US20100030334A1 - Spinal implant construct and method for implantation - Google Patents
Spinal implant construct and method for implantation Download PDFInfo
- Publication number
- US20100030334A1 US20100030334A1 US12/587,272 US58727209A US2010030334A1 US 20100030334 A1 US20100030334 A1 US 20100030334A1 US 58727209 A US58727209 A US 58727209A US 2010030334 A1 US2010030334 A1 US 2010030334A1
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- Prior art keywords
- elongate member
- spinal implant
- intervertebral space
- transverse dimension
- spinal
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- Abandoned
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
- A61F2/447—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section
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- A—HUMAN NECESSITIES
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- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2/4611—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
-
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/28—Bones
- A61F2002/2817—Bone stimulation by chemical reactions or by osteogenic or biological products for enhancing ossification, e.g. by bone morphogenetic or morphogenic proteins [BMP] or by transforming growth factors [TGF]
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
- A61F2002/30507—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a threaded locking member, e.g. a locking screw or a set screw
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30576—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30576—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs
- A61F2002/30578—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs having apertures, e.g. for receiving fixation screws
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30579—Special structural features of bone or joint prostheses not otherwise provided for with mechanically expandable devices, e.g. fixation devices
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30593—Special structural features of bone or joint prostheses not otherwise provided for hollow
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30772—Apertures or holes, e.g. of circular cross section
- A61F2002/30784—Plurality of holes
- A61F2002/30785—Plurality of holes parallel
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30772—Apertures or holes, e.g. of circular cross section
- A61F2002/30784—Plurality of holes
- A61F2002/30789—Plurality of holes perpendicular with respect to each other
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
-
- A—HUMAN NECESSITIES
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- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00005—The prosthesis being constructed from a particular material
- A61F2310/00011—Metals or alloys
- A61F2310/00017—Iron- or Fe-based alloys, e.g. stainless steel
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00005—The prosthesis being constructed from a particular material
- A61F2310/00011—Metals or alloys
- A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys
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- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Neurology (AREA)
- Transplantation (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Cardiology (AREA)
- Physical Education & Sports Medicine (AREA)
- Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Prostheses (AREA)
Abstract
A spinal construct and method for implantation is provided which utilizes a spinal implant adapted for insertion within an intervertebral space between an adjacent pair of vertebral bodies, and an elongate member adapted for anchoring to the adjacent vertebral bodies. The spinal implant defines a first transverse dimension and a different second transverse dimension, and is initially inserted into the intervertebral space while in a first operational configuration wherein the first transverse dimension extends along the height of the intervertebral space. The elongate member is anchored to the vertebral bodies to establish and maintain a select height of the intervertebral space. The spinal implant is then rotated to a second operational configuration wherein the second transverse dimension extends along the height of the intervertebral space. The elongate member serves to maintain the select height of the intervertebral space to provide a controlled amount of compression onto the spinal implant and/or a bone growth promoting material contained therein. The elongate member also serves to resist tensile loads during extensional movement of the vertebral bodies to maintain the vertebral endplates in intimate contact with the spinal implant.
Description
- The present invention relates generally to a spinal interbody implant construct and method for implantation. While the actual nature of the invention covered herein can only be determined with reference to the claims appended hereto, one aspect of the present invention involves insertion of a fusion device into a space between adjacent vertebral bodies from which at least a portion of an intervertebral disc has been removed via a discectomy procedure. Another aspect of the present invention involves rotation of the fusion device within the intervertebral space to establish and maintain controlled compression between the opposing endplates of the adjacent vertebral bodies and the device and/or bone growth promoting material contained within the device. A further aspect of the present invention involves the prevention of an unintentional change of position or orientation of the fusion device subsequent to implantation. There is a general need in the industry to provide an improved spinal implant construct and method of implantation. The present invention meets this need and provides other benefits and advantages in a novel and unobvious manner.
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FIG. 1 is a front elevational view of a device according to one form of the present invention, as inserted within a disc space between adjacent vertebral bodies in a first operational configuration. -
FIG. 2 is a side view of the device illustrated inFIG. 1 in the first operational configuration. -
FIG. 3 is a front elevational view of the device illustrated inFIG. 1 , as transitioned to a second operational configuration. -
FIG. 4 is a side view of the device illustrated inFIG. 3 in the second operational configuration. - For the purposes of promoting an understanding of the principles of the invention, reference will now be made to the embodiments illustrated in the drawings and specific language will be used to describe the same. It will nevertheless be understood that no limitation of the scope of the invention is hereby intended, such alterations and further modifications in the illustrated devices, and such further applications of the principles of the invention as illustrated herein being contemplated as would normally occur to one skilled in the art to which the invention relates.
