Surgical spacer device for a joint - Patent application

Abstract

The present invention relates to a second end face (103) of a generally cylindrical or frusto-conical body (101) hollow inside and configured for insertion into a traction joint (1, 2), the first end face (102) being generally flat and configured to abut a first bone portion (1) of the joint (1, 2), and the second end face (103) being generally annular and configured to abut a second bone portion (2) of the joint (1, 2) opposite the first bone portion (1), the second end face (103) having a first opening (10) for access to the second bone portion (2). A surgical spacer device (100) for a joint, comprising an end face (103) and at least one side element (104) configured to maintain a spaced three-dimensional structure between the first end face (102) and the second end face (103), the at least one side element (104) defining a second opening (20) configured to allow lateral access to the interior of the body (101) and further access to the second bone portion (2) through the first opening (10).

Description

[Technical field]

[0001] SURGICAL SPACER DEVICE FOR A JOINT FIELD OF THE DISCLOSURE The present invention relates to instruments that may be used in the field of surgery.

[0002] The present invention is particularly useful in the surgical implantation of prosthetic shoulder joints having different types of glenoid components, and the following disclosure will be made with reference to this particular application to simplify its explanation.

[0003] In general, it is not excluded that the present invention may be applied to other types of surgery, such as hip, knee, spine, etc., for maintaining the ends of a joint spaced apart. [Background technology]

[0004] In the field of shoulder prostheses, the use of multiple modular prostheses, typically consisting of multiple elements that can be combined with each other to obtain a prosthesis, either a reverse prosthesis or an anatomical prosthesis, or in some cases to convert an anatomical prosthesis into a reverse prosthesis, is already widespread.

[0005] Some commonly used shoulder prostheses provide for the utilization of a glenoid anchor inserted into a pre-obtained hole substantially in the center of the glenoid. In anatomical prostheses, a polyethylene insert is typically secured onto the glenoid anchor, while in reverse prostheses, a convex glenoid component called a glenosphere is typically secured onto the glenoid anchor.

[0006] In some types of surgical procedures for implanting a shoulder prosthesis, a medial-lateral extending humeral through hole is drilled in the humeral head to provide glenoid-humeral clearance between the humeral head and the glenoid cavity of the scapula for access, surgery, and implantation.

[0007] For this purpose, it is known to provide a retractor device which can be inserted through a deltoid pectoralis major incision to provide space between the humeral head and the glenoid cavity for the insertion of a bone processing instrument.

[0008] An example of a retractor instrument is a simple surgical forceps, but its maneuverability is obviously poor.

[0009] US Patent Application Publication No. 2019 / 216615 refers to a specific retractor surgical instrument for implanting the glenoid component of a shoulder prosthesis having a first annular element that abuts the humeral head to allow access through the humeral through hole and a second generally U-shaped element that bottom-encloses the coracoid process to abut the coracoid process to keep the glenoid free.

[0010] A new challenge is to retract the glenohumeral joint in a stable and precise manner to allow the surgeon to implant the prosthetic component.

[0011] In the prior art, the problem of maintaining the positional stability of the glenohumeral joint once it has been retracted is that in practice the space available to the surgeon is suddenly reduced, with the risk of damaging the patient's anatomical structures, especially the nerves. Summary of the Invention

[0012] SUMMARY OF THE PRESENT EMBODIMENT It is an object of the present invention to provide a surgical device having structural and functional characteristics which overcome the shortcomings of the prior art.

[0013] A further object of the present invention is to allow stable and accurate maintenance of the position of a retracted joint during prosthetic joint implantation surgery.

[0014] A further object of the present invention is to allow the surgeon better visibility and access to the joint area during prosthetic joint implantation surgery.

[0015] The solution idea underlying the present invention is to provide a surgical spacer device configured to penetrate the retracted joint and thus maintain it for the duration of the operation, which can fit within the patient's anatomical structures, in particular the glenoid cavity and the resected humerus.

[0016] Advantageously, insertion of the surgical spacer device creates the space necessary to ensure visibility of the joint and also the possibility to insert further processing instruments, primarily, but not solely, to the glenoid area.

