US 6395034: "Intervertebral disc prosthesis"



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Patent Overview

Patent Title: Intervertebral disc prosthesis
Patent Number: 6395034 Filing Date:
Application Number: 09448490 Issue Date: May 28, 2002
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Claims

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I claim:


1. A method of replacing a damaged intervertebral disc, comprising steps ofremoving a damaged disc nucleus from its intervertebral space, inserting an expandable stent having opposed convex heads and structure extending between the heads which is expandable lengthwise, but not retractable, into the intervertebral space, placing the stent so that its convex ends face the endplates of the respective vertebral bodies on either side of the intervertebral space, expanding said structure so that the heads bear against the endplates, injecting a hardenable material into the intervertebral space between the convex heads, and allowing the hardenable material to harden around the stent so as to form a permanent disc prosthesis.

2. The method of claim 1, wherein the stent has points on each of said convex ends, and the expanding step includes pressing the points against the endplates of the respective vertebral bodies on either side of the intervertebral space.

3. An intervertebral disc prosthesis, comprisinga stent having at least two telescoping elements, each of said elements having a head adapted to engage an endplate of a respective one of said vertebral bodies, a structure extending between said heads, said structure be expandable lengthwise, but not retractable, and a mass of hardenable material for filling the space between said heads.

4. The stent of claim 3, wherein each of said heads has a convex surface for engaging the endplate of a respective one of said vertebral bodies.

5. The stent of claim 3, wherein each of said heads has a point for digging into the endplate of a respective one of said vertebral bodies, to keep the stent in place.

6. The prosthesis of claim 3, wherein each of said heads has a convex surface for engaging the endplate of a respective one of said vertebral bodies.

7. The prosthesis of claim 3, wherein each of said heads has a point for digging into the endplate of a respective one of said vertebral bodies, to keep the stent in place.

8. The prosthesis of claim 3, wherein said hardenable material is a plastic polymeric material.

9. The prosthesis of claim 8, wherein said material is a resin.

Referenced By:

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Patent Number Issue Date Title Author
7008424 Mar 07, 2006 Percutaneous vertebral fusion system Teitelbaum, George P.
7503936 Mar 17, 2009 Methods for forming and retaining intervertebral disc implants Trieu, Hai H.
7520900 Apr 21, 2009 Intervertebral disc nucleus implants and methods Trieu, Hai H.
7544208 Jun 09, 2009 Adjustable corpectomy apparatus Mueller, Richard; Budd, Andrew
7799032 Sep 21, 2010 Guide pin introducer for guiding instrumentation through soft tissue to a point on the spine Assell, Robert L.; Ainsworth, Stephen D.; Cragg, Andrew H.; Dickhudt, Eugene A.
7938860 May 10, 2011 Intervertebral disc nucleus implants and methods Trieu, Hai H.
7018416 Mar 28, 2006 Bone implants and methods Hanson, David A.; Longhini, Ross A.; McPhillips, Daniel D.; Seme, Steven J.
7473256 Jan 06, 2009 Method and apparatus for spinal distraction Assell, Robert L.; Ainsworth, Steven D.; Cragg, Andrew L.; Dickhudt, Eugene A.
7311732 Dec 25, 2007 System of intervertebral prostheses Link, Helmut D.; Keller, Arnold
7320708 Jan 22, 2008 Cervical interbody device Bernstein, Avi
7273496 Sep 25, 2007 Artificial vertebral disk replacement implant with crossbar spacer and method Mitchell, Steve
7481840 Jan 27, 2009 Multi-piece artificial spinal disk replacement device with selectably positioning articulating element Zucherman, James F.; Hsu, Ken Y.
7537612 May 26, 2009 Lumbar composite nucleus Kunzler, Alex
7575600 Aug 18, 2009 Artificial vertebral disk replacement implant with translating articulation contact surface and method Zucherman, James F.; Hsu, Ken Y.
7628800 Dec 08, 2009 Formed in place corpectomy device Sherman, Michael C.; Shaolian, Samuel M.
7758648 Jul 20, 2010 Stabilized, adjustable expandable implant and method Castleman, David W.; Heinz, Eric S.
7763076 Jul 27, 2010 Artificial disc prosthesis Navarro, Richard R.; Ananthan, Bharadwaj; Theken, Randall R.
7771476 Aug 10, 2010 Curable orthopedic implant devices configured to harden after placement in vivo by application of a cure-initiating energy before insertion Justis, Jeff R.; Trieu, Hai H.; Protopsaltis, Dimitri; Sherman, Michael C.
7771432 Aug 10, 2010 Insertion device and techniques for orthopaedic implants Schwab, Frank J.; White, John L.
7771480 Aug 10, 2010 Artificial disc prosthesis Navarro, Richard R.; Ananthan, Bharadwaj; Theken, Randall R.
7794480 Sep 14, 2010 Artificial functional spinal unit system and method for use Gordon, Charles R.; Harbold, Corey T.; Hanson, Heather S.; Wagner, Erik J.
7879096 Feb 01, 2011 Centrally driven expandable implant Dickson, Andrew M.; Harrop, James S.; Karahalios, Dean G.; Potts, Eric A.; Shaffrey, Christopher I.; Wang, Jeffrey C.
7905908 Mar 15, 2011 Spinal mobility preservation method Cragg, Andrew H.; Assell, Robert L.; Ainsworth, Steven D.; Dickhudt, Eugene A.; Wessman, Bradley J.
7918876 Apr 05, 2011 Spinal implant adjustment device Mueller, Richard; Budd, Andrew; Silski, Marc
7931688 Apr 26, 2011 Expandable interbody fusion device Landry, Michael; Wysocki, Steve
7641692 Jan 05, 2010 Implantable joint prosthesis Bryan, Vincent; Kunzler, Alex; Clark, Charles R.; Conta, Robert; Gil, Carlos E.
7402176 Jul 22, 2008 Intervertebral disc prosthesis Malek, Michel H.
8092536 Jan 10, 2012 Retention structure for in situ formation of an intervertebral prosthesis Ahrens, Michael; Martz, Erik O.
8152852 Apr 10, 2012 Variable height vertebral body replacement implant Biyani, Ashok
8157844 Apr 17, 2012 Dampener system for a posterior stabilization system with a variable length elongated member Gimbel, Jonathan A.; Schular, Michael S.; Wagner, Erik J.
8187304 May 29, 2012 Facet fusion system Malek, Michel H.
8257440 Sep 04, 2012 Method of insertion of an expandable intervertebral implant Gordon, Charles R.; Harbold, Corey T.; Hanson, Heather S.
8268004 Sep 18, 2012 Stabilized, adjustable expandable implant and method Castleman, David W.; Heinz, Eric S.
8292928 Oct 23, 2012 Method and apparatus for spinal distraction and fusion Cragg, Andrew H.; Assell, Robert L.; Dickhudt, Eugene A.
8337556 Dec 25, 2012 Curable media for implantable medical device Shaolian, Samuel M.; Teitelbaum, George P.; Van Nguyen, Thanh; Pham, To V.; Estes, Richard H.
6730126 May 04, 2004 Device and method for lumbar interbody fusion Boehm, Jr., Frank H.; Melnick, Benedetta Delorenzo
7727262 Jun 01, 2010 Formed in place fixation system with thermal acceleration Shaolian, Samuel M.; Teitelbaum, George P.; Pham, To V.; Nguyen, Thanh Van; Dabney, Hunt
7753958 Jul 13, 2010 Expandable intervertebral implant Gordon, Charles R.; Harbold, Corey T.; Hanson, Heather S.