- Referring to
FIGS. 1-4 , shown therein is a schematic representation of a portion of the spinal column in which two adjacentvertebral bodies distraction tool 13 to provide anintervertebral space 14 between the vertebral bodies following the removal of at least a portion of a natural intervertebral disc (not shown). However, it should be understood that such distraction of the vertebral bodies via thedistraction tool 13 is not essential to practicing the present invention, and in some instances can be avoided. - In a preferred embodiment of the invention, it is desirable to establish fusion between the
vertebral bodies assembly 16 is provided according to one form of the present invention. In the illustrated embodiment, thefusion construct 16 is generally comprised of acage portion 17 and anelongate plate portion 26. However, it should be understood that other configurations of thefusion construct 16 are also contemplated as falling within the scope of the present invention. For example, in other embodiments of the invention, thecage portion 17 can be configured as a spacer-type device or any other type of intervertebral implant. Additionally, in other embodiments of the invention, theelongate plate portion 26 can be configured as a rod, a staple, a cable, a tether, or any other type of elongate member. The components of thefusion construct 16 may be formed from any bio-compatible material such as, for example, titanium, stainless steel or any other suitable material. - In one embodiment of the present invention, the
cage portion 17 of thefusion construct 16 extends along alongitudinal axis 18 and has a generally rectangular, parallelepiped configuration including front andrear portions right side portions bottom portions fusion cage 17 are also contemplated as falling within the scope of the present invention. For example, thefusion cage 17 can take on an elliptical or semi-elliptical configuration, a cam-like configuration, a polygonal configuration, or any other suitable configuration. The overall height of thecage 17 between the top andbottom portions FIG. 1 ) is less than the overall width of thecage 17 between the left andright side portions FIG. 1 ). This dimensional configuration facilitates insertion of thecage 17 into theintervertebral space 14 between thelower endplate 11P of uppervertebral body 11 and theupper endplate 12P of lowervertebral body 12 by simply pushing thecage 17 in the direction of arrow 21 (FIG. 2 ). - In the illustrated embodiment of the
cage 17, theprimary side portions primary side portions vertebral endplates cage 17, thesecondary side portions secondary side portions cage 17 into theintervertebral space 14. - In the illustrated embodiment of the invention, the
cage 17 includes features for engaging theplate 26. For example, thecage 17 defines a threadedopening 22 positioned generally along thelongitudinal axis 18 which opens onto a front surface of thefront end portion 17F. Additionally, thecage 17 includes a first pair ofposts front end portion 17F and radially offset from and located on diametrically opposite sides of thelongitudinal axis 18. However, it should be understood that other positions and arrangements of theposts elongate plate 26 is selectively engaged with thecage 17 via afastener 27. However, it should be understood that in other embodiments of the invention, theplate 26 need not necessarily be engaged with thecage 17. In a specific embodiment, theelongate plate 26 is provided with acentral passage 32 through which extends a threadedshank 28 of thefastener 27. The threadedshank 28 is in turn threadedly engaged within the opening 22 in thecage 17, as shown inFIG. 2 , to securely engage theplate 26 with thecage 17. In a further embodiment of the invention, theplate 26 extends along alongitudinal axis 33 and defines a pair ofopenings - The
elongate plate 26 also defines a pair ofpassages longitudinal axis 18. Thepassages respective posts cage 17 therein. As should be appreciated, the angular orientation of theposts cage 17 is initially offset 90° from the angular orientation of thepassages plate 26 when thecage 17 is positioned in the first operational configuration illustrated inFIGS. 1 and 2 . However, when thecage 17 is rotated to the second operational configuration illustrated inFIGS. 3 and 4 , theposts passages fastener 27 into the threadedopening 22 in thecage 17 results in displacement of thecage 17 toward theplate 26 and positioning of theposts passages fastener 27 into the threadedopening 22 in thecage 17 may result in displacement of theplate 26 toward thecage 17 to position theposts passages - Positioning of the
posts passages cage 17 relative to theplate 26. However, it should be understood that thecage 17 and theplate 26 may define other elements or features that interlock with one another to selectively prevent rotational and/or lateral displacement therebetween. For example, in another embodiment of the invention, thecage 17 and theplate 26 may have a splined configuration wherein thecage 17 and theplate 26 define a number of splines that are positionable within a corresponding number of grooves to selectively prevent rotational and/or lateral displacement therebetween. Other interlocking elements or features are also contemplated including, for example, a tongue and groove configuration, or any other interlocking configuration suitable for selectively preventing rotational and/or lateral displacement between thecage 17 and theplate 26. - The
