WO2008112607A2 - Implant rachidien - Google Patents
Implant rachidien Download PDFInfo
- Publication number
- WO2008112607A2 WO2008112607A2 PCT/US2008/056359 US2008056359W WO2008112607A2 WO 2008112607 A2 WO2008112607 A2 WO 2008112607A2 US 2008056359 W US2008056359 W US 2008056359W WO 2008112607 A2 WO2008112607 A2 WO 2008112607A2
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- teeth
- spinal implant
- implant according
- spinal
- extended
- Prior art date
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Classifications
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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
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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
- A61F2/46—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
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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
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
-
- 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
- A61F2/28—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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- 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
- A61F2/28—Bones
- A61F2002/2835—Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
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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
- A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
- A61F2002/3006—Properties of materials and coating materials
- A61F2002/30092—Properties of materials and coating materials using shape memory or superelastic materials, e.g. nitinol
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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
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30518—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements with possibility of relative movement between the prosthetic parts
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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
- A61F2002/30579—Special structural features of bone or joint prostheses not otherwise provided for with mechanically expandable devices, e.g. fixation devices
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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
- A61F2002/30594—Special structural features of bone or joint prostheses not otherwise provided for slotted, e.g. radial or meridian slot ending in a polar aperture, non-polar slots, horizontal or arcuate slots
-
- 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
- A61F2002/30841—Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
-
- 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
- A61F2/46—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
- A61F2002/4625—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 with relative movement between parts of the instrument during use
- A61F2002/4627—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 with relative movement between parts of the instrument during use with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument
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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
- A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2210/0014—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol
-
- 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
- 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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- 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
- A61F2310/00179—Ceramics or ceramic-like structures
- A61F2310/00293—Ceramics or ceramic-like structures containing a phosphorus-containing compound, e.g. apatite
Definitions
- the present invention relates to interbody implants and more particularly to fusion cages.
- Spinal fusion surgery has become a common procedure for the treatment of degenerative disease of the spine.
- spinal hardware is installed to stabilize the movement across the affected joint, thereby facilitating fusion between the vertebrae.
- spinal hardware includes plates, screws, and rods.
- fusion rates can be dramatically increased if the affected disc is removed entirely and a spacer inserted into the disc space.
- Spinal hardware called “spinal implants” or “fusion cages” was designed to be inserted into the disc space. These implants were created in a variety of designs and configurations.
- fusion cages are either cylindrical or rectangular devices having an external threaded or toothed portion for engaging the vertebral end plates in order to prevent the cage from slipping.
- Such cages are generally hollow. They can be filled with graft in order to induce fusion of the two vertebrae together. Such devices provide great potential for eliminating the large incisions required for posterior instrumentation and open a door for minimally invasive surgery.
- the cages are typically classified by the insertion technique (e.g. anterior, posterior, lateral, or posterior lateral) or by a characteristic of the cage (e.g. threaded, expandable, or stackable). Threaded cages must be rotated or turned into position.
- Expandable cages include a body that changes height as part of the implantation procedure. Stackable cages must be assembled in situ in a procedure similar to building with Lego ® building blocks. All of these cages are undesirably complicated structurally and/or undesirably difficult to install.
- the cages or implants must also be inserted in such a way and using sufficient hardware so as to ensure that the implant will not unintentionally move after implantation. This is a difficult task, because the implants must be able to provide some flex to ensure that patient movement is not unduly restricted, while not slipping out of position and causing further damage.
- the prior art implants have typically utilized a variety of bone screws to accomplish this task. However, failure of such a bone screw can cause additional damage and in an effort to limit the size of the implant usually few screws are used to hold the implant in place. Therefore, failure of a screw can impact the effectiveness/stability of the entire implant.
- the present invention provides a spinal implant includes a body and extendable teeth within the body.
- the teeth are extended after positioning so that the teeth engage the vertebrae/bone and maintain the cage in position.
- the installed cage provides structural support for the joint.
- the cage also provides a lattice that facilitates fusion.
- the present invention has distinct advantages over prior art implants. First, it can be inserted smoothly and easily during an atraumatic procedure. Second, the extendable teeth enable the cage to be secured or anchored in position effectively and easily.
