An intervertebral prosthesis for insertion between adjacent vertebrae includes an upper plate, a lower plate and a core. The core is retained between the upper and lower plates by a retention feature in the form of central projections on the plates and a corresponding opening in the core. The retention feature is designed to allow the plates to slide over the upper and lower surfaces of the core in the anterior/posterior direction and in the lateral direction and to allow the plates to rotate with respect to each other and the core. The retention feature is also designed to prevent contact between the first and second plates during sliding movement of the plates over the core. Each central projection has a diameter that is smaller than a smallest diameter of a central opening of the core.
An intervertebral disc includes a superior endplate having an upper vertebral contacting surface and a lower bearing surface, wherein the upper vertebral contacting surface of the superior endplate has a central portion that is raised relative to a peripheral portion of the superior endplate, and wherein the lower bearing surface has a concavity disposed opposite the raised central portion. The disc includes an inferior endplate having a lower vertebral contacting surface and an upper surface, wherein the lower vertebral contacting surface of the inferior endplate has a central portion and wherein the upper bearing surface has a concavity disposed opposite the central portion. A core is positioned between the upper and inferior endplates, the core having upper and lower core bearing surfaces configured to mate with the bearing surfaces of the upper and inferior endplates. The upper vertebral contacting surface of the superior end plate has a different shape than the lower vertebral contacting surface of the inferior end plate.
Surgical instruments, systems and methods are described for selecting a size and cutting bone for inserting of an intervertebral disc prosthesis. The surgical instrument includes a combined intervertebral disc prosthesis sizing trial and a slot or channel cutter which is movable with respect to the sizing trial.
Systems and methods for robotically distracting a disc space are provided for implantation of an intervertebral prosthetic disc. The system includes a 3D modeling system for creating a 3D model of first and second vertebra adjacent the disc space and identifying positions of the first and second vertebrae and generating and storing position data for the positions of the first and second vertebrae. A robotic distractor determines a size of an intervertebral disc prosthesis to be implanted between the first and second vertebrae and precisely opens the disc space just large enough to receive a selected intervertebral disc. A computing system stores and processes the 3D model and the positions of the first and second vertebrae before and after distraction.
Systems and methods are provided for robotically assisted disc prosthesis selection and implantation. The system includes a 3D modeling system for creating a 3D model of first and second vertebra adjacent the intended surgical site and identifying and storing data for the positions of the first and second vertebrae. A computing system for stores and processes the 3D model and the position data. A robot connected to the computing system attaches to a plurality of instruments including sizing templates, trials, cutters or placement instruments for intervertebral disc prostheses. An interface on the computing system allows the surgeon to sequentially deliver the plurality of instruments with the robot to a registration position to improve the speed and accuracy of the surgical procedure.
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
A61B 34/10 - Computer-aided planning, simulation or modelling of surgical operations
Systems and methods for robotically preparing a disc space are provided for implantation of an intervertebral prosthetic disc. The system includes three-dimensional modeling to identify positions of vertebrae adjacent a surgical site and a disc selection interface in a computing system to allow the surgeon to select an intervertebral disc prosthesis for implantation. A bone cutting interface allows the surgeon to determine a bone cutting pattern tailored to both the three-dimensional positions of the vertebrae and the selected intervertebral disc. A robot controls a cutting device or guides a cutting device to cut the vertebral bone in the bone cutting pattern.
The disclosure provides an implant including first and second interconnected elongated articulating portions with vertebral contacting outer surfaces. The first and second interconnected elongated articulating portions have a first configuration for insertion into a disc space and a second configuration upon deployment in the disc space. In a first configuration the axes of the first and second interconnected elongated articulating portions are substantially axially aligned with each other and in a second configuration the axes of the portions are axially unaligned with each other. The first and second interconnected elongated articulating portions are configured to be deployed in situ from the first configuration to the second configuration by both pivoting. The implant is expandable in the height direction between the vertebral contacting outer surfaces while the implant is inside the disc space by sliding a portion of at least one of the first and second elongated articulating portions.
An intervertebral spacer is designed particularly for patients who are not candidates for total disc replacement. The intervertebral spacer maintains disc height and prevents subsidence with a large vertebral body contacting surface area while substantially reducing recovery time by eliminating the need for bridging bone. The intervertebral spacer or fusion spacer includes a rigid spacer body sized and shaped to fit within an intervertebral space between two vertebral bodies. In one embodiment, the intervertebral spacer body has two opposed metallic vertebral contacting surfaces, at least one fin extending from each of the vertebral contacting surfaces and configured to be positioned within slots cut into the two vertebral bodies. Holes within the vertebral body contacting surfaces to provide increased bone on growth surfaces and to prevent subsidence.
The disclosure provides an intervertebral disc and related methods. An upper plate includes an upper vertebra contacting portion and a lower bearing surface portion. The upper vertebra contacting portion includes a convex central portion, and a fin or anchoring element with a transverse hole therethrough. A lower plate has a lower vertebra contacting surface and an upper bearing surface. The lower vertebra contacting surface of the lower plate has a convex central portion. The upper bearing surface has a concavity disposed opposite the convex central portion and wherein the convex central portion and the concavity have nesting curvatures. A core positioned between the upper and lower plates has rigid upper and lower convex surfaces configured to slide and translate over the bearing surfaces of the upper and lower plates.
Surgical instruments, systems and methods are described for selecting a size and cutting bone for inserting of an intervertebral disc prosthesis. The surgical instrument includes a combined intervertebral disc prosthesis sizing trial and a slot or channel cutter which is movable with respect to the sizing trial.
