Method and apparatus for computerized surgery

• US 7,338,526 B2
• Filed: 09/07/2001
• Issued: 03/04/2008
• Est. Priority Date: 03/07/1999
• Status: Expired due to Term

• Current Assignee: Nuvasive Incorporated
• Original Assignee: Active Implants Corporation
• Inventors: Steinberg, Amiram
• Primary Examiner(s): Isabella; David J.
• Application Number:
  US09/948,940
• Publication Number:
  US 20020107573A1
• Time in Patent Office: 2,370 Days
• Field of Search: 623 1711- 1715, 623/16.11, 623/11.11, 623/14.13, 623/14.12, 623 2364- 2368, 606/61, 606/151, 606191-195
• US Class Current: 623/17.12
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/1631 Special drive shafts, e.g. flexible shafts A61B17/1642, A61B17/164 take precedence
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2017/1602 Mills
• CPC Class Codes: A61B 2034/104 Modelling the effect of the tool, e.g. the effect of an implanted prosthesis or for predicting the effect of ablation or burring
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/742 Joysticks
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 34/30 Surgical robots
• CPC Class Codes: A61B 34/70 Manipulators specially adapted for use in surgery
• CPC Class Codes: A61B 6/506 for diagnosis of nerves
• CPC Class Codes: A61B 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61B 90/14 Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins
• CPC Class Codes: A61F 2/08 Muscles; Tendons; Ligaments sutures A61B17/04
• CPC Class Codes: A61F 2/28 Bones joints A61F2/30
• CPC Class Codes: A61F 2/30742 Bellows or hose-like seals; Sealing membranes A61B17/8808 takes precedence; sealing membranes for retaining bone substitute A61F2/2846
• CPC Class Codes: A61F 2/30749 : Fixation appliances for connecting prostheses to the body
• CPC Class Codes: A61F 2/30767 : Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
• CPC Class Codes: A61F 2/30965 : Reinforcing the prosthesis by embedding particles or fibres during moulding or dipping
• CPC Class Codes: A61F 2/32 : for the hip
• CPC Class Codes: A61F 2/36 : Femoral heads ; Femoral endoprostheses
• CPC Class Codes: A61F 2/3601 : for replacing only the epiphyseal or metaphyseal parts of the femur, e.g. endoprosthetic femoral heads or necks directly fixed to the natural femur by internal fixation devices non-prosthetic internal fixation devices for the femoral head or neck A61B17/74
• CPC Class Codes: A61F 2/3662 : Femoral shafts
• CPC Class Codes: A61F 2/38 : for elbows or knees
• CPC Class Codes: A61F 2/44 : for the spine, e.g. vertebrae, spinal discs
• CPC Class Codes: A61F 2/441 : made of inflatable pockets or chambers filled with fluid, e.g. with hydrogel
• 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 2/4609 : of acetabular cups
• 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 2002/30009 : differing in fibre orientations
• CPC Class Codes: A61F 2002/30014 : differing in elasticity, stiffness or compressibility
• CPC Class Codes: A61F 2002/30062 : (bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
• CPC Class Codes: A61F 2002/3007 : Coating or prosthesis-covering structure made of elastic material, e.g. of elastomer
• CPC Class Codes: A61F 2002/30133 : kidney-shaped or bean-shaped
• CPC Class Codes: A61F 2002/30136 : undulated or wavy, e.g. serpentine-shaped or zigzag-shaped
• CPC Class Codes: A61F 2002/30156 : triangular
• CPC Class Codes: A61F 2002/30197 : Omega-shaped
• CPC Class Codes: A61F 2002/30242 : spherical
• CPC Class Codes: A61F 2002/30289 : helically-coiled
• CPC Class Codes: A61F 2002/30354 : Cylindrically-shaped protrusion and recess, e.g. cylinder of circular basis
• CPC Class Codes: A61F 2002/30369 : Limited lateral translation of the protrusion within a larger recess
• CPC Class Codes: A61F 2002/3037 : Translation along the common longitudinal axis, e.g. piston
• CPC Class Codes: A61F 2002/30383 : made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
• CPC Class Codes: A61F 2002/30398 : Sliding
• CPC Class Codes: A61F 2002/30426 : Bayonet coupling
• CPC Class Codes: A61F 2002/30448 : using adhesives
• CPC Class Codes: A61F 2002/305 : Snap connection
• CPC Class Codes: A61F 2002/30515 : using a locking wedge or block
