US20110282459A1 - Articulating interbody spacer, vertebral body replacement - Google Patents
Articulating interbody spacer, vertebral body replacement Download PDFInfo
- Publication number
- US20110282459A1 US20110282459A1 US13/189,939 US201113189939A US2011282459A1 US 20110282459 A1 US20110282459 A1 US 20110282459A1 US 201113189939 A US201113189939 A US 201113189939A US 2011282459 A1 US2011282459 A1 US 2011282459A1
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- US
- United States
- Prior art keywords
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- vertebral body
- connector mechanism
- assembly
- link
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
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- A61F2/442—Intervertebral or spinal discs, e.g. resilient
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- 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
-
- 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
Definitions
- one of the plurality of links preferably comprises a body portion comprising serrated sides; at least one first hole configured through a top of the body portion; a second hole configured through a side of the body portion and transverse to the at least first hole; a third hole configured through the body portion and transverse to the second hole; a pair of connector flanges positioned transverse to the serrated sides; a fourth hole configured through each of the pair of connector flanges; a connector mechanism positioned transverse to the serrated sides; and a fifth hole configured through the connector mechanism.
- one of the plurality of links may comprise a body portion comprising serrated sides; at least one first hole configured through a top of the body portion; a second hole configured through a side of the body portion and transverse to the at least first hole; a third hole configured through the body portion and transverse to the second hole; a pair of connector flanges positioned transverse to the serrated sides; a fourth hole configured through each of the pair of connector flanges; and a fifth hole configured through a rear portion of the body portion.
- the assembly may further comprise a retaining pin adapted to retain the elongated connector mechanism to one of the plurality of links.
- a first link of the plurality of links is pivotally connected to a second link of the plurality of links.
- the second link of the plurality of links is preferably pivotally connected to a third link of the plurality of links.
- the elongated connector mechanism is preferably flexible.
- each one of the plurality of links may comprise a groove and a hole configured through a side of the each of the plurality of links.
- the elongated connector mechanism may comprise a substantially J-shaped mechanism adapted to allow the plurality of links to slide thereon.
- the plurality of links may comprise a continuous flexible structure.
- the connector mechanism is dimensioned and configured to have a length-to-width ratio greater than a length-to-width ratio of each of the plurality of links.
- Another embodiment provides an interbody spacer implant apparatus for interbody fusion in a vertebral body, wherein the apparatus comprises a plurality of individually articulating links and a connector mechanism adapted to retain the plurality of links and allow the plurality of links to articulate with respect to one another, wherein the connector mechanism is dimensioned and configured to have a length-to-width ratio greater than a length-to-width ratio of each of the plurality of links.
- the apparatus may further comprise an insertion rod adapted to insert the plurality of links and the connector mechanism into the vertebral body.
- FIGS. 1(B) through 1(G) illustrate schematic diagrams of the articulating interbody spacer apparatus of FIG. 1(A) according to an embodiment herein;
- FIGS. 3(A) through 3(C) illustrate schematic diagrams of the retaining pin of the articulating interbody spacer apparatus of FIGS. 1(A) through 1(G) according to an embodiment herein;
- FIGS. 4(A) through 4(F) illustrate schematic diagrams of the first hinged rod of the articulating interbody spacer apparatus of FIGS. 1(A) through 1(G) according to an embodiment herein;
- FIGS. 5(A) through 5(F) illustrate schematic diagrams of the second hinged rod of the articulating interbody spacer apparatus of FIGS. 1(A) through 1(G) according to an embodiment herein;
- FIGS. 6(A) through 6(F) illustrate schematic diagrams of the third hinged rod of the articulating interbody spacer apparatus of FIGS. 1(A) through 1(G) according to an embodiment herein;
- FIGS. 7(A) through 7(F) illustrate schematic diagrams of the insertion rod of the articulating interbody spacer apparatus of FIGS. 1(A) through 1(G) according to an embodiment herein;
- FIGS. 8(A) through 8(F) illustrate schematic diagrams of the first link of the articulating interbody spacer apparatus of FIGS. 1(A) through 1(G) according to an embodiment herein;
- FIGS. 9(A) through 9(C) illustrate schematic diagrams of the hinge pin of the articulating interbody spacer apparatus of FIGS. 1(A) through 1(G) according to an embodiment herein;
- FIGS. 10(A) through 10(F) illustrate schematic diagrams of the second link of the articulating interbody spacer apparatus of FIGS. 1(A) through 1(G) according to an embodiment herein;
- FIGS. 12(A) through 12(F) are schematic diagrams illustrating subsequent stages of insertion of the articulating interbody spacer assembly of FIG. 2 into a vertebral body according to an embodiment herein;
- FIG. 13 is a schematic diagram of a first alternate embodiment of an articulating interbody spacer assembly according to the embodiments herein;
- FIGS. 14(A) through 14(C) are schematic diagrams of a second alternate embodiment of an articulating interbody spacer assembly according to the embodiments herein;
- FIGS. 15(A) and 15(B) are schematic diagrams of a third alternate embodiment of an articulating interbody spacer assembly according to the embodiments herein;
- FIGS. 16(A) and 16(B) are schematic diagrams of a fourth alternate embodiment of an articulating interbody spacer assembly according to the embodiments herein;
- FIG. 17 is a flow diagram illustrating a preferred method according to an embodiment herein.
- FIGS. 1(A) through 17 where similar reference characters denote corresponding features consistently throughout the figures, there are shown preferred embodiments.
- first hinged rod 2 is adapted to connect to the second hinged rod 3
- second hinged rod 3 is adapted to connect to the third hinged rod 4
- the retaining pin 1 is adapted to securely connect the first hinged rod 2 to the first link 6
- the insertion rod 5 is adapted to connect to the third hinged rod 4 , whereby the insertion rod 5 is adapted to be disconnected from the third hinged rod 4 .
- FIG. 2 illustrates a schematic diagram of an articulating interbody spacer assembly 101 according to an embodiment herein.
- the difference between the assembly 101 of FIG. 2 and the apparatus of FIGS. 1(A) through 1(G) is that the assembly 101 does not include the insertion rod 5 (i.e., after the insertion rod 5 has been disconnected from the third hinged rod 4 ).