[0017] In accordance with this solution idea, a surgical spacer device for a joint is provided, comprising a generally cylindrical or frustoconical body, hollow and configured for insertion into a retracted joint, the body comprising a first end surface, generally planar and configured to abut a first bone portion of the joint, a second end surface, generally annular and configured to abut a second bone surface of the joint opposite the first bone portion, the second end surface having a first opening for access to the second bone portion, and at least one side element configured to maintain a spaced three-dimensional structure between the first end surface and the second end surface, the at least one side element defining a second opening configured to allow lateral access to the interior of the body and further access to the second bone portion via the first opening.

[0018] Thereby, the same tension that is present in the retracted joint maintains the surgical spacer device in the interposed state, the stability of which is assured without the need for any external personnel to maintain it in place.

[0019] Thus, advantageously, it becomes possible to maintain a stable and accurate joint position during the prosthetic joint implantation procedure.

[0020] Additionally, visibility and access to the joint area is advantageously improved for the operating surgeon during the prosthetic joint implantation procedure.

[0021] Preferably, the first and second end faces of the surgical spacer device are not parallel to one another but are inclined to provide a wedge shape at diametrically opposed portions of the second opening, thereby advantageously facilitating the insertion of the body into the retracted joint.

[0022] Preferably, said first end surface of said body further comprises a hole, advantageously configured for the passage of an instrument or anchor between said first bone portion.

[0023] Moreover, preferably in the surgical spacer device according to the invention, the body is divided into two parts along the coronal plane. Advantageously, by allowing opening of the body into two halves, removal of the surgical spacer device according to the invention is facilitated once the final implant has been placed.

[0024] Further, preferably, in the surgical spacer device according to the present invention, the body may be associated with one or more generally flat modular shims configured to increase the overall thickness in the height direction and to adjust, and in particular increase, the amount of traction of the joint based on surgical requirements.

[0025] Advantageously, a surgical spacer apparatus in accordance with a preferred embodiment of the present invention is configured for insertion into a retracted glenoid joint and the first opening is sized to encompass the glenoid cavity and to allow bone preparation and implantation of the glenoid component of a prosthetic joint. Effect of the Invention

[0026] Further characteristics and advantages of the invention will become apparent from the following detailed description, given for illustrative and non-limiting purposes, and from the claims, which form an integral part of this specification. [Brief description of the drawings]

[0027] [Figure 1] 1 illustrates a perspective view of one embodiment of a surgical spacer apparatus according to the present invention; [Diagram 2] 2 shows a top view of the surgical spacer device of FIG. 1; [Diagram 3] 1 illustrates a perspective view of a surgical spacer apparatus according to the present invention inserted into an anatomical structure and further associated with a surgical instrument; [Figure 4] FIG. 3 shows the view of FIG. 3 with the glenoid component of a shoulder prosthesis added thereto, inserted via a surgical spacer device. [Diagram 5] 1 shows a perspective view of a further embodiment of a surgical spacer apparatus according to the present invention; [Figure 6] The diagram in FIG. 5 shows all of the modular shims installed in their final positions. [Figure 7] 1A-1D show side, rear and medial views of an embodiment of a modular shim of a surgical spacer apparatus according to the present invention. [Figure 8] 7 illustrates a front schematic view of the surgical spacer device of FIG. 6 inserted within an anatomical structure. [Figure 9] 9 illustrates a front schematic view of the surgical spacer apparatus of FIG. 8 further associated with a surgical instrument; [Figure 10] 1 shows a perspective view of a further embodiment of a surgical spacer apparatus according to the present invention in an open configuration; [Figure 11] 1 illustrates a perspective view of yet a further embodiment of a surgical spacer apparatus according to the present invention in an open configuration; [Figure 12] 1 illustrates a perspective view of yet a further embodiment of a surgical spacer apparatus according to the present invention in a closed configuration; [Figure 13] 13 shows a cross-sectional view of the surgical spacer device of FIG. 12. [Figure 14] 13 shows a perspective view of a further embodiment of a surgical spacer apparatus according to the present invention made in a single piece; DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0028] In the different drawings, like elements are designated by like reference numbers.

