WO1999047083A1 - Intervertebral implant with reduced contact area and method - Google Patents
Intervertebral implant with reduced contact area and method Download PDFInfo
- Publication number
- WO1999047083A1 WO1999047083A1 PCT/US1999/005895 US9905895W WO9947083A1 WO 1999047083 A1 WO1999047083 A1 WO 1999047083A1 US 9905895 W US9905895 W US 9905895W WO 9947083 A1 WO9947083 A1 WO 9947083A1
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- WO
- WIPO (PCT)
- Prior art keywords
- implant
- implant according
- opposing
- bearing surfaces
- support member
- 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
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- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
- A61F2/447—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section
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- A61F2/446—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 having a circular or elliptical cross-section substantially parallel to the axis of the spine, e.g. cylinders or frustocones
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- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0028—Shapes in the form of latin or greek characters
- A61F2230/0058—X-shaped
-
- 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0063—Three-dimensional shapes
- A61F2230/0069—Three-dimensional shapes cylindrical
-
- 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
- A61F2310/00017—Iron- or Fe-based alloys, e.g. stainless steel
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00005—The prosthesis being constructed from a particular material
- A61F2310/00011—Metals or alloys
- A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys
Definitions
- This invention pertains to procedures for intervertebral stabilization.
- the disclosure provides implants, instrumentation and methods to facilitate stabilization or fusion between two vertebrae.
- Surgical techniques have been developed to remove the diseased disk material and fuse the joint between opposing vertebral bodies. Stabilization and/or arthrodesis of the intervertebral joint can reduce the pain associated with movement of an intervertebral joint having diseased disk material.
- fusion techniques involve removal of the diseased disk and packing the void area with a suitable matrix for facilitating a bony union between the opposing vertebral bodies.
- Surgical devices for facilitating interbody fusion have also been developed. These devices typically provide for maintaining appropriate intervertebral spacing and stabilization of the vertebrae during the fusion process. Generally, these devices are referred to as cages. Examples of such devices are disclosed in, for example, U.S. Patent Nos. 5,458,638, 5,489,307, 5,055,104, 5,026,373, 5,015,247, 4,961,740, 4,743,256 and 4,501,269, the entire disclosures of which are incorporated herein by reference.
- the fusion device is implanted within a site prepared between opposing vertebrae.
- the site is a bore formed in the disk material and extends through the cortical end plates and into the cancellous bone of the opposing vertebrae.
- Many of the present fusion devices have a chamber enclosed by a cylindrical or rectangular wall that substantially contacts the entire interior surface of the bore. After placement of the device into the bore, the enclosed chamber (interior of the cage) can be filled with bone chips or other suitable material for facilitating bony union between the vertebrae.
- Most of the present fusion devices provide vertebral stabilization during the fusion process by contact of the entire outer wall of the fusion device with substantially the entire interior surface of the wall of the insertion bore. While support provided by contact of the device with the entire wall of the bore provides 2
- the present invention is directed to addressing these needs.
- the invention is directed to procedures for intervertebral stabilization of opposing vertebrae.
- the disclosure provides implants, instruments and methods for stabilization or fusion of opposing vertebrae.
- An implant according to the invention includes an implant body having a first and second end spaced apart by a longitudinal axis of the implant.
- the implant body includes a first transverse member and a second transverse member maintained in spaced apart relationship by a central support member.
- the transverse members each include a bearing surface oriented to contact opposing vertebral surfaces.
- the bearing surfaces of the implant can be linear, curved or other suitable configuration.
- the bearing surfaces can include a pattern for anchoring the implant and/or resisting displacement once the implant is inserted between opposing vertebrae.
- An implant of the invention provides a reduced displacement volume relative to the insertion bore necessary to accommodate the implant.
- support member or transverse members can also include openings which further reduce the displacement volume of the implants.
- the reduced displacement volume of the implant facilitates assessment of the fusion process using known imaging modalities.
- FIG. 1 is a perspective view of an implant embodiment of the invention having a first and second curved bearing surfaces;
- FIG. 2 is a side elevation view of the implant of FIG. 1 (the opposite side being identical in appearance);
- FIG. 3 is a top plan view of a first transverse member of the implant of FIG. 1 (the top view of the second transverse member view being identical in appearance);
- FIG. 4 is an elevation view of a trailing end of the implant of FIG 1 ;
- FIG. 5 is an elevation view of a leading end of the implant of FIG. 1;
- FIG. 6 is a perspective view of a second embodiment of an implant according to the invention.
