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US20050113924A1 - Apparatus and method for performing spinal surgery - Google Patents

Apparatus and method for performing spinal surgery Download PDF

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Publication number
US20050113924A1
US20050113924A1 US10/913,510 US91351004A US2005113924A1 US 20050113924 A1 US20050113924 A1 US 20050113924A1 US 91351004 A US91351004 A US 91351004A US 2005113924 A1 US2005113924 A1 US 2005113924A1
Authority
US
United States
Prior art keywords
compressible
vertebral body
prosthetic device
intervertebral
fixation
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
US10/913,510
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English (en)
Inventor
Glenn Buttermann
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Dynamic Spine Inc
Original Assignee
Dynamic Spine Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Dynamic Spine Inc filed Critical Dynamic Spine Inc
Priority to US10/913,510 priority Critical patent/US20050113924A1/en
Publication of US20050113924A1 publication Critical patent/US20050113924A1/en
Assigned to DYNAMIC SPINE, INC. reassignment DYNAMIC SPINE, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: ANDERMAN, JEFFREY JOSEPH, BUTTERMANN, GLENN ROBIN, FERRIS, FRANK ROBERT, JR.
Priority to US11/948,427 priority patent/US8057549B2/en
Priority to US13/293,941 priority patent/US20120059479A1/en
Abandoned legal-status Critical Current

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    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/442—Intervertebral or spinal discs, e.g. resilient
    • A61F2002/444—Intervertebral or spinal discs, e.g. resilient for replacing the nucleus pulposus
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2002/449—Joints for the spine, e.g. vertebrae, spinal discs comprising multiple spinal implants located in different intervertebral spaces or in different vertebrae
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2210/0004—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof bioabsorbable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys
    • 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
    • A61F2310/00029—Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00179—Ceramics or ceramic-like structures
    • 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
    • A61F2310/00353—Bone cement, e.g. polymethylmethacrylate or PMMA
    • 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
    • A61F2310/00359—Bone or bony tissue
    • 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
    • A61F2310/00389—The prosthesis being coated or covered with a particular material
    • A61F2310/00592—Coating or prosthesis-covering structure made of ceramics or of ceramic-like compounds
    • A61F2310/00796—Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite
    • 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
    • A61F2310/00389—The prosthesis being coated or covered with a particular material
    • A61F2310/00976—Coating or prosthesis-covering structure made of proteins or of polypeptides, e.g. of bone morphogenic proteins BMP or of transforming growth factors TGF

Definitions

  • This invention relates to the field of spinal surgery. More specifically, this invention relates to a novel implantable apparatus for replacing the functionality of one or more failing intervertebral discs, without fusing the vertebral bodies above and below the disc(s). This invention also relates to devices for implanting and securing the intervertebral prosthetic device in cavities in a vertebral body and in one or more adjacent intervertebral discs. The invention further relates to methods for performing spinal surgery.
  • the human spine is a flexible structure comprised of twenty-three mobile vertebrae.
  • Intervertebral discs separate and cushion adjacent vertebrae.
  • the top and bottom surfaces of intervertebral discs abut vertebral body endplates.
  • the intervertebral discs act as shock absorbers and allow bending between the vertebrae.
  • An intervertebral disc comprises two major components: the nucleus pulposus and the annulus fibrosis.
  • the nucleus pulposus is centrally located in the disc and occupies 25-40% of the disc's total cross-sectional area.
  • the nucleus pulposus usually contains 70-90% water by weight and mechanically functions like an incompressible hydrostatic material.
  • the annulus fibrosis surrounds the nucleus pulposus and resists torsional and bending forces applied to the disc. Thus, the annulus fibrosis serves as the disc's main stabilizing structure.
  • a healthy disc relies on the unique relationship of the nucleus and annulus to one another.
  • a conventional treatment for degenerative disc disease is spinal fusion.
  • a surgeon removes the damaged natural disc and then fuses the two adjacent vertebral bodies into one piece.
  • the surgeon fuses the vertebral bodies by grafting bone between the adjacent vertebrae and sometimes using metal rods, cages, or screws to hold the graft in place until the graft heals.
  • spinal fusion may alleviate pain associated with degenerative disc disease, it also results in loss of motion at the fused vertebral joint. Lack of motion at the fused site puts additional stress on the discs above and below the fusion. The additional stress may cause the adjacent discs to degenerate and produce pain, thereby recreating the original problem.
  • the endplates of the vertebral bodies are nonuniform and typically sclerotic, which prevents the close physical joining of endplate and device surfaces required for bone ingrowth to provide adhesion and can lead to subsidence of the disc replacement device into the bone of the vertebral bodies if the endplates are shaved for contour matching.
  • the devices display limited motion. Specifically, as a result of the oversized implant relative to the narrow disc space, total disc replacement often results in a range of motion of only about 3.8° to 4.6°. Such a limited range of motion is the equivalent of a spinal fusion, which is defined to be motion of less than about 5°.
  • U.S. Pat. No. 4,759,769 to Hedman et al. discloses a synthetic disc having upper and lower plates hinged together. Although the hinged disc allows forward bending between adjacent vertebrae, the hinged disc does not allow axial compression or lateral flexion. Nor does it allow axial rotation of the vertebral column at the site of the implant. Therefore, the Hedman et al. device lacks the biomechanics of a natural disc.
  • the prosthetic disc device disclosed in U.S. Pat. No. 4,309,777 to Patil does not replicate natural motion between adjacent discs.
  • the Patil device includes two cups, one of which overlaps the other and is spaced from the other by springs. The cups move only in a single axial dimension.
  • the Patil device does not enable natural flexion of the spine in any direction.
  • the highly constrained motion of the Patil device can lead to high device/tissue interface stresses and implant loosening.
  • nucleus replacement devices In the case of nucleus replacement devices, historically these devices required perforation or partial excision of the annulus to insert the device. Breaking the continuity of the annular ring precludes normal stress loading of the annulus, which may be necessary for later healing. Further, degeneration of the annulus, exacerbated by damage done during implantation, may also result in increased loads placed upon the implant. Increased loads of this nature may lead to subsidence of the device into the vertebral body, device extrusion through the annular defect, or expulsion from the nuclear space. Moreover, these problems are exacerbated in the situation in which more than one disc is to be replaced because any or all of the devices may develop these problems. These problems are particularly challenging in the lumbar spine, where the discs are most highly stressed due to high bearing requirements.
  • intervertebral synthetic prosthetic device that greatly reduces the problems associated with total disc replacement and conventional nucleus replacement devices is disclosed in U.S. Pat. No. 5,827,328 (“the '328 patent”) to Buttermann.
  • the Buttermann devices excise the nucleus pulposus while maintaining the biomechanical functionality of the intact annulus fibrosis.
  • the intervertebral prosthetic device permits at least four degrees of relative motion between two vertebral bodies on either side of targeted intervertebral disc. These degrees of relative motion include sagittal bending, coronal bending, axial rotation, and axial compression.
  • the compressible member permits small increments of translational movement between the vertebral bodies (i.e., fifth and sixth degrees of relative motion, namely anterior-posterior translation and side-to-side, or lateral, translation).
  • FIG. 1 shows an embodiment of an intervertebral prosthetic device 10 according to one embodiment of the '328 patent that is designed to replace a damaged natural disc.
  • This device 10 is implanted by making holes in two adjacent vertebral bodies and boring through the nucleus pulposus of the intervertebral disc between the vertebral bodies.
  • the intervertebral prosthetic device 10 has a first fixation member 14 , a second fixation member 16 , and a compressible member 18 that is positioned between the first fixation member 14 and the second fixation member 16 .
  • the compressible member 18 acts as a shock absorber to minimize impact loading and, thus, minimize device failure or vertebral fracture.
  • the first fixation member 14 is positioned in a first vertebral body 20 .
  • the second fixation member 16 is positioned within a second vertebral body 22 adjacent the first vertebral body 20 .
  • Each fixation member 14 , 16 has an adjustable member 28 , 30 , respectively, and a support member 32 , 34 , respectively. Controlling the height of the adjustable members 28 and 30 , along with selecting an appropriately sized support member, controls the “disc” height.
  • the disc height is defined as the axial distance between the vertebrae above and below the operative disc.
  • the adjustable member 28 of the first fixation member 14 has an imaginary first longitudinal axis (shown by double-arrowed line A-A in FIG. 1 ) and adjustment elements 24 that allow adjustment of the height of the adjustable member 28 substantially along its longitudinal axis.
  • the second fixation member 16 is structurally similar to the first fixation member 14 , but inverted.
  • the adjustable member 30 of the second fixation member 16 has a second longitudinal axis (shown by double-arrowed line B-B) and adjustment elements 26 that allow adjustment of the height of the adjustable member 30 substantially along its longitudinal axis.
  • FIG. 4 shows one embodiment of the first fixation member 14 .
  • the second fixation member 16 is structurally similar to the first fixation member 14 , but inverted. Thus, the following discussion also applies to the second fixation member 16 .
  • the adjustable member 28 of the first fixation member 14 is adjustable in an axial direction by adjustment elements 24 .
  • the adjustment elements 24 comprise telescopic struts extending between a first, outer plate 31 and a second, inner plate 33 .
  • the outer plate 31 is farther from the operative intervertebral disc and hence farther from the compressible member 18 .
  • the inner plate 33 is closer to the operative intervertebral disc area and hence closer to the compressible member 18 .
  • the outer plate 31 has a bone-contacting surface 27
  • the inner plate 33 has a surface 35 for positioning against the support member 32 .
  • the adjustment elements 24 adjust the distance between the first bone-contacting plate 31 and the second plate 33 , thus adjusting the height of the adjustable member 28 .
  • a surgeon may adjust the telescopic struts to increase the height of the adjustable member and thus mechanically pre-load the compressible member 18 to reproduce the axial compression absorbed by a nucleus pulposus of a natural disc.
  • Pre-loading the compressible member restores the intervertebral height at the operative joint, restores the function of the annulus fibrosis. Pre-loading also assures close apposition of an ingrowth surface 27 , 29 of the device to bone 36 , 38 .
  • Each telescopic strut is provided with a lock screw 63 to adjust the length of the strut 24 and hence control the height of the adjustable member.
  • the lock screw 63 may comprise, for example, a pin (not shown) that extends through both the telescoping portion 65 and the housing portion 67 of the strut 24 .
  • Each strut 24 is independently adjustable.
  • FIG. 5 shows a top view of the second plate 33 of the adjustable member 28 .
  • the adjustment elements 24 preferably are spaced equidistant from each other to enable specific height adjustment of various regions of the adjustable member.
  • the first and second fixation members 14 and 16 have porous portions, such as the bone-contacting surface 27 , to permit bone ingrowth.
  • the bone-contacting surface 27 of the adjustable member 28 is positioned against the subchondral bone of an endplate 36 of the superior vertebral body 20
  • the bone-contacting surface 29 of the adjustable member 30 is positioned against the subchondral bone of an endplate 38 of the inferior vertebral body 22 .
  • a biocompatible fabric or suitable material may be wrapped around the fixation members to enable bone ingrowth.
  • a biocompatible coating may be applied to the fixation members to facilitate bone ingrowth.
  • the prosthetic device of FIG. 1 does not require conventional mechanical attachments, such as pegs or screws, to hold the prosthesis permanently in place.
  • the intravertebral (i.e., within a vertebral body) positioning of the fixation members 14 , 16 maintains the prosthetic device 10 in stable relationship at the operative intervertebral joint.
  • the prosthetic device may include mechanical or other attachments to supplement the porous portions of the fixation members and to temporarily fix the prosthetic device in place until bone ingrowth has occurred.
  • the adjustment elements 24 may include fins 66 extending outward from an exterior surface of the element 24 , as shown in FIG. 4 .
  • the fins 66 increase the surface area of the fixation member 14 to which bone may attach.
  • these fins 66 are located on the adjustment elements that are positioned on the anterior side of the adjustable member 28 .
  • the prosthetic device also may include protuberances (not shown) on the bone-contacting surface of the adjustable members to increase the surface area of the porous portion of the fixation members and, thus, encourage bone ingrowth.
  • FIG. 6 shows a cross-section of support member 32 .
  • the support member 32 has a first surface 72 that operably faces away from the compressible member 18 and a second surface 74 that operably faces towards the compressible member 18 .
  • the first and second surfaces 72 and 74 are oblique so that a circumferential surface 77 around the support member 32 varies in width, as shown in FIG. 4 .
  • the support member 32 is wedge-shaped.
  • the support member 32 preferably tapers from a maximum thickness at one side 73 to a minimum thickness at an opposite side 75 .
  • the support member 32 is thicker on the side of the fixation member 14 placed anteriorly in a patient's spine to account for the spine's natural curvature.
  • the support members are constructed with various thicknesses and with various angled surfaces, depending upon the vertebral level of the operative intervertebral joint.
  • An angle ⁇ shown in FIG. 6 ranges between 3°-10°.
  • the support members are shaped to maintain sagittal alignment. Maintaining sagittal alignment avoids nonuniform loading of the compressible member and avoids early fatigue failure of that member.
  • the compressible member 18 which is shown in FIG. 2 , can comprise at least one spring and, in the illustrated embodiment, comprises a plurality of springs 40 .
  • the compressible member 18 which is implanted in the region of an excavated nucleus pulposus of the operative intervertebral disc, is dimensioned so that the annulus fibrosis of the natural disc is at least substantially (if not completely) maintained.
  • the intervertebral prosthetic device restores the mechanical properties of the disc without disrupting the annulus fibrosis. Retention of the annulus fibrosis maintains stability of the intervertebral joint at the implant site.
  • the annulus fibrosis serves as a boundary for the compressible member and, therefore, minimizes the potential for accidental dislodgment of the prosthetic device.
  • the compressible member 18 has a top plate 42 , a bottom plate 44 , and a plurality of coil springs 40 extending between the top plate 42 and the bottom plate 44 .
  • the top plate 42 has a first surface 46 , which is connectable to the first fixation member 14 , and a second surface 48 .
  • the bottom plate 44 also has a first surface 50 , which is connectable to the second fixation member 16 , and a second surface 52 .
  • the springs 40 extend between the second surfaces 48 and 52 of the top plate 42 and bottom plate 44 , respectively.
  • the compressible member 18 When pre-loaded, the compressible member 18 can have an axial height of approximately 1.5 cm, greatest at the L45 vertebral level and slightly less at the upper lumbar vertebrae.
  • the coil springs 40 can have non-linear stiffness so that they become stiffer at higher applied loads; the nonlinear stiffness simulates physiological intervertebral stiffness.