An intervertebral prosthesis for insertion between adjacent vertebrae includes an upper plate, a lower plate and a core. The core is retained between the upper and lower plates by a retention feature in the form of central projections on the plates and a corresponding opening in the core. The retention feature is designed to allow the plates to slide over the upper and lower surfaces of the core in the anterior/posterior direction and in the lateral direction and to allow the plates to rotate with respect to each other and the core. The retention feature is also designed to prevent contact between the first and second plates during sliding movement of the plates over the core. Each central projection has a diameter that is smaller than a smallest diameter of a central opening of the core.
A dynamic intervertebral spacer includes a ring which is split on an anterior portion. A posterior portion of the ring acts as a torsion spring. After implantation, the ring is able to act as a spring between superior and inferior vertebral bodies, thus allowing dynamic bone growth in fusion procedures.
Embodiments of the disclosure provide systems and methods of removing a core from an intervertebral prosthetic disc. The method may include: securing a multipart prosthetic disc to a distal end of a removal instrument by grasping at least a portion of the multipart prosthetic disc between a pair of core removal arms on the placement instrument; inserting the pair of core removal arms between two prosthetic disc plates of the intervertebral prosthetic disc to distract the plates away from one another; and removing the core from the intervertebral prosthetic disc with the removal instrument. The removal instrument may include: an inner shaft connected to the pair of core removal arms; and an outer shaft movable with respect to the inner shaft and including an activation mechanism for causing the arms to grasp the core for removal.
Various implementations include intervertebral discs and associated methods of use and imaging. One implementation includes an intervertebral disc capable of imaging under MRI, the disc including: an upper plate including a polyaryletherketone (PAEK) portion having a lower bearing surface and an upper vertebra contacting surface, the upper surface formed at least in part from a metal for improved bone attachment; a lower plate including a PAEK portion having an upper bearing surface and a lower vertebra contacting surface, the lower surface formed at least in part from a metal for improved bone attachment; and a ceramic core to mate and articulate with respect to the bearing surfaces of the upper and lower plates, wherein upon imaging under X-ray the PAEK portion of the upper and lower plates are substantially completely invisible and the upper and lower vertebral contacting surfaces of the upper and lower plates are substantially completely visible.
An intervertebral disc includes a superior endplate having an upper vertebral contacting surface and a lower bearing surface, wherein the upper vertebral contacting surface of the superior endplate has a central portion that is raised relative to a peripheral portion of the superior endplate, and wherein the lower bearing surface has a concavity disposed opposite the raised central portion. The disc includes an inferior endplate having a lower vertebral contacting surface and an upper surface, wherein the lower vertebral contacting surface of the inferior endplate has a central portion and wherein the upper bearing surface has a concavity disposed opposite the central portion. A core is positioned between the upper and inferior endplates, the core having upper and lower core bearing surfaces configured to mate with the bearing surfaces of the upper and inferior endplates. The upper vertebral contacting surface of the superior end plate has a different shape than the lower vertebral contacting surface of the inferior end plate.
An intervertebral prosthetic disc placement instrument is provided for implantation of an intervertebral prosthetic disc. The placement instrument shaft has a distal end and a proximal end and an instrument handle on the proximal end having an activation mechanism. A pair of grasping jaws on the distal end of the instrument shaft are configured to move with respect to one another to grasp a multipart prosthetic disc in a non-articulating configuration. The grasping jaws are movable from a tightened to a released position by the activation mechanism. A prosthetic disc ejector on the distal end of the instrument shaft moves distally with respect to the pair of grasping jaws when the grasping jaws are in the released position and the ejector is configured to contact the prosthetic disc to fully disengage the prosthetic disc from the placement instrument. An intervertebral prosthetic disc core removal instrument is also provided for use in distracting plates of the intervertebral disc away from one another to allow the core to be more easily removed.
A prosthetic intervertebral disc is formed of first and second end plates sized and shaped to fit within an intervertebral space and to be implanted from the back of the patient, thereby decreasing the invasiveness of the procedure. The posterior approach provides for a smaller posterior surgical incision and avoids important blood vessels located anterior to the spine particularly for lumbar disc replacements. The first and second plates are each formed of first, second and third parts are arranged in a first configuration in which the parts are axially aligned to form a low profile device appropriate for insertion through the small opening available in the TLIF or PLIF approaches described above. The three parts of both of the plates rotate and translate with respect to one another in situ to a second configuration or a deployed configuration in which the parts are axially unaligned with each other to provide a maximum coverage of the vertebral end plates for a minimum of insertion profile. Upon deployment of the disc, a height of the disc is increased.
An intervertebral disc is provided having an upper plate, a lower plate, and a core. The upper and lower plates include outer vertebral body contacting surfaces which are provided with attachment enhancing features to ensure bone integration. The attachment enhancing features shown include one or more fins, serrations and teeth. An opposite surface of the plates from the vertebral body contacting surfaces is formed with a recess which serves as a bearing surface for the core. In order to form an intervertebral disc with a lower disc height, at least one of the recesses is provided opposite a corresponding dome shaped portion on the vertebral body contacting surfaces. This allows the plates to be formed with a thinner profile for a smaller overall disc height. In addition to providing a lower overall height to the artificial disc, the dome shaped portion of the plates also provides a more anatomically shaped outer vertebral body contacting surface.
Systems and methods for robotically distracting a disc space are provided for implantation of an intervertebral prosthetic disc. The system includes a 3D modeling system for creating a 3D model of first and second vertebra adjacent the disc space and identifying positions of the first and second vertebrae. A robotic distractor precisely opens the disc space just large enough to receive a selected intervertebral disc. A computing system stores and processes the 3D model and the positions of the first and second vertebrae before and after distraction. A surgeon interface on the computing system allows the surgeon to select an intervertebral disc prosthesis to be implanted and a desired distraction distance or force to be achieved.