- the first link 6 , second link 8 , and third link 9 are pivotally connected to one another in the manner described above by using the hinge pins 7 for the various connections (i.e., connection of the first link 6 to the second link 8 and the connection of the second link 8 to the third link 9 ), and as such allows the assembly 101 to articulate from a generally straight position to a generally curved position.
- FIGS. 3(A) through 3(C) illustrate schematic diagrams of the retaining pin 1 of the articulating interbody spacer apparatus 100 of FIGS. 1(A) through 1(G) according to an embodiment herein.
- the retaining pin 1 comprises a shaft 11 with a cap portion 13 positioned on top of the shaft 11 .
- the cap portion 13 has an exposed under surface 12 such that the circumferential configuration of the cap portion 13 is preferably larger than the circumferential configuration of the shaft 11 .
- FIGS. 4(A) through 4(F) illustrate schematic diagrams of the first hinged rod 2 of the articulating interbody spacer apparatus 100 of FIGS. 1(A) through 1(G) according to an embodiment herein.
- the first hinged rod 2 is generally embodied in an elongated configuration.
- the first hinged rod 2 comprises an elongated body portion 15 that is generally rounded terminating in a pair of ends 16 , 17 opposed from one another.
- the first end 17 of the body portion 15 is defined by an upper generally flat base 20 bounded by a generally sloping wall 21 .
- a pivot peg 19 outwardly extends from the flat base 20 in a generally perpendicular manner.
- FIGS. 5(A) through 5(F) illustrate schematic diagrams of the second hinged rod 3 of the articulating interbody spacer apparatus 100 of FIGS. 1(A) through 1(G) according to an embodiment herein.
- the second hinged rod 3 is generally embodied in an elongated configuration and comprises two generally rounded longitudinal sides 32 and two substantially flat sides 30 .
- the flat sides 30 allow for flexion in the needed direction during articulation of the second hinged rod 3 .
- a pair of ends 33 , 34 opposed from one another is also provided on the second hinged rod 3 .
- the first end 34 is defined by an upper generally flat base 37 bounded by a generally sloping wall 36 .
- a pivot peg 35 outwardly extends from the flat base 37 in a generally perpendicular manner.
- the first end 42 further includes a pivot hole 43 configured substantially transverse to the longitudinal axis of the two generally rounded longitudinal sides 46 and two substantially flat sides 40 .
- the second end 41 is defined by an upper generally flat base 49 bounded by a generally sloping wall 48 .
- a pivot peg 45 outwardly extends from the flat base 49 in a generally perpendicular manner.
- the upper surface of the flat base 49 is positioned below the upper surface of the top generally rounded longitudinal side 46 such that the upper surface of the pivot peg 45 may be substantially planar to the upper surface of the top generally rounded longitudinal side 46 .
- FIGS. 7(A) through 7(F) illustrate schematic diagrams of the insertion rod 5 of the articulating interbody spacer apparatus 100 of FIGS. 1(A) through 1(G) according to an embodiment herein.
- the insertion rod 5 is generally embodied in an elongated configuration.
- the insertion rod 5 comprises an elongated body portion 51 that is generally rounded terminating in a pair of ends 52 , 53 opposed from one another.
- the first end 52 of the body portion 51 is defined by an upper generally flat base 55 bounded by a generally sloping wall 56 .
- the upper surface of the flat base 55 is positioned below the upper surface of the body portion 51 .
- the first end 52 further comprises a pivot hole 54 configured substantially transverse to the longitudinal axis of the body portion 51 .
- the second end 53 is adapted to be attached to an inserter tool/mechanism (not shown).
- FIG. 13 is a schematic diagram of a first alternate embodiment of an articulating interbody spacer assembly 204 according to the embodiments herein.
- FIG. 13 illustrates the assembly in its initial position 250 as well as its articulated final position 251 within a vertebral body 200 .
- the hinged links 306 of the implant are made of a single piece flexible material held together by a cable or guide wire 205 as opposed to having separate links 6 , 8 , 9 pivoting off a hinge pin 7 .
- the implant assembly 101 comprises various structural features, which provides it with enhanced functionality.
- the serrated sides 61 provide friction and avoid dislocation after the assembly 101 is implanted in the vertebral body 200 .
- the tapered walls 63 allow for the structural distraction of adjacent vertebral bodies during insertion of the assembly 101 into the vertebral body 200 .
- the horizontal bone graft window 64 allows for bone packing prior to assembly 101 implantation in the vertebral body 200 .
- the rod retention hole 67 is adapted to accommodate the first hinged rod 2 .
- the horizontal bone graft window 132 allows for bone packing prior to assembly 101 implantation in the vertebral body 200 .
- the rod retention hole 97 is adapted to accommodate the first, second, and third hinged rods 2 , 3 , 4 and the insertion rod 5 during insertion of the connected rods 2 , 3 , 4 , 5 during assembly of the apparatus 100 .
- the threaded hole 131 is adapted to connect with an inserter tool/mechanism (not shown) during implantation of the assembly 101 into a vertebral body 200 . This connection is temporary as both the insertion rod 5 and the inserter tool/mechanism (not shown) are removed once the implant assembly 101 is fully articulated in its final position in the vertebral body 200 . This is possible because the rod retention hole 97 is properly sized to allow release of the insertion rod 5 and the inserter tool/mechanism (not shown) once full articulation and final positioning of the assembly 101 is achieved in the vertebral body 200 .
- the pivoting rods 2 , 3 , 4 (or some other connecting mechanism 205 , 305 , 307 ) are configured to have a greater length-to-width ratio than the length-to-width ratio of each one of the individual links 6 , 8 , 9 (or 306 , 406 ).
- the links 6 , 8 , 9 (or 306 , 406 ) preferably only articulate one at a time sequentially, starting with the first link 6 and ending with the second link 8 . More specifically, the third link 9 does not articulate; only the first link 6 and second link 8 articulate with reference to the third link 9 as shown in FIGS. 12(A) through 12(F) .
- the embodiments herein may be utilized in surgery to stabilize the human spine. It may be used to replace a human disc that is no longer functioning properly and restore height between to vertebral bodies, or used to as a full or partial vertebral body replacement device. Preferably, the embodiments herein may be used with some form of the many available fixation devices either from a posterior, anterior, or lateral approach. Moreover, the embodiments herein provide an improvement over conventional devices in terms of the structure of the device, the method of implantation, and patient stability after implantation. The embodiments herein are dimensioned and configured to be manufactured from any appropriate implantable material(s) and may utilize all the standard surgical tools that accompany such devices.
