Height-adjustable implant to be inserted between vertebral bodies and corresponding handling tool

The invention relates to implant ein.höhenverstellbares Insertion between vertebral bodies.

An example from DE 196 22 827 A1 known implant comprises a first and a second sleeve part , wherein the second sleeve part has an external thread, which rotationally fixed with a longitudinal section of the first sleeve part and axially movable and rests at its first out of the sleeve member out projecting longitudinal section of a in the external thread engaging nut covers. By turning the nut the second sleeve part is out from the first sleeve part emotional. To actuate the mother is a rod-shaped Handling tool with its free end in a recess on The outer periphery of the nut inserted. By a pivoting movement of the tool in a direction transverse to the longitudinal axis of the implant Level is the mother to one of the swivel angle Tool corresponding piece is rotated further. Thereafter, the Tool 'drawn from the mother out and described repeated the process until the implant the required Height has. Do While the mother of the rotary actuator fail to rotate the first sleeve part, so that this in Normally be held with another tool have to be. requires the higher position in the known implant thus an increased time and equipment expense. ' In addition, a relatively large surgical opening is required make hindrance to the said manipulation can

From US 2003 / 045877A a height-adjustable implant is in accordance known to the preamble of Patent Claim first

Considering this, it is the object of the invention, an implant and propose a handling tool with which the Insertion is facilitated in the spine.

This object is achieved by the subject matter of claim 1 dissolved.

According to claim 1 the mother wearing a Sprocket is so designed as gear. With help of a Tool with a suitable counter element, for example, a drive gear can be the height of the implant adjust, wherein the handling tool no pivoting movements must be performed. Moreover, it is not necessary the tool often implement. Rather, it can throughout the process in one and the der.Höhenverstellung same position held, what the operation much simplified and operation time saved.

In a preferred embodiment, the mother carries the gear ring at its side facing the first sleeve part bottom. The operation of the nut can thereby with a drive gear take place, its axis of rotation perpendicular to the axis of rotation of Mother runs. A deflection of the rotational movement of the axle, as with parallel to the case of a drive gear axis of rotation Mother aligned axis would be the case is not required, favors whereby a compact construction and the Production costs are lowered.

In order to ensure a rotational fixation of the first sleeve part this is a threaded hole present at the a Mother driving handling tool can be fixed. In contrast to conventional implants thus is only a single both for driving the mother as well as for fixing the first sleeve part serving tools required.

In the implant known from DE 196 22 827 A1 is based the mother during the extension of the second sleeve part at their end facing from the first sleeve part. Otherwise but is not fixed to the first sleeve part, the mother. The Height of the known implant can therefore only increased, not but decreased, ie, the second sleeve member can not be moved into the first sleeve part. With the inventive Implant, however, is the nut with a axialwirksamen Form-fitting, so in both axial directions on the first fixed sleeve part, whereby both an increase as a reduction of the implant height is possible. The latter may be required, for example if after the onset the implant made too great a height adjustment has been.

In a particularly preferred embodiment, the two sleeve parts axially extending, facing in their mutually Ends opening out window, wherein between two adjacent windows disposed peripheral portions in the Windows of the respective other sleeve part axially displaceably einliegen. Compared with a configuration in which two sleeve parts concentrically interlocking, it firstly has the advantage, that less material is required, and the implant thereby lighter overall. There is also a significantly greater interior space available, the bone material or the like. can be replenished. By the comb-like fashion grab the two sleeve parts is finally a mutual Rotary fixation ensured.

To support the implant on a vertebral body is a radially widened end plate provided. In a preferred Configuration is this a separate, removably fixed Part. It can then in each case the appropriate faceplate, for example, one with an angle to the central axis the implant extending flat plane, are used. If the end plate by means of a snap connection fixed sleeve part, on the one hand is a sure grip on the sleeve part guarantees and secondly an easy interchangeability. A simple in manufacturing and assembly technically Embodiment provides that near the end face of a Annular groove is present in the inner wall of the sleeve part, in the integrally formed on the underside of the end plate catch noses intervention.

