AU2022335774B2

AU2022335774B2 - Spinal plate

Info

Publication number: AU2022335774B2
Application number: AU2022335774A
Authority: AU
Inventors: Youngbo AHN; Larry T. Khoo; Jae Shik Lee; Fernando L. Villamil
Original assignee: Aegis Spine Inc
Current assignee: Aegis Spine Inc
Priority date: 2021-08-26
Filing date: 2022-08-25
Publication date: 2025-08-28
Anticipated expiration: 2042-08-25
Also published as: AU2022335774A1; JP2024530278A; WO2023026238A1

Abstract

The present invention provides a spinal plate which is used to perform fixation surgery on a spine in orthopedic surgery and neurosurgery. The spinal plate comprises a central body and a pair of rotation portions which are disposed on both sides in a longitudinal direction of the central body and each of the pair of rotation portions has bone screw. The spinal plate also comprises spike screw in each of the pair of rotation portions. Each of the pair of rotation portions include a rotation connection portion, and the central body includes a rotation support portion. Rotation pins are used to connect the central body with the pair of rotation portions disposed on both sides in a longitudinal direction of the central body and enable the pair of rotation portions to rotate clockwise or counterclockwise with respect to the central body.

Description

SPINAL PLATE 21920592_1 (GHMatters) P123782.AU

Cross-reference to related applications 5 This application claims priority to U.S. Patent Application No. 17/412,820 filed August 26, 2021, which is a 2022335774

continuation-in-part application of U.S. Patent Application No. 16/821,321, filed on March 17, 2020, and the content of the aforementioned application is incorporated herein by reference 10 in their entirety.

Field of the Invention The present invention relates to a spinal plate, and more specifically to a spinal plate which is used to perform fixation 15 surgery on a spine in orthopedic surgery and neurosurgery.

Description of the Related Art In general, a spine forms a pillar of the body, and an upper portion thereof is a portion forming a backbone of a human 20 body that connects an upper skull and a lower pelvis. The spine includes 7 cervical vertebrae, 12 thoracic vertebrae, 5 lumbar vertebrae, 5 sacral vertebrae, and 3 to 5 coccyges from the top. In such a spine, symptoms such as an intervertebral disc disease and lumbar herniated intervertebral disc are likely to occur by 25 prolonged or excessive use. In general, patients having spinal disorders such as spinal fracture and dislocation are subjected to treatment and correction by fixing the respective vertebrae so as not to be moved relative to each other. For this, a spinal fixation device has been widely used for fixing the vertebrae 30 during fusion in the art. Such a spinal plate generally refers to an implantation plate used for treatment of the spinal disorders. The spinal

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implant is used for spinal fusion in which a fusion cage of an artificial implant is inserted between vertebrae from which a damaged intervertebral disk is removed due to various spinal 21920592_1 (GHMatters) P123782.AU

disorders, thus to restore and maintain an interval between the 5 vertebrae. In the conventional case, the fusion cage inserted between the vertebrae is used simultaneously with bone screws 2022335774

and a rod applied simultaneously to the back of the vertebral body, or is used in such a manner in which the cage is coupled and fixed by a plate and connection bolts screwed to the 10 vertebrae, or the cage itself is equipped with bone screw holes that can be installed the bone screws to directly fix the cage to the vertebrae. However, since spin shapes are very diverse depending on conditions of the patients during the surgery, a case in which 15 a doctor needs to use the spinal plate by modifying the shape thereof for each situation occurs. However, it is not easy to accurately modify the shape of the spinal plate according to the various spin shapes of the patients. Therefore, when actually performing the surgery, there are problems that the 20 spinal plate does not adhere to the vertebrae but is detached or somewhat incompletely attached, thereby side effects occur or the surgery has to be performed again. In addition, the patients prefer minimally invasive spine (MIS) surgery because of its potential benefits: less blood loss 25 from surgery, reduced risk of muscle damage, reduced risk of infection and postoperative pain, faster recovery time, better cosmetic results because of relatively smaller skin incisions, etc. In order to perform MIS surgery, it is crucial that the doctors should be able to gain access to the spinal area by 30 making as smaller skin incisions as possible and insert the spinal plate through these small skin incisions. In other words, the spinal plate, whose shape can be easily modified

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depending on conditions of the patients during the surgery and which can be inserted through patients’ small skin incisions, is required for successful MIS surgery. 21920592_1 (GHMatters) P123782.AU

[Prior Art Document] 5 [Patent Document] (Patent Document 1) U.S. Patent Application Publication 2022335774

No. US 2018-0235671A (Patent Document 2) U.S. Patent Application Publication No. US 2013-0060283A 10

Summary It may be seen as desirable to provide a spinal plate in which a rotation device and a locking device are installed so 15 as to be used by fixing any one or more of longitudinal ends of the plate with being rotated at any angle, thereby allowing a doctor to use the spinal plate by modifying a shape thereof to the shape desired by the doctor during a surgery, and to perform the surgery by coping with various spine shapes of patients. 20 According to one aspect, the present disclosure provides a spinal plate comprising: a central body; a pair of rotation portions, the pair of rotation portions being disposed on both sides of the central body in a width direction of the central body with respect to a longitudinal direction of the central 25 body; and rotation pins; wherein each of the pair of rotation portions comprises a bone screw for being inserted into vertebrae, wherein the rotation pins are configured to connect the central body with the pair of rotation portions and are configured to enable the pair of rotation portions to rotate 30 with respect to the central body at any angle, wherein each of the pair of rotation portions is configured to rotate with respect to the central body clockwise for a rotation portion

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disposed on a right side of the central body and counterclockwise for a rotation portion disposed on a left side of the central body, and wherein a first angle between each of 21920592_1 (GHMatters) P123782.AU

the pair of rotation portions and the central body is less than 5 45 degree with respect to the longitudinal direction of the central body. 2022335774

According to another aspect of the present disclosure, there is provided a spinal plate including: a central body; and a pair of end bodies which are disposed on both sides of the 10 central body and have one or more fixing screw holes in which fixing screws to be inserted into vertebrae are received, wherein at least one of the pair of end bodies includes a rotation device configured to fix the end body to the central body in a selectively rotatable manner, and a locking device 15 configured to maintain the rotation device in an unlocked state or a locked state. Herein, the central body may include one or more fixing screw holes formed therein, in which fixing screws to be inserted into vertebrae are received. 20 In addition, the rotation device may include: central pin joints formed at both ends of the central body; end pin joints formed at ends of the end bodies; and rotation pins which are inserted into the central pin joints and the end pin joints in a penetration manner. 25 Further, the locking device may include: central locking parts formed in the central pin joints so as to be located outside the rotation pin; end locking part formed in the end pin joint so as to be located outside the rotation pin; and a locking tube which is inserted into the central pin joints and 30 the end pin joint outside of the rotation pin to be fastened to the end locking part and the central locking parts so as to prevent rotations thereof.