Abstract
An interbody spacer implant assembly for interbody fusion in a vertebral body and a method of insertion comprises a plurality of links and an elongated connector mechanism adapted to retain the plurality of links and allow the plurality of links to articulate with respect to one another. An interbody spacer implant apparatus for interbody fusion in a vertebral body comprises a plurality of individually articulating links and a connector mechanism adapted to retain the plurality of links and allow the plurality of links to articulate with respect to one another, wherein the connector mechanism is dimensioned and configured to have a length-to-width ratio greater than a length-to-width ratio of each of the plurality of links. The apparatus may further comprise an insertion rod adapted to insert the plurality of links and the connector mechanism into the vertebral body.
Description
- This application is a divisional of U.S. patent application Ser. No. 11/533,782 filed on Sep. 21, 2006, the contents of which, in its entirety, is herein incorporated by reference.
- 1. Technical Field
- The embodiments herein generally relate to medical devices, and, more particularly, to implantable devices used to stabilize the human spine.
- 2. Description of the Related Art
- The spinal column is a highly flexible structure comprising bones and connective tissue. While, the spine is capable of multiple degrees of motion, spinal injuries or anatomical irregularities may result in spinal pathologies which limit this range of motion. Orthopedic surgeons often aim to correct spinal irregularities and restore stability to traumatized through immobilization of spinal components.
- Most conventional vertebral spacers and inter body devices do not provide adequate surface coverage and ease of ideal positioning, and others are generally too large or bulky to be inserted in the traditional posterior or transforaminal lumbar interbody approaches. The conventional large-sized spacers that may provide this adequate surface coverage typically must be inserted from an anterior or extreme lateral approach.
- An example of a vertebral spacer is described in U.S. Pat. No. 7,018,413, the complete disclosure of which, in its entirety, is herein incorporated by reference. Generally, the conventional designs do not provide the surface coverage and ideal placement located towards the anterior side of the vertebral endplate while being implanted through a narrow passageway for transforaminal lumbar interbody fusion (TLIF) or posterior lumbar interbody fusion (PLIF) approaches. Generally, surgeons must lightly impact a spacer laterally towards the medial anterior side, and then try to position it medially once inside the spinal column to get more even coverage. Due to nerve anatomy, this can be a difficult task even for skilled surgeons.
- Accordingly, there remains a need for a new spinal spacer capable of being properly inserted towards the anterior side of the vertebral endplate and which can be easily constructed and ultimately used by a surgeon during a spinal surgical procedure.
- In view of the foregoing, an embodiment provides an interbody spacer implant assembly for interbody fusion in a vertebral body, wherein the assembly comprises a plurality of links and an elongated connector mechanism adapted to retain the plurality of links and allow the plurality of links to articulate with respect to one another. Preferably, one of the plurality of links comprises a body portion comprises partially serrated sides; at least one first hole configured through a top of the body portion; a second hole configured through a side of the body portion and transverse to the at least first hole; a third hole configured through the body portion and transverse to the second hole; a fourth hole configured substantially parallel to the at least one first hole; a connector mechanism positioned transverse to the partially serrated sides; and a fifth hole configured through the connector mechanism.
- Additionally, one of the plurality of links preferably comprises a body portion comprising serrated sides; at least one first hole configured through a top of the body portion; a second hole configured through a side of the body portion and transverse to the at least first hole; a third hole configured through the body portion and transverse to the second hole; a pair of connector flanges positioned transverse to the serrated sides; a fourth hole configured through each of the pair of connector flanges; a connector mechanism positioned transverse to the serrated sides; and a fifth hole configured through the connector mechanism.
- Moreover, one of the plurality of links may comprise a body portion comprising serrated sides; at least one first hole configured through a top of the body portion; a second hole configured through a side of the body portion and transverse to the at least first hole; a third hole configured through the body portion and transverse to the second hole; a pair of connector flanges positioned transverse to the serrated sides; a fourth hole configured through each of the pair of connector flanges; and a fifth hole configured through a rear portion of the body portion.
- The assembly may further comprise a hinge pin adapted to connect a first link of the plurality of links to a second link of the plurality of links. Furthermore, the elongated connector mechanism preferably comprises a plurality of pivoting connecting rods pivotally connected to one another. Moreover, one of the plurality of pivoting connecting rods may comprise a body portion; a peg; and a hole, wherein the peg and the hole are positioned on opposite sides of the body portion, wherein the body portion may comprise a pair of substantially flat side surfaces.
- Additionally, the assembly may further comprise a retaining pin adapted to retain the elongated connector mechanism to one of the plurality of links. Preferably, a first link of the plurality of links is pivotally connected to a second link of the plurality of links. Also, the second link of the plurality of links is preferably pivotally connected to a third link of the plurality of links. Also, the elongated connector mechanism is preferably flexible. Furthermore, each one of the plurality of links may comprise a groove and a hole configured through a side of the each of the plurality of links. Moreover, the elongated connector mechanism may comprise a substantially J-shaped mechanism adapted to allow the plurality of links to slide thereon. Additionally, the plurality of links may comprise a continuous flexible structure. Preferably, the connector mechanism is dimensioned and configured to have a length-to-width ratio greater than a length-to-width ratio of each of the plurality of links.
- Another embodiment provides an interbody spacer implant apparatus for interbody fusion in a vertebral body, wherein the apparatus comprises a plurality of individually articulating links and a connector mechanism adapted to retain the plurality of links and allow the plurality of links to articulate with respect to one another, wherein the connector mechanism is dimensioned and configured to have a length-to-width ratio greater than a length-to-width ratio of each of the plurality of links. The apparatus may further comprise an insertion rod adapted to insert the plurality of links and the connector mechanism into the vertebral body.
- Another embodiment provides a method of inserting an interbody spacer implant assembly for interbody fusion into a vertebral body, wherein the method comprises connecting an elongated connector mechanism to a plurality of links; and inserting the elongated connector mechanism and the plurality of links into the vertebral body, wherein specified ones of individual links of the plurality of links are adapted to articulate individually with respect to other individual links upon insertion into the vertebral body. The method may further comprise attaching an insertion rod to the elongated connector mechanism; using the insertion rod to push the elongated connector mechanism and the plurality of links into the vertebral body; and removing the insertion rod from the elongated connector mechanism upon full insertion and final positioning of the elongated connector mechanism and the plurality of links into the vertebral body.
