Search Images Maps Play YouTube News Gmail Drive More »
Sign in
Screen reader users: click this link for accessible mode. Accessible mode has the same essential features but works better with your reader.

Patents

  1. Advanced Patent Search
Publication numberUS20040143332 A1
Publication typeApplication
Application numberUS 10/699,618
Publication date22 Jul 2004
Filing date31 Oct 2003
Priority date31 Oct 2002
Also published asCA2502292A1, CA2502292C, EP1567098A2, EP1567098B1, US7909877, US20060116768, WO2004041131A2, WO2004041131A3
Publication number10699618, 699618, US 2004/0143332 A1, US 2004/143332 A1, US 20040143332 A1, US 20040143332A1, US 2004143332 A1, US 2004143332A1, US-A1-20040143332, US-A1-2004143332, US2004/0143332A1, US2004/143332A1, US20040143332 A1, US20040143332A1, US2004143332 A1, US2004143332A1
InventorsDavid Krueger, Erik Wagner
Original AssigneeKrueger David J., Wagner Erik J.
Export CitationBiBTeX, EndNote, RefMan
External Links: USPTO, USPTO Assignment, Espacenet
Movable disc implant
US 20040143332 A1
Abstract
A disc implant is provided which maintains intervertebral spacing and stability within the spine. In an embodiment, a disc implant may include three or more components. Components of the implant may imitate certain physiological movements associated with a healthy spine. In certain embodiments, the components of the implant may limit physiological movements to within certain ranges, imitating normal spinal movements.
Images(22)
Previous page
Next page
Claims(45)
What is claimed is:
1. An artificial disc implant for a human spine, comprising:
two engaging plates, wherein each engaging plate comprises:
a recess; and
two or more slots configured to engage an insertion instrument during insertion of the disc implant, wherein the slots are at an angle relative to an anterior-posterior axis of the engaging plates; and
one or more members positionable between the engaging plates, wherein at least one of the members comprises a portion configured to complement at least one of the recesses to allow axial rotation, lateral movement and anteroposterior movement of the engaging plates relative to each other during use.
2. The implant of claim 1, wherein one or more sides of at least one of the recesses are tapered.
3. The implant of claim 1, wherein a height of a posterior side exceeds a height of an anterior side of at least one of the recesses.
4. The implant of claim 1, wherein the portion configured to complement at least one of the recesses is a convex portion, and wherein at least one of the recesses comprises a concave portion complementary to the convex portion.
5. The implant of claim 1, wherein at least one of the engaging plates comprises a convex portion, wherein at least one of the members comprises a concave portion, and wherein the convex portion is complementary to the concave portion.
6. The implant of claim 1, wherein the two engaging plates and the one or more members are made of metal.
7. The implant of claim 1, wherein the slots are dovetailed.
8. A system for inserting an artificial disc implant between human vertebrae, comprising:
an inserter having a body, a passage through the body, and arms, wherein the arms are configured to be releasably coupled to engaging plates of the artificial disc implant; and
a distractor positionable in the passage in the body, wherein the distractor is configured to separate the arms of the inserter such that engaging plates coupled to the arms of the inserter remain substantially parallel during separation of the engaging plates to form a disc space between the human vertebrae.
9. The system of claim 8, wherein the inserter is configured such that coupling the inserter to the engaging plates does not increase separation between the engaging plates.
10. The system of claim 8, wherein the arms of the inserter are configured to be releasably coupled to dovetailed slots in the engaging plates.
11. The system of claim 8, wherein the inserter and the distractor are configured such that the distractor does not contact the engaging plates during insertion of the engaging plates.
12. The system of claim 8, further comprising a pusher, wherein the pusher is configured to drive a member through a passage in the distractor and position the member between the engaging plates.
13. The system of claim 8, further comprising a member seater configured to seat a member in the engaging plates through the passage in the inserter.
14. The system of claim 8, further comprising trial endplates and one or more additional distractors, wherein the trial endplates are configured to be used in combination with the distractors to determine height and lordotic angle of the artificial disc implant to be inserted.
15. A method for forming an artificial disc implant between human vertebrae, comprising:
positioning two engaging plates between the human vertebrae;
separating the engaging plates such that the engaging plates remain substantially parallel;
positioning one or more members between the engaging plates such that a surface of at least one of the members contacts a complementary surface of at least one of the engaging plates; and
wherein the engaging plates and at least one of the members are configured to allow relative movement of the engaging plates during use.
16. The method of claim 15, further comprising determining a height, size and lordotic angle of the artificial disc implant to be formed between the vertebrae before positioning the engaging plates between the vertebrae.
17. The method of claim 15, further comprising forming a recess in at least one of the vertebrae to engage a projection on at least one of the engaging plates.
18. The method of claim 15, wherein positioning at least one of the members comprises positioning such members in a rounded recess in at least one of the engaging plates.
19. The method of claim 15, wherein the engaging plates are positioned using an angulated anterior approach to the vertebrae.
20. The method of claim 15, wherein the engaging plates are positioned using an anterior approach to the vertebrae.
21. A disc implant, comprising:
a first engaging plate and a second engaging plate;
a member positionable between the engaging plates;
wherein the first engaging plate comprises a recess configured to receive a base of the member, wherein one or more sides of the recess are tapered; and
wherein a surface of the second engaging plate complements a surface of the member to allow axial rotation, lateral movement and anteroposterior movement of the engaging plates relative to each other during use.
22. The implant of claim 21, wherein a height of a posterior side of the recess is greater than a height of an anterior side of the recess.
23. The implant of claim 21, wherein at least one of the engaging plates comprises a concave portion complementary to a convex portion of the member.
24. The implant of claim 21, wherein at least one of the engaging plates comprises a convex portion complementary to a concave portion of the member.
25. The implant of claim 21, wherein at least one of the engaging plates comprises at least one coupling projection.
26. The implant of claim 21, wherein the engaging plates comprise one or more slots, wherein the slots are configured to engage an instrument for insertion of the implant.
27. The implant of claim 21, wherein the engaging plates comprise one or more slots wherein the slots are configured to engage an instrument for insertion of the implant and wherein the slots are positioned at an angle relative to anterior-posterior axes of the engaging plates.
28. A system for inserting an artificial disc implant, comprising:
an inserter having a body, a passage through the body and arms, wherein the arms are configured to be releasably coupled to engaging plates of the artificial disc implant; and
one or more distractors positionable through the passage in the body, the distractors configured to move the arms to establish a separation distance between engaging plates coupled to the arms.
29. The system of claim 28, further comprising a pusher configured to drive a member down a passage through the distractor to a position between the engaging plates.
30. The system of claim 28, further comprising a member seater configured to seat a member between the engaging plates.
31. The system of claim 28, further comprising trial endplates, wherein the trial endplates in combination with at least one distractor are configured to determine height and lordotic angle of the artificial disc implant to be inserted.
32. An instrument kit, comprising:
one or more trial endplates;
a plurality of implant components; and
an inserter configured to couple to selected implant components to allow the components to be positioned in a disc space;
one or more distractors configured to couple to the inserter to establish a separation distance between the selected implant components coupled to the inserter.
33. The instrument kit of claim 32, wherein the inserter is configured to couple to the trial endplates.
34. The instrument kit of claim 32, wherein one or more of the trial endplates are sloped.
35. The instrument kit of claim 32, further comprising a pusher configured to position an implant component between the selected implant components coupled to the inserter.
36. The instrument kit of claim 32, further comprising a member seater, wherein the member seater is configured to apply pressure to one of the implant components.
37. The instrument kit of claim 32, further comprising a pusher configured to position an implant component between the selected implant components coupled to the inserter.
38. A method for forming an implant between vertebrae of a spine, comprising:
coupling a pair of engaging plates to a portion of an inserter;
positioning the engaging plates between adjacent vertebrae;
positioning one or more members between the engaging plates; and
wherein at least a portion of the engaging plates and at least a portion of at least one member is configured to allow at least some movement of a first vertebra relative to a second vertebra.
39. The method of claim 38, wherein positioning the engaging plates comprises an anterior approach to the vertebrae.
40. The method of claim 38, wherein positioning the engaging plates comprises an angled anterior approach to the vertebrae.
41. The method of claim 38, further comprising positioning a distractor in the inserter wherein the distractor is configured to separate in a substantially parallel direction one engaging plate from a second engaging plate.
42. The method of claim 38, further comprising positioning a distractor in the inserter wherein the distractor is configured to separate one engaging plate from a second engaging plate and wherein positioning a member of the one or more members between the engaging plates comprises guiding the member through the distractor with a pusher.
43. The method of claim 38, wherein the movement comprises at least axial rotation and lateral movement of the spine.
44. The method of claim 38, further comprising inserting one or more trial implants and one or more distractors in the vertebral space before coupling the engaging plates to the inserter to determine a lordotic angle of the engaging plates and a height of the members to be inserted.
45. An instrument for insertion of a disc implant, comprising:
a body;
one or more arms configured to couple to one or more engaging plates;
a distractor positionable in an opening of the body, wherein the distractor is configured to separate in a substantially parallel direction one engaging plate from a second engaging plate.
Description
    PRIORITY CLAIM
  • [0001]
    This application claims priority to U.S. Provisional Patent Application No. 60/422,764 entitled “MOVABLE DISC IMPLANT” filed on Oct. 31, 2002. The above-referenced provisional application is incorporated by reference as if fully set forth herein.
  • BACKGROUND
  • [0002]
    1. Field of Invention
  • [0003]
    The present invention generally relates to the field of medical devices. Some embodiments of the invention relate to spinal disc implants and instruments used to insert the implants. Other embodiments of the invention relate to methods of forming spinal disc implants and methods for positioning the implants during surgical procedures.
  • [0004]
    2. Description of Related Art
  • [0005]
    Bone may be subject to degeneration caused by trauma, disease and/or aging. Degeneration may destabilize bone and affect surrounding structures. For example, destabilization of a spine may result in alteration of a natural spacing between adjacent vertebrae. Alteration of a natural spacing between adjacent vertebrae may subject nerves that pass between vertebral bodies to pressure. Pressure applied to the nerves may cause pain and/or nerve damage. Maintaining the natural spacing between vertebrae may reduce pressure applied to nerves that pass between vertebral bodies. A disc implant may be used to maintain the natural spacing between vertebrae and to inhibit relative motion of the vertebrae.
  • [0006]
    A disc space may be created by full or partial removal of an intervertebral disc between two vertebral bodies. Spinal implants for a lumbar region of the spine may be positioned in an intervertebral space after a discectomy procedure. The implant may be inserted using an anterior, lateral and/or posterior approach. The spinal implant may be a fusion device or an artificial disc. Conventional systems and methods for posterolateral spinal fusion may involve dissecting and retracting soft tissue proximate the surgical site. Dissection and retraction of soft tissue may cause trauma to the soft tissue and extend recovery time. Minimally invasive procedures and systems may reduce recovery time as well as trauma to the soft tissue surrounding a stabilization site.
  • [0007]
    Spinal disc implants and/or disc implant insertion instruments are described in U.S. Pat. No. 5,676,701 to Yuan et al.; U.S. Pat. No. 5,401,269 to Buttner-Janz et al.; U.S. Pat. No. 5,370,697 to Baumgartner; U.S. Pat. No. 5,314,477 to Marnay and International Application No. WO 01/19295 to Marnay, all of which are incorporated by reference as if fully set forth herein.
  • SUMMARY
  • [0008]
    In certain embodiments, a disc implant may be used to stabilize vertebrae of a human spine while allowing normal movement of the vertebrae relative to each other. An artificial disc implant may replace a diseased or defective intervertebral disc. An artificial disc implant may be easy to install with only minimal intrusion to adjacent tissue and muscle. A disc implant may introduce minimal risk of dural damage or neural damage during installation and use.
  • [0009]
    An artificial disc implant may include one or more engaging plates and one or more members. Engaging plates may fit between and engage adjacent vertebrae of the spine. The plates may maintain a space between the adjacent vertebrae. One or more members may be positioned in the space between the engaging plates. Engaging plates and members may be designed to allow axial rotation, anteroposterior movement and/or lateral movement of adjacent vertebrae (i.e., the spine). Lateral movement may include lateral bending. Anteroposterior movement may include flexion and/or extension. In some embodiments, a range of motion of one engaging plate relative to another engaging plate may be limited.
  • [0010]
    In some embodiments, an engaging plate may include a recess complementary to a portion of a member. In certain embodiments, an engaging plate may include slots. The slots may be dovetailed. The slots may be complementary to a portion of an instrument used to insert engaging plates between vertebrae. In some embodiments, slots may be formed at an angle relative to an anterior-posterior axis of an engaging plate. In some embodiments, an angular orientation of a recess may correspond to an angle of slots in an engaging plate. Angulation of the slots may allow insertion of a disc implant using a modified (e.g., angulated) anterior approach. A modified anterior approach may facilitate retraction of blood vessels above the L5 vertebrae.
  • [0011]
    In certain embodiments, an engaging plate may include one or more coupling projections. One or more coupling projections may penetrate a vertebral surface. In some embodiments, a coupling projection may be positioned in a recess formed in a vertebral surface. Once positioned in the vertebra, the coupling projection may inhibit movement of an engaging plate relative to the vertebra.
  • [0012]
    In some embodiments, a disc implant may include two engaging plates and a member. The member may have a convex portion. The engaging plates may be shaped to complement surfaces of the member, including the convex portion. The member may be positioned between the engaging plates to allow axial rotation, lateral and/or anteroposterior movement of a first engaging plate relative to a second engaging plate.
  • [0013]
    In disc implant embodiments including two engaging plates and a member, the member may allow the engaging plates to undergo three independent components of motion relative to each other. The member may have a convex portion and a recess. The recess of the member may complement a projection on a first engaging plate to allow rotation of a first engaging plate relative to the member. The convex portion of the member may complement a concave portion of the second engaging plate to allow anteroposterior and/or lateral movement of the second engaging plate relative to the member.
  • [0014]
    In some embodiments, a disc implant may include two engaging plates and two members. The members may allow the engaging plates to undergo three independent components of motion relative to each other. A convex portion of a first engaging plate may complement a concave portion of a first member to allow lateral bending of the first engaging plate relative to a second engaging plate. A projection on the first member may complement a recess in a second member to allow axial rotation of the first engaging plate relative to the second engaging plate. A convex portion of the second member may complement a concave portion of the second engaging plate to allow movement of the engaging plates relative to each other.
  • [0015]
    In other disc implant embodiments including two engaging plates and two members, a first member may couple to a first engaging plate to allow axial rotation of the first engaging plate relative to a second engaging plate. A convex portion of the first member may complement a concave portion of a second member to allow lateral bending of the engaging plates relative to each other. A convex portion of the second member may complement a concave portion of the second engaging plate to allow flexion and/or extension of vertebrae adjacent to the engaging plates.
  • [0016]
    In disc implant embodiments including a member and two engaging plates, a member may have a spherical shape. The member may be positioned between concave portions of the engaging plates. The member may allow axial-rotation, anteroposterior movement and/or lateral movement of the engaging plates relative to each other.
  • [0017]
    An instrumentation set for a disc implant insertion procedure may include various guidance and/or insertion instruments. Insertion instruments may include, but are not limited to, chisels, reamers, hex drivers, slap hammers, inserters, distractors and pushers. An instrumentation set may include trial endplates and disc implant components. Trial endplates may be plates of various sizes and lordotic alignment. Trial endplates may include stops and/or instrument guides to facilitate removal of bone material from a vertebral surface. Distractors in combination with trial endplates may determine a size, height and lordotic alignment of implant components to be used in a disc implant insertion procedure. Implant components may include, but are not limited to, engaging plates of various sizes and lordotic alignment and members of various sizes and shapes.
  • [0018]
    An inserter may be used to position engaging plates between two vertebrae. A distractor may be positioned between the engaging plates to establish a desired separation distance between the engaging plates. One or more members may be guided through a body of the distractor and into the space between the engaging plates. In some embodiments, members may be guided through a body of a distractor with a pusher. The pusher may maintain the position of the members when a distractor is removed from the inserter.
  • [0019]
    In certain embodiments, trial endplates, members and engaging plates may be formed from various materials including plastics, ceramics, polymers, composites and metals. Materials may be chosen based on factors including, but not limited to, durability, biocompatibility, galling characteristics, mechanical strength and/or wear properties. In some embodiments, radiological markers may be used in combination with materials that are “invisible” to radiological techniques. In certain embodiments, steps may be taken to adjust a coefficient of friction of materials chosen to form members (e.g., surfaces may be polished or roughened). In other embodiments, surfaces of engaging plates and/or members may be coated to reduce noise created by contact of a member with an engaging plate and/or another member.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • [0020]
    Advantages of the present invention will become apparent to those skilled in the art with the benefit of the following detailed description and upon reference to the accompanying drawings in which:
  • [0021]
    [0021]FIG. 1 is a perspective view of components of a disc implant.
  • [0022]
    [0022]FIG. 2 is a bottom view of an embodiment of an engaging plate.
  • [0023]
    [0023]FIG. 3 is a bottom view of an embodiment of an engaging plate.
  • [0024]
    [0024]FIG. 4 is a cross-sectional view of an embodiment of a disc implant.
  • [0025]
    [0025]FIG. 5 is a side view of components of a disc implant.
  • [0026]
    [0026]FIG. 6 is a perspective view of components of a disc implant.
  • [0027]
    [0027]FIG. 7 is a cross-sectional view of an embodiment of a disc implant.
  • [0028]
    [0028]FIG. 8 is a bottom view of an engaging plate.
  • [0029]
    [0029]FIG. 9 is a perspective view of components of a disc implant.
  • [0030]
    [0030]FIG. 10 is a cross-sectional view of an embodiment of a disc implant.
  • [0031]
    [0031]FIG. 11 is a perspective view of components of a disc implant.
  • [0032]
    [0032]FIG. 12 is a top view of a member.
