US20150012100A1 - Implants having three distinct surfaces - Google Patents
Implants having three distinct surfaces Download PDFInfo
- Publication number
- US20150012100A1 US20150012100A1 US14/450,316 US201414450316A US2015012100A1 US 20150012100 A1 US20150012100 A1 US 20150012100A1 US 201414450316 A US201414450316 A US 201414450316A US 2015012100 A1 US2015012100 A1 US 2015012100A1
- Authority
- US
- United States
- Prior art keywords
- microns
- implant
- features
- average amplitude
- maximum peak
- 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.)
- Abandoned
Links
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
- A61F2/4465—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages having a circular or kidney shaped cross-section substantially perpendicular to the axis of the spine
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/3094—Designing or manufacturing processes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
- A61F2/447—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/3094—Designing or manufacturing processes
- A61F2/30965—Reinforcing the prosthesis by embedding particles or fibres during moulding or dipping
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2/4611—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/28—Bones
- A61F2002/2817—Bone stimulation by chemical reactions or by osteogenic or biological products for enhancing ossification, e.g. by bone morphogenetic or morphogenic proteins [BMP] or by transforming growth factors [TGF]
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/28—Bones
- A61F2002/2835—Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
- A61F2002/30004—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis
- A61F2002/30011—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis differing in porosity
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
- A61F2002/30004—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis
- A61F2002/30014—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis differing in elasticity, stiffness or compressibility
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30108—Shapes
- A61F2002/3011—Cross-sections or two-dimensional shapes
- A61F2002/30112—Rounded shapes, e.g. with rounded corners
- A61F2002/30133—Rounded shapes, e.g. with rounded corners kidney-shaped or bean-shaped
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30108—Shapes
- A61F2002/30199—Three-dimensional shapes
- A61F2002/30273—Three-dimensional shapes pyramidal
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30317—The prosthesis having different structural features at different locations within the same prosthesis
- A61F2002/30321—The prosthesis having different structural features at different locations within the same prosthesis differing in roughness
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30317—The prosthesis having different structural features at different locations within the same prosthesis
- A61F2002/30322—The prosthesis having different structural features at different locations within the same prosthesis differing in surface structures
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30405—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by screwing complementary threads machined on the parts themselves
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30433—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels, rivets or washers e.g. connecting screws
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30451—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements soldered or brazed or welded
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30469—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using band clamps
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
- A61F2002/30481—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a locking clip
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
- A61F2002/305—Snap connection
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
- A61F2002/30507—Connections 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30593—Special structural features of bone or joint prostheses not otherwise provided for hollow
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2002/30769—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth madreporic
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30772—Apertures or holes, e.g. of circular cross section
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30772—Apertures or holes, e.g. of circular cross section
- A61F2002/30774—Apertures or holes, e.g. of circular cross section internally-threaded
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30772—Apertures or holes, e.g. of circular cross section
- A61F2002/30777—Oblong apertures
- A61F2002/30779—Oblong apertures arcuate
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30772—Apertures or holes, e.g. of circular cross section
- A61F2002/30784—Plurality of holes
- A61F2002/30785—Plurality of holes parallel
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30772—Apertures or holes, e.g. of circular cross section
- A61F2002/30784—Plurality of holes
- A61F2002/30787—Plurality of holes inclined obliquely with respect to each other
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30772—Apertures or holes, e.g. of circular cross section
- A61F2002/30784—Plurality of holes
- A61F2002/30789—Plurality of holes perpendicular with respect to each other
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30836—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves knurled
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30838—Microstructures
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/3084—Nanostructures
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
- A61F2002/30891—Plurality of protrusions
- A61F2002/30892—Plurality of protrusions parallel
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2002/30906—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth shot- sand- or grit-blasted
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2002/3092—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth having an open-celled or open-pored structure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2002/30925—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth etched
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2002/3093—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth for promoting ingrowth of bone tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/3094—Designing or manufacturing processes
- A61F2002/3097—Designing or manufacturing processes using laser
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/3094—Designing or manufacturing processes
- A61F2002/30971—Laminates, i.e. layered products
- A61F2002/30973—Two joined adjacent layers having complementary interlocking protrusions and recesses
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/3094—Designing or manufacturing processes
- A61F2002/30985—Designing or manufacturing processes using three dimensional printing [3DP]
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2002/448—Joints for the spine, e.g. vertebrae, spinal discs comprising multiple adjacent spinal implants within the same intervertebral space or within the same vertebra, e.g. comprising two adjacent spinal implants
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2002/4629—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof connected to the endoprosthesis or implant via a threaded connection
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0004—Rounded shapes, e.g. with rounded corners
- A61F2230/0015—Kidney-shaped, e.g. bean-shaped
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0018—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in elasticity, stiffness or compressibility
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00005—The prosthesis being constructed from a particular material
- A61F2310/00011—Metals or alloys
- A61F2310/00017—Iron- or Fe-based alloys, e.g. stainless steel
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00005—The prosthesis being constructed from a particular material
- A61F2310/00011—Metals or alloys
- A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00005—The prosthesis being constructed from a particular material
- A61F2310/00011—Metals or alloys
- A61F2310/00035—Other metals or alloys
- A61F2310/00047—Aluminium or Al-based alloys
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00005—The prosthesis being constructed from a particular material
- A61F2310/00011—Metals or alloys
- A61F2310/00035—Other metals or alloys
- A61F2310/00053—Vanadium or V-based alloys
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00005—The prosthesis being constructed from a particular material
- A61F2310/00011—Metals or alloys
- A61F2310/00035—Other metals or alloys
- A61F2310/00131—Tantalum or Ta-based alloys
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00389—The prosthesis being coated or covered with a particular material
- A61F2310/00395—Coating or prosthesis-covering structure made of metals or of alloys
- A61F2310/00407—Coating made of titanium or of Ti-based alloys
-
- Y—GENERAL 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
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
- Y10T29/00—Metal working
- Y10T29/49—Method of mechanical manufacture
Definitions
- the present invention relates generally to interbody spinal implants and methods of making such implants and, more particularly, to spinal implants having at least three distinct surfaces.
- the spine is a column made of vertebrae and discs.
- the vertebrae provide the support and structure of the spine while the spinal discs, located between the vertebrae, act as cushions or “shock absorbers.” These discs also contribute to the flexibility and motion of the spinal column. Over time, the discs may become diseased or infected, may develop deformities such as tears or cracks, or may simply lose structural integrity (e.g., the discs may bulge or flatten). Impaired discs can affect the anatomical functions of the vertebrae, due to the resultant lack of proper biomechanical support, and are often associated with chronic back pain.
- Spinal fusion has become a recognized surgical procedure for mitigating back pain by restoring biomechanical and anatomical integrity to the spine.
- Spinal fusion techniques involve the removal, or partial removal, of at least one intervertebral disc and preparation of the disc space for receiving an implant by shaping the exposed vertebral endplates. An implant is then inserted between the opposing endplates.
- Spinal fusion procedures can be achieved using a posterior or an anterior approach, for example.
- Anterior interbody fusion procedures generally have the advantages of reduced operative times and reduced blood loss. Further, anterior procedures do not interfere with the posterior anatomic structure of the lumbar spine. Anterior procedures also minimize scarring within the spinal canal while still achieving improved fusion rates, which is advantageous from a structural and biomechanical perspective. These generally preferred anterior procedures are particularly advantageous in providing improved access to the disc space, and thus correspondingly better endplate preparation.
- the present invention provides for interbody spinal implants having at least three distinct surfaces: (1) at least one integration surface; (2) at least one graft contact surface; and (3) at least one soft tissue surface.
- the integration surface includes macro, micro, and nano features having a fusion and biologically active surface geometry and frictionally engages preserved bone structures.
- the graft contact surface includes micro and nano features, which positively influence naturally occurring biological bone remodeling and fusion responses.
- the soft tissue surface includes a low friction surface with nano features (and optionally micro features) to avoid unintentional laceration or abrasion of delicate soft tissues (e.g., blood vessels, nerves, and muscles) the implant contacts during insertion, after insertion, or both.
- the soft tissue surface can also provide an anchoring point and signaling function to bone forming cells in order to positively influence the fusion and healing processes.
- Various implant body shapes are provided to allow for implantation through various access paths to the spine through a patient's body.
- the structures and surfaces are designed to work in concert to preserve endplate bone structures, provide for sufficient bioactivity in each respective location, and provide stability within the disc space and the graft containment axial column.
- the shapes and textures of the bioactive surfaces vary based on the implant insertion path, location within the disc space, and frictional characteristics of the surfaces.
- the present invention provides an implant comprising a body having a top surface, a bottom surface, opposing lateral sides, opposing anterior and posterior portions, a substantially hollow center, and a single vertical aperture; and optionally, at least one of a first integration plate affixed to the top surface of the body and a second integration plate affixed to the bottom surface of the body, wherein the first integration plate and the second integration plate each have a top surface, a bottom surface, opposing lateral sides, opposing anterior and posterior portions, and a single vertical aperture extending from the top surface to the bottom surface and aligning with the single vertical aperture of the body.
- the interbody spinal implant further comprises (a) at least one integration surface having a roughened surface topography including macro features, micro features, and nano features, without sharp teeth that risk damage to bone structures; (b) at least one graft contact surface having a coarse surface topography including micro features and nano features; and (c) at least one soft tissue surface having a substantially smooth surface including nano features and optionally, micro features.
- the integration surface may include the top, bottom, or both surfaces of the implant. In the case of no integration plates, this would include the top, bottom, or both surfaces of the body of the implant. In the case of one integration plate affixed to the top of the body of the implant, this would include the top of the integration plate, the bottom of the body, or both surfaces. In the case of one integration plate affixed to the bottom of the body of the implant, this would include the top of the body, the top of the integration plate (i.e., the outer surface of the integration plate at the bottom of the implant), or both surfaces. In the case of two integration plates sandwiched around the body of the implant, this would include the top of the first integration plate, the top of the second integration plate, or both surfaces (i.e., the outer surfaces of both integration plates at the top and bottom of the implant).
- the graft contact surface may include the interior surfaces of the implant.
- the graft contact surfaces may include any surfaces that may be in contact with bone growth inducing materials (once added to the inside of the implant).
- the surfaces typically in contact with bone growth inducing materials include one or more surfaces defined by the single vertical aperture, one or more surfaces defined by at least one transverse aperture, and one or more surfaces defined by one or more openings in the implant.
- the soft tissue surface may include the exterior surfaces of the implant, except for the integration surface.
- the soft tissue surfaces may include any outer surfaces which may contact bone or soft tissue during or after implantation.
- the soft tissue surface may include the opposing lateral sides of the body and the opposing anterior and posterior portions of the body.
- the soft tissue surface may additionally include the opposing lateral sides of the integration plate and the opposing anterior and posterior portions of the integration plate.
- the soft tissue surface may additionally include the opposing lateral sides of both integration plates and the opposing anterior and posterior portions of both integration plates.
- the soft tissue surface may also include any rounded edges on the interbody spinal implant including rounded edges on the body or either or both of the integration plates.
- the implant body and/or the integration plate(s) may be fabricated from a metal.
- a preferred metal is titanium or a titanium alloy.
- the implant body may be fabricated from both a metal and a non-metallic material.
- a composite implant may be formed with integration plates made of titanium combined with a body also made of titanium.
- a composite interbody spinal implant comprises a body having a top surface, a bottom surface, opposing lateral sides, opposing anterior and posterior portions, a substantially hollow center, a single vertical aperture, and at least one transverse aperture; a first integration plate affixed to the top surface of the body; and a second integration plate affixed to the bottom surface of the body.
- the first integration plate and the second integration plate each have a top surface comprising an integration surface, a bottom surface, opposing lateral sides, opposing anterior and posterior portions, and a single vertical aperture extending from the top surface to the bottom surface and aligning with the single vertical aperture of the body, defining a transverse rim.
- the top surface of the first integration plate and the top surface of the second integration plate may each have a roughened surface topography including macro features, micro features, and nano features, without sharp teeth that risk damage to bone structures, adapted to grip bone through friction generated when the implant is placed between two vertebrae and to inhibit migration of the implant.
- a surface defined by the single vertical aperture, a surface defined by the at least one transverse aperture, and a surface defined by an optional opening may each comprise a graft contact surface having a coarse surface topography including micro features and nano features.
- the opposing lateral sides of the body, the opposing anterior and posterior portions of the body, the opposing lateral sides of the first integration plate, the opposing anterior and posterior portions of the first integration plate, the opposing lateral sides of the second integration plate, the opposing anterior and posterior portions of the second integration plate, and an optional rounded edge of the interbody spinal implant may each comprise a soft tissue surface having a substantially smooth surface including nano features.
- the present invention also encompasses a process of fabricating a predetermined surface topography.
- the process may include macro processing at least one integration surface, micro processing at least one integration surface and at least one graft contact surface, and nano processing at least one integration surface, at least one graft contact surface, and at least one soft tissue surface.
- the macro, micro, and nano process may include mechanical or chemical removal of at least a portion of the surface.
- the nano process may include mild chemical etching, laser or other directed energy material removal, abrasion, blasting, or tumbling, followed by cleaning.
- FIG. 1 shows a perspective view of an embodiment of the interbody spinal implant having three distinct surfaces
- FIG. 2A shows a perspective view of an embodiment of the interbody spinal implant having a generally oval shape and roughened surface topography on the top surface;
- FIG. 2B shows a top view of the embodiment of the interbody spinal implant illustrated in FIG. 2A ;
- FIG. 3 shows an anterior view of an embodiment of the interbody spinal implant having two integration plates, which sandwich the body of the implant;
- FIGS. 4A-4C depict a technique to form the macro features of the roughened surface topography on the integration surface in an embodiment of the invention
- FIG. 4D depicts the macro features of the roughened surface topography on the integration surface in an embodiment of the invention.
- FIG. 5A represents macro-, micro-, and nano-scaled features on a surface
- FIG. 5B shows Ra, Rmax, and Sm for a roughened surface topography
- FIG. 6 shows an exploded view of a generally oval-shaped implant with an integration plate
- FIG. 7 shows an exploded view of a curved implant with an integration plate
- FIG. 8 shows an exploded view of a posterior implant with an integration plate
- FIG. 9 shows an exploded view of a lateral lumbar implant with an integration plate
- FIG. 10 shows an exploded view of a generally oval-shaped anterior cervical implant with an integration plate.
- FIG. 11 illustrates one set of process steps that can be used to form macro, micro, or nano processes
- FIG. 12 graphically represents the average amplitude, Ra
- FIG. 13 graphically represents the average peak-to-valley roughness, Rz
- FIG. 14 graphically represents the maximum peak-to-valley height, Rmax
- FIG. 15 graphically represents the total peak-to-valley waviness profile
- FIG. 16 graphically represents the mean spacing, Sm.
- Certain embodiments of the present invention may be especially suited for placement between adjacent human vertebral bodies.
- the implants of the present invention may be used in procedures such as Anterior Lumbar Interbody Fusion (ALIF), Posterior Lumbar Interbody Fusion (PLIF), Transforaminal Lumbar Interbody Fusion (TLIF), and cervical fusion. Certain embodiments do not extend beyond the outer dimensions of the vertebral bodies.
- Interbody spinal implants allow for improved seating over the apophyseal rim of the vertebral body. Still further, interbody spinal implants, as now taught, better utilize this vital surface area over which fusion may occur and may better bear the considerable biomechanical loads presented through the spinal column with minimal interference with other anatomical or neurological spinal structures. Even further, interbody spinal implants, according to certain aspects of the present invention, allow for improved visualization of implant seating and fusion assessment. Interbody spinal implants, as now taught, may also facilitate osteointegration (e.g., formation of direct structural and functional interface between the artificial implant and living bone or soft tissue) with the surrounding living bone.
- osteointegration e.g., formation of direct structural and functional interface between the artificial implant and living bone or soft tissue
- implant fixation may depend, at least in part, on the stimulation and proliferation of bone modeling and forming cells, such as osteoclasts and osteoblasts and like-functioning cells upon the implant surface. Still further, it appears that these cells attach more readily to relatively rough surfaces rather than smooth surfaces. In this manner, a surface may be bioactive due to its ability to stimulate cellular attachment and osteointegration.
- FIGS. 1 and 2A show a perspective view of a first embodiment of the interbody spinal implant 1 especially well adapted for use in an ALIF procedure.
- the interbody spinal implant 1 includes a body 2 having a top surface 10 , a bottom surface 20 , opposing lateral sides 30 , and opposing anterior 40 and posterior 50 portions.
- the interbody spinal implant 1 may include implants made of a single piece of material or composite implants.
- Interbody spinal implants 1 made of a single piece of material do not include integration plates 82 .
- the integration surface may include the top surface 10 of the body 2 of the implant 1 , the bottom surface 20 of the body 2 of the implant 1 , or both.
- the integration surfaces have a roughened surface topography 80 including macro features, micro features, and nano features, without sharp teeth that risk damage to bone structures.
- the implant 1 may be composed of a suitable biocompatible material.
- implant 1 is formed of metal.
- the metal may be coated or not coated. Suitable metals, such as titanium, aluminum, vanadium, tantalum, stainless steel, and alloys of those metals, may be selected by one of ordinary skill in the art.
- the metal is at least one of titanium, aluminum, and vanadium, without any coatings.
- the implant 1 is comprised of titanium or a titanium alloy. An oxide layer may naturally form on a titanium or titanium alloy. Titanium and its alloys are generally preferred for certain embodiments of the present invention due to their acceptable, and desirable, strength and biocompatibility. In this manner, certain embodiments of the present interbody spinal implant 1 may have improved structural integrity and may better resist fracture during implantation by impact.
- Composite implants include at least a body 2 and one or two integration plates 82 , which may be formed from the same or different materials.
- the implant 1 includes a first integration plate 82 affixed to the top surface 10 of the body 2 and an optional second integration plate 82 (shown in FIG. 3 ) affixed to the bottom surface 20 of the body 2 .
- the first integration plate 82 and optional second integration plate 82 each have a top surface 81 , a bottom surface 83 , opposing lateral sides, opposing anterior portion 41 and posterior portion 51 , and a single vertical aperture 61 extending from the top surface 81 to the bottom surface 83 and aligning with the single vertical aperture 60 of the body 2 .
- the integration plate(s) 82 comprise an integration surface (e.g., the top surface 81 of the integration plate 82 ), which is adapted to grip bone through friction generated when the implant 1 is placed between two vertebrae and to inhibit migration of the implant 1 once implanted.
- the integration surfaces may also have a fusion and biologically active surface geometry.
- at least a portion of the top surface 81 of the first integration plate 82 (e.g., a first integration surface) and optionally a top surface 81 of a second integration plate 82 (e.g., a second integration surface) has a roughened surface topography 80 including macro features, micro features, and nano features, without sharp teeth that risk damage to bone structures.
- the roughened surface topography 80 may include macro features, micro features, and nano features of a regular repeating pattern, which may promote biological and chemical attachment or fusion with the bone structure.
- the body 2 and at least one integration plate 82 are preferably compatibly shaped, such that the implant 1 having the body 2 and integration plate(s) 82 joined together may have a generally oval shape, a generally rectangular shape, a generally curved shape, or any other shape described or exemplified in this specification.
- the body 2 and the integration plate(s) 82 may be generally oval-shaped in transverse cross-section.
- the body 2 and the integration plate(s) 82 may be generally rectangular-shaped in transverse cross-section.
- the body 2 and the integration plate(s) 82 may be generally curved-shaped in transverse cross-section.
- the body 2 and integration plate(s) 82 of the implant 1 may be the same material or may be different.
- the body 2 and the integration plate(s) 82 may be composed of a suitable biocompatible material.
- the body 2 and optional integration plate(s) 82 are formed of metal, which may be coated or not coated. Suitable metals, such as titanium, aluminum, vanadium, tantalum, stainless steel, and alloys of the metals, may be selected by one of ordinary skill in the art. In a preferred embodiment, however, the metal is at least one of titanium, aluminum, and vanadium, without any coatings.
- the body 2 and optional integration plate(s) 82 are comprised of titanium or a titanium alloy. An oxide layer may naturally form on a titanium or titanium alloy.
- the body 2 may be composed of a non-metal biocompatible material.
- the body 2 of the implant 1 is formed of a plastic, polymeric, or composite material.
- suitable polymers may comprise silicones, polyolefins, polyesters, polyethers, polystyrenes, polyurethanes, acrylates, and co-polymers and mixtures of the polymers.
- Certain embodiments of the present invention may be comprised of a biocompatible, polymeric matrix reinforced with bioactive fillers, fibers, or both.
- Certain embodiments of the present invention may be comprised of urethane dimethacrylate (DUDMA)/tri-ethylene glycol dimethacrylate (TEDGMA) blended resin and a plurality of fillers and fibers including bioactive fillers and E-glass fibers.
- the body 2 comprises polyetherether-ketone (PEEK), hedrocel, or ultra-high molecular weight polyethylene (UHMWPE).
- PEEK polyetherether-ketone
- Hedrocel is a composite material composed of carbon and an inert metal, such as tantalum.
- UHMWPE also known as high-modulus polyethylene (HMPE) or high-performance polyethylene (HPPE)
- HMPE high-modulus polyethylene
- HPPE high-performance polyethylene
- interbody spinal implant 1 are substantially hollow and have a generally oval-shaped transverse cross-sectional area.
- substantially hollow means at least about 33% of the interior volume of the interbody spinal implant 1 is vacant.
- the substantially hollow portion may be filled with cancellous autograft bone, allograft bone, demineralized bone matrix (DBM), porous synthetic bone graft substitute, bone morphogenic protein (BMP), or combinations of those materials.
- DBM demineralized bone matrix
- BMP bone morphogenic protein
- the anterior portion 40 , or trailing edge, of the implant 1 is preferably generally greater in height than the opposing posterior portion 50 . Accordingly, the implant 1 may have a lordotic angle to facilitate sagittal alignment. The implant 1 may better compensate, therefore, for the generally less supportive bone found in the posterior regions of the vertebral endplate.
- the posterior portion 50 of the interbody implant 1 preferably including the posterior-lateral corners, may also be highly radiused, thus allowing for ease of implantation into the disc space. Thus, the posterior portion 50 may have a generally blunt nosed profile.
- the anterior portion 40 of the implant 1 may also preferably be configured to engage a delivery device, driver, or other surgical tool (and, therefore, may have an opening 90 ).
- the anterior portion 40 of the implant 1 is substantially flat.
- the anterior portion 40 provides a face that can receive impact from a tool, such as a surgical hammer, to force the implant 1 into position.
- the implant 1 has a sharp edge 8 where the anterior portion 40 meets the top surface 10 , where the anterior portion 40 meets the bottom surface 20 , or in both locations.
- the sharp edge or edges 8 function to resist pullout of the implant 1 once it is inserted into position.
- the three surfaces of the implant 1 are designed to balance friction with roughened integration surfaces, preserve critical tissues and influence the natural biological responses of cells forming bone structures in contact with the outer smooth soft tissue surfaces, and enhance healing of joint space fusion treatments by providing graft contact surfaces.
- the at least three distinct surfaces described in this document may also better promote the osteointegration of certain embodiments of the present invention.