- These and other aspects of the embodiments herein will be better appreciated and understood when considered in conjunction with the following description and the accompanying drawings. It should be understood, however, that the following descriptions, while indicating preferred embodiments and numerous specific details thereof, are given by way of illustration and not of limitation. Many changes and modifications may be made within the scope of the embodiments herein without departing from the spirit thereof, and the embodiments herein include all such modifications.
- The embodiments herein will be better understood from the following detailed description with reference to the drawings, in which:
-
FIG. 1(A) illustrates an exploded schematic diagram of an articulating interbody spacer apparatus according to an embodiment herein; -
FIGS. 1(B) through 1(G) illustrate schematic diagrams of the articulating interbody spacer apparatus ofFIG. 1(A) according to an embodiment herein; -
FIG. 2 illustrates a schematic diagram of an articulating interbody spacer assembly according to an embodiment herein; -
FIGS. 3(A) through 3(C) illustrate schematic diagrams of the retaining pin of the articulating interbody spacer apparatus ofFIGS. 1(A) through 1(G) according to an embodiment herein; -
FIGS. 4(A) through 4(F) illustrate schematic diagrams of the first hinged rod of the articulating interbody spacer apparatus ofFIGS. 1(A) through 1(G) according to an embodiment herein; -
FIGS. 5(A) through 5(F) illustrate schematic diagrams of the second hinged rod of the articulating interbody spacer apparatus ofFIGS. 1(A) through 1(G) according to an embodiment herein; -
FIGS. 6(A) through 6(F) illustrate schematic diagrams of the third hinged rod of the articulating interbody spacer apparatus ofFIGS. 1(A) through 1(G) according to an embodiment herein; -
FIGS. 7(A) through 7(F) illustrate schematic diagrams of the insertion rod of the articulating interbody spacer apparatus ofFIGS. 1(A) through 1(G) according to an embodiment herein; -
FIGS. 8(A) through 8(F) illustrate schematic diagrams of the first link of the articulating interbody spacer apparatus ofFIGS. 1(A) through 1(G) according to an embodiment herein; -
FIGS. 9(A) through 9(C) illustrate schematic diagrams of the hinge pin of the articulating interbody spacer apparatus ofFIGS. 1(A) through 1(G) according to an embodiment herein; -
FIGS. 10(A) through 10(F) illustrate schematic diagrams of the second link of the articulating interbody spacer apparatus ofFIGS. 1(A) through 1(G) according to an embodiment herein; -
FIGS. 11(A) through 11(F) illustrate schematic diagrams of the third link of the articulating interbody spacer apparatus ofFIGS. 1(A) through 1(G) according to an embodiment herein; -
FIGS. 12(A) through 12(F) are schematic diagrams illustrating subsequent stages of insertion of the articulating interbody spacer assembly ofFIG. 2 into a vertebral body according to an embodiment herein; -
FIG. 13 is a schematic diagram of a first alternate embodiment of an articulating interbody spacer assembly according to the embodiments herein; -
FIGS. 14(A) through 14(C) are schematic diagrams of a second alternate embodiment of an articulating interbody spacer assembly according to the embodiments herein; -
FIGS. 15(A) and 15(B) are schematic diagrams of a third alternate embodiment of an articulating interbody spacer assembly according to the embodiments herein; -
FIGS. 16(A) and 16(B) are schematic diagrams of a fourth alternate embodiment of an articulating interbody spacer assembly according to the embodiments herein; and -
FIG. 17 is a flow diagram illustrating a preferred method according to an embodiment herein. - The embodiments herein and the various features and advantageous details thereof are explained more fully with reference to the non-limiting embodiments that are illustrated in the accompanying drawings and detailed in the following description. Descriptions of well-known components and processing techniques are omitted so as to not unnecessarily obscure the embodiments herein. The examples used herein are intended merely to facilitate an understanding of ways in which the embodiments herein may be practiced and to further enable those of skill in the art to practice the embodiments herein. Accordingly, the examples should not be construed as limiting the scope of the embodiments herein.
- As mentioned, there remains a need for a new spinal spacer capable of being properly inserted towards the anterior side of the vertebral endplate and which can be easily constructed and ultimately used by a surgeon during a spinal surgical procedure. The embodiments herein achieve this by providing an articulating interbody spacer that is dimensioned and configured to be inserted through a proportionately narrow passageway and which provides optimal surface coverage and placement, thereby reducing the chances of subsidence into the vertebral endplates. Referring now to the drawings, and more particularly to
FIGS. 1(A) through 17 , where similar reference characters denote corresponding features consistently throughout the figures, there are shown preferred embodiments. -
FIGS. 1(A) through 1(G) illustrate various views of an articulatinginterbody spacer apparatus 100 according to an embodiment herein. Generally, theapparatus 100 comprises a retainingpin 1, a first hingedrod 2, a second hingedrod 3, a third hingedrod 4, aninsertion rod 5, afirst link 6, asecond link 8,third link 9, and a plurality of hinge pins 7. One of the hinge pins 7 is used to connect thefirst link 6 to thesecond link 8, while theother hinge pin 7 is used to connect thesecond link 8 to thethird link 9. Moreover, the first hingedrod 2 is adapted to connect to the second hingedrod 3, and the second hingedrod 3 is adapted to connect to the third hingedrod 4. The retainingpin 1 is adapted to securely connect the first hingedrod 2 to thefirst link 6, and theinsertion rod 5 is adapted to connect to the third hingedrod 4, whereby theinsertion rod 5 is adapted to be disconnected from the third hingedrod 4. -
FIG. 2 illustrates a schematic diagram of an articulatinginterbody spacer assembly 101 according to an embodiment herein. The difference between theassembly 101 ofFIG. 2 and the apparatus ofFIGS. 1(A) through 1(G) is that theassembly 101 does not include the insertion rod 5 (i.e., after theinsertion rod 5 has been disconnected from the third hinged rod 4). AsFIG. 2 illustrates, thefirst link 6,second link 8, andthird link 9 are pivotally connected to one another in the manner described above by using the hinge pins 7 for the various connections (i.e., connection of thefirst link 6 to thesecond link 8 and the connection of thesecond link 8 to the third link 9), and as such allows theassembly 101 to articulate from a generally straight position to a generally curved position. -