- FIG. 7 is a top plan view of a first transverse member of the implant of FIG. 6 (the top view of the second transverse member being identical in appearance);
- FIG. 8 is a perspective view of a third embodiment of an implant according to the invention.
- FIG. 9 is a side elevation view of an embodiment of a tapered implant according to the invention (the opposite side being identical in appearance);
- FIG. 10 is a top plan view of the implant of FIG. 9 taken 90° from the view of FIG. 9 (the opposite side being identical in appearance);
- FIG. 11 is a side elevation view of an implant according to the invention illustrating a first and second taper (the opposite side being identical in appearance);
- FIG. 12 is a top plan view of the implant of FIG. 11 taken 90° from the view of FIG. 11 (the opposite side being identical in appearance);
- FIG. 13 is a side elevation view of another embodiment of an implant according to the invention having a first and second taper;
- FIG. 14 is an end view of two opposing vertebrae stretched apart and including two implants of FIGs. 1-5 disposed therebetween;
- FIG. 15 is a side elevation view of an insertion tool for use with an implant of invention. 4
- FIG. 16 is a side view of a distal end of the insertion tool of FIG. 15;
- FIG. 17 is perspective view of an implant of FIGs. 1-5 and the distal end of the insertion tool of FIG. 15;
- FIG. 18 is an end on view of the distal end of the insertion tool of FIG. 15 with an implant of FIGs. 1-5;.
- FIG. 19 is a side elevation view of an alternative embodiment of an insertion tool according to the invention.
- FIG. 20 is an end on view of an implant of FIGs. 1-5 loaded onto the distal end of the insertion tool of FIG. 19.
- the present invention is directed to intervertebral stabilization and arthrodesis procedures that can provide for greater structural integrity of the bony union between fused vertebral bodies of the vertebral column.
- the devices and methods disclosed herein facilitate greater continuity between the bone formed at the fusion site and the remainder of the vertebral body.
- the invention provides enhanced ability to assess new bone growth during the fusion process using typical diagnostic imaging modalities such as x-rays.
- An implant of the invention can be prepared from known implant materials including, for example, titanium, stainless steel, porous titanium, bone or other suitable material used to manufacture orthopedic implants. Unlike prior implants, the present implants have no surrounding sidewalls and no chamber.
- the disclosed implants support the axial load of the vertebral column by a "central support member” that separates opposing bearing surfaces of the implant.
- the "central support member” provides for stabilization of the vertebral bodies with a reduced area of contact between the exterior surface of the implant and the inside surface of a bore formed to accommodate the implant.
- the reduced contact area also reduces obstruction of assessment of the fusion process. Further reduction in obstruction of assessment of the fusion process can be provided by forming openings in the bearing surfaces and/or providing the central support member in the form of one or more columns having openings in between.
- the present implants have a reduced displacement volume relative to the cylindrical bore size necessary for insertion of the implant.
- the displacement volume of the implant takes up about 10% to 40% of the bore volume necessary to accommodate the implant between opposing vertebrae.
- the implant takes up about 24% or less of the bore volume 5
- the remaining 76% of the bore volume can be filled with bone or other suitable bone support matrix.
- the BAK implant U.S. Patent No. 5,489,308
- the Proximity implant U.S. Patent No. 5,609,636
- Sulzer Spine-Tech, Inc. takes up about 30% of the bore volume on a relative basis.
- the central support member is located between the bearing surfaces of the implant and typically does not extend to the lateral edges of the bearing surfaces.
- the term “central” includes an implant having a support member located away from the exact center of the bearing surfaces but providing the same function of a herein described centrally located support member.
- the “bearing surfaces” are the surfaces of the implant that directly contact the opposing vertebral bodies.
- the “lateral edges” of the bearing surfaces are the lateral most aspects of the bearing surfaces.
- the implants also have a leading end and trailing end that are spaced apart along the longitudinal axis of the implant.
