WO2005027761A1 - Locking rachidial implant provided with a tightness indicator - Google Patents

Locking rachidial implant provided with a tightness indicator Download PDF

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Publication number
WO2005027761A1
WO2005027761A1 PCT/FR2004/002346 FR2004002346W WO2005027761A1 WO 2005027761 A1 WO2005027761 A1 WO 2005027761A1 FR 2004002346 W FR2004002346 W FR 2004002346W WO 2005027761 A1 WO2005027761 A1 WO 2005027761A1
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WO
WIPO (PCT)
Prior art keywords
threaded
threaded plug
mounting part
ring
locking screw
Prior art date
Application number
PCT/FR2004/002346
Other languages
French (fr)
Inventor
Maurice Bergoin
Original Assignee
Euros
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Publication date
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Publication of WO2005027761A1 publication Critical patent/WO2005027761A1/en

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7032Screws or hooks with U-shaped head or back through which longitudinal rods pass
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03Automatic limiting or abutting means, e.g. for safety
    • A61B2090/037Automatic limiting or abutting means, e.g. for safety with a frangible part, e.g. by reduced diameter

Definitions

  • the present invention relates to a spinal implant which comprises:
  • a mounting part comprising a threaded housing capable of receiving at its bottom a connecting rod extending on either side of said mounting part, and
  • - locking means intended to cooperate with said mounting part to block said connecting rod inside said threaded housing, these locking means comprising: o a ring intended to be positioned on said mounting part, o a threaded plug intended to be screwed into said threaded housing of the mounting part, and o a locking screw whose threaded body is intended to be screwed through said threaded plug to bear against said connecting rod.
  • This type of implant assembled with a connecting rod is used to treat arthritis, vertebral fractures or to correct deviations of the spine such as scoliosis or kyphosis. In general, the surgeon fixes two implants per vertebra then places in each of the implants a rod, these two rods being parallel and previously bent depending on the treatment and the correction to be made on the spine.
  • the ring is a simple sleeve put in place by sliding on the mounting part of the implant simultaneously with the threaded plug which is screwed inside the threaded housing.
  • the threaded plug has an annular rim which, when it is screwed into the mounting part, bears against the annular edge of the ring to slide it over said mounting part and lock it in abutment on the connecting rod.
  • the locking screw comprises, opposite its end which bears on the connecting rod, a simple hexagonal recess for the introduction of the tip of a screwing tool.
  • the locking screw is short in length so that after screwing into the threaded plug it is fully inserted into said plug.
  • the main drawback of these already known implants is that the installation of the threaded plug in the housing of the mounting part provided with the more or less bent connecting rod is often a difficult and delicate operation to carry out.
  • the more or less curved connecting rod is positioned inside the threaded housing of the mounting part of this implant, it tends to go back up out of the housing by blocking the access of the threaded plug to the thread of the housing.
  • the surgeon must then press the rod using the threaded plug while screwing it inside the housing and helping said ring to slide on said mounting part to force said connecting rod to be positioned in the housing and lock it inside the latter using the threaded plug and the ring.
  • the invention provides a spinal implant as defined in the introduction, characterized in that the threaded plug and the ring are integral with each other before mounting on said implant mounting part , in that the threaded body of the locking screw is screwed into said threaded plug so as to allow the tightening of said threaded plug in said mounting part by means of said locking screw, and in that said locking screw comprises for this purpose a gripping head which emerges from said threaded plug and which is provided with a tightening indicator suitable for signaling to the surgeon that the threaded plug is screwed into the mounting part of the implant at a given tightening torque.
  • the locking screw is provided with another tightening indicator.
  • this other tightening indicator is capable of signaling to the surgeon that the locking screw bearing on said connecting rod is screwed into said threaded plug at a given tightening torque.
  • this allows the surgeon to ensure that the locking or blocking of the connecting rod in the mounting part of the implant is correctly carried out by said locking means.
  • the other tightening indicator is a part of weaker resistance which connects said gripping head to said threaded body of the locking screw and which is capable of being break by twisting under the effect of a given tightening torque.
  • said first tightening indicator is a ring surrounding the base of said gripping head of the locking screw, intended to bear on said threaded plug during screwing the threaded body of said locking screw into said threaded plug, and linked to said gripping head by a link frangible capable of breaking by shearing under the effect of a given tightening torque.
  • - said threaded plug and said ring are two separate parts assembled together by means of complementary locking means cooperating with each other, - the threaded plug comprises a head capable of being force-fitted into said ring, - said ring carries on its internal face an annular rim intended to bear against the upper edge of the mounting part, - the threaded plug comprises at the head a rim capable of bearing on the annular rim of said ring, - the threaded plug and the ring form a single piece, - said gripping head of the locking screw has at one end a receiving impression of the end of a screwing tool, and - said locking screw is a single piece.
  • FIG. 1 is a schematic perspective view of an embodiment of the spinal implant according to the invention.
  • FIG. 2A is an exploded perspective view of the locking means of the spinal implant of Figure 1;