• CPC Class Codes: A61F 2002/30563 : having elastic means or damping means, different from springs, e.g. including an elastomeric core or shock absorbers
• CPC Class Codes: A61F 2002/30574 : with an integral complete or partial collar or flange
• CPC Class Codes: A61F 2002/30579 : with mechanically expandable devices, e.g. fixation devices
• CPC Class Codes: A61F 2002/30581 : having a pocket filled with fluid, e.g. liquid
• CPC Class Codes: A61F 2002/30593 : hollow
• CPC Class Codes: A61F 2002/30594 : slotted, e.g. radial or meridian slot ending in a polar aperture, non-polar slots, horizontal or arcuate slots
• CPC Class Codes: A61F 2002/30599 : stackable
• CPC Class Codes: A61F 2002/30604 : modular
• CPC Class Codes: A61F 2002/30639 : having rolling elements between both articulating surfaces
• CPC Class Codes: A61F 2002/30642 : having a single rolling (or sliding) ball articulating between two cups
• CPC Class Codes: A61F 2002/30652 : Special cut-outs, e.g. flat or grooved cut-outs
• CPC Class Codes: A61F 2002/30662 : with rotation-limiting means
• CPC Class Codes: A61F 2002/30673 : Lubricating means, e.g. synovial pocket
• CPC Class Codes: A61F 2002/30733 : Inserts placed into an endoprosthetic cavity, e.g. for modifying a material property
• CPC Class Codes: A61F 2002/30777 : Oblong apertures
• CPC Class Codes: A61F 2002/30795 : Blind bores, e.g. of circular cross-section
• CPC Class Codes: A61F 2002/3082 : Grooves
• CPC Class Codes: A61F 2002/30878 : with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
• CPC Class Codes: A61F 2002/30879 : Ribs
• CPC Class Codes: A61F 2002/30884 : Fins or wings, e.g. longitudinal wings for preventing rotation within the bone cavity
• CPC Class Codes: A61F 2002/30919 : Sleeves
• CPC Class Codes: A61F 2002/30934 : Special articulating surfaces
• CPC Class Codes: A61F 2002/30971 : Laminates, i.e. layered products
• CPC Class Codes: A61F 2002/30973 : Two joined adjacent layers having complementary interlocking protrusions and recesses
• CPC Class Codes: A61F 2002/3208 : Bipolar or multipolar joints, e.g. having a femoral head articulating within an intermediate acetabular shell whilst said shell articulates within the natural acetabular socket or within an artificial outer shell
• CPC Class Codes: A61F 2002/3216 : tripolar
• CPC Class Codes: A61F 2002/3412 : with pins or protrusions, e.g. non-sharp pins or protrusions projecting from a shell surface
• CPC Class Codes: A61F 2002/3429 : with an integral peripheral collar or flange, e.g. oriented away from the shell centre line
• CPC Class Codes: A61F 2002/3611 : Heads or epiphyseal parts of femur
• CPC Class Codes: A61F 2002/3613 : with lateral or oblique apertures, holes or openings
• CPC Class Codes: A61F 2002/3631 : with an integral complete or partial peripheral collar or bearing shoulder at its base
• CPC Class Codes: A61F 2002/3652 : Connections of necks to shafts
• CPC Class Codes: A61F 2002/3694 : with longitudinal bores
• 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 2002/4619 : for extraction
• CPC Class Codes: A61F 2002/4632 : using computer-controlled surgery, e.g. robotic surgery
• CPC Class Codes: A61F 2002/4635 : using minimally invasive surgery
• CPC Class Codes: A61F 2210/0004 : bioabsorbable
• CPC Class Codes: A61F 2220/0008 : Fixation appliances for connecting prostheses to the body
• 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 2220/005 : using adhesives
• CPC Class Codes: A61F 2230/0004 : Rounded shapes, e.g. with rounded corners
• CPC Class Codes: A61F 2230/0015 : Kidney-shaped, e.g. bean-shaped
• CPC Class Codes: A61F 2230/0023 : triangular
• CPC Class Codes: A61F 2230/0045 : Omega-shaped
• CPC Class Codes: A61F 2230/0071 : spherical
• CPC Class Codes: A61F 2230/0091 : helically-coiled or spirally-coiled, i.e. having a 2-D spiral cross-section
• CPC Class Codes: A61F 2250/0018 : differing in elasticity, stiffness or compressibility
• CPC Class Codes: A61F 2250/0028 : differing in fibre orientations
• CPC Class Codes: A61F 2250/0063 : Nested prosthetic parts
• CPC Class Codes: A61F 2310/00017 : Iron- or Fe-based alloys, e.g. stainless steel