elongate plate 26 further defines a pair of curved orarcuate slots opposite edges plate 26 and progressing inwardly toward the center of theplate 26 adjacent thelongitudinal axis 33. In the illustrated embodiment, thearcuate slots FIG. 1 , thefront end portion 17F of thecage 17 defines a pair of tool-receivingpassages passages longitudinal axis 18 and are positioned generally along the radius of thearcuate slots passages respective portions FIG. 4 ). As should be appreciated, the angular orientation of the tool-receivingpassages cage 17 is initially offset 90° from thelongitudinal axis 33 of theplate 26 when thecage 17 is positioned in the first operational configuration illustrated inFIGS. 1 and 2 . However, as thecage 17 is rotated to the second operational configuration illustrated inFIGS. 3 and 4 , the tool-receivingpassages respective portions arcuate slots plate 26 to avoid interference between the tool 51 and theplate 26. Once rotated to the second operational configuration, the tool 51 may be disengaged from thepassages - In a preferred embodiment of the invention, a bone growth promoting material may be packed within a hollow interior portion of the
cage 17 to promote fusion with the adjacentvertebral endplates primary side portions cage 17 define a number of relatively smalldiameter fusion openings 47 extending therethrough in communication with the hollow interior of thecage 17. However, it should be understood that various types and sizes of openings may be provided to expose the bone growth promoting material to thevertebral endplates primary side portions cage 17. In another embodiment of the invention, at least theprimary side portions cage 17 may be formed of a relatively porous material to promote bony on-growth. Additionally, although not specifically shown in the illustrated embodiment of the invention, thesecondary side portions cage 17 may be provided with a number of fusion openings and/or may be formed of a porous material to further promote fusion between the adjacentvertebral endplates secondary side portions cage 17. - In one embodiment of the invention, the bone growth promoting material is comprised of a bone graft material, a bone morphogenic protein (BMP), or any other suitable bone growth promoting material or substance including but not limited to bone chips or bone marrow, a demineralized bone matrix (DBM), mesenchymal stem cells, and/or a LIM mineralization protein (LMP). It should be understood that the bone growth promoting material can be used with or without a suitable carrier. In a further embodiment of the invention, the bone growth promoting material is positioned within the hollow interior of the
cage 17 prior to insertion within thespace 14 between the adjacentvertebral bodies cage 17 subsequent to insertion within theintervertebral space 14. - Having illustrated and described various elements and features associated with the
fusion construct 16, reference will now be made to a technique for engaging the fusion construct 16 with the adjacentvertebral bodies - The vertebral level to be treated is initially identified followed by the removal of at least a portion of the natural intervertebral disc via a total or partial discectomy. The
endplates vertebral bodies vertebral endplates cage 17 as the cage is rotated about thelongitudinal axis 18. As discussed above, the upper and lowervertebral bodies distraction tool 13 to provide anopen space 14 between the vertebral bodies following the discectomy. Depending on the preference of the surgeon, thedistraction tool 13 may be removed or left in place throughout the remainder of the surgical procedure. - The
cage 17 used for treatment of the spinal column is selected such that the transverse dimension A between thesecondary side portions cage 17 within theintervertebral space 14 between thevertebral endplate FIGS. 1 and 2 . Additionally, the transverse dimension B between theprimary side portions intervertebral space 14 between thevertebral endplate cage 17 and/or the bone growth promoting material contained therein following rotation of thecage 17 to the second operational configuration illustrated inFIGS. 3 and 4 . - After selection of the appropriately
sized cage 17, thecage 17 is inserted into theintervertebral space 14, preferably via an anterior surgical approach, with thesecondary side portions vertebral endplates cage 17 may be inserted into theintervertebral space 14 via other surgical approaches, such as, for example, via a posterior surgical approach. Following insertion of thecage 17 within theintervertebral space 14, theelongate plate 26 is attached to the upper and lowervertebral bodies FIGS. 3 and 4 ) that are received through theopenings plate 26. Attachment of theplate 26 to thevertebral bodies plate 26 with thecage 17 via the threaded fastener 27 (FIG. 2 ). However, it should be understood that in other embodiments, theelongate plate 26 may be attached to thevertebral bodies cage 17. As shown inFIGS. 3 and 4 , theelongate plate 26 extends between thevertebral bodies intervertebral space 14. - With the