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Further, the locking tube may include: a tube locking part which is formed on an outer circumference thereof to come into contact with the end locking part and the central locking 21920592_1 (GHMatters) P123782.AU

part, and is configured to fix a relative position between the 5 end locking part and the central locking part; and a knob formed at one end thereof. 2022335774

Further, the central locking part may be a central serration formed in the central pin joint along an inner circumference thereof, the end locking part may be an end 10 serration formed in the end pin joint along an inner circumference thereof, and the tube locking part may be a tube serration formed on an outer circumference of the locking tube to come into contact with both the central serration and the end serration. 15 Further, the central locking part may be a plurality of locking grooves or locking protrusions formed on an inner circumference of the central pin joint in a circumferential direction thereof, the end locking part may be a plurality of locking grooves or locking protrusions formed on an inner 20 circumference of the end pin joint in a circumferential direction thereof, and the tube locking part may be a key groove or a key protrusion which is formed on the outer circumference of the locking tube in an elongated form so as to fix the relative position between the central locking part and the end 25 locking part. Further, the knob may be formed in a polygonal shape, or may have protrusions or grooves formed on an outer circumference thereof, so as to facilitate gripping. Further, the knob may have a device coupling part formed 30 on an inner surface thereof for coupling with the device. Further, the device coupling part may be a female thread formed on the inner surface of the knob.

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Further, the device coupling part may be coupling recesses or coupling protrusions formed on the inner surface of the knob. Further, the rotation device may include one and/or two 21920592_1 (GHMatters) P123782.AU

end pin joint(s) and two and/or one central pin joint(s), such 5 that the one end/central pin joint is inserted between the two central/end pin joints. 2022335774

Further, a rotation pin support seat may be formed only in one end/central pin joint of the two central/end pin joints. Further, the rotation device may include rotational 10 locking units which are rotatably disposed in the central body, and come into contact with an outer surface of the end pin joint to prevent a rotation of the end body. Furthermore, the central body may include: rotational locking unit seats formed therein, into which the rotational 15 locking units are inserted; and openings formed on one side of each rotational locking unit seat to expose a side face of the rotational locking unit toward the end pin joint. Furthermore, the rotational locking unit may include: a rotational protrusion inserted into the rotational protrusion 20 seat formed in the rotational locking unit seat; a rotational locking unit body formed integrally with the rotational protrusion; a contact surface formed on one portion of an outer surface of the rotational locking unit body to come into contact with the end pin joint; and a non-contact surface which is 25 formed on the other portion of the outer surface of the rotational locking unit body and continuously forms the contact surface without contacting the end pin joint. Furthermore, the spinal plate may include: a central body; a pair of rotation portions, the pair of rotation portions being 30 disposed on both sides in a longitudinal direction of the central body. Each of the pair of rotation portions comprises a bone screw for being inserted into vertebrae.

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Furthermore, the central body may include: a central hole; and two rotational locking units. The two rotational locking units are configured to be released or fastened. 21920592_1 (GHMatters) P123782.AU

Furthermore, each of the pair of rotation portions 5 comprises a rotation connection portion, and the central body comprises a rotation support portion. 2022335774

Furthermore, the spinal plate may include rotation pins. The rotation pins are configured to connect the central body with the pair of rotation portions and are configured to enable 10 the pair of rotation portions to rotate with respect to the central body at any angle. Furthermore, each of the pair of rotation portions is configured to rotate with respect to the central body counterclockwise for a rotation portion disposed on a right side 15 of the central body and clockwise for a rotation portion disposed on a left side of the central body. An angle between each of the pair of rotation portions and the central body is up to 90 degree with respect to the longitudinal direction of the central body. 20 Furthermore, the angle between each of the pair of rotation portions and the central body is larger than 90 degree with respect to the longitudinal direction of the central body. Furthermore, each of the pair of rotation portions comprises a rotation connection portion, and the central body 25 comprises a rotation support portion. A rotation of each of the pair of rotation portions is restricted by an upper portion of the rotation support portion as the rotation connection portion rotates with each of the pair of rotation portions. Furthermore, each of the pair of rotation portions is 30 configured to rotate with respect to the central body clockwise for a rotation portion disposed on a right side of the central body and counterclockwise for a rotation portion disposed on a

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left side of the central body. An angle between each of the pair of rotation portions and the central body is less than 45 degree with respect to the longitudinal direction of the central 21920592_1 (GHMatters) P123782.AU

body. 5 Furthermore, a rotation of each of the pair of rotation portions is restricted by a rotational angle control portion 2022335774

formed between a bottom portion of the central body and a bottom portion of each of the pair of rotation portions. Furthermore, each of the pair of rotation portions 10 comprises a spike screw. Furthermore, the spike screw comprises a head portion and a body portion, and the head portion and the body portion have different threads. Furthermore, a pitch of the thread in the head portion is 15 smaller than a pitch of the thread in the body portion, thereby enabling self-locking while pulling the vertebrae to the spinal plate. Furthermore, a washer is put on the bone screw on a washer support part on each of the pair of rotation portions. 20 Furthermore, the spinal plate is designed such that the washer is configured to rotate with respect to each of the pair of rotation portions and a head of the bone screw is configured to rotate with respect to the washer. Furthermore, the angle between each of the pair of 25 rotation portions and the central body may be up to 20 degree with respect to the longitudinal direction of the central body. According to the present invention, the rotation device and the locking device may be installed so as to be used by fixing any one or more of longitudinal ends of the plate with 30 being rotated at any angle, thereby allowing a doctor to modify a shape of the spinal plate to the shape desired by the doctor, and to perform the surgery by coping with various spin shapes

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of the patients.

