Hydraulically actuated expanding spine cage with extendable locking anchor

• US 8,435,296 B2
• Filed: 08/26/2009
• Issued: 05/07/2013
• Est. Priority Date: 02/22/2008
• Status: Active Grant

• Current Assignee: Howmedica Osteonics Corp. (Stryker Corporation)
• Original Assignee: Coalign Innovations Inc. (Stryker Corporation)
• Inventors: Kadaba, Murali, Simpson, Philip J., Ashley, John E., Gillespie, Walter Dean, Grotz, Thomas, Mansfield, George A. III, Matsuura, David G., Pretti, Rudy
• Primary Examiner(s): Yang, Andrew
• Application Number:
  US12/548,260
• Publication Number:
  US 20100057204A1
• Time in Patent Office: 1,350 Days
• Field of Search: 623/17.11, 623/17.12, 623/17.13, 623/17.15
• US Class Current: 623/17.12
• 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 2/44 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 2/482 Electrical means
• CPC Class Codes: A61F 2/484 Fluid means, i.e. hydraulic or pneumatic
• CPC Class Codes: A61F 2002/30079 magnetic
• CPC Class Codes: A61F 2002/3008 radio-opaque, e.g. radio-opaque markers
• CPC Class Codes: A61F 2002/30133 kidney-shaped or bean-shaped
• CPC Class Codes: A61F 2002/30365 with additional means for limiting said rotation
• CPC Class Codes: A61F 2002/30405 made by screwing complementary threads machined on the parts themselves
• CPC Class Codes: A61F 2002/30476 locked by an additional locking mechanism
• CPC Class Codes: A61F 2002/30484 Mechanically expandable devices located on the first prosthetic part for locking into or onto the second prosthetic part
• CPC Class Codes: A61F 2002/30495 using a locking ring
• CPC Class Codes: A61F 2002/30505 spring biased
• CPC Class Codes: A61F 2002/30514 using a locking washer
• CPC Class Codes: A61F 2002/30522 releasable, e.g. using a releasable ratchet
• CPC Class Codes: A61F 2002/30525 Worm gears
• CPC Class Codes: A61F 2002/3055 for adjusting length
• 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 2002/30589 : Sealing means
• 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 2210/009 : magnetic
• 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 2230/0015 : Kidney-shaped, e.g. bean-shaped
• CPC Class Codes: A61F 2250/0007 : for adjusting length
• CPC Class Codes: A61F 2250/0069 : Sealing means
• CPC Class Codes: A61F 2250/0098 : radio-opaque, e.g. radio-opaque markers
• CPC Class Codes: A61F 2310/00017 : Iron- or Fe-based alloys, e.g. stainless steel
• CPC Class Codes: A61F 2310/00023 : Titanium or titanium-based alloys, e.g. Ti-Ni alloys

Abstract

A spinal implant which is configured to be deployed between adjacent vertebral bodies. The implant has at least one extendable support element with a retracted configuration to facilitate deployment of the implant and an extended configuration so as to expand the implant and effectively distract the disc space, stabilize the motion segments and eliminate pathologic spine motion. Angular deformities can also be corrected, and natural curvatures restored. Preferably, the implant has a minimal dimension in its unexpanded state that is smaller than the dimensions of the neuroforamen through which it typically passes to be deployed within the intervertebral space. The implant is provided with a locking system preferably having a plurality of locking elements to lock the implant in an extended configuration. Bone engaging anchors also may be provided to ensure secure positioning.

Claims

1. A spinal implant for placement between first and second vertebral bodies, comprising:

a. a first member having a surface for engaging an end of a first vertebral body;

b. a second member having a surface for engaging an end of a second vertebral body;

c. at least one extendable support element having a contracted configuration to facilitate deployment of the implant between the superior and inferior vertebral bodies and at least one extended configuration to extend the first member so that the surface thereof engages the end of the first vertebral body; and

d. a locking system comprising a locking element that mechanically engages or interlocks with the extendable support element of the first member in a locked position to lock the implant between the first and second vertebral bodies in an expanded configuration, and a locking actuator disposed within the implant that moves the locking element into the locked position in response to deployment of the implant to said at least one extended configuration.

2. The spinal implant of claim 1 wherein the first surface for engaging an end of the first vertebral body includes a top end plate and the second surface for engaging an end of the second vertebral body includes a base plate.

3. The spinal implant of claim 2 wherein at least one top end plate cooperates with and is coupled to the extendable support element.

4. The spinal implant of claim 3 wherein the extendable support element is adapted to be extended by fluid.

5. The spinal implant of claim 4 wherein the fluid is an incompressible fluid.

6. The spinal implant of claim 2 wherein the at least one extendable member is a piston that engages the top plate.

7. The spinal implant of claim 6 including an internal cylinder configured to receive the piston.

8. The spinal implant of claim 7 including a source for fluid to extend the piston within the cylinder and raise the top plate.

9. The spinal implant of claim 7, wherein at least one said locking element is disposed within the cylinder.

10. The spinal implant of claim 6 including a pair of independently actuatable pistons which are rotatably interconnected to an articulating top plate.

