JP2007090114A - Artificial intervertebral joint to allow parallel translation and rotating operation - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an artificial intervertebral joint which allows a parallel translation and rotating operation between embedded prosthetic implements and can be easily embedded in a circular disk space. <P>SOLUTION: An artificial intervertebral joint which has a bowl component part (22) to engage a first vertebral bone (26), and a gutter-shaped component part (24) to engage a second vertebral bone (27) next to this first vertebral bone is disclosed. This gutter-shaped component part (24) is equipped with an approximate concave surface (50) with an approximate flat part (52). When the bowl component part (22) and the gutter-shaped component part (24) engage their respective vertebral bones, a bowl component part (72) and the gutter-shaped component part (24) engage mutually and allow vertebral bones to rotate each other and to be translated in parallel. The both component parts have flanges (34 and 56) to engage the vertebral bones. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

  The present invention relates to an artificial facet joint. More specifically, the present invention includes devices that are implanted in place of degenerated or lost disc tissue, and instruments and methods for implanting the devices.

  When treating diseases, injuries or deformations that affect the moving part of the spinal column (including the two adjacent vertebrae and the disc tissue, or the space between them), especially treat the part that affects the disc tissue In doing so, it has been known for many years to denature, produce hernias, or remove some or all of the other bad discs. If the disc tissue is removed from the working part of the spinal column or otherwise no disc tissue is present, a corrective means is needed to ensure proper spacing between the vertebrae separated by the previously removed disc tissue Is done. Generally, the two vertebrae are fused together using an implanted bone tissue, an artificial fusion element, or other composition or device. Fusing adjacent vertebrae is a tens of thousands of methods each year in the United States or Canada.

  However, biomechanical stiffness of facet joint fusions is of increasing interest in the medical field of the spine with regard to rapidly degrading the moving part of its adjacent spinal column. For example, in J. Neurosurg 88: 943-948, 1998, embedded by BH Cummins, JT Robertson, and S. Gill. See Surgical Experience With An Implanted Artificial Cervical Joint. For example, removing the intervertebral disc and then fusing the C3-C4 vertebrae may spur degradation of the C2-C3 and C4-C5 portions. Spinal fusion prevents the fused vertebrae from rotating or translationally moving relative to each other, as allowed by natural disc tissue. This lack of operability increases the stress on the moving part of the adjacent spinal column. A follow-up study of patients with successful fusion shows that the rate of illness in the adjacent area is as high as 20%, and that 50% of patients who have performed fusion still complain of pain. Is clear. Several conditions have been observed in the spinal segment adjacent to the fused portion of the spine, including disc degeneration, disc herniation, instability, spinal stenosis, spondylosis, and facet joint arthritis . As a result, many patients require additional disc removal and / or fusion methods as a result of spinal fusion. For this reason, it is clear that there is of course an advantage if there is an alternative means of fusion of the working part of the spinal column.

  Several different types of arthroplasty devices have been proposed to prevent collapse of the space between adjacent vertebrae, reduce pain, and maintain stability and rotational range of motion between vertebrae. For example, U.S. Pat. No. 5,755,796 discloses a prosthesis that is implanted in a disc space between adjacent vertebrae. This prosthesis has two elements: one element attached to the vertebra above the disc space and the other element attached to the vertebra below the disc space. The lower element includes a hollow box-shaped frame having a spherical seat therein, and the upper element includes a spherically shaped head portion that fits into the spherical seat. In US Pat. No. 5,556,431, two plates, each having a hollow on one side, are secured to adjacent vertebrae so that the two hollow portions face each other across the disc space. A three-part artificial disc in the body is disclosed. This third element is a core with an outwardly rounded surface on each side that fits within the hollow portion of the vertebral disc. Similarly, US Pat. No. 5,684,296 discloses a prosthesis comprising two L-shaped members, each having a curved portion, with an elastic disc body disposed between the curved portions. It is disclosed.

  U.S. Pat. Nos. 5,782,832 and 5,683,465 disclose an implant having two plate members secured to adjacent vertebrae in a disc space. In U.S. Pat. No. 5,782,832, the upper plate member has a rounded lower portion, and the lower plate member engages with the lower portion of the upper plate member to allow rotation thereof. have. In US Pat. No. 5,683,465, the plate member has a snap-fit ball and socket engagement portion that allows rotation. Other artificial discs are also known. Some are composite components with metal and rubber or polymer inserts that allow the discs to move when adjacent vertebrae separate and operate relative to each other. Designed to simulate features and performance. Each design is of a more mechanical nature, including a spring or other damping mechanism designed to approximate normal disc behavior.

  The normal movement of the vertebrae with respect to each other involves rotational and translational variations. These motion components are determined by the shape and size of the individual vertebrae, including the relative position of the lordosis joint (in the cervical spine), the direction of facet joints and the direction of compression of the ligaments. In short, the axis of rotation for any two vertebrae is unique and moves or translates while bending or stretching.

  The prior art describes artificial discs or joints that require a constant axis of rotation, which does not allow translational movement, and therefore tends to prevent and prevent normal movement. (Tend to jam). The latter results in excessive stress on the prosthesis and wear or breakage, or the stress is transmitted to adjacent working parts, causing pain and / or accelerated degeneration.

