FR2872021A1 - IMPROVEMENT TO A SCOLIOTIC AUTOCORRECTION DEVICE REQUIRING MORE INTERVENTIONS AFTER IMPLANTATION - Google Patents

Abstract

1-Device 1 for self-correction of scoliosis (1) consisting of the sets of means (2), (3), (4) and (5), the sub-assembly of means 2 consisting of a rod (21) attached to the ends of the scoliosis concavity by two fasteners (22, and 23) of a set of means (3) comprising two rods (31 and 32) attached to the spine by other fastening means (33 and 34) located at the ends of the bowstring defined by the curvature. R of scoliosis, the rods (31 and 32) being able to slide freely through orifices located at the ends of a part (4) which has the shape of a U widely open to allow optimal guidance of said rods, the part (4) itself being composed of a rod (41) comprising on its body identical indentations capable of receiving needle screws, making it possible to ensure a connection between the sub-assemblies (2) and (3) via in one piece (5) as well as a minimum adjustment when installing the device (1), it preferably has the shape of a small one-piece block allowing the passage of the rods (21 and 41)

Description

2872021 1

  TECHNICAL FIELD OF THE INVENTION The present invention relates to a device for self-correcting a scoliosis, which once placed on the spine of a child no longer requires interventions.

  Prior Art: US Patent Application No. 5,261,908 relates to an expandable intervertebral prosthesis which is fixed on the patient's ribs and which thus makes it possible to prevent scoliosis from worsening, this invention could not reduce scoliosis, it adapts to certain vertebral pathologies for which it is difficult or impossible to focus on the vertebrae, 1.5 means used and the problem to be solved are different.

  The first patent Fortin entitled Scolotic self-correction device no longer requiring interventions deposit 0407138 described and claims a first device providing this function with some minor drawbacks: the maximum reduction of the scoliotic arrow residual is less important assembly that in the improvement (embodiment 2 of the present invention) the old rods which were growing longer were poorly protected from surrounding tissues The present invention solves the problem of scoliosis correction without any intervention other than the implantation of the present device.

  In addition, the means implemented to obtain the desired effects are new, and two embodiments are proposed. The present invention, thanks to the new means implemented will correct the scoliosis at a young age, without re-intervention of the operator, moreover its design confert an easy implementation in a minimum of congestion.

  2872021 2 The drawings used for understanding the invention are: Figure1 board 1/11 overview of a first variant device assembled without rings Figure 2 board 1/11 overview of the device 5 assembled with anti-rings retour Figure 3 plate 2/11 overview of the device placed on a spine Figure 4 plate 3/11 view of a connecting piece connecting the 10 two essential subassemblies of the device Figure 5 board 3/11 connecting part view in the sagittal plane with curved rods Figure 6 plate 3/11 perspective view of a connecting connector with its sliding and gripping holes Figures 7a, 8a, 9a plate 4/11 Three diagrams showing the Straightening Dynamics.

  Figures 7b, 8b, 9b plate 5/11 Evolution of the geometrical parameters corresponding to the previous figures of plate 4/11 (Dynamic of recovery) Figures 10 and 11 plate 6/11 second variant of the device Figure 10 perspective view of another version improving the first device Figure 11 sectional view of the same new device Figure 12 board 7/11 exploded view of the means forming this new device that improves the first Figures 13,14, 15, and 16 board 8/11 overview in perspective showing the various phases of its assemblies and adjustment during its implementation Figure 17 plate 9/11 perspective view of the same device with ring connection.

  Figures 18 plate 9/11 perspective view of the device (version 2) with all of its means with n hook by link that slides through a central tube Figures 19, 20, and 21 plate 10/11 three views in perspective 5 of the device corresponding to phases of adjustments of the central rod during the implementation Figure 20d plate 10/11 detail of the cross-sectional view of the transverse rod with an adjustable distance the longitudinal tube 10 which follows Growth Figures 22,23,24,25,26,27 and 28 Plate 11/11: perspective views of a set of means or small elements that are part of the version 2 device.

  The definition of self-correction of the described and claimed device (s) arises from the fact that the growth of the child is used to reduce scoliosis.

  They adapt to all the deformities during its installation They correct the scoliosis by the growth of the child, and 20 are constituted of extremely simple means compatible with the environment of the human body and resistant.

