US20230157834A1 - Magnetic intervertebral disc replacement devices and methods thereof - Google Patents
Magnetic intervertebral disc replacement devices and methods thereof Download PDFInfo
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- US20230157834A1 US20230157834A1 US18/099,505 US202318099505A US2023157834A1 US 20230157834 A1 US20230157834 A1 US 20230157834A1 US 202318099505 A US202318099505 A US 202318099505A US 2023157834 A1 US2023157834 A1 US 2023157834A1
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Images
Classifications
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- 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
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- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/442—Intervertebral or spinal discs, e.g. resilient
- A61F2/4425—Intervertebral or spinal discs, e.g. resilient made of articulated components
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- 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
- A61F2002/3006—Properties of materials and coating materials
- A61F2002/30079—Properties of materials and coating materials magnetic
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- 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
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- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
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- 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
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- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
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- 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
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- A61F2310/00035—Other metals or alloys
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- 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
- A61F2310/00089—Zirconium or Zr-based alloys
Definitions
- the present invention relates generally to prosthetic devices and their use.
- the present invention relates to devices containing magnets for use in replacing intervertebral discs.
- the spine provides the primary support for the body and is comprised of 33 individual bones, or vertebrae.
- the spine is divided into five regions: the cervical, thoracic, and lumbar regions, which are made up of 24 vertebrae that are movable; and the sacral and coccygeal regions, which comprise 9 vertebrae that are fused or unmovable.
- each vertebra 1 consists of a vertebral body 3 , a vertebral arch 5 , and posterior processes 7 that extend from the vertebral arch 5 .
- the movable vertebrae are stacked in series and are separated and cushioned by an intervertebral disc 20 .
- motion segment The unit formed by two adjacent vertebrae and the intervertebral disc therebetween (along with adjoining ligaments) is referred to as a “motion segment” or “spine segment” 15 , and it is regarded as the smallest physiological motion unit of the spine to exhibit biomechanical characteristics that are similar to those of the entire spine.
- the intervertebral disc 20 is composed of an annulus or outer ring of fibrous tissue 23 and the nucleus pulposus 25 , which is a gel-like substance contained within the annulus 23 and between the cartilaginous endplates (not shown) of the adjacent vertebral bodies 3 .
- the nucleus pulposus 25 acts as an incompressible fluid and forms a hard sphere-like structure within the nuclear recess or fossa (not shown) of the endplates, resembling a fulcrum to give mobility to the spine. Stability of the spine is achieved by balancing loads in the intervertebral disc 20 and the two facet joints 9 .
- Degenerative disc disease affects the physiology and function of the intervertebral disc and may be caused by aging, protrusion of the nucleus pulposus into the annulus or endplates, trauma, arthritis, or other causes.
- the result of the disease is a change in the biomechanical properties of the disc, often including a reduction in disc height that alters the loading pattern of the disc.
- Degeneration of the disc also frequently results in degeneration of the facet joints, loss of stability of the motion segment, and compression of the nerves branching out of the spinal column. Compression of these nerves can cause clinical symptoms including pain.
- Surgical treatments for degenerative disc disease include discectomy (surgical removal of abnormal intervertebral disc material), fusion (surgical technique that joins two or more vertebrae), and others.
- discectomy and fusion can alter the biomechanics of the motion segment and can often lead to degeneration of the adjacent motion segments. And even though a segment is fused or motion is prevented, pain and clinical symptoms frequently persist. For this reason, replacement of the intervertebral disc, which aims to preserve and restore normal motion to the spine segment, has emerged as an important treatment option.
- disc replacement was not approved in the United States by the FDA until 2004.
- Materials that can be used in the construction of disc replacements include medical grade plastics (primarily polyethylene and polyetheretherketone (PEEK)), metals (primarily cobalt chromium and titanium alloys), and ceramics (including aluminum oxide, zirconia, and others).
- Disc designs include two-piece designs consisting of two plates that attach to the adjacent vertebral bodies and that have surfaces which articulate against each other, such as a cup-and-dish configuration. These types of devices often have a polymeric surface and a metallic surface that articulate, but metal/metal and polymer/polymer devices have also been available.
- the polymeric surface(s) may be contained within a metal shell, which provides a surface optimized for attachment to the vertebral body endplates.
- disc replacements may have a three-piece design, containing two plates (usually metallic) that attach to the vertebral endplates, and a soft, usually polymeric, spacer that articulates between the two surfaces.
- the present invention relates to intervertebral disc replacement devices and methods for their use in treating or preventing degenerative disc disease.
- An aspect of the invention relates to an intervertebral disc replacement device that comprises a first, or “superior,” plate and a second, or “inferior,” plate, in which each plate contains one or more magnets.
- Each plate comprises a fixation surface, an inner surface, and an edge surface.
- the magnet(s) in the superior plate and the magnet(s) in the inferior plate are oriented such that a magnetic force exists between the magnet(s) in the superior plate and the magnet(s) in the inferior plate.
- the magnetic force is repulsive.
- the fixation surface of the superior plate and/or the inferior plate comprises a surface geometry or a surface feature that helps adhere the plate to a vertebra endplate.
- the fixation surface, the inner surface, or both, of the superior plate and/or the inferior plate may be flat or may comprise a curvature.
- a linking material is attached to both the superior plate and the inferior plate.
- An aspect of the invention relates to an intervertebral disc replacement device that comprises a superior plate and an inferior plate, in which each plate contains one or more magnets.
- Each plate comprises a fixation surface, an articulating surface, and an edge surface.
- the articulating surface of the superior plate is configured to articulate against the articulating surface of the inferior plate.
- the magnet(s) in the superior plate and the magnet(s) in the inferior plate are oriented such that a magnetic force exists between the magnet(s) in the superior plate and the magnet(s) in the inferior plate.
- the magnetic force is repulsive.
- the fixation surface of the superior plate and/or the inferior plate comprises a surface geometry or a surface feature that helps adhere the plate to a vertebra endplate.
- an intervertebral disc replacement device that comprises a superior plate, an inferior plate, and a spacer positioned between the superior and inferior plates.
- the superior and inferior plates each comprise a fixation surface, an articulating surface, and an edge surface
- the spacer comprises a superior articulating surface, an inferior articulating surface, and an edge surface.
- the articulating surface of the superior plate is configured to articulate against the superior articulating surface of the spacer
- the articulating surface of the inferior plate is configured to articulate against the inferior articulating surface of the spacer.
- each plate contains one or more magnets, and, in certain embodiments, the magnet(s) in each of the plates are oriented such that a magnetic force exists between the magnet(s) of the superior plate and the magnet(s) of the inferior plate.
- each plate and the spacer contain one or more magnets and, in certain embodiments, the magnet(s) in each of the plates and the spacer are oriented such that a magnetic force exists between the magnet(s) of the superior plate and the magnet(s) of the spacer, and/or between the magnet(s) of the inferior plate and the magnet(s) of the spacer.
- the magnetic force may be repulsive or attractive.
- the fixation surface of the superior plate and/or the inferior plate comprises a surface geometry or a surface feature that helps adhere the plate to a vertebra endplate.
- a further aspect of the invention relates to (i) a method of treating degenerative disc disease in an intervertebral disc, (ii) a method of relieving pain caused by degenerative disc disease in an intervertebral disc, or (iii) a method of reducing pain caused by degenerative disc disease in an intervertebral disc; these methods comprise implanting an intervertebral disc replacement device described above.
- FIGS. 1 A and 1 B are different views of a motion segment of the human spine.
- FIG. 1 A is a lateral view of the motion segment
- FIG. 1 B is an anterior view of the motion segment.
- FIGS. 2 A and 2 B are different views of a two-plate non-contacting intervertebral disc replacement device according to embodiments of the present invention.
- FIG. 2 A is a lateral view of the device
- FIG. 2 B is an anterior view of the device.
- FIGS. 3 A and 3 B are different views of a two-plate non-contacting intervertebral disc replacement device according to embodiments of the present invention, in which the device includes a linking material between each plate.
- FIG. 3 A is a lateral view of the device
- FIG. 3 B is an anterior view of the device.
- FIGS. 4 A and 4 B are different views of a two-plate contacting intervertebral disc replacement device according to embodiments of the present invention.
- FIG. 4 A is a lateral view of the device
- FIG. 4 B is an anterior view of the device.
- FIGS. 5 A and 5 B are different views of a two-plate-with-spacer contacting intervertebral disc replacement device according to embodiments of the present invention.
- FIG. 5 A is a lateral view of the device
- FIG. 5 B is an anterior view of the device.
- FIGS. 6 A and 6 B are different views of a two-plate non-contacting intervertebral disc replacement device according to embodiments of the present invention, implanted into a motion segment of a human spine.
- FIG. 6 A is lateral view of the device implanted into the motion segment
- FIG. 6 B is an anterior view of the device implanted into the motion segment.
