Anterior spinal implant system for vertebral body prosthesis

• US 5,916,267 A
• Filed: 04/07/1997
• Issued: 06/29/1999
• Est. Priority Date: 04/07/1997
• Status: Expired due to Fees

• Current Assignee: Arthit Sitiso, Frank Bailly, John Wagner, Pibul Itiravivong, Prakit Tienboon, Somsak Kuptniratsaikul, Tawechai Tejapongvorachai
• Original Assignee: Arthit Sitiso, Frank Bailly, John Wagner, Pibul Itiravivong, Prakit Tienboon, Somsak Kuptniratsaikul, Tawechai Tejapongvorachai
• Inventors: Tienboon, Prakit
• Primary Examiner(s): ISABELLA, DAVID J
• Application Number:
  US08/826,000
• Time in Patent Office: 813 Days
• Field of Search: 623/16, 623/17, 623/18, 606/61, 606/63
• US Class Current: 623/17.11
• 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 2/44 for the spine, e.g. vertebrae, spinal discs
• CPC Class Codes: A61F 2002/30411 having two threaded end parts connected by a threaded central part with opposite threads at its opposite ends, i.e. for adjusting the distance between both end parts by rotating the central part
• CPC Class Codes: A61F 2002/3055 for adjusting length
• CPC Class Codes: A61F 2002/30578 having apertures, e.g. for receiving fixation screws
• CPC Class Codes: A61F 2002/30601 telescopic
• CPC Class Codes: A61F 2002/30841 Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
• CPC Class Codes: A61F 2002/30892 parallel
• CPC Class Codes: A61F 2220/0025 Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements

Abstract

A vertebral body prosthesis is disclosed which is easily implantable intermediate the endplates of upper and lower vertebrae to replace the removed vertebral body and restore stability and normal vertebrae spacing to the spinal column while facilitating the occurrence of bony integration to fuse the aforesaid vertebrae together. A first embodiment, which may be used in the cervical spine and installed from an anterior surgical approach, is a vertebral body T-cage, which is fixed in height, and is for installation intermediate the endplates of two vertebrae located immediately above and below a removed vertebra. A second embodiment, which may be installed using a posterior surgical approach, is a fixed height vertebral body prosthesis for installation intermediate the endplates of vertebrae located immediately above and below a removed vertebra, with the device being affixed using curved mounting plates located on either the left or the right lateral side of the vertebrae. A third embodiment is a variable height vertebral body prosthesis similar to the fixed height vertebral body prosthesis, but which may be adjusted in height once it is installed in place to adjust the spacing between the vertebrae.

Claims

1. A vertebral body prosthesis for installation intermediate the inferior endplate of an upper vertebra and the superior endplate of a lower vertebra to replace a removed vertebra, said vertebral body prosthesis comprising:

a vertebrae support member having an upper end and a lower end, said upper end of said vertebrae support member being arranged and configured for placement adjacent to the inferior endplate of the upper vertebra, said lower end of said vertebrae support member being arranged and configured for placement adjacent to the superior endplate of the lower vertebra, said vertebrae support member having a channel located therein which channel is open at said upper and lower ends of said vertebrae support member;

an upper mounting plate mechanically connected to said upper end of said vertebrae support member at a side thereof, said upper mounting plate extending upwardly from said upper end of said vertebrae support member, said upper mounting plate having a horizontally concave contour to lie close adjacent to a side of the upper vertebra when said upper end of said vertebrae support member is located close adjacent to the inferior endplate of the upper vertebra, said upper mounting plate having a plurality of angularly spaced-apart mounting apertures located therein such that screws inserted therethrough will extend into the side of the upper vertebra at a converging relative angle to each other to secure said upper end of said vertebrae support member in a fixed position with respect to the upper vertebra; and

a lower mounting plate mechanically connected to said lower end of said vertebrae support member at a side thereof, said lower mounting plate extending downwardly from said lower end of said vertebrae support member, said lower mounting plate having a horizontally concave contour to lie close adjacent to a side of the lower vertebra when said lower end of said vertebrae support member is located close adjacent to the superior endplate of the lower vertebra, said lower mounting plate having a plurality of angularly spaced-apart mounting apertures located therein such that screws inserted therethrough will extend into the side of the lower vertebra at a converging relative angle to each other to secure said lower end of said vertebrae support member in a fixed position with respect to the lower vertebra.

2. A vertebral body prosthesis as defined in claim 1, wherein said vertebrae support member has a plurality of blood holes extending through the sides thereof, said blood holes thereby defining a plurality of paths of fluid communication between said channel located in said vertebrae support member and the exterior of said vertebrae support member.

3. A vertebral body prosthesis as defined in claim 1, wherein said vertebrae support member comprises:

a hollow column of square cross-section, said hollow column having upper and lower ends and having a square aperture extending vertically therethrough intermediate said upper and lower ends of said column.