Abstract

An implant for use in spinal surgery comprises a resilient element having an inflatable cavity. It is formed of a biologically compatible material and is arranged for placement between end plates of adjacent vertebra. The implant may also include a wound disc replacement element. A method of performing spinal surgery on a patient comprises securely mounting a patient onto a patient support table; imaging a spinal region of the patient; building up a three-dimensional image file of the spinal region of the patient; storing the image file; and utilizing the image file for planning and carrying out computer controlled spinal surgery on the patient utilizing the implant. A computer-controlled surgical implant system comprises a steerable endosurgical implanting assembly operative to install the implant at a desired location in a patient; and a computerized controlled, which operates the steerable endosurgical implanting assembly.

Claims

1. An implant for use in spinal surgery comprising:

a resilient element of a biologically compatible material having an inflatable cavity and being arranged for placement between end plates of adjacent vertebra; and

a coiling apparatus carried on the surface of said resilient element over said inflatable cavity operatively configured for winding in situ an artificial annulus fibrosis around said resilient element.

2. The implant according to claim 1 wherein a seat element is seated in a recess formed in said resilient element, said seat element defining a generally circular inner recess which defines a bearing race, and wherein the implant further comprises a plurality of balls forming a bearing in said bearing race.

3. The implant according to claim 2 wherein said seat element also defines an outer recess which corresponds to said recess formed in said resilient element and also defines an outer flange which rests against a surface of said resilient element.

4. The implant according to claim 3 further comprising:

a circular sprocket rotatably seated in said outer recess of said seat element in relationship with said balls in said bearing race.

5. The implant according to claim 4 wherein said circular sprocket comprises:

an underlying bearing race defining a circular recess;

an inner circular array of outwardly facing teeth to be engaged by a toothed drive belt;

an outer circular array of outwardly facing teeth, each of which is formed with a transverse recess;

wherein said outer circular array of outwardly facing teeth are arranged for drivingly engaging a correspondingly configured upstanding disc replacement coil element for winding thereof.

6. The implant according to claim 5 wherein said sprocket further comprises an overlying bearing race defining a circular recess which retains therein a plurality of balls forming a bearing.

7. An implant for use in spinal surgery comprising:

a resilient element of a biologically compatible material having an inflatable cavity and being configured for placement between end plates of adjacent vertebra;

a coiling apparatus carried on the surface of said resilient element over said inflatable cavity, said coiling apparatus operatively configured for winding in situ a band around said resilient element; and

a bi-directional inflation valve connected to said inflatable cavity of said resilient element.

8. An implant for use in spinal surgery comprising:

a resilient element of a biologically compatible material having an inflatable cavity and being configured for placement between end plates of adjacent vertebra;

a coiling apparatus carried on the surface of said resilient element over said inflatable cavity, said coiling apparatus operatively configured for winding in situ a band separate from the resilient element around said resilient element; and

an inflation valve connected to said inflatable cavity in said resilient element wherein said inflation valve is distinct and separate from said coiling apparatus.