EP1011505A1 - Procede et dispositif d'ancrage d'une cage de fusion filetee - Google Patents

Procede et dispositif d'ancrage d'une cage de fusion filetee

Info

Publication number
EP1011505A1
EP1011505A1 EP98918683A EP98918683A EP1011505A1 EP 1011505 A1 EP1011505 A1 EP 1011505A1 EP 98918683 A EP98918683 A EP 98918683A EP 98918683 A EP98918683 A EP 98918683A EP 1011505 A1 EP1011505 A1 EP 1011505A1
Authority
EP
European Patent Office
Prior art keywords
anchoring
vertebral
fusion cage
central portion
plate
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP98918683A
Other languages
German (de)
English (en)
Inventor
Charles Dean Ray
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Tegementa LLC
Original Assignee
Tegementa LLC
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Tegementa LLC filed Critical Tegementa LLC
Publication of EP1011505A1 publication Critical patent/EP1011505A1/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
    • A61F2/446—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages having a circular or elliptical cross-section substantially parallel to the axis of the spine, e.g. cylinders or frustocones
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4611—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/442—Intervertebral or spinal discs, e.g. resilient
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/30224—Three-dimensional shapes cylindrical
    • A61F2002/30235—Three-dimensional shapes cylindrical tubular, e.g. sleeves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30576—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs
    • A61F2002/30578—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs having apertures, e.g. for receiving fixation screws
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30593—Special structural features of bone or joint prostheses not otherwise provided for hollow
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30772—Apertures or holes, e.g. of circular cross section
    • A61F2002/30774—Apertures or holes, e.g. of circular cross section internally-threaded
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/3085—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2002/449—Joints for the spine, e.g. vertebrae, spinal discs comprising multiple spinal implants located in different intervertebral spaces or in different vertebrae
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2002/4625—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof with relative movement between parts of the instrument during use
    • A61F2002/4627—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof with relative movement between parts of the instrument during use with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0069—Three-dimensional shapes cylindrical