FIGS. 3(A) through 3(C) illustrate schematic diagrams of the retainingpin 1 of the articulatinginterbody spacer apparatus 100 ofFIGS. 1(A) through 1(G) according to an embodiment herein. The retainingpin 1 comprises ashaft 11 with acap portion 13 positioned on top of theshaft 11. Moreover, thecap portion 13 has an exposed undersurface 12 such that the circumferential configuration of thecap portion 13 is preferably larger than the circumferential configuration of theshaft 11. -
FIGS. 4(A) through 4(F) illustrate schematic diagrams of the first hingedrod 2 of the articulatinginterbody spacer apparatus 100 ofFIGS. 1(A) through 1(G) according to an embodiment herein. The first hingedrod 2 is generally embodied in an elongated configuration. The first hingedrod 2 comprises anelongated body portion 15 that is generally rounded terminating in a pair ofends first end 17 of thebody portion 15 is defined by an upper generallyflat base 20 bounded by a generally slopingwall 21. Apivot peg 19 outwardly extends from theflat base 20 in a generally perpendicular manner. The upper surface of theflat base 20 is positioned below the upper surface of thebody portion 15 such that the upper surface of thepivot peg 19 may be substantially planar to the upper surface of thebody portion 15. Thesecond end 16 of thebody portion 15 comprises aretention hole 18 configured substantially transverse to the longitudinal axis of thebody portion 15. -
FIGS. 5(A) through 5(F) illustrate schematic diagrams of the second hingedrod 3 of the articulatinginterbody spacer apparatus 100 ofFIGS. 1(A) through 1(G) according to an embodiment herein. The second hingedrod 3 is generally embodied in an elongated configuration and comprises two generally roundedlongitudinal sides 32 and two substantially flat sides 30. Theflat sides 30 allow for flexion in the needed direction during articulation of the second hingedrod 3. A pair ofends rod 3. Thefirst end 34 is defined by an upper generallyflat base 37 bounded by a generally slopingwall 36. Apivot peg 35 outwardly extends from theflat base 37 in a generally perpendicular manner. The upper surface of theflat base 37 is positioned below the upper surface of the top generally roundedlongitudinal side 32 such that the upper surface of thepivot peg 35 may be substantially planar to the upper surface of the top generally roundedlongitudinal side 32. Thesecond end 33 comprises a generally flatupper surface 39 bounded by a generally slopingwall 38. Thesecond end 33 further includes apivot hole 31 configured substantially transverse to the longitudinal axis of the two generally roundedlongitudinal sides 32 and two substantially flat sides 30. -
FIGS. 6(A) through 6(F) illustrate schematic diagrams of the third hingedrod 4 of the articulatinginterbody spacer apparatus 100 ofFIGS. 1(A) through 1(G) according to an embodiment herein. The third hingedrod 4 is generally embodied in an opposite configuration of the second hingedrod 3. The third hingedrod 4 also comprises a generally elongated configuration and includes two generally roundedlongitudinal sides 46 and two substantially flat sides 40. Theflat sides 40 allow for flexion in the needed direction during articulation of the third hingedrod 4. A pair ofends rod 4. Thefirst end 42 comprises a generally flatupper surface 44 bounded by a generally slopingwall 47. Thefirst end 42 further includes apivot hole 43 configured substantially transverse to the longitudinal axis of the two generally roundedlongitudinal sides 46 and two substantially flat sides 40. Thesecond end 41 is defined by an upper generallyflat base 49 bounded by a generally slopingwall 48. Apivot peg 45 outwardly extends from theflat base 49 in a generally perpendicular manner. The upper surface of theflat base 49 is positioned below the upper surface of the top generally roundedlongitudinal side 46 such that the upper surface of thepivot peg 45 may be substantially planar to the upper surface of the top generally roundedlongitudinal side 46. -
FIGS. 7(A) through 7(F) illustrate schematic diagrams of theinsertion rod 5 of the articulatinginterbody spacer apparatus 100 ofFIGS. 1(A) through 1(G) according to an embodiment herein. Theinsertion rod 5 is generally embodied in an elongated configuration. Theinsertion rod 5 comprises anelongated body portion 51 that is generally rounded terminating in a pair ofends first end 52 of thebody portion 51 is defined by an upper generallyflat base 55 bounded by a generally slopingwall 56. The upper surface of theflat base 55 is positioned below the upper surface of thebody portion 51. Thefirst end 52 further comprises apivot hole 54 configured substantially transverse to the longitudinal axis of thebody portion 51. Thesecond end 53 is adapted to be attached to an inserter tool/mechanism (not shown). -
FIGS. 8(A) through 8(F) illustrate schematic diagrams of thefirst link 6 of the articulatinginterbody spacer apparatus 100 ofFIGS. 1(A) through 1(G) according to an embodiment herein. Thefirst link 6 comprises abody portion 71 having atop end 77 and abottom end 78, whereby thetop end 77 is configured with a pair of verticalbone graft windows 62 that are adapted to allow for bone growth during fusion. Thebody portion 71 of thefirst link 6 also comprises a pair of opposed partiallyserrated sides 61 each terminating with unserratedtapered walls 63 towards afront end 72 of thebody portion 71. Thetop end 77 terminates with a downwardly slopingwall 79 towards thefront end 72. Moreover, thebottom end 78 terminates with an upwardlysloping wall 179 towards thefront end 72. The back end of thebody portion 71 comprises a generally slopingwall 70 having aconnector mechanism 69 extending therefrom. Theconnector mechanism 69 has generally flat side surfaces 68 and a throughhole 65 configured transversely with respect to the longitudinal axis of thebody portion 71. Arod retention hole 67 extends from the slopingwall 70 at the rear of thebody portion 71 through to the slopingwall 79 at the front of thebody portion 71. Additionally, therod retention hole 67 extends through the upper part of thebody portion 71 along a substantially longitudinal axis of thebody portion 71 and is dimensioned and configured to accommodate the first hingedrod 2 of theapparatus 100 ofFIGS. 1(A) through 1(G) . Also, configured in the upwardlysloping wall 179 is aretention pin hole 66, which is dimensioned and configured to accommodate the retainingpin 1 of theapparatus 100 ofFIGS. 1(A) through 1(G) . A horizontalbone graft window 64 is positioned in the generally central part of thebody portion 71 and is configured to be substantially transverse to the longitudinal axis of thebody portion 71. In other words, the horizontalbone graft window 64 and thethroughhole 65 are substantially parallel to one another. -