[0029] FIG. 1 illustrates a perspective view of one embodiment of a surgical spacer apparatus 100 in accordance with the present invention.

[0030] The surgical spacer device 100 includes a body 101 that is generally cylindrical or frusto-conical and hollow therein.

[0031] As will be further explained, the body can be made in two versions, either one that is of one-piece construction or one that is openable and therefore separable into two halves, as desired.

[0032] In the embodiment illustrated in FIG. 1, the body 101 is not of unitary construction but is rotatable about a hinge or axis 107 and openable into first and second halves 101a, 101b which are maintained in a closed configuration by a closure 108 which will be described below.

[0033] The body 101 is configured for insertion into a retracted joint in a manner that will be further described.

[0034] The body 101 is generally flat and includes a first end surface 102 configured to abut a first bone portion of a joint.

[0035] The body 101 is generally annular and further comprises a second end surface 103 configured to abut a second bone portion of a joint opposite the first bone portion.

[0036] The second end surface 103, as shown, comprises a generally annular closed loop element, i.e., the second end surface 103 has a closed crown-like shape configured to abut the second bone portion of the joint. In particular, the shape of the second end surface 103 is configured to distribute pressure as evenly as possible on the second bone portion of the joint.

[0037] The second end face 103 has a first opening 10 for access to a second bone portion in a manner to be further described.

[0038] The body 101 further comprises at least one side element 104 between the first end surface 102 and the second end surface 103 that is configured to maintain the spaced apart three-dimensional structure of the body 101 .

[0039] In this embodiment, at least one side element 104 is divided between the first half 101 a and the second half 101 b forming the body 101 .

[0040] The side element 104 defines a second opening 20 that provides access to the hollow interior of the body 101. The second opening 20 is thus configured to allow lateral access to the interior of the body 101 and further allow access to a second bone portion at the second end surface 103 through the first access opening 10.

[0041] That is, in the "front" region of the in-use configuration, the surgical spacer device 100 has an opening in the lateral element 104, namely the second opening 20. The second opening 20 has the purpose of allowing the surgeon to view the joint space and the insertion of the instruments necessary to prepare the bone ends, e.g. the glenoid cavity, for the subsequent implantation of the prosthetic joint component.

[0042] In particular, in this embodiment, the first half 101a comprises a first portion of the first end face 102 and a first portion of the second end face 103, and further comprises a first portion of the at least one side element 104 that includes the second opening 20, while the second half 101b comprises a second portion of the first end face 102 and a second portion of the second end face 103, and further comprises a second portion of the at least one side element 104 radially opposite the second opening 20.

[0043] Generally, at least one side element 104 has a thickness and / or circumferential extension configured to maintain first end surface 102 and second end surface 103 at a predetermined distance apart.

[0044] From a different perspective of the body 101 of the surgical spacer device 100, it can be said that the first end surface 102 is maintained at a predetermined distance from the generally annular second end surface 103 by a number of small posts or at least one abutting wall, the total wall provided by such a number of posts or abutting walls in particular extending over more than half the circumference of the ring of the second end surface 103.

[0045] Furthermore, as described above, the plane in which the first end face 102 resides and the plane in which the generally annular second end face 103 resides slightly converge to provide a wedge shape at radially opposite portions of the second opening 20.

[0046] Preferably, the first end surface 102 further includes a bore 30 configured for passage of an instrument or anchor from the first bone portion, in a manner to be further described.

[0047] Preferably, the second opening 20 occupies an angular sector of the side element 104 in the circumferential direction that is greater than 90°, preferably greater than 135°, and even more preferably greater than 160°, to allow wide access to the joint area involved in the surgery.

[0048] Preferably, furthermore, the second opening 20 occupies substantially the entire height thickness available between the first end surface 102 and the second end surface 103 .

[0049] Preferably, the generally annular second end surface 103 further has a circular coronal extension approximately equal to the wall thickness of the body 101, thus maximizing access to the bone region of the joint.

[0050] In particular, such angular sector and / or height and / or thickness are determined based on technical considerations as a compromise between accessibility and mechanical resistance to withstand the loads to which the surgical spacer device is subjected.

[0051] FIG. 2 shows a top view of the surgical spacer apparatus 100.

