New! View global litigation for patent families

US20100174371A9 - Artificial intervertebral disc trials having a cylindrical engagement surface - Google Patents

Artificial intervertebral disc trials having a cylindrical engagement surface Download PDF

Info

Publication number
US20100174371A9
US20100174371A9 US10784597 US78459704A US2010174371A9 US 20100174371 A9 US20100174371 A9 US 20100174371A9 US 10784597 US10784597 US 10784597 US 78459704 A US78459704 A US 78459704A US 2010174371 A9 US2010174371 A9 US 2010174371A9
Authority
US
Grant status
Application
Patent type
Prior art keywords
intervertebral
trial
disc
static
artificial
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.)
Granted
Application number
US10784597
Other versions
US20050055095A1 (en )
US8357167B2 (en )
Inventor
Joseph Errico
Michael Didasik
Rafail Zubok
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.)
SpineCore Inc
Errico Joseph P
Original Assignee
SpineCore Inc
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

Links

Images

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603Special 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
    • A61F2/4611Special 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/442Intervertebral or spinal discs, e.g. resilient
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/442Intervertebral or spinal discs, e.g. resilient
    • A61F2/4425Intervertebral or spinal discs, e.g. resilient made of articulated components
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/4455Joints 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
    • A61F2/446Joints 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4684Trial or dummy prostheses
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30721Accessories
    • A61F2/30742Bellows or hose-like seals; Sealing membranes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/3011Cross-sections or two-dimensional shapes
    • A61F2002/30159Concave polygonal shapes
    • A61F2002/30171Concave polygonal shapes rosette- or star-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/3011Cross-sections or two-dimensional shapes
    • A61F2002/30182Other shapes
    • A61F2002/30187D-shaped or half-disc-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/30199Three-dimensional shapes
    • A61F2002/302Three-dimensional shapes toroidal, e.g. rings
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331Connections 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331Connections 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
    • A61F2002/30362Connections 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 with possibility of relative movement between the protrusion and the recess
    • A61F2002/30364Rotation about the common longitudinal axis
    • A61F2002/30365Rotation about the common longitudinal axis with additional means for limiting said rotation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331Connections 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
    • A61F2002/30378Spherically-shaped protrusion and recess
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30433Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting screws
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30433Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting screws
    • A61F2002/30441Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting screws using rivets or directly riveted
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30433Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting screws
    • A61F2002/30443Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting screws using washers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30433Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting screws
    • A61F2002/30443Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting screws using washers
    • A61F2002/30444Split washers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30433Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting screws
    • A61F2002/30443Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting screws using washers
    • A61F2002/30446Spring washers, e.g. Belleville washers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30451Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements soldered or brazed or welded
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30451Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements soldered or brazed or welded
    • A61F2002/30454Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements soldered or brazed or welded by high energy welding, e.g. laser beam welding, electron beam welding, plasma welding
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30492Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a locking pin
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/305Snap connection
    • A61F2002/30502Press-buttons
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30507Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a threaded locking member, e.g. a locking screw or a set screw
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30518Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements with possibility of relative movement between the prosthetic parts
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30518Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements with possibility of relative movement between the prosthetic parts
    • A61F2002/30528Means for limiting said movement
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30537Special structural features of bone or joint prostheses not otherwise provided for adjustable
    • A61F2002/30538Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30563Special structural features of bone or joint prostheses not otherwise provided for having elastic means or damping means, different from springs, e.g. including an elastomeric core or shock absorbers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30565Special structural features of bone or joint prostheses not otherwise provided for having spring elements
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30565Special structural features of bone or joint prostheses not otherwise provided for having spring elements
    • A61F2002/30571Leaf springs
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30594Special structural features of bone or joint prostheses not otherwise provided for slotted
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30604Special structural features of bone or joint prostheses not otherwise provided for modular
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30621Features concering the anatomical functioning or articulation of the prosthetic joint
    • A61F2002/30649Ball-and-socket joints
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth
    • A61F2002/30769Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth madreporic
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes, grooves
    • A61F2002/30772Apertures or holes, e.g. of circular cross section
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes, grooves
    • A61F2002/30772Apertures or holes, e.g. of circular cross section
    • A61F2002/30774Apertures or holes, e.g. of circular cross section internally-threaded
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes, grooves
    • A61F2002/30772Apertures or holes, e.g. of circular cross section
    • A61F2002/30784Plurality of holes
    • A61F2002/30785Plurality of holes parallel
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes, grooves
    • A61F2002/30841Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth
    • A61F2/30907Nets or sleeves applied to surface of prostheses or in cement
    • A61F2002/30909Nets
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth
    • A61F2002/3092Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth having an open-celled or open-pored structure
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/3094Designing or manufacturing processes
    • A61F2002/30975Designing or manufacturing processes made of two halves
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/442Intervertebral or spinal discs, e.g. resilient
    • A61F2/4425Intervertebral or spinal discs, e.g. resilient made of articulated components
    • A61F2002/443Intervertebral or spinal discs, e.g. resilient made of articulated components having two transversal endplates and at least one intermediate component
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603Special 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
    • A61F2002/4619Special 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 for extraction
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603Special 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
    • A61F2002/4625Special 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
    • A61F2002/4627Special 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603Special 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
    • A61F2002/4625Special 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
    • A61F2002/4628Special 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 an axis transverse to the instrument axis or to the implantation direction, e.g. clamping
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033Connections 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0041Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting screws
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0058Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements soldered or brazed or welded
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0028Shapes in the form of latin or greek characters
    • A61F2230/0034D-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0028Shapes in the form of latin or greek characters
    • A61F2230/005Rosette-shaped, e.g. star-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063Three-dimensional shapes
    • A61F2230/0065Three-dimensional shapes toroidal, e.g. ring-shaped, doughnut-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2250/00Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0004Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof adjustable
    • A61F2250/0006Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof adjustable for adjusting angular orientation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00011Metals or alloys
    • A61F2310/00017Iron- or Fe-based alloys, e.g. stainless steel
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00011Metals or alloys
    • A61F2310/00023Titanium or titanium-based alloys, e.g. Ti-Ni alloys
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00365Proteins; Polypeptides; Degradation products thereof
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10STECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S606/00Surgery
    • Y10S606/914Toolkit for installing or removing spinal positioner or stabilizer

Abstract

Instrumentation for implanting an artificial intervertebral disc includes static trials, the static trials including first and second trial baseplates immovably coupled to one another via a trunk extending therebetween, each trial baseplate having an outwardly facing surface approximating a contour of a corresponding outwardly facing surface of an articifial intervertebral disc baseplate, at least one of the trial baseplates having a plurality of engagement holes extending into the at least one of the trial baseplates in a direction substantially perpendicular to each of a plurality of a surgical approach directions used to insert the trial into the intervertebral space, each of the plurality of engagement holes being disposed on the at least one of the trial baseplates to correspond to a respective one of the surgical approach directions such that selection for use of one of the plurality of engagement holes corresponds to selection of the respective surgical approach.

