U.S. patent application number 13/103588 was filed with the patent office on 2011-11-03 for anterior implant for the spine.
This patent application is currently assigned to WARSAW ORTHOPEDIC, INC.. Invention is credited to Richard ASSAKER, Jean-Francois D'Amore, Richard-Laurent Minfelde.
Application Number | 20110270311 13/103588 |
Document ID | / |
Family ID | 9525953 |
Filed Date | 2011-11-03 |
United States Patent
Application |
20110270311 |
Kind Code |
A1 |
ASSAKER; Richard ; et
al. |
November 3, 2011 |
ANTERIOR IMPLANT FOR THE SPINE
Abstract
Implant for the cervical spine comprising an anterior plate (1)
for maintaining a bone graft, bone anchorage screws (6,7,8) for the
plate and means (22) for blocking the screws and preventing any
migration of the screws, characterized in that the blocking means
comprises at least one slide (22) slidably mounted on the plate so
as to be applicable on at least one anchorage screw head (15, 16).
The slide cooperates with means (33, 34) for retaining the slide on
the head of the screw. The slide may be formed by a thin platelet
(22a) which is provided with lateral flanges (25) and is slidable
in a complementary cavity (18) provided in the plate (1) while
being flush with the surface of the plate (1). The plate (1)
includes ramps (26) for retaining the slide (22) on which the
flanges (25) are slidable, the slide (22) being slidable to a
position in which it at least partly overlaps the heads of the
associated screws (6 or 7) and is locked in position by suitable
means.
Inventors: |
ASSAKER; Richard; (Kain,
BE) ; Minfelde; Richard-Laurent; (Paris, FR) ;
D'Amore; Jean-Francois; (Montevrain, FR) |
Assignee: |
WARSAW ORTHOPEDIC, INC.
Warsaw
IN
|
Family ID: |
9525953 |
Appl. No.: |
13/103588 |
Filed: |
May 9, 2011 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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11734140 |
Apr 11, 2007 |
8016864 |
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13103588 |
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10693604 |
Oct 27, 2003 |
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11734140 |
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09692894 |
Oct 20, 2000 |
6652525 |
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10693604 |
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Current U.S.
Class: |
606/246 |
Current CPC
Class: |
A61B 17/7059 20130101;
A61B 17/8042 20130101 |
Class at
Publication: |
606/246 |
International
Class: |
A61B 17/70 20060101
A61B017/70 |
Foreign Application Data
Date |
Code |
Application Number |
Apr 30, 1998 |
FR |
98 05558 |
Apr 30, 1999 |
IB |
PCT/IB99/00794 |
Claims
1. An implant for the spine comprising: an anterior plate for
stabilizing the spine and maintaining a bone graft, the plate
having a number of openings, a number of bone anchorage screws for
correspondingly engaging the openings of the plate, and means for
blocking the screws and preventing any migration of the screws,
characterized in that the blocking means comprise at least one
slide slidably mounted on the plate so as to be capable of
partially covering to at least on anchorage screw head, and the
slide cooperates with means for retaining the slide on the bead of
the screw.
2. An implant for the spine characterized in that it comprises: a
plate for stabilizing the spine, the plate having a number of
openings; a number of bone anchorage screws each operable to engage
a corresponding one of the openings of the plate; and means for
blocking the screws and preventing screw migration, the blocking
means including at least one slide slidably mounted on the plate to
selectively cover at least a part of at least one of the screws and
means for retaining the slide on the at least one of the screws,
the slide cooperating with the retaining means.
3. An implant for the spine characterized in that it comprises: a
plate for stabilizing the spine, the plate including a number of
openings and defining a cavity adjacent at least one of the
openings; a number of bone anchorage screws each operable to pass
through a corresponding one of the openings of the plate to engage
the spine; and a slide slidably mounted in the cavity of the plate,
the slide being operable to selectively cover at least a portion of
at least one of the screws mounted in the at least one of the
openings.
4. The implant according to claim 1 or 2, characterized in that the
retaining means comprises a boss on the slide which is clicked into
a corresponding recess defined by a bridge of the plate when the
slide is in a position for blocking the screws.
5. The implant according to claim 1 or 2, wherein the plate defines
a cavity and the slide is mounted within the cavity.
6. The implant according to claim 3, wherein the plate includes a
bridge adjacent the slide, and one of the bridge and the slide
includes a boss and another of the bridge and the slide includes a
recess to correspondingly receive the boss to retain the slide in a
screw retaining position.
7. The implant according to claim 5 or 6, characterized in that the
slide is formed by a platelet including at least one flange, the
cavity includes at least one ramp to engage the at least one flange
and retain the platelet on the plate.