- the roughened surface topography 80 of the integration surfaces may better grip the vertebral endplate surfaces and inhibit implant migration upon placement and seating.
- the coarse surface topography of the graft contact surface may positively promote naturally occurring biological bone remodeling and fusion responses, for example, by stabilizing the graft materials and transferring loads from the motion of the joint through the implant body to those graft materials.
- the smooth surface topography of the soft tissue surface may provide an anchoring point and signaling function to bone forming cells to positively influence the fusion and healing responses.
- the smooth surface topography functions as a low friction surface so as to not cause unintentional abrasion or laceration of delicate soft tissue that the implant may contact during or after insertion.
- the implant 1 includes a roughened surface topography 80 or integration surface on at least a portion of the top surface, bottom surface, or both (e.g., the top surface 81 of an integration plate 82 ).
- the integration surface is the surface at least partially in contact with the vertebral or bone structure.
- the roughened surface topography 80 is obtained by combining separate macro processing, micro processing, and nano processing steps.
- the term “macro” typically means relatively large; for example, in the present application, dimensions measured in millimeters (mm).
- micro typically means one millionth (10 ⁇ 6 ); for example, in the present application, dimensions measured in microns ( ⁇ m) which correspond to 10 ⁇ 6 meters.
- nano typically means one billionth (10 ⁇ 9 ); for example, in the present application, dimensions measured in nanometers (nm) which correspond to 10 ⁇ 9 meters.
- FIG. 5A depicts macro, micro, and nano-sized surface features on a surface.
- the interbody implant 1 has a roughened surface topography 80 on the integration surface(s).
- the integration surface may include the top, bottom, or both surfaces of the implant. In the case of no integration plates 82 , this would include the top 10 , bottom 20 , or both surfaces of the body 2 of the implant 1 . In the case of one integration plate 82 affixed to the top 10 of the body 2 of the implant, this would include the top 81 of the integration plate 82 , the bottom 20 of the body 2 , or both surfaces.
- the top 10 of the body 2 In the case of one integration plate 82 affixed to the bottom 20 of the body 2 of the implant 1 , this would include the top 10 of the body 2 , the top 81 of the integration plate 82 (i.e., the outer surface of the integration plate 82 at the bottom of the implant), or both surfaces. In the case of two integration plates 82 sandwiched around the body 2 of the implant 1 , this would include the top 81 of the first integration plate 82 , the top 81 of the second integration plate 82 , or both surfaces (i.e., the outer surfaces of both integration plates 82 at the top and bottom of the implant, respectively).
- the integration surface(s) comprise predefined surface features that (a) engage the vertebral endplates with a friction fit and, following an endplate preserving surgical technique, (b) attain initial stabilization, and (c) benefit fusion.
- the composition of the endplate is a thin layer of notch-sensitive bone that is easily damaged by features (such as teeth) that protrude sharply from the surface of traditional implants. Avoiding such teeth and the attendant risk of damage, the roughened surface topography 80 of the integration surface(s) does not have teeth or other sharp, potentially damaging structures; rather, the roughened surface topography 80 may have a pattern of repeating features of predetermined sizes, smooth shapes, and orientations.
- predetermined means determined beforehand, so that the predetermined characteristic must be determined, i.e., chosen or at least known, before use of the implant 1 .
- the shapes of the frictional surface protrusions of the roughened surface topography 80 are formed using processes and methods commonly applied to remove metal during fabrication of implantable devices such as chemical, electrical, electrochemical, plasma, or laser etching; cutting and removal processes; casting; forging; machining; drilling; grinding; shot peening; abrasive media blasting (such as sand or grit blasting); and combinations of these subtractive processes.
- Additive processes such as welding, thermal, coatings, sputtering, and optical melt additive processes are also suitable.
- the resulting surfaces either can be random in the shape and location of the features or can have repeating patterns.
- This flexibility allows for the design and production of surfaces that resist motion induced by loading in specific directions that are beneficial to the installation process and resist the opposing forces that can be the result of biologic or patient activities such as standing, bending, or turning or as a result of other activities.
- the shapes of the surface features, when overlapping, work to increase the surface contact area but do not result in undercuts that generate a cutting or aggressively abrasive action on the contacting bone surfaces.
- These designed surfaces are composed of various sizes of features that, at the microscopic level, interact with the tissues and stimulate their natural remodeling and growth. At a larger scale these features perform the function of generating non-stressful friction that, when combined with a surgical technique that retains the most rigid cortical bone structures in the disc space, allow for a friction fit that does not abrade, chip, perforate, or compromise the critical endplate structures.
- the features may be divided into three size scales: nano, micro, and macro. The overlapping of the three feature sizes can be achieved using manufacturing processes that are completed sequentially and, therefore, do not remove or degrade the previous method.
- the first step in the process may be mechanical (e.g., machining though conventional processes) or chemical bulk removal, for example, to generate macro features.
- the macro features may be of any suitable shape, for example, roughly spherical in shape, without undercuts or protruding sharp edges. Other shapes are possible, such as ovals, polygons (including rectangles), and the like.
- These features may be at least partially overlapped with the next scale (micro) of features using either chemical or mechanical methods (e.g., AlO 2 blasting) in predetermined patterns which also do not result in undercuts or protruding sharp edges.
- the third and final process step is completed through more mild (less aggressive) etching (e.g., HCl acid etching) that, when completed, generates surface features in both the micro and nano scales over both of the features generated by the two previous steps.
- the nano layer may dictate the final chemistry of the implant material.
- the graft contact surface includes micro and nano features, which positively influence naturally occurring biological bone remodeling and fusion responses. Such results may occur by stabilizing the graft materials and transferring loads from the motion of the joint through the implant body to these materials.
- the graft contact surface may include surfaces that are in contact with or may become in contact with contained bone growth inducing materials.
- the substantially hollow portion of the implant 1 may be filled with bone growth inducing materials once the implant 1 has been inserted into position.
- Suitable bone growth inducing materials may include, but are not limited to, cancellous autograft bone, allograft bone, demineralized bone matrix (DBM), porous synthetic bone graft substitute, bone morphogenic protein (BMP), and combinations of those materials.
- the graft contact surface may include the interior surfaces of the implant 1 .
- the graft contact surfaces may include any surfaces that may be in contact with bone growth inducing materials (once added to the inside of the implant).
- the surfaces typically in contact with bone growth inducing materials include one or more surfaces defined by the single vertical aperture 60 , one or more surfaces defined by at least one transverse aperture 70 , and one or more surfaces defined by one or more alternative openings 92 in the implant 1 .
- the graft contact surfaces include each of surface 60 a defined by the single vertical aperture 60 , surfaces 70 a defined by two transverse apertures 70 , and surface 92 a defined by alternative opening 92 .
- the graft contact surface may have a “coarse” surface topography in that the surface topography is roughened or textured in the microscopic and nanoscopic levels.
- the micro features may be formed using either chemical or mechanical methods (e.g., AlO 2 blasting) in predetermined patterns, which also do not result in undercuts or protruding sharp edges.
- the nano features may be formed through more mild (less aggressive) etching (e.g., HCl acid etching).
- the graft contact surface may have a mid-level of friction when evaluated in comparison to the integration surface and the soft tissue surface. In other words, a frictional relationship (e.g., a coefficient of friction) between the integration surface, the graft contact surface, and the soft tissue surface may be defined as follows: the integration surface ⁇ the graft contact surface ⁇ the soft tissue surface.
- the soft tissue surface or insertion surface includes a low friction surface with nano features (and optionally micro features) to avoid unintentional laceration or abrasion of delicate soft tissues the implant 1 contacts during insertion, after insertion, or both.
- the soft tissue surface can also provide an anchoring point and signaling function to bone forming cells in order to positively influence the fusion and healing processes.
- the soft tissue surface may include the exterior surfaces of the implant 1 , except for the integration surface.
- the soft tissue surfaces may include any outer surfaces which may contact bone or soft tissues during or after implantation.
- the soft tissue surface may include the opposing lateral sides 30 of the body 2 , the opposing anterior portion 40 of the body 2 , and the posterior portion 50 of the body 2 .
- the soft tissue surface may additionally include the opposing lateral sides of the integration plate 82 , the opposing anterior portion 41 of the integration plate 82 , and the posterior portion 51 of the integration plate 82 .
- the soft tissue surface may include the opposing lateral sides of both integration plates 82 and the opposing anterior portion 41 and posterior portion 51 of both integration plates 82 .
- the soft tissue surface may also include any rounded edges 7 on the interbody spinal implant including rounded edges 7 on the body 2 or either or both of the integration plates 82 .
- the soft tissue surface may have a “smooth” surface topography in that the surface topography appears substantially smooth to the unaided eye.
- the smooth surface may include, however, intentional nano-sized features, and optionally, micro features.
- the nano features, and optionally, the micro features may be formed through more mild (less aggressive) etching (e.g., HCl acid etching), for example.
- the soft tissue surface may have a low degree of friction when evaluated in comparison to the integration surface and the soft tissue surface.
- FIG. 11 illustrates one set of process steps that can be used to form macro, micro, or nano processes. As illustrated, there may be some overlap in the processes that can be applied to form each of the three types of features (macro, micro, and nano). For example, acid etching can be used to form the macro features, then the same or a different acid etching process can be used to form the micro features.
- the features may be provided in a random design or a predetermined pattern (e.g., a repeating pattern).
- the macro features are relatively large features (e.g., on the order of millimeters).
- the macro features may be formed from subtractive techniques (e.g., mechanical or chemical bulk removal, for example) or additive techniques (e.g., deposition).
- the macro features are formed by subtractive techniques, which remove at least portions of the surface (e.g., from the titanium material that was used to form the part).
- Suitable subtractive techniques may include for example, machining (e.g., machine tools, such as saws, lathes, milling machines, and drill presses, are used with a sharp cutting tool to physically remove material to achieve a desired geometry) or unmasked or masked etching (e.g., portions of the surface is protected by a masking material which resists etching and an etching substance is applied to unmasked portions).
- machining e.g., machine tools, such as saws, lathes, milling machines, and drill presses, are used with a sharp cutting tool to physically remove material to achieve a desired geometry
- unmasked or masked etching e.g., portions of the surface is protected by a masking material which resists etching and an etching substance is applied to unmasked portions.
- the patterns may be organized in regular repeating patterns and optionally overlapping each other.
- the macro features may be formed in three, sequential steps.
- FIG. 4A illustrates the result of the first step in forming the macro features 102 .
- a first cut pattern 103 of the macro features is formed in a surface (e.g., the top surface 81 of the integration plate 82 ).
- the “cut 1 ” features of the first cut pattern 103 may cover about 20% of the total area of the surface, for example, leaving about 80% of the original surface 104 remaining. The range of these percentages may be about ⁇ 20%, preferably ⁇ 10%, and more preferably about ⁇ 5%.
- the “cut 1 ” features of the first cut pattern 103 do not have any undercuts. In one embodiment, these “cut 1 ” features have the smallest diameter and greatest depth of the macro features that are formed during the sequential steps.
- FIG. 4B illustrates the result of the second step in forming the macro features.
- a second cut pattern 105 of the macro features is formed in the surface.
- the “cut 1 ” features of the first cut pattern 103 and the “cut 2 ” features of the second cut pattern 105 may cover about 85% of the total area of the surface, for example, leaving about 15% of the original surface 104 remaining.
- the range of these percentages may be about ⁇ 10% and preferably ⁇ 5%.
- these “cut 2 ” features have both a diameter and a depth between those of the “cut 1 ” and “cut 3 ” features of the macro features that are formed during the first and third steps of the process of forming the macro features.
- FIG. 4C illustrates the result of the third and final step in forming the macro features.
- a third cut pattern 107 of the macro features may be formed in the surface.
- the “cut 1 ” features of the first cut pattern 103 , the “cut 2 ” features of the second cut pattern 105 , and the “cut 3 ” features of the third cut pattern 107 cover about 95% of the total area of the surface, for example, leaving about 5% of the original surface 104 remaining.
- the range of these percentages may be about ⁇ 1%.
- these “cut 3 ” features may have the largest diameter and least depth of the macro features that are formed during the sequential process steps.
- FIG. 4D also depicts the roughened surface topography 80 of the integration surface on the implant 1 following completion of the three, sequential processing steps.
- the finished macro features comprise multiple patterns of the three, overlapping cuts: the first cut pattern 103 , the second cut pattern 105 , and the third cut pattern 107 .
- the micro surface features may be applied to all or a portion of the surface (for example, to the integration surface, the graft contact surface, the soft tissue surfaces, or all three).
- the micro features may also be formed from subtractive techniques (e.g., mechanical or chemical bulk removal, for example) or additive techniques (e.g., deposition).
- the micro features are also formed by subtractive techniques.
- the micro features are cut by masked or unmasked etching, such as acid etching.
- portions of the surface may be exposed to a chemical etching.
- the micro process includes an acid etching, with a strong acid, such as hydrochloric acid (HCl), hydroiodic acid (HI), hydrobromic acid (HBr), hydrofluoric (HF), perchloric acid (HClO 4 ), nitric acid (HNO 3 ), sulfuric acid (H 2 SO 4 ), and the like.
- a strong acid such as hydrochloric acid (HCl), hydroiodic acid (HI), hydrobromic acid (HBr), hydrofluoric (HF), perchloric acid (HClO 4 ), nitric acid (HNO 3 ), sulfuric acid (H 2 SO 4 ), and the like.
- the etching process may be repeated a number of times as necessitated by the amount and nature of the irregularities required for any particular application. Control of the strength of the etchant material, the temperature at which the etching process takes place, and the time allotted for the etching process allows fine control over the resulting surface produced by the process. The number of repetitions of the etching process can also be used to control the surface features.
- the micro features may be obtained via the repetitive masking and chemical or electrochemical milling processes described in U.S. Pat. No. 5,258,098; No. 5,507,815; No. 5,922,029; and No. 6,193,762, the contents of which are incorporated by reference into this document, in their entirety, and for all purposes.
- an etchant mixture of at least one of nitric acid and hydrofluoric acid may be repeatedly applied to a titanium surface to produce an average etch depth of about 0.53 mm.
- chemical modification of a titanium surface can be achieved using at least one of hydrofluoric acid, hydrochloric acid, and sulfuric acid.
- the first exposure may be to hydrofluoric acid and the second may be to a hydrochloric acid and sulfuric acid mixture.
- Chemical acid etching alone may enhance osteointegration without adding particulate matter (e.g., hydroxyapatite) or embedding surface contaminants (e.g., grit particles).
- the micro features may also be cut by abrasive or grit blasting, for example, by applying a stream of abrasive material (such as alumina, sand, and the like) to the surface.
- abrasive material such as alumina, sand, and the like
- the abrasive material may include inert and non-bioactive materials.
- the abrasive material may include those reactive with biological functions as part of healing and fusions.
- the micro features are created, at least partially, with an aqueous hydrochloric acid etching step and at least partially with an AlO 2 blasting step. Patterns may be organized in regular repeating patterns and optionally overlapping each other. After the micro features are formed, it is possible that less than about 3% of the original surface 104 remains. The range of that percentage may be about ⁇ 1%.
- the nano surface features may be applied to all or a portion of the surface (for example, to the integration surface, the graft contact surface, the soft tissue surfaces, or all three).
- the nano features may also be formed from subtractive techniques (e.g., mechanical or chemical bulk removal, for example) or additive techniques (e.g., deposition).
- the nano features are also formed by subtractive techniques.
- the nano features are cut by masked or unmasked etching.
- portions of the surface including optionally portions of the surface exposed by the macro and micro steps described above in the case of the integration surface, may be exposed to a chemical etching.
- the nano process also includes an acid etching, with a strong or weak acid, such as hydrochloric acid (HCl), hydroiodic acid (HI), hydrobromic acid (HBr), hydrofluoric (HF), perchloric acid (HClO 4 ), nitric acid (HNO 3 ), sulfuric acid (H 2 SO 4 ), and the like.
- the acid etching process for the nano step is preferably less aggressive than the acid etching process in the micro step. In other words, a less acidic, mild, or more diluted acid may be selected.
- the nano features are created, at least partially, with an aqueous hydrochloric acid etching step.
- the nano features may be formed by preparing an acid solution comprising hydrochloric acid, water, and titanium; applying the acid solution to the desired surface; removing the acid solution by rinsing with water; and heating and subsequently cooling the surface being treated.
- the acid solution may be prepared using any suitable techniques known in the art.
- the acid solution may be prepared by combining hydrochloric acid and water, simultaneously or sequentially.
- the aqueous hydrochloric acid solution may optionally be heated, for example, to a temperature of about 150-250° F., preferably about 200-210° F., and most preferably about 205° F.
- the titanium may be seeded (e.g., added) in the aqueous hydrochloric acid solution or may already be present from titanium previously removed from at least one surface of the implant, for example, in a continuous manufacturing process.
- the solution may optionally be cooled.
- the acid solution may comprise a concentration of 20-40% hydrochloric acid, preferably about 25-31% hydrochloric acid, and more preferably about 28% hydrochloric acid, based on the weight percent of the solution.
- the etch rate is substantially constant.
- the etch rate in a metal-free solution is typically erratic.
- the metal may be passive for some period and then suddenly start reacting (sometimes at an exceptionally high rate), then may even go passive again. Therefore, it is preferred that the metal (e.g., titanium) is present from the manufacturing process or the titanium is seeded with the aqueous hydrochloric acid solution.
- the acid solution may be applied to the surface (e.g., a treated surface) using any suitable mechanism or techniques known in the art, for example, immersion, spraying, brushing, and the like.
- the acid solution is applied to the surface by immersing the entire part (e.g., the integration plate 82 ) in the solution. It is also contemplated that the part (e.g., the integration plate 82 ) may be immersed in the acid solution alone or in combination with the entire implant 1 or the assembled implant 1 (i.e., including the body 2 ). If desired, certain areas of the surface or the implant 1 may be masked in patterns to protect certain portions of the implant 1 .
- the acid solution may be heated when it is applied to the surface.
- the solution may be heated to a temperature of about 150-250° F., preferably about 200-210° F., and most preferably about 205° F.
- the solution may also be applied for any suitable period of time.
- the solution may be applied to the surface for a period of time of about 5-30 minutes, preferably about 15-25 minutes, and more preferably about 20 minutes.
- the acid solution may be removed, for example, by rinsing with water (e.g., deionized water).
- water e.g., deionized water
- the treated surface or the entire implant 1 may be subsequently dried.
- the treated surface may be dried using any suitable mechanism or techniques known in the art, for example, by heating in an oven (e.g., a dry oven).
- the treated surface (or entire implant) may be heated to a temperature of about 110-130° F., preferably about 120-125° F., and most preferably about 122.5° F.
- the treated surface (or entire implant) may be heated for any suitable period of time, for example about 30-50 minutes, preferably about 35-45 minutes, and more preferably about 40 minutes. After heating, the treated surface may be cooled to room temperature, for example.
- the nano features may also be removed by the abrasive or grit blasting, for example, described for the micro processing step. Patterns may be organized in regular repeating patterns and optionally overlapping each other. After the nano features are formed, it is possible that less than about 1% of the original surface 104 remains. For example, after the nano features are formed, the nano features (and optionally, the macro and micro features) may cover substantially the entire surface.
- the nano features may also be achieved by tumble finishing (e.g., tumbling) the part or the implant 1 .
- tumble finishing e.g., tumbling
- Suitable equipment and techniques can be selected by one of ordinary skill in the art.
- a barrel may be filled with the parts or implants and the barrel is then rotated.
- the parts or implants may be tumbled against themselves or with steel balls, shot, rounded-end pins, ballcones, or the like.
- the tumbling process may be wet (e.g., with a lubricant) or dry.
- the process steps described in this document can be adjusted to create a mixture of depths, diameters, feature sizes, and other geometries suitable for a particular implant application.
- the orientation of the pattern of features can also be adjusted. Such flexibility is desirable, especially because the ultimate pattern of the surface topography desired, for example, the integration surface of the implant 1 may be oriented in opposition to the biologic forces on the implant 1 and to the insertion direction.
- the pattern of the roughened surface topography 80 may be modeled after an S-shaped tire tread. It is also contemplated that the same or different process steps may be used to create each of the macro, micro, and nano features on each of the desired surfaces.
- FIG. 5B illustrates all three parameters, namely, Ra, Rmax, and Sm, for the macro features 102 of the integration plate 82 .
- Surface roughness may be measured using a laser profilometer or other standard instrumentation.
- the five parameters are: (1) average amplitude, Ra; (2) average peak-to-valley roughness, Rz; (3) maximum peak-to-valley height, Rmax; (4) total peak-to-valley of waviness profile, Wt; and (5) mean spacing, Sm.
- Each parameter is explained in detail as follows.
- Ra is the most commonly used roughness parameter. It is the arithmetic average height. Mathematically, Ra is computed as the average distance between each roughness profile point and the mean line. In FIG. 12 , the average amplitude is the average length of the arrows.
- the average peak-to-valley roughness, Rz is defined by the ISO and ASME 1995 and later. Rz is based on one peak and one valley per sampling length. The RzDIN value is based on the determination of the peak-to-valley distance in each sampling length. These individual peak-to-valley distances are averaged, resulting in the RzDIN value, as illustrated in FIG. 13 .
- the maximum peak-to-valley height, Rmax is the maximum peak-to-valley distance in a single sampling length—as illustrated in FIG. 14 .
- the total peak-to-valley of waviness profile (over the entire assessment length) is illustrated in FIG. 15 .
- the mean spacing, Sm is the average spacing between positive mean line crossings.
- the distance between each positive (upward) mean line crossing is determined and the average value is calculated, as illustrated in FIG. 16 .
- the parameters Sm, Rmax, and Ra can be used define the surface roughness following formation of each of the three types of features macro, micro, and nano.
- the following preferred ranges are as follows for the macro features for each of the three parameters.
- the mean spacing, Sm is between about 400-2,000, with a range of 750-1,750 preferred and a range of 1,000-1,500 most preferred.
- the maximum peak-to-valley height, Rmax is between about 40-500, with a range of 150-400 preferred and a range of 250-300 most preferred.
- the average amplitude, Ra is between about 8-200, preferably, 20-200, more preferably 50-150, and most preferably 100-125.
- the following preferred ranges are as follows for the micro features for each of the three parameters.
- the mean spacing, Sm is between about 20-400, with a range of 100-300 preferred and a range of 200-250 most preferred.
- the maximum peak-to-valley height, Rmax is between about 2-40, with a range of 2-20 preferred and a range of 9-13 most preferred.
- the average amplitude, Ra is between about 1-20, preferably 2-15, more preferably 4-10, even more preferably 2-8, and most preferably 2-6.
- the following preferred ranges are as follows for the nano features for each of the three parameters.
- the mean spacing, Sm is between about 0.5-20, with a range of 1-15 preferred and a range of 5-12 most preferred.
- the maximum peak-to-valley height, Rmax is between about 0.2-2, with a range of 0.2-1.8 preferred and a range of 0.3-1.3 most preferred.
- the average amplitude, Ra is between about 0.01-2, preferably 0.01-1, more preferably, 0.02-0.8, and most preferably 0.03-0.6.
