WO1995014437A1 - Implant for an osteosynthesis device, particularly for the spine, and positioning instrument therefor - Google Patents

Implant for an osteosynthesis device, particularly for the spine, and positioning instrument therefor Download PDF

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Publication number
WO1995014437A1
WO1995014437A1 PCT/FR1993/001164 FR9301164W WO9514437A1 WO 1995014437 A1 WO1995014437 A1 WO 1995014437A1 FR 9301164 W FR9301164 W FR 9301164W WO 9514437 A1 WO9514437 A1 WO 9514437A1
Authority
WO
WIPO (PCT)
Prior art keywords
ring
implant
plug
branches
holder
Prior art date
Application number
PCT/FR1993/001164
Other languages
French (fr)
Inventor
Dominique Petit
Marie-Agnès SIFFERLEN
Mounir Zaouali
Original Assignee
Sofamor Danek Group, Inc.
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 Sofamor Danek Group, Inc. filed Critical Sofamor Danek Group, Inc.
Priority to PCT/FR1993/001164 priority Critical patent/WO1995014437A1/en
Priority to AU55667/94A priority patent/AU5566794A/en
Publication of WO1995014437A1 publication Critical patent/WO1995014437A1/en

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7032—Screws or hooks with U-shaped head or back through which longitudinal rods pass
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
    • A61B17/7091—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for applying, tightening or removing longitudinal element-to-bone anchor locking elements, e.g. caps, set screws, nuts or wedges