Brief Description of the Drawings 21920592_1 (GHMatters) P123782.AU

The above and other objects, features and other 5 advantages of the present invention will be more clearly understood from the following detailed description taken in 2022335774

conjunction with the accompanying drawings, in which: FIG. 1 is a perspective view illustrating a spinal plate according to Embodiment 1 of the present disclosure; 10 FIG. 2 is a perspective view illustrating a central body of the spinal plate according to Embodiment 1 of the present disclosure; FIG. 3 is a perspective view illustrating an end body of the spinal plate according to Embodiment 1 of the present 15 disclosure; FIG. 4 is a perspective view illustrating a rotation pin of the spinal plate according to Embodiment 1 of the present disclosure; FIG. 5 is a perspective view illustrating a locking tube 20 of the spinal plate according to Embodiment 1 of the present disclosure; FIG. 6 is a perspective view illustrating a state in which the locking tube is released in the spinal plate according to Embodiment 1 of the present disclosure; 25 FIG. 7 is a perspective view illustrating a state in which the locking tube is fastened in the spinal plate according to Embodiment 1 of the present disclosure; FIG. 8 is a perspective view illustrating a state in which the end bodies are rotated with respect to the central body and 30 then the locking tubes are fastened to lock the end bodies of the spinal plate according to Embodiment 1 of the present disclosure;

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FIG. 9 is a perspective view illustrating a state in which the end bodies are rotated with respect to the central body and then the locking tubes are released to unlock the end bodies of 21920592_1 (GHMatters) P123782.AU

the spinal plate according to Embodiment 1 of the present 5 disclosure; FIG. 10 is a perspective view illustrating a spinal plate 2022335774

according to Embodiment 2 of the present disclosure with being unlocked; FIG. 11 is a perspective view illustrating a central body 10 of the spinal plate according to Embodiment 2 of the present disclosure; FIG. 12 is a perspective view illustrating an end body of the spinal plate according to Embodiment 2 of the present disclosure; 15 FIG. 13 is a perspective view illustrating a rotational locking unit of the spinal plate according to Embodiment 2 of the present disclosure; FIG. 14 is a perspective view illustrating a rotation pin of the spinal plate according to Embodiment 2 of the present 20 disclosure; FIG. 15 is a partially enlarged perspective view of the spinal plate according to Embodiment 2 of the present invention with the rotational locking units being disclosure; FIG. 16 is a partially enlarged perspective view of the 25 spinal plate according to Embodiment 2 of the present disclosure with the rotational locking units being fastened; FIG. 17 is a perspective view illustrating the spinal plate according to Embodiment 2 of the present disclosure with being locked; 30 FIG. 18 is a perspective view illustrating a spinal plate according to Embodiment 3 of the present disclosure;

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FIG. 19 is a top view illustrating a spinal plate according to Embodiment 3 of the present disclosure; FIG. 20 is a bottom view illustrating a spinal plate 21920592_1 (GHMatters) P123782.AU

according to Embodiment 3 of the present disclosure; 5 FIG. 21 is a perspective view of separate components in a spinal plate according to Embodiment 3 of the present 2022335774

disclosure; FIG. 22 is a partially enlarged perspective view of the spinal plate according to Embodiment 3 of the present disclosure 10 with a washer put on a bone screw on a washer support part on each of the pair of rotation portions; and FIG. 23 is a partially enlarged perspective view of the spinal plate according to Embodiment 3 of the present disclosure with a rotational angle control portion formed between a bottom 15 portion of the central body and a bottom portion of each of the pair of rotation portions.

Detailed description of specific embodiments Hereinafter, the present invention will be described in 20 detail with reference to the accompanying drawings. In denoting reference numerals to constitutional elements of respective drawings, it should be noted that the same elements will be denoted by the same reference numerals although they are illustrated in different drawings. In the embodiments of the 25 present invention, the publicly known functions and configurations that are judged to be able to make the purport of the present invention unnecessarily obscure will not be described. A spinal plate 100 according to Embodiment 1 of the 30 present invention will be described with reference to FIGS. 1 to 9. FIG. 1 is a perspective view illustrating the spinal plate 100 according to Embodiment 1 of the present invention.

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As illustrated in FIG. 1, the spinal plate 100 basically includes: a central body 102; and a pair of end bodies 104 and 106 which are disposed on both sides in a longitudinal direction 21920592_1 (GHMatters) P123782.AU

of the central body 102 and have one or more fixing screw holes 5 110 formed therein, in which fixing screws to be inserted into vertebrae are received, wherein at least one of the pair of end 2022335774

bodies 104 and 106 includes a rotation device for fixing the end body to the central body 102 in a selectively rotatable manner, and a locking device for maintaining the rotation device 10 in an unlocked state or a locked state. The spinal plate 100 may be made of a known material such as titanium, a Co-Cr alloy, or the like, but it is not limited thereto. The fixing screw hole 110 may include a screw support 15 part 108 so as to support a head of the received fixing screw (not illustrated). When using the spinal plate 100 between a pair of adjacent vertebral bodies, it is sufficient for the fixing screw holes 110 formed in the end bodies 104 and 106 on both sides, but when using the spinal plate for three or more 20 vertebral bodies, it is possible to further from one or more fixing screw holes for receiving the fixing screws to be inserted into the vertebrae in the central body 102. FIG. 2 is a perspective view illustrating the central body of the spinal plate 100 according to Embodiment 1 of the 25 present invention. As illustrated in FIG. 2, the central body 102 may include: central pin joints 118 and 124 formed at both ends thereof; and central locking parts formed in the central pin joints 118 and 124 and a window 128 formed in a central portion thereof. 30 FIG. 3 is a perspective view illustrating the end body of the spinal plate according to Embodiment 1 of the present invention. As illustrated in FIG. 3, the end bodies 104 and

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106 may include one or more fixing screw holes 110 which are disposed on both sides in the longitudinal direction of the central body 102, and receive the fixing screws to be inserted 21920592_1 (GHMatters) P123782.AU

into the vertebrae. In addition, the end bodies 104 and 106 5 may include an end pin joint 112 formed at an end thereof and an end locking part formed in the end pin joint 112. 2022335774

The end locking part may be an end serration 114 formed on the inner circumference of the end pin joint 112, and may be a plurality of locking grooves or locking protrusions (not 10 illustrated) formed on the inner circumference of the end pin joint 112 in a circumferential direction thereof. The rotation device may include: the central pin joints 118 and 124 formed at the both ends of the central body 102; the end pin joints 112 formed at the ends of the end bodies 104 15 and 106; and rotation pins 130 which are inserted into the central pin joints 118 and 124 and the end pin joints 112 in a penetration manner. In Embodiment 1, the rotation device may include one end pin joint 112 and two central pin joints 118 and 124 spaced 20 apart from each other, and the end pin joint 112 is inserted between the two central pin joints 118 and 124. On the other hand, in one variant, the rotation device may include two end pin joints and one central pin joint, such that the central pin joint is inserted between the two end pin joints. Additionally, 25 the rotation device may also include one central pin joint and one end pin joint, and various variants are possible other than the above-described configurations. The locking device may include: the central locking parts formed in the central pin joints 118 and 124 so as to be located 30 outside the rotation pin 130; the end locking part formed in the end pin joint 112 so as to be located outside the rotation pin 130; and a locking tube 140 which is inserted into the