  • FIG. 2B is an assembled view cut longitudinally of the locking means of Figure 2A;
  • FIG. 3 is a schematic perspective view of several spinal implants according to the invention placed on vertebrae.
  • a spinal implant 100 which has an anchoring portion 110 to a vertebra.
  • the spinal implant 100 is a pedicle screw whose anchoring part is a threaded body 110 capable of being anchored by screwing into the pedicle of the vertebra 1 considered (see FIG. 3).
  • the spinal implant according to the invention can be a pedicle hook, the anchoring part of which is a hook capable of hanging on the pedicle of the vertebra considered.
  • the spinal implant 100 further comprises a mounting part 120 surmounting the anchoring part 110.
  • This mounting part 120 generally extends along the axis X of the anchoring part 110. It comprises a threaded housing 121 open on the side opposite to the anchoring part 110, comprising opposite lateral openings 122 to receive in its bottom 123 a connecting rod 10 which extends on either side of said mounting part to make the link with one or several other 100 spinal implants of the same type (see Figure 3).
  • the anchoring part 110 and the mounting part 120 of the spinal implant 100 form a single piece.
  • provision can be made for the anchoring and mounting parts of the implant to be separate parts assembled together.
  • the bottom of the threaded housing of the mounting part has a through hole in which the head of the anchoring part is engaged.
  • the spinal implant 100 further comprises locking means 130 intended to cooperate with said mounting part 120 to block the connecting rod 10 inside said threaded housing 121.
  • these locking means 130 comprise: - a ring 131 intended to be positioned on said mounting part 120, - a threaded plug 132 intended to be screwed into said threaded housing 121 of the mounting part 120, and - a locking screw 133 having a threaded body 133A intended to be screwed through said threaded plug 132 to bear against said connecting rod and block it in abutment against the bottom 123 of the threaded housing 121 of the mounting part 120 of the spinal implant 100.
  • FIG. 2B shows said locking means 130 of the spinal implant 100 ready for use before mounting on said mounting part 120.
  • the threaded plug 132 and the ring 131 are integral with each other before mounting on said mounting part 120 of the spinal implant 100.
  • the threaded plug 132 and said ring 131 are two separate parts assembled together by means of complementary locking means cooperating with one another.
  • the threaded plug 132 comprises a head whose annular rim 132B is capable of being force-fitted into said ring 131.
  • said ring 131 carries on its internal face 131 A an annular rim 131 B intended to bear against the upper edge of the mounting part 120 of the spinal implant 100 and said annular flange 132B of said threaded plug 132 is able to bear on the annular flange 131 B of said ring 131.
  • said threaded plug and the ring may provide that the threaded plug and the ring form a single piece.
  • the threaded body 133A of the locking screw 133 is screwed in a through duct 132A at least partially tapped with said threaded plug 132 so as to allow the threaded plug 132 to be tightened in the mounting part 120 by means of the locking screw 133.
  • the locking screw 133 comprises a gripping head 133B which emerges from the threaded plug 132 and which is provided with a tightening indicator 133D.
  • the gripping head 133B is in the form of a generally cylindrical barrel of revolution of axis X and comprises at one end accessible to the surgeon an imprint 133E for receiving the end of a screwing tool.
  • the imprint 133E is a hexagonal imprint.
  • the tightening indicator 133D is a ring which surrounds the base of the gripping head 133B of the locking screw and which is linked to the latter by a frangible link capable of breaking by shearing under the effect of a couple of given tightening. As shown in FIG. 2B, the ring 133D carried by the gripping head 133 is intended to bear on said threaded plug 132 when the threaded body 133A of the locking screw 133 is screwed into said threaded plug 132.
  • the gripping head 133B is connected to the threaded body 133A of the locking screw 133 by a cylindrical portion 133C of lower resistance which is capable of breaking by torsion under the effect of a given tightening torque.
  • This lower resistance cylindrical part 133C constitutes a further tightening indicator for the locking screw 133.
  • the locking screw 133 is a single piece.
  • the ring 131 slides on said mounting part 120 and prevents the spacing of its branches.
  • the stop formed by the ring 133D bearing against the threaded plug 132 makes it possible to link said locking screw 133 to said threaded plug 132 so that the screwing of the locking screw 133 causes that of said threaded plug 132.
  • the surgeon screws or tightens the threaded plug 132 in said threaded housing 121 of the mounting part 120 of the implant until the annular flange 131 B of the ring 131 comes to bear against the mounting part 120 and the tightening torque applied to the locking screw 133 and therefore transmitted the threaded plug causes the frangible link connecting the ring 133D to the said locking screw to break by shearing.
  • the disengagement of the ring 133D indicates to the surgeon that the threaded plug 132 is tightened correctly to a given tightening torque in the housing threaded 121 of the mounting portion 120 of the implant. This means in particular that all the threads of the thread of said threaded plug 132 cooperate or are engaged with the threads of the thread of said threaded housing 121.
  • the surgeon continues to screw the locking screw 133 in said threaded plug 132. Because the locking screw 133 is disengaged in rotation from the threaded plug 132, it passes through it to come into abutment against the connecting rod 10 placed in the bottom 123 of the threaded housing 121 of the mounting part 120. The surgeon then tightens the locking screw 133 in said threaded plug 132 until the tightening torque applied to the locking screw 133 causes the weakest part 133C to rupture by torsion connecting the threaded body 133A of the locking screw 133 to its gripping head 133B.