  Furthermore, many conventional devices are relatively difficult to embed. Most are designed to be attached to the vertebral face facing the disc space via an integral anchor. In order to implant such a device, adjacent vertebrae must be expanded substantially further than their normal distance relative to each other, the prosthesis must be manipulated between the vertebrae, and the anchors inserted into their respective vertebrae. . Such manipulation entails the additional risk of damaging the vertebra itself due to misalignment or scratching of the anchor and damaging other tissues due to the vertebra extending beyond its normal extent.

  Thus, there remains a need for artificial facet joints that allow translational and rotational movement between implanted prosthetic devices and that are easily implanted within the disc space. There is also a need for methods and instruments for implanting such artificial facet joints.

  The present invention relates to an artificial intervertebral joint having a ball component that engages a first vertebra and a saddle-like component that engages a second vertebra adjacent to the first vertebra. The bowl-shaped component includes a substantially concave surface having a substantially flat portion. When the ball component and the saddle-like component engage their respective vertebrae, the ball component and the saddle-like component engage with each other in a ball-and-socket relationship to allow rotation and translation relative to each other. To do. Both the ball component and the bowl-shaped component include a flange for engaging the vertebra at one end of the component.

  The ball component includes a generally spherical convex portion that engages a generally spherical concave portion of the bowl-shaped component, and the concave portion includes a flat portion. In one embodiment, each flange of the component has a hole through which a bone screw can be attached to attach the component to its respective vertebra. The flange may be configured to conform to the overall shape of the human vertebra.

  By allowing the ball component to slide or translate within the bowl-like component, the present invention sets the rotational axis and translation of the joint to an acceptable range due to the anatomical constraints of the moving part. Make it possible to do.

  The present invention is for implanting an artificial facet joint having a long handle portion and a portion engaging an artificial facet joint having an element that grips one or more portions of the artificial facet joint. It also relates to the instrument used. In one embodiment, the artificial intervertebral joint engaging portion of the instrument allows the artificial intervertebral joint or portion thereof to be maintained in a predetermined orientation, i.e., in a predetermined spatial relationship. Having a central flange and / or face configured as such. If the artificial facet joint has a hole for receiving a bone screw, the artificial facet engaging portion of the instrument pierces the hole in the bone screw and / or holds the artificial facet joint to the instrument; Preferably it includes an associated hole.

  The present invention is a method for implanting a two-part artificial facet joint, wherein the artificial facet part is arranged in a predetermined spatial relationship, and one of the artificial facet parts is arranged. 2 to abut one of the vertebrae and the other part of the artificial facet joint to another vertebra so that the predetermined spatial relationship of the artificial facet part is maintained. It is also directed to a method comprising inserting into a disc space between two adjacent vertebrae and fastening that portion to its respective vertebra. A special embodiment of this method is to connect the parts to the insertion instrument in a predetermined relationship with respect to each other and within the disc space between the vertebrae where parts of both parts of the artificial facet joint are adjacent. And inserting the insertion device into the body and fastening each portion of the artificial facet joint to the respective vertebra. One preferred embodiment of this fastening step is to drill a hole in the vertebra through an artificial facet portion and a hole in the connected insertion instrument, and screw a screw through the hole and into the bone. Including.

  The present invention provides an artificial facet joint, and an instrument and method for implantation that allow normal translation and rotation range between adjacent vertebrae to which the artificial facet joint is fastened. This artificial facet joint can be easily implanted through its flange and expands the disc space so that it is not necessary to expand adjacent vertebrae. The artificial facet joint is also implanted with the artificial facet joint in a predetermined orientation or a predetermined spatial relationship between its components. This reduces or eliminates the need for adjustment in the body. Also, the artificial facet joint of the present invention has a low height and a minimum number of parts. These and other advantages will be apparent to those of ordinary skill in the art by reference to the drawings and detailed description of the specification.

  For the purposes of facilitating an understanding of the principles of the invention, reference will now be made to one embodiment illustrated in the drawings and specific language will be used to describe the same. However, this is not intended to limit the scope of the present invention in any way, and such modifications and further modifications of the illustrated apparatus and further applications of the illustrated principles of the present invention are One of ordinary skill in the art would normally devise.

  Referring generally to FIGS. 1-12, one embodiment of an artificial facet joint 20 of the present invention is illustrated. The artificial facet joint 20 includes a ball component 22 and a saddle-like component 24 that are mutually engageable to form the artificial facet joint 20. Within the intervertebral disc space 28 between two adjacent vertebrae 26, 27, the ball component 22 is secured to one of the adjacent vertebrae (eg, vertebra 26 in FIG. 1) and the saddle component 24 is connected to another Secured to adjacent vertebrae (eg, vertebra 27 of FIG. 1), these components are interengaged within at least a portion of intervertebral space 28.

  Ball component 22 includes a generally convex surface 30 and, in one embodiment, an opposing generally flat vertebra engaging surface 32. In one particular embodiment, the generally convex surface 30 has a generally spherical shape. In one particular embodiment, one end of the vertebral engagement surface 32 is provided with a wedge-shaped surface 33 that makes it easier to insert the ball component 22 into the disc space and The ball component 22 is prevented from being displaced. In order to attach the ball component 22 to the vertebra, a flange 34 is provided at one end of the ball component 22 and is preferably formed to have a low height and a small volume. In one embodiment in which the ball component 22 includes a wedge-shaped surface 33, the flange 34 is provided at the other end of the ball component opposite the wedge-shaped surface 33. The flange 34 has a vertebra engaging surface 35.

