Expandable articulating intervertebral implant with spacer

• US 20050273174A1
• Filed: 05/20/2005
• Published: 12/08/2005
• Est. Priority Date: 08/05/2003
• Status: Active Grant

• Current Assignee: Flexuspine Incorporated
• Original Assignee: Flexuspine Incorporated
• Inventors: Gordon, Charles R., Hanson, Heather S., Harbold, Corey T.
• Granted Patent: US 8,118,870 B2
• Time in Patent Office: Days
• US Class Current: 623/17.160
• CPC Class Codes: A61B 17/7005 Parts of the longitudinal elements, e.g. their ends, being specially adapted to fit in the screw or hook heads
• CPC Class Codes: A61B 17/7007 Parts of the longitudinal elements, e.g. their ends, being specially adapted to fit around the screw or hook heads
• CPC Class Codes: A61B 17/7008 with parts of, or attached to, the longitudinal elements, bearing against an outside of the screw or hook heads, e.g. nuts on threaded rods A61B17/7007 takes precedence
• CPC Class Codes: A61B 17/701 Longitudinal elements with a non-circular, e.g. rectangular, cross-section A61B17/7005, A61B17/7007 take precedence
• CPC Class Codes: A61B 17/7023 with a pivot joint
• CPC Class Codes: A61B 17/7032 Screws or hooks with U-shaped head or back through which longitudinal rods pass
• CPC Class Codes: A61B 17/7037 wherein pivoting is blocked when the rod is clamped
• CPC Class Codes: A61B 17/7064 Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor
• CPC Class Codes: A61B 17/80 Cortical plates , i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
• CPC Class Codes: A61B 17/86 Pins or screws or threaded wires; nuts therefor A61B17/72 take precedence
• CPC Class Codes: A61F 2/30767 Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
• CPC Class Codes: A61F 2/4405 for apophyseal or facet joints, i.e. between adjacent spinous or transverse processes devices implanted between spinous or transverse processes A61B17/7062
• CPC Class Codes: A61F 2/4425 made of articulated components
• CPC Class Codes: A61F 2/4455 for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages intervertebral discs A61F2/442
• CPC Class Codes: A61F 2/4611 of spinal prostheses
• CPC Class Codes: A61F 2002/2835 Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
• CPC Class Codes: A61F 2002/30092 using shape memory or superelastic materials, e.g. nitinol
• CPC Class Codes: A61F 2002/30131 horseshoe- or crescent- or C-shaped or U-shaped
• CPC Class Codes: A61F 2002/30133 kidney-shaped or bean-shaped
• CPC Class Codes: A61F 2002/30225 Flat cylinders, i.e. discs
• CPC Class Codes: A61F 2002/3023 : wedge-shaped cylinders
• CPC Class Codes: A61F 2002/30235 : tubular, e.g. sleeves
• CPC Class Codes: A61F 2002/30331 : made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
• CPC Class Codes: A61F 2002/30365 : with additional means for limiting said rotation
• CPC Class Codes: A61F 2002/30369 : Limited lateral translation of the protrusion within a larger recess
• CPC Class Codes: A61F 2002/30383 : made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
• CPC Class Codes: A61F 2002/30462 : retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2002/30471 : connected by a hinged linkage mechanism, e.g. of the single-bar or multi-bar linkage type
• CPC Class Codes: A61F 2002/30476 : locked by an additional locking mechanism
• CPC Class Codes: A61F 2002/30492 : using a locking pin
• CPC Class Codes: A61F 2002/305 : Snap connection
• CPC Class Codes: A61F 2002/30505 : spring biased
• CPC Class Codes: A61F 2002/30507 : using a threaded locking member, e.g. a locking screw or a set screw
• CPC Class Codes: A61F 2002/30515 : using a locking wedge or block
• CPC Class Codes: A61F 2002/3052 : unrestrained in only one direction, e.g. moving unidirectionally
• CPC Class Codes: A61F 2002/30538 : for adjusting angular orientation
• CPC Class Codes: A61F 2002/3055 : for adjusting length
• CPC Class Codes: A61F 2002/30556 : for adjusting thickness
• CPC Class Codes: A61F 2002/30563 : having elastic means or damping means, different from springs, e.g. including an elastomeric core or shock absorbers
• CPC Class Codes: A61F 2002/30565 : having spring elements
• CPC Class Codes: A61F 2002/30578 : having apertures, e.g. for receiving fixation screws
• CPC Class Codes: A61F 2002/30579 : with mechanically expandable devices, e.g. fixation devices
• CPC Class Codes: A61F 2002/30601 : telescopic
• CPC Class Codes: A61F 2002/30624 : Hinged joint, e.g. with transverse axle restricting the movement
• CPC Class Codes: A61F 2002/30649 : Ball-and-socket joints
• CPC Class Codes: A61F 2002/30662 : with rotation-limiting means
• CPC Class Codes: A61F 2002/30772 : Apertures or holes, e.g. of circular cross section
• CPC Class Codes: A61F 2002/30785 : parallel
• CPC Class Codes: A61F 2002/3079 : Stepped or enlarged apertures, e.g. having discrete diameter changes
• CPC Class Codes: A61F 2002/30841 : Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
• CPC Class Codes: A61F 2002/30904 : serrated profile, i.e. saw-toothed
• CPC Class Codes: A61F 2002/443 : having two transversal endplates and at least one intermediate component
• CPC Class Codes: A61F 2002/4622 : having the shape of a forceps or a clamp
• CPC Class Codes: A61F 2002/4627 : with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument
• CPC Class Codes: A61F 2002/4628 : with linear motion along or rotating motion about an axis transverse to the instrument axis or to the implantation direction, e.g. clamping
• CPC Class Codes: A61F 2002/4629 : connected to the endoprosthesis or implant via a threaded connection
• CPC Class Codes: A61F 2210/0014 : using shape memory or superelastic materials, e.g. nitinol
• CPC Class Codes: A61F 2220/0025 : Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2220/0033 : made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
• CPC Class Codes: A61F 2220/0075 : sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2220/0091 : connected by a hinged linkage mechanism, e.g. of the single-bar or multi-bar linkage type
• CPC Class Codes: A61F 2230/0013 : Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped
• CPC Class Codes: A61F 2230/0015 : Kidney-shaped, e.g. bean-shaped
• CPC Class Codes: A61F 2230/0069 : cylindrical
• CPC Class Codes: A61F 2250/0006 : for adjusting angular orientation
• CPC Class Codes: A61F 2250/0009 : for adjusting thickness
• CPC Class Codes: A61F 2310/00023 : Titanium or titanium-based alloys, e.g. Ti-Ni alloys