Systems and methods for robotically preparing a disc space are provided for implantation of an intervertebral prosthetic disc. The system includes three-dimensional modeling to identify positions of vertebrae adjacent a surgical site and a disc selection interface in a computing system to allow the surgeon to select an intervertebral disc prosthesis for implantation. A bone cutting interface allows the surgeon to determine a bone cutting pattern tailored to both the three- dimensional positions of the vertebrae and the selected intervertebral disc. A robot controls a cutting device or guides a cutting device to cut the vertebral bone in the bone cutting pattern.
Systems and methods are provided for robotically assisted disc prosthesis selection and implantation. The system includes a 3D modeling system for creating a 3D model of first and second vertebra adjacent the intended surgical site and identifying and storing data for the positions of the first and second vertebrae. A computing system for stores and processes the 3D model and the position data. A robot connected to the computing system attaches to a plurality of instruments including sizing templates, trials, cutters or placement instruments for intervertebral disc prostheses. An interface on the computing system allows the surgeon to sequentially deliver the plurality of instruments with the robot to a registration position to improve the speed and accuracy of the surgical procedure.
Systems and methods for robotically preparing a disc space are provided for implantation of an intervertebral prosthetic disc. The system includes three-dimensional modeling to identify positions of vertebrae adjacent a surgical site and a disc selection interface in a computing system to allow the surgeon to select an intervertebral disc prosthesis for implantation. A bone cutting interface allows the surgeon to determine a bone cutting pattern tailored to both the three-dimensional positions of the vertebrae and the selected intervertebral disc. A robot controls a cutting device or guides a cutting device to cut the vertebral bone in the bone cutting pattern.
Systems and methods for robotically distracting a disc space are provided for implantation of an intervertebral prosthetic disc. The system includes a 3D modeling system for creating a 3D model of first and second vertebra adjacent the disc space and identifying positions of the first and second vertebrae. A robotic distractor precisely opens the disc space just large enough to receive a selected intervertebral disc. A computing system stores and processes the 3D model and the positions of the first and second vertebrae before and after distraction. A surgeon interface on the computing system allows the surgeon to select an intervertebral disc prosthesis to be implanted and a desired distraction distance or force to be achieved.
A61B 17/58 - Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or the like
A61B 17/60 - Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or the like for external osteosynthesis, e.g. distractors or contractors
A61F 2/00 - 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
A61F 2/46 - Special tools for implanting artificial joints
A61B 34/10 - Computer-aided planning, simulation or modelling of surgical operations
A prosthetic disc for insertion between adjacent vertebrae includes upper and lower plates, a core disposed between the plates, and at least one projection extending from at least one of the upper and lower curved surfaces of the core into at least one recess of one of the inner surfaces of the plates. The recess is oversize with respect to the projection to allow sliding movement of the plate over the core while retaining the core between the plates during such sliding movement. The projection(s) may include a rod extending through an axial hole in the core, multiple surface features of the core, or the like.
Spinal implants composed of artificial material; Surgical instruments for use in orthopedic and spinal surgery; Medical and surgical apparatus and instruments, namely, devices used in orthopedic surgery to position surgical instruments, implants and/or patients' limbs; Medical devices for spinal disc repair in the nature of spinal disc implants made from artificial substances; Medical devices, namely, spinal implants composed of artificial materials; Surgical, medical, dental and veterinary apparatus and instruments; Artificial limbs, eyes and teeth; Orthopedic articles; Suture materials; Therapeutic and assistive devices adapted for persons with disabilities; Massage apparatus; Apparatus, devices and articles for nursing infants; Sexual activity apparatus, devices and articles.
An intervertebral prosthesis for insertion between adjacent vertebrae includes an upper plate, a lower plate and a core. The core is retained between the upper and lower plates by a retention feature in the form of central projections on the plates and a corresponding opening in the core. The retention feature is designed to allow the plates to slide over the upper and lower surfaces of the core in the anterior/posterior direction and in the lateral direction and to allow the plates to rotate with respect to each other and the core. The retention feature is also designed to prevent contact between the first and second plates during sliding movement of the plates over the core.
An intervertebral disc includes a superior endplate having an upper vertebral contacting surface and a lower bearing surface, wherein the upper vertebral contacting surface of the superior endplate has a central portion that is raised relative to a peripheral portion of the superior endplate, and wherein the lower bearing surface has a concavity disposed opposite the raised central portion. The disc includes an inferior endplate having a lower vertebral contacting surface and an upper surface, wherein the lower vertebral contacting surface of the inferior endplate has a central portion and wherein the upper bearing surface has a concavity disposed opposite the central portion. A core is positioned between the upper and inferior endplates, the core having upper and lower core bearing surfaces configured to mate with the bearing surfaces of the upper and inferior endplates. The upper vertebral contacting surface of the superior endplate has a different shape than the lower vertebral contacting surface of the inferior endplate.
A prosthetic intervertebral disc is formed of first and second end plates sized and shaped to fit within an intervertebral space and to be implanted from the back of the patient, thereby decreasing the invasiveness of the procedure. The posterior approach provides for a smaller posterior surgical incision and avoids important blood vessels located anterior to the spine particularly for lumbar disc replacements. The first and second plates are each formed of first, second and third parts are arranged in a first configuration in which the parts are axially aligned to form a low profile device appropriate for insertion through the small opening available in the TLIF or PLIF approaches described above. The three parts of both of the plates rotate and translate with respect to one another in situ to a second configuration or a deployed configuration in which the parts are axially unaligned with each other to provide a maximum coverage of the vertebral end plates for a minimum of insertion profile. Upon deployment of the disc, a height of the disc is increased.