Definitions

  • the present disclosure concerns devices and methods for stabilizing fusion inserts placed for the purpose of fusing two adjacent joints such as vertebrae of the spine, and more particularly, to a threaded fusion cage anchoring device.
  • joint complexes consist of two bony structures and an interposed flexible, movable portion.
  • the bony structures are the vertebrae and the movable portion is the mtervertebral disc.
  • the disc is composed of a multilayered outer ligamentous belt, the annulus, constructed m concentric laminations rather like the plies of an automobile tire.
  • the annulus ring In the core of the disc there is a small mass of flexible fibrogel, contained by the annulus ring.
  • the fibrogel mass is a hydrogel which on absorbing water exerts a substantial swelling pressure to lift the vertebra and balance the forces applied against the disc by gravity and surrounding muscular contractions. Therefore, the hydrogel is important for resisting potentially disruptive forces applied to the vertebrae.
  • the internally contained hydrogel begins to lose its water- bmdmg ability and shrinks. This shrinkage leads to a loosening of the annulus fibers which permits an abnormal range of motion of the segment with buckling and delammation of the overlapping plies. Tears m as few as several layers of the approximately 12 to 20 concentric laminations of the annulus may permit a herniation of the pressured central nucleus material outward through the annulus defect.
  • insertion of threaded vertebral fusion cages is made more efficient because the threaded outer surface permits easy adjustment of the depth and penetration of the cage into the disc space.
  • the threaded outer surface also prevents dislodgment or expulsion of the cage.
  • the graft bone packed within the threaded fusion cages presents or effuses through these perforations and comes into intimate contact with the bone of the adjacent vertebral bodies.
  • the lateral walls of the cage are oriented horizontally and face the disc cavity. These lateral cage walls are blocked (i.e., contains no apertures) and therefore are a barrier against any potential ingrowth of residual disc tissue into the contained graft area which could interfere with or weaken the fusion formation of these adjacent vertebrae.
  • the present disclosure is directed to an anchoring device and system for stabilizing adjacent vertebral joints.
  • the anchoring device includes an anchoring plate adapted to be secured to at least one vertebral disc having a central portion, extended end portions and at least one lateral extension.
  • the central portion includes an anchoring nut for fastening the anchoring plate to a vertebral implant and the end portions include anchoring screws for fastening the anchoring plate to the at least one vertebral disc.
  • the vertebral implant is preferably a threaded fusion cage, wherein the anchoring nut is rotatably fixed to both the anchoring plate and the threaded fusion cage.
  • the anchoring device preferably includes the central portion and each extended end portion having at least one locking tab for rotatably locking the anchoring nut and anchoring screws. Additionally, the central portion further includes a plurality of projecting detents along an outer periphery thereof which mate with corresponding slots on the threaded fusion cage.
  • the present disclosure is also directed to a method of implanting an anchoring device to at least one vertebral disc having a vertebral implant.
  • the method includes providing an anchoring plate having a central portion and extended end portions.
  • the central portion includes an anchoring nut for fastening the anchoring plate to a vertebral implant and at least one locking tab along an outer periphery thereof .
  • the end portions include anchoring screws for fastening the anchoring plate to at least one vertebral disc and at least one locking tab along an outer periphery thereof .
  • the method further includes: situating the anchoring plate m a corresponding relationship to the at least one vertebral disc and the vertebral implant; fastening the anchoring nut to the vertebral implant; and fastening the anchoring screws to the at least one vertebral disc.
  • the locking tabs are then positioned into engagement with the anchoring nut and anchoring screws .
  • FIG. 1 is a view illustrating several adjacent spinal segments and two anchoring devices according to the present disclosure mounted to the spinal segments;
  • FIG. 2 is a bottom plan view of the anchoring device according to the present disclosure;
  • FIG. 3 is a perspective view illustrating a posterior aspect of a fusion cage and associated fusion cage inserting drive shaft;
  • FIG. 4 is a plan view of an anchoring nut associated with the anchoring device of the present disclosure.
  • FIG. 5 is a bottom plan view illustrating an anchoring device of an alternative embodiment according to the present disclosure.
  • the following discussion includes a description of the threaded fusion cage anchoring device utilized m performing a spinal fusion followed by a description of the preferred method for implanting the threaded fusion cage anchoring device m accordance with the present disclosure .
  • FIGS. 1 and 2 Reference will now be made m detail to the preferred embodiments of the disclosure, which are illustrated m the accompanying figures.
  • FIGS. 1 and 2 attention is first directed to FIGS. 1 and 2.
  • FIG. 1 An anterior view of a fused vertebral section 10 including two implanted anchoring devices 12 across three adjacent spinal segments 14, 16 and 18 are generally shown at FIG. 1.
  • the spinal segments 14, 16 and 18, for instance, cervical spinal segments, are separated by two interposed disc spaces 20 and 22.
  • Threaded fusion cages 24 are implanted between spinal segments 14 and 16 and spinal segments 16 and 18 and across the interposed disc spaces 20 and 22, respectively.
  • the anchoring device 12 of the present disclosure generally includes an anchoring plate 26, anchoring nut 28 and anchoring screws 30.