  • any spring arrangement may be used that achieves sufficient axial compressive stiffness to replicate the biomechanics of the natural disc.
  • the compressible member includes an imaginary longitudinal axis (shown by the dashed line C-C) and an outer periphery in a plane transverse to its longitudinal axis.
  • a largest dimension of the compressible member's outer periphery is less than or substantially equal to the diameter of a nucleus pulposus of the natural intervertebral disc.
  • the annulus fibrosis of the natural disc which is substantially (if not completely) preserved during the implantation procedure, circumscribes the compressible member 18 .
  • the outer periphery of the compressible member circumscribes the springs, and the largest dimension of that outer periphery may extend to, but does not extend beyond, the nucleus pulposus.
  • the compressible member includes a top plate and a bottom plate, and where those plates fit within the annulus fibrosis and extend beyond the outermost portions of the springs, the outer periphery of the compressible member equals the larger of the two plate peripheries.
  • the outer periphery of the compressible member preferably ranges between 2.0 cm to 3.0 cm, which approximates the diameter of the nucleus pulposus of a natural intervertebral disc.
  • FIGS. 3A-3C show three embodiments of a coil spring designed to possess non-linear stiffness.
  • the coil spring 54 has a variable, or non-uniform, cross-sectional diameter 56 .
  • FIG. 3B shows another embodiment in which a coil spring 58 has a variable pitch 60 , where the pitch is defined as the distance between successive coils of the spring 58 .
  • FIG. 3C shows a third embodiment of a coil spring 62 in which at least two of the spring coils have different radii 64 measured from an imaginary axis D-D extending along the central axis of the spring 62 .
  • FIG. 8 shows a pathological intervertebral disc 90 located between a superior vertebral body 92 and an inferior vertebral body 94 .
  • a surgeon Prior to implantation, a surgeon performs a partial vertebrectomy to excise bone matter from the superior vertebral body 92 for receipt of a fixation member. This procedure can be performed using a cutting guide and reamer. Bone harvested from the vertebral body 92 by the reamer can be used after implantation of the prosthetic device to promote bone ingrowth into the prosthetic device, as later described.
  • FIG. 9 shows a cross-sectional view of the superior vertebral body 92 after the partial vertebrectomy, as taken along line 9 - 9 in FIG. 8 .
  • the surgeon next excises the nucleus pulposus of the damaged disc to create a cavity 100 , as shown in FIG. 10 , for receipt of the compressible member.
  • the annulus fibrosis 102 seen in FIG. 11 , is maintained.
  • the surgeon implants a fixation member 104 into the inferior vertebral body 94 , as shown in FIG. 11 .
  • the surgeon can select a support member with an appropriate thickness to accommodate the angulation at the operative intervertebral levels.
  • the surgeon then inserts a compressible member 106 (via the cavity formed in the superior vertebral body 92 ) into the cavity formerly containing the nucleus pulposus of the damaged disc and connects it to the inferior fixation member 104 , as shown in FIG. 12 .
  • the compressible member 106 and the fixation member 104 may be connected by conventional attachment members, such as screws, or by biocompatible cement or a suitable adhesive composition.
  • the surgeon implants another fixation member, similar to the one implanted in the inferior vertebral body 94 , yet inverted, in the superior vertebral body 92 .
  • Connection of that fixation member to the compressible member 106 forms an intervertebral prosthetic device like the one shown in FIG. 1 .
  • FIG. 13 shows rotation of the lock screws 112 of individual telescopic struts 108 to secure the struts at an appropriate height.
  • the surgeon next packs cancellous bone grafts 118 , typically obtained during creation of the cavity in the vertebral body, around the struts of each adjustable member, as shown in FIG. 14 .
  • the growth of bone around the fixation member and into its porous surfaces secures the intervertebral prosthetic device in place, absent mechanical attachments typically used in conventional disc prostheses.
  • the surgeon then replaces the cortical bone from the partial vertebrectomy procedure and, if needed, secures it with a bone screw, suture or bone cement.
  • the surgeon may elect to use bone cement to attach the fixation members to the vertebrae.
  • FIG. 7 shows an intervertebral prosthetic device 76 according to this second embodiment that comprises a first fixation member 78 , a second fixation member 80 , and a compressible member 82 .
  • the compressible member 82 is positioned between the first and second fixation members 78 , 80 .
  • the second fixation member 80 comprises a wedge-shaped support member with an upper surface 84 that attaches to the compressible member 82 and a lower surface 86 that rests upon subchondral bone of a near endplate 88 of an inferior vertebral body.
  • adjustment of the first fixation member 78 pre-loads the compressible member 82 to an appropriate extent.
  • a lower surface 86 of the support member 80 may be composed of a porous material and may have a slightly convex shape to match the natural contour of the near endplate of the inferior vertebral body.
  • FIG. 7 embodiment The implantation of the FIG. 7 embodiment is similar to the implantation of the FIG. 1 embodiment. Specifically, similar to the embodiment shown in FIG. 10 , a cavity may be formed in the superior vertebral body 92 and then extended through the nucleus pulposus of the intervertebral disc therebelow. At this time, the compressible member with the lower fixation member 80 affixed thereto may be inserted through the cavity in the vertebral body and then pushed downward into the cavity 100 in the intervertebral disc. Subsequently, the upper fixation member 78 is: (a) positioned in the cavity formed in the superior vertebral body 92 ; (b) connected to the compressible member; and (c) adjusted in the manner previous discussed with respect to the FIG. 1 embodiment. Of course, the cavity in the superior vertebral body 92 is then closed also in the manner previously described.
  • the intervertebral prosthetic device embodiments have a modular design so that the prosthesis may be sized to the patient's anatomy and designed for the patient's condition.
  • the modular design also enables replacement of individual components of the prosthesis (i.e., a fixation member or a compressible member), rather than replacement of the entire prosthesis should one component fail.
  • the compressible member can be attached to the fixation members by mechanical attachments, such as screws, rather than bone cement so that a surgeon may easily replace damaged or worn components.
  • the embodiment shown in FIG. 1 precludes use when reconstructing multiple adjacent discs.
  • the less invasive embodiment shown in FIG. 7 may be implanted via only one vertebral body hole, it may be less effective than the embodiment shown in FIG. 1 when used in patients with low bone density.
  • the FIG. 7 may be less effective as a result of inability to adequately fix the lower fixation member 80 to the vertebral body below the compressible member. Further, this inability to adequate fix the lower fixation member 80 may, in turn, lead to subsidence of the device into the vertebral body adjacent the lower fixation member 80 .
  • a prosthetic device that includes: a fixation member sized to fit within a cavity in a first vertebral body; and a compressible member sized to substantially replace a nucleus pulposus of an intervertebral disc adjacent the vertebral body.
  • a first side of the compressible member is configured to engage the fixation member and a second side of the compressible member is configured to engage a second vertebral body.
  • the second side of the compressible member is configured to fit within a seat formed in the cortical bone of the endplate of the second vertebral body.
  • an intervertebral prosthetic device for implantation in a spine that includes: (a) a rigid fixation member having a fixed length, the rigid fixation member being configured to be placed in a cavity of a vertebral body and against bone of the vertebral body; and (b) a first compressible member configured to be placed in a cavity in a first intervertebral disc adjacent the vertebral body and to be secured to the rigid fixation member.
  • the compressible member is constructed to remain compressible after implantation and has at least one compressible element that remains compressible after implantation.
  • the rigid fixation member is sized to compress the compressible member a predetermined amount when the rigid fixation member and the first compressible member are placed in the cavity in the first vertebral body and in the cavity in the first intervertebral disc, respectively.
  • This device includes: (a) a fixation member configured to be placed in a cavity of a vertebral body, the fixation member including: (i) an outer member configured to be placed against bone of the vertebral body; (ii) an inner member opposite the outer member; and (iii) at least one adjustment element that extends between the outer and inner members and that is configured to adjust a length dimension of the fixation member along its longitudinal axis; (b) a compressible member configured to be placed in a cavity in an intervertebral disc adjacent the vertebral body and configured to be secured to the inner member of the fixation member; and (c) a spacer sized to fit between the outer and inner members of the fixation member to maintain the fixation member at a desired length dimension.
  • This device includes: (a) a fixation member configured to be placed in a cavity of a vertebral body, the fixation member including: (i) an outer member configured to be placed against bone of the vertebral body; (ii) an inner member opposite the outer member; and (iii) a longitudinal axis extending between the outer and inner members; and (b) a compressible member configured to be placed in a cavity in an intervertebral disc and to be secured to the inner member of the fixation member.
  • the compressible member is constructed to remain compressible after implantation.
  • the outer member includes a tab extending outward along an axis different from the longitudinal axis.
  • Another embodiment of the invention addresses a method of spinal prosthetic implantation.
  • This method includes: (a) creating a cavity in a first vertebral body; (b) cutting a first hole through either a lower or an upper endplate of the vertebral body and through the nucleus pulposus of a first intervertebral disc adjacent thereto, thereby creating a first opening in the first intervertebral disc; (c) cutting a second hole through the other of the lower and upper endplate of the vertebral body and through the nucleus pulposus of a second intervertebral disc adjacent thereto, thereby creating a second opening in the second intervertebral disc; (d) implanting a first compressible member into one of the first and second openings; (e) implanting a second compressible member into the other of the first or second openings; and (f) implanting a fixation member into the cavity in the first vertebral body.
  • Another embodiment of the invention addresses a method of spinal prosthetic implantation.
  • This method includes: (a) creating a cavity in a first vertebral body; (b) cutting through an endplate of the vertebral body and through the nucleus pulposus of an adjacent intervertebral disc, thereby creating an opening in the intervertebral disc; (c) cutting into the cortical bone of a second vertebral body on the other side of the intervertebral disc to create a seat; (d) implanting a compressible member into the opening in the intervertebral disc such that a distal end of the compressible member sits within the seat in the second vertebral body; and (e) implanting a fixation member in the cavity in the first vertebral body.
  • Another embodiment of the invention addresses a method of spinal prosthetic implantation.
  • This method includes: (a) creating a cavity in a vertebral body; (b) cutting a hole through either a lower or an upper endplate of the vertebral body and through the nucleus pulposus of an intervertebral disc adjacent thereto, thereby creating an opening in the intervertebral disc; (c) implanting a compressible member into the opening in the intervertebral disc; and (d) implanting a fixation member into the cavity in the first vertebral body.
  • the compressible member comprises a base member that is wider than the hole cut in the vertebral body through which the first compressible member is implanted.
  • the step of implanting the compressible member into the opening includes: (i) maneuvering the base member of the compressible member so that it passes through the hole and into the opening; and (ii) rotating the base member so that it substantially covers the hole.
  • FIG. 1 is a schematic, cut-away side view of a prior art intervertebral prosthetic device implanted in a spine.
  • FIG. 2 is a top perspective view of a compressible member of the intervertebral prosthetic device of FIG. 1 .
  • FIG. 4 is a top perspective, partially exploded view of a fixation member of the intervertebral prosthetic device of FIG. 1 and shows an adjustable member and a support member.
  • FIG. 6 is a side view, in cross-section, of the support member shown in FIG. 1 .
  • FIG. 8 is a schematic, cut-away side view showing subchondral bones of a superior vertebral body after a partial vertebrectomy.
  • FIG. 9 is a sectional view of a vertebra after creating a cavity within the vertebral body, as taken along line 9 - 9 of FIG. 8 .
  • FIG. 10 is a schematic, cut-away side view of a vertebral joint area after creating a cavity within the vertebral body and excision of a nucleus pulposus of a natural disc.
  • FIG. 11 is a schematic, cut-away side view of a vertebral joint and shows a fixation member, including an adjustable member and a support member, implanted in an inferior vertebral body.
  • FIG. 12 is a schematic, cut-away side view of a vertebral joint and shows a compressible member implanted in an intervertebral joint.
  • FIG. 13 is a schematic, cut-away side view of a vertebral joint and shows a technique for adjusting the height of an adjustable member implanted in a superior vertebral body.
  • FIG. 15A is a top perspective view of an intervertebral prosthetic device and a drill guide used to drill holes in the intervertebral bone in accordance with the invention
  • FIGS. 15B-15D are a first side elevation view, a second side elevation view, and a top plan view, respectively, of the intervertebral prosthetic device and the drill guide of FIG. 15A .
  • FIGS. 16A-16D are a top perspective view, a first side elevation view, a second side elevation view, and a top plan view, respectively, of the drill guide of FIG. 15A .
  • FIG. 17A is a top perspective view of the intervertebral prosthetic device and the drill guide of FIG. 15A , showing placement of anchor elements through the drill guide and a compressible member of the intervertebral prosthetic device;
  • FIGS. 17B-17D are a first side elevation view, a second side elevation view, and a top plan view, respectively, of the intervertebral prosthetic device, including the anchor elements, and the drill guide of FIG. 17A .
  • FIGS. 19A-19E are a top perspective view, a bottom plan view, a bottom perspective view, a first side elevation view, and a second side elevation view, respectively, of a plate of an embodiment of a fixation member in accordance with the invention.
  • FIG. 20 is a sectional view of a vertebra, including a plate, as shown in FIGS. 19A-19E , implanted in the vertebra.
  • FIG. 21A is a top perspective view of an intervertebral prosthetic device, including anchor elements and spacers, in accordance with another embodiment of the invention
  • FIGS. 21B-21D are a first side elevation view, a second side elevation view, and a top plan view, respectively, of the intervertebral prosthetic device, including the anchor elements and the spacers, of FIG. 21A .
  • FIG. 22A is a top perspective view of an intervertebral prosthetic device, including spacers, in accordance with another embodiment of the invention
  • FIGS. 22B-22D are a first side elevation view, a second side elevation view, and a top plan view, respectively, of the intervertebral prosthetic device, including the spacers, of FIG. 21A .
  • FIGS. 23A-23D are a top perspective view, a first side elevation view, a second side elevation view, and a top plan view, respectively, of a spacer.
  • FIG. 25 is a top perspective view of the implantable device of FIG. 24 .
  • FIG. 27 is another side perspective view of the implantable device of FIG. 24 .
  • FIG. 28 is a perspective view of the implantable device of FIG. 24 having anchor elements therethrough.
  • FIGS. 29A and 29B are respective cross-sectional and perspective views of an alternate embodiment compressible member
  • FIGS. 29C and 29D are respective cross-sectional and perspective views of another alternate embodiment compressible member
  • FIG. 29E is a cross-sectional view of either of the embodiments shown in FIGS. 29A-29D implanted in an intervertebral disc.