  • [0033]
    [0033]FIG. 13 is a cross-sectional view of an embodiment of a disc implant.
  • [0034]
    [0034]FIG. 14 is a perspective view of components of a disc implant.
  • [0035]
    [0035]FIG. 15 is a cross-sectional view of an embodiment of a disc implant.
  • [0036]
    [0036]FIG. 16 is a perspective view of components of a disc implant.
  • [0037]
    [0037]FIG. 17 is a cross-sectional view of an embodiment of a disc implant.
  • [0038]
    [0038]FIG. 18 is a perspective view of components of a disc implant.
  • [0039]
    [0039]FIG. 19 is a cross-sectional view of an embodiment of a disc implant.
  • [0040]
    [0040]FIG. 20 is a side view of an embodiment of a disc implant.
  • [0041]
    [0041]FIG. 21 is a perspective view of an embodiment of a disc implant.
  • [0042]
    [0042]FIG. 22 is a cross-sectional view of an embodiment of a disc implant.
  • [0043]
    FIGS. 23-27 depict embodiments of coupling projections.
  • [0044]
    [0044]FIG. 28 is a perspective view of an embodiment of an inserter.
  • [0045]
    [0045]FIG. 29 is a side view of a portion of an embodiment of an inserter coupled to engaging plates.
  • [0046]
    [0046]FIG. 30 is a side view of an embodiment of an inserter.
  • [0047]
    [0047]FIG. 31 is a perspective view of an embodiment of a slap hammer coupled to an inserter.
  • [0048]
    [0048]FIG. 32 is a perspective view of an embodiment of a distractor.
  • [0049]
    [0049]FIG. 33 is a perspective view of an embodiment of a distractor positioned in an inserter.
  • [0050]
    [0050]FIG. 34 is a perspective view of an embodiment of a pusher.
  • [0051]
    [0051]FIG. 35 is a side view of an embodiment of a pusher coupled to an inserter.
  • [0052]
    [0052]FIG. 36 is a perspective view of an embodiment of an instrument guide.
  • [0053]
    [0053]FIG. 37 is a perspective view of an instrument guide coupled to an inserter
  • [0054]
    [0054]FIG. 38 and FIG. 38A depict an embodiment of a chisel.
  • [0055]
    [0055]FIG. 39 is a perspective view of a chisel in working relation to an instrument guide.
  • [0056]
    [0056]FIG. 40 is a perspective view of a reamer in working relation to an instrument guide.
  • [0057]
    [0057]FIG. 41 depicts embodiments of trial spacers.
  • [0058]
    [0058]FIG. 42 is a bottom view of an embodiment of a trial endplate.
  • [0059]
    [0059]FIG. 43 is a perspective view of a member seater.
  • [0060]
    While the invention is susceptible to various modifications and alternative forms, specific embodiments thereof are shown by way of example in the drawings and will herein be described in detail. The drawings may not be to scale. It should be understood that the drawings and detailed description thereto are not intended to limit the invention to the particular form disclosed, but on the contrary, the intention is to cover all modifications, equivalents and alternatives falling within the spirit and scope of the present invention as defined by the appended claims.
  • DETAILED DESCRIPTION
  • [0061]
    An intervertebral disc implant may be used to stabilize a portion of the spine. The artificial intervertebral disc implant may replace all or a portion of an intervertebral disc that requires replacement due to degeneration from natural wear, trauma or disease. The artificial intervertebral disc may restore the normal separation distance between the vertebrae and allow normal movement and flexibility of the spine.
  • [0062]
    Disc implants may allow movement of adjacent vertebrae relative to each other in ranges associated with normal limits for human vertebrae. Disc implants may allow axial rotation, axial compression and lateral and/or anteroposterior movement. In a human spine, axial rotation may include rotation of about 0.1 to about 3 about a longitudinal axis of the spine. An axis of rotation between vertebrae may be off-center due to the fibrocartilaginous nature of an intervertebral disc. An axis of rotation between two vertebrae may be located posterior to a mid-point between the vertebrae. Lateral movement may include lateral bending. Lateral bending may include motion to the left and/or right up to a maximum of about 0.5 to about 10. Anteroposterior movement may include flexion and/or extension. Flexion may include anterior motion up to a maximum of about 0.5 to about 20. Extension may include posterior motion up to a maximum of about 0.5 to about 10.
  • [0063]
    Some implant embodiments may inhibit movement outside of normal limits for vertebrae. Limiting a range of motion may decrease chances of injury. Tissue and structure adjacent to vertebrae separated by a disc may limit some ranges of motion. For example, surrounding tissue and structure may limit axial rotation of vertebrae.
  • [0064]
    In some embodiments, artificial disc implants may be used to replace a disc or discs in the lumbar region of a spine. In certain embodiments, artificial disc implants may be used in cervical or thoracic portions of the spine. In some embodiments, artificial disc implants may be used with other systems or devices to provide stability to the spine. In other embodiments, a disc implant may be used as a stand-alone system.
  • [0065]
    [0065]FIG. 1 is a perspective view of components of an embodiment of a disc implant that may be inserted between two vertebrae. Disc implant 100 may include engaging plate 102, member 104 and engaging plate 106. When the implant is installed in a patient, each engaging plate of the implant may cover at least 70% of the vertebral surface that the engaging plate contacts. Member 104 may separate engaging plate 102 from engaging plate 106. In certain embodiments, member 104 may be held between engaging plates 102, 106 at least partially by pressure resulting from natural compression of the spine.
  • [0066]
    Engaging plates 102, 106 may contact adjacent vertebrae to anchor the disc implant to the spine. Coupling projections 108 positioned on outer surfaces 110, 110′ of engaging plates 102, 106 may be positioned in a recess of a vertebral surface. Coupling projections 108′ positioned on outer surfaces 110, 110′ of engaging plates 102, 106 may penetrate into vertebral surfaces to inhibit movement of the engaging plates relative to the vertebrae. In certain embodiments, engaging plates may be coupled to vertebrae using methods other than, or in addition to, coupling projections 108, 108′. For example, fasteners may be used to attach an engaging plate to a vertebra. Fasteners may include, but are not limited to, screws, nails, rivets, trocars, pins and barbs.
  • [0067]
    Inner surface 112 of engaging plate 102 may include slots 114 and recess 116. Slots 114 may have a cross-sectional shape including, but not limited to, square, rectangular, trapezoidal, or irregular. Inner surface 112′ of engaging plate 106 may include slots 114′ that align with slots 114 of engaging plate 102 when disc implant 100 is assembled. Slots 114, 114′ may include indents 118. Indents 118 may engage an instrument used to facilitate insertion of implant 100 during a surgical procedure. In some embodiments, slots 114, 114′ may be dovetailed. Slots 114, 114′ may allow use of insertion instruments without adding a height and/or a thickness to the overall dimension of implant 100.
  • [0068]
    In some embodiments, slots in an engaging plate may be parallel or substantially parallel to an anterior-posterior axis of the engaging plates. FIG. 2 depicts an embodiment of engaging plate 106 wherein slots 114′ are parallel to anterior-posterior axis 119. In some embodiments, slots may be at acute angle relative to the anterior-posterior axis of the engaging plate. FIG. 3 depicts an embodiment of engaging plate 106 wherein slots 114′ are angled relative to anterior-posterior axis 119. Slots 114, 114′ may be formed at an angle ranging from about 15 to about 30 relative to anterior-posterior axis 119. In some embodiments, slots 114, 114′ may be formed at about a 25 angle relative to anterior-posterior axis 119. Angulation of slots 114, 114′ may allow insertion of implant 100 using a modified (e.g., angulated) anterior approach. In some embodiments, an angular orientation of recess 116 may correspond to angulation of slots 114, 114′. A modified anterior approach may facilitate retraction of blood vessels above the L5 vertebrae. In some embodiments, engaging plates 102, 106 with slots 114, 114′ angled relative to anterior-posterior axis 119 may not include a central coupling projection (i.e., a keel).
  • [0069]
    Recess 116 of engaging plate 102 may have a cross-sectional shape including, but not limited to, circular, elliptical, square, rectangular or irregular. Sides of recess 116 may be tapered. Posterior side 120 of recess 116 may be at least twice the height of anterior side 122 of recess 116. A height difference between anterior side 122 and posterior side 120 may minimize overdistraction of the vertebrae required during positioning of member 104 between engaging plates 102, 106 in a disc implant procedure. In some embodiments, a bottom portion of the recess may include an opening or openings to allow residual body fluids and/or bone matter to be removed from the recess.
  • [0070]
    Base 124 of member 104 may fit in recess 116 of engaging plate 102. Base 124 may substantially conform to the shape of recess 116. In some embodiments, member 104 may be a tapered boss. A width of base 124 that fits in recess 116 may be slightly less than a width of the recess to allow member 104 to translate in the recess. Recess 116 may maintain a position of member 104 between engaging plates 102, 106.
  • [0071]
    Member 104 may include center section 126. A height of center section 126 of member 104 may add thickness to a height of implant 100. Center section 126 may range in height from about 5 mm to about 20 mm. In certain embodiments, center section 126 may have a height of about 9 mm. In some embodiments, center section 126 may have a height of about 11 mm. In other embodiments, center section 126 may have a height of about 13 mm.
  • [0072]
    Center section 126 may include projections 128. Projections 128 may be an integral part of center section 126. In some embodiments, projections 128 may be glued, press fit and/or welded to center section 126. Projections 128 may be the same height as center section 126. Projections 128 may engage an instrument to facilitate insertion of member 104 between engaging plates 102, 106.
  • [0073]
    Member 104 may include convex portion 130. Convex portion 130 may be, but is not limited to being, an ellipsoidal section, an ovate section or a spherical section. Inner surface 112′ of engaging plate 106 may include a recess. FIG. 2 depicts a bottom view of inner surface 112′ of engaging plate 106 shown in FIG. 1. Recess 132 may complement convex portion 130 of member 104. In some embodiments, a height of convex portion 130 may exceed a depth of recess 132. As used herein, “complement” or “complementary” refers to shapes of implant components that fit together to allow smooth relative motion of the components.
  • [0074]
    [0074]FIG. 3 depicts a bottom view of inner surface 112′ of an embodiment of engaging plate 106 with slots 114′ angled relative to anterior-posterior axis 119. Slots 114′ may be formed at an angle ranging from about 15 to about 30 relative to anterior-posterior axis 119. In some embodiments, slots 114′ may be formed at about a 25 angle relative to anterior-posterior axis 119. In certain embodiments, an orientation of recess 132 may be angled to correspond to an angle of slots 114′. Angulation of slots 114′ may allow insertion of implant 100 using a modified (e.g., angulated) anterior approach.
  • [0075]
    [0075]FIG. 4 depicts a cross-sectional view of the implant shown in FIG. 1 after the implant has been assembled. Convex portion 130 of member 104 may complement recess 132 of engaging plate 106. A shape of convex portion 130 may allow engaging plate 106 to move (e.g., rock) in an anteroposterior plane and/or a mediolateral plane relative to engaging plate 102. Movement of engaging plate 106 relative to engaging plate 102 in the anteroposterior plane indicated by arrow 134 may allow flexion and extension of vertebrae adjacent to the engaging plates. Movement of engaging plate 106 relative to engaging plate 102 in the mediolateral plane indicated by arrow 136 in FIG. 1 may allow lateral bending of the vertebrae adjacent to engaging plates 102, 106. Engaging plate 106 may rotate relative to engaging plate 102 around axis of rotation 138 in the plane indicated by arrow 140. In some embodiments, axial rotation of engaging plate 106 relative to engaging plate 102 may be limited by tissue, bone or other material in the patient.
  • [0076]
    In some embodiments, a height of convex portion 130 and a depth of recess 132 may be chosen to limit lateral movement of engaging plate 106 relative to engaging plate 102. For example, a height of convex portion 130 may allow engaging plate 106 to contact engaging plate 102 when engaging plate 106 rocks in the direction of engaging plate 102. Contact of inner surfaces 112, 112′ of engaging plates 102, 106 may provide a limit to anteroposterior movement of engaging plate 106 relative to engaging plate 102. Contact of inner surfaces 112, 112′ of engaging plates 102, 106 may limit flexion and/or extension of the adjacent vertebrae. A height of convex portion 130 may determine maximum flexion and/or extension allowed by the implant. In some embodiments, a maximum amount of flexion may be limited to a range between about 0.5 and about 20. In some embodiments, maximum flexion allowed by the implant may be about 10. In other embodiments, maximum flexion allowed by the implant may be about 15. In some embodiments, a maximum amount of extension may be limited to a range between about 0.5 and about 12. In some embodiments, maximum extension allowed by the implant may be about 8. In other embodiments, maximum extension allowed by the implant may be about 5.
  • [0077]
    In some embodiments, components of an implant may include surfaces that contact to limit a maximum amount of lateral bending. In some embodiments, an implant may allow equal amounts of lateral bending so that the patient can laterally bend the same amount to the right or the left. In some embodiments, a maximum amount of lateral bending to the left may be different than a maximum amount of lateral bending to the right to accommodate specific needs of a patient. In some embodiments, an implant may be designed to allow a maximum amount of lateral bending within a range between 0.5 to about 15. In some embodiments, the maximum amount of lateral bending may be about 10. In some embodiments, the maximum amount of lateral bending allowable by an implant may be about 5.
  • [0078]
    In alternative embodiments, a concave portion of a member may complement a convex portion of an engaging plate. As shown in FIG. 5, convex portion 142 of engaging plate 106 may complement recess 144 of member 104 to form an implant. A large contact area between engaging plate 106 and member 104 may advantageously distribute a compressive load applied to the implant over a relatively large area.
  • [0079]
    [0079]FIG. 6 depicts a perspective view of components of an implant embodiment. Implant 100 may allow a full range of physiological movement of vertebrae adjacent to the implant. Inner surface 112 of engaging plate 102 may include at least one projection. Projection 146 may be coupled to engaging plate 102. In some embodiments, projection 146 may be an integral part of engaging plate 102. Projection 146 may have a shape that allows engaging plate 102 to rotate freely relative to member 104. The shape of projection 146 may be, but is not limited to being, tapered, round or square. Member 104 may include recess 148 (shown in FIG. 7). Recess 148 may complement projection 146. Recess 148 may have a slightly larger cross section than projection 146 to allow engaging plate 102 to move relative to member 104. A size and/or shape of recess 148 relative to projection 146 may determine a range of rotation of member 104 relative to engaging plate 102.
  • [0080]
    As depicted in FIG. 7, recess 148 and projection 146 may define axis of rotation 138. Friction between engaging plate 102 and member 104 may be low enough to allow rotation of the engaging plate relative to the member. Engaging plate 102 may rotate relative to member 104 as indicated by arrow 140. Rotation of engaging plate 102 relative to member 104 may imitate axial rotation of the spine. A large contact area between recess 148 of member 104 and projection 146 of engaging plate 102 may distribute a compressive load applied to implant 100 over a relatively large surface area.
  • [0081]
    Member 104 may include convex portion 150. Inner surface 112′ of engaging plate 106 may include recess 152. Recess 152 of engaging plate 106 may complement convex portion 150 of member 104. The shape of convex portion 150 may allow engaging plate 106 to move (e.g., rock) relative to member 104. Movement of engaging plate 106 relative to member 104 may allow lateral movement (e.g., lateral bending) of vertebrae adjacent to the engaging plates. In an alternative embodiment, member 104 may include a recess complementary to a convex part of engaging plate 106.
  • [0082]
    Convex portion 150 may have an arcuate cross-sectional shape in an anteroposterior plane and/or in a mediolateral plane. An arcuate shape of convex portion 150 in the anteroposterior plane may allow engaging plate 106 to rock relative to engaging plate 102 in the directions indicated by arrows 134 in FIG. 7. Movement of engaging plate 106 relative to engaging plate 102 in the anteroposterior plane may allow flexion and extension of vertebrae adjacent to the engaging plates. An arcuate shape of convex portion 150 in the mediolateral plane may allow engaging plate 106 to move relative to engaging plate 102 in directions indicated by arrow 136 in FIG. 6. Movement of engaging plate 106 relative to engaging plate 102 in the mediolateral plane may allow lateral bending of vertebrae adjacent to the engaging plates.
  • [0083]
    [0083]FIG. 8 depicts a bottom view of inner surface 112′ of engaging plate 106 shown in FIG. 7. Engaging plate 106 may include recess 152. A shape of recess 152 may complement convex portion 150 of member 104. Recess 152 may be concave with an arcuate cross-sectional shape in an anteroposterior plane and/or in a mediolateral plane. A shape of recess 152 may allow movement of engaging plate 106 relative to member 104 in an anteroposterior plane and/or in a mediolateral plane. Movement of engaging plate 106 relative to member 104 in an anteroposterior plane and/or in a mediolateral plane may allow flexion, extension and/or lateral bending of vertebrae adjacent to engaging plates 102, 106.
  • [0084]
    In some embodiments, engaging plate 106 may include limiter 154, as shown in FIG. 7. Limiter 154 may be positioned to contact surface 156 of member 104. Contact of limiter 154 and surface 156 may limit posterior movement of engaging plate 106 relative to engaging plate 102. Contact of limiter 154 and surface 156 may therefore limit extension of vertebrae adjacent to engaging plates 102, 106. A height of limiter 154 relative to inner surface 112′ of engaging plate 106 and/or a height of surface 156 relative to inner surface 112 of engaging plate 102 may be chosen to limit extension of vertebrae adjacent the implant. Maximum extension allowed by implant 100 may range from about 3 to about 12. In some embodiments, maximum extension allowed by implant 100 may be about 8. In other embodiments, maximum extension allowed by implant 100 may be about 5.