A vertebral body replacement includes first and second end plates, and a compliant connector section between the end plates having one or more helical cuts to provide limited compliance between the end plates. The compliant connector section can be provided in a separate spacer that fits between the end plates or directly in one or more of the end plates. The adjoining end plate surfaces, and/or adjoining surfaces of the spacer, include a rotational interlock to inhibit rotational motion between the surfaces and allow a modular stacking assembly of the vertebral body replacement to accommodate a wide range of patients.
An intervertebral prosthesis for insertion between adjacent vertebrae includes an upper plate, a lower plate and a core. The core is retained between the upper and lower plates by a retention feature in the form of central projections on the plates and a corresponding opening in the core. The retention feature is designed to allow the plates to slide over the upper and lower surfaces of the core in the anterior/posterior direction and in the lateral direction and to allow the plates to rotate with respect to each other and the core. The retention feature is also designed to prevent contact between the first and second plates during sliding movement of the plates over the core.
An intervertebral prosthesis for insertion between adjacent vertebrae includes an upper plate, a lower plate and a core. The core is retained between the upper and lower plates by a retention feature in the form of central projections on the plates and a corresponding opening in the core. The retention feature is designed to allow the plates to slide over the upper and lower surfaces of the core in the anterior/posterior direction and in the lateral direction and to allow the plates to rotate with respect to each other and the core. The retention feature is also designed to prevent contact between the first and second plates during sliding movement of the plates over the core.
A prosthetic disc for insertion between adjacent vertebrae includes a core having upper and lower curved surfaces and upper and lower plates. At least one of the curved surfaces of the core is metallic, and in some embodiments the entire core is metallic. Each plate has an outer surface which engages a vertebra and a metallic inner curved surface which is shaped to slide over one of the curved surfaces of the core. In some embodiments, the center of rotation of the core is free to move relative to the upper and lower metallic plates. In some embodiments, one or more channels extend across one or both of the curved surfaces of the core for allowing passage of bodily fluid to promote lubrication between the core and at least one of the plates.
A dynamic intervertebral spacer includes a ring which is split on an anterior portion. A posterior portion of the ring acts as a torsion spring. After implantation, the ring is able to act as a spring between superior and inferior vertebral bodies, thus allowing dynamic bone growth in fusion procedures.
An intervertebral prosthesis for insertion between adjacent vertebrae, in one embodiment, includes upper and lower prosthesis plates and a movable core. The prosthesis plates and optionally the core are formed of polyaryletherketone (PAEK) for improved imaging properties. A metallic insert is provided on each of the PAEK prosthesis plates providing a bone ongrowth surface.
A prosthesis system comprises plates that can be positioned against vertebrae and a selected resilient core that can be positioned between the plates to allow the plates to articulate. The selected resilient core can be chosen from a plurality of cores in response to patient characteristics, such as age and/or intervertebral mobility, such that the prosthesis implanted in the patient is tailored to the needs of the patient. The plurality of cores may comprise cores with different resiliencies, and one of the cores can be selected such that the upper and lower plates articulate with the desired shock absorbing resiliency and/or maximum angle of inclination when the one selected core is positioned between the plates.
A prosthesis system comprises plates that can be positioned against vertebrae and a selected resilient core that can be positioned between the plates to allow the plates to articulate. The selected resilient core can be chosen from a plurality of cores in response to patient characteristics, such as age and/or intervertebral mobility, such that the prosthesis implanted in the patient is tailored to the needs of the patient. The plurality of cores may comprise cores with different resiliencies, and one of the cores can be selected such that the upper and lower plates articulate with the desired shock absorbing resiliency and/or maximum angle of inclination when the one selected core is positioned between the plates.
A prosthetic disc for insertion between adjacent vertebrae includes a core having upper and lower curved surfaces, upper and lower plates, and peripheral restraining structure on at least one of the upper plate, the lower plate and the core. Each plate has an outer surface which engages a vertebra and an inner curved surface which slides over the curved surface of the core. The peripheral restraining structure serves to hold the core against a curved surface of at least one of the plates during sliding movement of the plates over the core.
An intervertebral disc is provided having an upper plate, a lower plate, and a core. The upper and lower plates include outer vertebral body contacting surfaces which are provided with attachment enhancing features to ensure bone integration. The attachment enhancing features shown include one or more fins, serrations and teeth. An opposite surface of the plates from the vertebral body contacting surfaces is formed with a recess which serves as a bearing surface for the core. In order to form an intervertebral disc with a lower disc height, at least one of the recesses is provided opposite a corresponding dome shaped portion on the vertebral body contacting surfaces. This allows the plates to be formed with a thinner profile for a smaller overall disc height. In addition to providing a lower overall height to the artificial disc, the dome shaped portion of the plates also provides a more anatomically shaped outer vertebral body contacting surface.
A method for inserting an intervertebral disc prosthesis into a space between two vertebrae involves inserting the prosthesis partway into the space under constraint to prevent endplates of the prosthesis from articulating, releasing the prosthesis from constraint, and inserting the unconstrained prosthesis farther into the space. In some embodiments, the method involves grasping the prosthesis with a grasping device to insert the prosthesis partway under constraint, loosing the grasping device to release the prosthesis from constraint, and pushing the prosthesis farther into the disc space using the grasping device and/or one or more separate pusher devices. A system includes a grasping device, at least one separate pushing device, and optionally a vertebral spreading device and/or a vertebral midline indicator device.
A prosthesis system comprises plates that can be positioned against vertebrae and a selected resilient core that can be positioned between the plates to allow the plates to articulate. The selected resilient core can be chosen from a plurality of cores in response to patient characteristics, such as age and/or intervertebral mobility, such that the prosthesis implanted in the patient is tailored to the needs of the patient. The plurality of cores may comprise cores with different resiliencies, and one of the cores can be selected such that the upper and lower plates articulate with the desired shock absorbing resiliency and/or maximum angle of inclination when the one selected core is positioned between the plates.