Description

    CROSS-REFERENCE TO RELATED APPLICATIONS
  • [0001]
    The present application is a continuation application of U.S. patent application Ser. No. 10/282,356 (filed Oct. 29, 2002) entitled “Instrumentation and Methods for use in Implanting an Artificial Intervertebral Disc”, which is a continuing application of U.S. patent application Ser. No. 10/256,160 (filed Sep. 26, 2002) entitled “Artificial Intervertebral Disc Having Limited Rotation Using a Captured Ball and Socket Joint With a Solid Ball and Compression Locking Post”, which is a continuing application of U.S. patent application Ser. No. 10/175,417 (filed Jun. 19, 2002) entitled “Artificial Intervertebral Disc Utilizing a Ball Joint Coupling”, which is a continuing application of U.S. patent application Ser. No. 10/151,280 (filed May 20, 2002) entitled “Tension Bearing Artificial Disc Providing a Centroid of Motion Centrally Located Within an Intervertebral Space”, which is a continuing application of both U.S. patent application Ser. No. 09/970,479 (filed Oct. 4, 2001) entitled “Intervertebral Spacer Device Utilizing a Spirally Slotted Belleville Washer Having Radially Extending Grooves” as well as U.S. patent application Ser. No. 10/140,153 (filed May 7, 2002) entitled “Artificial Intervertebral Disc Having a Flexible Wire Mesh Vertebral Body Contact Element”, the former being a continuing application of U.S. patent application Ser. No. 09/968,046 (filed Oct. 1, 2001) entitled “Intervertebral Spacer Device. Utilizing a Belleville Washer Having Radially Extending Grooves” and the latter being a continuing application of both U.S. patent application Ser. No. 09/970,479 (detailed above) as well as U.S. patent application Ser. No. 10/128,619 (filed Apr. 23, 2002) entitled “Intervertebral Spacer Having a Flexible Wire Mesh Vertebral Body Contact Element”, which is a continuing application of both U.S. patent application Ser. No. 09/906,119 (filed Jul. 16, 2001) and entitled “Trial Intervertebral Distraction Spacers” as well as U.S. patent application Ser. No. 09/982,148 (filed Oct. 18, 2001) and entitled “Intervertebral Spacer Device Having Arch Shaped Spring Elements”. All of the above mentioned applications are hereby incorporated by reference herein in their respective entireties.
  • FIELD OF THE INVENTION
  • [0002]
    This invention relates generally to systems and methods for use in spine arthroplasty, and more specifically to instruments for distracting an intervertebral space, inserting and removing trial artificial intervertebral discs, and inserting, impacting, repositioning, leveling and extracting artificial intervertebral discs, and methods of use thereof.
  • BACKGROUND OF THE INVENTION
  • [0003]
    The bones and connective tissue of an adult human spinal column consists of more than twenty discrete bones coupled sequentially to one another by a tri-joint complex that consists of an anterior disc and the two posterior facet joints, the anterior discs of adjacent bones being cushioned by cartilage spacers referred to as intervertebral discs. These more than twenty bones are anatomically categorized as being members of one of four classifications: cervical, thoracic, lumbar, or sacral. The cervical portion of the spine, which comprises the top of the spine, up to the base of the skull, includes the first seven vertebrae. The intermediate twelve bones are the thoracic vertebrae, and connect to the lower spine comprising the five lumbar vertebrae. The base of the spine is the sacral bones (including the coccyx). The component bones of the cervical spine are generally smaller than those of the thoracic spine, which are in turn smaller than those of the lumbar region. The sacral region connects laterally to the pelvis. While the sacral region is an integral part of the spine, for the purposes of fusion surgeries and for this disclosure, the word spine shall refer only to the cervical, thoracic, and lumbar regions.
  • [0004]
    The spinal column is highly complex in that it includes these more than twenty bones coupled to one another, housing and protecting critical elements of the nervous system having innumerable peripheral nerves and circulatory bodies in close proximity. In spite of these complications, the spine is a highly flexible structure, capable of a high degree of curvature and twist in nearly every direction.
  • [0005]
    Genetic or developmental irregularities, trauma, chronic stress, tumors, and degenerative wear are a few of the causes that can result in spinal pathologies for which surgical intervention may be necessary. With respect to the failure of the intervertebral disc, and the insertion of implants and/or height restorative devices, several methods and devices have been disclosed in the prior art that achieve immobilization and/or fusion of adjacent bones by implanting artificial assemblies in or on the spinal column. More recently, the development of non-fusion implant devices, which purport to permit continued natural movement in the tri-joint complex, have provided great promise as a preferably alternative to fusion devices. The region of the back that needs to be corrected, as well as the individual variations in anatomy, determine the appropriate surgical protocol and implantation assembly. Generally, the preparation of the intervertebral space for the receipt of fusion or non-fusion devices involves removing the damaged disc material and thereafter distracting the adjacent vertebral bones to their appropriate distance apart. Once the proper height of the intervertebral space is restored, the fusion or non-fusion device can be implanted.
  • [0006]
    It is an object of the invention to provide instrumentation and methods that enable surgeons to more accurately, easily, and efficiently prepare the intervertebral space and implant fusion or non-fusion devices. Other objects of the invention not explicitly stated will be set forth and will be more clearly understood in conjunction with the descriptions of the preferred embodiments disclosed hereafter.
  • SUMMARY OF THE INVENTION
  • [0007]
    The preceding objects are achieved by the invention, which includes static trial artificial intervertebral discs (sometimes referred to herein as a “static trial”), a static trial artificial intervertebral disc holder (sometimes referred to herein as a “static trial holder”), a dynamic trial artificial intervertebral disc (sometimes referred to herein as a “dynamic trial”), an artificial intervertebral disc inserter/impactor (sometimes referred to herein as an “inserter/impactor”), an artificial intervertebral disc repositioner/extractor (sometimes referred to herein as a “repositioner/extractor”), and an artificial intervertebral disc leveler (sometimes referred to herein as a “leveler”).
  • [0008]
    More particularly, the systems and methods disclosed herein are intended for use in spine arthroplasty procedures, and specifically for use with the systems and methods described herein in conjunction with the systems and method described in U.S. patent application Ser. No. 10/256,160 (filed Sep. 26, 2002) entitled “Artificial Intervertebral Disc Having Limited Rotation Using a Captured Ball and Socket Joint With a Solid Ball and Compression Locking Post” (hereinafter referred to as “the '160 application”) as well as U.S. patent application Ser. No. 09/906,127 (filed Jul. 16, 2001) entitled “Insertion Tool For Use With Intervertebral Spacers” (hereinafter referred to as “the '127 application”), both applications of which are mentioned above. However, it should be understood that the systems and methods described herein are also suitable for use with other systems and methods without departing from the scope of the invention.
  • [0009]
    For example, while the static trials described herein are primarily intended for use in determining the appropriate size of particular embodiments of the artificial intervertebral disc implants described in the '160 application to be implanted (or whether a particular size can be implanted) into the distracted intervertebral space, they can also be used for determining the appropriate size of any other suitably configured orthopedic implant or trial to be implanted (or whether a particular size can be implanted) into the distracted intervertebral space.
  • [0010]
    And, for example, while the static trial holder described herein is primarily intended for use in holding, inserting, removing, and otherwise manipulating the static trials described herein, it can also be used for manipulating any embodiment of the trial spacers described in the '127 application (also referred to therein and herein as distraction spacers), and can also be used for manipulating any other suitably configured orthopedic device.
  • [0011]
    And, for example, while the dynamic trial described herein is primarily intended for use in distracting an intervertebral space according to the procedures described herein and/or for determining the appropriate size of particular embodiments artificial intervertebral disc implants described in the '160 application to be implanted (or whether a particular size can be implanted) into the distracted intervertebral space, it can also be used for distracting an intervertebral space according to other procedures and/or for determining the appropriate size of any other suitably configured orthopedic implant or trial to be implanted (or whether a particular size can be implanted) into the distracted intervertebral space.
  • [0012]
    And, for example, while the inserter/impactor described herein is primarily intended for use in holding, inserting, removing, impacting, extracting, and otherwise manipulating particular embodiments of the artificial intervertebral disc implants described in the '160 application, it can also be used for manipulating any other suitably configured orthopedic implant or trial.
  • [0013]
    And, for example, while the repositioners/extractors described herein is primarily intended for use in repositioning and/or extracting and/or otherwise manipulating particular embodiments of the artificial intervertebral disc implants described in the '160 application, it can also be used for manipulating any other suitably configured orthopedic implant or trial.
  • [0014]
    And, for example, while the leveler described herein is primarily intended for use in setting the proper position of, and/or otherwise manipulating, particular embodiments of the artificial intervertebral disc implants' described in the '160 application, it can also be used for manipulating any other suitably configured orthopedic implant or trial.
  • [0015]
    While the instrumentation described herein (e.g., the static trials, static trial holder, dynamic trial, inserter/impactor, repositioners/extractors, and leveler) will be discussed for use with the artificial intervertebral disc of FIGS. 1 g-n, such discussions are merely by way of example and not intended to be limiting of their uses. Thus, it should be understood that the tools can be used with any of the artificial intervertebral discs disclosed in the '160 application, or any other artificial intervertebral disc having (or being modifiable or modified to have) suitable features therefor. Moreover, it is anticipated that the features of the artificial intervertebral disc (e.g., the flat surfaces and accompanying holes) and/or the static trials (e.g., the cylindrical trunks and flat surfaces and accompanying holes) that are used by the tools discussed herein to hold and/or manipulate these devices (such features, it should be noted, were first shown and disclosed in the '160 application and the '127 application) can be applied, individually or collectively or in various combinations, to other trials, spacers, artificial intervertebral discs or other orthopedic devices as stand-alone innovative features for enabling such trials, spacers, artificial intervertebral discs, or other orthopedic devices to be more efficiently and more effectively held and/or manipulated by the tools described herein or by other tools having suitable features. In addition, it should be understood that the invention encompasses artificial intervertebral discs, spacers, trials (static or dynamic), and/or other orthopedic devices, that have one or more of the features disclosed herein, in any combination, and that the invention is therefore not limited to artificial intervertebral discs, spacers, trials, and/or other orthopedic devices having all of the features simultaneously.
  • [0016]
    More particularly with regard to the static trials described herein, a plurality of static trials are provided primarily for use in determining the appropriate size of an artificial intervertebral disc to be implanted (or whether a particular size of the artificial intervertebral disc can be implanted) into the distracted intervertebral space (e.g., the artificial intervertebral disc 160 of FIGS. 1 g-n). Preferably, for each artificial intervertebral disc to be implanted, a plurality of sizes of the artificial intervertebral disc would be available. That is, preferably, a plurality of the same type of artificial intervertebral disc would be available, each of the plurality having a respective width and depth dimension combination that allows it to fit within a correspondingly dimensioned intervertebral space. For example, the plurality of artificial intervertebral discs could include artificial intervertebral discs having widths being either 35 mm or 40 mm, and depths ranging from 14 mm to 18 mm in 1 mm increments, for a total of 10 discs. Accordingly, preferably, each of the plurality of static trials 100 for use with a particular plurality of differently sized artificial intervertebral discs would have a respective width and depth dimension set corresponding to the width and depth of a respective one of the plurality of differently sized artificial intervertebral discs. For example, the plurality of static trials 100 for use with the set of artificial intervertebral discs described for example could include static trials 100 having widths being either 35 mm or 40 mm, and depths ranging from 14 mm to 18 mm in 1 mm increments, for a total of 10 static trials. It should be understood that the artificial intervertebral discs and/or the static trials 100 can be offered in a variety of dimensions without departing from the scope of the invention, and that the dimensions specifically identified and quantified herein are merely exemplary. Moreover, it should be understood that the set of static trials 100 need not include the same number of trials for each artificial intervertebral disc in the set of artificial intervertebral discs, but rather, none, one, or more than one trial can be included in the trial set for any particular artificial intervertebral disc in the set.
  • [0017]
    Each of the plurality of static trials preferably further includes features that can be used by the static trial holder (described below), the inserter/impactor (described below), and the repositioners/extractors (described below). With regard to a feature that can be used by the static trial holder, each static trial preferably includes a recess that can be gripped by the opposing semicircular extents of the static trial holder. Preferably, this recess forms an annular groove that establishes a cylindrical trunk between the baseplates of the static trial, such that the baseplates extend as flanges from either end of the cylindrical trunk. Accordingly, preferably, the opposing semicircular extents each have a thickness smaller than the width of the annular groove, and as such fit into the annular groove to grip the cylindrical trunk between them.
  • [0018]
    With regard to features that can be used by the inserter/impactor, each static trial (and each artificial intervertebral disc that the trials approximate) preferably includes an anteriorly facing flat surface, flanked by two anteriolaterally facing flat surfaces (one on each side of the anteriorly facing flat surface), and, to provide for holding of the static trial or disc for an anterior insertion approach, a hole spaced from the anteriorly facing flat surface, the hole having a longitudinal axis parallel to the anteriorly facing flat surface. The holding pin of the inserter/impactor fits within the hole, and the angled flat surfaces of the static trial or disc fit against the correspondingly angled flat surfaces of the inserter/impactor, and operation of the inserter/impactor pulls the holding pin toward the flat surface of the inserter/impactor opposite the pin, to rigidly hold the static trial or disc by the baseplate. When the static trial is held in this manner, rotation of the static trial or disc about a longitudinal axis (e.g., in the case of the trials, an axis parallel to the longitudinal axis of the cylindrical trunk) relative to the inserter/impactor is prevented by interference of the corners of the static trial's or disc's flat surfaces and the corners of the inserter/impactor's flat surfaces, similar to the manner in which a wrench holding a nut prevents rotation of the nut relative to the wrench. Further, the holding of the static trial or disc in this manner allows for some repositioning of the static trial or disc in the intervertebral space via rotation of the static trial or disc in either direction about the longitudinal axis of the intervertebral space.
  • [0019]
    Preferably, both of the baseplates of the static trial or disc have similarly configured flat surfaces, and both baseplates' flat surfaces fit against the angled flat surfaces of the inserter/impactor to provide for a more secure holding of the static trial or disc by the inserter/impactor. Also preferably, in order to provide for a holding of the static trial or disc for two additional (here, anteriolateral) insertion approaches, each static trial or disc also include two additional holes, one spaced apart from one of the anteriolaterally facing flat surfaces, and the other spaced apart from the other of the anteriolaterally facing flat surfaces. Accordingly, operation of the inserter/impactor can fit the holding pin into either of these two additional holes, and hold the anteriolaterally facing flat surface (the one associated with the hole into which the pin is fit) of the static trial or disc against the flat surface of the inserter/impactor opposite the pin. It should be understood that preferably, in order to facilitate these two additional approaches, the angle separating the anteriorly facing flat surface of the static trial or disc and one of the anteriolaterally facing flat surfaces of the static trial or disc is equal to the angle separating the anteriorly facing flat surface and the other of the anteriolaterally facing flat surfaces.
  • [0020]
    With regard to features that can be used by the repositioners/extractors, each static trial (and each artificial intervertebral disc that the trials approximate) preferably includes at least two holes extending longitudinally into one of the baseplates of the trial or disc from the inwardly facing surface of the baseplate. More than two holes can be used to provide for multiple repositioning/extracting approaches. Preferably, in order for the same repositioning/extracting tool to be used for multiple approaches on the same trial or artificial intervertebral disc; adjacent holes should be separated by the same distance separating other adjacent holes.
  • [0021]
    As discussed in greater detail below with regard to the repositioners/extractors, in order to engage two of the holes, each repositioner extractor has two pins extending in parallel from a central shaft, perpendicular to the longitudinal axis of the central shaft. The pins can be inserted into the holes, and pulling or pushing on the central shaft along its longitudinal axis when the holes are engaged pulls or pushes the static trial or artificial intervertebral disc in the intervertebral space. Further, because two holes are engaged, the static trial or artificial intervertebral disc can be rotated in either direction about a longitudinal axis passing through the intervertebral space, by rotating of the central shaft of the repositioner/extractor about its distal end, about an axis parallel to the longitudinal axes of the pins.
  • [0022]
    On each repositioner/extractor, the pins are formed on prongs that extend laterally from the central shaft. The direction of the prongs, and the location of the pins relative to the central shaft, determine the angle or angles of surgical approach for which a particular repositioner/extractor can be used. Further, the number and location of holes further determine the angle or angles of surgical approach for which a particular repositioner/extractor can be used. Accordingly, the present invention contemplates a variety of repositioner/extractors, and a variety of holes configurations, to provide the surgeon with a variety of possible surgical approach angles.
  • [0023]
    As described in greater detail below, three repositioner/extractors are illustrated and described (symmetric, offset left, and offset right) for example, and, for example, two hole configurations are illustrated and described. A first hole configuration includes the hole configuration described above, that is, three holes on one of the baseplates (e.g., the lower baseplate), the holes being configured so that a first hole is located in the anterior-posterior plane, and the adjacent (second and third) holes are located in respective opposing ariteriolateral planes on either side of the first hole. A second hole configuration includes four holes on one of the baseplates (e.g., the upper baseplate), the holes being configured so that first and second holes straddle the anterior-posterior plane, a third hole is located so that the third hole and the first hole straddle one of the opposing anteriolateral planes, and a fourth hole is located so that the fourth hole and the second hole straddle the other of the opposing anteriolateral planes.
  • [0024]
    With further regard to the static trial holder described herein, the static trial holder is provided primarily for use in holding, inserting, removing, and otherwise manipulating the static trials described herein. Preferably, the static trial holder has a pair of opposing prongs that open away from one another and dose toward one another. Each of the prongs has a semicircular extent and the semicircular extents face one another to define a circular holding enclosure that is useful for capturing the cylindrical trunk of the static trial between them. The prongs are spring biased toward a neutral position such that the holding enclosure is spring biased to a receptive state in which the cylindrical trunk can be snapped into (or out of) the holding enclosure by temporarily placing the holding enclosure in an expanded state (by forcing the cylindrical trunk against the mouth of the enclosure) that allows passage of the cylindrical trunk through the mouth of the enclosure. Once the cylindrical trunk is in the enclosure, the holding enclosure can be placed in a contracted state, or locked, where the trial is more securely held, so that the trial will not escape the holding enclosure as it is experiencing greater forces while being inserted and removed from the intervertebral space. This locking is effected by rotating a sleeve that surrounds the prongs. The bore of the sleeve is configured to press the prongs together when the sleeve is rotated a quarter turn, and to allow them to separate when the sleeve is again rotated a quarter turn (in either direction). The sleeve is biased toward stopping its rotation at either the “locked” or “unlocked” states of the holding enclosure, by the cooperation of recesses on the extension's outer surface and corresponding spring plungers radially disposed to project from the sleeve's inner surface. It should be understood that when the static trial is being held (either when the holding enclosure is in its receptive state or in its contracted state), because the semicylindrical extents fit within the annular groove of the static trial, the static trial will not escape from the enclosure along the longitudinal axis of the cylindrical trunk. While the static trial holder is discussed herein as primarily used for manipulating the static trials, it preferably is also useful for manipulating the distraction spacers described in the '127 application, in that the semicircular extents of the pincers preferably also interact with the annular grooves and cylindrical trunk of those distraction spacers in the same manner as described herein.
  • [0025]
    With regard to the dynamic trial described herein, the dynamic trial is provided primarily for distracting an intervertebral space according to the procedures described herein and/or for determining the appropriate size of an artificial intervertebral disc to be implanted (or whether a particular size can be implanted) into the distracted intervertebral space. While the distraction systems and methods described in the '127 application are also useful for distracting an intervertebral space, the dynamic trial is provided as an additional or alternate distraction tool. Further, while the static trials described herein as useful for determining the appropriate size of an artificial intervertebral disc to be implanted (or whether a particular size can be implanted), the dynamic trial is provided as an additional or alternate sizing tool.
  • [0026]
    The dynamic trial preferably includes a shaft having a bifurcated trial at a distal end. Each half of the bifurcated trial preferably has on its outwardly facing surface a convex dome that is shaped like the convex dome of the corresponding baseplate of the artificial intervertebral disc that the dynamic trial approximates. The shaft includes an inner shaft portion that centrally divides into upper and lower distal extensions that, from the point of division to their distal ends, are each biased toward positions in which they converge toward one another. The lower distal extension is connected to the lower half of the bifurcated trial, and the upper distal extension is connected to the upper half of the bifurcated trial. Preferably, the upper half is adjustably connected to the upper distal extension by a pivot pin that allows the upper half to rotate about a lateral axis that passes through the longitudinal and lateral center of the bifurcated trial. This axis of rotation allows the upper half, when separating from the lower half, to adjust to the orientation of the upper vertebral bone without causing the bone to hinge relative to the lower vertebral bone. In order to effect the separation of the upper and lower halves, the shaft further includes an outer shaft potion that is translatable adjacent the inner shaft portion, the outer shaft portion having a pin that passes between the distal extensions.
  • [0027]
    The outer shaft portion is preferably translatable distally by the forward movement of a control knob near the proximal end of the shaft, and translatable proximally by backward movement of the control knob. As the outer shaft portion is pushed distally, the pin is pushed distally to overcome the bias of the divided extensions to separate them and correspondingly separate the halves of the bifurcated trial. Preferably, markings are provided on the inner shaft portion to quantify the depth (to which the bifurcated trial has been expanded) corresponding to the distance that the outer shaft portion has been translated with respect to the inner shaft portion. It is anticipated that the pushing force required to separate the halves will increase as they separate, due to the compression of the spine seeking to close the intervertebral space and the annulus seeking to prevent the adjacent vertebral discs from separating beyond a certain point. Therefore, to provide a mechanical advantage to the operator in the event that greater distraction is required, but the operator cannot push the control knob farther with unaided human effort, an fine control knob is provided. The fine control knob is preferably threaded onto the proximal end of the inner shaft portion, proximal to the control knob. Thus, rotation of the fine control knob about the longitudinal axis of the inner shaft portion will cause the body of the fine control knob to press against the control knob to move it farther distally. The interference of the threads of the fine control knob-inner shaft portion interface prevents the fine control knob from backing up proximally unless the fine control knob is reverse rotated to effect that result. Finally, the proximal end of the shaft is preferably flanged to serve as a slap hammer for impaction; if necessary for proper positioning of the bifurcated trial, and/or forced extraction of the bifurcated trial.
  • [0028]
    With further regard to the inserter/impactor described herein, the inserter/impactor is provided primarily for holding, inserting, repositioning, removing, impacting, extracting, and otherwise manipulating an artificial intervertebral disc (or static trial) having features suitable for being manipulated by the inserter/impactor. Exemplary suitable artificial intervertebral discs are described in the '160 application with regard to FIGS. 8 a-y, 9 a-t, 10 a-t, 11 a-j, and 12 a-o thereof and by the accompanying descriptions therefor (e.g., embodiments identified as the first, second, third, fourth, and fifth preferred embodiments of the fourth embodiment family, etc.). Regarding the features suitable for being manipulated by the inserter/impactor, such features include those discussed above as being suitable features on the static trials and artificial intervertebral disc, namely, an anteriorly facing flat surface on the second (e.g., lower) baseplate of the trial or disc, flanked by two anteriolaterally facing flat surfaces (one on each side of the anteriorly facing flat surface), and, to provide for holding of the trial or disc for an anterior insertion approach, a hole spaced from the anteriorly facing flat surface, the hole having a longitudinal axis parallel to the anteriorly facing flat surface.
  • [0029]
    The inserter/impactor includes a shaft having a distal end that has angled flat surfaces corresponding to and fittable against the angled flat surfaces of the static trial or artificial intervertebral disc, and a holding pin that extends from the center flat surface along a longitudinal axis of the shaft, the pin having a distal end that bends downward. The holding pin is spring loaded in a central channel of the shaft, so that it is biased toward and against the central flat surface (preferably, the bent end of the pin prevents it from entering the central channel). A flange, mechanically connected to the pin and translating adjacent the shaft, can be pushed distally to overcome the bias of the spring to space the pin away from the central flat surface. In this position, the pin can be inserted in the hole in the baseplate of the artificial intervertebral disc. Releasing the knob allows the spring to pull the pin back, causing the anteriorly facing surface of the baseplate to be held against the central flat surface of the inserter/impactor and the anteriolaterally facing flat surfaces of the artificial intervertebral disc to be held against the other corresponding flat surfaces of the inserter/impactor. A knob on the inserter/impactor can be rotated about the longitudinal axis of the shaft to pull the pin tighter and lock its position to more securely hold the baseplate, and reverse rotated to unlock and loosen the pin.
  • [0030]
    When the static trial or artificial intervertebral disc is held in this manner, rotation of the trial or disc about its longitudinal axis relative to the inserter/impactor is prevented by interference of the corners of the trial's or disc's flat surfaces and the corners of the inserter/impactor's flat surfaces, similar to the manner in which a wrench holding a nut prevents rotation of the nut relative to the wrench. Further, the holding of the trial or disc in this manner allows for some repositioning of the trial or disc in the intervertebral space via rotation of the trial or disc in either direction about the longitudinal axis of the intervertebral space.
  • [0031]
    Preferably, both of the baseplates of the static trial or disc have similarly configured and oriented flat surfaces, and both baseplates' flat surfaces fit against the angled flat surfaces of the inserter/impactor, to provide for a more secure holding of the static trial or disc by the inserter/impactor.
  • [0032]
    Also preferably, in order to provide for a holding of the static trial or disc for two additional (here, anteriolateral) insertion approaches, each static trial or disc also includes two additional holes, one spaced apart from one of the anteriolaterally facing flat surfaces, and the other spaced apart from the other of the anteriolaterally facing flat surfaces. Accordingly, operation of the inserter/impactor can fit the holding pin into either of these two additional holes, and hold the associated anteriolaterally facing flat surface (the one associated with the hole into which the pin is fit) of the static trial or disc against the flat surface of the inserter/impactor opposite the pin. It should be understood that preferably, in order to facilitate these two additional approaches, the angle separating the anteriorly facing flat surface of the static trial or disc and one of the anteriolaterally facing flat surfaces of the static trial or disc is equal to the angle separating the anteriorly facing flat surface and the other of the anteriolaterally facing flat surfaces.
  • [0033]
    Also preferably, as shown the baseplates of each of the plurality of static trials are appropriately lordotically angled relative to one another to ease insertion of the static trial or artificial intervertebral disc into the intervertebral space and to mimic how the artificial intervertebral disc will typically be oriented as it is being inserted.
  • [0034]
    With further regard to the repositioners/extractors described herein, each repositioner/extractor is provided primarily for repositioning and/or extracting a static trial or artificial intervertebral disc having features suitable for being manipulated by the repositioner/extractor. Exemplary suitable artificial intervertebral discs are described in the '160 application with regard to FIGS. 8 a-y, 9 a-t, 10 a-t, 11 a-j, and 12 a-o thereof and by the accompanying descriptions therefor (e.g., embodiments identified as the first, second, third, fourth, and fifth preferred embodiments of the fourth embodiment family, etc.). Regarding the features suitable for being manipulated by each repositioner/extractor, such features include at least two holes extending longitudinally into one of the baseplates of the static trial or artificial intervertebral disc from the inwardly facing surface of the baseplate. More than two holes can be used to provide for multiple repositioning/extracting approaches. Preferably, in order for the same repositioning/extracting tool to be used for multiple approaches on the same trial or artificial intervertebral disc, adjacent holes should be separated by the same distance separating other adjacent holes.
  • [0035]
    In order to engage the two holes, each repositioner/extractor has two pins extending in parallel from a central shaft, perpendicular to the longitudinal axis of the central shaft. The pins are spaced to engage the two holes simultaneously, and each pin has a diameter smaller than the diameter of the hole it is to engage. Therefore, the pins can be inserted into the holes, and pulling or pushing on the central shaft along its longitudinal axis when the holes are engaged pulls or pushes the static trial or artificial intervertebral disc in the intervertebral space. Further, because two holes are engaged, the static trial or artificial intervertebral disc can be rotated in either direction about a longitudinal axis passing through the intervertebral space, by rotating of the central shaft of the repositioner/extractor about its distal end, about an axis parallel to the longitudinal axes of the pins. A handle at a proximal end of the central shaft is useful for pushing or pulling on the shaft A flange adjacent the proximal end of the shaft is useful for impaction (either with a distally directed force or a proximally directed force), if necessary to manipulate the shaft.
  • [0036]
    On each repositioner/extractor, the pins are formed on prongs that extend laterally from the central shaft. The direction of the prongs, and the location of the pins relative to the central shaft, determine the angle or angles of surgical approach for which a particular repositioner/extractor can be used. Further, the number and location of holes further determine the angle or angles of surgical approach for which a particular repositioner/extractor can be used. Accordingly, the present invention contemplates a variety of repositioner/extractors, and a variety of holes configurations, to provide the surgeon with a variety of possible surgical approach angles.
  • [0037]
    With further regard to the leveler described herein, the leveler is provided primarily for establishing a parallel orientation of the baseplates (relative to one another), and/or securing the purchase of the stabilizig spikes, of an artificial intervertebral disc having features suitable for being manipulated by the leveler. Exemplary suitable artificial intervertebral discs are described in the '160 application with regard to FIGS. 8 a-y, 9 a-t, 10 a-t, 11 a-j, and 12 a-o thereof and by the accompanying descriptions therefor (e.g., embodiments identified as the first, second, third, fourth, and fifth preferred embodiments of the fourth embodiment family, etc.). Regarding the features suitable for being manipulated by the leveler, such features include suitably formed inwardly facing surfaces of the baseplates of the artificial intervertebral disc.
  • [0038]
    More particularly, the leveler includes a shaft having a forked distal end formed by two opposing tongs that are symmetric to one another about a longitudinal axis of the shaft. Each of the tongs has an extent that initially curves laterally outward away from the shaft and from the other tong's extent, to define a central pocket forward of the shaft between the tongs' extents. Each tong's extent then resumes a distal direction to become parallel to the shaft and to the other tong's extent.
  • [0039]
    Each tong's extent has an upper surface and a lower surface. The upper surface is preferably shaped to conform against the inwardly facing surface of a first (e.g., upper) baseplate of an artificial intervertebral disc, and the lower surface is preferably shaped to conform against the inwardly facing surface of a second (e.g., lower) baseplate of the artificial intervertebral disc, so that insertion of the forked distal end of the leveler between the baseplates, with the central pocket of the distal end avoiding the central portion of the artificial intervertebral disc, and with the upper and lower surfaces so engaging the inwardly facing surfaces of the baseplates, causes the baseplates to be placed in parallel orientation with respect to one another. A handle is provided at a proximal end of the shaft for pushing, pulling, and otherwise manipulating the leveler as needed.
  • [0040]
    When the artificial intervertebral disc is inserted into the intervertebral space, its baseplates will typically be lordotically angled with respect to one another. The leveler can be applied to the artificial intervertebral disc to bring the baseplates parallel to one another. The forked distal end of the leveler is inserted so that the tongs' extents are placed between the inwardly facing surfaces of the baseplates, and so that the central pocket of the leveler avoids that portion of the artificial intervertebral disc that joins the baseplates. As the leveler is inserted, the tongs act as wedges to force the posterior portions of the baseplates away from one another. Accordingly, as the posterior portions are being separated, the stabilizing spikes on the outwardly facing surfaces of the baseplates find or secure their purchase in the hard bone of the outer ring of the vertebral body endplates. When the forked distal end is fully seated, the extents of the tongs hold the baseplates' parallel to one another, and so that the spikes are fully engaged in the endplates.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • [0041]
    FIGS. 1 a-f show front (FIG. 1 a), side (FIG. 1 b), perspective (FIG. 1 c), top (FIG. 1 d), bottom cutaway (FIG. 1 e) and top cutaway (FIG. 1 f) views of a static trial of the present invention
  • [0042]
    FIGS. 1 g-n show front (FIG. 1 g), side cutaway (FIG. 1 h), top (FIG. 1 i), side cutaway (FIG. 1 j), bottom cutaway (FIG. 1 k), top cutaway (FIG. 1 l), bottom perspective (FIG. 1 m), and top perspective (FIG. 1 n) views of an exemplary artificial intervertebral disc of the present invention.
  • [0043]
    FIGS. 2 a-k show top (FIG. 2 a), side (FIG. 2 b), perspective (FIG. 2 c), disassembly (FIG. 2 d-j), and side cutaway (FIG. 2 k) views of a static trial holder of the present invention
  • [0044]
    FIGS. 3 a-d show side (FIG. 3 a), top (FIG. 3 b), side cutaway (FIG. 3 c), and perspective (FIG. 3 d) views of a dynamic trial of the present invention.
  • [0045]
    FIGS. 4 a-d show side (FIG. 4 a), top (FIG. 4 b), side cutaway (FIG. 4 c), and perspective (FIG. 4 d) views of an inserter/impactor of the present invention.
  • [0046]
    FIGS. 4 e-h show side (FIG. 4 e), top (FIG. 4 f), side cutaway (FIG. 4 g), and perspective (FIG. 4 h) views of an inserter/impactor of the present invention holding a static trial of the present invention.
  • [0047]
    FIGS. 4 i-j show top views of an inserter/impactor of the present invention holding a static trial of the present invention in two alternative ways.
  • [0048]
    FIGS. 4 k-n show side (FIG. 4 k), top (FIG. 4 l), side cutaway (FIG. 4 m), and perspective (FIG. 4 n) views of an inserter/impactor of the present invention holding an exemplary artificial intervertebral disc of the present invention.
  • [0049]
    FIGS. 4 o-p show top views of an inserter/impactor of the present invention holding an exemplary artificial intervertebral disc of the present invention in two alternative ways.
  • [0050]
    FIGS. 5 a-c show side (FIG. 5 a), top (FIG. 5 b), and perspective (FIG. 5 c) views of a symmetric repositioner/extractor of the present invention.
  • [0051]
    FIGS. 5 d-f show side (FIG. 5 d), top (FIG. 5 e), and perspective (FIG. 5 f) views of an offset left repositioner/extractor of the present invention.
  • [0052]
    FIGS. 5 g-i show side (FIG. 5 g), top (FIG. 5 h), and perspective (FIG. 5 i) views of an offset right repositioner/extractor of the present invention.
  • [0053]
    FIGS. 5 j-l show side (FIG. 5 j), top (FIG. 5 k), and perspective (FIG. 5 l) views of an alternative offset left repositioner/extractor of the present invention.
  • [0054]
    FIGS. 5 m-o show side (FIG. 5 m), top (FIG. 5 n), and perspective (FIG. 5 o) views of an alternative offset right repositioner/extractor of the present invention.
  • [0055]
    FIGS. 5 p-u show exemplary various possible repositioner/extractor approach angles with a three hole configuration of the present invention.
  • [0056]
    FIGS. 5 v-dd show exemplary various possible repositioner/extractor approach angles with a four hole configuration of the present invention.
  • [0057]
    FIGS. 6 a-d bottom (FIG. 6 a), side (FIG. 6 b), front (FIG. 6 c), top partial perspective (FIG. 6 d), and bottom partial perspective (FIG. 6 e) views of a leveler of the present invention.
  • DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
  • [0058]
    While the invention will be described more fully hereinafter with reference to the accompanying drawings, it is to be understood at the outset that persons skilled in the art may modify the invention herein described while achieving the functions and results of the invention. Accordingly, the descriptions that follow are to be understood as illustrative and exemplary of specific structures, aspects and features within the broad scope of the invention and not as limiting of such broad scope. Like numbers refer to similar features of like elements throughout.
  • [0059]
    A preferred embodiment of a static trial of the present invention, and a preferred embodiment of an artificial intervertebral disc of the present invention, both for use with the instrumentation of the present invention, will now be described.
  • [0060]
    Referring now to FIGS. 1 a-f, a static trial of the present invention is shown in front (FIG. 1 a), side (FIG. 1 b), perspective (FIG. 1 c), top (FIG. 1 d), bottom cutaway (FIG. 1 e) and top cutaway (FIG. 1 f) views. Referring now to FIGS. 1 g-n, an artificial intervertebral disc of the present invention is shown in front (FIG. 1 g), side cutaway (FIG. 1 h), top (FIG. 1 i), side cutaway (FIG. 1 j), bottom cutaway (FIG. 1 k), top cutaway (FIG. 1 l), bottom perspective (FIG. 1 m), and top perspective (FIG. 1 n) views.
  • [0061]
    It should be understood that the illustration and reference herein to the artificial intervertebral disc shown in FIGS. 1 g-n is merely to show an example of one type of artificial intervertebral disc that is contemplated by, encompassed by, and suitable for use with, the present invention, and that such illustration and reference herein is not meant to limit the scope of the present invention or limit the uses of the present invention. Rather, any other artificial intervertebral disc (or any other orthopedic device) having suitable features for being manipulated by the instrumentation and methods described herein are contemplated by the present invention. Indeed, the features suitable for manipulation (e.g., angled flat surfaces with adjacent holes) are encompassed by the present invention, regardless of to what orthopedic device they may be applied. Other exemplary suitable artificial intervertebral discs include, but are not limited to, the artificial intervertebral discs described in the '160 application with regard to FIGS. 8 a-y, 9 a-t, 10 a-t, 11 a-j, and 12 a-o thereof and by the accompanying descriptions therefor (e.g., embodiments identified as the first, second, third, fourth, and fifth preferred embodiments of the fourth embodiment family, etc.). It should be noted that, as can be seen from FIGS. 1 g-n, that the artificial intervertebral disc shown in FIGS. 1 g-n has features similar to those of these other suitable artificial intervertebral discs of the '160 application, and it should be understood that such similar features are structurally and functionally as described in the '160 application. Such similar features include an inwardly facing surface 164 a of the upper baseplate 164 a, and a convex structure 162 on the lower baseplate 168 b, the convex structure 162 having an inwardly facing surface 164 b.