8. The implant according to claim 7, characterized in that the
platelet is provided with 15 two lateral flanges each adapted to
slide along a corresponding one of two ramps, the ramps retaining
the platelet in the cavity and being formed on opposite sides of
the cavity, the platelet being cambered to allow the platelet to be
resiliency inserted in the cavity, and the platelet is dimensioned
for at least partially overlapping a pair of screw heads each
belonging to a corresponding one of the bone anchorage screws.
9. The implant according to claim 7 or 8, characterized in that the
cavity and the platelet are so dimensioned that the surface of the
platelet is generally flush with a surface of the plate when the
platelet is placed in the cavity.
10. The implant according to any of claims 7-9, characterized in
that plate defines another cavity arranged to receive another slide
slidably mounted to the plate.
11. The implant according to any of claims 7-10, characterized in
that the cavity communicates with a pair of the openings of the
plate.
12. The implant according to any of claims 10-11, wherein a central
part of the plate defines a central opening and further comprising
a selected bone anchorage screw to pass through the central
opening, the selected bone anchorage screw including a first thread
and a screw head, the first thread being separated from the screw
head by a generally smooth part, the first thread having a diameter
larger than the width of the screw pass; opening for preventing the
return of the selected bone anchorage screw after the bone
anchorage screw is inserted in through the central opening.
Description
TECHNICAL FIELD
[0001] The present invention relates to an implant for the spine,
and more particularly, but not exclusively relates to an anterior
plate for maintaining a bone graft, bone anchorage screws for the
plate and means for blocking the screws and preventing any
migration of the latter.
BACKGROUND
[0002] Spinal plates may be introduced from the anterior to
stabilize the cervical spine and maintain in position or secure a
bone graft which fills the spaces left by the extraction of at
least one vertebral disc and, possibly, part of a contiguous
cervical vertebra.
[0003] The bone anchorage screws used for fixing this type of plate
in position are either unicortical, and therefore short, since they
pass through only the anterior cortical of the vertebra, or
bicortical, and therefore long, since they extend through the
anterior cortical and the posterior cortical. The short unicortical
screws utilize a locking element when there is a possibility the
screws may back-out. On the other hand, the long biconical screws,
while less likely to unscrew, have other limitations making them
less desirable in certain situations.
[0004] In practice, the locking element employed up to the present
time for unicortical screws is an additional screw which is
positioned between two bone anchorage screws and whose head
overlaps the heads of these two screws. While there are thin
cervical plates without a locking element, the addition of an
existing locking element to a given plate design typically results
in an increase in plate size, such as the plate's thickness. These
additions may also result in a greater plate width than is
desirable. Thus, the general desire to further decrease the size of
surgical implants indicates a need for new plate and/or locking
element arrangements.
DISCLOSURE OF THE INVENTION
[0005] Accordingly, one object of the present invention is to
provide a unique device for stabilizing a patient's spine.
[0006] Additionally or alternatively, another object of the
invention is to provide an anterior cervical plate provided with
antimigration means for the screws arranged in such manner as to
avoid increasing the overall size of the plate.
[0007] One form of the present invention is a unique device for
stabilizing a patient's spine. In a further form, a slide is
incorporated into a spinal plate that may be operable to serve as a
locking element.
[0008] According to another form of the invention, a plate has
means for blocking the bone anchorage screws that comprises at
least one slide slidably mounted on the plate so as to be capable
of partially covering at least one anchorage screw head, and the
slide cooperates with means for retaining it on the head of the
screw.
[0009] In still another form, the slide is formed by a thin
platelet provided with at least one flange and slidable in a
complementary cavity provided on the surface of the plate, the
cavity having a ramp on which the flange can be engaged; the
retaining means are formed by a boss on the plate which clicks into
an associated recess when the slide is in its position for blocking
and locking the screw. The cavity and the platelet may be so
dimensioned that the surface of the platelet is flush with that of
the plate when it is placed in its cavity. Consequently, for this
form, the overall thickness of the anterior plate may not be
increased by the slide.
[0010] Further forms, embodiments, objects, aspects and features of
the invention will be apparent from the following description and
the accompanying drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
[0011] FIG. 1 is an elevation view of a cervical spine segment
provided with an anterior implant according to the invention for
maintaining a bone graft in position.
[0012] FIG. 2 is a perspective view, to a larger scale, of the
anterior plate of FIG. 1 provided with a slide for locking two of
the screws of the plate.
[0013] FIG. 3 is a perspective view, similar to FIG. 2, showing the
plate provided with two slides and two pairs of bone anchorage
screws.
[0014] FIG. 4 is a bottom perspective view, to a larger scale, of
one of the screw-blocking slides for the anterior plate of FIGS.
1-3.
[0015] FIG. 5 is a top view to a larger scale of the anterior plate
of FIGS. 1-3 provided with two screw locking slides, one of these
slides being in the locking position, while the other is in the
withdrawn position before locking.