Abstract

The invention relates to a rachidial implant (100) consisting of an anchoring part (110), a mounting part (120) receiving a connecting rod (10) and clamping means (130) for blocking said connecting rod in the mounting part and comprising a ring (131) positioned on said mounting part, a threaded plug (132) screwable therein and a blocking screw (133). The inventive threaded plug and the ring are connected to each other before mounting on said mounting part. The threaded plug is screwed into the mounting part by means of the blocking screw which is screwed into said threaded plug and consists of a grasp head (133B) emerging from the threaded plug and provided with an indicator (133D) of the correct tightness of the threaded plug in the mounting part.

Description

Implant rachidien à moyens de verrouillage munis d'un témoin de serrage. La présente invention concerne un implant rachidien qui comporte : Spinal implant with locking means provided with a tightening indicator. The present invention relates to a spinal implant which comprises:
- une partie d'ancrage à une vertèbre,- an anchoring part to a vertebra,
- une partie de montage comprenant un logement taraudé apte à recevoir dans son fond une tige de liaison s'étendant de part et d'autre de ladite partie de montage, eta mounting part comprising a threaded housing capable of receiving at its bottom a connecting rod extending on either side of said mounting part, and
- des moyens de verrouillage destinés à coopérer avec ladite partie de montage pour bloquer ladite tige de liaison à l'intérieur dudit logement taraudé, ces moyens de verrouillage comprenant : o une bague destinée à être positionnée sur ladite partie de montage, o un bouchon fileté destiné à être vissé dans ledit logement taraudé de la partie de montage, et o une vis de verrouillage dont le corps fileté est destiné à être vissé au travers dudit bouchon fileté pour prendre appui contre ladite tige de liaison. Ce type d'implant assemblé avec une tige de liaison est utilisé pour traiter des arthroses, des fractures vertébrales ou pour corriger des déviations de la colonne vertébrale telles qu'une scoliose ou une cyphose. En général, le chirurgien fixe deux implants par vertèbre puis place dans chacun des implants une tige, ces deux tiges étant parallèles et préalablement cintrées en fonction du traitement et de la correction à apporter sur la colonne vertébrale. On connaît des documents EP 0 465 158 et US 6 077 262 des implants dont les caractéristiques correspondent à celles qui sont énoncées en introduction. Toutefois selon le document EP 0 465 158, la bague est un simple manchon mis en place par coulissement sur la partie de montage de l'implant simultanément avec le bouchon fileté qui est vissé à l'intérieur du logement taraudé. Le bouchon fileté comporte un rebord annulaire qui, lors de son vissage dans la partie de montage, prend appui contre le bord annulaire de la bague pour la faire glisser sur ladite partie de montage et la bloquer en appui sur la tige de liaison. En outre, la vis de verrouillage comporte, à l'opposé de son extrémité qui prend appui sur la tige de liaison, une simple empreinte hexagonale pour l'introduction de la pointe d'un outil de vissage. La vis de verrouillage est de courte longueur de sorte qu'après vissage dans le bouchon fileté elle est complètement enfoncée dans ledit bouchon. L'inconvénient principal de ces implants déjà connus est que la mise en place du bouchon fileté dans le logement de la partie de montage munie de la tige de liaison plus ou moins cintrée est souvent une opération difficile et délicate à réaliser. En effet, lorsque la tige de liaison plus ou moins cintrée est positionnée à l'intérieur du logement taraudé de la partie de montage de cet implant, elle a tendance à remonter pour sortir du logement en bloquant l'accès du bouchon fileté au taraudage du logement. Le chirurgien doit alors appuyer sur la tige à l'aide du bouchon fileté tout en vissant celui-ci à l'intérieur du logement et en aidant ladite bague à coulisser sur ladite partie de montage pour obliger ladite tige de liaison à se positionner dans le logement et la bloquer à l'intérieur de ce dernier à l'aide du bouchon fileté et de la bague. Dans certains cas, lorsque la tige présente un cintrage accentué, il se peut que lors du vissage du bouchon fileté dans le logement taraudé de la partie de montage, le filetage dudit bouchon rompt. De plus le chirurgien n'est jamais assuré que le bouchon fileté est vissé dans ledit logement taraudé de la partie de montage de l'implant avec le bon couple de serrage. Cette opération de serrage du bouchon fileté n'est pas une opération reproductible dans le sens où le chirurgien n'est jamais assuré de serrer plusieurs bouchons filetés du même type avec le même couple de serrage. Enfin, lorsque la tige de liaison présente un cintrage accentué les filets du bouchon fileté ne viennent pas tous en prise avec les filets du taraudage du logement de la partie de montage de l'implant et la solidarisation de la tige de liaison à la partie de montage de l'implant est fragile. Par ailleurs, on connaît du document US 6 224 558 un implant qui ne comporte pas de bague mais un bouchon fileté et une vis de verrouillage dont le corps fileté est destiné à être vissé au travers dudit bouchon pour prendre appui contre la tige de liaison. Cette vis de verrouillage comprend une tête de préhension qui émerge du bouchon et qui est munie d'un témoin de serrage constitué par une partie de plus faible résistance reliant la tête de préhension au corps fileté de la vis de verrouillage et apte à se rompre par torsion sous l'effet d'un couple de serrage donné. Toutefois tout comme l'implant selon le document US 6 077 262, dans l'implant selon le document US 6 224 598 le bouchon fileté est préalablement vissé dans la partie de montage de l'implant avant que la vis de verrouillage intervienne à travers celui-ci pour immobiliser la tige dans ladite partie de montage et il n'est pas possible au chirurgien de contrôler le serrage de bouchon fileté. Afin de pallier les inconvénients précités, l'invention propose un implant rachidien tel que défini en introduction, caractérisé en ce que le bouchon fileté et la bague sont solidaires l'un de l'autre avant montage sur ladite partie de montage de l'implant, en ce que le corps fileté de la vis de verrouillage est vissé dans ledit bouchon fileté de manière à permettre le serrage dudit bouchon fileté dans ladite partie de montage par l'intermédiaire de ladite vis de verrouillage, et en ce que ladite vis de verrouillage comprend à cet effet une tête de préhension qui émerge dudit bouchon fileté et qui est munie d'un témoin de serrage adapté à signaler au chirurgien que le bouchon fileté est vissé dans la partie de montage de l'implant à un couple de serrage donné Avantageusement de cette manière, l'opération de serrage du bouchon fileté dans ladite partie de montage est une opération reproductible facilement contrôlée par le chirurgien. Selon une autre