A management tool for an implant of the above Art has according to claim 10, a mother with the cooperating Gear on. Preferably on a handling tool Retaining means for retaining the implant available. The Gear is arranged so that its axis in driving the transverse to the axis of the nut of the gear ring. deflection the rotation of the driving axle is, as already mentioned above, is not required. A particularly space-saving and easy-to-use arrangement provides that disposed the toothed ring on the end face of a pipe section and in that the pipe section penetrated by a rod is projecting the free end of the tube section and in the threaded bore of the first sleeve part is screwed. allows the coaxial arrangement of the pipe section and the rod a compact and easy-to-use handling tool.

The invention will now be illustrated by the accompanying drawings explained. Show it:<dl tsize="6"><dt>Fig. 1</dt><dd>a partially cutaway perspective view of a Implant with a first sleeve part and a fact axially movable inset second sleeve portion, the second sleeve part in its retracted position is,</dd><dt>Fig. 2</dt><dd>the implant of Fig. 1 with partially extended second sleeve part,</dd><dt>Fig. 3</dt><dd>a perspective view 'of the first sleeve part,</dd><dt>Fig. 4</dt><dd>a perspective view of the extendable second Sleeve part,</dd><dt>Fig. 5</dt><dd>one for driving the first sleeve part serving mother,</dd><dt>Fig. 6</dt><dd>a fixable to a sleeve part end plate,</dd><dt>Fig. 7</dt><dd>a tool for handling of the implant.</dd></dl>

The implant shown in the figures comprises as the main components a first sleeve part 1, a second sleeve part 2 and a nut 3 on. The sleeve part 2 is provided with an in substantially over its entire length extending outer thread 4 provided. Both sleeve parts 1,2 have axially extending, facing in their in the assembled state in its side End face 5a, b opening out windows 6. The between two adjacent windows are remaining peripheral portions 7a, b are in the windows of the other 6 1,2 sleeve part an axially displaceable. Here is the game between the peripheral portions 7a, b such that a wobble-free Seat of yet two sleeve parts together and a slight displacement is ensured. The sleeve parts 1.2 have approximately the same thickness and the same Internal diameter, ie the peripheral portions 7b of the second Sleeve part 2 are neither the foreign nor the The inner circumference of the sleeve part 1 addition. The axial length of the windows 6 or the peripheral sections 7a, b is such that at maximum retracted sleeve part 2 between the end face 5a, b a peripheral portion 7a, b and the base 8 a Sleeve part 1.2 a axial distance 9 is present.

For height adjustment and for extending and retracting the sleeve part 2 is the nut 3, which includes both sleeve parts 1,2. It is with your first sleeve member axially fixed and rotatable connected. Your the two sleeve parts 1,2 inside comprehensive has an upper, provided with an internal thread 10 Längsab'schnitt and an adjoining threadless Longitudinal section. 13 In these is an annular groove 14 incorporated. The nut 3 is positioned on the sleeve part 1, that only the thread-free longitudinal section 13 the peripheral portions 7a of the sleeve part 1 includes the internal thread and 10 with the external thread 4 of the sleeve member 2 in engagement stands. Near the end face 7a 5a a circumferential section a circular segment-shaped, over its entire width extending projection 15 formed, of the annular groove 14 Mother intervenes. The nut 3 may be, although at rotate sleeve part 1, but is at this in two axial directions fixed. The facing the free ends of the peripheral portions 7b Side of the nut 3 carries a coaxial with the central longitudinal axis 16 of the implant extending annular gear 17. The Ring gear 17 is integrally formed on der.Mutter 3, for example milled. It serves the nut 3 using a tool described below in more detail in rotation to move and thereby the sleeve part 2 from the sleeve part 1 to move out or into, so the height the implant to adjust.

The remote to the free ends of the peripheral portions 7a, b End faces 18 carrying a radially around the circumference of the sleeve parts 1.2 out standing end plate 19. The end plates 19 are removably attached to the sleeve parts by means of a snap connection 1.2 fixed. For this purpose is on the inside of Sleeve parts 1.2 near the end faces 18 a groove 20 is present, in which at the end faces 18a, b facing side the end plate disposed locking projections 23 engage. The Locking projections 23 are formed on a skirt 24 that a central opening 21 bounded in the faceplate 19th In the Edge 25 of the skirt 24 are a plurality of circumferentially equal distributed recesses 26 introduced. The between the recesses 26 existing peripheral portions 27 carrying the locking projections 23. The peripheral portions 27 are slightly radially can be deflected elastically inwards, whereby the fixing or Remove the face plate 19 is facilitated. On the outer sides 28 of the end plates 19 is a toothed ring 29 in the direction the longitudinal axis 16 before. This is used to clawing the Implant on a vertebral body.