  In a particular embodiment of the ball component 22, the flange 34 has one or more bone screw holes 36, and in a special embodiment, passes through the flange 34 and has two bones. The screw holes 36 are formed symmetrically. In this particular embodiment, one or more bone screws 37 (FIG. 4) are screwed into the vertebrae through one or more holes 36 to secure the ball component 22 to the vertebrae. In the illustrated embodiment, a hole 38 (FIGS. 2 and 3) is formed through the flange 34 for a detent screw 39 (FIG. 1). After the ball component 22 is attached to the vertebra using the bone screw 37, the detent screw 39 is screwed into the detent screw hole 38 of the flange 34 to cover the head of the bone screw 37 and the bone screw 37 is Prevents the ball component 22 from loosening. Further, the illustrated embodiment of the ball component 22 has a concave portion 40 for gripping the ball component 22 with an insertion tool, as will be further described below. The concave portion 40 is preferably located at the base of the flange 34, where the flange 34 preferably intersects the generally flat vertebra engaging surface 32.

  The flange 34 may be angled with respect to the vertebral engagement surface 32 of the ball component 22. In the particularly preferred embodiment illustrated in FIG. 3, the internal angle A between the vertebral engagement surface 35 and the vertebral engagement surface 32 is about 80 °. It has been found that this angle can provide a good fit of the middle or lower cervical spinal motion part, such as C4-C5, with the anterior part of the upper vertebra. The ball component 22 can also be structured to have different angles with the vertebral engagement surfaces 35, 32 according to the vertebra to be implanted and the patient's needs. For example, in the case of an upper cervical spine moving part such as C2-C3, the internal angle between the vertebra engaging surface 35 and the vertebra engaging surface 32 should be somewhat sharper in the range of 70 to 80 °. Can do. Further, the flange 34 can be slightly curved toward the side as shown in FIG. Such curvature approximates the lateral curvature of the anterior surface of the human vertebra, and is particularly useful in placing the artificial facet joint 20 from the front.

  In the illustrated embodiment, the bowl-shaped component 24 is similar to the ball component 22 in many respects. The bowl-shaped component 24 has a substantially concave surface 50, and the concave surface 50 includes a substantially flat portion 52 (FIGS. 5 to 7). Opposite the concave surface 50 is a vertebra engaging surface 54 that, in the illustrated embodiment, has a wedged surface 55 similar to the wedged surface 33 of the ball component 22. I have. The saddle-shaped component 24 also includes a flange 56 and a flange vertebra engaging surface 57 similar to the flange 34 and flange vertebra engaging surface 35 of the ball component 22.

  As with the specific embodiment of the ball component 22, the illustrated embodiment of the flange 56 of the bowl-shaped component 24 has at least one hole 58, preferably two symmetrical holes 58, Each of the holes can receive a bone screw 59 (FIG. 8). In this embodiment, the flange 56 may include a detent screw hole 60 and a detent screw 61 as described with respect to the ball component 22. Furthermore, the bowl-shaped component 24 in one embodiment has a concave portion 62 that is in the same position as the concave portion 40 of the ball component 22 and has a similar structure. Also, in one preferred embodiment, the flange 56 of the saddle-shaped component 24 is angled with respect to the vertebral engagement surface 54. In the illustrated embodiment, the internal angle B between the vertebral engagement surface 57 and the vertebral engagement surface 54 of the flange is about 95 °, which is the lower side of the middle or lower cervical spine working portion. A good fit with the anterior portion of the vertebra can be provided. As described for the ball component 22, the saddle-shaped component 24 can be manufactured with different angles between the surfaces 57, 54 according to patient needs or other factors. For example, in the case of the upper cervical spine moving part, the angle between the surfaces 57, 54 can be 90 ° to 100 °.

  Referring now to FIGS. 5, 7 and 10, there is illustrated a generally concave surface 50 of the saddle-shaped component 24 in one embodiment of the present invention. In this embodiment, the substantially concave surface 50 has a substantially flat (in this case, a cylindrical shape instead of a spherical) surface 52 disposed substantially at the center of the substantially concave surface 50. In a particular embodiment, the generally concave surface 50 has a generally spherical surface 64 on both sides of the generally flat surface 52. The generally flat surface 52 can be of any desired geometric shape, but in the presently preferred embodiment, the generally flat surface 52 is a rectangular shape similar to the slot formed in the generally concave surface 50. It has a shape and is substantially parallel to the flange 56. In a particularly preferred embodiment of the ball component 22 and the bowl-shaped component 24, the radius of the generally convex surface 30 and the radius of the spherical portion of the generally concave surface 50 are substantially equal.

  In use, the ball component 22 and the saddle-shaped component 24 are attached to adjacent vertebrae so that a portion of the components 22, 24 are within the disc space and engage each other to provide a ball and socket mechanism. It is done. This ball and socket mechanism allows rotation and translation of the components, thereby allowing rotation and translation of the vertebrae where these components are fixed relative to each other. To accomplish this, when the artificial intervertebral joint 20 is implanted, the generally convex surface 30 of the ball component 22 engages the generally concave surface 50 of the bowl-shaped component 24. When engaged with the generally concave surface 50, the generally convex surface 30 can be rotated in any direction. When the substantially convex surface 30 comes into contact with the substantially flat portion 52 of the substantially concave surface 50, the substantially convex surface 30 can translate along the substantially flat portion 52 and rotate relative to the substantially concave surface 50. In a particular embodiment of the artificial facet joint 20, the ball component 22 is an “upper” component and is fixed to a vertebra (ie, a vertebra closer to the head) that is directly above or above the disc space. Is done. In this embodiment, the saddle-shaped component 24 is attached to the lower or lower vertebra (ie, the vertebra close to the coccyx). Thus, when the ball component 22 is attached to one vertebra and the saddle-like component 24 is attached to an adjacent vertebra, the generally convex surface 30 and the generally concave surface 50 are engaged and the artificial intervertebral Joint 20 allows adjacent vertebrae to rotate and translate relative to each other, providing a normal range of motion for the facet joint.