- Fig. 1 is a side elevational view of the spinal cage of the present invention (the opposite side view being the mirror image thereof);
- Fig. 2 is a top plan view of the spinal cage (the bottom plan view being the mirror image thereof);
- Fig. 3 is a sectional view taken along Line HI-III in Fig. 2 and showing the teeth retracted;
- Fig. 4 is a sectional view taken along Line IV-IV in Fig. 3;
- Fig. 5 is an elevalional view of one pair of retracted teeth
- Fig. 6 is a sectional view similar to Fig. 3 but showing the teeth extended
- Fig. 7 is a sectional view similar to Fig. 4 but showing the teeth extended;
- Fig. 8 is an elevational view similar to Fig. 5 but showing the teeth extended;
- Fig. 9 is an end view of the cage
- Fig. 10 is a sectional view of the inserter
- Fig. 11 is a sectional view of the cage positioned within the inserter positioned in a disc space;
- Fig. 12 is a sectional view taken along Line XII-XII in Fig. 11 ;
- Fig. 13 is a sectional view showing the cage inserted into its final position within the disc space
- Fig. 14 is a sectional view showing the cage remaining in position in the disc space while the inserter is partially withdrawn;
- Fig. 15 is a sectional view showing the cage in position in the disc space with the inserter fully withdrawn.
- a spinal implant or fusion cage in accordance with a current embodiment of the present invention is illustrated in the drawings and generally designated 10.
- the illustrated implant is an example, and alternative implants can be used.
- the implant includes an implant body 12 and an extendable tooth assembly 14.
- the tooth assembly is retracted (Figs. 3-5) during insertion of the implant between vertebrae.
- the tooth assembly is extended (Figs. 6-8) after the implant is in position within the disc space to anchor the cage to the adjacent vertebrae.
- the implant 10 includes a body portion generally indicated at 12.
- the body portion 12 can be manufactured from various materials, such as composite materials of one or more metals, plastics, hydroxyapatite, resorbable material, polymer, and ceramic, and may additionally incorporate bone chips, bone particulate, bone fibers, bone growth materials, bone cement, or other materials well known in the art. Such devices can be either machined or molded, depending upon the material from which the implant 10 is made.
- the implant 10 can be made from a material having spring like qualities.
- the body 12 can be made from a plastic material or composite which can be molded into the desired shape.
- the present invention can be made from a shape memory polymer or alloy such as Nitinol. Such materials can be bent to a desired shape, such as bending the body 12 into contracted shape and maintaining the contracted shape.
- an instrument can be used to cause an electric current, heat or cold to be applied to the body thereby inducing the memory metal to return to its original expanded shape.
- the implant can be inserted into a collapsed or substantially collapsed disc space between two vertebrae.
- the stimulus such as heat, electric current, or cold can be applied to the implant whereby the implant will then return to its expanded shape thereby expanding the disc space to effectuate relief of the pinched nerves or the like.
- the implant will then maintain the spacing thereby effectuating relief to the patient.
- the structures optionally may include perforations extending from outer to inner surfaces, or recesses formed in outer surfaces that do not extend through inner surfaces.
- Geometries such as circular depressions, dimples formed from a spherical geometry, diamond shapes, or rectangular shapes may be used to promote bone fusion.
- the body 12 defines a single horizontal slot 16 and a pair of vertical slots 18.
- the slots reduce the mass of the implant body 12 and provide a lattice to facilitate fusion.
- the body 12 also defines a plurality of vertical holes 20 and a pair of horizontal holes 22 for purposes to be described.
- the implant body 12 includes a rounded anterior or insertion end 13 and a blunt posterior end 15.
- the implant body 12 can be shaped differently for example to reduce or eliminate sharp or cornered edges.
- the horizontal holes 22 open through the posterior end as illustrated in Fig. 9. Additionally, the posterior end 15 defines a hole 17 for receiving a press 50 (to be described).
- the body 12 includes an outer surface 19 and an inner surface (not visible).
- the inner surface defines a hollow inner chamber (not visible) for containing a graft material
- the outer surface 19 can include a porous coating, as is known in the art, for allowing bone growth.
- the outer surface 19 can also be otherwise textured to enhance bone fixation.
- the tooth assembly 14 is illustrated in Figs. 5 and 8.
- the tooth assembly 14 includes a plurality of upper teeth 30, a plurality of lower teeth 32, a cam actuator 34 or other engagement device therebetween.
- the teeth 30 and 32 are each installed within one of the vertical holes 20 and are capable of traveling within the holes.
- the cam actuator 34 is accessible through the horizontal holes 22.
- the teeth are defined herein as spikes or other similarly shaped protrusions that can extend out from the implant body or any other shape suitable for accomplishing the function disclosed herein.
- the teeth can have a smooth exterior surface or can have a jagged exterior surface.
- the smooth surface enables the implant to be removed more easily as the teeth are easily removed from bone tissue.
- the jagged or otherwise modified exterior surface creates a more firm connection between the implant and the bone, because the jagged surface creates more surface area contact between the teeth and the bone.