  • [0085]
    In some embodiments, inner surface 112′ of engaging plate 106 may contact surface 156 of member 104. Contact of inner surface 112′ with surface 156 may limit anterior movement of engaging plate 106 relative to engaging plate 102. Contact of inner surface 112′ of engaging plate 106 with surface 156 of member 104 may limit flexion of vertebrae adjacent engaging plates 102, 106. A height of surface 156 relative to inner surface 112 of engaging plate 102 may be chosen to limit flexion of vertebrae adjacent to engaging plates 102, 106. Maximum flexion allowed by implant 100 may range from about 5 to about 20. In some embodiments, maximum flexion allowed by implant 100 may be about 10. In other embodiments, maximum flexion allowed by implant 100 may be about 15.
  • [0086]
    [0086]FIG. 9 depicts a perspective view of components of an embodiment of an implant. Implant 100 may allow limited axial rotation of vertebrae adjacent to engaging plates 102, 106. Engaging plate 102 may include recess 158. Edges of recess 158 may be arced. The arcs may share a common center point. Base 124 of member 104 may fit in recess 158. A surface of base 124 may substantially conform to an arced surface of recess 158. A width of base 124 may be less than a width of recess 158 such that member 104 may be able to translate in recess 158 along curves defined by the edges of the recess.
  • [0087]
    [0087]FIG. 10 depicts a cross-sectional view of the implant shown in FIG. 9 after the implant has been assembled. Base 124 of member 104 may complement recess 158 of engaging plate 102. Axis of rotation 138 may be at or near the centroid of engaging plates 102, 106 or offset from the engaging plates. Rotation of engaging plate 102 relative to engaging plate 106 may allow rotation of vertebrae adjacent implant 100.
  • [0088]
    A shape of recess 158 may allow engaging plate 102 to rotate axially relative to engaging plate 106 in the plane indicated by arrow 140. Movement of base 124 in recess 158 may limit axial rotation of the vertebrae adjacent to engaging plates 102, 106. Maximum axial rotation allowed by implant 100 may range from about 0.1 to about 6. In some embodiments, maximum axial rotation allowed by implant 100 may be about 3. In other embodiments, maximum axial rotation allowed by implant 100 may be about 1.
  • [0089]
    Engaging plate 106 may include recess 152. Recess 152 may complement convex portion 150 of member 104. In an alternative embodiment, member 104 may include a recess complementary to a convex portion of engaging plate 106. Convex portion 150 may have an arcuate cross-sectional shape in an anteroposterior plane and/or in a mediolateral plane. An arcuate shape of convex portion 150 in an anteroposterior plane may allow engaging plate 106 to move (e.g., rock) relative to member 104 in the directions indicated by arrow 134. Movement of engaging plate 106 relative to member 104 in the anteroposterior plane may allow flexion and/or extension of the vertebrae adjacent to the engaging plates. An arcuate shape of convex portion 150 in a mediolateral plane may allow engaging plate 106 to move (e.g., rock) relative to member 104 in the directions indicated by arrows 136 in FIG. 9. Movement of engaging plate 106 relative to member 104 in the mediolateral plane may allow lateral bending of the vertebrae adjacent to the engaging plates.
  • [0090]
    In some embodiments, inner surface 112′ of engaging plate 106 (shown in FIG. 10) may contact surface 156 of member 104. Contact of inner surface 112′ with surface 156 may limit movement of engaging plate 106 relative to engaging plate 102 in the anteroposterior plane. Contact of inner surface 112′ with surface 156 may limit flexion of the spine. In certain embodiments, a height of a surface 156 relative to inner surface 112 may be chosen to limit flexion of the spine. Maximum flexion allowed by implant 100 may range from about 5 to about 20. In some embodiments, maximum flexion allowed by implant 100 may be about 10. In other embodiments, maximum flexion allowed by implant 100 may be about 15.
  • [0091]
    In some embodiments, posterior movement of engaging plate 106 relative to engaging plate 102 may be limited. Engaging plate 106 may include limiter 154. During use, limiter 154 may contact surface 156 to limit posterior movement of engaging plate 106 relative to engaging plate 102. Contact of limiter 154 with surface 156 may limit extension of the spine. A height of limiter 154 relative to inner surface 112′ and/or a height of contact surface 156 relative to inner surface 112 may be chosen to limit extension of the spine. Maximum extension allowed by implant 100 may range from about 3 to about 12. In some embodiments, maximum extension allowed by implant 100 may be about 8. In other embodiments, maximum extension allowed by implant 100 may be about 5.
  • [0092]
    In some embodiments, inner surface 112 of engaging plate 102 may have a convex portion. Engaging plate 102 of implant 100 shown in FIG. 11 includes convex portion 160. Convex portion 160 may have an arcuate cross-sectional shape in an anteroposterior plane and/or in a mediolateral plane. Member 104 may include recess 162, as shown in FIG. 12. Edges of recess 162 may be arced. The arcs may share a common center point. Convex portion 160 may fit in recess 162 of member 104. Convex portion 160 of engaging plate 102 may complement recess 162. A width of convex portion 160 may be less than a width of recess 162. Engaging plate 102 may translate in recess 162 along curves defined by edges of the recess.
  • [0093]
    [0093]FIG. 13 depicts a cross-sectional view of the implant shown in FIG. 11 after the implant has been assembled. Recess 162 of member 104 may complement convex portion 160 of engaging plate 102. A shape of convex portion 160 may allow relative movement of engaging plates 102, 106 in the plane indicated by arrow 140 about axis of rotation 138. Axis of rotation 138 may be at or near the centroid of implant 100 or offset from the centroid.
  • [0094]
    Maximum axial rotation allowed by implant 100 may range from about 0.1 to about 6. In some embodiments, maximum axial rotation allowed by implant 100 may be about 3. In other embodiments, maximum axial rotation allowed by implant 100 may be about 1. Rotation of engaging plate 102 relative to engaging plate 106 may be limited by a height of convex portion 160 relative to a depth of recess 162. In some embodiments, rotation of engaging plate 102 relative to engaging plate 106 may be limited by a curvature of convex portion 160 and/or a curvature of recess 162.
  • [0095]
    Inner surface 112′ of engaging plate 106 may include recess 152. Recess 152 may be complementary in shape to convex portion 150 of member 104. Convex portion 150 may complement recess 152. Convex portion 150 may allow engaging plate 106 to move (e.g., rock) relative to member 104. Movement of engaging plate 106 relative to member 104 may allow lateral movement of the spine. In some embodiments, member 104 may include a recess complementary to a convex portion of engaging plate 106.
  • [0096]
    Convex portion 150 may have an arcuate cross-sectional shape in an anteroposterior plane and/or in a mediolateral plane. An arcuate shape of convex portion 150 in the anteroposterior plane may allow engaging plate 106 to move relative to member 104 in the directions indicated by arrow 134. Movement of engaging plate 106 relative to engaging plate 102 in the anteroposterior plane may allow flexion and/or extension of the spine. The arcuate shape of convex portion 150 in the mediolateral plane may allow engaging plate 106 to move relative to member 104 in the directions indicated by arrow 136 shown in FIG. 11. Movement of engaging plate 106 relative to member 104 in the mediolateral plane may allow lateral bending of the spine.
  • [0097]
    Inner surface 112′ of engaging plate 106 may contact surface 156 of member 104. Contact of inner surface 112′ with surface 156 may limit anterior movement of engaging plate 106 relative to engaging plate 102. Contact of inner surface 112′ with surface 156 may therefore limit flexion of vertebrae adjacent to engaging plates 102, 106. A thickness of an edge of member 104 may limit flexion allowed by implant 100. Maximum flexion allowed by implant 100 may range from about 5 to about 20. In some embodiments, maximum flexion allowed by implant 100 may be about 10. In other embodiments, maximum flexion allowed by implant 100 may be about 15.
  • [0098]
    In certain embodiments, disc implant 100 may include two engaging plates and two members as depicted in FIGS. 14 and 16. FIGS. 15 and 17 are cross-sectional views of implants 100 shown in FIGS. 14 and 16, respectively. Engaging plate 102 of implants 100 may have convex portion 164. Convex portion 164 may have an arcuate cross-sectional shape along at least one axis. The arcuate cross-sectional shape along one axis of convex portion 164 may increase an area of contact between engaging plate 102 and member 104. Member 104 may include recess 166. Recess 166 may complement convex portion 164. A shape of convex portion 164 may allow anteroposterior translation of member 104 relative to engaging plate 102. Translation of member 104 relative to engaging plate 102 may allow positioning of implant 100 during a spinal stabilization procedure.
  • [0099]
    A thickness of engaging plate 102 proximate convex portion 164 may exceed a thickness of engaging plate 102 proximate edges 168, 168′ such that inner surfaces 112, 112″ are sloped relative to an outer surface of the engaging plate. In some embodiments, a slope of inner surface 112 may be different than a slope of inner surface 112″. In certain embodiments, a thickness of member 104 proximate recess 166 may exceed a thickness of the member at edges 170, 170′ such that surfaces 172, 172′ are sloped relative to surface 156.
  • [0100]
    Inner surfaces 112, 112″ and surfaces 172, 172′ may be sloped to allow movement (e.g., rocking) of engaging plate 102 relative to member 104 in a mediolateral plane. Movement of member 104 in the direction indicated by arrow 136 may allow lateral bending of vertebrae adjacent to engaging plates 102, 106. Inner surfaces 112, 112″ and surfaces 172, 172′ may be sloped such that lateral movement of the spine in a mediolateral plane is restricted. In some embodiments, a slope of surface 172 relative to surface 156 may be different than a slope of surface 172′ relative to surface 156. In some embodiments, slopes of surfaces 172, 172′ may be opposite in sign to slopes of inner surfaces 112, 112″. Movement of engaging plate 102 relative to member 104 may allow inner surfaces 112, 112″ to contact surfaces 172, 172′. Contact of inner surfaces 112, 112″ and surfaces 172, 172′ may distribute a compressive load applied to implant 100 over a relatively large surface area.
  • [0101]
    Member 104 may include projection 146. Projection 146 may be coupled to member 104. In some embodiments, projection 146 may be an integral part of member 104. A shape of projection 146 may be, but is not limited to being, tapered, round or square. Member 174 may include recess 148, as depicted in FIGS. 15 and 17. Recess 148 may complement projection 146. Recess 148 may have a slightly larger cross section than projection 146 to allow relative movement of members 104, 174. In some embodiments, member 174 may rotate relative to member 104 about axis of rotation 138 indicated by arrow 140. As shown in FIG. 15, axis of rotation 138 may be near a center of implant 100. In some embodiments, axis of rotation 138 may be located more off-center, as depicted in FIG. 17. A range of rotation of member 174 relative to member 104 may be limited by a size and/or shape of recess 148 relative to a size and/or shape of projection 146.
  • [0102]
    Surface 176 of member 174 may contact surface 156 of member 104 when projection 146 fits in recess 148. A relatively large contact area between member 104 and member 174 may distribute an effective load applied to implant 100 while allowing rotation of vertebrae adjacent to the implant. For example, projection 146 (shown in FIG. 14) has a flat surface that may increase a contact area between projection 146 and recess 148. Reducing friction between member 104 and member 174 may allow facile rotation of the members relative to each other.
  • [0103]
    Member 174 may have convex portion 178. Convex portion 178 may have an arcuate cross-sectional shape in an anteroposterior plane. Engaging plate 106 may include recess 180 (shown in FIG. 15 and FIG. 17). Recess 180 may be concave with an arcuate cross-sectional shape in an anteroposterior plane. Recess 180 may complement convex portion 178 of member 174. In some embodiments, recess 180 may have a slightly larger cross section than convex portion 178 to allow movement of engaging plate 106 relative to member 174. Movement of engaging plate 106 relative to member 174 may allow for flexion and/or extension of vertebrae adjacent to the engaging plates in the plane indicated by arrows 134 in FIGS. 15 and 17.
  • [0104]
    In some embodiments, anteroposterior and/or lateral movement of components of implant 100 relative to each other may be limited. As shown in FIGS. 14 and 15, engaging plate 106 may include limiter 154. Limiter 154 may be a projection extending from inner surface 112′ of engaging plate 106. In an embodiment, limiter 154 may extend along a side of engaging plate 106. Limiter 154 may be positioned to contact surface 182 of member 174 when engaging plate 106 rocks in a posterior direction toward engaging plate 102. Increasing a length of limiter 154 may increase an area of contact between limiter 154 and member 174. Increasing the area of contact between limiter 154 and member 174 may distribute a compressive load on implant 100 over a relatively large area. Distributing the load over a relatively large area may reduce stress among components of implant 100.
  • [0105]
    Contact of limiter 154 with surface 182 may limit movement of engaging plate 106 relative to member 174. A height of limiter 154 relative to inner surface 112′ and/or a distance between surfaces 176 and 182 of member 174 may be chosen to limit movement of engaging plate 106 relative to member 174. In certain embodiments, surface 182 of member 174 may be sloped relative to surface 176 to increase an area of contact between surface 182 and limiter 154. Surface 182 may be sloped to increase a range of motion between engaging plate 106 and member 174. In some embodiments, a slope of surface 182 may limit movement of engaging plate 106 relative to member 174. In certain embodiments, maximum extension allowed by implant 100 may range from about 3 to about 12. In some embodiments, maximum extension allowed by implant 100 may be about 8. In other embodiments, maximum extension allowed by implant 100 may be about 5. Some implant embodiments may include a limiter designed to limit another component of motion of a disc implant. Other implant embodiments may include one or more additional limiters designed to limit other components of motion of a disc implant.
  • [0106]
    In certain embodiments, inner surface 112′ of engaging plate 106 may contact surface 182 of member 174. Contact of inner surface 112′ with surface 182 may limit flexion of vertebrae adjacent to engaging plates 102, 106. A distance between surfaces 176 and 182 of member 174 may be chosen to limit flexion between vertebrae adjacent to engaging plates 102, 106. Maximum flexion allowed by implant 100 may range from about 5 to about 20. In some embodiments, maximum flexion allowed by implant 100 may be about 10. In other embodiments, maximum flexion allowed by implant 100 may be about 15.
  • [0107]
    In certain embodiments, components of implant 100 may be coupled to one another. Coupling of components of implant 100 may allow partial assembly of the implant prior to a surgical procedure. In some embodiments, a manufacturer of implant 100 may at least partially assemble the implant prior to shipment. Some of the components of implant 100 may be held together during use, at least partially, by pressure resulting from the natural compression of the spine.
  • [0108]
    [0108]FIG. 18 depicts a perspective view of components of implant 100, including engaging plate 102, members 104 and 174, and engaging plate 106. FIG. 19 depicts a cross-sectional view of the implant shown in FIG. 18 after the implant has been assembled. As shown in FIGS. 18 and 19, engaging plate 102 may include projection 146 and opening 184. Projection 146 may be coupled to engaging plate 102. In some embodiments, projection 146 may be an integral part of engaging plate 102. A shape of projection 146 may be, but is not limited to being, round, square, rectangular or irregular. Projection 146 may complement recess 148 (shown in FIG. 19) in member 104. In certain embodiments, recess 148 may have a slightly larger cross section than projection 146 to allow engaging plate 102 to move relative to member 104. In some embodiments, recess 148 may have a cross section substantially equal to a cross section of projection 146 to inhibit rotation of engaging plate 102 relative to member 104.
  • [0109]
    In some embodiments, opening 184 may extend through engaging plate 102. In other embodiments, opening 184 may extend to a fixed depth in engaging plate 102. Opening 184 may be designed (e.g., threaded) to receive a coupling device such as coupler 186. Coupler 186 may be, but is not limited to being, a screw, a bolt or a pinch clamp. Coupler 186 may couple member 104 to engaging plate 102. During use, coupler 186 may extend through at least a portion of member 104 into opening 184 of engaging plate 102. A head of coupler 186 may be recessed in opening 188 of member 104. Coupler 186 may allow engaging plate 102 to move relative to member 104. In some embodiments, engaging plate 102 may rotate around axis of rotation 138 relative to first member 104 in the plane indicated by arrow 140 in FIG. 19. Relative movement of engaging plates 102, 106 may allow axial rotation of vertebrae adjacent to implant 100. Axis of rotation 138 may be offset from a center of engaging plates 102, 106 to imitate a longitudinal axis of rotation of a spine.
  • [0110]
    As shown in FIG. 18, member 104 may have convex portion 164. Convex portion 164 may have an arcuate cross-sectional shape along at least one axis. Member 174 may include recess 166. Recess 166 may have an arcuate cross section along at least one axis. Recess 166 may complement convex portion 164 of member 104, as shown in the side view of implant 100 in FIG. 20. In some embodiments, a thickness of engaging plate 102 proximate member 104 may exceed a thickness of the engaging plate at ends 168, 168′ such that inner surfaces 112, 112″ slope toward an outer surface of the engaging plate. In some embodiments, a slope of inner surface 112 may be different than a slope of inner surface 112″. A thickness of member 174 proximate recess 166 may exceed a thickness of the member at ends 190, 190′ such that surfaces 192, 192′ of second member 174 slope away from engaging plate 102. In some embodiments, a slope of surface 192 may be different than a slope of surface 192′. In some embodiments, slopes of surfaces 192, 192′ may be substantially the same magnitude as slopes of inner surfaces 112, 112″, respectively.
  • [0111]
    Sloped surfaces 112, 112″ may allow engaging plate 102 to move (e.g., rock) relative to member 104 in a mediolateral plane. Relative movement of engaging plates 102, 106 may allow lateral bending of vertebrae adjacent to the engaging plates in the plane indicated by arrow 136 in FIG. 18. Contact of surfaces 112, 112″ and 192, 192′, respectively, may distribute a compressive load applied to implant 100 over a relatively large area.
  • [0112]
    In some embodiments, member 174 may have convex portion 178. Convex portion 178 may have an arcuate cross-sectional shape. Engaging plate 106 may include recess 180. Recess 180 may be concave with an arcuate cross-sectional shape. Recess 180 may complement convex portion 178. Recess 180 may have a slightly larger cross section than convex portion 178 to allow engaging plate 106 to move (e.g., rock) toward engaging plate 102 as indicated by arrow 134 in FIG. 19. Movement of engaging plate 106 relative to member 174 may allow flexion and/or extension of vertebrae adjacent to engaging plates 102, 106.