  The present invention is also directed to an insertion instrument 70 that is used to implant an artificial facet joint 20. As shown in FIGS. 13-17, the insertion instrument 70 has, in one embodiment, a long handle portion 72 that is integral with or attached to the elongated portion 74. An artificial facet joint engaging portion 76 is attached to the end of the elongated portion 74. The artificial facet joint engagement portion 76 has an artificial facet joint engagement surface 78. In the illustrated embodiment, the artificial facet engagement surface 78 has a central separation flange 79. The illustrated embodiment of the artificial facet joint engaging portion 76 also has a set of holes 80. This embodiment of the insertion instrument 70 is intended for use with the ball component 22 and the saddle-shaped component 24 of the embodiment having bone screw holes 36, 58, respectively, and an artificial facet joint. The hole 80 of the engaging portion 76 is configured to communicate with the hole 36 of the ball component 22 and the hole 58 of the bowl-shaped component 24. In this embodiment, the hole 80 is sized slightly larger than the head of the bone screw 37, so that the screw 37 can be inserted into the hole 80 without securing the instrument 70 to provide an artificial vertebra. The components 22, 24 of the facet joint 20 can be secured to their respective vertebrae.

  The artificial facet engagement portion 76 of the insertion instrument 70 can also hold the artificial facet joint 20 engaged with the artificial facet joint engagement portion 76. The illustrated embodiment of the artificial facet joint engaging portion 76 also includes a pair of clips 82 on either side of the artificial facet joint engaging portion 76. Clip 82 is designed to also hold embodiments of ball component 22 and saddle component 24 having concave portions 40 and 62, respectively. Each of the clips 82 is attached to an artificial intervertebral joint engaging portion 76 that is inserted into the recessed portion 40 of the ball component 22 and the recessed portion 62 of the bowl-shaped component 24. Two clip fingers 84 having portions 86 are provided. In one alternative embodiment of the insertion instrument 70 (FIGS. 15a-15b), the artificial facet engagement portion 76 is provided with a hole 80 and a pair of cam screws 90, The pair of cam screws extend through one hole 80 at each side of the separation flange 79. In embodiments where the ball component 22 and the saddle-shaped component 24 have bone screw holes 36, 58, respectively, the ball component 22 and the saddle-shaped component 24 engage the artificial facet joint engagement surface 78. Thus, the holes 36, 58 communicate with the hole 80 of the artificial facet joint engaging portion 76. Next, a cam screw 90 is inserted into one of the holes 36 and one of the holes 58 so that the ball component 22 and the saddle-shaped component 24 can be locked against the artificial facet engagement surface 76. .

  As illustrated in FIGS. 14a-17, a particular embodiment of the artificial facet engagement portion 76 maintains the ball component 22 and the saddle component 24 in a predetermined spatial relationship or neutral position, The components are configured to ensure accurate alignment and placement relative to each other and to the disc space and vertebrae in which the components are implanted. The separation flange 79 of the artificial facet joint engaging portion 76 is configured to fit between the ball component 22 and the saddle-like component 24 and to ensure an accurate spacing therebetween. Yes. The artificial facet joint 76, when cooperating with the flange 79, can hold the ball component 22 and the saddle component 24 in precise predetermined spatial relationship with respect to each other. The engagement surface 78 is angled. For example, in the embodiment described above where the vertebral engagement surfaces 32, 35 of the ball component 22 have an internal angle of 80 °, the artificial intervertebral joint engagement surface 78 has an internal angle of approximately 80 ° with respect to the separation flange 79. The part which forms is included. Similarly, in an embodiment of the saddle component 24 where the vertebral engagement surfaces 54, 57 have an interior angle of approximately 95 °, the artificial facet engagement surface 78 is approximately 95 ° with respect to the separation flange 79. The part which forms the interior angle of is included. Thereby, the ball component 22 and the saddle-shaped component 24 are held together so that they can be implanted, and the vertebra engaging surface 32 of the ball component 22 and the vertebra engaging surface 54 of the saddle-shaped component 24 are substantially parallel, and The convex surface 30 engages with the concave surface 50.

  The insertion tool 70 has been primarily described above with respect to the embodiment of the artificial facet joint 20 described herein. However, the insertion tool 70 is also useful for other artificial facet joints that have parts that must be held in a specific predetermined orientation or that must be held in a specific spatial relationship. Will be understood by those skilled in the art.