  • [0062]
    And, while the instrumentation described herein (e.g., the static trials, static trial holder, dynamic trial, inserter/impactor, repositioners/extractors, and leveler) will be discussed for use with the artificial intervertebral disc of FIGS. 1 g-n, such discussions are merely by way of example and not intended to be limiting of their uses. Thus, it should be understood that the tools can be used with any of the artificial intervertebral discs disclosed in the '160 application, or any other artificial intervertebral disc having (or being modifiable or modified to have) suitable features therefor. Moreover, it is anticipated that the features of the artificial intervertebral disc (e.g., the flat surfaces and accompanying holes) and/or the static trials (e.g., the cylindrical trunks and flat surfaces and accompanying holes) that are used by the tools discussed herein to hold and/or manipulate these devices (such features, it should be noted, were first shown and disclosed in the '160 application and the '127 application) can be applied, individually or collectively or in various combinations, to other trials, spacers, artificial intervertebral discs or other orthopedic devices as stand-alone innovative features for enabling such trials, spacers, artificial intervertebral discs, or other orthopedic devices to be more efficiently and more effectively held and/or manipulated by the tools described herein or by other tools having suitable features. In addition, it should be understood that the invention encompasses artificial intervertebral discs, spacers, trials (static or dynamic), and/or other orthopedic devices, that have one or more of the features disclosed herein, in any combination, and that the invention is therefore not limited to artificial intervertebral discs, spacers, trials, and/or other orthopedic devices having all of the features simultaneously.
  • [0063]
    A plurality of static trials 100 are provided primarily for use in determining the appropriate size of an artificial intervertebral disc to be implanted (or whether a particular size of the artificial intervertebral disc can be implanted) into the distracted intervertebral space (e.g., the artificial intervertebral disc 160 of FIGS. 1 g-n). Preferably, for each artificial intervertebral disc to be implanted, a plurality of sizes of the artificial intervertebral disc would be available. That is, preferably, a plurality of the same type of artificial intervertebral disc would be available, each of the plurality having a respective width and depth dimension combination that allows it to fit within a correspondingly dimensioned intervertebral space. For example, the plurality of artificial intervertebral discs could include artificial intervertebral discs having widths being either 35 mm or 40 mm, and depths ranging from 14 mm to 18 mm in 1 mm increments, for a total of 10 discs. Accordingly, preferably, each of the plurality of static trials 100 for use with a particular plurality of differently sized artificial intervertebral discs would have a respective width and depth dimension set corresponding to the width and depth of a respective one of the plurality of differently sized artificial intervertebral discs. For example, the plurality of static trials 100 for use with the set of artificial intervertebral discs described for example could include static trials 100 having widths being either 35 mm or 40 mm, and depths ranging from 14 mm to 18 mm in 1 mm increments, for a total of 10 static trials. It should be understood that the artificial intervertebral discs and/or the static trials 100 can be offered in a variety of dimensions without departing from the scope of the invention, and that the dimensions specifically identified and quantified herein are merely exemplary. Moreover, it should be understood that the set of static trials 100 need not include the same number of trials for each artificial intervertebral disc in the set of artificial intervertebral discs, but rather, none, one, or more than one trial can be included in the trial set for any particular artificial intervertebral disc in the set
  • [0064]
    Each of the static trials (the static trial 100 shown is exemplary for all of the static trials in the plurality of static trials; preferably the static trials in the plurality differ from one another only with regard to overall dimensions as described above) includes at least one feature that can be gripped by a tool. Suitable tools include, but are not limited to, the static trial holder 200 described below, the inserter/impactor 400 described below, and the repositioners/extractors 510,520,530,540 described below. Specifically, the static trial 100 includes a recess 102 that can be gripped by the opposing semicircular extents 216 a-b of the static trial holder 200. Preferably, this recess 102 forms an annular groove 104 that establishes a cylindrical trunk 106 between the upper and lower baseplates 108 a-b of the static trial 100, such that the baseplates 108 a-b extend as flanges 110 a-b from either end of the cylindrical trunk 106. Accordingly, preferably, the opposing semicircular extents 216 a-b each have a thickness smaller than the width of the annular groove 104, and as such fit into the annular groove 104 to grip the cylindrical trunk 106 between them.
  • [0065]
    In some embodiments, while not shown in FIGS. 1 a-f, it is also preferable that the annular groove 104 radially widen outwardly, such that the walls 112 of the annular groove 104 are tapered toward one another with the increasing depth of the groove 104, such that the floor 114 of the groove 104 is more narrow than the opening 116 of the groove 104. Accordingly, preferably, in such embodiments, each semicircular extent 216 a-b correspondingly radially widens outwardly, such that the thinner portion of the extent 216 a-b fits closer to the floor 114 of the annular groove 104, so that the tapered surfaces of the extents 216 a-b compress against the tapered walls 112 of the annular groove 104 when the static trial 100 is gripped by the static trial holder 200. This taper locking provides for a secure grip so that the static trial 100 can be manipulated accurately and efficiently.
  • [0066]
    In some embodiments, while not shown in FIGS. 1 a-f, it is also preferable that the floor of the annular groove 104 of the cylindrical trunk 106 be ridged (e.g., have ridges that run parallel to the longitudinal axis of the cylindrical trunk), and the surfaces of the semicircular extents 216 a-b of the static trial holder 200 that compress against the floor of the annular groove 104 when the static trial holder 200 grips the static trial 100 be correspondingly provided with ridges. The interlocking of the ridges of the static trial 100 with the ridges of the static trial holder 200 when the static trial 100 is gripped prevents rotation of the static trial 100 about the longitudinal axis of the cylindrical trunk 106 with respect to the static trial holder 200.
  • [0067]
    Additionally with regard to features that can be gripped by a tool, each of the static trials includes at least one feature that can be gripped by a tool that preferably is also used to grip the artificial intervertebral disc that the trial approximates. Suitable tools that can grip both the trial and the artificial intervertebral disc include, but are not limited to, the inserter/impactor 400 described below. Specifically, for being gripped by the inserter/impactor 400, each static trial 100 and artificial intervertebral disc 160 includes an anteriorly facing flat surface 120 b,180 b, flanked by two anteriolaterally facing flat surfaces 120 a,180 a and 120 c,180 c (one on each side of the anteriorly facing flat surface 120 b,180 b), and, to provide for holding of the static trial 100 or disc 160 for an anterior insertion approach, a hole 122 b,182 b spaced from the anteriorly facing flat surface, the hole 122 b,182 b having a longitudinal axis parallel to the anteriorly facing flat surface 120 b,180 b.
  • [0068]
    The holding pin 408 of the inserter/impactor 400 fits within the hole 122 b,182 b, and the angled flat surfaces 120 a-c,180 a-c of the static trial 100 or disc 160 fit against the correspondingly angled flat surfaces 420 a-c of the inserter/impactor 400, and operation of the inserter/impactor 400 pulls the holding pin 408 toward the flat surface 120 b,180 b of the inserter/impactor 400 opposite the pin 408, to rigidly hold the static trial 100 or disc 160 by the structure of the static trial 100 or disc 160 having the hole 122 b,182 b (e.g., the baseplate 108 b,168 b). When the static trial 100 or disc 160 is held in this manner, rotation of the static trial 100 or disc 160 about a longitudinal axis (of the static trial 100 or disc 160) relative to the inserter/impactor 400 is prevented by interference of the corners of the static trial's 100 or disc's 160 flat surfaces 120 a-c,180 a-c and the corners of the inserter/impactor's 400 flat surfaces 420 a-c, similar to the manner in which a wrench holding a nut prevents rotation of the nut relative to the wrench. Further, the holding of the static trial 100 or disc 160 in this manner allows for some repositioning of the static trial 100 or disc 160 in the intervertebral space via rotation of the static trial 100 or disc 160 in either direction about the longitudinal axis of the intervertebral space.
  • [0069]
    Preferably, both of the baseplates of the static trial 100 or disc 160 have similarly configured flat surfaces. For example, the lower baseplate's 108 b,168 b flat surfaces 120 a-c,180 a-c have similarly configured and similarly oriented counterpart flat surfaces 120 d-f,180 d-f on the upper baseplate 108 a,168 a. Further preferably, both baseplates' 108 a-b,168 a-b flat surfaces 120 a-f,180 a-f face the angled flat surfaces 420 a-c of the inserter/impactor 400 when the static trial 100 or disc 160 is held by the inserter/impactor 400. For example, as discussed below with regard to the inserter/impactor 400, in an anterior approach for the trial 100 (as shown in FIGS. 4 e-h), 120 a and 120 d facing 420 a, 120 b and 120 e facing 420 b, and 120 c and 120 f facing 420 c, and in an anterior approach for the disc 160 (as shown in FIGS. 4 k-n), 180 a and 180 d facing 420 a, 180 b and 180 e facing 420 b, and 180 c and 180 f facing 420 c.
  • [0070]
    It should be noted that preferably, when the static trial 100 is held by the inserter/impactor 400, the flat surfaces 120 a-c and the counterpart flat surfaces 120 d-f are tightly held against the angled flat surfaces 420 a-c of the inserter/impactor 400 as described above. It is also preferable that the baseplates 108 a-b of each of the plurality of static trials 100 be appropriately lordotically angled relative to one another to ease insertion of the static trial 100 into the intervertebral space and to mimic how the artificial intervertebral disc 160 will typically be oriented as it is being inserted using the inserter/impactor 400, and to ease insertion of the static trial 100 into the intervertebral space. While not shown in FIGS. 1 a-f, in some embodiments, when the static trials 100 are formed in such a lordotically oriented configuration, it is preferable that the flat surfaces 120 d-f on the first (e.g., upper) baseplate 108 a be parallel to the flat surfaces 120 a-c of the second (e.g., lower) baseplate 108 b in the static trial's 100 appropriately lordotically oriented configuration, so that when the static trial 100 is held tightly by the inserter/impactor 400, the flat surfaces 120 a-f are flush with the flat surfaces 420 a-c of the inserter/impactor 400 even though the baseplates 108 a-b are lordotically angled with respect to one another.
  • [0071]
    By contrast, preferably, when the artificial intervertebral disc 160 is held by the inserter/impactor 400, the flat surfaces 180 a-c are tightly held against the angled flat surfaces 420 a-c of the inserter/impactor 400 as described above, but the counterpart flat surfaces 180 d-f are loosely held against the angled flat surfaces 420 a-c of the inserter/impactor 400. As such, the structure of the artificial intervertebral disc 160 having the counterpart flat surfaces 180 d-f (e.g., the upper baseplate 168 a) is able to angulate and rotate to a limited extent relative to the structure of the artificial intervertebral disc 160 having the flat surfaces 180 a-c. This permits the artificial intervertebral disc 160 to adjust to the intervertebral space (e.g., to the angulation of the adjacent vertebral endplates, defining the intervertebral space, relative to one another) as it is being inserted thereinto. That is, typically, the adjacent vertebral endplates will be lordotically angled with respect to one another as a result of the intervertebral space being prepared and distracted. As the artificial intervertebral disc 160 is then inserted into the intervertebral space using the inserter/impactor 400, then, the baseplates 168 a-b will be permitted to lordotically angle with respect to one another to squeeze into the intervertebral space.
  • [0072]
    Also preferably, in order to provide for a holding of the static trial 100 or disc 160 for two additional (here, anteriolateral) insertion approaches, each static trial 100 or disc 160 also includes two additional holes 122 a,182 a and 122 c,182 c, one (e.g., 122 a,182 a) spaced apart from one of the anteriolaterally facing flat surfaces (e.g., 120 a,180 a), and the other (e.g., 122 c,182 c) spaced apart from the other of the anteriolaterally facing flat surfaces (e.g., 120 c,180 c). Accordingly, operation of the inserter/impactor 400 can fit the holding pin 408 into either of these two additional holes 122 a,182 a or 122 c,182 c, and hold the associated anteriolaterally facing flat surface (the one associated with the hole into which the pin 408 is fit) of the static trial 100 or disc 160 against the flat surface of the inserter/impactor 400 opposite the pin 408. For example, as discussed below with regard to the inserter/impactor 400, in a first anteriolateral approach for the trial 100 (as shown in FIG. 4 i), 120 a and 120 d facing 420 b, 120 b and 120 e not confronted, and 120 c and 120 f facing 420 a, and a first anteriolateral approach for the disc 160 (as shown in FIG. 4 o), 180 a and 180 d facing 420 b, 180 b and 180 e not confronted, 180 c and 180 f facing 0.420 a. And, for example, as discussed below with regard to the inserter/impactor 400, in a second anteriolateral approach for the trial 100 (as shown in FIG. 4 j), 120 a and 120 d facing 420 c, 120 b and 120 e facing 420 a, and 120 c and 120 f not confronted, and a second anteriolateral approach for the disc 160 (as shown in FIG. 4 p), 180 a and 180 d facing 420 c, 180 b and 180 e facing 420 a, 180 c and 180 f not confronted.
  • [0073]
    It should be understood that preferably, in order to facilitate these additional approaches, the angle separating the anteriorly facing flat surface of the static trial 100 or disc 160 and one of the anteriolaterally facing flat surfaces of the static trial 100 or disc 160 is equal to the angle separating the anteriorly facing flat surface and the other of the anteriolaterally facing flat surfaces. Preferably, the surfaces are angled with respect to one another at an angle of 33.4 degrees.
  • [0074]
    It should also be understood that the inclusion of additional adjacent angulated surfaces (or placing the angulated surfaces in other locations on the trial or disc), and/or including corresponding holes adjacent to such surfaces, can provide the surgeon with additional approaches, e.g., other anteriolateral approaches, directly lateral approaches, posteriolateral approaches, and/or directly posterior approaches. For example, a trial or disc can have angled surfaces (and corresponding holes) along the entire perimeter of one or both of the baseplates, and thus enable the surgeon to engage the trial or disc from a number of angles, including anterior, posterior, lateral, anteriolateral, and posteriolateral angles.
  • [0075]
    Additionally with regard to features that can be gripped by a tool, each of the static trials includes at least one feature that can be gripped by a tool that preferably is also used to grip the artificial intervertebral disc that the trial approximates. Suitable tools that can grip both the trial and the artificial intervertebral disc include, but are not limited to, the repositioners/extractors 500,510,520,530,540 described below. Specifically, for being gripped by the repositioners/extractors, each static trial 100 and artificial intervertebral disc 160 includes at least two holes extending longitudinally into one of the baseplates of the static trial 100 or artificial intervertebral disc 160 from the inwardly facing surface of the baseplate. More than two holes can be used to provide for multiple repositioning/extracting approaches. Preferably, in order for the same repositioning/extracting tool to be used for multiple approaches on the same trial or artificial intervertebral disc, adjacent holes should be separated by the same distance separating other adjacent holes.
  • [0076]
    As discussed in greater detail below with regard to the repositioners/extractors 500,510,520,530,540, in order to engage two of the holes, each repositioner/extractor has two pins extending in parallel from a central shaft, perpendicular to the longitudinal axis of the central shaft. The pins are spaced to engage the two holes simultaneously, and each pin has a diameter smaller than the diameter of the hole it is to engage. Therefore, the pins can be inserted into the holes, and pulling or pushing on the central shaft along its longitudinal axis when the holes are engaged pulls or pushes the static trial or artificial intervertebral disc in the intervertebral space. Further, because two holes are engaged, the static trial or artificial intervertebral disc can be rotated in either direction about a longitudinal axis passing through the intervertebral space, by rotating of the central shaft of the repositioner/extractor about its distal end, about an axis parallel to the longitudinal axes of the pins. A handle at a proximal end of the central shaft is useful for pushing or pulling on the shaft. A flange adjacent the proximal end of the shaft is useful for impaction (either with a distally directed force or a proximally directed force), if necessary to manipulate the shaft.
  • [0077]
    On each repositioner/extractor, the pins are formed on prongs that extend laterally from the central shaft. The direction of the prongs, and the location of the pins relative to the central shaft, determine the angle or angles of surgical approach for which a particular repositioner/extractor can be used. Further, the number and location of holes further determine the angle or angles of surgical approach for which a particular repositioner/extractor can be used. Accordingly, the present invention contemplates a variety of repositioner/extractors, and a variety of holes configurations, to provide the surgeon with a variety of possible surgical approach angles.
  • [0078]
    As described in greater detail below, three repositioner/extractors are illustrated and described (symmetric, offset left, and offset right) for example, and, for example, two hole configurations are illustrated and described. Referring again to FIGS. 1 a-n, a first hole configuration includes the hole configuration described above, that is, three holes on one of the baseplates (e.g., the lower baseplate 108 b,168 b), the holes being configured so that a first hole 122 b,182 b is located in the anterior-posterior plane, and the adjacent (second 122 a,182 a and third 122 c,182 c) holes are located in respective opposing anteriolateral planes on either side of the first hole 122 b,182 b. (This hole configuration is also shown in FIGS. 5 p-u, each of which shows a top cutaway view of the artificial intervertebral disc 160 of FIGS. 1 g-n, showing its lower baseplate 168 b, having the first hole configuration, engaged by one of the repositioners/extractors 500,510,520. Each view of the lower baseplate 168 b shows the first hole 182 b, the second hole 182 a, and the third hole 182 c of the first hole configuration.)
  • [0079]
    Referring again to FIGS. 1 a-n, a second hole configuration includes four holes on one of the baseplates (e.g., the upper baseplate 108 a,168 a), the holes being configured so that first (e.g., 130 c,190 c) and second (e.g., 130 b,190 b) holes straddle the anterior-posterior plane, a third hole (e.g., 130 d,190 d) is located so that the third hole and the first hole straddle one of the opposing anteriolateral planes, and a fourth hole (e.g., 130 a,190 a) is located so that the fourth hole and the second hole straddle the other of the opposing anteriolateral planes. (This hole configuration is also shown in FIGS. 5 v-dd, each of which shows a bottom cutaway view of the artificial intervertebral disc of FIGS. 1 g-n, showing its upper baseplate 168 a, having the second hole configuration, engaged by one of the repositioners/extractors 500,510,520. Each view of the upper baseplate shows the first hole 190 c, the second hole 190 b, the third hole 190 d, and the fourth hole 190 a, of the second hole configuration.)
  • [0080]
    It should be understood that configurations having more or fewer holes, and in a variety of locations, are contemplated by the invention, and the detailed descriptions of only two hole configurations is not meant to limit the invention to only these two configurations. Importantly, the invention encompasses using a hole or any number of holes, bored at any suitable angle, whether parallel to other holes or not, in any number of locations on a spacer, a trial or an artificial intervertebral disc (not limited to locations on the baseplates), for purposes of enabling the spacer, trial or disc to be gripped by a manipulation instrument (not limited to a repositioner/extractor) that engages the hole, and/or to enable the surgeon to work from a variety of approaches. For example, as described in more detail below, the first and second hole configurations described herein, in cooperation with the repositioner/extractors, provide the surgeon with the ability to work from a directly anterior approach, as well as several anteriolateral approaches. It should be understood that additional hole configurations can enable the surgeon to work from a directly posterior approach, posteriolateral approaches, directly lateral approaches, or anteriolateral approaches that are different that those illustrated. For example, the placement of one or more suitably spaced holes (or the addition of one or more holes) on the posterior edge, and/or one or both of the lateral edges of one or both of the baseplates, would enable the surgeon to use the repositioner/extractors of the present invention to achieve such approaches.
  • [0081]
    Thus, it can be seen that each of the repositioner/extractors can be used in more than one manner depending on the tool desired and the approach desired. These manners are described in greater detail below and illustrated in FIGS. 5 p-dd with regard to the detailed description of the repositioners/extractors.
  • [0082]
    Also preferably, the baseplates 108 a-b of each of the plurality of static trials 100 preferably has a convex dome 124 a-b on its outwardly facing surface 126 a-b that is shaped like the convex dome 184 a-b on the outwardly facing surface 186 a-b of the corresponding baseplate 168 a-b of the artificial intervertebral disc 160 that the static trial 100 approximates. Preferably, each convex dome 124 a-b is smooth, rather than having a porous coating that is preferred for the convex domes 184 a-b of the artificial intervertebral disc 160, and each outwardly facing surface 126 a-b does not have stabilizing spikes such as the stabilizing spikes 188 a-b on the outwardly facing surfaces 186 a-b of the artificial intervertebral disc 160. The omission of these device stabilizing and bone ingrowth encouraging structures and surfaces on the static trials 100 enables the surgeon to test the size of the artificial intervertebral disc 160 to be implanted without traumatically engaging the vertebral body endplates.
  • [0083]
    Accordingly, the surgeon can prepare and distract the intervertebral space, and then insert and remove at least one of the static trials (or more, as necessary) to find the size that is most appropriate for the intervertebral space.
  • [0084]
    A preferred embodiment of a static trial holder of the present invention will now be described.
  • [0085]
    Referring to FIGS. 2 a-c and 2 k, a static trial holder of the present invention is shown in side (FIG. 2 a), top (FIG. 2 b), perspective (FIG. 2 c), and side cutaway (FIG. 2 k) views. In addition, referring to FIGS. 2 d-f, a sleeve of the static trial holder is shown in side cutaway (FIG. 2 d), front (FIG. 2 e), and back (with partial cutaway) (FIG. 2 f) views. In addition, referring to FIGS. 2 g-i, an extension of the static trial holder is shown in top (FIG. 2 g), proximal cutaway (FIG. 2 h), side (FIG. 2 i), and distal cutaway (FIG. 2 j) views.
  • [0086]
    The static trial holder 200 is provided primarily for use in holding, inserting and removing the static trials described herein, or distraction spacers having suitable features therefor, such as the distraction spacers disclosed in the '127 application
  • [0087]
    More specifically, the static trial holder 200 includes a handle 202, an extension 204, and a sleeve 206. As shown in FIG. 2 k, the handle 202 and the extension 204 are fixed to one another (preferably by the distal end of the handle 202 being fixed to the proximal end of the extension 204) to form a shaft 208. The sleeve 206 surrounds the extension 204 and is rotatable with respect to the handle 202 and the extension 204 about the longitudinal axis of the shaft 208. The handle 202 preferably has an flange 232 at its proximal end for use in applying a distally or proximally directed force to get the static trial 100 (or distraction spacer) into or out of the intervertebral space, and/or for use in helping the surgeon rotate the sleeve 206 with respect to the extension 204 (by gripping the flange 232 and the control knob 219 described below).
  • [0088]
    The distal end of the extension 204 forms a contractable and expandable holding enclosure 210 in that the distal end is divided at a fulcrum 212 into two prongs 214 a-b, each of which terminates in a semicircular extent 216 a-b, each of which has a tapered end 215 a-b. The extents 216 a-b are oriented such that the tapered ends 215 a-b face one another to define a radially inwardly tapering mouth 213, and such that the semicircular openings oppose one another to define the holding enclosure 210. The prongs 214 a-b are spring biased toward a neutral position (preferably by the formation of the fulcrum 212 in combination with the strength of the material of which the extension 204 is made) such that the holding enclosure 210 is spring biased to a receptive state (described below), but the prongs 214 a-b can be brought together to contract the holding enclosure 210 to a contracted state, (described below) or the prongs 214 a-b can be further separated to expand the holding enclosure 210 to an expanded state (described below).
  • [0089]
    When the holding enclosure 210 is in the receptive state, the width of the mouth 213 of the holding enclosure 210 does not accommodate the diameter of the cylindrical trunk 106 of the static trial 100 (or distraction spacer) for passage therethrough. However, from this receptive state, the mouth 213 can be temporarily widened (placing the holding enclosure 210 in its expanded state) to accommodate the diameter (for passage of the cylindrical trunk 106 through the mouth 213), if a sufficient force is applied to overcome the neutral position bias of the prongs 214 a-b and thus widen the mouth 213. (Preferably, there is enough space between the outer surfaces of the prongs 214 a-b and the inner surface of the bore 218 of the sleeve, when the prongs 214 a-b are in their neutral position, so that the prongs 214 a-b can be separated without interference.) The sufficient force can be applied by pressing the cylindrical trunk 106 against the tapered ends 215 a-b of the mouth 213, in that the separating force component of the radially inward force of the pressing will be applied to the semicircular extents 216 a-b by the taper of the tapered ends 215 a-b. Because the holding enclosure 210 is biased toward the receptive state, after the cylindrical trunk 106 is passed through the mouth 213 and into the holding enclosure 210, the holding enclosure 210 will return to its receptive state in which the width of the mouth 213 does not allow passage of the cylindrical trunk 106 without the sufficient force. Preferably, the force required to widen the mouth 213 is greater than gravity and/or the greatest force that will be experienced by moving the static trial holder 200 prior to placing the holding enclosure 210 in the contracted state. Therefore, once the cylindrical trunk 106 is in the holding enclosure 210, even before the holding enclosure 210 is placed in its contracted state, the cylindrical trunk 106 will not escape the holding enclosure 210 as the static trial holder 200 is oriented with the holding enclosure 210 downward, or is moved about.
  • [0090]
    It should be understood that when the static trial 100 (or distraction spacer) is being held (either when the holding enclosure 210 is in its receptive state or in its contracted state discussed below), because the semicylindrical extents 216 a-b fit within the annular groove 104, of the static trial 100 (or distraction spacer), the static trial 100 (or distraction spacer) will not escape from the enclosure along the longitudinal axis of the cylindrical trunk 106. That is, as noted above, the recess 102 of each static trial 100 (or distraction spacer) forms an annular groove 104 that establishes the cylindrical trunk 106 between the baseplates of the static trial (or distraction spacer), such that the baseplates extend as flanges from either end of the cylindrical trunk 106. Accordingly, preferably, the opposing semicircular extents each have a thickness smaller than the width of the annular groove 104, and as such fit into the annular groove 104 to grip the cylindrical trunk 106 between them.
  • [0091]
    In some embodiments, while not shown in FIGS. 1 a-f or FIGS. 2 a-k, it is preferable that the annular groove 104 radially widen outwardly, such that the walls of the annular groove 104 taper toward one another with the increasing depth of the groove, such that the floor of the groove is more narrow than the opening 116 of the groove. Accordingly, preferably, in such embodiments, each semicircular extent 216 a-b correspondingly radially widens outwardly, such that the thinner portion of the extent 216 a-b fits closer to the floor of the annular groove 104, so that the tapered surfaces 215 a-b of the extents 216 a-b compress against the tapered walls of the annular groove 104 when the static trial 100 is gripped by the static trial holder 200. This taper locking provides for a secure grip so that the static trial 100 can be manipulated accurately and efficiently.
  • [0092]
    In some embodiments, while not shown in FIGS. 1 a-f or FIGS. 2 a-k, it is also preferable that the floor of the annular groove 104 of the cylindrical trunk 106 be ridged (e.g., have ridges that run parallel to the longitudinal axis of the cylindrical trunk), and the surfaces of the semicircular extents 216 a-b of the static trial holder 200 that compress against the floor of the annular groove 104 when the static trial holder 200 grips the static trial 100 be correspondingly provided with ridges. The interlocking of the ridges of the static trial 100 with the ridges of the static trial holder 200 when the static trial 100 is gripped prevents rotation of the static trial 100 about the longitudinal axis of the cylindrical trunk 106 with respect to the static trial holder 200.
  • [0093]
    In order to more tightly hold the static trial 100 (or distraction spacer) for manipulation of the static trial 100 (or distraction spacer) during surgical procedures in which greater forces will be experienced by the static trial 100 (or distraction spacer) and the static trial holder 200, the holding enclosure 210 can be placed in a contracted state. The holding encdosure 210 can be considered “unlocked” in its receptive or expanded states, and “locked” in its contracted state, with respect to the nature of the hold that the static trial holder 200 potentially can have or has on the cylindrical trunk 106. Preferably, when the holding enclosure 210 is locked, a force greater than that which is applicable by an unaided surgeon or nurse (i.e., that which can be applied to remove the cylindrical trunk 106 from the holding enclosure 210 when the holding enclosure 210 is in its receptive state), and greater than that which will be experienced by the static trial 100 (or distraction spacer) and the static trial holder 200 during surgical procedures) would be required to pull the cylindrical trunk 106 out of the holding enclosure 210. The placement of the holding enclosure 210 in its locked state or unlocked state is effected by operation of a holding assembly that includes the extension 204 and the sleeve 206 and the manner in which they are configured and interact.
  • [0094]
    More particularly, the prongs 214 a-b can be brought together, to lock the holding enclosure 210, by a rotation of the sleeve 206 with respect to the handle 202 and the extension 204 about the longitudinal axis of the shaft 208. A rotation control knob 219 is provided to ease the rotation of the sleeve 206. As shown in FIGS. 2 g and 2 i-j in view of FIGS. 2 d-e, the bore 218 of the sleeve 206 (shown in cutaway in FIG. 2 e) defines a cross-section that has a width 220 that is greater than its depth 222. Further as shown in those figures, the prongs 214 a-b when separated (shown in cutaway in FIG. 2 j) define a cross-section having a width 224 that is greater than its depth 226, the width 224 and depth 226 of the prongs' cross-section being closely accommodated by the width 220 and depth 222 of the bore's cross-section. When the prongs 214 a-b are together, the width of prongs' cross-section is closely accommodated by the depth 222 of the bore's cross-section. Thus, when the sleeve 206 is rotated with respect to the extension 204, the sides of the bore defining the depth 222 of its cross-section bear against the sides of the prongs 214 a-b defining the width of their cross-section.
  • [0095]
    It should be noted that in order to ease the rotation of the sleeve 210 so that the side of the bore 218 can bear against the sides of the prongs 214 a-b, the corners of the bore 218 are radiused, and at least the sides (that face away from one another) of the prongs 214 a-b are curved. Preferably, as shown, the prongs 214 a-b when separated define a partial cylindrical cross-section. The effect of the bearing (of the sides of the bore 218 against the sides of the prongs 214 a-b) is borne by the space between the prongs 214 a-b, so that the space narrows and the prongs 214 a-b are brought toward one another until they are accommodated within the bore's depth 222. The bringing together of the prongs 214 a-b brings the semicircular extents 216 a-b together to place the holding enclosure 210 into its contracted state, locking it.
  • [0096]
    Preferably, the sleeve 206 is biased toward establishing the holding enclosure 210 in either an unlocked position or a locked position. Stated alternatively, when the holding enclosure 210 is unlocked (or locked), the force required to begin rotation of the sleeve 206 is greater than the force required to continue rotating the sleeve 206 once rotation has begun. And, as the sleeve 206 is rotated toward a position that will unlock (or lock), the holding enclosure 210, it is biased toward stopping its rotation at that upcoming position Stated alternatively, as the sleeve 206 is being rotated, the force required to rotate the sleeve 206 past that upcoming position is greater than the force that is required to rotate it prior to reaching that upcoming position.
  • [0097]
    This biasing of the sleeve 206 toward positions that will either unlock or lock the holding enclosure 210 is effected by the inclusion of at least one spaced recess 228 on the outer surface of the extension 204, and at least one radial bore 230 through the wall of the sleeve 206 (preferably through the rotation control knob 219 as shown), which bores 230 each have secured therein a spring plunger (not shown) (it should be understood that functionally equivalent devices can also be used in place of a spring plunger). Preferably, each recess 228 is associated with a respective cooperating bore 230 and spring plunger. When a given bore 230 (and spring plunger) is aligned with its associated recess 228, the sleeve 206 is in a position at which the holding enclosure 210 is either unlocked or locked. Each of the spring plungers is biased radially inwardly from the inner surface of the sleeve 206, and as such presses against the outer surface of the extension 204 as the sleeve 206 is being rotated. Thus, when a recess 230 is presented to the spring plunger, it plunges into the recess 230, stopping the rotation of the sleeve 206. In order to restart (or continue) rotation of the sleeve 206, the bias of the spring plunger must be overcome when the restarting (or continuing) rotational force is applied. In order to lower the overcoming force required to restart or continue the rotation, the end of the spring plunger is preferably convexly curvate, and the recess is concavely curvate. Preferably, four recesses 228 and bores 230 (and spring plungers) are provided, each pair representing one of four quarter-turn rotated positions of the sleeve 206. At each position of the sleeve 206, all four plungers plunge into the recesses 228, securing the sleeve 206 at that position until a sufficient force is applied to overcome their plunging bias.
  • [0098]
    Accordingly; the static trials 100 of the invention (or distraction spacers such as those disclosed in the '127 application) can be held and manipulated with the static trial holder 200. Holding the handle 202 of the static trial holder 200 in one hand, an operator can push the cylindrical trunk 106 of the static trial 100 (or the distraction spacer) against the mouth 213 of the holding enclosure 210 with enough force to temporarily expand the mouth 213 to a width that will accommodate the diameter of the cylindrical trunk 106 for passage through the mouth 213. The radially inward tapering of the sides of the mouth 213 (the facing ends 215 a-b of the semicircular extents 216 a-b of the prongs 214 a-b) facilitates this insertion. Once the cylindrical trunk 106 has passed into the holding enclosure 210, the operator can let go of the static trial 100 (or distraction spacer) because the prongs 214 a-b will be overcome by their bias toward their neutral state and thus hold the static trial 100 in the holding enclosure 210 to prevent the static trial 100 from falling out or slipping out as the static trial holder 200 is moved with the static trial 100 prior to closing (e.g., locking) the holding enclosure 210. (When the static trial 100 (or distraction spacer) is being held in this manner, and the holding enclosure 210 is unlocked, the static trial 100 can be removed from the holding enclosure 210 by a pulling of the static trial 100 through the mouth 213 of the holding enclosure 210 with a force required to again temporarily overcome the bias of the prongs 214 a-b toward their neutral state, to separate them and make the width of the mouth 213 accommodate the diameter of the cylindrical trunk 106.)
  • [0099]
    Once the operator is ready to lock the holding enclosure 210, while still gripping the handle 202 of the static trial holder 200, he rotates the rotation control knob 219 either clockwise or counterclockwise to move the sleeve 206 to the next quarter-turn position. If the rotation control knob 219 is rotated with enough force to cause the spring plungers in the bores 230 to back out of the recesses 228, the sleeve 206 will rotate as desired. Once the sleeve 206 has reached the next quarter-turn position, the spring plungers will find the recesses 228 associated with that position, and plunge into the recesses 228 to snap the sleeve 206 into the proper position. As the sleeve 206 rotates, the sides of the sleeve's bore's inner surface bear against the curved outer surfaces of the prongs 214 a-b to push the prongs 214 a-b together so that they are accommodated by the depth 222 of the bore 218. When the prongs 214 a-b are pressed against one another and held in that closed position by the maintenance of the sleeve 206 in the new position (maintained by the spring plungers in the recesses 228), the semicircular extents 216 a-b move toward one another and are correspondingly maintained together about the cylindrical trunk 106. When the prongs 214 a-b are held in this manner, the cylindrical trunk 106 cannot be removed through the mouth 213 of the now-tighter (e.g., locked) holding enclosure 210 without the application of forces preferably greater than will be encountered when inserting and removing the static trial 100 from the intervertebral space during the surgical procedures. Once the static trial 100 has been inserted and removed from the intervertebral space (or the distraction spacer has been inserted and removed from the intervertebral space after being used to distract the space), the operator can lock the holding enclosure 210 by rotating the sleeve 206 another quarter turn (in either the clockwise or the counterclockwise direction). Again, if the rotation control knob 219 is rotated with enough force to cause the spring plungers to back out of the recesses 228, the sleeve 206 will rotate as desired. Once the sleeve 206 has reached the next quarter-turn position, the spring plungers will find the recesses 228 associated with that position, and plunge into the recesses 228 to snap the sleeve 206 into the proper position. As the sleeve 206 rotates, the sides of the sleeve's bore's inner surface move away from the curved outer surfaces of the prongs 214 a-b and allow the prongs 214 a-b to separate (under their own bias toward the neutral position) as they are accommodated by the width 220 of the bore 218. When the prongs 214 a-b are separated and allowed to remain in that position by the maintenance of the sleeve 206 in the new position (maintained by the spring plungers in the recesses 228), the semicircular extents 216 a-b are separated from one another and hold the cylindrical trunk 106 against falling or slipping out. That is, the cylindrical trunk 106 can be removed by the operator if the operator applies a sufficient force to widen the mouth 213 of the holding enclosure 210 enough to let the cylindrical trunk 106 pass through the mouth 213. Once the static trial 100. (or distraction spacer) is removed, another one can be inserted and manipulated if required.
  • [0100]
    Accordingly, the static trial holder 200 can be used to insert and remove the distraction spacers of the '127 application to distract the intervertebral space as described in the '127, and thereafter (or during the distraction) hold to insert and remove the static trials 100 to find the appropriate size of artificial intervertebral disc to be implanted.
  • [0101]
    A preferred embodiment of a dynamic trial of the present invention will now be described.
  • [0102]
    Referring now to FIGS. 3 a-d, a dynamic trial of the present invention is shown in top (FIG. 3 a), side (FIG. 3 b), side cutaway (FIG. 3 c) and perspective (FIG. 3 d) views.
  • [0103]
    The dynamic trial 300 is provided primarily for distracting an intervertebral space according to the procedures described herein and/or for determining the appropriate size of an artificial intervertebral disc to be implanted (or whether a particular size can be implanted) into the distracted intervertebral space. While the distraction systems and methods described in the '127 application are also useful for distracting an intervertebral space, the dynamic trial 300 is provided as an additional or alternate distraction tool. Further, while the static trials described herein as useful for determining the appropriate size of an artificial intervertebral disc to be implanted (or whether a particular size can be implanted), the dynamic trial 300 is provided as an additional or alternate sizing tool.
  • [0104]
    More specifically, the dynamic trial 300 includes a shaft 302 having a bifurcated trial 304 at a distal end of the shaft 302. The trial 304 has an exterior that is preferably formed like the artificial intervertebral disc that it is meant to approximate. Accordingly, each half 306 a-b of the bifurcated trial 304 has on its outwardly facing surface a convex dome 308 a-b that is shaped like the convex dome of the corresponding baseplate of the artificial intervertebral disc that the dynamic trial 300 approximates (e.g., the convex domes 184 a-b of the baseplates 168 a-b of the artificial intervertebral disc 160 of FIGS. 1 g-n). Preferably, each convex dome 308 a-b is smooth, rather than having a porous coating that is preferred for the convex domes 184 a-b of the artificial intervertebral disc 160, and each half 306 a-b does not have stabilizing spikes such as the stabilizing spikes 188 a-b on the outwardly facing surfaces 186 a-b of the artificial intervertebral disc 160. The omission of these device stabilizing and bone ingrowth encouraging structures and surfaces on the dynamic trial 300 enables the surgeon to test the size of the artificial intervertebral disc 160 to be implanted without invading the vertebral body endplates. The shaft 302 includes an inner shaft portion 310 that centrally divides at a fulcrum 311 into upper and lower distal extensions 312 a-b. The lower distal extension 312 b is fixed to the upper distal extension 312 a at the fulcrum 311, preferably by screws 313 a-b that are plug welded in place. Preferably, as shown, at least the most proximal screw 313 b extends above the top surface of the upper distal extension 312 a to serve as a backup stop to prevent extreme forward movement of the control knob 318 that is operated to separate the distal extensions 312 a-b (described below).