  • [0113]
    Member 104 may include one or more stops 194 (shown in FIGS. 18 and 19). Stops 194 may be coupled to one or both ends of member 104. In some embodiments, stops 194 may be an integral part of member 104. Stops 194 may restrict anteroposterior translation of member 174 relative to member 104. Restriction of translation of member 174 relative to member 104 may facilitate positioning of implant 100 between vertebrae.
  • [0114]
    In certain embodiments, contact of stop 194 with inner surface 112′ of engaging plate 106 may limit extension of vertebrae adjacent to implant 100. A height of stop 194 and/or a thickness of engaging plate 106 may limit extension allowed by implant 100. Maximum extension allowed by implant 100 may range from about 3 to about 12. In some embodiments, maximum extension allowed by implant 100 may be about 8. In other embodiments, maximum extension allowed by implant 100 may be about 5.
  • [0115]
    Surface 182 of member 174 may be sloped relative to surfaces 192, 192′ of the member. Inner surface 112′ of engaging plate 106 may be sloped relative to an outer surface of the engaging plate. A slope of surface 182 and/or a slope of inner surface 112′ may be chosen to increase a contact area between surface 182 and limiter 154 of engaging plate 106. A slope of surface 182 may be chosen to increase a range of motion between engaging plate 106 and member 174. In some embodiments, a shape and/or size of recess 180 may limit motion of engaging plate 106 relative to another component of the implant.
  • [0116]
    In certain embodiments, inner surface 112′ of engaging plate 106 may contact surface 182 of member 174. Contact of inner surface 112′ and surface 182 may limit flexion of the spine. A distance between surface 182 and surfaces 192, 192′ of member 174 may be chosen to limit flexion between vertebrae adjacent to engaging plates 102, 106. Maximum flexion allowed by implant 100 may be from about 5 to about 20. In some embodiments, maximum flexion allowed by implant 100 may be about 10. In other embodiments, maximum flexion allowed by implant 100 may be about 15.
  • [0117]
    In some embodiments, a first engaging plate may be substantially the same as a second engaging plate. Manufacturing costs may be reduced for implants with substantially equivalent engaging plates. FIG. 21 depicts a perspective view of implant 100 with substantially equivalent engaging plates 102. Member 104 may separate engaging plates 102. In certain embodiments, member 104 may have a rounded shape including, but not limited to, ovoid, spheroid and ellipsoid. Member 104 may be formed from metal (e.g., chrome) or ceramic. In certain embodiments, member 104 may be highly polished to inhibit wear. Engaging plates 102 may include concave portions 132. Concave portions 132 may complement member 104. A thickness of member 104 may exceed a cumulative depth of concave portions 132.
  • [0118]
    [0118]FIG. 22 depicts a cross-sectional view of the implant shown in FIG. 21 after the implant has been assembled. A separation of engaging plates 102 by member 104 may allow the engaging plates to “rock” relative to one another. Rocking of engaging plates 102 relative to one another in an anteroposterior plane may allow flexion and/or extension in the plane indicated by arrows 134. Rocking of engaging plates 102 relative to one another in a mediolateral plane may allow lateral bending in the plane indicated by arrows 136 in FIG. 21.
  • [0119]
    A shape of member 104 may provide a large contact area between the surface of member 104 and concave portions 132. A shape of member 104 may decrease wear and/or failure of implant 100. Concave portions 132 with an oval shape may allow member 104 to imitate the movement of a human spine around axis of rotation 138. Engaging plates 102 may freely rotate relative to one another around axis of rotation 138 in the plane indicated by arrow 140. In some embodiments, a position of axis of rotation 138 may change as member 104 translates in recesses 132. In an embodiment, a range of motion (e.g., axial rotation) may be limited by the shape of member 104 and/or the shape of concave portion 132.
  • [0120]
    In an embodiment, an inner surface of engaging plates 102 proximate concave portions 132 may be elevated. An elevation of one or more surfaces 196A-196D (shown in FIG. 21) may be chosen to limit relative movement of engaging plates 102. One or more surfaces 196A-196D may be sloped relative to outer surfaces of engaging plates 102 as shown in FIGS. 21 and 22. Slopes of surfaces 196A-196D may increase a contact area between engaging plates 102. Increasing a contact area between engaging plates 102 may inhibit wear of the implant.
  • [0121]
    In certain embodiments, surfaces 196D may limit flexion of vertebrae adjacent to the spinal implant. Surfaces 196B may limit extension of vertebrae adjacent to implant 100. Surfaces 196A and 196C may limit lateral bending of vertebra adjacent to implant 100. In some embodiments, axial rotation of engaging plates 102 relative to each other may be limited.
  • [0122]
    In some embodiments, an implant may be curved to accommodate radial curvature of vertebrae. Implants may be provided with varying amounts of radial curvature. For example, disc implants may be provided with large, medium and/or small radial curvatures. An indication of an amount of radial curvature provided by an implant may be etched or otherwise marked on the implant.
  • [0123]
    In some disc implant embodiments, engaging plates may be sloped to establish a desired lordotic curvature of a spine. Several different implant components with differing lordotic curvatures may be available to a surgeon so that the surgeon can form an implant with a desired lordotic angle. Lordotic indications may be etched or otherwise marked (e.g., color coded) on the disc implant to indicate the amount of lordosis that the implant will provide. In an embodiment, a lumbar disc implant may have a lordotic angle range of about 5 to about 20 (e.g., about 12).
  • [0124]
    An engaging plate may be designed to promote coupling of the engaging plate to a vertebral surface. Coupling engaging plates of an implant to adjacent vertebrae may stabilize the disc implant. An engaging plate may include one or more coupling projections to facilitate coupling of the engaging plate to a vertebra. A coupling projection may extend from an outer surface of an engaging plate. Coupling projections may be, but are not limited to being, press fit, welded, glued or otherwise affixed to an engaging plate. Alternatively, coupling projections may be formed as part of an engaging plate. Any combination of coupling projections 108 may be used together to ensure stability of implant 100.
  • [0125]
    An engaging plate may include one coupling projection 108, as shown, for example, in FIGS. 9-11. FIG. 23 depicts a view of engaging plate 102 with two coupling projections 108. In some embodiments, an engaging plate may include a plurality of coupling projections 108, as shown in FIGS. 24 and 25. In some embodiments, an engaging plate may include coupling projections of substantially the same shape and size. In certain embodiments, an engaging plate may include coupling projections of different sizes and/or shapes. A shape and/or size of a coupling projection may be chosen based on factors including, but not limited to, durability, distribution of load and ease of forming a complementary recess in a vertebra.
  • [0126]
    In certain embodiments, a coupling projection extending from an engaging plate may be positioned in a recess formed in a vertebra. The recess may complement the coupling projection. Coupling projection 108 may have an arcuate cross section, as depicted, for example, in FIGS. 9-11. In some embodiments, a coupling projection may have a square or rectangular cross section. FIG. 26 depicts a view of coupling projection 108 with a rectangular cross section. In certain embodiments, a coupling projection may be tapered in one or more directions. Coupling projection 108 shown in FIG. 27 is tapered in an anteroposterior direction. A tapered coupling projection may allow the coupling projection to be wedged into a recess in a bone to secure the engaging plate to the bone. Wedging the coupling projection in the recess may inhibit movement of the engaging plate relative to the vertebra and/or expulsion of the engaging plate from the bone. In some embodiments, surfaces of the coupling projection that are to be positioned adjacent to bone may be roughened or include a coating (e.g., hydroxyapatite) to promote osseointegration of the coupling projection with the bone. In some embodiments, coupling projections, such as those depicted in FIGS. 1, 24 and 25, may penetrate adjacent bone to inhibit movement of the engaging plate relative to the vertebra and/or to inhibit expulsion of the engaging plate from the bone.
  • [0127]
    In some embodiments, one or more coupling projections may be oriented substantially in an anteroposterior plane to facilitate implant insertion using an anterior approach. In some embodiments, one or more coupling projections may be oriented substantially in a mediolateral plane to facilitate implant insertion using a lateral approach. In certain embodiments, combinations of coupling projections of various cross-sectional shapes, such as those depicted in FIG. 1 may be used to inhibit movement of the engaging plate relative to the vertebra and/or expulsion of the engaging plate from the bone.
  • [0128]
    In some embodiments, a fastening system may be used to couple an implant to a vertebra. The implant may include a tab with an opening in a face of the tab. The opening may engage or couple to a head of a bone fastener. A fastening system may include a fastener and a locking mechanism. The locking mechanism may be positioned between the implant and the fastener. The locking mechanism may inhibit backout of the fastener from the vertebra and from the implant. In some embodiments, the locking mechanism may be a ring positioned in an opening in the implant. When the ring is in the opening, a head of the fastener inserted through the ring may contact the ring if the fastener begins to back out of the opening. The ring and fastener head combination may be too large to exit the opening, thereby inhibiting backout of the fastener from the vertebrae and from the implant. When the ring is positioned in the opening, the ring may lock to the fastener head without locking to the implant, thus allowing the plate to be securely tightened to the vertebra. U.S. Pat. No. 6,454,769 to Wagner et al. and U.S. Pat. No. 6,331,179 to Freid et al., both of which are incorporated by reference as if fully set forth herein, describe fastening systems including locking mechanism for inhibiting backout of fasteners.
  • [0129]
    In certain embodiments, one or more instruments may be used to insert and/or position a disc implant between adjacent vertebrae after a discectomy has been performed. An inserter may be used to position an implant in a prepared disc space between adjacent vertebrae. The inserter may be sufficiently long to allow placement of a distal end of the inserter in the disc space from above an incision in a patient. Engaging plates of an implant may be coupled to arms at the distal end of the inserter.
  • [0130]
    [0130]FIG. 28 depicts a perspective view of an embodiment of inserter 210. Inserter 210 may include body 212 and arms 214. Body 212 may have opening 216. Opening 216 may be sized to allow one or more guidance, insertion and/or removal instruments to be positioned in inserter 210. Arms 214 may include extensions 218 for coupling inserter 210 to engaging plates of an implant. Extensions 218 may be chamfered, rounded, dovetailed or otherwise machined to engage slots 114 in engaging plates 102, 106 (shown in FIG. 1). Extensions 218 may include detents 220. Detents 220 may be positioned in indents 118 of engaging plates 102, 106 to couple inserter 210 to an implant. FIG. 29 depicts extensions 218 coupled to engaging plates 102, 106.
  • [0131]
    Portions of arms 214 may be angled relative to each other to establish a tapering separation distance between the arms. The angled portions of arms 214 may facilitate insertion of instruments that establish a desired separation distance between engaging plates 102, 106 attached to inserter 210.
  • [0132]
    Arms 214 may include mechanisms 222. FIG. 30 depicts a perspective side-view of inserter 210 that shows mechanisms 222 on arms 214. As depicted in FIG. 28, inserter 210 may include slots 224. Slots 224 may extend through arms 214 and extensions 218 from the mechanism 222 to a portion of the inserter near detents 220. Slots 224 may allow section 226 of inserter 210 to bend. Pressing mechanisms 222 may move section 226 and allow disengagement of detents 220 from indents located in engaging plates. When mechanisms 222 are pressed, detents may be disengaged from indents in engaging plates to separate inserter 210 from the engaging plates. In some embodiments, arms 214 may include reinforcement members 228 that stabilize portions of the inserter that are not able to move when mechanisms 222 are pressed. Reinforcement members 228 may limit outward movement of sections 226.
  • [0133]
    A proximal end of inserter 210 may be formed to engage a driving instrument or a guidance instrument, such as a slap hammer or a pusher. Slots 230 in a proximal end of inserter 210 (shown in FIG. 28) may be machined or otherwise designed to receive a coupling device such as coupler 232 shown in FIG. 31. FIG. 31 depicts a perspective view of inserter 210 coupled to slap hammer 234. Coupler 232 may engage an attachment mount of a driving instrument or a guidance instrument. Slap hammer 234 may include attachment mount 236. Coupler 232 may couple attachment mount 236 to inserter 210.
  • [0134]
    During some implant insertion procedures, an intervertebral space may be too small to allow insertion of implant components coupled to an inserter without scarring the surfaces of adjacent vertebrae. Shims may be placed adjacent to the vertebrae. Engaging plates coupled to an inserter may be positioned next to the shims. The inserter may be driven downwards to separate the vertebrae and insert the engaging plates between the vertebrae. After insertion of the engaging plates, the shims may be removed.
  • [0135]
    In some embodiments, a distractor may be used to separate adjacent vertebrae and/or to separate engaging plates to allow insertion of a member between the engaging plates. FIG. 32 depicts a perspective view of an embodiment of a distractor. Distractor 238 may include body 240, arms 242 and attachment mount 244. Body 240 and arms 242 may include grooves 246. Grooves 246 may be slightly larger in cross-section than projections 128 of member 104 (shown in FIG. 1). Projections 128 of member 104 may fit in grooves 246 to allow member 104 to be guided through body 240 and arms 242 to a position between engaging plates.
  • [0136]
    In some embodiments, grooves 246 may be sized and/or shaped to accept only a particular sized member of an implant. For example, a member for a 13 mm implant will not fit in a distractor that establishes a separation distance sized for an 11 mm implant. In some embodiments, members and distractors may be color coded substantially the same color. A surgeon may know to only put a member into a distractor of substantially the same color.
  • [0137]
    In certain embodiments, arms 242 may include reinforcement member 248. Reinforcement member 248 may inhibit movement of arms 242 during insertion of a member between engaging plates to form an implant.
  • [0138]
    Slots 250 on attachment mount 244 may be machined to receive a coupler. A coupler may couple distractor 238 to a drive instrument, such as a slap hammer.
  • [0139]
    [0139]FIG. 33 depicts a perspective view of distractor 238 positioned in inserter 210. Arms 242 may separate arms 214 of inserter 210. As arms 214 are separated by distractor 238, engaging plates 102, 106 are separated. Slots in engaging plates 102, 106 and arms 242 may separate arms 214 such that the engaging plates remain substantially parallel during the separation process. Engaging plates 102, 106 may remain substantially parallel during insertion of a member between the engaging plates. Separation of arms 214 with distractor 238 may minimize or eliminate contact of the distractor with engaging plates 102, 106. Minimizing or eliminating contact of distractor 238 with engaging plates 102, 106 during distraction may inhibit undesired separation of the engaging plates from the inserter 210.
  • [0140]
    [0140]FIG. 34 depicts a perspective view of an embodiment of a pusher. Pusher 252 may include body 254 and attachment mount 256. A width of a distal end of body 254 may be less than a width of a proximal end of the body. Body 254 may include projections 258. Projections 258 may fit in grooves 246 of distractor 238 (shown in FIG. 32) to allow pusher 252 to be guided through body 240 and arms 242 of the distractor. In some embodiments, pushers may be color coded to match to a particular size of distractor. In some embodiments, projections 258 may be sized so that the pusher fits in any size of distractor.
  • [0141]
    Pusher 252 may be used to move a member through distractor 238 to a desired position between engaging plates. FIG. 35 depicts a side view of an embodiment of pusher 252 positioned in distractor 238 and inserter 210. When pusher 252 is positioned in inserter 210, the pusher may maintain a position of a member between engaging plates 102, 106 and allow for removal of distractor 238 from the engaging plates.
  • [0142]
    During some implant insertion procedures, a channel or channels may be formed in vertebrae. The channel or channels may correspond to a coupling projection or coupling projections of engaging plates. Instrument guides may be used to facilitate formation of a channel or channels in vertebrae. In some embodiments, two instrument guides may be coupled to an inserter. The instrument guides may be inserted into a disc space. A distractor may be introduced into the inserter to move the instrument guides against vertebrae. Channels may be formed in the vertebrae using instruments in combination with the instrument guides.
  • [0143]
    [0143]FIG. 36 depicts a perspective view of instrument guide 260. Instrument guide 260 may include slots 261, stops 262, and guide piece 264. Slots 261 may allow instrument guide 260 to be coupled to extensions of arms of an inserter. Stops 262 may limit an insertion depth of instrument guide 260 between vertebrae. Stops 262 may have openings 266. Fasteners may be positioned through openings 266 to secure instrument guide 260 to a vertebra during formation of a channel or channels in the vertebra. The fasteners may include, but are not limited to, screws, pins, barbs, or trocars. A head of a fastener may be too large to pass through opening 266.
  • [0144]
    Guide piece 264 may be used to place a cutting edge of an instrument (e.g., chisel, drill, reamer) at a desired location relative to a vertebra. The instrument may be passed through guide piece opening 268. Guide piece opening may properly orient a cutting portion of the instrument relative to a vertebra that the instrument is to form a channel in. A portion of the instrument may be positioned in groove 270 to guide the cutting edge of the instrument during formation of a channel in the vertebra. As the instrument travels along groove 270, bone matter may be removed from the vertebral surface adjacent to instrument guide 260 to form a groove in the vertebra. Bone matter may be removed to form an opening of a length and/or depth similar to a cross-sectional shape of a coupling projection on an engaging plate.
  • [0145]
    [0145]FIG. 37 depicts a perspective view of distractor 238, driver 272 and instrument guides 260 coupled to inserter 210. Driver 272 may position a shaft of fastener 274 through an opening in stop 262 so that the fastener couples instrument guide 260 to the vertebra.
  • [0146]
    [0146]FIG. 38 depicts a top view of chisel 276. FIG. 38A depicts a side view of chisel 276. Chisel 276 may include end member 278, shaft 280 and handle 282. End member 278 may include a cutting edge capable of penetrating bone. In some embodiments, shaft 280 may be bent to accommodate an angle between a proximal portion of an inserter and a channel guide positioned between vertebrae.