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central pin joints 118 and 124 and the end pin joint 112 outside of the rotation pin 130 to be fastened to the end locking part and the central locking parts so as to prevent rotations 21920592_1 (GHMatters) P123782.AU

thereof. 5 The central locking parts may be central serrations 120 and 126 formed on an inner circumference of the central pin 2022335774

joints 118 and 124. As pitches of the central serrations 120 and 126 are decreased, various angles may be implemented, but on the other hand, the pitch is reduced to cause a deterioration 10 in mechanical performance. Therefore, it is important to determine the pitch of the central serrations 120 and 126 so that the stability can be secured through a performance test, as well as a range of angle change can be small. In addition, the central locking parts may be a plurality 15 of locking grooves or locking protrusions (not illustrated) formed on the inner circumference of the central pin joints 118 and 124 in a circumferential direction thereof. The window 128 may serve as a view port for checking a vertebral surface that comes into contact with the spinal plate 20 during the surgery, and may also be utilized as an application for coupling a device through the window 128. FIG. 4 is a perspective view illustrating the rotation pin 130 of the spinal plate 100 according to Embodiment 1 of the present invention. As illustrated in FIG. 4, the rotation 25 pin 130 may include a rotation pin central portion 132 and rotation pin end portions 134 and 136, and pass through the central pin joints 118 and 124 and the end serration 114 to be inserted into the central locking parts and the end locking part. A length of the rotation pin 130 may be equal to or 30 shorter than a distance between the outermost ends of two central body joints 118 and 124 so as not to be exposed to an outside of the two central body joints 118 and 124.

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In addition, the end pin joint 112 may have a rotation pin support seat 116 formed therein, on which the rotation pin 130 is rotatably seated while being in contact therewith. By 21920592_1 (GHMatters) P123782.AU

forming the rotation pin support seat 116 in the end pin joint 5 112, it is possible to stably support the rotation pin 130 so as to prevent it from being removed outward. Further, to this 2022335774

end, a cross section of a portion of the rotation pin 130 that comes into contact with the rotation pin support seat 116 may be formed to be smaller than those of outer portions from the 10 portion in the longitudinal direction. FIG. 5 is a perspective view illustrating the locking tube 140 of the spinal plate 100 according to Embodiment 1 of the present invention. As illustrated in FIG. 5, the locking tube 140 may include a tube locking part which is formed on an 15 outer circumference thereof to come into contact with the end locking part and the central locking part, and is configured to fix a relative position between the end locking part and the central locking part, and a knob 144 formed at one end thereof. The tube locking part may be a tube serration 142 formed 20 on an outer circumference of the locking tube 140 having teeth 143 to come into contact with both the central serrations 120 and 126 and the end serration 114. In addition, the tube locking part may be a key groove or a key protrusion (not illustrated) which is formed on the outer 25 circumference of the locking tube 140 in an elongated form so as to fix the relative position between the central locking part and the end locking part. That is, two or more key grooves or key protrusions are formed on the outer circumference of the locking tube 140 as the tube locking part, so as to be inserted 30 into a plurality of protrusions or grooves which are radially formed on inner circumferences of the central pin joints 118 and 124 as the central locking part and the end pin joint 112

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as the end locking part at any angle corresponding to the key groove or key protrusion of the tube locking part. The shapes of the tube locking part, the central locking 21920592_1 (GHMatters) P123782.AU

part, and the end locking part are not limited to those described 5 above, and various modifications are possible. The knob 144 may be formed in a polygonal shape, or may 2022335774

have protrusions or grooves formed on the outer circumference thereof, thereby facilitating gripping. The knob 144 may serve as a grip to facilitate insertion when inserting the locking 10 tube 140 into the central locking part and the end locking part. In addition, the knob 144 may have a device coupling part 146 formed on an inner surface thereof for coupling with the device, and the device coupling part 146 may be a female thread, coupling recesses or coupling protrusions formed on the inner 15 surface of the knob 144. In the present invention, by forming the female thread, coupling recesses or coupling protrusions in the knob 144 as the device coupling part 146, even after the locking tube 140 is fastened to the central locking part and the end locking part to be the locked state, the locking tube 20 140 is released by coupling a device (not illustrated) to the device coupling part 146 formed in the knob 144 to return it to the unlocked state again. At this time, in a state in which the rotation pin 130 is pressed to one side, the device (not illustrated) is coupled to the device coupling part 146, or the 25 length of the rotation pin 130 is formed to be smaller than an entire length of the central pin joint 118 and 124 and the end pin joint 112. FIG. 6 is a perspective view illustrating a state in which the locking tube 140 is released in the spinal plate 100 30 according to Embodiment 1 of the present invention, and FIG. 7 is a perspective view illustrating a state in which the locking tube 140 is fastened in the spinal plate 100 according to

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Embodiment 1 of the present invention. As illustrated in FIGS. 6 and 7, the rotation pin 130 is inserted through the central pin joints 118 and 124 and the end pin joint 112, and may be 21920592_1 (GHMatters) P123782.AU

stably inserted due to the rotation pin support seat 116 formed 5 in the end pin joint 112. In the unlocked state which is a state before the locking 2022335774

tube 140 is completely fastened to the central locking part and the end locking part as illustrated in FIG. 6, it is possible to adjust so that the end bodies 104 and 106 are positioned at 10 a desired angle with respect to the central body 102. Further, in the locked state which is a state in which the locking tube 140 is completely fastened to the central locking part and the end locking part as illustrated in FIG. 7, rotations of the end bodies 104 and 106 with respect to the central body 102 are 15 prevented to be a fixed state. FIG. 8 is a perspective view illustrating a state in which the end bodies 104 and 106 are rotated with respect to the central body 102 and then the locking tubes 140 are fastened to lock the end bodies 104 and 106 of the spinal plate 100 according 20 to Embodiment 1 of the present invention, and FIG. 9 is a perspective view illustrating a state in which the end bodies 104 and 106 are rotated with respect to the central body 102 and then the locking tubes 140 are released to unlock the end bodies 104 and 106 of the spinal plate 100 according to 25 Embodiment 1 of the present invention. As illustrated in FIGS. 8 and 9, according to the present invention, the end bodies 104 and 106 may be adjusted to be positioned at a desired angle with respect to the central body 102. Even after the locked state as illustrated in FIG. 8, the locking tube 140 may be released 30 by the device coupling part 146 formed in the knob 144 of the locking tube 140 to return it to the unlocked state again as illustrated in FIG. 9.