7951154 May 31, 2011 Insertion device and techniques for orthopaedic implants Schwab, Frank J.; White, John L.
8083774 Dec 27, 2011 Percutaneous vertebral fusion system Teitelbaum, George P.
8092542 Jan 10, 2012 Implantable joint prosthesis Bryan, Vincent; Kunzler, Alex; Clark, Charles R.; Conta, Robert; Gil, Carlos E.
7799034 Sep 21, 2010 Tissue distraction device Johnson, Wesley D.; Lipschultz, Tyler; Wales, Larry; Kieval, Robert
6749614 Jun 15, 2004 Formable orthopedic fixation system with cross linking Teitelbaum, George P.; Shaolian, Samuel M.; Pham, To V.; Nguyen, Thanh Van
7588574 Sep 15, 2009 Kits for enabling axial access and procedures in the spine Assell, Robert L.; Ainsworth, Stephen D.; Cragg, Andrew H.; Dickhudt, Eugene A.
7601174 Oct 13, 2009 Wear-resistant endoprosthetic devices Kelly, Aaron; Tokish, Leonard; Edfast, Jeff; Yager, David; Kunzler, Alex; Bryan, Vincent; Allard, Randy; Rouleau, Jeff; Conta, Robert; Gil, Carlos
7674278 Mar 09, 2010 Tissue distraction device Manzi, Richard J.; Logan, Joseph N.; Wysocki, Steven J.; Bono, Frank S.; Raymond, Spanky A.
7708778 May 04, 2010 Expandable articulating intervertebral implant with cam Gordon, Charles R.; Harbold, Corey T.; Hanson, Heather S.
7691146 Apr 06, 2010 Method of laterally inserting an artificial vertebral disk replacement implant with curved spacer Zucherman, James F.; Hsu, Ken Y.; Mitchell, Steven T.
7771478 Aug 10, 2010 Artificial disc prosthesis Navarro, Richard R.; Ananthan, Bharadwaj; Theken, Randall R.
7799082 Sep 21, 2010 Artificial functional spinal unit system and method for use Gordon, Charles R.; Harbold, Corey T.; Hanson, Heather S.; Wagner, Erik J.
7582106 Sep 01, 2009 Formable orthopedic fixation system with cross linking Teitelbaum, George P.; Shaolian, Samuel M.; Pham, To V.; Nguyen, Thanh Van
7857818 Dec 28, 2010 Method and apparatus for delivering an intervertebral disc implant Trieu, Hai H.; Justis, Jeff R.; Lim, Roy
7862618 Jan 04, 2011 Expandable vertebral body implants and methods of use White, John; Edie, Jason A.
7875078 Jan 25, 2011 Expandable interbody fusion device Wysocki, Steve; Logan, Joseph N.; Manzi, Richard; Paxson, Robert D.; Pafford, John; LoGuidice, Mark D.; Lipschultz, Tyler P.; Nilsson, Carl Michael; Savage, Daniel S.
7905922 Mar 15, 2011 Surgical implant suitable for replacement of an intervertebral disc Bergeron, Brian J.
7909870 Mar 22, 2011 Height-adjustable spinal implant and operating instrument for the implant Kraus, Kilian
7255714 Aug 14, 2007 Vertically adjustable intervertebral disc prosthesis Malek, Michel H.
8048118 Nov 01, 2011 Adjustable interspinous process brace Lim, Roy; Carls, Thomas; Bruneau, Aurelien; Lange, Eric C.; Anderson, Kent M.; Trieu, Hai H.
8062366 Nov 22, 2011 Ratcheting expandable corpectomy/vertebrectomy cage Melkent, Anthony J.
8066750 Nov 29, 2011 Port structures for non-rigid bone plates Oi, Nelson; Companioni, Wilder; May, Jason Michael; West, Michael V.; White, Stephen Edward
8066714 Nov 29, 2011 Instrumentation for distraction and insertion of implants in a spinal disc space Shipp, Kenneth S.; Campbell, Mitchell J.; Chen, Richard Evan
6736850 May 18, 2004 Vertebral pseudo arthrosis device and method Davis, Reginald J.
6562074 May 13, 2003 Adjustable bone fusion implant and method Gerbec, Daniel E.; Fallin, T. Wade; Faciszewski, Tom
7309338 Dec 18, 2007 Methods and apparatus for performing therapeutic procedures in the spine Cragg, Andrew H.
8097038 Jan 17, 2012 Prosthetic vertebral assembly Malek, Michel H.
8118870 Feb 21, 2012 Expandable articulating intervertebral implant with spacer Gordon, Charles R.; Harbold, Corey T.; Hanson, Heather S.
8123810 Feb 28, 2012 Expandable intervertebral implant with wedged expansion member Gordon, Charles R.; Harbold, Corey T.; Hanson, Heather S.
8162994 Apr 24, 2012 Posterior stabilization system with isolated, dual dampener systems Gimbel, Jonathan A.; Schular, Michael S.; Wagner, Erik J.
8182514 May 22, 2012 Dampener system for a posterior stabilization system with a fixed length elongated member Gimbel, Jonathan A.; Schular, Michael S.; Wagner, Erik J.
8187330 May 29, 2012 Dampener system for a posterior stabilization system with a variable length elongated member Gimbel, Jonathan A.; Schular, Michael S.; Wagner, Erik J.
8211178 Jul 03, 2012 Intervertebral implant with a pivoting end cap Melkent, Anthony J.; Potts, Eric A.; Palmatier, Stanley T.
8206398 Jun 26, 2012 Apparatus for spinal fusion Johnson, Wesley D.; Lipschultz, Tyler; Wales, Larry; Kieval, Robert
