Spinal implant and methods for changing spatial relationships between vertebrae

• US 7,892,261 B2
• Filed: 01/13/2004
• Issued: 02/22/2011
• Est. Priority Date: 08/20/1998
• Status: Expired due to Fees

• Current Assignee: Bonutti Skeletal Innovations LLC (Acacia Research Corporation)
• Original Assignee: P TECH, LLC
• Inventors: Bonutti, Peter M.
• Primary Examiner(s): Robert; Eduardo C
• Assistant Examiner(s): Comstock; David
• Application Number:
  US10/756,001
• Publication Number:
  US 20040153072A1
• Time in Patent Office: 2,597 Days
• Field of Search: 606/61, 606/90, 606/105, 606/246, 606/279, 623/17.11, 623/17.14, 623/17.15, 623/17.16, 623/16.11, 623/20.32, 623/20.35
• US Class Current: 606/279
• CPC Class Codes: A61B 17/562 Implants for placement in joint gaps without restricting joint motion, e.g. to reduce arthritic pain
• CPC Class Codes: A61B 17/8095 Wedge osteotomy devices
• CPC Class Codes: A61B 17/86 Pins or screws or threaded wires; nuts therefor A61B17/72 take precedence
• CPC Class Codes: A61F 2/0077 Special surfaces of prostheses, e.g. for improving ingrowth A61F2/30767 takes precedence
• CPC Class Codes: A61F 2/30734 Modular inserts, sleeves or augments, e.g. placed on proximal part of stem for fixation purposes or wedges for bridging a bone defect
• CPC Class Codes: A61F 2/38 for elbows or knees
• 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 2002/0086 for preferentially controlling or promoting the growth of specific types of cells or tissues
• CPC Class Codes: A61F 2002/30128 concentric ellipses
• CPC Class Codes: A61F 2002/30187 D-shaped or half-disc-shaped
• CPC Class Codes: A61F 2002/3023 wedge-shaped cylinders
• CPC Class Codes: A61F 2002/30232 Half-cylinders
• CPC Class Codes: A61F 2002/30518 with possibility of relative movement between the prosthetic parts
• CPC Class Codes: A61F 2002/30556 for adjusting thickness
• CPC Class Codes: A61F 2002/30578 having apertures, e.g. for receiving fixation screws
• CPC Class Codes: A61F 2002/30622 Implant for fusing a joint or bone material
• CPC Class Codes: A61F 2002/30736 Augments or augmentation pieces, e.g. wedges or blocks for bridging a bone defect
• CPC Class Codes: A61F 2002/30754 Implants for interposition between two natural articular surfaces
• CPC Class Codes: A61F 2002/30787 inclined obliquely with respect to each other
• CPC Class Codes: A61F 2220/0025 : Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2230/0008 : elliptical or oval
• CPC Class Codes: A61F 2230/0034 : D-shaped
• CPC Class Codes: A61F 2230/0069 : cylindrical
• CPC Class Codes: A61F 2250/0009 : for adjusting thickness
• CPC Class Codes: A61F 2310/00976 : Coating or prosthesis-covering structure made of proteins or of polypeptides, e.g. of bone morphogenic proteins BMP or of transforming growth factors TGF
• CPC Class Codes: Y10S 606/907 : Composed of particular material or coated
• CPC Class Codes: Y10S 606/909 : Bone

Abstract

To change a spatial relationship between two or more bones in a patient'"'"'s body, a wedge member is moved into a joint between the bones. As the wedge member enters the joint, pivotal movement occurs between the bones to change the orientation of the bones relative to each other. The wedge member may have a circular cross sectional configuration and be moved into the joint by rotating the wedge member about an axis which extends between a thin leading edge portion and a thick trailing edge portion of the wedge member. Alternatively, the wedge member may have a cam-shaped configuration and be rotated through less than a revolution to apply force against the bones. The wedge member may have a porous construction which enables bone to grow through the wedge member and immobilize the joint. The wedge member may be coated with and/or contain bone growth promoting material. The wedge member may be connected to only one of the bones or may be connected to two adjacent bones. If the wedge member is connected to only one bone, the joint may be capable of being flexed after the wedge member is inserted into the joint.

Claims

1. A method of changing a spatial relationship between a first vertebra having a first central longitudinal axis and a second vertebrae having a second central longitudinal axis, the first and second vertebrae interconnected at a joint in a patient'"'"'s body, the method comprising:

providing a spinal implant including a unitary body having superior and inferior faces;

positioning the spinal implant in the joint between the first and second vertebrae;

expanding at least a portion of the joint by moving the spinal implant into the joint to apply a force against the first and second vertebrae with the spinal implant, such that the spatial relationship between the first and second central longitudinal axes changes as the spinal implant is moved into the joint;

affixing only one of the superior and inferior faces to one of the first and second vertebrae such that the other of the superior and inferior faces moves freely with respect to the other of the first and second vertebrae; and

maintaining a freedom of movement of the other of the superior and inferior faces after the one of the superior and inferior faces has been affixed.

2. The method of claim 1, wherein the other of the superior and inferior faces articulates against the other of the first and second vertebrae.

3. The method of claim 1, wherein moving the spinal implant into the joint between the first and second vertebrae includes sliding one of the superior and inferior faces along an end portion of one of the first and second vertebrae and sliding the other of the superior and inferior faces along an end portion of the other of the first and second vertebrae.

4. The method of claim 3, wherein the spinal implant comprises a first end portion having a first thickness and a second end portion opposite the first end portion having a second thickness less than the first thickness.