- the integration plate shown in the drawing as component 82 ( FIGS. 3 and 6 ), 182 a ( FIG. 7 ), 182 ( FIG. 8 ), 382 ( FIG. 9 ), and 282 ( FIG. 10 ), respectively, includes the roughened surface topography 80 , 180 , 180 a , 280 , and 380 for the integration surface, and is connectable to either or both of the top surface 10 , 110 , 110 a , 210 , and 310 or bottom surface 20 , 120 , 120 a , 220 , and 320 .
- the integration plate 82 , 182 , 182 a , 282 , and 382 includes a top surface 81 , 181 , 181 a , 281 , and 381 ; a bottom surface 83 , 183 , 183 a , 283 , and 383 ; an anterior portion 41 , 141 , 141 a , 241 , and 341 ; a posterior portion 51 , 151 , 151 a , 251 , and 351 ; and at least one vertical aperture 61 , 161 , 161 a , 261 , and 361 .
- the anterior portion 41 , 141 , 141 a , 241 , and 341 preferably aligns with the anterior portion 40 , 140 , 140 a , 240 , and 340 of the main body 2 of the implant 1 , 101 , 101 a , 201 , and 301 , respectively, and the posterior portion 51 , 151 , 151 a , 251 , and 351 aligns with the posterior portion 50 , 150 , 150 a , 250 , and 350 of the main body 2 of the implant 1 , 101 , 101 a , 201 , and 301 , respectively.
- the vertical aperture 61 , 161 , 161 a , 261 , and 361 preferably aligns with the vertical aperture 60 , 160 , 160 a , 260 , and 360 of the main body 2 of the implant 1 , 101 , 101 a , 201 , and 301 , respectively.
- the integration plate vertical aperture 61 , 161 , 161 a , 261 , and 361 and the body vertical aperture 60 , 160 , 160 a , 260 , and 360 preferably comprise substantially the same shape.
- the integration plate 82 , 182 , 182 a , 282 , and 382 may be attached or affixed to the main body of the implant 1 , 101 , 101 a , 201 , and 301 using any suitable mechanisms known in the art.
- the bottom surface 83 , 183 , 183 a , 283 , and 383 of the integration plate 82 , 182 , 182 a , 282 , and 382 may comprise a reciprocal connector structure, such as a plurality of posts 84 , 184 , 184 a , 284 , and 384 that align with and insert into a corresponding connector structure such as a plurality of holes 12 , 112 , 112 a , 212 , and 312 on the top surface 10 , 110 , 110 a , 210 , and 310 and/or bottom surface 20 , 120 , 120 a , 220 , and 320 of the main body 2 of the implant 1 , 101 , 101 a , 201 , and 301 , respectively, and thus facilitate the connection between the integration plate 82 , 182 , 182 a , 282 , and 382 and the main body 2 of the implant 1 , 101 , 101 a , 301
- integration plates 82 , 182 , 182 a , 282 , and 382 with different sizes, shapes, or features may be used in connection with the implant 1 , 101 , 101 a , 201 , and 301 , for example, to accommodate attributes of the spine of the patient to which the implant 1 , 101 , 101 a , 201 , and 301 is to be implanted.
- these different sizes, shapes, and features are lordotic angles; anti-expulsion edges 8 , 108 , 108 a , 208 , and 308 ; and anti-expulsion angles as described throughout this specification.
- the implant 1 , 101 , 101 a , 201 , and 301 is configured to receive the integration plate 82 , 182 , 182 a , 282 , and 382 , respectively.
- the top surface 10 , 110 , 110 a , 210 , and 310 and/or bottom surface 20 , 120 , 120 a , 220 , and 320 of the implant 1 , 101 , 101 a , 201 , and 301 may be optionally recessed, and comprise a plurality of holes 12 , 112 , 112 a , 212 , and 312 that mate with the plurality of posts 84 , 184 , 184 a , 284 , and 384 on the bottom surface 83 , 183 , 183 a , 283 , and 383 of the integration plate 82 , 182 , 182 a , 282 , and 382 .
- FIG. 1 shows that the top surface 10 is recessed and comprises a plurality of holes 12 , but the recessed bottom surface 20 and its holes 12 are not shown.
- FIG. 6 shows that the top surface 110 a is recessed and comprises a plurality of holes 112 a , but the recessed bottom surface 120 a and its holes 112 a are not shown.
- FIG. 7 shows that the top surface 110 is recessed and comprises a plurality of holes 112 , but the recessed bottom surface 120 and its holes 112 are not shown.
- FIG. 8 shows that the top surface 310 is recessed and comprises a plurality of holes 312 , but the recessed bottom surface 320 and its holes 312 are not shown.
- top surface 210 is recessed and comprises a plurality of holes 212 , but the recessed bottom surface 220 and its holes 212 are not shown.
- the recess may be at a depth D, and the recess depth D preferably is uniform throughout the top surface 10 , 110 , 110 a , 210 , and 310 and/or bottom surface 20 , 120 , 120 a , 220 , and 320 .
- the recess depth D preferably corresponds to a thickness T of the integration plate 82 , 182 , 182 a , 282 , and 382 .
- the depth D and thickness T are the same so that once the integration plate 82 , 182 , 182 a , 282 , and 382 and body of the implant 1 , 101 , 101 a , 201 , and 301 , respectively, are placed together, the top surface 10 , 110 , 110 a , 210 , and 310 and/or bottom surface 20 , 120 , 120 a , 220 , and 320 of the implant 1 , 101 , 101 a , 201 , and 301 is substantially even, at least at the seam/junction between the integration plate 82 , 182 , 182 a , 282 , and 382 and the top surface 10 , 110 , 110 a , 210 , and 310 or bottom surface 20 , 210 , 120 a , 2
- the posterior portion 51 , 151 , 151 a , 251 , and 351 and the anterior portion 41 , 141 , 141 a , 241 , and 341 of the integration plate 82 , 182 , 182 a , 282 , and 382 have different thicknesses such that the anterior portion 41 , 141 , 141 a , 241 , and 341 has a greater thickness than the thickness of the posterior portion 51 , 151 , 151 a , 251 , and 351 .
- the recess depth D and the thickness T may each independently be from about 0.1 mm to about 10 mm. In preferred aspects, the recess depth D and the thickness T may each independently be from about 1 mm to about 5 mm. Thus, for example, the recess depth D or the thickness T may be selected from about 0.1 mm, about 0.25 mm, about 0.5 mm, about 0.75 mm, about 1 mm, about 1.25 mm, about 1.5 mm, about 1.75 mm, about 2 mm, about 2.25 mm, about 2.5 mm, about 2.75 mm, about 3 mm, about 3.25 mm, about 3.5 mm, about 3.75 mm, about 4 mm, about 4.25 mm, about 4.5 mm, about 4.75 mm, about 5 mm, 5.5 mm, about 6 mm, about 6.5 mm, about 7 mm, about 75 mm, or about 8 mm.
- Recessing the top surface 10 , 110 , 110 a , 210 , and 310 or bottom surface 20 , 120 , 120 a , 220 , and 320 exposes a ridge 11 , 111 , 111 a , 211 , and 311 against which the anterior portion 41 , 141 , 141 a , 241 , and 341 , posterior portion 51 , 151 , 151 a , 251 , and 251 , or lateral side of the integration plate 82 , 182 , 182 a , 282 , and 382 may be seated when brought together with the implant 1 , 101 , 101 a , 201 , and 301 .
- the integration plate 82 , 182 , 182 a , 282 , and 382 may be used with an implant suitable for ALIF (e.g., implant 1 , integration plate 82 ), PLIF (e.g., implant 101 , integration plate 182 ), or TLIF fusion (e.g., implant 101 a , integration plate 182 a ); may be used with an implant suitable for cervical fusion (e.g., implant 201 , integration plate 282 ); and may be used with an implant suitable for lateral lumbar insertion (e.g., implant 301 , integration plate 382 ).
- ALIF e.g., implant 1 , integration plate 82
- PLIF e.g., implant 101 , integration plate 182
- TLIF fusion e.g., implant 101 a , integration plate 182 a
- an implant suitable for cervical fusion e.g., implant 201 , integration plate 282
- the reciprocal connector such as the post 84 , 184 , 184 a , 284 , and 384 preferably is secured within the connector of the body such as the hole 12 , 112 , 112 a , 212 , and 312 to mediate the connection between the integration plate 82 , 182 , 182 a , 282 , and 382 and the implant 1 , 101 , 101 a , 201 , and 301 .
- the connection should be capable of withstanding significant loads and shear forces when implanted in the spine of the patient.
- connection between the post 84 , 184 , 184 a , 284 , and 384 and the hole 12 , 112 , 112 a , 212 , and 312 may comprise a friction fit.
- the reciprocal connector such as the post 84 , 184 , 184 a , 284 , and 384 and the connector of the body such as the hole 12 , 112 , 112 a , 212 , and 312 have additional compatible structures and features to further strengthen the connection between the integration plate 82 , 182 , 182 a , 282 , and 382 and the implant 1 , 101 , 101 a , 201 , and 301 .
- the structures and features may be on either or both of the integration plate 82 , 182 , 182 a , 282 , and 382 and the main body 2 of the implant 1 , 101 , 101 a , 201 , and 301 .
- the structures include fasteners, compatibly shaped joints, compatibly shaped undercuts, and/or other suitable connectors having different shapes, sizes, and configurations.
- a fastener may include a pin, screw, bolt, rod, anchor, snap, clasp, clip, clamp, or rivet.
- an adhesive may be used to further strengthen any of the integration plate 82 , 182 , 182 a , 282 , and 382 and implant 1 , 101 , 101 a , 201 , and 301 connections described in this specification.
- An adhesive may comprise cement, glue, polymer, epoxy, solder, weld, or other suitable binding materials.
- the integration plate 82 , 182 , 182 a , 282 , and 382 may comprise one or more reciprocal connectors (not shown), such as one or more posts, each having a bore, extending through a horizontal plane.
- the post may be inserted into a connector such as a hole through the implant 1 , 101 , 101 a , 201 , and 301 .
- a fastener (not shown), such as a pin, may be inserted through the bore thereby preventing the post from being disengaged from the hole.
- the pin may be threaded through a second bore that passes through the walls of the implant 1 , 101 , 101 a , 201 , and 301 itself; although it is preferable that the implant 1 , 101 , 101 a , 201 , and 301 does not include a second bore through its walls and that the bore is accessible from the space inside of the implant.
- the integration plate 82 , 182 , 182 a , 282 , and 382 may comprise a plurality of bores (not shown) present on and having an opening accessible from the bottom of the integration plate 82 , 182 , 182 a , 282 , and 382 .
- the bores may mate with a plurality of fasteners, which may comprise rods integral with or otherwise attached to the top surface or bottom surface of the implant 1 , 101 , 101 a , 201 , and 301 .
- the rods may be molded as upward-facing extensions or snap-fit into the bores.
- the hole 12 , 112 , 112 a , 212 , and 312 may not be present, and the screw or bolt (not shown) may be screwed directly into the plastic or polymeric material, with the screw threads tightly gripping the plastic or polymeric material to form the connection.
- the bottom surface 83 , 183 , 183 a , 283 , and 383 of the integration plate 82 , 182 , 182 a , 282 , and 382 may comprise undercuts (not shown) in shapes that form a tight junction with compatible shapes on the implant 1 , 101 , 101 a , 201 , and 301 .
- the bottom surface 83 , 183 , 183 a , 283 , and 383 may comprise a dovetail joint, bevel, or taper that fits with a counterpart dovetail joint, bevel, or taper on the body 2 of the implant 1 , 101 , 101 a , 201 , and 301 .
- An adhesive may directly join the integration plate 82 , 182 , 182 a , 282 , and 382 and the body 2 of the implant 1 , 101 , 101 a , 201 , and 301 together, with or without other connecting features.
- the adhesive may be applied to the bottom surface 83 , 183 , 183 a , 283 , and 383 of the integration plate 82 , 182 , 182 a , 282 , and 382 .
- the adhesive may be applied to the top surface 10 , 110 , 110 a , 210 , and 310 or bottom surface 20 , 120 , 120 a , 220 , and 320 , or both surfaces of the implant 1 , 101 , 101 a , 201 , and 301 .
- the foregoing describes various non-limiting examples of how the one or two integration plates 82 , 182 , 182 a , 282 , and 382 may be joined together with the implant 1 , 101 , 101 a , 201 , and 301 .
- the implant 1 may comprise some or all of the following implant features, for example.
- the interbody spinal implant 1 is substantially hollow and has a generally oval-shaped transverse cross-sectional area with smooth, rounded, or both smooth and rounded lateral sides 30 and posterior-lateral corners.
- the implant 1 includes at least one vertical aperture 60 that extends the entire height of the implant body 2 .
- the vertical aperture 60 defines an interior surface 60 a or hollow cavity within the implant 1 , which may be filled with bone growth inducing materials.
- the vertical aperture (a) extends from the top surface to the bottom surface, (b) has a size and shape predetermined to maximize the surface area of the top surface and the bottom surface available proximate the anterior and posterior portions while maximizing both radiographic visualization and access to the substantially hollow center, and (c) optionally defines a transverse rim.
- the vertical aperture 60 may further define a transverse rim 100 having a greater posterior portion thickness 55 than an anterior portion thickness 45 .
- the opposing lateral sides 30 and the anterior portion 40 have a rim thickness 45 of about 5 mm, while the posterior portion 50 has a rim thickness 55 of about 7 mm.
- the rim posterior portion thickness 55 may allow for better stress sharing between the implant 1 and the adjacent vertebral endplates and helps to compensate for the weaker posterior endplate bone.
- the transverse rim 100 has a generally large surface area and contacts the vertebral endplate. The transverse rim 100 may act to better distribute contact stresses upon the implant 1 , and hence minimize the risk of subsidence while maximizing contact with the apophyseal supportive bone.
- transverse rim 100 it is also possible for the transverse rim 100 to have a substantially constant thickness (e.g., for the anterior portion thickness 45 to be substantially the same as the posterior portion thickness 55 ) or for the posterior portion 50 to have a rim thickness 55 less than that of the opposing lateral sides 30 and the anterior portion 40 .
- the implant 1 may be shaped to reduce the risk of subsidence, and improve stability, by maximizing contact with the apophyseal rim of vertebral endplates.
- Embodiments may be provided in a variety of anatomical footprints having a medial-lateral width ranging from about 32 mm to about 44 mm.
- An interbody spinal implant 1 generally does not require extensive supplemental or obstructive implant instrumentation to maintain the prepared disc space during implantation.
- the interbody spinal implant 1 and associated implantation methods allow for larger-sized implants as compared with other size-limited interbody spinal implants known in the art. This advantage allows for greater medial-lateral width and correspondingly greater contact with the apophyseal rim.
- the implant 1 has an opening 90 in the anterior portion 40 .
- the posterior portion 50 may have a similarly shaped opening 90 (not shown).
- only the anterior portion 40 has the opening 90 while the posterior portion 50 has an alternative opening 92 (which may have a size and shape different from the opening 90 ).
- the opening 92 defines an interior surface 92 a or hollow cavity, which may be filled with bone growth inducing materials.
- the opening 90 , 290 , and 390 has a number of functions. One function is to facilitate manipulation of the implant 1 , 201 , and 301 by the caretaker.
- the caretaker may insert a surgical tool into the opening 90 , 290 , and 390 and, through the engagement between the surgical tool and the opening 90 , 290 , and 390 , manipulate the implant 1 , 201 , and 301 .
- the opening 90 , 290 , and 390 may be threaded to enhance the engagement.
- a suitable surgical tool such as a distractor (not shown), may be selected by one of ordinary skill in the art.
- the anterior portion 140 , 140 a may have a tapered nose 142 , 142 a to facilitate insertion of the implant 101 .
- the implant 1 may further include at least one transverse aperture 70 that extends the entire transverse length of the implant body.
- the transverse aperture 70 defines an interior surface 70 a or hollow cavity, which may be filled with bone growth inducing materials.
- the at least one transverse aperture 70 may provide improved visibility of the implant 1 during surgical procedures to ensure proper implant placement and seating, and may also improve post-operative assessment of implant fusion.
- the transverse aperture 70 may be broken into two, separate sections by an intermediate wall. Suitable shapes and dimensions for the transverse aperture 70 may be selected by one of ordinary skill in the art. In particular, all edges of the transverse aperture 70 may be rounded, smooth, or both.
- the intermediate wall may be made of the same material as the remainder of the body 2 of the implant 1 (e.g., plastic), or it may be made of another material (e.g., metal).
- the intermediate wall may offer one or more of several advantages, including reinforcement of the implant 1 and improved bone graft containment.
- the implant 1 may be provided with a solid rear wall (not shown).
- the rear wall may extend the entire width of the implant body and nearly the entire height of the implant body. Thus, the rear wall can essentially close the anterior portion 40 of the implant 1 .
- the rear wall may offer one or more of several advantages, including reinforcement of the implant 1 and improved bone graft containment. In the cervical application, it may be important to prevent bone graft material from entering the spinal canal.
- the implant 1 may also have a lordotic angle to facilitate alignment.
- One lateral side 30 is preferably generally greater in height than the opposing lateral side 30 . Therefore, the implant 1 may better compensate for the generally less supportive bone found in certain regions of the vertebral endplate. As much as seven degrees of lordosis (or more) may be built into the implant 1 to help restore cervical balance.
- the implant 1 , 101 , 101 a , 201 , and 301 may comprise one or more anti-expulsion edges 8 , 108 , 108 a , 208 , and 308 that tend to “dig” into the end-plates slightly and help to resist expulsion.
- the anti-expulsion edges 8 , 108 , 108 a , 208 , and 308 may be present on the top surface 81 of the integration plate 82 affixed to the top surface 10 , 110 , 110 a , 210 , and 310 ; the bottom surface 20 , 120 , 120 a , 220 , and 320 ; or both surfaces of the implant 1 , 101 , 101 a , 201 , and 301 .
- the anti-expulsion edges 8 , 108 , 108 a , 208 , and 308 may be present on the top surface 10 , 110 , 110 a , 210 , and 310 ; the bottom surface 20 , 120 , 120 a , 220 , and 320 ; or both surfaces of the body of the implant 1 , 101 , 101 a , 201 , and 301 .
- FIG. 6 shows an anti-expulsion edge 8 on the top surface 81 of the integration plate 82 and the bottom surface 20 of the anterior face 40 of the implant 1 .
- Each anti-expulsion edge 8 may protrude above the plane of the top surface 81 of the integration plate 82 and bottom surface 20 , with the amount of protrusion increasing toward the anterior face 40 and the highest protrusion height P at the anterior-most edge of the top surface 81 of the integration plate 82 or bottom surface 20 .
- An anti-expulsion edge 8 , 108 , 108 a , 208 , and 308 may be oriented toward the anterior portion 40 , 140 , 140 a , 240 , and 340 , or the posterior portion 50 , 150 , 150 a , 250 , and 350 , or either of the opposing lateral sides 30 , 130 , 130 a , 230 , and 330 .
- the orientation of the anti-expulsion edge 8 , 108 , 108 a , 208 , and 308 may depend on the intended orientation of the implant 1 , 101 , 101 a , 201 , and 301 when it has been implanted between vertebrae in the patient.
- the disc space may be accessed using a standard mini open retroperitoneal laparotomy approach.
- the center of the disc space is located by AP fluoroscopy taking care to make sure the pedicles are equidistant from the spinous process.
- the disc space is then incised by making a window in the annulus for insertion of certain embodiments of the spinal implant 1 (a 32 or 36 mm window in the annulus is typically suitable for insertion).
- the process according to the invention minimizes, if it does not eliminate, the cutting of bone.
- the endplates are cleaned of all cartilage with a curette, however, and a size-specific rasp (or broach) may then be used.
- a rasp preferably substantially minimizes or eliminates removal of bone, thus substantially minimizing or eliminating impact to the natural anatomical arch, or concavity, of the vertebral endplate while preserving much of the apophyseal rim.
- Preservation of the anatomical concavity is particularly advantageous in maintaining biomechanical integrity of the spine. For example, in a healthy spine, the transfer of compressive loads from the vertebrae to the spinal disc is achieved via hoop stresses acting upon the natural arch of the endplate. The distribution of forces, and resultant hoop stress, along the natural arch allows the relatively thin shell of subchondral bone to transfer large amounts of load.
- the vertebral endplate natural arch may be significantly removed due to excessive surface preparation for implant placement and seating. This is especially common where the implant 1 is to be seated near the center of the vertebral endplate or the implant 1 is of relatively small medial-lateral width. Breaching the vertebral endplate natural arch disrupts the biomechanical integrity of the vertebral endplate such that shear stress, rather than hoop stress, acts upon the endplate surface. This redistribution of stresses may result in subsidence of the implant into the vertebral body.
- interbody spinal implant 1 , 101 , 101 a , 201 , and 301 include smooth, rounded, and highly radiused posterior portions and lateral sides which may minimize extraneous bone removal for endplate preparation and reduce localized stress concentrations.
- interbody surgical implant 1 , 101 , 101 a , 201 , and 301 and methods of using it are particularly useful in preserving the natural arch of the vertebral endplate and minimizing the chance of implant subsidence.
- endplates are spared during the process of inserting the spinal implant 1 , 101 , 101 a , 201 , and 301 .
- Spared endplates allow the transfer of axial stress to the apophasis. Endplate flexion allows the bone graft placed in the interior of the spinal implant 1 to accept and share stress transmitted from the endplates.
- spared endplates minimize the concern that BMP might erode the cancellous bone.
- Interbody spinal implant 1 is durable and can be impacted between the endplates with standard instrumentation. Therefore, certain embodiments of the invention may be used as the final distractor during implantation. In this manner, the disc space may be under-distracted (e.g., distracted to some height less than the height of the interbody spinal implant 1 ) to facilitate press-fit implantation. Further, certain embodiments of the current invention having a smooth and rounded posterior portion (and lateral sides) may facilitate easier insertion into the disc space. Still further, the surface roughened topography 80 may lessen the risk of excessive bone removal during distraction as compared to implants having teeth, ridges, or threads currently known in the art even in view of a press-fit surgical distraction method.
- the interbody surgical implant 1 may provide secure seating and prove difficult to remove.
- certain embodiments of the interbody spinal implant 1 , 101 , 101 a , 201 , and 301 may maintain a position between the vertebral endplates due, at least in part, to resultant annular tension attributable to press-fit surgical implantation and, post-operatively, improved osteointegration.
- Implant systems and methods tension the vertebral annulus via distraction. These embodiments and methods may also restore spinal lordosis, thus improving sagittal and coronal alignment.
- Implant systems currently known in the art require additional instrumentation, such as distraction plugs, to tension the annulus. These distraction plugs require further tertiary instrumentation, however, to maintain the lordotic correction during actual spinal implant insertion. If tertiary instrumentation is not used, then some amount of lordotic correction may be lost upon distraction plug removal.
- Interbody spinal implant 1 is particularly advantageous in improving spinal lordosis without the need for tertiary instrumentation, thus reducing the instrument load upon the surgeon. This reduced instrument load may further decrease the complexity, and required steps, of the implantation procedure.