  • Anchoring plate 26 is generally m the shape of a figure-eight and includes a large central bore 32 and extension arms 34. Each extension arm 34 includes at least one anchoring screw bore 36 for receiving anchoring screw 30.
  • the anchoring device 12 of the present disclosure is preferably fabricated from a suitable biocompatible rigid material such as titanium and/or alloys of titanium, stainless steel, ceramic materials or rigid polymeric materials.
  • Anchoring plate 26 includes a fusion cage mating side 38 (bottom, i.e., FIG.2) and an anchoring nut mating side 40 (top, i.e., FIG. 1) .
  • the fusion cage mating side 38 includes projecting detents or pins 42 for engaging slots 44 of fusion cage 24 (FIG. 3) .
  • the projecting detents 42 are preferably located along the outer periphery of central bore 32.
  • the anchoring device 12 of the present disclosure and associated threaded fusion cage 24 may include any number of detents 42 and mating slots 44, wherein the higher quantity of projecting detents 42 and mating slots 44 provide for an optimal fixed relationship between the fusion cage 24 and the anchoring plate 26 without a large angular change m the implanted fusion cage 24 position.
  • the altering of the number of slots 44 of fusion cage 24, as well as, the mating projecting detents 42 of anchoring plate 26 will incrementally alter the angular relationship between the anchoring plate 26 and fusion cage 24.
  • minor angular changes m the orientation of the anchoring plate 26 with respect to the fusion cage 24 is beneficial so that the initial optimal depth of penetration of implanted fusion cage 24 into the joint space need not be markedly altered from the possible rotation attributable to the implantation of anchoring device 12.
  • the orientation or angular displacement of the anchoring plate 26 relative to the longitudinal axis of the spinal column may be altered from 0 to 80 degrees as needed to provide appropriate stability to the fusion cage 24 relative to the adjacent vertebrae.
  • This broad angular displacement assures a safe positioning of the anchoring plate 26 relative to certain anatomical structures, such as, the vertebral end plate, nearby traversing nerves or bony obstructions.
  • the anchoring plates 26 are preferably set substantially parallel to each other.
  • each anchoring plate 26 may be altered m order to obtain optimal anchoring screw 30 placement m the vertebral bodies.
  • the common angulation of the anchoring plates 26 may be altered for optimal anchoring screw 30 placement into the adjacent vertebral bodies.
  • Both the cages 24 and anchoring plates 26 may be placed by an anterior or posterior surgical approach to the lumbar spine. However, m the thoracic and cervical spinal areas an anterior method alone is recommended .
  • the anchoring device 12 of the present disclosure is placed over the implanted fusion cages 24 and attached to each fusion cage 24 with a threaded anchoring nut 28 which screws into matching threads 46 inside the inner periphery of fusion cage 24.
  • anchoring nut 28 is prohibited from loosening by a plurality of malleable nut locking tabs 48 positioned on opposing sides of the central bore 32 of anchoring plate 26. The bending of the nut locking tabs 48 over the anchoring nut 28 will engage at least one flat portion of the anchoring nut collared head 50 and thereby prevent the anchoring nut 28 from rotating and becoming loose.
  • the extension arms 34 of anchoring plate 26 include anchoring screw bores 36 through which slotted head anchoring screws 30 are passed and tightened into the vertebral bodies at convenient and safe locations.
  • the anchoring screws 30 are prevented from unscrewing by a plurality of malleable screw locking tabs 52 placed on opposing sides of the anchoring screw bores 36 on extension arms 34.
  • the screw locking tabs 52 are oriented so that at least one of them will firmly mate with at least one slot located on the head of anchoring screws 30 when locking tabs 52 are bent over anchoring screws 30.
  • the anchoring device 12 provides the additional support needed to fully stabilize the fusion cage 24 relative to spinal segments 14, 16 and 18. By crossing the interposed disc space 20 and 22 and attaching the anchoring screws 30 to the vertebral bodies at an extended distance from fusion cage 24, a substantial increase m mechanical fixation strength is provided. Essentially, the anchoring device 12 keeps the vertebrae from moving apart and therefore from distracting away from the fusion cage 24 as postoperative spinal motions occur. Further, the anchoring plate 26 significantly improves the initial overall rigidity of the fusion cage system.
  • a fusion cage 24 inserting drive shaft 54 for seating a threaded fusion cage 24 inside a bore made between adjacent surfaces of a spinal segment is shown.
  • the fusion cage 24 attaches to a retractable central threaded coupler 58 which rotates freely within the drive shaft 54.
  • the fusion cage slots 44 mate with the projecting tabs 56 of drive shaft 54.
  • the threaded coupler 58 engages the matching fusion cage threads 46 located along an inner periphery of fusion cage 24.
  • the mated slots 44 and projecting tabs 56 are used to rotatably drive the fusion cage 24 into position after which the threaded coupler 58 is unscrewed releasing both the drive shaft 54 and threaded coupler 58 from the fusion cage 24.
  • the drive shaft 54 may be mated to the fusion cage 24 via projecting tabs 56 and slots 44 to torque the fusion cage 24 into a final position without the necessity of firmly reattaching the threaded coupler 58 to the fusion cage 24.
  • Anchoring plate 26 further includes additional lateral extensions or tangs 60 for further stabilizing the interposed disc spaces 20 and 22 by being forced into the spaces 20 and 22 as the anchoring nut 28 is tightened onto anchoring plate 26 and into fusion cage 24.
  • the space between the margins of lateral tangs 60 may accommodate additional bone growth material such as cancellous or soft bone from another human (allograft) or from the same patient (autograft) which serves to provide a better fusion of spinal segments 14, 16 and 18.