  We will now describe each of the devices by explaining the functionality of the means, in two preferred embodiments whose general mode of design is

  explained on page 9 of this description.

  In a first embodiment corresponding to a first version of the self-correction device, the device 1 consists of a set of means 2,3,4 and 5 (FIG. 1) formed of 30 subassemblies whose means combine functionally to reduce scoliosis.

  The sub-assembly of means 2 consists of a rod 21 of two fixing means 22 and 23 of the rod 21 on the rachis (hooks or screws), these hooking means being fixed at the top of the concavity The set of means 3 comprises two rods 31 and 32 5 attached to the spine by means 33 and 34 at the ends of the rope D of the arc defined by the curvature.

  These clipping means 33 and 34 may be: hooks pedicle screws or stirrups clinging to the ribs.

  These rods 31 and 32 can freely slide through the orifices 43 (a and b) and 44 (a and b) located at the ends of a part 4 which preferably has the shape of a U open to allow optimal guiding . This piece 4 could also be of parallelepipedal shape such as a small block, with orifices 43 (a and b) and 44 (a and b).

  The part 4 is composed of a rod 41 having on its body identical impressions 42 a, b, c. .. which can receive for example needle screws, to ensure a connection between the subassembly 2 and the subassembly 3 this via a part 5.

  The part 5 still called subassembly 5 is preferably a small block (FIG. 6) of suitable shape, it may also be a hook. The part 5 comprises: two holes 51 and 52 allowing the passage in a perpendicular manner of the rods 21 and 41 They also comprise two means such as notches 53 and 54 holes for gripping with a surgical tool.

  It also has a tapping 55 to receive a needle screw which will be placed in one of the conical notches 42 (a, b, c.) This to ensure a rigid connection between all means 2 and 3 to increase as much as possible at the time of implantation, the radius R of the scoliosis minimizing the distance f between the maximum curvature and the middle of the rectilinear part of the part 4 (minimum distance targeted during the implantation of the device) The entire device 1 is connectable to the spine or ribs by the subassembly 3 which is constituted by fastening means such as for example: stirrups, hooks or pedicle screws The self-correction device 1 through the combination of the together means previously described has a number of mechanical characteristics that ensure self-correction only by growth, knowing that certain geometric parameters are fundamental: Distance D between the The clipping devices 33 and 34 are expandable, this distance increasing to D1 D2 D3 (Figures 7b, 8b, 9b) with growth.

  Arrow f between the curvature and a catch 45 located in the middle of the rectilinear part of the U-shaped piece 4, k being a constant value with f = k by construction of the device 1 radius R of scoliosis curvature, which value increases with growth.

  Under the action of the growth of the child, D increases (in D1, D2, D3) because the rods 31 and 32 are attached to the vertebrae or the ribs and that said rods 31 and 32 can freely slide in the room 4.

  The growth of the child leads, because of the constancy of f, an increase in the radius of curvature R scoliosis, ie a recovery that tends to transform the curvature in a straight line, this thanks to the mechanical characteristics chosen the construction of this self-correction device, which needs no intervention, except a follow-up by medical imaging.

  Other essential characteristics of the invention are as follows: The rods 31 and 32 slide in the orifices (43a and b) and (44a and b) with a clearance allowing good sliding even for curved rods while maintaining a good rigidity to the device 1 The manufacturing material used has good ductility with elasticity adapted to the forces that are discontinuous and non-linear, it must allow without breaking the bending of the rods 31 and 32,. It must of course be biocompatible The part 4 accepts to receive slightly curved sliding rods thanks to the preceding characteristics of the selected material or materials, the surface conditions and the games are determined with precision, moreover no salient profile is accepted, for that the device 1 avoids hurting the surrounding tissue.

  On each of the rods 31 and 32 can be implanted according to the pathologies of the "anti-return" rings 310 and 320 located on the side of the fixing of the rod 31 or 32 and resting on one of the outer face of the end. U of the piece 4 (Figure 2) Their function is to maintain a sufficient tension between the fasteners to the spine 33 and 34 located at each end of the rods 31 and 32, increasing the distance D, thus avoiding a return to the initial state , before the growth effect takes over.