  • FIG. 35 is a schematic view of a compressor with endplate and nucleus cutters inserted into the cavities of adjacent vertebral bodies.
  • FIG. 36A is a schematic view of an alternative embodiment of the endplate and nucleus cutter in accordance with the invention
  • FIG. 36B is a bottom plan view of a main body of the endplate and nucleus cutter of FIG. 36A
  • FIGS. 36C and 36D are a top perspective view and a bottom plan view, respectively, of the cutting surface of the endplate and nucleus cutter of FIG. 36A
  • FIG. 36E is a perspective view of another alternative embodiment of the endplate and nucleus cutter.
  • the less invasive embodiment shown in FIG. 7 may not be as effective as the embodiment shown in FIG. 1 and/or may be subject to subsidence, the ability to implant a disc replacement prosthetic device via a hole formed in only one adjacent vertebral body is minimally invasive and is, therefore, advantageous.
  • the question becomes: how can one replace one or more discs via one vertebral body hole while: (a) greatly reducing the likelihood of subsidence, (b) making the device adaptable to particular patients and/or to the particular disc being replaced; (c) ensuring that the device remains in proper position; (d) providing a straightforward method of implantation; (e) making it cost effective for the patient.
  • FIGS. 15A-15D and 17 A- 17 D relate to a prosthetic device embodiment having a compressible member and only one fixation member.
  • FIGS. 21A-21D a prosthetic device having a fixation member on either side of the compressible member
  • FIGS. 25-28 a prosthetic device having two compressible members on either side of a fixation member
  • Adjacent plates of the adjustable fixation member 214 and the compressible member 218 can be secured directly together. That is, an inner plate 252 of the fixation member 214 can include an angled protrusion 253 that mates with an angled recess 243 in the first plate 242 of the compressible member 218 in the manner of a dovetail joint's tenon and mortise.
  • the angled portions 253 , 243 secure the fixation member 214 and the compressible member 218 together in a keyed fit, without need for other fasteners or fastening materials.
  • the angled protrusion can be formed on the first plate of the compressible member, and the angled recess can be formed in the inner plate of the fixation member.
  • the prosthetic device 200 is designed to minimize subsidence of the device 200 into bone adjacent the device 200 by employing anchor elements to secure the device 200 into hard outer cortical bone.
  • plate 244 of the compressible member 218 includes holes 246 for receipt of anchor elements 310 .
  • a drill guide can be used to create holes through the cortical bone toward the holes 246 in the device 200 .
  • FIGS. 16A-16D show an embodiment of the drill guide 300 .
  • the drill guide 300 includes an L-shaped body 302 having a curved face 304 at one end and a drill positioning block 306 at the other end.
  • the drill positioning block 306 can have one or more drilling channels 308 .
  • the drilling channels 308 are configured to guide a drill bit through the bone toward the holes 246 in the plate 244 of the compressible member 218 .
  • the drill guide 300 can temporarily engage prosthetic device 200 to guide the drilling of holes through bone toward holes 246 in prosthetic device 200 .
  • the guide 300 subsequently facilitates placement of the anchor elements 310 through the holes 246 , as best seen in FIG. 17A .
  • an upper portion 301 of the L-shaped body 302 is pushed between two adjustment elements 224 of the fixation member 214 such that the curved face 304 aligns with and engages a third adjustment element 224 of fixation member 214 , as shown in FIG. 15A .
  • the drill guide need not include curved face 304 and can be configured to mount to other portions of the prosthetic device.
  • the L-shaped body of the drill guide 300 can be configured to be adjustable along each of the two legs that form the “L”.
  • each leg of the “L” can comprise telescoping elements to lengthen or shorten the leg, depending on the size of the prosthetic device and the position of holes 246 of the compressible member 218 .
  • the guide 300 can be mounted to the outer vertebral body set to receive fixation member 214 .
  • another technique such as fluoroscopic imaging, may be used to determine drill placement. However, such a protocol may be less accurate.
  • anchor elements 310 can be inserted through drilling channels 308 , through the newly-drilled holes in the bone, and through the holes 246 in the compressible member 218 , as shown in FIGS. 17A-17D .
  • the drill guide 300 then can be removed from the prosthetic device 200 .
  • holes 246 can be arranged so that the anchor elements 310 diverge or converge.
  • Appropriate holes can be drilled through the cortical bone by reconfiguring drilling channels 308 in the drill positioning block 306 to align with the converging/diverging holes in the prosthetic device.
  • the drill guide 300 may be repositioned after drilling a first hole through the bone that is aligned with a first hole in the prosthetic device, and before drilling a second hole that is aligned with a second hole in the prosthetic device.
  • the anchor elements 310 are dimensioned to traverse the entire diameter of the vertebral body to obtain bi-cortical purchase, that is, fixation in the hard outer cortical bone on either side of the vertebral body.
  • the anchor elements 310 can be shortened so that they to traverse only part of the diameter of the vertebral body to obtain uni-cortical purchase, that is, fixation in the hard outer cortical bone on only one side of the vertebral body.
  • anchor elements 310 are shown passing through the bottom plate 244 of the compressible member 218 , in alternative embodiments, the site for placement of the anchor elements 310 can be through either plate 250 , 252 of the fixation member 214 or through the upper plate 242 of the compressible member 218 . Moreover, as shown in FIGS. 18A-18D , rather than passing through a portion of the prosthetic device, the anchor elements 310 can pass under and adjacent the lowermost plate of the prosthetic device to minimize subsidence of the device into the cancellous subchondral bone in the central portion of the vertebral body.
  • FIGS. 18A-18D show an embodiment of a prosthetic device 400 having a fixation member 414 and a compressible member 418 .
  • the compressible member 418 has a bottom plate 444 , here shown with a convex lowermost surface 445 .
  • the convex lowermost surface 445 may be configured to sit within a correspondingly shaped concave seat 2050 (shown in FIG. 24 ) formed in the cortical bone of an endplate of an adjacent vertebral body.
  • the anchor elements 310 are positioned under and just adjacent to this lowermost surface 445 to minimize subsidence of the prosthetic device 400 .
  • the inner plate 752 of the fixation member 714 can have a notch 754
  • each plate 842 , 844 of the compressible member can have a well 846 .
  • the peg 626 of the spacer 620 is configured to pass through the notch 754 and snap into the well 846 , to lock the spacer 620 in place in a snap fit, as shown in FIG. 21A .
  • the second box portion 624 resides between the adjustment elements 724 of the fixation member 714 , as shown in FIG. 21B .
  • the spacers 620 may be configured in varying shapes and of various heights to accommodate different sized vertebrae.
  • the spacers 620 can be positioned in fixation members 714 after the fixation members 714 are properly positioned in the vertebral bodies. That is, once the fixation members 714 are positioned in the vertebral bodies, the tension or load experienced by the compressible member 818 needs to be adjusted to optimize the normal loading and compression (i.e., the functionality) of the particular disc being replaced.
  • a surgeon can use a tensioner, (such as the tensioner described in U.S. Pat. No. 6,761,723) to move the plates 750 , 752 of the fixation member 714 toward the endplates of the vertebral body.
  • the tensioner may be used to elongate the fixation member 714 until a proper elongation distance between the plates 750 , 752 is achieved.
  • plate 752 contacts and encounters resistance from the compressible member 818 .
  • the surgeon can continue to apply a load via the tensioner to the fixation member 714 until a desired corresponding reactive load from the compressible member 818 is reached.
  • the struts 224 can be configured for adjustment like a crutch, that is, by having a hole through an outer casing and a plurality of holes through an adjustable inner member.
  • a fastener can be inserted through the hole in one side of the casing, through the corresponding hole in the inner member, and then through the hole in the other side of the casing. The fastener immobilizes the inner member with respect to the casing and maintains the proper elongation distance between the upper and lower plates 250 , 252 of the fixation member 214 .
  • a tripod also can be used to maintain the proper distance between the plates 250 , 252 .
  • the surgeon can select a tripod of an appropriate height, that is, of a height equal to the desired elongation distance, and slide it into the fixation member 214 .
  • the surgeon then can position the legs of the tripod on the lower plate 252 , preferably against three struts 224 , and position the top of the tripod against the upper plate 250 .
  • FIGS. 22A-22D show another embodiment of the prosthetic device 700 ′.
  • This prosthetic device 700 ′ is similar to the prosthetic device 700 of FIGS. 21A-21D , except that the outer plates 750 ′ of the fixation members 714 ′ of the device 700 ′ shown in FIGS. 22A-22D do not include the risers 753 present on the outer plates 750 of the fixation members 714 of the device 700 shown in FIGS. 21A-21D .
  • All other elements of the fixation members 714 ′, 716 ′ of the device 700 ′ shown in FIGS. 22A-22D are the same as the corresponding elements of the fixation members 714 , 716 of the device 700 shown in FIGS. 21A-21D and, therefore, are similarly numbered but include a differentiating apostrophe.
  • FIG. 24 Another prosthetic device embodiment, which is shown in FIG. 24 , restores normal biomechanics and motion of a pair of failing, adjacent intervertebral discs.
  • the prosthetic device 2000 is designed to spare the annulus fibrosis of the discs and the anterior longitudinal ligament of the spine. Moreover, the prosthetic device ensures solid bone fixation via attachment to cancellous vertebral body bone, rather than to the external surface of non-uniform and/or sclerotic vertebral body endplates.
  • the prosthetic device 2000 includes first and second compressible members 2020 and a fixation member 2030 sized to fit within a cavity in the vertebral body 2130 between the first compressible member 2020 and the second compressible member 2020 .
  • the first compressible member 2020 is sized to substantially replace the nucleus pulposus of a first intervertebral disc 2120 .
  • the second compressible member 2020 is sized to substantially replace the nucleus pulposus of a second intervertebral disc 2140 that is separated from the first intervertebral disc 2120 by the vertebral body 2130 .
  • the second compressible member 2020 has the same structure as the first compressible member 2020 .
  • Each compressible member 2020 comprises a compressible body portion formed of one or more compressible bodies 2022 .
  • the compressible bodies 2022 may be made of a biocompatible material compressible in an axial direction (i.e., in a direction substantially parallel to the spine).
  • the fixation member 2030 may include one or more adjustment members 2038 and/or a locking mechanism, as best shown in FIGS. 26 and 27 .
  • the adjustment members 2038 may be telescoping struts, the length of which may be fixed by a locking mechanism such as the c-shaped clamps, tripods, spacers, or other suitable extension devices, as previously discussed.
  • the locking mechanism fixes the load applied to the fixation member 2030 .
  • the fixation member 2030 engages the compressible members 2020 by sliding the slots 2039 formed in the first and second plates 2032 , 2034 of the fixation member 2030 onto the adjacent correspondingly shaped projections 2027 formed on the first plate 2024 of the compressible members 2020 .
  • the compressible members 2020 may include drilling channels 2029 through the second plates 2026 .
  • the drilling channels 2029 may be configured to receive anchor elements 2160 (e.g., screws, other fasteners, plates, etc.), as shown in FIG. 28 .
  • the anchor elements 2160 may be journalled through the drilling channels 2029 and into the cortical bone of a vertebral body, in the manner previously discussed.
  • the orientation of the compressible members 2020 with respect to the vertebral body may be additionally stabilized.
  • either plate of the fixation member 2030 and either plate of the compressible members 2020 can include a tab, as previously discussed, to help minimize subsidence of the prosthetic device.
  • an endplate and nucleus cutter attached may be used to cut (which may be in the form of boring) through the first endplate of the vertebral body adjacent the first failing intervertebral disc to be replaced. Once through the endplate, the cutting can continue through the nucleus pulposus of the first failing disc to excise the nucleus pulposus thereof, creating a cavity for a compressible member 2020 .
  • a first compressible member 2020 is positioned in the cavity in the vertebral body and then pushed through the hole in the endplate and into the space left by the excised nucleus of the first failing disc.
  • the convex surface 2028 As the first compressible member 2020 is inserted into the first failing disc, the convex surface 2028 is pushed into the seat 2050 in the vertebral body endplate on the other side of the disc.
  • the convex surface 2028 may be positioned in cancellous bone in the interior of a vertebral body, it is preferably position in the cortical bone, to help minimize the risk that the second plate 2026 will, over time, undesirably creep into the vertebral body as a result of loading.
  • a second compressible member 2020 is inserted into the second failing intervertebral disc in the same manner. Similarly, the convex surface 2028 of the second compressible member 2020 is inserted into the seat 2050 adjacent the second failing disc. It should be readily recognized that the order in which the compressible members 2020 are inserted can be reversed.
  • the surgeon slides a fixation member 2030 into the cavity in the vertebral body while engaging the projections 2027 of the compressible members 2020 and the slots 2039 in the first and second plates 2032 , 2034 of the fixation member 2030 .
  • the fixation member 2030 is fixedly joined to the compressible members 2020 .
  • the compressible members 2020 and the fixation member 2030 may be connected by conventional attachment members, such as screws, or by biocompatible cement or a suitable adhesive composition.
  • the compressible members 2020 and/or the fixation member 2030 may have drilling channels 2029 for receiving anchor elements 2160 (e.g., screws) to supplement immediate fixation during healing of the bone graft, as previously described.
  • anchor elements 2160 e.g., screws
  • a porous bone ingrowth coating and/or surface texturing may also be applied to the device.
  • hydroxyapatite or other bone-to-implant chemical or biological interface surface treatment may be applied to the first and second plates 2032 , 2034 of the fixation member 2030 and/or to the convex surfaces 2028 (each of which is in contact with bone), to enhance bone growth into a textured porous surface.
  • the compressible elements 2022 used in the compressible members 2020 may be designed to combat this problem.
  • the selected compressible elements 2022 may have spring constants which are greater or less than the spring constants of the remaining compressible elements 2022 . As a result, corrective loading on the scoliotic bodies can be better achieved.
  • intervertebral disc prosthetic device embodiments (and the methods of implanting them) have been described. In conjunction with these embodiments, however, various modifications may be used to address a particular patient's condition and/or the level in the spine in which the device will be implanted (e.g., between Lumbar-5 and Sacrum-1 there is a great variation among patients in the shape of the joint). Accordingly, the following describes various alternative compressible member embodiments which may be employed with any of the aforementioned prosthetic device embodiments.
  • FIGS. 29A-29E show two alternate embodiments for a compressible member. Specifically, FIGS. 29A and 29B respectively show a cross-sectional view and a perspective view of a compressible member 2100 and FIG. 29E shows the compressible member 2100 positioned in a disc.