- the teeth can also include a coating on the exterior surface that promotes bone growth.
- the teeth can be hollow and can include a lattice or otherwise porous surface that enables the interior to be filled with graft material that can diffuse through the tooth into the bone enabling stronger fusion.
- the teeth are present on at least one exterior surface of the implant.
- the teeth can be present at each end of the surface and can also be present in the middle or the surface, thereby ensuring that even if one tooth fails, the implant will remain in place.
- the teeth can be in at least two conditions: a disengaged/retracted condition in which the teeth are generally retracted within or drawn into the body of the spinal implant; and an engaged/extended condition in which the teeth extend from the body to engage the bony surface onto which the spinal implant is placed.
- the extended condition can include a partially extended configuration and a fully extended configuration. This enables greater control with regard to the extent that the teeth are extended into the bone. In other words, the extent to which the teeth are inserted into the bone can be adjusted.
- the “engagement device” can be any device that is capable to moving the teeth from a retracted to an extended condition.
- the engagement device is a cam actuated rod, which, when turned, forces the teeth into engagement with the bone.
- Multiple rods can also be used, wherein each rod controls the action of one or more teeth.
- a variety of other devices and combinations of devices can also be used.
- a plunger can be used that forces the teeth into engagement or a hydraulic system can be used.
- An expandable solution/fluid that can provide sufficient strength to force the teeth into engagement without having negative side effects can also be used. Examples of such fluids include sol gels and other similar substances.
- the teeth can be "spring-loaded" within the implant body such that prior to insertion, the teeth are held in a retracted position before positioning, and once the implant is positioned, all of the teeth are allowed to extend.
- a tapered screw can be used that drives the teeth out of the cage as the tapered screw is engaged within the cage.
- the actuator device used to manipulate the engagement device changes based upon the chosen engagement device. For example, when using a cam, a wrench or other similar device can be used to twist or turn the cam into the desired position.
- Other actuator devices can include an Allen wrench, a plunger or any other device capable of manipulating the engagement device, and preferably is able to function within the small confines of the body and through the incision.
- a spring-loaded engagement device it is possible that no actuator device would be required or that only a release device would be required.
- the implant 10 can be any spinal implant. Examples include, but are not limited to, fusion cage, spinal plate, artificial disc, transverse connector and spinal fixation assemblies.
- the implant is inserted into the spine of a patient and can be used to promote bone fusion while maintaining the stability of the spine.
- the teeth enable the implant to be rigidly affixed to the bone of the spine and to prevent slippage of the implant.
- the implant 10 is inserted using an insertional device or inserter 40 (Fig. 10).
- the inserter includes an upper sled 42 and a lower sled 44 which are spaced from one another a distance to closely receive the implant 10.
- One or more slops 46 are provided on the exterior of the upper and lower sleds 42 and 44 to limit the travel of the inserter into a disc space.
- the inserter 40 can provide retraction of the thecal sac by using a silastic collar around the upper and lower sleds (allowing medial and lateral retraction).
- the inserter 40 is inserted into the disc space between the two adjacent vertebrae. As the sleds are inserted between the adjacent vertebrae, the sleds expand the disc space providing adequate room in which to insert the implant 10.
- Fig. 11 illustrates the implant 10 within the inserter 40 after the inserter has been positioned within the disc space with the stops 46 essentially adjacent the vertebrae. The sleds 42 and 44 are positioned between the vertebrae with the implant 10 not yet pushed forward between the vertebrae.
- a press 50 is that inserted into the hole 17 within the implant 10 so that the implant can be pushed forward through the inserter 40. See Figs. 11-12. The implant 10 is then pushed forward until the implant is positioned between the sleds 42 and 44 and therefore within the disc space. See Fig. 13. When fully inserted, the posterior end 15 of the implant 10 is generally aligned with the posterior edge of the adjacent vertebrae.
- the inserter 40 is withdrawn while the press 50 is used to retain the implant in position within the disc space.
- the inserter 40 is shown partially withdrawn in Fig. 14 and fully withdrawn in Fig. 15. After the inserter has been full withdrawn, the implant 10 remains in position within the disc space with its posterior end 15 generally aligned with the posterior edge of the vertebrae.
- An actuator device (not shown) then is inserted into each of the holes 22 to rotate or to actuate the cam mechanisms 34.
- each cam mechanism 34 is rotated, the teeth 30 and 32 are extended from the implant body 12 to engage and become anchored within the adjacent vertebrae. At this point, the implant 10 has been fully placed and anchored in position.