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Next, a spinal plate 200 according to Embodiment 2 of the present invention will be described with reference to the FIGS. 10 to 17. FIG. 10 is a perspective view illustrating the spinal 21920592_1 (GHMatters) P123782.AU

plate 200 according to Embodiment 2 of the present invention. 5 As illustrated in FIG. 10, the spinal plate 200 basically includes: a central body 202; and a pair of end bodies 204 and 2022335774

206 which are disposed on both sides in a longitudinal direction of the central body 202 and have one or more fixing screw holes 210 in which the fixing screws to be inserted into vertebrae 10 are received, wherein at least one of the pair of end bodies 204 and 206 includes a rotation device for fixing the end body to the central body 202 in a selectively rotatable manner, and a locking device for maintaining the rotation device in an unlocked state or a locked state, which are the same as 15 Embodiment 1. The spinal plate 200 may be made of a known material such as titanium, Co-Cr alloy, but it is not limited thereto. The fixing screw hole 210 may include a screw support part 208 so as to support a head of the received fixing screw 20 (not illustrated). When using the spinal plate 200 between a pair of adjacent vertebral bodies, it is sufficient for the fixing screw holes 210 formed in the end bodies 204 and 206 on both sides, but when using the spinal plate for three or more vertebral bodies, it is possible to further from one or more 25 fixing screw holes for receiving the fixing screws to be inserted into the vertebrae in the central body 202. FIG. 11 is a perspective view illustrating the central body 202 of the spinal plate 200 according to Embodiment 2 of the present invention. As illustrated in FIG. 11, the central 30 body 202 may include: central pin joints 218 and 224 formed at both ends thereof; and central pin holes 220 and 226 formed in

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the central pin joints 218 and 224. Further, a window 228 may be additionally formed in the central body 202. FIG. 12 is a perspective view illustrating the end body 21920592_1 (GHMatters) P123782.AU

of the spinal plate according to Embodiment 2 of the present 5 invention. As illustrated in FIG. 12, the end bodies 204 and 206 may include one or more fixing screw holes 210 which are 2022335774

disposed on both sides in the longitudinal direction of the central body 202, and receive the fixing screws to be inserted into the vertebrae. In addition, the end bodies 204 and 206 10 may include an end pin joint 212 formed at an end thereof and an end pin hole 214 formed in the end pin joint 212. The rotation device may include: the central pin joint 218 and 224 formed at the both ends of the central body 202; the end pin joints 212 formed at the ends of the end bodies 204 15 and 206; and rotation pins 230 which are inserted into the central pin joints 218 and 224 and the end pin joints 212 in a penetration manner. In Embodiment 2, the rotation device may include one end pin joint 212 and two central pin joints 218 and 224 spaced 20 apart from each other, and the end pin joint 212 is inserted between the two central pin joints 218 and 224. On the other hand, in one variant, the rotation device may include two end pin joints and one central pin joint, such that the central pin joint is inserted between the two end pin joints. Additionally, 25 the rotation device may also include one central pin joint and one end pin joint, and various variants are possible other than the above-described configurations. The spinal plate 200 of Embodiment 2 is characterized in that the rotation device includes rotational locking units 240 30 which are rotatably disposed in the central body 202, and come into contact with an outer surface of the end pin joint 212 to prevent rotations of the end bodies 204 and 206.

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To this end, the central body 202 may include: rotational locking unit seats 252 formed therein, into which the rotational locking units 240 are inserted; and openings 254 formed on one 21920592_1 (GHMatters) P123782.AU

side of each rotational locking unit seat 252 to expose a side 5 face of the rotational locking unit 240 toward the end pin joint 212. In addition, a rotational protrusion seat 256 may be 2022335774

formed in the rotational locking unit seat 252 to rotatably support the rotational locking unit 240. In addition, as illustrated in FIG. 13, the rotational 10 locking unit 240 may include: a rotational protrusion 248 inserted into the rotational protrusion seat 256 formed in the rotational locking unit seat 252; a rotational locking unit body 242 formed integrally with the rotational protrusion 248; a contact surface 244 formed on one portion of an outer surface 15 of the rotational locking unit body 242 to come into contact with the end pin joint; and a non-contact surface 246 which is formed on the other portion of the outer surface of the rotational locking unit body 242 and continuously forms the contact surface 244 without contacting the end pin joint 212. 20 Further, the rotational locking unit body 242 may have a device groove 250 formed on an upper side thereof, into which a device is inserted. On the other hand, a device protrusion may be formed on the rotational locking unit body 242 to be inserted the device. 25 The rotational protrusion seat 256 and the rotational protrusion 248 are coupled to each other in such a way that: the rotational protrusion 248 is inserted into a rotation ring, an annular ring, or an annular groove formed in the rotational protrusion seat 256; the rotational protrusion 248 has a 30 structure formed on the outer circumference thereof corresponding to the rotational protrusion seat 256 to be tightly fitted with each other; or an end of the rotational

20

21920592_1 (GHMatters) P123782.AU

protrusion 248 penetrates a hole formed in the rotational protrusion seat 256 and fixed thereto by using known techniques such as riveting or inserting a fixing bolt. The rotational 21920592_1 (GHMatters) P123782.AU

locking unit body 242 may have a bolt shape as a whole, and the 5 device groove 250 formed at the upper center thereof may have a known shape such as a hexagonal or star shape. Further, it 2022335774

is also possible to form a hexagonal or star-shaped protrusion in the rotational locking unit body 242 in place of the device groove 250. The outer circumference of the rotational locking 10 unit body 242 has a cylindrical shape as a whole, and a cut-out portion thereof on one side corresponds to the non-contact surface 246, and the remaining portion thereof, which is not cut-out, corresponds to the contact surface 244. A center angle of the non-contact surface 246 and the contact surface 244 can 15 be selected by a designer as necessary. However, in Embodiment 2, when the non-contact surface 246 is positioned at the opening 254, a width of the non-contact surface 246 is substantially equal to that of the opening 254. In addition, a cut-out thickness of the non-contact surface 246 is set so as to have 20 a level coinciding with surrounding surfaces when the non- contact surface 246 is located at the opening 254. The window 228 is formed in the central body 202 to serve as a view port for checking a vertebral surface that comes into contact with the spinal plate during the surgery, and may also 25 be utilized as an application for coupling a device through the window 228. FIG. 14 is a perspective view illustrating the rotation pin 230 of the spinal plate 200 according to Embodiment 2 of the present invention. As illustrated in FIG. 14, the rotation 30 pin 230 may include a rotation pin central portion 232 and the rotation pin end portions 234 and 236, and pass through the central pin joints 218 and 224 and the end locking part to be

