Expandable intervertebral implant for use with instrument

• US 20060229729A1
• Filed: 02/01/2006
• Published: 10/12/2006
• Est. Priority Date: 08/05/2003
• Status: Abandoned Application

• Current Assignee: Charles R. Gordon, Corey T Harbold, Heather S Hanson
• Original Assignee: Charles R. Gordon, Corey T Harbold, Heather S Hanson
• Inventors: Gordon, Charles R., Hanson, Heather S., Harbold, Corey T.
• Application Number:
  US11/345,602
• Publication Number:
  US 20060229729A1
• 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 17/7035 Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
• CPC Class Codes: A61B 17/7037 wherein pivoting is blocked when the rod is clamped
• 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: A61F 2/28 Bones joints A61F2/30
• 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 2002/30092 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 2002/30563 : 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 2002/30841 : 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 2002/4627 : 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 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 inferior surface and a superior surface, wherein the superior surface of the upper body is configured to engage a first vertebra of the human spine;

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 inferior surface of the upper body and the superior surface of the lower body; and

an opening proximate a corner of the lower body configured to accept an instrument configured to engage the insert, wherein engaging the insert comprises at least partially rotating the insert between the upper body and the lower body such that the insert increases a separation distance between the upper body and the lower body.

159-178. -178. (canceled)

179. An instrument for expanding an intervertebral implant between vertebrae of a human spine, comprising:

a body comprising a passageway through at least a portion of the length of the body;

an extension coupled to a distal end of the body, wherein the extension comprises a first end and a second end;

a tip protruding from the passageway at the distal end of the body, wherein the tip is positioned between the first end of the extension and the second end of the extension, and wherein the tip is rotatable with respect to the extension;

an elongated member at least partially positioned in the passageway, wherein the distal end of the elongated member comprises the tip, wherein the proximal portion of the elongated member is coupled to a knob, and wherein the knob is configured to be used to rotatably advance the tip during use; and

a mechanism coupled to the elongated member that limits protrusion of the tip from the passageway at a distal end of the instrument.

180-186. -186. (canceled)

187. A system for stabilizing vertebrae of a human spine, comprising:

a dynamic implant configured to be positioned between a first vertebra and a second vertebra, the dynamic implant configured to allow for articulation of the first vertebra relative to the second vertebra; and

a facet replacement device configured to couple to the first vertebra and the second vertebra, wherein the facet replacement device comprises a first pedicle screw, a second pedicle screw, and an elongated member, wherein the elongated member of the facet replacement device is configured to move relative to the first pedicle screw during use.

188. The system of claim 187, wherein the elongated member comprises a rod.

189. The system of claim 187, wherein the elongated member comprises a retaining plate.

190. The system of claim 187, wherein the elongated member comprises a rod having a ball joint.

191. The system of claim 187, wherein the dynamic implant comprises an expandable implant.

197. The system of claim 187, wherein the dynamic implant comprises:

an upper body having a superior surface configured to engage a first vertebra of the human spine;

a lower body having an inferior surface configured to engage a second vertebra of the human spine;

an insert configured to be positioned between an inferior surface of the upper body and a superior surface of the lower body; and

an opening proximate a corner of the lower body configured to accept an instrument configured to rotate the insert such that the insert increases a separation distance between the upper body and the lower body.

198. The system of claim 197, wherein the lower body further comprises a stop configured to limit rotation of the insert.

199. The system of claim 197, wherein the insert comprises a projection configured to engage a cam ramp of the lower body.

200. The system of claim 197, wherein the insert comprises a projection configure to engage a cam ramp of the upper body.

201. The system of claim 197, wherein upper body comprises an extension configured to engage a cam ramp of the insert.

202. The system of claim 197, wherein lower body comprises an extension configured to engage a cam ramp of the insert.

203. The system of claim 197, wherein the upper body comprises at least one stabilizer configured to limit the separation distance between the upper body and the lower body.

204. The system of claim 197, wherein the lower body comprises at least one stabilizer configured to limit the separation distance between the upper body and the lower body.

192. A method of stabilizing vertebrae in a human spine, comprising:

positioning a dynamic implant between a first vertebra and a second vertebra;

coupling a non-rigid posterior element to the first vertebra and the second vertebra, wherein the non-rigid posterior element is configured to limit a range of motion between the first vertebra and the second vertebra.

193. The method of claim 192, further comprising coupling a second non-rigid posterior element to the first vertebra and the second vertebra.

194. The method of claim 192, wherein coupling the non-rigid posterior element comprises coupling a first pedicle screw to the first vertebra, coupling a second pedicle screw to the second vertebra, and coupling an elongated member to the first pedicle screw and the second pedicle screw, wherein at least a portion of the elongated member is able to move relative to the first pedicle screw.

195. The method of claim 194, wherein at least a portion of the elongated member is able to move relative to the second pedicle screw.

196. The method of claim 192, wherein the positioning the dynamic implant comprises placing the dynamic implant between the first vertebra and the second vertebra, and using an instrument to increase a separation distance between an upper body of the dynamic implant and a lower body of the dynamic implant.