Surgery – Instruments – Orthopedic instrumentation
Patent
1995-05-10
1997-12-30
Buiz, Michael
Surgery
Instruments
Orthopedic instrumentation
606 73, A61B 1770
Patent
active
057023956
DESCRIPTION:
BRIEF SUMMARY
The present invention relates to a spinal osteosynthesis instrumentation for an anterior approach.
In the field of spinal instrumentation, instrumentation for a posterior approach has been widely explored and still remains an interesting solution in many pathological cases.
However, this technique has the drawback of not permitting direct access to the vertebral bodies, which often limits the use thereof and encourages an exploration of another approach, such as the anterior approach.
Although it is much more delicate and complex than the instrumentation for a posterior approach, the instrumentation for an anterior approach opens up a wider field of investigation. It is becoming necessary to investigate this field despite the fact that this approach requires considerable technical means and environment in the hospital and a specific training of very highly specialized orthopaedic surgery practitioners.
Depending on the vertebral level to be reached, several techniques of access by an anterior approach are at present practiced. They are:
For each of these techniques, the approach on the left side of the vertebral column is preferred despite the proximity of the aorta, owing to the presence on the right side of the vena cava which is more fragile and less easy to move than the aorta.
However, the extension of the large vessels along the vertebral bodies has repercussions on the mounting of an instrumentation.
The technique by the anterior approach of the dorsolumbar spine is employed: kyphosis.
Some surgeons are afraid of this technique; however, it is acknowledged to favour the treatment of certain pathologies. It is even indispensable in certain cases.
Whatever be the surgical schools of thought formed around spinal instrumentation, all surgeons acknowledge the following advantages of this technique: correction of dorso-lumbar scolioses; correction of cyphoses, and an improved nerve decompression; and in the median region of the column;
Reduced medullary risks owing to a direct approach to the marrow and the necessity of distraction by a posterior action.
These advantages are of course not exhaustive and there could also be mentioned: an improved decompression, the non-destruction and therefore the preservation of the posterior stabilizing elements such as the muscles and ligaments, etc.
Resulting from the interest of the development of instrumentation for an anterior approach, many technical propositions have been made which may be resumed as follows:
Devices employing plates or the like fixed at the ends of the latter to the vertebrae located on each side of the vertebral region to be treated;
Devices employing rods, usually two rods, stiffened therebetween by transverse bars to which they are fixed thus forming a rectangular frame.
Each of the proposed structures has its specific advantages but also its drawbacks, with the result that the considered instrumentation is not or relatively rarely employed.
Two known examples may be mentioned: a rigid plate. Such a device corresponds to the specific requirements of fractures and tumors and of the degenerative field, but is hardly suitable for vertebral deviations.
French patent 2653413 (9001970, inventor J. DUBOUSSET) proposes the use of two metal rods fixed along the vertebral column and interconnected transversely by two rigid bars, which imparts to the instrumentation a rectangular frame arrangement.
This solution is well suited to the problems of spinal deviations, but does not satisfy all the technological and surgical requirements.
In particular, the large number of parts making up the instrumentation implies a relatively long operating time and consequently this instrumentation, although effective, is costly, which hinders its extension and marketing. In brief, the instrumentation for an anterior approach is very delicate and represents for the surgeons a high risk that technological innovation must attempt to reduce as far as possible.
Therefore, an object of the invention is to provide an instrumentation which permits overcoming these shortcomings a
REFERENCES:
patent: 4289123 (1981-09-01), Dunn
patent: 5030220 (1991-07-01), Howland
patent: 5074864 (1991-12-01), Cozad et al.
patent: 5108395 (1992-04-01), Laurain
patent: 5147360 (1992-09-01), Dubousset
patent: 5152303 (1992-10-01), Allen
patent: 5312405 (1994-05-01), Korotko et al.
patent: 5330473 (1994-07-01), Howland
Buiz Michael
Reip David O.
Sofamor S.N.C.
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