Prosthetic implant

• US 4,834,757 A
• Filed: 03/28/1988
• Issued: 05/30/1989
• Est. Priority Date: 01/22/1987
• 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): Cannon, Alan W.
• Application Number:
  US07/173,928
• Time in Patent Office: 428 Days
• Field of Search: 623/17, 623/16, 623/18, 623/21, 623/22, 623/23, 623/66, 128/92 YG, 128/92 YM, 128/92 YJ, 128/92 W, 128/305
• US Class Current: 623/17.11
• CPC Class Codes: A61B 17/16 Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans arthroscopic bone cutters A61B17/320016; dental implant drills potentially for other surgical use A61C8/0089; bone grinders A61F2/4644, A22C17/06; A61B17/1662 takes precedence over all other subgroups except A61B17/17
• CPC Class Codes: A61B 17/1604 Chisels; Rongeurs; Punches; Stamps
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/1757 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: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61F 2/30723 Plugs or restrictors for sealing a cement-receiving space tools for inserting plugs A61F2/4614; sealing collars for use during cementing A61B17/8808
• CPC Class Codes: A61F 2/30767 Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
• CPC Class Codes: A61F 2/30771 applied in original prostheses, e.g. holes or grooves
• CPC Class Codes: A61F 2/30965 Reinforcing the prosthesis by embedding particles or fibres during moulding or dipping
• CPC Class Codes: A61F 2/42 for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
• 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 2/4455 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 2/446 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 2/4603 for insertion or extraction of endoprosthetic joints or of accessories thereof
• CPC Class Codes: A61F 2/4611 of spinal prostheses
• CPC Class Codes: A61F 2/4684 : Trial or dummy 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 2002/2839 : Bone plugs or bone graft dowels
• CPC Class Codes: A61F 2002/3008 : radio-opaque, e.g. radio-opaque markers
• CPC Class Codes: A61F 2002/30113 : circular
• CPC Class Codes: A61F 2002/30123 : with two diametrically opposed lobes
• CPC Class Codes: A61F 2002/30153 : rectangular
• CPC Class Codes: A61F 2002/30154 : square
• 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 2002/30405 : made by screwing complementary threads machined on the parts themselves
• 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 2002/30593 : hollow
• CPC Class Codes: A61F 2002/30772 : Apertures or holes, e.g. of circular cross section
• CPC Class Codes: A61F 2002/30774 : internally-threaded
• CPC Class Codes: A61F 2002/30797 : internally-threaded
• CPC Class Codes: A61F 2002/308 : oblong
• CPC Class Codes: A61F 2002/30805 : Recesses of comparatively large area with respect to their low depth
• CPC Class Codes: A61F 2002/30836 : knurled
• CPC Class Codes: A61F 2002/30841 : Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
• CPC Class Codes: A61F 2002/3085 : with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface
• CPC Class Codes: A61F 2002/30904 : serrated profile, i.e. saw-toothed
• 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 2002/449 : comprising multiple spinal implants located in different intervertebral spaces or in different vertebrae
• 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 2002/4629 : connected to the endoprosthesis or implant via a threaded connection
• CPC Class Codes: A61F 2220/0025 : Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2230/0006 : circular
• CPC Class Codes: A61F 2230/0019 : rectangular
• CPC Class Codes: A61F 2230/0021 : square
• 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
• CPC Class Codes: A61F 2250/0098 : radio-opaque, e.g. radio-opaque markers
• CPC Class Codes: A61F 2310/00017 : Iron- or Fe-based alloys, e.g. stainless steel
• CPC Class Codes: A61F 2310/00023 : Titanium or titanium-based alloys, e.g. Ti-Ni alloys
• CPC Class Codes: A61F 2310/00029 : Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
• CPC Class Codes: Y10S 606/907 : Composed of particular material or coated

Abstract

Gauge blocks or plugs and permanent implant plugs are provided for surgical procedures to support and fuse together adjacent vertebrae in a vertebral column. The plugs are rectangular with tapered front ends and tool receiving rear ends. The gauge blocks are smooth faced for removal but the implant plugs have roughened surfaces to grip the vertebrae and provide channels for bone ingrowth. The plugs have recesses in the form of through slots to be packed with bone graft material. In the surgical procedure, undamaged annulus fibrosus disc tissue connecting the adjacent vertebrae is preserved and a pair of side-by-side roughened implant plugs are forced into side-by-side transverse channels in the adjoining vertebrae to stretch the remaining annulus disc tissue and form struts supporting the vertebrae. The plugs are bottomed in the channels on cortex bone and bone ingrowth is facilitated to fuse the plugs to the vertebrae.

Claims

1. A surgical prosthetic device adapted for fusing together adjoining vertebrae bodies connected by tissue of a damaged collapsed disc and having spaced opposed faces on opposite sides of the disc space therebetween with transverse channels in said faces including hard peripheral cortex bone surrounding central cancellous bone which comprises a rigid inert parallelpiped plug sized and shaped for snug seating in said channels spanning and stretching the disc tissue to maintain a desired disc space between the adjoining vertebrae bodies with opposite faces bottomed on at least the cortex bone portion of both adjacent bodies, said plug having at least one open ended slot therethrough exposed to the bone and adapted to be packed with bone implant material, and irregular surfaces on said plug having passages therebetween communicating with said slot and facilitating ingrowth of bone implant material from the slot and bone from the vertebrae bodies bottomed thereon to fuse said bodies together in fixed relation.

7. The device of claim 1, wherein the channels have flat sides and extend in a posterior to anterior direction.

8. The device of claim 1, wherein the plug has two slots intersecting each other at the longitudinal axis of the plug.

9. The device of claim 1, wherein the nubs have front faces sloping in the direction of insertion into the channels and sharp edges at their apices.

2. A prosthetic device adapted for fusing together adjoining vertebrae with spaced opposed faces on opposite sides of a damaged collapsed vertebrae disc having tissue connecting the adjoining vertebrae bodies, said opposed faces of the vertebrae bodies having a pair of laterally spaced posterior to anterior extending transverse channels cut therein, and said disc tissue having openings therethrough aligned with the channels, which comprises a rigid inert plug having a greater height than the damaged disc space between the bottoms of the aligned channels for force fit into the channels to stretch the disc tissue to maintain the original undamaged disc space, and spaced nubs radiating from said plug for biting into surfaces of the channels and having passages therebetween to facilitate ingrowth of bone from the vertebrae bodies bottomed in the channels to fuse the bodies together in fixed relation.

10. The device of claim 2, wherein the plug is a parallelepiped.

11. The device of claim 2, wherein the plug is composed of radiolucent material.

3. A surgical prosthetic device adapted for fusing together adjoining vertebrae bodies which comprises a parallelepiped inert rigid plug having top, bottom, and side walls, a leading end and a trailing end, said leading end having a reduced nose surrounded by bevelled edges diverging to said top, bottom and side walls in spaced relation from each other, each nub having an inclined front face and a back wall cooperating therewith to define a sharp biting edge at the intersection thereof, and an open end slot through said plug between said leading and trailing ends communicating with said nubs and adapted to be packed with bone implant material.

4. The device of claim 3 including a first slot open to the top and bottom walls of the plug and a second slot intersecting the first slot open to the side walls of the plug.

5. The device of claim 3, wherein the plug has a length greater than height and a width less than height.

6. The device of claim 3, wherein the plug is composed of radiolucent material.