caractéristique avantageuse de l'implant rachidien conforme à l'invention, la vis de verrouillage est munie d'un autre témoin de serrage. Préférentiellement, cet autre témoin de serrage est apte à signaler au chirurgien que la vis de verrouillage en appui sur ladite tige de liaison est vissée dans ledit bouchon fileté à un couple de serrage donné. Avantageusement, cela permet au chirurgien de s'assurer que le verrouillage ou le blocage de la tige de liaison dans la partie de montage de l'implant est correctement réalisé par lesdits moyens de verrouillage. Selon un mode de réalisation préférentiel de l'implant rachidien conforme à l'invention, l'autre témoin de serrage est une partie de plus faible résistance qui relie ladite tête de préhension audit corps fileté de la vis de verrouillage et qui est apte à se rompre par torsion sous l'effet d'un couple de serrage donné. En outre selon ce mode de réalisation préférentiel de l'implant rachidien conforme à l'invention, ledit premier témoin de serrage est un anneau entourant la base de ladite tête de préhension de la vis de verrouillage, destiné à prendre appui sur ledit bouchon fileté lors du vissage du corps fileté de ladite vis de verrouillage dans ledit bouchon fileté, et lié à ladite tête de préhension par un lien frangible apte à se rompre par cisaillement sous l'effet d'un couple de serrage donné. D'autres caractéristiques non limitatives et avantageuses de l'implant rachidien conforme à l'invention sont les suivantes : - ledit bouchon fileté et ladite bague sont deux pièces distinctes assemblées entre elles par l'intermédiaire de moyens de blocage complémentaires coopérant entre eux, - le bouchon fileté comprend une tête apte à être emmanchée en force dans ladite bague, - ladite bague porte sur sa face interne un rebord annulaire destiné à s'appuyer contre le bord supérieur de la partie de montage, - le bouchon fileté comprend en tête un rebord apte à prendre appui sur le rebord annulaire de ladite bague, - le bouchon fileté et la bague forment une seule pièce monobloc, - ladite tête de préhension de la vis de verrouillage comporte à une extrémité une empreinte de réception de l'extrémité d'un outil de vissage, et - ladite vis de verrouillage est une pièce monobloc. La description qui va suivre en regard des dessins annexés, donnés à titre d'exemples non limitatifs, fera bien comprendre en quoi consiste l'invention et comment elle peut être réalisée. Sur les dessins annexés :- locking means intended to cooperate with said mounting part to block said connecting rod inside said threaded housing, these locking means comprising: o a ring intended to be positioned on said mounting part, o a threaded plug intended to be screwed into said threaded housing of the mounting part, and o a locking screw whose threaded body is intended to be screwed through said threaded plug to bear against said connecting rod. This type of implant assembled with a connecting rod is used to treat arthritis, vertebral fractures or to correct deviations of the spine such as scoliosis or kyphosis. In general, the surgeon fixes two implants per vertebra then places in each of the implants a rod, these two rods being parallel and previously bent depending on the treatment and the correction to be made on the spine. Documents EP 0 465 158 and US 6 077 262 disclose implants whose characteristics correspond to those set out in the introduction. However, according to document EP 0 465 158, the ring is a simple sleeve put in place by sliding on the mounting part of the implant simultaneously with the threaded plug which is screwed inside the threaded housing. The threaded plug has an annular rim which, when it is screwed into the mounting part, bears against the annular edge of the ring to slide it over said mounting part and lock it in abutment on the connecting rod. In addition, the locking screw comprises, opposite its end which bears on the connecting rod, a simple hexagonal recess for the introduction of the tip of a screwing tool. The locking screw is short in length so that after screwing into the threaded plug it is fully inserted into said plug. The main drawback of these already known implants is that the installation of the threaded plug in the housing of the mounting part provided with the more or less bent connecting rod is often a difficult and delicate operation to carry out. In fact, when the more or less curved connecting rod is positioned inside the threaded housing of the mounting part of this implant, it tends to go back up out of the housing by blocking the access of the threaded plug to the thread of the housing. The surgeon must then press the rod using the threaded plug while screwing it inside the housing and helping said ring to slide on said mounting part to force said connecting rod to be positioned in the housing and lock it inside the latter using the threaded plug and the ring. In some cases, when the rod has an accentuated bending, it may be that when screwing the threaded plug into the threaded housing of the mounting part, the threading of said plug breaks. In addition, the surgeon is never assured that the threaded plug is screwed into said threaded housing of the mounting part of the implant with the correct tightening torque. This tightening operation of the threaded plug is not a reproducible operation in the sense that the surgeon is never guaranteed to tighten several threaded plugs of the same type with the same tightening torque. Finally, when the connecting rod has an accentuated bending, the threads of the threaded plug do not all come into engagement with the threads of the thread of the housing of the mounting part of the implant and the securing of the connecting rod to the part of implant mounting is fragile. Furthermore, document US 6 224 558 discloses an implant which does not have a ring but a threaded plug and a locking screw whose threaded body is intended to be screwed through said plug to bear against the connecting rod. This locking screw comprises a gripping head which emerges from the plug and which is provided with a tightening indicator constituted by a part of weaker resistance connecting the gripping head to the threaded body of the locking screw and capable of breaking by torsion under the effect of a given tightening torque. However, just like the implant according to document US 6 077 262, in the implant according to document US 6 224 598 the threaded plug is previously screwed into the mounting part of the implant before the locking screw intervenes through it to immobilize the rod in said mounting part and it is not possible for the surgeon to control the tightening of the threaded plug. In order to overcome the aforementioned drawbacks, the invention provides a spinal implant as defined in the introduction, characterized in that the threaded plug and the ring are integral with each other before mounting on said implant mounting part , in that the threaded body of the locking screw is screwed into said threaded plug so as to allow the tightening of said