8236058 Aug 07, 2012 Spine surgery method and implant Fabian, Henry F.; Cicoretti, Larry A.
8267998 Sep 18, 2012 Operating instrument for a height-adjustable spinal implant Kraus, Kilian
8337562 Dec 25, 2012 Device for distracting body tissue Landry, Michael; Wysocki, Steve
8349014 Jan 08, 2013 Expandable device for distracting spinal tissue surfaces Barreiro, Peter; Ty, Dennis; Landry, Michael E.
8348978 Jan 08, 2013 Interosteotic implant Trieu, Hai H.; Carls, Thomas; Lim, Roy; Lange, Eric C.; Anderson, Kent M.; Bruneau, Aurelien
7780734 Aug 24, 2010 Tissue distraction device Johnson, Wesley D.; Lipschultz, Tyler; Wales, Larry; Kieval, Robert
7776042 Aug 17, 2010 Methods and apparatus for provision of therapy to adjacent motion segments Ainsworth, Stephen D.; Assell, Robert L.; Cragg, Andrew H.; Dickhudt, Eugene A.; Schwarz, Tawney A.; Wessman, Bradley J.
6852129 Feb 08, 2005 Adjustable bone fusion implant and method Gerbec, Daniel E.; Fallin, T. Wade; Faciszewski, Tom
6863673 Mar 08, 2005 Methods for adjustable bone fusion implants Gerbec, Daniel E.; Fallin, T. Wade; Faciszewski, Tom
7419505 Sep 02, 2008 Collapsible, rotatable, and tiltable hydraulic spinal disc prosthesis system with selectable modular components Fleischmann, Lewis W.; Galuardi, Christopher
7547317 Jun 16, 2009 Methods of performing procedures in the spine Cragg, Andrew H.
7608077 Oct 27, 2009 Method and apparatus for spinal distraction and fusion Cragg, Andrew H.; Assell, Robert L.; Dickhudt, Eugene A.
7618461 Nov 17, 2009 Composite intervertebral disc implants and methods for forming the same Trieu, Hai H.
7744637 Jun 29, 2010 Method for restoring vertebral body height Johnson, Wesley D.; Lipschultz, Tyler; Wales, Larry; Kieval, Robert
7763025 Jul 27, 2010 Spinal fusion kit for guiding instrumentation through soft tissue to a point on the spine Assell, Robert L; Ainsworth, Stephen D; Cragg, Andrew H; Dickhudt, Eugene A
7780705 Aug 24, 2010 Formed in place fixation system with thermal acceleration Shaolian, Samuel M.; Teitelbaum, George P.; Pham, To V.; Nguyen, Thanh Van; Dabney, James Huntington
7799033 Sep 21, 2010 Access kits for enabling axial access and procedures in the spine Assell, Robert L.; Ainsworth, Stephen D.; Cragg, Andrew H.; Dickhudt, Eugene A.
8062373 Nov 22, 2011 Spine surgery method and motion preserving implant Fabian, Jr., Henry F.
8080041 Dec 20, 2011 Device and method for lumbar interbody fusion Boehm, Jr., Frank H.; Melnick, Benedetta Delorenzo
8105365 Jan 31, 2012 Methods and apparatus for performing therapeutic procedures in the spine Cragg, Andrew H.
6821277 Nov 23, 2004 Percutaneous vertebral fusion system Teitelbaum, George P.
7077865 Jul 18, 2006 Method of making an intervertebral disc prosthesis Bao, Qi-Bin; Hudgins, Robert Garryl; Felt, Jeffrey C.; Arsenyev, Alexander; Yuan, Hansen A.
6899713 May 31, 2005 Formable orthopedic fixation system Shaolian, Samuel M.; Teitelbaum, George P.; Pham, To V.; Nguyen, Thanh Van
7083649 Aug 01, 2006 Artificial vertebral disk replacement implant with translating pivot point Zucherman, James F.; Hsu, Ken Y.; Winslow, Charles J.; Yerby, Scott A.; Mitchell, Steve; Flynn, John
6966929 Nov 22, 2005 Artificial vertebral disk replacement implant with a spacer Mitchell, Steve
7500977 Mar 10, 2009 Method and apparatus for manipulating material in the spine Assell, Robert L.; Ainsworth, Steven D.; Cragg, Andrew L.; Dickhudt, Eugene A.
7530993 May 12, 2009 Method of spinal fixation Assell, Robert L.; Ainsworth, Steven D.; Cragg, Andrew H
7621953 Nov 24, 2009 End device for a vertebral implant Braddock, Jr., Danny Horton; Karahalios, Dean G.
7691105 Apr 06, 2010 Tissue augmentation, stabilization and regeneration technique Attawia, Mohamed; O'Neil, Michael J
7713301 May 11, 2010 Intervertebral disc prosthesis Bao, Qi-Bin; Hudgins, Robert Garryl; Felt, Jeffrey C.; Arsenyev, Alexander; Yuan, Hansen A.
7740633 Jun 22, 2010 Guide pin for guiding instrumentation along a soft tissue tract to a point on the spine Assell, Robert L.; Ainsworth, Stephen D.; Cragg, Andrew H.; Dickhudt, Eugene A.
7670377 Mar 02, 2010 Laterally insertable artifical vertebral disk replacement implant with curved spacer Zucherman, James F.; Hsu, Ken Y.; Mitchell, Steven T.
7766965 Aug 03, 2010 Method of making an intervertebral disc prosthesis Bao, Qi-Bin; Hudgins, Robert Garryl; Felt, Jeffrey C.; Arsenyev, Alexander; Yuan, Hansen A.
7794501 Sep 14, 2010 Expandable intervertebral spacers and methods of use Edie, Jason A; Cooper, Lloyd Guyton Bowers; Walker, II, Don Byron
D0626233 Oct 26, 2010 Expandable intervertebral implant Cipoletti, Robert; Alheidt, Thomas; Willis, Steven