  • [0147]
    [0147]FIG. 39 depicts a perspective view of instrument guides 260, distractor 238, and chisel 276 coupled to inserter 210. End member 278 of chisel 276 may be inserted through a guide piece opening in guide piece 264 and positioned in groove 270 of instrument guide 260. Cutting edges of end member 278 may be forced into a vertebra. Insertion depth of end member 278 into the vertebra may be monitored using fluoroscopic imaging. In some embodiments, shaft 280 may be marked with a scale. When the end member of the chisel first contacts the vertebra, a first reading of the scale relative to a top of the inserter may be taken. As the chisel is driven into the vertebra, an estimate of the insertion depth may be provided by taking the difference between the current scale reading relative to the top of the inserter and the first reading of the scale relative to the top of the inserter. In some embodiments, a stop may be positioned on shaft 280 to limit insertion depth of the chisel into a vertebra. The stop may contact guide piece 264.
  • [0148]
    [0148]FIG. 40 depicts a perspective view of a reamer in combination with inserter 210, distractor 238 and instrument guides 260. Reamer 284 may allow removal of bone matter from a vertebral surface to form a groove in the vertebral surface. The groove may have an arcuate cross-sectional shape to complement an arcuate shaped coupling projection on an engaging plate (as shown in FIGS. 9-11). Reamer 284 may include cutter 286, body 288 and handle 290. In some embodiments, a drive shaft may be positioned in body 288. The drive shaft may be coupled to cutter 286 and to handle 290. The drive shaft may be flexible or include flexible joints so that cutter 286 will be oriented in a proper direction relative to the inserter and the vertebra. Cutter 286 may be inserted in an opening of guide piece 264 of instrument guide 260. Rotation of handle 290 may allow cutter 286 to remove vertebral bone and form a groove in the vertebra. Contact of stop 292 with guide piece 264 may limit an insertion depth of cutter 286 into the vertebra. A position of stop 292 along body 288 may be adjustable. In some embodiments, insertion depth of cutter 286 into the vertebra may be monitored during formation of the groove using fluoroscopic imaging.
  • [0149]
    In certain embodiments, a trial spacer may be used during formation of a disc space between vertebrae. A trial spacer may be used to determine when an appropriate sized disc space is formed between vertebrae. The trial spacer may also determine a size of trial endplates and/or engaging plates. FIG. 41 depicts embodiments of trial spacers 294. A distal end of trial spacer 294 may be similar in size (e.g., small, medium or large) to engaging plates and/or trial endplates.
  • [0150]
    During some implant insertion procedures, trial endplates may be used to determine the proper height and lordotic angle of the implant to be inserted into the patient. Top surfaces of the trial endplates may be smooth and/or polished so that the trial endplates easily slide between vertebrae. FIG. 42 depicts a bottom view of trial endplate 296. Trial endplate 296 may include slots 114 to engage extensions of arms of an inserter. Slots 114 may include indents 118. Indents 118 may engage detents of an inserter to securely couple the inserter to trial endplate 296.
  • [0151]
    Trial endplates 296 may vary in thickness. For example, a thickness of trial endplate 296 at an edge near slots 114 may exceed a thickness of the trial endplate at an edge opposite the slots. Trial endplates 296 may have slopes ranging from about 2 to about 22 (e.g., about 3, about 6, about 9, about 12). The combined angle of a top trial endplate and a bottom trial endplate may determine the lordotic angle that will be established by engaging plates of a implant that correspond to the trial endplates. For example, if two trial endplates with 3 of slope are used, an implant formed between the vertebrae may be formed with two engaging plates, each engaging plate having 3 of slope. The formed implant may establish a 6 lordotic angle between the vertebra. If the top trial endplate has 3 of slope and the bottom trial endplate has 6 of slope, an implant formed between the vertebrae may be formed with a top engaging plate having a 3 slope and a bottom engaging plate having a 6 slope. The formed implant may establish a 9 lordotic angle between the vertebrae.
  • [0152]
    An instrumentation kit for an implant insertion procedure may include individual trial endplates that correspond in height and slope to each engaging plate supplied in the instrumentation kit. If more than two engaging plates of the same size and slope are supplied in the instrumentation set, only two trial endplates corresponding to that size and slope engaging plate are needed in the instrumentation set. Having a trial endplate that corresponds to each engaging plate allows a surgeon to insert trial endplates that correspond to available engaging plates between the vertebrae. The surgeon is able to test every combination of implant that can be formed using the trial endplates supplied in the instrumentation kit. The surgeon can test an exact model of the implant that is to be formed in the disc space by choosing the appropriate trial endplates and distractor.
  • [0153]
    When the trial endplates are coupled to an inserter and positioned in the disc space, a distractor may be positioned in the inserter to separate the trial endplates. If the distractor easily slides into the inserter, a larger distractor may be tried. If the distractor cannot be inserted into the inserter, a smaller distractor may be tried. If some force is needed to insert the distractor into the inserter, the distractor may be the appropriate distractor. An appropriate distractor may overdistract vertebrae by about 1.5 mm to about 2.0 mm. Overdistraction of vertebrae by about 1.5 mm to about 2.0 mm may extend ligaments proximate the vertebrae sufficiently to allow for relative movement of components of a disc implant once the implant has been inserted. A fluoroscopic image may be obtained to determine if the trial endplates establish desired lordosis and height between the vertebrae. If the lordosis or height is not correct, other trial endplates and/or distractors may be coupled to the inserter. The inserter may be positioned between the vertebra until the trial endplates and distractor establish a desired height and lordotic angle between the vertebrae. Engaging plates that correspond to the trial endplates and a member that will slide down the distractor may be obtained from the instrumentation kit.
  • [0154]
    [0154]FIG. 43 depicts perspective view of a member seater. Member seater 298 may facilitate seating of a member of an implant between engaging plates. Member seater 298 may include arms 300, 300′ and handles 302, 302′. Arms 300, 300′ may be pivotally coupled to handles 302, 302′. Arm 300′ may be positioned on a topside of projection 128 of member 104 (depicted in FIG. 1). Arm 300′ may engage slots 114 of engaging plate 102 (depicted in FIG. 1). Compression of handle 302 in the direction of handle 302′ may allow arm 300′ to move toward arm 300. Movement of arm 300′ toward arm 300 may allow member 104 to be securely positioned in recess 116 of engaging plate 102. After seating member 104, member seater 298 may be removed from the intervertebral space.
  • [0155]
    Engaging plates, members and/or trial endplates may be made of one or more biocompatible materials including, but not limited to, metals, alloys, ceramics, polymers and/or composites. For example, an alloy may include cobalt-chrome-molybdenum (CoCrMo). Ceramics may include, but are not limited to, alumina, zirconia or composites. Polymers used for implant components may include ultra-high molecular weight polyethylene, polyfluorocarbons and/or polyesteresterketone (PEEK). In some embodiments, all components of a disc implant may be formed of metal. In certain embodiments, engaging plates and/or members may be formed of titanium, titanium alloys, steel and/or steel alloys. In addition, materials may be chosen based upon characteristics such as durability and ease with which biological tissue, such as human bone, fuse with the material. For example, titanium may wear poorly over time, but may fuse well with bone. A cobalt-chrome-molybdenum alloy may wear well, but may not fuse as well with biological tissue.
  • [0156]
    In some embodiments, engaging plates and/or members may be or may include bioabsorbable material. Surfaces of engaging plates and/or members that contact bone may include a coating to promote osseointegration of the implant component with bone. The coating may be, but is not limited to, a bone morphogenic protein, hydroxyapatite and/or a titanium plasma spray.
  • [0157]
    In certain embodiments, engaging plates, members and/or trial endplates of an implant may be formed of different materials to decrease wear of the implant over time. An implant embodiment may include engaging plates formed of titanium or cobalt-chrome-molybdenum and one or more members formed of ceramic (such as alumina) or polymer (such as ultra-high molecular weight polyethylene). Material choice may be influenced by various factors. For example, many polymers tend to “flow” when they are produced at less than a certain thickness, possibly deforming and leading to the failure of an implant. Ceramics, however, do not tend to deform, but may potentially shatter under pressure.
  • [0158]
    In certain embodiments, an implant and/or trial endplates may be distributed and/or sold pre-assembled and stored in sterile packaging until needed. In some implant embodiments, radiological markers may be placed in components of an implant that are invisible to x-rays. The radiological markers may allow the position of the component to be determined using x-rays or other imaging techniques. The ability to determine the position of all components of an implant may eliminate a need to have a surgical procedure to determine the location of the implant.
  • [0159]
    In some embodiments, steps may be taken to adjust the coefficient of friction of materials used to form engaging plates, members and/or trial endplates. Implant components may be machined, formed and/or chemically treated to decrease the coefficient of friction and reduce the amount of wear on engaging plates and/or members. In some implant embodiments, an insert, coating, liner or other covering may be placed on all, or a portion, of a surface of the engaging plates and/or members. The insert, coating, liner or covering may modify frictional or other physical properties of an engaging plate and/or member relative to another component of an implant. In some embodiments, a surface of a member and/or an inner surface of an engaging plate may include a surface coating to reduce noise resulting from contact between implant components.
  • [0160]
    An implant may be positioned in an intervertebral space between adjacent vertebrae using an anterior, lateral and/or posterior approach. A surgeon may perform a discectomy to remove all or a portion of an intervertebral disc. Instruments such as curettes, rongeurs and bone shavers may be used to prepare the disc space for the implant. Vertebral surfaces that will contact engaging plates of an implant may be cleaned of cartilage or other tissue. The vertebral surfaces may be shaped to substantially conform to outer surfaces of engaging plates to be placed against the vertebral surfaces.
  • [0161]
    In an implant insertion procedure, trial spacers may be inserted in the intervertebral space to determine if a formed disc space is sufficiently large and/or to determine a size of an implant to be inserted in the disc space (e.g., small, medium or large). Radiological images may be taken during the discectomy with a trial spacer positioned between the vertebrae to determine if a disc space of the proper width and depth has been formed. One or more marks may be scored or burned into a surface of a vertebra close to a center of an edge of the vertebra. The mark or marks may be used as references to determine a proper lateral position of the implant and/or instrumentation during insertion of the implant.
  • [0162]
    If needed, instrument guides may be positioned against vertebrae. A reamer or a chisel may be used in conjunction with the instrument guides to form recesses in the vertebrae. The recess may have a shape that conforms to a shape of a coupling projection that extends from an engaging plate of an implant to be positioned between vertebrae.
  • [0163]
    Trial endplates may be coupled to an inserter. The trial endplates may be positioned between the vertebrae. A distractor of a determined height may be positioned in the inserter to separate the trial endplates. During some insertion procedures, a mallet or other impact device may be used to drive the distractor into the inserter. If the trial endplates and distractor combination do not establish a desired separation height and/or lordotic angle between the vertebrae, different trial endplates and/or different distractors may be tested until a combination of trial endplates and distractor is found that establishes the desired separation height and lordotic alignment of the vertebrae. If removal of trial endplates from a disc space is difficult, a slap hammer or other impact device may be used to facilitate removal of the inserter and trial endplates from the disc space. Using various combinations of trial endplates and distractors may allow a surgeon to determine the correct lordotic angle and height of implant components to be inserted in the intervertebral space.
  • [0164]
    Engaging plates that correspond to trial spacers that establish a desired separation height and lordotic angle may be chosen from available engaging plates supplied in an instrumentation kit. The chosen engaging plates may be coupled to arms of an inserter. The engaging plates may be positioned in the disc space. The chosen distractor may be positioned in the inserter. During some insertion procedures, a mallet or other impact device may be used to drive the distractor into the inserter. Positioning the distractor in the inserter may separate engaging plates attached to the arms to a desired separation distance. Separation of the engaging plates may force coupling projections of the engaging plates into surfaces of adjacent vertebrae to anchor the engaging plates to the bone.
  • [0165]
    A member that will slide down channels of the distractor may be obtained from the instrumentation set. The member may be positioned in the distractor and guided between engaging plates with a pusher. The pusher may be coupled to the inserter to maintain a position of the member between the engaging plates. After the member is positioned between the engaging plates, a mechanism on the arms of the inserter may be engaged to release the extension on the arms from the engaging plates. The inserter, distractor and pusher may be removed from the disc space. During some insertion procedures, a slap hammer may be used to facilitate removal of the inserter, distractorand/or pusher from the disc space. Radiological images may be taken to ensure that the implant is positioned as desired.
  • [0166]
    During some insertion procedures, a member seater may be used after an inserter has been removed from the engaging plates. The member seater may be positioned on a projection of a member and in a slot of an engaging plate. Handles of the member seater may be compressed to securely seat the member in a recess of the engaging plate. The handles may be released to disengage the arms from the projections and from the engaging plate. The member seater may be removed from the intervertebral space.
  • [0167]
    In this patent, certain U.S. patents have been incorporated by reference. The text of such U.S. patents, is, however, only incorporated by reference to the extent that no conflict exists between such text and the other statements and drawings set forth herein. In the event of such conflict, then any such conflicting text in such incorporated by reference U.S. patents is specifically not incorporated by reference in this patent.
  • [0168]
    Further modifications and alternative embodiments of various aspects of the invention will be apparent to those skilled in the art in view of this description. Accordingly, this description is to be construed as illustrative only and is for the purpose of teaching those skilled in the art the general manner of carrying out the invention. It is to be understood that the forms of the invention shown and described herein are to be taken as examples of embodiments. Elements and materials may be substituted for those illustrated and described herein, parts and processes may be reversed and certain features of the invention may be utilized independently, all as would be apparent to one skilled in the art after having the benefit of this description of the invention. Changes may be made in the elements described herein without departing from the spirit and scope of the invention as described in the following claims.