11. The spinal implant of claim 1 wherein the locking system comprises a plurality of inter-engaging locking elements.

12. The spinal implant of claim 11 wherein one of the inter-engaging locking elements is a locking actuator configured to move the locking element into mechanical engagement or interlock with the extendable support element or first member after expansion of the expandable support member so as to lock the implant in an expanded configuration.

13. The spinal implant of claim 11 wherein one of the inter-engaging locking elements is an upper lock support member and another of the inter-engaging locking elements is a lower lock support member.

14. The spinal implant of claim 13 wherein the upper lock support member has a multi-stepped support surface and the lower lock support member has a multi-stepped support surface configured to engage the multi-stepped support surface of the upper lock support member.

15. The spinal implant of claim 14 including a locking actuator that is configured to effect relative motion between the upper and lower lock support members when the at least one extendable member is extended so as to lock the implant in an extended configuration by engaging the multi-stepped support surfaces of the upper lock support members and the lower lock support members.

16. The spinal implant of claim 15 wherein the multi-stepped support surface of the lower lock support member has an upper surface with a lock support stop which prevents over rotation of the arcuate lower lock support member.

17. The spinal implant of claim 14 wherein the lower and upper lock support members have arcuate shapes.

18. The spinal implant of claim 17 wherein the lower and upper lock support members have matching arcuate shapes.

19. The spinal implant of claim 18 wherein the arcuate shaped lower lock support member is disposed about a cylinder configured to receive a piston.

20. The spinal implant of claim 19 wherein the arcuate shaped upper lock support member is disposed about the piston and is secured to the top plate.

21. The spinal implant of claim 18 wherein the lock support members are circular.

22. The spinal implant of claim 21 wherein the circular lock support members have a plurality of multi-stepped support surfaces.

23. The spinal implant of claim 18 wherein the lower lock support member is disposed within the cylinder and the upper lock support member is within the piston.

24. The spinal implant of claim 15 wherein the locking actuator is a biased member configured to move one of the lock support members relative to the other.

25. The spinal implant of claim 24 wherein the biased member is a spring located in a groove in a base of the implant.

26. The spinal implant of claim 25 wherein the spring has a forward end configured to engage and rotate the lower lock support member when the implant is extended.

27. The spinal implant of claim 26 wherein the groove has an arcuate shape.

28. The spinal implant of claim 26 wherein the lower lock support member has a lower surface with a locking actuator transfer element configured to engage the forward end of the spring which effects rotation of the lower lock support member.

29. The spinal implant of claim 13 wherein the upper and lower lock support members are disposed between a pair of pistons and a pair of cylinders.

30. The spinal implant of claim 13 wherein a pair of upper and lower lock support members are disposed on opposite sides of a piston and cylinder.

31. The spinal implant of claim 13 wherein the upper lock support member is secured to the extendable member.

32. The spinal implant of claim 1 wherein the locking element which mechanically engages or interlocks with the expandable member or the first member directly applies a vertical force to the expandable member or the first member so as to lock the implant in the expanded configuration.

33. The spinal implant of claim 1 including a housing which contains at least in part the at least one extendable support element and the locking system.

34. The spinal implant of claim 1 wherein the locking element directly applies a vertical force to the extendable support element or the first member.

35. The spinal implant of claim 1, wherein the bone engaging surface of the first member comprises a bone anchor with a sharpened leading edge configured for anchoring into the bone.

36. The spinal implant of claim 35, wherein said bone engaging surface comprises a conically shaped member.

37. The spinal implant of claim 35, wherein said bone engaging surface comprises a spike.

38. The spinal implant of claim 35, wherein said bone engaging surface comprises a blade.

39. The spinal implant of claim 35, wherein said bone engaging surface comprises a screw threaded member.

40. The spinal implant of claim 35 wherein the bone anchor includes barbs.

41. The spinal implant of claim 1, further comprising:

at least a second extendable support member having a contracted configuration to facilitate deployment of the implant between the first and second vertebral bodies and at least one extended configuration to extend the second member so that the surface thereof engages the end of the second vertebral body; and

at least two locking elements, at least one each engaging or interlocking with each said extendable support element.

42. The spinal implant of claim 1, further comprising:

at least one third member having a surface for engaging bony tissue of the vertebral body, said third member being oriented laterally with respect to the first and second members;

at least a second extendable support element having a contracted configuration to facilitate deployment of the implant between the first and second vertebral bodies and at least one extended configuration to extend the third member so that the surface thereof engages a vertebral body; and

at least two locking elements, at least one each engaging or interlocking with each said extendable support element.

43. The spinal implant of claim 1, wherein said at least one extendable support element comprises at least two telescoping members received within a base cylinder.

44. A spinal implant for placement between first and second vertebral bodies, comprising:

a. a first member having a surface for engaging an end of a first vertebral body;

b. a second member having a surface for engaging an end of a second vertebral body;

c. at least one extendable support element having a contracted configuration to facilitate deployment of the implant between the superior and inferior vertebral bodies and at least one extended configuration to extend the first member so that the surface thereof engages the end of the first vertebral body; and

d. a locking system which has a locking element that mechanically engages or interlocks with the extendable support element of the first member to lock the implant between the first and second vertebral bodies in an expanded configuration;

said spinal implant further comprising;

at least two said first members;

at least two said extendable support elements, one each supporting one of said first members; and

at least two locking elements, at least one each engaging or interlocking with each said extendable support element or first member.

