Expandable intervertebral cage and surgical method

• US 5,665,122 A
• Filed: 01/31/1995
• Issued: 09/09/1997
• Est. Priority Date: 01/31/1995
• Status: Expired due to Fees

• Current Assignee: Parviz Kambin
• Original Assignee: Parviz Kambin
• Inventors: Kambin, Parviz
• Primary Examiner(s): Weiss, John G.
• Assistant Examiner(s): SNOW, BRUCE EDWARD
• Application Number:
  US08/381,400
• Time in Patent Office: 952 Days
• Field of Search: 623/16-17, 411/24-25, 411/55, 411/18, 411/21, 411/35, 606/61-63, 606/67
• US Class Current: 623/17.16
• CPC Class Codes: A61B 17/8886 holding the screw head
• 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 2/4611 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 2002/30143 hexagonal
• CPC Class Codes: A61F 2002/30205 conical
• CPC Class Codes: A61F 2002/30232 Half-cylinders
• 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 2002/30332 Conically- or frustoconically-shaped protrusion and recess
• CPC Class Codes: A61F 2002/3037 Translation along the common longitudinal axis, e.g. piston
• CPC Class Codes: A61F 2002/30405 made by screwing complementary threads machined on the parts themselves
• CPC Class Codes: A61F 2002/30428 made by inserting a protrusion into a slot
• CPC Class Codes: A61F 2002/30507 using a threaded locking member, e.g. a locking screw or a set screw
• CPC Class Codes: A61F 2002/3055 for adjusting length
• CPC Class Codes: A61F 2002/30556 for adjusting thickness
• CPC Class Codes: A61F 2002/30579 with mechanically expandable devices, e.g. fixation devices
• 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 2002/30782 : inclined obliquely
• 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 2002/30975 : made of two halves
• 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 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 2230/0017 : Angular shapes
• CPC Class Codes: A61F 2230/0067 : conical
• CPC Class Codes: A61F 2230/0069 : cylindrical
• CPC Class Codes: A61F 2250/0009 : for adjusting thickness
• CPC Class Codes: Y10S 606/907 : Composed of particular material or coated

Abstract

An expandable intervertebral cage apparatus includes a pair of cage components, each generally in the shape of a half cylinder. Each of the cage components provides a corresponding, abutting conically shaped recess that cooperates with a conical end portion of an expansion screw. One of the cage components carries a fitting with an internally threaded bore that receives external threads of the expansion screw. As the expansion screw advances into the cage, the conically shaped end portion of the expansion screw engages the conically shaped recesses on the cage components to expand the two cage components apart until they are in contact with the vertebral plates of adjacent vertebrae. The cage components have passageways for packing with bone-inducing-growth material allowing the cage to become part of a spinal fusion. A surgical method for installing the expandable intervertebral cage is also disclosed.

Claims

1. A bio-compatible intervertebral prosthesis for implantation between adjacent vertebrae comprising:

a) a cage body that includes a plurality of components including at least first and second separable cage sections configured and sized to be inserted between adjacent vertebrae;

b) said cage sections being separable along the longitudinal axis of said cage body;

c) the cage body having an anterior section with an internally threaded bore;

d) the cage body having an internal recess defined by a recess surface;

e) the cage body having anterior and posterior end portions;

f) An expansion screw with proximal and distal end portions, the proximal end having means thereon for forming a connection with a rotary driver for rotating the screw, the distal end portion being sized and shaped to force the first and second cage sections apart as the screw advances longitudinally within the cage body to engage the recess surface along the length of the distal end of said expansion screw and in a direction from the anterior to the posterior end portions thereof;

g) wherein said expansion screw has a length less than the length of the cage body and wherein said expansion screw does not extend beyond the end of said cage body; and

h) wherein the first and second cage sections move apart incrementally as the screw advances into the internally threaded bore and recess surface.

2. The apparatus of claim 1, wherein the cage body has an outer surface with a generally cylindrical shape.

3. The apparatus of claim 1 wherein the cage body sections each have corresponding flat abutting surfaces.

4. The apparatus of claim 1 wherein the cage body recesses are generally conically shaped.

5. The apparatus of claim 1 wherein each of the cage sections has a recess portion that engages the expansion screw.

6. The apparatus of claim 1 wherein the distal end of the expansion screw is conically shaped.

7. The apparatus of claim 1 wherein the anterior section includes an anterior fitting that carries the internally threaded bore.