  • the compressible member 2100 is formed of a base member 2102 that may, as shown, be in the shape of a cup.
  • the lower surface 2112 of the base member 2102 may be attached to a fixation member (not shown in FIGS. 29A-29E ) in any manner previously discussed (e.g., screws, dovetail tenon/mortise joint, etc.)
  • a circumferential wall 2114 of the base member 2102 which rises upward from the lower surface 2112 , encloses a plurality of compressible elements 2104 (e.g., springs, or any other compressible element previously discussed). As shown in FIG. 29E , the wall 2114 , when implanted, compensates for anatomic variations and assures that the endplate 2122 of the vertebral body 2120 engages solid metal.
  • compressible elements 2104 e.g., springs, or any other compressible element previously discussed.
  • the other ends of the compressible elements 2104 are attached to an upper member 2106 , in a manner similar to the previously described compressible member embodiments.
  • the upper member 2106 may have a convex surface 2108 which is configured to rest within a seat 2050 (shown in FIG. 24 ) formed in a vertebral body endplate, as previously discussed.
  • the compressible member embodiment 2100 ′ shown in FIGS. 29C-29D is substantially similar to the compressible member embodiment 2100 shown in FIGS. 29A-29B , except that the wall 2114 in the base member 2102 in the embodiment shown in FIGS. 29A-29B is replaced with a slotted wall 2114 ′ defining an alternative base member 2102 ′.
  • slotted wall 2114 ′ The reason for the slotted wall 2114 ′ is that for some individuals and/or some disc locations, additional clearance may serve to facilitate placing the springs over as wide an area as possible. However, as the slots reduce the support and attachment to the cortical bone of the vertebral body, the desires to use certain spring designs and to enhance support/attachment must be weighed in each particular instance.
  • FIGS. 30A-30B Another compressible member 2200 embodiment is shown in FIGS. 30A-30B .
  • the compressible member 2200 includes a base member 2202 , compressible elements 2204 , and an upper member 2206 .
  • the base member 2202 is wider than the diameter of the hole 2210 but narrow enough so that it can go through the hole 2210 at an angle after which it can be maneuvered so as to cover the hole 2210 , as shown in FIG. 30B .
  • the base member 2202 rests against the cortical bone of the vertebral body 2220 , thereby reducing the likelihood that the compressible member 2200 may experience subsidence into the vertebral body 2220 as a result of cyclical loads applied to the compressible member 2200 .
  • FIGS. 30C and 30D Another compressible member 2200 ′ embodiment is shown in FIGS. 30C and 30D .
  • the base member 2202 ′ is expandable to be wider than the diameter of the hole 2210 in a vertebral body endplate through which the compressible member 2200 ′ is implanted.
  • the base member 2202 ′ includes a rotatable driving plate 2240 and a plurality of radially adjustable leaves 2250 .
  • the rotatable plate includes a plurality of projections 2242 that, when the rotatable plate 2240 rotates, push the leaves 2250 radially outward along rails 2260 , thereby radially adjusting the overall diameter of the base member 2202 ′.
  • the base member 2202 ′ may be radially expanded to fix the base member 2202 ′ in a manner similar to that shown in FIG. 30B .
  • the size of base member 2202 ′ is described as being adjusted by means of leaves, the embodiment is not so limited. Rather, the base member could be adjusted in other ways such as, for example, by means of screws, telescoping rods, etc.
  • FIG. 31 Another compressible member 2400 embodiment is shown in FIG. 31 .
  • a first compressible member 2300 which is provided in a first disc, abuts (along a concave seat 2050 ) a first vertebral body 2430 and is connected to a fixation member 2440 .
  • This first compressible member 2300 and the fixation member 2440 may be any of the compressible member embodiments and fixation member embodiments, respectively, previously discussed.
  • it is a second compressible member 2400 , which is also connected to the fixation member 2440 , which is the focus of FIG. 31 .
  • the second compressible member 2400 is shown as being part of a dual compressible member device, it should readily be recognized that it could be incorporated in a single compressible member device.
  • the second compressible member 2400 like previous embodiments, includes a base member 2402 supporting a plurality of compressible elements 2404 .
  • the other ends of the compressible elements 2404 are connected to another plate 2406 .
  • the plate 2406 would rest against a vertebral body, in this embodiment, the plate 2406 is attached to a ball-and-socket joint comprised of a socket 2408 and a ball 2410 .
  • the socket 2408 is attached to the plate 2406 and the ball 2410 is immobilized in the vertebral body 2460 by means of a spike 2412 or screw.
  • the purpose of the ball-and-socket connection is to accommodate anatomic variation in which the angle between vertebral endplates may be highly variable among patients. This is particularly helpful between Lumbar-5 and Sacrum-1 where there is a great variation among patients in the shape of the joint and where replacement of two discs (as shown in FIG. 31 ) in this area is particularly complicated.
  • the compressible member embodiments 2300 , 2400 shown in FIG. 31 can be switched.
  • the compressible member embodiment 2300 currently adjacent the upper vertebral body 2430 can be switched with the compressible member embodiment 2400 currently adjacent the lower vertebral body 2460 .
  • FIG. 32 shows another embodiment of a compressible member 2500 , which like the embodiment 2400 shown in FIG. 31 employs a spike 2512 to immobilize a plate 2506 , as hereafter explained in detail.
  • the compressible member embodiment 2500 like previous embodiments, has a base member 2502 , an upper member 2506 , and a plurality of compressible elements 2504 which extend between the base member 2502 and the upper member 2506 .
  • FIGS. 33A-33C illustrate a surgical implement, that is, a cutting implement that can be mounted to a compressor 900 (shown in FIG. 34A ) or a distractor 910 (shown in FIG. 34B ) to cut through an endplate of a vertebral body and the nucleus pulposus of the intervertebral disc adjacent the vertebral body.
  • the exemplary cutting implement is in the form of an endplate and nucleus cutter 920 having a substantially circular sidewall 921 that terminates in a cutting edge 922 .
  • the maximum diameter of the sidewall 921 of the endplate and nucleus cutter 920 should not be greater than the minimum diameter of the nucleus pulposus and/or the diameter of the prosthesis to be implanted.
  • the cutting edge 922 can be smooth or, alternatively, serrated.
  • the cutting edge 922 may be thinner than the sidewall 921 and may be tapered to a sharp end.
  • the endplate and nucleus cutter 920 optionally can have a projection 923 , as shown in FIG. 33B .
  • the tip of the projection 923 can be used to create a notch in an endplate, thereby bracing the endplate and nucleus cutter 920 relative to the endplate; the projection 923 can serve as an axis of rotation.
  • this bracing effect enables a surgeon to cut through the endplate with the sharp end of the endplate and nucleus cutter 920 , without risk that the endplate and nucleus cutter 920 will inadvertently slide from its proper position relative to the endplate surface.
  • FIG. 33C An alternative embodiment of the endplate and nucleus cutter 920 ′ is shown in FIG. 33C .
  • the only difference between this embodiment and the one shown in FIG. 33B is that the projection 923 ′ is cylindrical in shape and has a concave end.
  • An advantage of employing the embodiment of FIG. 33C with the embodiment of FIG. 33B on a single compressor 900 is that when the sharp edges of the two endplate and nucleus cutters 920 approach each other, the tip of the projection 923 on the first cutter 920 will be partially journalled into the concave end portion of the projection 923 ′ of the second cutter 920 ′.
  • an endplate and nucleus cutter 920 can be attached to an end portion 901 of a first arm 902 of the compressor 900 to face a second arm 904 .
  • an endplate and nucleus cutter 920 which is attached to an end portion 903 of the second arm 904 , faces toward the first arm 902 and toward the other endplate and nucleus cutter 920 .
  • the first and second arms 902 , 904 move toward each other.
  • they maintain their approximately parallel orientation, and the endplate and nucleus cutters 920 approach each other.
  • the endplate and nucleus cutters 920 on the first and second arms 902 , 904 can share a common central axis so that, when the handle 905 is fully compressed, the cutting edges 922 of the endplate and nucleus cutters 920 contact each other.
  • the endplate and nucleus cutters 920 can be either fixedly mounted or rotatably mounted to the arms 902 , 904 of the compressor 900 .
  • the surgeon can manually rotate the cutters 920 by swinging the handle 905 of the compressor 900 side-to-side. This side-to-side motion, combined with compression of the handle 905 , enables the cutting edges 922 to cut through the endplate and nucleus pulposus of the damaged disc.
  • the endplate and nucleus cutters 920 may be rotatably mounted to the compressor 900 .
  • a motor or other drive source can be connected to the cutters 920 to rotate them relative to the arms 902 , 904 of the compressor 900 .
  • the compressor 900 can be used when a surgeon wants to implant a prosthetic device having two fixation members, one of which is to go into a vertebral body above a problematic disc and the other of which is to go into the vertebral body below the problematic disc.
  • FIG. 35 shows a compressor 900 being inserted into adjacent vertebral bodies to remove the nucleus pulposus of a damaged disc.
  • a distractor 910 with only one, outwardly facing endplate and nucleus cutter 920 may be used.
  • FIG. 34B shows a distractor 910 having one endplate and nucleus cutter 920 on a first arm 912 which faces outward and away from a second arm 914 .
  • An outwardly facing plate 930 is rotatably attached to the second arm 914 by an axle 931 .
  • the plate 930 is designed to be placed against an endplate in a vertebral body and to remain immobile relative to the vertebral body.
  • the endplate and nucleus cutter 920 of the distractor 910 either is manually rotated by the surgeon (in an embodiment where the endplate and nucleus cutter 920 is fixedly mounted to the distractor 500 ) or rotates as a result of a motor (in an embodiment where the endplate and nucleus cutter 920 is rotatably mounted to the distractor 910 ), the endplate and nucleus cutter 920 will cut through one endplate in a vertebral body, while the plate 930 remains pressed against the other endplate in the vertebral body. The plate 930 will not abrade the vertebral body against which it is placed because it does not rotate with respect to that endplate.
  • the plate 930 will move in one direction to contact the endplate of the vertebral body, and the endplate and nucleus cutter 920 will move in an opposite direction to contact the other endplate of the vertebral body.
  • the handle 915 and rotation of the endplate and nucleus cutter 920 will force the cutter 920 through the endplate and the nucleus pulposus of the adjacent intervertebral disc.
  • an endplate and nucleus cutter 920 can be mounted to devices having a configuration different than the compressor 900 and distractor 910 .
  • an endplate and nucleus cutter 920 can be attached to an end of a single arm, and a surgeon can grip the opposite end of the single arm to position the endplate and nucleus cutter 920 appropriately to cut through the endplate and the nucleus pulposus of a damaged disc.
  • the single arm can be bent to provide additional leverage.
  • FIGS. 36A-36D illustrate another embodiment of an endplate and nucleus cutter 1000 .
  • This cutter 1000 includes a rotating axle 1002 with multiple arms 1004 , a cylindrical main body 1006 with a pair of oblique slots 1008 to receive the arms 1004 of the axle 1002 , and a cutting surface 1010 that attaches to the cylindrical main body 1006 .
  • the cutting surface 1010 can have a flat profile or it can have a convex, domed profile as seen in FIGS. 36A, 36C , and 36 D.
  • the cutting surface 1010 includes cutting edges 1012 that enable the cutter 1000 , when rotated, to cut through the endplate and the nucleus pulposus of the disc.
  • a serrated cutting edge 1010 ′ can be defined around a perimeter of a cup-shaped cutter 1000 ′ which is similar in shaped to the endplate and nucleus cutter 920 shown in FIGS. 33A and 33B .
  • the cutter 1000 can be mounted to the arm of a compressor or a distractor and, once positioned at a cutting location in a vertebral body, can elongate and move away from the arm. Accordingly, the cutter 1000 can be placed through a relatively small vertebral body window and still reach all the way through the vertebral body endplate and the nucleus pulposus of the damaged disc.
  • the arms 1004 of the axle 1002 are positioned in the slots 1008 at a location close to the cutting surface 1010 . With rotation of the axle 1002 , friction forces the arms 1004 to slide up the slots 1008 , which in turn elongates the cutter 1000 and moves the cutting surface 1010 toward the area to be cut.
  • intervertebral prosthetic device embodiments of the present invention offer several advantages.
  • the intervertebral prosthetic device embodiments replicate the mechanical properties of a natural intervertebral disc.
  • the intervertebral prosthetic device embodiments restore disc height, defined as the axial distance between vertebrae adjacent the damaged disc, and duplicate the range of motion of a natural intervertebral joint.
  • the intervertebral prosthetic device embodiments suffer minimal degradation of the prosthetic material and produce minimal wear debris under long-term cyclic loading conditions.
  • the prosthetic device embodiments (a) can axially compress and thus dissipate energy; (b) may be easily repaired or replaced; (c) may be easily manufactured and implanted by a surgeon; and (d) are durable and modular.
  • the prosthetic device embodiments need not include plastic polymers or elastomeric components, the prosthetic device embodiments do not degrade under long-term cyclic loading conditions.
  • the benefit of the implantation procedure for the one compressible member/one fixation member embodiment and the dual compressible member/one fixation member embodiments is that only one vertebral body cavity is formed. As a result, both the time necessary for the implantation procedure and the amount of resultant healing are greatly reduced.
  • the prosthetic device embodiments can comprise biocompatible metallic materials, such as a titanium alloy having, for example, 4% vanadium and 6% aluminum. Persons of skill in the art will recognize other suitable materials, for example, a cobalt-chromium alloy, such as alloy number 301.
  • the prosthetic device embodiments with the exception of the springs of the compressible member, can comprise a ceramic material, such as aluminum oxide or zirconium oxide.
  • the porous surfaces of the fixation members can be coated with hydroxyapatite or bioactive proteins (e.g., bone morphogenic protein) to encourage bone ingrowth.
  • fixation members of the prosthetic device embodiments which may be composed of carbon fiber polyetheretherketone, bone graft (auto- or allo-graft bone), bone cement, etc., support the compressible member(s) until the bone graft (which is packed into the open space of the fixation members) heals. Once the bone graft heals, however, the fixation members may no longer be needed. Accordingly, the fixation members of the prosthetic device embodiments may be composed of a bioresorbable material that would gradually be replaced by bone over time. Suitable bioresorbable materials to form the fixation members include structural allograft (bank) bone, or polymers made of polylactic acid or polyglycolic acid. Similarly, the anchor members also can be made of carbon fiber or of a bioresorbable material, such as polylactic acid, polyglycolic acid, or a combination of those materials.