  After the disc is excised and / or the disc space is processed, the artificial facet joint 20 of the present invention can be implanted. The ball component 22 and the saddle-shaped component 24 of the prosthesis 20 are preferably placed in a predetermined relationship with respect to each other by engaging the insertion device 70 or equivalent device of the present invention. Next, the components 22, 24 held in a predetermined spatial relationship are inserted into the body so that the vertebral engagement surfaces 32, 54 are in the disc space. In embodiments of components 22 and 24 having wedge surfaces 33 and 55, respectively, if necessary, the adjacent vertebrae are slightly biased and separated when advanced into the disc space, if necessary. By doing so, the wedge-shaped surfaces 33, 35 make it easier to implant the artificial facet joint 20. If the components 22, 24 are inserted into the disc space, the wedge-shaped surfaces 33, 55 will engage their respective vertebrae to prevent or prevent displacement of the artificial facet joint 20.

  When the artificial facet joint 20 is in place between the vertebrae, the components 22, 24 are attached to the vertebrae via flanges 34, 56 in one embodiment. In the embodiment of the invention in which the flanges 34, 56 have bone screw holes 36, 58, respectively, the attachment of the components 22, 24 to the vertebra is by drilling holes into the vertebra through the holes 36, 58. It can be carried out. The drill is then removed and a bone screw is screwed into the vertebra through the holes 36, 58, thereby securing the components 22, 24 relative to their respective vertebrae. Once all the holes have been drilled and all the screws 37 have been screwed into the vertebrae (if using an instrument), the insertion instrument 70 is removed and the detent screw (the hole is the component 22). , 24), screw into the holes 38, 60, thereby terminating the operation.

  A particular embodiment of a method for implanting the prosthesis 20 includes using one embodiment of the insertion tool 70. In the method of using the embodiment of the insertion instrument 70 having four holes 80 and clips 82 on both sides of the artificial facet joint engaging portion 76, the components 22, 24 of the artificial joint 20 are described above. The insertion tool 70 is engaged in such a predetermined spatial relationship. Insertion tool 70 is inserted into the body so that prosthesis 20 is in the disc space between adjacent vertebrae. Insert a drill (and drill sleeve, if necessary) through hole 80 in artificial facet engagement portion 76 and hole 36 or 58 in component 22 or component 24 communicating with hole 80, and A hole is drilled in the lower vertebra. This drilling procedure is repeated for each hole 80 of the artificial facet joint portion 76 that communicates with the hole 36 or hole 58 of the ball component 22 or saddle component 24, respectively. Screw 37 is screwed into vertebra through hole 80 and holes 36, 58 to secure components 22 and 24 to their respective vertebrae. The hole 80 in the artificial intervertebral joint engaging portion 76 is sized slightly larger than the head of the bone screw 37 used to attach the components 22, 24 to their respective vertebrae. Once all the holes have been drilled and all the screws have been screwed into the bone, the clip 82 is removed from the components 22, 24 and the insertion tool 70 is removed. Similarly, in the embodiment of the insertion instrument 70 illustrated in FIGS. 15a and 15b having a cam screw 90, the components 22, 24 are artificially secured by locking the cam screw 90 in each of the holes 36, 58. Attach to the facet joint engaging portion 76. A hole is drilled through the hole 80 and the holes 36, 58 without the cam screw 90. After such drilling, a screw is screwed into the vertebral hole. The cam screw is then unlocked, the insertion tool 70 is removed, and the remaining holes are drilled through the holes 36, 58 of the components 22, 24. A bone screw 37 is screwed into the vertebrae through the components 22 and 24 to complete the fixation of the components 22 and 24 to their respective vertebrae.

  The devices and methods of the present invention are currently considered to be most useful for repairing vertebral joints in the cervical region. However, the devices and methods of the present invention are also considered useful for repairing other spinal motion parts.

  In the embodiment of the ball component 22 and the bowl-shaped component 24, each having a detent screw hole 38, 60, the detent screw (not shown) is screwed into the hole 38, 60 to provide the prosthesis 20 Fixing is complete. Once the components 22 and 24 of the prosthesis 20 have been secured to satisfaction, the procedure can be terminated.

  Mainly described with respect to attaching the components 22, 24 to the vertebrae through the use of bone screws to secure the components to the vertebrae. As long as the components 22, 24 are firmly fixed to their respective vertebrae to withstand the stresses inevitably associated with continuous rotational and translational movements, the vertebra engaging surfaces 32, 35, 54 and / or It will be appreciated that alternative attachment structures or methods may be used, such as by stapling 57 or applying adhesive. Further, the artificial joint 20 and the bone screw or other structure used to implant the artificial joint into the body may be a biocompatible material such as stainless steel, titanium or other known biocompatible material or equivalent thereof. It is preferable that it is made of. The insertion tool 70 is preferably stainless steel, but can be made of any suitable material.

  While the invention has been illustrated in detail in the drawings and described in detail in the foregoing description, this is by way of example only and is not intended to limit its nature, only the preferred embodiments have been shown and described. All changes and modifications within the spirit of the invention are desired to be protected.