Patent Citations
Cited PatentFiling datePublication dateApplicantTitle
US20040002758 *11 Aug 20031 Jan 2004Landry Michael E.Spinal implant including a compressible connector
Referenced by
Citing PatentFiling datePublication dateApplicantTitle
US6908484 *6 Mar 200321 Jun 2005Spinecore, Inc.Cervical disc replacement
US6972037 *11 Feb 20046 Dec 2005Spinecore, Inc.Cervical disc replacement
US6972038 *11 Feb 20046 Dec 2005Spinecore, Inc.Cervical disc replacement
US6994727 *15 Dec 20037 Feb 2006Amedica CorporationTotal disc implant
US6994729 *11 Feb 20047 Feb 2006Spinecore, Inc.Cervical disc replacement
US6997955 *11 Feb 200414 Feb 2006Spinecore, Inc.Cervical disc replacement
US7008452 *26 Jun 20037 Mar 2006Depuy Acromed, Inc.Dual durometer elastomer artificial disc
US7198643 *11 Feb 20043 Apr 2007Spinecore, Inc.Cervical disc replacement
US7250060 *27 Jan 200431 Jul 2007Sdgi Holdings, Inc.Hybrid intervertebral disc system
US7294134 *28 Jul 200413 Nov 2007Weber Instrumente GmbhSurgical instrument for the introduction of a multi-component intervertebral prosthesis
US7383164 *23 Mar 20043 Jun 2008Depuy Products, Inc.System and method for designing a physiometric implant system
US7473276 *17 Dec 20026 Jan 2009Synthes (U.S.A.)Intervertebral implant with joint parts mounted on roller bodies
US7485146 *8 Mar 20053 Feb 2009Nuvasive, Inc.Total disc replacement system and related methods
US748833026 Jan 200610 Feb 2009Depuy Spine, Inc.Modular static intervertebral trial
US749124116 Sep 200317 Feb 2009Spinecore, Inc.Intervertebral spacer device having recessed notch pairs for manipulation using a surgical tool
US7503935 *5 Nov 200417 Mar 2009Kyphon SarlMethod of laterally inserting an artificial vertebral disk replacement with translating pivot point
US7547309 *23 Sep 200416 Jun 2009Spine Solutions, Inc.Distractor for lumbar insertion instrument
US7549995 *7 Jul 200423 Jun 2009Aesculap AgSurgical instrument for handling an implant
US762195620 Apr 200424 Nov 2009Globus Medical, Inc.Prosthetic spinal disc replacement
US7637955 *23 Mar 200429 Dec 2009Warsaw Orthopedic, Inc.Constrained artificial spinal disc
US764165418 Feb 20045 Jan 2010Spinecore, Inc.Instrumentation and methods for use in implanting a cervical disc replacement device
US7641666 *30 Jul 20045 Jan 2010Globus Medical, Inc.Prosthetic spinal disc replacement
US764851118 Feb 200419 Jan 2010Spinecore, Inc.Instrumentation and methods for use in implanting a cervical disc replacement device
US765504527 Jul 20062 Feb 2010Aesculap Implant Systems, LlcArtificial intervertebral disc
US766218219 Feb 200416 Feb 2010Spinecore, Inc.Instrumentation and methods for use in implanting a cervical disc replacement device
US766622912 Nov 200423 Feb 2010Amedica CorporationCeramic-ceramic articulation surface implants
US7670377 *5 Nov 20042 Mar 2010Kyphon SarlLaterally insertable artifical vertebral disk replacement implant with curved spacer
US76742926 May 20049 Mar 2010Spinecore, Inc.Instrumentation and methods for use in implanting a cervical disc replacement device
US768239631 Oct 200323 Mar 2010Ldr MedicalIntervertebral disc prosthesis
US7691146 *5 Nov 20046 Apr 2010Kyphon SarlMethod of laterally inserting an artificial vertebral disk replacement implant with curved spacer
US769551618 Apr 200513 Apr 2010Ldr MedicalIntervertebral disc prosthesis
US769552112 Aug 200513 Apr 2010Amedica CorporationHip prosthesis with monoblock ceramic acetabular cup
US770428023 Jan 200627 Apr 2010Synthes Usa, LlcIntervertebral implant comprising temporary blocking means
US7708777 *3 Feb 20064 May 2010Depuy Spine, Inc.Modular intervertebral disc replacements
US770877820 May 20054 May 2010Flexuspine, Inc.Expandable articulating intervertebral implant with cam
US770878019 Nov 20044 May 2010Spinecore, Inc.Instrumentation and methods for use in implanting a cervical disc replacement device
US771330228 Apr 200411 May 2010Spinecore, Inc.Intervertebral spacer device utilizing a spirally slotted belleville washer having radially spaced concentric grooves
US771330428 Dec 200511 May 2010Globus Medical, Inc.Transforaminal prosthetic spinal disc replacement
US773175315 Nov 20058 Jun 2010Spinal Kinetics, Inc.Prosthetic intervertebral discs
US77539583 Feb 200513 Jul 2010Gordon Charles RExpandable intervertebral implant
US77586469 Jun 200520 Jul 2010Amedica CorporationTotal disc implant
US776696627 Jul 20063 Aug 2010Aesculap Implant Systems, LlcArtificial intervertebral disc
US777147728 Apr 200410 Aug 2010Spinecore, Inc.Intervertebral spacer device utilizing a belleville washer having radially spaced concentric grooves
US777148119 Sep 200710 Aug 2010Amedica CorporationTotal disc implant
US77760858 Sep 200517 Aug 2010Amedica CorporationKnee prosthesis with ceramic tibial component
US778073821 Dec 200424 Aug 2010Amedica CorporationPolymer-ceramic articulation
US77853518 Mar 200631 Aug 2010Flexuspine, Inc.Artificial functional spinal implant unit system and method for use
US77944808 Mar 200614 Sep 2010Flexuspine, Inc.Artificial functional spinal unit system and method for use
US77990828 Mar 200621 Sep 2010Flexuspine, Inc.Artificial functional spinal unit system and method for use
US780316221 Jul 200328 Sep 2010Spine Solutions, Inc.Instruments and method for inserting an intervertebral implant
US780318929 Sep 200628 Sep 2010Spinal Kinetics, Inc.Prosthetic facet and facet joint replacement device
US781128923 Feb 200412 Oct 2010Spinecore, Inc.Artificial intervertebral disc trial having a controllably separable distal end
US78113293 Mar 200612 Oct 2010Globus MedicalTransforaminal prosthetic spinal disc replacement and methods thereof
US7815679 *31 Oct 200319 Oct 2010Cardo Medical, Inc.Modular motion preservation artificial spinal joint assembly
US783240919 Oct 200716 Nov 2010Aesculap Implant Systems, LlcMethod of inserting an artificial intervertebral disc
US783324614 Oct 200316 Nov 2010Kyphon SRLInterspinous process and sacrum implant and method
US7833273 *18 Apr 200616 Nov 2010Karin Buettner-JanzPhysiologically movable intervertebral disc prosthesis for the lumbar and cervical spine
US7837734 *12 Apr 200723 Nov 2010Warsaw Orthopedic, Inc.System and method for replacing degenerated spinal disks
US784204323 Feb 200430 Nov 2010Spinecore, Inc.Instrumentation for inserting and impacting an artificial intervertebral disc in an intervertebral space
US7842088 *27 Jan 200630 Nov 2010Ldr MedicalIntervertebral disc prosthesis
US7850697 *6 Dec 200514 Dec 2010Axiomed Spine CorporationMethod and apparatus for replacing a spinal disc
US78507356 Feb 200414 Dec 2010Warsaw Orthopedic, Inc.Articular disc prosthesis and method for treating spondylolisthesis
US7879101 *13 Feb 20041 Feb 2011SpinevisionIntervertebral prosthesis
US7887590 *2 May 200615 Feb 2011Spineart SaIntervertebral disc prosthesis
US78922621 Mar 200622 Feb 2011GlobusMedicalPosterior prosthetic spinal disc replacement and methods thereof
US7905886 *7 Jul 200415 Mar 2011Nuvasive Inc.System and methods for performing transforaminal lumbar interbody fusion
US790591926 Feb 201015 Mar 2011Biomedflex LlcProsthetic joint
US790986912 Feb 200422 Mar 2011Flexuspine, Inc.Artificial spinal unit assemblies
US790987713 Jun 200522 Mar 2011Zimmer Spine, Inc.Spinal disc implant with complimentary members between vertebral engaging plates
US791458029 Jun 201029 Mar 2011Biomedflex LlcProsthetic ball-and-socket joint
US792275029 Nov 200712 Apr 2011Paradigm Spine, LlcInterlaminar-interspinous vertebral stabilization system
US7959677 *19 Jan 200714 Jun 2011Flexuspine, Inc.Artificial functional spinal unit system and method for use
US795967815 Apr 200514 Jun 2011Zimmer GmbhIntervertebral disk implant
US79765509 Aug 200712 Jul 2011Pioneer Surgical TechnologyInsertion instrument for artificial discs
US800283428 Apr 200923 Aug 2011Spinalmotion, Inc.Intervertebral prosthetic disc with metallic core
US8016888 *18 Apr 200613 Sep 2011Karin Buettner-JanzIntervertebral disc prosthesis with transversally arched, curved cyclindrical articulation surfaces for the lumbar and cervical spine
US80295682 Jul 20104 Oct 2011Spinecore, Inc.Intervertebral spacer device having a slotted partial circular domed arch strip spring
US802957431 Dec 20104 Oct 2011Biomedflex LlcProsthetic knee joint
US803871323 Apr 200318 Oct 2011Spinecore, Inc.Two-component artificial disc replacements
US8043379 *21 Apr 200625 Oct 2011Depuy Spine, Inc.Disc prosthesis having remote flexion/extension center of rotation
US80527238 Mar 20068 Nov 2011Flexuspine Inc.Dynamic posterior stabilization systems and methods of use
US806237128 Apr 200922 Nov 2011Spinalmotion, Inc.Intervertebral prosthetic disc with metallic core
US80667747 Apr 200629 Nov 2011Warsaw Orthopedic, Inc.Artificial disc implants and associated methods and instrumentation
US807082328 Mar 20116 Dec 2011Biomedflex LlcProsthetic ball-and-socket joint
US8083796 *2 Mar 200927 Dec 2011Nuvasive, Inc.Implants and methods for spinal fusion
US80837974 Feb 200527 Dec 2011Spinalmotion, Inc.Intervertebral prosthetic disc with shock absorption
US809042811 Nov 20093 Jan 2012Spinalmotion, Inc.Spinal midline indicator
US809253815 Apr 200810 Jan 2012Spinalmotion, Inc.Intervertebral prosthetic disc
US80925391 Jul 201010 Jan 2012Spinecore, Inc.Intervertebral spacer device having a belleville washer with concentric grooves
US810538131 Jan 200731 Jan 2012Spine Solutions, Inc.Intervertebral implant, insertion tool and method of inserting same
US81099799 Dec 20097 Feb 2012Spinecore, Inc.Instrumentation and methods for use in implanting a cervical disc replacement device
US81188698 Mar 200621 Feb 2012Flexuspine, Inc.Dynamic interbody device
US811887020 May 200521 Feb 2012Flexuspine, Inc.Expandable articulating intervertebral implant with spacer
US811887120 May 200521 Feb 2012Flexuspine, Inc.Expandable articulating intervertebral implant
US81188729 Aug 200721 Feb 2012Pioneer Surgical Technology, Inc.System and methods for inserting a spinal disc device into an intervertebral space
US812381020 May 200528 Feb 2012Gordon Charles RExpandable intervertebral implant with wedged expansion member
US812381227 Aug 200928 Feb 2012Amedica CorporationCeramic-ceramic articulation surface implants
US8133281 *23 Jan 200613 Mar 2012Synthes Usa, LlcIntervertebral implant comprising dome-shaped joint surfaces
US813740428 Mar 200620 Mar 2012Depuy Spine, Inc.Artificial disc replacement using posterior approach
US814755020 May 20053 Apr 2012Flexuspine, Inc.Expandable articulating intervertebral implant with limited articulation
US815784422 Oct 200717 Apr 2012Flexuspine, Inc.Dampener system for a posterior stabilization system with a variable length elongated member
US816299422 Oct 200724 Apr 2012Flexuspine, Inc.Posterior stabilization system with isolated, dual dampener systems
US816794811 Oct 20051 May 2012Globus Medical, Inc.Anterior prosthetic spinal disc replacement
US8172848 *11 Apr 20088 May 2012Spinemedica, LlcSurgical instruments for spinal disc implants and related methods
US817290216 Jul 20098 May 2012Spinemedica, LlcSpinal interbody spacers
US817290320 May 20058 May 2012Gordon Charles RExpandable intervertebral implant with spacer
US818251422 Oct 200722 May 2012Flexuspine, Inc.Dampener system for a posterior stabilization system with a fixed length elongated member
US818733022 Oct 200729 May 2012Flexuspine, Inc.Dampener system for a posterior stabilization system with a variable length elongated member
US82064477 Mar 200826 Jun 2012Spinalmotion, Inc.Methods and apparatus for intervertebral disc prosthesis insertion
US820644916 Jul 200926 Jun 2012Spinalmotion, Inc.Artificial intervertebral disc placement system
US82266912 Aug 201024 Jul 2012Stryker SpineInsertion guide for a spinal implant
US823162830 Nov 200931 Jul 2012Spinecore, Inc.Instrumentation and methods for use in implanting a cervical disc replacement device
US825205816 Feb 200628 Aug 2012Amedica CorporationSpinal implant with elliptical articulatory interface
US825743926 Jan 20094 Sep 2012Ldr MedicalIntervertebral disc prosthesis
US825744020 May 20054 Sep 2012Gordon Charles RMethod of insertion of an expandable intervertebral implant
US8262733 *2 Jul 200911 Sep 2012Aesculap AgIntervertebral disk prosthesis system
US826796522 Oct 200718 Sep 2012Flexuspine, Inc.Spinal stabilization systems with dynamic interbody devices
US826799915 Apr 200918 Sep 2012Ldr MedicalIntervertebral disc prosthesis
US827750728 May 20102 Oct 2012Spinecore, Inc.Spacerless artificial disc replacements
US82775097 Dec 20092 Oct 2012Globus Medical, Inc.Transforaminal prosthetic spinal disc apparatus
US828264112 Jul 20079 Oct 2012Depuy Spine, Inc.Methods and instrumentation for disc replacement
US83036017 Jun 20066 Nov 2012Stryker SpineCollet-activated distraction wedge inserter
US83036599 Mar 20076 Nov 2012Spinecore, Inc.Intervertebral spacer device having engagement hole pairs
US8303660 *23 Apr 20076 Nov 2012Samy AbdouInter-vertebral disc prosthesis with variable rotational stop and methods of use
US83088123 Jan 201213 Nov 2012Biomedflex, LlcProsthetic joint assembly and joint member therefor
US832881419 May 200811 Dec 2012Aesculap AgSurgical guiding instrument
US833750030 Jul 200725 Dec 2012Synthes Usa, LlcDrilling/milling guide and keel cut preparation system
US834318925 Sep 20081 Jan 2013Zyga Technology, Inc.Method and apparatus for facet joint stabilization
US83432196 Jun 20081 Jan 2013Ldr MedicalIntersomatic cage, intervertebral prosthesis, anchoring device and implantation instruments
US83490179 Sep 20108 Jan 2013Spine Solutions, Inc.Instruments and method for inserting an intervertebral implant
US835716712 Oct 200422 Jan 2013Spinecore, Inc.Artificial intervertebral disc trials with baseplates having inward tool engagement holes
US837208424 Sep 200712 Feb 2013Pioneer Surgical Technology, Inc.System and methods for inserting a spinal disc device into an intervertebral space
US8377098 *19 Jan 200719 Feb 2013Flexuspine, Inc.Artificial functional spinal unit system and method for use
US8388686 *17 Dec 20025 Mar 2013Max AebiIntervertebral implant with tiltable joint parts
US8394125 *24 Jul 200912 Mar 2013Zyga Technology, Inc.Systems and methods for facet joint treatment
US83987129 Nov 201119 Mar 2013Spinalmotion, Inc.Intervertebral prosthetic disc with shock absorption
US840398727 Sep 200626 Mar 2013Spinal Kinetics Inc.Prosthetic intervertebral discs having compressible core elements bounded by fiber-containing membranes
US84039892 Feb 201026 Mar 2013Karin Buettner-JanzPhysologically movable intervertebral disc prosthesis for the lumbar and cervical spine
US840921318 Mar 20102 Apr 2013Pioneer Surgical Technology, Inc.Insertion instrument for artificial discs
US841461612 Sep 20079 Apr 2013Pioneer Surgical Technology, Inc.Mounting devices for fixation devices and insertion instruments used therewith
US84146523 Oct 20119 Apr 2013Depuy Spine, Inc.Disc prosthesis having remote flexion/extension center of rotation
US842560318 Dec 200923 Apr 2013Synthes Usa, LlcOrthopedic implant with flexible keel
US843529722 Sep 20097 May 2013Spinecore, Inc.Intervertebral disc replacement
US843530116 Sep 20117 May 2013DePuy Synthes Products, LLCArtificial intervertebral disc implant
US84399315 May 200914 May 2013Ldr MedicalInstrumentation and methods for inserting an intervertebral disc prosthesis
US844469512 May 200921 May 2013Spinalmotion, Inc.Prosthetic disc for intervertebral insertion
US845469813 Feb 20084 Jun 2013Spinalmotion, Inc.Prosthetic disc for intervertebral insertion
US845469927 Oct 20084 Jun 2013Synergy Disc Replacement, IncSystems and methods for vertebral disc replacement
US846554616 Feb 200718 Jun 2013Ldr MedicalIntervertebral disc prosthesis insertion assemblies
US84700413 Oct 201125 Jun 2013Spinecore, Inc.Two-component artificial disc replacements
US8470045 *5 May 200925 Jun 2013K2M, Inc.Endplate for an intervertebral prosthesis and prosthesis incorporating the same
US8480715 *22 May 20079 Jul 2013Zimmer Spine, Inc.Spinal implant system and method
US84861474 Feb 200816 Jul 2013Spinalmotion, Inc.Posterior spinal device and method
US850663115 Sep 201013 Aug 2013Spinalmotion, Inc.Customized intervertebral prosthetic disc with shock absorption
US850663430 Nov 200413 Aug 2013DePuy Synthes Products, LLCIntervertebral implant
US85124139 Sep 201120 Aug 2013Biomedflex, LlcProsthetic knee joint
US852391222 Oct 20073 Sep 2013Flexuspine, Inc.Posterior stabilization systems with shared, dual dampener systems
US853532630 Aug 200617 Sep 2013DePuy Synthes Products, LLCInsertion instrument for an intervertebral implant
US8545561 *2 Aug 20061 Oct 2013Taurus Gmbh & Co. KgOrthopaedic medical device