elongate plate 26 secured to thevertebral bodies cage 17 engaged with the plate 26 (but still rotatable relative thereto), a tool 51 includingaxial prongs 52 and 53 (FIG. 4 ) is advanced in the direction of arrow 54 until the tool prongs 52, 53 are inserted into the correspondingtool receiving opening cage 17. The tool 51 is then rotated in a clockwise direction (in the direction ofarrow 56 inFIG. 1 ) to correspondingly rotate thecage 17 90° from the first operational configuration/orientation illustrated inFIGS. 1 and 2 to the second operational configuration/orientation illustrated inFIGS. 3 and 4 . Once rotated to the second operational configuration/orientation, theprimary side portions vertebral endplates vertebral bodies secondary side portions vertebral endplates - As discussed above, as the
cage 17 is rotated from the first operation configuration to the second operational configuration, the tool prongs 52, 53 are displaced through thearcuate slots plate 26 to avoid interference between the tool 51 and theedges plate 26. However, in an alternative embodiment of the invention, it is possible to omit thearcuate slots plate 26 via relocation of thetool receiving openings alternative locations FIG. 1 . As should be appreciated, with thetool receiving openings locations cage 17 to the second operational configuration illustrated inFIG. 3 would avoid any interference between the tool prongs 52, 53 and the lateral edges 42, 43 of theplate 26. - As discussed above, the transverse dimension B between the
primary side portions cage 17 and/or the bone growth promoting material contained therein following rotation of thecage 17 to the second operational configuration. Theplate 26 extending between thevertebral bodies vertebral bodies cage 17 to the second operational configuration, thereby controlling the amount of compression exerted onto thecage 17 and/or the bone growth promoting material contained therein. As should be appreciated, the distance between the screw-receivingopenings plate 26 controls the height of the intervertebral space formed between thevertebral endplate cage 17 and the bone growth promoting material contained therein by thevertebral endplate plate 26 therefore functions in a strut-like manner to control the amount of compression exerted onto thecage 17 and the bone growth promoting material. Additionally, theplate 26 may also function to resist tensile loads and/or to limit extension or separation of thevertebral bodies vertebral bodies - Following rotation of the
cage 17 to the second operational configuration illustrated inFIGS. 3 and 4 , thetool 57 may be removed from thepassages cage 17. Additionally, thefastener 27 is further threaded into thepassage 22 in thecage 17, thereby resulting in displacement of thecage 17 in the direction ofarrow 57 toward the plate 26 (FIGS. 2 and 4 ). Displacement of thecage 17 in the direction ofarrow 57 in turn results in the positioning of thepins cage 17 within thepassages plate 26. Positioning of thepins passages cage 17 relative to theplate 26. Additionally, since theplate 26 is securely engaged to thevertebral bodies pins passages cage 17 relative to thevertebral bodies - In one embodiment of the invention, the
cage 17 is provided with a transition feature between theprimary side portions secondary side portions cage 17 between the first and second operational configurations. In the illustrated embodiment, the transition feature comprises arounded corner 61 defining a convex outer surface (FIGS. 1 and 3 ). In effect, therounded corners 61 provide a smooth transition between theprimary side portions secondary side portions rounded corners 61 thereby serve to eliminate the sharp corners or edges otherwise associated with the rectangular-shapedcage 17, thereby allowing for rotation of thecage 17 between the first and second operational configurations without undue interference by or disturbance of the adjacentvertebral bodies cage 17 from thefront portion 17F to therear portion 17R. However, other shapes and configurations of the transition surfaces 61 are also contemplated as would occur to one of ordinary skill in the art. Additionally, although the illustrated embodiment of thecage 17 includes a transition surfaces 61 at each of its four corners, it should be understood that in another embodiment, only the opposite corners of thecage 17 that directly contact thevertebral endplates cage 17 need necessarily be provided with atransition surface 61. - While the invention has been illustrated and described in detail in the drawings and foregoing description, the same is to be considered as illustrative and not restrictive in character, it being understood that only the preferred embodiments have been shown and described and that all changes and modifications that come within the spirit of the invention are desired to be protected.