Definitions

  • Implant for osteosynthesis device in particular of the spine and corresponding delivery instrument
  • the present invention has for ODje ⁇ - an iii ⁇ iit for osteosynthesis device, in particular of the spine, as well as an ancillary instrument adapted to facilitate its correct positioning.
  • 91 10 402 describe an implant comprising a part intended for bone anchoring and a body for fixing on an osteosynthesis rod, in which the body comprises two lateral branches delimiting between them a channel opening onto a posterior part of the body (implant of the open body type), and open on either side of the body to be able to receive the rod.
  • This implant also includes a threaded plug adapted to be screwed into threads formed on the inner walls of the two lateral branches.
  • An annular patch surrounds the branches of the body in order to avoid the opening of said branches when the plug is screwed.
  • This arrangement makes the connection between the open implant (screw or hook) and the osteosynthesis rod.
  • a conical nut is screwed onto the threaded outer walls of the screw.
  • a second known embodiment comprises an intermediate piece between the rod and a nut, which is fixed on a thread of this intermediate piece.
  • another device described in French patent 90 03 694 (2 659 546), comprises a threaded plug which is screwed between the branches of the U-shaped body with the interposition of an olive between the rod and this plug, a cap covering the ends of the branches of the body to prevent spreading thereof when screwing the cap.
  • the threads of the two branches provide the threaded plug with insufficient guidance, the consequences of which are, first of all, a certain difficulty in introducing the plug, and a risk of setting the plug at an angle, with damage or alteration of the thread of 1 'implant.
  • the object of the invention is to produce an implant of the type described in French patent 91 10
  • the pellet has two circular threaded sectors, extending on either side of the plug between the branches of the body, and complementary to the threads of said branches in order to carry out with the latter continuous tapping for screwing the plug .
  • the threaded plug is guided on the one hand, by the two threaded walls of the branches of the body of the implant, and on the other hand, by the two threaded portions of the patch, complementary to the threads of the branches and which provide with those here the continuity of the cap guide.
  • the patch conforms to the external shape of the body of the implant and opposes the opening of the two branches when the plug is screwed.
  • the ancillary instrument also provided by the invention is suitable for fitting the plug and the implant disc. It comprises in combination a cork holder handle provided with a profiled end adapted to penetrate into a conjugate profiled impression of the cork, and a pellet holder ring which can be threaded on the handle and slide thereon, one of the ends of this ring being provided with means for gripping the pellet.
  • Figure 1 is a perspective view on an enlarged scale of an embodiment of one implant according to the invention, secured with a rod of osteosyn ⁇ these.
  • Figure 2 is a top view of the patch fitted to the implant of Figure 1, on an enlarged scale.
  • Figure 4 is a perspective view of a first embodiment of a pellet holder ring forming part of the ancillary instrument provided by the invention.
  • Figure 5 is a half-sectional mid-elevation view, according to 5.5 of Figure 6, on an enlarged scale, of the pellet holder ring.
  • FIG. 6 is an end elevation view along arrow K of FIG. 5.
  • FIG. 7 is a top view of the pad holder ring of FIGS. 4 to 6.
  • FIG. 8 is an end elevation view along arrow L of the ring of FIG. 5.
  • FIG. 9 is an axial mid-sectional view mid-elevation of a screwing handle for the plug and adapted to support the pad holder ring of FIGS. 4 to 8.
  • Figure 10 is an elevational view in enlarged scale and cross section of the osteosynthesis rod, an implant and the corresponding ancil ⁇ instrument in position of placement on the implant of the patch and the plug .
  • FIG. 11 is a perspective view of an alternative embodiment of the body of the implant according to the invention.
  • Figure 12 is an axial sectional view of a second embodiment of the cork holder handle.
  • FIG. 13 is a view in longitudinal elevation of the handle of FIG. 12.
  • FIG. 14 is a perspective view of a second embodiment of the tablet holder ring, adapted to the cork holder handle of FIGS. 12 and 13.
  • FIG. 15 is a perspective view, with cutaway, of a tool for screwing the plug, adapted to be inserted inside the tubular handle of FIGS. 12 and 13.
  • the implant 1 illustrated in FIG. 1 is intended for an osteosynthesis device, not shown, in particular of the spine. It includes a part 2 intended for bone anchoring, which can be either a threaded rod or a hook.
  • the implant 1 also comprises a body 3 for fixing to a rod 4 with roughness, for example a knurled rod or with diamond points.
  • the body 3 comprises two lateral branches 5 delimiting between them a channel 6 (FIG. 10) opening onto a rear part of the body and open on either side of the latter so as to be able to receive the rod 4.
  • the body 3 thus has a section U-shaped in a transverse plane to channel 6.
  • the implant also includes a plug 7 provided with a thread 8 (FIG. 10) and in which is machined a recess 9 shaped to be able to receive a profiled end 12, for example hexagonal, of a screwing tool 13 (FIG. 9) .
  • the plug 7 can be screwed into corresponding threads 14 formed on the inner walls of the branches 5 of the body 3 ( Figure 1).
  • the face of the plug 7 in contact with the rod 4 is advantageously provided with means for hooking to the latter.
  • These means can be produced for example as described in French patent 88 08 538 (2 633 177).
  • the implant 1 comprises an annular patch 16 surrounding the branches 5, of which it marries the external configuration.
  • This patch 16 comprises two threaded circular sectors 17 which extend opposite one another on either side of the plug, in diametrically opposite positions between the branches 5 of the body 3.
  • the sectors circular 17 are complementary to the internal threads 14 with which they constitute a practically continuous internal thread over the entire periphery of the plug 7.
  • Notches 18 are formed in areas of the external wall of the patch 16 located opposite the threaded sectors 17. These notches are adapted to be able to receive the ends of a ring 19 carrier holder (shown in Figure 7) which will described below.
  • the sections of the patch 16 constituted by the threaded sectors 17 are connected by curved portions 20 conforming to the convex external contour of the branches 5.
  • the height of the arms 5 of the implant 1 is determined so that the patch 16 is, in the most unfavorable case, flush with the end face of said arms.