US85455642 Nov 20101 Oct 2013Spinecore, Inc.Intervertebral spacer device having an articulation member and housing
US857991116 Jan 200912 Nov 2013Spinecore, Inc.Instruments and methods for inserting artificial intervertebral implants
US857997810 Jan 201212 Nov 2013DePuy Synthes Products, LLCIntervertebral implant, insertion tool and method of inserting same
US859735819 Jan 20073 Dec 2013Flexuspine, Inc.Dynamic interbody devices
US86031688 Mar 200610 Dec 2013Flexuspine, Inc.Artificial functional spinal unit system and method for use
US86230885 Dec 20087 Jan 2014Nuvasive, Inc.Spinal fusion implant and related methods
US863680423 Feb 200428 Jan 2014Spinecore, Inc.Instrumentation for properly seating an artificial intervertebral disc in an intervertebral space
US863680521 May 201228 Jan 2014Spinalmotion, Inc.Artificial intervertebral disc placement system
US864738622 Jul 201011 Feb 2014Charles R. GordonExpandable intervertebral implant system and method
US86632293 May 20074 Mar 2014DePuy Synthes Products, LLCInstruments and method for preparing an intervertebral space for receiving an artificial disc implant
US866329311 Apr 20114 Mar 2014Zyga Technology, Inc.Systems and methods for facet joint treatment
US8673008 *10 Jan 201218 Mar 2014Spinadyne, Inc.Posterior spinal arthroplasty system
US8673009 *10 Jan 201218 Mar 2014Spinadyne, Inc.Spinal prosthesis and facet joint prosthesis
US867918229 Aug 201225 Mar 2014Spinecore, Inc.Spacerless artificial disc replacements
US868510325 Jul 20121 Apr 2014Globus Medical, Inc.Transforaminal prosthetic spinal disc apparatus
US86967077 Mar 200615 Apr 2014Zyga Technology, Inc.Facet joint stabilization
US8728163 *25 Apr 201220 May 2014K2M, Inc.Artificial disc replacement device
US873451912 Apr 200727 May 2014Spinalmotion, Inc.Posterior spinal device and method
US875339820 May 200517 Jun 2014Charles R. GordonMethod of inserting an expandable intervertebral implant without overdistraction
US875844122 Oct 200824 Jun 2014Spinalmotion, Inc.Vertebral body replacement and method for spanning a space formed upon removal of a vertebral body
US87648339 Mar 20091 Jul 2014Spinalmotion, Inc.Artificial intervertebral disc with lower height
US877135614 Sep 20128 Jul 2014Spinalmotion, Inc.Intervertebral prosthetic disc
US877795924 May 200615 Jul 2014Spinecore, Inc.Intervertebral disc and insertion methods therefor
US87844929 Jan 201322 Jul 2014Spinecore, Inc.Artificial disc replacements with natural kinematics
US8795342 *7 Sep 20075 Aug 2014Erhard ReisbergImplant, implant system, and use of an implant and implant system
US879537121 Jun 20075 Aug 2014DePuy Synthes Products, LLCIntervertebral implant
US880178914 Jun 201312 Aug 2014Spinecore, Inc.Two-component artificial disc replacements
US880179222 Jul 201012 Aug 2014Spinalmotion, Inc.Posterio spinal device and method
US8814938 *24 Oct 200626 Aug 2014K2M, Inc.Intervertebral disc replacement and associated instrumentation
US883448227 Apr 200716 Sep 2014Paradigm Spine, LlcInstrument system for use with an interspinous implant
US884572925 Nov 200930 Sep 2014Simplify Medical, Inc.Prosthetic disc for intervertebral insertion
US884573016 Jul 200930 Sep 2014Simplify Medical, Inc.Posterior prosthetic intervertebral disc
US885223511 Sep 20077 Oct 2014Spinadyne, Inc.Posteriorly inserted artificial disc and an artificial facet joint
US88586354 Feb 200514 Oct 2014Ldr MedicalIntervertebral disc prosthesis
US88768366 Aug 20134 Nov 2014DePuy Synthes Products, LLCInsertion instrument for an intervertebral implant
US888283926 Feb 201311 Nov 2014DePuy Synthes Products, LLCIntervertebral implant
US888885115 Aug 201118 Nov 2014Karin Buettner-JanzIntervertebral disc prosthesis with transversally arched, curved cylindrical articulation surfaces for the lumbar and cervical spine
US8894709 *27 Oct 200825 Nov 2014Synergy Disc Replacement, Inc.Systems and methods for vertebral disc replacement
US89366409 May 200520 Jan 2015Spinecore, Inc.Cervical disc replacement
US8940022 *19 Jan 200727 Jan 2015Flexuspine, Inc.Artificial functional spinal unit system and method for use
US894004722 Jan 200927 Jan 2015Spinecore, Inc.Intervertebral spacer device having recessed notch pairs for manipulation using a surgical tool
US89400514 Mar 201327 Jan 2015Flexuspine, Inc.Interbody device insertion systems and methods
US8956412 *22 Jun 200717 Feb 2015Axiomed, LLCArtificial disc
US89616084 Apr 201324 Feb 2015Spinecore, Inc.Intervertebral disc replacement
US8968407 *10 Jun 20113 Mar 2015Zimmer GmbhIntervertebral disk implant
US897453021 Jul 200510 Mar 2015DePuy Synthes Products, LLCIntervertebral implant
US897453130 Dec 200910 Mar 2015Simplify Medical, Inc.Methods and apparatus for intervertebral disc prosthesis insertion
US89745338 Jan 201410 Mar 2015Simplify Medical, Inc.Prosthetic disc for intervertebral insertion
US899899024 Jul 20077 Apr 2015DePuy Synthes Products, LLCIntervertebral implant with keel
US90053067 Nov 200714 Apr 2015Biomedflex, LlcMedical Implants With Compliant Wear-Resistant Surfaces
US90053075 Dec 201114 Apr 2015Biomedflex, LlcProsthetic ball-and-socket joint
US901154417 Aug 201021 Apr 2015Simplify Medical, Inc.Polyaryletherketone artificial intervertebral disc
US9017410 *26 Oct 201128 Apr 2015Globus Medical, Inc.Artificial discs
US90285529 May 200512 May 2015Spinecore, Inc.Cervical disc replacement
US90340387 Apr 200919 May 2015Spinalmotion, Inc.Motion limiting insert for an artificial intervertebral disc
US9066811 *19 Jan 200730 Jun 2015Flexuspine, Inc.Artificial functional spinal unit system and method for use
US908468225 Oct 201321 Jul 2015DePuy Synthes Products, Inc.Intervertebral implant, insertion tool and method of inserting same
US90846836 Jan 201221 Jul 2015Pbn Spinal Implants, LlcSpinal implant system and method
US909545113 Jan 20144 Aug 2015Spinecore, Inc.Intervertebral disc and insertion methods therefor
US910149317 Feb 201211 Aug 2015Pioneer Surgical Technology, Inc.System and methods for inserting a spinal disc device into an intervertebral space
US91077549 Nov 201218 Aug 2015Biomedflex, LlcProsthetic joint assembly and prosthetic joint member
US91077623 Nov 201118 Aug 2015Spinalmotion, Inc.Intervertebral prosthetic disc with metallic core
US91257518 May 20138 Sep 2015Globus Medical, Inc.Transforaminal prosthetic spinal disc replacement and methods thereof
US9144504 *27 Mar 201529 Sep 2015Globus Medical, Inc.Artificial discs
US916814618 Jun 201427 Oct 2015Spinecore, Inc.Artificial disc replacements with natural kinematics
US916815227 Dec 201127 Oct 2015Nuvasive, Inc.Implants and methods for spinal fusion
US917374513 Jun 20113 Nov 2015Ldr MedicalInstruments and methods for removing fixation devices from intervertebral implants
US919877031 Jul 20131 Dec 2015Globus Medical, Inc.Artificial disc devices and related methods of use
US919877331 Jan 20141 Dec 2015Spinecore, Inc.Spacerless artificial disc replacements
US92206031 Jul 200929 Dec 2015Simplify Medical, Inc.Limited motion prosthetic intervertebral disc
US922683722 Jun 20155 Jan 2016Spinecore, Inc.Intervertebral disc and insertion methods therefor
US923300615 Nov 201212 Jan 2016Zyga Technology, Inc.Systems and methods for facet joint treatment
US92330115 May 201412 Jan 2016Pioneer Surgical Technology, Inc.Systems and apparatuses for inserting an implant in intervertebral space
US925413916 Nov 20129 Feb 2016DePuy Synthes Products, Inc.Drilling/milling guide and keel cut preparation system
US926561824 Feb 200623 Feb 2016Ldr MedicalIntervertebral disc prosthesis and instrumentation for insertion of the prosthesis between the vertebrae
US926562013 Mar 201423 Feb 2016Raed M. Ali, M.D., Inc.Devices and methods for transpedicular stabilization of the spine
US92779308 Aug 20148 Mar 2016K2M, Inc.Intervertebral disc replacement and associated instrumentation
US9278006 *26 Oct 20068 Mar 2016European Foot Platform ScAnkle prosthesis with neutral position adjustment
US927800726 Sep 20068 Mar 2016Spinal Kinetics, Inc.Prosthetic intervertebral discs having cast end plates and methods for making and using them
US928931010 Mar 200722 Mar 2016Spinesmith Partners, L.P.Artificial disc with post and modular collar
US9308100 *18 Apr 200612 Apr 2016Karin Buettner-JanzIntervertebral disc prosthesis with a motion-adapted edge for the lumbar and cervical spine
US931427721 Aug 201319 Apr 2016Zyga Technology, Inc.Systems and methods for facet joint treatment
US93268613 Aug 20123 May 2016Globus Medical, Inc.Stabilizing joints
US93330954 Feb 200810 May 2016Ldr MedicalIntervertebral disc prosthesis, surgical methods, and fitting tools
US935184625 Aug 201431 May 2016Simplify Medical, Inc.Posterior prosthetic intervertebral disc
US935185214 Aug 201231 May 2016Pioneer Surgical Technology, Inc.Artificial disc device
US935812110 Mar 20077 Jun 2016Spinesmith Partners, L.P.Artificial disc with unique articulating geometry and associated methods
US93581271 Feb 20127 Jun 2016Globus Medical, Inc.Intervertebral fusion implant
US936433627 Sep 200614 Jun 2016Spinal Kinetics Inc.Prosthetic intervertebral discs
US93643401 Sep 201514 Jun 2016Globus Medical, Inc.Low profile plate
US936434326 Dec 201314 Jun 2016Globus Medical, Inc.Intervertebral fusion implant
US9381098 *28 Sep 20065 Jul 2016Spinal Kinetics, Inc.Tool systems for implanting prosthetic intervertebral discs
US938708610 Mar 201512 Jul 2016DePuy Synthes Products, Inc.Intervertebral implant with keel
US940274524 Nov 20092 Aug 2016Simplify Medical, Inc.Intervertebral prosthesis placement instrument
US94397747 Jan 201113 Sep 2016Simplify Medical Pty LtdIntervertebral prosthetic disc
US943977522 May 201413 Sep 2016Simplify Medical Pty LtdArtificial intervertebral disc with lower height
US9445916 *17 Sep 200720 Sep 2016Pioneer Surgical Technology, Inc.Joint arthroplasty devices having articulating members
US9452060 *4 Mar 201527 Sep 2016Globus Medical, Inc.Six degree spine stabilization devices and methods
US945690616 Aug 20134 Oct 2016Globus Medical, Inc.Expandable intervertebral implant
US947462214 Sep 201525 Oct 2016Globus Medical, IncExpandable intervertebral implant
US94805798 Oct 20151 Nov 2016Globus Medical, Inc.Expandable intervertebral implant
US94863251 Apr 20158 Nov 2016Globus Medical, Inc.Expandable intervertebral implant
US94863271 Dec 20148 Nov 2016Globus Medical, Inc.Standalone interbody implants
US949228820 Feb 201415 Nov 2016Flexuspine, Inc.Expandable fusion device for positioning between adjacent vertebral bodies
US949228916 Apr 201515 Nov 2016Globus Medical, Inc.Expandable intervertebral implant
US951714424 Apr 201413 Dec 2016Exactech, Inc.Limited profile intervertebral implant with incorporated fastening mechanism
US952662426 Jan 201527 Dec 2016DePuy Synthes Products, Inc.Intervertebral implant
US952662715 Nov 201227 Dec 2016Exactech, Inc.Expandable interbody device system and method
US95266309 Dec 201527 Dec 2016Globus Medical, Inc.Low profile plate
US95266344 Apr 201627 Dec 2016Spinecore, Inc.Intervertebral disc and insertion methods therefor
US953910331 Mar 201610 Jan 2017Globus Medical, Inc.Expandable intervertebral implant
US953910923 Oct 201510 Jan 2017Globus Medical, Inc.Low profile plate
US953911410 Oct 201310 Jan 2017Spinecore, Inc.Instruments and methods for inserting artificial intervertebral implants
US954532015 May 201417 Jan 2017Globus Medical, Inc.Standalone interbody implants
US955491712 Jul 201331 Jan 2017Simplify Medical Pty LtdCustomized intervertebral prosthetic disc with shock absorption
US956615722 Oct 201314 Feb 2017Biomedflex, LlcThree-member prosthetic joint
US957267913 Oct 201521 Feb 2017Spinecore, Inc.Artificial disc replacements with natural kinematics
US95791242 Apr 201228 Feb 2017Flexuspine, Inc.Expandable articulating intervertebral implant with limited articulation
US95857637 Jul 20157 Mar 2017DePuy Synthes Products, Inc.Intervertebral implant, insertion tool and method of inserting same
US958576514 Feb 20137 Mar 2017Globus Medical, IncDevices and methods for correcting vertebral misalignment
US960371616 Feb 201528 Mar 2017Spinecore, Inc.Intervertebral disc replacement
US961593613 Mar 201411 Apr 2017Globus Medical, Inc.Intervertebral fusion implant
US96228824 Apr 201618 Apr 2017Spinecore, Inc.Intervertebral disc and insertion methods therefor
US965574110 May 201623 May 2017Simplify Medical Pty LtdProsthetic disc for intervertebral insertion
US966887811 Aug 20166 Jun 2017Simplify Medical Pty LtdArtificial intervertebral disc with lower height
US967546522 May 201413 Jun 2017Globus Medical, Inc.Standalone interbody implants
US96754672 Nov 201213 Jun 2017Globus Medical, Inc.Intervertebral fusion implant
US96819591 Jun 201520 Jun 2017Globus Medical, Inc.Low profile plate
US96873552 Dec 201627 Jun 2017Simplify Medical Pty LtdCustomized intervertebral prosthetic disc with shock absorption
US96938728 Jan 20164 Jul 2017Pioneer Surgical Technology, Inc.Intervertebral disc implant
US97004293 Feb 201611 Jul 2017Spinecore, Inc.Intervertebral spacer device having recessed notch pairs for manipulation using a surgical tool
US97070928 Jul 201518 Jul 2017Globus Medical, Inc.Expandable intervertebral implant
US971751114 Jan 20161 Aug 2017DePuy Synthes Products, Inc.Drilling/milling guide and keel cut preparation system
US9724135 *16 Dec 20118 Aug 2017DePuy Synthes Products, Inc.Methods and systems for minimally invasive posterior arch expansion
US97242076 Nov 20158 Aug 2017DePuy Synthes Products, Inc.In-situ formed intervertebral fusion device and method
US97506151 Jan 20085 Sep 2017Spinal Kinetics, Inc.Prosthetic intervertebral discs having end plates and fibers between those end plates
US20040133281 *15 Dec 20038 Jul 2004Khandkar Ashok C.Total disc implant
US20040167534 *23 Feb 200426 Aug 2004Errico Joseph P.Instrumentation for inserting and impacting an artificial intervertebral disc in an intervertebral space
US20040167536 *23 Feb 200426 Aug 2004Errico Joseph P.Instrumentation for properly seating an artificial intervertebral disc in an intervertebral space
US20040167537 *23 Feb 200426 Aug 2004Errico Joseph P.Artificial intervertebral disc trial having a controllably separable distal end
US20040172021 *31 Oct 20032 Sep 2004Khalili Farid BruceModular motion preservation artificial joint assembly
US20040176772 *18 Feb 20049 Sep 2004Rafail ZubokInstrumentation and methods for use in implanting a cervical disc replacement device
US20040176774 *18 Feb 20049 Sep 2004Rafail ZubokInstrumentation and methods for use in implanting a cervical disc replacement device
US20040176844 *6 Mar 20039 Sep 2004Rafail ZubokCervical disc replacement
US20040176845 *11 Feb 20049 Sep 2004Rafail ZubokCervical disc replacement
US20040176846 *11 Feb 20049 Sep 2004Rafail ZubokCervical disc replacement
US20040176849 *11 Feb 20049 Sep 2004Rafail ZubokCervical disc replacement
US20040176850 *11 Feb 20049 Sep 2004Rafail ZubokCervical disc replacement
US20040176851 *11 Feb 20049 Sep 2004Rafail ZubokCervical disc replacement
US20040220670 *6 Feb 20044 Nov 2004Sdgi Holdings, Inc.Articular disc prosthesis and method for treating spondylolisthesis
US20050010290 *26 Jun 200313 Jan 2005Hawkins John R.Dual durometer elastomer artificial disc
US20050033305 *7 Jul 200410 Feb 2005Robert SchultzSurgical instrument for handling an implant
US20050043800 *20 Apr 200424 Feb 2005Paul David C.Prosthetic spinal disc replacement
US20050049706 *14 Sep 20043 Mar 2005Amedica Corporation, A Delaware CorporationRadiolucent spinal fusion cage
US20050060035 *16 Sep 200317 Mar 2005Errico Joseph P.Intervertebral spacer device having recessed notch pairs for manipulation using a surgical tool
US20050060036 *6 Jul 200417 Mar 2005Robert SchultzSpinal column implant
US20050090903 *12 Nov 200428 Apr 2005Khandkar Ashok C.Metal-ceramic composite articulation
US20050107888 *21 Dec 200419 May 2005Amedica CorporationMetal-ceramic composite articulation
US20050143820 *5 Nov 200430 Jun 2005St. Francis Medical Technologies, Inc.Method of laterally inserting an artificial vertebral disk replacement implant with translating pivot point
US20050159818 *17 Dec 200421 Jul 2005Jason BlainTotal disc replacement system and related methods
US20050165407 *23 Jan 200428 Jul 2005Diaz Robert L.Disk arthroplasty instrumentation and implants
US20050165485 *27 Jan 200428 Jul 2005Sdgi Holdings, Inc.Hybrid intervertebral disc system
US20050177238 *20 Jan 200511 Aug 2005Khandkar Ashok C.Radiolucent bone graft
US20050197814 *23 Mar 20048 Sep 2005Aram Luke J.System and method for designing a physiometric implant system
US20050216086 *23 Mar 200429 Sep 2005Sdgi Holdings, Inc.Constrained artificial spinal disc
US20050216092 *23 Mar 200429 Sep 2005Sdgi Holdings, Inc.Constrained artificial implant for orthopaedic applications