- spinal implant 1 , 101 , 101 a , 201 , and 301 may also reduce deformities (such as isthmic spondylolythesis) caused by distraction implant methods.
- Traditional implant systems require secondary or additional instrumentation to maintain the relative position of the vertebrae or distract collapsed disc spaces.
- interbody spinal implant 1 , 101 , 101 a , 201 , and 301 may be used as the final distractor and thus maintain the relative position of the vertebrae without the need for secondary instrumentation.
- Certain embodiments collectively comprise a family of implants, each having a common design philosophy. These implants and the associated surgical technique have been designed to address at least the ten, separate challenges associated with the current generation of traditional anterior spinal fusion devices listed above in the Background section of this document.
- embodiments of the invention first adequately distract the disc space by inserting (through impaction) and removing sequentially larger sizes of very smooth distractors, which have been size matched with the size of the available implant 1 . Once adequate distraction is achieved, the surgeon prepares the end-plate with a rasp. There is no secondary instrumentation required to keep the disc space distracted while the implant 1 , 101 , 101 a , 201 , and 301 is inserted, as the implant 1 , 101 , 101 a , 201 , and 301 has sufficient mechanical strength that it is impacted into the disc space.
- the height of the implant 1 , 101 , 101 a , 201 , and 301 is preferably about 1 mm greater than the height of the rasp used for end-plate preparation, to create some additional tension in the annulus by implantation, which creates a stable implant construct in the disc space.
- the implant geometry has features which allow it to be implanted via any one of an anterior, antero-lateral, or lateral approach, providing tremendous intra-operative flexibility of options.
- the implant 1 , 101 , 101 a , 201 , and 301 has adequate strength to allow impact, and the sides of the implant 1 , 101 , 101 a , 201 , and 301 may have smooth surfaces to allow for easy implantation and, specifically, to prevent binding of the implant 1 , 101 , 101 a , 201 , and 301 to soft tissues during implantation.
- the invention encompasses a number of different implant 1 , 101 , 101 a , 201 , and 301 configurations, including a composite implant formed of top and optional bottom plates (components), for example, made out of titanium.
- the integration surfaces exposed to the vertebral body have a roughened surface topography 80 to allow for bony in-growth over time, and to provide resistance against expulsion.
- the top and bottom titanium plates may be assembled together with the implant body.
- the net result is a composite implant that has engineered stiffness for its clinical application.
- the axial load may be borne by the polymeric component of the construct.
- an intact vertebral end-plate deflects like a diaphragm under axial compressive loads generated due to physiologic activities. If a spinal fusion implant is inserted in the prepared disc space via a procedure which does not destroy the end-plates, and if the implant contacts the end-plates only peripherally, the central dome of the end-plates can still deflect under physiologic loads. This deflection of the dome can pressurize the bone graft material packed inside the spinal implant, hence allowing it to heal naturally.
- the implant 1 , 101 , 101 a , 201 , and 301 designed according to certain embodiments allows the vertebral end-plate to deflect and allows healing of the bone graft into fusion.
Landscapes
- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Neurology (AREA)
- Heart & Thoracic Surgery (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Cardiology (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Manufacturing & Machinery (AREA)
- Prostheses (AREA)
Abstract
Description
- This application is a continuation of U.S. patent application Ser. No. 13/557,727, filed on Jul. 25, 2012, which is a continuation-in-part of U.S. patent application Ser. No. 12/151,198, filed on May 5, 2008, and issued as U.S. Pat. No. 8,262,737, which is a continuation-in-part of U.S. patent application Ser. No. 11/123,359, filed on May 6, 2005, and issued as U.S. Pat. No. 7,662,186. The contents of both prior applications are incorporated by reference into this document, in their entirety and for all purposes.
- The present invention relates generally to interbody spinal implants and methods of making such implants and, more particularly, to spinal implants having at least three distinct surfaces.
- In the simplest terms, the spine is a column made of vertebrae and discs. The vertebrae provide the support and structure of the spine while the spinal discs, located between the vertebrae, act as cushions or “shock absorbers.” These discs also contribute to the flexibility and motion of the spinal column. Over time, the discs may become diseased or infected, may develop deformities such as tears or cracks, or may simply lose structural integrity (e.g., the discs may bulge or flatten). Impaired discs can affect the anatomical functions of the vertebrae, due to the resultant lack of proper biomechanical support, and are often associated with chronic back pain.
- Several surgical techniques have been developed to address spinal defects, such as disc degeneration and deformity. Spinal fusion has become a recognized surgical procedure for mitigating back pain by restoring biomechanical and anatomical integrity to the spine. Spinal fusion techniques involve the removal, or partial removal, of at least one intervertebral disc and preparation of the disc space for receiving an implant by shaping the exposed vertebral endplates. An implant is then inserted between the opposing endplates.
- Spinal fusion procedures can be achieved using a posterior or an anterior approach, for example. Anterior interbody fusion procedures generally have the advantages of reduced operative times and reduced blood loss. Further, anterior procedures do not interfere with the posterior anatomic structure of the lumbar spine. Anterior procedures also minimize scarring within the spinal canal while still achieving improved fusion rates, which is advantageous from a structural and biomechanical perspective. These generally preferred anterior procedures are particularly advantageous in providing improved access to the disc space, and thus correspondingly better endplate preparation.
- There are a number of problems, however, with traditional spinal implants including, but not limited to, improper seating of the implant, implant subsidence (defined as sinking or settling) into the softer cancellous bone of the vertebral body, poor biomechanical integrity of the endplates, damaging critical bone structures during or after implantation, and the like. In summary, at least ten, separate challenges can be identified as inherent in traditional anterior spinal fusion devices. Such challenges include: (1) end-plate preparation; (2) implant difficulty; (3) materials of construction; (4) implant expulsion; (5) implant subsidence; (6) insufficient room for bone graft; (7) stress shielding; (8) lack of implant incorporation with vertebral bone; (9) limitations on radiographic visualization; and (10) cost of manufacture and inventory.
- The present invention provides for interbody spinal implants having at least three distinct surfaces: (1) at least one integration surface; (2) at least one graft contact surface; and (3) at least one soft tissue surface. The integration surface includes macro, micro, and nano features having a fusion and biologically active surface geometry and frictionally engages preserved bone structures. The graft contact surface includes micro and nano features, which positively influence naturally occurring biological bone remodeling and fusion responses. The soft tissue surface includes a low friction surface with nano features (and optionally micro features) to avoid unintentional laceration or abrasion of delicate soft tissues (e.g., blood vessels, nerves, and muscles) the implant contacts during insertion, after insertion, or both. The soft tissue surface can also provide an anchoring point and signaling function to bone forming cells in order to positively influence the fusion and healing processes. Various implant body shapes are provided to allow for implantation through various access paths to the spine through a patient's body. The structures and surfaces are designed to work in concert to preserve endplate bone structures, provide for sufficient bioactivity in each respective location, and provide stability within the disc space and the graft containment axial column. In particular, the shapes and textures of the bioactive surfaces vary based on the implant insertion path, location within the disc space, and frictional characteristics of the surfaces.
- In one embodiment, the present invention provides an implant comprising a body having a top surface, a bottom surface, opposing lateral sides, opposing anterior and posterior portions, a substantially hollow center, and a single vertical aperture; and optionally, at least one of a first integration plate affixed to the top surface of the body and a second integration plate affixed to the bottom surface of the body, wherein the first integration plate and the second integration plate each have a top surface, a bottom surface, opposing lateral sides, opposing anterior and posterior portions, and a single vertical aperture extending from the top surface to the bottom surface and aligning with the single vertical aperture of the body. The interbody spinal implant further comprises (a) at least one integration surface having a roughened surface topography including macro features, micro features, and nano features, without sharp teeth that risk damage to bone structures; (b) at least one graft contact surface having a coarse surface topography including micro features and nano features; and (c) at least one soft tissue surface having a substantially smooth surface including nano features and optionally, micro features.
- The integration surface may include the top, bottom, or both surfaces of the implant. In the case of no integration plates, this would include the top, bottom, or both surfaces of the body of the implant. In the case of one integration plate affixed to the top of the body of the implant, this would include the top of the integration plate, the bottom of the body, or both surfaces. In the case of one integration plate affixed to the bottom of the body of the implant, this would include the top of the body, the top of the integration plate (i.e., the outer surface of the integration plate at the bottom of the implant), or both surfaces. In the case of two integration plates sandwiched around the body of the implant, this would include the top of the first integration plate, the top of the second integration plate, or both surfaces (i.e., the outer surfaces of both integration plates at the top and bottom of the implant).
- The graft contact surface may include the interior surfaces of the implant. In other words, the graft contact surfaces may include any surfaces that may be in contact with bone growth inducing materials (once added to the inside of the implant). In particular, the surfaces typically in contact with bone growth inducing materials include one or more surfaces defined by the single vertical aperture, one or more surfaces defined by at least one transverse aperture, and one or more surfaces defined by one or more openings in the implant.
- The soft tissue surface may include the exterior surfaces of the implant, except for the integration surface. In other words, other than the one or more integration surfaces, the soft tissue surfaces may include any outer surfaces which may contact bone or soft tissue during or after implantation. In particular, the soft tissue surface may include the opposing lateral sides of the body and the opposing anterior and posterior portions of the body. In the case of one integration plate, the soft tissue surface may additionally include the opposing lateral sides of the integration plate and the opposing anterior and posterior portions of the integration plate. In the case of two integration plates, the soft tissue surface may additionally include the opposing lateral sides of both integration plates and the opposing anterior and posterior portions of both integration plates. The soft tissue surface may also include any rounded edges on the interbody spinal implant including rounded edges on the body or either or both of the integration plates.
- The implant body and/or the integration plate(s) may be fabricated from a metal. A preferred metal is titanium or a titanium alloy. The implant body may be fabricated from both a metal and a non-metallic material. In an exemplary embodiment, a composite implant may be formed with integration plates made of titanium combined with a body also made of titanium.
- In another embodiment of the invention, a composite interbody spinal implant comprises a body having a top surface, a bottom surface, opposing lateral sides, opposing anterior and posterior portions, a substantially hollow center, a single vertical aperture, and at least one transverse aperture; a first integration plate affixed to the top surface of the body; and a second integration plate affixed to the bottom surface of the body. The first integration plate and the second integration plate each have a top surface comprising an integration surface, a bottom surface, opposing lateral sides, opposing anterior and posterior portions, and a single vertical aperture extending from the top surface to the bottom surface and aligning with the single vertical aperture of the body, defining a transverse rim. The top surface of the first integration plate and the top surface of the second integration plate may each have a roughened surface topography including macro features, micro features, and nano features, without sharp teeth that risk damage to bone structures, adapted to grip bone through friction generated when the implant is placed between two vertebrae and to inhibit migration of the implant. A surface defined by the single vertical aperture, a surface defined by the at least one transverse aperture, and a surface defined by an optional opening may each comprise a graft contact surface having a coarse surface topography including micro features and nano features. The opposing lateral sides of the body, the opposing anterior and posterior portions of the body, the opposing lateral sides of the first integration plate, the opposing anterior and posterior portions of the first integration plate, the opposing lateral sides of the second integration plate, the opposing anterior and posterior portions of the second integration plate, and an optional rounded edge of the interbody spinal implant may each comprise a soft tissue surface having a substantially smooth surface including nano features.
- The present invention also encompasses a process of fabricating a predetermined surface topography. The process may include macro processing at least one integration surface, micro processing at least one integration surface and at least one graft contact surface, and nano processing at least one integration surface, at least one graft contact surface, and at least one soft tissue surface. The macro, micro, and nano process may include mechanical or chemical removal of at least a portion of the surface. For example, the nano process may include mild chemical etching, laser or other directed energy material removal, abrasion, blasting, or tumbling, followed by cleaning.
- The invention is best understood from the following detailed description when read in connection with the accompanying drawing. It is emphasized that, according to common practice, the various features of the drawing are not to scale. On the contrary, the dimensions of the various features are arbitrarily expanded or reduced for clarity. Included in the drawing are the following figures:
-
FIG. 1 shows a perspective view of an embodiment of the interbody spinal implant having three distinct surfaces; -
FIG. 2A shows a perspective view of an embodiment of the interbody spinal implant having a generally oval shape and roughened surface topography on the top surface; -
FIG. 2B shows a top view of the embodiment of the interbody spinal implant illustrated inFIG. 2A ; -
FIG. 3 shows an anterior view of an embodiment of the interbody spinal implant having two integration plates, which sandwich the body of the implant; -
FIGS. 4A-4C depict a technique to form the macro features of the roughened surface topography on the integration surface in an embodiment of the invention; -
FIG. 4D depicts the macro features of the roughened surface topography on the integration surface in an embodiment of the invention; -
FIG. 5A represents macro-, micro-, and nano-scaled features on a surface; -
FIG. 5B shows Ra, Rmax, and Sm for a roughened surface topography; -
FIG. 6 shows an exploded view of a generally oval-shaped implant with an integration plate; -
FIG. 7 shows an exploded view of a curved implant with an integration plate; -
FIG. 8 shows an exploded view of a posterior implant with an integration plate; -
FIG. 9 shows an exploded view of a lateral lumbar implant with an integration plate; -
FIG. 10 shows an exploded view of a generally oval-shaped anterior cervical implant with an integration plate. -
FIG. 11 illustrates one set of process steps that can be used to form macro, micro, or nano processes; -
FIG. 12 graphically represents the average amplitude, Ra; -
FIG. 13 graphically represents the average peak-to-valley roughness, Rz; -
FIG. 14 graphically represents the maximum peak-to-valley height, Rmax; -
FIG. 15 graphically represents the total peak-to-valley waviness profile; and -
FIG. 16 graphically represents the mean spacing, Sm. - Certain embodiments of the present invention may be especially suited for placement between adjacent human vertebral bodies. The implants of the present invention may be used in procedures such as Anterior Lumbar Interbody Fusion (ALIF), Posterior Lumbar Interbody Fusion (PLIF), Transforaminal Lumbar Interbody Fusion (TLIF), and cervical fusion. Certain embodiments do not extend beyond the outer dimensions of the vertebral bodies.
- The ability to achieve spinal fusion is directly related to the available vascular contact area over which fusion is desired, the quality and quantity of the fusion mass, and the stability of the interbody spinal implant. Interbody spinal implants, as now taught, allow for improved seating over the apophyseal rim of the vertebral body. Still further, interbody spinal implants, as now taught, better utilize this vital surface area over which fusion may occur and may better bear the considerable biomechanical loads presented through the spinal column with minimal interference with other anatomical or neurological spinal structures. Even further, interbody spinal implants, according to certain aspects of the present invention, allow for improved visualization of implant seating and fusion assessment. Interbody spinal implants, as now taught, may also facilitate osteointegration (e.g., formation of direct structural and functional interface between the artificial implant and living bone or soft tissue) with the surrounding living bone.
- It is generally believed that the surface of an implant determines its ultimate ability to integrate into the surrounding living bone. Without being limited by theory, it is hypothesized that the cumulative effects of at least implant composition, implant surface energy, and implant surface roughness play a major role in the biological response to, and osteointegration of, an implant device. Thus, implant fixation may depend, at least in part, on the stimulation and proliferation of bone modeling and forming cells, such as osteoclasts and osteoblasts and like-functioning cells upon the implant surface. Still further, it appears that these cells attach more readily to relatively rough surfaces rather than smooth surfaces. In this manner, a surface may be bioactive due to its ability to stimulate cellular attachment and osteointegration.
- Referring now to the drawing, in which like reference numbers refer to like elements throughout the various figures that comprise the drawing,
FIGS. 1 and 2A show a perspective view of a first embodiment of the interbodyspinal implant 1 especially well adapted for use in an ALIF procedure. The interbodyspinal implant 1 includes abody 2 having atop surface 10, abottom surface 20, opposinglateral sides 30, and opposinganterior 40 and posterior 50 portions. The interbodyspinal implant 1 may include implants made of a single piece of material or composite implants. - Interbody
spinal implants 1 made of a single piece of material do not includeintegration plates 82. Thus, the integration surface may include thetop surface 10 of thebody 2 of theimplant 1, thebottom surface 20 of thebody 2 of theimplant 1, or both. The integration surfaces have a roughenedsurface topography 80 including macro features, micro features, and nano features, without sharp teeth that risk damage to bone structures. Theimplant 1 may be composed of a suitable biocompatible material. In an exemplary embodiment,implant 1 is formed of metal. The metal may be coated or not coated. Suitable metals, such as titanium, aluminum, vanadium, tantalum, stainless steel, and alloys of those metals, may be selected by one of ordinary skill in the art. In a preferred embodiment, however, the metal is at least one of titanium, aluminum, and vanadium, without any coatings. In a more preferred embodiment, theimplant 1 is comprised of titanium or a titanium alloy. An oxide layer may naturally form on a titanium or titanium alloy. Titanium and its alloys are generally preferred for certain embodiments of the present invention due to their acceptable, and desirable, strength and biocompatibility. In this manner, certain embodiments of the present interbodyspinal implant 1 may have improved structural integrity and may better resist fracture during implantation by impact. - Composite implants include at least a
body 2 and one or twointegration plates 82, which may be formed from the same or different materials. As depicted inFIG. 6 , theimplant 1 includes afirst integration plate 82 affixed to thetop surface 10 of thebody 2 and an optional second integration plate 82 (shown inFIG. 3 ) affixed to thebottom surface 20 of thebody 2. Thefirst integration plate 82 and optionalsecond integration plate 82 each have atop surface 81, abottom surface 83, opposing lateral sides, opposinganterior portion 41 andposterior portion 51, and a singlevertical aperture 61 extending from thetop surface 81 to thebottom surface 83 and aligning with the singlevertical aperture 60 of thebody 2. - When present, the integration plate(s) 82 comprise an integration surface (e.g., the
top surface 81 of the integration plate 82), which is adapted to grip bone through friction generated when theimplant 1 is placed between two vertebrae and to inhibit migration of theimplant 1 once implanted. The integration surfaces may also have a fusion and biologically active surface geometry. In other words, at least a portion of thetop surface 81 of the first integration plate 82 (e.g., a first integration surface) and optionally atop surface 81 of a second integration plate 82 (e.g., a second integration surface) has a roughenedsurface topography 80 including macro features, micro features, and nano features, without sharp teeth that risk damage to bone structures. The roughenedsurface topography 80 may include macro features, micro features, and nano features of a regular repeating pattern, which may promote biological and chemical attachment or fusion with the bone structure. - The
body 2 and at least oneintegration plate 82 are preferably compatibly shaped, such that theimplant 1 having thebody 2 and integration plate(s) 82 joined together may have a generally oval shape, a generally rectangular shape, a generally curved shape, or any other shape described or exemplified in this specification. Thus, for example, thebody 2 and the integration plate(s) 82 may be generally oval-shaped in transverse cross-section. Thebody 2 and the integration plate(s) 82 may be generally rectangular-shaped in transverse cross-section. Thebody 2 and the integration plate(s) 82 may be generally curved-shaped in transverse cross-section. - The
body 2 and integration plate(s) 82 of theimplant 1 may be the same material or may be different. Thebody 2 and the integration plate(s) 82 may be composed of a suitable biocompatible material. In an exemplary embodiment, thebody 2 and optional integration plate(s) 82 are formed of metal, which may be coated or not coated. Suitable metals, such as titanium, aluminum, vanadium, tantalum, stainless steel, and alloys of the metals, may be selected by one of ordinary skill in the art. In a preferred embodiment, however, the metal is at least one of titanium, aluminum, and vanadium, without any coatings. In a more preferred embodiment, thebody 2 and optional integration plate(s) 82 are comprised of titanium or a titanium alloy. An oxide layer may naturally form on a titanium or titanium alloy. - Alternatively, the
body 2 may be composed of a non-metal biocompatible material. In one embodiment, thebody 2 of theimplant 1 is formed of a plastic, polymeric, or composite material. For example, suitable polymers may comprise silicones, polyolefins, polyesters, polyethers, polystyrenes, polyurethanes, acrylates, and co-polymers and mixtures of the polymers. Certain embodiments of the present invention may be comprised of a biocompatible, polymeric matrix reinforced with bioactive fillers, fibers, or both. Certain embodiments of the present invention may be comprised of urethane dimethacrylate (DUDMA)/tri-ethylene glycol dimethacrylate (TEDGMA) blended resin and a plurality of fillers and fibers including bioactive fillers and E-glass fibers. In another embodiment, thebody 2 comprises polyetherether-ketone (PEEK), hedrocel, or ultra-high molecular weight polyethylene (UHMWPE). Hedrocel is a composite material composed of carbon and an inert metal, such as tantalum. UHMWPE, also known as high-modulus polyethylene (HMPE) or high-performance polyethylene (HPPE), is a subset of the thermoplastic polyethylene, with a high molecular weight, usually between 2 and 6 million. - Certain embodiments of the interbody
spinal implant 1 are substantially hollow and have a generally oval-shaped transverse cross-sectional area. Substantially hollow, as used in this document, means at least about 33% of the interior volume of the interbodyspinal implant 1 is vacant. Still further, the substantially hollow portion may be filled with cancellous autograft bone, allograft bone, demineralized bone matrix (DBM), porous synthetic bone graft substitute, bone morphogenic protein (BMP), or combinations of those materials. - The
anterior portion 40, or trailing edge, of theimplant 1 is preferably generally greater in height than the opposingposterior portion 50. Accordingly, theimplant 1 may have a lordotic angle to facilitate sagittal alignment. Theimplant 1 may better compensate, therefore, for the generally less supportive bone found in the posterior regions of the vertebral endplate. Theposterior portion 50 of theinterbody implant 1, preferably including the posterior-lateral corners, may also be highly radiused, thus allowing for ease of implantation into the disc space. Thus, theposterior portion 50 may have a generally blunt nosed profile. Theanterior portion 40 of theimplant 1 may also preferably be configured to engage a delivery device, driver, or other surgical tool (and, therefore, may have an opening 90). - As illustrated in
FIG. 2A , theanterior portion 40 of theimplant 1 is substantially flat. Thus, theanterior portion 40 provides a face that can receive impact from a tool, such as a surgical hammer, to force theimplant 1 into position. Theimplant 1 has asharp edge 8 where theanterior portion 40 meets thetop surface 10, where theanterior portion 40 meets thebottom surface 20, or in both locations. The sharp edge oredges 8 function to resist pullout of theimplant 1 once it is inserted into position. - The three surfaces of the
implant 1 are designed to balance friction with roughened integration surfaces, preserve critical tissues and influence the natural biological responses of cells forming bone structures in contact with the outer smooth soft tissue surfaces, and enhance healing of joint space fusion treatments by providing graft contact surfaces. The at least three distinct surfaces described in this document may also better promote the osteointegration of certain embodiments of the present invention. The roughenedsurface topography 80 of the integration surfaces may better grip the vertebral endplate surfaces and inhibit implant migration upon placement and seating. The coarse surface topography of the graft contact surface may positively promote naturally occurring biological bone remodeling and fusion responses, for example, by stabilizing the graft materials and transferring loads from the motion of the joint through the implant body to those graft materials. The smooth surface topography of the soft tissue surface may provide an anchoring point and signaling function to bone forming cells to positively influence the fusion and healing responses. In addition, the smooth surface topography functions as a low friction surface so as to not cause unintentional abrasion or laceration of delicate soft tissue that the implant may contact during or after insertion. - The
implant 1 includes a roughenedsurface topography 80 or integration surface on at least a portion of the top surface, bottom surface, or both (e.g., thetop surface 81 of an integration plate 82). As used in this document, the integration surface is the surface at least partially in contact with the vertebral or bone structure. In one embodiment of the present invention, the roughenedsurface topography 80 is obtained by combining separate macro processing, micro processing, and nano processing steps. The term “macro” typically means relatively large; for example, in the present application, dimensions measured in millimeters (mm). The term “micro” typically means one millionth (10−6); for example, in the present application, dimensions measured in microns (μm) which correspond to 10−6 meters. The term “nano” typically means one billionth (10−9); for example, in the present application, dimensions measured in nanometers (nm) which correspond to 10−9 meters.FIG. 5A depicts macro, micro, and nano-sized surface features on a surface. - The
interbody implant 1 has a roughenedsurface topography 80 on the integration surface(s). The integration surface may include the top, bottom, or both surfaces of the implant. In the case of nointegration plates 82, this would include the top 10, bottom 20, or both surfaces of thebody 2 of theimplant 1. In the case of oneintegration plate 82 affixed to the top 10 of thebody 2 of the implant, this would include the top 81 of theintegration plate 82, the bottom 20 of thebody 2, or both surfaces. In the case of oneintegration plate 82 affixed to the bottom 20 of thebody 2 of theimplant 1, this would include the top 10 of thebody 2, the top 81 of the integration plate 82 (i.e., the outer surface of theintegration plate 82 at the bottom of the implant), or both surfaces. In the case of twointegration plates 82 sandwiched around thebody 2 of theimplant 1, this would include the top 81 of thefirst integration plate 82, the top 81 of thesecond integration plate 82, or both surfaces (i.e., the outer surfaces of bothintegration plates 82 at the top and bottom of the implant, respectively). - The integration surface(s) comprise predefined surface features that (a) engage the vertebral endplates with a friction fit and, following an endplate preserving surgical technique, (b) attain initial stabilization, and (c) benefit fusion. The composition of the endplate is a thin layer of notch-sensitive bone that is easily damaged by features (such as teeth) that protrude sharply from the surface of traditional implants. Avoiding such teeth and the attendant risk of damage, the roughened
surface topography 80 of the integration surface(s) does not have teeth or other sharp, potentially damaging structures; rather, the roughenedsurface topography 80 may have a pattern of repeating features of predetermined sizes, smooth shapes, and orientations. As used in the document, “predetermined” means determined beforehand, so that the predetermined characteristic must be determined, i.e., chosen or at least known, before use of theimplant 1. - The shapes of the frictional surface protrusions of the roughened
surface topography 80 are formed using processes and methods commonly applied to remove metal during fabrication of implantable devices such as chemical, electrical, electrochemical, plasma, or laser etching; cutting and removal processes; casting; forging; machining; drilling; grinding; shot peening; abrasive media blasting (such as sand or grit blasting); and combinations of these subtractive processes. Additive processes such as welding, thermal, coatings, sputtering, and optical melt additive processes are also suitable. The resulting surfaces either can be random in the shape and location of the features or can have repeating patterns. This flexibility allows for the design and production of surfaces that resist motion induced by loading in specific directions that are beneficial to the installation process and resist the opposing forces that can be the result of biologic or patient activities such as standing, bending, or turning or as a result of other activities. The shapes of the surface features, when overlapping, work to increase the surface contact area but do not result in undercuts that generate a cutting or aggressively abrasive action on the contacting bone surfaces. - These designed surfaces are composed of various sizes of features that, at the microscopic level, interact with the tissues and stimulate their natural remodeling and growth. At a larger scale these features perform the function of generating non-stressful friction that, when combined with a surgical technique that retains the most rigid cortical bone structures in the disc space, allow for a friction fit that does not abrade, chip, perforate, or compromise the critical endplate structures. The features may be divided into three size scales: nano, micro, and macro. The overlapping of the three feature sizes can be achieved using manufacturing processes that are completed sequentially and, therefore, do not remove or degrade the previous method.
