Surgical prosthetic implant facilitating vertebral interbody fusion and method

• US 4,743,256 A
• Filed: 01/22/1987
• Issued: 05/10/1988
• Est. Priority Date: 10/04/1985
• Status: Expired due to Term

• Current Assignee: Depuy Acromed Incorporated (Johnson & Johnson)
• Original Assignee: John W. Brantigan
• Inventors: Brantigan, John W.
• Primary Examiner(s): Apley, Richard J.
• Assistant Examiner(s): NOT, DEFINED
• Application Number:
  US07/005,785
• Time in Patent Office: 474 Days
• Field of Search: 623/17, 623/18, 623/66, 623/16, 128/92 Z, 128/92 Y, 128/92 ZW, 128/92 YM, 128/92 YJ, 128/92 YF
• US Class Current: 128/898
• CPC Class Codes: A61B 17/1604 Chisels; Rongeurs; Punches; Stamps
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/686 Plugs, i.e. elements forming interface between bone hole and implant or fastener, e.g. screw
• CPC Class Codes: A61B 17/7059 Cortical plates A61B17/7007, A61B17/7058 take precedence
• 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 2/442 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 2/446 having a circular or elliptical cross-section substantially parallel to the axis of the spine, e.g. cylinders or frustocones
• CPC Class Codes: A61F 2/4465 having a circular or kidney shaped cross-section substantially perpendicular to the axis of the spine
• CPC Class Codes: A61F 2/447 substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section
• 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 2002/2839 Bone plugs or bone graft dowels
• CPC Class Codes: A61F 2002/30179 X-shaped
• CPC Class Codes: A61F 2002/30224 cylindrical
• CPC Class Codes: A61F 2002/30261 parallelepipedal
• CPC Class Codes: A61F 2002/30263 cubical
• CPC Class Codes: A61F 2002/3028 polyhedral different from parallelepipedal and pyramidal
• CPC Class Codes: A61F 2002/30576 with extending fixation tabs
• CPC Class Codes: A61F 2002/30578 having apertures, e.g. for receiving fixation screws
• CPC Class Codes: A61F 2002/30841 Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
• 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 2230/0058 : X-shaped
• CPC Class Codes: A61F 2230/0063 : Three-dimensional shapes
• CPC Class Codes: A61F 2230/0069 : cylindrical
• CPC Class Codes: A61F 2230/0082 : parallelepipedal
• CPC Class Codes: A61F 2230/0084 : cubical

Abstract

A surgical prosthetic implant for the vertebral column in the form of a rigid, preferably inert metal, plug having a porous metal surface allowing ingrowth of bone cells for biologic fixation is provided to achieve vertebral interbody fusion for treating or preventing back pain in patients with ruptured or degenerated vertebral discs. The plug forms a strut spanning and maintaining the disc space between adjoining vertebrae and has opposite ends bottomed in channels that are cut into the opposing faces of the vertebrae or opposed faces bottomed on the end faces of adjoining vertebrae. Bone ingrowth into the porous surface of the plug achieves long term biological fixation with living bone. Local bone graft harvested from the channel cuts into the vertebrae to receive the plug supplements the fusion. The implant minimizes or eliminates the need for bone graft material obtained from a second surgical site or from a bone bank and simplifies the method of achieving the interbody fusion.

Claims

1. The method of fusing together adjoining vertebrae bodies having spaced opposed faces with a disc space therebetween and peripheral hard cortex bone surrounding soft cancellous bone which comprises cutting transverse opposed channels in said spaced opposed faces open at one end to the sides of the adjoining vertebrae bodies and defined by both hard cortex bone and soft cancellous bone, inserting through said open ends of the transverse channels an inert rigid plug spanning the disc space, bottoming opposite ends of the plug in said channels at least partially on said hard cortex bone to provide a rigid strut spanning and maintaining said disc space, providing irregular non-yielding surfaces on said plug, and facilitating bone ingrowth around said surfaces in bonded relation therewith.

3. The method of claim 1 including the step of cutting each channel from the anterior or posterior sides of the adjacent vertebrae bodies, terminating the cutting in advance of the opposite sides of the adjacent vertebrae to provide a closed end for each channel, inserting the plug through the open end of each channel, and bottoming the plug on said closed end of each channel.

4. The method of claim 1 including the added step of cutting a pair of transverse opposed channels in side-by-side relation in each of said spaced opposed faces, and inserting a separate unitary rigid plug into each pair of opposed channels.

5. The method of claim 1 including the step of cutting fragmental cylindrical opposed channels in said spaced opposed faces and inserting a cylindrical rigid plug endwise into said channels to transversely span the disc space.

6. The method of claim 1 including the step of correlating the depth of the channels and the height of the plug to maintain the disc space.

2. The method of fusing together adjacent vertebrae bodies without excising a vertebrae body in a vertebral column and without loss of disc space which comprises preparing opposed transversely extending plug bottoming sites in the opposed faces of the adjacent vertebrae bodies including hard cancellous bone of said bodies, inserting at least one rigid plug with a porous metal coating into the disc space bottomed on the prepared sites including said hard cancellous bone to span the disc space forming a strut between the adjacent vertebrae bodies, and fusing the prepared sites to the coating.