Surgery – Instruments – Orthopedic instrumentation
Patent
1996-02-27
1998-08-25
Buiz, Michael
Surgery
Instruments
Orthopedic instrumentation
606 54, 606 59, A61B 1770
Patent
active
057979103
DESCRIPTION:
BRIEF SUMMARY
The invention concerns operative equipment for correcting a spinal deformity prior to the installation of implanted spinal instrumentation such as an osteosynthetic device, an intervertebral device for treating instabilities or a corrective dynamic implanted orthosis, or other such.
BACKGROUND OF THE INVENTION
Spinal osteosynthetic devices are already known for treating scoliotic deformities, consisting of components for anchoring to the vertebrae, such as hooks or intrapedicular screws, and rods or frames fixed to the anchoring components to impose a relative position on the different vertebrae. These rigid, semi-rigid or semi-flexible osteosynthetic devices rigidify the spinal column in the corrected position and are more often associated with an intervertebral arthrodesis with or without a bone graft.
These known osteosynthetic devices still present many problems as regards the installation and stability of the anchoring components, and the attachment of rods, plates or frames to the anchoring components, which must be carried out simultaneously to reduce deformity.
Thus, reducing deformity by installing an osteosynthetic device still presents problems. In point of fact, it must be possible to produce this reduction in deformity at the same time as, and by the attachment of, vertebral instrumentation, and this in three dimensions. In particular, with a scoliosis, it is advisable not only to reposition the vertebrae in the same sagittal plane, but also to re-establish the kyphosis and/or the lordosis while carrying out a derotation of the vertebrae. Osteosynthetic devices of the Cotrel-Dubousset type enable this problem to be partially resolved. They consist of two posterior bilateral rods, arched during the operation, immediately before their attachment to the anchoring components, in relation to the lateral deviation, then turned through 90.degree. to place their curvature in a sagittal plane in order to re-establish the kyphosis or lordosis and to carry out a derotation of the vertebrae, at least partially. The correction is limited by the fact that it is carried out only by the rod of the concavity which is first turned and then attached to the anchoring components: it thus stabilizes the correction obtained but it practically annuls any corrective potential of the rod of the convexity which only has a stabilizing effect through its insertion and attachment. The two rods are then connected together by transverse tensioning rods stabilizing the assembly in the position obtained. Even if the curvature of the rods can be adjusted, after their insertion, by the lever arms, the latter can ensure the desired kyphosis or lordosis but they do not allow satisfactory derotation of the vertebrae to be achieved.
Other types of osteosynthetic devices are employed for treating spinal deformities and use sub-laminar wires connected to rods (Luque) or to frames (Dove) or connect plates or rods while engaging the vertebrae by means of hooks and/or intrapedicular screws. Apart from the risk of neurological complications presented by these systems through the entry of equipment into the canal, their potential for correcting vertebral deformities remains limited and incomplete.
Moreover, it is also desirable to have available operative equipment suitable for installing new dynamic orthoses which preserve the physiological mobility of the vertebrae and comprise means for elastic return which has to be installed extended, and has the characteristics that must be determined prior to this installation to ensure that the resulting correction is maintained, and to permit movements in the instrumented vertebral zone.
Known operative equipment consisting of single clamps with two articulated arms and exerting forces of distraction or compression, does not resolve the various problems associated with total correction of spinal deformities.
Kluger has described operative equipment for the correction of vertebral collapse (traumatic or tumoral) by supporting the two adjacent vertebrae, the separation of which is achieved by a d
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Buiz Michael
Dutton, Jr. Harold H.
Fairant Paulette
Shai Daphna
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