- a transverse cross section taken through the longitudinal axis of the present implants has a substantially “I” shaped configuration.
- the "central support member” forms the vertical arm of the "I” and the “transverse members” form the horizontal arms of the "I”.
- the central support member is typically oriented parallel to the longitudinal axis of the vertebral column and the transverse members are oriented perpendicular.
- Each transverse member has a peripheral surface that is in direct contact with one of the opposing vertebral bodies.
- the transverse members also have an inner surface that is continuous with the lateral aspect of the central support member.
- a "channel" is present on either side of the central support member within the inner surface of the transverse member.
- the channel extends through the leading and trailing ends of the implant and opens laterally between opposing transverse members. As discussed below, after insertion of the implant between opposing vertebrae, the channel can be filled with a bone support matrix to facilitate new bone growth.
- the bearing surfaces are curved to provide an external surface configured for insertion of the implant into a circular bore formed between opposing vertebrae.
- the opposing bearing surfaces can be parallel to one another along the longitudinal dimension of the implant from the trailing end to leading end.
- the implant can include a single or double taper including at least a first taper diverging from the longitudinal axis of the implant from the leading end to the trailing end.
- curved bearing surfaces can include a pattern for anchoring the implant between opposing vertebrae.
- the pattern can be, for example, knurls or other intermittently raised surface.
- the pattern can be a portion of a helical thread pattern which resists displacement of the implant from an insertion bore and also provides for threaded insertion of the implant into the bore.
- the bearing surfaces can be substantially linear.
- at least one of the bearing surfaces includes a pattern for anchoring the implant and reducing the chance of displacement of the implant from of the insertion bore.
- the invention also provides a kit comprising a plurality of incrementally sized implants which can be selected by the clinician based on the size needed for a particular patient.
- kits are provided which include instrumentation for performing an implant procedure with or without a plurality of incrementally sized implants. Instruments and methods suitable for insertion of an implant of the invention are disclosed in, for example, U.S. Patent Nos. 5,489,308 and 5,458,638, and co-pending application U.S. Ser. Nos. 08/902,083 and 08/921,001, the entire disclosures of which are incorporated herein by reference. Additional instruments particularly advantageous for the implants disclosed herein are described in detail below.
- a "bone support matrix” is a material that facilitates new bone growth between the opposing vertebral bodies.
- Suitable bone support matrices can be resorbable or nonresorbable and osteoconductive or osteoinductive.
- suitable matrices according to the invention include synthetic materials, such as HealousTM, available from Orquest, Mountain View, California; NeOsteoTM, available from Sulzer Orthopedic Biologies, Denver, Colorado; or any of a variety of bone morphogenic proteins (BMPs).
- Suitable bone support matrices also include heterologous, homologous, or autologous bone and derivatives thereof.
- the bone support matrix is radiolucent on x-rays.
- the bone support matrix can be packed into the bore after insertion of the implant between the vertebral bodies.
- a bone support matrix can be configured to fit into the longitudinal channels on either side of the central support member before or after installation of the implant into the site of implantation.
- the external surface of the bone support matrix can include a portion of a helical thread. According to this embodiment, when used with an implant having a portion of helical threads on a bearing surface, the helical 7
- threads of the bone matrix can be complimentary to the helical threads on the implant such that when placed into the channel a complete helical thread pattern is formed for threadedly inserting the implant into the prepared site.
- FIGs. 1 -5 illustrate a first embodiment of an implant of the invention having a first transverse member 1 and a second transverse member 2 spaced apart by a central support member 3.
- each transverse member When inserted between opposing vertebrae, each transverse member is oriented transverse to the longitudinal axis of the vertebral column and the central support member is oriented parallel to the longitudinal axis of the vertebral column.
- the transverse members can also be referred to as a "cranial transverse member” and a “caudal transverse member” to indicate that when inserted between opposing vertebrae, one transverse member is oriented cranially and the other transverse member is oriented caudally.
- the first transverse member 1 has a first bearing surface 4 and the second transverse member 2 has a second bearing surface 5.
- the first bearing surface 4 and the second bearing surface 5 include a pattern 7 for anchoring the implant within an insertion bore.
- the illustrated pattern 7 is a portion of a helical thread 7a which provides for threadedly inserting implant 10 into a bore prepared between opposing vertebrae.