  • an ancillary instrument 21 designed to allow easy and correct fitting of the plug 7 and the patch 16.
  • the instrument 21 comprises in combination the tool 13 consisting of a cork-carrying handle provided with the polygonal end 12, slotted for gripping the cork 7, con ugué of the recess 9 of the cork 7, and the carrier ring -pastille 19.
  • This comprises a ring proper 22, of axis XX, dimensioned to be able to be threaded on the cylindrical handle 13 and slide thereon.
  • the ring 22 is extended on one side by two flexible longitudinal legs 23 constituting lamellae terminated by respective ends 24.
  • the legs 23 are preferably diametrically opposite with respect to the ring 22 and their ends 24 are dimensioned so as to be able to engage in the notches 18 of the patch 16. Thus the latter can be held by elastic clamping between the end portions 24.
  • the ends of the tabs 23 are provided with at least one shoulder ent inside and preferably two diametrically opposite shoulders 29 (FIGS. 5 and 8), which can form axial stops for the pad 16.
  • the ring 19 is extended by a longitudinal lug 25, parallel to the axis XX of the ring 22 like the lugs 23, and terminated by a member for hanging on the handle 13.
  • this member is formed by an elastic spout 26 forming a "clip ", adapted to be able to snap into a corres ⁇ ponding groove 27 for stopping the pad holder ring 19, formed on the surface of the tool 13.
  • the ring 19 is completed by a longitudinal tongue 28 for manual gripping, which extends parallel to the tab 25 and preferably is markedly longer than the latter as shown in FIGS. 5 and 7.
  • the tabs 23 terminate in chamfered ends 23a which facilitate the introduction of the patch 16 between the tabs 23 (Fig. 5).
  • the legs 23 move apart elastically and the pad 16 can be slid until it comes into abutment against the circular shoulders 29.
  • the ring 16 is then held by elastic clamping between the legs 23.
  • the ancillary instrument 21 consisting of the handle 13 cork holder and the ring 19 pellet holder is used in the following manner: a) the pellet holder ring 19 is moved on the tool 13 in the direction which releases the slotted end 12 for the plug, the spout elastic 26 then being located beyond the groove 27; b) the surgeon executes the plug 7, then lowers the ring 19 until the spout 26 comes to snap into the groove 27; c) at the end of this sliding of the ring
  • the assembly is positioned above the implant 1 and the patch 16 and guided on the outside diameter of the body 3.
  • the patch 16 is guided on the body 3 to its final position ( Figures 1 and 10) , in which it is slightly set back, from a distance e. for example about a millimeter (FIG. 10) relative to the end faces of the branches 5.
  • the guiding of the patch 16 on the body 3 facilitates the fitting of the plug 7 between the branches 5. This prior centering allows guiding of the plug in the taps 14 and 17. Thus, the risk of fitting the plug 7 at an angle and altering the threads 14 and 17 is greatly reduced.
  • the distance e. separating the end faces of the patch 16 and of the branches 5 corresponds to the value of the pitch of the plug 7.
  • the patch 16 is never in relief relative to the end of the body 3.
  • the ancillary stopper holder 13 is maneuvered clockwise allowing the screwing of the stopper 7 in the threads 14 and 17. During this movement, the stopper 7 descends inside the body 3 and the ring 19 rises relative to the stopper holder 13, its relative position relative to the implant 1 remaining unchanged.
  • the ancillary instrument 13, 19 is removed.
  • the non-threaded end of length d of the branches 5 of the implant 1 is eliminated (d being equal to approximately 1 mm). Therefore, the pad 16, on which the plug 7 can be previously screwed with a thread engaged as illustrated in the upper part of Figure 11, (not 1, or 1 mm) is flush at the end of the implant 1.
  • the assembly formed by the plug 7 of the patch 16 is positioned on the open implant 1, the guidance being provided by the patch 16.
  • the ancillary instrument shown in FIGS. 12 to 15, it comprises a cork holder handle 31 made up of a tubular piece, the end part of which is formed by a flexible fork 32 for picking up the plug 7 by the outside of the latter and by the ends of the branches of the fork 32 (FIG. 13).
  • a cork holder handle 31 made up of a tubular piece, the end part of which is formed by a flexible fork 32 for picking up the plug 7 by the outside of the latter and by the ends of the branches of the fork 32 (FIG. 13).
  • an internal bore 33 adapted to be able to thread there a tool 34 for tightening the plug 7 by means of a terminal tip 35 adapted to the profile of the imprint 9.
  • the pad holder ring 36 of this instrument (FIG. 14) is extended by longitudinal flexible tabs 37 adapted to be able to be inserted into the external notches 18 of the pad 16. Dishes 38 are produced on each side of the tabs 37 and constitute stops of the pad 16, which simplifies the arrangement of the ring relative to that of FIG. 4.
  • the ring 36 is dimensioned so that it can be threaded onto the handle 31 and equipped with a hooking means to the latter, such as a longitudinal flexible tongue 39 cut in the tubular wall of the ring 36, and the free end of which carries a ball 41. The latter can be snapped into one of two stop grooves 42 , 43 arranged on the surface of the sleeve 31 at suitable distances from the fork
  • the ball 41 can be indexed in one or other of the grooves 42, 43, which corresponds to two possible positions of the ring 36 on the handle 31.
  • the two parts 31 and 36 are assembled by threading the ring 36 on the handle 31, the ring 36 being placed in the high position, in which the ball 41 is housed in the groove 43 (the legs 37 of course being placed on the side of fork 32).
  • the plug 16 is taken by the flexible tabs 37 of the ring 36,
  • the implant and to the ancillary instrument for fitting the plug and the patch within the framework of the invention.
  • the pad holder ring can be produced in any other equivalent way, the abutment shoulders 29 can for example be any number, or even be reduced to a single one extending over a sufficient angular sector.

Abstract

An implant (1) including a bone anchor portion (2) and a body (3) attachable to a rod (4) and provided with two side arms (5) defining a channel (6). Said implant further includes a screw cap (7) for screwing onto the inner walls of the two arms (5), the rod-engaging surface of the cap being provided with rod-gripping portions, and a ring-shaped plate (16) surrounding the arms (5) and having two threaded circular segments extending on either side of the cap between said arms (5). As a result, the plate (16) and the threads of the arms (5) continuously guide the cap (7) so that, with the arms (5) held in position, the cap (7) will not pop out during final high-torque tightening thereof.

