Stackable cage system for corpectomy/vertebrectomy

• US 6,159,211 A
• Filed: 10/22/1998
• Issued: 12/12/2000
• Est. Priority Date: 10/22/1998
• Status: Expired due to Term

• Current Assignee: DePuy Motech Acromed Inc (Johnson & Johnson)
• Original Assignee: Depuy Acromed Incorporated (Johnson & Johnson)
• Inventors: Savage, Daniel S., Mraz, Paul J., Pait, T. Glenn, Boriani, Stefano, Bilsky, Mark H., Lissy, Dawn Abens, Boland, Patrick J.
• Primary Examiner(s): Buiz, Michael
• Assistant Examiner(s): Woo, Julian W.
• Application Number:
  US09/177,645
• Time in Patent Office: 782 Days
• Field of Search: 606/61, 606/72, 606/73, 606/69, 623/17
• US Class Current: 606/279
• CPC Class Codes: A61B 17/7001 Screws or hooks combined with longitudinal elements which do not contact vertebrae A61B17/7058 takes precedence
• CPC Class Codes: A61B 17/7059 Cortical plates A61B17/7007, A61B17/7058 take precedence
• CPC Class Codes: A61F 2/44 for the spine, e.g. vertebrae, spinal discs
• 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 2/447 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 2002/30153 rectangular
• CPC Class Codes: A61F 2002/30266 wedge-shaped parallelepipeds
• CPC Class Codes: A61F 2002/30367 with additional means for preventing said rotation
• CPC Class Codes: A61F 2002/30494 Cooperating protrusions and recesses, e.g. radial serrations, located on abutting end surfaces of a longitudinal connection
• 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 2002/30593 hollow
• CPC Class Codes: A61F 2002/30599 stackable
• CPC Class Codes: A61F 2002/30774 internally-threaded
• CPC Class Codes: A61F 2002/30787 inclined obliquely with respect to each other
• CPC Class Codes: A61F 2002/30904 serrated profile, i.e. saw-toothed
• CPC Class Codes: A61F 2002/4649 Bone graft or bone dowel harvest sites
• 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 2230/0019 : rectangular
• CPC Class Codes: A61F 2230/0082 : parallelepipedal
• CPC Class Codes: A61F 2250/0063 : Nested prosthetic parts
• CPC Class Codes: A61F 2310/00011 : Metals or alloys

Abstract

Surgical prosthetic modular devices used singularly or stacked together are provided for use to replace excised vertebral tissue. The devices are rigid plugs, dimensionally similar to normal vertebral bodies, and have ridged faces to engage adjacent vertebral bodies or to interdigitate when stacked. Ridges extend in both the medial/lateral and anterior/posterior directions to prevent slipping in the anterior/posterior and medial/lateral directions respectively. A locking screw may be used to secure a stack to form a singular rigid prosthetic device. The devices are also provided with a plurality of threaded openings. In the method of this invention, a device is used to replace excised vertebral tissue, threaded bolts are inserted into the threaded openings, and other spine stabilization devices are attached to the bolts. In corporectomies, the device can be bolted to a plate, which in turn is fixed to adjacent vertebrae. In spondylectomies, the device can be fixed to a series of posteriorly placed rods.

Claims

1. A prosthetic device to integrate with and support vertebrae in a vertebral column, comprising:

a plurality of inert bodies conforming in shape and size with hard end plates of vertebrae on which the prosthetic device is to be seated,

each of the bodies having ridged top and bottom faces adapted to selectively interdigitate with faces of adjacent bodies and to bite into adjoining vertebrae, the ridged top and bottom faces having anterior/posterior and medial/lateral ridges to provide stability in the medial/lateral and anterior/posterior directions respectively,

each of the bodies also having side walls disposed between the ridged top and bottom faces to define an aperture which opens through the faces, and a plurality of threaded openings disposed within the side walls, said plurality of threaded openings positioned and designed to receive threaded components of additional spine stabilization devices.

2. The device of claim 1, further comprising a fastener opening positioned through the top and bottom faces and extending generally in the same direction as the vertebral column, the fastener opening positioned to receive a fastener to secure a stack of the bodies.

3. The device of claim 2, wherein the fastener opening is further defined by recesses in the ridged top and bottom faces and a passageway extending there between.

4. The device of claim 3, wherein the fastener comprises a locking screw and is sized such that it does not protrude beyond the stack of bodies.

5. The device of claim 1, wherein the threaded component is a connecting screw and the device further comprises a protective sleeve to cover an end of the connecting screw.

6. The device of claim 1, wherein the anterior/posterior and medial/lateral ridges intersect to form a crisscross pattern.

7. The device of claim 1, wherein the device is comprised of radiolucent material.

8. The device of claim 7, wherein the radiolucent material comprises a carbon fiber reinforced polymer.

9. A prosthetic device for vertebral fusion, comprising:

a plurality of inert bodies conforming in shape and size with hard end plates of vertebrae on which the prosthetic device is to be seated,

each of said bodies having ridged top and bottom faces adapted to selectively interdigitate with faces of adjacent bodies to form a stack and to bite into adjoining vertebrae, the ridged top and bottom faces having anterior/posterior and medial/lateral ridges to provide stability in the medial/lateral and anterior/posterior directions respectively,

side walls disposed between the ridged top and bottom faces to define an aperture which opens through the faces, and

a fastener opening extending from the top face to the bottom face and extending through each body generally in the same direction as the vertebral column but recessed from the top and bottom faces, the fastener opening positioned to receive a fastener therein, and the fastener is sized to secure the stack of bodies without protruding from the stack.