  • the compressible members may be, for example, springs, elastomers, monolithic bodies, elastic polymers, hydrogels, disc allograft, or any other material which displays similar mechanical properties when placed under stress (i.e., tension and/or compression) and which substantially regains its original shape upon removal of the stress.
  • the embodiments of the prosthetic device previously described have advantages over conventional devices.
  • the prosthetic device may be implanted using a straight anterior approach, it may be implanted using an anterolateral approach to the spine that is a retroperitoneal approach in the plane between the abdominal vessels and the psoas muscle.
  • the embodiments described herein only disrupt bone material in the adjacent vertebral body and the nucleus pulposus in the intervertebral disc. The bone heals and the nucleus pulposus is replaced by the prosthetic device.
  • the embodiments of the prosthetic device described herein minimally infringe upon areas of the vertebral body which would be used to provide a fusion should that later become necessary.
  • the anterolateral approach helps maintain spinal function and stability.
  • an anterolateral approach on one side of a vertebral body allows for a later opposite side approach for adjustment of the device or for adjacent level disc replacement should that become necessary. Further, this opposite side approach would not be hindered by scar tissue from the previous procedure.
  • the prosthetic device embodiments also allow for bending and torsion motion, as well as axial displacement and elastic compression. Further, unlike an articulated joint, the prosthetic device deforms similarly to a normal, healthy disc. Moreover, unlike previous total disc replacement devices which may result in motion of about 3.8° to 4.6°, the embodiments of the invention herein described maintain the motion at a nearly healthy level of motion, i.e., about 7° to about 12°.
  • fixation member allows for a more precise restoration of disc height.
  • fixation members may be anchored entirely to cancellous bone, at least some embodiments avoid problems inherent to poor bony ingrowth, which may result from sclerotic endplates. As a result, the risk of device loosening is minimized. And, as the device is enclosed entirely by bone and the annulus fibrosis, ejection, dislocation, and migration of the device is very unlikely.
  • intramedullary fixation of the fixation member in the vertebral body provides greater stability.
  • the fixation member is provided within the cancellous bone of a vertebral body adjacent the failing disc(s), to maximize the osteogenic potential of bone to grow into the fixation member. Further, the replacement of the autologous bone removed from the vertebral body during the procedure (or the addition of bone cement) into the open vertebral body facilitates the transfer of loads to the cortical bone walls of the vertebral body once the bone heals.
  • fibrous soft tissue growth into the compressible members will fill the normal volume of the disc nucleus.
  • this tissue will bulge outward and radially load the inner annulus fibrosis in a manner similar to a healthy nucleus. The radially outward loading will restore the function of the retained annulus fibrosis.
  • prosthetic device embodiments may be used no matter how collapsed a patient's disc may be.
  • An overdistraction problem inherent for installation of total disc replacements does not arise with respect to the prosthetic device described herein.

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Public Health (AREA)
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  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Vascular Medicine (AREA)
  • Transplantation (AREA)
  • Cardiology (AREA)
  • Neurology (AREA)
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US10/913,510 2003-08-07 2004-08-09 Apparatus and method for performing spinal surgery Abandoned US20050113924A1 (en)

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Cited By (54)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20050085910A1 (en) * 2003-10-16 2005-04-21 Sweeney Patrick J. Vertebral prosthesis
US20050277930A1 (en) * 2004-05-27 2005-12-15 Depuy Spine, Inc. Tri-joint implant
US20060149381A1 (en) * 2004-12-30 2006-07-06 Kim Chong C Prosthetic spinal discs
US20070173941A1 (en) * 2006-01-25 2007-07-26 Sdgi Holdings, Inc. Intervertebral prosthetic disc and method of installing same
US20080021555A1 (en) * 2006-07-19 2008-01-24 John White Expandable vertebral body implants and methods of use
US20080071375A1 (en) * 2005-10-10 2008-03-20 Carver Donna J Artificial spinal disc replacement system and method
US20080140202A1 (en) * 2006-12-08 2008-06-12 Randall Noel Allard Energy-Storing Spinal Implants and Methods of Use
US20080154381A1 (en) * 2006-12-21 2008-06-26 Rob Gene Parrish Intervertebral disc spacer
US20080195213A1 (en) * 2007-02-12 2008-08-14 Brigham Young University Spinal implant
US20080221691A1 (en) * 2007-03-10 2008-09-11 Christopher Chaput Surgical implant secured by pegs and associated methods
WO2008106912A1 (fr) * 2007-03-07 2008-09-12 Ulrich Gmbh & Co. Kg Implant intervertébral comportant un composant élastique
US20080243194A1 (en) * 2005-09-26 2008-10-02 The Regents Of The University Of California Articulating instrumentation for dynamic spinal stabilization
US20080249623A1 (en) * 2006-12-22 2008-10-09 Qi-Bin Bao Implant Restraint Device and Methods
US20100082106A1 (en) * 2006-11-08 2010-04-01 Muhanna Nabil L Vertebral body replacement
WO2010059866A1 (fr) * 2008-11-19 2010-05-27 Endospinal, Inc. Système de réparation intramédullaire pour fractures des vertèbres
US20100137862A1 (en) * 2008-11-19 2010-06-03 Endoorthopaedics, Inc. Intramedullary Repair System for Bone Fractures
US20100185291A1 (en) * 2008-12-31 2010-07-22 Jimenez Omar F Methods and apparatus for vertebral body distraction and fusion employing flexure members
US20100211106A1 (en) * 2009-02-19 2010-08-19 Bowden Anton E Compliant Dynamic Spinal Implant And Associated Methods
US20100217334A1 (en) * 2009-02-23 2010-08-26 Hawkes David T Press-On Link For Surgical Screws
US20100241232A1 (en) * 2007-02-12 2010-09-23 Peter Halverson Spinal implant
WO2010078468A3 (fr) * 2008-12-31 2010-11-25 Jimenez Omar F Procédés et appareils de déplacement et de fusion de corps vertébraux utilisant des éléments de flexion
US7875079B2 (en) 2006-12-14 2011-01-25 Warsaw Orthopedic, Inc. Vertebral implant containment device and methods of use
US20110138948A1 (en) * 2009-07-22 2011-06-16 Jimenez Omar F Coaxial screw gear sleeve mechanism
US8034081B2 (en) 2007-02-06 2011-10-11 CollabComl, LLC Interspinous dynamic stabilization implant and method of implanting
US20120059471A1 (en) * 2004-09-23 2012-03-08 Cervitech, Inc. Prosthesis for partial replacement of a vertebral body
US8211178B2 (en) 2009-06-18 2012-07-03 Warsaw Orthopedic Intervertebral implant with a pivoting end cap
US8353957B2 (en) 2010-04-20 2013-01-15 Warsaw Orthopedic, Inc. Expandable medical device and method
EP2244671A4 (fr) * 2008-01-25 2013-03-20 Spinalmotion Inc Disque prothétique intervertébral avec partie centrale absorbant les chocs comprenant des ressorts à disques
US8628577B1 (en) 2009-03-19 2014-01-14 Ex Technology, Llc Stable device for intervertebral distraction and fusion
US8636746B2 (en) 2009-12-31 2014-01-28 Spinex Tec, Llc Methods and apparatus for insertion of vertebral body distraction and fusion devices
US20140031939A1 (en) * 2012-07-25 2014-01-30 Steve Wolfe Mesh spacer hybrid
US8702686B2 (en) 2009-09-11 2014-04-22 Materialise Nv Adaptable therapeutic, diagnostic or surgical guide
US8740980B2 (en) 2011-01-27 2014-06-03 Warsaw Orthopedic, Inc. Expandable medical implant
US8894687B2 (en) 2011-04-25 2014-11-25 Nexus Spine, L.L.C. Coupling system for surgical construct
US8920502B1 (en) * 2006-11-08 2014-12-30 Spinal Usa, Inc. Vertebral body replacement
US8940049B1 (en) 2014-04-01 2015-01-27 Ex Technology, Llc Expandable intervertebral cage
US8945228B2 (en) 2012-11-15 2015-02-03 DePuy Synthes Products, LLC Endplate for a vertebral implant
US9157497B1 (en) 2009-10-30 2015-10-13 Brigham Young University Lamina emergent torsional joint and related methods
US9333008B2 (en) 2010-02-19 2016-05-10 Brigham Young University Serpentine spinal stability device
US9486328B2 (en) 2014-04-01 2016-11-08 Ex Technology, Llc Expandable intervertebral cage
WO2016193801A1 (fr) * 2015-06-03 2016-12-08 Nicolas Perren Renfort pour dilatation de tissu
US9642651B2 (en) 2014-06-12 2017-05-09 Brigham Young University Inverted serpentine spinal stability device and associated methods
US9700425B1 (en) 2011-03-20 2017-07-11 Nuvasive, Inc. Vertebral body replacement and insertion methods
WO2018031801A1 (fr) * 2016-08-11 2018-02-15 Amnon Yadin Remplacement de disque intervertébral
US10390959B2 (en) 2015-11-24 2019-08-27 Agada Medical Ltd. Intervertebral disc replacement
US20200046511A1 (en) * 2018-08-07 2020-02-13 Minimally Invasive Spinal Technology, LLC Device and method for correcting spinal deformities in patients
US10682237B2 (en) * 2015-09-03 2020-06-16 Cmc Sert Ltd. Prosthesis for replacing joint in a human hand or foot
US11234835B2 (en) 2019-03-05 2022-02-01 Octagon Spine Llc Transversely expandable minimally invasive intervertebral cage
US11298931B2 (en) * 2015-11-24 2022-04-12 Agada Medical Ltd. Intervertebral disc replacement
US20220168114A1 (en) * 2020-12-01 2022-06-02 Bret Michael Berry Compliant spinal implant
US11497622B2 (en) 2019-03-05 2022-11-15 Ex Technology, Llc Transversely expandable minimally invasive intervertebral cage and insertion and extraction device
US12011365B2 (en) 2022-07-18 2024-06-18 Octagon Spine Llc Transversely expandable minimally invasive inter vertebral cage
US12023257B2 (en) 2021-10-05 2024-07-02 Spineology Inc. Mesh spacer hybrid spinal implant
US12097126B2 (en) 2021-09-29 2024-09-24 Ex Technology, Llc Expandable intervertebral cage

Families Citing this family (27)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7879095B2 (en) * 1994-03-18 2011-02-01 Madhavan Pisharodi Method of inserting, rotating and releasing a spring-loaded artificial disk
US9028550B2 (en) 2005-09-26 2015-05-12 Coalign Innovations, Inc. Selectively expanding spine cage with enhanced bone graft infusion
WO2007130699A2 (fr) * 2006-01-13 2007-11-15 Clifford Tribus dispositif de reduction et de stabilisation spinale
US7892285B2 (en) * 2007-01-02 2011-02-22 Zimmer Spine, Inc. Universal joint total disc replacement
US20100145455A1 (en) 2008-12-10 2010-06-10 Innvotec Surgical, Inc. Lockable spinal implant
US12232975B2 (en) 2008-02-22 2025-02-25 Howmedica Osteonics Corp. Lockable spinal implant
US8932355B2 (en) 2008-02-22 2015-01-13 Coalign Innovations, Inc. Spinal implant with expandable fixation
US8992620B2 (en) 2008-12-10 2015-03-31 Coalign Innovations, Inc. Adjustable distraction cage with linked locking mechanisms
US7927375B2 (en) * 2008-09-12 2011-04-19 Doty Keith L Dynamic six-degrees-of-freedom intervertebral spinal disc prosthesis
DE102008051588A1 (de) * 2008-10-14 2010-04-15 Global Medical Consulting Gmbh Bewegliche Bandscheibenprothese
CA2750917A1 (fr) * 2008-12-26 2010-07-01 Scott Spann Approche laterale retroperitoneale a invasion minime pour chirurgie spinale
US20110106258A1 (en) * 2009-10-30 2011-05-05 Warsaw Orthopedic, Inc. End cap for a vertebral implant
US20110126745A1 (en) * 2009-11-30 2011-06-02 Andrew Porterfield Refractory support device and associated method
EP3073969B1 (fr) 2013-11-27 2023-08-16 Howmedica Osteonics Corp. Élément d'insertion de support structural pour cage de spondylodèse
EP3228282B1 (fr) 2016-04-07 2023-02-15 Howmedica Osteonics Corp. Implant intersomatique extensible
EP3245982B1 (fr) 2016-05-20 2023-11-01 Howmedica Osteonics Corp. Implant intervertébral extensible ayant une correction de lordose
US10537434B2 (en) * 2016-08-08 2020-01-21 Wu Jau Ching Intervertebral implant
AU2017228529B2 (en) 2016-09-12 2022-03-10 Vb Spine Us Opco Llc Interbody implant with independent control of expansion at multiple locations
US10314718B2 (en) 2016-09-22 2019-06-11 Loubert S. Suddaby Expandable intervertebral fusion implant
AU2017251734B2 (en) 2016-10-26 2022-10-20 Vb Spine Us Opco Llc Expandable interbody implant with lateral articulation