[0052] As can be seen, preferably the first end face 102 and the second end face 103 are not parallel to each other, but are slightly inclined so as to partially reduce the thickness in the height direction of the body 101 in the radially opposite portion of the second opening 20, in particular in the portion identified by the second half 101b. It is recalled that a wedge shape is thereby given to the body 101, which is openable into the first half 101a and the second half 101b. Such a wedge shape makes the body 101 thinner in the radially opposite portion of the second opening 20, facilitating the insertion of the body 101 into the retracted joint.

[0053] In the anterior / posterior plane relative to the in-use configuration, the conical or wedge shape of the body 101 facilitates advanced insertion of the surgical spacer device 100 into a joint, for example into a retracted glenohumeral joint.

[0054] Preferably, the surgical spacer device 100 is offered in different sizes to ensure a precise fit to a patient's particular anatomy.

[0055] FIG. 3 shows a perspective view of a surgical spacer apparatus 100 inserted into an anatomical structure 1, 2 and further associated with a surgical instrument 3.

[0056] As discussed above, the body 101 is configured for insertion into a retracted joint. In this example, the surgical spacer device 100 is inserted into a retracted glenohumeral joint, where the first bone portion 1 is the humerus and the second bone portion 2 is the glenoid cavity.

[0057] As can be seen, the first opening 10 is preferably sized to surround the glenoid cavity of the part 2 to allow bone preparation and implantation of the glenoid component of the artificial joint through the body 101 .

[0058] Preferably, the first end surface 102 has a hole 30 (not visible in the figures) configured for passage of an instrument 3 or anchor from the first bone portion 1, as described above.

[0059] Additionally, the holes 30 also function to stabilize the relative movement between the surgical spacer device 100 and the humerus 1 .

[0060] The particular purpose of the surgical spacer device 100 is to retract the glenohumeral joint 1, 2, which, due to its shape, can be adapted both to the glenoid anatomical structure 2 and to one of the resected humeri 1. The conical taper that characterizes the body 101 on the anterior / posterior side allows the surgical spacer device 100, offered in several sizes, to be easily positioned in the joint, with its forward insertion creating the space necessary to guarantee visibility of the joint, in addition to the possibility of inserting further machining instruments mainly (but not only) for the glenoid region 2.

[0061] The advantageous geometry of the surgical spacer device 100, both in the anterior / posterior and medial / lateral planes, allows the tension present in the joint to ensure its stability without the need for any external personnel to keep it in place.

[0062] 4 shows the view of FIG. 3 with the glenoid component of a shoulder prosthesis 4 added thereto, which is inserted through the surgical spacer device 100. In particular, the glenoid component of a shoulder prosthesis 4 is inserted through the second opening 20 in the body 101, previously described.

[0063] As described, the glenoid side of the surgical spacer device 100 has a generally annular second end surface 103 which surrounds the glenoid cavity, thereby ensuring the possibility of using the instruments necessary to prepare the glenoid cavity for subsequent implantation of the glenoid prosthesis.

[0064] FIG. 5 shows a perspective view of a further embodiment of a surgical spacer apparatus 100. As shown in FIG.

[0065] The surgical spacer apparatus 100 is generally planar and may further include one or more modular shims 201 , 202 associated with the body 101 at the first end surface 102 .

[0066] These modular shims 201, 202 are configured to increase the overall thickness along the height of the body 101 of the surgical spacer device 100 to increase the amount of traction at the joint.

[0067] FIG. 6 shows FIG. 5 with the two modular shims 201 and one end modular shim 202 all installed in their final positions.

[0068] As will be further explained, the modular shims 201 and 202 include one central slit or notch 206 that allows for the insertion of any element, be it an instrument or anchor, that has already been inserted into the hole 30 of the surgical spacer device 100.

[0069] The central slit 206 allows the modular shims 201 and 202 to be inserted prior to positioning the surgical spacer apparatus 100 in the joint, or after the process if the tension achieved is not such as to allow for maintaining the surgical spacer apparatus 100 in the correct position.

[0070] Preferably, modular shims 201 and 202 have different thicknesses from each other, and in a non-limiting example, end modular shim 202 has a thinner thickness than the other modular shims.