- FIGS. 7 A and 7 B are different views of a two-plate non-contacting intervertebral disc replacement device according to embodiments of the present invention, implanted into a motion segment of a human spine, in which the magnet of the superior plate and the magnet of the inferior plate are shown.
- FIG. 7 A is lateral view of the device implanted into the motion segment
- FIG. 7 B is an anterior view of the device implanted into the motion segment.
- FIGS. 8 A and 8 B are different views of a two-plate non-contacting intervertebral disc replacement device according to embodiments of the present invention, implanted into a motion segment of a human spine, in which the device includes a linking material between each plate.
- FIG. 8 A is lateral view of the device implanted into the motion segment
- FIG. 8 B is an anterior view of the device implanted into the motion segment.
- FIGS. 9 A and 9 B are different views of a two-plate non-contacting intervertebral disc replacement device according to embodiments of the present invention, implanted into a motion segment of the human spine, in which the device includes a material between each plate and the magnet of a superior plate and the magnet of the inferior plate are shown.
- FIG. 9 A is lateral view of the device implanted into the motion segment
- FIG. 9 B is an anterior view of the device implanted into the motion segment.
- FIGS. 10 A and 10 B are different views of a two-plate contacting intervertebral disc replacement device according to embodiments of the present invention, implanted into a motion segment of a human spine.
- FIG. 10 A is lateral view of the device implanted into the motion segment
- FIG. 10 B is an anterior view of the device implanted into the motion segment.
- FIGS. 11 A and 11 B are different views of a two-plate contacting intervertebral disc replacement device according to embodiments of the present invention, implanted into a motion segment of a human spine, in which the magnet of the superior plate and the magnet of the inferior plate are shown.
- FIG. 11 A is lateral view of the device implanted into the motion segment
- FIG. 11 B is an anterior view of the device implanted into the motion segment.
- FIGS. 12 A and 12 B are different views of a two-plate-with-spacer contacting intervertebral disc replacement device according to embodiments of the present invention, implanted into a motion segment of the human spine.
- FIG. 12 A is lateral view of the device implanted into the motion segment
- FIG. 12 B is an anterior view of the device implanted into the motion segment.
- FIGS. 13 A and 13 B are different views of a two-plate-with-spacer contacting intervertebral disc replacement device according to embodiments of the present invention, implanted into a motion segment of the human spine, in which the magnet of the superior plate and the magnet of the inferior plate are shown.
- FIG. 13 A is lateral view of the device implanted into the motion segment
- FIG. 13 B is an anterior view of the device implanted into the motion segment.
- FIGS. 14 A and 14 B are different views of a two-plate-with-spacer contacting intervertebral disc replacement device according to embodiments of the present invention, implanted into a motion segment of the human spine, in which the magnet of the superior plate, the magnet of the inferior plate, and the magnet of the spacer are shown.
- FIG. 14 A is lateral view of the device implanted into the motion segment
- FIG. 14 B is an anterior view of the device implanted into the motion segment.
- FIGS. 15 A and 15 B are different views of a two-plate-with-spacer contacting intervertebral disc replacement device according to embodiments of the present invention, implanted into a motion segment of the human spine, in which the magnet of the superior plate, the magnet of the inferior plate, and the magnets of the spacer that are in association with each articulating surface of the spacer are shown.
- FIG. 15 A is lateral view of the device implanted into the motion segment
- FIG. 15 B is an anterior view of the device implanted into the motion segment.
- FIG. 16 is a plot of the repulsion forces generated between the magnets of the disc replacement devices according to embodiments of the present invention at various magnet diameters and separation distances, and with a magnet thickness of 3 mm, as set forth in Example 1.
- FIG. 17 is a plot of the repulsion forces generated between the magnets of the disc replacement devices according to embodiments of the present invention at various magnet diameters and separation distances, and with a magnet thickness of 5 mm, as set forth in Example 1.
- FIG. 18 is a plot of the repulsion forces generated between the magnets of the disc replacement devices according to embodiments of the present invention at various magnet thicknesses and separation distances, and with a magnet diameter of 25 mm, as set forth in Example 1.
- FIG. 19 shows the angle of the magnets of a two-plate non-contact intervertebral disc replacement device according to embodiments of the present invention, as analyzed in Example 2.
- FIG. 20 shows the magnetic fields generated from the magnets of a two-plate non-contact intervertebral disc replacement device according to embodiments of the present invention, as analyzed in Example 2.
- the present invention relates to intervertebral disc replacement devices and methods thereof.
- the intervertebral disc replacement device of the present invention comprises magnets, which, upon implantation, generate a magnetic force field to maintain and/or control separation of the two vertebral bodies adjacent to the disc that is being replaced.
- the separation distance allows a normal range—or at least a desired range—of motion in all planes.
- An aspect of the invention relates to an intervertebral disc replacement device that comprises a superior plate and an inferior plate, in which each plate contains one or more magnets embedded therein.
- the superior plate is fixated to the adjacent vertebra superior to the disc that is being replaced
- the inferior plate is fixated to the adjacent vertebra inferior to the disc that is being replaced
- the superior plate and inferior plate are separated by a distance from each other, and thus there is no contact.
- the terms “superior” and “inferior” reflect how these plates are positioned relative to each other when the device is implanted as a disc replacement.
- a benefit of the two-plate non-contacting device compared to all other disc replacements is that there is no wear and no wear debris generated by the plates. Such a result occurs, because the plates do not have any contacting surfaces, or at least the contacting surfaces are reduced. Wear debris can and often does have serious detrimental effects on the tissues surrounding any articulating joint replacement and may be a major factor in failure and need for revision of the device. This is primarily due to the adverse tissue reaction that wear debris particles can elicit as a result of their size and composition.
- Superior plate 100 and inferior plate 100 ′ may each comprise a fixation surface 105 and 105 ′, respectively; an inner surface 110 and 110 ′, respectively; and an edge surface 115 and 115 ′, respectively.
- fixation surface 105 and 105 ′ may each comprise a fixation surface 105 and 105 ′, respectively; an inner surface 110 and 110 ′, respectively; and an edge surface 115 and 115 ′, respectively.
- fixation surface 105 and 105 ′ may face the endplate of the vertebrae adjacent to the intervertebral disc that is being replaced, such that fixation surface 105 may face the endplate of vertebra 1 that is superior to the disc that is being replaced, and fixation surface 105 ′ may face the endplate of vertebra 1 ′ that is inferior to the intervertebral disc that is being replaced.
- inner surface 110 of superior plate 100 may face inner surface 110 ′ of inferior plate 100 ′.
- Edge surface 115 and 115 ′ refers to the surface that is formed from the thickness of the plate 100 and 100 ′, respectively.
- Each plate may also comprise a fixation extension that extends beyond the fixation surface of the plate. This is illustrated in FIGS. 2 A- 3 B , in which plate 100 and 100 ′ comprises fixation extension 120 and 120 ′.
- the fixation extension may comprise a single unit (see, e.g., fixation extension 120 ′ of inferior plate 100 ′ shown in FIG. 2 B or 3 B ) or may comprise more than one unit (see, e.g., fixation extension 120 of superior plate 100 shown in FIG. 2 A or 3 A ).
- fixation extension 120 and 120 ′ may be a surface that can adhere to the outside surface of vertebral body 3 and 3 ′, respectively, of vertebra 1 and 1 ′, respectively, that are adjacent to the intervertebral disc being replaced.
- Each plate may generally have the same shape, although that shape may vary.
- the plate may comprise a shape that generally resembles a sphere, cylinder, ellipsoid, prism (e.g., cube, rectangular prism, triangular prism, pentagonal prism, hexagonal prism, etc.), pyramid, cone, or other three-dimensional shapes known in the art.
- the plates may comprise a cross-sectional shape that generally resembles the cross-sectional shape of the vertebral body portion of a vertebra.
- the plates may comprise a shape that resembles, is derived from, or is largely the same as, plates that are apart of intervertebral disc replacement devices known in the art.
- intervertebral disc replacement devices include those that are described in U.S. Pat. Nos. 6,001,130, 7,491,240, 7,494,508, 7,766,966, 8,353,964, 8,858,635, 8,911,498, 9,566,164, and 9,883,945, each of which are incorporated herein by reference.
- each plate may be flat as shown in FIGS. 2 A- 3 B (see fixation surface 105 and 105 ′ and inner surface 110 and 110 ′); (ii) may be curved (not shown); or (iii) a combination thereof (e.g., some portions of the surfaces are flat, while other portions are curved) (not shown).
- a curvature may be present on the inner surface of one or both plate as needed to provide the desired distances for separation between the plates, and/or to prevent contact between the inner surface of the superior plate and the inner surface f inferior plate at potential extreme angles of motion or translation.
- the fixation surface of the plates may comprise a surface geometry, a surface feature, or a combination thereof, that can help adhere the plates to the endplates of the vertebrae adjacent to the intervertebral disc that is being replaced.
- the surface geometry and/or surface feature may also provide initial stability and resistance to torsional or shear loading to the plates.