7846185 Dec 07, 2010 Expandable interspinous process implant and method of installing same Carls, Thomas; Anderson, Kent M.; Lange, Eric C.; Lim, Roy; Trieu, Hai H.; Bruneau, Aurelien
7905885 Mar 15, 2011 Reduction system for restoration of a vertebral body Johnson, Wes; Lipschultz, Tyler; Wales, Larry; Kieval, Robert
7905905 Mar 15, 2011 Spinal mobility preservation apparatus Cragg, Andrew H.; Assell, Robert L.; Alnsworth, Steven D.; Dickhudt, Eugene A.; Wessman, Bradley J.
7909869 Mar 22, 2011 Artificial spinal unit assemblies Gordon, Charles R.; Harbold, Corey T.; Hanson, Heather S.
7914581 Mar 29, 2011 Expandable implant, instrument, and method Dickson, Andrew M.; Braddock, Jr., Danny H.; Harrop, James S.; Karahalios, Dean G.; Potts, Eric A.; Shaffrey, Christopher I.
7959677 Jun 14, 2011 Artificial functional spinal unit system and method for use Landry, Michael E.; Wagner, Erik J.; Schular, Michael S.; Wang, Jeffrey C.
7935133 May 03, 2011 Interlaminar hook Malek, Michel H.
7981157 Jul 19, 2011 Self-contained expandable implant and method Castleman, David W.; Heinz, Eric S.
8052613 Nov 08, 2011 Spinal nucleus extraction tool Assell, Robert L.; Ainsworth, Stephen D.; Cragg, Andrew H.; Dickhudt, Eugene A.
8105357 Jan 31, 2012 Interspinous process brace Bruneau, Aurelien; Anderson, Kent M.; Lim, Roy; Lange, Eric C.; Carls, Thomas; Trieu, Hai H.
8118869 Feb 21, 2012 Dynamic interbody device Gordon, Charles R.; Harbold, Corey T.; Hanson, Heather S.; Wagner, Erik J.
8123757 Feb 28, 2012 Inserter instrument and implant clip Zalenski, Edward B.; Frank, Dale W.; Sorrenti, Michael D.; Grinberg, Alexander
6648917 Nov 18, 2003 Adjustable bone fusion implant and method Gerbec, Daniel E.; Fallin, T. Wade; Faciszewski, Tom
7776045 Aug 17, 2010 Instrumentation and methods for vertebral distraction Heinz, Eric Steven
7014633 Mar 21, 2006 Methods of performing procedures in the spine Cragg, Andrew H.
8182537 May 22, 2012 Vertebral body replacement device and method for use to maintain a space between two vertebral bodies within a spine Refai, Daniel; Farris, Jeffrey A.
8197545 Jun 12, 2012 Nucleus augmentation delivery device and technique O'Neil, Michael; Rusbarsky, Christine; Hawkins, J. Riley
7931689 Apr 26, 2011 Method and apparatus for treating a vertebral body Hochschuler, Stephen; Johnson, Wesley D.; Nickels, Kevin L.; Hektner, Thomas R.; Wales, Larry; Lipschults, Tyler
8231681 Jul 31, 2012 Self-contained expandable implant and method Castleman, David W.; Heinz, Eric S.
7909873 Mar 22, 2011 Delivery apparatus and methods for vertebrostenting Tan-Malecki, Francisca; Hamilton, John V.; Sennett, Andrew R.; Sahatjian, Ronald; Coyle, James; Cannon, James; Farrissey, Liam; Mugan, John; Bruggemann, Martin; Gallagher, Dion; Ryan, Damien
8267965 Sep 18, 2012 Spinal stabilization systems with dynamic interbody devices Gimbel, Jonathan A.; Schular, Michael S.; Wagner, Erik J.
8308769 Nov 13, 2012 Implant device and method for interspinous distraction Farr, Morteza M.
8308777 Nov 13, 2012 Method and apparatus for removable spinal implant extending between at least two adjacent vertebral bodies Assell, Robert L.; Ainsworth, Stephen D.; Arthurs, Brandon
7833249 Nov 16, 2010 Formable orthopedic fixation system Shaolian, Samuel M.; Teitelbaum, George P.; Pham, To V.; Nguyen, Thanh Van
8337561 Dec 25, 2012 Spinal disc prosthesis system Sweeney, Patrick J.
8343193 Jan 01, 2013 Method of supporting and distracting opposing vertebral bodies Johnson, Wesley D.; Lipschultz, Tyler; Wales, Larry; Kieval, Robert
6666891 Dec 23, 2003 Device and method for lumbar interbody fusion Boehm, Jr., Frank H.; Melnick, Benedetta Delorenzo
7001431 Feb 21, 2006 Intervertebral disc prosthesis Bao, Qi-Bin; Hudgins, Robert Garryl; Felt, Jeffrey C.; Arsenyev, Alexander; Yuan, Hansen A.
7329259 Feb 12, 2008 Articulating spinal implant Cragg, Andrew H.
7727263 Jun 01, 2010 Articulating spinal implant Cragg, Andrew H.
7744599 Jun 29, 2010 Articulating spinal implant Cragg, Andrew H.
7794463 Sep 14, 2010 Methods and apparatus for performing therapeutic procedures in the spine Cragg, Andrew H
6921403 Jul 26, 2005 Method and apparatus for spinal distraction and fusion Cragg, Andrew H.; Assell, Robert L.; Dickhudt, Eugene A.
7452379 Nov 18, 2008 Artificial vertebral disk replacement implant with crossbar spacer and method Mitchell, Steve
7320707 Jan 22, 2008 Method of laterally inserting an artificial vertebral disk replacement implant with crossbar spacer Zucherman, James F.; Hsu, Ken Y.; Mitchell, Steven T.