- the present invention provides a spinal implant that can be readily and securely installed within a disc space to enhance fusion.
- the device creates a minimum of trauma and produces excellent fusion results.
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- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Transplantation (AREA)
- Neurology (AREA)
- Heart & Thoracic Surgery (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Cardiology (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
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- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Physical Education & Sports Medicine (AREA)
- Prostheses (AREA)
Abstract
Cette invention a trait à un implant rachidien comprenant un corps et des dents déployables au sein du corps. Les dents au sein du corps sont exposées après mise en place de l'implant de sorte que lesdites dents s'introduisent dans la vertèbre/l'os et maintiennent la cage en position. La cage mise en place fournit un soutien structurel à l'articulation et produit aussi un réseau qui facilite la fusion.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US89390807P | 2007-03-09 | 2007-03-09 | |
US60/893,908 | 2007-03-09 |
Publications (2)
Publication Number | Publication Date |
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WO2008112607A2 true WO2008112607A2 (fr) | 2008-09-18 |
WO2008112607A3 WO2008112607A3 (fr) | 2008-12-04 |
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Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
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PCT/US2008/056359 WO2008112607A2 (fr) | 2007-03-09 | 2008-03-10 | Implant rachidien |
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Cited By (15)
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US8894710B2 (en) | 2008-12-10 | 2014-11-25 | Coalign Innovations, Inc. | Lockable spinal implant |
US8932355B2 (en) | 2008-02-22 | 2015-01-13 | Coalign Innovations, Inc. | Spinal implant with expandable fixation |
US8992620B2 (en) | 2008-12-10 | 2015-03-31 | Coalign Innovations, Inc. | Adjustable distraction cage with linked locking mechanisms |
US9028550B2 (en) | 2005-09-26 | 2015-05-12 | Coalign Innovations, Inc. | Selectively expanding spine cage with enhanced bone graft infusion |
US9216096B2 (en) | 2010-03-16 | 2015-12-22 | Pinnacle Spine Group, Llc | Intervertebral implants and related tools |
US9380932B1 (en) | 2011-11-02 | 2016-07-05 | Pinnacle Spine Group, Llc | Retractor devices for minimally invasive access to the spine |
WO2017074277A1 (fr) * | 2015-10-26 | 2017-05-04 | Tobb Ekonomi Ve Teknoloji Universitesi | Cage extensible |
US9693876B1 (en) | 2012-03-30 | 2017-07-04 | Ali H. MESIWALA | Spinal fusion implant and related methods |
US10070970B2 (en) | 2013-03-14 | 2018-09-11 | Pinnacle Spine Group, Llc | Interbody implants and graft delivery systems |
US10292833B2 (en) | 2013-11-27 | 2019-05-21 | Howmedica Osteonics Corp. | Structurally supporting insert for spinal fusion cage |
US10470891B2 (en) | 2016-09-12 | 2019-11-12 | Howmedica Osteonics Corp. | Interbody implant with independent control of expansion at multiple locations |
US10485675B2 (en) | 2016-10-26 | 2019-11-26 | Howmedica Osteonics Corp. | Expandable interbody implant with lateral articulation |
US10548738B2 (en) | 2016-04-07 | 2020-02-04 | Howmedica Osteonics Corp. | Expandable interbody implant |
US10729553B2 (en) | 2017-09-15 | 2020-08-04 | Stryker European Operations Holdings Llc | Intervertebral body fusion device expanded with hardening material |
US10940018B2 (en) | 2016-05-20 | 2021-03-09 | Howmedica Osteonics Corp. | Expandable interbody implant with lordosis correction |
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Cited By (35)
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US9814600B2 (en) | 2005-09-26 | 2017-11-14 | Howmedica Osteonics Corp. | Selectively expanding spine cage with enhanced bone graft infusion |
US9028550B2 (en) | 2005-09-26 | 2015-05-12 | Coalign Innovations, Inc. | Selectively expanding spine cage with enhanced bone graft infusion |
US11564806B2 (en) | 2005-09-26 | 2023-01-31 | Howmedica Osteonics Corp. | Selectively expanding spine cage with enhanced bone graft infusion |