Claims (26)
1. A spinal construct for engagement with adjacent vertebral bodies, comprising:
a spinal implant comprising an interbody implant configured for implantation within an intervertebral space between the adjacent vertebral bodies, said spinal implant extending along a longitudinal axis and having a first transverse dimension sized for insertion into the intervertebral space and a second transverse dimension greater than said first transverse dimension and corresponding to a select height of said intervertebral space; and
an elongate member sized to span the intervertebral space and engaged between the adjacent vertebral bodies to maintain said select height of the intervertebral space; and
wherein said spinal implant is rotatably coupled to said elongate member by a connector member such that said spinal implant is rotatable relative to said elongate member about the longitudinal axis, wherein said connector member selectively interlocks said spinal implant with said elongate member to selectively prevent rotational and lateral movement of said spinal implant relative to said elongate member subsequent to alignment of said second transverse dimension along said select height of the intervertebral space.
2. The spinal construct of claim 1 , wherein said spinal implant includes:
a first pair of side surfaces spaced apart and arranged generally opposite one another to define said first transverse dimension; and
a second pair of side surfaces spaced apart and arranged generally opposite one another to define said second transverse dimension.
3. The spinal construct of claim 2 , wherein said second pair of side surfaces are arranged substantially parallel to one another.
4. The spinal construct of claim 2 , wherein said second pair of side surfaces are angled relative to one another to define a taper extending along said longitudinal axis corresponding to the natural lordotic angle between the adjacent vertebral bodies.
5. The spinal construct of claim 2 , wherein said first pair of side surfaces are angled relative to one another to define a taper extending along said longitudinal axis to facilitate insertion of said spinal implant within the intervertebral space between the adjacent vertebral bodies.
6.-9. (canceled)
10. The spinal construct of claim 1 , further comprising an interlock between said spinal implant and said elongate member to selectively prevent at least one of said rotational and lateral movement of said spinal implant relative to said elongate member subsequent to alignment of said second transverse dimension along said select height of the intervertebral space.
11. (canceled)
12. The spinal construct of claim 10 , wherein said interlock comprises:
at least one projection portion extending from one of said spinal implant and said elongate member; and
at least one aperture defined by another of said spinal implant and said elongate member; and
wherein said connector member forces said at least one projection into a respective one of said at least one aperture; and
wherein insertion of said at least one projection portion into a said respective one of said at least one aperture prevents said rotational and lateral movement of said spinal implant relative to said elongate member.
13.-23. (canceled)
24. The spinal construct of claim 1 , wherein said elongate member comprises a plate having first and second end portions, said plate defining at least one opening adjacent each of said first and second end portions; and
further comprising a bone screw extending through each of said at least one opening for engaging said plate to the adjacent vertebral bodies.
25. A spinal implant assembly, comprising:
an interbody fusion device adapted for insertion into an intervertebral space between an adjacent pair of vertebral bodies, said interbody fusion device extending along a longitudinal axis and defining a primary transverse dimension and a secondary transverse dimension, said secondary transverse dimension sized for insertion into the intervertebral space, said primary transverse dimension sized greater than said secondary transverse dimension and corresponding to a select height of said intervertebral space; and
an elongate member sized to span the intervertebral space and engaged between the adjacent vertebral bodies to maintain said select height of the intervertebral space; and
wherein said interbody fusion device is rotatable coupled to said elongate member by a connector member such that said interbody fusion device is rotatable relative to said elongate member about the longitudinal axis, wherein said connector member selectively interlocks said interbody fusion device with said elongate member to selectively prevent rotational and lateral movement of said interbody fusion device relative to said elongate member subsequent to alignment of said primary transverse dimension along said select height of the intervertebral space.
26.-29. (canceled)
30. The spinal implant assembly of claim 25 , further comprising an interlock between said interbody fusion device and said elongate member to selectively prevent said rotational and lateral movement of said interbody fusion device relative to said elongate member subsequent to alignment of said primary transverse dimension along said select height of the intervertebral space.