7481839 Jan 27, 2009 Bioresorbable interspinous process implant for use with intervertebral disk remediation or replacement implants and procedures Zucherman, James F.; Hsu, Ken Y.
7497859 Mar 03, 2009 Tools for implanting an artificial vertebral disk Zucherman, James F.; Hsu, Ken Y.; Winslow, Charles J.; Yerby, Scott A.; Mitchell, Steve; Flynn, John
7503935 Mar 17, 2009 Method of laterally inserting an artificial vertebral disk replacement with translating pivot point Zucherman, James F.; Hsu, Ken Y.; Winslow, Charles J.; Yerby, Scott A.; Mitchell, Steven T.; Flynn, John J.
7520899 Apr 21, 2009 Laterally insertable artificial vertebral disk replacement implant with crossbar spacer Zucherman, James F.; Hsu, Ken Y.; Mitchell, Steven T.
7112223 Sep 26, 2006 Pseudo arthrosis device Davis, Reginald
7625379 Dec 01, 2009 Methods and instrumentation for inserting intervertebral grafts and devices Puno, Rolando M; Berry, Bret M.; Gareiss, W. Scott
7695515 Apr 13, 2010 Spinal disc prosthesis system Sweeney, Patrick J.
7708779 May 04, 2010 Expandable intervertebral spacers and methods of use Edie, Jason A.; Cooper, Lloyd Guyton Bowers; Windham, Jerrod Bradley; Dawson, John Caleb; Walker, II, Don Byron
7763075 Jul 27, 2010 Artificial disc prosthesis Navarro, Richard R.; Ananthan, Bharadwaj; Theken, Randall R.
7785351 Aug 31, 2010 Artificial functional spinal implant unit system and method for use Gordon, Charles R.; Harbold, Corey T.; Hanson, Heather S.; Wagner, Erik J.
7799079 Sep 21, 2010 Vertebral fusion device and method Hestad, Hugh D.; Maertens, Jack; Robie, Bruce; Hudgins, Robert Garryl
7806935 Oct 05, 2010 Artificial disc prosthesis Navarro, Richard R.; Ananthan, Bharadwaj; Theken, Randall R.
7811331 Oct 12, 2010 Tissue distraction device Johnson, Wesley D.; Lipschultz, Tyler; Wales, Larry; Kieval, Robert
7815683 Oct 19, 2010 Implants with helical supports and methods of use for spacing vertebral members Melkent, Anthony J.; Dewey, Jonathan M.
6964667 Nov 15, 2005 Formed in place fixation system with thermal acceleration Shaolian, Samuel M.; Teitelbaum, George P.; Pham, To V.; Nguyen, Thanh Van; Dabney, Hunt
7867279 Jan 11, 2011 Intervertebral disc prosthesis Hester, Douglas L.; Maguire, Paul S.; Grinberg, Alexander D.
7879103 Feb 01, 2011 Vertebral disc repair Gertzman, Arthur A.; Merboth, Barbara L.; Schuler, Michael; Steiner, Anton J.; Semler, Eric J.; Yannariello-Brown, Judith I.
7967867 Jun 28, 2011 Expandable interbody fusion device Barreiro, Peter; Ty, Dennis; Landry, Michael E.
7988735 Aug 02, 2011 Mechanical apparatus and method for delivering materials into the inter-vertebral body space for nucleus replacement Yurek, Matthew; Segal, Jerome; Gambhir, Kabir; Vedder, Kurt; Huffman, Robert
8052723 Nov 08, 2011 Dynamic posterior stabilization systems and methods of use Gordon, Charles R.; Harbold, Corey T.; Hanson, Heather S.; Wagner, Erik J.
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8123755 Feb 28, 2012 Tissue distraction device Johnson, Wesley D.; Lipschultz, Tyler; Wales, Larry; Kieval, Robert
8142435 Mar 27, 2012 Multi-functional surgical instrument and method of use for inserting an implant between two bones Refai, Daniel; Farris, Jeffrey A.
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8172903 May 08, 2012 Expandable intervertebral implant with spacer Gordon, Charles R.; Harbold, Corey T.; Hanson, Heather S.
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8252031 Aug 28, 2012 Molding device for an expandable interspinous process implant Carls, Thomas; Anderson, Kent M.; Lange, Eric C.; Lim, Roy; Trieu, Hai H.; Bruneau, Aurelien
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8328871 Dec 11, 2012 Expanding vertebral body implant Capote, Marco D.; Miller, Keith E.; Karahalios, Dean G.; Potts, Eric A.
6932843 Aug 23, 2005 Apparatus and method for the in-situ formation of a structural prosthesis Smith, Stephen A.; Fallin, T. Wade
8075623 Dec 13, 2011 Apparatus and kit for distraction of tissue surfaces Johnson, Wesley D.; Lipschultz, Tyler; Wales, Larry; Kieval, Robert
7749255 Jul 06, 2010 Method for fusing adjacent bones Johnson, Wes; Lipschultz, Tyler; Wales, Larry; Kieval, Robert
7780707 Aug 24, 2010 Method for reducing a vertebra using stacked elements Johnson, Wes; Lipschultz, Tyler; Wales, Larry; Kieval, Robert
8328847 Dec 11, 2012 Assemblies for provision of therapy to motion segments Ainsworth, Stephen D.; Assell, Robert L.; Cragg, Andrew H.; Wessman, Bradley J.
8167947 May 01, 2012 Methods for push distraction and for provision of therapy to adjacent motion segments Ainsworth, Stephen D.; Assell, Robert L.; Cragg, Andrew H.; Wessman, Bradley