US10610374B2 (en) | 2005-09-26 | 2020-04-07 | Howmedica Osteonics Corp. | Selectively expanding spine cage with enhanced bone graft infusion |
US9931222B2 (en) | 2008-02-22 | 2018-04-03 | Howmedica Osteonics Corp. | Spinal implant with expandable fixation |
US11191647B2 (en) | 2008-02-22 | 2021-12-07 | Howmedica Osteonics Corp. | Adjustable distraction cage with linked locking mechanisms |
US11202712B2 (en) | 2008-02-22 | 2021-12-21 | Howmedica Osteonics Corp. | Spinal implant with expandable fixation |
US9545316B2 (en) | 2008-02-22 | 2017-01-17 | Howmedica Osteonics Corp. | Adjustable distraction cage with linked locking mechanisms |
US10342673B2 (en) | 2008-02-22 | 2019-07-09 | Howmedica Osteonics Corp. | Adjustable distraction cage with linked locking mechanisms |
US8956413B2 (en) | 2008-02-22 | 2015-02-17 | Coalign Innovations, Inc. | Hydraulically actuated expanding spine cage with extendable locking anchor |
US8932355B2 (en) | 2008-02-22 | 2015-01-13 | Coalign Innovations, Inc. | Spinal implant with expandable fixation |
US10405988B2 (en) | 2008-02-22 | 2019-09-10 | Howmedica Osteonics Corp. | Spinal implant with expandable fixation |
US8992620B2 (en) | 2008-12-10 | 2015-03-31 | Coalign Innovations, Inc. | Adjustable distraction cage with linked locking mechanisms |
US8894710B2 (en) | 2008-12-10 | 2014-11-25 | Coalign Innovations, Inc. | Lockable spinal implant |
US9788973B2 (en) | 2010-03-16 | 2017-10-17 | Pinnacle Spine Group, Llc | Spinal implant |
US9216096B2 (en) | 2010-03-16 | 2015-12-22 | Pinnacle Spine Group, Llc | Intervertebral implants and related tools |
US9649203B2 (en) | 2010-03-16 | 2017-05-16 | Pinnacle Spine Group, Llc | Methods of post-filling an intervertebral implant |
US9380932B1 (en) | 2011-11-02 | 2016-07-05 | Pinnacle Spine Group, Llc | Retractor devices for minimally invasive access to the spine |
US9693876B1 (en) | 2012-03-30 | 2017-07-04 | Ali H. MESIWALA | Spinal fusion implant and related methods |
US10238504B2 (en) | 2012-03-30 | 2019-03-26 | Ali H. MESIWALA | Spinal fusion implant and related methods |
US10070970B2 (en) | 2013-03-14 | 2018-09-11 | Pinnacle Spine Group, Llc | Interbody implants and graft delivery systems |
US10292833B2 (en) | 2013-11-27 | 2019-05-21 | Howmedica Osteonics Corp. | Structurally supporting insert for spinal fusion cage |
US11229527B2 (en) | 2013-11-27 | 2022-01-25 | Howmedica Osteonics Corp. | Structurally supporting insert for spinal fusion cage |
WO2017074277A1 (fr) * | 2015-10-26 | 2017-05-04 | Tobb Ekonomi Ve Teknoloji Universitesi | Cage extensible |
US10548738B2 (en) | 2016-04-07 | 2020-02-04 | Howmedica Osteonics Corp. | Expandable interbody implant |
US11583407B2 (en) | 2016-04-07 | 2023-02-21 | Howmedica Osteonics Corp. | Expandable interbody implant |
US10940018B2 (en) | 2016-05-20 | 2021-03-09 | Howmedica Osteonics Corp. | Expandable interbody implant with lordosis correction |
US11806249B2 (en) | 2016-05-20 | 2023-11-07 | Howmedica Osteonics Corp. | Expandable interbody implant with lordosis correction |
US11058547B2 (en) | 2016-09-12 | 2021-07-13 | Howmedica Osteonics Corp. | Interbody implant with independent control of expansion at multiple locations |
US10470891B2 (en) | 2016-09-12 | 2019-11-12 | Howmedica Osteonics Corp. | Interbody implant with independent control of expansion at multiple locations |
US11071633B2 (en) | 2016-10-26 | 2021-07-27 | Howmedica Osteonics Corp. | Expandable interbody implant with lateral articulation |
US10485675B2 (en) | 2016-10-26 | 2019-11-26 | Howmedica Osteonics Corp. | Expandable interbody implant with lateral articulation |
US11992418B2 (en) | 2016-10-26 | 2024-05-28 | Howmedica Osteonics Corp. | Expandable interbody implant with lateral articulation |
US10729553B2 (en) | 2017-09-15 | 2020-08-04 | Stryker European Operations Holdings Llc | Intervertebral body fusion device expanded with hardening material |
US11712348B2 (en) | 2017-09-15 | 2023-08-01 | Stryker European Operations Holdings Llc | Intervertebral body fusion device expanded with hardening material |
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WO2008112607A3 (fr) | 2008-12-04 |
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