the intersection with the transverse edge.

Thus, when the surgeon has performed the correction orientation relative to the vertebrae by means of the correcting rod tool is orecchi, implanted in the vertebrae, he has the ability to replace the plate for osteosynthesis so that corrective rods of tool correction would take place through these incisions, with the exit, and begin fixing plate, leaving the adjustment rods in place.

Mainly the slots made for fixing the adjustment rod tool to correct orientation relative to the vertebrae, are after partial fixation plate for osteosynthesis and removal corrective rods tool for correction, for final fixation plate for osteosynthesis.

Mostly, at least one of the slots, connected to the side plate has an angular shape, L-shaped or another, including the first cross-section facing the side plate, extended second longitudinal section, strictly oriented in the longitudinal direction.

Plate according to the invention since its introduction between the adjusting rod of the tool is actively involved in the retention of elements of the vertebral column.

The plate may, therefore, have two connected slots are L-shaped or one having an exit slot in an L-shape and the other having an exit slot oriented transversely, or both in the region have the exit slot, oriented transversely.

Plate for osteosynthesis of the spine has mainly two connected slots angular shape, L-shape or other, containing the first cross-section, facing the side of the plate, continued the second longitudinal section, strictly oriented in the longitudinal direction.

Mainly also, at least one of the sites that do not go to the side plate has a second area, strictly oriented in the longitudinal direction in order to make possible automatic postoperative compensation seal intervertebral space often bone graft.

Mainly the distance between the slits facing the side plate corresponds interdominios.com the distance between the N vertebrae, where N is an integer greater than or equal to two.

One of the options plate contains, in addition, at least one hole is provided strictly on the middle longitudinal axis for attachment of a bone graft or other interanational element.

According to a preferred variant, the plate contains, in addition, at least one fixing hole closing plates designed to close at least partially the above FIC is then after fixing, moreover, the above-mentioned closing plate mostly curved and has also predominantly at least one hole for attachment, often two holes for mounting, of which at least one elongated, allowing pressing of the closing plate to the plate for osteosynthesis to adapt it to the profile plate for osteosynthesis.

According to a special variant of execution of the invention, at least one of the above slots for the passage of fastening means has at least two positions of the reception of fastening means: the receiving position on the surface, in which the above-mentioned fastening tilted strictly on a certain angle with respect to the above-mentioned plate, and a receiving position in depth, in which the above-mentioned fastening occupy an inclined position at a variable angle.

The present invention relates also to a system for osteosynthesis of the spine, containing many plates for osteosynthesis of the spine to keep the correct orientation relative to the vertebrae, through the use of a tool for the correction, and the above-mentioned plate for osteosynthesis of the spine are generally rectangular in shape and each have at least four slots for pass in each of the slots means to FIC the purpose, however, at least two slots open onto the side of the above-mentioned plate for osteosynthesis of the spine, in order to make possible the installation and fixation of the plate without removing the front of this instrument for the correction of orientation relative to the vertebrae, and the distance between the slits individually for each plate that allows the surgeon to choose during the operation plate, with the distance between the slits close to the distance between the vertebrae of the patient.

The invention will be better understood from the description below, only with the purpose of explaining one of the embodiments with reference to the accompanying drawings:

- figure 1 is a schematic representation of a plate for osteosynthesis of the spine according to the invention;

- figure 2 represents the axonometric image plate for osteosynthesis of the spine during fixation without vertebrae;

- figure 3 represents the axonometric image plate for osteosynthesis of the spine, according to figure 2, with the closing plate;

- figure 4 is a partial top view of one of the slots in the two receiving positions of the plate for osteosynthesis of the spine according to the invention;

- figure 5 and 6 represent, respectively, a partial top view of two positions of the positioning on the surface or at depth is not bone screws in the slotted plate for osteosynthesis of the spine according to the invention;

- 7 and 8 represent, respectively, a side view of two mounting screws that can be installed on the surface or in the depth of the plate for osteosynthesis of the spine in two provisions of the acquisition;

Fig.9 represents the axonometric image of the install phase plate for osteosynthesis of the spine according to the invention; and

figure 10 represents the axonometric image phase mounting plate for osteosynthesis of the spine according to the invention.