  • anchoring device 12 of the present disclosure will now be described with respect to a single anchoring device 12 although multiple anchoring devices 12 can be implanted across one or more vertebral discs or spinal segments 14, 16 and 18.
  • a standard surgical approach is used to gam access to the surface of the vertebral bodies to be fused. This may consist of an anterior approach the neck and thoracic spine or an anterior or posterior approach m the lumbar spine.
  • One or more bores are drilled into selected mtervertebral spaces and tissue debris is cleaned out therefrom.
  • the bore may be tapped to match the threaded portion of the fusion cages. In other cases, a self -tapping fusion cage may be used and no threading will be required.
  • a threaded fusion cage 24 having slots 44 along its outer edge 62 is mated to projecting tabs 56 on the tip of the drive shaft 54, wherein the threaded coupler 58 is threaded onto the inner fusion cage threads 46 of fusion cage 24 to secure the fusion cage 24 to the drive shaft 54 during insertion thereof within the mtervertebral spaces.
  • the fusion cage 24 is screwed into its optimal position the prepared mtervertebral bore and the threaded coupler 58 and drive shaft 54 are detached.
  • anchoring device 12 is dependent upon the actual location of the implanted fusion cage 24. If a single fusion cage 24 or alternatively a pair of fusion cages 24 are implanted at multiple vertebral levels, then the orientation of the anchoring plates 26 will be m parallel pairs throughout the multiple fused vertebral segments.
  • the projecting detents 42 located along the mating surface 38 of anchoring plate 26 mates with equivalently spaced slots 44 located on the outer edge 62 of the implanted fusion cage 24.
  • a minor angular adjustment is made m the orientation of the anchoring plate 26 and fusion cage 24 relative to the longitudinal axis of the spme to maintain clearance of any anatomical structures.
  • the anchoring plate 26 may be bent slightly, before or after being attached to the fusion cage 24, to conform with the curving surface of the vertebral bodies or to establish clearance from other adjacent structures.
  • the anchoring nut 28 is passed through the central bore 32 of the anchoring plate 26 and screwed into the corresponding mating fusion cage threads 46 portion of the implanted fusion cage 24. Since the anchoring device 12 and fusion cage 24 can include a plurality of projecting detents 42 and mating slots 44, the anchoring plate 26 can be incrementally rotated to bring the anchoring plate 26 into its most advantageous position relative to the fusion cage 24 position. The rotation or adjusting of the anchoring plate 26 with respect to the fusion cage 24 is performed prior to tightening the anchoring nut 28 to the anchoring plate 26 and fusion cage 24.
  • Pilot holes or bores are then drilled into the vertebrae through the anchoring screw bores 36 of extension arms 34.
  • the extension arms 34 are next fitted with anchoring screws 30 of the appropriate length tnrough bores 36 which are screwed and anchored into the vertebral bone.
  • Both nut locking tabs 48 and screw locking tabs 52 are bent over the edges of anchoring nut 28 and the slots of anchoring screw 30, respectively, to prevent either from loosening or unscrewing.
  • Bone inducing material is then packed inside fusion cage 24, through central bore 32 and the center of anchoring nut 28. Alternatively, bone inducing material may be packed into fusion cage 24 prior to insertion.
  • anchoring device 12 depicted at FIG. 5, wherein like components and methods correspond to those of previously described embodiments described herein and are designated by like reference numerals.
  • the implantation of anchoring plate 26 further includes the addition of bone inducing material laterally placed along fusion cage 24 prior to attaching anchoring plate 26 to fusion cage 24.
  • the anchoring device 12 of the present disclosure may include any number of nut locking tabs 48 and screw locking tabs 52 to better secure each nut 28 and screw 30, respectively.
  • anchoring device 12 may include one or more extension arms 34 radially displaced along an angular relationship from central bore 32 which would provide better stabilization of the anchoring device 12, fusion cage 24 and associated bone segments 14, 16 and 18. Therefore, the above description should not be construed as limiting, but merely as exemplifications of preferred embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Transplantation (AREA)
  • Neurology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Cardiology (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Prostheses (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention porte sur un dispositif d'ancrage et sur un procédé de stabilisation d'articulations vertébrales adjacentes. Le dispositif d'ancrage (12) comprend une plaque d'ancrage (26) conçue pour être fixée à au moins un disque intervertébral comportant une partie centrale (32), des parties terminales étendues (34) et au moins une extension latérale (60). La partie centrale comprend un écrou d'ancrage (28) permettant de fixer la plaque d'ancrage à un implant vertébral (24), et les parties terminales comportent des vis d'ancrage (30) permettant de fixer la plaque d'ancrage au disque intervertébral. L'implant vertébral est de préférence une cage de fusion filetée, l'écrou d'ancrage pouvant tourner tout en étant fixé à la fois à la plaque d'ancrage et à la cage de fusion filetée. Le dispositif d'ancrage comprend de préférence la partie centrale, et chaque partie terminale étendue étant pourvue d'au moins une patte de verrouillage (48, 52) qui bloque par rotation l'écrou et les vis d'ancrage. La partie centrale comprend, de plus, sur sa périphérie externe, une pluralité d'ergots d'encliquetage saillants (42) qui s'adaptent dans les fentes correspondantes (44) de la cage de fusion filetée.
EP98918683A 1997-04-25 1998-04-24 Procede et dispositif d'ancrage d'une cage de fusion filetee Withdrawn EP1011505A1 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US4419097P 1997-04-25 1997-04-25
US44190P 1997-04-25
PCT/US1998/008272 WO1998048718A1 (fr) 1997-04-25 1998-04-24 Procede et dispositif d'ancrage d'une cage de fusion filetee