Abstract

An artificial functional spinal unit including an expandable intervertebral implant that can be inserted via a posterior surgical approach and used with one or more facet replacement devices to provide an anatomically correct range of motion is described. Lordotic and non-lordotic expandable, articulating implants and cages are described, along with embodiments of facet replacement devices and instruments for insertion. Methods of insertion are also described.

Claims

1-157. -157. (canceled)

158. An intervertebral implant for a human spine, comprising:

an upper body comprising an upper portion and a lower portion, wherein a superior surface of the upper portion of the upper body is configured to engage a first vertebra of the human spine, and wherein at least a portion of the inferior surface of the upper portion of the upper body and at least a portion of the superior surface of the lower portion of the upper body are configured to be coupled to allow articulation of the upper body;

a lower body comprising a superior surface and an inferior surface, wherein the inferior surface of the lower body is configured to engage a second vertebra of the human spine;

an insert configured to be positioned between the superior surface of the lower body and the inferior surface of the lower portion of the upper body before insertion of the intervertebral implant between the first vertebra and the second vertebra of the human spine, wherein the insert comprises a recess, wherein the insert is configured such that translation or rotation of the insert increases a separation distance between the upper body and the lower body;

a spacer configured to be inserted between the lower body and the lower portion of the upper body to maintain at least a portion of the increased separation distance between the upper body and the lower body, wherein the spacer comprises a protrusion; and

wherein the protrusion of the spacer is configured to substantially mate with the recess of the insert to inhibit unintentional removal of the spacer from the intervertebral implant during use.

159. The intervertebral implant of claim 158, wherein the spacer comprises an internal lip or an external lip around at least a portion of the spacer, wherein the lip is configured to facilitate insertion or retention of the spacer between the lower body and the lower portion of the upper body.

160. The intervertebral implant of claim 158, wherein the spacer comprises a lip around at least a superior portion or an inferior portion of the spacer, wherein the lip is configured to facilitate insertion or retention of the spacer between the lower body and the lower portion of the upper body.

161. The intervertebral implant of claim 158, wherein the thickness of the spacer increases from one side of the spacer to the other side to achieve a desired lordotic angle of the intervertebral implant.

162. The intervertebral implant of claim 158, wherein the spacer is further configured to be press fit between the lower body and the lower portion of the upper body.

163. The intervertebral implant of claim 158, wherein the spacer is further configured to be loose fit between the lower body and the lower portion of the upper body.

164. The intervertebral implant of claim 158, wherein the spacer is further configured to be reversibly locked in place between the lower body and the lower portion of the upper body.

165. The intervertebral implant of claim 158, wherein the spacer is further configured to be irreversibly locked in place between the lower body and the lower portion of the upper body.

166. The intervertebral implant of claim 158, wherein the lower portion of the upper body further comprises a lip configured to facilitate insertion or retention of the spacer in the intervertebral implant.

167. The intervertebral implant of claim 158, wherein the lower body further comprises a lip configured to facilitate insertion or retention of the spacer in the intervertebral implant.

