Devices and methods for facilitating controlled bone growth or repair

• US 8,617,246 B2
• Filed: 10/12/2010
• Issued: 12/31/2013
• Est. Priority Date: 12/14/2000
• Status: Expired due to Term

• Current Assignee: DePuy Synthes Products LLC (Johnson & Johnson)
• Original Assignee: Depuy Spine Incorporated (Johnson & Johnson)
• Inventors: Malone, David G.
• Primary Examiner(s): STEWART, ALVIN J
• Application Number:
  US12/902,932
• Publication Number:
  US 20110029081A1
• Time in Patent Office: 1,176 Days
• Field of Search: 623 1711- 1716, 623/16.11, 623/18.11, 623 2111- 2119, 606/60, 606246-249, 606/86.R, 606/232, 606/228
• US Class Current: 623/17.16
• CPC Class Codes: A61B 17/7064 Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor
• CPC Class Codes: A61B 17/72 Intramedullary pins, nails or other devices A61B17/744 takes precedence
• CPC Class Codes: A61B 17/80 Cortical plates , i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
• CPC Class Codes: A61B 17/864 hollow, e.g. with socket or cannulated
• CPC Class Codes: A61B 17/8685 comprising multiple separate parts
• CPC Class Codes: A61F 2/30744 End caps, e.g. for closing an endoprosthetic cavity
• CPC Class Codes: A61F 2/36 Femoral heads ; Femoral endoprostheses
• CPC Class Codes: A61F 2/3662 Femoral shafts
• CPC Class Codes: A61F 2/446 having a circular or elliptical cross-section substantially parallel to the axis of the spine, e.g. cylinders or frustocones
• CPC Class Codes: A61F 2/4611 of spinal prostheses
• CPC Class Codes: A61F 2002/2817 Bone stimulation by chemical reactions or by osteogenic or biological products for enhancing ossification, e.g. by bone morphogenetic or morphogenic proteins [BMP] or by transforming growth factors [TGF]
• 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 2002/30028 differing in tissue ingrowth capacity, e.g. made from both ingrowth-promoting and ingrowth-preventing parts
• CPC Class Codes: A61F 2002/30115 circular-O-shaped
• CPC Class Codes: A61F 2002/30143 hexagonal
• CPC Class Codes: A61F 2002/30153 rectangular
• CPC Class Codes: A61F 2002/30235 tubular, e.g. sleeves
• CPC Class Codes: A61F 2002/30364 Rotation about the common longitudinal axis
• CPC Class Codes: A61F 2002/30593 hollow
• CPC Class Codes: A61F 2002/30604 modular
• CPC Class Codes: A61F 2002/30616 : Sets comprising a plurality of prosthetic parts of different sizes or orientations
• CPC Class Codes: A61F 2002/30677 : Means for introducing or releasing pharmaceutical products, e.g. antibiotics, into the body
• CPC Class Codes: A61F 2002/30787 : inclined obliquely with respect to each other
• CPC Class Codes: A61F 2002/3085 : with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface
• CPC Class Codes: A61F 2002/30904 : serrated profile, i.e. saw-toothed
• CPC Class Codes: A61F 2002/30932 : for retarding or preventing ingrowth of bone tissue
• CPC Class Codes: A61F 2002/3611 : Heads or epiphyseal parts of femur
• CPC Class Codes: A61F 2002/368 : with lateral apertures, bores, holes or openings, e.g. for reducing the mass, for receiving fixation screws or for communicating with the inside of a hollow shaft
• 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 2220/0033 : made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
• CPC Class Codes: A61F 2230/0006 : circular
• CPC Class Codes: A61F 2230/0017 : Angular shapes
• CPC Class Codes: A61F 2230/0019 : rectangular
• CPC Class Codes: A61F 2230/0069 : cylindrical
• 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

Bone implantable devices and methodologies permit careful application of biologically active substances and management of bone growth processes. The device includes a body defining a carrier receiving area for locating adjacent bone. Carrier material is located in the carrier receiving area. Substance is delivered onto carrier material through a port. A pathway delivers substance from the carrier receiving area to the bone surface. The body may be in the form of a spinal fusion cage, facet fusion screw, artificial joint, bone fixation plate, interbody graft, IM nail, hip stem, or other bone-to-bone appliances or bone-to-device appliances. In use, carrier is installed in the carrier receiving area of the device. The device is then implanted adjacent a bone. The substance is applied to the carrier for subsequent delivery to the bone. By doping carrier material after device implantation, inadvertent contact of the substance with non-target bone is more easily eliminated.

Claims

1. An interbody spine fusion cage for promoting fusion between adjacent bone structures, comprising:

a cage body having a posterior end and an anterior end and an outer surface extending longitudinally therebetween, the cage body defining an internal cavity and having a plurality of apertures extending through the outer surface in communication with the internal cavity, the outer surface comprising a preselected pattern of perforated and non-perforated areas and having a plurality of threads extending therearound; and

first and second non-perforated end closures at the posterior end and the anterior end of said cage body, respectively, wherein at least one of the end closures has a longitudinally extending occluding surface that is -rotatable relative to the cage body so as to selectively occlude at least one of the plurality of apertures from providing access to the internal cavity, and wherein a distance from the first end closure to the second end closure is configured to remain constant during rotation of the longitudinally extending occluding surface,

wherein, upon implantation, a perforated area in contact with an adjacent bone structure is configured to allow bone growth therethrough while a perforated area not in contact with adjacent bone structure is occluded by the longitudinally extending occluding surface of the end closure.