- The first step in the process may be mechanical (e.g., machining though conventional processes) or chemical bulk removal, for example, to generate macro features. The macro features may be of any suitable shape, for example, roughly spherical in shape, without undercuts or protruding sharp edges. Other shapes are possible, such as ovals, polygons (including rectangles), and the like. These features may be at least partially overlapped with the next scale (micro) of features using either chemical or mechanical methods (e.g., AlO2 blasting) in predetermined patterns which also do not result in undercuts or protruding sharp edges. The third and final process step is completed through more mild (less aggressive) etching (e.g., HCl acid etching) that, when completed, generates surface features in both the micro and nano scales over both of the features generated by the two previous steps. The nano layer may dictate the final chemistry of the implant material.
- The graft contact surface includes micro and nano features, which positively influence naturally occurring biological bone remodeling and fusion responses. Such results may occur by stabilizing the graft materials and transferring loads from the motion of the joint through the implant body to these materials. The graft contact surface may include surfaces that are in contact with or may become in contact with contained bone growth inducing materials. For example, the substantially hollow portion of the
implant 1 may be filled with bone growth inducing materials once theimplant 1 has been inserted into position. Suitable bone growth inducing materials may include, but are not limited to, cancellous autograft bone, allograft bone, demineralized bone matrix (DBM), porous synthetic bone graft substitute, bone morphogenic protein (BMP), and combinations of those materials. - The graft contact surface may include the interior surfaces of the
implant 1. In other words, the graft contact surfaces may include any surfaces that may be in contact with bone growth inducing materials (once added to the inside of the implant). In particular, the surfaces typically in contact with bone growth inducing materials include one or more surfaces defined by the singlevertical aperture 60, one or more surfaces defined by at least onetransverse aperture 70, and one or more surfaces defined by one or morealternative openings 92 in theimplant 1. In an exemplary embodiment depicted inFIG. 1 , the graft contact surfaces include each ofsurface 60 a defined by the singlevertical aperture 60, surfaces 70 a defined by twotransverse apertures 70, and surface 92 a defined byalternative opening 92. - The graft contact surface may have a “coarse” surface topography in that the surface topography is roughened or textured in the microscopic and nanoscopic levels. The micro features may be formed using either chemical or mechanical methods (e.g., AlO2 blasting) in predetermined patterns, which also do not result in undercuts or protruding sharp edges. The nano features may be formed through more mild (less aggressive) etching (e.g., HCl acid etching). The graft contact surface may have a mid-level of friction when evaluated in comparison to the integration surface and the soft tissue surface. In other words, a frictional relationship (e.g., a coefficient of friction) between the integration surface, the graft contact surface, and the soft tissue surface may be defined as follows: the integration surface≧the graft contact surface≧the soft tissue surface.
- The soft tissue surface or insertion surface includes a low friction surface with nano features (and optionally micro features) to avoid unintentional laceration or abrasion of delicate soft tissues the
implant 1 contacts during insertion, after insertion, or both. The soft tissue surface can also provide an anchoring point and signaling function to bone forming cells in order to positively influence the fusion and healing processes. - The soft tissue surface may include the exterior surfaces of the
implant 1, except for the integration surface. In other words, other than the one or more integration surfaces, the soft tissue surfaces may include any outer surfaces which may contact bone or soft tissues during or after implantation. In particular, the soft tissue surface may include the opposinglateral sides 30 of thebody 2, the opposinganterior portion 40 of thebody 2, and theposterior portion 50 of thebody 2. In the case of oneintegration plate 82, the soft tissue surface may additionally include the opposing lateral sides of theintegration plate 82, the opposinganterior portion 41 of theintegration plate 82, and theposterior portion 51 of theintegration plate 82. In the case of twointegration plates 82, the soft tissue surface may include the opposing lateral sides of bothintegration plates 82 and the opposinganterior portion 41 andposterior portion 51 of bothintegration plates 82. The soft tissue surface may also include anyrounded edges 7 on the interbody spinal implant including roundededges 7 on thebody 2 or either or both of theintegration plates 82. - The soft tissue surface may have a “smooth” surface topography in that the surface topography appears substantially smooth to the unaided eye. The smooth surface may include, however, intentional nano-sized features, and optionally, micro features. The nano features, and optionally, the micro features, may be formed through more mild (less aggressive) etching (e.g., HCl acid etching), for example. The soft tissue surface may have a low degree of friction when evaluated in comparison to the integration surface and the soft tissue surface. In other words, a frictional relationship (e.g., a coefficient of friction) between the integration surface, the graft contact surface, and the soft tissue surface may be defined as follows: a high degree of friction for the integration surface relative to a medium degree of friction for the graft contact surface relative to a low degree of friction for the soft tissue surface.
-
FIG. 11 illustrates one set of process steps that can be used to form macro, micro, or nano processes. As illustrated, there may be some overlap in the processes that can be applied to form each of the three types of features (macro, micro, and nano). For example, acid etching can be used to form the macro features, then the same or a different acid etching process can be used to form the micro features. The features may be provided in a random design or a predetermined pattern (e.g., a repeating pattern). - The macro features are relatively large features (e.g., on the order of millimeters). The macro features may be formed from subtractive techniques (e.g., mechanical or chemical bulk removal, for example) or additive techniques (e.g., deposition). Preferably, the macro features are formed by subtractive techniques, which remove at least portions of the surface (e.g., from the titanium material that was used to form the part). Suitable subtractive techniques may include for example, machining (e.g., machine tools, such as saws, lathes, milling machines, and drill presses, are used with a sharp cutting tool to physically remove material to achieve a desired geometry) or unmasked or masked etching (e.g., portions of the surface is protected by a masking material which resists etching and an etching substance is applied to unmasked portions). The patterns may be organized in regular repeating patterns and optionally overlapping each other. In a preferred embodiment, the macro features may be formed in three, sequential steps.
-
FIG. 4A illustrates the result of the first step in forming the macro features 102. Specifically, afirst cut pattern 103 of the macro features is formed in a surface (e.g., thetop surface 81 of the integration plate 82). The “cut 1” features of thefirst cut pattern 103 may cover about 20% of the total area of the surface, for example, leaving about 80% of theoriginal surface 104 remaining. The range of these percentages may be about ±20%, preferably ±10%, and more preferably about ±5%. The “cut 1” features of thefirst cut pattern 103 do not have any undercuts. In one embodiment, these “cut 1” features have the smallest diameter and greatest depth of the macro features that are formed during the sequential steps. -
FIG. 4B illustrates the result of the second step in forming the macro features. Specifically, asecond cut pattern 105 of the macro features is formed in the surface. Together, the “cut 1” features of thefirst cut pattern 103 and the “cut 2” features of thesecond cut pattern 105 may cover about 85% of the total area of the surface, for example, leaving about 15% of theoriginal surface 104 remaining. The range of these percentages may be about ±10% and preferably ±5%. In an embodiment of the invention, these “cut 2” features have both a diameter and a depth between those of the “cut 1” and “cut 3” features of the macro features that are formed during the first and third steps of the process of forming the macro features. -
FIG. 4C illustrates the result of the third and final step in forming the macro features. Specifically, athird cut pattern 107 of the macro features may be formed in the surface. Together, the “cut 1” features of thefirst cut pattern 103, the “cut 2” features of thesecond cut pattern 105, and the “cut 3” features of thethird cut pattern 107 cover about 95% of the total area of the surface, for example, leaving about 5% of theoriginal surface 104 remaining. The range of these percentages may be about ±1%. In an embodiment of the invention, these “cut 3” features may have the largest diameter and least depth of the macro features that are formed during the sequential process steps. -
FIG. 4D also depicts the roughenedsurface topography 80 of the integration surface on theimplant 1 following completion of the three, sequential processing steps. As shown, the finished macro features comprise multiple patterns of the three, overlapping cuts: thefirst cut pattern 103, thesecond cut pattern 105, and thethird cut pattern 107. - Depending on the surface structure desired, the micro surface features (e.g., on the order of micrometers) may be applied to all or a portion of the surface (for example, to the integration surface, the graft contact surface, the soft tissue surfaces, or all three). The micro features may also be formed from subtractive techniques (e.g., mechanical or chemical bulk removal, for example) or additive techniques (e.g., deposition). Preferably, the micro features are also formed by subtractive techniques.
- In an exemplary embodiment, the micro features are cut by masked or unmasked etching, such as acid etching. For example, portions of the surface, optionally including portions of the surface exposed by the macro step(s) described above for the case of the integration surface, may be exposed to a chemical etching. In an exemplary embodiment, the micro process includes an acid etching, with a strong acid, such as hydrochloric acid (HCl), hydroiodic acid (HI), hydrobromic acid (HBr), hydrofluoric (HF), perchloric acid (HClO4), nitric acid (HNO3), sulfuric acid (H2SO4), and the like. The etching process may be repeated a number of times as necessitated by the amount and nature of the irregularities required for any particular application. Control of the strength of the etchant material, the temperature at which the etching process takes place, and the time allotted for the etching process allows fine control over the resulting surface produced by the process. The number of repetitions of the etching process can also be used to control the surface features. For example, the micro features may be obtained via the repetitive masking and chemical or electrochemical milling processes described in U.S. Pat. No. 5,258,098; No. 5,507,815; No. 5,922,029; and No. 6,193,762, the contents of which are incorporated by reference into this document, in their entirety, and for all purposes.
- By way of example, an etchant mixture of at least one of nitric acid and hydrofluoric acid may be repeatedly applied to a titanium surface to produce an average etch depth of about 0.53 mm. In another example, chemical modification of a titanium surface can be achieved using at least one of hydrofluoric acid, hydrochloric acid, and sulfuric acid. In a dual acid etching process, for example, the first exposure may be to hydrofluoric acid and the second may be to a hydrochloric acid and sulfuric acid mixture. Chemical acid etching alone may enhance osteointegration without adding particulate matter (e.g., hydroxyapatite) or embedding surface contaminants (e.g., grit particles).
- The micro features may also be cut by abrasive or grit blasting, for example, by applying a stream of abrasive material (such as alumina, sand, and the like) to the surface. The abrasive material may include inert and non-bioactive materials. Alternatively, the abrasive material may include those reactive with biological functions as part of healing and fusions. In an exemplary embodiment, the micro features are created, at least partially, with an aqueous hydrochloric acid etching step and at least partially with an AlO2 blasting step. Patterns may be organized in regular repeating patterns and optionally overlapping each other. After the micro features are formed, it is possible that less than about 3% of the
original surface 104 remains. The range of that percentage may be about ±1%. - Depending on the surface structure desired, the nano surface features (e.g., on the order of nanometers) may be applied to all or a portion of the surface (for example, to the integration surface, the graft contact surface, the soft tissue surfaces, or all three). The nano features may also be formed from subtractive techniques (e.g., mechanical or chemical bulk removal, for example) or additive techniques (e.g., deposition). Preferably, the nano features are also formed by subtractive techniques.
- In an exemplary embodiment, the nano features are cut by masked or unmasked etching. For example, portions of the surface, including optionally portions of the surface exposed by the macro and micro steps described above in the case of the integration surface, may be exposed to a chemical etching. In an exemplary embodiment, the nano process also includes an acid etching, with a strong or weak acid, such as hydrochloric acid (HCl), hydroiodic acid (HI), hydrobromic acid (HBr), hydrofluoric (HF), perchloric acid (HClO4), nitric acid (HNO3), sulfuric acid (H2SO4), and the like. The acid etching process for the nano step is preferably less aggressive than the acid etching process in the micro step. In other words, a less acidic, mild, or more diluted acid may be selected. In an exemplary embodiment, the nano features are created, at least partially, with an aqueous hydrochloric acid etching step.
- As an example, the nano features may be formed by preparing an acid solution comprising hydrochloric acid, water, and titanium; applying the acid solution to the desired surface; removing the acid solution by rinsing with water; and heating and subsequently cooling the surface being treated.
- The acid solution may be prepared using any suitable techniques known in the art. For example, the acid solution may be prepared by combining hydrochloric acid and water, simultaneously or sequentially. The aqueous hydrochloric acid solution may optionally be heated, for example, to a temperature of about 150-250° F., preferably about 200-210° F., and most preferably about 205° F. The titanium may be seeded (e.g., added) in the aqueous hydrochloric acid solution or may already be present from titanium previously removed from at least one surface of the implant, for example, in a continuous manufacturing process. The solution may optionally be cooled. The acid solution may comprise a concentration of 20-40% hydrochloric acid, preferably about 25-31% hydrochloric acid, and more preferably about 28% hydrochloric acid, based on the weight percent of the solution.
- It is preferred that the etch rate is substantially constant. The etch rate in a metal-free solution is typically erratic. For example, the metal may be passive for some period and then suddenly start reacting (sometimes at an exceptionally high rate), then may even go passive again. Therefore, it is preferred that the metal (e.g., titanium) is present from the manufacturing process or the titanium is seeded with the aqueous hydrochloric acid solution.
- The acid solution may be applied to the surface (e.g., a treated surface) using any suitable mechanism or techniques known in the art, for example, immersion, spraying, brushing, and the like. In an exemplary embodiment, the acid solution is applied to the surface by immersing the entire part (e.g., the integration plate 82) in the solution. It is also contemplated that the part (e.g., the integration plate 82) may be immersed in the acid solution alone or in combination with the
entire implant 1 or the assembled implant 1 (i.e., including the body 2). If desired, certain areas of the surface or theimplant 1 may be masked in patterns to protect certain portions of theimplant 1. The acid solution may be heated when it is applied to the surface. For example, the solution may be heated to a temperature of about 150-250° F., preferably about 200-210° F., and most preferably about 205° F. The solution may also be applied for any suitable period of time. For example, the solution may be applied to the surface for a period of time of about 5-30 minutes, preferably about 15-25 minutes, and more preferably about 20 minutes. - After the acid solution is applied, the acid solution may be removed, for example, by rinsing with water (e.g., deionized water). The treated surface or the
entire implant 1 may be subsequently dried. The treated surface may be dried using any suitable mechanism or techniques known in the art, for example, by heating in an oven (e.g., a dry oven). The treated surface (or entire implant) may be heated to a temperature of about 110-130° F., preferably about 120-125° F., and most preferably about 122.5° F. The treated surface (or entire implant) may be heated for any suitable period of time, for example about 30-50 minutes, preferably about 35-45 minutes, and more preferably about 40 minutes. After heating, the treated surface may be cooled to room temperature, for example. - It is contemplated that the nano features may also be removed by the abrasive or grit blasting, for example, described for the micro processing step. Patterns may be organized in regular repeating patterns and optionally overlapping each other. After the nano features are formed, it is possible that less than about 1% of the
original surface 104 remains. For example, after the nano features are formed, the nano features (and optionally, the macro and micro features) may cover substantially the entire surface. - The nano features may also be achieved by tumble finishing (e.g., tumbling) the part or the
implant 1. Suitable equipment and techniques can be selected by one of ordinary skill in the art. For example, a barrel may be filled with the parts or implants and the barrel is then rotated. Thus, the parts or implants may be tumbled against themselves or with steel balls, shot, rounded-end pins, ballcones, or the like. The tumbling process may be wet (e.g., with a lubricant) or dry. - As should be readily apparent to a skilled artisan, the process steps described in this document can be adjusted to create a mixture of depths, diameters, feature sizes, and other geometries suitable for a particular implant application. The orientation of the pattern of features can also be adjusted. Such flexibility is desirable, especially because the ultimate pattern of the surface topography desired, for example, the integration surface of the
implant 1 may be oriented in opposition to the biologic forces on theimplant 1 and to the insertion direction. In one particular embodiment, for example, the pattern of the roughenedsurface topography 80 may be modeled after an S-shaped tire tread. It is also contemplated that the same or different process steps may be used to create each of the macro, micro, and nano features on each of the desired surfaces. - Several separate parameters can be used to characterize the roughness of an implant surface. Among those parameters are the average amplitude, Ra; the maximum peak-to-valley height, Rmax; and the mean spacing, Sm. Each of these three parameters, and others, are explained in detail below. Meanwhile,
FIG. 5B illustrates all three parameters, namely, Ra, Rmax, and Sm, for the macro features 102 of theintegration plate 82. Surface roughness may be measured using a laser profilometer or other standard instrumentation. - In addition to the parameters Ra, Rmax, and Sm mentioned above, at least two other parameters can be used to characterize the roughness of an implant surface. In summary, the five parameters are: (1) average amplitude, Ra; (2) average peak-to-valley roughness, Rz; (3) maximum peak-to-valley height, Rmax; (4) total peak-to-valley of waviness profile, Wt; and (5) mean spacing, Sm. Each parameter is explained in detail as follows.
- In practice, “Ra” is the most commonly used roughness parameter. It is the arithmetic average height. Mathematically, Ra is computed as the average distance between each roughness profile point and the mean line. In
FIG. 12 , the average amplitude is the average length of the arrows. - In mathematical terms, this process can be represented as
-
- The average peak-to-valley roughness, Rz, is defined by the ISO and ASME 1995 and later. Rz is based on one peak and one valley per sampling length. The RzDIN value is based on the determination of the peak-to-valley distance in each sampling length. These individual peak-to-valley distances are averaged, resulting in the RzDIN value, as illustrated in
FIG. 13 . - The maximum peak-to-valley height, Rmax, is the maximum peak-to-valley distance in a single sampling length—as illustrated in
FIG. 14 . - The total peak-to-valley of waviness profile (over the entire assessment length) is illustrated in
FIG. 15 . - The mean spacing, Sm, is the average spacing between positive mean line crossings. The distance between each positive (upward) mean line crossing is determined and the average value is calculated, as illustrated in
FIG. 16 . - The parameters Sm, Rmax, and Ra can be used define the surface roughness following formation of each of the three types of features macro, micro, and nano.
- The following preferred ranges (all measurements in microns) are as follows for the macro features for each of the three parameters. The mean spacing, Sm, is between about 400-2,000, with a range of 750-1,750 preferred and a range of 1,000-1,500 most preferred. The maximum peak-to-valley height, Rmax, is between about 40-500, with a range of 150-400 preferred and a range of 250-300 most preferred. The average amplitude, Ra, is between about 8-200, preferably, 20-200, more preferably 50-150, and most preferably 100-125.
- The following preferred ranges (all measurements in microns) are as follows for the micro features for each of the three parameters. The mean spacing, Sm, is between about 20-400, with a range of 100-300 preferred and a range of 200-250 most preferred. The maximum peak-to-valley height, Rmax, is between about 2-40, with a range of 2-20 preferred and a range of 9-13 most preferred. The average amplitude, Ra, is between about 1-20, preferably 2-15, more preferably 4-10, even more preferably 2-8, and most preferably 2-6.
- The following preferred ranges (all measurements in microns) are as follows for the nano features for each of the three parameters. The mean spacing, Sm, is between about 0.5-20, with a range of 1-15 preferred and a range of 5-12 most preferred. The maximum peak-to-valley height, Rmax, is between about 0.2-2, with a range of 0.2-1.8 preferred and a range of 0.3-1.3 most preferred. The average amplitude, Ra, is between about 0.01-2, preferably 0.01-1, more preferably, 0.02-0.8, and most preferably 0.03-0.6.