Description

(click to expand)

BACKGROUND OF THE INVENTION


This invention relates to orthopedic surgery, more particularly to a prosthetic intervertebral disc, and stent used in the construction thereof, and a surgical procedure for implanting the construct in the intervertebral disc space.

The normal intervertebral disc has an outer fibrous ring, constituted mainly of collagen fibers, which strongly binds the vertebral elements together. This fibrous outer layer, or annulus, encircles a soft gel-like matrix, or nucleus, which serves both as a cushion and as a mobile and compressible element that allows motion to occur between the vertebral bodies above and below the intervertebral disc. This gel matrix is 95% water. The types of motion that can occur at the level of the intervertebral disc include flexion, extension, lateral bending and varying degrees of torsion or rotation.

In the course of a day, the normal intervertebral disc may encounter various combinations of these bending or twisting motions several thousand times. As a consequence of such repetitive motion, natural discs deteriorate over time, much as the padded cushion on a well-used chair might do.

The effect of this deterioration is a loss of water content of the gel matrix of the nucleus and a concomitant compacting of its fibers with a resultant loss of disc space height which in turn causes a loosening of the surrounding support ligaments of the spine and the development of what is termed degenerative instability. This instability results in a pathologic excess of movement at the intervertebral disc space that further accentuates the degeneration of both the nucleus and the annulus of the disc. With continued deterioration, the annulus of the disc can bulge or even develop radial tears that allow the inner nuclear material to protrude or even extrude from the disc space. This bulging of the annulus or protrusion of the nucleus can compress nerves and cause disabling sciatic pain. Distension or bulging of the annulus alone is frequently sufficient to produce disabling back pain because or compression or inflammation of free nerve endings present in the outer annulus of the disc.

The time-honored method of addressing degenerative lumbar instability resulting from severely damaged intervertebral discs has been to remove the damaged disc and fuse the two adjacent vertebral bones to eliminate pathological motion. While this approach does well at eliminating pathological motion, it also prevents any natural motion at that segment. The consequence of eliminating natural motion at a single segment generally is that greater degrees of stress occur above or below that segment. This in turn accelerates degeneration of the neighboring intervertebral spaces, often necessitating additional fusion surgeries.

It would be desirable, therefore, to preserve natural motion at every disc space and thus eliminate the degenerative domino effect that disectomy and fusion seems to produce. Since the earliest pathologic change evident in a degenerative disc is loss of water content with conco-mitant loss of disc space height, maintenance of disc space height seems critical for maintaining the way opposing vertebral surfaces alter position with each other during bending and twisting. Indeed, loss of disc space height seems to be the most crucial early feature of degenerative instability. With degenerative instability the ligaments may ultimately become so lax that buckling of the ligaments occurs, or even pathologic slippage of the spine (spondylolithesis). Preserving disc space height is therefore important in preventing secondary degenerative changes that occur as a consequence of loss of disc space height from mechanical damage or dessication due to aging.

An intervertebral disc endoprosthesis ought, ideally, to restore and preserve disc space height while permitting sufficient natural motion (flexion, extension, lateral bending, and rotation) to prevent excessive stresses on spinal segments above and below the prosthesis. Natural motion may also play a role in the health of the annulus and surrounding ligaments, much as natural stresses play a role in the maintenance of strength and density of normal living bone.

Many synthetic structures have been used as intervertebral disc implants, but few materials are durable enough to withstand the tremendous and repetitive forces a natural disc must withstand. In addition, the majority of intervertebral implants fail to restore and maintain sufficient disc space height to keep spinal support ligaments taut. Many constructs designed to address natural motion at the disc space have either been to complex to achieve commercial success or too challenging to implant, from a surgical perspective.

SUMMARY OF THE INVENTION


It is an object of this invention to provide an intervertebral disc endoprosthesis that simultaneously restores sufficient disc space height and mobility to provide a semblance of functional normalcy and to reduce or eliminate abnormal stresses on adjacent intervertebral segments.

Another object is to provide an intervertebral disc endoprosthesis which is simple to implant surgically and easy to manufacture from common materials.

To achieve these objectives, a stent according to this invention includes at least two telescoping elements, each having a head adapted to engage an endplate of each of the adjacent vertebral bodies, and means for changing the distance between said heads.

The stent is placed between adjacent vertebral bodies in a collapsed state, after the nucleus of the disc has been removed, through a small disectomy incision. The stent is then expanded in the disc space until the paraspinal ligaments and annular structures are taut and disc space height is restored. The end surfaces of the stent contacting the vertebral body endplate is smooth and convex, mirroring the normally concave surface of the vertebral endplate. The convex surfaces are in turn held apart by a connecting rod that allows expansion but not contraction when in use. The convex surface also has a spike or spur that digs into the endplate in its center portion to resist movement or shifting of the stent during distraction. This spike or spur also serves to prevent extrusion of the construct assembly in its final state. Once satisfactory distraction of the disc space has occurred, and the annulus and surrounding ligaments are deemed to be taut, the empty space formerly occupied by the damaged nucleus is replaced by synthetic material such as a resinous polymer or plastic that conforms to the shape of the nuclear envelope formed by the annulus and surrounding support ligaments. As the resin polymerizes, it hardens to form a stable endoprosthetic construct having a superior and inferior smooth metallic surface in contact with the vertebral endplates, and a surrounding ring of resinous material, that serves both to stabilize the stent and to replicate the gross anatomy of the enucleated segment of the disc. This construct serves to restore disc space height and annular ligamentous tension while simultaneously allowing the duplication of natural motion by virtue of its anatomic conformity to the preexisting disc nucleus.