- a surface geometry for the present invention may include, but is not limited to, a texture, porous coating, bioactive coating, and a combination thereof.
- a surface feature for the present invention may include, but is not limited to, one or more keels, one or more pegs, one or more screws, and the like, including a combination thereof.
- the inner surface of the plates may be polished or may have an as-fabricated surface.
- the inner surface may have a surface geometry and/or surface feature as described above.
- the diameter or, in the case of a non-circular plate, long axis (widest distance across) of the plates (shown as 125 and 125 ′ of plate 100 and 100 ′, respectively, in FIGS. 2 A- 3 B ) may be about 3 mm to about 50 mm, or about 5 mm to about 30 mm, or about 10 mm to about 20 mm.
- the thickness of the plates (shown as 126 and 126 ′ of plate 100 and 100 ′, respectively, in FIGS. 2 A- 3 B ) may be about 1 mm to about 15 mm, or about 2 mm to about 10 mm, or about 4 mm to about 8 mm.
- the fixation extensions may extend beyond the fixation surface by a distance (shown as 127 and 127 ′ of plate 100 and 100 ′, respectively, in FIGS. 2 A- 3 B ) of about 0.5 to 5 mm, or about 1 to about 3 mm.
- the plates may be of a material appropriate for implantation into the body.
- the material may be a metal such as titanium or cobalt chromium alloys; a biopolymer such as PEEK; a ceramic such as aluminum oxide or zirconia alloys; or a combination thereof.
- a linking material may be attached to both the superior and inferior plates.
- the material may be between each plate, may cover each plate or a portion of each plate, or both.
- the material may be between each plate, such as attached to the inner surface of each plate.
- FIGS. 3 A and 3 B shows a superior plate 100 and an inferior plate 100 ′, in which a linking material 140 is located between—and attached to—each plate 100 and 100 ′.
- the material 140 may be a mesh or similar fabric or a soft material, such as a polyurethane or other polymeric or rubber material. The material may allow the device to be implanted as one piece.
- Each plate comprises one or more appropriate-sized rare earth magnets.
- the one or more magnets may be embedded within the plates, such that the magnet(s) are not exposed to outside of the plate.
- the shape of the magnets includes, but is not limited to, a shape that generally resembles a sphere, cylinder, hollow cylinder, ellipsoid, prism (e.g., cube, rectangular prism, triangular prism, pentagonal prism, hexagonal prism, etc.), hollow prism, pyramid, cone, torus, or other three-dimensional shapes known in the art.
- more than one magnet may be present in a plate, such as in a configuration or array that provides the appropriate magnetic field for interacting with the magnet(s) of the other plate. If more than one magnet is present, the magnets may have any of the shapes described above, or portions thereof.
- the magnets may comprise materials known in the art.
- the magnets may be iron-based, nickel-based, cobalt-based, or an alloy of rare-earth metals.
- the magnets may be a rare-earth magnet, which generally has strong attraction and repulsion forces and have high retentive capacity and resistance to demagnification.
- the rare-earth magnet is an alloy of neodymium, iron, and boron (“NdFeB”). NdFeB magnets provide strong permanent magnetism, high retentive capacity, and resistance to demagnetization.
- the diameter or, in the case of a non-circular magnet, long axis (widest distance across) of the magnet(s) may be about 5 mm to about 30 mm, or about 10 mm to about 20 mm.
- the thickness of the magnet(s) plate may be about 0.5 mm to about 10 mm, or about 1 mm to about 6 mm.
- Example 1 One of ordinary skill in the art would be able to determine the arrangement of magnet(s) in the superior plate and magnet(s) in the inferior plate in order to achieve a prescribed magnetic force between the magnet(s) of the superior plate and the magnet(s) of the inferior plate, based upon the teachings in the Examples provided below.
- the skilled artisan would understand from Example 1 the factors that impact the generated magnetic force, including magnet thickness, the magnet diameter, and the separation distance between the magnets, and understand the size of the magnets and arrangement of the magnets within the superior and inferior plates necessary to apply the prescribed force.
- the skilled artisan can determine how to arrange the magnets by considering the size and dimensions of the space of the disc that requires replacement, the type of force that is required for the treatment (e.g., a levitating force or a reducing force to decrease wear), as well as other factors such as the subject's weight, height, activity level, etc., which could all have an effect on loading forces experienced in the spine.
- the type of force that is required for the treatment e.g., a levitating force or a reducing force to decrease wear
- other factors such as the subject's weight, height, activity level, etc., which could all have an effect on loading forces experienced in the spine.
- An aspect of the invention relates to an intervertebral disc replacement device that comprises a superior plate and an inferior plate, in which each plate contains one or more magnets embedded therein.
- the superior plate is fixated to the adjacent vertebra superior to the disc that is being replaced
- the inferior plate is fixated to the adjacent vertebra inferior to the disc that is being replaced
- the superior plate and the inferior plate are in contact with each other via articulating surfaces.
- an advantage of a two-plate contacting device with non-zero loading across the articulating surfaces may be the additional stability provided by the articulating surfaces.
- Such stability helps produce and maintain normal or desired size and motion, as well as constrain any abnormal motions or translations created by the magnetic fields generated from the embedded magnets or by the body.
- the additional stability provided by the two-plate contacting device can help reduce wear and the generation of wear debris. As noted above, wear debris can elicit an adverse tissue reaction which can lead to treatment failure and need for device removal.
- Superior plate 200 and inferior plate 200 ′ may each comprise a fixation surface 205 and 205 ′, respectively; an articulating surface 210 and 210 ′, respectively; and an edge surface 215 and 215 ′, respectively.
- fixation surface 205 and 205 ′ may be fixated to a fixation surface 205 and 205 ′, respectively; an articulating surface 210 and 210 ′, respectively; and an edge surface 215 and 215 ′, respectively.
- fixation surface 205 and 205 ′ may face the endplate of the vertebrae adjacent to the intervertebral disc that is being replaced, such that fixation surface 205 may face the endplate of vertebra 1 that is superior to the disc that is being replaced, and fixation surface 205 ′ may face the endplate of vertebra 1 ′ that is inferior to the intervertebral disc that is being replaced. Further, articulating surface 210 of the superior plate 200 may articulate against articulating surface 210 ′ of inferior plate 200 ′. Edge surface 215 and 215 ′ is formed from the thickness of plate 200 and 200 ′, respectively.
- Each plate may also comprise a fixation extension that extends beyond the fixation surface of the plate. This is illustrated in FIGS. 4 A and 4 B , in which plate 200 and 200 ′ comprises fixation extension 220 and 220 ′, respectively.
- the fixation extension may comprise a single unit (see, e.g., fixation extension 220 ′ of inferior plate 200 ′ shown in FIG. 4 B ) or may comprise more than one unit (see, e.g., fixation extension 220 of superior plate 200 shown in FIG. 4 A ).
- fixation extension may comprise a single unit (see, e.g., fixation extension 220 ′ of inferior plate 200 ′ shown in FIG. 4 B ) or may comprise more than one unit (see, e.g., fixation extension 220 of superior plate 200 shown in FIG. 4 A ).
- fixation extension 220 and 220 ′ may be a surface that can adhere to the outside surface of vertebral body 3 and 3 ′, respectively, of vertebra 1 and 1 ′, respectively, that are adjacent to the intervertebral disc being replaced.
- Each plate may generally have the same shape, although that shape may vary.
- the plates may comprise a shape that generally resembles a sphere, cylinder, ellipsoid, prism (e.g., cube, rectangular prism, triangular prism, pentagonal prism, hexagonal prism, etc.), pyramid, cone, or other three-dimensional shapes known in the art.
- each plate may comprise a cross-sectional shape that generally resembles the cross-sectional shape of the vertebral body portion of a vertebra.
- the plates may comprise a shape that resembles, is derived from, or is largely the same as, plates that are apart of intervertebral disc replacement devices known in the art.
- intervertebral disc replacement devices include those that are described in U.S. Pat. Nos. 6,001,130, 7,491,240, 7,494,508, 7,766,966, 8,353,964, 8,858,635, 8,911,498, 9,566,164, and 9,883,945, each of which are incorporated herein by reference.
- the fixation surface of each plate may be flat as shown in FIGS. 4 A and 4 B (see fixation surface 205 and 205 ′); (ii) may be curved (not shown); or (ii) a combination thereof (e.g., some portions of the surfaces are flat, while other portions are curved) (not shown).
- the fixation surface of the plates may comprise a surface geometry, a surface feature, or a combination thereof, that can help adhere the plates to the endplates of the vertebrae adjacent to the intervertebral disc that is being replaced.
- the surface geometry and/or surface feature may also provide initial stability and resistance to torsional or shear loading to plates.
- a surface geometry for the present invention may include, but is not limited to, a texture, porous coating, bioactive coating, and a combination thereof.
- a surface feature for the present invention may include, but is not limited to, one or more keels, one or more pegs, one or more screws, and the like, including a combination thereof.