- An example of such data is provided in Table 1 below.
-
TABLE 1 EXAMPLE DATA BY PROCESS STEP Size (Sm) Depth (Rmax) Roughness (Ra) Surface Feature Size and Roughness (Metric): Macro (μm) Max. 2,000 500 200 Min. 400 40 20 Avg. 1,200 270 110 Surface Feature Size and Roughness (Metric): Micro (μm) Max. 400 40 20 Min. 20 2 1 Avg. 210 11 5.5 Surface Feature Size and Roughness (Metric): Nano (μm) Max. 20 2 1 Min. 0.5 0.2 0.01 Avg. 10.25 1.1 0.505 - In the case of a
composite implant FIGS. 3 and 6 ), 182 a (FIG. 7 ), 182 (FIG. 8 ), 382 (FIG. 9 ), and 282 (FIG. 10 ), respectively, includes the roughenedsurface topography top surface bottom surface integration plate top surface bottom surface anterior portion posterior portion vertical aperture anterior portion anterior portion main body 2 of theimplant posterior portion posterior portion main body 2 of theimplant vertical aperture vertical aperture main body 2 of theimplant vertical aperture vertical aperture - The
integration plate implant bottom surface integration plate posts holes top surface bottom surface main body 2 of theimplant integration plate main body 2 of theimplant integration plates implant implant anti-expulsion edges - The
implant integration plate top surface bottom surface implant holes posts bottom surface integration plate posts holes -
FIG. 1 shows that thetop surface 10 is recessed and comprises a plurality ofholes 12, but the recessedbottom surface 20 and itsholes 12 are not shown.FIG. 6 shows that thetop surface 110 a is recessed and comprises a plurality ofholes 112 a, but the recessedbottom surface 120 a and itsholes 112 a are not shown.FIG. 7 shows that thetop surface 110 is recessed and comprises a plurality ofholes 112, but the recessedbottom surface 120 and itsholes 112 are not shown.FIG. 8 shows that thetop surface 310 is recessed and comprises a plurality ofholes 312, but the recessedbottom surface 320 and itsholes 312 are not shown.FIG. 9 shows that thetop surface 210 is recessed and comprises a plurality ofholes 212, but the recessedbottom surface 220 and itsholes 212 are not shown. The recess may be at a depth D, and the recess depth D preferably is uniform throughout thetop surface bottom surface - The recess depth D preferably corresponds to a thickness T of the
integration plate integration plate implant top surface bottom surface implant integration plate top surface bottom surface posterior portion anterior portion integration plate anterior portion posterior portion - The recess depth D and the thickness T may each independently be from about 0.1 mm to about 10 mm. In preferred aspects, the recess depth D and the thickness T may each independently be from about 1 mm to about 5 mm. Thus, for example, the recess depth D or the thickness T may be selected from about 0.1 mm, about 0.25 mm, about 0.5 mm, about 0.75 mm, about 1 mm, about 1.25 mm, about 1.5 mm, about 1.75 mm, about 2 mm, about 2.25 mm, about 2.5 mm, about 2.75 mm, about 3 mm, about 3.25 mm, about 3.5 mm, about 3.75 mm, about 4 mm, about 4.25 mm, about 4.5 mm, about 4.75 mm, about 5 mm, 5.5 mm, about 6 mm, about 6.5 mm, about 7 mm, about 75 mm, or about 8 mm.
- Recessing the
top surface bottom surface ridge anterior portion posterior portion integration plate implant - The
integration plate implant 1, integration plate 82), PLIF (e.g.,implant 101, integration plate 182), or TLIF fusion (e.g., implant 101 a,integration plate 182 a); may be used with an implant suitable for cervical fusion (e.g.,implant 201, integration plate 282); and may be used with an implant suitable for lateral lumbar insertion (e.g.,implant 301, integration plate 382). - The reciprocal connector such as the
post hole integration plate implant post hole post hole integration plate implant - The structures and features may be on either or both of the
integration plate main body 2 of theimplant integration plate implant - The
integration plate implant implant implant integration plate integration plate implant body 2 of theimplant hole - It is also contemplated that the
bottom surface integration plate implant bottom surface body 2 of theimplant - An adhesive (not shown) may directly join the
integration plate body 2 of theimplant bottom surface integration plate top surface bottom surface implant - The foregoing describes various non-limiting examples of how the one or two
integration plates implant - The
implant 1 may comprise some or all of the following implant features, for example. In some aspects, the interbodyspinal implant 1 is substantially hollow and has a generally oval-shaped transverse cross-sectional area with smooth, rounded, or both smooth and roundedlateral sides 30 and posterior-lateral corners. Theimplant 1 includes at least onevertical aperture 60 that extends the entire height of theimplant body 2. Thevertical aperture 60 defines aninterior surface 60 a or hollow cavity within theimplant 1, which may be filled with bone growth inducing materials. The vertical aperture (a) extends from the top surface to the bottom surface, (b) has a size and shape predetermined to maximize the surface area of the top surface and the bottom surface available proximate the anterior and posterior portions while maximizing both radiographic visualization and access to the substantially hollow center, and (c) optionally defines a transverse rim. Thevertical aperture 60 may further define atransverse rim 100 having a greaterposterior portion thickness 55 than ananterior portion thickness 45. - In at least one embodiment, the opposing
lateral sides 30 and theanterior portion 40 have arim thickness 45 of about 5 mm, while theposterior portion 50 has arim thickness 55 of about 7 mm. Thus, the rimposterior portion thickness 55 may allow for better stress sharing between theimplant 1 and the adjacent vertebral endplates and helps to compensate for the weaker posterior endplate bone. In some aspects, thetransverse rim 100 has a generally large surface area and contacts the vertebral endplate. Thetransverse rim 100 may act to better distribute contact stresses upon theimplant 1, and hence minimize the risk of subsidence while maximizing contact with the apophyseal supportive bone. It is also possible for thetransverse rim 100 to have a substantially constant thickness (e.g., for theanterior portion thickness 45 to be substantially the same as the posterior portion thickness 55) or for theposterior portion 50 to have arim thickness 55 less than that of the opposinglateral sides 30 and theanterior portion 40. - The
implant 1 may be shaped to reduce the risk of subsidence, and improve stability, by maximizing contact with the apophyseal rim of vertebral endplates. Embodiments may be provided in a variety of anatomical footprints having a medial-lateral width ranging from about 32 mm to about 44 mm. An interbodyspinal implant 1 generally does not require extensive supplemental or obstructive implant instrumentation to maintain the prepared disc space during implantation. Thus, the interbodyspinal implant 1 and associated implantation methods allow for larger-sized implants as compared with other size-limited interbody spinal implants known in the art. This advantage allows for greater medial-lateral width and correspondingly greater contact with the apophyseal rim. - As illustrated in
FIG. 1 andFIG. 2A , theimplant 1 has anopening 90 in theanterior portion 40. In one embodiment, theposterior portion 50 may have a similarly shaped opening 90 (not shown). In some aspects, only theanterior portion 40 has theopening 90 while theposterior portion 50 has an alternative opening 92 (which may have a size and shape different from the opening 90). Theopening 92 defines aninterior surface 92 a or hollow cavity, which may be filled with bone growth inducing materials. - The
opening implant opening opening implant opening - As best shown in
FIG. 7 andFIG. 8 , theanterior portion nose implant 101. - The
implant 1 may further include at least onetransverse aperture 70 that extends the entire transverse length of the implant body. Thetransverse aperture 70 defines aninterior surface 70 a or hollow cavity, which may be filled with bone growth inducing materials. The at least onetransverse aperture 70 may provide improved visibility of theimplant 1 during surgical procedures to ensure proper implant placement and seating, and may also improve post-operative assessment of implant fusion. Thetransverse aperture 70 may be broken into two, separate sections by an intermediate wall. Suitable shapes and dimensions for thetransverse aperture 70 may be selected by one of ordinary skill in the art. In particular, all edges of thetransverse aperture 70 may be rounded, smooth, or both. The intermediate wall may be made of the same material as the remainder of thebody 2 of the implant 1 (e.g., plastic), or it may be made of another material (e.g., metal). The intermediate wall may offer one or more of several advantages, including reinforcement of theimplant 1 and improved bone graft containment. - The
implant 1 may be provided with a solid rear wall (not shown). The rear wall may extend the entire width of the implant body and nearly the entire height of the implant body. Thus, the rear wall can essentially close theanterior portion 40 of theimplant 1. The rear wall may offer one or more of several advantages, including reinforcement of theimplant 1 and improved bone graft containment. In the cervical application, it may be important to prevent bone graft material from entering the spinal canal. - The
implant 1 may also have a lordotic angle to facilitate alignment. Onelateral side 30 is preferably generally greater in height than the opposinglateral side 30. Therefore, theimplant 1 may better compensate for the generally less supportive bone found in certain regions of the vertebral endplate. As much as seven degrees of lordosis (or more) may be built into theimplant 1 to help restore cervical balance. - To enhance movement resistance and provide additional stability under spinal loads in the body, the
implant anti-expulsion edges top surface 81 of theintegration plate 82 affixed to thetop surface bottom surface implant anti-expulsion edges top surface bottom surface implant - By way of example,
FIG. 6 shows ananti-expulsion edge 8 on thetop surface 81 of theintegration plate 82 and thebottom surface 20 of theanterior face 40 of theimplant 1. Eachanti-expulsion edge 8 may protrude above the plane of thetop surface 81 of theintegration plate 82 andbottom surface 20, with the amount of protrusion increasing toward theanterior face 40 and the highest protrusion height P at the anterior-most edge of thetop surface 81 of theintegration plate 82 orbottom surface 20. - An
anti-expulsion edge anterior portion posterior portion lateral sides anti-expulsion edge implant - The following examples of surgical methods are included to more clearly demonstrate the overall nature of the invention. These examples are exemplary, not restrictive, of the invention.
- Certain embodiments of the invention are particularly suited for use during interbody spinal implant procedures currently known in the art. For example, the disc space may be accessed using a standard mini open retroperitoneal laparotomy approach. The center of the disc space is located by AP fluoroscopy taking care to make sure the pedicles are equidistant from the spinous process. The disc space is then incised by making a window in the annulus for insertion of certain embodiments of the spinal implant 1 (a 32 or 36 mm window in the annulus is typically suitable for insertion). The process according to the invention minimizes, if it does not eliminate, the cutting of bone. The endplates are cleaned of all cartilage with a curette, however, and a size-specific rasp (or broach) may then be used.
- Use of a rasp preferably substantially minimizes or eliminates removal of bone, thus substantially minimizing or eliminating impact to the natural anatomical arch, or concavity, of the vertebral endplate while preserving much of the apophyseal rim. Preservation of the anatomical concavity is particularly advantageous in maintaining biomechanical integrity of the spine. For example, in a healthy spine, the transfer of compressive loads from the vertebrae to the spinal disc is achieved via hoop stresses acting upon the natural arch of the endplate. The distribution of forces, and resultant hoop stress, along the natural arch allows the relatively thin shell of subchondral bone to transfer large amounts of load.
- During traditional fusion procedures, the vertebral endplate natural arch may be significantly removed due to excessive surface preparation for implant placement and seating. This is especially common where the
implant 1 is to be seated near the center of the vertebral endplate or theimplant 1 is of relatively small medial-lateral width. Breaching the vertebral endplate natural arch disrupts the biomechanical integrity of the vertebral endplate such that shear stress, rather than hoop stress, acts upon the endplate surface. This redistribution of stresses may result in subsidence of the implant into the vertebral body. - Preferred embodiments of the surgical method minimize endplate bone removal on the whole, while still allowing for some removal along the vertebral endplate far lateral edges where the subchondral bone is thickest. Still further, certain embodiments of the interbody
spinal implant surgical implant - Because the endplates are spared during the process of inserting the
spinal implant spinal implant 1 to accept and share stress transmitted from the endplates. In addition, spared endplates minimize the concern that BMP might erode the cancellous bone. - Interbody
spinal implant 1 is durable and can be impacted between the endplates with standard instrumentation. Therefore, certain embodiments of the invention may be used as the final distractor during implantation. In this manner, the disc space may be under-distracted (e.g., distracted to some height less than the height of the interbody spinal implant 1) to facilitate press-fit implantation. Further, certain embodiments of the current invention having a smooth and rounded posterior portion (and lateral sides) may facilitate easier insertion into the disc space. Still further, the surface roughenedtopography 80 may lessen the risk of excessive bone removal during distraction as compared to implants having teeth, ridges, or threads currently known in the art even in view of a press-fit surgical distraction method. Nonetheless, once implanted, the interbodysurgical implant 1 may provide secure seating and prove difficult to remove. Thus, certain embodiments of the interbodyspinal implant - Surgical implants and methods tension the vertebral annulus via distraction. These embodiments and methods may also restore spinal lordosis, thus improving sagittal and coronal alignment. Implant systems currently known in the art require additional instrumentation, such as distraction plugs, to tension the annulus. These distraction plugs require further tertiary instrumentation, however, to maintain the lordotic correction during actual spinal implant insertion. If tertiary instrumentation is not used, then some amount of lordotic correction may be lost upon distraction plug removal. Interbody
spinal implant 1, according to certain embodiments of the invention, is particularly advantageous in improving spinal lordosis without the need for tertiary instrumentation, thus reducing the instrument load upon the surgeon. This reduced instrument load may further decrease the complexity, and required steps, of the implantation procedure. - Certain embodiments of the
spinal implant spinal implant - Certain embodiments collectively comprise a family of implants, each having a common design philosophy. These implants and the associated surgical technique have been designed to address at least the ten, separate challenges associated with the current generation of traditional anterior spinal fusion devices listed above in the Background section of this document.
- After desired annulotomy and discectomy, embodiments of the invention first adequately distract the disc space by inserting (through impaction) and removing sequentially larger sizes of very smooth distractors, which have been size matched with the size of the
available implant 1. Once adequate distraction is achieved, the surgeon prepares the end-plate with a rasp. There is no secondary instrumentation required to keep the disc space distracted while theimplant implant implant - The implant geometry has features which allow it to be implanted via any one of an anterior, antero-lateral, or lateral approach, providing tremendous intra-operative flexibility of options. The
implant implant implant - The invention encompasses a number of
different implant surface topography 80 to allow for bony in-growth over time, and to provide resistance against expulsion. The top and bottom titanium plates may be assembled together with the implant body. The net result is a composite implant that has engineered stiffness for its clinical application. The axial load may be borne by the polymeric component of the construct. - It is believed that an intact vertebral end-plate deflects like a diaphragm under axial compressive loads generated due to physiologic activities. If a spinal fusion implant is inserted in the prepared disc space via a procedure which does not destroy the end-plates, and if the implant contacts the end-plates only peripherally, the central dome of the end-plates can still deflect under physiologic loads. This deflection of the dome can pressurize the bone graft material packed inside the spinal implant, hence allowing it to heal naturally. The
implant - Although illustrated and described above with reference to certain specific embodiments and examples, the present invention is nevertheless not intended to be limited to the details shown. Rather, various modifications may be made in the details within the scope and range of equivalents of the claims and without departing from the spirit of the invention. It is expressly intended, for example, that all ranges broadly recited in this document include within their scope all narrower ranges which fall within the broader ranges. In addition, features of one embodiment may be incorporated into another embodiment.
Claims (32)
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US14/450,316 US20150012100A1 (en) | 2005-05-06 | 2014-08-04 | Implants having three distinct surfaces |
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US11/123,359 US7662186B2 (en) | 2005-05-06 | 2005-05-06 | Anterior interbody spinal implant |
US12/151,198 US8262737B2 (en) | 2005-05-06 | 2008-05-05 | Composite interbody spinal implant having openings of predetermined size and shape |
US13/557,727 US8814939B2 (en) | 2005-05-06 | 2012-07-25 | Implants having three distinct surfaces |
US14/450,316 US20150012100A1 (en) | 2005-05-06 | 2014-08-04 | Implants having three distinct surfaces |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US13/557,727 Continuation US8814939B2 (en) | 2005-05-06 | 2012-07-25 | Implants having three distinct surfaces |
Publications (1)
Publication Number | Publication Date |
---|---|
US20150012100A1 true US20150012100A1 (en) | 2015-01-08 |
Family
ID=47293810
Family Applications (3)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US13/557,727 Active US8814939B2 (en) | 2005-05-06 | 2012-07-25 | Implants having three distinct surfaces |
US13/930,424 Abandoned US20130292357A1 (en) | 2005-05-06 | 2013-06-28 | Process of fabricating implants having three distinct surfaces |
US14/450,316 Abandoned US20150012100A1 (en) | 2005-05-06 | 2014-08-04 | Implants having three distinct surfaces |
Family Applications Before (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US13/557,727 Active US8814939B2 (en) | 2005-05-06 | 2012-07-25 | Implants having three distinct surfaces |
US13/930,424 Abandoned US20130292357A1 (en) | 2005-05-06 | 2013-06-28 | Process of fabricating implants having three distinct surfaces |
Country Status (1)
Country | Link |
---|---|
US (3) | US8814939B2 (en) |
Cited By (9)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US10182923B2 (en) | 2015-01-14 | 2019-01-22 | Stryker European Holdings I, Llc | Spinal implant with porous and solid surfaces |
US10195816B2 (en) * | 2014-12-01 | 2019-02-05 | Industrial Technology Research Institute | Metal/polymer composite material and method for fabricating the same |
US10271959B2 (en) | 2009-02-11 | 2019-04-30 | Howmedica Osteonics Corp. | Intervertebral implant with integrated fixation |
US10463500B2 (en) | 2014-11-07 | 2019-11-05 | Industrial Technology Research Institute | Medical composite material, method for fabricating the same and applications thereof |
US10537666B2 (en) | 2015-05-18 | 2020-01-21 | Stryker European Holdings I, Llc | Partially resorbable implants and methods |
US10603182B2 (en) | 2015-01-14 | 2020-03-31 | Stryker European Holdings I, Llc | Spinal implant with fluid delivery capabilities |