FIGS. 9(A) through 9(C) illustrate schematic diagrams of thehinge pin 7 of the articulatinginterbody spacer apparatus 100 ofFIGS. 1(A) through 1(G) according to an embodiment herein. Thehinge pin 7 is generally configured in a cylindrical embodiment, although other configurations may be used in accordance with the embodiments herein. Thehinge pin 7 comprises ashaft 75 terminating in a pair ofends -
FIGS. 10(A) through 10(F) illustrate schematic diagrams of thesecond link 8 of the articulatinginterbody spacer apparatus 100 ofFIGS. 1(A) through 1(G) according to an embodiment herein. Thesecond link 8 comprises abody portion 81 having atop end 82 and abottom end 83, whereby thetop end 82 is configured with a pair of verticalbone graft windows 122 that are adapted to allow for bone growth during fusion. Thebody portion 81 of thesecond link 8 also comprises a pair of opposedserrated sides 88. Thetop end 82 terminates with a downwardly slopingwall 186, which then terminates with a further downwardly slopingwall 84 sandwiched in between a pair ofconnector flanges 85. Eachconnector flange 85 comprises a throughhole 120 aligned with one another. The rear of thebody portion 81 comprises a generally slopingwall 86 having aconnector mechanism 87 extending therefrom. Theconnector mechanism 87 has generally flat side surfaces 124 and a throughhole 121 configured transversely with respect to the longitudinal axis of thebody portion 81. Arod retention hole 89 extends from the slopingwall 86 at the rear of thebody portion 81 through to thesloping wall 186 at the front of thebody portion 81. Additionally, therod retention hole 89 extends through the upper part of thebody portion 81 along a substantially longitudinal axis of thebody portion 81 and is dimensioned and configured to accommodate portions of the second hingedrod 3 and third hingedrod 4 of theapparatus 100 ofFIGS. 1(A) through 1(G) . A horizontalbone graft window 123 is positioned in the generally central part of thebody portion 81 and is configured to be substantially transverse to the longitudinal axis of thebody portion 81. In other words, the horizontalbone graft window 123 and thethroughhole 121 are substantially parallel to one another. -
FIGS. 11(A) through 11(F) illustrate schematic diagrams of thethird link 9 of the articulatinginterbody spacer apparatus 100 ofFIGS. 1(A) through 1(G) according to an embodiment herein. Thethird link 9 comprises abody portion 91 having atop end 92 and abottom end 93, whereby thetop end 92 is configured with a pair of verticalbone graft windows 99 that are adapted to allow for bone growth during fusion. Thebody portion 91 of thethird link 9 also comprises a pair of opposedserrated sides 98. Thetop end 92 terminates with a downwardly slopingwall 188, which then terminates with a further downwardly slopingwall 94 sandwiched in between a pair ofconnector flanges 95. Eachconnector flange 95 comprises a throughhole 130 aligned with one another. Arod retention hole 97 extends from therear wall 96 of thebody portion 91 through to thesloping wall 188 at the front of thebody portion 91. Additionally, therod retention hole 97 extends through the upper part of thebody portion 91 along a substantially longitudinal axis of thebody portion 91 and is dimensioned and configured to accommodate portions of the second hingedrod 3, the third hingedrod 4, and theinsertion rod 5 of theapparatus 100 ofFIGS. 1(A) through 1(G) . A horizontalbone graft window 132 is positioned in the generally central part of thebody portion 91 and is configured to be substantially transverse to the longitudinal axis of thebody portion 91. Accordingly, the horizontalbone graft window 132 and thethroughhole 130 are substantially parallel to one another. A threadedhole 131 extends through the lower part of thebody portion 91 along a substantially longitudinal axis of thebody portion 91 and has its opening at therear wall 96. Preferably, threadedhole 131 is positioned off axis directed towards thetop end 92 to keep theimplant assembly 101 from articulating prematurely during impaction. Furthermore,rear wall 96 is preferably perpendicular to threadedhole 131 for the same reason. -
FIGS. 12(A) through 12(F) are schematic diagrams illustrating subsequent stages of insertion of the articulatinginterbody spacer assembly 101 ofFIG. 2 into avertebral body 200 according to an embodiment herein. In practice, theassembly 101 will be inserted using theinsertion rod 5. In the first stage of insertion shown inFIG. 12(A) , theassembly 101 is in a generally straight configuration and is inserted into a previously drilled opening in thevertebral body 200. In the second stage of insertion shown inFIG. 12(B) , theassembly 101 is still in a generally straight configuration and is nearly entirely inside thevertebral body 200. In the third stage of insertion shown inFIG. 12(C) , theassembly 101 begins to articulate such that thefirst link 6 begins to pivot. In the fourth stage of insertion shown inFIG. 12(D) , theassembly 101 is entirely within thevertebral body 200 with thefirst link 6 in its pivoted position. In the fifth stage of insertion shown inFIG. 12(E) , theassembly 101 is entirely within thevertebral body 200 with each of the first, second, andthird links FIG. 12(F) , theassembly 101 is in its final position of insertion (i.e., resting position) with each of the first, second, andthird links -
FIG. 13 is a schematic diagram of a first alternate embodiment of an articulatinginterbody spacer assembly 204 according to the embodiments herein.FIG. 13 illustrates the assembly in itsinitial position 250 as well as its articulatedfinal position 251 within avertebral body 200. In this embodiment (also referred to as a living hinge embodiment) the hingedlinks 306 of the implant are made of a single piece flexible material held together by a cable orguide wire 205 as opposed to havingseparate links hinge pin 7. -
FIGS. 14(A) through 14(C) are schematic diagrams of a second alternate embodiment of an articulatinginterbody spacer assembly 304 according to the embodiments herein. Thisassembly 304 compriseslinks 306 connected by a flexible (living)hinge 307. Connection rivets 308 are used to attach theflexible hinge 307 to thelinks 306. Theflexible hinge 307 is made of a separate material (with respect to the links 306) and is securely attached to thelinks 306 with proper spacing so that thelinks 306 can articulate to provide the desired articulating result. Theflexible hinge 307 may comprise implantable stainless steel, titanium alloy, or nitinol. Moreover, thelinks 306 may comprise carbon fiber, PEEK optima, or titanium. -
FIGS. 15(A) and 15(B) are schematic diagrams of a third alternate embodiment of an articulatinginterbody spacer assembly 201 according to the embodiments herein. Thisassembly 201 is similar to theassembly 101 ofFIG. 2 except the first, second, and third hingedrods assembly 101 are replaced with a single cable orguide wire 205 that is allowed to flex or bend where the first, second, and third hingedlinks -
