Device for assisting in the attachment of a surgical implant after placement, namely an intervertebral cage

Abstract

The invention relates to a device for assisting in the attachment of a surgical implant after placement, namely an intervertebral cage, in particular a cage intended to be used at a facet joint, wherein the implant (2) is intended to be inserted into a bone cavity and to be attached thereto by means of at least one screw or the like that passes through the bone material before reaching the implant (2) and penetrating a hole (20) therein, which screw or the like is then screwed into the bone material. It comprises, in combination with means (31) for holding the implant (2) which are designed to be capable of holding the implant (2) while the implant is arranged in the bone cavity, drill guide means (42) which are fixedly connected to the holding means (31) through conformable connecting means (40, 41) so that the drilling axis (X) is aligned with the hole (20).

Description

[0001] DEVICE FOR ASSISTANCE IN THE FIXATION OF A SURGICAL IMPLANT, NAMELY AN INTERVERTEBRAL CAGE, AFTER PLACEMENT THEREOF

[0002] The present invention relates to a device for assisting in the fixing of a surgical implant after its placement, and more particularly of a cage of the intervertebral cage type such as a cage intended to be used at the level of a facet joint.

[0003] In the field of orthopedic surgery, certain implants, not limited to cage-type implants, require immobilization using one or more screws. Inserting a screw sometimes requires prior drilling, which must of course be carried out not only in the correct location but also along a precise axis.

[0004] When the screw is intended to first pass through the implant and then be screwed into the bone material, it is common to use drilling templates, placed in the space intended to receive the implant, to serve as a guide for drilling.

[0005] When the screw has to be screwed into the bone material then into the implant and then into the bone material again, it is not possible to use a template, and it is common to resort to X-ray images, with the disadvantage of having to take several and therefore, in addition to a probable extension of the duration of the intervention, a risk of overexposure to radiation for the patient, and even for the medical staff.

[0006] Documents US2019216454 and US2012 / 022533 disclose devices for performing aiming. They are particularly intended to be used for the placement of an intramedular nail. These devices are so bulky that they cannot be adapted to the placement of a cage of the type intended for use at the level of a facet joint.

[0007] The present invention aims to remedy the aforementioned drawbacks by proposing a device for assisting in the fixing of a surgical implant such as a cage intended for

[0008] RECTIFIED SHEET (RULE 91) ISA / EP to be used at the level of a facet cage joint, after it has been put in place.

[0009] The device for assisting in fixing a surgical implant, namely a cage intended to be used at the level of a facet joint after its installation, where said cage is intended to be introduced into a bone cavity, to be fixed there by means of at least one screw or the like by passing through the bone material before reaching said cage and penetrating an orifice thereof, then being screwed into the bone material, comprising, in association with means for holding said cage designed to hold said implant cage while it is arranged in said bone cavity, drilling guide means, fixedly connected to said holding means through conformable connecting means so that the drilling axis is aligned with said orifice, is characterized in that it incorporates an implant-holder part which comprises said means for holding the cage, and which cooperates with a sighting part,which comprises means for receiving and securing said implant-holder part, said implant-holder part being in the form of a bar, one end of which is provided with said means for holding the implant, while the opposite part comprises a gripping portion, and an intermediate zone is intended for securing said aiming part.,

[0010] The assistance device according to the invention can thus be intended to be used with existing implant holders, and for this purpose the connecting means are designed to be able to allow the orientation and positioning of the implant relative to the drilling axis.

[0011] It is also possible to use an implant holder specifically dedicated to the type of implant, not requiring prior adjustments.

[0012] Thus, according to a particular embodiment of the assistance device according to the invention, it incorporates an implant-holder part which comprises the means for holding the implant, and which cooperates with an aiming part, which comprises means for receiving and securing said implant-holder part.

[0013] RECTIFIED SHEET (RULE 91) ISA / EP According to an additional characteristic of the assistance device according to the invention, the aiming part is in the form of a bar comprising at one end means for cooperating with a drilling tool, and at its other end means for receiving the part.

[0014] According to another additional characteristic of the assistance device according to the invention, the receiving means consist of a sleeve whose characteristics allow a portion of the implant-holder part to be introduced therein, while a screw passes through the wall of said sleeve so that it can be screwed into the implant-holder part, in a tapped hole forming an indexing means.

[0015] According to another additional characteristic of the assistance device according to the invention, the implant-holder part is shaped, in bending and / or in torsion, according to the characteristics of the implant and the conditions of its insertion, while the aiming part is shaped, in particular by the choice of the directions of the axis (Y) of attachment of the implant-holder part and of the drilling axis, to take into account the particular conformation of said implant-holder part.

[0016] It is indeed important that the implant holder does not constitute an obstacle to the surgeon's visualization of the site, it must therefore offer sufficient clearance within the limits of possibilities, whether it is straight or curved, the characteristics of this conformation of the implant holder part are therefore taken into account at the level of the different axes of the aiming part.

[0017] According to another additional characteristic of the assistance device according to the invention, the means for holding the implant consist of screwing means.

[0018] According to another additional characteristic of the assistance device according to the invention, the means for holding the implant consist of pinching means.

[0019] The advantages and characteristics of the assistance device according to the invention will emerge more clearly from the description which follows and which refers to the appended drawing, which represents a non-limiting embodiment thereof.

[0020] In the attached drawing:

[0021] Figure 1 shows a schematic perspective view of a device for assisting in the fixation of an implant.

[0022] RECTIFIED SHEET (RULE 91) ISA / EP surgical after placement thereof and according to the invention,

[0023] Figure 2 represents a plan view of a part of the same device,

[0024] Figure 3 shows a perspective view of the same part.