US10736752B1 (en) | 2017-10-24 | 2020-08-11 | Omnia Medical, LLC | Multi-material multi-component spinal implant |
US10835388B2 (en) | 2017-09-20 | 2020-11-17 | Stryker European Operations Holdings Llc | Spinal implants |
US11766339B1 (en) | 2017-10-24 | 2023-09-26 | Omnia Medical, LLC | Multi-material multi-component spinal implant |
Families Citing this family (53)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8197472B2 (en) | 2005-03-25 | 2012-06-12 | Maquet Cardiovascular, Llc | Tissue welding and cutting apparatus and method |
US7918848B2 (en) | 2005-03-25 | 2011-04-05 | Maquet Cardiovascular, Llc | Tissue welding and cutting apparatus and method |
US8562684B2 (en) | 2005-05-06 | 2013-10-22 | Titan Spine, Llc | Endplate-preserving spinal implant with an integration plate having a roughened surface topography |
US8585765B2 (en) | 2005-05-06 | 2013-11-19 | Titan Spine, Llc | Endplate-preserving spinal implant having a raised expulsion-resistant edge |
US8585767B2 (en) | 2005-05-06 | 2013-11-19 | Titan Spine, Llc | Endplate-preserving spinal implant with an integration plate having durable connectors |
US8814939B2 (en) | 2005-05-06 | 2014-08-26 | Titan Spine, Llc | Implants having three distinct surfaces |
US8551176B2 (en) | 2005-05-06 | 2013-10-08 | Titan Spine, Llc | Spinal implant having a passage for enhancing contact between bone graft material and cortical endplate bone |
US11096796B2 (en) | 2005-05-06 | 2021-08-24 | Titan Spine, Llc | Interbody spinal implant having a roughened surface topography on one or more internal surfaces |
US8591590B2 (en) | 2005-05-06 | 2013-11-26 | Titan Spine, Llc | Spinal implant having a transverse aperture |
US8992622B2 (en) | 2005-05-06 | 2015-03-31 | Titan Spine, Llc | Interbody spinal implant having a roughened surface topography |
US9168147B2 (en) | 2005-05-06 | 2015-10-27 | Titan Spine, Llc | Self-deploying locking screw retention device |
US8758442B2 (en) | 2005-05-06 | 2014-06-24 | Titan Spine, Llc | Composite implants having integration surfaces composed of a regular repeating pattern |
US8562685B2 (en) | 2005-05-06 | 2013-10-22 | Titan Spine, Llc | Spinal implant and integration plate for optimizing vertebral endplate contact load-bearing edges |
US8262737B2 (en) | 2005-05-06 | 2012-09-11 | Titan Spine, Llc | Composite interbody spinal implant having openings of predetermined size and shape |
US9125756B2 (en) | 2005-05-06 | 2015-09-08 | Titan Spine, Llc | Processes for producing regular repeating patterns on surfaces of interbody devices |
US8585766B2 (en) | 2005-05-06 | 2013-11-19 | Titan Spine, Llc | Endplate-preserving spinal implant with an integration plate having durable connectors |
US8617248B2 (en) | 2005-05-06 | 2013-12-31 | Titan Spine, Llc | Spinal implant having variable ratios of the integration surface area to the axial passage area |
US8758443B2 (en) | 2005-05-06 | 2014-06-24 | Titan Spine, Llc | Implants with integration surfaces having regular repeating surface patterns |
US9402680B2 (en) | 2008-05-27 | 2016-08-02 | Maquet Cardiovasular, Llc | Surgical instrument and method |
US9700431B2 (en) | 2008-08-13 | 2017-07-11 | Smed-Ta/Td, Llc | Orthopaedic implant with porous structural member |
US10842645B2 (en) | 2008-08-13 | 2020-11-24 | Smed-Ta/Td, Llc | Orthopaedic implant with porous structural member |
US9955858B2 (en) | 2009-08-21 | 2018-05-01 | Maquet Cardiovascular Llc | Surgical instrument and method for use |
EP2595576A1 (en) * | 2010-07-20 | 2013-05-29 | X-spine Systems, Inc. | Composite orthopedic implant having a low friction material substrate with primary frictional features and secondary frictional features |
US9132021B2 (en) | 2011-10-07 | 2015-09-15 | Pioneer Surgical Technology, Inc. | Intervertebral implant |
US8992619B2 (en) | 2011-11-01 | 2015-03-31 | Titan Spine, Llc | Microstructured implant surfaces |
WO2013142480A1 (en) | 2012-03-20 | 2013-09-26 | Titan Spine, Llc | Friction-fit spinal endplate and endplate-preserving method |
EP2716261A1 (en) | 2012-10-02 | 2014-04-09 | Titan Spine, LLC | Implants with self-deploying anchors |
US9498349B2 (en) | 2012-10-09 | 2016-11-22 | Titan Spine, Llc | Expandable spinal implant with expansion wedge and anchor |
WO2015048997A1 (en) * | 2013-10-02 | 2015-04-09 | Vigas | Spinal implant for interbody use |
US9615935B2 (en) | 2014-01-30 | 2017-04-11 | Titan Spine, Llc | Thermally activated shape memory spring assemblies for implant expansion |
EP3777753B1 (en) | 2014-04-11 | 2024-05-22 | Biomet 3I, LLC | Implant with high primary stability and accelerated secondary stability |
US10687956B2 (en) | 2014-06-17 | 2020-06-23 | Titan Spine, Inc. | Corpectomy implants with roughened bioactive lateral surfaces |
US10105240B2 (en) | 2014-08-19 | 2018-10-23 | Oxford Performance Materials, Inc. | Spinal implant and method for fabricating the same |
CN107205825A (en) * | 2014-12-16 | 2017-09-26 | 陶瓷技术有限责任公司 | Vertebra Invasive lumbar fusion device and its insertion instrument |
US10271958B2 (en) | 2015-01-27 | 2019-04-30 | K2M, Inc. | Interbody spacer |
US10028841B2 (en) | 2015-01-27 | 2018-07-24 | K2M, Inc. | Interbody spacer |
WO2016137983A1 (en) | 2015-02-24 | 2016-09-01 | X-Spine Systems, Inc. | Modular interspinous fixation system with threaded component |
EP3064175B1 (en) * | 2015-03-03 | 2023-11-01 | SMed - TA/TD LLC | Orthopaedic implant with porous structural member |
CA3005742A1 (en) | 2015-11-20 | 2017-05-26 | Titan Spine, Llc | Processes for additively manufacturing orthopedic implants |
TWI726940B (en) | 2015-11-20 | 2021-05-11 | 美商泰坦脊柱股份有限公司 | Processes for additively manufacturing orthopedic implants |
TWI548391B (en) | 2015-12-01 | 2016-09-11 | 財團法人工業技術研究院 | Bone implant and manufacturing method thereof |
AU2017307558B2 (en) | 2016-08-03 | 2022-08-11 | Titan Spine, Inc. | Implant surfaces that enhance osteoinduction |
US10265189B2 (en) | 2016-09-13 | 2019-04-23 | Warsaw Orthopedic, Inc. | Interbody spinal fusion device |
KR101846828B1 (en) * | 2016-10-04 | 2018-04-09 | (주)메디쎄이 | Spinal complex cage |
WO2018081114A1 (en) * | 2016-10-24 | 2018-05-03 | Corelink, Llc | Interbody spacer for spinal fusion |
JP2020533070A (en) | 2017-09-08 | 2020-11-19 | パイオニア サージカル テクノロジー インコーポレイテッド | Intervertebral implants, instruments, and methods |
USD907771S1 (en) | 2017-10-09 | 2021-01-12 | Pioneer Surgical Technology, Inc. | Intervertebral implant |
US11051953B2 (en) | 2019-07-31 | 2021-07-06 | Zavation Medical Products, Llc | Porous spinal implant |
US11857436B1 (en) | 2019-07-31 | 2024-01-02 | Zavation Medical Products, Llc | Porous spinal implant |
US11278420B2 (en) * | 2019-10-25 | 2022-03-22 | Zavation, Llc | Recessed pocket spinal implant |
JPWO2021153658A1 (en) * | 2020-01-31 | 2021-08-05 | ||
AU2022304563A1 (en) * | 2021-06-28 | 2024-01-18 | Spine Wave, Inc. | Bellows shaped spinal implant |
US11826265B2 (en) * | 2021-06-28 | 2023-11-28 | Spine Wave, Inc. | Bellows shaped spinal implant having gyroid lattice structures |
Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5865845A (en) * | 1996-03-05 | 1999-02-02 | Thalgott; John S. | Prosthetic intervertebral disc |
US20020156529A1 (en) * | 1998-03-11 | 2002-10-24 | Panjian Li | Surface-mineralized spinal implants |
WO2006102347A2 (en) * | 2005-03-21 | 2006-09-28 | The Regents Of The University Of California | Controllable nanostructuring on micro-structured surfaces |
US20080262623A1 (en) * | 2005-05-06 | 2008-10-23 | Titan Spine, Llc | Composite interbody spinal implant having openings of predetermined size and shape |
US20100274358A1 (en) * | 2009-02-25 | 2010-10-28 | Spinewelding Ag | Spine stabilization device, and method and kit for its implantation |
Family Cites Families (244)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3933961A (en) * | 1974-12-13 | 1976-01-20 | Pennwalt Corporation | Tabletting spherical dental amalgam alloy |
US4163698A (en) * | 1978-05-22 | 1979-08-07 | Olin Corporation | In situ reference electrode for diaphragm cells |
US4314876A (en) | 1980-03-17 | 1982-02-09 | The Diversey Corporation | Titanium etching solution |
US4834757A (en) | 1987-01-22 | 1989-05-30 | Brantigan John W | Prosthetic implant |
GB8718627D0 (en) | 1987-08-06 | 1987-09-09 | Showell A W Sugicraft Ltd | Spinal implants |
US6923810B1 (en) | 1988-06-13 | 2005-08-02 | Gary Karlin Michelson | Frusto-conical interbody spinal fusion implants |
US5015247A (en) | 1988-06-13 | 1991-05-14 | Michelson Gary K | Threaded spinal implant |
US7452359B1 (en) | 1988-06-13 | 2008-11-18 | Warsaw Orthopedic, Inc. | Apparatus for inserting spinal implants |
US6123705A (en) | 1988-06-13 | 2000-09-26 | Sdgi Holdings, Inc. | Interbody spinal fusion implants |
US5609635A (en) | 1988-06-28 | 1997-03-11 | Michelson; Gary K. | Lordotic interbody spinal fusion implants |
CA1333209C (en) | 1988-06-28 | 1994-11-29 | Gary Karlin Michelson | Artificial spinal fusion implants |
CA1318469C (en) | 1989-02-15 | 1993-06-01 | Acromed Corporation | Artificial disc |
EP0388576B1 (en) | 1989-03-23 | 1993-09-15 | Institut Straumann Ag | Metallic implant |
DE8912648U1 (en) | 1989-10-23 | 1990-11-22 | Mecron Medizinische Produkte Gmbh, 1000 Berlin | Vertebral body implant |
US5258098A (en) | 1991-06-17 | 1993-11-02 | Cycam, Inc. | Method of production of a surface adapted to promote adhesion |
US5306309A (en) | 1992-05-04 | 1994-04-26 | Calcitek, Inc. | Spinal disk implant and implantation kit |
DE9216092U1 (en) | 1992-11-26 | 1993-01-14 | S + G Implants GmbH, 2400 Lübeck | Disc-shaped implant for stiffening adjacent vertebral bones |
NO924697D0 (en) | 1992-12-04 | 1992-12-04 | Jan Erik Ellingsen | SURGICAL IMPLANT AND A PROCEDURE FOR TREATMENT OF SURGICAL IMPLANT |
US5584831A (en) | 1993-07-09 | 1996-12-17 | September 28, Inc. | Spinal fixation device and method |
US5425772A (en) | 1993-09-20 | 1995-06-20 | Brantigan; John W. | Prosthetic implant for intervertebral spinal fusion |
BE1007549A3 (en) | 1993-09-21 | 1995-08-01 | Beckers Louis Francois Charles | Implant. |
US5443514A (en) | 1993-10-01 | 1995-08-22 | Acromed Corporation | Method for using spinal implants |
US20010039454A1 (en) | 1993-11-02 | 2001-11-08 | John Ricci | Orthopedic implants having ordered microgeometric surface patterns |
US7048870B1 (en) | 1993-12-20 | 2006-05-23 | Astrazeneca Ab | Metallic implant and process for treating a metallic implant |
CA2551185C (en) | 1994-03-28 | 2007-10-30 | Sdgi Holdings, Inc. | Apparatus and method for anterior spinal stabilization |
US6344057B1 (en) | 1994-11-22 | 2002-02-05 | Sdgi Holdings, Inc. | Adjustable vertebral body replacement |
US5863201A (en) | 1994-11-30 | 1999-01-26 | Implant Innovations, Inc. | Infection-blocking dental implant |
US6652765B1 (en) | 1994-11-30 | 2003-11-25 | Implant Innovations, Inc. | Implant surface preparation |
ATE274861T1 (en) | 1994-11-30 | 2004-09-15 | Implant Innovations Inc | PREPARATION OF AN IMPLANT SURFACE |
US6491723B1 (en) | 1996-02-27 | 2002-12-10 | Implant Innovations, Inc. | Implant surface preparation method |
US5766252A (en) | 1995-01-24 | 1998-06-16 | Osteonics Corp. | Interbody spinal prosthetic implant and method |
DE19504867C1 (en) | 1995-02-14 | 1996-02-29 | Harms Juergen | Position retainer for spine |
US6758849B1 (en) | 1995-02-17 | 2004-07-06 | Sdgi Holdings, Inc. | Interbody spinal fusion implants |
US5860973A (en) | 1995-02-27 | 1999-01-19 | Michelson; Gary Karlin | Translateral spinal implant |
ES2161865T3 (en) | 1995-03-08 | 2001-12-16 | Synthes Ag | INTERVERTEBRAL IMPLANT |
US5782919A (en) | 1995-03-27 | 1998-07-21 | Sdgi Holdings, Inc. | Interbody fusion device and method for restoration of normal spinal anatomy |
US5702449A (en) | 1995-06-07 | 1997-12-30 | Danek Medical, Inc. | Reinforced porous spinal implants |
US6039762A (en) | 1995-06-07 | 2000-03-21 | Sdgi Holdings, Inc. | Reinforced bone graft substitutes |
US6423095B1 (en) | 1995-10-16 | 2002-07-23 | Sdgi Holdings, Inc. | Intervertebral spacers |
DE19541114A1 (en) | 1995-10-26 | 1997-04-30 | Artos Med Produkte | Intervertebral implant |
US6033582A (en) | 1996-01-22 | 2000-03-07 | Etex Corporation | Surface modification of medical implants |
US5968098A (en) | 1996-10-22 | 1999-10-19 | Surgical Dynamics, Inc. | Apparatus for fusing adjacent bone structures |
US20050165483A1 (en) | 2004-01-27 | 2005-07-28 | Ray Eddie F.Iii | Bone grafts |
US6241771B1 (en) | 1997-08-13 | 2001-06-05 | Cambridge Scientific, Inc. | Resorbable interbody spinal fusion devices |
FR2767675B1 (en) | 1997-08-26 | 1999-12-03 | Materiel Orthopedique En Abreg | INTERSOMATIC IMPLANT AND ANCILLARY OF PREPARATION SUITABLE FOR ALLOWING ITS POSITION |
DE29720022U1 (en) | 1997-11-12 | 1998-01-15 | SCHÄFER micomed GmbH, 73035 Göppingen | Intervertebral implant |
US6086613A (en) | 1997-12-23 | 2000-07-11 | Depuy Acromed, Inc. | Spacer assembly for use in spinal surgeries |
US6482233B1 (en) | 1998-01-29 | 2002-11-19 | Synthes(U.S.A.) | Prosthetic interbody spacer |
DE19807236C2 (en) | 1998-02-20 | 2000-06-21 | Biedermann Motech Gmbh | Intervertebral implant |
US6296664B1 (en) | 1998-06-17 | 2001-10-02 | Surgical Dynamics, Inc. | Artificial intervertebral disc |
US5885079A (en) | 1998-06-22 | 1999-03-23 | Core-Vent Corporation | Selective surface, endosseous dental implants |
GB2338652A (en) | 1998-06-23 | 1999-12-29 | Biomet Merck Ltd | Vertebral body replacement |
ATE263526T1 (en) | 1998-08-03 | 2004-04-15 | Synthes Ag | INTERVERTEBRATE ALLOGRAPH SPACER |
US6193757B1 (en) | 1998-10-29 | 2001-02-27 | Sdgi Holdings, Inc. | Expandable intervertebral spacers |
EP1023910A1 (en) | 1999-01-29 | 2000-08-02 | Institut Straumann AG | Preparation of osteophilic surfaces for metallic prosthetic devices anchorable to bone |
US6929662B1 (en) | 1999-02-04 | 2005-08-16 | Synthes (Usa) | End member for a bone fusion implant |
US6245108B1 (en) | 1999-02-25 | 2001-06-12 | Spineco | Spinal fusion implant |
US6241770B1 (en) | 1999-03-05 | 2001-06-05 | Gary K. Michelson | Interbody spinal fusion implant having an anatomically conformed trailing end |
AU4348400A (en) | 1999-04-16 | 2000-11-02 | Nuvasive, Inc. | Systems for securing facet joints together |
US6342074B1 (en) | 1999-04-30 | 2002-01-29 | Nathan S. Simpson | Anterior lumbar interbody fusion implant and method for fusing adjacent vertebrae |
CA2363562C (en) | 1999-05-05 | 2010-08-03 | Gary Karlin Michelson | Nested interbody spinal fusion implants |
ATE291398T1 (en) | 1999-06-04 | 2005-04-15 | Sdgi Holdings Inc | ARTIFICIAL INTERVERBEL IMPLANT |
FR2795945B1 (en) | 1999-07-09 | 2001-10-26 | Scient X | ANATOMICAL INTERSOMATIC IMPLANT AND GRIPPER FOR SUCH AN IMPLANT |
WO2002009626A1 (en) | 1999-07-26 | 2002-02-07 | Advanced Prosthetic Technologies, Inc. | Improved spinal surgical prosthesis |
FR2897259B1 (en) | 2006-02-15 | 2008-05-09 | Ldr Medical Soc Par Actions Si | INTERSOMATIC TRANSFORAMINAL CAGE WITH INTERBREBAL FUSION GRAFT AND CAGE IMPLANTATION INSTRUMENT |
US6080158A (en) | 1999-08-23 | 2000-06-27 | Lin; Chih-I | Intervertebral fusion device |
US6436101B1 (en) | 1999-10-13 | 2002-08-20 | James S. Hamada | Rasp for use in spine surgery |
US6830570B1 (en) | 1999-10-21 | 2004-12-14 | Sdgi Holdings, Inc. | Devices and techniques for a posterior lateral disc space approach |
WO2001028469A2 (en) | 1999-10-21 | 2001-04-26 | Sdgi Holdings, Inc. | Devices and techniques for a posterior lateral disc space approach |
US6592624B1 (en) | 1999-11-24 | 2003-07-15 | Depuy Acromed, Inc. | Prosthetic implant element |
US7115143B1 (en) | 1999-12-08 | 2006-10-03 | Sdgi Holdings, Inc. | Orthopedic implant surface configuration |
US6827740B1 (en) | 1999-12-08 | 2004-12-07 | Gary K. Michelson | Spinal implant surface configuration |
TW447286U (en) | 1999-12-10 | 2001-07-21 | Lin Jr Yi | Intervertebral restorer |
JP2001170092A (en) | 1999-12-21 | 2001-06-26 | Nippon Electric Glass Co Ltd | Vertebral arch spacer for enlarging operation of vertebral canal |
US6096107A (en) | 2000-01-03 | 2000-08-01 | Norton Company | Superabrasive products |
US20050203630A1 (en) | 2000-01-30 | 2005-09-15 | Pope Bill J. | Prosthetic knee joint having at least one diamond articulation surface |
US7169183B2 (en) | 2000-03-14 | 2007-01-30 | Warsaw Orthopedic, Inc. | Vertebral implant for promoting arthrodesis of the spine |
US6183255B1 (en) | 2000-03-27 | 2001-02-06 | Yoshiki Oshida | Titanium material implants |
US6350283B1 (en) | 2000-04-19 | 2002-02-26 | Gary K. Michelson | Bone hemi-lumbar interbody spinal implant having an asymmetrical leading end and method of installation thereof |
FR2808673B1 (en) | 2000-05-11 | 2002-12-06 | Scient X | INTERSOMATIC IMPLANT FORE LUMBAR |
US6635086B2 (en) | 2000-05-30 | 2003-10-21 | Blacksheep Technologies Incorporated | Implant for placement between cervical vertebrae |
US6579318B2 (en) | 2000-06-12 | 2003-06-17 | Ortho Development Corporation | Intervertebral spacer |
US6808537B2 (en) | 2000-07-07 | 2004-10-26 | Gary Karlin Michelson | Expandable implant with interlocking walls |
US6730127B2 (en) | 2000-07-10 | 2004-05-04 | Gary K. Michelson | Flanged interbody spinal fusion implants |
FR2811543B1 (en) | 2000-07-12 | 2003-07-04 | Spine Next Sa | INTERSOMATIC IMPLANT |
CH694935A5 (en) | 2000-07-26 | 2005-09-30 | Straumann Holding Ag | Oberflaechenmodifizierte implants. |
US6458159B1 (en) | 2000-08-15 | 2002-10-01 | John S. Thalgott | Disc prosthesis |
US7226480B2 (en) | 2000-08-15 | 2007-06-05 | Depuy Spine, Inc. | Disc prosthesis |
US7204851B2 (en) | 2000-08-30 | 2007-04-17 | Sdgi Holdings, Inc. | Method and apparatus for delivering an intervertebral disc implant |
ATE415982T1 (en) | 2000-09-19 | 2008-12-15 | Aldecoa Eduardo Anitua | METHOD FOR SURFACE TREATMENT OF IMPLANTS OR PROStheses MADE OF TITANIUM |
US6743231B1 (en) | 2000-10-02 | 2004-06-01 | Sulzer Spine-Tech Inc. | Temporary spinal fixation apparatuses and methods |
US6743256B2 (en) | 2000-10-11 | 2004-06-01 | Michael D. Mason | Graftless spinal fusion device |
JP2004533272A (en) | 2000-10-24 | 2004-11-04 | ハウメディカ・オステオニクス・コーポレイション | Healing implant device |
US6520993B2 (en) | 2000-12-29 | 2003-02-18 | Depuy Acromed, Inc. | Spinal implant |
US6599322B1 (en) | 2001-01-25 | 2003-07-29 | Tecomet, Inc. | Method for producing undercut micro recesses in a surface, a surgical implant made thereby, and method for fixing an implant to bone |
US7018418B2 (en) | 2001-01-25 | 2006-03-28 | Tecomet, Inc. | Textured surface having undercut micro recesses in a surface |
US6620332B2 (en) | 2001-01-25 | 2003-09-16 | Tecomet, Inc. | Method for making a mesh-and-plate surgical implant |
ATE326925T1 (en) | 2001-01-30 | 2006-06-15 | Synthes Ag | BONE IMPLANT, IN PARTICULAR INTERVERBEL IMPLANT |
US6863689B2 (en) | 2001-07-16 | 2005-03-08 | Spinecore, Inc. | Intervertebral spacer having a flexible wire mesh vertebral body contact element |
US6899734B2 (en) | 2001-03-23 | 2005-05-31 | Howmedica Osteonics Corp. | Modular implant for fusing adjacent bone structure |
US7128760B2 (en) | 2001-03-27 | 2006-10-31 | Warsaw Orthopedic, Inc. | Radially expanding interbody spinal fusion implants, instrumentation, and methods of insertion |
US6890355B2 (en) | 2001-04-02 | 2005-05-10 | Gary K. Michelson | Artificial contoured spinal fusion implants made of a material other than bone |
US7083618B2 (en) | 2001-04-06 | 2006-08-01 | Sherwood Services Ag | Vessel sealer and divider |
US6719794B2 (en) | 2001-05-03 | 2004-04-13 | Synthes (U.S.A.) | Intervertebral implant for transforaminal posterior lumbar interbody fusion procedure |
US6974480B2 (en) | 2001-05-03 | 2005-12-13 | Synthes (Usa) | Intervertebral implant for transforaminal posterior lumbar interbody fusion procedure |
US6558424B2 (en) | 2001-06-28 | 2003-05-06 | Depuy Acromed | Modular anatomic fusion device |
US6436102B1 (en) | 2001-07-16 | 2002-08-20 | Third Millennium Engineering, Llc | Method of distracting vertebral bones |
US7018412B2 (en) | 2001-08-20 | 2006-03-28 | Ebi, L.P. | Allograft spinal implant |
US6569201B2 (en) | 2001-09-28 | 2003-05-27 | Depuy Acromed, Inc. | Hybrid composite interbody fusion device |
WO2003030957A1 (en) | 2001-10-11 | 2003-04-17 | Straumann Holding Ag | Osteophilic implants |
US6709439B2 (en) | 2001-10-30 | 2004-03-23 | Depuy Spine, Inc. | Slaphammer tool |
US20030139812A1 (en) | 2001-11-09 | 2003-07-24 | Javier Garcia | Spinal implant |
US6979353B2 (en) | 2001-12-03 | 2005-12-27 | Howmedica Osteonics Corp. | Apparatus for fusing adjacent bone structures |
US7238203B2 (en) | 2001-12-12 | 2007-07-03 | Vita Special Purpose Corporation | Bioactive spinal implants and method of manufacture thereof |
SE520756C2 (en) | 2001-12-21 | 2003-08-19 | Nobel Biocare Ab | Method of providing surface structure on implants as well as such implants |
US6740118B2 (en) | 2002-01-09 | 2004-05-25 | Sdgi Holdings, Inc. | Intervertebral prosthetic joint |
US6923830B2 (en) | 2002-02-02 | 2005-08-02 | Gary K. Michelson | Spinal fusion implant having deployable bone engaging projections |
US7077864B2 (en) | 2002-02-12 | 2006-07-18 | Cross Medical Products, Inc. | Vertebral interbody cage with translatable locking screw |
US6808538B2 (en) | 2002-03-15 | 2004-10-26 | Stryker Spine | Vertebral body spacer having variable wedged endplates |
US7309358B2 (en) | 2002-03-21 | 2007-12-18 | Warsaw Orthopedic, Inc. | Vertebral body and disc space replacement devices |