  • [0105]
    From the point of division to their distal ends, each of the upper and lower distal extensions 312 a-b are spring biased (preferably by the formation of the fulcrum 311 in combination with the strength of the material of which the extensions 312 a-b are made, although the use of other types of springs is contemplated by the present invention) toward positions in which they converge toward one another (in the figures, the extensions 312 a-b are shown in these positions). The lower distal extension 312 b is connected (preferably fixed as shown) to the lower half 306 b of the bifurcated trial 304, and the upper distal extension 312 a is connected to the upper half 306 a of the bifurcated trial 304. Preferably, as shown, the upper half 306 a is adjustably connected to the upper distal extension 312 a by a pivot pin 315 that allows the upper half 306 a to rotate about a lateral axis that passes through the longitudinal and lateral center of the bifurcated trial 304. This axis of rotation allows the upper half 306 a, when separating from the lower half 306 b, to adjust to the orientation of the upper (adjacent) vertebral bone without causing the bone to hinge relative to the lower vertebral bone (the bone adjacent the lower half 306 b).
  • [0106]
    In order to effect the separation of the, upper and lower halves 306 a-b, the shaft 302 further includes an outer shaft potion 314 that is longitudinally translatable adjacent the inner shaft portion 310. The outer shaft portion 314 preferably straddles the inner shaft portion 310 as shown, and includes a pin 316 that passes between the distal extensions 312 a-b. The outer shaft portion 314 is preferably translatable distally by the forward movement of a control knob 318 near the proximal end of the shaft 302, and translatable proximally by backward movement of the control knob 318. That is, when the control knob 318 is pushed distally, the outer shaft portion 314 is moves distally, and accordingly the pin 316 moves distally. If the pushing force is great enough to overcome the bias of the divided extensions 312 a-b (their bias toward one another), the divided extensions 312 a-b will separate as the pin 316 moves between them (to make room for the pin 316). The separation of the extensions 312 a-b will correspondingly separate the halves 306 a-b of the bifurcated trial 304. It should be understood that preferably, if the control knob 318 is released, the bias of the divided extensions 312 a-b will press against the pin 316, causing the pin 316 (and correspondingly the outer shaft portion 314 and the control knob 318) to move proximally to allow the divided extensions 312 a-b to return to their biased position, which will bring the halves 306 a-b of the trial 304 back together so they can be removed from the intervertebral space. Preferably, markings 320 are provided on the inner shaft portion 310 (preferably on its top surface so that the surgeon can more easily see the markings 320) to quantify the depth (to which the bifurcated trial 304 is expanded) corresponding to the distance that the outer shaft portion 314 is translated with respect to the inner shaft portion 310.
  • [0107]
    It is anticipated that the pushing force required to separate the halves 306 a-b will increase as they separate, due to the compression of the spine seeking to close the intervertebral space and the annulus seeking to prevent the adjacent vertebral discs from separating beyond a certain point. Therefore, to provide a mechanical advantage to the operator in the event that greater distraction is required, but the operator cannot push the control knob 318 farther with unaided human effort, an fine control knob 322 is provided. The fine control knob 322 is preferably threaded onto the proximal end of the inner shaft portion 310, proximal to the control knob 318. Thus, rotation of the fine control knob 322 about the longitudinal axis of the inner shaft portion 310 will cause the body of the fine control knob 322 to press against the control knob 318 to move it farther distally. The interference of the threads of the fine control knob-inner shaft portion interface prevents the fine control knob 322 from backing up proximally unless the fine control knob 322 is reverse rotated to effect that result.
  • [0108]
    Preferably, as shown, the proximal end 324 of the shaft 302 is preferably flanged to serve as a slap hammer for impaction (by hitting the proximal end 324 with a mallet with a distally directed force, e.g.), if necessary for proper positioning of the bifurcated trial 304, and/or forced extraction of the bifurcated trial 304 (by hitting the flange of the proximal end 324 with a mallet with a proximally directed force, e.g.).
  • [0109]
    Accordingly, the dynamic trial 300 can be used as an additional or alternative distracting tool (e.g., to the distraction spacers), and/or as an alternative or additional sizing tool (e.g., to the static trials). As an example of a use for the dynamic trial 300 as an alternative or additional distraction tool and an alterative sizing tool, once the intervertebral space is distracted to (or, without distraction, is at) a depth that is at least equal to the depth of the closed bifurcated trial 304, the bifurcated trial 304 of the dynamic trial 300 can be inserted into the intervertebral space. (If the intervertebral space must be distracted initially because it starts out more shallow than the depth of the closed bifurcated trial 304, the distraction spacers of the '127 application and the methods disclosed therein can be used, e.g.) The control knob 318 and/or fine control knob 322 can be operated to separate the halves 306 a-b of the bifurcated trial 304 to distract the space as clinically appropriate. Because the bifurcated trial 304 is shaped externally to approximate the artificial intervertebral disc to be implanted (e.g., the artificial intervertebral disc 160), and because the pivoting of the upper half 306 a of the bifurcated trial 304 allows the halves 306 a-b to appropriately lordotically orient themselves, when the surgeon determines the intervertebral space to be distracted to its proper dimension (based on how much compression is being experienced on the dynamic trial 300 and how tight the annulus is), he can read the markings 320 on the shaft 302 to determine what size of artificial intervertebral disc 160 is suitable for the dimensioned intervertebral space. A subsequent bringing together of the halves 306 a-b and a removal of the dynamic trial 300 can then be followed by insertion of the appropriately sized artificial intervertebral disc 160 (e.g., in a manner described below with regard to the inserter/impactor 400).
  • [0110]
    As an example of a use for the dynamic trial 300 as an alternative distraction tool and an additional sizing tool, after the surgeon has initially distracted the intervertebral space (preferably with the distraction spacers of the '127 application), and applied one or more of the static trials 100 to the intervertebral space to determine the appropriate size of the artificial intervertebral disc to be implanted (e.g., the artificial intervertebral disc 160), the surgeon can apply the dynamic trial 300, expand it to the size of the static trial 100 that was determined to be the appropriate size for the intervertebral space, and then further open the dynamic trial 300 for a final sizing. An example of a final sizing that would be useful would be to test the amount of farther distraction that is clinically possible, without having to remove and replace static trials 100 when the compression force of the spine and the tension force of the annulus are at their higher levels. Also, the surgeon may wish to distract the space slightly more than the size of the appropriately sized static trial 100 or artificial intervertebral disc 160, so that the artificial intervertebral disc 160 can be more easily inserted after removal of the static 100 or dynamic trial 300 results in a compressive settling of the intervertebral space. The surgeon may also wish to distract the space slightly more than the size of the appropriately sized static trial 100 or artificial intervertebral disc 160, to prepare it for easy insertion of the artificial intervertebral disc 160 to be implanted, with consideration for the height of the stabilizing spikes 188 a-b on the outwardly facing surfaces 186 a-b of the baseplates 168 a-b of the artificial intervertebral disc 160. While the artificial intervertebral disc 160 having the spikes 188 a-b can be implanted without the additional distraction, some surgeons may find such additional distraction useful or desirable for a particular case.
  • [0111]
    A preferred embodiment of an inserter/impactor of the present invention will now be described.
  • [0112]
    Referring now to FIGS. 4 a-d, an inserter/impactor of the present invention is shown in side (FIG. 4 a), top (FIG. 4 b), side cutaway (FIG. 4 c) and perspective (FIG. 4 d) views. FIGS. 4 e-h show side (FIG. 4 e), top (FIG. 4 i), side cutaway (FIG. 4 g), and perspective (FIG. 4 h) views of an inserter/impactor of the present invention holding a static trial of the present invention. FIGS. 4 i-j show top views of an inserter impactor of the present invention holding a static trial of the present invention in two alternative ways. FIGS. 4 k-n show side (FIG. 4 k), top (FIG. 4 l), side cutaway (FIG. 4 m), and perspective (FIG. 4 n) views of an inserter/impactor of the present invention holding an exemplary artificial intervertebral disc of the present invention. FIGS. 4 p show top views of an inserter/impactor of the present invention holding an exemplary artificial intervertebral disc of the present invention in two alternative ways.
  • [0113]
    The inserter/impactor 400 is provided primarily for holding, inserting, repositioning, removing, impacting, extracting, and otherwise manipulating an artificial intervertebral disc having features suitable for being manipulated by the inserter/impactor. (However, it can also be used to hold, insert, reposition, remove, impact, extract, and otherwise manipulate the static trials 100 as described above, as well as any other orthopedic device having suitable features therefor.) Exemplary suitable artificial intervertebral discs include, but are not limited to, the artificial intervertebral disc 160 described herein and the artificial intervertebral discs described in the '160 application with regard to FIGS. 8 a-y, 9 a-t, 10 a-t, 11 a-j, and 12 a-o thereof and by the accompanying descriptions therefor (e.g., embodiments identified as the first, second, third, fourth, and fifth preferred embodiments of the fourth embodiment family, etc.). Regarding the features suitable for being manipulated by the inserter/impactor 400, such features include those discussed above as being suitable features on the static trials 100 and disc 160, namely, an anteriorly facing flat surface on the second (e.g., lower) baseplate of the trial or disc, flanked by two anteriolaterally facing flat surfaces (one on each side of the anteriorly facing flat surface), and, to provide for holding of the trial or disc for an anterior insertion approach, a hole spaced from the anteriorly facing flat surface, the hole having a longitudinal axis parallel to the anteriorly facing flat surface.
  • [0114]
    More particularly, the inserter/impactor 400 includes a shaft 402 having a distal end 404 that has angled flat surfaces 420 a-c corresponding to and fittable against angled flat surfaces of the static trial (e.g., the surfaces 120 a-c of the static trial 100) or artificial intervertebral disc (e.g., the surfaces 180 a-c of the artificial intervertebral disc 160) to be implanted. For example, in an anterior approach for the trial 100 (as shown in FIGS. 4 e-h), 120 a and 120 d facing 420 a, 120 b and 120 e facing 420 b, and 120 c and 120 f facing 420 c, and in an anterior approach for the disc 160 (as shown in FIGS. 4 k-n), 180 a and 180 d facing 420 a, 180 b and 180 e facing 420 b, and 180 c and 180 f facing 420 c.
  • [0115]
    Further, the inserter/impactor 400 includes a holding pin 408 that extends from the center flat surface 420 b along a longitudinal axis of the shaft 402, the pin 408 having a distal end 410 that bends downward. The holding pin 408 is spring loaded (by a spring 409) in a central channel of the shaft 402, so that it is biased toward and against the central flat surface 420 b (preferably, the bent end 410 of the pin 408 prevents it from entering the central channel).
  • [0116]
    A flange 411, mechanically connected to the pin 408 and translating adjacent the shaft 402, can be pushed distally to overcome the bias of the spring 409 to space the pin 408 away from the central flat surface 420 b. In this position, the pin 408 can be inserted in the hole 120 b,180 b in the baseplate 108 b,168 b of the static trial 100 or artificial intervertebral disc 160. Releasing the flange 411 allows the spring 409 to pull the pin 408 back, causing the anteriorly facing surface 120 b,180 b of the baseplate 108 b,168 b to be held against the central flat surface 420 b of the inserter/impactor 400 and the anterioloaterally facing flat surfaces 120 a,c,180 a,c of the static trial 100 or artificial intervertebral disc 160 to be held against the other corresponding flat surfaces 420 a,c of the inserter/impactor 400. A knob 412, threaded on the shaft 402, can be rotated about the longitudinal axis of the shaft 402 to push the flange 411 farther proximally, to pull the pin 409 tighter and therefore lock its position (the interference of the threads of the knob-shaft interface prevents the knob 412 from moving distally unless the knob 412 is reverse rotated to effect that result) to more securely hold the baseplate 108 b,168 b, and reverse rotated to unlock and loosen the pin 409.
  • [0117]
    When the static trial 100 or disc 160 is held in this manner, rotation of the static trial 100 or disc 160 about a longitudinal axis (of the static trial 100 or disc 160) relative to the inserter/impactor 400 is prevented by interference of the corners of the static trial's 100 or disc's 160 flat surfaces 120 a-c,180 a-c and the corners of the inserter/impactor's 400 flat surfaces 420 a-c, to the manner in which a wrench holding a nut prevents rotation of the nut relative to the wrench. Further, the holding of the static trial 100 or disc 160 in this manner allows for some repositioning of the static trial 100 or disc 160 in the intervertebral space via rotation of the static trial 100 or disc 160 in either direction about the longitudinal axis of the intervertebral space.
  • [0118]
    Preferably, both of the baseplates of the static trial 100 or disc 160 have similarly configured flat surfaces. For example, the lower baseplate's 108 b,168 b flat surfaces 120 a-c,180 a-c have similarly configured and similarly oriented counterpart flat surfaces 120 d-f,180 d-f on the upper baseplate 108 a,168 a. Further preferably, both baseplates' 108 a-b,168 a-b flat surfaces 120 a-f,180 a-f face the angled flat surfaces 420 a-c of the inserter/impactor 400′ when the static trial 100 or disc 160 is held by the inserter/impactor 400. For example, in an anterior approach for the trial 100 (as shown in FIGS. 4 e-h), 120 a and 120 d facing 420 a,120 b and 120 e facing 420 b, and 120 c and 120 f facing 420 c, and in an anterior approach for the disc 160 (as shown in FIGS. 4 k-n), 180 a and 180 d facing 420 a, 180 b and 180 e facing 420 b, and 180 c and 180 f facing 420 c.
  • [0119]
    It should be noted that preferably, when the static trial 100 is held by the inserter/impactor 400, the flat surfaces 120 a-c and the counterpart flat surfaces 120 d-f are tightly held against the angled flat surfaces 420 a-c of the inserter/impactor 400 as described above. It is also preferable that the baseplates 108 a-b of each of the plurality of static trials 100 be appropriately lordotically angled relative to one another to ease insertion of the static trial 100 into the intervertebral space and to mimic how the artificial intervertebral disc 160 will typically be oriented as it is being inserted using the inserter/impactor 400, and to ease insertion of the static trial 100 into the intervertebral space. While not shown in FIGS. 1 a-f, in some embodiments, when the static trials 100 are formed in such a lordotically oriented configuration, it is preferable that the flat surfaces 120 d-f on the first (e.g., upper) baseplate 108 a be parallel to the flat surfaces 120 a-c of the second (e.g., lower) baseplate 108 b in the static trial's 100 appropriately lordotically oriented configuration, so that when the static trial 100 is held tightly by the inserter/impactor 400, the flat surfaces 120 a-f are flush with the flat surfaces 420 a-c of the inserter/impactor 400 even though the baseplates 108 a-b are lordotically angled with respect to one another.
  • [0120]
    By contrast, preferably, when the artificial intervertebral disc 160 is held by the inserter/impactor 400, the flat surfaces 180 a-c are tightly held against the angled flat surfaces 420 a-c of the inserter/impactor 400 as described above, but the counterpart flat surfaces 180 d-f are loosely held against the angled flat surfaces 420 a-c of the inserter/impactor 400. As such, the structure of the artificial intervertebral disc 160 having the counterpart flat surfaces 180 d-f (e.g., the upper baseplate 168 a) is able to angulate and rotate to a limited extent relative to the structure of the artificial intervertebral disc 160 having the flat surfaces 180 a-c. This permits the artificial intervertebral disc 160 to adjust to the intervertebral space (e.g., to the angulation of the adjacent vertebral endplates, defining the intervertebral space, relative to one another) as it is being inserted thereinto. That is, typically, the adjacent vertebral endplates will be lordotically angled with respect to one another as a result of the intervertebral space being prepared and distracted. As the artificial intervertebral disc 160 is then inserted into the intervertebral space using the inserter/impactor 400, then, the baseplates 168 a-b will be permitted to lordotically angle with respect to one another to squeeze into the intervertebral space.
  • [0121]
    Also preferably, in order to provide for a holding of the static trial 100 or disc 160 for two additional (here, anteriolateral) insertion approaches, each static trial 100 or disc 160 also includes two additional holes 122 a,182 a and 122 c,182 c, one (e.g., 122 a,182 a) spaced apart from one of the anteriolaterally facing flat surfaces (e.g., 120 a,180 a), and the other (e.g., 122 c,182 c) spaced apart from the other of the anteriolaterally facing flat surfaces (e.g., 120 c,180 c). Accordingly, operation of the inserter/impactor 400 can fit the holding pin 408 into either of these two additional holes 122 a,182 a or 122 c,182 c, and hold the associated anteriolaterally facing flat surface (the one associated with the hole into which the pin 408 is fit) of the static trial 100 or disc 160 against the flat surface of the inserter/impactor 400 opposite the pin 408. For example, as discussed below with regard to the inserter/impactor 400, in a first anteriolateral approach for the trial 100 (as shown in FIG. 4 i), 120 a and 120 d facing 420 b, 120 b and 120 e not confronted, and 120 c and 120 f facing 420 a, and a first anteriolateral approach for the disc 160 (as shown in FIG. 4 o), 180 a and 180 d facing 420 b, 180 b and 180 e not confronted, 180 c and 180 f facing 420 a. And, for example, as discussed below with regard to the inserter/impactor 400, in a second anteriolateral approach for the trial 100 (as shown in FIG. 4 j), 120 a and 120 d facing 420 c, 120 b and 120 e facing 420 a, and 120 c and 120 f not confronted, and a second anteriolateral approach for the disc 160 (as shown in FIG. 4 p), 180 a and 180 d facing 420 c, 180 b and 180 e facing 420 a, 180 c and 180 f not confronted.
  • [0122]
    It should be understood that preferably, in order to facilitate these additional approaches, the angle separating the anteriorly facing flat surface of the static trial 100 or disc 160 and one of the anteriolaterally facing flat surfaces of the static trial 100 or disc 160 is equal to the angle separating the anteriorly facing flat surface and the other of the anteriolaterally facing flat surfaces. Preferably, the surfaces are angled with respect to one another at an angle of 33.4 degrees.
  • [0123]
    It should also be understood that the inclusion of additional adjacent angulated surfaces (or placing the angulated surfaces in other locations on the trial or disc), and/or including corresponding holes adjacent to such surfaces, can provide the surgeon with additional approaches, e.g., other anteriolateral approaches, directly lateral approaches, posteriolateral approaches, and/or directly posterior approaches. For example, a trial or disc can have angled surfaces (and corresponding holes) along the entire perimeter of one or both of the baseplates, and thus enable the surgeon to engage the trial or disc from a number of angles, including anterior, posterior, lateral, anteriolateral, and posteriolateral angles.
  • [0124]
    The inserter/impactor 400 further includes at a proximal end a cap 414 for use as an impact surface if the trial 100 or disc 160 must be impacted further into the intervertebral space after insertion, or forcibly extracted from the intervertebral space. A mallet can be used to strike the cap 414 (in a distal direction for impaction, or in a proximal direction (using the flange of the cap 414) for extraction). It should be noted a string of the cap 414 will translate the striking force to the baseplates through the shaft 402 and the flat surfaces, but will not damage the holding pin 408 because the holding pin 408 is spring loaded in the central channel and thus buffered from the striking force thereby.
  • [0125]
    Accordingly, the inserter/impactor 300 can be used to grip either the static trials or the artificial intervertebral disc to be implanted, and hold the same during insertion and/or removal of the same, and is useful for a variety of surgical approach angles.
  • [0126]
    Preferred embodiments of a repositioner/extractor of the present invention will now be described.
  • [0127]
    Referring now to FIGS. 5 a-c, a symmetric repositioner/extractor of the present invention is shown in side (FIG. 5 a), top (FIG. 5 b), and perspective (FIG. 5 c) views. And referring now to FIGS. 5 d-f, an offset left repositioner/extractor of the present invention is shown in side (FIG. 5 d), top (FIG. 5 e), and perspective (FIG. 5 f) views. And referring now to FIGS. 5 g-i, an offset right repositioner/extractor of the present invention is shown in side (FIG. 5 g), top (FIG. 5 h), and perspective (FIG. 5 i) views. And referring now to FIGS. 5 j-l, an alternative offset left repositioner/extractor of the present invention is shown in side (FIG. 5 j), top (FIG. 5 k), and perspective (FIG. 5 l) views. And referring now to FIGS. 5 m-o, an alternative offset right repositioner/extractor of the present invention is shown in side (FIG. 5 m), top (FIG. 5 n), and perspective (FIG. 5 o) views.
  • [0128]
    Each repositioner/extractor is provided primarily for repositioning and/or extracting a static trial or artificial intervertebral disc having features suitable for being manipulated by the repositioner/extractor. Exemplary suitable artificial intervertebral discs are described in the '160 application with regard to FIGS. 8 a-y, 9 a-t, 10 a-t, 11 a-j, and 12 a-o thereof and by the accompanying descriptions therefor (e.g., embodiments identified as the first, second, third, fourth, and fifth preferred embodiments of the fourth embodiment family, etc.). Regarding the features suitable for being manipulated by each repositioner/extractor, such features include at least two holes extending longitudinally into one of the baseplates of the static trial or artificial intervertebral disc from the inwardly facing surface of the baseplate. More than two holes can be used to provide for multiple repositioning/extracting approaches. Preferably, in order for the same repositioning/extracting tool to be used for multiple approaches on the same trial or artificial intervertebral disc, adjacent holes should be separated by the same distance separating other adjacent holes.
  • [0129]
    In order to engage the two holes, each repositioner/extractor has two pins extending in parallel from a central shaft, perpendicular to the longitudinal axis of the central shaft. The pins are spaced to engage the two holes simultaneously, and each pin has a diameter smaller than the diameter of the hole it is to engage. Therefore, the pins can be inserted into the holes, and pulling or pushing on the central shaft along its longitudinal axis when the holes are engaged pulls or pushes the static trial or artificial intervertebral disc in the intervertebral space. Further, because two holes are engaged, the static trial or artificial intervertebral disc can be rotated in either direction about a longitudinal axis passing through the intervertebral space, by rotating of the central shaft of the repositioner/extractor about its distal end, about an axis parallel to the longitudinal axes of the pins. A handle at a proximal end of the central shaft is useful for pushing or pulling on the shaft. A flange adjacent the proximal end of the shaft is useful for impaction (either with a distally directed force or a proximally directed force), if necessary to manipulate the shaft
  • [0130]
    On each repositioner/extractor, the pins are formed on prongs that extend laterally from the central shaft. The direction of the prongs, and the location of the pins relative to the central shaft, determine the angle or angles of surgical approach for which a particular repositioner/extractor can be used. Further, the number and location of holes further determine the angle or angles of surgical approach for which a particular repositioner/extractor can be used. Accordingly, the present invention contemplates a variety of repositioner/extractors, and a variety of holes configurations, to provide the surgeon with a variety of possible surgical approach angles.
  • [0131]
    For example, three repositioner/extractors are illustrated, and, for example, two hole configurations are illustrated.
  • [0132]
    The first, symmetric, repositioner/extractor 500, shown in FIGS. 5 a-c, includes a shaft 502 having a distal end that is symmetrically divided into two prongs 504 a-b, each of the prongs having a pin 506 a-b extending upwardly and parallel to the pin on the other prong. The second and third, left offset and right offset, repositioners/extractors 510,520, shown in FIGS. 5 d-f and 5 g-i, respectively, each include a shaft 512,522 having a distal end that bends diagonally laterally, the left offset distal end 514 bending in one direction (e.g., to the left), the right offset distal end 524 bending in an opposite direction (e.g., to the right). The distal end of each of the second and third repositioners/extractors 510,520 has two pins 516 a-b,526 a-b serially spaced on the bent portion, and each of the pins extends upwardly and parallel to the other pin. (As shown in FIGS. 5 j-l and 5 m-o, alternative embodiments 530,540 of the second and third, left offset and right offset, repositioners/extractors each include a shaft 532,542 having a distal end that has a straight prong 534 a,544 a and a curved lateral prong 534 b,544 b, where the curved lateral prong 534 b extends in one direction (e.g., left) for the alternative left offset repositioner extractor 530, and where the curved lateral prong 544 b extends in an opposite direction (e.g., right) for the alternative right offset repositioner/extractor 540. Each of the prongs 534 a-b,544 a-b has a pin 536 a-b,546 a-b extending upwardly and parallel to the pin on the other prong. The alternative repositioners/extractors 530,540, each having a space between the pins 536 a,b,546 a,b, provides for avoidance of any structures on the static trial or artificial intervertebral disc that may be present between the holes.) On each of the repositioners/extractors 500,510,520,530,540, the pins are spaced so that they simultaneously each fit into a respective one of the two adjacent holes in the baseplate of the static trial or artificial intervertebral disc. Each of the repositioners/extractors 500,510,520,530,540 has a handle 508,518,528,538,548 at a proximal end of the central shaft which is useful for pushing or pulling on the shaft, and a flange 509,519,529,539,549 adjacent the proximal end of the shaft that is useful for impaction (either with a distally directed force or a proximally directed force), if necessary to manipulate the shaft.
  • [0133]
    As noted above, the repositioner/extractor that is appropriate or desired for a given case depends at least in part on the configuration of the holes in the baseplates. Two hole configurations are disclosed, as examples of suitable configurations, although other configurations are possible and contemplated by the present invention. A first hole configuration includes three holes on one of the baseplates, the holes being configured so that a first hole is located in the anterior-posterior plane, and the adjacent (second and third) holes are located in respective opposing anteriolateral planes on either side of the first hole. This hole configuration is shown in FIGS. 5 p-u, each of which shows a top cutaway view of the artificial intervertebral disc of FIGS. 1 g-n, showing its lower baseplate, having the first hole configuration, engaged by one of the repositioners/extractors 500,510,520. Each view of the lower baseplate shows the first hole 550, the second hole 552, and the third hole 554 of the first hole configuration.
  • [0134]
    A second hole configuration includes four holes on one of the baseplates, the holes being configured so that first and second holes straddle the anterior-posterior plane, a third hole is located so that the third hole and the first hole straddle one of the opposing anteriolateral planes, and a fourth hole is located so that the fourth hole and the second hole straddle the other of the opposing anteriolateral planes. This hole configuration is shown in FIGS. 5 v-dd, each of which shows a bottom cutaway view of the artificial intervertebral disc of FIGS. 1 g-n, showing its upper baseplate, having the second hole configuration, engaged by one of the repositioners/extractors 500,510,520. Each view of the upper baseplate shows the first hole 560, the second hole 562, the third hole 564, and the fourth hole 566, of the second hole configuration.
  • [0135]
    It should be understood that configurations having more or fewer holes, and in a variety of locations, are contemplated by the invention, and the detailed descriptions of only two hole configurations is not meant to limit the invention to only these two configurations. Importantly, the invention encompasses using a hole or any number of holes, bored at any suitable angle, whether parallel to other holes or not, in any number of locations on a spacer, a trial or an artificial intervertebral disc (not limited to locations on the baseplates), for purposes of enabling the spacer, trial, or disc to be gripped by a manipulation instrument (not limited to a repositioner/extractor) that engages the hole, and/or to enable the surgeon to work from a variety of approaches. For example, as described in more detail below, the first and second hole configurations described herein, in cooperation with the repositioner/extractors, provide the surgeon with the ability to work from a directly anterior approach, as well as several anteriolateral approaches. It should be understood that additional hole configurations can enable the surgeon to work from a directly posterior approach, posteriolateral approaches, directly lateral approaches, or anteriolateral approaches that are different that those illustrated. For example, the placement of one or more suitably spaced holes (or the addition of one or more holes) on the posterior edge, and/or one or both of the lateral edges of one or both of the baseplates, would enable the surgeon to use the repositioner/extractors of the present invention to achieve such approaches.
  • [0136]
    As noted above, and referring now to FIGS. 5 p-dd, it can be seen that each of the repositioner/extractors can be used in more than one manner depending on the tool desired and the approach desired. For example, with reference to FIGS. 5 p-q, regarding the first hole configuration (three holes in one of the baseplates), the symmetric repositioner/extractor 500 can be used in either of two anteriolateral approaches (see FIGS. 5 p-q). That is, the symmetric repositioner/extractor's shaft 502 can be inserted into the wound from either of the two anteriolateral approaches, and the pins 506 a-b can be inserted into the first 550 and second 552 holes (for one of the two anteriolateral approaches) (FIG. 5 p) or the first 550 and third 552 holes (for the other of the two anteriolateral approaches) (FIG. 5 q) of the first hole configuration.
  • [0137]
    Also, for example, with reference to FIGS. 5 r-u, regarding the first hole configuration, each of the left offset repositioner/extractor 510 and the right offset repositioner/extractor 520 can be used in either a directly anterior approach (FIGS. 5 r,t) or a respective anteriolateral approach (FIGS. 5 s,u). That is, the right offset repositioner/extractor's shaft 522 can be inserted into the wound from a direct anterior approach, and the right offset repositioner/extractor's pins 526 a-b can then be placed into the first 550 and second 552 holes of the first hole configuration (FIG. 5 r). And, the right offset repositioner/extractor's shaft 522 can be inserted into the wound from an anteriolateral approach, and the right offset repositioner/extractor's pins 526 a-b can then be placed into the first 550 and third 554 holes of the first hole configuration (FIG. 5 s). And, the left offset repositioner/extractor's shaft 512 can be inserted into the wound from a direct anterior approach, and the left offset repositioner/extractor's pins 516 a-b can then be placed into the first 550 and third 554 holes of the first hole configuration (FIG. 5 t). And, the left offset repositioner/extractor's shaft 512 can be inserted into the wound from an anteriolateral approach, and the left offset repositioner/extractor's pins 516 a-b can then be placed into the first 550 and second 552 holes of the first hole configuration (FIG. 5 u). It should be noted that the alternate left offset 530 and alternate right offset 540 repositioners/extractors can also fit into the holes of the first hole configuration in the same manner as described here with regard to the left offset 510 and right offset 520 repositioners/extractors.
  • [0138]
    Also, for example, with reference to FIGS. 5 v-dd, regarding the second hole configuration (four holes in one of the baseplates), the symmetric repositioner/extractor 500 can be used in a directly anterior approach (FIG. 5 v), and either of two anteriolateral approaches (FIGS. 5 w-x). That is, the symmetric repositioner/extractor's shaft 502 can be inserted into the wound from a directly anterior approach, and the pins 506 a-b can be inserted into the first 560 and second 562 holes of the second hole configuration (FIG. 5 v). And, the symmetric repositioner/extractor's shaft 502 can be inserted into the wound from either of the two anteriolateral approaches, and the pins 506 a-b can be inserted into the first 560 and third 564 holes (for one of the two anteriolateral approaches) (FIG. 5 w) or the second 562 and fourth 566 holes (for the other of the two anteriolateral approaches) (FIG. 5 x) of the second hole configuration.
  • [0139]
    Also, for example, with reference to FIGS. 5 y-dd, regarding the second hole configuration, each of the left offset repositioner/extractor 510 and the right offset repositioner/extractor 520 can be used in any of three respective anteriolateral approaches. That is, the right offset repositioner/extractor's shaft 522 can be inserted into the wound from any of its three possible anteriolateral approaches, and the right offset repositioner/extractor's pins 526 a-b can then be placed into the first 560 and second 562 holes (FIG. 5 y) (for a first of the three anteriolateral approaches), the first 560 and third 564 holes (FIG. 5 z) (for a second of the three anteriolateral approaches), or the second 562 and fourth 566 holes (FIG. 5 aa) (for a third of the three anteriolateral approaches). And, the left offset repositioner/extractor's shaft 512 can be inserted into the wound from any of its three possible anteriolateral approaches, and the left offset repositioner/extractor's pins 516 a-b can then be placed into the first 560 and second 562 holes (FIG. 5 bb) (for a first of the three anteriolateral approaches), the first 560 and third 564 holes (FIG. 5 cc) (for a second of the three anteriolateral approaches), or the second 562 and fourth 566 holes (FIG. 5 dd) (for a third of the three anteriolateral approaches). It should be noted that the alternate left offset 530 and alternate right offset 540 repositioners/extractors can also fit into the holes of the second hole configuration in the same manner as described here with regard to the left offset 510 and right offset 520 repositioners/extractors.
  • [0140]
    It should be noted from the illustrations in FIGS. 5 p-dd that the anteriolateral approaches are at a variety of angles relative to the anterior-posterior plane, and further that the illustrated angles are merely exemplary. That is, the invention encompasses additional approach angles, in that such additional approach angles are possible by (as described above) adding or deleting holes, and/or changing the location of holes, and/or changing the spacing between holes (in conjunction with changing the spacing between pins), and/or changing the angle at which the offset repositioner/extractors' pins are placed relative to one another and to the shaft of such repositioner/extractors.
  • [0141]
    As discussed above, once the pins are established in the two adjacent holes, manipulating the shaft of the repositioner/extractor will reposition the static trial or artificial intervertebral disc in the intervertebral space and/or extract it from the intervertebral space. The use of more than one pin (versus one pin) enables the static trial or artificial intervertebral disc to be rotated in either direction about a longitudinal axis passing through the intervertebral space.
  • [0142]
    A preferred embodiment of a leveler of the present invention will now be described.
  • [0143]
    Referring now to FIGS. 6 a-e, a leveler of the present invention is shown in bottom (FIG. 6 a), side (FIG. 6 b), front (FIG. 6 c), top partial perspective (FIG. 6 d), and bottom partial perspective (FIG. 6 e) views. More particularly, FIG. 6 d shows a top perspective view of the distal end of the leveler, and FIG. 6 e shows a bottom perspective view of the distal end of the leveler.
  • [0144]
    The leveler is provided primarily for establishing a parallel orientation of the baseplates (relative to one another), and/or securing the purchase of the stabilizing spikes, of an artificial intervertebral disc having features suitable for being manipulated by the leveler. Exemplary suitable artificial intervertebral discs are described in the '160 application with regard to FIGS. 8 a-y, 9 a-t, 10 a-t, 11 a-j, and 12 a-o thereof and by the accompanying descriptions therefor (e.g., embodiments identified as the first, second, third, fourth, and fifth preferred embodiments of the fourth embodiment family, etc.). Regarding the features suitable for being manipulated by the leveler, such features include suitably formed inwardly facing surfaces of the baseplates of the artificial intervertebral disc.
  • [0145]
    More particularly, the leveler 600 includes a shaft 602 having a forked distal end formed by two opposing tongs 604 a-b that are symmetric to one another about a longitudinal axis of the shaft 602. Each of the tongs 604 a-b has an extent that initially curves laterally outward away from the shaft 602 and from the other tong's extent, to define a central pocket 606 forward of the shaft 602 between the tongs' extents. Each tong's extent then resumes a distal direction to become parallel to the shaft 602 and to the other tong's extent
  • [0146]
    Each tong's extent has an upper surface 608 a-b and a lower surface 610 a-b. The upper surface 608 a-b is preferably shaped to conform against the inwardly facing surface of a first (e.g., upper) baseplate of an artificial intervertebral disc, and the lower surface 610 a-b is preferably shaped to conform against the inwardly facing surface of a second (e.g., lower) baseplate of the artificial intervertebral disc, so that insertion of the forked distal end of the leveler 600 between the baseplates, with the central pocket 606 of the distal end avoiding the central portion of the artificial intervertebral disc, and with the upper 608 a-b and lower surfaces 610 a-b so engaging the inwardly facing surfaces of the baseplates, causes the baseplates to be placed in parallel orientation with respect to one another.
  • [0147]
    More particularly, for example for use with the exemplary artificial intervertebral disc of FIGS. 1 g-n, the upper surface 608 a-b of each extent is flat, except for a tapered section 612 a-b at the distal tip of the extent, which tapered section narrows the tip, and the lower surface 610 a-b of each extent is curved to form opposing concave contours 614 a-b that are cooperatingly shaped to conform against the inwardly facing surface of the convex structure of the artificial intervertebral disc.
  • [0148]
    The preferred use of the leveler 600 is as follows. As discussed above, once the intervertebral space has been prepared and distracted to a dimension that will accept the artificial intervertebral disc to be implanted, the artificial intervertebral disc 160 is engaged at its lower baseplate 168 b by the inserter/impactor 400 discussed above. During insertion (and, if necessary, impaction) of the artificial intervertebral disc 160 into the intervertebral space, the upper baseplate 168 a remains free to angulate with respect to the lower baseplate 168 b, so that the angulation of the baseplates conforms to the angulation of the intervertebral space as the artificial intervertebral disc is being inserted thereinto. Typically, the endplates of the prepared and distracted intervertebral space-will be lordotically angled with respect to one another, due to the use of the static trials 100 as described above, which are-formed to have a lordotic taper as discussed above. Thus, when the artificial intervertebral disc is inserted into the intervertebral space, its baseplates will be lordotically angled with respect to one another. Once the artificial intervertebral disc 160 is inserted, the inserter/impactor 400 can be disengaged, and the repositioner/extractors 500,510,520,530,540 discussed above can be applied to the artificial intervertebral disc, if necessary to achieve a more optimal positioning.
  • [0149]
    Once the positioning is established, the leveler 600 is preferably applied to the artificial intervertebral disc 160. The forked distal end of the leveler 600 is inserted so that the extents 604 a-b are placed between the inwardly facing surface 164 a of the upper baseplate 168 a and the inwardly facing surface 164 b of the convex structure 162 on the lower baseplate 168 b, and so that the central pocket 606 of the leveler 600 avoids the ball-and-socket joint of the artificial intervertebral disc 160. If the baseplates are lordotically angled with respect to one another, the tapered sections 612 a-b of the upper surfaces 608 a-b of the forked distal end will be approximately parallel to, and will first encounter, the angled inwardly facing surface 164 a of the upper baseplate 168 a. At the same time, the concave contours 614 a-b of the lower surfaces 610 a-b will accommodate the inwardly facing surface 164 b of the convex structure 162 on the lower baseplate 168 b. As the tapered sections 612 a-b press against the inwardly facing surface 164 a of the upper baseplate 168 a, and the concave contours 614 a-b slip into place against the inwardly facing surface 164 b of the convex structure 162 on the lower baseplate 168 b, the tapers 612 a-b will function as wedges to force the posterior portion of the upper baseplate 168 a away from the posterior portion of the lower baseplate 168 b. Accordingly, as the posterior portions are being separated, the stabilizing spikes 188 a-b on the outwardly facing surfaces 186 a-b of the baseplates 168 a-b find or secure their purchase in the hard bone of the outer ring of the vertebral body endplates. When the forked distal end is fully seated (stops 616 a-b are provided to butt up against the anterior portions of the baseplates 168 a-b to prevent the forked distal end from being inserted too far), the extents of the tongs 604 a-b hold the baseplates 168 a-b parallel to one another, and so that the spikes 188 a-b are fully engaged in the endplates. The surgeon then slips the leveler 600 out from between the baseplates 168 a-b, and out from the wound and completes the procedure. A handle 618 is provided at a proximal end of the shaft 602 for pushing, puling, and otherwise manipulating the leveler 600 as needed.
  • [0150]
    While there has been described and illustrated specific embodiments of instrumentation, it will be apparent to those skilled in the art that variations and modifications are possible without deviating from the broad spirit and principle of the invention. The invention, therefore, shall not be limited to the specific embodiments discussed herein.