- the helical thread 7a is generally rectangular in profile. However, a thread pattern having sharp surfaces or a combination of rectangular and sharp threads can be used. In addition, other surface patterns, such as knurls, could be provided on the bearing surface and the device implanted by impact into a bore.
- the illustrated central support member 3 comprises a plurality of columns 8a-8d with openings 9a-9c therebetween.
- Columns 8a-8d of central support member 3 maintain transverse members 1 and 2 in a fixed spatial relationship and provide rigid support and stabilization of opposing vertebral bodies which contact bearing surfaces 4 and 5. Openings 9a-9c between columns 8a-8d promote greater 8
- FIG. 3 illustrates a top view of the bearing surface 4 of the first transverse member 1. Rotation of the implant 180° would show the bearing surface 5 of the second transverse member 2 which is substantially identical in appearance.
- the bearing surface 4 (and 5) includes rigid transverse supports, or trusses,13a-13d having openings 12a- 12c therebetween. As illustrated, the portion of helical thread 7a can be continuous in the region of the transverse supports 13a-13d. In addition to facilitating greater structural integrity of the bony union, the openings 12a-12d also enhance the ability to assess new bone formation during the fusion process.
- FIG. 4 is an elevation view of the trailing end 20 of implant 10.
- the inner surfaces 21a, 21b of transverse member 1 oppose the inner surfaces 22a, 22b of transverse member 2.
- the inner surfaces of the transverse members are continuous with the lateral surfaces 23a, 23b of the central support member 3.
- Channel 24a is defined by surfaces 21a, 22a and 23 a
- channel 24b is defined by surfaces 21b, 22b and 23b.
- Channels 24a and 24b not only provide a large area for uninterrupted new bone growth around the implant, but they also provide an arrangement for attachment of an insertion tool described below.
- undercut segments 27a, 28a, 27b and 28b are undercut segments between each inner surface 21a, 22a, 21b and 22b and its respective lateral edge 25a, 26a, 25b and 26b of transverse members 1 and 2, there are undercut segments 27a, 28a, 27b and 28b.
- the angle A between undercut segments 27a and 28a and the angle B between undercut segments 27b and 28b can be different. As will be discussed below, asymmetry of angles A and B can provide for proper orientation of the helical threads 7a of implant 10 with complimentary threads of a below described insertion tool.
- FIG. 5 is an elevation view of the leading end 30 of the implant 10.
- trailing column 8d of central support member 3 includes lateral tabs 31a and 31b. Lateral tabs 31 a and 31b render the leading end distinguishable from the trailing end such that implant 10 can only be loaded onto a below described implant insertion tool in a certain orientation.
- the leading end 30 and trailing end 20 are spaced apart along the longitudinal axis X-X of implant 10 to provide a length L.
- the implant 10 can be provided with different lengths L between leading end 30 and trailing end 20 as well as different heights H between the bearing surfaces 4 and 5 of transverse members 1 and 2, respectively. Incrementally sized length and height 9
- implants 10 can be provided in a kit for selected use by the surgeon based on the particular patient's needs.
- the channels 24a, 24b and any other area of the bore not occupied by the implant can be filled with a bone support matrix.
- a bone support matrix 40 is illustrated.
- the bone support matrix 40 can be a resorbable matrix 41 configured to fit within channels 24a or 24b.
- the inner surface 42 of bone support matrix 40 can be shaped to follow the contours of channels 24a or 24b.
- the outer surface 43 of bone support matrix 40 can include a portion of helical threads 43 which are complimentary to portions of helical threads 7a of implant 10.
- the implant 10 can be threaded into a tapped insertion bore with bone support matrix 40 in place.
- a bone support matrix configured to follow the contours of channels 24a and 24b but without a threaded outer surface can be inserted into the channels 24a and 24b of the implant.
- the implant 100 includes four generally linear thread segments 101, 102, 103 and 104.
- Linear thread segments 101 and 103 provide a bearing surface 105 of a first transverse member 106 and linear thread segments 102 and 104 provide a bearing surface 107 of a second transverse member 108.
- thread segments 101 and 103 (and 102 and 104) are maintained in spaced apart alignment by transverse supports 109, 110 and 111.