threaded plug in said mounting part by means of said locking screw, and in that said locking screw comprises for this purpose a gripping head which emerges from said threaded plug and which is provided with a tightening indicator suitable for signaling to the surgeon that the threaded plug is screwed into the mounting part of the implant at a given tightening torque. in this way, the operation of tightening the threaded plug in said mounting part is a reproducible operation easily controlled by the surgeon. According to another advantageous characteristic of the spinal implant according to the invention, the locking screw is provided with another tightening indicator. Preferably, this other tightening indicator is capable of signaling to the surgeon that the locking screw bearing on said connecting rod is screwed into said threaded plug at a given tightening torque. Advantageously, this allows the surgeon to ensure that the locking or blocking of the connecting rod in the mounting part of the implant is correctly carried out by said locking means. According to a preferred embodiment of the spinal implant according to the invention, the other tightening indicator is a part of weaker resistance which connects said gripping head to said threaded body of the locking screw and which is capable of being break by twisting under the effect of a given tightening torque. In addition, according to this preferred embodiment of the spinal implant according to the invention, said first tightening indicator is a ring surrounding the base of said gripping head of the locking screw, intended to bear on said threaded plug during screwing the threaded body of said locking screw into said threaded plug, and linked to said gripping head by a link frangible capable of breaking by shearing under the effect of a given tightening torque. Other non-limiting and advantageous characteristics of the spinal implant according to the invention are the following: - said threaded plug and said ring are two separate parts assembled together by means of complementary locking means cooperating with each other, - the threaded plug comprises a head capable of being force-fitted into said ring, - said ring carries on its internal face an annular rim intended to bear against the upper edge of the mounting part, - the threaded plug comprises at the head a rim capable of bearing on the annular rim of said ring, - the threaded plug and the ring form a single piece, - said gripping head of the locking screw has at one end a receiving impression of the end of a screwing tool, and - said locking screw is a single piece. The description which follows with reference to the appended drawings, given by way of nonlimiting examples, will make it clear what the invention consists of and how it can be implemented. In the accompanying drawings:
- la figure 1 est une vue schématique en perspective d'un mode de réalisation de l'implant rachidien selon l'invention ;- Figure 1 is a schematic perspective view of an embodiment of the spinal implant according to the invention;
- la figure 2A est une vue éclatée en perspective des moyens de verrouillage de l'implant rachidien de la figure 1 ;- Figure 2A is an exploded perspective view of the locking means of the spinal implant of Figure 1;
- la figure 2B est une vue assemblée coupée longitudinalement des moyens de verrouillage de la figure 2A ; et- Figure 2B is an assembled view cut longitudinally of the locking means of Figure 2A; and
- la figure 3 est une vue schématique en perspective de plusieurs implants rachidiens selon l'invention mis en place sur des vertèbres. Sur les figures 1 , 2A et 2B on a représenté un implant rachidien 100 qui comporte une partie d'ancrage 110 à une vertèbre. Ici, l'implant rachidien 100 est une vis pédiculaire dont la partie d'ancrage est un corps fileté 110 apte à s'ancrer par vissage dans le pédicule de la vertèbre 1 considérée (voir figure 3). Toutefois, selon une variante de réalisation non représentée, l'implant rachidien conforme à l'invention peut être un crochet pediculaire dont la partie d'ancrage est un crochet apte à s'accrocher au pédicule de la vertèbre considérée. L'implant rachidien 100 comporte en outre une partie de montage 120 surmontant la partie d'ancrage 110. Cette partie de montage 120 s'étend globalement selon l'axe X de la partie d'ancrage 110. Elle comporte un logement taraudé 121 ouvert du côté opposé à la partie d'ancrage 110, comprenant des ouvertures latérales opposées 122 pour recevoir dans son fond 123 une tige de liaison 10 qui s'étend de part et d'autre de ladite partie de montage pour faire le lien avec un ou plusieurs autres implants rachidiens 100 du même type (voir figure 3). Ici la partie d'ancrage 110 et la partie de montage 120 de l'implant rachidien 100 forment une seule pièce monobloc. Toutefois, selon une variante non représentée, on peut prévoir que les parties d'ancrage et de montage de l'implant soient des pièces distinctes assemblées entre elles. Dans ce cas, le fond du logement taraudé de la partie de montage comporte un orifice traversant dans lequel est engagée la tête de la partie d'ancrage. L'implant rachidien 100 comporte en outre des moyens de verrouillage 130 destinés à coopérer avec ladite partie de montage 120 pour bloquer la tige de liaison 10 à l'intérieur dudit logement taraudé 121. Comme le montrent plus particulièrement les figures 2A et 2B, ces moyens de verrouillage 130 comprennent : - une bague 131 destinée à être positionnée sur ladite partie de montage 120, - un bouchon 132 fileté destiné à être vissé dans ledit logement taraudé 121 de la partie de montage 120, et - une vis de verrouillage 133 présentant un corps fileté 133A destiné à être vissé au travers dudit bouchon fileté 132 pour prendre appui contre ladite tige de liaison et la bloquer en appui contre le fond 123 du logement taraudé 121 de la partie montage 120 de l'implant rachidien 100. La figure 2B montre lesdits moyens de verrouillage 130 de l'implant rachidien 100 prêts à l'emploi avant montage sur ladite partie de montage 120. Avantageusement, selon l'invention, comme le montre la figure 2B, le bouchon fileté 132 et la bague 131 sont solidaires l'un de l'autre avant montage sur ladite partie de montage 120 de l'implant rachidien 100. Ici le bouchon fileté 132 et ladite bague 131 sont deux pièces distinctes assemblées entre elles par l'intermédiaire de moyens de blocage complémentaires coopérant entre eux. Préférentieliement, le bouchon fileté 132 comprend une tête dont le rebord annulaire 132B est apte à être emmanché en force dans ladite bague 131. Plus particulièrement, ladite bague 131 porte sur sa face interne 131 A un rebord annulaire 131 B destiné à s'appuyer contre le bord supérieur de la partie de montage 120 de l'implant rachidien 100 et ledit rebord annulaire 132B dudit bouchon fileté 132 est apte à prendre appui sur le rebord annulaire 131 B de ladite bague 131. Bien entendu, selon une variante non représentée, on peut prévoir que le bouchon fileté et la bague forment une