  In a second embodiment, the self-correction device 10 comprises: a preferably cylindrical tube 11 having a solid portion in the center and in which two symmetrical identical rods 12 connected to the hooks 33 and 34 slide freely in the hollow parts; and which have means for guiding and abutting start and end of stroke, namely: -guiding means of the rod 12 in the tube 11 which are: at the inlet of the tube a bearing 122 which guides the rod in the tube at the end of the rod 12, a piston 121 which slides inside the tube 11 - end stop means the stroke of the rod 12 in both directions and which are on one side the stop 110 and on the side of the maximum elongation the bearings 120 on which the piston 121 comes to lock - at least one vent 110 which avoids a compression of air or gas which will enter the tube 11 and which could block the 10 rods -a pivot rod 13 that can translate and rotate This swivel rod 13 comprises a cylindrical ring 130 encircling the tube which can itself translate and rotate around the tube 11.

  This ring 130 is connected to a rod 31 or which is part of it, it may be fluted threaded or have notches allowing a connection between the means 6 (screw) and the tube 11.

  During the introduction of the device 10, the pivot rod 13 is placed in the housing 64 (Figure 14) of the head of the fastening screw on a vertebra of the spine (middle 6) in which it can translate before fixation, this which allows the operator to minimize the arrow f (as in the first embodiment) by bringing the attachment 6 as close as possible to the tube 11, which is then blocked by tightening a threaded plug 61. Compared in the first embodiment, this second embodiment further reduces the arrow f at the time of installation of the device. After placing and tightening the means 6, the protruding, useless, or even annoying portion of the rod 31 is severed.

  Another embodiment of this attachment (FIG. 17) thus consists of the means 5 (of the first embodiment): a small block (FIG. 6) associated with the pivot rod 13 with the means 2 and comprising the rod 21 carrying at its end two hooks 22 and 23 2872021 8 In this second embodiment the piece 4 of the first embodiment is thus replaced by a set of means 7 comprising a pivot pin 13 and a tube 11 combined with a ring 130 which will allow the sliding rods 12 along the axis of the elongation.

  In another illustrative example of this embodiment, the pivot rod 13 is replaced by a connecting rod 14 which translates transversely through the solid portion of the tube 11 which can be determined the location of the attachment with a maximum of traction and then we will block at this location with a screw 15, which will keep constant the arrow f.

  The connection of the tube 11 with the means 2 is provided by a ring 141 connected to the rod 14 or which is part thereof and which receives the rod 21 carrying fastening means attached to the vertebrae of the spine.

  In this embodiment, a reinforcement can be added. 8 (Figure 28) positioned on the tube 11 longitudinally at its center (Figure 18) and lock the rod 14 by clamping a screw 81 applying on the rod, thus ensuring an optimum mechanical strength.

  The implementation phases are as follows: 1- Placement on the vertebrae or on the bones concerned of the attachment means 22, 23, 6, 33, 34.

  2- Placing the tube 11 receiving the two sliding rods 12 with the means 13 or 14 4- Fixing the ends of the rods 12 with the hooking means 5-Maximum connection of the means 6 or 2 to the tube 11 of such so that the arrow f is as small as possible in order to achieve the best possible correction of the scoliosis curvature.

  6-Sectioning the protruding portion of the connecting rod 13, 14, to ensure the locking of the residual arrow 2872021 9 The most essential feature of this invention comes from the fact that it has elongated hooking means to the bones to guide growth in a straight line, said means being combined with traction means hooked to the top of the concavity of the curvature of the spine and which exert traction on it to cause its recovery during this growth, these functionalities are obtained by devices 1 and 10 given by way of example.

  The elongation means of the devices 1 and 10 are for example rods 31, 32 or 12 being slidable in sets of means 4 or 7; the rods 31, 32 or 12 being attached to the bones by hooking means 33 and 34.

  The attachment means at the top of the curvature of the spine 2 or 6 are for example a rod 21 attached to the vertebrae of the spine by hooks 22 and 23, the rod 21 being connected.

  on the one hand by a transverse connection 41 or 13 to the set of means of extension of the device 4 or 7, and on the other hand to the mid-point of the rod 21 by an adjustable fastening means 5 or 6; The attachment means are connected by a set of means 4 or 7, the essential means of connection being the rod 41 or 14, which is fixed to the mounting the length of attachment to the vertebrae of the spine by tightening screws or plug 15 or 61, this to optimize a minimum distance or residual arrow of scoliosis.