- the articulating surface of the superior plate and the articulating surface of the inferior plate may have conforming or near-conforming geometries to allow motion through articulation of these surfaces.
- conforming or near-conforming geometries include those resembling a ball-and-socket interface; a cup-and-dish interface; a flat-surface interface; toroidal-surface interface such as the surfaces described in U.S. Pat. No. 9,173,748, which is incorporated herein by reference; or the like.
- the diameter or, in the case of a non-circular plate, long axis (widest distance across) of the plates may be about 3 mm to about 50 mm, or about 5 mm to about 30 mm, or about 10 mm to about 20 mm.
- the thickness of the plates may be about 1 mm to about 15 mm, or about 2 mm to about 10 mm, or about 4 mm to about 8 mm.
- the fixation extensions may extend beyond the fixation surface by a distance (shown as 227 and 227 ′ of plate 200 and 200 ′, respectively, in FIGS. 4 A and 4 B ) of about 0.5 to 5 mm, or about 1 to about 3 mm.
- the plates may be of a material appropriate for implantation into the body.
- the material may be a metal such as titanium or cobalt chromium alloys; a biopolymer such as PEEK; a ceramic such as aluminum oxide or zirconia alloys; or a combination thereof.
- Each plate comprises one or more appropriate-sized rare earth magnets.
- the one or more magnets may be embedded within the plates, such as embedded in the articulating surface of the superior plate and/or in the articulating surface of the inferior plate; however, the magnet(s) are not exposed to outside of the plate.
- the shape of the magnets includes, but is not limited to, a shape that generally resembles a sphere, cylinder, hollow cylinder, ellipsoid, prism (e.g., cube, rectangular prism, triangular prism, pentagonal prism, hexagonal prism, etc.), hollow prism, pyramid, cone, torus, or other three-dimensional shapes known in the art.
- more than one magnet may be present in a plate, such as in a configuration or array that provides the appropriate magnetic field for interacting with the magnet(s) of the other plate. If more than one magnet is present, the magnets may have any of the shapes described above, or portions thereof.
- the magnets may comprise materials known in the art.
- the magnets may be iron-based, nickel-based, cobalt-based, or an alloy of rare-earth metals.
- the magnets may be a rare-earth magnet, which generally has strong attraction and repulsion forces and have high retentive capacity and resistance to demagnification.
- the rare-earth magnet is an alloy of NdFeB.
- the diameter or, in the case of a non-circular magnet, long axis (widest distance across) of the magnet(s) may be about 5 mm to about 30 mm, or about 10 mm to about 20 mm.
- the thickness of the magnet(s) plate may be about 0.5 mm to about 10 mm, or about 1 mm to about 6 mm.
- Example 1 One of ordinary skill in the art would be able to determine the arrangement of magnet(s) in the superior plate and magnet(s) in the inferior plate in order to achieve a prescribed magnetic force between the magnet(s) of the superior plate and the magnet(s) of the inferior plate, based upon the teachings in the Examples provided below.
- the skilled artisan would understand from Example 1 the factors that impact the generated magnetic force, including magnet thickness, the magnet diameter, and the separation distance between the magnets, and understand the size of the magnets and arrangement of the magnets within the superior and inferior plates necessary to apply the prescribed force.
- the skilled artisan can determine how to arrange the magnets by considering the size and dimensions of the space of the disc that requires replacement, the type of force that is required for the treatment (e.g., a levitating force or a reducing force to decrease wear), as well as other factors such as the subject's weight, height, activity level, etc., which could all have an effect on loading forces experienced in the spine.
- the type of force that is required for the treatment e.g., a levitating force or a reducing force to decrease wear
- other factors such as the subject's weight, height, activity level, etc., which could all have an effect on loading forces experienced in the spine.
- An aspect of the invention relates to an intervertebral disc replacement device that comprises a superior plate, an inferior plate, and a spacer.
- the superior plate is fixated to the adjacent vertebra superior to the disc that is being replaced
- the inferior plate is fixated to the adjacent vertebra inferior to the disc that is being replaced
- the spacer is between the superior and inferior plates.
- Each plate contains one or more magnets embedded therein and optionally, the spacer may have one or more magnets embedded therein.
- an advantage of a two-plate-with-spacer contacting device may be the additional decrease in wear and generation of wear debris.
- the spacer may comprise one or more magnets that interact with the magnet(s) of the superior and/or inferior plates and decrease the separation distance between the magnet surfaces, therefore providing additional stability to the intervertebral disc replacement device.
- Superior plate 300 and inferior plate 300 ′ may each comprise a fixation surface 305 and 305 ′, respectively; an articulating surface 310 and 310 ′, respectively; and an edge surface 315 and 315 ′, respectively.
- Spacer 350 may comprise a superior articulating surface 355 , an inferior articulating surface 360 , and an edge surface 365 .
- fixation surface 305 and 305 ′ may face the endplate of the vertebrae adjacent to the intervertebral disc that is being replaced, such that fixation surface 305 may face the endplate of vertebra 1 that is superior to the disc that is being replaced, and fixation surface 305 ′ may face the endplate of vertebra 1 ′ that is inferior to the intervertebral disc that is being replaced; superior articulating surface 355 of spacer 350 may form an articulating interface with articulating surface 310 of superior plate 300 ; and inferior articulating surface 360 of spacer 350 may form an articulating interface with articulating surface 310 ′ of inferior plate 300 ′.
- Edge surface 315 and 315 ′, and 365 is formed from the thickness of plates 300 and 300 ′ and of spacer 350 , respectively.
- Each plate may also comprise a fixation extension that extends beyond the fixation surface of the plate. This is illustrated in FIGS. 5 A and 5 B , in which plate 300 and 300 ′ comprises fixation extension 320 and 320 ′, respectively.
- the fixation extension may comprise a single unit (see, e.g., fixation extension 320 ′ of inferior plate 300 ′ shown in FIG. 5 B ) or may comprise more than one unit (see, e.g., fixation extension 320 of superior plate 300 shown in FIG. 5 A ).
- fixation extension may comprise a single unit (see, e.g., fixation extension 320 ′ of inferior plate 300 ′ shown in FIG. 5 B ) or may comprise more than one unit (see, e.g., fixation extension 320 of superior plate 300 shown in FIG. 5 A ).
- fixation extension 320 and 320 ′ may form a surface that can adhere to the outside surface of vertebral body 3 and 3 ′, respectively, of vertebra 1 and 1 ′, respectively, that are adjacent to the intervertebral disc being replaced.
- Each plate generally has the same shape, although that shape may vary.
- the plates may comprise a shape that generally resembles a sphere, cylinder, ellipsoid, prism (e.g., cube, rectangular prism, triangular prism, pentagonal prism, hexagonal prism, etc.), pyramid, cone, or other three-dimensional shapes known in the art.
- each plate may comprise a cross-sectional shape that generally resembles the cross-sectional shape of the vertebral body portion of a vertebra.
- the plates may comprise a shape that resembles, is derived from, or is largely the same as, plates that are apart of intervertebral disc replacement devices known in the art.
- intervertebral disc replacement devices include those that are described in U.S. Pat. Nos. 6,001,130, 7,491,240, 7,494,508, 7,766,966, 8,353,964, 8,858,635, 8,911,498, 9,566,164, and 9,883,945, each of which are incorporated herein by reference.
- the fixation surface of each plate may be flat as shown in FIGS. 5 A and 5 B (see fixation surfaces 305 and 305 ′); (ii) may be curved (not shown); or (iii) a combination thereof (e.g., some portions of the surfaces are flat, while other portions are curved) (not shown).
- the fixation surface of the plates may comprise a surface geometry, a surface feature, or a combination thereof, that can help adhere the plates to the endplates of the vertebrae adjacent to the intervertebral disc that is being replaced.
- the surface geometry and/or surface feature may also provide initial stability and resistance to torsional or shear loading to plates.
- a surface geometry for the present invention may include, but is not limited to, a texture, porous coating, bioactive coating, and a combination thereof.
- a surface feature for the present invention may include, but is not limited to, one or more keels, one or more pegs, one or more screws, and the like, including a combination thereof.
- the articulating surface of the superior plate and the superior articulating surface of the spacer may have conforming or near-conforming geometries to allow motion through articulation of these surfaces.
- the articulating surface of the inferior plate and the inferior articulating surface of the spacer may also have conforming or near-conforming geometries to allow motion through articulation of these surfaces. Examples of such conforming or near-conforming geometries include those resembling a ball-and-socket interface; a cup-and-dish interface; a flat-surface interface; toroidal-surface interface such as the surfaces described in U.S. Pat. No. 9,173,748, which is incorporated herein by reference; or the like.
- the diameter or, in the case of a non-circular plate, long axis (widest distance across) of the plates may be about 3 mm to about 50 mm, or about 5 mm to about 30 mm, or about 10 mm to about 20 mm.
- the thickness of the plates may be about 1 mm to about 15 mm, or about 2 mm to about 10 mm, or about 4 mm to about 8 mm.
