Posterior prosthetic spinal disc replacement and methods thereof

• US 20070010826A1
• Filed: 03/01/2006
• Published: 01/11/2007
• Est. Priority Date: 07/31/2003
• Status: Active Grant

• Current Assignee: Globus Medical, Inc.
• Original Assignee: Globus Medical, Inc.
• Inventors: Angelucci, Christopher, Paul, David, Boyer, Michael, Rhoda, William, Duffield, William
• Granted Patent: US 7,892,262 B2
• Time in Patent Office: Days
• US Class Current: 606/99
• CPC Class Codes: A61B 17/1604 Chisels; Rongeurs; Punches; Stamps
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/1735 for rasps or chisels
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 2017/0046 with a releasable handle; with handle and operating part separable for prosthetic joint-implanting tools A61F2/4603
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61F 2/442 Intervertebral or spinal discs, e.g. resilient non-disc-shaped intervertebral inflatable pockets A61F2/441; non-disc-shaped intervertebral fusion implants A61F2/4455
• CPC Class Codes: A61F 2/4425 made of articulated components
• CPC Class Codes: A61F 2002/30014 differing in elasticity, stiffness or compressibility
• CPC Class Codes: A61F 2002/30113 circular
• CPC Class Codes: A61F 2002/30125 elliptical or oval
• CPC Class Codes: A61F 2002/30166 H-shaped or I-shaped
• CPC Class Codes: A61F 2002/302 toroidal, e.g. rings
• CPC Class Codes: A61F 2002/30224 cylindrical
• CPC Class Codes: A61F 2002/30365 with additional means for limiting said rotation
• 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 2002/30545 for adjusting a diameter
• 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 2002/30568 Multiple spring systems including two or more helical springs
• CPC Class Codes: A61F 2002/30571 Leaf springs
• CPC Class Codes: A61F 2002/30579 : with mechanically expandable devices, e.g. fixation devices
• CPC Class Codes: A61F 2002/30594 : slotted, e.g. radial or meridian slot ending in a polar aperture, non-polar slots, horizontal or arcuate slots
• CPC Class Codes: A61F 2002/30604 : modular
• CPC Class Codes: A61F 2002/30649 : Ball-and-socket joints
• CPC Class Codes: A61F 2002/30662 : with rotation-limiting means
• CPC Class Codes: A61F 2002/30769 : madreporic
• CPC Class Codes: A61F 2002/30772 : Apertures or holes, e.g. of circular cross section
• CPC Class Codes: A61F 2002/30878 : with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
• CPC Class Codes: A61F 2002/30884 : Fins or wings, e.g. longitudinal wings for preventing rotation within the bone cavity
• CPC Class Codes: A61F 2002/443 : having two transversal endplates and at least one intermediate component
• CPC Class Codes: A61F 2002/448 : comprising multiple adjacent spinal implants within the same intervertebral space or within the same vertebra, e.g. comprising two adjacent spinal implants
• 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 2220/0091 : connected by a hinged linkage mechanism, e.g. of the single-bar or multi-bar linkage type
• CPC Class Codes: A61F 2230/0006 : circular
• CPC Class Codes: A61F 2230/0008 : elliptical or oval
• CPC Class Codes: A61F 2230/0028 : Shapes in the form of latin or greek characters
• CPC Class Codes: A61F 2230/0065 : toroidal, e.g. ring-shaped, doughnut-shaped
• CPC Class Codes: A61F 2230/0069 : cylindrical
• CPC Class Codes: A61F 2230/0071 : spherical
• CPC Class Codes: A61F 2250/001 : for adjusting a diameter
• CPC Class Codes: A61F 2250/0018 : differing in elasticity, stiffness or compressibility
• CPC Class Codes: A61F 2310/00407 : Coating made of titanium or of Ti-based alloys
• CPC Class Codes: A61F 2310/00796 : Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite

Abstract

The present invention relates generally to a prosthetic spinal disc for replacing a damaged disc between two vertebrae of a spine. The present invention also relates to a method for implanting a prosthetic spinal disc via posterior or posterior lateral implantation. Other surgical approaches for implanting the prosthetic disc may also be used. The present invention also involves a method for implanting the prosthetic spinal disc while either avoiding or minimizing contact with the spinal cord and nerve rootlets, or reducing the time and extent that they need to be repositioned during implantation.

Claims

1. An apparatus for inserting intervertebral artificial disc assemblies from a posterior approach to the spine, comprising:

a trial comprising a trial head, wherein said trial head is configured and dimensioned to receive a first blade portion,

a first chisel comprising a first blade portion, wherein the first blade portion is configured to slide over at least a portion of said trial,

a positioning member comprised of an attaching portion and a guiding portion, said positioning member configured to attach to said trial;

a second chisel comprising a second blade portion, wherein said second chisel is configured to interact with said guiding member such that the second blade portion of said second chisel is spaced apart at predetermined distances and angles to said first blade portion of said first chisel.

2. The apparatus according to claim 1, wherein the trial further comprises a first substantially straight shaft connected to said trial head and wherein said second chisel comprises a second substantially straight shaft connected to said second blade portion.

3. The apparatus according to claim 2, wherein the trial head further comprises a keyed recess, wherein said keyed recess is capable of receiving the first blade portion of the first chisel.