[0071] 7A, 7B, and 7C show a side view, a rear view, and an inner side view, respectively, of the modular shim 201. FIG.

[0072] Preferably, the plurality of modular shims 201 include a plurality of grooves 203 and a plurality of guide pins 204 on opposite faces.

[0073] The first end face 102, as already described, preferably comprises a plurality of grooves 105, the grooves 203 or 105 and the guide pins 204 being configured to modularly guide the subsequent insertion of one or more modular shims 201.

[0074] Preferably, the plurality of grooves 203 are open on one side of the side element 104 , which is the second opening 20 side.

[0075] Preferably, the respective grooves 203 are parallel to one another, while the respective guide pins 204 are offset from one another relative to the grooves 203 so as to sequentially engage the respective grooves 203 and improve guidance during insertion of the modular shim 201 .

[0076] As will be appreciated by those skilled in the art, in the example of the terminal modular shim 202, the groove 203 may not be provided and only the guide pin 204 may be provided to provide an end surface that provides for contact with the anatomical structure that is generally smooth.

[0077] As previously mentioned, additional modular shims 201 and / or 202 may be added on the humeral side to modify the original height of the surgical spacer apparatus 100 and thus ensure greater joint traction.

[0078] Preferably, the modular shims 201 and / or 202 comprise magnetic coupling means 205, such as button magnets, configured to maintain stable contact between each other and, overall, with the body 101. That is, the magnets 205 ensure a stable coupling of the modular assembly of the surgical spacer apparatus 100 once the desired positioning within the anatomy has been obtained.

[0079] Generally, one or more modular shims 201 and / or 202 , each generally C-shaped with a central notch 206 , are configured to surround an instrument 3 or anchor applied to the bone portion 2 at the first end surface 102 .

[0080] FIG. 8 shows a schematic lateral view of a surgical spacer device 100 inserted into the anatomy of a retracted glenohumeral joint 1,2.

[0081] As can be seen, preferably the body 101 further comprises a latching means 106 on the inner surface at the side element 104 at a position opposite the second opening 20 .

[0082] Such latch means 106 is configured to releasably couple to a handle (not shown, described below) for insertion of the surgical spacer device 100 into the retracted joint.

[0083] FIG. 9 shows a schematic front view of the surgical spacer apparatus 100 further associated with the surgical instruments 3 and 5.

[0084] The surgical spacer device 100 can be positioned within the glenohumeral spaces 1, 2 either manually or by means of a specific handle 5 which hooks onto a latching means 106 to avoid its undesired removal during the procedure.

[0085] After its insertion, the handle 5, if present, is removed and it is assessed whether the tension reached in the retracted joints 1, 2 ensures the stability of the surgical spacer device 100 and corrects the accessibility and visibility of the anatomical elements.

[0086] If the tension is not sufficient, the need to add one or more modular shims 201, 202 is evaluated.

[0087] The insertion of the surgical spacer device 100 allows for a stable and precise maintenance of the position of the joints 1, 2 during the artificial joint implantation procedure.

[0088] Furthermore, the surgical spacer device 100, provided with a hollow body 101, a specific first opening 10 and a specific second opening 20, allows improved visibility and access to the joint areas 1, 2 during the prosthetic joint implantation procedure.

[0089] FIG. 10 shows a perspective view of a further embodiment of a surgical spacer apparatus 100 in an open configuration.

[0090] As previously explained, the body 101 is openable into a first half 101a and a second half 101b. The first half 101a comprises a first portion of a first end face 102 and a first portion of a second end face 103, and comprises a first portion of at least one side element 104 that includes the second opening 20. The second half 101b comprises a second portion of the first end face 102 and a second portion of the second end face 103, and comprises a second portion of the at least one side element 104 that is diametrically opposite the second opening 20.

[0091] The surgical spacer device 100 includes at least one hinge or axis 107 configured to rotatably connect the first half 101a to the second half 101b. In particular, the at least one hinge or axis 107 is configured for relative rotation of the first half 101a with respect to the second half 101b in at least one plane parallel to the first end surface 102 and / or the second end surface 103. Preferably, but not limited to, the first half 101a may be rotatable at least 180° with respect to the second half 101b.