[0016] FIG. 6 is a cross-sectional view taken on line 6-6 of FIG.
5.
[0017] FIG. 7 is a partial cross-sectional view taken on line 7-7
of FIG. 3.
MODE(S) FOR CARRYING OUT THE INVENTION
[0018] For the purposes of promoting an understanding of the
principles of the invention, reference will now be made to the
embodiments illustrated in the drawings and specific language will
be used to describe the same. It will nevertheless be understood
that no limitation of the scope of the invention is intended Any
alterations and further modifications in the illustrated or
described embodiments, and any further applications of the
principles of the invention as described or illustrated therein
being contemplated as would normally occur to one skilled in the
art to which the invention relates.
[0019] Shown in FIG. 1 is a cervical spine segment C2, C3, C4, C5,
and between the vertebrae C4 and CS (more usually C4 and CS) of
which 8 bone graft G (partially visible) is disposed, this graft G
being covered by an anterior plate 1 whose function is to stabilize
the spine and to maintain this bone graft G in position.
[0020] Referring additionally to FIG. 2, the plate 1 has an
elongate shape with two large concave sides 2, 3 connected to
rounded ends 4, 5, these large sides 2, 3 extend from the vertebra
C4 to the vertebra C5. The plate 1 is provided adjacent to each of
its ends 4, 5 with a pair of bone anchorage screws 6, 7 at C4 and
C5 which are unicortical and therefore short, and a central screw 8
which is engaged in an oblong opening 9. Each of the screws 6,7
extends through a corresponding opening 11, 12 which is of
generally circular section but has a spherical wall 13,14 acting as
a bearing surface for the corresponding head 15, 16 of screws 6,
7.
[0021] Each pair of openings 11 and 12 opens onto a respective
cavity 18 provided in the adjacent surface 1a of the plate 1.
Formed in this cavity 18, which in the presently described
embodiment opens onto the opposite faces of the plate 1, is a
bridge 19 which defines at one end a part of the circumference of
the openings 11, 12 and extends from the latter to the opposite
wall 21 of the cavity 18. However, the thickness of each bridge 19
is less than that of the plate I so that the surface 19a of each
bridge 19 is situated within the cavity 18 at a distance d from the
surface 1a of the plate 1 (FIG. 2).
[0022] Each pair of bone anchorage screws 6, and each pair of
screws 7, is associated with a slide 22 for locking screws 6, 7
after anchorage in the vertebral bodies C4, C5, respectively; and
thereby preventing migration of the screws 6, 7. Referring further
to FIGS. 3 and 4, each slide 22 is formed by a thin platelet 22a
whose thickness is at the most about equal to the distance d,
between the upper surface 1a of the plate 1 and the surface 19a of
the bridge 19. This platelet 22a has an elongate shape whose larger
dimension l is just equal to the width of the cavity 18 to allow
insertion of the platelet 22a in the latter. Each platelet 22a, not
cambered in the free state, is generally slightly cambered in order
to make it possible to insert it into its housing cavity 18. This
insertion is carried out by positioning it on the bridge 19 and
applying a force such that its opposite sides 23 slidably and
resiliently bear against the retaining ramps 26. Retaining ramps 26
are each defined along a corresponding one of the opposite sides 24
of cavity 18.
[0023] Further, each platelet 22a is provided with two lateral
flanges 25 which project from the sides 23 under the central part
of the platelet 22a. Each of the flanges 25 is adapted to form a
shoe 25a slidable along a respective retaining ramp 26 (FIGS. 2 and
6). The flanges 25 have a width l allowing their insertion in the
slots 26a between the sides 24 of the cavity 18 and the opposing
sides 20 of the bridge 19, so that their inner faces 27 are placed
in sliding contact with the sides 20 of the bridge 19 (FIG. 6) when
the platelet 22a has been placed in position.
[0024] The two large sides 28, 29 of each platelet 22a are concave
and the apices 31,32 of each platelet 22a are rounded so that the
rounded apices 31, 32 of the sides 28 close to the screws 6 or 7
are able to partly overlap the heads 15, 16 of the screws 6,7 when
the platelets 22a are in position for locking the screws 6, 7
(FIGS. 1, 2, 5, 6). Indeed, the openings 11, 12 and the heads 15,
16 are so arranged that, when the screws 6, 7 have been screwed
into the vertebral bodies with possibly an inclination in regard to
plate 1, their heads 15,16 have their surfaces in a position in
which they are just flush with the underside of the round apices
31, 32.
[0025] Referring more specifically to FIGS. 2-6, means are provided
for retaining the platelets 22a in their position for locking the
screws 6, 7. In the presently-described embodiment, these means
comprise, for each platelet 22a, a central boss 33 projecting from
the lower face 33a of the platelet 22a, namely that placed in
contact with the surface 19a of the support bridge 19, and 8
corresponding recess 34 provided in the central part of the bridge
19. Thus, when the platelet 22a reaches the position for locking
the screws 6, 7; its boss 33 clicks into the recess 34 and
maintains the platelet 22a in this position and prevents it from
moving forwardly or rearwardly in its cavity 18.