4. The apparatus according to claim 1, wherein the trial further comprises a first handle portion.

5. The apparatus according to claim 4, wherein the first handle portion comprises a flat face.

6. The apparatus according to claim 1, wherein the first chisel comprises a second handle portion.

7. The apparatus according to claim 6, wherein the second handle portion comprises a flat face.

8. The apparatus according to claim 1, wherein the second chisel comprises a third handle portion.

9. The apparatus according to claim 8, wherein the third handle portion comprises a flat face.

10. The apparatus according to claim 6, wherein the second handle portion of the first chisel is detachable, wherein after detaching said second handle portion at least some of said first substantially straight shaft of the trial is exposed.

11. The apparatus according to claim 10, wherein the attaching member of the positioning member is configured to attach to an exposed portion of the substantially straight shaft of the trial.

12. The apparatus according to claim 11, wherein said second substantially straight shaft of the second chisel comprises a hollow portion.

13. The apparatus according to claim 12, wherein the second substantially straight shaft of the second chisel comprises an opening that provides access to said hollow portion.

14. The apparatus according to claim 13, wherein the guiding member of the positioning member is configured to engage said hollow portion through said window portion of said second chisel such that said second chisel may be slid over the guiding member.

15. The apparatus according to claim 14, wherein said interaction between said guiding member and said second chisel causes the second blade portion of the second chisel to be parallel to and spaced apart at predetermined distances from the second blade portion of the second chisel.

16. The apparatus according to claim 2, wherein said first substantially straight shaft is offset from said trial head such that during insertion the first substantially straight shaft is spaced apart from the spinal cord.

17. The apparatus according to claim 16, wherein the second substantially straight shaft of the second chisel is offset with respect to the second blade portion such that during insertion the substantially straight shaft is spaced apart from the spinal cord.

18. A method of inserting intervertebral prosthetic disc assemblies from a posterior approach comprising;

inserting a trial into an intervertebral space;

creating at least one first pathway in at least one vertebral body with a chisel, wherein the location of said pathway is determined by the position of the trial;

creating at least one second pathway in said vertebral body with a chisel, wherein the location of said second pathway is determined by the position of the trial;

inserting a first assembly of a prosthetic disc into an intervertebral space using one of said first or second pathways, wherein said first or second pathway determines the position of the first assembly; and

inserting a second assembly of a prosthetic disc into the intervertebral space using the other of said first or second pathways, wherein the other of said first or second pathway determines the position of the second assembly.

19. The method of claim 18, wherein each intervertebral prosthetic disc assembly comprises at least one keel.

20. The method of claim 18, wherein each intervertebral prosthetic disc assembly comprises more than one keel.

21. The method of claim 19, wherein a pathway is created for each keel on the intervertebral prosthetic disc assembly.

22. The method of claim 18, wherein the trial further comprises at least one keyed recess.

23. The method of claim 22, wherein the trial further comprises more than one keyed recess.

24. The method of claim 22, wherein the number of keyed recesses equals the number of keels on an intervertebral prosthetic disc assembly.

25. The method of claim 23, wherein the creation of a pathway is accomplished using a chisel, the chisel further comprising at least one blade portion.

26. The method of claim 25, wherein the number of blade portions equals the number of keyed recesses on the trial.

27. The method of claim 26, wherein one or more blade portions of the chisel engage the one or more keyed recess of the trial.

28. The method of claim 18, wherein said second pathway is spaced apart from said first pathway by a predetermined distance.

29. The method of claim 28, wherein said predetermined distance is determined by the position of the trial.

30. An apparatus for inserting intervertebral artificial disc assemblies from a posterior approach to the spine, comprising:

a trial comprising a trial head, wherein said trial head is configured and dimensioned to receive a first blade portion,

a first chisel comprising a first blade portion, wherein the first blade portion is configured to slide over at least a portion of said trial,

a second chisel comprising a second blade portion, wherein said second chisel is configured to interact with either said trial or said first chisel such that the blade portion of said second chisel is spaced apart at predetermined distances and angles to said first blade portion of said first chisel.

31. The apparatus according to claim 30, wherein said trial head comprises at least one keyed recess configured to receive said first blade portion.

32. The apparatus according to claim 31, wherein said trial head further comprises a window.

33. The apparatus according to claim 32, wherein said window comprises a center post.

34. The apparatus according to claim 33, wherein said window and center post are visible during fluoroscopy and configured to aid a user in positioning said trial head within the intervertebral space.

35. An apparatus for inserting intervertebral prosthetic disc assemblies from a posterior approach, comprising:

a kit including at least a first and second assembly;

wherein the second assembly is capable of being inserted into the intervertebral space at a position that is determined by the position of said first assembly.

36. The apparatus of claim 35, further comprising a trial wherein said trial further comprises an offset trial head and a substantially straight shaft, wherein said trial head comprises a keyed recess,

37. The apparatus of claim 36, further comprising a first chisel, wherein said chisel comprises an offset blade portion and a substantially straight shaft, wherein the substantially straight shaft of the first chisel is configured to slide over at least a portion of said trial, wherein the keyed recess of the trial head is capable of receiving the blade portion of the chisel.

38. The apparatus of claim 37, further comprising a positioning member, said positioning member further comprising an attaching portion and a guiding portion, wherein said positioning member is configured to attach to said substantially straight shaft of said trial.

39. The apparatus of claim 38, further comprising a second chisel, wherein said second chisel comprises a blade portion and a substantially straight shaft, wherein said substantially straight shaft of the second chisel is configured to interact with said guiding member such that the blade portion of said second chisel is spaced apart at a predetermined distance and generally parallel to said blade portion of said first trial.