- the fixation extensions may extend beyond the fixation surface by a distance (shown as 327 and 327 ′ of plate 300 and 300 ′, respectively, in FIGS. 5 A and 5 B ) of about 0.5 to 5 mm, or about 1 to about 3 mm.
- the spacer may comprise a shape that generally resembles a sphere, cylinder, ellipsoid, prism (e.g., cube, rectangular prism, triangular prism, pentagonal prism, hexagonal prism, etc.), pyramid, cone, or other three-dimensional shapes known in the art.
- the spacer may comprise a cross-sectional shape that generally resembles the cross-sectional shape of the superior and/or inferior plate.
- the diameter or, in the case of a non-circular spacer, long axis (widest distance across) of the spacer (shown as 375 of spacer 350 in FIGS. 5 A and 5 B ) may be about 1 mm to about 48 mm, or about 2 mm to about 45 mm.
- the thickness of the spacer (shown as 376 of spacer 350 in FIGS. 5 A and 5 B ) may be about 3 mm to about 25 mm, or about 5 mm to about 20 mm.
- the plates and the spacer may be of a material appropriate for implantation into the body.
- the plates may comprise a metal such as titanium or cobalt chromium alloys; a biopolymer such as PEEK; a ceramic such as aluminum oxide or zirconia alloys; or a combination thereof.
- the spacer may comprise a polymer.
- each plate may comprise one or more appropriate-sized rare earth magnets and the spacer does not comprise a magnet.
- the one or more magnets may be embedded within the plates, such as embedded in the articulating surface of the superior plate and in the articulating surface of inferior plate; however, the magnet(s) are not exposed to outside of the plate.
- the magnet(s) of the superior plate and the magnet(s) of the inferior plate may be oriented such that a repulsive magnetic force exists between the magnet(s) of the superior plate and the magnet(s) of the inferior plate.
- the magnet(s) of the superior plate and the magnet(s) of the inferior plate may be oriented such that an attractive magnetic force exists between the magnet(s) of the superior plate and the magnet(s) of the inferior plate.
- each plate and the spacer may comprise one or more appropriate-sized rare earth magnets.
- the one or more magnets may be embedded within the plates, such as embedded in the articulating surface of the superior plate and in the articulating surface of the inferior plate, and may be embedded within the spacer.
- the one or more magnets may be embedded in the superior articulating surface and/or in the inferior articular surface of the spacer; however, the magnet(s) are not exposed to outside of the plate or the spacer.
- the magnet(s) embedded in the spacer may be oriented such that a repulsive magnetic force exists with the magnet(s) embedded in the superior plate and/or a repulsive magnetic force exists with the magnet(s) embedded in the inferior plate.
- a repulsive magnetic force exists with the magnet(s) embedded in the superior plate and/or a repulsive magnetic force exists with the magnet(s) embedded in the inferior plate.
- each interface of two articulating surfaces experience a repulsive magnetic force in an effort to reduce contact stress and subsequent wear of the materials.
- the magnet(s) embedded in the spacer may be oriented such that an attractive magnetic force exists with the magnet(s) embedded in the superior plate, and/or an attractive magnetic force exists with the magnet(s) embedded in the inferior plate.
- the magnet(s) embedded in the spacer may be oriented such that a repulsive magnetic force exists with the magnet(s) embedded in the superior plate, and/or an attractive magnetic force exists with the magnet(s) embedded in the inferior plate.
- the magnet(s) embedded in the spacer may be oriented such that an attractive magnetic force exists with the magnet(s) embedded in the superior plate, and/or a repulsive magnetic force exists with the magnet(s) embedded in the inferior plate.
- the shape of the magnets includes, but is not limited to, a shape that generally resembles a sphere, cylinder, hollow cylinder, ellipsoid, prism (e.g., cube, rectangular prism, triangular prism, pentagonal prism, hexagonal prism, etc.), hollow prism, pyramid, cone, torus, or other three-dimensional shapes known in the art.
- more than one magnet may be present in a plate or the spacer, such as in a configuration or array that provides the appropriate magnetic field for interacting with the magnet(s) of the other plate(s) and/or of the spacer. If more than one magnet is present, the magnets may have any of the shapes described above, or portions thereof.
- the magnets may comprise materials known in the art.
- the magnets may be iron-based, nickel-based, cobalt-based, or an alloy of rare-earth metals.
- the magnets may be a rare-earth magnet, which generally has strong attraction and repulsion forces and have high retentive capacity and resistance to demagnification.
- the rare-earth magnet is NdFeB.
- the diameter or, in the case of a non-circular magnet, long axis (widest distance across) of the magnet(s) may be about 5 mm to about 30 mm, or about 10 mm to about 20 mm.
- the thickness of the magnet(s) plate may be about 0.5 mm to about 10 mm, or about 1 mm to about 6 mm.
- One of ordinary skill in the art would be able to determine the arrangement of magnet(s) in the superior plate, magnet(s) in the inferior plate, and/or magnets in the spacer in order to achieve a prescribed magnetic force between or among the magnet(s) of the superior plate, the magnet(s) of the inferior plate, and/or the magnet(s) of the spacer, based upon the teachings in the Examples provided below.
- the skilled artisan would understand from Example 1 the factors that impact the generated magnetic force, including magnet thickness, the magnet diameter, and the separation distance between the magnets, and understand the size of the magnets and arrangement of the magnets within the superior plate, inferior plate, and/or spacer necessary to apply the prescribed force.
- the skilled artisan can determine how to arrange the magnets by considering the size and dimensions of the space of the disc that requires replacement, the type of force that is required for the treatment (e.g., a levitating force or a reducing force to decrease wear), as well as other factors such as the subject's weight, height, activity level, etc., which could all have an effect on loading forces experienced in the spine.
- the type of force that is required for the treatment e.g., a levitating force or a reducing force to decrease wear
- other factors such as the subject's weight, height, activity level, etc., which could all have an effect on loading forces experienced in the spine.
- the devices of the present invention may be used to address or help treat health issues that require replacement of one or more intervertebral discs.
- aspects of the invention are directed to (i) a method of treating degenerative disc disease in an intervertebral disc, (ii) a method of relieving pain caused by degenerative disc disease in an intervertebral disc, and (iii) a method of reducing pain caused by degenerative disc disease in an intervertebral disc.
- aspects of the invention are also directed to use of the intervertebral disc replacement devices according to embodiments of the present invention to (i) treat degenerative disc disease in an intervertebral disc, (ii) relieve pain caused by degenerative disc disease in an intervertebral disc, and (iii) reduce pain caused by degenerative disc disease in an intervertebral disc.
- FIG. 1 Further aspects of the invention are directed to an intervertebral disc replacement devices according to embodiments of the present invention for use in (i) treating degenerative disc disease in an intervertebral disc, (ii) relieving pain caused by degenerative disc disease in an intervertebral disc, and (iii) reducing pain caused by degenerative disc disease in an intervertebral disc.
- these methods and uses may comprise replacing the intervertebral disc subject to the degenerative disc disease, which involves removing the intervertebral disc, and implanting the device.
- removal of the intervertebral disc comprises removing the disc material and annulus.
- the method may further comprise denuding the cartilage endplates and preparing the surfaces of the endplates of the adjacent vertebrae.
- the result of implanting the device is a levitating force or a force to reduce wear, either of which can lead to treatment of degenerative disc disease in an intervertebral disc, relief of pain caused by degenerative disc disease in an intervertebral disc, and/or reduction of pain caused by degenerative disc disease in an intervertebral disc, as well as increased function.
- the device is implanted by first exposing the disc space and inserting distracting pins in the vertebral bodies superior and inferior to the disc space.
- the joint may then be distracted using the pins for leverage and then a discectomy is performed whereby the annulus and nucleus, as well as the cartilage on the endplates of the vertebral bodies, are removed.
- the implant may then be trialed to determine the appropriate size implant and the actual implant placed in the disc space.
- the distraction may then be released and the implant may be put through a range of motion.
- the pins may then be removed and the wound is closed.
- FIGS. 6 A- 15 B Implantation of devices of the invention are illustrated in FIGS. 6 A- 15 B .
- FIGS. 6 A- 9 B show a two-plate non-contacting intervertebral disc replacement device according to embodiments of the invention, implanted between vertebra 1 that is superior to the replaced disc and vertebra 1 ′ that is inferior to the replaced disc.
- FIGS. 6 A- 7 B show implantation of the device having no linking material between plates 100 and 100 ′, in which FIGS. 7 A and 7 B show magnets 130 and 130 ′ within plates 100 and 100 ′, respectively.
- FIGS. 8 A- 9 B show implantation of the device having a linking material 140 present between plates 100 and 100 ′, in which FIGS. 9 A and 9 B show magnets 130 and 130 ′ within plates 100 and 100 ′, respectively.