Claims (20)

  1. 1. An apparatus for preparing an intervertebral space for implantation of an artificial intervertebral disc therein, the apparatus comprising:
    first and second apparatus baseplates immovably coupled to one another via a trunk extending therebetween,
    each apparatus baseplate having an outwardly facing surface approximating a contour of a corresponding outwardly facing surface of a disc baseplate of the articifial intervertebral disc,
    at least one of the apparatus baseplates having a plurality of engagement holes extending into the at least one of the apparatus baseplates in a direction substantially perpendicular to each of a plurality of a surgical approach directions used to insert the apparatus into the intervertebral space,
    each of the plurality of engagement holes being disposed on the at least one of the apparatus baseplates to correspond to a respective one of the surgical approach directions such that selection for use of one of the plurality of engagement holes corresponds to selection of the respective surgical approach.
  2. 2. The apparatus according to claim 1, wherein the contour includes a dome.
  3. 3. The apparatus according to claim 1, wherein the apparatus baseplates are angled with respect to one another at an apparatus baseplate angle of lordosis approximating a preferred angle of lordosis at which the disc baseplates are held during implantation of the disc.
  4. 4. An apparatus according to claim 3, wherein the preferred angle of lordosis is approximately 15 degrees.
  5. 5. The apparatus according to claim 1, wherein the trunk is cylindrical.
  6. 6. The apparatus according to claim 1, wherein the baseplates and the trunk are configured to form a groove.
  7. 7. The apparatus according to claim 6, wherein the groove is annular.
  8. 8. The apparatus according to claim 6, wherein a floor of the groove is narrower than an opening of the grove.
  9. 9. The apparatus according to claim 6, wherein a floor of the groove is ridged.
  10. 10. The apparatus according to claim 1, wherein at least one of the surgical approach directions is one of an anterior surgical approach direction and an anterior-lateral surgical approach direction.
  11. 11. The apparatus according to claim 10, wherein the surgical approach directions include an anterior surgical approach direction and two anterior-lateral surgical approach directions, the anterior-lateral surgical approach directions being substantially symmetrical with respect to one another about the anterior surgical approach direction.
  12. 12. The apparatus according to claim 11, wherein at least one of the baseplates comprises an anteriorly facing surface extending perpendicular to the anterior surgical approach direction, and two anterio-laterally facing surfaces, each extending perpendicular to a respective one of the anterior-lateral surgical approach directions, the anteriorly facing surface being between the two anterior-laterally facing surfaces.
  13. 13. The apparatus according to claim 12, wherein each of the anteriorly facing surfaces is angled at approximately 33.4 degrees with respect to each of the anterior-laterally facing surfaces.
  14. 14. The apparatus according to claim 12, wherein the anteriorly facing surface and each of the anterior-laterally facing surfaces has a respective one of the holes spaced inwardly therefrom.
  15. 15. A set of apparatuses according to claim 1, wherein each of the apparatuses has a combination of width and depth dimensions different from each other of the apparatuses.
  16. 16. The set of apparatuses according to claim 15, wherein the width dimension is in a range of 35 mm to 40 mm inclusively.
  17. 17. The set of apparatuses according to claim 15, wherein the depth dimension is in a range of 14 mm to 18 mm inclusively.
  18. 18. An apparatus for preparing an intervertebral space for implantation of an artificial intervertebral disc therein the apparatus comprising:
    first and second apparatus baseplates immovably coupled to one another via a trunk extending therebetween,
    each apparatus baseplate having an outwardly facing surface approximating a contour of a corresponding outwardly facing surface of a disc baseplate of the articifial intervertebral disc,
    at least one of the apparatus baseplates having a plurality of engagement holes extending into the at least one of the apparatus baseplates in a direction substantially perpendicular to each of a plurality of a surgical approach directions used to insert the apparatus into the intervertebral space,
    the plurality of engagement holes being disposed in pairs on the at least one of the apparatus baseplates, each of the pairs corresponding to a respective one of the surgical approach directions such that selection for use of one of the pairs of engagement holes corresponds to selection of the respective surgical approach.
  19. 19. The apparatus according to claim 18, wherein the surgical approach directions include an anterior surgical approach direction and two anterior-lateral surgical approach directions, the anterior-lateral surgical approach directions being substantially symmetrical with respect to one another about the anterior surgical approach direction, and wherein at least one of the baseplates comprises an anteriorly facing surface extending perpendicular to the anterior surgical approach direction, and two anterio-laterally facing surfaces, each extending perpendicular to a respective one of the anterior-lateral surgical approach directions, the anteriorly facing surface being between the two anterior-laterally facing surfaces.
  20. 20. The apparatus according to claim 12, wherein the anteriorly facing surface and each of the anterior-laterally facing surfaces has a respective one of the hole pairs spaced inwardly therefrom.
US10784597 2001-02-15 2004-10-12 Artificial intervertebral disc trials with baseplates having inward tool engagement holes Active 2026-01-26 US8357167B2 (en)

Priority Applications (11)

Application Number Priority Date Filing Date Title
US09906119 US6607559B2 (en) 2001-07-16 2001-07-16 Trial intervertebral distraction spacers
US09968046 US20020111687A1 (en) 2001-02-15 2001-10-01 Intervertebral spacer device utilizing a belleville washer having radially extending grooves
US09970479 US6669730B2 (en) 2001-02-15 2001-10-04 Intervertebral spacer device utilizing a spirally slotted belleville washer having radially extending grooves
US09982148 US6673113B2 (en) 2001-10-18 2001-10-18 Intervertebral spacer device having arch shaped spring elements
US10128619 US6863689B2 (en) 2001-07-16 2002-04-23 Intervertebral spacer having a flexible wire mesh vertebral body contact element
US10140153 US20030069642A1 (en) 2001-10-04 2002-05-07 Artificial intervertebral disc having a flexible wire mesh vertebral body contact element
US10151280 US7604664B2 (en) 2001-07-16 2002-05-20 Spinal baseplates with ball joint coupling and a retaining member
US10175417 US7563285B2 (en) 2001-07-16 2002-06-19 Artificial intervertebral disc utilizing a ball joint coupling
US10256160 US6989032B2 (en) 2001-07-16 2002-09-26 Artificial intervertebral disc
US10282356 US7169182B2 (en) 2001-07-16 2002-10-29 Implanting an artificial intervertebral disc
US10784597 US8357167B2 (en) 2001-07-16 2004-10-12 Artificial intervertebral disc trials with baseplates having inward tool engagement holes

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
US10784597 US8357167B2 (en) 2001-07-16 2004-10-12 Artificial intervertebral disc trials with baseplates having inward tool engagement holes

Related Parent Applications (1)

Application Number Title Priority Date Filing Date
US10282356 Continuation US7169182B2 (en) 2001-02-15 2002-10-29 Implanting an artificial intervertebral disc

Publications (3)

Publication Number Publication Date
US20050055095A1 true US20050055095A1 (en) 2005-03-10
US20100174371A9 true true US20100174371A9 (en) 2010-07-08
US8357167B2 US8357167B2 (en) 2013-01-22

Family

ID=39764719

Family Applications (7)

Application Number Title Priority Date Filing Date
US10282356 Active US7169182B2 (en) 2001-02-15 2002-10-29 Implanting an artificial intervertebral disc
US10784628 Active 2023-02-12 US7842043B2 (en) 2001-02-15 2004-02-23 Instrumentation for inserting and impacting an artificial intervertebral disc in an intervertebral space
US10784637 Expired - Fee Related US8636804B2 (en) 2001-02-15 2004-02-23 Instrumentation for properly seating an artificial intervertebral disc in an intervertebral space
US10784646 Active 2024-03-15 US7811289B2 (en) 2001-02-15 2004-02-23 Artificial intervertebral disc trial having a controllably separable distal end
US10784629 Expired - Fee Related US7632281B2 (en) 2001-02-15 2004-02-23 Instrumentation for manipulating artificial intervertebral disc trials having a cylindrical engagement surface
US10784597 Active 2026-01-26 US8357167B2 (en) 2001-02-15 2004-10-12 Artificial intervertebral disc trials with baseplates having inward tool engagement holes
US10784598 Active 2026-08-08 US8758358B2 (en) 2001-02-15 2004-10-12 Instrumentation for repositioning and extraction an artificial intervertebral disc from an intervertebral space

Family Applications Before (5)

Application Number Title Priority Date Filing Date
US10282356 Active US7169182B2 (en) 2001-02-15 2002-10-29 Implanting an artificial intervertebral disc
US10784628 Active 2023-02-12 US7842043B2 (en) 2001-02-15 2004-02-23 Instrumentation for inserting and impacting an artificial intervertebral disc in an intervertebral space
US10784637 Expired - Fee Related US8636804B2 (en) 2001-02-15 2004-02-23 Instrumentation for properly seating an artificial intervertebral disc in an intervertebral space
US10784646 Active 2024-03-15 US7811289B2 (en) 2001-02-15 2004-02-23 Artificial intervertebral disc trial having a controllably separable distal end
US10784629 Expired - Fee Related US7632281B2 (en) 2001-02-15 2004-02-23 Instrumentation for manipulating artificial intervertebral disc trials having a cylindrical engagement surface

Family Applications After (1)

Application Number Title Priority Date Filing Date
US10784598 Active 2026-08-08 US8758358B2 (en) 2001-02-15 2004-10-12 Instrumentation for repositioning and extraction an artificial intervertebral disc from an intervertebral space

Country Status (3)

Country Link
US (7) US7169182B2 (en)
JP (1) JP4979741B2 (en)
CA (2) CA2632125C (en)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20060264959A1 (en) * 2005-05-23 2006-11-23 Custom Spine, Inc. Rod pusher
US7896919B2 (en) * 2003-08-04 2011-03-01 Zimmer Spine S.A.S. Method of implanting intervertebral disk prosthesis
US8142441B2 (en) * 2008-10-16 2012-03-27 Aesculap Implant Systems, Llc Surgical instrument and method of use for inserting an implant between two bones
US9034046B2 (en) 2007-10-30 2015-05-19 Aesculap Implant Systems, Llc Vertebral body replacement device and method for use to maintain a space between two vertebral bodies within a spine
US20150230930A1 (en) * 2009-05-06 2015-08-20 Stryker European Holdings I, Llc Expandable spinal implant apparatus and method of use