[0092] The surgical spacer device 100 includes a mechanical closure 108 configured to maintain the first and second halves 101a, 101b in adjacent relation to form the body 101. In this preferred, but not limiting example, the mechanical closure 108 is in diametrically opposed relation to at least one hinge or axis 107.

[0093] In this illustrative, but non-limiting example, the mechanical closure 108 allows the first half 101a and the second half 101b to be latched by a mechanical connection, with the half 101a moving upwards and inserting a pivot 109 located at its upper end inside a seat 110 provided in the half 101b. Once the pivot 109 is inserted in the seat 110, the half 101a is positioned in alignment with the half 101b and the pivot 109 of the half 101a enters and is blocked in a specific seat 110 of the half 101b.

[0094] FIG. 11 illustrates a perspective view of yet another embodiment of the surgical spacer apparatus 100 in an open configuration.

[0095] In this illustrative, non-limiting example, the mechanical closure 108 allows the first half 101a and the second half 101b to be latched by different mechanical connections, said half 101a being rotated and the elastic element 111 of the half 101b being inserted into a corresponding seat 112 provided on the half 101b. Once the elastic element 111 is inserted into the seat 112, the half 101a is positioned in alignment with the half 101b and is restrained by it.

[0096] FIG. 12 illustrates a perspective view of yet another embodiment of a surgical spacer apparatus 100 according to the present invention in a closed configuration, while FIG. 13 illustrates a cross-sectional view of the surgical spacer apparatus 100 of FIG.

[0097] In this illustrative, non-limiting example, the mechanical closure 108 allows the first half 101a and the second half 101b to be latched via a mechanical connection comprising a pivot 109 and a seat 110 as already described with reference to FIG. 10.

[0098] Further, to construct the body 101, a spring clamp 113 is provided which helps to stably restrain the first half 101a and the second half 101b.

[0099] The open configuration of the surgical spacer 100 facilitates its removal from the joints 1, 2 once the surgery is completed and the glenoid implant is positioned, thus avoiding the possibility of obstruction of the surgical spacer device 100 by the glenoid implant during removal of the surgical spacer device 100 from the joint.

[0100] FIG. 14 shows a perspective view of a further embodiment of a surgical spacer device 100 that is made of a single piece and is therefore not releasable.

[0101] If glenoid implantation does not present significant obstacles to removal of the surgical spacer device 100, it is possible to provide a body 101 that is generally cylindrical or frusto-conical, has a hollow interior, and is made from a single piece.

[0102] In this embodiment, as in those already described, the body 101 comprises, inter alia, a first end surface 102, a second end surface 103 and at least side elements 104 which enable the construction of the surgical spacer device.

[0103] Further implementations and modifications of the present invention are apparent to those skilled in the art to meet foreseeable needs. The above embodiments are therefore to be understood as being provided for illustrative, non-limiting purposes.

[0104] For example, even if in the described embodiment at least one side element 104 is represented by a single continuous side element or, in any case, by multiple continuous side elements belonging to the two halves 101a and 101b, in a variant multiple side elements spaced apart from one another may be used, for example columnar or spaced apart elements configured to form a cage-like structure or frame and to maintain the spaced three-dimensional structure of the main body 101.

Claims

1. 1. A surgical spacer device (100) for a shoulder joint, comprising a generally cylindrical or generally frusto-conical body (101) that is hollow inside and configured for insertion into a traction joint (1, 2), The body (101) a first end surface (102) that is substantially flat and configured to abut a first bone portion (1) of said shoulder joint (1, 2); a second end surface (103) that is substantially annular and configured to abut a second bone portion (2) of the shoulder joint (1, 2) opposite the first bone portion (1), the second end surface (103) having a first opening (10) for access to the second bone portion (2); at least one side element (104) configured to maintain a spaced three-dimensional structure between said first end face (102) and said second end face (103), said at least one side element (104) defining a second opening (20) configured to allow lateral access to an interior of said body (101) and further access to said second bone portion (2) via said first opening (10); Equipped with said second opening (20) occupies an angular sector of said lateral element (104) in the circumferential direction that is greater than 90° in order to allow wide access to the joint area involved in the procedure; A surgical spacer device (100).