- Separation distance 135 between magnet 130 of superior plate 100 and magnet 130 ′ of inferior plate 100 ′, as well as the size of magnets 130 and 130 ′, are chosen so that a sufficient force is generated to maintain separation of the two vertebral bodies to normal physiology height or the desired separation height and the separation distance allows a normal range of motion in all planes or the desired range of motion (see, e.g., Example 1).
- the two-plate non-contacting intervertebral disc replacement device is implanted such that distance 135 between magnet 130 and magnet 130 ′ may be about 0.25 mm to about 20 mm, or about 0.5 mm to about 15 mm, or about 1 mm to about 10 mm.
- FIGS. 10 A- 11 B show a two-plate contacting intervertebral disc replacement device according to embodiments of the invention, implanted between vertebra 1 that is superior to the replaced disc and vertebra 1 ′ that is inferior to the replaced disc.
- FIGS. 11 A and 11 B show magnets 230 and 230 ′ within plates 100 and 100 ′, respectively. Separation distance 235 between magnet 230 of superior plate 200 and magnet 230 ′ of inferior plate 200 ′, as well as the size of magnets 230 and 230 ′, are chosen to reduce the contact stress and subsequent wear and debris generated since wear and debris generation is a function of load (see, e.g., Example 1).
- the two-plate contacting intervertebral disc replacement device is implanted such that distance 235 between magnet 230 and magnet 230 ′ may be about 0.25 mm to about 20 mm, or about 0.5 mm to about 15 mm, or about 1 mm to about 10 mm.
- FIGS. 12 A- 15 B show a two-plate-with-spacer contacting intervertebral disc replacement device according to embodiments of the invention, implanted between vertebra 1 that is superior to the replaced disc and vertebra 1 ′ that is inferior to the replaced disc.
- FIGS. 13 A and 13 B show magnets 330 and 330 ′ of plates 300 and 300 ′, respectively, upon implantation of a device according to embodiments in which spacer 350 does not have any magnets. Separation distance 335 is between magnet 330 of superior plate 300 and magnet 330 ′ of inferior plate.
- FIGS. 12 A- 15 B show a two-plate-with-spacer contacting intervertebral disc replacement device according to embodiments of the invention, implanted between vertebra 1 that is superior to the replaced disc and vertebra 1 ′ that is inferior to the replaced disc.
- FIGS. 13 A and 13 B show magnets 330 and 330 ′ of plates 300 and 300 ′, respectively, upon implantation of a device according to embodiments in which space
- FIGS. 14 A and 14 B show magnets 330 and 330 ′ of plates 300 and 300 ′, respectively, and magnet 370 of spacer 350 upon implantation of a device according to embodiments in which spacer 350 contains a magnet that is not in association with either of its superior articulating surface 355 or its inferior articulating surface 360 .
- Separation distance 336 is between magnet 330 of superior plate 300 and magnet 370 of spacer 350
- separation distance 336 ′ is between magnet 330 ′ of inferior plate 300 ′ and magnet 370 of the spacer 350 .
- 15 A and 15 B show magnets 330 and 330 ′ of plates 300 and 300 ′, respectively, and magnets 371 and 371 ′ of spacer's articulating surfaces 355 and 360 , respectively, upon implantation of a device according to embodiments in which spacer 350 contains a magnet 371 in association with its superior articulating surface 355 and contains a magnet 371 ′ in association with its inferior articulating surface 360 .
- Separation distance 337 between magnet 330 of superior plate 300 and magnet 371 associated with superior articulating surface 355 of spacer 350 , and separation distance 337 ′ between magnet 330 ′ of inferior plate 300 ′ and magnet 371 ′ associated with inferior articulating surface 360 of spacer 350 , as well as the size of magnets 330 , 330 ′, 370 , 371 , and 371 ′, are chosen to either reduce the contact stress and subsequent wear and debris generated since wear and debris generation is a function of load (see, e.g., Example 1), or to generate a sufficient attractive magnetic force.
- the load across the articulating surfaces can be reduced as much as desired.
- the two-plate-with-spacer contacting intervertebral disc replacement device is implanted such that distance 335 , 336 , 336 ′, 337 , and/or 337 ′ may be about 0.25 mm to about 20 mm, or about 0.5 mm to about 15 mm, or about 1 mm to about 10 mm.
- JMAG utilizes finite element analysis to calculate the magnetic forces and fields. Briefly, the geometry of the magnets is loaded into the simulation software, and the magnetic strength and pole orientation is assigned when the simulation is performed.
- the analyses are designed to mimic the repulsion force generated between the magnet of a superior plate and the magnet of an inferior plate in a two-plate non-contacting intervertebral disc replacement device according to embodiments of the present invention; or between the magnet of a superior plate and the magnet of an inferior plate in a two-plate contacting intervertebral disc replacement device according to embodiments of the present invention; or between the magnet of a superior/inferior plate and the magnet of a spacer in a two-plate-with-spacer contacting intervertebral disc replacement device, according to embodiments of the present invention.
- the analyses considered magnet thicknesses of 3 mm and 5 mm; magnet diameters of 10 mm, 15 mm, 20 mm, and 25 mm; and separation distances of 0.25 mm, 0.5 mm, 1 mm, 3 mm, 5 mm, 7 mm, and 10 mm.
- a finite element analysis was conducted using JMAG as described in Example 1 to study how the magnetic repulsion forces are impacted by motion between the superior plate and inferior plate of an intervertebral disc replacement device.
- the analysis assesses the magnetic force field that is generated when the angle between the plates, and therefore the angle between the magnets that are embedded therein, is at 7°.
- compositions can also consist essentially of, or consist of, any combination of the recited plates, spacers, and/or materials, unless described otherwise.
- methods are described as including particular steps, it is contemplated that the methods can also consist essentially of, or consist of, any combination of the recited steps, unless described otherwise.
- the invention illustratively disclosed herein suitably may be practiced in the absence of any element or step which is not specifically disclosed herein.
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Abstract
Description
- This application is a divisional of U.S. application Ser. No. 16/361,980 filed on Mar. 22, 2019, which claims the benefit of U.S. Provisional Application Ser. No. 62/701,518 filed on Jul. 20, 2018, the entireties of both applications of which are herein incorporated by reference.
- The present invention relates generally to prosthetic devices and their use. In particular, the present invention relates to devices containing magnets for use in replacing intervertebral discs.
- The spine provides the primary support for the body and is comprised of 33 individual bones, or vertebrae. The spine is divided into five regions: the cervical, thoracic, and lumbar regions, which are made up of 24 vertebrae that are movable; and the sacral and coccygeal regions, which comprise 9 vertebrae that are fused or unmovable. As shown in
FIGS. 1A and 1B , eachvertebra 1 consists of avertebral body 3, avertebral arch 5, andposterior processes 7 that extend from thevertebral arch 5. The movable vertebrae are stacked in series and are separated and cushioned by anintervertebral disc 20. The unit formed by two adjacent vertebrae and the intervertebral disc therebetween (along with adjoining ligaments) is referred to as a “motion segment” or “spine segment” 15, and it is regarded as the smallest physiological motion unit of the spine to exhibit biomechanical characteristics that are similar to those of the entire spine. - Each movable vertebra transmits loads to adjacent bodies via the
intervertebral disc 20 and twoposterior facet joints 9. Theintervertebral disc 20 is composed of an annulus or outer ring offibrous tissue 23 and the nucleus pulposus 25, which is a gel-like substance contained within theannulus 23 and between the cartilaginous endplates (not shown) of the adjacentvertebral bodies 3. In a healthy disc, the nucleus pulposus 25 acts as an incompressible fluid and forms a hard sphere-like structure within the nuclear recess or fossa (not shown) of the endplates, resembling a fulcrum to give mobility to the spine. Stability of the spine is achieved by balancing loads in theintervertebral disc 20 and the twofacet joints 9. - Degenerative disc disease affects the physiology and function of the intervertebral disc and may be caused by aging, protrusion of the nucleus pulposus into the annulus or endplates, trauma, arthritis, or other causes. The result of the disease is a change in the biomechanical properties of the disc, often including a reduction in disc height that alters the loading pattern of the disc. Degeneration of the disc also frequently results in degeneration of the facet joints, loss of stability of the motion segment, and compression of the nerves branching out of the spinal column. Compression of these nerves can cause clinical symptoms including pain.
- Surgical treatments for degenerative disc disease include discectomy (surgical removal of abnormal intervertebral disc material), fusion (surgical technique that joins two or more vertebrae), and others. However, these treatments are not without problems and complications. Discectomy and fusion can alter the biomechanics of the motion segment and can often lead to degeneration of the adjacent motion segments. And even though a segment is fused or motion is prevented, pain and clinical symptoms frequently persist. For this reason, replacement of the intervertebral disc, which aims to preserve and restore normal motion to the spine segment, has emerged as an important treatment option.