FIG. 6 is a partial cross-sectional view showing a side view of one embodiment of an artificial facet joint of the present invention implanted between adjacent vertebrae. FIG. 2 is a cross-sectional view of the embodiment of the artificial facet joint illustrated in FIG. 1. FIG. 2 is a front view of one embodiment of the ball component of the artificial facet joint shown in FIG. 1. FIG. 3 is a cross-sectional view of the ball component shown in FIG. 2 along line 3-3, shown in the direction of the arrow. FIG. 4 is a cross-sectional view of the ball component shown in FIG. 2 along line 4-4, shown in the direction of the arrow. FIG. 2 is a perspective view of one embodiment of the prosthetic face joint component of the artificial facet joint illustrated in FIG. 1. FIG. 2 is a front view of one embodiment of the prosthetic spinal joint component shown in FIG. 1. FIG. 7 is a cross-sectional view of the bowl-shaped component shown in FIG. 5 taken along line 7-7 of FIG. 6, shown in the direction of the arrow. FIG. 9 is a cross-sectional view of the bowl-shaped component shown in FIG. 5 taken along line 8-8 in FIG. 6, shown in the direction of the arrow. FIG. 3 is a side view of one embodiment of the ball component illustrated in FIG. 2. FIG. 6 is a side view of one embodiment of the bowl-shaped component illustrated in FIG. 5. FIG. 10 is a cross-sectional view of the ball component shown in FIG. 9 along line 11-11, shown in the direction of the arrow. 12 is a cross-sectional view of the bowl-shaped component shown in FIG. 10 along line 12-12, shown in the direction of the arrow. 1 is a perspective view of one embodiment of an insertion instrument of the present invention. FIG. FIG. 14 is a side view of the embodiment of the insertion tool illustrated in FIG. 13. 14b is a plan view of the embodiment of the insertion instrument illustrated in FIG. 13 rotated 90 ° about the longitudinal axis illustrated in FIG. 14a. FIG. FIG. 6 is a side view of one alternative embodiment of the insertion tool of the present invention. FIG. 15b is a perspective view of one embodiment of the artificial facet joint of the present invention engaged with the artificial facet engagement portion of the embodiment of the insertion instrument shown in FIG. 15a. FIG. 14 is a perspective view of one embodiment of the artificial facet joint of the present invention engaged with the insertion instrument illustrated in FIG. 13. FIG. 14 is a side view of one embodiment of the artificial facet joint of the present invention engaged with one embodiment of the artificial facet engagement surface of the insertion instrument illustrated in FIG. 13.

Explanation of symbols

20 artificial facet joint 22 ball component 24 saddle-shaped component 34 flange 56 flange

Claims (80)