[0026] Referring next to FIGS. 2, 3, 5, and 7, the first thread 36
of the central screw 8 (i.e., the thread closest to its head 37,
See FIG. 7) is separated from the latter by a smooth part 38. The
diameter of this first thread 36 is larger than that of the smooth
part 38 and the width e of the oblong opening 9 arranged to receive
screw 8 (See FIG. 2). To place the screw 8 in position, it is
therefore necessary to force it through the opening 9 and cause the
latter to pass beyond the first thread 36. Thereafter, the latter
performs the function of means for retaining screw 8 in plate
1.
[0027] To place the plate 1 and its locking slides 22 in position
on the cervical segment such as C4, C5 of FIG. 1, the procedure is
the following. Referring generally to FIGS. 1-7, first of all,
after the bone graft G has been placed in position in the discal
space previously prepared, the surgeon positions the plate 1
equipped with slides 22 and attaches it by means of screws 6 and 7.
Afterwards he makes each slide 22 run from the bottom of its
housing cavity 18 until flanges 25 come and stop against screws
heads 15 and 16. The latter are then partially covered by rounded
tops 31, 32 as shown in FIGS. 1, 2, 3, and 5 for at least one of
slides 22. When the slides 22 reach this position, in which they
partly overlap the heads 15, 16; their respective boss 33 clicks
into the respective recess 34 so that each slide 22 is locked in
this position in which it locks the associated screws 15, 16
against any migration and therefore against any posterior
movement.
[0028] As can be seen in FIG. 6, the slides 22 do not project above
the surface of the plate 1 owing to their small thickness which is
at the maximum equal to about d, and to the provision of a suitable
cavity 18. Thus the surface 22b of the slides 22 is generally flush
with surface 1a of the plate 1 whose overall thickness is
consequently not increased by the presence of the locking slides
22. The locking platelets 22a do not impose to increase the width
of the plate 1 in respect to its minimum width such that the same
results from the chosen gap between the axis of screws 6 and 7.
[0029] It should be appreciated that the scope of the invention is
not intended to be limited to the described embodiments and may
encompass variants. For example, boss 33 can be formed on support
19 whilst recess 34 is formed on the platelet 22a. Thus the means
33, 34 for blocking the slides 22 in their locking position may be
replaced by any other like system. Further, in another arrangement,
a slide is associated with each screw and has a single flange that
is suitably dimensioned for this purpose. Optionally, the plate may
be provided with only a single blocking slide 22, the second pair
of screws being for example associated with other blocking means,
or being absent. Moreover, in further embodiments, the implant
according to the invention can be used, not only for the cervical
spine, but also for other spine segments, for example thoracic and
lumbar, and possibly without any bone grafts. Further, in other
embodiments, the screw-locking slide and plate arrangement may be
used to reduce undesired migration of one or more screws of a type
other than the unicortical variety; and may be used to check
undesired migration of other types of fasteners use in addition to
or as an alternative to one or more screws.
[0030] In one alternative embodiment of the present invention, an
implant for the spine includes an anterior plate for stabilizing
the spine and maintaining a bone graft that has a number of
openings, a number of bone anchorage screws for correspondingly
engaging the openings of the plate, and means for blocking the
screws and preventing any migration of the screws. This implant is
further characterized in that the blocking means comprises at least
one slide slidably mounted on the plate so as to be capable of
partially covering at least one anchorage screw head. This slide
cooperates with means for retaining the slide on the head of the
screw.
[0031] In further embodiment, an implant for the spine includes: a
plate for stabilizing the spine that has a number of openings; a
number of bone anchorage screws each operable to engage a
corresponding one of the openings of the plate; and means for
blocking the 20 screws and preventing screw migration. The blocking
means includes at least one slide slidably mounted on the plate to
selectively cover at least a part of at least one of the screws and
means for retaining the slide on at least one of the screws.
[0032] In an additional embodiment, an implant for the spine
includes: a plate for stabilizing the spine that comprises a number
of openings and defines a cavity adjacent at least one of the
openings; a number of bone anchorage screws each operable to pass
through a corresponding one of the openings of the plate to engage
the spine; and a slide slidably mounted in the cavity of the plate.
The slide is operable to selectively cover at least a portion of at
least one of the screws mounted in at least one of the
openings.
[0033] While the invention has been illustrated and described in
detail in the drawings and 30 foregoing description, the same is to
be considered as illustrative and not restrictive in character, it
being understood that only the preferred embodiment has been shown
and described and that all changes and modifications that come
within the spirit of the invention are desired to be protected.
* * * * *