Plate for osteosynthesis of the spine in a non-limiting example, described in the designation of figure 1, has a generally rectangular shape and has four slots 1, 2, 4, 5 for the passage of fastening plate for osteosynthesis of the spine, such as, for example, bone fastening screws 20. The average slot 3 makes possible the attachment of a bone graft or any other element interanational support.

Two slots 4, 5 come out on the side plate 6 in order to make possible the installation place and the final fixation plate without removing the adjustment rods 18 of the tool 19 to correct orientation relative to the vertebrae, as shown in figure 2.

At least one opening on the side of the slots 4, 5 and preferably both of the slot 4, 5 are of angular shape, L-shaped or another, involved in the cross-section, open lateral side 6 of the plate respectively through the two grooves 7, 8; the first transverse section, respectively (9, 11) is oriented in the transverse direction perpendicular to the side 6 and the second longitudinal section, respectively (10, 12) is oriented strictly along the longitudinal direction of G.

Slots 1, 2 are made extra long.

The thread of the screw, ensuring the fixing of the adjustment rods 18 of the tool 19 for the correction of the vertebrae, mainly exactly the same threaded bone screws 20.

Mostly plate according to the invention has, in addition, at least one hole 13, 13’ for fastening the closing plate 14, as shown in figure 3.

The closing plate has at least one hole 15, 15’for interacting respectively with the holes 13, 13’ for fastening in order to provide an opportunity to enter the screws 16, 16’ for fastening the closing plate 14 on the plate for osteosynthesis of the spine. The screw 16’ is not shown in figure 3 in order to keep the image is quite clear and precise.

The closing plate 14 is intended to cover the set screws. The closing plate 14 is a longitudinal section of a convex shape, which prevents the loosening of the screws 16, 16’ due to the effect of springback, as well as to generate the, in order to adapt it to the convexity of the plate for osteosynthesis of the spine. To improve the latter effect, at least one of the holes 15, 15’ for fastening has an oval elongated shape.

The closing plate 14 prevents the loosening of the screws 16, 16’ due to the effect of springiness, but does not block completely the bone fastening screws 20, because the latter always have the ability to move second longitudinal segments of the slots 1, 2, 4, 5 in order to automatically compensate for seal intervertebral space.

Mainly the closing plate 14 is positioned in the slot made on the surface of the plate for osteosynthesis of the spine.

According to a special variant of execution, at least one of the above slots 1, 2, 4, 5 for the passage of means of fixation, as shown in figure 4, has at least two positions of the administration of S and P fixation means: position S reception on the surface, in which the above-mentioned fixation device visibly tilted at a constant angle with respect to the above-mentioned plate, as shown in figure 5, and the position P of admission to the depth at which the above-mentioned fixation device visibly tilted to some variable angle, as shown in Fig.6.

For mounting at a fixed angle fixation devices in the receiving position is and the surface it is necessary to choose a bone fixing screw 20 - traditional, as shown in Fig.7, while for mounting on a variable angle, at which you can transfer funds fixation in the receiving position on the depth, you need to choose a bone fixing screw 20’, having a head 22, the inner chamfer of which is rounded, and the segment of smaller cross-section 21 located between the head 22 and a threaded part 23 of the screw, as shown in Fig.

The plate according to the invention is used as follows.

On the vertebrae establish corrective rods 18 in order to be able to expose the vertebrae using the tool 19 for correction, and remove the intervertebral disk.

Now you can start introducing bone graft, if necessary, with compression of the graft due to the tool 19 for the correction.