Description

Implant pour dispositif d'osteosynt ese, notamment du rachis et instrument correspondant de pose La présente invention a pour ODjeτ- un iii αiit pour dispositif d'osteosynthese, notamment du rachis, ainsi qu'un instrument ancillaire adapté pour faciliter sa mise en place correcte. Les demandes de brevet français 90 01 972 Implant for osteosynthesis device, in particular of the spine and corresponding delivery instrument The present invention has for ODjeτ- an iii αiit for osteosynthesis device, in particular of the spine, as well as an ancillary instrument adapted to facilitate its correct positioning. . French patent applications 90 01 972
(2658414) 91 10 402 décrivent un implant comprenant une partie destinée à 1 'ancrage osseux et un corps de fixation sur une tige d'osteosynthese, dans lequel le corps comprend deux branches latérales délimitant entre elles un canal débouchant sur une partie postérieure du corps (implant du type à corps ouvert), et ouvert de part et d'autre du corps pour pouvoir recevoir la tige. Cet implant comprend également un bouchon fileté adapté pour pouvoir être vissé dans des taraudages formés sur les parois intérieures des deux branches latérales. Une pastille annulaire entoure les branches du corps afin d'éviter l'ouverture desdites branches lors du vissage du bouchon.(2658414) 91 10 402 describe an implant comprising a part intended for bone anchoring and a body for fixing on an osteosynthesis rod, in which the body comprises two lateral branches delimiting between them a channel opening onto a posterior part of the body (implant of the open body type), and open on either side of the body to be able to receive the rod. This implant also includes a threaded plug adapted to be screwed into threads formed on the inner walls of the two lateral branches. An annular patch surrounds the branches of the body in order to avoid the opening of said branches when the plug is screwed.
Cet agencement réalise la solidarisation entre l'implant ouvert (vis ou crochet) et la tige d'ostéosynthèse.This arrangement makes the connection between the open implant (screw or hook) and the osteosynthesis rod.
On connaît d'autres réalisations assurant cette fonction. Ainsi, dans un premier dispositif, un écrou conique vient se visser sur les parois extérieures filetées de la vis. Une seconde réalisation connue comporte une pièce intermédiaire entre la tige et un écrou, lequel vient se fixer sur un filetage de cette pièce intermédiaire. Enfin, un autre dispositif décrit dans le brevet français 90 03 694 (2 659 546), comprend un bouchon fileté venant se visser entre les branches du corps en U avec interposition d'une olive entre la tige et ce bouchon, un capuchon coiffant les extrémités des branches du corps pour empêcher 1 'écartement de celles-ci lors du vissage du bouchon.Other embodiments ensuring this function are known. Thus, in a first device, a conical nut is screwed onto the threaded outer walls of the screw. A second known embodiment comprises an intermediate piece between the rod and a nut, which is fixed on a thread of this intermediate piece. Finally, another device described in French patent 90 03 694 (2 659 546), comprises a threaded plug which is screwed between the branches of the U-shaped body with the interposition of an olive between the rod and this plug, a cap covering the ends of the branches of the body to prevent spreading thereof when screwing the cap.
Si dans la plupart des cas ces dispositifs antérieurs donnent satisfaction, ils présentent cependant parfois des inconvénients : - la tige peut subir un certain glissement par rapport à l'implant en raison d'un effort de serrage insuffisant sur celle-ci ; en fin de serrage du bouchon fileté, l'effort exercé par celui-ci sur les branches du corps de l'implant peut être suffisamment élevé pour provoquerIf in most cases these prior devices are satisfactory, they sometimes have drawbacks: - the rod can undergo a certain sliding with respect to the implant due to an insufficient clamping force thereon; at the end of tightening of the threaded plug, the force exerted by it on the branches of the body of the implant may be high enough to cause
1'écartement des branches et de ce fait la sortie ( sau ) du bouchon.The spacing of the branches and therefore the outlet (sau) of the plug.
- les taraudages des deux branches assurent au bouchon fileté un guidage insuffisant, dont les conséquences sont d'abord une certaine difficulté d'introduction du bouchon, et un risque de mise en place du bouchon en biais, avec endommagement ou altération du taraudage de 1 'implant.- the threads of the two branches provide the threaded plug with insufficient guidance, the consequences of which are, first of all, a certain difficulty in introducing the plug, and a risk of setting the plug at an angle, with damage or alteration of the thread of 1 'implant.
L'invention a pour but de réaliser un implant du type de celui décrit dans le brevet français 91 10The object of the invention is to produce an implant of the type described in French patent 91 10
402, avec lequel ces inconvénients sont évités, ainsi qu'un instrument ancillaire adapté pour faciliter la mise en place du bouchon et de la pastille.402, with which these drawbacks are avoided, as well as an ancillary instrument adapted to facilitate the positioning of the plug and the patch.
Selon l'invention, la pastille comporte deux secteurs circulaires taraudés, s'étendant de part et d'autre du bouchon entre les branches du corps, et complémentaires des taraudages desdites branches afin de réaliser avec ces derniers un taraudage continu pour le vissage du bouchon. Ainsi le bouchon fileté est guidé d'une part, par les deux parois taraudées des branches du corps de l'implant, et d'autre part, par les deux portions taraudées de la pastille, complémentaires des taraudages des branches et qui assurent avec ceux-ci la continuité du guidage du bouchon. Par ailleurs, la pastille épouse la forme extérieure du corps de l'implant et s'oppose à l'ouver¬ ture des deux branches lors du vissage .du bouchon. La combinaison des deux avantages ci-dessus, à savoir la continuité du serrage sur toute la circonférence et le maintien des branches, supprime le risque de saut du bouchon lors du serrage final effectué à un couple élevé. L'instrument ancillaire également prévu par 1'invention est adapté pour la pose du bouchon et de la pastille de l'implant. Il comprend en combinaison un manche porte-bouchon pourvu d'une extrémité profilée adaptée pour pénétrer dans une empreinte profilée conjuguée du bouchon, et une bague porte-pastille pouvant être enfilée sur le manche et coulisser sur celui-ci, l'une des extrémités de cette bague étant pourvue de moyens de préhension de la pastille.According to the invention, the pellet has two circular threaded sectors, extending on either side of the plug between the branches of the body, and complementary to the threads of said branches in order to carry out with the latter continuous tapping for screwing the plug . Thus the threaded plug is guided on the one hand, by the two threaded walls of the branches of the body of the implant, and on the other hand, by the two threaded portions of the patch, complementary to the threads of the branches and which provide with those here the continuity of the cap guide. Furthermore, the patch conforms to the external shape of the body of the implant and opposes the opening of the two branches when the plug is screwed. The combination of the two advantages above, namely the continuity of the tightening over the entire circumference and the maintenance of the branches, eliminates the risk of the plug jumping during the final tightening carried out at a high torque. The ancillary instrument also provided by the invention is suitable for fitting the plug and the implant disc. It comprises in combination a cork holder handle provided with a profiled end adapted to penetrate into a conjugate profiled impression of the cork, and a pellet holder ring which can be threaded on the handle and slide thereon, one of the ends of this ring being provided with means for gripping the pellet.