An intervertebral spacer is designed particularly for patients who are not candidates for total disc replacement. The spacer maintains disc height and prevents subsidence with a large vertebral body contacting surface area while substantially reducing recovery time by eliminating the need for bridging bone. The intervertebral spacer or fusion spacer includes a rigid spacer body sized and shaped to fit within an intervertebral space between two vertebral bodies. In one embodiment, the spacer body has two opposed metallic vertebral contacting surfaces, at least one fin extending from each of the vertebral contacting surfaces and configured to be positioned within slots cut into the two vertebral bodies. Holes, if present, cover less than 40 percent of the entire vertebral body contacting surfaces to provide increased bone ongrowth surfaces and to prevent subsidence.
A radiolucent intervertebral prosthesis is implanted in an environment that has been prepared in a manner which enhances radiopacity of the prosthesis and/or the environment. A liquid, powder, or other fluid radiopaque (RO) material, such as iohexol, is introduced into an implantation site, either by directly introducing the material into the site and/or by applying the material to a surface of the implant. The presence of the RO material in the implantation site provides contrast with the material of radiolucent prosthesis while the implantation site is being radiographically imaged, e.g. during fluoroscopic visualization while the prosthesis is being implanted. During implantation, the RO material helps the physician view and manipulate the implant, and after the implantation is complete, the RO material will be resorbed or otherwise lost from the implantation site so that the area returns to a radiolucent condition to facilitate subsequent radiographic imaging when needed.
An intervertebral disc is provided having an upper plate, a lower plate, and a core. The upper and lower plates include outer vertebral body contacting surfaces which are provided with attachment enhancing features to ensure bone integration. The attachment enhancing features shown include one or more fins, serrations and teeth. An opposite surface of the plates from the vertebral body contacting surfaces is formed with a recess which serves as a bearing surface for the core. In order to form an intervertebral disc with a lower disc height, at least one of the recesses is provided opposite a corresponding dome shaped portion on the vertebral body contacting surfaces. This allows the plates to be formed with a thinner profile for a smaller overall disc height. In addition to providing a lower overall height to the artificial disc, the dome shaped portion of the plates also provides a more anatomically shaped outer vertebral body contacting surface.
An intervertebral disc includes a superior endplate having an upper vertebral contacting surface and a lower bearing surface, wherein the upper vertebral contacting surface of the superior endplate has a central portion that is raised relative to a peripheral portion of the superior endplate, and wherein the lower bearing surface has a concavity disposed opposite the raised central portion. The disc includes an inferior endplate having a lower vertebral contacting surface and an upper surface, wherein the lower vertebral contacting surface of the inferior endplate has a central portion and wherein the upper bearing surface has a concavity disposed opposite the central portion. A core is positioned between the superior and inferior endplates, the core having upper and lower core bearing surfaces configured to mate with the bearing surfaces of the superior and inferior endplates. The upper vertebral contacting surface of the superior endplate has a different shape than the lower vertebral contacting surface of the inferior endplate.
A dynamic intervertebral spacer includes a ring which is split on an anterior portion. A posterior portion of the ring acts as a torsion spring. After implantation, the ring is able to act as a spring between superior and inferior vertebral bodies, thus allowing dynamic bone growth in fusion procedures.
A prosthetic disc for insertion between adjacent vertebrae includes upper and lower plates, a core disposed between the plates, and at least one projection extending from at least one of the upper and lower curved surfaces of the core into at least one recess of one of the inner surfaces of the plates. The recess is oversize with respect to the projection to allow sliding movement of the plate over the core while retaining the core between the plates during such sliding movement. The projection(s) may include a rod extending through an axial hole in the core, multiple surface features of the core, or the like.
A dynamic intervertebral spacer includes a ring which is split on an anterior portion. A posterior portion of the ring acts as a torsion spring. After implantation, the ring is able to act as a spring between superior and inferior vertebral bodies, thus allowing dynamic bone growth in fusion procedures.
A prosthetic intervertebral disc is formed of first and second end plates sized and shaped to fit within an intervertebral space and to be implanted from the back of the patient, thereby decreasing the invasiveness of the procedure. The posterior approach provides for a smaller posterior surgical incision and avoids important blood vessels located anterior to the spine particularly for lumbar disc replacements. The first and second plates are each formed of first, second and third parts are arranged in a first configuration in which the parts are axially aligned to form a low profile device appropriate for insertion through the small opening available in the TLIF or PLIF approaches described above. The three parts of both of the plates rotate and translate with respect to one another in situ to a second configuration or a deployed configuration in which the parts are axially unaligned with each other to provide a maximum coverage of the vertebral end plates for a minimum of insertion profile. Upon deployment of the disc, a height of the disc is increased.
An intervertebral disc includes a superior endplate having an upper vertebral contacting surface and a lower bearing surface, wherein the upper vertebral contacting surface of the superior endplate has a central portion that is raised relative to a peripheral portion of the superior endplate, and wherein the lower bearing surface has a concavity disposed opposite the raised central portion. The disc includes an inferior endplate having a lower vertebral contacting surface and an upper surface, wherein the lower vertebral contacting surface of the inferior endplate has a central portion and wherein the upper bearing surface has a concavity disposed opposite the central portion. A core is positioned between the upper and inferior endplates, the core having upper and lower core bearing surfaces configured to mate with the bearing surfaces of the upper and inferior endplates. The upper vertebral contacting surface of the superior endplate has a different shape than the lower vertebral contacting surface of the inferior endplate.