- Although first used in Europe in the 1980's, disc replacement was not approved in the United States by the FDA until 2004. There are now a number of different disc designs available for use in disc replacement surgery, but all have the same goal of reproducing the size (height) and function (range of motion) of the normal intervertebral disc. Materials that can be used in the construction of disc replacements include medical grade plastics (primarily polyethylene and polyetheretherketone (PEEK)), metals (primarily cobalt chromium and titanium alloys), and ceramics (including aluminum oxide, zirconia, and others).
- Disc designs include two-piece designs consisting of two plates that attach to the adjacent vertebral bodies and that have surfaces which articulate against each other, such as a cup-and-dish configuration. These types of devices often have a polymeric surface and a metallic surface that articulate, but metal/metal and polymer/polymer devices have also been available. The polymeric surface(s) may be contained within a metal shell, which provides a surface optimized for attachment to the vertebral body endplates. Alternatively, disc replacements may have a three-piece design, containing two plates (usually metallic) that attach to the vertebral endplates, and a soft, usually polymeric, spacer that articulates between the two surfaces.
- Problems associated with current intervertebral disc replacements are similar to those seen in other arthroplasty or joint replacement devices such as total hip and knee replacement devices. These problems include failure of the plates of the device to attach to the endplates of the vertebrae and/or loosening of the interface. This can be the result of the constraining nature of the articulation, excessive wear and wear debris generated at the articulating surfaces, and, in the case of a three-piece device, dislocation or dissociation of the polymeric spacer between the two plates.
- Thus, there remains a need for an intervertebral disc replacement device that will maintain stable attachment to adjacent vertebrae and provide normal biomechanics to the motion segment.
- The present invention relates to intervertebral disc replacement devices and methods for their use in treating or preventing degenerative disc disease.
- An aspect of the invention relates to an intervertebral disc replacement device that comprises a first, or “superior,” plate and a second, or “inferior,” plate, in which each plate contains one or more magnets. Each plate comprises a fixation surface, an inner surface, and an edge surface. The magnet(s) in the superior plate and the magnet(s) in the inferior plate are oriented such that a magnetic force exists between the magnet(s) in the superior plate and the magnet(s) in the inferior plate. In some embodiments, the magnetic force is repulsive. In some embodiments, the fixation surface of the superior plate and/or the inferior plate comprises a surface geometry or a surface feature that helps adhere the plate to a vertebra endplate. In some embodiments, the fixation surface, the inner surface, or both, of the superior plate and/or the inferior plate may be flat or may comprise a curvature. In certain embodiments, a linking material is attached to both the superior plate and the inferior plate.
- An aspect of the invention relates to an intervertebral disc replacement device that comprises a superior plate and an inferior plate, in which each plate contains one or more magnets. Each plate comprises a fixation surface, an articulating surface, and an edge surface. The articulating surface of the superior plate is configured to articulate against the articulating surface of the inferior plate. The magnet(s) in the superior plate and the magnet(s) in the inferior plate are oriented such that a magnetic force exists between the magnet(s) in the superior plate and the magnet(s) in the inferior plate. In some embodiments, the magnetic force is repulsive. In some embodiments, the fixation surface of the superior plate and/or the inferior plate comprises a surface geometry or a surface feature that helps adhere the plate to a vertebra endplate.
- Another aspect of the invention relates to an intervertebral disc replacement device that comprises a superior plate, an inferior plate, and a spacer positioned between the superior and inferior plates. The superior and inferior plates each comprise a fixation surface, an articulating surface, and an edge surface, and the spacer comprises a superior articulating surface, an inferior articulating surface, and an edge surface. The articulating surface of the superior plate is configured to articulate against the superior articulating surface of the spacer, and the articulating surface of the inferior plate is configured to articulate against the inferior articulating surface of the spacer. In some embodiments, each plate contains one or more magnets, and, in certain embodiments, the magnet(s) in each of the plates are oriented such that a magnetic force exists between the magnet(s) of the superior plate and the magnet(s) of the inferior plate. In other embodiments, each plate and the spacer contain one or more magnets and, in certain embodiments, the magnet(s) in each of the plates and the spacer are oriented such that a magnetic force exists between the magnet(s) of the superior plate and the magnet(s) of the spacer, and/or between the magnet(s) of the inferior plate and the magnet(s) of the spacer. The magnetic force may be repulsive or attractive. In some embodiments, the fixation surface of the superior plate and/or the inferior plate comprises a surface geometry or a surface feature that helps adhere the plate to a vertebra endplate.
- A further aspect of the invention relates to (i) a method of treating degenerative disc disease in an intervertebral disc, (ii) a method of relieving pain caused by degenerative disc disease in an intervertebral disc, or (iii) a method of reducing pain caused by degenerative disc disease in an intervertebral disc; these methods comprise implanting an intervertebral disc replacement device described above.
- The present disclosure will be further explained with reference to the attached drawing figures, wherein like structures are referred to by like numerals throughout the several views. The drawing figures shown are not necessarily to scale, with emphasis instead generally being placed upon illustrating the principles of the present disclosure, and some features may be exaggerated to show details of particular components. In addition, any measurements, specifications and the like shown in the drawing figures, or described below, are intended to be illustrative, and not restrictive. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a representative basis for teaching one skilled in the art to variously employ the intervertebral disc replacement devices, and methods thereof.
-
FIGS. 1A and 1B are different views of a motion segment of the human spine.FIG. 1A is a lateral view of the motion segment, andFIG. 1B is an anterior view of the motion segment. -
FIGS. 2A and 2B are different views of a two-plate non-contacting intervertebral disc replacement device according to embodiments of the present invention.FIG. 2A is a lateral view of the device, andFIG. 2B is an anterior view of the device. -
FIGS. 3A and 3B are different views of a two-plate non-contacting intervertebral disc replacement device according to embodiments of the present invention, in which the device includes a linking material between each plate.FIG. 3A is a lateral view of the device, andFIG. 3B is an anterior view of the device. -
FIGS. 4A and 4B are different views of a two-plate contacting intervertebral disc replacement device according to embodiments of the present invention.FIG. 4A is a lateral view of the device, andFIG. 4B is an anterior view of the device. -
FIGS. 5A and 5B are different views of a two-plate-with-spacer contacting intervertebral disc replacement device according to embodiments of the present invention.FIG. 5A is a lateral view of the device, andFIG. 5B is an anterior view of the device. -
FIGS. 6A and 6B are different views of a two-plate non-contacting intervertebral disc replacement device according to embodiments of the present invention, implanted into a motion segment of a human spine.FIG. 6A is lateral view of the device implanted into the motion segment, andFIG. 6B is an anterior view of the device implanted into the motion segment. -
FIGS. 7A and 7B are different views of a two-plate non-contacting intervertebral disc replacement device according to embodiments of the present invention, implanted into a motion segment of a human spine, in which the magnet of the superior plate and the magnet of the inferior plate are shown.FIG. 7A is lateral view of the device implanted into the motion segment, andFIG. 7B is an anterior view of the device implanted into the motion segment. -
FIGS. 8A and 8B are different views of a two-plate non-contacting intervertebral disc replacement device according to embodiments of the present invention, implanted into a motion segment of a human spine, in which the device includes a linking material between each plate.FIG. 8A is lateral view of the device implanted into the motion segment, andFIG. 8B is an anterior view of the device implanted into the motion segment. -
FIGS. 9A and 9B are different views of a two-plate non-contacting intervertebral disc replacement device according to embodiments of the present invention, implanted into a motion segment of the human spine, in which the device includes a material between each plate and the magnet of a superior plate and the magnet of the inferior plate are shown.FIG. 9A is lateral view of the device implanted into the motion segment, andFIG. 9B is an anterior view of the device implanted into the motion segment. -
FIGS. 10A and 10B are different views of a two-plate contacting intervertebral disc replacement device according to embodiments of the present invention, implanted into a motion segment of a human spine.FIG. 10A is lateral view of the device implanted into the motion segment, andFIG. 10B is an anterior view of the device implanted into the motion segment. -
FIGS. 11A and 11B are different views of a two-plate contacting intervertebral disc replacement device according to embodiments of the present invention, implanted into a motion segment of a human spine, in which the magnet of the superior plate and the magnet of the inferior plate are shown.FIG. 11A is lateral view of the device implanted into the motion segment, andFIG. 11B is an anterior view of the device implanted into the motion segment. -
FIGS. 12A and 12B are different views of a two-plate-with-spacer contacting intervertebral disc replacement device according to embodiments of the present invention, implanted into a motion segment of the human spine.FIG. 12A is lateral view of the device implanted into the motion segment, andFIG. 12B is an anterior view of the device implanted into the motion segment. -
FIGS. 13A and 13B are different views of a two-plate-with-spacer contacting intervertebral disc replacement device according to embodiments of the present invention, implanted into a motion segment of the human spine, in which the magnet of the superior plate and the magnet of the inferior plate are shown.FIG. 13A is lateral view of the device implanted into the motion segment, andFIG. 13B is an anterior view of the device implanted into the motion segment. -
FIGS. 14A and 14B are different views of a two-plate-with-spacer contacting intervertebral disc replacement device according to embodiments of the present invention, implanted into a motion segment of the human spine, in which the magnet of the superior plate, the magnet of the inferior plate, and the magnet of the spacer are shown.FIG. 14A is lateral view of the device implanted into the motion segment, andFIG. 14B is an anterior view of the device implanted into the motion segment. -
FIGS. 15A and 15B are different views of a two-plate-with-spacer contacting intervertebral disc replacement device according to embodiments of the present invention, implanted into a motion segment of the human spine, in which the magnet of the superior plate, the magnet of the inferior plate, and the magnets of the spacer that are in association with each articulating surface of the spacer are shown.FIG. 15A is lateral view of the device implanted into the motion segment, andFIG. 15B is an anterior view of the device implanted into the motion segment. -
FIG. 16 is a plot of the repulsion forces generated between the magnets of the disc replacement devices according to embodiments of the present invention at various magnet diameters and separation distances, and with a magnet thickness of 3 mm, as set forth in Example 1. -
FIG. 17 is a plot of the repulsion forces generated between the magnets of the disc replacement devices according to embodiments of the present invention at various magnet diameters and separation distances, and with a magnet thickness of 5 mm, as set forth in Example 1. -
FIG. 18 is a plot of the repulsion forces generated between the magnets of the disc replacement devices according to embodiments of the present invention at various magnet thicknesses and separation distances, and with a magnet diameter of 25 mm, as set forth in Example 1. -
FIG. 19 shows the angle of the magnets of a two-plate non-contact intervertebral disc replacement device according to embodiments of the present invention, as analyzed in Example 2. -
FIG. 20 shows the magnetic fields generated from the magnets of a two-plate non-contact intervertebral disc replacement device according to embodiments of the present invention, as analyzed in Example 2. - The present invention relates to intervertebral disc replacement devices and methods thereof. The intervertebral disc replacement device of the present invention comprises magnets, which, upon implantation, generate a magnetic force field to maintain and/or control separation of the two vertebral bodies adjacent to the disc that is being replaced. The separation distance allows a normal range—or at least a desired range—of motion in all planes.