Cet instrument facilite considérablement la mise en place du bouchon et de la pastille en contribuant à éviter une pose défectueuse de ceux-ci. D'autres particularités et avantages deThis instrument considerably facilitates the fitting of the plug and the patch by helping to avoid faulty fitting thereof. Other features and advantages of
1 'invention apparaîtront au cours de la description qui va suivre, faite en référence aux dessins annexés qui en illustrent trois formes de réalisation à titre d'exemples non limitatifs. La figure 1 est une vue en perspective à échelle agrandie d'une forme de réalisation de 1 'implant selon l'invention, solidarisée avec une tige d'osteosyn¬ these.1 invention will appear during the description which follows, made with reference to the accompanying drawings which illustrate three embodiments by way of non-limiting examples. Figure 1 is a perspective view on an enlarged scale of an embodiment of one implant according to the invention, secured with a rod of osteosyn¬ these.
La figure 2 est une vue de dessus de la pastille équipant l'implant de la figure 1, à échelle agrandie.Figure 2 is a top view of the patch fitted to the implant of Figure 1, on an enlarged scale.
La figure 3 et une vue en coupe suivant 3.3 de la figure 2.Figure 3 and a sectional view along 3.3 of Figure 2.
La figure 4 est une vue en perspective d'une première forme de réalisation d'une bague porte-pastille faisant partie de 1 ' instrument ancillaire prévu par 1' invention.Figure 4 is a perspective view of a first embodiment of a pellet holder ring forming part of the ancillary instrument provided by the invention.
La figure 5 est une vue mi-coupe mi-éléva¬ tion, suivant 5.5 de la figure 6, à échelle agrandie, de la bague porte-pastille.Figure 5 is a half-sectional mid-elevation view, according to 5.5 of Figure 6, on an enlarged scale, of the pellet holder ring.
La figure 6 est une vue en élévation en bout suivant la flèche K de la figure 5.FIG. 6 is an end elevation view along arrow K of FIG. 5.
La figure 7 est une vue de dessus de la bague porte-pastille des figures 4 à 6. La figure 8 est une vue en élévation en bout suivant la flèche L de la bague de la figure 5.FIG. 7 is a top view of the pad holder ring of FIGS. 4 to 6. FIG. 8 is an end elevation view along arrow L of the ring of FIG. 5.
La figure 9 est une vue mi-coupe axiale mi- élévation d'un manche de vissage du bouchon et adapté pour supporter la bague porte-pastille des figures 4 à 8.FIG. 9 is an axial mid-sectional view mid-elevation of a screwing handle for the plug and adapted to support the pad holder ring of FIGS. 4 to 8.
La figure 10 est une vue en élévation à échelle agrandie et coupe transversale de la tige d'osteosynthese, d'un implant et de l'instrument ancil¬ laire correspondant en position de mise en place sur l'implant de la pastille et du bouchon.Figure 10 is an elevational view in enlarged scale and cross section of the osteosynthesis rod, an implant and the corresponding ancil¬ instrument in position of placement on the implant of the patch and the plug .
La figure 11 est une vue en perspective d'une variante de réalisation du corps de 1'implant selon 1'invention.FIG. 11 is a perspective view of an alternative embodiment of the body of the implant according to the invention.
La figure 12 est une vue en coupe axiale d'une seconde forme de réalisation du manche porte- bouchon.Figure 12 is an axial sectional view of a second embodiment of the cork holder handle.
La figure 13 est une vue en élévation longitudinale du manche de la figure 12.FIG. 13 is a view in longitudinal elevation of the handle of FIG. 12.
La figure 14 est une vue en perspective d'une seconde forme de réalisation de la bague porte-pastille, adaptée au manche porte-bouchon des figures 12 et 13.FIG. 14 is a perspective view of a second embodiment of the tablet holder ring, adapted to the cork holder handle of FIGS. 12 and 13.
La figure 15 est une vue en perspective, avec arrachements, d'un outil de vissage du bouchon, adapté pour être introduit à 1 ' intérieur du manche tubulaire des Figures 12 et 13. L'implant 1 illustré à la figure 1 est destiné à un dispositif d'osteosynthese non représenté, notamment du rachis. Il comprend une partie 2 destinée à l'ancrage osseux, et qui peut être soit une tige filetée, soit un crochet. L'implant 1 comprend également un corps 3 de fixation sur une tige 4 à aspérités, par exemple une tige moletée ou à pointes de diamant. Le corps 3 comprend deux branches latérales 5 délimitant entre elles un canal 6 (figure 10) débouchant sur une partie postérieure du corps et ouvert de part et d'autre de ce dernier pour pouvoir recevoir la tige 4. Le corps 3 présente ainsi une section en U dans un plan transver¬ sal au canal 6.FIG. 15 is a perspective view, with cutaway, of a tool for screwing the plug, adapted to be inserted inside the tubular handle of FIGS. 12 and 13. The implant 1 illustrated in FIG. 1 is intended for an osteosynthesis device, not shown, in particular of the spine. It includes a part 2 intended for bone anchoring, which can be either a threaded rod or a hook. The implant 1 also comprises a body 3 for fixing to a rod 4 with roughness, for example a knurled rod or with diamond points. The body 3 comprises two lateral branches 5 delimiting between them a channel 6 (FIG. 10) opening onto a rear part of the body and open on either side of the latter so as to be able to receive the rod 4. The body 3 thus has a section U-shaped in a transverse plane to channel 6.
L'implant comprend également un bouchon 7 pourvu d'un filetage 8 (figure 10) et dans lequel est usiné un évidement 9 conformé pour pouvoir recevoir une extrémité profilée 12, par exemple hexagonale, d'un outil 13 de vissage ( figure 9 ) . Le bouchon 7 peut être vissé dans des taraudages correspondants 14 ménagés sur les parois intérieures des branches 5 du corps 3 ( figure 1) . La face du bouchon 7 en contact avec la tige 4 est avantageusement pourvue de moyens d'accrochage à celle- ci. Ces moyens non représentés, peuvent être réalisés par exemple comme décrit dans le brevet français 88 08 538 (2 633 177).The implant also includes a plug 7 provided with a thread 8 (FIG. 10) and in which is machined a recess 9 shaped to be able to receive a profiled end 12, for example hexagonal, of a screwing tool 13 (FIG. 9) . The plug 7 can be screwed into corresponding threads 14 formed on the inner walls of the branches 5 of the body 3 (Figure 1). The face of the plug 7 in contact with the rod 4 is advantageously provided with means for hooking to the latter. These means, not shown, can be produced for example as described in French patent 88 08 538 (2 633 177).
L'implant 1 comporte une pastille annulaire 16 entourant les branches 5, dont elle épouse la configu¬ ration extérieure. Cette pastille 16 comporte deux secteurs circulaires taraudés 17 qui s'étendent en vis-à- vis l'un de l'autre de part et d'autre du bouchon, dans des positions diamétralement opposées entre les branches 5 du corps 3. Les secteurs circulaires 17 sont complémen¬ taires des taraudages 14 avec lesquels ils constituent un taraudage pratiquement continu sur toute la périphérie du bouchon 7. Des encoches 18 sont ménagées dans des zones de la paroi externe de la pastille 16 situées en regard des secteurs taraudés 17. Ces encoches sont adaptées pour pouvoir recevoir les extrémités d'une bague 19 porte- pastille (représentée à la figure 7) qui sera décrite ci- après.The implant 1 comprises an annular patch 16 surrounding the branches 5, of which it marries the external configuration. This patch 16 comprises two threaded circular sectors 17 which extend opposite one another on either side of the plug, in diametrically opposite positions between the branches 5 of the body 3. The sectors circular 17 are complementary to the internal threads 14 with which they constitute a practically continuous internal thread over the entire periphery of the plug 7. Notches 18 are formed in areas of the external wall of the patch 16 located opposite the threaded sectors 17. These notches are adapted to be able to receive the ends of a ring 19 carrier holder (shown in Figure 7) which will described below.