5. The method of claim 1, wherein the providing step includes:

providing a plurality of spinal implants each having a first end portion having a first thickness and a second end portion opposite the first end portion having a second thickness less than the first thickness, wherein the first and second thickness of at least one of the plurality of spinal implants is different from the first and second thickness of the other of the plurality of spinal implants; and

selecting the spinal implant from the plurality of spinal implants for positioning in the joint between the first and second vertebrae.

6. The method of claim 5, further comprising:

selecting a second spinal implant from the plurality of spinal implants;

positioning the second spinal implant between one of the first and second vertebrae and the spinal implant; and

further expanding at least a portion of the joint interconnecting the first and second vertebrae by moving the second spinal implant into the joint to apply a force against the first and second vertebrae with the second spinal implant, such that the spatial relationship between the first and second central longitudinal axes changes as the second spinal implant is moved into the joint.

7. The method of claim 6, further comprising:

affixing one of the superior and inferior faces of the second spinal implant to the other of the first and second vertebrae.

8. The method of claim 7, wherein the other of the superior and inferior faces of the spinal implant moves freely with respect to the other of the superior and inferior faces of the second spinal implant.

9. The method of claim 1, wherein:

said unitary body is a wedge body having a thick end portion and a thin end portion;

said superior external face is a first major side surface of said wedge body;

said inferior external face is a second major side surface of said wedge body;

said first major side surface extends from said thin end portion to said thick end portion;

said second major side surface intersects said first major side surface to form an edge at said thin end portion and extends from said thin end portion to said thick end portion; and

a minor side surface extends between said first and second major side surfaces and tapers from said thick end portion to said thin end portion.

10. The method of claim 9, wherein said wedge body has a compartment formed therein for containing a bone growth inducing material.

11. The method of claim 1, wherein:

said unitary body has a passage to said one of the superior and inferior external faces; and

a screw with a head and a tip is disposed in said passage, said tip extending beyond said one of the superior and inferior external faces, and said head is recessed within said passage.

12. A method of changing a spatial relationship between a first vertebrae and a second vertebrae, the first and second vertebrae interconnected at a joint in a patient'"'"'s body, the method comprising:

providing a spinal implant including a unitary body having superior and inferior faces;

positioning the spinal implant in the joint between the first and second vertebrae by sliding one of the superior and inferior faces along an end portion of one of the first and second vertebrae and sliding the other of the superior and inferior faces along an end portion of the other of the first and second vertebrae without prior removal of material from the ends of the first and second vertebrae;

expanding at least a portion of the joint by moving the spinal implant into the joint to apply a force against the first and second vertebrae with the spinal implant, such that the spatial relationship between the first and second vertebrae changes as the spinal implant is moved into the joint; and

affixing only one of the superior and inferior faces to one of the first and second vertebrae such that the other of the superior and inferior faces moves freely with respect to the other of the first and second vertebrae.

13. The method of claim 12, wherein:

said unitary body has a passage to said one of the superior and inferior external faces; and

a screw with a head and a tip is disposed in said passage, said tip extending beyond said one of the superior and inferior external faces, and said head is recessed within said passage.

14. A method of stabilizing a joint between a first vertebra and a second vertebrae, the first and second vertebrae interconnected at the joint, the method comprising:

providing a spinal implant including a unitary body having superior and inferior faces;

positioning the spinal implant in the joint between the first and second vertebrae;

affixing only one of the superior and inferior faces to one of the first and second vertebrae such that the other of the superior and inferior faces moves freely with respect to the other of the first and second vertebrae; and

maintaining a freedom of movement of the other of the superior and inferior faces after the one of the superior and inferior faces has been affixed.

15. The method of claim 14, wherein:

said unitary body has a passage to said one of the superior and inferior external faces; and

a screw with a head and a tip is disposed in said passage, said tip extending beyond said one of the superior and inferior external faces, and said head is recessed within said passage.

16. The method of claim 15, wherein said step of affixing includes engaging at least the tip of the screw with only cortical bone of the one of the first and second vertebrae.

17. The method of claim 14, wherein said step of affixing includes inserting a plurality of screw members through at least a portion of the body such that an end portion of each of the plurality of screw members extends beyond the body for engaging the one of the first and second vertebrae.

18. The method of claim 14, wherein the body tapers from a thick end portion to a thin end portion.

19. The method of claim 14, wherein at least a portion of the body is made of biocompatible material, has an open cellular structure, and a plurality of cavities created by the open cellular structure in which bone can grow through.

20. The method of claim 19, wherein the at least a portion of the body is made of tantalum.

21. The method of claim 19, wherein at least some of the plurality of cavities contain a bone growth promoting material.

22. The method of claim 14, wherein a bone growth promoting material is disposed on the body.

23. The method of claim 14, wherein said step of affixing includes inserting a screw member through at least a portion of the body such that an end portion of the screw member extends beyond the body for engaging the one of the first and second vertebrae.

24. The method of claim 23, wherein the screw member engages only cortical bone of one of the first and second vertebrae.

25. The method of claim 14, wherein the body has a side surface with a configuration corresponding to the configuration of a portion of an outer side surface of one of the first and second vertebrae.

26. The method of claim 14, wherein:

said unitary body is a wedge body having a thick end portion and a thin end portion;

said superior external face is a first major side surface of said wedge body;

said inferior external face is a second major side surface of said wedge body;

said first major side surface extends from said thin end portion to said thick end portion;

said second major side surface intersects said first major side surface to form an edge at said thin end portion and extends from said thin end portion to said thick end portion; and

a minor side surface extends between said first and second major side surfaces and tapers from said thick end portion to said thin end portion.

27. The method of claim 26, wherein said wedge body has a compartment formed therein for containing a bone growth inducing material.

28. The method of claim 14, further comprising the step of providing bone growth promoting material at the joint.

29. The method of claim 14, wherein the unitary body includes a ceramic material.