- Transverse members 106 and 108 are maintained in spaced apart alignment by central support member 120.
- central support member 120 comprises columns 121, 122 and 123 and has openings 124 and 125 therebetween. It will be appreciated that the transverse members and central support member of an implant need not include any openings as described thus far.
- the central support member can include several fine thickness support columns with several fine openings interspersed therebetween giving a profile appearance similar to the tines of a comb.
- a similar arrangement can be provided for the transverse members rather than having the trusses and openings illustrated.
- Implant 200 has a more classic "I-beam" appearance in cross section. Similar to the 10
- first transverse member 201 and second transverse member 202 are maintained in spaced apart alignment by central support member 203.
- Transverse member 201 also includes transverse supports 204, 205 and 206 having openings 207-210 therebetween.
- Transverse member 202 has an identical arrangement of transverse supports and openings.
- central support member 203 comprises columns 211, 212, and 213 has openings 214-216 therebetween.
- Bearing surfaces 220 and 221 include a pattern 223 of intermittent raised edges 224 which reduce the chance of displacement of the implant 200 once inserted into a bore.
- a pattern such as intermittent raised surface 224 or other non-helical thread pattern can be present on the bearing surface.
- the implant can simply be impacted by driving it into the bore along the X-X axis of the implant.
- FIGs. 9 and 10 illustrate an implant 300 having a first taper diverging from longitudinal axis X-X from leading end 301 to trailing end 302.
- implant 300 has a substantially frusto-conical shape with a conical angle equal to a desired lordosis between the vertebrae into which the implant 300 is to be placed as fully described in co-pending application U.S. Serial No.
- angle ⁇ is 8°.
- implant 300 will be available in a wide variety of sizes.
- such implants may be provided having angles ranging from 1° to 20° in 1° increments to permit a physician to select a desired implant to attain a desired lordosis.
- such implants can be provided in varying heights (i.e., the diameter of the implants) to accommodate desired distraction and lordosis between opposing vertebrae.
- the first transverse member 304 and second transverse member 305 include a surface pattern 306 comprising a portion of helical threads 306a along first bearing surface 308 and second bearing surface 309.
- the threads 306a are generally square in cross-section with their flat outer peripheral surfaces 310 set at an angle of one-half ⁇ with respect to the longitudinal axis X-X and defined valleys 311 between the threads 306a.
- the implant has a major diameter D M measured between diametrically opposite outer radial surfaces 310 of the threads 306a at the leading end 301.
- the implant 300 has a minor diameter D m measured as the distance across the implant 300 between the valleys 311 of the thread pattern 306a. 11
- the implant 300 has a major diameter D' M measured between diametrically opposite outer radial surfaces 310 of threads 306a at the trailing end 302. Finally, at the trailing end 302, the implant 300 has a minor diameter D' ra measured between diametrically opposite valleys 311 at the trailing end 302.
- the central support member 320 of implant 300 comprises vertical columns 321, 322 and 323 including openings 324 and 325 therebetween.
- first transverse member 304 and also second transverse member 305) include transverse supports 330, 331 and 332 and include openings 333 and 334 therebetween.
- the number of columns and transverse supports can vary. The objective being to provide rigid support with the greatest amount of free space.
- FIGs. 11-13 another embodiment of an implant 400 is shown.
- the first transverse member 401 and second transverse member 402 are maintained in spaced apart relationship by central support member 403.
- Central support member 403 includes columns 420, 421 and 422 with openings 423 and 424 therebetween.
- First transverse member 401 includes transverse supports 425, 426 and 427 with openings 428 and 429 therebetween.
- the second transverse member 402 has an identical arrangement.
- Implant 400 has a first and second taper and a longitudinal axis X-X extending from a leading end 404 to a trailing end 405.
- the trailing end 405 of the present embodiment comprises a "trailing end rise" (TER) 406 and a terminal end 407.
- TER trailing end rise
- the first taper of implant 400 diverges from the axis from the leading end 404 to the trailing end rise 406 of the trailing end 405.
- the second taper diverges from the axis from the terminal end 407 to the TER 406.
- the trailing end rise 406 is the region of greatest diameter of the implant 400.