Les sections de la pastille 16 constituées par les secteurs taraudés 17 sont reliées par des portions courbes 20 épousant le contour extérieur convexe des branches 5.The sections of the patch 16 constituted by the threaded sectors 17 are connected by curved portions 20 conforming to the convex external contour of the branches 5.
La hauteur des branches 5 de 1 'implant 1 est déterminée pour que la pastille 16 soit, dans le cas le plus défavorable, affleurante à la face d'extrémité desdites branches. On décrira maintenant en référence aux figures 4 à 10, un instrument ancillaire 21 conçu pour permettre une pose aisée et correcte du bouchon 7 et de la pastille 16.The height of the arms 5 of the implant 1 is determined so that the patch 16 is, in the most unfavorable case, flush with the end face of said arms. There will now be described with reference to FIGS. 4 to 10, an ancillary instrument 21 designed to allow easy and correct fitting of the plug 7 and the patch 16.
L'instrument 21 comprend en combinaison l'outil 13 constitué d'un manche porte-bouchon pourvu de l'extrémité polygonale 12, fendue pour la prise du bouchon 7, con uguée de 1 'évidement 9 du bouchon 7, et la bague porte-pastille 19. Celle-ci comporte une bague proprement dite 22, d'axe XX, dimensionnée pour pouvoir être enfilée sur le manche cylindrique 13 et coulisser sur celui-ci. La bague 22 est prolongée d'un côté par deux pattes flexibles longitudinales 23 constituant des lamelles terminées par des extrémités respectives 24. Les pattes 23 sont de préférence diamétralement opposées par rapport à la bague 22 et leurs extrémités 24 sont dimensionnées pour pouvoir s 'engager dans les encoches 18 de la pastille 16. Ainsi cette dernière peut être maintenue par serrage élastique entre les parties terminales 24. Les extrémités des pattes 23 sont munies d'au moins un épaule ent intérieur et de préférence deux épaulements 29 diamétralement opposés (figures 5 et 8), pouvant former des butées axiales pour la pastille 16. Du côté opposé aux pattes de préhension 23 de la pastille 16, la bague 19 est prolongée par une patte longitudinale 25, parallèle à l'axe XX de la bague 22 comme les pattes 23, et terminée par un organe d'accro¬ chage au manche 13. Dans l'exemple représenté cet organe est formé par un bec élastique 26 formant "clip", adapté pour pouvoir venir s'encliqueter dans une gorge corres¬ pondante 27 d'arrêt de la bague porte-pastille 19, ménagée sur la surface de l'outil 13.The instrument 21 comprises in combination the tool 13 consisting of a cork-carrying handle provided with the polygonal end 12, slotted for gripping the cork 7, con ugué of the recess 9 of the cork 7, and the carrier ring -pastille 19. This comprises a ring proper 22, of axis XX, dimensioned to be able to be threaded on the cylindrical handle 13 and slide thereon. The ring 22 is extended on one side by two flexible longitudinal legs 23 constituting lamellae terminated by respective ends 24. The legs 23 are preferably diametrically opposite with respect to the ring 22 and their ends 24 are dimensioned so as to be able to engage in the notches 18 of the patch 16. Thus the latter can be held by elastic clamping between the end portions 24. The ends of the tabs 23 are provided with at least one shoulder ent inside and preferably two diametrically opposite shoulders 29 (FIGS. 5 and 8), which can form axial stops for the pad 16. On the side opposite to the gripping tabs 23 of the pad 16, the ring 19 is extended by a longitudinal lug 25, parallel to the axis XX of the ring 22 like the lugs 23, and terminated by a member for hanging on the handle 13. In the example shown, this member is formed by an elastic spout 26 forming a "clip ", adapted to be able to snap into a corres¬ ponding groove 27 for stopping the pad holder ring 19, formed on the surface of the tool 13.
La bague 19 est complétée par une languette longitudinale 28 de préhension manuelle, qui s'étend parallèlement à la patte 25 et de préférence est nette¬ ment plus longue que celle-ci comme représenté aux figures 5 et 7.The ring 19 is completed by a longitudinal tongue 28 for manual gripping, which extends parallel to the tab 25 and preferably is markedly longer than the latter as shown in FIGS. 5 and 7.
Pour monter la bague 19 sur le manche porte- bouchon 13, il suffit d'enfiler sa partie annulaire 22 sur ce manche et de faire glisser 1'ensemble de la bague jusqu'à la position voulue, par exemple jusqu'à ce que le bec flexible 26 vienne s 'encliqueter dans la gorge 27.To mount the ring 19 on the cork holder handle 13, it suffices to thread its annular part 22 on this handle and to slide the whole of the ring to the desired position, for example until the flexible spout 26 snaps into the groove 27.
Les pattes 23 se terminent par des extrémités chanfreinées 23a qui facilitent 1 ' introduction de la pastille 16 entre les pattes 23 (Fig. 5). Les pattes 23 s'écartent élastiquement et on peut faire glisser la pastille 16 jusqu'à ce qu'elle vienne en butée contre les épaulements circulaires 29. La bague 16 est alors maintenue par serrage élastique entre les pattes 23. L'instrument ancillaire 21, constitué du manche 13 porte-bouchon et de la bague 19 porte-pastille est utilisé de la manière suivante : a) la bague porte-pastille 19 est déplacée sur l'outil 13 dans le sens qui dégage l'extrémité profilée 12 fendue pour la prise du bouchon, le bec élastique 26 se trouvant alors au-delà de la gorge 27 ; b) le chirurgien exécute la prise du bouchon 7, puis redescend la bague 19 jusqu'à ce que le bec 26 vienne s 'encliqueter dans la gorge 27 ; c) au terme de ce coulissement de la bagueThe tabs 23 terminate in chamfered ends 23a which facilitate the introduction of the patch 16 between the tabs 23 (Fig. 5). The legs 23 move apart elastically and the pad 16 can be slid until it comes into abutment against the circular shoulders 29. The ring 16 is then held by elastic clamping between the legs 23. The ancillary instrument 21 , consisting of the handle 13 cork holder and the ring 19 pellet holder is used in the following manner: a) the pellet holder ring 19 is moved on the tool 13 in the direction which releases the slotted end 12 for the plug, the spout elastic 26 then being located beyond the groove 27; b) the surgeon executes the plug 7, then lowers the ring 19 until the spout 26 comes to snap into the groove 27; c) at the end of this sliding of the ring
19, les parties terminales 24 des pattes 23 viennent s'introduire dans les encoches 18, la pastille 16 étant retenue axialement par les épaulements 29 ; d) 1 'ensemble est positionné au dessus de l'implant 1 et la pastille 16 et guidé sur le diamètre extérieur du corps 3. La pastille 16 vient se guider sur le corps 3 jusqu'à sa position finale (figures 1 et 10), dans laquelle elle est légèrement en retrait, d'une distance e. par exemple d'un millimètre environ (figure 10) par rapport aux faces terminales des branches 5. Le guidage de la pastille 16 sur le corps 3 facilite la mise en place du bouchon 7 entre les branches 5. Ce centrage préalable permet un guidage du bouchon dans les tarauda¬ ges 14 et 17. Ainsi, le risque de mise en place du bouchon 7 en biais et d'altération des filets 14 et 17 est fortement diminué.19, the end portions 24 of the legs 23 are introduced into the notches 18, the pellet 16 being retained axially by the shoulders 29; d) the assembly is positioned above the implant 1 and the patch 16 and guided on the outside diameter of the body 3. The patch 16 is guided on the body 3 to its final position (Figures 1 and 10) , in which it is slightly set back, from a distance e. for example about a millimeter (FIG. 10) relative to the end faces of the branches 5. The guiding of the patch 16 on the body 3 facilitates the fitting of the plug 7 between the branches 5. This prior centering allows guiding of the plug in the taps 14 and 17. Thus, the risk of fitting the plug 7 at an angle and altering the threads 14 and 17 is greatly reduced.