2. 2. The surgical spacer device of claim 1, wherein the first end surface (102) and the second end surface (103) are not parallel to each other but are inclined to partially reduce a thickness in a height direction of the body (101) at radially opposite portions of the second opening (20), thereby imparting a wedge shape to the body (101) to facilitate insertion of the body (101) into the retracted joint (1, 2).

3. 3. The surgical spacer device (100) of claim 1 or 2, wherein the first end surface (102) further comprises a hole (30) configured for passage of an instrument (3) or an anchor from the first bone portion (1).

4. said body (101) being openable into a first half (101a) and a second half (101b); the first half (101a) comprises a first portion of the first end face (102) and a first portion of the second end face (103), the first half (101a) comprising a first portion of the at least one side element (104) that includes the second opening (20); The surgical spacer device (100) of any one of claims 1 to 3, wherein the second half (101b) comprises a second portion of the first end face (102) and a second portion of the second end face (103), and the second half (101b) comprises a second portion of the at least one side element (104) radially opposite the second opening (20).

5. The surgical spacer apparatus (100) of claim 4, comprising at least one hinge or axis (107) configured to rotatably connect said first half (101a) to said second half (101b).

6. 6. The surgical spacer device (100) of claim 5, wherein the at least one hinge or axis (107) is configured for relative rotation of the first half (101a) and the second half (101b) about at least one plane parallel to the first end face (102) and / or the second end face (103).

7. 7. The surgical spacer apparatus (100) of claim 5 or 6, further comprising a mechanical closure (108) configured to maintain the first half (101a) and the second half (101b) adjacent to each other to form the body (101).

8. 8. The surgical spacer device (100) of claim 1, wherein the surgical spacer device (100) is configured for insertion into a retracted glenoid humeral joint (1, 2), the first bone portion (1) being the humerus and the second bone portion (2) being the glenoid cavity, and the first opening (10) is sized to surround the glenoid cavity and to allow bone preparation and implantation of a glenoid component (4) of an artificial joint through the body (101).

9. 9. The surgical spacer device (100) of claim 1, further comprising one or more modular, generally planar shims (201; 202) associated with the body (101) at the first end surface (102) for increasing an overall thickness in a height direction of the body (101) so as to increase the amount of traction of the shoulder joint (1, 2).

10. 10. The surgical spacer apparatus of claim 9, wherein the one or more modular shims (201;202) have a plurality of grooves (203) and a plurality of guide pins (204) on opposite faces, and the first end face (102) further comprises a plurality of grooves (105), the grooves (203;105) and the guide pins (204) configured to modularly guide subsequent insertion of the one or more modular shims (201;202).

11. 11. The surgical spacer apparatus of claim 10, wherein the grooves are parallel to one another and the guide pins are offset relative to one another and configured to sequentially engage the respective grooves.

12. 12. The surgical spacer device (100) of claim 10 or 11, wherein the groove (203;105) is open on one side facing the second opening (20) of the at least one side element (104).

13. The surgical spacer apparatus (100) of any one of claims 9 to 12, wherein the one or more modular shims (201;202) comprise magnetic coupling means (205) configured to maintain stable contact with the body (101).

14. 14. The surgical spacer apparatus (100) of any one of claims 9 to 13, wherein the one or more modular shims (201; 202) are generally C-shaped with a central notch (206) and configured to surround an instrument (3) or anchor applied at the first end surface (102).

15. 15. The surgical spacer device (100) of claim 1, wherein the body (101) further comprises a hooking means (106) on an inner surface of the at least one side element (104) at a position opposite the second opening (20), the hooking means (106) configured for releasably coupling to a handle (5) for insertion into the retracted joint (1, 2).

16. 16. The surgical spacer device of claim 1, wherein the at least one side element (104) has a thickness and / or a circumferential extension configured to maintain the first end surface (102) and the second end surface (103) at a predetermined distance apart.

17. A surgical spacer device (100) as described in any one of claims 1 to 16, wherein the angular sector occupied by the second opening (20) in the circumferential direction is greater than 135°.

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