- the first taper provides the bi-tapered implant 400 with a substantially frusto-conical shape with a conical angle ⁇ equal to a desired lordosis between selected vertebrae.
- the angle ⁇ of the illustrated embodiment, measured from the leading end 404 to the TER 406 is 8°, however, as previously stated, the herein disclosed implants will be available with a variety of angles and sizes.
- the leading end 404 has a major diameter D M measured between diametrically opposite outer radial surfaces 410 of the threads 411 at the leading end 404.
- the leading end 404 also has a minor diameter D m measured between diametrically opposite inner radial surfaces 412 of the valleys 413 of the thread pattern 411 of implant 400.
- the implant 400 has a major diameter D' M measured between diametrically opposite outer radial surfaces 414 of the threads 12
- the trailing end 405 also has a minor diameter D' m measured across terminal end 407.
- the second taper of the implant 400 has a second angle, ⁇ , extending from the terminal end 407 to the TER 406.
- the angle ⁇ will vary with the diameter D' M of the TER 406, the diameter D' m of the terminal end 407, and the longitudinal distance L E therebetween.
- the diameter D' m of the terminal end 407 is equal to the major diameter D M of the leading end 404.
- the longitudinal distance L E can be about 5% to 25% of the overall length L of the implant. Generally, L E is less than 15% of the overall length L, typically about 8-10%.
- m is about 1 (45°).
- the actual slope dimensions m can vary, typically, between .58 (30°) and 1.73 (60°).
- the helical threads 411 can extend along the second taper as illustrated at 415 of FIGs. 11-12. Alternatively, as illustrated in FIG. 13, the threads 411 can stop at the terminal end rise 406 and the second taper comprise a flat 416, undulating or other non-threaded surface, from trailing end rise 406 to terminal end 407. Implant 400 can also include other features as previously described for an implant.
- FIG. 14 diagrammatically illustrates two implants 10 inserted into a threaded bore between opposing vertebral bodies 450, 451. It should be noted that in a preferred method, the openings 12a- 12c of implants 10 are beyond the cortical 13
- a bone support matrix can be packed around the implants 10.
- FIGs. 15-18 illustrate one preferred insertion tool 500.
- Insertion tool 500 includes a tool body 502 extending from a proximal end 504 to a distal end 506.
- an internal bore 508 extends completely through the tool from the proximal end 504 to the distal end 506.
- the bore can be provided with internal threads 510.
- a handle 508 is provided at the proximal end 504 to permit a surgeon to manipulate the tool 500.
- the grips include threaded grips 522, 523.
- the threaded grips 522, 523 have opposing interior surfaces 524, 525 configured to slide into channels 24a and 24b of implant 10.
- the exterior surfaces of the grips 522, 523 are provided with threads 526 and valleys 527 which are complimentary to helical thread portions 7a of the implant 10.
- FIG. 17 illustrates a perspective view of implant 10 and the distal end
- each gripper 522 and 523 each include a pair of tapered ridges 560 and 561.
- the angle A formed between tapered ridges 561 is different than the angle B formed between tapered ridges 560.
- angle A between tapered ridges 561 is identical to angle A of implant 10 and angle B of tapered ridges 560 is identical to angle B of implant 10 (see FIG. 5).
- angle B of tapered ridges 560 is identical to angle B of implant 10 (see FIG. 5).
- the opposing interior surfaces 524, 525 of the distal end 506 of grips 522 and 523 also include notches 570a and 570b which receive tabs 31a and 31b of implant 10, respectively.
- unthreaded grips 570 and 571 have opposing interior surfaces 572, 573 that provide for sliding grips 570 and 571 into channels 24a and 24b of implant 10.
- the lateral aspects 574, 575 of grips 570, 571, respectively, do not 14
- the insertion tool 500 can also to include two additional grips that slide into the regions between thread segments 101 and 103 and 102 and 104 of implant embodiment 100.
- additional grips are illustrated, for example, in FIGs. 24, 27, 28 and 31 of co- assigned U.S. Patent No. 5,609,636, the entire disclosure of which is incorporated herein by reference.
- an insertion tool as described above can also be prepared for tapered implants 300 and 400.