Families Citing this family (203)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20080215058A1 (en) * 1997-01-02 2008-09-04 Zucherman James F Spine distraction implant and method
DE59914691D1 (en) 1999-07-02 2008-04-24 Spine Solutions Inc Intervertebral implant
EP1792586B1 (en) * 1999-09-14 2012-12-26 Spine Solutions Inc. Insert instrument for an implant between vertebrae
US20050027361A1 (en) * 1999-10-22 2005-02-03 Reiley Mark A. Facet arthroplasty devices and methods
WO2001062191B1 (en) * 2000-02-22 2002-03-21 Sdgi Holdings Inc Anterior impacted bone graft and driver instruments
USRE43317E1 (en) 2000-05-08 2012-04-17 Depuy Spine, Inc. Medical installation tool
USRE45639E1 (en) 2000-05-08 2015-08-04 DePuy Synthes Products, Inc. Medical installation tool
US7115132B2 (en) 2001-07-16 2006-10-03 Spinecore, Inc. Static trials and related instruments and methods for use in implanting an artificial intervertebral disc
US7771477B2 (en) * 2001-10-01 2010-08-10 Spinecore, Inc. Intervertebral spacer device utilizing a belleville washer having radially spaced concentric grooves
US8940047B2 (en) * 2001-02-15 2015-01-27 Spinecore, Inc. Intervertebral spacer device having recessed notch pairs for manipulation using a surgical tool
US8366775B2 (en) * 2001-07-16 2013-02-05 Spinecore, Inc. Intervertebral spacer device having an angled perimeter for manipulation using a surgical tool
US7491241B2 (en) 2001-07-16 2009-02-17 Spinecore, Inc. Intervertebral spacer device having recessed notch pairs for manipulation using a surgical tool
US6989032B2 (en) * 2001-07-16 2006-01-24 Spinecore, Inc. Artificial intervertebral disc
US20030069642A1 (en) * 2001-10-04 2003-04-10 Ralph James D. Artificial intervertebral disc having a flexible wire mesh vertebral body contact element
US7169182B2 (en) * 2001-07-16 2007-01-30 Spinecore, Inc. Implanting an artificial intervertebral disc
US7563285B2 (en) * 2001-07-16 2009-07-21 Spinecore, Inc. Artificial intervertebral disc utilizing a ball joint coupling
US8858564B2 (en) * 2001-02-15 2014-10-14 Spinecore, Inc. Wedge plate inserter/impactor and related methods for use in implanting an artificial intervertebral disc
US7575576B2 (en) * 2001-07-16 2009-08-18 Spinecore, Inc. Wedge ramp distractor and related methods for use in implanting artificial intervertebral discs
US7208014B2 (en) * 2001-10-01 2007-04-24 Spinecore, Inc. Intervertebral spacer device utilizing a belleville washer having radially extending grooves
US7713302B2 (en) 2001-10-01 2010-05-11 Spinecore, Inc. Intervertebral spacer device utilizing a spirally slotted belleville washer having radially spaced concentric grooves
US7604664B2 (en) 2001-07-16 2009-10-20 Spinecore, Inc. Spinal baseplates with ball joint coupling and a retaining member
US6669730B2 (en) 2001-02-15 2003-12-30 Spinecore, Inc. Intervertebral spacer device utilizing a spirally slotted belleville washer having radially extending grooves
US7223291B2 (en) * 2001-07-16 2007-05-29 Spinecore, Inc. Intervertebral spacer device having engagement hole pairs for manipulation using a surgical tool
US7235081B2 (en) * 2001-07-16 2007-06-26 Spinecore, Inc. Wedge plate inserter/impactor and related methods for use in implanting an artificial intervertebral disc
US20090177283A9 (en) * 2001-10-01 2009-07-09 Ralph James D Intervertebral spacer device utilizing a spirally slotted belleville washer and a rotational mounting
FR2824261B1 (en) 2001-05-04 2004-05-28 Ldr Medical intervertebral disc prosthesis and method and implementation tools
US7722675B2 (en) * 2001-07-16 2010-05-25 Spinecore, Inc. Instruments for reorienting vertebral bones for the treatment of scoliosis
JP4654125B2 (en) * 2002-10-29 2011-03-16 スパインコア,インコーポレイテッド Instrumentation for use in implanting an artificial intervertebral disc, and functions
US6607559B2 (en) 2001-07-16 2003-08-19 Spine Care, Inc. Trial intervertebral distraction spacers
US6673113B2 (en) * 2001-10-18 2004-01-06 Spinecore, Inc. Intervertebral spacer device having arch shaped spring elements
US20080027548A9 (en) 2002-04-12 2008-01-31 Ferree Bret A Spacerless artificial disc replacements
US8038713B2 (en) 2002-04-23 2011-10-18 Spinecore, Inc. Two-component artificial disc replacements
US6706068B2 (en) 2002-04-23 2004-03-16 Bret A. Ferree Artificial disc replacements with natural kinematics
US8388684B2 (en) 2002-05-23 2013-03-05 Pioneer Signal Technology, Inc. Artificial disc device
US8043376B2 (en) * 2002-06-14 2011-10-25 Us Spine, Inc. Percutaneous posterior lateral in-situ cage
ES2306774T3 (en) * 2002-09-18 2008-11-16 Synthes Gmbh Implant with a two part linkage.
JP4429909B2 (en) * 2002-09-19 2010-03-10 ビリアーズ, マラン デ Intervertebral prosthesis
EP1558184A2 (en) * 2002-10-08 2005-08-03 SDGI Holdings, Inc. Insertion device and techniques for orthopaedic implants
JP2007521843A (en) 2003-05-15 2007-08-09 バイオメリクス コーポレーション Reticulated elastomeric matrix, their preparation and use in implantable devices
FR2846550B1 (en) 2002-11-05 2006-01-13 Ldr Medical Prothese of intervertebral disc
US7204852B2 (en) 2002-12-13 2007-04-17 Spine Solutions, Inc. Intervertebral implant, insertion tool and method of inserting same
US7364589B2 (en) * 2003-02-12 2008-04-29 Warsaw Orthopedic, Inc. Mobile bearing articulating disc
EP1681985A4 (en) * 2003-10-17 2011-06-01 Spinecore Inc Intervertebral disc replacement trial
US6908484B2 (en) 2003-03-06 2005-06-21 Spinecore, Inc. Cervical disc replacement
WO2004084742A1 (en) * 2003-03-24 2004-10-07 Theken Surgical Llc Spinal implant adjustment device
US20040193259A1 (en) * 2003-03-25 2004-09-30 Shlomo Gabbay Sizing apparatus for cardiac prostheses and method of using same
US7510573B2 (en) * 2003-03-25 2009-03-31 Shlomo Gabbay Sizing apparatus
CA2519925A1 (en) * 2003-04-07 2004-10-21 Cervitech, Inc. Prosthetic joint of cervical intervertebral for a cervical spine
US8012212B2 (en) * 2003-04-07 2011-09-06 Nuvasive, Inc. Cervical intervertebral disk prosthesis
US7491204B2 (en) * 2003-04-28 2009-02-17 Spine Solutions, Inc. Instruments and method for preparing an intervertebral space for receiving an artificial disc implant
US7105024B2 (en) * 2003-05-06 2006-09-12 Aesculap Ii, Inc. Artificial intervertebral disc
US7291173B2 (en) 2003-05-06 2007-11-06 Aesculap Ii, Inc. Artificial intervertebral disc
US20050143824A1 (en) * 2003-05-06 2005-06-30 Marc Richelsoph Artificial intervertebral disc
DE10324108B3 (en) * 2003-05-21 2005-01-27 Aesculap Ag & Co. Kg Backbone implant is inserted with contracted contact disc which is expanded to optimum area following insertion
EP2226038A1 (en) * 2003-05-27 2010-09-08 Spinalmotion, Inc. Prosthetic disc for intervertebral insertion
DE10330698B4 (en) * 2003-07-08 2005-05-25 Aesculap Ag & Co. Kg Intervertebral implant
US20050015095A1 (en) * 2003-07-15 2005-01-20 Cervitech, Inc. Insertion instrument for cervical prostheses
US7320689B2 (en) * 2003-07-15 2008-01-22 Cervitech, Inc. Multi-part cervical endoprosthesis with insertion instrument
US7803162B2 (en) * 2003-07-21 2010-09-28 Spine Solutions, Inc. Instruments and method for inserting an intervertebral implant
US7806932B2 (en) * 2003-08-01 2010-10-05 Zimmer Spine, Inc. Spinal implant
DE10339170B4 (en) * 2003-08-22 2009-10-15 Aesculap Ag Intervertebral implant
DE20315613U1 (en) * 2003-10-08 2003-12-11 Aesculap Ag & Co. Kg Intervertebral implant
US7588590B2 (en) * 2003-12-10 2009-09-15 Facet Solutions, Inc Spinal facet implant with spherical implant apposition surface and bone bed and methods of use
US8562649B2 (en) * 2004-02-17 2013-10-22 Gmedelaware 2 Llc System and method for multiple level facet joint arthroplasty and fusion
US7588578B2 (en) * 2004-06-02 2009-09-15 Facet Solutions, Inc Surgical measurement systems and methods
US7763077B2 (en) 2003-12-24 2010-07-27 Biomerix Corporation Repair of spinal annular defects and annulo-nucleoplasty regeneration
US8123757B2 (en) 2003-12-31 2012-02-28 Depuy Spine, Inc. Inserter instrument and implant clip
US7625379B2 (en) * 2004-01-26 2009-12-01 Warsaw Orthopedic, Inc. Methods and instrumentation for inserting intervertebral grafts and devices
FR2865629B1 (en) 2004-02-04 2007-01-26 Ldr Medical Prothese of intervertebral disc
US7393361B2 (en) * 2004-02-20 2008-07-01 Spinecore, Inc. Artificial intervertebral disc having a bored semispherical bearing with a compression locking post and retaining caps
CA2556486C (en) * 2004-02-20 2010-03-23 Spinecore, Inc. Artificial intervertebral disc having a universal joint
US20050222683A1 (en) * 2004-03-31 2005-10-06 Sdgi Holdings Shape memory alloy disc replacement device
FR2869528B1 (en) 2004-04-28 2007-02-02 Ldr Medical Prothese of intervertebral disc
US20050251261A1 (en) * 2004-05-05 2005-11-10 Sdgi Holdings, Inc. Artificial intervertebral disc for lateral insertion
DE202004009542U1 (en) * 2004-06-16 2004-08-12 Aesculap Ag & Co. Kg Artificial intervertebral disk, comprising core with intensely curved upper and less curved lower surface
US7608080B2 (en) * 2004-07-02 2009-10-27 Warsaw Orthopedic, Inc. Device for inserting implants
US20060009541A1 (en) * 2004-07-09 2006-01-12 Yih-Fang Chen Saturant for friction material containing friction modifying layer
JP2008505708A (en) * 2004-07-09 2008-02-28 パイオニア ラボラトリーズ インコーポレイテッド Skeletal reconstruction device
US7585326B2 (en) 2004-08-06 2009-09-08 Spinalmotion, Inc. Methods and apparatus for intervertebral disc prosthesis insertion
DE102004043996B4 (en) * 2004-09-08 2008-04-17 Aesculap Ag & Co. Kg A surgical instrument and implant system
DE102004043995A1 (en) * 2004-09-08 2006-03-30 Aesculap Ag & Co. Kg A surgical instrument
US7547309B2 (en) * 2004-09-23 2009-06-16 Spine Solutions, Inc. Distractor for lumbar insertion instrument
US20060069436A1 (en) * 2004-09-30 2006-03-30 Depuy Spine, Inc. Trial disk implant
WO2006042484A1 (en) * 2004-10-18 2006-04-27 Buettner-Janz Karin Bent sliding core as part of an intervertebral disk endoprosthesis
WO2006042487A1 (en) 2004-10-18 2006-04-27 Buettner-Janz Karin Intervertebral disc endoprosthesis having cylindrical articulation surfaces
WO2006044920A3 (en) * 2004-10-19 2006-12-21 David Chow Adjustable instrumentation for spinal implant insertion
US20060229627A1 (en) * 2004-10-29 2006-10-12 Hunt Margaret M Variable angle spinal surgery instrument
US20060149284A1 (en) * 2004-12-15 2006-07-06 Sdgi Holdings, Inc. Insertion device and method for inserting a member within the body
FR2879436B1 (en) * 2004-12-22 2007-03-09 Ldr Medical Prothese of intervertebral disc
US7488330B2 (en) * 2005-01-27 2009-02-10 Depuy Spine, Inc. Modular static intervertebral trial
US8083797B2 (en) 2005-02-04 2011-12-27 Spinalmotion, Inc. Intervertebral prosthetic disc with shock absorption
US8911498B2 (en) * 2005-02-10 2014-12-16 DePuy Synthes Products, LLC Intervertebral prosthetic disc
US7690381B2 (en) * 2005-02-10 2010-04-06 Depuy Spine, Inc. Intervertebral prosthetic disc and method for installing using a guidewire
US8353933B2 (en) * 2007-04-17 2013-01-15 Gmedelaware 2 Llc Facet joint replacement
EP1879530A2 (en) * 2005-04-19 2008-01-23 Ali Adl Hinged artificial spinal disk device
US20060241641A1 (en) * 2005-04-22 2006-10-26 Sdgi Holdings, Inc. Methods and instrumentation for distraction and insertion of implants in a spinal disc space
US20060247655A1 (en) * 2005-05-02 2006-11-02 Sdgi Holdings, Inc. Instrument to insert a prosthetic implant
US8777959B2 (en) 2005-05-27 2014-07-15 Spinecore, Inc. Intervertebral disc and insertion methods therefor
US8864829B1 (en) 2007-07-02 2014-10-21 Theken Spine, Llc Spinal cage having deployable member
FR2887762B1 (en) 2005-06-29 2007-10-12 Ldr Medical Soc Par Actions Si insertion instrumentation intervertebral disk prosthesis between vertebrae
US20070244562A1 (en) * 2005-08-26 2007-10-18 Magellan Spine Technologies, Inc. Spinal implants and methods of providing dynamic stability to the spine
US20070050028A1 (en) * 2005-08-26 2007-03-01 Conner E S Spinal implants and methods of providing dynamic stability to the spine
FR2891135B1 (en) * 2005-09-23 2008-09-12 Ldr Medical Sarl Prothese of intervertebral disc
US7618459B2 (en) * 2005-09-26 2009-11-17 Infinity Orthopedics Ltd. Universal spinal disc implant system
US8696681B2 (en) * 2005-09-29 2014-04-15 K2M, Inc. Adjustable interbody introducer device and method
US20070123904A1 (en) * 2005-10-31 2007-05-31 Depuy Spine, Inc. Distraction instrument and method for distracting an intervertebral site
US7867237B2 (en) * 2005-10-31 2011-01-11 Depuy Spine, Inc. Arthroplasty revision device and method
US20070123903A1 (en) * 2005-10-31 2007-05-31 Depuy Spine, Inc. Medical Device installation tool and methods of use
FR2893838B1 (en) 2005-11-30 2008-08-08 Ldr Medical Soc Par Actions Si intervertebral disk prosthesis and instrumentation for inserting the prosthesis between the vertebrae
US20070168040A1 (en) * 2006-01-17 2007-07-19 Douglas Raymond Motion disc spike seating instrument
US7867279B2 (en) * 2006-01-23 2011-01-11 Depuy Spine, Inc. Intervertebral disc prosthesis
US8377072B2 (en) * 2006-02-06 2013-02-19 Depuy Spine, Inc. Medical device installation tool
US8409290B2 (en) 2006-03-08 2013-04-02 Seaspine, Inc. Interbody device for spinal applications
US20070213826A1 (en) 2006-03-08 2007-09-13 Seaspine, Inc. Intervertebral spacer and insertion tool providing multiple angles of insertion
US20070213737A1 (en) * 2006-03-08 2007-09-13 Seaspine, Inc. Insertion tool for an intervertebral spacer providing multiple angles of insertion
US7875034B2 (en) * 2006-03-14 2011-01-25 Warsaw Orthopedic, Inc. Spinal disc space preparation instruments and methods for interbody spinal implants
US7806901B2 (en) * 2006-03-17 2010-10-05 Depuy Spine, Inc. Arthroplasty final seating instruments
KR20090007418A (en) 2006-04-12 2009-01-16 스피날모우션, 인코포레이티드 Posterior spinal device and method
CA2651884A1 (en) * 2006-05-10 2007-11-22 Biomerix Corp Spinal implants and devices and methods for their controlled insertion
DE102006024809A1 (en) * 2006-05-27 2007-11-29 Copf jun., Franz, Dr. Surgical extractor for the operative removal of plate prosthetics comprises a support plate with a hinge part and two fork-like sides inserted into the intermediate chamber between support plates to support blocking elements
US8303601B2 (en) 2006-06-07 2012-11-06 Stryker Spine Collet-activated distraction wedge inserter
CA2658876C (en) 2006-07-24 2015-03-17 Spine Solutions, Inc. Intervertebral implant with keel
US20080027544A1 (en) * 2006-07-28 2008-01-31 Warsaw Orthopedic Inc. Instruments and techniques for engaging spinal implants for insertion into a spinal space
CN101547656A (en) 2006-07-31 2009-09-30 辛迪思有限责任公司 Drilling/milling guide and keel cut preparation system
US8409213B2 (en) * 2006-08-10 2013-04-02 Pioneer Surgical Technology, Inc. Insertion instrument for artificial discs
US7976550B2 (en) * 2006-08-10 2011-07-12 Pioneer Surgical Technology Insertion instrument for artificial discs
WO2008021972A3 (en) * 2006-08-10 2008-07-03 Pioneer Surgical Tech Inc Intervertebral disc space sizing tools and methods
US8118872B2 (en) * 2006-08-10 2012-02-21 Pioneer Surgical Technology, Inc. System and methods for inserting a spinal disc device into an intervertebral space
WO2010065545A1 (en) * 2008-12-01 2010-06-10 Pioneer Surgical Technology, Inc Intervertebral disc space sizing tools and methods
US8414616B2 (en) * 2006-09-12 2013-04-09 Pioneer Surgical Technology, Inc. Mounting devices for fixation devices and insertion instruments used therewith
US8715350B2 (en) 2006-09-15 2014-05-06 Pioneer Surgical Technology, Inc. Systems and methods for securing an implant in intervertebral space
US8454621B2 (en) * 2006-09-19 2013-06-04 Warsaw Orthopedic, Inc. Instruments and methods for spinal implant revision
US20100292800A1 (en) 2006-09-21 2010-11-18 Spinecore, Inc. Intervertebral disc implants and tooling
US8372084B2 (en) 2006-09-22 2013-02-12 Pioneer Surgical Technology, Inc. System and methods for inserting a spinal disc device into an intervertebral space
US7686809B2 (en) 2006-09-25 2010-03-30 Stryker Spine Rod inserter and rod with reduced diameter end
US9381098B2 (en) * 2006-09-28 2016-07-05 Spinal Kinetics, Inc. Tool systems for implanting prosthetic intervertebral discs
US8715352B2 (en) * 2006-12-14 2014-05-06 Depuy Spine, Inc. Buckling disc replacement
US8465546B2 (en) * 2007-02-16 2013-06-18 Ldr Medical Intervertebral disc prosthesis insertion assemblies
US8579910B2 (en) 2007-05-18 2013-11-12 DePuy Synthes Products, LLC Insertion blade assembly and method of use
FR2916956B1 (en) 2007-06-08 2012-12-14 Ldr Medical The intersomatic cage, intervertebral prosthesis, the anchoring device and implant instrumentation
US8292958B1 (en) 2007-07-02 2012-10-23 Theken Spine, Llc Spinal cage having deployable member
US8142508B1 (en) 2007-07-02 2012-03-27 Theken Spine, Llc Spinal cage having deployable member which is removable
US8545562B1 (en) 2007-07-02 2013-10-01 Theken Spine, Llc Deployable member for use with an intervertebral cage
US8486081B2 (en) 2007-07-23 2013-07-16 DePuy Synthes Products, LLC Implant insertion device and method
US20090043391A1 (en) 2007-08-09 2009-02-12 Spinalmotion, Inc. Customized Intervertebral Prosthetic Disc with Shock Absorption
US8801758B2 (en) 2007-08-13 2014-08-12 Stryker Spine Insertion instrument for intervertebral implants
US8758441B2 (en) * 2007-10-22 2014-06-24 Spinalmotion, Inc. Vertebral body replacement and method for spanning a space formed upon removal of a vertebral body
US8267997B2 (en) * 2007-11-12 2012-09-18 Theken Spine, Llc Vertebral interbody compression implant
US20090138084A1 (en) * 2007-11-19 2009-05-28 Magellan Spine Technologies, Inc. Spinal implants and methods
WO2009091615A3 (en) 2008-01-18 2009-12-30 Spinecore, Inc. Instruments and methods for inserting artificial intervertebral implants
WO2009094477A1 (en) * 2008-01-25 2009-07-30 Spinalmotion, Inc. Compliant implantable prosthetic joint with preloaded spring
US9247943B1 (en) 2009-02-06 2016-02-02 Kleiner Intellectual Property, Llc Devices and methods for preparing an intervertebral workspace
US8840622B1 (en) 2008-02-14 2014-09-23 Nuvasive, Inc. Implant installation assembly and related methods
US8343163B1 (en) 2008-02-14 2013-01-01 Nuvasive, Inc. Spinal implant installation device
US20090222011A1 (en) * 2008-02-28 2009-09-03 Warsaw Orthopedic, Inc. Targeting surgical instrument for use in spinal disc replacement and methods for use in spinal disc replacement
US8216317B2 (en) 2008-03-31 2012-07-10 Stryker Spine Spinal implant apparatus and methods
US8147499B2 (en) * 2008-04-24 2012-04-03 Spinecore, Inc. Dynamic distractor
EP2116211A1 (en) * 2008-05-05 2009-11-11 Christian Röbling Intervertebral prosthesis
JP2011519637A (en) * 2008-05-05 2011-07-14 スパイナルモーション, インコーポレイテッド Polyaryletherketone artificial disc
US8172902B2 (en) * 2008-07-17 2012-05-08 Spinemedica, Llc Spinal interbody spacers
US8114088B2 (en) 2008-09-19 2012-02-14 Zimmer Spine, Inc. Geared spinal implant inserter-distractor
US8366748B2 (en) 2008-12-05 2013-02-05 Kleiner Jeffrey Apparatus and method of spinal implant and fusion
US8425603B2 (en) * 2008-12-22 2013-04-23 Synthes Usa, Llc Orthopedic implant with flexible keel
US20120035730A1 (en) 2008-12-26 2012-02-09 Scott Spann Minimally-invasive retroperitoneal lateral approach for spinal surgery
US8636746B2 (en) 2009-12-31 2014-01-28 Spinex Tec, Llc Methods and apparatus for insertion of vertebral body distraction and fusion devices
US8523944B2 (en) 2008-12-31 2013-09-03 Spinex Tec, Llc Methods and apparatus for vertebral body distraction and fusion employing flexure members
US9480511B2 (en) 2009-12-17 2016-11-01 Engage Medical Holdings, Llc Blade fixation for ankle fusion and arthroplasty
US20100262245A1 (en) * 2009-02-18 2010-10-14 Alfaro Arthur A Intervertebral spacer
US8628577B1 (en) 2009-03-19 2014-01-14 Ex Technology, Llc Stable device for intervertebral distraction and fusion
US8906033B2 (en) * 2009-03-30 2014-12-09 DePuy Synthes Products, LLC Cervical motion disc inserter
WO2010120970A1 (en) * 2009-04-15 2010-10-21 Synthes Usa, Llc Trial implant assembly
US20100286777A1 (en) 2009-05-08 2010-11-11 Stryker Spine Stand alone anterior cage
EP2432429B1 (en) * 2009-05-19 2016-03-30 Synthes GmbH Dynamic trial implants
KR101043865B1 (en) * 2009-06-30 2011-06-22 주식회사 하이닉스반도체 Fuse structure for high integrated semiconductor device
EP2456396B1 (en) 2009-07-22 2017-09-13 Spinex Tec, LLC Apparatuses for vertebral body distraction and fusion employing a coaxial screw gear sleeve mechanism
US9629729B2 (en) 2009-09-18 2017-04-25 Spinal Surgical Strategies, Llc Biological delivery system with adaptable fusion cage interface
US9668882B2 (en) * 2009-10-02 2017-06-06 Amedica Corporation Biomedical implant inserters and related apparatus, systems, and methods
US9028553B2 (en) 2009-11-05 2015-05-12 DePuy Synthes Products, Inc. Self-pivoting spinal implant and associated instrumentation
US9301853B2 (en) * 2010-04-09 2016-04-05 DePuy Synthes Products, Inc. Holder for implantation and extraction of prosthesis
US8425529B2 (en) 2010-09-30 2013-04-23 Stryker Spine Instrument for inserting surgical implant with guiding rail
US8603175B2 (en) 2010-09-30 2013-12-10 Stryker Spine Method of inserting surgical implant with guiding rail
US8858637B2 (en) 2010-09-30 2014-10-14 Stryker Spine Surgical implant with guiding rail
US20120116457A1 (en) * 2010-11-06 2012-05-10 Limited Liability Company; Stabilizer for assisting stabilization of a spinal implant and method of using the stabilizer
US9925051B2 (en) 2010-12-16 2018-03-27 Engage Medical Holdings, Llc Arthroplasty systems and methods
US8603101B2 (en) 2010-12-17 2013-12-10 Zimmer, Inc. Provisional tibial prosthesis system
US9597090B2 (en) 2010-12-17 2017-03-21 Zimmer, Inc. Cut guide attachment for use in tibial prosthesis systems
EP2608749B1 (en) 2011-03-11 2016-08-10 FBC Device Aps Spinal implant
KR101297346B1 (en) 2011-04-01 2013-08-19 김희경 Intervertebral disk prosthesis
US9220607B2 (en) * 2011-10-28 2015-12-29 Warsaw Oorthopedic, Inc. Pivotable interbody implant system
US9254130B2 (en) 2011-11-01 2016-02-09 Hyun Bae Blade anchor systems for bone fusion
US9615856B2 (en) 2011-11-01 2017-04-11 Imds Llc Sacroiliac fusion cage
US9492290B2 (en) 2012-03-30 2016-11-15 Zimmer, Inc. Tibial prosthesis systems, kits, and methods
US9855065B2 (en) * 2012-09-28 2018-01-02 Depuy Ireland Unlimited Company Orthopaedic surgical instrument assembly for implanting a prosthetic patella component
US9445918B1 (en) 2012-10-22 2016-09-20 Nuvasive, Inc. Expandable spinal fusion implants and related instruments and methods
EP2724692B1 (en) * 2012-10-24 2015-05-20 WALDEMAR LINK GmbH & Co. KG Holder for a medical implant
US9872777B2 (en) * 2013-03-15 2018-01-23 Paradigm Spine, Llc Modular, customizable spine stabilization system
US9592133B2 (en) 2013-09-23 2017-03-14 Zimmer, Inc. Spacer block
US9486328B2 (en) 2014-04-01 2016-11-08 Ex Technology, Llc Expandable intervertebral cage
US8940049B1 (en) 2014-04-01 2015-01-27 Ex Technology, Llc Expandable intervertebral cage
US9440623B2 (en) * 2014-11-07 2016-09-13 Jeffery Beauregard Pitts Landing gear locking mechanism
USD797290S1 (en) 2015-10-19 2017-09-12 Spinal Surgical Strategies, Llc Bone graft delivery tool
USD814037S1 (en) * 2017-01-17 2018-03-27 Paragon 28, Inc. Spacer wedge
USD813394S1 (en) * 2017-01-17 2018-03-20 Paragon 28, Inc. Wedge insert

Citations (99)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6179873B2 (en) *
US916421A (en) * 1908-10-09 1909-03-30 Orlando Crittenden Nut-lock.
US1425845A (en) * 1922-02-23 1922-08-15 Robert B Foster Flange wrench
US1518205A (en) * 1922-06-13 1924-12-09 Kountz John Burt Fishing-rod handle
US1539221A (en) * 1923-10-30 1925-05-26 Tennant John William Welder's rod holder
US1882462A (en) * 1931-07-31 1932-10-11 Weber Stanley Spanner wrench
US2121682A (en) * 1936-06-23 1938-06-21 Boucher Parks Filler rod holder
US2127424A (en) * 1936-09-19 1938-08-16 No Kap Closures U S A Inc Nozzle closure means for containers and washers for use therein
US2319992A (en) * 1941-08-13 1943-05-25 Chance Co Ab Operating tool for high tension electric lines
US2669896A (en) * 1951-01-19 1954-02-23 Robert S Clough Retractable jaw wrench having parallel resilient jaws
US2719688A (en) * 1949-11-21 1955-10-04 Seifert Karl Telescopic tubes
US3195380A (en) * 1963-09-20 1965-07-20 Bicks Jean Leonard Device for engaging, holding and releasing objects
US3278107A (en) * 1963-07-24 1966-10-11 Cv Heljestrand Ab Instrument for applying so-called staple sutures
US3326254A (en) * 1965-06-21 1967-06-20 Julius A Diehl Holder for elongated article
US3486505A (en) * 1967-05-22 1969-12-30 Gordon M Morrison Orthopedic surgical instrument
US3604487A (en) * 1969-03-10 1971-09-14 Richard S Gilbert Orthopedic screw driving means
US3659661A (en) * 1970-02-02 1972-05-02 Dresser Ind Earth boring machine
US3679244A (en) * 1970-09-21 1972-07-25 Robert R Reddy Releasable shaft lock
US3743042A (en) * 1972-09-11 1973-07-03 K Hilterhaus Gaff-scale
US3948141A (en) * 1974-08-20 1976-04-06 Katsumi Shinjo Load indicating washer
US4077618A (en) * 1977-03-24 1978-03-07 Durant Thomas O Portable vise
US4105407A (en) * 1975-04-24 1978-08-08 Sanderson Roger S Sterilizing and storing medical items
US4263903A (en) * 1979-01-08 1981-04-28 Richards Manufacturing Co., Inc. Medical staple means
US4303001A (en) * 1977-08-18 1981-12-01 Trungold Emanuel H Bolt tension indicating means
US4303268A (en) * 1980-05-22 1981-12-01 Davidson Harvey D Method and apparatus for removing embedded ticks
US4317387A (en) * 1980-05-23 1982-03-02 General Motors Corporation Telescoping steering assembly
US4457484A (en) * 1981-12-28 1984-07-03 Hameister Helen M Display mounting assembly for collector plates
US4528980A (en) * 1983-10-19 1985-07-16 Howmedica, Inc. Acetabulum sizer and drill guide
US4531517A (en) * 1983-03-24 1985-07-30 Forte Thomas E Extractor for intramedullary fasteners
US4917704A (en) * 1987-07-09 1990-04-17 Sulzer Brothers Limited Intervertebral prosthesis
US4955908A (en) * 1987-07-09 1990-09-11 Sulzer Brothers Limited Metallic intervertebral prosthesis
US4968010A (en) * 1988-03-09 1990-11-06 Odobasic Steven Lazar Slotted disc and elastomeric matrix damper assembly
US4969907A (en) * 1985-01-08 1990-11-13 Sulzer Brothers Limited Metal bone implant
US4997432A (en) * 1988-03-23 1991-03-05 Waldemar Link Gmbh & Co. Surgical instrument set
US5002576A (en) * 1988-06-06 1991-03-26 Mecron Medizinische Produkte Gmbh Intervertebral disk endoprosthesis
US5015247A (en) * 1988-06-13 1991-05-14 Michelson Gary K Threaded spinal implant
US5030219A (en) * 1990-01-22 1991-07-09 Boehringer Mannheim Corporation Glenoid component installation tools
US5192327A (en) * 1991-03-22 1993-03-09 Brantigan John W Surgical prosthetic implant for vertebrae
US5258007A (en) * 1992-05-14 1993-11-02 Robert F. Spetzler Powered surgical instrument
US5306309A (en) * 1992-05-04 1994-04-26 Calcitek, Inc. Spinal disk implant and implantation kit
US5314477A (en) * 1990-03-07 1994-05-24 J.B.S. Limited Company Prosthesis for intervertebral discs and instruments for implanting it
US5376120A (en) * 1992-10-21 1994-12-27 Biomet, Inc. Biocompatible implant and method of using same
US5405400A (en) * 1993-10-05 1995-04-11 Orthomet, Inc. Joint prosthesis enabling rotary circumduction
US5443514A (en) * 1993-10-01 1995-08-22 Acromed Corporation Method for using spinal implants
US5458641A (en) * 1993-09-08 1995-10-17 Ramirez Jimenez; Juan J. Vertebral body prosthesis
US5514180A (en) * 1994-01-14 1996-05-07 Heggeness; Michael H. Prosthetic intervertebral devices
US5534029A (en) * 1992-12-14 1996-07-09 Yumiko Shima Articulated vertebral body spacer
US5549690A (en) * 1993-12-17 1996-08-27 Avanta Orthopaedics Prosthetic thumb joint and method of manufacture
US5556432A (en) * 1991-12-11 1996-09-17 Joachim Theusner Artificial joint
US5562736A (en) * 1994-10-17 1996-10-08 Raymedica, Inc. Method for surgical implantation of a prosthetic spinal disc nucleus
US5571109A (en) * 1993-08-26 1996-11-05 Man Ceramics Gmbh System for the immobilization of vertebrae
US5593456A (en) * 1994-05-17 1997-01-14 Crp, Inc. Foot and leg prosthesis and method of making same
US5599279A (en) * 1994-03-16 1997-02-04 Gus J. Slotman Surgical instruments and method useful for endoscopic spinal procedures
US5645605A (en) * 1995-09-18 1997-07-08 Ascension Orthopedics, Inc. Implant device to replace the carpometacarpal joint of the human thumb
US5653762A (en) * 1994-03-18 1997-08-05 Pisharodi; Madhavan Method of stabilizing adjacent vertebrae with rotating, lockable, middle-expanded intervertebral disk stabilizer
US5667347A (en) * 1992-12-10 1997-09-16 Matthews; Norman Leslie Fastener
US5674295A (en) * 1994-10-17 1997-10-07 Raymedica, Inc. Prosthetic spinal disc nucleus
US5683399A (en) * 1995-12-01 1997-11-04 Stelkast Incorporated Acetabular cup insertion tool
US5718254A (en) * 1996-10-25 1998-02-17 Murphy; David A. Adjustable bed canopy and curtain system
US5732992A (en) * 1996-12-26 1998-03-31 Exactech, Incorporated Medical appliance tool providing one hand actuation
US5733290A (en) * 1995-12-21 1998-03-31 Johnson & Johnson Professional, Inc. Quick-release tibial alignment handle
US5749916A (en) * 1997-01-21 1998-05-12 Spinal Innovations Fusion implant
US5755798A (en) * 1995-10-26 1998-05-26 Artos Medizinische Produkte Gmbh Intervertebral implant
US5766252A (en) * 1995-01-24 1998-06-16 Osteonics Corp. Interbody spinal prosthetic implant and method
US5769856A (en) * 1996-06-24 1998-06-23 Osteonics Corp. Drill guide and implant method
US5776198A (en) * 1994-12-09 1998-07-07 Sdgi Holdings, Inc. Adjustable vertebral body replacement
US5782830A (en) * 1995-10-16 1998-07-21 Sdgi Holdings, Inc. Implant insertion device
US5888223A (en) * 1995-12-08 1999-03-30 Bray, Jr.; Robert S. Anterior stabilization device
US5910141A (en) * 1997-02-12 1999-06-08 Sdgi Holdings, Inc. Rod introduction apparatus
US5916267A (en) * 1997-04-07 1999-06-29 Arthit Sitiso Anterior spinal implant system for vertebral body prosthesis
US5928284A (en) * 1998-07-09 1999-07-27 Mehdizadeh; Hamid M. Disc replacement prosthesis
US5976186A (en) * 1994-09-08 1999-11-02 Stryker Technologies Corporation Hydrogel intervertebral disc nucleus
US6051751A (en) * 1995-01-20 2000-04-18 Spire Corporation Arthroplasty process for securely anchoring prostheses to bone, and arthroplasty products therefor
US6050999A (en) * 1997-12-18 2000-04-18 Keravision, Inc. Corneal implant introducer and method of use
US6063088A (en) * 1997-03-24 2000-05-16 United States Surgical Corporation Method and instrumentation for implant insertion
US6066175A (en) * 1993-02-16 2000-05-23 Henderson; Fraser C. Fusion stabilization chamber
US6080155A (en) * 1988-06-13 2000-06-27 Michelson; Gary Karlin Method of inserting and preloading spinal implants
US6093205A (en) * 1997-06-25 2000-07-25 Bridport-Gundry Plc C/O Pearsalls Implants Surgical implant
US6093207A (en) * 1994-03-18 2000-07-25 Pisharodi; Madhavan Middle expanded, removable intervertebral disk stabilizer disk
US6096080A (en) * 1998-05-06 2000-08-01 Cortek, Inc. Apparatus for spinal fusion using implanted devices
US6106557A (en) * 1998-07-23 2000-08-22 Howmedica Gmbh Reconstruction system for vertebra
US6111222A (en) * 1998-06-23 2000-08-29 Japan Unix Co., Ltd. Soldering apparatus with safety device
US6113638A (en) * 1999-02-26 2000-09-05 Williams; Lytton A. Method and apparatus for intervertebral implant anchorage
US6113602A (en) * 1999-03-26 2000-09-05 Sulzer Spine-Tech Inc. Posterior spinal instrument guide and method
US6113639A (en) * 1999-03-23 2000-09-05 Raymedica, Inc. Trial implant and trial implant kit for evaluating an intradiscal space
US6113637A (en) * 1998-10-22 2000-09-05 Sofamor Danek Holdings, Inc. Artificial intervertebral joint permitting translational and rotational motion
US6113367A (en) * 1999-08-25 2000-09-05 Alliedsignal Truck Brake Systems Company Oil-less/oil-free air brake compressor with a dual piston arrangement
US6139550A (en) * 1997-02-11 2000-10-31 Michelson; Gary K. Skeletal plating system
US6143012A (en) * 1997-05-06 2000-11-07 Orthofix S.R.L. Intramedullary awl assembly for preparation for a femoral-style nailing
US6159211A (en) * 1998-10-22 2000-12-12 Depuy Acromed, Inc. Stackable cage system for corpectomy/vertebrectomy
US6162252A (en) * 1997-12-12 2000-12-19 Depuy Acromed, Inc. Artificial spinal disc
US6174311B1 (en) * 1998-10-28 2001-01-16 Sdgi Holdings, Inc. Interbody fusion grafts and instrumentation
US6179873B1 (en) * 1995-08-11 2001-01-30 Bernhard Zientek Intervertebral implant, process for widening and instruments for implanting an intervertebral implant
US6190413B1 (en) * 1998-04-16 2001-02-20 Ulrich Gmbh & Co. Kg Vertebral implant
US6190414B1 (en) * 1996-10-31 2001-02-20 Surgical Dynamics Inc. Apparatus for fusion of adjacent bone structures
US20010027343A1 (en) * 2000-04-04 2001-10-04 Arnold Keller Plastic implant
US6471725B1 (en) * 2001-07-16 2002-10-29 Third Millenium Engineering, Llc Porous intervertebral distraction spacers
US6607558B2 (en) * 2001-07-03 2003-08-19 Axiomed Spine Corporation Artificial disc
US20030176925A1 (en) * 2002-03-15 2003-09-18 Francois Paponneau Vertebral body spacer having variable wedged endplates