4. A vertebral body prosthesis as defined in claim 3, wherein said upper and lower ends of said hollow column are essentially flat.

5. A vertebral body prosthesis as defined in claim 3, wherein said upper and lower ends of said hollow column comprise convex curved surfaces on opposing lateral sides of said hollow column.

6. A vertebral body prosthesis as defined in claim 3, wherein said upper and lower ends of said hollow column are spaced further apart on one side of said hollow column than they are on an opposing side of said hollow column.

7. A vertebral body prosthesis as defined in claim 1, wherein said upper and lower mounting plates are arranged and configured for placement adjacent the anterior sides of the upper and lower vertebrae, respectively.

8. A vertebral body prosthesis as defined in claim 1, wherein said vertebrae support member comprises:

a hollow vertebrae support column having an upper end and a lower end thereof;

an upper base member for installation onto said upper end of said vertebrae support column, said upper base member having an aperture extending therethrough which aperture is in communication with the hollow interior of said vertebrae support column, said upper mounting plate being mounted onto a side of said upper base member; and

a lower base member for installation onto said lower end of said vertebrae support column, said lower base member having an aperture extending therethrough which aperture is in communication with the hollow interior of said vertebrae support column, said lower mounting plate being mounted onto a side of said lower base member.

9. A vertebral body prosthesis as defined in claim 8, wherein said upper and lower base members are permanently and fixedly installed on said upper and lower ends of said vertebrae support column, said vertebral body prosthesis thereby being of a fixed height.

10. A vertebral body prosthesis as defined in claim 8, wherein said upper and lower base members are movably installed on said upper and lower ends of said vertebrae support column such that said upper and lower base members may be moved closer together or further away relative to each other, said vertebral body prosthesis thereby being of an adjustable height.

11. A vertebral body prosthesis as defined in claim 8, wherein said vertebrae support column comprises:

a threaded outer surface located at said upper end of said vertebrae support column; and

a threaded outer surface located at said lower end of said vertebrae support column; and

wherein said upper base member comprises;

a threaded inner surface located in said aperture extending through said upper base member, said threaded outer surface located at said upper end of said vertebrae support column being screwed into said threaded inner surface located in said aperture extending through said upper base member; and

wherein said lower base member comprises;

a threaded inner surface located in said aperture extending through said lower base member, said threaded outer surface located at said lower end of said vertebrae support column being screwed into said threaded inner surface located in said aperture extending through said lower base member.

12. A vertebral body prosthesis as defined in claim 11, wherein said threaded outer surface located at said upper end of said vertebrae support column and said threaded inner surface located in said aperture extending through said upper base member have threads in a first direction, and wherein said threaded outer surface located at said lower end of said vertebrae support column and said threaded inner surface located in said aperture extending through said lower base member have threads in a second direction opposite to said first direction.

13. A vertebral body prosthesis as defined in claim 12, wherein said threaded outer surface located at said upper end of said vertebrae support column and said threaded inner surface located in said aperture extending through said upper base member have standard (right hand) threads, and wherein said threaded outer surface located at said lower end of said vertebrae support column and said threaded inner surface located in said aperture extending through said lower base member have reverse (left hand) threads.

14. A vertebral body prosthesis as defined in claim 12, wherein said vertebrae support column additionally comprises:

a central portion having a series of angularly spaced apertures extending radially therethrough, wherein a handle may be inserted into an opposed pair of said angularly spaced apertures to rotate said vertebrae support column to adjust the height of said vertebral body prosthesis.

15. A vertebral body prosthesis as defined in claim 12, additionally comprising:

an upper setscrew for adjustable installation in said upper base member to selectively secure said upper end of said vertebrae support column in a fixed position in said threaded inner surface located in said aperture extending through said upper base member; and

a lower setscrew for adjustable installation in said lower base member to selectively secure said lower end of said vertebrae support column in a fixed position in said threaded inner surface located in said aperture extending through said lower base member.

16. A vertebral body prosthesis as defined in claim 1, wherein said upper and lower mounting plates are arranged and configured for placement adjacent either the right or the left lateral sides of the upper and lower vertebrae, respectively.

17. A vertebral body prosthesis as defined in claim 1, wherein said vertebral body prosthesis is made of titanium.

18. A vertebral body prosthesis as defined in claim 1, additionally comprising:

a first plurality of small spikes extending from the superior side of said upper base member; and

a second plurality of small spikes extending from the inferior side of said lower base member.

19. A vertebral body prosthesis as defined in claim 1, additionally comprising:

a wedge-shaped member for installation intermediate at least one of said upper and lower base members and said upper and lower vertebrae, respectively.

20. A vertebral body prosthesis as defined in claim 1, additionally comprising:

a recess located in at least one of said upper and lower base members; and

a wedging member having a first portion receivable in said recess and a second portion extending above said recess and defining a movable wedge.