168. An intervertebral implant for a human spine, comprising:

an upper body comprising an upper portion and a lower portion, wherein a superior surface of the upper portion of the upper body is configured to engage a first vertebra of the human spine, and wherein at least a portion of the inferior surface of the upper portion of the upper body and at least a portion of the superior surface of the lower portion of the upper body are configured to be coupled to allow articulation of the upper body;

a lower body comprising a superior surface and an inferior surface, wherein the inferior surface of the lower body is configured to engage a second vertebra of the human spine;

an insert configured to be positioned between the superior surface of the lower body and the inferior surface of the lower portion of the upper body such that the lower portion of the upper body contacts the lower body before insertion of the intervertebral implant between the first vertebra and the second vertebra of the human spine, wherein the insert is configured such that translation or rotation of the insert increases a height of the intervertebral implant;

a spacer configured to be inserted between the lower body and the lower portion of the upper body to maintain at least a portion of the increased height of the intervertebral implant; and

wherein a portion of the spacer is configured to engage a portion of the intervertebral implant such that full insertion of the spacer between the lower body and the lower portion of the upper body provides a tactile sensation to the surgeon inserting the spacer.

169. The intervertebral implant of claim 168, wherein the spacer comprises an internal lip or an external lip around at least a portion of the spacer, wherein the lip is configured to facilitate insertion or retention of the spacer between the lower body and the lower portion of the upper body.

170. The intervertebral implant of claim 168, wherein the spacer comprises a lip around at least a superior portion or an inferior portion of the spacer, wherein the lip is configured to facilitate insertion or retention of the spacer between the lower body and the lower portion of the upper body.

171. The intervertebral implant of claim 168, wherein the thickness of the spacer increases from one side of the spacer to the other side to achieve a desired lordotic angle of the intervertebral implant.

172. The intervertebral implant of claim 168, wherein the spacer is further configured to be press fit between the lower body and the lower portion of the upper body.

173. The intervertebral implant of claim 168, wherein the spacer is further configured to be loose fit between the lower body and the lower portion of the upper body.

174. The intervertebral implant of claim 168, wherein the spacer is further configured to be reversibly locked in place between the lower body and the lower portion of the upper body.

175. The intervertebral implant of claim 168, wherein the spacer is further configured to be irreversibly locked in place between the lower body and the lower portion of the upper body.

176. The intervertebral implant of claim 168, wherein the lower portion of the upper body further comprises a lip configured to facilitate insertion or retention of the spacer in the intervertebral implant.

177. The intervertebral implant of claim 168, wherein the lower body further comprises a lip configured to facilitate insertion or retention of the spacer in the intervertebral implant.

178. An intervertebral implant for a human spine, comprising:

an upper body comprising an upper portion and a lower portion, wherein a superior surface of the upper portion of the upper body is configured to engage a first vertebra of the human spine, and wherein at least a portion of the inferior surface of the upper portion of the upper body and at least a portion of the superior surface of the lower portion of the upper body are configured to be coupled to allow articulation of the upper body;

a lower body comprising a superior surface and an inferior surface, wherein the inferior surface of the lower body is configured to engage a second vertebra of the human spine;

an insert configured to be positioned between the superior surface of the lower body and the inferior surface of the lower portion of the upper body before insertion of the intervertebral implant between the first vertebra and the second vertebra of the human spine, wherein the insert is configured such that translation or rotation of the insert increases a height of the intervertebral implant to expand the intervertebral implant; and

a spacer configured to be inserted between the lower body and the lower portion of the upper body to maintain at least a portion of the increased height of the intervertebral implant, wherein the spacer comprises an opening, and wherein a tool may be removably coupled to the opening to facilitate insertion of the spacer between the lower body and the lower portion of the upper body after the intervertebral implant is expanded between the first vertebra and the second vertebra of the human spine.

179. The intervertebral implant of claim 178, wherein the opening in the spacer is a threaded opening.

180. The intervertebral implant of claim 178, wherein the spacer comprises an internal lip or an external lip around at least a portion of the spacer, wherein the lip is configured to facilitate insertion or retention of the spacer between the lower body and the lower portion of the upper body.

181. The intervertebral implant of claim 178, wherein the spacer comprises a lip around at least a superior portion or an inferior portion of the spacer, wherein the lip is configured to facilitate insertion or retention of the spacer between the lower body and the lower portion of the upper body.

182. The intervertebral implant of claim 178, wherein the thickness of the spacer increases from one side of the spacer to the other side to achieve a desired lordotic angle of the intervertebral implant.

183. The intervertebral implant of claim 178, wherein the spacer is further configured to be press fit between the lower body and the lower portion of the upper body.

184. The intervertebral implant of claim 178, wherein the spacer is further configured to be loose fit between the lower body and the lower portion of the upper body.

185. The intervertebral implant of claim 178, wherein the spacer is further configured to be reversibly locked in place between the lower body and the lower portion of the upper body.

186. The intervertebral implant of claim 178, wherein the spacer is further configured to be irreversibly locked in place between the lower body and the lower portion of the upper body.

187. The intervertebral implant of claim 178, wherein the lower portion of the upper body further comprises a lip configured to facilitate insertion or retention of the spacer in the intervertebral implant.

188. The intervertebral implant of claim 178, wherein the lower body further comprises a lip configured to facilitate insertion or retention of the spacer in the intervertebral implant.