Family Cites Families (303)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US801151A (en) 1905-04-05 1905-10-03 George R Brown Wrench.
US856660A (en) 1906-05-10 1907-06-11 Fred H Schall Wrench.
US1117562A (en) 1913-10-27 1914-11-17 Elbert D Hale Wrench.
US1099811A (en) 1913-12-06 1914-06-09 Leonard C Moise Wrench.
US1243860A (en) 1915-03-10 1917-10-23 Charles A Olson Wrench.
US2193122A (en) * 1937-09-23 1940-03-12 Westinghouse Electric & Mfg Co Electric switch
US2546287A (en) * 1949-05-26 1951-03-27 Albert V Zelgert Wrench having pivoted outer jaw provided with guide slot for handle-jaw extension
US3014749A (en) * 1958-08-05 1961-12-26 Burnett T Carrow Bowling pin rake
CA992255A (en) 1971-01-25 1976-07-06 Cutter Laboratories Prosthesis for spinal repair
DE2263842A1 (en) 1972-12-28 1974-07-04 Hoffmann Daimler Siegfried Dr Disc prosthesis
DE3023492C2 (en) 1980-06-24 1982-08-26 Chemische Fabrik Kalk Gmbh, 5000 Koeln, De
US4309777A (en) 1980-11-13 1982-01-12 Patil Arun A Artificial intervertebral disc
US4566466A (en) * 1984-04-16 1986-01-28 Ripple Dale B Surgical instrument
US4678800A (en) * 1984-06-15 1987-07-07 Ciba-Geigy Corporation Gamma-r-glutamoyl derivatives
EP0176728B1 (en) 1984-09-04 1989-07-26 Humboldt-Universität zu Berlin Intervertebral-disc prosthesis
US4605417A (en) 1984-10-03 1986-08-12 Fleischauer K E Prosthetic joint
US5034254A (en) * 1984-10-29 1991-07-23 The Boeing Company Blind-side panel repair patch
DE3637314C2 (en) 1986-11-03 1988-08-18 Lutz 7730 Villingen-Schwenningen De Biedermann
DE3772033D1 (en) 1987-01-08 1991-09-12 Sulzer Ag Joint prosthesis.
CA1283501C (en) 1987-02-12 1991-04-30 Thomas P. Hedman Artificial spinal disc
DE3722893C1 (en) 1987-07-10 1988-06-09 Messerschmitt Boelkow Blohm Spring, spiral spring arms
DE69433702T2 (en) * 1993-06-10 2005-03-31 Karlin Technology, Inc., Saugus Protection device with two bushings for surgery of the intervertebral space
CA1333209C (en) 1988-06-28 1994-11-29 Gary Karlin Michelson Artificial spinal fusion implants
US4961740B1 (en) 1988-10-17 1997-01-14 Surgical Dynamics Inc V-thread fusion cage and method of fusing a bone joint
CA1318469C (en) 1989-02-15 1993-06-01 Acromed Corporation Artificial disc
US5458638A (en) 1989-07-06 1995-10-17 Spine-Tech, Inc. Non-threaded spinal implant
DE8912648U1 (en) 1989-10-23 1990-11-22 Mecron Medizinische Produkte Gmbh, 1000 Berlin, De
US5236460A (en) 1990-02-12 1993-08-17 Midas Rex Pneumatic Tools, Inc. Vertebral body prosthesis
DE4025146C2 (en) * 1990-08-08 1992-07-02 Teckentrup Gmbh & Co Kg, 5974 Herscheid, De
GB9125798D0 (en) 1991-12-04 1992-02-05 Customflex Limited Improvements in or relating to spinal vertebrae implants
US5425773A (en) 1992-01-06 1995-06-20 Danek Medical, Inc. Intervertebral disk arthroplasty device
US5258031A (en) 1992-01-06 1993-11-02 Danek Medical Intervertebral disk arthroplasty
DE4208115A1 (en) 1992-03-13 1993-09-16 Link Waldemar Gmbh Co intervertebral disc prosthesis
DE4208116C2 (en) 1992-03-13 1995-08-03 Link Waldemar Gmbh Co intervertebral disc prosthesis
DE59206917D1 (en) 1992-04-21 1996-09-19 Sulzer Medizinaltechnik Ag Artificial disc body
DE9216092U1 (en) 1992-11-26 1993-01-14 S + G Implants Gmbh, 2400 Luebeck, De
US5676701A (en) * 1993-01-14 1997-10-14 Smith & Nephew, Inc. Low wear artificial spinal disc
RU2077288C1 (en) 1993-03-21 1997-04-20 Российский научно-исследовательский нейрохирургический институт им.проф.А.Л.Поленова Device for stabilization of vertebral column
DE4315757C1 (en) 1993-05-11 1994-11-10 Plus Endoprothetik Ag Vertebral body implant
US5458642A (en) 1994-01-18 1995-10-17 Beer; John C. Synthetic intervertebral disc
FR2718635B1 (en) 1994-04-15 1996-07-05 Axcyl Medical cervical prosthesis.
JP3509103B2 (en) * 1994-05-23 2004-03-22 スルザー スパイン−テック インコーポレイテッド Implant for an intervertebral fusion
US7494507B2 (en) * 2000-01-30 2009-02-24 Diamicron, Inc. Articulating diamond-surfaced spinal implants
US5674296A (en) * 1994-11-14 1997-10-07 Spinal Dynamics Corporation Human spinal disc prosthesis
FR2728159B1 (en) 1994-12-16 1997-06-27 Tornier Sa A disk prosthesis elastic
FR2730159B1 (en) 1995-02-06 1997-04-25 Teule Jean Germain Prothese for intervertebral disc
US6206922B1 (en) 1995-03-27 2001-03-27 Sdgi Holdings, Inc. Methods and instruments for interbody fusion
US6558387B2 (en) 2001-01-30 2003-05-06 Fastemetix, Llc Porous interbody fusion device having integrated polyaxial locking interference screws
WO1997007745A1 (en) * 1995-08-24 1997-03-06 Nobles-Lai Engineering, Inc. Method and apparatus for suturing
US5734959A (en) * 1995-10-12 1998-03-31 Zimmer, Inc. Method of making an orthopaedic implant having a porous surface using an organic binder
US6423095B1 (en) 1995-10-16 2002-07-23 Sdgi Holdings, Inc. Intervertebral spacers
CA2229822C (en) * 1995-10-20 2004-03-09 Synthes (U.S.A.) Inter-vertebral implant
US5683465A (en) 1996-03-18 1997-11-04 Shinn; Gary Lee Artificial intervertebral disk prosthesis
US5800433A (en) 1996-05-31 1998-09-01 Acromed Corporation Spinal column retaining apparatus
US5755796A (en) * 1996-06-06 1998-05-26 Ibo; Ivo Prosthesis of the cervical intervertebralis disk
DE19622827B4 (en) 1996-06-07 2009-04-23 Ulrich, Heinrich Implant for insertion between vertebral bodies as a placeholder
US5782832A (en) 1996-10-01 1998-07-21 Surgical Dynamics, Inc. Spinal fusion implant and method of insertion thereof
US5895428A (en) 1996-11-01 1999-04-20 Berry; Don Load bearing spinal joint implant
DE19646891A1 (en) 1996-11-13 1998-05-14 Kubein Meesenburg Dietmar Artificial joint, especially endoprosthesis for replacement of natural joints
US5827328A (en) 1996-11-22 1998-10-27 Buttermann; Glenn R. Intervertebral prosthetic device
US5720751A (en) 1996-11-27 1998-02-24 Jackson; Roger P. Tools for use in seating spinal rods in open ended implants
US6712819B2 (en) 1998-10-20 2004-03-30 St. Francis Medical Technologies, Inc. Mating insertion instruments for spinal implants and methods of use
US6514256B2 (en) 1997-01-02 2003-02-04 St. Francis Medical Technologies, Inc. Spine distraction implant and method
US5836948A (en) 1997-01-02 1998-11-17 Saint Francis Medical Technologies, Llc Spine distraction implant and method
US6902566B2 (en) * 1997-01-02 2005-06-07 St. Francis Medical Technologies, Inc. Spinal implants, insertion instruments, and methods of use
US6652534B2 (en) 1998-10-20 2003-11-25 St. Francis Medical Technologies, Inc. Apparatus and method for determining implant size
US7101375B2 (en) * 1997-01-02 2006-09-05 St. Francis Medical Technologies, Inc. Spine distraction implant
WO1998034552A1 (en) * 1997-02-06 1998-08-13 Surgical Dynamics Expandable non-threaded spinal fusion device
US6641614B1 (en) 1997-05-01 2003-11-04 Spinal Concepts, Inc. Multi-variable-height fusion device
US6129547A (en) 1997-05-06 2000-10-10 Ballard Medical Products Oral care system
US5893889A (en) 1997-06-20 1999-04-13 Harrington; Michael Artificial disc
US6280458B1 (en) * 1997-07-22 2001-08-28 Karl Storz Gmbh & Co. Kg Surgical grasping and holding forceps
US6146421A (en) 1997-08-04 2000-11-14 Gordon, Maya, Roberts And Thomas, Number 1, Llc Multiple axis intervertebral prosthesis
US6228118B1 (en) * 1997-08-04 2001-05-08 Gordon, Maya, Roberts And Thomas, Number 1, Llc Multiple axis intervertebral prosthesis
US5824094A (en) 1997-10-17 1998-10-20 Acromed Corporation Spinal disc
US6605093B1 (en) * 1997-10-24 2003-08-12 Tekia, Inc. Device and method for use with an ophthalmologic insertor apparatus
EP1027005A1 (en) 1997-10-24 2000-08-16 Robert S. Bray, Jr. Bone plate and bone screw guide mechanism
US6139579A (en) 1997-10-31 2000-10-31 Depuy Motech Acromed, Inc. Spinal disc
US5888226A (en) 1997-11-12 1999-03-30 Rogozinski; Chaim Intervertebral prosthetic disc
KR20010032576A (en) 1997-11-29 2001-04-25 안토니 알. 피어스 Surgical implant and surgical fixing screw
US6325828B1 (en) 1997-12-02 2001-12-04 Rose Biomedical Research Apparatus for knee prosthesis
US5899941A (en) 1997-12-09 1999-05-04 Chubu Bearing Kabushiki Kaisha Artificial intervertebral disk
US6146420A (en) 1997-12-10 2000-11-14 Sdgi Holdings, Inc. Osteogenic fusion device
US6159215A (en) * 1997-12-19 2000-12-12 Depuy Acromed, Inc. Insertion instruments and method for delivering a vertebral body spacer
DE29901613U1 (en) 1998-01-23 1999-04-08 Aesculap Ag & Co Kg Intervertebral implant
US5989291A (en) 1998-02-26 1999-11-23 Third Millennium Engineering, Llc Intervertebral spacer device
US6241740B1 (en) 1998-04-09 2001-06-05 Origin Medsystems, Inc. System and method of use for ligating and cutting tissue
US6019792A (en) 1998-04-23 2000-02-01 Cauthen Research Group, Inc. Articulating spinal implant
US6679915B1 (en) 1998-04-23 2004-01-20 Sdgi Holdings, Inc. Articulating spinal implant
JP2002512079A (en) 1998-04-23 2002-04-23 コーゼン リサーチ グループ インク. Articulated spine implant
FR2778088B1 (en) 1998-04-30 2000-09-08 Materiel Orthopedique En Abreg anterior implant in particular for the cervical spine
US6800093B2 (en) 1998-05-06 2004-10-05 Cortek, Inc. Device for spinal fusion
US6136031A (en) 1998-06-17 2000-10-24 Surgical Dynamics, Inc. Artificial intervertebral disc
WO1999065412A1 (en) 1998-06-18 1999-12-23 Pioneer Laboratories, Inc. Spinal fixation system
US6682561B2 (en) 1998-06-18 2004-01-27 Pioneer Laboratories, Inc. Spinal fixation system
US6231609B1 (en) 1998-07-09 2001-05-15 Hamid M. Mehdizadeh Disc replacement prosthesis
US6063121A (en) 1998-07-29 2000-05-16 Xavier; Ravi Vertebral body prosthesis
US5989294A (en) 1998-07-29 1999-11-23 Marlow; Aaron L. Ball-and-socket joint, particularly a prosthetic hip joint
DE29814174U1 (en) 1998-08-07 1999-12-16 Howmedica Gmbh Instrument for introducing an implant into the human spine
DE69940641D1 (en) 1998-10-02 2009-05-07 Synthes Gmbh Ffe
US20010016773A1 (en) 1998-10-15 2001-08-23 Hassan Serhan Spinal disc
ES2301219T3 (en) 1998-10-20 2008-06-16 Synthes Gmbh Box regulatory compression spinal fusion surgery welding.
US6039763A (en) 1998-10-27 2000-03-21 Disc Replacement Technologies, Inc. Articulating spinal disc prosthesis
US6193757B1 (en) 1998-10-29 2001-02-27 Sdgi Holdings, Inc. Expandable intervertebral spacers
US6241732B1 (en) 1998-11-03 2001-06-05 David W. Overaker Biocompatible absorbable rivets and pins for use in surgical procedures
FR2787019B1 (en) 1998-12-11 2001-03-02 Dimso Sa intervertebral disk prosthesis has mechanical behavior improves
FR2787018B1 (en) 1998-12-11 2001-03-02 Dimso Sa The prosthetic spinal disc enclosure liquid
FR2787014B1 (en) 1998-12-11 2001-03-02 Dimso Sa Prothese of intervertebral disc friction reduced
FR2787015B1 (en) 1998-12-11 2001-04-27 Dimso Sa intervertebral disc prosthesis has compressible body
FR2787017B1 (en) * 1998-12-11 2001-04-27 Dimso Sa intervertebral disk prosthesis has mechanical behavior improves
FR2787016B1 (en) * 1998-12-11 2001-03-02 Dimso Sa Prothese of intervertebral disc
US6214049B1 (en) 1999-01-14 2001-04-10 Comfort Biomedical, Inc. Method and apparatus for augmentating osteointegration of prosthetic implant devices
DE60044258D1 (en) * 1999-01-25 2010-06-02 Warsaw Orthopedic Inc Instrument for creating an intervertebral space for receiving an implant
DE19903762C1 (en) * 1999-01-30 2000-11-16 Aesculap Ag & Co Kg A surgical instrument for inserting intervertebral implants
US6228023B1 (en) * 1999-02-17 2001-05-08 Abiomed, Inc. Tissue pick and method for use in minimally invasive surgical procedures
WO2000053110A1 (en) 1999-03-09 2000-09-14 Synthes Ag Chur Bone plate
US6368350B1 (en) 1999-03-11 2002-04-09 Sulzer Spine-Tech Inc. Intervertebral disc prosthesis and method
US6582451B1 (en) 1999-03-16 2003-06-24 The University Of Sydney Device for use in surgery
US6558423B1 (en) 1999-05-05 2003-05-06 Gary K. Michelson Interbody spinal fusion implants with multi-lock for locking opposed screws
US6579321B1 (en) 1999-05-17 2003-06-17 Vanderbilt University Intervertebral disc replacement prosthesis
ES2195470T3 (en) 1999-05-21 2003-12-01 Link Waldemar Gmbh Co Intervertebral endoprosthesis with a toothed connection plate.
US6261324B1 (en) 1999-05-26 2001-07-17 Crp, Inc. Foot prosthesis
DE60018924D1 (en) 1999-06-04 2005-04-28 Sdgi Holdings Inc Artificial intervertebral implant
US6520996B1 (en) 1999-06-04 2003-02-18 Depuy Acromed, Incorporated Orthopedic implant
US20020128714A1 (en) * 1999-06-04 2002-09-12 Mark Manasas Orthopedic implant and method of making metal articles
US6277149B1 (en) 1999-06-08 2001-08-21 Osteotech, Inc. Ramp-shaped intervertebral implant
US20020017789A1 (en) 1999-06-16 2002-02-14 Holmes William W. Gland pipe fitting
WO2001001895A1 (en) 1999-07-02 2001-01-11 Petrus Besselink Reinforced expandable cage
US6419675B1 (en) 1999-09-03 2002-07-16 Conmed Corporation Electrosurgical coagulating and cutting instrument
WO2001017465A1 (en) 1999-09-03 2001-03-15 Cook Daniel J Temporary spine fixation device and method
EP1792586B1 (en) * 1999-09-14 2012-12-26 Spine Solutions Inc. Insert instrument for an implant between vertebrae
US20030040796A1 (en) 1999-10-08 2003-02-27 Ferree Bret A. Devices used to treat disc herniation and attachment mechanisms therefore
FR2799638B1 (en) * 1999-10-14 2002-08-16 Fred Zacouto Fixative and vertebral joint
US6277122B1 (en) 1999-10-15 2001-08-21 Sdgi Holdings, Inc. Distraction instrument with fins for maintaining insertion location
FR2799639B1 (en) * 1999-10-18 2002-07-19 Dimso Sa intervertebral disk prosthesis has toothed faces
US6524318B1 (en) * 1999-10-18 2003-02-25 Sulzer Spine-Tech Inc. Spinal surgery instruments and methods
US6592625B2 (en) * 1999-10-20 2003-07-15 Anulex Technologies, Inc. Spinal disc annulus reconstruction method and spinal disc annulus stent
JP2001130954A (en) * 1999-10-29 2001-05-15 Tdk Corp Ferrite sintered compact
US6461359B1 (en) 1999-11-10 2002-10-08 Clifford Tribus Spine stabilization device
US6432106B1 (en) * 1999-11-24 2002-08-13 Depuy Acromed, Inc. Anterior lumbar interbody fusion cage with locking plate
US6592624B1 (en) 1999-11-24 2003-07-15 Depuy Acromed, Inc. Prosthetic implant element
ES2214900T3 (en) 1999-12-10 2004-09-16 Synthes Ag Chur Device for stretching or compressing the bones or bone parts.
US6319257B1 (en) * 1999-12-20 2001-11-20 Kinamed, Inc. Inserter assembly
US6447512B1 (en) 2000-01-06 2002-09-10 Spinal Concepts, Inc. Instrument and method for implanting an interbody fusion device
FR2805733B1 (en) 2000-03-03 2002-06-07 Scient X A disk prosthesis for cervical vertebra
FR2805985B1 (en) 2000-03-10 2003-02-07 Eurosurgical Prothese of intervertebral disc
US7169183B2 (en) 2000-03-14 2007-01-30 Warsaw Orthopedic, Inc. Vertebral implant for promoting arthrodesis of the spine
US6296665B1 (en) 2000-03-20 2001-10-02 Electro-Biology, Inc. Method and apparatus for spinal fixation
US6821298B1 (en) 2000-04-18 2004-11-23 Roger P. Jackson Anterior expandable spinal fusion cage system
US6500205B1 (en) 2000-04-19 2002-12-31 Gary K. Michelson Expandable threaded arcuate interbody spinal fusion implant with cylindrical configuration during insertion
US6342057B1 (en) 2000-04-28 2002-01-29 Synthes (Usa) Remotely aligned surgical drill guide
US6478800B1 (en) * 2000-05-08 2002-11-12 Depuy Acromed, Inc. Medical installation tool
US20030229348A1 (en) 2000-05-25 2003-12-11 Sevrain Lionel C. Auxiliary vertebrae connecting device
US7018416B2 (en) 2000-07-06 2006-03-28 Zimmer Spine, Inc. Bone implants and methods
US6308483B1 (en) * 2000-07-07 2001-10-30 Robert L. Romine Roofing fastener assembly
WO2002003885A3 (en) 2000-07-10 2002-06-20 Gary K Michelson Flanged interbody spinal fusion implants
FR2811543B1 (en) * 2000-07-12 2003-07-04 Spine Next Sa interbody implant
US6610093B1 (en) 2000-07-28 2003-08-26 Perumala Corporation Method and apparatus for stabilizing adjacent vertebrae
JP4617408B2 (en) 2000-08-08 2011-01-26 ワルシャワ オーソピディック、インク. Implantable artificial joints
US20020035400A1 (en) 2000-08-08 2002-03-21 Vincent Bryan Implantable joint prosthesis
US6599291B1 (en) 2000-10-20 2003-07-29 Sdgi Holdings, Inc. Methods and instruments for interbody surgical techniques
US6666866B2 (en) 2000-11-07 2003-12-23 Osteotech, Inc. Spinal intervertebral implant insertion tool
US6413259B1 (en) 2000-12-14 2002-07-02 Blackstone Medical, Inc Bone plate assembly including a screw retaining member
DE10065232C2 (en) 2000-12-27 2002-11-14 Ulrich Gmbh & Co Kg Implant for insertion between vertebral bodies, as well as surgical instrument for handling of the implant
US20020084562A1 (en) 2000-12-29 2002-07-04 Kelsey Donald J. Disk spring
EP1222903B1 (en) 2001-01-12 2005-01-19 Link Spine Group, Inc. Surgical instrument for implanting an intervertebral prosthesis
EP1272130B1 (en) * 2001-02-04 2004-11-17 MICHELSON, Gary Karlin Instrumentation for inserting and deploying an expandable interbody spinal fusion implant
US6576017B2 (en) 2001-02-06 2003-06-10 Sdgi Holdings, Inc. Spinal implant with attached ligament and methods
US6562073B2 (en) 2001-02-06 2003-05-13 Sdgi Holding, Inc. Spinal bone implant
US7223291B2 (en) * 2001-07-16 2007-05-29 Spinecore, Inc. Intervertebral spacer device having engagement hole pairs for manipulation using a surgical tool
US20030069642A1 (en) 2001-10-04 2003-04-10 Ralph James D. Artificial intervertebral disc having a flexible wire mesh vertebral body contact element
US20020111687A1 (en) 2001-02-15 2002-08-15 Ralph James D. Intervertebral spacer device utilizing a belleville washer having radially extending grooves
US6863688B2 (en) 2001-02-15 2005-03-08 Spinecore, Inc. Intervertebral spacer device utilizing a spirally slotted belleville washer having radially spaced concentric grooves
US7169182B2 (en) 2001-07-16 2007-01-30 Spinecore, Inc. Implanting an artificial intervertebral disc
US6764515B2 (en) 2001-02-15 2004-07-20 Spinecore, Inc. Intervertebral spacer device utilizing a spirally slotted belleville washer and a rotational mounting
US7575576B2 (en) 2001-07-16 2009-08-18 Spinecore, Inc. Wedge ramp distractor and related methods for use in implanting artificial intervertebral discs
US20020111682A1 (en) * 2001-02-15 2002-08-15 Ralph James D. Intervertebral spacer device having a radially thinning belleville spring
US6740117B2 (en) 2001-02-15 2004-05-25 Spinecore, Inc. Intervertebral spacer device having a radially thinning slotted belleville spring
US7713302B2 (en) * 2001-10-01 2010-05-11 Spinecore, Inc. Intervertebral spacer device utilizing a spirally slotted belleville washer having radially spaced concentric grooves
US7235081B2 (en) 2001-07-16 2007-06-26 Spinecore, Inc. Wedge plate inserter/impactor and related methods for use in implanting an artificial intervertebral disc
US7563285B2 (en) 2001-07-16 2009-07-21 Spinecore, Inc. Artificial intervertebral disc utilizing a ball joint coupling
US7491241B2 (en) 2001-07-16 2009-02-17 Spinecore, Inc. Intervertebral spacer device having recessed notch pairs for manipulation using a surgical tool
US7160327B2 (en) * 2001-07-16 2007-01-09 Spinecore, Inc. Axially compressible artificial intervertebral disc having limited rotation using a captured ball and socket joint with a solid ball and compression locking post
US7115132B2 (en) * 2001-07-16 2006-10-03 Spinecore, Inc. Static trials and related instruments and methods for use in implanting an artificial intervertebral disc
US6989032B2 (en) 2001-07-16 2006-01-24 Spinecore, Inc. Artificial intervertebral disc
US6669730B2 (en) * 2001-02-15 2003-12-30 Spinecore, Inc. Intervertebral spacer device utilizing a spirally slotted belleville washer having radially extending grooves
US6887274B2 (en) 2001-02-15 2005-05-03 Spinecore, Inc. Intervertebral spacer device utilizing a belleville washer having radially spaced concentric grooves
US6827743B2 (en) 2001-02-28 2004-12-07 Sdgi Holdings, Inc. Woven orthopedic implants
US6551316B1 (en) * 2001-03-02 2003-04-22 Beere Precision Medical Instruments, Inc. Selective compression and distraction instrument
US20040106927A1 (en) 2002-03-01 2004-06-03 Ruffner Brian M. Vertebral distractor
WO2002071986A3 (en) * 2001-03-13 2002-11-14 Asaf Ben-Arye Vertebral body replacement device
DE10116412C1 (en) 2001-04-02 2003-01-16 Ulrich Gmbh & Co Kg Implant for insertion between vertebral bodies of the spine
US6749636B2 (en) 2001-04-02 2004-06-15 Gary K. Michelson Contoured spinal fusion implants made of bone or a bone composite material
FR2823096B1 (en) 2001-04-06 2004-03-19 Materiel Orthopedique En Abreg Bone plate apparatus of vertebrae L5 and S1 osteosynthesis device including such a plate, and the tool for placing such a plate
US6440142B1 (en) 2001-04-27 2002-08-27 Third Millennium Engineering, Llc Femoral ring loader
US20030149438A1 (en) 2001-04-30 2003-08-07 Howmedica Osteonics Corp. Insertion instrument
FR2824261B1 (en) 2001-05-04 2004-05-28 Ldr Medical intervertebral disc prosthesis and method and implementation tools
DE10130825A1 (en) 2001-06-26 2002-03-07 Helge Steffen Inter articular disk prosthesis, comprises a spiral which is made of a metal with memory, and has spherical ends extending into the prosthesis coupling knobs
US6440133B1 (en) 2001-07-03 2002-08-27 Sdgi Holdings, Inc. Rod reducer instruments and methods
DE10132588C2 (en) * 2001-07-05 2003-05-22 Fehling Instr Gmbh Disc prosthesis
US6863689B2 (en) 2001-07-16 2005-03-08 Spinecore, Inc. Intervertebral spacer having a flexible wire mesh vertebral body contact element
US6554864B2 (en) * 2001-07-16 2003-04-29 Spinecore, Inc Surgical method of treating scoliosis
US6527806B2 (en) * 2001-07-16 2003-03-04 Third Millennium Engineering, Llc Intervertebral spacer device having a spiral wave washer force restoring element
US6478801B1 (en) 2001-07-16 2002-11-12 Third Millennium Engineering, Llc Insertion tool for use with tapered trial intervertebral distraction spacers
US7153310B2 (en) 2001-07-16 2006-12-26 Spinecore, Inc. Vertebral bone distraction instruments
US6447548B1 (en) 2001-07-16 2002-09-10 Third Millennium Engineering, Llc Method of surgically treating scoliosis
US6805716B2 (en) 2001-07-16 2004-10-19 Spine Core, Inc. Orthopedic device set for reorienting vertebral bones for the treatment of scoliosis
US6436102B1 (en) * 2001-07-16 2002-08-20 Third Millennium Engineering, Llc Method of distracting vertebral bones
US20030014115A1 (en) 2001-07-16 2003-01-16 Ralph James D. Insertion tool for use with intervertebral spacers
US20070198092A1 (en) * 2001-07-16 2007-08-23 Spinecore, Inc. System for inserting artificial intervertebral discs
US6468310B1 (en) 2001-07-16 2002-10-22 Third Millennium Engineering, Llc Intervertebral spacer device having a wave washer force restoring element
US6607559B2 (en) 2001-07-16 2003-08-19 Spine Care, Inc. Trial intervertebral distraction spacers
WO2003007780A3 (en) 2001-07-16 2003-04-10 Third Millenium Engineering Ll Artificial intervertebral disc having a wave washer force restoring element
JP4654125B2 (en) * 2002-10-29 2011-03-16 スパインコア,インコーポレイテッド Instrumentation for use in implanting an artificial intervertebral disc, and functions
US6562047B2 (en) 2001-07-16 2003-05-13 Spine Core, Inc. Vertebral bone distraction instruments
US6428544B1 (en) * 2001-07-16 2002-08-06 Third Millennium Engineering, Llc Insertion tool for use with trial intervertebral distraction spacers
US6375682B1 (en) 2001-08-06 2002-04-23 Lewis W. Fleischmann Collapsible, rotatable and expandable spinal hydraulic prosthetic device
EP1287795B1 (en) * 2001-08-24 2008-06-18 Zimmer GmbH Artificial spinal disc
US20030055503A1 (en) * 2001-09-19 2003-03-20 O'neil Michael J. Alignment verification device and method of use
US6652533B2 (en) 2001-09-20 2003-11-25 Depuy Acromed, Inc. Medical inserter tool with slaphammer
EP1429692A2 (en) 2001-09-28 2004-06-23 Sulzer Spine-Tech Inc. Skeletal stabilization implant
US6648917B2 (en) 2001-10-17 2003-11-18 Medicinelodge, Inc. Adjustable bone fusion implant and method
US6673113B2 (en) 2001-10-18 2004-01-06 Spinecore, Inc. Intervertebral spacer device having arch shaped spring elements
WO2003032801A3 (en) * 2001-10-18 2003-11-27 Third Millennium Engineering L Artificial intervertebral disc having a spider spring force restoring element
WO2003037230A3 (en) * 2001-10-29 2003-09-25 Arnold Keller Instrumentation for insertion of an inter-vertebral prosthesis
US6709439B2 (en) 2001-10-30 2004-03-23 Depuy Spine, Inc. Slaphammer tool
US6923814B1 (en) * 2001-10-30 2005-08-02 Nuvasive, Inc. System and methods for cervical spinal fusion
WO2003037228A3 (en) 2001-10-30 2003-07-31 Osteotech Inc Bone implant and insertion tools
US20030083749A1 (en) * 2001-10-31 2003-05-01 Kuslich Stephen D. Corpectomy device
US7025787B2 (en) * 2001-11-26 2006-04-11 Sdgi Holdings, Inc. Implantable joint prosthesis and associated instrumentation
US6669699B2 (en) * 2001-11-30 2003-12-30 Spinecore, Inc. Distraction instrument for use in anterior cervical fixation surgery
US6572653B1 (en) 2001-12-07 2003-06-03 Rush E. Simonson Vertebral implant adapted for posterior insertion
US7238203B2 (en) 2001-12-12 2007-07-03 Vita Special Purpose Corporation Bioactive spinal implants and method of manufacture thereof
CA2470196A1 (en) 2001-12-13 2003-06-26 Sdgi Holdings, Inc. Instrumentation and method for delivering an implant into a vertebral space
US6736850B2 (en) 2001-12-28 2004-05-18 Spinal Concepts, Inc. Vertebral pseudo arthrosis device and method
US6740118B2 (en) * 2002-01-09 2004-05-25 Sdgi Holdings, Inc. Intervertebral prosthetic joint
US6652233B2 (en) * 2002-01-14 2003-11-25 Toyota Jidosha Kabushiki Kaisha Control system for a turbo-charged diesel aircraft engine
US7011684B2 (en) 2002-01-17 2006-03-14 Concept Matrix, Llc Intervertebral disk prosthesis
US7575578B2 (en) * 2002-02-13 2009-08-18 Karl Storz Gmbh & Co. Kg Surgical drill guide
US6682563B2 (en) 2002-03-04 2004-01-27 Michael S. Scharf Spinal fixation device
US20030181982A1 (en) 2002-03-04 2003-09-25 Spineology, Inc. No-profile, lumbo-sacral fixation device and method
US6893464B2 (en) 2002-03-05 2005-05-17 The Regents Of The University Of California Method and apparatus for providing an expandable spinal fusion cage
DE60314096T2 (en) 2002-03-11 2008-01-24 Spinal Concepts, Inc., Austin Device for use of spinal implants
RU2303422C2 (en) 2002-03-12 2007-07-27 Сервитек Инк. Intervertebral prosthesis and system of intervertebral prostheses, in peculiar case, for cervical department of vertebral column
US20030176921A1 (en) 2002-03-13 2003-09-18 Lawson Kevin Jon Two-part prosthetic nucleus replacement for surgical reconstruction of intervertebral discs
US20050080425A1 (en) * 2002-03-18 2005-04-14 Mohit Bhatnagar Minimally invasive bone manipulation device and method of use
WO2003084449A1 (en) * 2002-03-30 2003-10-16 Cool Brace Intervertebral device and method of use
US20080027548A9 (en) 2002-04-12 2008-01-31 Ferree Bret A Spacerless artificial disc replacements
US7223289B2 (en) * 2002-04-16 2007-05-29 Warsaw Orthopedic, Inc. Annulus repair systems and techniques
US20040030390A1 (en) 2002-04-23 2004-02-12 Ferree Bret A. Intradiscal component installation apparatus and methods
US20030233097A1 (en) 2002-04-23 2003-12-18 Ferree Bret A. Artificial disc replacement (ADR) distraction sleeves and cutting guides
US6706068B2 (en) 2002-04-23 2004-03-16 Bret A. Ferree Artificial disc replacements with natural kinematics
US20030233148A1 (en) * 2002-04-23 2003-12-18 Ferree Bret A. Modular components to improve the fit of artificial disc replacements
US20040030391A1 (en) 2002-04-24 2004-02-12 Bret Ferree Artificial intervertebral disc spacers
US6878167B2 (en) 2002-04-24 2005-04-12 Bret A. Ferree Methods and apparatus for placing intradiscal devices
US8696749B2 (en) 2002-04-25 2014-04-15 Blackstone Medical, Inc. Artificial intervertebral disc
US7338525B2 (en) 2002-04-30 2008-03-04 Ferree Bret A Methods and apparatus for preventing the migration of intradiscal devices
US20040024461A1 (en) 2002-05-10 2004-02-05 Ferree Bret A. Spring and spherical joint artificial disc replacements
WO2003099146A3 (en) 2002-05-21 2005-03-03 Todd C Bonvallet Device for distracing bone segments
US7278995B2 (en) 2002-06-04 2007-10-09 Howmedica Osteonics Corp. Apparatus for securing a spinal rod system
US8317798B2 (en) 2002-06-25 2012-11-27 Warsaw Orthopedic Minimally invasive expanding spacer and method
US7070598B2 (en) * 2002-06-25 2006-07-04 Sdgi Holdings, Inc. Minimally invasive expanding spacer and method
US7087055B2 (en) * 2002-06-25 2006-08-08 Sdgi Holdings, Inc. Minimally invasive expanding spacer and method
US6793678B2 (en) 2002-06-27 2004-09-21 Depuy Acromed, Inc. Prosthetic intervertebral motion disc having dampening
US20040024471A1 (en) 2002-06-27 2004-02-05 Ferree Bret A. Bone cell covered arthroplasty devices
US20040002759A1 (en) 2002-06-28 2004-01-01 Ferree Bret A. Fusion and arthroplasty devices configured to receive bone growth promoting substances
US6880787B2 (en) * 2002-07-30 2005-04-19 Nmc Group, Inc. Ring-post fastener
WO2004019828A1 (en) 2002-09-02 2004-03-11 Mathys Medizinaltechnik Ag Intervertebral implant comprising a three-part articulation
ES2306774T3 (en) 2002-09-18 2008-11-16 Synthes Gmbh Implant with a two part linkage.
US20040059343A1 (en) * 2002-09-25 2004-03-25 Kevin Shearer Novel enhanced system for intraocular lens insertion
US6837905B1 (en) 2002-09-26 2005-01-04 Daniel M. Lieberman Spinal vertebral fusion implant and method
US6899735B2 (en) 2002-10-02 2005-05-31 Sdgi Holdings, Inc. Modular intervertebral prosthesis system
US20040068320A1 (en) 2002-10-04 2004-04-08 Robie Bruce H. Prosthetic disc and vertebral body replacement device having pyrolytic carbon bearing members
US7063725B2 (en) 2002-10-21 2006-06-20 Sdgi Holdings, Inc. Systems and techniques for restoring and maintaining intervertebral anatomy
US7125425B2 (en) 2002-10-21 2006-10-24 Sdgi Holdings, Inc. Systems and techniques for restoring and maintaining intervertebral anatomy
US6966929B2 (en) 2002-10-29 2005-11-22 St. Francis Medical Technologies, Inc. Artificial vertebral disk replacement implant with a spacer
CA2502292C (en) 2002-10-31 2011-07-26 Spinal Concepts, Inc. Movable disc implant
US7204852B2 (en) 2002-12-13 2007-04-17 Spine Solutions, Inc. Intervertebral implant, insertion tool and method of inserting same
US6994727B2 (en) 2002-12-17 2006-02-07 Amedica Corporation Total disc implant
US20040148028A1 (en) * 2002-12-19 2004-07-29 Ferree Bret A. Artificial disc replacement (ADR) extraction methods and apparatus
US7048764B2 (en) * 2003-01-07 2006-05-23 Ferree Bret A Artificial disc replacements with articulating components
US7364589B2 (en) * 2003-02-12 2008-04-29 Warsaw Orthopedic, Inc. Mobile bearing articulating disc
US6908484B2 (en) 2003-03-06 2005-06-21 Spinecore, Inc. Cervical disc replacement
US7326216B2 (en) * 2003-04-02 2008-02-05 Warsaw Orthopedic, Inc. Methods and instrumentation for positioning implants in spinal disc space in an anterior lateral approach
US7491204B2 (en) * 2003-04-28 2009-02-17 Spine Solutions, Inc. Instruments and method for preparing an intervertebral space for receiving an artificial disc implant
FR2856587B1 (en) * 2003-06-26 2006-02-24 Scient X A disk prosthesis for cervical vertebrae ALL TRAVEL Control
US7563266B2 (en) 2003-06-30 2009-07-21 Depuy Products, Inc. Slide and kit for delivering implants
US7153325B2 (en) * 2003-08-01 2006-12-26 Ultra-Kinetics, Inc. Prosthetic intervertebral disc and methods for using the same
EP1504733B1 (en) * 2003-08-04 2007-06-06 Cervitech Inc. Cervical prosthesis with insertion instrument
US20050033430A1 (en) 2003-08-05 2005-02-10 Russell Powers Surgical kit and method for providing sterilized equipment for use in spinal surgery
US7235082B2 (en) 2003-08-12 2007-06-26 Depuy Spine, Inc. Device for insertion of implants
DE10339170B4 (en) 2003-08-22 2009-10-15 Aesculap Ag Intervertebral implant
US7766914B2 (en) 2003-09-10 2010-08-03 Warsaw Orthopedic, Inc. Adjustable drill guide
US20050283237A1 (en) 2003-11-24 2005-12-22 St. Francis Medical Technologies, Inc. Artificial spinal disk replacement device with staggered vertebral body attachments
US7695517B2 (en) * 2003-12-10 2010-04-13 Axiomed Spine Corporation Apparatus for replacing a damaged spinal disc
US7763028B2 (en) * 2004-02-13 2010-07-27 Warsaw Orthopedic, Inc. Spacer with height and angle adjustments for spacing vertebral members
US7214244B2 (en) * 2004-02-19 2007-05-08 Spinecore, Inc. Artificial intervertebral disc having an articulating joint
US7083651B2 (en) * 2004-03-03 2006-08-01 Joint Synergy, Llc Spinal implant
US7294134B2 (en) 2004-07-28 2007-11-13 Weber Instrumente Gmbh Surgical instrument for the introduction of a multi-component intervertebral prosthesis
US7547309B2 (en) * 2004-09-23 2009-06-16 Spine Solutions, Inc. Distractor for lumbar insertion instrument
US8979857B2 (en) 2004-10-06 2015-03-17 DePuy Synthes Products, LLC Modular medical tool and connector
US8152837B2 (en) 2004-10-20 2012-04-10 The Board Of Trustees Of The Leland Stanford Junior University Systems and methods for posterior dynamic stabilization of the spine
US20070260315A1 (en) 2006-05-03 2007-11-08 Foley Kevin T Devices and methods for disc height restoration