FIGS. 16(A) and 16(B) are schematic diagrams of a fourth alternate embodiment of an articulatinginterbody spacer assembly 301 according to the embodiments herein. Theassembly 301 comprises animplantable ramp 305 comprising an initiallyopen end 309 and terminating with aclosed end 310. Theramp 305 is initially inserted between two vertebral bodies upon which thelinks 406 may slide down (terminating at the closed end 310) for optimal placement. Thelinks 406 comprise agroove 312 to allow thelinks 406 to slide on theramp 305. Theramp 305 then becomes part of thepermanent implant assembly 301. Thelinks 406 are not connected to one another, thusgaps 311 exist until thelinks 406 come to rest next to one another. After insertion, theopen end 309 may be appropriately bent or configured to prevent thelinks 406 from coming off of theramp 305. - With respect to
FIGS. 1(A) through 16(B) , theapparatus 100 may be assembled as follows: the first, second, andthird links hinge pins 7 to connect thefirst link 6 to thesecond link 8, and thesecond link 8 to thethird link 9. Specifically, theconnector mechanism 69 of thefirst link 6 is inserted between the pair ofconnector flanges 85 of thesecond link 8 such that thethroughhole 65 of theconnector mechanism 69 is aligned with each of thethroughholes 120 of the pair ofconnector flanges 85. The flat side surfaces 68 of theconnector mechanism 69 are dimensioned and configured to provide a frictional fit with the pair ofconnector flanges 85 of thesecond link 8 so theimplant assembly 101 will not buckle or articulate prematurely upon impaction. Similarly, the pair ofconnector flanges 85 are dimensioned and configured to provide a frictional fit with the flat side surfaces 68 of theconnector mechanism 69 so theimplant assembly 101 will not buckle or articulate prematurely upon impaction. Once thethrougholes hinge pin 7 is inserted therein to rotatably attach thefirst link 6 to thesecond link 8. Thehinge pin 7 allows for a pivot axis of thefirst link 6 and thesecond link 8 during the insertion stages (shown inFIGS. 12(A) through 12(F) ). After this, theconnector mechanism 87 of thesecond link 8 is inserted between the pair ofconnector flanges 95 of thethird link 9 such that thethroughhole 121 of theconnector mechanism 87 is aligned with each of thethroughholes 130 of the pair ofconnector flanges 95. The flat side surfaces 124 of theconnector mechanism 87 are dimensioned and configured to provide a frictional fit with the pair ofconnector flanges 95 of thethird link 9 so theimplant assembly 101 will not buckle or articulate prematurely upon impaction. Similarly, the pair ofconnector flanges 95 are dimensioned and configured to provide a frictional fit with the flat side surfaces 124 of theconnector mechanism 87. Once thethrougholes hinge pin 7 is inserted therein to rotatably attach thesecond link 8 to thethird link 9. - Next, pivot peg 19 of the first hinged
rod 2 is connected to pivothole 31 of the second hingedrod 3. Then, pivot peg 35 of the second hingedrod 3 is connected to pivothole 43 of the third hingedrod 4. After this, pivot peg 45 of the third hingedrod 4 is connected to pivothole 54 of theinsertion rod 5 and the assembledrods third links pin 1 is press fit intoretention pin hole 66 offirst link 6 and captures theretention hole 18 of the first hingedrod 2. More specifically, the exposed undersurface 12 of retainingpin 1 is flush seated inretention pin hole 66 offirst link 6. Thesecond end 53 of theinsertion rod 5 is adapted to be attached to an inserter tool/mechanism (not shown). Again, theinsertion rod 5 does not get implanted in thevertebral body 200. Rather, theinsertion rod 5 is removed once theimplant assembly 101 is fully articulated in its final position. - The
implant assembly 101 comprises various structural features, which provides it with enhanced functionality. For example, with respect to thefirst link 6, theserrated sides 61 provide friction and avoid dislocation after theassembly 101 is implanted in thevertebral body 200. Moreover, the taperedwalls 63 allow for the structural distraction of adjacent vertebral bodies during insertion of theassembly 101 into thevertebral body 200. Additionally, the horizontalbone graft window 64 allows for bone packing prior toassembly 101 implantation in thevertebral body 200. Also, therod retention hole 67 is adapted to accommodate the first hingedrod 2. - With respect to the
second link 8, theserrated sides 88 provide friction and avoid dislocation after theassembly 101 is implanted in thevertebral body 200. Additionally, the horizontalbone graft window 123 allows for bone packing prior toassembly 101 implantation in thevertebral body 200. Also, therod retention hole 89 is adapted to accommodate the first, second, and third hingedrods connected rods apparatus 100. With respect to thethird link 9, theserrated sides 98 provide friction and avoid dislocation after theassembly 101 is implanted in thevertebral body 200. Additionally, the horizontalbone graft window 132 allows for bone packing prior toassembly 101 implantation in thevertebral body 200. Also, therod retention hole 97 is adapted to accommodate the first, second, and third hingedrods insertion rod 5 during insertion of theconnected rods apparatus 100. Moreover, the threadedhole 131 is adapted to connect with an inserter tool/mechanism (not shown) during implantation of theassembly 101 into avertebral body 200. This connection is temporary as both theinsertion rod 5 and the inserter tool/mechanism (not shown) are removed once theimplant assembly 101 is fully articulated in its final position in thevertebral body 200. This is possible because therod retention hole 97 is properly sized to allow release of theinsertion rod 5 and the inserter tool/mechanism (not shown) once full articulation and final positioning of theassembly 101 is achieved in thevertebral body 200. - As mentioned, the
implant assembly 101 is preferably attached to and inserted or impacted by insertion means such as an inserter tool/mechanism (not shown). In a preferred mode, the inserter tool/mechanism (not shown) may comprise of a shaft of an appropriate length. On one end may comprise a protrusion that is attached to thethird link 9 via a thread, a snap fitting, or simply a friction fit stud. On the opposite end, the inserter tool/mechanism (not shown) may comprise a handle with an impact surface. The handle may also comprise a mechanism(s) to pull or push on theinsertion rod 5 to articulate theimplant assembly 101 during insertion into avertebral body 200. When the implant-loaded inserter is lightly impacted, theimplant assembly 101 is wedged between two vertebral bodies to slightly distract them (by means of taperedwalls 63 of the first link 6) while being impacted with sufficient force to overcome the friction between the two bone surfaces. - As the