  This arrow will remain constant during the elongation, which will allow an increase in the radius R (FIGS. 7a, 8b, 9b) during the growth, the latter causing the sliding of the rods 31, 32 or 12 which will generate self-redirection by traction at the point of maximum curvature of the spine. (see Figures 7a 8a 9a).

  After installation of one of these devices 1 or 10, there is no intervention on the patient In all these devices, whatever the embodiment, all the parts allows a very easy implementation to the 5 of the elements manufactured as well as their assembly practiced outside intervention or during the latter 15 20 25

Claims (3)

CLAIMS ----------------------   1-scoliotic autocorrection device (1) or (10), characterized in that it comprises: elongation means which are for example rods (31, 32 or 12) slidable in sets of means (4) or (7), said rods (31,32) or (12) being fixed to the bones by hooking means (33 and 34). fastening means at the top of the curvature of the spine (2) or (6) such as for example a rod (21) attached to the vertebrae of the spine by clashes (22 and 23), the rod (21) being itself connected on the one hand by a transversal connection (41), (13) or (14) to all means of extension of the device (4) or (7) and on the other hand at its midpoint by a adjustable hooking means (5) or (6), the attachment means to the spine being connected by a set of means (4) or (7), said connecting means (41) (13) or (14), can be adjusted in length between its attachment to the vertebrae and its attachment point (45) on one of the means: part (4) (13) or (14), by clamping with a screw or a a screw plug (15 or 61), at a determined clamping point, to optimize a minimum distance or a residual arrow (f) of the scoliosis, which remains constant during the elongation, this combination of means allowing an increase radius (R) of c curl of scoliosis during growth, caused by the possible sliding of the rods (31), (32) or (12) which lengthen during the growth, thus generating a self-straightening by traction at the point of maximum curvature spine.   2-self-correction device (10) according to claim 1 characterized in that it comprises: a-tube (11) preferably cylindrical having in the center a solid part and in which slide freely in the hollow portions two identical rods (12) ) symmetrical connected to the clashes (33 and 34) and which have guiding and abutment means of start and end of stroke, namely: -guiding means of the rod (12) in the tube (11) which are at the inlet of the tube a bearing (122) which guides the rod in the tube and at the end of the rod (12) a piston (121) which slides inside the tube (11) - stop means of end of the stroke of the rod (12) in both directions and which are on one side the stop (110) and on the side of the maximum elongation the bearings (120) on which the piston (121) comes to lock.   at least one vent (110) which avoids a compression of air or gas which will enter the tube (11) and which could block the rods; a pivot rod (13) able to translate and pivot freely around the tube; (11) 3-self-correction device (10) according to claim 2 characterized in that the pivot rod (13) comprises a ring (130) cylindrical encircling the tube which can translate and rotate around the tube (11), this ring ( 130) being connected to or forming part of the rod (13), said rod (13) being threaded, grooved, or having notches allowing a connection between the hooking means (6) and the tube (II). Self-correction device (10) according to claim 3, characterized in that the hooking means (6) is a screw comprising a head provided with a housing (64) in which the pivot rod (13) is located, and in which, it can translate before fixing, which allows the operator to minimize the arrow (f) in 2872021 13 approximating the fixing screw (6) as much as possible of the tube (11), which is then blocked by tightening a threaded plug (61). 5. Self-correction device (10) according to claim 1, characterized in that the fixing means on the rod (14) consists of the means (5) which is a small block associated with the pivot rod (13) with the means (2), comprising the rod (21) carrying at its end two hooks (22). and 23) 6-self-correction device (10) according to claim 2 characterized in that the pivot rod (13) is replaced by a connecting rod (14) which translates transversely through the solid part of the tube (11) the location of the attachment can be determined with maximum traction and then locked at this location by means of a screw (15) which makes it possible to maintain constant the deflection (f). autocorrection (10) according to claim 6 characterized in that the connection of the tube (11) with the means (2) is provided by a year (141) connected to the rod (14) or which is part thereof and which receives the rod (21) carrying fastening means attached to the vertebrae of the spine.   8-self-correction device 10 according to claim 1 characterized in that it comprises a reinforcement (8) positioned on the tube (11) longitudinally at its center and that it can be locked on the rod (14) by clamping d a screw (81) applying to said rod, which ensures an optimum mechanical strength.