La distance e. séparant les faces d'extrémité de la pastille 16 et des branches 5 correspond à la valeur du pas du bouchon 7. Dans tous les cas, une fois le montage réalisé, la pastille 16 n'est jamais en relief par rapport à 1 'extrémité du corps 3. e) 1 ' ancillaire porte-bouchon 13 est manoeu¬ vré dans le sens horaire permettant le vissage du bouchon 7 dans les taraudages 14 et 17. Durant ce mouvement, le bouchon 7 descend à 1 ' intérieur du corps 3 et la bague 19 remonte par rapport au porte-bouchon 13, sa position relative par rapport à l'implant 1 restant inchangé.The distance e. separating the end faces of the patch 16 and of the branches 5 corresponds to the value of the pitch of the plug 7. In all cases, once the assembly has been carried out, the patch 16 is never in relief relative to the end of the body 3. e) the ancillary stopper holder 13 is maneuvered clockwise allowing the screwing of the stopper 7 in the threads 14 and 17. During this movement, the stopper 7 descends inside the body 3 and the ring 19 rises relative to the stopper holder 13, its relative position relative to the implant 1 remaining unchanged.
Une fois le vissage du bouchon 7 terminé, l'instrument ancillaire 13, 19 est retiré. Suivant la variante d'exécution représentée à la figure 11, l'extrémité de longueur d non filetée des branches 5 de l'implant 1 est supprimée (d étant égal à environ 1 mm). De ce fait, la pastille 16, sur laquelle le bouchon 7 peut être préalablement vissé avec un filet en prise comme illustré à la partie supérieure de la Figure 11, (pas de 1, soit de 1 mm) est affleurante à l'extrémité de l'implant 1. Pour le montage, l'ensemble formé par le bouchon 7 de la pastille 16 est positionné sur 1'implant ouvert 1, le guidage étant assuré par la pastille 16.Once the plug 7 has been screwed on, the ancillary instrument 13, 19 is removed. Depending on the variant shown in FIG. 11, the non-threaded end of length d of the branches 5 of the implant 1 is eliminated (d being equal to approximately 1 mm). Therefore, the pad 16, on which the plug 7 can be previously screwed with a thread engaged as illustrated in the upper part of Figure 11, (not 1, or 1 mm) is flush at the end of the implant 1. For mounting, the assembly formed by the plug 7 of the patch 16 is positioned on the open implant 1, the guidance being provided by the patch 16.
Dans la seconde forme de réalisation de l'instrument ancillaire, représentée aux figures 12 à 15, celui-ci comprend un manche porte-bouchon 31 constitué d'une pièce tubulaire dont la partie terminale est formée par une fourchette flexible 32 pour la prise du bouchon 7 par 1 'extérieur de ce dernier et par les extrémités des branches de la fourchette 32 (figure 13). Dans la pièce 32 est ménagé un alésage interne 33 adapté pour pouvoir y enfiler un outil 34 de serrage du bouchon 7 au moyen d'un embout terminal 35 adapté au profil de l'empreinte 9.In the second embodiment of the ancillary instrument, shown in FIGS. 12 to 15, it comprises a cork holder handle 31 made up of a tubular piece, the end part of which is formed by a flexible fork 32 for picking up the plug 7 by the outside of the latter and by the ends of the branches of the fork 32 (FIG. 13). In the part 32 is provided an internal bore 33 adapted to be able to thread there a tool 34 for tightening the plug 7 by means of a terminal tip 35 adapted to the profile of the imprint 9.
La bague porte-pastille 36 de cet instrument (figure 14) est prolongée par des pattes flexibles longitudinales 37 adaptées pour pouvoir être introduites dans les encoches externes 18 de la pastille 16. Des plats 38 sont réalisés de chaque côté des pattes 37 et constituent des butées d'arrêt de la pastille 16, ce qui simplifie l'agencement de la bague par rapport à celui de la figure 4. La bague 36 est dimensionnée pour pouvoir être enfilée sur le manche 31 et équipée d'un moyen d'accrochage à ce dernier, tel qu'une languette flexible longitudinale 39 découpée dans la paroi tubulaire de la bague 36, et dont l'extrémité libre porte une bille 41. Cette dernière peut venir s 'encliqueter dans l'une de deux gorges d'arrêt 42, 43 agencées sur la surface du manche 31 à des distances convenables de la fourchetteThe pad holder ring 36 of this instrument (FIG. 14) is extended by longitudinal flexible tabs 37 adapted to be able to be inserted into the external notches 18 of the pad 16. Dishes 38 are produced on each side of the tabs 37 and constitute stops of the pad 16, which simplifies the arrangement of the ring relative to that of FIG. 4. The ring 36 is dimensioned so that it can be threaded onto the handle 31 and equipped with a hooking means to the latter, such as a longitudinal flexible tongue 39 cut in the tubular wall of the ring 36, and the free end of which carries a ball 41. The latter can be snapped into one of two stop grooves 42 , 43 arranged on the surface of the sleeve 31 at suitable distances from the fork
32 et avec un écartement approprié entre-elles. Ainsi, la bille 41 peut venir s'indexer dans l'une ou l'autre des gorges 42, 43, ce qui correspond à deux positions possibles de la bague 36 sur le manche 31.32 and with an appropriate spacing therebetween. Thus, the ball 41 can be indexed in one or other of the grooves 42, 43, which corresponds to two possible positions of the ring 36 on the handle 31.
Le mode d'utilisation de cet instrument ancillaire est le suivant :The mode of use of this ancillary instrument is as follows:
- on assemble les deux pièces 31 et 36 en enfilant la bague 36 sur le manche 31, la bague 36 étant placée en position haute, dans laquelle la bille 41 vient se loger dans la gorge 43 (les pattes 37 étant bien entendu placées du côté de la fourchette 32) .- The two parts 31 and 36 are assembled by threading the ring 36 on the handle 31, the ring 36 being placed in the high position, in which the ball 41 is housed in the groove 43 (the legs 37 of course being placed on the side of fork 32).
- on exécute la prise du bouchon 7 par la fourchette 32. - on fait coulisser la bague 36 sur le manche- the plug 7 is taken by the fork 32. - the ring 36 is slid on the handle
31 jusqu'à ce que la bille 41 descende dans la gorge 42,31 until the ball 41 descends into the groove 42,
- on exécute la prise de la pastille 16 par les pattes flexibles 37 de la bague 36,the plug 16 is taken by the flexible tabs 37 of the ring 36,
- on positionne 1 'ensemble sur 1'implant ouvert, puis on introduit le tournevis 34 dans l'alésage- the assembly is positioned on the open implant, then the screwdriver 34 is inserted into the bore
33 du manchon tubulaire 31,33 of the tubular sleeve 31,
- et enfin on procède au serrage du bouchon 7 dans l'implant.- And finally we tighten the plug 7 in the implant.
Diverses variantes d'exécution peuvent être apportées à l'implant et à l'instrument ancillaire de mise en place du bouchon et de la pastille, dans le cadre de l'invention. Ainsi la bague porte-pastille peut être réalisée de toute autre manière équivalente, les épaule¬ ments de butée 29 pouvant par exemple être en nombre quelconque, ou même être réduits à un seul s'étendant sur un secteur angulaire suffisant. Various variant embodiments can be made to the implant and to the ancillary instrument for fitting the plug and the patch, within the framework of the invention. Thus the pad holder ring can be produced in any other equivalent way, the abutment shoulders 29 can for example be any number, or even be reduced to a single one extending over a sufficient angular sector.