10. A device of claim 9 wherein the fastener comprises a locking screw.

23. The device of claim 10 wherein the side walls further comprise a plurality of corners defining a plurality of side faces at a variety of angles to each other, the side walls further comprising a plurality of threaded openings designed to receive threaded components of an additional spine stabilization device, and positioned in a variety of angles to enable a custom fit.

11. A prosthetic device adapted for fusing together adjoining vertebrae, comprising:

an inert body conforming in shape and size with hard end plates of vertebrae on which the prosthetic device is to be seated,

the body having ridged top and bottom faces, side walls disposed between the ridged top and bottom faces, the side walls having a plurality of beveled corners defining a plurality of side faces at varying angles to each other and a plurality of threaded openings disposed within the side faces, said plurality of threaded openings positioned and designed to receive threaded components of an additional spine stabilization device.

12. A device of claim 11 wherein the additional spine stabilization device comprises an anterior plate or rod system.

13. A device of claim 11 wherein the additional spine stabilization device comprises a posterior rod or plate system.

14. A method of vertebral fusion comprising the steps of

providing a plurality of inert bodies shaped to fit opposed end faces of vertebrae in a vertebral column, each of the bodies having ridged top and bottom faces adapted to selectively interdigitate with faces of adjacent bodies to form a stack and to bite into adjoining vertebrae, the ridged top and bottom faces having anterior/posterior and medial/lateral ridges to provide stability in the medial/lateral and anterior/posterior directions respectively, each of the bodies also having side walls disposed between the ridged top and bottom faces to define an aperture which opens through the faces, and each of the bodies having a fastener opening extending through each body from the top face to the bottom face and extending generally in the same direction as the vertebral column,

selecting the appropriate combination of bodies for fusion within the vertebral column,

stacking the appropriate combination of bodies by allowing the ridged top and bottom faces of adjacent bodies to interdigitate,

providing a fastener,

fastening the stacked bodies by extending the fastener through the fastener opening in each of the bodies to form a rigid prosthetic device,

preparing the vertebral column to receive the rigid prosthetic device, and inserting the rigid prosthetic device into the vertebral column.

15. The method of claim 14 wherein the fastener opening is further defined by recesses in the ridged top and bottom faces and extends there between, and the fastener is sized such that it does not protrude from the rigid prosthetic device.

16. The method of claim 15 wherein the fastener comprises a locking screw.

17. The method of claim 14 wherein each of the bodies further comprises a plurality of threaded openings disposed within the side walls, and the method further comprises the steps of

providing an additional spine stabilization device, including a threaded component thereof, and

threading the threaded component into one of the threaded openings disposed within the side walls.

18. The method of claim 14, further comprising the step of placing bone graft material in the aperture prior to inserting the rigid prosthetic device into the vertebral column.

19. A method of vertebral fusion comprising the steps of

providing a plurality of inert bodies shaped to fit opposed end faces of vertebrae in a vertebral column, each of the bodies having ridged top and bottom faces adapted to bite into adjoining vertebrae, the ridged top and bottom faces having anterior/posterior and medial/lateral ridges to provide stability in the medial/lateral and anterior/posterior directions respectively, each of the bodies also having side walls disposed between the ridged top and bottom faces to define an aperture which opens through the faces, and a plurality of openings disposed within the side walls,

preparing a stack of at least one of the bodies,

preparing the vertebral column to receive the stack,

inserting the stack into the vertebral column,

providing an additional spine stabilization device, and

attaching the additional spine stabilization device to one of the openings disposed within the side walls.

20. The method of claim 19 wherein the plurality of openings disposed within the side walls are threaded.

21. The method of claim 20 wherein the additional spine stabilization device includes a plate and a screw, the step of preparing the vertebral column to receive the stack includes performing a corpectomy, the attaching step involves extending the screw through an opening in the plate and threading the screw into one of the openings disposed within the side walls, and the method includes the additional step of securing the plate to a vertebra.

22. The method of claim 20 wherein the additional spine stabilization device includes a rod and a screw, the step of preparing the vertebral column to receive the stack includes performing a vertebrectomy, the attaching step involves securing the rod to the stack by threading the screw into one of the openings disposed within the side walls, and the method includes the additional step of securing the rod to the vertebral column in a location distinct from the stack.

24. A prosthetic device to integrate with and support vertebrae in a vertebral column, comprising:

a plurality of inert bodies conforming in shape and size with hard end plates of vertebrae on which the prosthetic device is to be seated,

each of the bodies having ridged top and bottom faces adapted to selectively interdigitate with faces of adjacent bodies and to bite into adjoining vertebrae, the ridged top and bottom faces having anterior/posterior and medial/lateral ridges to provide stability in the medial/lateral and anterior/posterior directions respectively,

each of the top and bottom faces having recesses therein, and each of the bodies having a fastener opening extending generally in the same direction as the vertebral column from the recess in the top face to the recess in the bottom face, the fastener opening positioned to receive a locking screw to secure a stack of the bodies, the locking screw sized such that it does not protrude beyond the stack of bodies,

each of the bodies also having side walls disposed between the ridged top and bottom faces to define an aperture which opens through the faces, and a plurality of threaded openings disposed within the side walls, said plurality of threaded openings positioned and designed to receive threaded components of additional spine stabilization devices.

25. The device of claim 24, further comprising a protective sleeve to cover an end of the connecting screw.

26. The device of claim 24, wherein the anterior/posterior and medial/lateral ridges intersect to form a crisscross pattern.

27. The device of claim 24, wherein the device is comprised of radiolucent material.

28. The device of claim 27, wherein the radiolucent material comprises a carbon fiber reinforced polymer.

29. The device of claim 24 wherein the side walls further comprise a plurality of corners defining a plurality of side faces at a variety of angles to each other and the threaded openings are located on the side faces and positioned in a variety of angles to better accommodate the additional spine stabilization devices.