US11701239B2 (en) 2017-01-26 2023-07-18 Loubert S. Suddaby Stand-alone expandable interbody spinal fusion device with integrated fixation mechanism
US11207192B2 (en) 2017-01-26 2021-12-28 Loubert S. Suddaby Stand-alone expandable interbody spinal fusion device with integrated fixation mechanism
US10716553B2 (en) 2017-04-19 2020-07-21 Pantheon Spinal, Llc Spine surgery retractor system and related methods
EP3456294B1 (fr) 2017-09-15 2024-06-05 Stryker European Operations Holdings LLC Dispositif de fusion de corps intervertébraux expansé à l'aide d'un matériau durcissable
US10596010B2 (en) 2017-09-18 2020-03-24 Loubert S. Suddaby Stand-alone expandable interbody spinal fusion device with locking mechanism
US11219532B2 (en) 2017-09-18 2022-01-11 Loubert S. Suddaby Stand-alone expandable interbody spinal fusion device with locking mechanism
CN117017591B (zh) * 2023-10-09 2024-01-23 北京爱康宜诚医疗器材有限公司 椎间假体及椎间假体组件

Citations (91)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3426364A (en) * 1966-08-25 1969-02-11 Colorado State Univ Research F Prosthetic appliance for replacing one or more natural vertebrae
US4242758A (en) * 1977-06-01 1981-01-06 University Of Leeds Industrial Service Ltd. Elbow prosthesis
US4309777A (en) * 1980-11-13 1982-01-12 Patil Arun A Artificial intervertebral disc
US4586496A (en) * 1984-03-05 1986-05-06 Waldemar Link Gmbh & Co. Surgical chisel
US4697586A (en) * 1986-06-24 1987-10-06 Gazale William J Combined chisel-guide surgical instrument
USD295318S (en) * 1985-10-02 1988-04-19 Gazale William J Combined surgical single chisel and guide
USD295317S (en) * 1985-10-02 1988-04-19 Gazale William J Combined surgical double chisel and guide
US4759769A (en) * 1987-02-12 1988-07-26 Health & Research Services Inc. Artificial spinal disc
US4911718A (en) * 1988-06-10 1990-03-27 University Of Medicine & Dentistry Of N.J. Functional and biocompatible intervertebral disc spacer
US4932975A (en) * 1989-10-16 1990-06-12 Vanderbilt University Vertebral prosthesis
US4936856A (en) * 1987-11-03 1990-06-26 Waldemar Link Gmbh & Co. Hip joint socket prosthesis
US5002576A (en) * 1988-06-06 1991-03-26 Mecron Medizinische Produkte Gmbh Intervertebral disk endoprosthesis
US5015255A (en) * 1989-05-10 1991-05-14 Spine-Tech, Inc. Spinal stabilization method
US5047055A (en) * 1990-12-21 1991-09-10 Pfizer Hospital Products Group, Inc. Hydrogel intervertebral disc nucleus
US5055104A (en) * 1989-11-06 1991-10-08 Surgical Dynamics, Inc. Surgically implanting threaded fusion cages between adjacent low-back vertebrae by an anterior approach
US5059193A (en) * 1989-11-20 1991-10-22 Spine-Tech, Inc. Expandable spinal implant and surgical method
US5108438A (en) * 1989-03-02 1992-04-28 Regen Corporation Prosthetic intervertebral disc
US5123926A (en) * 1991-02-22 1992-06-23 Madhavan Pisharodi Artificial spinal prosthesis
US5141513A (en) * 1990-05-04 1992-08-25 John Fortune Surgical template
US5236460A (en) * 1990-02-12 1993-08-17 Midas Rex Pneumatic Tools, Inc. Vertebral body prosthesis
US5246458A (en) * 1992-10-07 1993-09-21 Graham Donald V Artificial disk
US5290312A (en) * 1991-09-03 1994-03-01 Alphatec Artificial vertebral body
US5306310A (en) * 1991-08-27 1994-04-26 Man Ceramics Gmbh Vertebral prosthesis
US5314477A (en) * 1990-03-07 1994-05-24 J.B.S. Limited Company Prosthesis for intervertebral discs and instruments for implanting it
US5336223A (en) * 1993-02-04 1994-08-09 Rogers Charles L Telescoping spinal fixator
US5390683A (en) * 1991-02-22 1995-02-21 Pisharodi; Madhavan Spinal implantation methods utilizing a middle expandable implant
US5397359A (en) * 1991-08-07 1995-03-14 Oscobal Ag Metal wire structure for endoprosthetics
US5405391A (en) * 1993-02-16 1995-04-11 Hednerson; Fraser C. Fusion stabilization chamber
US5423816A (en) * 1993-07-29 1995-06-13 Lin; Chih I. Intervertebral locking device
US5433005A (en) * 1994-06-27 1995-07-18 Cogdill; Sean D. Chipping hammer
US5445639A (en) * 1989-05-10 1995-08-29 Spine-Tech, Inc. Intervertebral reamer construction
US5458638A (en) * 1989-07-06 1995-10-17 Spine-Tech, Inc. Non-threaded spinal implant
US5458641A (en) * 1993-09-08 1995-10-17 Ramirez Jimenez; Juan J. Vertebral body prosthesis
US5458642A (en) * 1994-01-18 1995-10-17 Beer; John C. Synthetic intervertebral disc
US5480442A (en) * 1993-06-24 1996-01-02 Man Ceramics Gmbh Fixedly adjustable intervertebral prosthesis
US5480401A (en) * 1993-02-17 1996-01-02 Psi Extra-discal inter-vertebral prosthesis for controlling the variations of the inter-vertebral distance by means of a double damper
US5489307A (en) * 1993-02-10 1996-02-06 Spine-Tech, Inc. Spinal stabilization surgical method
US5490860A (en) * 1993-12-08 1996-02-13 Sofamor Danek Properties, Inc. Portable power cutting tool
US5514139A (en) * 1994-09-02 1996-05-07 Hudson Surgical Design, Inc. Method and apparatus for femoral resection
US5549679A (en) * 1994-05-20 1996-08-27 Kuslich; Stephen D. Expandable fabric implant for stabilizing the spinal motion segment
US5591235A (en) * 1995-03-15 1997-01-07 Kuslich; Stephen D. Spinal fixation device
US5597379A (en) * 1994-09-02 1997-01-28 Hudson Surgical Design, Inc. Method and apparatus for femoral resection alignment
US5782832A (en) * 1996-10-01 1998-07-21 Surgical Dynamics, Inc. Spinal fusion implant and method of insertion thereof
US5810827A (en) * 1994-09-02 1998-09-22 Hudson Surgical Design, Inc. Method and apparatus for bony material removal
US5827328A (en) * 1996-11-22 1998-10-27 Buttermann; Glenn R. Intervertebral prosthetic device
US5873579A (en) * 1996-07-17 1999-02-23 Krupp Bautechnik Gmbh Protective device for a fluid-operated percussion tool
US5893889A (en) * 1997-06-20 1999-04-13 Harrington; Michael Artificial disc
US5897590A (en) * 1996-04-25 1999-04-27 Medtronic, Inc. Method for forming a tissue pocket to receive an implantable device
US5928284A (en) * 1998-07-09 1999-07-27 Mehdizadeh; Hamid M. Disc replacement prosthesis
US5951553A (en) * 1997-07-14 1999-09-14 Sdgi Holdings, Inc. Methods and apparatus for fusionless treatment of spinal deformities
US6039763A (en) * 1998-10-27 2000-03-21 Disc Replacement Technologies, Inc. Articulating spinal disc prosthesis
US6056749A (en) * 1999-03-15 2000-05-02 Spineology, Inc. Method and device for fixing and correcting spondylolisthesis anteriorly
US6063121A (en) * 1998-07-29 2000-05-16 Xavier; Ravi Vertebral body prosthesis
US6086589A (en) * 1999-02-02 2000-07-11 Spineology, Inc. Method and device for fixing spondylolisthesis posteriorly
US6110175A (en) * 1999-01-20 2000-08-29 Synthes (Usa) Surgical chisel and method of using same
US6174311B1 (en) * 1998-10-28 2001-01-16 Sdgi Holdings, Inc. Interbody fusion grafts and instrumentation
US6209886B1 (en) * 1999-04-30 2001-04-03 Medtronic, Inc. Resecting tool with independent variable axial extension for tool implements and guide sleeves
US6231609B1 (en) * 1998-07-09 2001-05-15 Hamid M. Mehdizadeh Disc replacement prosthesis
US6264695B1 (en) * 1999-09-30 2001-07-24 Replication Medical, Inc. Spinal nucleus implant
US6287308B1 (en) * 1997-07-14 2001-09-11 Sdgi Holdings, Inc. Methods and apparatus for fusionless treatment of spinal deformities
US20020016583A1 (en) * 2000-02-16 2002-02-07 Cragg Andrew H. Methods of performing procedures in the spine
US6383188B2 (en) * 2000-02-15 2002-05-07 The Spineology Group Llc Expandable reamer
US20020055740A1 (en) * 2000-11-08 2002-05-09 The Cleveland Clinic Foundation Method and apparatus for correcting spinal deformity
US20020058944A1 (en) * 2000-12-14 2002-05-16 Michelson Gary K. Spinal interspace shaper
US6419704B1 (en) * 1999-10-08 2002-07-16 Bret Ferree Artificial intervertebral disc replacement methods and apparatus
US6454806B1 (en) * 1999-07-26 2002-09-24 Advanced Prosthetic Technologies, Inc. Spinal surgical prosthesis
US20030009224A1 (en) * 2001-07-03 2003-01-09 Axiomed Inc. Artificial disc
US6517544B1 (en) * 1998-06-09 2003-02-11 Gary K. Michelson Device and method for preparing a space between adjacent vertebrae to receive an insert
US6520996B1 (en) * 1999-06-04 2003-02-18 Depuy Acromed, Incorporated Orthopedic implant
US6527804B1 (en) * 1998-12-11 2003-03-04 Dimso (Distribution Medicale Du Sud-Quest) Intervertebral disk prosthesis
US6558390B2 (en) * 2000-02-16 2003-05-06 Axiamed, Inc. Methods and apparatus for performing therapeutic procedures in the spine
US6558386B1 (en) * 2000-02-16 2003-05-06 Trans1 Inc. Axial spinal implant and method and apparatus for implanting an axial spinal implant within the vertebrae of the spine
US6572653B1 (en) * 2001-12-07 2003-06-03 Rush E. Simonson Vertebral implant adapted for posterior insertion
US6575978B2 (en) * 2001-04-05 2003-06-10 Spineology, Inc. Circumferential resecting reamer tool
US6582468B1 (en) * 1998-12-11 2003-06-24 Spryker Spine Intervertebral disc prosthesis with compressible body
US6589281B2 (en) * 2001-01-16 2003-07-08 Edward R. Hyde, Jr. Transosseous core approach and instrumentation for joint replacement and repair
US6605648B1 (en) * 1999-04-06 2003-08-12 Phillips Plastics Corporation Sinterable structures and method
US6607559B2 (en) * 2001-07-16 2003-08-19 Spine Care, Inc. Trial intervertebral distraction spacers
US6610093B1 (en) * 2000-07-28 2003-08-26 Perumala Corporation Method and apparatus for stabilizing adjacent vertebrae
US20040002761A1 (en) * 2002-06-27 2004-01-01 Christopher Rogers Intervertebral disc having translation
US6673113B2 (en) * 2001-10-18 2004-01-06 Spinecore, Inc. Intervertebral spacer device having arch shaped spring elements
US20040024461A1 (en) * 2002-05-10 2004-02-05 Ferree Bret A. Spring and spherical joint artificial disc replacements
US20040034426A1 (en) * 2001-07-16 2004-02-19 Errico Joseph P. Axially compressible artificial intervertebral disc having limited rotation using a captured ball and socket joint with a solid ball and compression locking post
US20040034421A1 (en) * 2001-07-16 2004-02-19 Errico Joseph P. Circumferentially buried wire mesh endplate attachment device for use with an orthopedic device
US20040044410A1 (en) * 2002-05-10 2004-03-04 Ferree Bret A. Prosthetic components with contained compressible resilient members
US6719796B2 (en) * 1999-07-26 2004-04-13 Advanced Prosthetic Technologies, Inc. Spinal surgical prosthesis
US6733532B1 (en) * 1998-12-11 2004-05-11 Stryker Spine Intervertebral disc prosthesis with improved mechanical behavior
US6740117B2 (en) * 2001-02-15 2004-05-25 Spinecore, Inc. Intervertebral spacer device having a radially thinning slotted belleville spring
US20040111155A1 (en) * 2002-05-10 2004-06-10 Ferree Bret A. Artificial disc replacement (ADR) using elastic tether member
US6761723B2 (en) * 2002-01-14 2004-07-13 Dynamic Spine, Inc. Apparatus and method for performing spinal surgery
US6869445B1 (en) * 2000-05-04 2005-03-22 Phillips Plastics Corp. Packable ceramic beads for bone repair

Family Cites Families (29)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3426864A (en) * 1966-11-29 1969-02-11 Jack S Halperin Seat belt controlled motor starter system
US4445639A (en) * 1980-07-25 1984-05-01 The Garrett Corporation Heat pump systems for residential use
NO153341C (no) * 1981-06-16 1986-02-26 Maruzen Sewing Machine Broderingsanordning for symaskin.
US4553273A (en) * 1983-11-23 1985-11-19 Henry Ford Hospital Vertebral body prosthesis and spine stabilizing method
EP0176728B1 (fr) * 1984-09-04 1989-07-26 Humboldt-Universität zu Berlin Prothèse pour disques intervertébraux
FR2598311B1 (fr) 1986-05-07 1988-09-09 Laboureau Jacques Instrument chirurgical de visee et de pose pour la plastie (ou remplacement prothetique) du ligament croise posterieur du genou
EP0278184A1 (fr) * 1987-02-11 1988-08-17 Thierry Hermann Prothèse d'articulation, en particulier pour articulation de doigt
US4863477A (en) * 1987-05-12 1989-09-05 Monson Gary L Synthetic intervertebral disc prosthesis
JP2719345B2 (ja) * 1988-03-30 1998-02-25 豊田工機株式会社 力センサを用いた加工制御装置
CA1318469C (fr) 1989-02-15 1993-06-01 Acromed Corporation Disque artificiel
US5171278A (en) 1991-02-22 1992-12-15 Madhavan Pisharodi Middle expandable intervertebral disk implants
RU2008851C1 (ru) 1991-11-28 1994-03-15 Научно-практический центр имплантатов с памятью формы "Доктор" Эндопротез тел позвонков
DE4220218C2 (de) 1992-06-20 1994-09-22 S & G Implants Gmbh Implantat mit einer offenzelligen oder offenporigen Metallstruktur
FR2692952B1 (fr) 1992-06-25 1996-04-05 Psi Amortisseurs perfectionnes a limite de deplacement.