Claims

REVENDICATIONS
1. Implant (1) pour dispositif d'ostéosynthè- se, notamment du rachis, comprenant une partie (2) destinée à 1'ancrage osseux et un corps (3) de fixation sur une tige (4) , dans lequel le corps comprend deux branches latérales ( 5 ) délimitant entre elles un canal (6) débouchant sur une partie postérieure du corps et ouvert de part et d' autre du corps pour pouvoir recevoir la tige, cet implant comprenant également un bouchon fileté (7) adapté pour pouvoir être vissé dans des taraudages (14) formés sur les parois intérieures des deux branches latérales, et une pastille annulaire (16) entourant les branches (5) du corps, caractérisé en ce que la pastille comporte deux secteurs circulaires taraudés (17), s 'étendant de part et d'autre du bouchon entre les branches du corps et complémentaires des taraudages desdites branches, afin de réaliser avec ces derniers un taraudage continu pour le vissage du bouchon.1. Implant (1) for an osteosynthesis device, in particular of the spine, comprising a part (2) intended for bone anchoring and a body (3) for fixing on a rod (4), in which the body comprises two lateral branches (5) delimiting between them a channel (6) opening onto a rear part of the body and open on either side of the body so as to be able to receive the rod, this implant also comprising a threaded plug (7) adapted to be able to be screwed into threads (14) formed on the inner walls of the two lateral branches, and an annular pad (16) surrounding the branches (5) of the body, characterized in that the pad comprises two circular threaded sectors (17), s 'extending on either side of the plug between the branches of the body and complementary to the threads of said branches, in order to achieve with the latter a continuous thread for screwing the plug.
2. Implant selon la revendication 1, caracté- risé en ce que dans des zones de la paroi externe de la pastille (16) situées en regard des secteurs taraudés (17), des encoches (18) sont agencées pour pouvoir recevoir des extrémités ( 24 ) d'un outil de manutention (19) de la pastille. 2. Implant according to claim 1, characterized in that in zones of the external wall of the patch (16) located opposite the threaded sectors (17), notches (18) are arranged to be able to receive ends ( 24) of a handling tool (19) of the pellet.
3. Implant selon la revendication 1 ou 2, caractérisé en ce que la hauteur des branches (5) de l'implant (1) est déterminée pour que la pastille (16) soit, dans le cas le plus défavorable, affleurante à la face d'extrémité desdites branches. 3. Implant according to claim 1 or 2, characterized in that the height of the branches (5) of the implant (1) is determined so that the patch (16) is, in the most unfavorable case, flush with the face end of said branches.
4. Instrument ancillaire pour la pose du bouchon (7) et de la pastille (16) de l'implant (1) selon l'une des revendications 1 à 3, caractérisé en ce qu'il comprend en combinaison un manche porte-bouchon ( 13) pourvu d'une extrémité profilée et fendue (12), adaptée pour pénétrer dans une empreinte profilée (9) conjuguée du bouchon, et une bague porte-pastille (19) pouvant être enfilée sur le manche et coulisser sur celui-ci, l'une des extrémités de cette bague étant pourvue de moyens de préhension (23, 24) de la pastille. 4. Ancillary instrument for fitting the plug (7) and the patch (16) of the implant (1) according to one of claims 1 to 3, characterized in that it comprises in combination a cork holder handle (13) provided with a profiled and slotted end (12), adapted to penetrate into a conjugate profiled cavity (9) of the stopper, and a pellet holder ring (19) which can be slid onto the handle and slide thereon, one end of this ring being provided with means for gripping (23, 24) of the pellet.
5. Instrument selon la revendication 4, lorsque celle-ci est rattachée à 1 'une des revendications 2 et 3, caractérisé en ce que la bague (19) est prolongée par des pattes flexibles longitudinales ( 23 ) , dont les extrémités ( 24 ) peuvent être introduites dans les encoches externes (18) de la pastille (16) et serrer élastiquement cette dernière entre elles, et ces extrémi¬ tés des pattes sont munies d'au moins un épaulement (29 ) intérieur de butée axiale pour la pastille.5. Instrument according to claim 4, when the latter is attached to one of claims 2 and 3, characterized in that the ring (19) is extended by flexible longitudinal lugs (23), the ends of which (24) can be introduced into the external notches (18) of the pad (16) and elastically tighten the latter between them, and these extremi¬ ted legs are provided with at least one shoulder (29) inner axial stop for the pad.
6. Instrument selon la revendication 5, caractérisé en ce que du côté opposé aux pattes (23) de préhension de la pastille, la bague (19) comporte un organe (26) d'accrochage au manche (13) porte-bouchon, par exemple une patte longitudinale (25) dont l'extrémité forme un bec élastique (26), qui peut venir s 'encliqueter dans une gorge (27) d'arrêt de la bague, formée sur la surface du manche porte-bouchon.6. Instrument according to claim 5, characterized in that on the side opposite to the tabs (23) for gripping the pellet, the ring (19) comprises a member (26) for hooking to the handle (13) cork holder, by example a longitudinal tab (25) whose end forms an elastic spout (26), which can be snapped into a groove (27) for stopping the ring, formed on the surface of the cork-holder handle.
7. Instrument selon la revendication 6, caractérisé en ce que la bague porte-pastille ( 19 ) comprend une languette longitudinale (28) de préhension manuelle, s'étendant du côté opposé aux pattes (23) de préhension de la pastille (16).7. Instrument according to claim 6, characterized in that the tablet holder ring (19) comprises a longitudinal tongue (28) for manual gripping, extending on the side opposite to the tabs (23) for gripping the tablet (16) .
8. Instrumentation selon la revendication 4, caractérisée en ce que le manche porte-bouchon est une pièce tubulaire (31) dont une partie terminale est constituée d'une fourchette flexible (32) pour la prise du bouchon (7) par l'extérieur de ce dernier, et l'alé¬ sage interne (33 ) de cette pièce est adapté pour pouvoir y enfiler un outil (34) de serrage du bouchon.8. Instrumentation according to claim 4, characterized in that the cork-holder handle is a tubular part (31) of which an end part consists of a flexible fork (32) for gripping the cork (7) from the outside of the latter, and the internal bore (33) of this part is suitable for being able to thread a tool (34) for tightening the plug therein.
9. Instrument selon la revendication 8, caractérisé en ce que la bague porte-pastille (36) est prolongée par des pattes flexibles longitudinales (37) adaptées pour être introduites dans les encoches externes (18) de la pastille (16) et serrer élastiquement cette dernière entre elles, et des plats (38) formant butées d'arrêt de la pastille sont réalisés de chaque côté des pattes.9. Instrument according to claim 8, characterized in that the pellet holder ring (36) is extended by longitudinal flexible lugs (37) adapted to be introduced into the external notches (18) of the pad (16) and to tighten it elastically between them, and dishes (38) forming stops for stopping the pad are produced on each side of the legs.
10. Instrument selon la revendication 9, caractérisé en ce que la bague (36) est équipée de moyens d'accrochage au manche porte-bouchon (31), tels qu'une languette flexible longitudinale (39) découpée dans la bague et dont l'extrémité libre porte une bille (41) pouvant venir s'encliqueter dans l'une des gorges d'arrêt (42, 43) agencées sur la surface du manche porte-bouchon (31). 10. Instrument according to claim 9, characterized in that the ring (36) is equipped with means for hooking to the cork holder handle (31), such as a flexible longitudinal tongue (39) cut from the ring and the l the free end carries a ball (41) which can snap into one of the stop grooves (42, 43) arranged on the surface of the cork holder handle (31).
PCT/FR1993/001164 1993-11-25 1993-11-25 Implant for an osteosynthesis device, particularly for the spine, and positioning instrument therefor WO1995014437A1 (en)

Priority Applications (2)

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PCT/FR1993/001164 WO1995014437A1 (en) 1993-11-25 1993-11-25 Implant for an osteosynthesis device, particularly for the spine, and positioning instrument therefor
AU55667/94A AU5566794A (en) 1993-11-25 1993-11-25 Implant for an osteosynthesis device, particularly for the spine, and positioning instrument therefor

Applications Claiming Priority (1)

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PCT/FR1993/001164 WO1995014437A1 (en) 1993-11-25 1993-11-25 Implant for an osteosynthesis device, particularly for the spine, and positioning instrument therefor

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Cited By (29)

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US8894655B2 (en) 2006-02-06 2014-11-25 Stryker Spine Rod contouring apparatus and method for percutaneous pedicle screw extension
US8979848B2 (en) 2006-09-25 2015-03-17 Stryker Spine Force limiting persuader-reducer
US9011447B2 (en) 2006-09-25 2015-04-21 Stryker Spine Rod contouring alignment linkage
US9277940B2 (en) 2008-02-05 2016-03-08 Zimmer Spine, Inc. System and method for insertion of flexible spinal stabilization element
US9402663B2 (en) 2010-04-23 2016-08-02 DePuy Synthes Products, Inc. Minimally invasive instrument set, devices and related methods
US9408716B1 (en) 2013-12-06 2016-08-09 Stryker European Holdings I, Llc Percutaneous posterior spinal fusion implant construction and method
US9498262B2 (en) 2006-04-11 2016-11-22 DePuy Synthes Products, Inc. Minimally invasive fixation system
US9510875B2 (en) 2013-03-14 2016-12-06 Stryker European Holdings I, Llc Systems and methods for percutaneous spinal fusion
US9700357B2 (en) 2003-09-24 2017-07-11 Stryker European Holdings I, Llc Methods and devices for improving percutaneous access in minimally invasive surgeries
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US9750545B2 (en) 2009-03-27 2017-09-05 Globus Medical, Inc. Devices and methods for inserting a vertebral fixation member
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US9827020B2 (en) 2013-03-14 2017-11-28 Stryker European Holdings I, Llc Percutaneous spinal cross link system and method
US9895182B2 (en) 2005-05-18 2018-02-20 Stryker European Holdings I. Llc System and method for orthopedic implant configuration
US10034690B2 (en) 2014-12-09 2018-07-31 John A. Heflin Spine alignment system
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US8808327B2 (en) 1998-06-17 2014-08-19 Howmedica Osteonics Corp. Device for securing spinal rods
US7780703B2 (en) 1998-06-17 2010-08-24 Howmedica Osteonics Corp. Device for securing spinal rods
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US8579943B2 (en) 2002-06-04 2013-11-12 Howmedica Osteonics Corp. Apparatus for securing a spinal rod system
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