A prosthetic disc for insertion between adjacent vertebrae includes upper and lower plates, a core disposed between the plates, and at least one projection extending from at least one of the upper and lower curved surfaces of the core into at least one recess of one of the inner surfaces of the plates. The recess is oversize with respect to the projection to allow sliding movement of the plate over the core while retaining the core between the plates during such sliding movement. The projection(s) may include a rod extending through an axial hole in the core, multiple surface features of the core, or the like.
An intervertebral disc is provided having an upper plate, a lower plate, and a core. The upper and lower plates include outer vertebral body contacting surfaces which are provided with attachment enhancing features to ensure bone integration. The attachment enhancing features shown include one or more fins, serrations and teeth. An opposite surface of the plates from the vertebral body contacting surfaces is formed with a recess which serves as a bearing surface for the core. In order to form an intervertebral disc with a lower disc height, at least one of the recesses is provided opposite a corresponding dome shaped portion on the vertebral body contacting surfaces. This allows the plates to be formed with a thinner profile for a smaller overall disc height. In addition to providing a lower overall height to the artificial disc, the dome shaped portion of the plates also provides a more anatomically shaped outer vertebral body contacting surface.
41 - Education, entertainment, sporting and cultural services
Goods & Services
Medical and surgical apparatus and instruments, namely, orthopedic fixation device used in orthopedic transplant and/or implant surgery; Surgical implants comprising artificial material and associated surgical instrument sets; Vertebral orthopedic apparatus; Orthopedic articles. Advertising; Business management; Business administration; Office functions. Entertainment; Cultural activities.
54.
Customized intervertebral prosthetic disc with shock absorption
A prosthesis system comprises plates that can be positioned against vertebrae and a selected resilient core that can be positioned between the plates to allow the plates to articulate. The selected resilient core can be chosen from a plurality of cores in response to patient characteristics, such as age and/or intervertebral mobility, such that the prosthesis implanted in the patient is tailored to the needs of the patient. The plurality of cores may comprise cores with different resiliencies, and one of the cores can be selected such that the upper and lower plates articulate with the desired shock absorbing resiliency and/or maximum angle of inclination when the one selected core is positioned between the plates.
An intervertebral disc includes a superior endplate having an upper vertebral contacting surface and a lower bearing surface, wherein the upper vertebral contacting surface of the superior endplate has a central portion that is raised relative to a peripheral portion of the superior endplate, and wherein the lower bearing surface has a concavity disposed opposite the raised central portion. The disc includes an inferior endplate having a lower vertebral contacting surface and an upper surface, wherein the lower vertebral contacting surface of the inferior endplate has a central portion and wherein the upper bearing surface has a concavity disposed opposite the central portion. A core is positioned between the upper and inferior endplates, the core having upper and lower core bearing surfaces configured to mate with the bearing surfaces of the upper and inferior endplates. The upper vertebral contacting surface of the superior endplate has a different shape than the lower vertebral contacting surface of the inferior endplate.
41 - Education, entertainment, sporting and cultural services
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Surgical, medical, dental and veterinary apparatus and instruments, artificial limbs, eyes and teeth; Orthopedic articles; Suture materials; Surgical and medical apparatus and instruments for use in orthopedic and spinal surgery; Surgical and medical apparatus and instruments, namely, orthopedic fixation devices used in orthopedic transplant and/or implant surgery; Spinal medical implants composed of artificial materials, prosthetic spinal discs, replacement spinal discs, and parts for all the aforesaid goods; Orthopedic and neurosurgical implants and prostheses; Surgical devices, namely, disc distractors, slot cutters, disc inserters, disc spreaders, disc impactors, disc retrievers, and disc sizers. Promoting public awareness of advancements in spinal and orthopedic surgery; Advertising; Business management; Business administration; Office functions. Education; Providing of training; Educational services in the field of medical devices; Educational services in the field of spinal and orthopedic surgery; Educational services, namely, conducting training, seminars, and workshops regarding spinal and orthopedic surgery and on the use of medical devices for treatment of the spine; Entertainment; Sporting and cultural activities.
An intervertebral disc placement system includes a multi part intervertebral disc, such as a mobile core disc, and an associated placement instrument. The placement instrument holds the disc securely with the disc endplates angled for ease of placement of the disc into an intervertebral disc space and quickly releases the implant within the disc space. The disc includes upper and lower plates having notches in inner surfaces for engagement of the placement instrument. The placement instrument has a rotatable key configured to fit into the first and second notches to grasp the disc from the interior and eliminate the need for an external grasping mechanism which could interfere with disc placement.
A prosthetic disc for insertion between adjacent vertebrae includes a core having upper and lower curved surfaces and upper and lower plates. At least one of the curved surfaces of the core is metallic, and in some embodiments the entire core is metallic. Each plate has an outer surface which engages a vertebra and a metallic inner curved surface which is shaped to slide over one of the curved surfaces of the core. In some embodiments, the center of rotation of the core is free to move relative to the upper and lower metallic plates. In some embodiments, one or more channels extend across one or both of the curved surfaces of the core for allowing passage of bodily fluid to promote lubrication between the core and at least one of the plates.
A prosthetic disc for insertion between adjacent vertebrae includes upper and lower plates and a core having upper and lower curved surfaces disposed between the plates. At least one of the plates and/or the core includes a resilient material for absorbing shock or other forces applied by vertebrae. Optionally, resilient support members may be disposed within the resilient material to connect two portions of a plate or the core. Such support members may be springs, cylinders, wires or other resilient structures. The resilient material is held within the core or plate(s) via a surrounding retaining structure, such as a membrane. The resilient material disposed in one or more components of the prosthetic disc provides for shock absorption.