[0025] With reference to figure 1, one can see, according to the invention, a device 1 for assisting in the fixing of a surgical implant 2 after its placement.

[0026] In this case, the implant 2 consists of a cage intended to be used at the level of a facet joint. The cage must be introduced into a cavity, and fixed there by means of at least one screw, not shown, which must be introduced into a drilling, then into an orifice 20 of the implant, and finally screwed into the bone material. The assistance device 1 according to the invention is intended to allow the drilling to be carried out in the bone material, without vision of the orifice 20.

[0027] The assistance device 1 comprises two parts, an implant-holder part 3 and a sighting part 4.

[0028] The implant-holder part 3 is in the form of a bar 30, one end of which is provided with means 31 for holding the implant 2, while the opposite part comprises a gripping portion 32, and an intermediate zone 33 is intended for securing the aiming part 4.

[0029] The aiming part 4 is also in the form of a bar 40, which comprises at one end means 41 for receiving and securing the implant-holder part 3, and at its other end means 42 for cooperating with a drilling tool, not shown.

[0030] The receiving and securing means 41 are in the form of a sleeve or the like 43, comprising a hole 44 into which the bar 30 of the implant-carrying part 3 is introduced, and immobilized at its portion 33. A screw 45 is screwed into the sleeve or the like 43 and into the portion 33, perpendicular to the axis of the implant-carrying part 3, in a non-visible tapped hole, for indexing and immobilization purposes.

[0031] The means 42 for cooperating with a drilling tool are configured to ensure a fixed drilling axis X.

[0032] RECTIFIED SHEET (RULE 91) ISA / EP In practice, the implant-holder part 3 allows the implant 2 to be put in place, its gripping portion 32 allowing it to be held, then the aiming part 4 is put in place and it is positioned and immobilized with the screw 45, while maintaining the assembly by the gripping portion 32, finally the drilling is carried out.

[0033] Referring to Figures 2 and 3, a variant of the aiming part 4 of the assistance device 1 according to the invention can be seen.

[0034] In Figure 3 we can see the screw 45 projecting into the hole 44, this screw 45 being operable by means of a wheel 46.

[0035] It can also be seen in these figures that, in addition to the drilling axis X, the insertion axis Y in the hole 44 of the implant-holder part 3, not shown, as well as the axis Z of the bar 40 have been reproduced.

[0036] The implant-holder part 3, not shown but visible in Figure 1, is shaped to facilitate the approach and placement of the implant, and in particular to maintain perfect visualization of the treated area during the intervention; for example, the part between the area 33 and the holding means 31 is curved.

[0037] Also, in order to be able to take into account the particular conformation of the implant-holder part 3, and to position the X axis optimally, the angular corrections are made at the level of the aiming part 4, and as is apparent for example from figure 3, the drilling X axis does not intersect the Y axis due to a twist along the Z axis, while, as is apparent from figure 2, the X axis does not extend in a plane perpendicular to the Y axis.

[0038] To allow interventions on either side of the spine, particularly in the case of the installation of cages intended to be used at the level of the facet joints, and to be able to use the same implant-holder part 3, it is planned to design different aiming parts 4, with in particular symmetrical angular corrections, one for an intervention on the left and the other for an intervention on the right.

[0039] CORRECTED SHEET (RULE 91) ISA / EP

Claims

He claims that he is 1) Device for assisting in the fixing of a surgical implant, namely an intervertebral cage, in particular a cage intended to be used at the level of a facet joint, after placement thereof, where said implant (2) is intended to be introduced into a bone cavity, to be fixed there by means of at least one screw or the like by passing through the bone material before reaching said implant (2) and penetrating an orifice (20) thereof, then being screwed into the bone material, comprises, in association with means (31) for holding said implant (2) designed capable of holding said implant (2) while the latter is arranged in said bone cavity, drilling guide means (42), fixedly connected to said holding means (31) through conformable connecting means (40, 41) so that the drilling axis (X) is aligned with said orifice (20),characterized in that it incorporates an implant-holder part (3) which comprises said means (31) for holding the cage (2), and which cooperates with a sighting part (4), which comprises means (41) for receiving and securing said implant-holder part (3), said implant-holder part (3) being in the form of a bar (30), one end of which is provided with said means (31) for holding the implant (2), while the opposite part comprises a gripping portion (32), and an intermediate zone (33) is intended for securing said sighting part (4)., 2) Assistance device according to claim 1, characterized in that the aiming part (4) is in the form of a bar (40) comprising at one end means (42) for cooperating with a drilling tool, and at its other end the means (41) for receiving the part. 3) Assistance device according to claim 2, characterized in that the receiving means (41) consist of a sleeve (43) whose characteristics allow a portion (33) of the implant-carrying part (3) to be introduced therein, while a screw (45) passes through the wall of said sleeve (43) to be able be screwed into the implant holder part (3), in a tapped hole forming an indexing means 4) Assistance device according to any one of claims 1 to 3, characterized in that the implant-holder part (3) is shaped, in bending and / or in torsion, according to the characteristics of the implant (2) and the conditions of its insertion, while the aiming part (4) is shaped, in particular by the choice of the directions of the axis (Y) of attachment of the implant-holder part (3) and of the drilling axis (X), to take into account the particular conformation of said implant-holder part (3). 5) Assistance device according to any one of claims 1 to 4, characterized in that the means (31) for holding the implant (2) consist of screwing means. 6) Assistance device according to any one of claims 1 to 4, characterized in that the means (31) for holding the implant (2) consist of pinching means.

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