seule pièce monobloc. Selon une autre caractéristique préférentielle de l'implant rachidien 100 conforme à l'invention, comme le montre également la figure 2B, avant montage sur ladite partie de montage 120 de l'implant, le corps fileté 133A de la vis de verrouillage 133 est vissé dans un conduit traversant 132A au moins partiellement taraudé dudit bouchon fileté 132 de manière à permettre le serrage du bouchon fileté 132 dans la partie de montage 120 par l'intermédiaire de la vis de verrouillage 133. À cet effet, la vis de verrouillage 133 comporte une tête de préhension 133B qui émerge du bouchon fileté 132 et qui est munie d'un témoin de serrage 133D. La tête de préhension 133B se présente sous la forme d'un fût globalement cylindrique de révolution d'axe X et comporte à une extrémité accessible au chirurgien une empreinte 133E de réception de l'extrémité d'un outil de vissage. Ici l'empreinte 133E est une empreinte hexagonale. Le témoin de serrage 133D est un anneau qui entoure la base de la tête de préhension 133B de la vis de verrouillage et qui est lié à celle-ci par un lien frangible apte à se rompre par cisaillement sous l'effet d'un couple de serrage donné. Comme le montre la figure 2B, l'anneau 133D porté par la tête de préhension 133 est destiné à prendre appui sur ledit bouchon fileté 132 lors du vissage du corps fileté 133A de la vis de verrouillage 133 dans ledit bouchon fileté 132. À son autre extrémité, la tête de préhension 133B est reliée au corps fileté 133A de la vis de verrouillage 133 par une partie 133C cylindrique de plus faible résistance qui est apte à se rompre par torsion sous l'effet d'un couple de serrage donné. Cette partie 133C cylindrique de plus faible résistance constitue un a utre témoin de serrage de la vis de verrouillage 133. Avantageusement, la vis de verrouillage 133 est une pièce monobloc. La mise en place de l'implant rachidien 100 sur une vertèbre 1 est réalisée par le chirurgien de la manière suivante. Le chirurgien ancre la partie d'ancrage 110 de l'implant dans la vertèbre de sorte qu'il a accès à sa partie de montage 120. Puis, il place à l'aide d'un outil, comme la pince représentée sur la figure 3, la tige de liaison 10 plus ou moins cintrée dans le fond 123 du logement taraudé 121 de ladite partie de montage 120. Tout en maintenant la tige de liaison 10 en place dans la partie de montage 120 à l'aide de la pince, il prend à l'aide d'un outil de vissage non représenté les moyens de verrouillage 130 assemblés de la manière représentée sur la figure 2B, c'est-à-dire avec le bouchon fileté 132 solidarisé à la bague 131 et la vis de verrouillage 133 vissée dans ledit bouchon fileté 132 de sorte que l'anneau 133D est en appui sur ce dernier, pour visser le bouchon fileté 132 dans le logement taraudé 121 de la partie de montage 120 de l'implant. Lors de cette opération de vissage ou de serrage du bouchon fileté 132 , la bague 131 coulisse sur ladite partie de montage 120 et empêche l'écartement de ses branches. La butée formée par l'anneau 133D en appui contre le bouchon fileté 132 permet de lier ladite vis de verrouillage 133 audit bouchon fileté 132 de sorte que le vissage de la vis de verrouillage 133 entraîne celui dudit bouchon fileté 132. Le chirurgien visse ou serre le bouchon fileté 132 dans ledit logement taraudé 121 de la partie de montage 120 de l'implant jusqu'à ce que le rebord annulaire 131 B de la bague 131 vienne en appui contre la partie de montage 120 et que le couple de serrage appliqué à la vis de verrouillage 133 et donc transmis au bouchon fileté provoque la rupture par cisaillement du lien frangible reliant l'anneau 133D à ladite vis de verrouillage 133. La désolidarisation de l'anneau 133D indique au chirurgien que le bouchon fileté 132 est serré correctement à un couple de serrage donné dans le logement taraudé 121 de la partie de montage 120 de l'implant. Cela veut dire notamment que tous les filets du filetage dudit bouchon fileté 132 coopèrent ou sont en prise avec les filets du taraudage dudit logement taraudé 121. Puis, le chirurgien continue à visser la vis de verrouillage 133 dans ledit bouchon fileté 132. Du fait que la vis de verrouillage 133 est désolidarisée en rotation du bouchon fileté 132, elle traverse celui-ci pour venir en appui contre la tige de liaison 10 placée dans le fond 123 du logement taraudé 121 de la partie de montage 120. Le chirurgien serre alors la vis de verrouillage 133 dans ledit bouchon fileté 132 jusqu'à ce que le couple de serrage appliquée à la vis de verrouillage 133 provoque la rupture par torsion de la partie 133C de plus faible résistance reliant le corps fileté 133A de la vis de verrouillage 133 à sa tête de préhension 133B. Lorsque cette rupture a eu lieu, le verrouillage de l'implant 100 est terminé et la tige de liaison 10 est bloquée en translation et en rotation dans le fond 123 du logement taraudé 121 de la partie de montage de l'implant 100. L'immobilisation de la tige de liaison 10 dans ledit logement taraudé 121 de la partie de montage 120 est réalisée exclusivement par la vis de verrouillage 133 puisque après serrage ni le bouchon fileté 132 ni la bague 131 n'est en contact avec ladite tige de liaison. Un tel implant rachidien 100 assemblé avec la tige de liaison 10 est utilisé pour traiter des arthroses, des fractures vertébrales ou pour corriger des déviations de la colonne telles qu'une scoliose ou une cyphose. La présente invention n'est nullement limitée au mode de réalisation décrit et représenté mais l'homme du métier pourra y apporter toute variante conforme à son esprit. - Figure 3 is a schematic perspective view of several spinal implants according to the invention placed on vertebrae. In Figures 1, 2A and 2B there is shown a spinal implant 100 which has an anchoring portion 110 to a vertebra. Here, the spinal implant 100 is a pedicle screw whose anchoring part is a threaded body 110 capable of being anchored by screwing into the pedicle of the vertebra 1 considered (see FIG. 3). However, according to a variant embodiment not shown, the spinal implant according to the invention can be a pedicle hook, the anchoring part of which is a hook capable of hanging on the pedicle of the vertebra considered. The spinal implant 100 further comprises a mounting part 120 surmounting the anchoring part 110. This mounting part 120 generally extends along the axis X of the anchoring part 110. It comprises a threaded housing 121 open on the side opposite to the anchoring part 110, comprising opposite lateral openings 122 to receive in its bottom 123 a connecting rod 10 which extends on either side of said mounting part to make the link with one or several other 100 spinal implants of the same type (see Figure 3). Here the anchoring part 110 and the mounting part 120 of the spinal implant 100 form a single piece. However, according to a variant not shown, provision can be made for the anchoring and mounting parts of the implant to be separate parts assembled together. In this case, the bottom of the threaded housing