TW256851B (fr) * 1992-11-18 1995-09-11 Ashland Oil Inc
US5423641A (en) * 1993-06-24 1995-06-13 Balough; Floyd Method and apparatus for aligning punch and die blocks or retainers
US5360430A (en) 1993-07-29 1994-11-01 Lin Chih I Intervertebral locking device
DE9413778U1 (de) 1994-08-26 1996-01-04 Schäfer micomed GmbH, 73614 Schorndorf Zwischenwirbelimplantat
FR2730158B1 (fr) * 1995-02-06 1999-11-26 Jbs Sa Dispositif de maintien d'un ecartement normal entre les vertebres et destine au remplacement de vertebres manquantes
EP0975288B1 (fr) * 1997-04-15 2002-10-02 Synthes AG Chur Prothese de vertebre telescopique
US6045579A (en) * 1997-05-01 2000-04-04 Spinal Concepts, Inc. Adjustable height fusion device
US5961522A (en) 1997-11-10 1999-10-05 Mehdizadeh; Hamid M. Laminectomy chisel and guide apparatus
US6162252A (en) 1997-12-12 2000-12-19 Depuy Acromed, Inc. Artificial spinal disc
US6136031A (en) * 1998-06-17 2000-10-24 Surgical Dynamics, Inc. Artificial intervertebral disc
US5989256A (en) 1999-01-19 1999-11-23 Spineology, Inc. Bone fixation cable ferrule
US6132151A (en) 1999-01-19 2000-10-17 Courmier; Jerry W. Device for stabilizing workstock on a broach tool guide sleeve
FR2799638B1 (fr) * 1999-10-14 2002-08-16 Fred Zacouto Fixateur et articulation vertebrale
US6669730B2 (en) 2001-02-15 2003-12-30 Spinecore, Inc. Intervertebral spacer device utilizing a spirally slotted belleville washer having radially extending grooves
WO2003032801A2 (fr) 2001-10-18 2003-04-24 Third Millennium Engineering Llc Disque intervertebral artificiel dote d'un element de restauration de force de rappel a ressort araignee

Patent Citations (99)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3426364A (en) * 1966-08-25 1969-02-11 Colorado State Univ Research F Prosthetic appliance for replacing one or more natural vertebrae
US4242758A (en) * 1977-06-01 1981-01-06 University Of Leeds Industrial Service Ltd. Elbow prosthesis
US4309777A (en) * 1980-11-13 1982-01-12 Patil Arun A Artificial intervertebral disc
US4586496A (en) * 1984-03-05 1986-05-06 Waldemar Link Gmbh & Co. Surgical chisel
USD295318S (en) * 1985-10-02 1988-04-19 Gazale William J Combined surgical single chisel and guide
USD295317S (en) * 1985-10-02 1988-04-19 Gazale William J Combined surgical double chisel and guide
US4697586A (en) * 1986-06-24 1987-10-06 Gazale William J Combined chisel-guide surgical instrument
US4759769A (en) * 1987-02-12 1988-07-26 Health & Research Services Inc. Artificial spinal disc
US4936856A (en) * 1987-11-03 1990-06-26 Waldemar Link Gmbh & Co. Hip joint socket prosthesis
US5002576A (en) * 1988-06-06 1991-03-26 Mecron Medizinische Produkte Gmbh Intervertebral disk endoprosthesis
US4911718A (en) * 1988-06-10 1990-03-27 University Of Medicine & Dentistry Of N.J. Functional and biocompatible intervertebral disc spacer
US5108438A (en) * 1989-03-02 1992-04-28 Regen Corporation Prosthetic intervertebral disc
US5015255A (en) * 1989-05-10 1991-05-14 Spine-Tech, Inc. Spinal stabilization method
US5445639A (en) * 1989-05-10 1995-08-29 Spine-Tech, Inc. Intervertebral reamer construction
US5458638A (en) * 1989-07-06 1995-10-17 Spine-Tech, Inc. Non-threaded spinal implant
US5489308A (en) * 1989-07-06 1996-02-06 Spine-Tech, Inc. Spinal implant
US4932975A (en) * 1989-10-16 1990-06-12 Vanderbilt University Vertebral prosthesis
US5055104A (en) * 1989-11-06 1991-10-08 Surgical Dynamics, Inc. Surgically implanting threaded fusion cages between adjacent low-back vertebrae by an anterior approach
US5059193A (en) * 1989-11-20 1991-10-22 Spine-Tech, Inc. Expandable spinal implant and surgical method
US5236460A (en) * 1990-02-12 1993-08-17 Midas Rex Pneumatic Tools, Inc. Vertebral body prosthesis
US5314477A (en) * 1990-03-07 1994-05-24 J.B.S. Limited Company Prosthesis for intervertebral discs and instruments for implanting it
US5141513A (en) * 1990-05-04 1992-08-25 John Fortune Surgical template
US5047055A (en) * 1990-12-21 1991-09-10 Pfizer Hospital Products Group, Inc. Hydrogel intervertebral disc nucleus
US5123926A (en) * 1991-02-22 1992-06-23 Madhavan Pisharodi Artificial spinal prosthesis
US5390683A (en) * 1991-02-22 1995-02-21 Pisharodi; Madhavan Spinal implantation methods utilizing a middle expandable implant
US5397359A (en) * 1991-08-07 1995-03-14 Oscobal Ag Metal wire structure for endoprosthetics
US5306310A (en) * 1991-08-27 1994-04-26 Man Ceramics Gmbh Vertebral prosthesis
US5290312A (en) * 1991-09-03 1994-03-01 Alphatec Artificial vertebral body
US5246458A (en) * 1992-10-07 1993-09-21 Graham Donald V Artificial disk
US5336223A (en) * 1993-02-04 1994-08-09 Rogers Charles L Telescoping spinal fixator
US5489307A (en) * 1993-02-10 1996-02-06 Spine-Tech, Inc. Spinal stabilization surgical method
US5405391A (en) * 1993-02-16 1995-04-11 Hednerson; Fraser C. Fusion stabilization chamber
US5480401A (en) * 1993-02-17 1996-01-02 Psi Extra-discal inter-vertebral prosthesis for controlling the variations of the inter-vertebral distance by means of a double damper
US5480442A (en) * 1993-06-24 1996-01-02 Man Ceramics Gmbh Fixedly adjustable intervertebral prosthesis
US5423816A (en) * 1993-07-29 1995-06-13 Lin; Chih I. Intervertebral locking device
US5458641A (en) * 1993-09-08 1995-10-17 Ramirez Jimenez; Juan J. Vertebral body prosthesis
US5490860A (en) * 1993-12-08 1996-02-13 Sofamor Danek Properties, Inc. Portable power cutting tool
US5458642A (en) * 1994-01-18 1995-10-17 Beer; John C. Synthetic intervertebral disc
US5549679A (en) * 1994-05-20 1996-08-27 Kuslich; Stephen D. Expandable fabric implant for stabilizing the spinal motion segment
US5433005A (en) * 1994-06-27 1995-07-18 Cogdill; Sean D. Chipping hammer
US5514139A (en) * 1994-09-02 1996-05-07 Hudson Surgical Design, Inc. Method and apparatus for femoral resection
US5597379A (en) * 1994-09-02 1997-01-28 Hudson Surgical Design, Inc. Method and apparatus for femoral resection alignment
US5810827A (en) * 1994-09-02 1998-09-22 Hudson Surgical Design, Inc. Method and apparatus for bony material removal
US6056754A (en) * 1994-09-02 2000-05-02 Hudson Surgical Design, Inc. Method and apparatus for patella resection and guide handle
US5591235A (en) * 1995-03-15 1997-01-07 Kuslich; Stephen D. Spinal fixation device
US5897590A (en) * 1996-04-25 1999-04-27 Medtronic, Inc. Method for forming a tissue pocket to receive an implantable device
US5873579A (en) * 1996-07-17 1999-02-23 Krupp Bautechnik Gmbh Protective device for a fluid-operated percussion tool
US5782832A (en) * 1996-10-01 1998-07-21 Surgical Dynamics, Inc. Spinal fusion implant and method of insertion thereof
US5827328A (en) * 1996-11-22 1998-10-27 Buttermann; Glenn R. Intervertebral prosthetic device
US5893889A (en) * 1997-06-20 1999-04-13 Harrington; Michael Artificial disc
US6287308B1 (en) * 1997-07-14 2001-09-11 Sdgi Holdings, Inc. Methods and apparatus for fusionless treatment of spinal deformities
US5951553A (en) * 1997-07-14 1999-09-14 Sdgi Holdings, Inc. Methods and apparatus for fusionless treatment of spinal deformities
US6517544B1 (en) * 1998-06-09 2003-02-11 Gary K. Michelson Device and method for preparing a space between adjacent vertebrae to receive an insert
US5928284A (en) * 1998-07-09 1999-07-27 Mehdizadeh; Hamid M. Disc replacement prosthesis
US6231609B1 (en) * 1998-07-09 2001-05-15 Hamid M. Mehdizadeh Disc replacement prosthesis
US6063121A (en) * 1998-07-29 2000-05-16 Xavier; Ravi Vertebral body prosthesis
US6039763A (en) * 1998-10-27 2000-03-21 Disc Replacement Technologies, Inc. Articulating spinal disc prosthesis
US6174311B1 (en) * 1998-10-28 2001-01-16 Sdgi Holdings, Inc. Interbody fusion grafts and instrumentation
US6582468B1 (en) * 1998-12-11 2003-06-24 Spryker Spine Intervertebral disc prosthesis with compressible body
US6733532B1 (en) * 1998-12-11 2004-05-11 Stryker Spine Intervertebral disc prosthesis with improved mechanical behavior
US6527804B1 (en) * 1998-12-11 2003-03-04 Dimso (Distribution Medicale Du Sud-Quest) Intervertebral disk prosthesis
US6110175A (en) * 1999-01-20 2000-08-29 Synthes (Usa) Surgical chisel and method of using same
US6086589A (en) * 1999-02-02 2000-07-11 Spineology, Inc. Method and device for fixing spondylolisthesis posteriorly
US6056749A (en) * 1999-03-15 2000-05-02 Spineology, Inc. Method and device for fixing and correcting spondylolisthesis anteriorly
US6605648B1 (en) * 1999-04-06 2003-08-12 Phillips Plastics Corporation Sinterable structures and method
US6209886B1 (en) * 1999-04-30 2001-04-03 Medtronic, Inc. Resecting tool with independent variable axial extension for tool implements and guide sleeves
US6520996B1 (en) * 1999-06-04 2003-02-18 Depuy Acromed, Incorporated Orthopedic implant
US6719796B2 (en) * 1999-07-26 2004-04-13 Advanced Prosthetic Technologies, Inc. Spinal surgical prosthesis
US6454806B1 (en) * 1999-07-26 2002-09-24 Advanced Prosthetic Technologies, Inc. Spinal surgical prosthesis
US6264695B1 (en) * 1999-09-30 2001-07-24 Replication Medical, Inc. Spinal nucleus implant
US6419704B1 (en) * 1999-10-08 2002-07-16 Bret Ferree Artificial intervertebral disc replacement methods and apparatus
US6383188B2 (en) * 2000-02-15 2002-05-07 The Spineology Group Llc Expandable reamer
US6558386B1 (en) * 2000-02-16 2003-05-06 Trans1 Inc. Axial spinal implant and method and apparatus for implanting an axial spinal implant within the vertebrae of the spine
US20020016583A1 (en) * 2000-02-16 2002-02-07 Cragg Andrew H. Methods of performing procedures in the spine
US6558390B2 (en) * 2000-02-16 2003-05-06 Axiamed, Inc. Methods and apparatus for performing therapeutic procedures in the spine
US6869445B1 (en) * 2000-05-04 2005-03-22 Phillips Plastics Corp. Packable ceramic beads for bone repair
US6610093B1 (en) * 2000-07-28 2003-08-26 Perumala Corporation Method and apparatus for stabilizing adjacent vertebrae
US20040039448A1 (en) * 2000-07-28 2004-02-26 Madhavan Pisharodi Method and apparatus for stabilizing adjacent vertebrae
US6551320B2 (en) * 2000-11-08 2003-04-22 The Cleveland Clinic Foundation Method and apparatus for correcting spinal deformity
US20020055740A1 (en) * 2000-11-08 2002-05-09 The Cleveland Clinic Foundation Method and apparatus for correcting spinal deformity
US20020058944A1 (en) * 2000-12-14 2002-05-16 Michelson Gary K. Spinal interspace shaper
US6589281B2 (en) * 2001-01-16 2003-07-08 Edward R. Hyde, Jr. Transosseous core approach and instrumentation for joint replacement and repair
US6716249B2 (en) * 2001-01-16 2004-04-06 Edward R. Hyde Joint prosthesis and method of implantation
US6740117B2 (en) * 2001-02-15 2004-05-25 Spinecore, Inc. Intervertebral spacer device having a radially thinning slotted belleville spring
US6575978B2 (en) * 2001-04-05 2003-06-10 Spineology, Inc. Circumferential resecting reamer tool
US20030009224A1 (en) * 2001-07-03 2003-01-09 Axiomed Inc. Artificial disc
US6607558B2 (en) * 2001-07-03 2003-08-19 Axiomed Spine Corporation Artificial disc
US20040034421A1 (en) * 2001-07-16 2004-02-19 Errico Joseph P. Circumferentially buried wire mesh endplate attachment device for use with an orthopedic device
US20040034426A1 (en) * 2001-07-16 2004-02-19 Errico Joseph P. Axially compressible artificial intervertebral disc having limited rotation using a captured ball and socket joint with a solid ball and compression locking post
US6607559B2 (en) * 2001-07-16 2003-08-19 Spine Care, Inc. Trial intervertebral distraction spacers
US20040111156A1 (en) * 2001-10-18 2004-06-10 Ralph James D. Intervertebral spacer device having a domed arch shaped spring
US6673113B2 (en) * 2001-10-18 2004-01-06 Spinecore, Inc. Intervertebral spacer device having arch shaped spring elements
US20040102849A1 (en) * 2001-10-18 2004-05-27 Ralph James D. Intervertebral spacer device having arch shaped spring elements
US6572653B1 (en) * 2001-12-07 2003-06-03 Rush E. Simonson Vertebral implant adapted for posterior insertion
US6761723B2 (en) * 2002-01-14 2004-07-13 Dynamic Spine, Inc. Apparatus and method for performing spinal surgery
US20040024461A1 (en) * 2002-05-10 2004-02-05 Ferree Bret A. Spring and spherical joint artificial disc replacements
US20040111155A1 (en) * 2002-05-10 2004-06-10 Ferree Bret A. Artificial disc replacement (ADR) using elastic tether member
US20040044410A1 (en) * 2002-05-10 2004-03-04 Ferree Bret A. Prosthetic components with contained compressible resilient members
US20040002761A1 (en) * 2002-06-27 2004-01-01 Christopher Rogers Intervertebral disc having translation

Cited By (113)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7819922B2 (en) * 2003-10-16 2010-10-26 Spinal Generations, Llc Vertebral prosthesis