The stent may be made of titanium or steel, or any other readily available biocompatible material already in use for human implantation. Any of currently available bone cements may be used for the polymer component of the construct, because they have been demonstrated to be biocompatible and have been used extensively in orthopedic joint implants. Bone cement is ideally suited as an endoprosthesis for disc replacement because it exhibits far greater strengths under compressive loads than under tensile forces. The forces which normally act on an intervertebral endoprosthesis are compressive in nature. Alternatively, any of a variety of synthetic materials that can be injected in a liquid or semisolid form and then allowed to harden could be used. Acrylics and carbonates, or other plastic materials, might also be used.

Because the endoprosthesis is in effect assembled within the disc space, the size of the stent in its collapsed state and its convex endplate surfaces are the only limiting factor regarding the size of the disectomy needed to allow implantation of the endoprosthesis, since bone cement or other synthetic polymers or plastics can be injected through relatively small ports. This potentially allows for endoprosthesis implantation through endoscopic or other similar minimally invasive surgical techniques. Indeed, because of the minimal exposure necessary for insertion of such a component construct, surgical implantation in an outpatient setting should be technically feasible. In addition, multiple disc replacements in a single sitting may be possible because of the ease of implantation.

Disc replacements done according to this invention would seem best suited to early disc degenerative conditions or so-call “black discs”, where the envelope of annular and longitudinal support ligaments are largely intact. A simple endoprosthesis in this setting can serve either as a permanent disc replacement, or as a means of temporizing and preserving functional mobility for the longest period of time possible prior to surgical fusion of the damaged segment.

BRIEF DESCRIPTION OF THE DRAWINGS


In the accompanying drawings,

FIG. 1A shows a ratchet-type intervertebral stent, in its collapsed condition, while FIG. 1B shows the stent in its expanded condition;

FIG. 2A shows a screw-type intervertebral stent in its collapsed condition, and FIG. 2B shows the stent in its expanded condition;

FIG. 3A is an anterior view of a segment of a spine, showing the stent of FIG. 1, collapsed and positioned between vertebral bodies, and FIG. 3B shows the stent expanded;

FIGS. 4A and 4B are similar to FIG. 3B, showing two stages of injection of a hardenable material;

FIGS. 5A and 5B are cranial-caudal (top) views taken on the section line 5A—5A and 5B—5B in FIGS. 4A and 4B, respectively;

FIGS. 6A and 6B are lateral (side) views showing a stent in its contracted and expanded configurations, respectively; and

FIGS. 7A and 7B are lateral views showing the injection of hardenable material around the stent.

DESCRIPTION OF THE PREFERRED EMBODIMENT(S)


FIGS. 1A, 1B, 2A and 2B show two forms of an intervertebral stent according to this invention, the only difference being the mechanism provided for expanding the stent. Each stent comprises a pair of elements 10,12, each having a broad head 14 with a convex surface 16 facing outwardly, away from the other element. By “convex”, I mean rounded, generally. A head whose surface is partially spherical is presently preferred. In any event, the geometry of the head (i.e., its radius of curvature) should be chosen to match that of the vertebral endplate against which it will bear. Those vertebral endplate surfaces are normally concave.

A telescoping mechanism extends between the heads, so that they can be retracted and distracted, that is, driven toward or away from one another. In either of the two contemplated mechanisms (FIGS. 1 and 2, respectively), each head has a stem 20, and the two stems have structure which allows them to be moved lengthwise, but prevents unintended retraction. In FIGS. 1A and 1B, that mechanism includes opposed ratchet teeth 22 which permit only outward movement; in FIGS. 2A and 2B, the mechanism is a screw mechanism 24 which requires relative turning of the parts.

Each head of the stent has at least one spur or small spike 26 extending from it, to dig into the facing vertebral endplate, so as to resist lateral dislodgement of the stent after placement.

The endoprosthesis of this invention includes both the stent described above and a mass of material 30 which is hardened in situ around the stent, in the disc space. This material is one which may be injected into the disc space around the stent, most preferably a setting resin.

In use, the surgeon first makes a small incision, through which he removes the damaged disc from its intervertebral space. He then inserts a stent, in its collapsed configuration, through the incision. After placing the stent so its heads face the endplates of the vertebral bodies in the correct position, he manipulates the telescoping mechanism to drive the heads apart until he judges that the intervertebral space is at is desired natural height. By now the stent is under compression from the paraspinal ligaments, and the spurs at either end dig into the endplates to prevent the stent from moving laterally. Now, the selected hardenable material is injected through the incision, into the disc space, completely filling it and enveloping the stent. Once the material has hardened, the stent is permanently embedded in it, and its convex end plates provide bearing points that permit natural relative movement of the vertebral bodies on either side.

It should be understood that because this invention is subject to variations and modifications, the foregoing description and the drawings should be interpreted as only illustrative of the invention described by the following claims.

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