In an artificial facet joint,
A ball component that engages a first vertebra, the ball component having a generally convex surface and a flange disposed at one end of the ball component that engages the first vertebra;
A saddle-shaped component that engages a second vertebra adjacent to the first vertebra, a generally concave surface having a generally flat portion, and an end of the saddle-shaped component that engages the second vertebra A flange-shaped component provided with a flange-shaped component, and when the ball component and the collar-shaped component engage the first vertebra and the second vertebra, respectively, the generally convex surface and the The generally concave surfaces engage together, and the engagement of the generally convex surface and the generally concave surface allows the ball component and the bowl-shaped component to rotate relative to each other, the generally convex surface And the generally flat portion of the generally concave surface to allow the ball component and the saddle-shaped component to translate relative to each other. The artificial facet joint according to claim 1, wherein the substantially convex surface is substantially spherical. The artificial facet joint according to claim 2, wherein the substantially concave surface comprises a substantially spherical portion connecting to the substantially flat portion. 4. The artificial intervertebral joint according to claim 3, wherein the substantially concave surface has two substantially spherical portions, and the substantially flat portion is disposed substantially at the center with respect to the substantially spherical portion. joint. 5. The artificial facet joint according to claim 4, wherein the substantially flat portion is substantially rectangular. 6. The artificial facet joint according to claim 5, wherein the substantially spherical portion of the substantially concave surface and the substantially spherical portion of the substantially convex surface have substantially equal radii. 5. The artificial facet joint according to claim 4, wherein the substantially flat portion is substantially parallel to the flange of the saddle-shaped component. The artificial facet joint according to claim 1, wherein each of the flange of the ball component and the flange of the saddle-like component has at least one hole for receiving a bone screw. 9. The artificial facet joint according to claim 8, wherein each of the flange of the ball component and the flange of the saddle-shaped component has two holes for receiving bone screws, the holes not being flush. An artificial facet joint with a directional axis. 9. The artificial intervertebral joint of claim 8, wherein each of the ball component and the saddle-shaped component has a hole for receiving a detent screw adjacent to the hole for receiving a bone screw. joint. The artificial facet joint according to claim 1, wherein both the flange of the ball component and the flange of the saddle-like component have curved portions. 2. The artificial facet joint of claim 1, wherein the ball component has a surface opposite the generally convex surface that engages a first vertebra, and the flange of the ball component is An artificial intervertebral joint that forms an internal angle of about 80 ° relative to the surface engaging the first vertebra. The artificial facet joint of claim 1, wherein the saddle-shaped component has a surface opposite the generally concave surface that engages a second vertebra, and the flange of the saddle-shaped component. An artificial intervertebral joint that forms an internal angle of about 95 ° relative to the surface engaging the second vertebra. An instrument used for implanting an artificial facet joint comprising: a long handle portion; an artificial facet engaging portion connected to the handle portion to hold the artificial facet joint; and an artificial facet joint And means connected to the artificial facet engagement portion to maintain engagement with the artificial facet engagement portion. 15. The instrument according to claim 14, wherein the artificial facet joint engaging portion further comprises a plurality of holes. 16. The instrument of claim 15, wherein the means for holding an artificial facet joint comprises a plurality of clips. 16. The instrument of claim 15, wherein the means for holding an artificial facet joint comprises a plurality of cam screws. 16. The instrument of claim 15, wherein the artificial facet engagement portion comprises an artificial facet engagement surface that keeps the artificial facet joint in a predetermined direction. The instrument of claim 18, wherein the artificial facet engagement surface comprises at least one portion configured in an oblique angle with respect to the handle. The instrument of claim 18, wherein the artificial facet engagement surface comprises a flange. 21. The instrument of claim 20, wherein the artificial intervertebral joint engagement surface comprises at least one surface portion that abuts the flange, configured at an oblique angle to the handle portion. In an instrument used to implant an artificial facet joint having a portion attached to an upper vertebra and a portion secured to a lower vertebra, each of the portions having at least one hole.
With a long handle part,
An artificial intervertebral joint engaging portion connected to the handle portion, wherein when the artificial intervertebral joint is engaged with the artificial intervertebral joint engaging portion, An artificial intervertebral joint engaging portion having a plurality of holes in communication with the holes;
Means connected to the artificial facet engagement portion to maintain the artificial facet joint in engagement with the artificial facet engagement portion;
Means for connecting a portion of the artificial facet joint to the artificial facet engagement portion to maintain a predetermined spatial relationship. 23. The instrument of claim 22, wherein the means for holding an artificial facet portion comprises a plurality of clip members. 24. The instrument of claim 23, wherein the clip member is adapted to engage simultaneously with both portions of an artificial facet joint. 23. The instrument of claim 22, wherein the means for holding a portion of an artificial facet joint comprises a plurality of cam screws that extend through the hole in the artificial facet engagement portion. And an instrument adapted to enter the hole in the artificial facet portion and hold the artificial facet portion. 23. The instrument of claim 22, wherein the means for retaining a portion of an artificial facet joint comprises an artificial facet engagement surface on the artificial facet engagement portion. 27. The instrument of claim 26, wherein the artificial facet engagement surface comprises at least one portion configured at an oblique angle with respect to the handle portion. 27. The instrument of claim 26, wherein the artificial facet engagement surface comprises a flange. 29. The instrument of claim 28, wherein the flange is disposed generally centrally at the artificial facet joint engagement surface. 30. The instrument of claim 28, wherein the artificial facet engagement surface comprises at least one surface portion that abuts the flange, configured at an oblique angle to the handle portion. In a method of implanting a two-part artificial facet joint into the body,
Placing a portion of the prosthesis in a predetermined spatial relationship;
One of the artificial facet portions abuts one of the vertebrae and the other facet of the artificial facet abuts the other vertebra so that the predetermined spatial relationship of the artificial facet portion is maintained Inserting an artificial facet portion into a disc space between two adjacent vertebrae;
Fastening an artificial facet portion to its respective vertebra. 32. The method of claim 31, wherein the placing step further comprises engaging an artificial facet portion with an insertion instrument. 34. The method of claim 32, wherein the engaging step further comprises the step of holding the artificial facet portion against the insertion instrument by a plurality of clips. 33. The method of claim 32, wherein the engaging step further comprises the step of holding the artificial facet portion against the insertion instrument by a plurality of cam screws. 32. The method of claim 31, wherein the inserting step further comprises inserting a portion of an artificial facet joint into the vertebra through an anterior approach. 32. The method of claim 31, wherein the fastening step comprises fastening a portion of an artificial facet joint to its respective vertebra with a plurality of bone screws. 32. The method of claim 31, wherein the fastening step comprises fastening an artificial facet portion to its respective vertebra with an adhesive. In a method of implanting a two-part artificial facet joint into the body,
Providing a two-part artificial facet joint, each artificial facet part comprising a flange having at least one through-hole;
Placing a portion of the prosthesis in a predetermined spatial relationship;
One flange of the artificial facet portion abuts one of the vertebrae, the other flange of the artificial facet portion abuts the other vertebra, and the predetermined spatial relationship of the artificial facet portion is Inserting an artificial intervertebral joint portion into a disc space between two adjacent vertebrae to be retained;