The screws or rods installed for billing, remain in place, and the plate is set according to the arrow R positioning, as shown in Fig.9, stringing the slots 4, 5 on the adjustment rods 18. When this plate is placed on the vertebrae.

Then proceed to the fixation plate for osteosynthesis of the spine using bone screws 20 or 20’, enter in slots 1, 2, as shown in figure 10. During this operation, the exposed position of the vertebrae is maintained by adjustment of the rods 18 which avoids any risks associated with displacement of a bone graft.

Tool 19 for correction can now be removed from the side of the slots 4, 5.

Bone fastening screws 20 or 20’ can now be installed in slots 4, 5 to complete the fixing plate for osteosynthesis of the spine.

Then on the plate for osteosynthesis of the spine fix the cover plate 14.

1. Plate for osteosynthesis of the spine to maintain the correct orientation relative to the vertebrae using (19) for the correction, and plate for osteosynthesis of the spine has a generally rectangular shape and includes at least four slots (1, 2, 4, 5) for passage through each fixation means, characterized in that at least two of the slots (4, 5) have access to the lateral side (6) of the above-mentioned plate for osteosynthesis of the spine, in order to make possible the installation place and the fixation plate without prior removal tool (19) for the correction of orientation relative to the vertebrae, and side (6) of the plate goes from the edge, located in the same direction as the longitudinal direction of the plate, with the longitudinal direction of the plate strictly coincides with the direction of the vertebral column.

2. Plate according to claim 1, characterized in that at least one of the slots 4, 5), having access to the lateral side (6) of the plate has an angular shape, L-shaped or another, including the first cross-section facing the lateral side (6) plate, extended second longitudinal section, strictly oriented in the longitudinal direction.

3. Plate according to claim 1 or 2, characterized in that at least one of the slots (1, 2) has a second longitudinal section, strictly oriented in the longitudinal direction in order to make possible automatic postoperative compensation phenomena seal the intervertebral space.

4. Plate according to any one of claims 1 to 3, characterized in that it contains, in addition, at least one opening (3)provided strictly on the middle longitudinal axis.

5. Plate according to any one of claims 1 to 4, characterized in that the distance between the slots (4, 5)facing the side (6) of the plate corresponds interdominios.com the distance between the N vertebrae, where N is an integer greater than or equal to two.

6. Plate according to any one of claims 1 to 5, characterized in that at least one of the above slots (1, 2, 4, 5) for the passage of fixing has at least two positions of the receiving means fixing: S admission to the surface in which the above-mentioned fixation means strictly tilted at a certain angle with respect to the plate, and the floor is laid on the R receive in depth, which means fixing occupy an inclined position at a variable angle.

7. Plate according to any one of claims 1 to 6, characterized in that it has at least one opening (13, 13’) for fastening the closing plate (14)designed to close at least partially funds commit after commit.

8. Plate according to claim 7, characterized in that the closing plate (14) is curved.

9. Plate according to claim 7 or 8, characterized in that the closing plate (14) includes at least one opening (15, 15’) for fastening.

10. Plate according to claim 9, characterized in that at least one of the holes (15, 15’) for fastening elongated.

11. System for osteosynthesis of the spine, containing several plates for osteosynthesis of the spine to keep the correct orientation relative to the vertebrae, through the use of a tool (19) for the correction, and plates for osteosynthesis of the spine are generally rectangular in shape and each have at least four slots (1, 2, 4, 5) for pass in each of the slots means of fixation, with at least two slots (4, 5) facing the side (6) of the above-mentioned plate for osteosynthesis in order to make possible the installation the fixation of the plate without removing the front of this tool (19) for correcting orientation relative POS is ankov, in addition, the distance between the slits individually for each plate that allows the surgeon to choose during the operation plate, with the distance between the slits close to the distance between the vertebrae of the patient, and side (6) of the plate defined by the party located in the same direction as the longitudinal direction of the plate, with the longitudinal direction of the plate strictly coincides with the direction of the vertebral column.



 

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