Publications (1)

Publication Number Publication Date
EP1011505A1 true EP1011505A1 (fr) 2000-06-28

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Family Applications (1)

Application Number Title Priority Date Filing Date
EP98918683A Withdrawn EP1011505A1 (fr) 1997-04-25 1998-04-24 Procede et dispositif d'ancrage d'une cage de fusion filetee

Country Status (5)

Country Link
EP (1) EP1011505A1 (fr)
JP (1) JP2001524853A (fr)
AU (1) AU735572B2 (fr)
CA (1) CA2287260A1 (fr)
WO (1) WO1998048718A1 (fr)

Families Citing this family (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6746450B1 (en) * 1999-07-07 2004-06-08 Children's Hospital Medical Center Spinal correction system
FR2815846B1 (fr) * 2000-10-30 2004-09-24 Fixano Dispositif d'arthrodese vertebrale
FR2822674B1 (fr) 2001-04-03 2003-06-27 Scient X Systeme stabilise de fusion intersomatique pour vertebres
US6908484B2 (en) 2003-03-06 2005-06-21 Spinecore, Inc. Cervical disc replacement
AU2004281165C1 (en) 2003-10-17 2010-11-18 Spinecore, Inc. Intervertebral disc replacement trial
US9072554B2 (en) 2005-09-21 2015-07-07 Children's Hospital Medical Center Orthopedic implant

Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4961740B1 (en) 1988-10-17 1997-01-14 Surgical Dynamics Inc V-thread fusion cage and method of fusing a bone joint
FR2651992B1 (fr) * 1989-09-18 1991-12-13 Sofamor Implant pour osteosynthese rachidienne dorso-lombaire anterieure destine a la correction de cyphoses.
US5534031A (en) * 1992-01-28 1996-07-09 Asahi Kogaku Kogyo Kabushiki Kaisha Prosthesis for spanning a space formed upon removal of an intervertebral disk
US5458641A (en) * 1993-09-08 1995-10-17 Ramirez Jimenez; Juan J. Vertebral body prosthesis

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See references of WO9848718A1 *

Also Published As

Publication number Publication date
JP2001524853A (ja) 2001-12-04
CA2287260A1 (fr) 1998-11-05
WO1998048718A1 (fr) 1998-11-05
AU735572B2 (en) 2001-07-12
AU7156198A (en) 1998-11-24

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