2. The interbody spine fusion cage according to claim 1, further comprising an upper perforated area for locating adjacent an upper bone structure to be fused and a lower perforated area for locating adjacent a lower bone structure to be fused, wherein said upper perforated area and said lower perforated area are separated exclusively by non-perforated areas.

3. The interbody spine fusion cage according to claim 1, wherein:

said non-perforated zones are on lateral sides of the cage and extend in opposing relation from the posterior end toward the anterior end; and

said perforated areas comprise two opposed perforated areas oriented so that upon insertion the perforated areas are adjacent the bone structures to be fused.

4. An apparatus to facilitate arthrodesis between bone structures while preventing bony overgrowth, comprising:

a threaded cage body having a posterior end and an anterior end and defining an internal cavity, the cage body further having an outer surface extending longitudinally between the posterior end and the anterior end and a plurality of apertures extending therethrough, the outer surface having a continuous thread extending from a first position anterior to the plurality of apertures to a second position posterior to the plurality of apertures, the plurality of apertures in communication with the internal cavity in areas of the outer surface which, upon implantation of the apparatus, allow for arthrodesis between the bone structures;

a non-perforated end closure coupled to at least one of said posterior and anterior ends of the cage body, wherein the end closure is rotatable relative to the cage body so as to selectively occlude at least one of the plurality of apertures from providing access to the internal cavity;

wherein no area of the cage body directed toward neural elements upon implantation of the apparatus is in communication with the internal cavity so as prevent bony overgrowth toward the neural elements.

5. The apparatus of claim 4, further comprising:

means on the cage body for aiding insertion of the cage body between adjacent vertebral bodies.

6. The apparatus of claim 4, further comprising:

a non-perforated removable end cap securable to the posterior end of the cage body.

7. In a body having vertebral bodies defining a central canal, a spinal cord located in the central canal, neural elements branching out from said spinal cord through openings between the vertebral bodies, an arthrodesis facilitating therapeutic combination comprising:

a cage body inserted between the adjacent vertebral bodies, said cage body having a posterior end and an anterior end and defining an internal cavity, the cage body further having an outer surface that forms a periphery of said cage body and extends along a longitudinal axis extending between the posterior and anterior ends, said outer surface having a plurality of longitudinally-spaced apertures formed therein, said apertures adjacent the vertebral bodies to be fused to allow bone growth across the vertebral interspace;

a non-perforated end closure having at least one longitudinal occluding surface configured to rotate relative to the cage body so as to selectively occlude at least one of the longitudinally-spaced apertures and at least one longitudinal opening extending to an end of the end closure for providing unobstructed access to the internal cavity from another of the longitudinally-spaced apertures;

a longitudinal occluded area on said cage body, said occluded area for preventing communication between said internal cavity and said outer surface; and

wherein said longitudinal occluded area shields the neural elements from said internal cavity so that bone can grow only into the vertebral bodies and away from the neural elements.

8. An apparatus for insertion between adjacent vertebral bodies to facilitate arthrodesis between bone structures of the adjacent vertebral bodies while preventing bony overgrowth toward neural elements, comprising:

a cage body having a posterior end and an anterior end and an outer surface extending longitudinally therebetween, the cage body defining an internal cavity, said outer surface having a plurality of apertures formed therein and a plurality of threads extending therearound;

wherein one of said posterior end and said anterior end is a non-perforated surface and one of said posterior end and said anterior end is an open end;

an end closure for locating at said open end of said cage body, said end closure having a longitudinal occluding surface configured to rotate relative to the cage body so as to selectively occlude apertures such that a longitudinal portion of said cage body from a posterior end to an anterior end is occluded, said longitudinal occluding surface being sized to provide an occluded portion of sufficient size to prevent bone growth from impinging on neural tissue when said cage body is inserted between adjacent vertebral bodies.

9. A cage to promote bony fusion of adjacent vertebral bodies comprising:

a cage body having a posterior end, an anterior end and an outer surface extending along a longitudinal axis between the posterior and anterior ends, said cage body defining an internal cavity and -a plurality of circumferentially- and longitudinally-separated apertures extending through said outer surface, said plurality of circumferentially- and longitudinally-separated apertures in communication with said internal cavity;

a first non-perforated zone on said cage body, said first non-perforated zone extending from said posterior end of said cage body a preselected length toward said anterior end;

a first lateral side of said cage body and a second lateral side of said cage body extending in opposing relation from said first zone further toward said anterior end;

a second non-perforated zone on said first lateral side of said cage body extending from said first zone further toward said anterior end;

a third non-perforated zone on said second lateral side of said cage body extending in opposing relation with respect to said second non-perforated zone and extending from said first zone further toward said anterior end;

two opposed perforated zones oriented so that upon insertion of said cage body between the adjacent vertebral bodies, the perforated zones are positioned adjacent the vertebral bodies to be fused for allowing bone growth across a vertebral interspace between the adjacent vertebral bodies, wherein each of the perforated zones contains at least one of the plurality of circumferentially- and longitudinally-separated apertures; and

a non-perforated end closure coupled to at least one of said posterior and anterior ends of the cage body, wherein the end closure has a longitudinally occluding surface configured to rotate relative to the cage body so as to selectively occlude at least one of the plurality of circumferentially- and longitudinally-separated apertures from providing access to the internal cavity.

10. The cage according to claim 9 wherein:

a center of said second non-perforated zone is offset approximately 90 degrees from a center of said two opposed perforated zones.