21

21920592_1 (GHMatters) P123782.AU

inserted into the central pin holes 220 and 226 and the end pin hole 214. A length of the rotation pin 230 may be equal to or shorter than a distance between the outermost ends of two 21920592_1 (GHMatters) P123782.AU

central pin joints 218 and 224 so as not to be exposed to the 5 outside of the two central pin joints 218 and 224. In addition, the end pin joint 212 may have a rotation 2022335774

pin support seat (not illustrated) formed therein, on which the rotation pin 230 is rotatably seated while being in contact therewith, which is the same as Embodiment 1. By forming the 10 rotation pin support seat in the end pin joint 212, it is possible to stably support the rotation pin 230 so as to prevent it from being removed outward. Further, to this end, a cross section of a portion of the rotation pin 230 that comes into contact with the rotation pin support seat may be formed to be 15 smaller than those of the portions outside the portion. In addition, the rotation pin support seat may be formed in any one of the central pin joints 218 and 224. Additionally, it is also possible to form the rotation pin support seats in both the central pin joints 218 and 224 and the end pin joint 212. 20 Hereinafter, an operation of the spinal plate 200 will be described with reference to FIGS. 15 to 17. As illustrated in FIG. 15, when the non-contact surface 246 of the rotational locking unit 240 is positioned at the opening 254 of the central body 202, it is referred to an open 25 state. In this case, since the non-contact surface 246 of the rotational locking unit 240 does not contact with the surface of the end pin joint 212, the end bodies 204 and 206 can move freely with respect to the central body 202. Thus, as illustrated in FIG. 16, a user rotates the end 30 bodies 204 and 206 with respect to the central body 202 to make the spinal plate be a desired angle, then rotates the rotational locking unit 240 so that the contact surface 244 protrudes

22

21920592_1 (GHMatters) P123782.AU

through the opening 254. In Embodiment 2 of the present invention, since four rotational locking units 240 are disposed by two on each side, the above-described operations are repeated 21920592_1 (GHMatters) P123782.AU

four times. 5 As a result, as illustrated in FIG. 17, the spinal plate 200 can be fixed with the end bodies 204 and 206 being angularly 2022335774

rotated with respect to the central body 202 at any angle. Next, a spinal plate 300 according to Embodiment 3 of the present invention will be described with reference to the FIGS. 10 18-23. FIG. 18 is a perspective view illustrating the spinal plate 300 according to Embodiment 3 of the present invention. FIG. 19 is a top view illustrating a spinal plate according to Embodiment 3 of the present invention. FIG. 20 is a bottom view illustrating a spinal plate according to Embodiment 3 of the 15 present invention. FIG. 21 is a perspective view of separate components in a spinal plate according to Embodiment 3 of the present invention. As illustrated in FIG. 18, the spinal plate 300 basically includes: a central body 302; and a pair of rotation portions 20 312 which are disposed on both sides in a longitudinal direction of the central body 302 and each of the pair of rotation portions 312 has bone screw 308. These bone screws 308 are inserted into vertebrae. The spinal plate 300 further includes: spike screw 306 in each of the pair of rotation portions 312. The central 25 body 302 includes a center hole 318 and two rotational locking units 340. These rotational locking units 340 can be released and/or fastened, as shown in FIGS. 15 and 16. Each of the pair of rotation portions 312 include a rotation connection portion 316, and the central body includes a rotation support portion 30 314. Rotation pins 330 are used to connect the central body 302 with the pair of rotation portions 312 disposed on both sides in a longitudinal direction of the central body 302 and

23

21920592_1 (GHMatters) P123782.AU

enable the pair of rotation portions 312 to rotate with respect to the central body 302. The rotation pins 330 are the same as Embodiments 1 and 2. 21920592_1 (GHMatters) P123782.AU

As illustrated in FIG. 18, the spinal plate 300 according 5 to Embodiment 3 of the present invention is specifically targeted for MIS surgery. 2022335774

The pair of rotation portions 312, disposed on both sides in a longitudinal direction of the central body 302, are rotated with respect to the central body 302 at any angle, thereby 10 allowing a doctor to use the spinal plate by modifying a shape thereof to the shape desired by the doctor during MIS surgery, and to perform the surgery by coping with various spin shapes of patients. In particular, each of the pair of rotation portions 312 can be rotated with respect to the central body 15 302 counterclockwise (for a rotation portion 312 disposed on the right side of the central body 302) or clockwise (for a rotation portion 312 disposed on the left side of the central body 302) so that an angle between each of the pair of rotation portions 312 and the central body 302 is up to 90 degree with 20 respect to a longitudinal direction of the central body 302 (“twelve o’clock”). This angle between each of the pair of rotation portions 312 and the central body 302 can be larger than 90 degree. The rotation of each of the pair of rotation portions 312 is restricted by an upper portion of the rotation 25 support portion 314 (surface on which two rotational locking units 340 are positioned) as the rotation connection portion 316 rotates with each of the pair of rotation portions 312. In addition, each of the pair of rotation portions 312 can be rotated with respect to the central body 302 clockwise 30 (for a rotation portion 312 disposed on the right side of the central body 302) or counterclockwise (for a rotation portion 312 disposed on the left side of the central body 302) so that