31. The spinal implant assembly of claim 30 , wherein said interlock comprises:
at least one projection portion extending from one of said interbody fusion device and said elongate member; and
at least one aperture defined by another of said interbody fusion device and said elongate member; and
wherein said connector member forces said at least one projection into a respective one of said at least one aperture; and
wherein insertion of said at least one projection portion into said respective one of said at least one aperture prevents said rotational and lateral movement of said interbody fusion device relative to said elongate member.
32.-34. (canceled)
35. A spinal construct for engagement with adjacent vertebral bodies, comprising:
a spinal implant comprising an interbody implant configured for implantation within an intervertebral space between the adjacent vertebral bodies, said spinal implant extending along a longitudinal axis and having a first transverse dimension sized for insertion into the intervertebral space between the adjacent vertebral bodies and a second transverse dimension greater than said first transverse dimension and corresponding to a select height of said intervertebral space;
an elongate member sized to span the intervertebral space and engaged between the adjacent vertebral bodies to maintain said select height of the intervertebral space;
means for rotatably coupling said spinal implant with said elongate member; and
means for interlocking said spinal implant with said elongate member to selectively prevent rotational and lateral movement of said spinal implant relative to said elongate member subsequent to alignment of said second transverse dimension along said select height of the intervertebral space.
36.-62. (canceled)
63. The spinal construct of claim 1 , wherein said connector member comprises a fastener extending through a passage in said elongate member and engaged with said spinal implant; and
wherein displacement of said fastener interlocks said spinal implant with said elongate member to selectively prevent said rotational and lateral movement of said spinal implant relative to said elongate member.
64. The spinal construct of claim 63 , wherein said fastener comprises a threaded fastener.
65. The spinal construct of claim 64 , wherein said threaded fastener extends through said passage in said elongate member and is threadedly engaged within a threaded opening in said spinal implant, wherein rotation of said threaded fastener threads said threaded fastener into said threaded opening and interlocks said spinal implant with said elongate member to selectively prevent said rotational and lateral movement of said spinal implant relative to said elongate member.
66. The spinal construct of claim 12 , wherein said connector member comprises a threaded fastener extending through a passage in said elongate member and threadedly engaged within a threaded opening in said spinal implant; and
wherein rotation of said fastener threads said fastener into said threaded opening and positions said at least one projection portion within said respective one of said at least one aperture to thereby selectively prevent said rotational and lateral movement of said spinal implant relative to said elongate member.
67. The spinal implant assembly of claim 25 , wherein said connector member comprises a fastener extending through a passage in said elongate member and engaged with said interbody fusion device; and
wherein displacement of said fastener interlocks said interbody fusion device with said elongate member to selectively prevent said rotational and lateral movement of said interbody fusion device relative to said elongate member.
68. The spinal implant assembly of claim 67 , wherein said fastener comprises a threaded fastener.
69. The spinal implant assembly of claim 68 , wherein said threaded fastener extends through said passage in said elongate member and is threadedly engaged within a threaded opening in said interbody fusion device, wherein rotation of said threaded fastener threads said threaded fastener into said threaded opening and interlocks said interbody fusion device with said elongate member to selectively prevent said rotational and lateral movement of said interbody fusion device relative to said elongate member.
70. The spinal implant assembly of claim 31 , wherein said connector member comprises a threaded fastener extending through a passage in said elongate member and threadedly engaged within a threaded opening in said interbody fusion device; and
wherein rotation of said fastener threads said fastener into said threaded opening and positions said at least one projection portion within said respective one of said at least one aperture to thereby selectively prevent said rotational and lateral movement of said interbody fusion device relative to said elongate member.
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Also Published As
Publication number | Publication date |
---|---|
AU2005206156A1 (en) | 2005-08-04 |
KR101210744B1 (en) | 2012-12-10 |
KR20060107580A (en) | 2006-10-13 |
JP2007517627A (en) | 2007-07-05 |
US20050159813A1 (en) | 2005-07-21 |
CA2553425A1 (en) | 2005-08-04 |
US7621938B2 (en) | 2009-11-24 |
WO2005070347A1 (en) | 2005-08-04 |
EP1715817A1 (en) | 2006-11-02 |
CN1921809A (en) | 2007-02-28 |
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