- grips 522 and 523 or 570 and 571 are tapered from the proximal end to the distal end as disclosed in co- pending application U.S. Ser. No. 08/902,083.
Abstract
Description
Claims
Priority Applications (5)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP99913945A EP1063949B1 (en) | 1998-03-20 | 1999-03-18 | Intervertebral implant with reduced contact area and method |
JP2000536326A JP2002506679A (en) | 1998-03-20 | 1999-03-18 | Intervertebral implant and method with reduced contact area |
CA002324104A CA2324104C (en) | 1998-03-20 | 1999-03-18 | Intervertebral implant with reduced contact area and method |
AU31905/99A AU3190599A (en) | 1998-03-20 | 1999-03-18 | Intervertebral implant with reduced contact area and method |
DE69919852T DE69919852T2 (en) | 1998-03-20 | 1999-03-18 | INTERMEDIATE PULSE IMPLANT WITH REDUCED CONTACT AREA AND IMPLANTING PROCEDURE |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US09/045,213 | 1998-03-20 | ||
US09/045,213 US6224631B1 (en) | 1998-03-20 | 1998-03-20 | Intervertebral implant with reduced contact area and method |
Publications (1)
Publication Number | Publication Date |
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WO1999047083A1 true WO1999047083A1 (en) | 1999-09-23 |
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PCT/US1999/005895 WO1999047083A1 (en) | 1998-03-20 | 1999-03-18 | Intervertebral implant with reduced contact area and method |
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US (3) | US6224631B1 (en) |
EP (1) | EP1063949B1 (en) |
JP (1) | JP2002506679A (en) |
AU (1) | AU3190599A (en) |
CA (1) | CA2324104C (en) |
DE (1) | DE69919852T2 (en) |
ES (1) | ES2230842T3 (en) |
WO (1) | WO1999047083A1 (en) |
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DE20004692U1 (en) * | 2000-03-14 | 2001-07-26 | Sofamor Danek Gmbh | Vertebral implant for screwing into an intervertebral space |
WO2002034141A2 (en) * | 2000-10-24 | 2002-05-02 | Howmedica Osteonics Corp. | Threaded, barrel-shaped apparatus for fusing adjacent bone structure |
EP1339363A1 (en) * | 2000-12-04 | 2003-09-03 | Roger P. Jackson | Threaded interbody device |
EP1349519A1 (en) * | 2000-12-05 | 2003-10-08 | SDGI Holdings, Inc. | Osteogenic fusion device |
EP1389962A2 (en) * | 2001-04-30 | 2004-02-25 | Howmedica Osteonics Corp. | Insertion instrument |
EP1585457A2 (en) * | 2002-09-24 | 2005-10-19 | Bogomir Gorensek | Stabilizing device for intervertebral disc, and methods thereof |
EP1882464A1 (en) * | 2006-07-27 | 2008-01-30 | Creaspine | Intervertebral implant for bone fusion |
US8845649B2 (en) | 2004-09-24 | 2014-09-30 | Roger P. Jackson | Spinal fixation tool set and method for rod reduction and fastener insertion |
US8852239B2 (en) | 2013-02-15 | 2014-10-07 | Roger P Jackson | Sagittal angle screw with integral shank and receiver |
US8870928B2 (en) | 2002-09-06 | 2014-10-28 | Roger P. Jackson | Helical guide and advancement flange with radially loaded lip |
US8894657B2 (en) | 2004-02-27 | 2014-11-25 | Roger P. Jackson | Tool system for dynamic spinal implants |
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Also Published As
Publication number | Publication date |
---|---|
EP1063949B1 (en) | 2004-09-01 |
US6224631B1 (en) | 2001-05-01 |
DE69919852T2 (en) | 2005-09-22 |
AU3190599A (en) | 1999-10-11 |
CA2324104A1 (en) | 1999-09-23 |
JP2002506679A (en) | 2002-03-05 |
US20010011191A1 (en) | 2001-08-02 |
DE69919852D1 (en) | 2004-10-07 |
EP1063949A1 (en) | 2001-01-03 |
ES2230842T3 (en) | 2005-05-01 |
US20050131539A1 (en) | 2005-06-16 |
US6855166B2 (en) | 2005-02-15 |
CA2324104C (en) | 2008-02-05 |
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