Fastening a flange of an artificial facet joint portion to its respective vertebra. 39. The method of claim 38, further comprising providing an insertion instrument having a plurality of holes in communication with the flange holes of the artificial facet joint portion, wherein the positioning step engages the prosthetic device portion with the insertion instrument. The method further comprising the step of combining. 40. The method of claim 39, wherein the engaging step further comprises the step of holding the artificial facet portion against the insertion instrument by a plurality of clips. 40. The method of claim 39, wherein the engaging step further comprises holding the artificial facet portion against the insertion instrument by a plurality of cam screws. 40. The method of claim 38, wherein the inserting step further comprises inserting an artificial facet portion from the front. 40. The method of claim 38, wherein the fastening step comprises:
Placing a drill through the hole in the insertion instrument and the associated hole in the artificial facet portion;
Drilling into the vertebrae;
Screwing the bone screw through the hole in the insertion instrument and the associated hole in the artificial facet portion into the hole in the vertebra. 44. The method of claim 43, wherein the step of positioning the drill, drilling and screwing steps are repeated for each flange of the artificial facet portion. 45. The method of claim 44, further comprising the step of screwing a detent screw into each of the artificial facet portions so as to cover a portion of each head of the bone screw. 40. The method of claim 38, wherein the fastening step comprises fastening an artificial intervertebral joint portion to its respective vertebra with an adhesive. In an artificial facet joint system,
A ball component having a generally convex surface and a flange adapted to be fastened to a first vertebra of two adjacent vertebrae;
A saddle-shaped component having a generally concave surface that engages the generally convex surface, the collar-shaped component adapted to be fastened to a second vertebra of two adjacent vertebrae;
An artificial intervertebral joint system comprising the ball component and the saddle-shaped component and an insertion instrument adapted to keep the component in a predetermined spatial relationship. 48. The system of claim 47, wherein each of the flange of the ball component and the flange of the bowl-shaped component has at least one through hole. 49. The system of claim 48, further comprising a plurality of bone screws that fasten the ball component and the bowl-shaped component to their respective vertebrae through the holes. 49. The system of claim 48, wherein the insertion instrument has a plurality of holes, and when the insertion instrument holds the component, the plurality of holes are the flange and the bowl-shaped component of the ball component. A system in communication with the hole through the flange. 51. The system of claim 50, wherein the insertion instrument has an artificial facet engagement surface, and when the insertion tool holds the component, the artificial facet engagement surface is in the configuration. A system configured to keep elements in the predetermined spatial relationship. 52. The system of claim 51, wherein the insertion instrument comprises a plurality of clip members that hold the component. 52. The system of claim 51, wherein the insertion instrument comprises a plurality of cam screws that hold the component. 48. The system of claim 47, wherein the substantially concave surface has a substantially flat portion. 55. The system of claim 54, wherein the generally concave surface has at least one generally spherical portion. 56. The system of claim 55, wherein the substantially convex surface is substantially spherical. 57. The system of claim 56, wherein at least one substantially spherical portion of the substantially concave surface and the substantially spherical substantially convex surface have substantially equal radii. A first component that engages the first vertebra, having a rounded surface and a flange provided at one end of the first component that engages the first vertebra The first component,
A second component that engages a second vertebra adjacent to the first vertebra and is provided at a flange-like surface and at one end of the second component that engages the second vertebra. And a second component, wherein the bowl-shaped surface has a spherical surface and a cylindrical surface therein,
The first component and the second component engage each other to form an artificial facet joint;
When the first component and the second component engage their respective vertebrae, the rounded surface and the bowl-shaped surface engage each other;
Engagement of the rounded surface and the bowl-shaped surface allows the first component and the second component to rotate relative to each other, the rounded surface and the cylinder A device wherein engagement with a planar surface allows the first component and the second component to translate relative to each other. 59. The apparatus of claim 58, wherein the rounded surface is spherical. 60. The apparatus of claim 58 or 59, wherein the bowl-shaped surface has a second spherical surface, and the spherical surface and the second spherical surface are on two side portions of the cylindrical surface. Artificial facet joint provided. 61. Apparatus according to any one of claims 58 to 60, wherein the cylindrical surface has a rectangular shape. 62. Apparatus according to any one of claims 58 to 61, wherein the flange of the first component has at least one hole for a bone screw. 64. The apparatus of claim 62, further comprising a bone screw in the hole. 64. Apparatus according to claim 62 or 63, wherein the flange of the first component has a hole for a detent screw. 65. The apparatus of claim 64, further comprising a detent screw in the detent screw hole. 66. The apparatus of claim 65, wherein the locking screw includes a head, the bone screw includes a head, and the head of the locking screw covers at least a portion of the head of the bone screw. apparatus. 66. The apparatus of claim 65, wherein the flange of the first component has a second hole for a second bone screw, the apparatus further comprising a second bone screw in the second hole. The second bone screw has a second head, the detent screw has a head, and the head of the detent screw includes the head of the bone screw and the second screw An apparatus covering at least a portion of the second head of a bone screw. 68. Apparatus according to any one of claims 58 to 67, wherein the flange of the second component has at least one hole for a bone screw. 69. The apparatus of claim 68, further comprising a bone screw in the hole of the flange of the second component. 70. The apparatus of claim 68 or 69, wherein the flange of the second component has a hole for a detent screw. 71. The apparatus of claim 70, further comprising a detent screw in the hole for the detent screw of the flange of the second component. 72. The apparatus of claim 71, wherein the detent screw in the second component has a head, the bone screw in the second component has a head, and the second configuration. The apparatus, wherein the head of the detent screw within an element covers at least a portion of the head of the bone screw within the second component. 72. The device of claim 71, wherein the flange of the first component has a second hole for a second bone screw, and the device further includes a second bone screw in the second hole. The second bone screw has a second head, the detent screw has a head, and the head of the detent screw includes the head of the bone screw and the second screw An apparatus covering at least a portion of the second head of a bone screw. 74. The apparatus of any one of claims 58 to 73, wherein the first component has a vertebral engagement surface adjacent to the flange of the first component; The apparatus wherein the angle between the vertebral engagement surface and the flange of the first component is in the range of 70-80 degrees. 75. The apparatus of any one of claims 58 to 74, wherein the second component has a vertebral engagement surface adjacent to the flange of the second component; The apparatus, wherein the angle between the vertebral engagement surface and the flange of the second component is in the range of 90-100 degrees. 76. A device according to any one of claims 58 to 75, wherein the first component has at least one concave portion for gripping the first component by an instrument. 77. The apparatus of claim 76, wherein the at least one concave portion is disposed at a base of the flange of the first component. 78. The apparatus of any one of claims 58 to 77, wherein the second component has at least one concave portion for grasping the second component by an instrument. 78. The apparatus of claim 77, wherein the at least one concave portion of the second component is disposed at a base of the flange of the second component. 80. Apparatus according to any one of claims 58 to 79, wherein at least one of the first component and the second component is provided with a wedge-shaped surface.

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