Surgery – Instruments – Orthopedic instrumentation
Reexamination Certificate
1999-08-06
2001-10-02
Mancene, Gene (Department: 3732)
Surgery
Instruments
Orthopedic instrumentation
C606S090000, C606S064000, C623S017110
Reexamination Certificate
active
06296647
ABSTRACT:
BACKGROUND OF THE INVENTION
1. Field of the Invention.
The invention relates to an instrument for removing vertebra and positioning an implant in the human spine as a replacement for one or more vertebrae.
2. Discussion of the Prior Art.
With diseases of the human spine it is increasingly necessary to remove one or more vertebra or vertebral bodies. After the removal a replacement implant must be inserted which assumes the load on the spine. To accomplish this, various devices are known. Primarily, cage-like bodies are utilized which are adapted to the shape of the vertebra body and leave adequate possibilities for the bone material to grow in. Additionally it is however necessary to attach a stabilizing implant which rigidly connects bordering healthy vertebra bodies to one another. The vertebra body space retainers although mostly in the position to transmit pressure forces, may however not carry out a lateral stabilization.
The implantation of such implants is effected from the front side of the patient, wherein the implant is inserted laterally into the spine. Before the insertion, as mentioned a clearing out of the diseased vertebra body and a dissection of the invertebral disc is required. With the present invention an instrument is created for the implantation of such implants in a way and manner which is simple as possible and which is gentle on the patient. Furthermore there is to be created a possibility of setting the healthy vertebral body or keeping it at a distance during the preparation work.
SUMMARY OF THE INVENTION
With the instrumentation according to the invention there are provided vertebra body plates which may be attached to the healthy vertebra body. The vertebra body plates may be part of the implant to be implanted, or plates attached separately to a rod. In this case, the plates temporarily may be brought into engagement with the healthy vertebra body and then removed. The instrumentation according to the invention further envisages distraction rods which are connectable at one end to each of the vertebra body plates. In the case of a removable plate the plate may be formed as one piece with the distraction rod. If the vertebra body plate is formed as part of the final implant the distraction rod is a separate piece and is preferably connected to the vertebra plate via a threaded connection.
The instrumentation according to the invention further envisages two U-shaped parts, whose limbs cooperate in a telescopic manner and form a tubular housing around the already attached distraction rods, wherein the U-shaped parts comprise inner sections which are supported on the distraction rods. The U-shaped parts or the tubular housing formed by them forms a type of tunnel which keeps soft parts away from the operating region and permits an access without hindrance to the operating region.
Finally there is provided a distraction instrument which is connectable to the other end of the distraction rods opposite the vertebra body plates for applying a force onto the rods transversely to their longitudinal extension. In this manner the vertebrae may be moved apart or the distance between the vertebrae may be retained.
According to one embodiment of the invention there are two vertebra plates which are formed approximately L-shaped with a first limb which bears against an end surface of the vertebral column or on the invertebral disk and with a second limb which bears on the circumferential surface of the vertebra body and which can be attached to this by a screw. The second limb comprises a threaded hole for screwing it to a distraction rod or an implant rod. Both plates may be identical.
In order to create the possibility of attaching a vertebra plate quite early to the healthy vertebra body or of setting the healthy vertebra, before the replacement implant is inserted, in another embodiment of the invention it is useful when a section of the replacement implant, which faces a vertebra body, comprises a receiving section and the first limb of the vertebra plate and the receiving section are formed such that the replacement implant may be inserted into a space cleared of one or more vertebra bodies whilst the vertebra plates are already attached to bone. For example the cooperating sections may comprise dovetail guides so that in the axial direction a secure connection between the vertebra plate and replacement implant is created.
Such an implant is described in our copending application Ser. No. 09/369,271 filed Jul. 22, 1999, the teachings of which are incorporated herein by reference.
So that no unnecessary injuries may take place the web of the U-shaped parts are curved outwardly in a circular arc shaped manner. According to another embodiment of the invention on the inner side they comprise a fork or jaw-shaped section which is supported on a distraction rod and may partially surround the same.
It is useful after adjustment that the U-shaped parts bearing on the distraction rib are fixed to one another in their position, since for the operation procedures it is also necessary to remove the distraction rods in order to carry out further manipulations. Therefore one embodiment of the invention envisages that on a lateral end edge of one limb a U-shaped part comprises a row of recesses and on the other U-shaped part there is linked a bar with a lateral peg which lockingly is introduceable into one of the recesses. The recesses may comprise a narrow location and the locking peg comprises an elongate cross section and is rotatably mounted in the bar. In the one rotational position the peg is therefore lockingly fixed in a recess, whilst in another position, for example rotated about 90°, it may be moved out of the recess.
According to another requirement it may also be necessary to lengthen the housing or the tunnel. One formation of the invention envisages that two or more pairs of U-shaped parts are provided which are formed so that they may be stuck onto one another.
A distraction frame according to a further embodiment of the invention is provided with two jaws of which one is attached to a connection piece in a rigid manner and the other adjustable in steps. Onto the jaws there are attached receiving pieces for the distraction rods, wherein the one receiving piece is adjustable with respect to the rigid receiving piece by way of a threaded spindle. In this manner a coarse and fine adjustment for the distraction procedure is created.
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Kotz Rainer
Lutz Christian
Robioneck Bernd
Vlasak Richard
Windhager Reinhard
Lerner David Littenberg Krumholz & Mentlik LLP
Mancene Gene
Priddy Michael B.
Stryker Trauma GmbH
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