In the peripheral portions 7a two openings 30 are present. The openings 30 and the central opening 21 in the end plates 19 serve for filling of bone material, Bone cement or the like. In one of the peripheral portions 7a is near the nut 3 is a radially directed threaded bore 33 available. This serves to fix the described below Manipulating tool.

As shown in FIG. 7 can be seen, this is essentially of a rod formed 34, one end of a handle 35 and whose other end carries a threaded portion 36th Which the threaded portion 36 extending away region of the rod 34 is of a rotary sleeve comprises 37 coaxially. That the handle 35 facing end of the rotating sleeve 37 carries a knurled wheel 38 and the opposite end a toothed ring 39. This is similar as in the nut 3 by a milled editing Sleeve end side produced. An axial movement of the sleeve 37 toward the handle 35 is formed by a stop flange 39 limited.

To adjust the height of the implant, for example, starting of the situation shown in Fig. 1, which is Handhabungswerkzeug'mit its threaded portion 36 into the threaded bore 33 is screwed. The toothed ring 39 stands with the Toothed ring 17 in the manner of a crown in the engagement, ie the axis of the ring gear 39 is substantially perpendicular to the axis of the ring gear 17. The thumbwheel 38 rests against the stop flange 29th

After the implant with the aid of the handling tool via A surgical opening was inserted into the spine, is to set a higher level of the implant Rotating sleeve 37 by actuating the knurled wheel '38 in rotation added. If it is the external thread 4 of the sleeve member 2 and the internal thread 10 of the nut is 3 um'Rechtsgewinde, must the nut 3 in the direction of arrow 40 and the Knurled wheel to rotate in the direction of arrow 43rd to release the handling tool from the implant is its threaded portion 36 by rotating the handle 35 from the threaded bore 33 away. Since the sleeve 37 rotate around the rod 34 can, it is not required, the rotary sleeve during the hold unscrewing the threaded portion 36th fixation the once adjusted relative position between two Sleeve parts 1,2 can accomplished in various ways will. A simple possibility is in the Threaded hole 33 a provided with a tip about Screw (not shown) screwed in.

LIST OF REFERENCE NUMBERS

<dl tsize="4" compact="compact"><dt>1</dt><dd>first sleeve part</dd><dt>2</dt><dd>second sleeve part</dd><dt>3</dt><dd>mother</dd><dt>4</dt><dd>external thread</dd><dt>a,b</dt><dd>front</dd><dt>6</dt><dd>window</dd><dt>7a,b</dt><dd>peripheral portion (A = first sleeve part; b = second sleeve part)</dd><dt>8</dt><dd>Basis</dd><dt>9</dt><dd>Axialabstand</dd><dt>10</dt><dd>internal thread</dd><dt>13</dt><dd>longitudinal section</dd><dt>14</dt><dd>groove</dd><dt>15</dt><dd>head Start</dd><dt>16</dt><dd>central longitudinal axis</dd><dt>17</dt><dd>toothed ring</dd><dt>18</dt><dd>front</dd><dt>19</dt><dd>Stirnplatte</dd><dt>20</dt><dd>groove</dd><dt>21</dt><dd>opening</dd><dt>23</dt><dd>Rastvorsprung</dd><dt>24</dt><dd>apron</dd><dt>25</dt><dd>Row</dd><dt>26</dt><dd>recess</dd><dt>27</dt><dd>peripheral portion</dd><dt>28</dt><dd>outside</dd><dt>29</dt><dd>toothed ring</dd><dt>thirty</dt><dd>perforation</dd><dt>33</dt><dd>threaded bore</dd><dt>34</dt><dd>Stab</dd><dt>35</dt><dd>Handle</dd><dt>36</dt><dd>threaded portion</dd><dt>37</dt><dd>Drehhülse</dd><dt>38</dt><dd>Rändelrad</dd><dt>39</dt><dd>stop flange</dd><dt>40</dt><dd>arrow</dd><dt>43</dt><dd>arrow</dd></dl>