of the mounting part has a through hole in which the head of the anchoring part is engaged. The spinal implant 100 further comprises locking means 130 intended to cooperate with said mounting part 120 to block the connecting rod 10 inside said threaded housing 121. As shown more particularly in FIGS. 2A and 2B, these locking means 130 comprise: - a ring 131 intended to be positioned on said mounting part 120, - a threaded plug 132 intended to be screwed into said threaded housing 121 of the mounting part 120, and - a locking screw 133 having a threaded body 133A intended to be screwed through said threaded plug 132 to bear against said connecting rod and block it in abutment against the bottom 123 of the threaded housing 121 of the mounting part 120 of the spinal implant 100. FIG. 2B shows said locking means 130 of the spinal implant 100 ready for use before mounting on said mounting part 120. Advantageously, according to the invention, as shown in FIG. 2B, the threaded plug 132 and the ring 131 are integral with each other before mounting on said mounting part 120 of the spinal implant 100. Here the threaded plug 132 and said ring 131 are two separate parts assembled together by means of complementary locking means cooperating with one another. Preferably, the threaded plug 132 comprises a head whose annular rim 132B is capable of being force-fitted into said ring 131. More particularly, said ring 131 carries on its internal face 131 A an annular rim 131 B intended to bear against the upper edge of the mounting part 120 of the spinal implant 100 and said annular flange 132B of said threaded plug 132 is able to bear on the annular flange 131 B of said ring 131. Of course, according to a variant not shown, may provide that the threaded plug and the ring form a single piece. According to another preferred characteristic of the spinal implant 100 according to the invention, as also shown in FIG. 2B, before mounting on said mounting portion 120 of the implant, the threaded body 133A of the locking screw 133 is screwed in a through duct 132A at least partially tapped with said threaded plug 132 so as to allow the threaded plug 132 to be tightened in the mounting part 120 by means of the locking screw 133. For this purpose, the locking screw 133 comprises a gripping head 133B which emerges from the threaded plug 132 and which is provided with a tightening indicator 133D. The gripping head 133B is in the form of a generally cylindrical barrel of revolution of axis X and comprises at one end accessible to the surgeon an imprint 133E for receiving the end of a screwing tool. Here the imprint 133E is a hexagonal imprint. The tightening indicator 133D is a ring which surrounds the base of the gripping head 133B of the locking screw and which is linked to the latter by a frangible link capable of breaking by shearing under the effect of a couple of given tightening. As shown in FIG. 2B, the ring 133D carried by the gripping head 133 is intended to bear on said threaded plug 132 when the threaded body 133A of the locking screw 133 is screwed into said threaded plug 132. At its other end, the gripping head 133B is connected to the threaded body 133A of the locking screw 133 by a cylindrical portion 133C of lower resistance which is capable of breaking by torsion under the effect of a given tightening torque. This lower resistance cylindrical part 133C constitutes a further tightening indicator for the locking screw 133. Advantageously, the locking screw 133 is a single piece. The placement of the spinal implant 100 on a vertebra 1 is carried out by the surgeon in the following manner. The surgeon anchors the anchoring part 110 of the implant in the vertebra so that he has access to its mounting part 120. Then, he places with the aid of a tool, like the forceps shown in the figure 3, the connecting rod 10 more or less bent in the bottom 123 of the threaded housing 121 of said mounting part 120. While holding the connecting rod 10 in place in the mounting part 120 using the pliers, using a screwing tool not shown, it takes the locking means 130 assembled in the manner shown in FIG. 2B, that is to say with the threaded plug 132 secured to the ring 131 and the screw locking device 133 screwed into said threaded plug 132 so that the ring 133D is supported on the latter, in order to screw the threaded plug 132 into the threaded housing 121 of the mounting part 120 of the implant. During this screwing or tightening operation of the threaded plug 132, the ring 131 slides on said mounting part 120 and prevents the spacing of its branches. The stop formed by the ring 133D bearing against the threaded plug 132 makes it possible to link said locking screw 133 to said threaded plug 132 so that the screwing of the locking screw 133 causes that of said threaded plug 132. The surgeon screws or tightens the threaded plug 132 in said threaded housing 121 of the mounting part 120 of the implant until the annular flange 131 B of the ring 131 comes to bear against the mounting part 120 and the tightening torque applied to the locking screw 133 and therefore transmitted the threaded plug causes the frangible link connecting the ring 133D to the said locking screw to break by shearing. The disengagement of the ring 133D indicates to the surgeon that the threaded plug 132 is tightened correctly to a given tightening torque in the housing threaded 121 of the mounting portion 120 of the implant. This means in particular that all the threads of the thread of said threaded plug 132 cooperate or are engaged with the threads of the thread of said threaded housing 121. Then, the surgeon continues to screw the locking screw 133 in said threaded plug 132. Because the locking screw 133 is disengaged in rotation from the threaded plug 132, it passes through it to come into abutment against the connecting rod 10 placed in the bottom 123 of the threaded housing 121 of the mounting part 120. The surgeon then tightens the locking screw 133 in said threaded plug 132 until the tightening torque applied to the locking screw 133 causes the weakest part 133C to rupture by torsion connecting the threaded body 133A of the locking screw 133 to its gripping head 133B. When this rupture has taken place, the locking of the implant 100 is complete and the connecting rod 10 is blocked in translation and in rotation in the bottom 123 of the threaded housing 121 of the mounting part of the implant 100. The immobilization of the connecting rod 10 in said threaded housing 121 of the mounting part 120 is carried out exclusively by the locking screw 133 since after tightening neither the threaded plug 132 nor the ring 131 is in contact with said connecting rod. Such a spinal implant 100 assembled with the connecting rod 10 is used to treat arthrosis, vertebral fractures or to correct deviations of the spine such as scoliosis or kyphosis. The present invention is in no way limited to the embodiment described and shown, but a person skilled in the art can make any variant which conforms to his spirit.