8. The apparatus of claim 1 wherein the expansion screw has a cylindrically shaped threaded section and a conically shaped unthreaded section.

9. The apparatus of claim 1 wherein the cage body sections are slideably attached at the posterior end portion thereof.

10. A bio-compatible intervertebral prosthesis for implantation between adjacent vertebrae comprising:

a) a cylindrically shaped cage body that includes at least first and second separable sections configured and sized to be inserted between adjacent vertebrae, each section having a flat inner surface portion that engages the flat inner surface of the other component;

b) said separable sections being separable along the longitudinal axis of said cage body;

c) the cage body having an anterior fitting integral thereto with an internally threaded bore;

d) the cage body having anterior and posterior end portions;

e) each of the cage body sections having a conically shaped internal recess with a bearing surface;

f) an externally threaded expansion screw that engages the internal threads of the fitting, the screw having proximal and distal end portions, the proximal end having a tool receptive socket thereon for forming a connection with a rotary driver tool that can rotate the screw, the distal end portion being sized and shaped to force the first and second components apart as the screw advances longitudinally within the cage body to engage the recess surface along the length of the distal end of said expansion screw and in a direction from the anterior to the posterior end portions thereof;

g) wherein said expansion screw has a length less than the length of the cage body and wherein said expansion screw does not extend beyond the end of said cage body; and

h) wherein the first and second sections move apart incrementally as the screw advances into the internally threaded bore and recess surface.

11. The apparatus of claim 10 further comprising means for receiving bone graft material.

12. The apparatus of claim 10 further comprising bore means for receiving bone fusion augmenting material.

13. The apparatus of claim 10 further comprising roughened surface means on the outer bone engaging surface of at least one of the components for enhancing fixation of the cage body to the patents vertebral bodies.

14. The apparatus of claim 10 wherein at least one of the components has a roughened surface for engaging the end plates of the patient'"'"'s vertebral bodies.

15. The apparatus of claim 10 wherein the tool receptive portion is a socket.

16. A bio-compatible intervertebral prothesis for implantation between adjacent vertebrae comprising:

a) a cylindrically shaped cage body that includes at least first and second separable cage sections configured and sized to be inserted between adjacent vertebrae, each having

b) a flat inner surface portion that engages the flat inner surface of the other component;

c) said separable sections being separable along the longitudinal axis of said cage body;

d) the cage body having an anterior fitting integral thereto with an internal bore;

e) the cage body having anterior and posterior end portions;

f) each of the cage body sections having a conically shaped internal recess surface with a bearing surface;

g) An expansion pin that engages the bore of the anterior fitting, the pin having proximal and distal end portions, the proximal end having a tool receptive portion thereon for forming a connection with a driver tool that can manipulate the pin, the distal end portion being sized and shaped to force the first and second sections apart as the pin advances longitudinally within the cage body to engage the recess surface along the length of the distal end of said expansion screw in a direction from the anterior to the posterior end portions thereof;

h) wherein said expansion screw has a length less than the length of the cage body and wherein said expansion screw does not extend beyond the end of said cage body; and

i) wherein the first and second sections move apart incrementally as the pin advances into the bore and recess surface.

17. The apparatus of claim 16 wherein the expansion pin is a threaded expansion screw.

18. The apparatus of claim 16 wherein the cage body bore is threaded.

19. A method for providing bio-compatible vertebral interbody fusion in the vertebral column comprising the steps of:

a) preparing a space for receiving an orthopedic prosthetic device between two vertebrae;

b) surgically inserting a substantially cylindrically shaped spinal cage body into the space between the vertebrae, wherein the spinal cage includes upper and lower cage sections;

each of the cage body sections having an internal recess with a bearing surface; and

c) advancing a unitary screw member to separate incrementally the upper and lower cage sections;

wherein said screw member has a length less than the length of the cage body and does not extend beyond the end of said cage body and wherein the screw member includes a distal end portion being sized and shaped to engage the recess surface of the first and second cage sections and to force the first and second cage sections apart as the screw advances longitudinally into the cage body.