A prosthetic disc for insertion between adjacent vertebrae includes upper and lower plates, a core disposed between the plates, and at least one projection extending from at least one of the upper and lower curved surfaces of the core into at least one recess of one of the inner surfaces of the plates. The recess is oversize with respect to the projection to allow sliding movement of the plate over the core while retaining the core between the plates during such sliding movement. The projection(s) may include a rod extending through an axial hole in the core, multiple surface features of the core, or the like.
A prosthesis system comprises plates that can be positioned against vertebrae and a selected resilient core that can be positioned between the plates to allow the plates to articulate. The selected resilient core can be chosen from a plurality of cores in response to patient characteristics, such as age and/or intervertebral mobility, such that the prosthesis implanted in the patient is tailored to the needs of the patient. The plurality of cores may comprise cores with different resiliencies, and one of the cores can be selected such that the upper and lower plates articulate with the desired shock absorbing resiliency and/or maximum angle of inclination when the one selected core is positioned between the plates.
An intervertebral prosthesis for insertion between adjacent vertebrae, in one embodiment, includes upper and lower prosthesis plates and a movable core. The prosthesis plates and optionally the core are formed of polyaryletherketone (PAEK) for improved imaging properties. A metallic insert is provided on each of the PAEK prosthesis plates providing a bone ongrowth surface.
An intervertebral joint assembly includes an upper support and a lower support, each of which has two or more components. The upper and lower support components are arranged in situ to form the upper and lower supports, respectively. By arranging the supports in situ, the supports can be introduced from the back of the patient, for example with an arthroscope. Each of the upper and lower supports has a surface adapted to engage a vertebra and a surface adapted to engage the other support or an intermediate member to form an articulate joint which articulates the joint assembly. In some embodiments, the components of the upper and lower supports are assembled in situ, for example with pivoting, telescoping or bending, to form the upper and lower supports, respectively. The supports can be attached to vertebrae with pedicles screws, and/or other anchors attached to the supports.
A spacer for an artificial spinal disc arrangement is provided. The artificial disc arrangement includes an upper plate, a lower plate, and articulating surfaces between the upper and lower plates arranged to permit motion between the upper and lower plates. The spacer has a first surface for contacting the upper plate and a second surface for contacting the lower plate and is of sufficient thickness such that, when disposed between the upper and lower plates, the spacer limits motion between the upper and lower plates. An artificial disc, a method of limiting motion of an artificial disc in a patient, and a method of performing spinal disc surgery are also disclosed.
A prosthetic disc for insertion between adjacent vertebrae includes a core having upper and lower curved surfaces, upper and lower plates, and peripheral restraining structure on at least one of the upper plate, the lower plate and the core. Each plate has an outer surface which engages a vertebra and an inner curved surface which slides over the curved surface of the core. The peripheral restraining structure serves to hold the core against a curved surface of at least one of the plates during sliding movement of the plates over the core.
An intervertebral disc placement system includes a multi part intervertebral disc, such as a mobile core disc, and an associated placement instrument. The placement instrument holds the disc securely with the disc endplates angled for ease of placement of the disc into an intervertebral disc space and quickly releases the implant within the disc space. The disc includes upper and lower plates having notches in inner surfaces for engagement of the placement instrument. The placement instrument has a rotatable key configured to fit into the first and second notches to grasp the disc from the interior and eliminate the need for an external grasping mechanism which could interfere with disc placement.
A prosthetic intervertebral disc is formed of first and second end plates sized and shaped to fit within an intervertebral space and to be implanted from the back of the patient, thereby decreasing the invasiveness of the procedure. The posterior approach provides for a smaller posterior surgical incision and avoids important blood vessels located anterior to the spine particularly for lumbar disc replacements. The first and second plates are each formed of first, second and third parts are arranged in a first configuration in which the parts are axially aligned to form a low profile device appropriate for insertion through the small opening available in the TLIF or PLIF approaches described above. The three parts of both of the plates rotate and translate with respect to one another in situ to a second configuration or a deployed configuration in which the parts are axially unaligned with each other to provide a maximum coverage of the vertebral end plates for a minimum of insertion profile. Upon deployment of the disc, a height of the disc is increased.
A prosthetic intervertebral disc includes an upper plate and a lower plate and employs congruent stepped features to provide limited articulating motion between the plates. The stepped features can be used to provide articulating motion of a rocking type rather than a rubbing or translating type of motion provided in many artificial discs. Each of two parts of the intervertebral disc includes two or more stepped bearing surfaces, having curved or flat shapes, which mate with one another to provide the articulation to the disc. The stepped features can be designed to restrict motion in flexion-extension or lateral bending to less than a predetermined angle. The stepped design can be modified to either allow or prevent rotational motion between the plates. The limited motion disc substantially prevents translation, however some limited translation can be provided by modification of the relative sizes of the stepped features.
An intervertebral disc is provided having an upper plate, a lower plate, and a core. The upper and lower plates include outer vertebral body contacting surfaces which are provided with attachment enhancing features to ensure bone integration. The attachment enhancing features shown include one or more fins, serrations and teeth. An opposite surface of the plates from the vertebral body contacting surfaces is formed with a recess which serves as a bearing surface for the core. In order to form an intervertebral disc with a lower disc height, at least one of the recesses is provided opposite a corresponding dome shaped portion on the vertebral body contacting surfaces. This allows the plates to be formed with a thinner profile for a smaller overall disc height. In addition to providing a lower overall height to the artificial disc, the dome shaped portion of the plates also provides a more anatomically shaped outer vertebral body contacting surface.
A prosthetic disc for insertion between adjacent vertebrae includes upper and lower plates, a core disposed between the plates, and at least one projection extending from at least one of the upper and lower curved surfaces of the core into at least one recess of one of the inner surfaces of the plates. The recess is oversize with respect to the projection to allow sliding movement of the plate over the core while retaining the core between the plates during such sliding movement. The projection(s) may include a rod extending through an axial hole in the core, multiple surface features of the core, or the like.