Claims

REVENDICATIONS
1. Implant rachidien (100) qui comporte :1. Spinal implant (100) which includes:
- une partie d'ancrage (110) à une vertèbre, - une partie de montage (120) comprenant un logement taraudé (121) apte à recevoir dans son fond (123) une tige de liaison (10) s'étendant de part et d'autre de ladite partie de montage (120), et- an anchoring part (110) to a vertebra, - a mounting part (120) comprising a threaded housing (121) capable of receiving in its bottom (123) a connecting rod (10) extending from one side and on the other side of said mounting part (120), and
- des moyens de verrouillage (130) destinés à coopérer avec ladite partie de montage (120) pour bloquer ladite tige de liaison (10) à l'intérieur dudit logement taraudé (121), ces moyens de verrouillage (130) comprenant : o une bague (131) destinée à être positionnée sur ladite partie de montage (120), o un bouchon fileté (132) destiné à être vissé dans ledit logement taraudé (121) de la partie de montage (120), et o une vis de verrouillage (133) dont le corps fileté (133A.) est destiné à être vissé au travers dudit bouchon fileté (132) pour prendre appui contre ladite tige de liaison (10), caractérisé en ce que le bouchon fileté (132) et la bague (131) sont solidaires l'un de l'autre avant montage sur ladite partie de montage (120) de l'implant, en ce que le corps fileté (132) de la vis de verrouillage (133) est vissé dans ledit bouchon fileté (132) de manière à permettre le serrage du bouchon fileté (132) dans la partie de montage (120) par l'intermédiaire de la vis de verrouillage (133), et en ce que ladite vis de verrouillage (133) comprend à cet effet une tête de préhension (133B) qui émerge dudit bouchon fileté (132) et qui est munie d 'un témoin de serrage (133D) adapté à signaler au chirurgien que le bouchon fileté (132) est vissé dans la partie de montage de l'implant à un couple de serrage donné. - locking means (130) intended to cooperate with said mounting part (120) for locking said connecting rod (10) inside said threaded housing (121), these locking means (130) comprising: o a ring (131) intended to be positioned on said mounting part (120), o a threaded plug (132) intended to be screwed into said threaded housing (121) of the mounting part (120), and o a locking screw (133) whose threaded body (133A.) Is intended to be screwed through said threaded plug (132) to bear against said connecting rod (10), characterized in that the threaded plug (132) and the ring ( 131) are integral with each other before mounting on said mounting portion (120) of the implant, in that the threaded body (132) of the locking screw (133) is screwed into said threaded plug ( 132) so as to allow the threaded plug (132) to be tightened in the mounting part (120) by means of area of the locking screw (133), and in that said locking screw (133) for this purpose comprises a gripping head (133B) which emerges from said threaded plug (132) and which is provided with a tightening indicator (133D) suitable for signaling to the surgeon that the threaded plug (132) is screwed into the mounting part of the implant at a given tightening torque.
2. Implant rachidien (100) selon la revendication 1 , caractérisé en ce que la vis de verrouillage (133) est munie d'un autre témoin de serrage (133C). 2. Spinal implant (100) according to claim 1, characterized in that the locking screw (133) is provided with another tightening indicator (133C).
3. Implant rachidien (100) selon la revendication 2, caractérisé en ce que l'autre témoin de serrage est une partie (133C) de plus faible résistance qui relie ladite tête de préhension (133B) audit corps fileté (133A) de la vis de verrouillage (133) et qui est apte à se rompre par torsion sous l'effet d'un couple de serrage donné. 3. Spinal implant (100) according to claim 2, characterized in that the other tightening indicator is a part (133C) of lower resistance which connects said gripping head (133B) to said threaded body (133A) of the screw lock (133) and which is capable of breaking by torsion under the effect of a given tightening torque.
4. Implant rachidien (100) selon l'une des revendications 1 à 3, caractérisé en ce que ledit témoin de serrage est un anneau (133D) entourant la base de ladite tête de préhension (133B) de la vis de verrouillage (133), destiné à prendre appui sur ledit bouchon fileté (132) lors du vissage du corps fileté (133A) de ladite vis de verrouillage (133) dans ledit bouchon fileté (132), et lié à ladite tête de préhension (133B) par un lien frangible apte à se rompre par cisaillement sous l'effet d'un couple de serrage donné. 4. Spinal implant (100) according to one of claims 1 to 3, characterized in that said tightening indicator is a ring (133D) surrounding the base of said gripping head (133B) of the locking screw (133) , intended to bear on said threaded plug (132) when the threaded body (133A) of said locking screw (133) is screwed into said threaded plug (132), and linked to said gripping head (133B) by a link frangible capable of breaking by shearing under the effect of a given tightening torque.
5. Implant rachidien (100) selon l'une des revendications 1 à 4, caractérisé en ce que ledit bouchon fileté (132) et lad ite bague (131) sont deux pièces distinctes assemblées entre elles par l'inte rmédiaire de moyens de blocage complémentaires coopérant entre eux. 5. Spinal implant (100) according to one of claims 1 to 4, characterized in that said threaded plug (132) and lad ite ring (131) are two separate parts assembled together by means of blocking means complementary cooperating with each other.
6. Implant rachidien (100) selon la revendication 5, caractérisé en ce que le bouchon fileté (132) comprend une tête apte à être emmanchée en force dans ladite bague (131). 6. Spinal implant (100) according to claim 5, characterized in that the threaded plug (132) comprises a head capable of being force fitted into said ring (131).
7. Implant rachidien (100) selon l'une des revendicationsl à 6, caractérisé en ce que ladite bague (131) porte sur sa face interne (131 A) un rebord annulaire (131 B) destiné à s'appuyer contre le bord supérieur de la partie de montage (120). 7. spinal implant (100) according to one of claimsl to 6, characterized in that said ring (131) carries on its internal face (131 A) an annular rim (131 B) intended to bear against the upper edge of the mounting part (120).
8. Implant rachidien (100) selon la revendication 7, caractérisé en ce que ledit bouchon fileté (132) comprend en tête un rebord (132B) apte à prendre appui sur le rebord annulaire (131B) de ladite bague (131). 8. Spinal implant (100) according to claim 7, characterized in that said threaded plug (132) comprises at the head a rim (132B) capable of bearing on the annular rim (131B) of said ring (131).
9. Implant rachidien (100) selon l'une des revendications 1 à 4, caractérisé en ce que le bouchon fileté (132) et la bague (131) forment une seule pièce monobloc. 9. Spinal implant (100) according to one of claims 1 to 4, characterized in that the threaded plug (132) and the ring (131) form a single piece.
10. Implant rachidien (100) selon l'une quelconque des revendications précédentes, caractérisé en ce que ladite tête de préhension (133B) de la vis de verrouillage (133) comporte à une extrémité une empreinte (133E) de réception de l'extrémité d'un outil de vissage. 10. Spinal implant (100) according to any one of the preceding claims, characterized in that said gripping head (133B) of the locking screw (133) has at one end an imprint (133E) for receiving the end a screwing tool.
1 1. Implant rachidien (100) selon l'une quelconque des revendications précédentes, caractérisé en ce que ladite vis de verrouillage (133) est une pièce monobloc. 1 1. Spinal implant (100) according to any one of the preceding claims, characterized in that said locking screw (133) is a single piece.
PCT/FR2004/002346 2003-09-17 2004-09-16 Locking rachidial implant provided with a tightness indicator WO2005027761A1 (en)

Applications Claiming Priority (2)

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FR0310905A FR2859620B1 (en) 2003-09-17 2003-09-17 SPINAL IMPLANT HAVING LOCKING MEANS WITH CLAMPING WRENCH
FR0310905 2003-09-17

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WO2005027761A1 true WO2005027761A1 (en) 2005-03-31

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US8641734B2 (en) 2009-02-13 2014-02-04 DePuy Synthes Products, LLC Dual spring posterior dynamic stabilization device with elongation limiting elastomers
US9320543B2 (en) 2009-06-25 2016-04-26 DePuy Synthes Products, Inc. Posterior dynamic stabilization device having a mobile anchor
US9161782B2 (en) 2009-10-16 2015-10-20 DePuy Synthes Products, Inc. Bone anchor assemblies and methods of manufacturing and use thereof
US9445844B2 (en) 2010-03-24 2016-09-20 DePuy Synthes Products, Inc. Composite material posterior dynamic stabilization spring rod

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FR2859620B1 (en) 2006-05-19

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