US6991653B2 (en) | 2002-03-21 | 2006-01-31 | Sdgi Holdings, Inc. | Vertebral body and disc space replacement devices |
US6758862B2 (en) | 2002-03-21 | 2004-07-06 | Sdgi Holdings, Inc. | Vertebral body and disc space replacement devices |
US6726720B2 (en) | 2002-03-27 | 2004-04-27 | Depuy Spine, Inc. | Modular disc prosthesis |
US7223289B2 (en) | 2002-04-16 | 2007-05-29 | Warsaw Orthopedic, Inc. | Annulus repair systems and techniques |
US6793678B2 (en) | 2002-06-27 | 2004-09-21 | Depuy Acromed, Inc. | Prosthetic intervertebral motion disc having dampening |
US20060100716A1 (en) * | 2002-06-27 | 2006-05-11 | Reto Lerf | Open-pored metal coating for joint replacement implants and method for production thereof |
SE523288C2 (en) | 2002-07-19 | 2004-04-06 | Astra Tech Ab | An implant and a method of treating an implant surface |
EP1585457B1 (en) | 2002-09-24 | 2010-03-31 | Bogomir Gorensek | Stabilizing device for intervertebral disc, and methods thereof |
DE10248170A1 (en) | 2002-10-16 | 2004-04-29 | Advanced Medical Technologies Ag | Implant for insertion between vertebras of a spinal column comprises two sides whose outer surfaces at the start of a vertebra spreading process converge towards the free ends of the sides |
DE10248171A1 (en) | 2002-10-16 | 2004-05-13 | Advanced Medical Technologies Ag | Implant for placement between vertebrae of the spine |
US7125425B2 (en) | 2002-10-21 | 2006-10-24 | Sdgi Holdings, Inc. | Systems and techniques for restoring and maintaining intervertebral anatomy |
AR037168A1 (en) | 2002-10-30 | 2004-10-27 | Carrasco Mauricio Rodolfo | IMPLANT FOR VERTEBRAL REPLACEMENT AND RESTORATION OF THE NORMAL SPINAL CURVATURE. |
US20040143332A1 (en) | 2002-10-31 | 2004-07-22 | Krueger David J. | Movable disc implant |
US20040092941A1 (en) | 2002-11-12 | 2004-05-13 | Jansen Keith E. | Serratome vertebral cortical endplate cutter |
US7192447B2 (en) | 2002-12-19 | 2007-03-20 | Synthes (Usa) | Intervertebral implant |
ATE345747T1 (en) | 2003-01-23 | 2006-12-15 | Dinkelacker Wolfgang | BONE IMPLANT AND METHOD FOR THE PRODUCTION THEREOF |
US7235101B2 (en) | 2003-09-15 | 2007-06-26 | Warsaw Orthopedic, Inc. | Revisable prosthetic device |
US20040167632A1 (en) | 2003-02-24 | 2004-08-26 | Depuy Products, Inc. | Metallic implants having roughened surfaces and methods for producing the same |
JP5079208B2 (en) | 2003-02-24 | 2012-11-21 | デピュイ・プロダクツ・インコーポレイテッド | Metal implant having a rough surface and method for manufacturing the same |
US7819903B2 (en) | 2003-03-31 | 2010-10-26 | Depuy Spine, Inc. | Spinal fixation plate |
US8251700B2 (en) | 2003-05-16 | 2012-08-28 | Biomet 3I, Llc | Surface treatment process for implants made of titanium alloy |
WO2005000094A2 (en) | 2003-06-03 | 2005-01-06 | Osteotech, Inc. | Bioimplant with nonuniformly configured protrusions on the load bearing surfaces thereof |
JP4825955B2 (en) | 2003-06-13 | 2011-11-30 | 独立行政法人産業技術総合研究所 | Biological implant material and method for producing the same |
US20040267367A1 (en) | 2003-06-30 | 2004-12-30 | Depuy Acromed, Inc | Intervertebral implant with conformable endplate |
US7141068B2 (en) | 2003-07-01 | 2006-11-28 | Thomas Ross | Spinal spacer assembly |
US20050119758A1 (en) | 2003-07-30 | 2005-06-02 | Bio-Lok International Inc. | Surgical implant for promotion of osseo-integration |
US7806932B2 (en) | 2003-08-01 | 2010-10-05 | Zimmer Spine, Inc. | Spinal implant |
US7545010B2 (en) * | 2003-08-08 | 2009-06-09 | Canon Kabushiki Kaisha | Catalytic sensor structure |
US7041137B2 (en) | 2003-10-07 | 2006-05-09 | Lanx, Llc | Spinal implant |
US7569074B2 (en) | 2003-12-11 | 2009-08-04 | Warsaw Orthopedic, Inc. | Expandable intervertebral implant |
US7137997B2 (en) | 2003-12-29 | 2006-11-21 | Globus Medical, Inc. | Spinal fusion implant |
US7238205B2 (en) | 2004-01-15 | 2007-07-03 | Warsaw Orthopedic, Inc. | Universal interference cleat |
US7250060B2 (en) | 2004-01-27 | 2007-07-31 | Sdgi Holdings, Inc. | Hybrid intervertebral disc system |
US7846183B2 (en) | 2004-02-06 | 2010-12-07 | Spinal Elements, Inc. | Vertebral facet joint prosthesis and method of fixation |
CA2802131C (en) | 2004-02-10 | 2015-10-06 | Spinal Elements, Inc. | System and method for protecting neurovascular structures |
US7833271B2 (en) | 2004-05-04 | 2010-11-16 | Zimmer Spine, Inc. | Spinal implants with body and insert |
US9504583B2 (en) | 2004-06-10 | 2016-11-29 | Spinal Elements, Inc. | Implant and method for facet immobilization |
US20060041313A1 (en) | 2004-08-19 | 2006-02-23 | Sdgi Holdings, Inc. | Intervertebral disc system |
US7648727B2 (en) * | 2004-08-26 | 2010-01-19 | Advanced Cardiovascular Systems, Inc. | Methods for manufacturing a coated stent-balloon assembly |
EP1809212A1 (en) | 2004-10-08 | 2007-07-25 | Warsaw Orthopedic, Inc. | Interior connecting interbody cage insertional tools, methods and devices |
US20060093646A1 (en) | 2004-10-28 | 2006-05-04 | Cima Michael J | Orthopedic and dental implant devices providing controlled drug delivery |
US7875080B2 (en) | 2004-11-10 | 2011-01-25 | Warsaw Orthopedic, Inc. | Intervertebral spacer |
US20060149372A1 (en) | 2004-12-17 | 2006-07-06 | Paxson Robert D | Artificial spinal disc |
US20060190079A1 (en) | 2005-01-21 | 2006-08-24 | Naim Istephanous | Articulating spinal disc implants with amorphous metal elements |
DK1841385T3 (en) | 2005-01-28 | 2011-01-10 | Advanced Med Tech | Implant for transforaminal intercorporeal fusion |
DE102005004563B4 (en) | 2005-02-01 | 2017-03-16 | Advanced Medical Technologies Ag | Spreadable implant for preferably dorsal arrangement between the vertebral bodies of the spine |
WO2006091582A2 (en) | 2005-02-24 | 2006-08-31 | Implant Innovations, Inc. | Surface treatment methods for implants made of titanium or titanium alloy |
US8470039B2 (en) | 2005-03-17 | 2013-06-25 | Spinal Elements, Inc. | Flanged interbody fusion device with fastener insert and retaining ring |
US7749269B2 (en) | 2005-03-28 | 2010-07-06 | Warsaw Orthopedic, Inc. | Spinal system and method including lateral approach |
CA2604622A1 (en) | 2005-04-15 | 2006-10-26 | Musculoskeletal Transplant Foundation | Vertebral disc repair |
US20060241760A1 (en) | 2005-04-26 | 2006-10-26 | Brandon Randall | Spinal implant |
US8480749B2 (en) | 2005-05-06 | 2013-07-09 | Titan Spine, Llc | Friction fit and vertebral endplate-preserving spinal implant |
US8435302B2 (en) | 2005-05-06 | 2013-05-07 | Titan Spine, Llc | Instruments and interbody spinal implants enhancing disc space distraction |
US8758442B2 (en) | 2005-05-06 | 2014-06-24 | Titan Spine, Llc | Composite implants having integration surfaces composed of a regular repeating pattern |
US8403991B2 (en) | 2005-05-06 | 2013-03-26 | Titan Spine Llc | Implant with critical ratio of load bearing surface area to central opening area |
US8562684B2 (en) | 2005-05-06 | 2013-10-22 | Titan Spine, Llc | Endplate-preserving spinal implant with an integration plate having a roughened surface topography |
US8585766B2 (en) | 2005-05-06 | 2013-11-19 | Titan Spine, Llc | Endplate-preserving spinal implant with an integration plate having durable connectors |
US8591590B2 (en) | 2005-05-06 | 2013-11-26 | Titan Spine, Llc | Spinal implant having a transverse aperture |
US8617248B2 (en) | 2005-05-06 | 2013-12-31 | Titan Spine, Llc | Spinal implant having variable ratios of the integration surface area to the axial passage area |
US7662186B2 (en) | 2005-05-06 | 2010-02-16 | Titan Spine, Llc | Anterior interbody spinal implant |
US8585765B2 (en) | 2005-05-06 | 2013-11-19 | Titan Spine, Llc | Endplate-preserving spinal implant having a raised expulsion-resistant edge |
US20110282454A1 (en) | 2010-05-14 | 2011-11-17 | Titan Spine, Llc | Interbody Spinal Implant Having Internally Textured Surfaces |
US8758443B2 (en) | 2005-05-06 | 2014-06-24 | Titan Spine, Llc | Implants with integration surfaces having regular repeating surface patterns |
US8562685B2 (en) | 2005-05-06 | 2013-10-22 | Titan Spine, Llc | Spinal implant and integration plate for optimizing vertebral endplate contact load-bearing edges |
US8814939B2 (en) | 2005-05-06 | 2014-08-26 | Titan Spine, Llc | Implants having three distinct surfaces |
US8585767B2 (en) | 2005-05-06 | 2013-11-19 | Titan Spine, Llc | Endplate-preserving spinal implant with an integration plate having durable connectors |
US8545568B2 (en) | 2005-05-06 | 2013-10-01 | Titan Spine, Llc | Method of using instruments and interbody spinal implants to enhance distraction |
US20120312779A1 (en) | 2005-05-06 | 2012-12-13 | Titian Spine, LLC | Methods for manufacturing implants having integration surfaces |
US8551176B2 (en) | 2005-05-06 | 2013-10-08 | Titan Spine, Llc | Spinal implant having a passage for enhancing contact between bone graft material and cortical endplate bone |
US20120303127A1 (en) | 2005-05-06 | 2012-11-29 | Titan Spine, Llc | Implants having internal features for graft retention and load transfer between implant and vertebrae |
US9125756B2 (en) | 2005-05-06 | 2015-09-08 | Titan Spine, Llc | Processes for producing regular repeating patterns on surfaces of interbody devices |
US7901462B2 (en) | 2005-06-23 | 2011-03-08 | Depuy Products, Inc. | Implants with textured surface and methods for producing the same |
US7368065B2 (en) | 2005-06-23 | 2008-05-06 | Depuy Products, Inc. | Implants with textured surface and methods for producing the same |
US20060293748A1 (en) | 2005-06-24 | 2006-12-28 | Spineworks, Llc | Prosthetic implant, and a method and tool for the insertion of same |
WO2007038546A1 (en) | 2005-09-26 | 2007-04-05 | Warsaw Orthopedic, Inc. | Anterior hybrid implant |
CN101272750A (en) | 2005-09-26 | 2008-09-24 | 华沙整形外科股份有限公司 | Transforaminal hybrid implant |
US7875075B2 (en) | 2005-09-26 | 2011-01-25 | Warsaw Orthopedic, Inc. | Hybrid intervertebral spinal fusion implant |
US20070093897A1 (en) | 2005-10-21 | 2007-04-26 | Stryker Spine (In France) | System and method for fusion cage implantation |
USD524443S1 (en) | 2005-11-04 | 2006-07-04 | Quantum Orthopedics, Inc. | Interbody fusion device |
USD533277S1 (en) | 2005-11-04 | 2006-12-05 | Quantum Orthopedics, Inc. | Interbody fusion device |
US7967862B2 (en) | 2005-11-23 | 2011-06-28 | Warsaw Orthopedic, Inc. | Posterior articular disc and method for implantation |
ATE548000T1 (en) | 2006-02-01 | 2012-03-15 | Synthes Gmbh | INTERSPINAL INTERVENTION SPACER |
US7955335B2 (en) | 2006-03-31 | 2011-06-07 | Warsaw Orthopedic, Inc. | Osteochondral plug graft trimming device and method |
US7850736B2 (en) | 2006-04-13 | 2010-12-14 | Warsaw Orthopedic, Inc. | Vertebral fusion implants and methods of use |
EP1847278A1 (en) | 2006-04-13 | 2007-10-24 | Camlog Biotechnologies AG | Bio-dissolvable salt coatings of implants for the protection against organic impurities |
US8002837B2 (en) | 2006-05-19 | 2011-08-23 | Pioneer Surgical Technology | Spinal stabilization device and methods |
WO2008066965A2 (en) | 2006-06-23 | 2008-06-05 | The Regents Of The University Of California | Articles comprising large-surface-area bio-compatible materials and methods for making and using them |
US8043377B2 (en) | 2006-09-02 | 2011-10-25 | Osprey Biomedical, Inc. | Implantable intervertebral fusion device |
US20080071380A1 (en) | 2006-09-19 | 2008-03-20 | Thomas Sweeney | Systems and Methods for Percutaneous Placement of Interspinous Process Spacers |
US8142355B2 (en) | 2006-09-25 | 2012-03-27 | Spinal Elements, Inc. | Surgical tissue retractor |
DE602007004271D1 (en) | 2006-09-27 | 2010-03-04 | Peter Bono | Intervertebral spacer |
US20080154378A1 (en) | 2006-12-22 | 2008-06-26 | Warsaw Orthopedic, Inc. | Bone implant having engineered surfaces |
US8652137B2 (en) | 2007-02-22 | 2014-02-18 | Spinal Elements, Inc. | Vertebral facet joint drill and method of use |
US8992533B2 (en) | 2007-02-22 | 2015-03-31 | Spinal Elements, Inc. | Vertebral facet joint drill and method of use |
US9358121B2 (en) | 2007-03-10 | 2016-06-07 | Spinesmith Partners, L.P. | Artificial disc with unique articulating geometry and associated methods |
US8163026B2 (en) | 2007-04-05 | 2012-04-24 | Zimmer Spine, Inc. | Interbody implant |
US20080255664A1 (en) * | 2007-04-10 | 2008-10-16 | Mdesign International | Percutaneously deliverable orthopedic joint device |
US8211148B2 (en) | 2007-04-24 | 2012-07-03 | Warsaw Orthopedic | Prostheses for locking an artificial disc in an intervertebral disc space |
US8062304B2 (en) | 2007-04-25 | 2011-11-22 | Spinal Elements, Inc. | Spinal implant distractor/inserter |
US8454622B2 (en) | 2007-04-25 | 2013-06-04 | Spinal Elements, Inc. | Spinal implant distractor/inserter |
US20100076559A1 (en) | 2007-05-04 | 2010-03-25 | Titan Spine, Llc | Composite telescoping anterior interbody spinal implant |
AU2008270563B2 (en) | 2007-06-28 | 2012-04-19 | Spinal Elements, Inc. | Spinal stabilization device |
EP2022447A1 (en) | 2007-07-09 | 2009-02-11 | Astra Tech AB | Nanosurface |
US20090014243A1 (en) | 2007-07-13 | 2009-01-15 | Petrolink Usa, Llc | Breather-sampling-filler assembly for liquid reservoirs/systems |
US8172854B2 (en) | 2007-07-19 | 2012-05-08 | Spinal Elements, Inc. | Attachable instrument guide with detachable handle |
CA2697710A1 (en) | 2007-08-24 | 2009-03-05 | Spinal Elements, Inc. | Loop rod spinal stabilization device |
ES2315194B1 (en) | 2007-09-10 | 2010-02-26 | Francisco J. GARCIA SABAN | PROCEDURE TO OBTAIN A NEW SURFACE OF A METAL IMPLANT BASED ON TITANIUM INTENDED TO BE INSERTED IN OSEO FABRIC. |
US8182534B2 (en) | 2007-09-27 | 2012-05-22 | K2M, Inc. | Orthopedic device assembly with elements coupled by a retaining structure |
US20090187247A1 (en) | 2008-01-23 | 2009-07-23 | Metcalf Jr Newton H | Spinal implant having a resorbable anchor device for temporarily securing an interbody device to adjacent upper and lower vertebrae |
USD599019S1 (en) | 2008-03-07 | 2009-08-25 | Nuvasive, Inc. | Spinal fusion implant |
US8864770B2 (en) | 2008-03-12 | 2014-10-21 | Spinal Elements, Inc. | Offset opposing arm spinal implant distractor/inserter |
US9357985B2 (en) | 2008-05-15 | 2016-06-07 | Spinal Elements, Inc. | Method for accessing a spinal facet joint |
WO2010045255A1 (en) | 2008-10-14 | 2010-04-22 | Praxis Powder Technology, Inc. | Hybrid intervertebral spinal implant |
DE102009014184A1 (en) | 2008-11-07 | 2010-05-20 | Advanced Medical Technologies Ag | Implant for fusion of spinal segments |
US8864767B2 (en) | 2008-11-10 | 2014-10-21 | Spinal Elements, Inc. | Rod reducer instrument for spinal surgery |
KR101122494B1 (en) | 2009-02-12 | 2012-02-29 | 서울대학교산학협력단 | Surface Modifying Process of Non-Bioactive Materials |
DE102009011648A1 (en) | 2009-03-04 | 2010-09-09 | Advanced Medical Technologies Ag | Implant system with support elements |
US9220547B2 (en) | 2009-03-27 | 2015-12-29 | Spinal Elements, Inc. | Flanged interbody fusion device |
US8454707B2 (en) | 2009-04-03 | 2013-06-04 | University Of Maryland | Biomedical implantable material and methods of producing the same |
CA2759249A1 (en) | 2009-04-23 | 2010-10-28 | Spinal Elements, Inc. | Transverse connectors |
US8475536B2 (en) | 2010-01-29 | 2013-07-02 | DePuy Synthes Products, LLC | Methods and devices for implants with improved cement adhesion |
US8303879B2 (en) | 2010-02-01 | 2012-11-06 | Sb Technologies, Llc | Composite interbody device and method of manufacture |
WO2011116136A1 (en) | 2010-03-16 | 2011-09-22 | Pinnacle Spine Group, Llc | Intervertebral implants and graft delivery systems and methods |
US8641418B2 (en) | 2010-03-29 | 2014-02-04 | Biomet 3I, Llc | Titanium nano-scale etching on an implant surface |
-
2012
- 2012-07-25 US US13/557,727 patent/US8814939B2/en active Active
-
2013
- 2013-06-28 US US13/930,424 patent/US20130292357A1/en not_active Abandoned
-
2014
- 2014-08-04 US US14/450,316 patent/US20150012100A1/en not_active Abandoned
Patent Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5865845A (en) * | 1996-03-05 | 1999-02-02 | Thalgott; John S. | Prosthetic intervertebral disc |
US20020156529A1 (en) * | 1998-03-11 | 2002-10-24 | Panjian Li | Surface-mineralized spinal implants |
WO2006102347A2 (en) * | 2005-03-21 | 2006-09-28 | The Regents Of The University Of California | Controllable nanostructuring on micro-structured surfaces |
US20080262623A1 (en) * | 2005-05-06 | 2008-10-23 | Titan Spine, Llc | Composite interbody spinal implant having openings of predetermined size and shape |
US20100274358A1 (en) * | 2009-02-25 | 2010-10-28 | Spinewelding Ag | Spine stabilization device, and method and kit for its implantation |
Cited By (16)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US10271959B2 (en) | 2009-02-11 | 2019-04-30 | Howmedica Osteonics Corp. | Intervertebral implant with integrated fixation |
US10463500B2 (en) | 2014-11-07 | 2019-11-05 | Industrial Technology Research Institute | Medical composite material, method for fabricating the same and applications thereof |
US10195816B2 (en) * | 2014-12-01 | 2019-02-05 | Industrial Technology Research Institute | Metal/polymer composite material and method for fabricating the same |
US11000386B2 (en) | 2015-01-14 | 2021-05-11 | Stryker European Holdings I, Llc | Spinal implant with porous and solid surfaces |
US10182923B2 (en) | 2015-01-14 | 2019-01-22 | Stryker European Holdings I, Llc | Spinal implant with porous and solid surfaces |
US10603182B2 (en) | 2015-01-14 | 2020-03-31 | Stryker European Holdings I, Llc | Spinal implant with fluid delivery capabilities |
US11266510B2 (en) | 2015-01-14 | 2022-03-08 | Stryker European Operations Holdings Llc | Spinal implant with fluid delivery capabilities |
US11623027B2 (en) | 2015-05-18 | 2023-04-11 | Stryker European Operations Holdings Llc | Partially resorbable implants and methods |
US10537666B2 (en) | 2015-05-18 | 2020-01-21 | Stryker European Holdings I, Llc | Partially resorbable implants and methods |
US10835388B2 (en) | 2017-09-20 | 2020-11-17 | Stryker European Operations Holdings Llc | Spinal implants |
US11622867B2 (en) | 2017-09-20 | 2023-04-11 | Stryker European Operations Holdings Llc | Spinal implants |
US10918497B1 (en) | 2017-10-24 | 2021-02-16 | Omnia Medical, LLC | Multi-material multi-component spinal implant |
US10751196B1 (en) | 2017-10-24 | 2020-08-25 | Omnia Medical, LLC | Multi-material multi-component spinal implant |
US10736752B1 (en) | 2017-10-24 | 2020-08-11 | Omnia Medical, LLC | Multi-material multi-component spinal implant |
US11766339B1 (en) | 2017-10-24 | 2023-09-26 | Omnia Medical, LLC | Multi-material multi-component spinal implant |
US11819418B1 (en) | 2017-10-24 | 2023-11-21 | Omnia Medical, LLC | Multi-material multi-component spinal implant |
Also Published As
Publication number | Publication date |
---|---|
US8814939B2 (en) | 2014-08-26 |
US20120316650A1 (en) | 2012-12-13 |
US20130292357A1 (en) | 2013-11-07 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US8814939B2 (en) | Implants having three distinct surfaces | |
US9011546B2 (en) | Composite implants having integration surfaces composed of a regular repeating pattern | |
US9655745B2 (en) | Methods for manufacturing implants having integration surfaces | |
US9327051B2 (en) | Implants with integration surfaces having regular repeating surface patterns | |
US20130304218A1 (en) | Process of fabricating implants having internal features for graft retention and load transfer between implant and vertebrae | |
US9125756B2 (en) | Processes for producing regular repeating patterns on surfaces of interbody devices | |
EP2877128B1 (en) | Implants having three distinct surfaces | |
US9848995B2 (en) | Process for fabricating bioactive vertebral endplate bone-contacting surfaces on a spinal implant | |
US9168147B2 (en) | Self-deploying locking screw retention device | |
US9498349B2 (en) | Expandable spinal implant with expansion wedge and anchor | |
US8480749B2 (en) | Friction fit and vertebral endplate-preserving spinal implant | |
US9642721B2 (en) | Implants with self-deploying anchors | |
US11510786B2 (en) | Corpectomy implants with roughened bioactive lateral surfaces | |
US20130282122A1 (en) | Interbody spinal implant having a roughened surface topography on one or more internal surfaces | |
EP2777725A2 (en) | Surface and subsurface chemistry of an integration surface | |
WO2013181234A1 (en) | Endplate-preserving spinal implant with an integration plate having a roughened surface topography |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
AS | Assignment |
Owner name: TITAN SPINE, LLC, WISCONSIN Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:ULLRICH, PETER F., JR.;PATTERSON, CHAD J.;SCHNEIDER, JENNIFER M.;SIGNING DATES FROM 20140812 TO 20140819;REEL/FRAME:033598/0239 |
|
STCB | Information on status: application discontinuation |
Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION |
|
AS | Assignment |
Owner name: MB FINANCIAL BANK, N.A., WISCONSIN Free format text: SECURITY INTEREST;ASSIGNOR:TITAN SPINE, LLC;REEL/FRAME:036799/0001 Effective date: 20151014 |
|
AS | Assignment |
Owner name: TITAN SPINE, LLC, WISCONSIN Free format text: SECURITY INTEREST;ASSIGNOR:FIFTH THIRD BANK SBM MB FINANCIAL BANK, N.A.;REEL/FRAME:050188/0722 Effective date: 20190627 |