US20050240271 *9 May 200527 Oct 2005Spinecore, Inc.Cervical disc replacement
US20050240272 *9 May 200527 Oct 2005Spinecore, Inc.Cervical disc replacement
US20050240273 *9 Jun 200527 Oct 2005Khandkar Ashock CTotal disc implant
US20050251261 *5 May 200410 Nov 2005Sdgi Holdings, Inc.Artificial intervertebral disc for lateral insertion
US20050261772 *15 Apr 200524 Nov 2005Zimmer GmbhIntervertebral disk implant
US20050273176 *12 Aug 20058 Dec 2005Amedica CorporationHip prosthesis with monoblock ceramic acetabular cup
US20060025777 *28 Jul 20042 Feb 2006Helmut WeberSurgical instrument for the introduction of a multi-component intervertebral prosthesis
US20060036261 *15 Aug 200516 Feb 2006Stryker SpineInsertion guide for a spinal implant
US20060036325 *11 Oct 200516 Feb 2006Globus Medical Inc.Anterior prosthetic spinal disc replacement
US20060041313 *18 May 200523 Feb 2006Sdgi Holdings, Inc.Intervertebral disc system
US20060041314 *22 Aug 200523 Feb 2006Thierry MillardArtificial disc prosthesis
US20060052875 *8 Sep 20059 Mar 2006Amedica CorporationKnee prosthesis with ceramic tibial component
US20060064107 *23 Sep 200423 Mar 2006Rudi BertagnoliDistractor for lumbar insertion instrument
US20060069441 *2 Nov 200430 Mar 2006Zucherman James FPosterior approach implant method for assembly of multi-piece artificial spinal disk replacement device in situ
US20060085011 *13 Oct 200520 Apr 2006Zimmer GmbhInstrument system for the insertion of intervertebral disk implants
US20060111785 *9 Jan 200625 May 2006O'neil Michael JIntervertebral implant with conformable endplate
US20060116768 *13 Jun 20051 Jun 2006Krueger David JMovable disc implant
US20060149273 *6 Dec 20056 Jul 2006Axiomed Spine CorporationMethod and apparatus for replacing a spinal disc
US20060167551 *26 Jan 200627 Jul 2006Shawn StadModular static intervertebral trial
US20060229724 *23 Jan 200612 Oct 2006Beat LechmannIntervertebral implant comprising temporary blocking means
US20060229725 *23 Jan 200612 Oct 2006Beat LechmannIntervertebral implant comprising dome-shaped joint surfaces
US20060235391 *7 Mar 200619 Oct 2006Sutterlin Chester IiiFacet joint stabilization
US20060235524 *13 Feb 200419 Oct 2006Dominique PetitIntervertebral prosthesis
US20060235527 *18 Apr 200619 Oct 2006Karin Buettner-JanzIntervertebral disc prosthesis with a motion- adapted edge for the lumbar and cervical spine
US20060235528 *18 Apr 200619 Oct 2006Karin Buettner-JanzAngled sliding core, also as part of an intervertebral disc prosthesis, for the lumbar and cervical spine
US20060235530 *22 Dec 200519 Oct 2006Shelokov Alexis PArtificial prosthesis
US20060235531 *18 Apr 200619 Oct 2006Karin Buettner-JanzIntervertebral disc prosthesis with transversally arched, curved cylindrical articulation surfaces for the lumbar and cervical spine
US20060241641 *22 Apr 200526 Oct 2006Sdgi Holdings, Inc.Methods and instrumentation for distraction and insertion of implants in a spinal disc space
US20060241772 *18 Apr 200626 Oct 2006Karin Buettner-JanzPhysiologically movable intervertebral disc prosthesis for the lumbar and cervical spine
US20060265074 *4 Apr 200623 Nov 2006Manoj KrishnaPosterior spinal arthroplasty-development of a new posteriorly inserted artificial disc, a new anteriorly inserted artifical disc and an artificial facet joint
US20070010826 *1 Mar 200611 Jan 2007Rhoda William SPosterior prosthetic spinal disc replacement and methods thereof
US20070016221 *30 Aug 200618 Jan 2007Boris BeyersdorffInsertion instrument for an intervertebral implant
US20070032875 *2 Aug 20068 Feb 2007Terence BlacklockOrthopaedic Medical Device
US20070050032 *1 Sep 20051 Mar 2007Spinal Kinetics, Inc.Prosthetic intervertebral discs
US20070055378 *3 Mar 20068 Mar 2007Ankney David WTransforaminal prosthetic spinal disc replacement and methods thereof
US20070073404 *27 Jan 200629 Mar 2007Ralph RashbaumIntervertebral disc prosthesis
US20070083200 *23 Sep 200512 Apr 2007Gittings Darin CSpinal stabilization systems and methods
US20070123906 *24 Jan 200731 May 2007Spinecore, Inc.Inserter/impactor for implanting an artificial intervertebral disc
US20070123907 *31 Jan 200731 May 2007Weber Instrumente GmbhSurgical instrument for the introduction of a multi-component intervertebral prosthesis
US20070123985 *24 May 200631 May 2007Spinecore, Inc.Intervertebral disc and insertion methods therefor
US20070135919 *17 Dec 200214 Jun 2007Max AebiIntervertebral implant with joint parts mounted on roller bodies
US20070155271 *24 Mar 20065 Jul 2007Touzov Igor VHeat conductive textile and method producing thereof
US20070156243 *9 Mar 20075 Jul 2007Spinecore, Inc.Intervertebral spacer device having engagement hole pairs
US20070167947 *29 Sep 200619 Jul 2007Gittings Darin CSpinal stabilization device
US20070168033 *26 Sep 200619 Jul 2007Kim Daniel HProsthetic intervertebral discs having substantially rigid end plates and fibers between those end plates
US20070168035 *29 Sep 200619 Jul 2007Koske Nicholas CProsthetic facet and facet joint replacement device
US20070173942 *26 Jan 200626 Jul 2007Sdgi Holdings, Inc.Intervertebral prosthetic disc
US20070173944 *12 Dec 200626 Jul 2007Waldemar Link Gmbh & Co. KgEndoprosthesis with intermediate part
US20070185578 *3 Feb 20069 Aug 2007Depuy Spine, Inc.Modular intervertebral disc replacements
US20070191952 *16 Feb 200616 Aug 2007Amedica CorporationSpinal implant with elliptical articulatory interface
US20070191955 *12 Apr 200716 Aug 2007St. Francis Medical Technologies, Inc.System and Method for Replacing Degenerated Spinal Disks
US20070198092 *24 Apr 200723 Aug 2007Spinecore, Inc.System for inserting artificial intervertebral discs
US20070198093 *17 Feb 200623 Aug 2007Amedica CorporationSpinal implant with offset keels
US20070208346 *3 May 20076 Sep 2007Theirry MarnayInstruments and method for preparing an intervertebral space for receiving an artificial disc implant
US20070233244 *28 Mar 20064 Oct 2007Depuy Spine, Inc.Artificial Disc Replacement Using Posterior Approach
US20070233261 *28 Mar 20064 Oct 2007Depuy Spine, Inc.Artificial Disc Replacement Using Posterior Approach
US20070239276 *7 Apr 200611 Oct 2007Sdgi Holdings, Inc.Artificial disc implants and associated methods and instrumentation
US20070250170 *21 Apr 200625 Oct 2007Depuy Spine, Inc.Disc prosthesis having remote flexion/extension center of rotation
US20070276498 *17 Dec 200229 Nov 2007Mayhys Medizinaltechnik AgInterbertebral Implant with Tiltable Joint Parts
US20070276499 *30 Jul 200429 Nov 2007Paul David CProsthetic spinal disc replacement
US20070281305 *5 Jun 20066 Dec 2007Sean Wuxiong CaoDetection of lymph node metastasis from gastric carcinoma
US20070299525 *25 Jul 200527 Dec 2007Biomedica S.R.L.Bone Spacer
US20080015609 *27 Apr 200717 Jan 2008Trautwein Frank TInstrument system for use with an interspinous implant
US20080039860 *9 Aug 200714 Feb 2008Pioneer Laboratories, Inc.Insertion Instrument for Artificial Discs
US20080051897 *12 Jul 200728 Feb 2008Depuy Spine, Inc.Methods and instrumentation for disc replacement
US20080065220 *20 Aug 200713 Mar 2008Neville AlleyneArtificial spinal disk
US20080077153 *24 Sep 200727 Mar 2008Pioneer Surgical Technology, Inc.System and methods for inserting a spinal disc device into an intervertebral space
US20080082101 *7 Sep 20073 Apr 2008Erhard ReisbergImplant, implant system, and use of an implant and implant system
US20080082169 *28 Sep 20063 Apr 2008Gittings Darin CTool systems for implanting prosthetic intervertebral discs
US20080103599 *1 Jan 20081 May 2008Spinal Kinetics, Inc.Prosthetic Intervertebral Discs Having Substantially Rigid End Plates and Fibers Between Those End Plates
US20080103603 *26 Oct 20061 May 2008Beat HintermannAnkle prosthesis with neutral position adjustment
US20080108997 *12 Sep 20078 May 2008Pioneer Surgical Technology, Inc.Mounting Devices for Fixation Devices and Insertion Instruments Used Therewith
US20080109005 *9 Aug 20078 May 2008Trudeau Jeffrey LSystem and Methods for Inserting a Spinal Disc Device Into an Intervertebral Space
US20080109081 *17 Sep 20078 May 2008Qi-Bin BaoJoint Arthroplasty Devices Having Articulating Members
US20080114453 *13 Nov 200615 May 2008Warsaw Orthopedic, Inc.Intervertebral prosthetic devices and surgical methods
US20080140204 *7 Dec 200612 Jun 2008Warsaw Orthopedic, Inc.Vertebral Implant Systems and Methods of Use
US20080221689 *10 Mar 200711 Sep 2008Christopher ChaputArtificial disc with unique articulating geometry and associated methods
US20080221691 *10 Mar 200711 Sep 2008Christopher ChaputSurgical implant secured by pegs and associated methods
US20080228225 *29 Nov 200718 Sep 2008Paradigm Spine, LlcInterlaminar-Interspinous Vertebral Stabilization System
US20080228275 *14 Mar 200718 Sep 2008Heather CannonIntervertebral implant component with three points of contact
US20080228276 *14 Mar 200718 Sep 2008Warsaw Orthopedic, Inc.Intervertebral Prosthesis, Instruments, and Methods of Implanting
US20080234740 *19 Jan 200725 Sep 2008Landry Michael EArtificial functional spinal unit system and method for use
US20080234741 *19 Jan 200725 Sep 2008Landry Michael EArtificial functional spinal unit system and method for use
US20080234764 *19 Jan 200725 Sep 2008Landry Michael EArtificial functional spinal unit system and method for use
US20080234823 *19 Jan 200725 Sep 2008Landry Michael EArtificial functional spinal unit system and method for use
US20080243253 *2 May 20062 Oct 2008Spineart SaIntervertebral Disc Prosthesis
US20080269756 *11 Apr 200830 Oct 2008Spinemedica, Inc.Surgical instruments for spinal disc implants and related methods
US20080312705 *19 May 200818 Dec 2008Aesculap Ag & Co. KgSurgical guiding instrument
US20080319548 *22 Jun 200725 Dec 2008Axiomed Spine CorporationArtificial disc
US20090024218 *14 Aug 200722 Jan 2009Robert FriggIntervertebral Implant
US20090076615 *27 Oct 200819 Mar 2009Synergy DiscSystems and Methods for Vertebral Disc Replacement
US20090076616 *27 Oct 200819 Mar 2009Synergy DiscSystems and Methods for Vertebral Disc Replacement
US20090182432 *18 Mar 200916 Jul 2009Warsaw Orthopedic, Inc.Artificial disc implant
US20090216329 *24 Oct 200627 Aug 2009Lee Casey KIntervertebral disc replacement and associated instrumentation
US20090326542 *23 Feb 200431 Dec 2009Errico Joseph PInstrumentation for properly seating an artificial intervertebral disc in an intervertebral space
US20100004749 *2 Jul 20097 Jan 2010Aesculap AgIntervertebral disk prosthesis system
US20100010634 *18 Jul 200614 Jan 2010Radames BinottoBiocompatible intervertebral spacer
US20100016970 *16 Jul 200921 Jan 2010John KapitanSpinal interbody spacers
US20100049331 *27 Aug 200925 Feb 2010Amedica CorporationCeramic-ceramic articulation surface implants
US20100070040 *22 Sep 200918 Mar 2010Spinecore, Inc.Intervertebral Disc Replacement
US20100137992 *2 Feb 20103 Jun 2010Buettner-Janz KarinPhysologically Movable Intervertebral Disc Prosthesis for the Lumbar and Cervical Spine
US20100161064 *26 Feb 201024 Jun 2010Kellar Franz WProsthetic joint
US20100204799 *15 Apr 201012 Aug 2010Link America Inc.Endoprosthesis with intermediate part
US20100249797 *18 Mar 201030 Sep 2010Trudeau Jeffrey LInsertion Instrument for Artificial Discs
US20100262250 *29 Jun 201014 Oct 2010Kellar Franz WProsthetic ball-and-socket joint
US20100280623 *26 Feb 20104 Nov 2010Kellar Franz WProsthetic joint
US20100324684 *26 May 201023 Dec 2010Warsaw Orthopedic, Inc.Spinal Prosthetic Joints
US20100324690 *1 Sep 201023 Dec 2010Heather CannonIntervertebral Implant Component With Three Points of Contact
US20110022089 *24 Jul 200927 Jan 2011Zyga Technology, IncSystems and methods for facet joint treatment
US20110022175 *2 Aug 201027 Jan 2011Stryker SpineInsertion guide for a spinal implant
US20110046744 *2 Nov 201024 Feb 2011Spinecore, Inc.Intervertebral spacer device having recessed notch pairs for manipulation using a surgical tool
US20110060416 *5 May 200910 Mar 2011Ogilvie William FEndplate for an intervertebral prosthesis and prosthesis incorporating the same
US20110137421 *7 Dec 20099 Jun 2011Noah HansellTransforaminal Prosthetic Spinal Disc Apparatus
US20110238185 *10 Jun 201129 Sep 2011Zimmer GmbhIntervertebral disk implant
US20120136445 *10 Jan 201231 May 2012Spinadyne, Inc.Posterior spinal arthroplasty system
US20120136446 *10 Jan 201231 May 2012Spinadyne, Inc.Spinal prosthesis and facet joint prosthesis
US20120158061 *16 Dec 201121 Jun 2012David KochMethods and systems for minimally invasive posterior arch expansion
US20120209389 *25 Apr 201216 Aug 2012Charles TheofilosArtificial disc replacement device
US20130110240 *26 Oct 20112 May 2013Noah HansellArtificial Discs
US20150173912 *4 Mar 201525 Jun 2015Globus Medical, Inc.Six degree spine stabilization devices and methods
US20160022342 *23 Jul 201528 Jan 2016Renovis Surgical Technologies, Inc.Modular surgical tool assembly
USD7310632 Dec 20132 Jun 2015Nuvasive, Inc.Spinal fusion implant
USD74148828 Mar 201420 Oct 2015Nuvasive, Inc.Spinal fusion implant
EP1647244A1 *15 Oct 200419 Apr 2006Zimmer GmbHSystem of instruments for the insertion of intervertebral disc implants
EP1793768A2 *16 Sep 200513 Jun 2007Spine Solutions, IncImproved distractor for lumbar insertion instrument
EP1793768A4 *16 Sep 200510 Dec 2008Spine Solutions IncImproved distractor for lumbar insertion instrument
EP1824430A2 *6 Dec 200529 Aug 2007Axiomed Spine CorporationMethod and apparatus for replacing a spinal disc
EP1824430A4 *6 Dec 200524 Oct 2012Axiomed Spine CorpMethod and apparatus for replacing a spinal disc
EP2196160A114 Dec 200916 Jun 2010SpineCore, Inc.Adjustable pin drill guide
EP2329797A1 *16 Sep 20058 Jun 2011Spine Solutions, IncImproved distractor for lumbar insertion instrument
WO2004039241A2 *27 Oct 200313 May 2004St. Francis Medical Technologies, Inc.Artificial vertebral disk replacement implant with crossbar spacer and method
WO2004039241A3 *27 Oct 200325 Nov 2004St Francis Medical Tech IncArtificial vertebral disk replacement implant with crossbar spacer and method
WO2005011522A3 *30 Jul 200425 Jan 2007Christopher M AngelucciProsthetic spinal disc replacement
WO2005046534A1 *19 Oct 200426 May 2005Laurent SalleTotal intervertebral-disc prothesis
WO2006017130A2 *8 Jul 200516 Feb 2006Pioneer Laboratories, Inc.Skeletal reconstruction device
WO2006017130A3 *8 Jul 20053 May 2007Qi-Bin BaoSkeletal reconstruction device
WO2006036579A216 Sep 20056 Apr 2006Spine Solutions, Inc.Improved distractor for lumbar insertion instrument
WO2006062960A26 Dec 200515 Jun 2006Axiomed Spine CorporationMethod and apparatus for replacing a spinal disc
WO2006062960A3 *6 Dec 200528 Sep 2006Axiomed Spine CorpMethod and apparatus for replacing a spinal disc
WO2007028098A3 *31 Aug 200628 Jun 2007Darin C GittingsProsthetic intervertebral discs
WO2007038611A3 *26 Sep 200631 May 2007Infinity Orthopedics Company LModular intervertebral implant and instrumentation
WO2007060099A1 *11 Nov 200631 May 2007Aesculap Ag & Co. KgSurgical guide instrument
WO2007118119A2 *4 Apr 200718 Oct 2007Warsaw Orthopedic, Inc.Artificial disc implants and associated methods and instrumentation
WO2007118119A3 *4 Apr 20073 Apr 2008Greg C MarikArtificial disc implants and associated methods and instrumentation
WO2007127918A1 *27 Apr 20078 Nov 2007Paradigm Spine, L.L.C.Instrument system for use with an interspinous implant
WO2008070821A1 *7 Dec 200712 Jun 2008Warsaw Orthopedic, Inc.Vertebral implant systems and methods of use
WO2008112392A3 *19 Feb 200829 Jan 2009Christopher ChaputArtificial disc with unique articulating geometry and associated methods
WO2008147621A1 *30 Apr 20084 Dec 2008Abbott LaboratoriesSpinal implant system and method
WO2009114546A2 *10 Mar 200917 Sep 2009Spinalmotion, Inc.Artificial intervertebral disc with lower height
WO2009114546A3 *10 Mar 20097 Jan 2010Spinalmotion, Inc.Artificial intervertebral disc with lower height
Legal Events
DateCodeEventDescription
5 Apr 2004ASAssignment
Owner name: SPINAL CONCEPTS, INC., TEXAS
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:KRUEGER, DAVID J.;WAGNER, ERIK J.;REEL/FRAME:015183/0986
Effective date: 20040219
20 Jan 2009ASAssignment
Owner name: ABBOTT SPINE, INC., TEXAS
Free format text: CHANGE OF NAME;ASSIGNOR:SPINAL CONCEPTS, INC.;REEL/FRAME:022136/0529
Effective date: 20050420
24 Sep 2009ASAssignment
Owner name: ZIMMER SPINE AUSTIN, INC., TEXAS
Free format text: CHANGE OF NAME;ASSIGNOR:ABBOTT SPINE INC.;REEL/FRAME:023281/0433
Effective date: 20081215
29 Sep 2009ASAssignment
Owner name: ZIMMER SPINE, INC., MINNESOTA
Free format text: MERGER;ASSIGNOR:ZIMMER SPINE AUSTIN, INC.;REEL/FRAME:023300/0867
Effective date: 20090828