24

21920592_1 (GHMatters) P123782.AU

an angle between each of the pair of rotation portions 312 and the central body 302 is less than 45 degree (preferably, up to 20 degree) with respect to a longitudinal direction of the 21920592_1 (GHMatters) P123782.AU

central body 302 (“four o’clock” or “eight o’clock”). The 5 reason for limiting up to 45 degree (preferably, up to 20 degree) is that the spinal plate is to be supported by the compressive 2022335774

force applied in a direction that an upper and a lower vertebrae are close to each other (the weight exerted by the human body). If this angle is greater than 45 degree, the rotation part 312 10 would fail to properly transmit the compression to the body. This rotation is restricted by a rotational angle control portion 310 formed between a bottom portion 322 of the central body 302 and a bottom portion 320 of each of the pair of rotation portions 312. This means that there are two rotational angle 15 control portions 310 formed between two opposite bottom end portions 322 of the central body 302 in a longitudinal direction of the central body 302 (bottom left end and bottom right end sides of the central body 302) and two bottom portions 320 of each of the pair of rotation portions 312. As illustrated in 20 FIG. 23, there is a gap between a bottom portion 322 of the central body 302 and a bottom portion 320 of each of the pair of rotation portions 312. In addition, two opposite bottom end portions 322 of the central body 302 are designed such that they are slightly indented inward toward a center of the central body 25 302 in the longitudinal direction of the central body 302. However, the design of two opposite bottom end portions 322 of the central body 302 is not limited as illustrated in FIG. 23. Specifically, when making a surgical path for surgery, and inserting the spinal plate 300 to the surgical path, each 30 of the pair of rotation portions 312 is folded upward with respect to the spinal plate 300. When the spinal plate 300 is placed on the surgical site (precisely, positioned to span the

25

21920592_1 (GHMatters) P123782.AU

upper and lower vertebrae around the disk), each of the pair of rotation portion 312 is rotated to contact the vertebrae. At this point, the end of the vertebrae is slightly larger in 21920592_1 (GHMatters) P123782.AU

diameter than other parts of the vertebrae. Therefore, with 5 the spinal plate 300 in contact with the vertebrae, each of the pair of rotation portion 312 rotates more than the spinal 2022335774

plate's longitudinal plane, which rotates as if it is surrounding the end of the vertebrae. At this point, the bone screw 308 is inserted. Due to the rotation of the each of the 10 pair of rotation part 312, the bone screw 308 is inserted inside the spine (e.g., in the disc direction) with respect to a perpendicular direction of the spinal plate 300. Therefore, insertion directions of the bone screw 308 can be adjusted to a horizontal or an upward direction of the spine using the 15 washer 304. The insertion of the bone screw 308 can then be fixed at any angle with friction between the washer 304 and the head of the bone screw 308, the washer 304 and the spinal plate 300, as discussed above. Furthermore, the washer 304 can enlarge the insertion directions of the bone screw 308 both 20 vertically and horizontally. Furthermore, the spinal plate 300 according to Embodiment 3 of the present invention includes spike screw 306 on each of the pair of rotation portions 312. In the conventional case, spike or teeth is used and formed integrally with the spinal 25 plate. However, this spike or teeth does not provide a robust capability to securely adhere the spinal plate to the vertebrae. Therefore, the present invention applies the spike screw 306 on each of the pair of rotation portions 312. This spike screw 306 includes a head portion 326 and a body portion 328, and the 30 head portion 326 and the body portion 328 have different threads. The spike screw 306 is designed such that a pitch of the thread in the head portion 326 is smaller than a pitch of

26

21920592_1 (GHMatters) P123782.AU

the thread in the body portion 328, thereby enabling self- locking while pulling the vertebrae to the spinal plate. The head portion 326 of the spike screw 306 is screwed with a spike 21920592_1 (GHMatters) P123782.AU

screw support part 334 of the rotation portion 312. 5 As illustrated in FIG. 22, a washer 304 is put on the bone screw 308 on a washer support part 332 on each of the pair 2022335774

of rotation portions 312. The washer 304 is assembled with the spinal plate 300 and pressed fitted in the manufacturing facility. During the manufacturing process, a top portion 324 10 of the washer 304 is inserted inside the washer support part 332 after deflation. The top portion 324 of the washer 304 is enlarged inside the washer support part 332 after the insertion. During the surgery, the bone screw 308 is inserted into the washer 304 to secure the spinal plate 300 to the vertebral body. 15 Therefore, a head of the bone screw 308 presses down on the washer 304, and the washer 304 presses down on the washer support part 332 of t20he rotation portion 312, thereby creating friction. The design of the washer 304 is not limited as illustrated in FIG. 21. The washer 304 surrounds a head of the 20 bone screw 308 and is designed such that the washer 304 can be easily put on the circular (oval or round) head of the bone screw 308. In order to increase insertion angles of the bone screw 308, the spinal plate 300 is designed such that the washer 304 rotates with respect to each of the pair of rotation portions 25 312 and a head of the bone screw 308 rotates with respect to the washer 304. By having large insertion angles of the bone screw 308, when both sides of rotation portion 312 are rotated downward than the body, inserting the bone screw 308 would cause the bone screw 308 to face inward. In order to solve this 30 problem, insertion angles of the bone screw 308 is designed such that these angles can be adjusted arbitrarily. Inserting and securing the bone screw 308 would push the washer 304, which

27

21920592_1 (GHMatters) P123782.AU

would tighten and hold the head of the bone screw 308 by friction. While the present invention has been described with 21920592_1 (GHMatters) P123782.AU

reference to the preferred embodiments and modified examples, 5 the present invention is not limited to the above-described specific embodiments and the modified examples, and it will be 2022335774

understood by those skilled in the related art that various modifications and variations may be made therein without departing from the scope of the present invention as defined by 10 the appended claims. According to the present invention, it is possible to use the spinal plate by modifying the shape thereof in the shape desired by the doctor during the surgery, thereby developing a spinal plate that can cope with the various spin shapes of the 15 patients. In addition, the shape of the spinal plate may be deformed at various angles with a single plate, it is possible to reduce the burden of preparing the plates for each operation during the surgery, thereby greatly reducing product costs from the 20 manufacturer’s point of view.

It is to be understood that, if any prior art is referred to herein, such reference does not constitute an admission that the prior art forms a part of the common general knowledge in 25 the art, in Australia or any other country. In the claims which follow and in the preceding description, except where the context requires otherwise due to express language or necessary implication, the word “comprise” or variations such as “comprises” or “comprising” is used in an 30 inclusive sense, i.e. to specify the presence of the stated features but not to preclude the presence or addition of further features in various embodiments of the invention.