Medical and surgical apparatus and instruments, including orthopedic fixation device used in orthopedic transplant and/or implant surgery; vertebral orthopedic apparatus; surgical implants comprising artificial material and associated surgical instrument sets.
72.
Methods and apparatus for intervertebral disc prosthesis insertion
A method for inserting an intervertebral disc prosthesis into a space between two vertebrae involves inserting the prosthesis partway into the space under constraint to prevent endplates of the prosthesis from articulating, releasing the prosthesis from constraint, and inserting the unconstrained prosthesis farther into the space. In some embodiments, the method involves grasping the prosthesis with a grasping device to insert the prosthesis partway under constraint, loosing the grasping device to release the prosthesis from constraint, and pushing the prosthesis farther into the disc space using the grasping device and/or one or more separate pusher devices. A system includes a grasping device, at least one separate pushing device, and optionally a vertebral spreading device and/or a vertebral midline indicator device.
An intervertebral joint assembly includes an upper support and a lower support, each of which has two or more components. The upper and lower support components are arranged in situ to form the upper and lower supports, respectively. By arranging the supports in situ, the supports can be introduced from the back of the patient, for example with an arthroscope. Each of the upper and lower supports has a surface adapted to engage a vertebra and a surface adapted to engage the other support or an intermediate member to form an articulate joint which articulates the joint assembly. In some embodiments, the components of the upper and lower supports are assembled in situ, for example with pivoting, telescoping or bending, to form the upper and lower supports, respectively. The supports can be attached to vertebrae with pedicles screws, and/or other anchors attached to the supports.
An intervertebral joint assembly includes an upper support and a lower support, each of which has two or more components. The upper and lower support components are arranged in situ to form the upper and lower supports, respectively. By arranging the supports in situ, the supports can be introduced from the back of the patient, for example with an arthroscope. Each of the upper and lower supports has a surface adapted to engage a vertebra and a surface adapted to engage the other support or an intermediate member to form an articulate joint which articulates the joint assembly. In some embodiments, the components of the upper and lower supports are assembled in situ, for example with pivoting, telescoping or bending, to form the upper and lower supports, respectively. The supports can be attached to vertebrae with pedicles screws, and/or other anchors attached to the supports.
A prosthetic disc for insertion between adjacent vertebrae includes upper and lower plates and a core having upper and lower curved surfaces disposed between the plates. At least one of the plates and/or the core includes a resilient material for absorbing shock or other forces applied by vertebrae. Optionally, resilient support members may be disposed within the resilient material to connect two portions of a plate or the core. Such support members may be springs, cylinders, wires or other resilient structures. The resilient material is held within the core or plate(s) via a surrounding retaining structure, such as a membrane. The resilient material disposed in one or more components of the prosthetic disc provides for shock absorption.
A method for inserting an intervertebral disc prosthesis into a space between two vertebrae involves inserting the prosthesis partway into the space under constraint to prevent endplates of the prosthesis from articulating, releasing the prosthesis from constraint, and inserting the unconstrained prosthesis farther into the space. In some embodiments, the method involves grasping the prosthesis with a grasping device to insert the prosthesis partway under constraint, loosing the grasping device to release the prosthesis from constraint, and pushing the prosthesis farther into the disc space using the grasping device and/or one or more separate pusher devices. A system includes a grasping device, at least one separate pushing device, and optionally a vertebral spreading device and/or a vertebral midline indicator device.
The invention concerns an intervertebral prosthesis placement instrument which can be used to facilitate accurate positioning of a spinal disc prosthesis between adjacent spinal vertebrae. The instrument (10) has opposed jaws 12 formed with tips (24) that are shaped for insertion between the vertebrae. The jaws can be moved apart from one another to distract the vertebrae, allowing the prosthesis to enter between the vertebrae. The jaws also have opposed surfaces which are shaped to embrace the prosthesis between them and to guide the prosthesis into position.
A61B 17/58 - Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or the like
A61B 17/60 - Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or the like for external osteosynthesis, e.g. distractors or contractors
A61F 2/00 - 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
A61B 1/32 - Devices for opening or enlarging the visual field, e.g. of a tube of the body
A prosthetic disc for insertion between adjacent vertebrae includes a core having upper and lower curved surfaces and upper and lower plates. At least one of the curved surfaces of the core is metallic, and in some embodiments the entire core is metallic. Each plate has an outer surface which engages a vertebra and a metallic inner curved surface which is shaped to slide over one of the curved surfaces of the core. In some embodiments, the center of rotation of the core is free to move relative to the upper and lower metallic plates. In some embodiments, one or more channels extend across one or both of the curved surfaces of the core for allowing passage of bodily fluid to promote lubrication between the core and at least one of the plates.
A prosthetic disc for insertion between adjacent vertebrae includes upper and lower plates, a core disposed between the plates, and at least one projection extending from at least one of the upper and lower curved surfaces of the core into at least one recess of one of the inner surfaces of the plates. The recess is oversize with respect to the projection to allow sliding movement of the plate over the core while retaining the core between the plates during such sliding movement. The projection(s) may include a rod extending through an axial hole in the core, multiple surface features of the core, or the like.
A prosthetic disc for insertion between adjacent vertebrae includes a core having upper and lower curved surfaces, upper and lower plates, and peripheral restraining structure on at least one of the upper plate, the lower plate and the core. Each plate has an outer surface which engages a vertebra and an inner curved surface which slides over the curved surface of the core. The peripheral restraining structure serves to hold the core against a curved surface of at least one of the plates during sliding movement of the plates over the core.