Patent Citations (100)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6179873B2 (en) *
US916421A (en) * 1908-10-09 1909-03-30 Orlando Crittenden Nut-lock.
US1425845A (en) * 1922-02-23 1922-08-15 Robert B Foster Flange wrench
US1518205A (en) * 1922-06-13 1924-12-09 Kountz John Burt Fishing-rod handle
US1539221A (en) * 1923-10-30 1925-05-26 Tennant John William Welder's rod holder
US1882462A (en) * 1931-07-31 1932-10-11 Weber Stanley Spanner wrench
US2121682A (en) * 1936-06-23 1938-06-21 Boucher Parks Filler rod holder
US2127424A (en) * 1936-09-19 1938-08-16 No Kap Closures U S A Inc Nozzle closure means for containers and washers for use therein
US2319992A (en) * 1941-08-13 1943-05-25 Chance Co Ab Operating tool for high tension electric lines
US2719688A (en) * 1949-11-21 1955-10-04 Seifert Karl Telescopic tubes
US2669896A (en) * 1951-01-19 1954-02-23 Robert S Clough Retractable jaw wrench having parallel resilient jaws
US3278107A (en) * 1963-07-24 1966-10-11 Cv Heljestrand Ab Instrument for applying so-called staple sutures
US3195380A (en) * 1963-09-20 1965-07-20 Bicks Jean Leonard Device for engaging, holding and releasing objects
US3326254A (en) * 1965-06-21 1967-06-20 Julius A Diehl Holder for elongated article
US3486505A (en) * 1967-05-22 1969-12-30 Gordon M Morrison Orthopedic surgical instrument
US3604487A (en) * 1969-03-10 1971-09-14 Richard S Gilbert Orthopedic screw driving means
US3659661A (en) * 1970-02-02 1972-05-02 Dresser Ind Earth boring machine
US3679244A (en) * 1970-09-21 1972-07-25 Robert R Reddy Releasable shaft lock
US3743042A (en) * 1972-09-11 1973-07-03 K Hilterhaus Gaff-scale
US3948141A (en) * 1974-08-20 1976-04-06 Katsumi Shinjo Load indicating washer
US4105407A (en) * 1975-04-24 1978-08-08 Sanderson Roger S Sterilizing and storing medical items
US4077618A (en) * 1977-03-24 1978-03-07 Durant Thomas O Portable vise
US4303001A (en) * 1977-08-18 1981-12-01 Trungold Emanuel H Bolt tension indicating means
US4263903A (en) * 1979-01-08 1981-04-28 Richards Manufacturing Co., Inc. Medical staple means
US4303268A (en) * 1980-05-22 1981-12-01 Davidson Harvey D Method and apparatus for removing embedded ticks
US4317387A (en) * 1980-05-23 1982-03-02 General Motors Corporation Telescoping steering assembly
US4457484A (en) * 1981-12-28 1984-07-03 Hameister Helen M Display mounting assembly for collector plates
US4531517A (en) * 1983-03-24 1985-07-30 Forte Thomas E Extractor for intramedullary fasteners
US4528980A (en) * 1983-10-19 1985-07-16 Howmedica, Inc. Acetabulum sizer and drill guide
US4969907A (en) * 1985-01-08 1990-11-13 Sulzer Brothers Limited Metal bone implant
US4917704A (en) * 1987-07-09 1990-04-17 Sulzer Brothers Limited Intervertebral prosthesis
US4955908A (en) * 1987-07-09 1990-09-11 Sulzer Brothers Limited Metallic intervertebral prosthesis
US4968010A (en) * 1988-03-09 1990-11-06 Odobasic Steven Lazar Slotted disc and elastomeric matrix damper assembly
US5122130A (en) * 1988-03-23 1992-06-16 Waldemar Link Gmbh & Co. Forceps for inserting intervertebral device
US4997432A (en) * 1988-03-23 1991-03-05 Waldemar Link Gmbh & Co. Surgical instrument set
US5002576A (en) * 1988-06-06 1991-03-26 Mecron Medizinische Produkte Gmbh Intervertebral disk endoprosthesis
US6080155A (en) * 1988-06-13 2000-06-27 Michelson; Gary Karlin Method of inserting and preloading spinal implants
US5015247A (en) * 1988-06-13 1991-05-14 Michelson Gary K Threaded spinal implant
US5030219A (en) * 1990-01-22 1991-07-09 Boehringer Mannheim Corporation Glenoid component installation tools
US5314477A (en) * 1990-03-07 1994-05-24 J.B.S. Limited Company Prosthesis for intervertebral discs and instruments for implanting it
US5192327A (en) * 1991-03-22 1993-03-09 Brantigan John W Surgical prosthetic implant for vertebrae
US5556432A (en) * 1991-12-11 1996-09-17 Joachim Theusner Artificial joint
US5306309A (en) * 1992-05-04 1994-04-26 Calcitek, Inc. Spinal disk implant and implantation kit
US5258007A (en) * 1992-05-14 1993-11-02 Robert F. Spetzler Powered surgical instrument
US5376120A (en) * 1992-10-21 1994-12-27 Biomet, Inc. Biocompatible implant and method of using same
US5667347A (en) * 1992-12-10 1997-09-16 Matthews; Norman Leslie Fastener
US5534029A (en) * 1992-12-14 1996-07-09 Yumiko Shima Articulated vertebral body spacer
US6066175A (en) * 1993-02-16 2000-05-23 Henderson; Fraser C. Fusion stabilization chamber
US5571109A (en) * 1993-08-26 1996-11-05 Man Ceramics Gmbh System for the immobilization of vertebrae
US5458641A (en) * 1993-09-08 1995-10-17 Ramirez Jimenez; Juan J. Vertebral body prosthesis
US5443514A (en) * 1993-10-01 1995-08-22 Acromed Corporation Method for using spinal implants
US5405400A (en) * 1993-10-05 1995-04-11 Orthomet, Inc. Joint prosthesis enabling rotary circumduction
US5549690A (en) * 1993-12-17 1996-08-27 Avanta Orthopaedics Prosthetic thumb joint and method of manufacture
US5514180A (en) * 1994-01-14 1996-05-07 Heggeness; Michael H. Prosthetic intervertebral devices
US5599279A (en) * 1994-03-16 1997-02-04 Gus J. Slotman Surgical instruments and method useful for endoscopic spinal procedures
US6093207A (en) * 1994-03-18 2000-07-25 Pisharodi; Madhavan Middle expanded, removable intervertebral disk stabilizer disk
US5653762A (en) * 1994-03-18 1997-08-05 Pisharodi; Madhavan Method of stabilizing adjacent vertebrae with rotating, lockable, middle-expanded intervertebral disk stabilizer
US5593456A (en) * 1994-05-17 1997-01-14 Crp, Inc. Foot and leg prosthesis and method of making same
US5976186A (en) * 1994-09-08 1999-11-02 Stryker Technologies Corporation Hydrogel intervertebral disc nucleus
US5674295A (en) * 1994-10-17 1997-10-07 Raymedica, Inc. Prosthetic spinal disc nucleus
US5562736A (en) * 1994-10-17 1996-10-08 Raymedica, Inc. Method for surgical implantation of a prosthetic spinal disc nucleus
US5776198A (en) * 1994-12-09 1998-07-07 Sdgi Holdings, Inc. Adjustable vertebral body replacement
US6051751A (en) * 1995-01-20 2000-04-18 Spire Corporation Arthroplasty process for securely anchoring prostheses to bone, and arthroplasty products therefor
US5766252A (en) * 1995-01-24 1998-06-16 Osteonics Corp. Interbody spinal prosthetic implant and method
US6179873B1 (en) * 1995-08-11 2001-01-30 Bernhard Zientek Intervertebral implant, process for widening and instruments for implanting an intervertebral implant
US5645605A (en) * 1995-09-18 1997-07-08 Ascension Orthopedics, Inc. Implant device to replace the carpometacarpal joint of the human thumb
US5782830A (en) * 1995-10-16 1998-07-21 Sdgi Holdings, Inc. Implant insertion device
US5755798A (en) * 1995-10-26 1998-05-26 Artos Medizinische Produkte Gmbh Intervertebral implant
US5683399A (en) * 1995-12-01 1997-11-04 Stelkast Incorporated Acetabular cup insertion tool
US5888223A (en) * 1995-12-08 1999-03-30 Bray, Jr.; Robert S. Anterior stabilization device
US5733290A (en) * 1995-12-21 1998-03-31 Johnson & Johnson Professional, Inc. Quick-release tibial alignment handle
US5769856A (en) * 1996-06-24 1998-06-23 Osteonics Corp. Drill guide and implant method
US5718254A (en) * 1996-10-25 1998-02-17 Murphy; David A. Adjustable bed canopy and curtain system
US6190414B1 (en) * 1996-10-31 2001-02-20 Surgical Dynamics Inc. Apparatus for fusion of adjacent bone structures
US5732992A (en) * 1996-12-26 1998-03-31 Exactech, Incorporated Medical appliance tool providing one hand actuation
US5749916A (en) * 1997-01-21 1998-05-12 Spinal Innovations Fusion implant
US6139550A (en) * 1997-02-11 2000-10-31 Michelson; Gary K. Skeletal plating system
US5910141A (en) * 1997-02-12 1999-06-08 Sdgi Holdings, Inc. Rod introduction apparatus
US6063088A (en) * 1997-03-24 2000-05-16 United States Surgical Corporation Method and instrumentation for implant insertion
US5916267A (en) * 1997-04-07 1999-06-29 Arthit Sitiso Anterior spinal implant system for vertebral body prosthesis
US6143012A (en) * 1997-05-06 2000-11-07 Orthofix S.R.L. Intramedullary awl assembly for preparation for a femoral-style nailing
US6093205A (en) * 1997-06-25 2000-07-25 Bridport-Gundry Plc C/O Pearsalls Implants Surgical implant
US6162252A (en) * 1997-12-12 2000-12-19 Depuy Acromed, Inc. Artificial spinal disc
US6050999A (en) * 1997-12-18 2000-04-18 Keravision, Inc. Corneal implant introducer and method of use
US6190413B1 (en) * 1998-04-16 2001-02-20 Ulrich Gmbh & Co. Kg Vertebral implant
US6096080A (en) * 1998-05-06 2000-08-01 Cortek, Inc. Apparatus for spinal fusion using implanted devices
US6111222A (en) * 1998-06-23 2000-08-29 Japan Unix Co., Ltd. Soldering apparatus with safety device
US5928284A (en) * 1998-07-09 1999-07-27 Mehdizadeh; Hamid M. Disc replacement prosthesis
US6106557A (en) * 1998-07-23 2000-08-22 Howmedica Gmbh Reconstruction system for vertebra
US6159211A (en) * 1998-10-22 2000-12-12 Depuy Acromed, Inc. Stackable cage system for corpectomy/vertebrectomy
US6113637A (en) * 1998-10-22 2000-09-05 Sofamor Danek Holdings, Inc. Artificial intervertebral joint permitting translational and rotational motion
US6174311B1 (en) * 1998-10-28 2001-01-16 Sdgi Holdings, Inc. Interbody fusion grafts and instrumentation
US6113638A (en) * 1999-02-26 2000-09-05 Williams; Lytton A. Method and apparatus for intervertebral implant anchorage
US6113639A (en) * 1999-03-23 2000-09-05 Raymedica, Inc. Trial implant and trial implant kit for evaluating an intradiscal space
US6113602A (en) * 1999-03-26 2000-09-05 Sulzer Spine-Tech Inc. Posterior spinal instrument guide and method
US6113367A (en) * 1999-08-25 2000-09-05 Alliedsignal Truck Brake Systems Company Oil-less/oil-free air brake compressor with a dual piston arrangement
US20010027343A1 (en) * 2000-04-04 2001-10-04 Arnold Keller Plastic implant
US6607558B2 (en) * 2001-07-03 2003-08-19 Axiomed Spine Corporation Artificial disc
US6471725B1 (en) * 2001-07-16 2002-10-29 Third Millenium Engineering, Llc Porous intervertebral distraction spacers
US20030176925A1 (en) * 2002-03-15 2003-09-18 Francois Paponneau Vertebral body spacer having variable wedged endplates

Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7896919B2 (en) * 2003-08-04 2011-03-01 Zimmer Spine S.A.S. Method of implanting intervertebral disk prosthesis
US8226721B2 (en) 2003-08-04 2012-07-24 Zimmer Spine S.A.S. Method of implanting intervertebral disk prosthesis
US20060264959A1 (en) * 2005-05-23 2006-11-23 Custom Spine, Inc. Rod pusher
US9034046B2 (en) 2007-10-30 2015-05-19 Aesculap Implant Systems, Llc Vertebral body replacement device and method for use to maintain a space between two vertebral bodies within a spine
US8142441B2 (en) * 2008-10-16 2012-03-27 Aesculap Implant Systems, Llc Surgical instrument and method of use for inserting an implant between two bones
US8702719B2 (en) * 2008-10-16 2014-04-22 Aesculap Implant Systems, Llc Surgical instrument and method of use for inserting an implant between two bones
US20150230930A1 (en) * 2009-05-06 2015-08-20 Stryker European Holdings I, Llc Expandable spinal implant apparatus and method of use
US9603715B2 (en) * 2009-05-06 2017-03-28 Stryker European Holdings I, Llc Expandable spinal implant apparatus and method of use

Also Published As

Publication number Publication date Type
US20030069586A1 (en) 2003-04-10 application
CA2632125A1 (en) 2004-05-13 application
US20050055095A1 (en) 2005-03-10 application
JP4979741B2 (en) 2012-07-18 grant
US8357167B2 (en) 2013-01-22 grant
US7169182B2 (en) 2007-01-30 grant
CA2632125C (en) 2010-02-23 grant
US20040167534A1 (en) 2004-08-26 application
US20040167536A1 (en) 2004-08-26 application
US7842043B2 (en) 2010-11-30 grant
US20040167537A1 (en) 2004-08-26 application
US8758358B2 (en) 2014-06-24 grant
CA2632115A1 (en) 2004-05-13 application
US20040167535A1 (en) 2004-08-26 application
US8636804B2 (en) 2014-01-28 grant
US20050038445A1 (en) 2005-02-17 application
US7632281B2 (en) 2009-12-15 grant
JP2009279413A (en) 2009-12-03 application
US7811289B2 (en) 2010-10-12 grant
CA2632115C (en) 2010-02-23 grant
US20090326542A9 (en) 2009-12-31 application

Similar Documents

Publication Publication Date Title
US6923814B1 (en) System and methods for cervical spinal fusion
US5776198A (en) Adjustable vertebral body replacement
US6984245B2 (en) Anterior impacted bone graft and driver instruments
US6669699B2 (en) Distraction instrument for use in anterior cervical fixation surgery
US7470273B2 (en) Tool for intervertebral implant manipulation
US8025684B2 (en) Instruments and methods for inserting a spinal implant
US7063725B2 (en) Systems and techniques for restoring and maintaining intervertebral anatomy
US6740118B2 (en) Intervertebral prosthetic joint
US7815681B2 (en) Orthopedic support locating or centering feature and method
US20090030423A1 (en) Inter-Body Implantation System and Method
US20100145461A1 (en) Instrumentation and procedure for implanting spinal implant devices
US6755841B2 (en) Medical installation tool
US20050165484A1 (en) Artificial disc replacement (ADR) fixation methods and apparatus
US8337559B2 (en) Expandable vertebral prosthesis
US6113637A (en) Artificial intervertebral joint permitting translational and rotational motion
US6719794B2 (en) Intervertebral implant for transforaminal posterior lumbar interbody fusion procedure
US20080027544A1 (en) Instruments and techniques for engaging spinal implants for insertion into a spinal space
US20050192671A1 (en) Artificial disc device
US20110276142A1 (en) Articulating Spacer
US6974480B2 (en) Intervertebral implant for transforaminal posterior lumbar interbody fusion procedure
US20060287728A1 (en) System and method for implanting intervertebral disk prostheses
US7887589B2 (en) Minimally invasive spinal disc stabilizer and insertion tool
US20080281425A1 (en) Orthopaedic Implants and Prostheses
US20100305704A1 (en) Intervertebral implant with fixation geometry
US6733535B2 (en) Spinal fusion implant having a trailing end adapted to engage an insertion device

Legal Events

Date Code Title Description
AS Assignment

Owner name: THIRD MILLENNIUM ENGINEERING, LLC, NEW JERSEY

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:ERRICO, JOSEPH P.;DUDASIK, MICHAEL W.;ZUBOK, RAFALL;REEL/FRAME:029344/0361

Effective date: 20021029

Owner name: THIRD MILLENNIUM ENGINEERING, LLC, NEW JERSEY

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:ERRICO, JOSEPH P.;DUDASIK, MICHAEL W.;ZUBOK, RAFAIL;REEL/FRAME:029344/0361

Effective date: 20021029

AS Assignment

Owner name: SPINECORE, INC., NEW JERSEY

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:THIRD MILLENNIUM ENGINEERING, LLC;REEL/FRAME:029353/0256

Effective date: 20030121

FPAY Fee payment

Year of fee payment: 4