28

21920592_1 (GHMatters) P123782.AU

[Description of Reference Numerals] 100, 200, 300: Spinal plate 21920592_1 (GHMatters) P123782.AU

102, 202, 302: Central body 5 104, 106, 204, 206: End body 108, 208: Screw support part 2022335774

110, 210: Fixing screw hole 112, 212: End pin joint 114: End serration 10 118, 124, 218, 224: Central pin joint 116: Rotation pin support seat 120, 126: Central serration 128, 228: Window 130, 230, 330: Rotation pin 15 132, 232: Rotation pin central portion 134, 136, 234, 236: Rotation pin end portion 140: Locking tube 142: Tube serration 143: Teeth 20 144: Knob 146: Device coupling part 214: End pin hole 220, 226: Central pin hole 240, 340: Rotational locking unit 25 242: Rotational locking unit body 244: Contact surface 246: Non-contact surface 248: Rotational protrusion 250: Device groove 30 252: Rotational locking unit seat 254: Opening 256: Rotational protrusion seat

29

21920592_1 (GHMatters) P123782.AU

304: Washer 306: Spike screw 308: Bone screw 21920592_1 (GHMatters) P123782.AU

310: Rotational angle control portion 5 312: Rotation portion 314: Rotation support portion 2022335774

316: Rotation connection portion 318: Center hole 320: Bottom portion of rotation portion 10 322: Bottom portion of central body 324: Top portion of washer 326: Head portion of spike screw 328: Body portion of spike screw 332: Washer support part 15 334: Spike screw support part

30

21920592_1 (GHMatters) P123782.AU

Claims

Claims WHAT IS CLAIMED IS: 21920592_1 (GHMatters) P123782.AU

1. A spinal plate comprising: a central body; 2022335774

a pair of rotation portions, the pair of rotation portions being disposed on both sides of the central body in a width direction of the central body with respect to a longitudinal direction of the central body; and rotation pins; wherein each of the pair of rotation portions comprises a bone screw for being inserted into vertebrae, wherein the rotation pins are configured to connect the central body with the pair of rotation portions and are configured to enable the pair of rotation portions to rotate with respect to the central body at any angle, wherein each of the pair of rotation portions is configured to rotate with respect to the central body clockwise for a rotation portion disposed on a right side of the central body and counterclockwise for a rotation portion disposed on a left side of the central body, and wherein a first angle between each of the pair of rotation portions and the central body is less than 45 degrees with respect to the longitudinal direction of the central body.

2. The spinal plate according to claim 1, wherein the central body comprises: a central hole; and two rotational locking units, wherein the two rotational locking units are configured to be released or fastened.

31

21920592_1 (GHMatters) P123782.AU

3. The spinal plate according to claim 1, wherein each of the pair of rotation portions comprises a rotation connection 21920592_1 (GHMatters) P123782.AU

portion, and the central body comprises a rotation support portion. 2022335774

4. The spinal plate according to claim 1, wherein each of the pair of rotation portions is configured to rotate with respect to the central body counterclockwise for a rotation portion disposed on a right side of the central body and clockwise for a rotation portion disposed on a left side of the central body, and wherein a second angle between each of the pair of rotation portions and the central body is up to 90 degree with respect to the longitudinal direction of the central body.

5. The spinal plate according to claim 1, wherein each of the pair of rotation portions is configured to rotate with respect to the central body counterclockwise for a rotation portion disposed on a right side of the central body and clockwise for a rotation portion disposed on a left side of the central body, and wherein a second angle between each of the pair of rotation portions and the central body is larger than 90 degree with respect to the longitudinal direction of the central body.

6. The spinal plate according to claim 1, wherein each of the pair of rotation portions comprises a rotation connection portion, and the central body comprises a rotation support portion, and wherein a rotation of each of the pair of rotation portions is restricted by an upper portion of the rotation

32

21920592_1 (GHMatters) P123782.AU

support portion as the rotation connection portion rotates with each of the pair of rotation portions. 21920592_1 (GHMatters) P123782.AU

7. The spinal plate according to claim 1, wherein a rotation of each of the pair of rotation portions is restricted by a rotational angle control portion formed between a bottom portion 2022335774

of the central body and a bottom portion of each of the pair of rotation portions.

8. The spinal plate according to claim 1, wherein each of the pair of rotation portions comprises a spike screw.

9. The spinal plate according to claim 8, wherein the spike screw comprises a head portion and a body portion, and wherein the head portion and the body portion have different threads.

10. The spinal plate according to claim 9, wherein a pitch of the thread in the head portion is smaller than a pitch of the thread in the body portion, thereby enabling self-locking while pulling the vertebrae to the spinal plate.

11. The spinal plate according to claim 8, wherein a washer is put on the bone screw on a washer support part on each of the pair of rotation portions.

12. The spinal plate according to claim 11, wherein the spinal plate is designed such that the washer is configured to rotate with respect to each of the pair of rotation portions and a head of the bone screw is configured to rotate with respect to the washer.

33

21920592_1 (GHMatters) P123782.AU

13. The spinal plate according to claim 1, wherein the first angle between each of the pair of rotation portions and the central body is up to 20 degree with respect to the longitudinal 21920592_1 (GHMatters) P123782.AU

direction of the central body. 2022335774

34

21920592_1 (GHMatters) P123782.AU

[FIG.

[FIG. 1] 1]

100 102

106

104

[FIG.

[FIG. 2] 2]

124 102

118

of 126 126 and 128 128

[FIG. 3]

104

108

110 110

112

114

[FIG. 4]

130

134

132

[FIG. 5]

143 140

to

142

146 146 144

[FIG. 6]

104

124

130 118

116 140 120

WO2023/02628 2023/026238 O PCT/IB2022/057983 4/15

[L

[FIG. 7]

104 124

118 118 130

116 140 120

[8

[FIG. 8]

100 104 106

130 130 102 102

[FIG. 9]

100 104

106 140 140 102 102 140

[FIG. 10]

204 200 202

240

228 206

[FIG. 11]

224 202

218 218 252 252 254

226 256 256 228 220

[FIG. 12]

204

208 208

210 210

212

214

[FIG. 13]

250 240

242 242

244 246

248

[FIG. 14]

230

234 234

232

[FIG. 15]

250 242 240 228 228

254 252 246 246

212 212

202

[FIG. 16]

250 242 228 246 & 240

254 252 244

212

PCT/ 9/15 9/15

[FIG. 17]

200 204 204

240

206 202

WO 2023/026238 2023/02623 OM PCT/IB2022/057983 10/15 1015

[FIG.

[FIG. 18] 18]

302 312 318 304 319 316

300 000

303 306

308 340 314 330

[FIG. 19]

304 302 302 316 316 318 318

312 312

308 308

306 306

330 330

340