21. A vertebral body prosthesis for installation intermediate the inferior endplate of an upper vertebra and the superior endplate of a lower vertebra to replace a removed vertebra, said vertebral body prosthesis comprising:

a vertebrae support column having an upper standard threaded end and a lower reverse threaded end thereof, said vertebrae support column having a channel located therein which channel is open at said upper and lower ends of said vertebrae support column;

an upper base member for installation onto said upper standard threaded end of said vertebrae support column, said upper base member having a standard threaded aperture extending therethrough which aperture is in communication with said channel in said vertebrae support column, said upper base member being arranged and configured for placement adjacent to the inferior endplate of the upper vertebra;

an upper mounting plate mechanically connected to said upper base member at a side thereof, said upper mounting plate extending upwardly from said upper base member, said upper mounting plate having a horizontally concave contour to lie close adjacent to a side of the upper vertebra when said upper base member is located close adjacent to the inferior endplate of the upper vertebra, said upper mounting plate having a plurality of angularly spaced-apart mounting apertures located therein such that screws inserted therethrough will extend into the side of the upper vertebra at a converging relative angle to each other to secure said upper end of said vertebrae support member in a fixed position with respect to the upper vertebra;

a lower base member for installation onto said lower reverse threaded end of said vertebrae support column, said lower base member having a reverse threaded aperture extending therethrough which aperture is in communication with said channel in said vertebrae support column, said lower base member being arranged and configured for placement adjacent to the superior endplate of the lower vertebra; and

a lower mounting plate mechanically connected to said lower base member at a side thereof, said lower mounting plate extending downwardly from said lower base member, said lower mounting plate having a horizontally concave contour to lie close adjacent to a side of the lower vertebra when said lower base member is located close adjacent to the superior endplate of the lower vertebra, said lower mounting plate having a plurality of angularly spaced-apart mounting apertures located therein such that screws inserted therethrough will extend into the side of the lower vertebra at a converging relative angle to each other to secure said lower end of said vertebrae support member in a fixed position with respect to the lower vertebra.

22. A vertebral body prosthesis for installation intermediate the inferior endplate of an upper vertebra and the superior endplate of a lower vertebra to replace a removed vertebra, said vertebral body prosthesis comprising:

a vertebrae support member having an upper end and a lower end, said upper end of said vertebrae support member being arranged and configured for placement adjacent the inferior endplate of the upper vertebra, said lower end of said vertebrae support member being arranged and configured for placement adjacent the superior endplate of the lower vertebra, said vertebrae support member being hollow intermediate said upper and lower ends thereof;

an upwardly extending upper mounting plate mechanically connected to said upper end of said vertebrae support member at a side thereof, said upper mounting plate having a horizontally concave contour, said upper mounting plate having a plurality of angularly spaced-apart mounting apertures located therein such that screws inserted therethrough will extend into the side of the upper vertebra at a converging relative angle to each other; and

a downwardly extending lower mounting plate mechanically connected to said lower end of said vertebrae support member at a side thereof, said lower mounting plate having a horizontally concave contour, said lower mounting plate having a plurality of angularly spaced-apart mounting apertures located therein such that screws inserted therethrough will extend into the side of the upper vertebra at a converging relative angle to each other.

23. A method of making a vertebral body prosthesis for installation intermediate the inferior endplate of an upper vertebra and the superior endplate of a lower vertebra to replace a removed vertebra, said method comprising:

providing a vertebrae support member having an upper end and a lower end, said upper end of said vertebrae support member being arranged and configured for placement adjacent to the inferior endplate of the upper vertebra, said lower end of said vertebrae support member being arranged and configured for placement adjacent to the superior endplate of the lower vertebra;

defining a channel in said vertebrae support member, said channel being open at said upper and lower ends of said vertebrae support member;

mechanically connecting an upper mounting plate to said upper end of said vertebrae support member at a side thereof, said upper mounting plate extending upwardly from said upper end of said vertebrae support member, said upper mounting plate having a horizontally concave contour to lie close adjacent to a side of the upper vertebra when said upper end of said vertebrae support member is located close adjacent to the inferior endplate of the upper vertebra, said upper mounting plate having a plurality of angularly spaced-apart mounting apertures located therein such that screws inserted therethrough will extend into the side of the upper vertebra at a converging relative angle to each other to secure said upper end of said vertebrae support member in a fixed position with respect to the upper vertebra; and

mechanically connecting a lower mounting plate to said lower end of said vertebrae support member at a side thereof, said lower mounting plate extending downwardly from said lower end of said vertebrae support member, said lower mounting plate having a horizontally concave contour to lie close adjacent to a side of the lower vertebra when said lower end of said vertebrae support member is located close adjacent to the superior endplate of the lower vertebra, said lower mounting plate having a plurality of angularly spaced-apart mounting apertures located therein such that screws inserted therethrough will extend into the side of the lower vertebra at a converging relative angle to each other to secure said lower end of said vertebrae support member in a fixed position with respect to the lower vertebra.