45. The spinal implant of claim 44, wherein said extendable support members are oriented act along separate, non-parallel axes.

46. The spinal implant of claim 44, wherein said at least two first members are joined by spaced apart elongate members to define a cavity surrounded by said elongate members and first members.

47. A spinal implant for placement between adjacent vertebral bodies, comprising:

a. a top end plate for engaging an end of a first adjacent vertebral body;

b. a bottom end plate for engaging an end of a second adjacent vertebral body;

c. at least one extendable piston member having a contracted configuration within the implant to facilitate deployment of the implant between the first and second vertebral bodies and an extended configuration to extend the top end plate into engagement with the end of the first adjacent vertebral body;

d. an upper lock support member having a multi-stepped support surface;

e. a lower lock support member having a multi-stepped support surface configured to engage the multi-stepped support surface of the upper lock support member; and

f. a locking actuator which causes relative motion between the upper and lower lock support members when the at least one extendable member is extended so as to lock the implant in an expanded configuration by engaging the multi-stepped support surfaces of the upper lock support members and the lower lock support members.

48. The spinal implant of claim 47 wherein the upper and lower lock support members have matching shapes which facilitate engagement of stepped support surfaces thereof.

49. The spinal implant of claim 48 wherein the upper and lower lock support members have matching arcuate shapes.

50. The spinal implant of claim 47 wherein a spring locking actuator is provided to move the lower lock support member toward the upper lock support when the at least one extendable member is extended.

51. The spinal implant of claim 47, wherein the bone engaging surface of the first member comprises a bone anchor with a sharpened leading edge configured for anchoring into the bone.

52. The spinal implant of claim 51, wherein the bone anchor includes barbs.

53. A spinal implant with hydraulically actuatable, locking bone anchors, comprising:

an implant housing defining a cylindrical opening with an inner wall surface;

a cylinder wall defining a cylinder disposed within said opening, the cylinder wall spaced from the inner wall surface of said opening to form an annular space therebetween;

a hydraulic piston disposed within the circular opening and received within the cylinder, said piston having an outer end movable from a contracted position to an extended position;

a bone engaging anchor including a screw member with bone cutting threads centrally disposed on the piston outer end and extending outward therefrom, said anchor being moveable with said outer end from a contracted position within said housing to an extended position out of said housing;

inner wall screw threads disposed on at least a part of said inner wall surface;

a piston flange extending from the piston outer end, over the cylinder wall and into said annular space;

flange screw threads disposed on an outer surface of said piston flange and cooperating with the inner wall screw threads to rotate the bone engaging anchor in response to linear movement of the piston in the cylinder.

54. The spinal implant of claim 53, further comprising a locking mechanism for locking the bone engaging anchor in the extended position.

55. The spinal implant of claim 54, wherein said locking mechanism comprises:

first, downward facing stepped engagement surfaces formed on the piston flange;

an arcuate member with second, upward facing stepped engagement surfaces opposing and engaging the first stepped engagement surfaces; and

a biasing element acting on said arcuate member and biasing said first and second stepped engagement surfaces in a contact direction.

56. A spinal implant with hydraulically actuatable, locking bone engaging surfaces, comprising:

a housing defining at least one laterally spaced circular opening having a cylinder wall defining a base cylinder within said at least one circular opening, the cylinder wall being spaced from the housing to provide an annular space between the cylinder wall and housing;

a first hydraulic piston disposed in said at least one opening, each said first piston having an outer end movable from a contracted position within said housing to an extended position out of said housing;

an intermediate piston disposed between the first piston and the housing, each intermediate piston received within said base cylinder, and also defining an intermediate cylinder receiving the first piston therein;

a bone engaging surface disposed at said first piston outer end; and

a locking mechanism cooperating with said piston to lock the piston in the extended position, said locking mechanism including at least one locking member slidably disposed in said annular space.

57. The spinal implant of claim 56, wherein the locking mechanism comprises:

an upper arcuate member with stepped engagement surfaces secured to the first piston and configured and dimensioned to be received in said annular space;

a lower arcuate member with stepped engagement surfaces slideably disposed in said annular space;

an intermediate arcuate member with upper and lower facing stepped engagement surfaces secured to the intermediate piston and configured and dimensioned to be received in said annular space with the upper engagement surfaces opposing and engaging the upper arcuate member engagement surfaces and the lower engagement surfaces opposing and engaging the lower arcuate member engagement surfaces; and

a biasing element biasing acting on the lower arcuate member to cause engagement of said stepped engagement surfaces.

58. The spinal implant of claim 56, wherein said bone engaging surface comprises a bone engaging anchor having a sharp leading edge configured to penetrate bony tissue under the force of the piston.

59. The spinal implant of claim 56, further comprising at least two said circular opening with first pistons and intermediate pistons disposed therein.