US20050085910A1 (en) * 2003-10-16 2005-04-21 Sweeney Patrick J. Vertebral prosthesis
US20050277930A1 (en) * 2004-05-27 2005-12-15 Depuy Spine, Inc. Tri-joint implant
US20050277938A1 (en) * 2004-05-27 2005-12-15 Depuy Spine, Inc. Tri-joint implant methods
US7819900B2 (en) 2004-05-27 2010-10-26 Depuy Spine, Inc. Tri-joint implant methods
US7708760B2 (en) * 2004-05-27 2010-05-04 Depuy Spine, Inc. Tri-joint implant
US8409285B2 (en) * 2004-09-23 2013-04-02 Cervitech, Inc. Prosthesis for partial replacement of a vertebral body
US20120059471A1 (en) * 2004-09-23 2012-03-08 Cervitech, Inc. Prosthesis for partial replacement of a vertebral body
US7309357B2 (en) 2004-12-30 2007-12-18 Infinesse, Corporation Prosthetic spinal discs
US20060149381A1 (en) * 2004-12-30 2006-07-06 Kim Chong C Prosthetic spinal discs
US20080243194A1 (en) * 2005-09-26 2008-10-02 The Regents Of The University Of California Articulating instrumentation for dynamic spinal stabilization
WO2007044740A3 (fr) * 2005-10-10 2008-04-10 Donna Jean Carver Systeme et procede de prothese artificielle de disque spinal
US20080071375A1 (en) * 2005-10-10 2008-03-20 Carver Donna J Artificial spinal disc replacement system and method
AU2006302190B2 (en) * 2005-10-10 2012-01-19 Chad Anthony Barrie Artificial spinal disc replacement system and method
US20070173941A1 (en) * 2006-01-25 2007-07-26 Sdgi Holdings, Inc. Intervertebral prosthetic disc and method of installing same
US20080021555A1 (en) * 2006-07-19 2008-01-24 John White Expandable vertebral body implants and methods of use
US7862618B2 (en) 2006-07-19 2011-01-04 Warsaw Orthopedic, Inc. Expandable vertebral body implants and methods of use
US9023107B2 (en) 2006-11-08 2015-05-05 Spinal Usa, Inc. Vertebral body replacement
US20100082106A1 (en) * 2006-11-08 2010-04-01 Muhanna Nabil L Vertebral body replacement
US8920502B1 (en) * 2006-11-08 2014-12-30 Spinal Usa, Inc. Vertebral body replacement
US20080140202A1 (en) * 2006-12-08 2008-06-12 Randall Noel Allard Energy-Storing Spinal Implants and Methods of Use
US7875079B2 (en) 2006-12-14 2011-01-25 Warsaw Orthopedic, Inc. Vertebral implant containment device and methods of use
US20080154381A1 (en) * 2006-12-21 2008-06-26 Rob Gene Parrish Intervertebral disc spacer
US8951300B2 (en) * 2006-12-21 2015-02-10 Rob Gene Parrish Intervertebral disc spacer
US20080249623A1 (en) * 2006-12-22 2008-10-09 Qi-Bin Bao Implant Restraint Device and Methods
US8163019B2 (en) 2006-12-22 2012-04-24 Pioneer Surgical Technology, Inc. Implant restraint device and methods
US8034081B2 (en) 2007-02-06 2011-10-11 CollabComl, LLC Interspinous dynamic stabilization implant and method of implanting
AU2008216406B2 (en) * 2007-02-12 2013-02-07 Brigham Young University Spinal implant
US9314346B2 (en) 2007-02-12 2016-04-19 Brigham Young University Spinal implant
US20100241232A1 (en) * 2007-02-12 2010-09-23 Peter Halverson Spinal implant
US8308801B2 (en) * 2007-02-12 2012-11-13 Brigham Young University Spinal implant
US20080195213A1 (en) * 2007-02-12 2008-08-14 Brigham Young University Spinal implant
US9034039B2 (en) 2007-03-07 2015-05-19 Ulrich Gmbh & Co.Kg Intervertebral implant with elastic part
WO2008106912A1 (fr) * 2007-03-07 2008-09-12 Ulrich Gmbh & Co. Kg Implant intervertébral comportant un composant élastique
US20100016969A1 (en) * 2007-03-07 2010-01-21 Marcus Richter Intervertebral implant with elastic part
US20080221691A1 (en) * 2007-03-10 2008-09-11 Christopher Chaput Surgical implant secured by pegs and associated methods
US10335288B2 (en) * 2007-03-10 2019-07-02 Spinesmith Partners, L.P. Surgical implant secured by pegs and associated methods
EP2244671A4 (fr) * 2008-01-25 2013-03-20 Spinalmotion Inc Disque prothétique intervertébral avec partie centrale absorbant les chocs comprenant des ressorts à disques
WO2010059866A1 (fr) * 2008-11-19 2010-05-27 Endospinal, Inc. Système de réparation intramédullaire pour fractures des vertèbres
US20100137987A1 (en) * 2008-11-19 2010-06-03 Endospinal, Inc. Intramedullary Repair System for Vertebra Fractures
US10321941B2 (en) 2008-11-19 2019-06-18 Endoorthopaedics, Inc. Intramedullary repair system for bone fractures
US20100137862A1 (en) * 2008-11-19 2010-06-03 Endoorthopaedics, Inc. Intramedullary Repair System for Bone Fractures
US9474556B2 (en) 2008-11-19 2016-10-25 Endoorthopaedics, Inc. Intramedullary repair system for bone fractures
US8906100B2 (en) 2008-12-31 2014-12-09 Ex Technology, Llc Methods and apparatus for vertebral body distraction and fusion employing flexure members
US9445917B2 (en) 2008-12-31 2016-09-20 Ex Technology, Llc Methods and apparatus for expandable medical device employing flexure members
US8523944B2 (en) 2008-12-31 2013-09-03 Spinex Tec, Llc Methods and apparatus for vertebral body distraction and fusion employing flexure members
US8540452B2 (en) 2008-12-31 2013-09-24 Spinex Tec, Llc Flexible joint arrangement incorporating flexure members
US20100209184A1 (en) * 2008-12-31 2010-08-19 Jimenez Omar F Flexible joint arrangement incorporating flexure members
WO2010078468A3 (fr) * 2008-12-31 2010-11-25 Jimenez Omar F Procédés et appareils de déplacement et de fusion de corps vertébraux utilisant des éléments de flexion
US10060469B2 (en) 2008-12-31 2018-08-28 Ex Technology, Llc Flexible joint arrangement incorporating flexure members
US20100185291A1 (en) * 2008-12-31 2010-07-22 Jimenez Omar F Methods and apparatus for vertebral body distraction and fusion employing flexure members
US9381092B2 (en) 2008-12-31 2016-07-05 Ex Technology, Llc Flexible joint arrangement incorporating flexure members
US8663286B2 (en) 2009-02-19 2014-03-04 Brigham Young University Compliant dynamic spinal implant and associated methods
US20100211106A1 (en) * 2009-02-19 2010-08-19 Bowden Anton E Compliant Dynamic Spinal Implant And Associated Methods
US20100217334A1 (en) * 2009-02-23 2010-08-26 Hawkes David T Press-On Link For Surgical Screws
US9232965B2 (en) 2009-02-23 2016-01-12 Nexus Spine, LLC Press-on link for surgical screws
US9867717B2 (en) 2009-03-19 2018-01-16 Ex Technology, Llc Stable device for intervertebral distraction and fusion
US8628577B1 (en) 2009-03-19 2014-01-14 Ex Technology, Llc Stable device for intervertebral distraction and fusion
US8211178B2 (en) 2009-06-18 2012-07-03 Warsaw Orthopedic Intervertebral implant with a pivoting end cap
US9358125B2 (en) 2009-07-22 2016-06-07 Spinex Tec, Llc Coaxial screw gear sleeve mechanism
US20110160861A1 (en) * 2009-07-22 2011-06-30 Jimenez Omar F Methods and apparatuses for vertebral body distraction and fusion employing a coaxial screw gear sleeve mechanism
US20110138948A1 (en) * 2009-07-22 2011-06-16 Jimenez Omar F Coaxial screw gear sleeve mechanism
US8303663B2 (en) 2009-07-22 2012-11-06 Spinex Tec, Llc Methods and apparatuses for vertebral body distraction and fusion employing a coaxial screw gear sleeve mechanism
US10369008B2 (en) 2009-07-22 2019-08-06 Spinex Tec Llc Medical device employing a coaxial screw gear sleeve mechanism
US11026804B2 (en) 2009-07-22 2021-06-08 Spinex Tec, Llc Coaxial screw gear sleeve mechanism
US11612496B2 (en) 2009-07-22 2023-03-28 Spinex Tec Llc Medical device employing a coaxial screw gear sleeve mechanism
US10117757B2 (en) 2009-07-22 2018-11-06 Spinex Tec, Llc Coaxial screw gear sleeve mechanism
US9474626B2 (en) 2009-07-22 2016-10-25 Spinex Tec Llc Methods and apparatuses for vertebral body distraction and fusion employing a coaxial screw gear sleeve mechanism
US8771360B2 (en) 2009-07-22 2014-07-08 Spinex Tec, Llc Methods and apparatuses for vertebral body distraction and fusion employing a coaxial screw gear sleeve mechanism
US8702686B2 (en) 2009-09-11 2014-04-22 Materialise Nv Adaptable therapeutic, diagnostic or surgical guide
US9157497B1 (en) 2009-10-30 2015-10-13 Brigham Young University Lamina emergent torsional joint and related methods
US8636746B2 (en) 2009-12-31 2014-01-28 Spinex Tec, Llc Methods and apparatus for insertion of vertebral body distraction and fusion devices
US9333008B2 (en) 2010-02-19 2016-05-10 Brigham Young University Serpentine spinal stability device
US8353957B2 (en) 2010-04-20 2013-01-15 Warsaw Orthopedic, Inc. Expandable medical device and method
US8740980B2 (en) 2011-01-27 2014-06-03 Warsaw Orthopedic, Inc. Expandable medical implant
US8801788B2 (en) 2011-01-27 2014-08-12 Warsaw Orthopedic, Inc. Expandable medical implant
US9700425B1 (en) 2011-03-20 2017-07-11 Nuvasive, Inc. Vertebral body replacement and insertion methods
US12186198B2 (en) 2011-03-20 2025-01-07 Nuvasive, Inc. Vertebral body replacement and insertion methods
US11389301B2 (en) 2011-03-20 2022-07-19 Nuvasive, Inc. Vertebral body replacement and insertion methods
US10485672B2 (en) 2011-03-20 2019-11-26 Nuvasive, Inc. Vertebral body replacement and insertion methods
US8894687B2 (en) 2011-04-25 2014-11-25 Nexus Spine, L.L.C. Coupling system for surgical construct
US8932302B2 (en) 2011-07-22 2015-01-13 Spinex Tec, Llc Methods and apparatus for insertion of vertebral body distraction and fusion devices
US9498270B2 (en) 2011-07-22 2016-11-22 SpineX Tee, LLC Methods and apparatus for insertion of vertebral body distraction and fusion devices
US20140031939A1 (en) * 2012-07-25 2014-01-30 Steve Wolfe Mesh spacer hybrid
US9925058B2 (en) 2012-07-25 2018-03-27 Spineology Inc. Mesh spacer hybrid
US10111756B2 (en) 2012-07-25 2018-10-30 Spineology Inc. Mesh spacer hybrid
US8945228B2 (en) 2012-11-15 2015-02-03 DePuy Synthes Products, LLC Endplate for a vertebral implant
US10687963B2 (en) 2014-04-01 2020-06-23 Ex Technology, Llc Expandable intervertebral cage
US9486328B2 (en) 2014-04-01 2016-11-08 Ex Technology, Llc Expandable intervertebral cage
US8940049B1 (en) 2014-04-01 2015-01-27 Ex Technology, Llc Expandable intervertebral cage
US10052214B2 (en) 2014-04-01 2018-08-21 Ex Technology, Llc Expandable intervertebral cage
US12156819B2 (en) 2014-04-01 2024-12-03 Ex Technology, Llc Expandable inter vertebral cage
US9668879B2 (en) 2014-04-01 2017-06-06 Ex Technology, Llc Expandable intervertebral cage
US11471301B2 (en) 2014-04-01 2022-10-18 Ex Technology, Llc Expandable intervertebral cage
US9642651B2 (en) 2014-06-12 2017-05-09 Brigham Young University Inverted serpentine spinal stability device and associated methods
JP2018517498A (ja) * 2015-06-03 2018-07-05 ニコラス ペレン， 組織拡張増幅器
US10722368B2 (en) * 2015-06-03 2020-07-28 Nicolas Perren Tissue expansion booster
WO2016193801A1 (fr) * 2015-06-03 2016-12-08 Nicolas Perren Renfort pour dilatation de tissu
US20180168810A1 (en) * 2015-06-03 2018-06-21 Nicolas Perren Tissue expansion booster
US10682237B2 (en) * 2015-09-03 2020-06-16 Cmc Sert Ltd. Prosthesis for replacing joint in a human hand or foot
US11298931B2 (en) * 2015-11-24 2022-04-12 Agada Medical Ltd. Intervertebral disc replacement
US10390959B2 (en) 2015-11-24 2019-08-27 Agada Medical Ltd. Intervertebral disc replacement
WO2018031801A1 (fr) * 2016-08-11 2018-02-15 Amnon Yadin Remplacement de disque intervertébral
US10893951B2 (en) * 2018-08-07 2021-01-19 Minimally Invasive Spinal Technology, LLC Device and method for correcting spinal deformities in patients
US20200046511A1 (en) * 2018-08-07 2020-02-13 Minimally Invasive Spinal Technology, LLC Device and method for correcting spinal deformities in patients
US11234835B2 (en) 2019-03-05 2022-02-01 Octagon Spine Llc Transversely expandable minimally invasive intervertebral cage
US11497622B2 (en) 2019-03-05 2022-11-15 Ex Technology, Llc Transversely expandable minimally invasive intervertebral cage and insertion and extraction device
US11911292B2 (en) 2019-03-05 2024-02-27 Octagon Spine Llc Transversely expandable minimally invasive intervertebral cage
US20220168114A1 (en) * 2020-12-01 2022-06-02 Bret Michael Berry Compliant spinal implant
US11678994B2 (en) * 2020-12-01 2023-06-20 Bret Michael Berry Compliant spinal implant
US12097126B2 (en) 2021-09-29 2024-09-24 Ex Technology, Llc Expandable intervertebral cage
US12023257B2 (en) 2021-10-05 2024-07-02 Spineology Inc. Mesh spacer hybrid spinal implant
US12011365B2 (en) 2022-07-18 2024-06-18 Octagon Spine Llc Transversely expandable minimally invasive inter vertebral cage

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US20080215153A1 (en) 2008-09-04
US20120059479A1 (en) 2012-03-08
EP1651150A4 (fr) 2009-11-11
US8057549B2 (en) 2011-11-15
EP1651150A2 (fr) 2006-05-03
WO2005013852A3 (fr) 2006-01-12
EP1651150B1 (fr) 2021-03-24
WO2005013852A2 (fr) 2005-02-17

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