implant assembly 101 is advanced into the spine, the surgeon may activate the mechanism(s) on the inserter tool/mechanism (not shown) to “bend” or articulate theimplant assembly 101 until it is implanted in its final position (as shown inFIGS. 12(A) through 12(F) ). Once theimplant assembly 101 is fully articulated in its final position, theinsertion rod 5 is allowed to disassemble from theimplant assembly 101 by sliding theinsertion rod 5 up or down towards thevertebral body 200. After the removal of theinsertion rod 5, the inserter tool/mechanism (not shown) is also removed from theimplant assembly 101. -
FIG. 17 , with reference toFIGS. 1(A) through 16(B) , is a flow diagram illustrating a method of inserting an interbodyspacer implant assembly 101 for interbody fusion into avertebral body 200 according to an embodiment herein, wherein the method comprises connecting (501) an elongated connector mechanism (rods wire 205 or ramp 305 or flexible hinge 307) to a plurality of links (6, 8, 9, 306, 406); and inserting (503) the elongated connector mechanism (rods wire 205 or ramp 305 or flexible hinge 307) and the plurality of links (6, 8, 9, 306, 406) into thevertebral body 200, wherein specified ones ofindividual links individual links vertebral body 200. The method may further comprise attaching aninsertion rod 5 to the elongated connector mechanism (rods insertion rod 5 to push the elongated connector mechanism (rods links vertebral body 200; and removing theinsertion rod 5 from the elongated connector mechanism (rods rods links vertebral body 200. - The
implant assembly 101 generally comprises a plurality oflinks rod mechanism links rods mechanism links rods mechanism individual links links first link 6 and ending with thesecond link 8. More specifically, thethird link 9 does not articulate; only thefirst link 6 andsecond link 8 articulate with reference to thethird link 9 as shown inFIGS. 12(A) through 12(F) . This constrained motion is due to the pivotingrods mechanism rods mechanism respective links links 6, 8 (or 306) are fully articulated, only then can theinsertion pivoting rod mechanism implant assembly 101. - The embodiments herein may be utilized in surgery to stabilize the human spine. It may be used to replace a human disc that is no longer functioning properly and restore height between to vertebral bodies, or used to as a full or partial vertebral body replacement device. Preferably, the embodiments herein may be used with some form of the many available fixation devices either from a posterior, anterior, or lateral approach. Moreover, the embodiments herein provide an improvement over conventional devices in terms of the structure of the device, the method of implantation, and patient stability after implantation. The embodiments herein are dimensioned and configured to be manufactured from any appropriate implantable material(s) and may utilize all the standard surgical tools that accompany such devices.
- The foregoing description of the specific embodiments will so fully reveal the general nature of the embodiments herein that others can, by applying current knowledge, readily modify and/or adapt for various applications such specific embodiments without departing from the generic concept, and, therefore, such adaptations and modifications should and are intended to be comprehended within the meaning and range of equivalents of the disclosed embodiments. It is to be understood that the phraseology or terminology employed herein is for the purpose of description and not of limitation. Therefore, while the embodiments herein have been described in terms of preferred embodiments, those skilled in the art will recognize that the embodiments herein can be practiced with modification within the spirit and scope of the appended claims.
Claims (8)
1. An interbody spacer implant assembly for interbody fusion in a vertebral body, said assembly comprising:
a plurality of links; and
a flexible elongated connector mechanism adapted to retain said plurality of links and allow said plurality of links to articulate with respect to one another.
2. The assembly of claim 1 , wherein each one of said plurality of links comprise:
a groove; and
a hole configured through a side of said each of said plurality of links.
3. The assembly of claim 2 , wherein said elongated connector mechanism comprises a substantially J-shaped mechanism adapted to allow said plurality of links to slide thereon.
4. The assembly of claim 1 , wherein said plurality of links comprise a continuous flexible structure.
5. An interbody spacer implant apparatus for interbody fusion in a vertebral body, said apparatus comprising:
a plurality of individually articulating links; and
a connector mechanism adapted to retain the plurality of links and allow said plurality of links to articulate with respect to one another,
wherein said connector mechanism is dimensioned and configured to have a length-to-width ratio greater than a length-to-width ratio of each of said plurality of links.
6. The apparatus of claim 5 , further comprising an insertion rod adapted to insert said plurality of links and said connector mechanism into said vertebral body.
7. A method of inserting an interbody spacer implant assembly for interbody fusion into a vertebral body, said method comprising:
connecting an elongated connector mechanism to a plurality of links; and
inserting said elongated connector mechanism and said plurality of links into said vertebral body,
wherein specified ones of individual links of said plurality of links are adapted to articulate individually with respect to other individual links upon insertion into said vertebral body.
8. The method of claim 7 , further comprising:
attaching an insertion rod to said elongated connector mechanism;
using said insertion rod to push said elongated connector mechanism and said plurality of links into said vertebral body; and
removing said insertion rod from said elongated connector mechanism upon full insertion and final positioning of said elongated connector mechanism and said plurality of links into said vertebral body.
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US13/401,972 US9138327B1 (en) | 2006-09-21 | 2012-02-22 | Pivoting interbody vertebral spacer |
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JP4757342B2 (en) | 2011-08-24 |
EP2076188A2 (en) | 2009-07-08 |
US20080125865A1 (en) | 2008-05-29 |
JP2010504162A (en) | 2010-02-12 |
WO2008036505A3 (en) | 2008-08-21 |
EP2076188A4 (en) | 2012-04-04 |
US8025697B2 (en) | 2011-09-27 |
JP2011224382A (en) | 2011-11-10 |
US9138327B1 (en) | 2015-09-22 |
WO2008036505A2 (en) | 2008-03-27 |
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