- An aspect of the invention relates to an intervertebral disc replacement device that comprises a superior plate and an inferior plate, in which each plate contains one or more magnets embedded therein. Upon implantation, the superior plate is fixated to the adjacent vertebra superior to the disc that is being replaced, the inferior plate is fixated to the adjacent vertebra inferior to the disc that is being replaced, and the superior plate and inferior plate are separated by a distance from each other, and thus there is no contact. The terms “superior” and “inferior” reflect how these plates are positioned relative to each other when the device is implanted as a disc replacement.
- Without being bound by theory, a benefit of the two-plate non-contacting device compared to all other disc replacements is that there is no wear and no wear debris generated by the plates. Such a result occurs, because the plates do not have any contacting surfaces, or at least the contacting surfaces are reduced. Wear debris can and often does have serious detrimental effects on the tissues surrounding any articulating joint replacement and may be a major factor in failure and need for revision of the device. This is primarily due to the adverse tissue reaction that wear debris particles can elicit as a result of their size and composition.
- An example of a two-plate non-contacting intervertebral disc replacement device according to embodiments of the invention is shown in
FIGS. 2A-3B .Superior plate 100 andinferior plate 100′ may each comprise afixation surface inner surface edge surface FIGS. 6A-9B ,fixation surface fixation surface 105 may face the endplate ofvertebra 1 that is superior to the disc that is being replaced, andfixation surface 105′ may face the endplate ofvertebra 1′ that is inferior to the intervertebral disc that is being replaced. In addition,inner surface 110 ofsuperior plate 100 may faceinner surface 110′ ofinferior plate 100′.Edge surface plate - Each plate may also comprise a fixation extension that extends beyond the fixation surface of the plate. This is illustrated in
FIGS. 2A-3B , in whichplate fixation extension fixation extension 120′ ofinferior plate 100′ shown inFIG. 2B or 3B ) or may comprise more than one unit (see, e.g.,fixation extension 120 ofsuperior plate 100 shown inFIG. 2A or 3A ). Upon implantation, as shown for example inFIGS. 6A-7B ,fixation extension vertebral body vertebra - Each plate may generally have the same shape, although that shape may vary. The plate may comprise a shape that generally resembles a sphere, cylinder, ellipsoid, prism (e.g., cube, rectangular prism, triangular prism, pentagonal prism, hexagonal prism, etc.), pyramid, cone, or other three-dimensional shapes known in the art. In some embodiments, the plates may comprise a cross-sectional shape that generally resembles the cross-sectional shape of the vertebral body portion of a vertebra.
- In some embodiments, the plates may comprise a shape that resembles, is derived from, or is largely the same as, plates that are apart of intervertebral disc replacement devices known in the art. Such devices include those that are described in U.S. Pat. Nos. 6,001,130, 7,491,240, 7,494,508, 7,766,966, 8,353,964, 8,858,635, 8,911,498, 9,566,164, and 9,883,945, each of which are incorporated herein by reference.
- The fixation surface and inner surface of each plate (i) may be flat as shown in
FIGS. 2A-3B (seefixation surface inner surface - The fixation surface of the plates may comprise a surface geometry, a surface feature, or a combination thereof, that can help adhere the plates to the endplates of the vertebrae adjacent to the intervertebral disc that is being replaced. The surface geometry and/or surface feature may also provide initial stability and resistance to torsional or shear loading to the plates. A surface geometry for the present invention may include, but is not limited to, a texture, porous coating, bioactive coating, and a combination thereof. A surface feature for the present invention may include, but is not limited to, one or more keels, one or more pegs, one or more screws, and the like, including a combination thereof.
- The inner surface of the plates may be polished or may have an as-fabricated surface. In some embodiments, the inner surface may have a surface geometry and/or surface feature as described above.
- The diameter or, in the case of a non-circular plate, long axis (widest distance across) of the plates (shown as 125 and 125′ of
plate FIGS. 2A-3B ) may be about 3 mm to about 50 mm, or about 5 mm to about 30 mm, or about 10 mm to about 20 mm. The thickness of the plates (shown as 126 and 126′ ofplate FIGS. 2A-3B ) may be about 1 mm to about 15 mm, or about 2 mm to about 10 mm, or about 4 mm to about 8 mm. The fixation extensions may extend beyond the fixation surface by a distance (shown as 127 and 127′ ofplate FIGS. 2A-3B ) of about 0.5 to 5 mm, or about 1 to about 3 mm. - The plates may be of a material appropriate for implantation into the body. For instance, the material may be a metal such as titanium or cobalt chromium alloys; a biopolymer such as PEEK; a ceramic such as aluminum oxide or zirconia alloys; or a combination thereof.
- In some embodiments, a linking material may be attached to both the superior and inferior plates. The material may be between each plate, may cover each plate or a portion of each plate, or both. In some embodiments, the material may be between each plate, such as attached to the inner surface of each plate. An example is shown in
FIGS. 3A and 3B , which shows asuperior plate 100 and aninferior plate 100′, in which a linkingmaterial 140 is located between—and attached to—eachplate material 140 may be a mesh or similar fabric or a soft material, such as a polyurethane or other polymeric or rubber material. The material may allow the device to be implanted as one piece. - Each plate comprises one or more appropriate-sized rare earth magnets. The one or more magnets may be embedded within the plates, such that the magnet(s) are not exposed to outside of the plate.
- The shape of the magnets includes, but is not limited to, a shape that generally resembles a sphere, cylinder, hollow cylinder, ellipsoid, prism (e.g., cube, rectangular prism, triangular prism, pentagonal prism, hexagonal prism, etc.), hollow prism, pyramid, cone, torus, or other three-dimensional shapes known in the art. In some embodiments, more than one magnet may be present in a plate, such as in a configuration or array that provides the appropriate magnetic field for interacting with the magnet(s) of the other plate. If more than one magnet is present, the magnets may have any of the shapes described above, or portions thereof.
- The magnets may comprise materials known in the art. For example, the magnets may be iron-based, nickel-based, cobalt-based, or an alloy of rare-earth metals. In certain embodiments, the magnets may be a rare-earth magnet, which generally has strong attraction and repulsion forces and have high retentive capacity and resistance to demagnification. In a preferred embodiment, the rare-earth magnet is an alloy of neodymium, iron, and boron (“NdFeB”). NdFeB magnets provide strong permanent magnetism, high retentive capacity, and resistance to demagnetization.
- The diameter or, in the case of a non-circular magnet, long axis (widest distance across) of the magnet(s) may be about 5 mm to about 30 mm, or about 10 mm to about 20 mm. The thickness of the magnet(s) plate may be about 0.5 mm to about 10 mm, or about 1 mm to about 6 mm.
- One of ordinary skill in the art would be able to determine the arrangement of magnet(s) in the superior plate and magnet(s) in the inferior plate in order to achieve a prescribed magnetic force between the magnet(s) of the superior plate and the magnet(s) of the inferior plate, based upon the teachings in the Examples provided below. For example, the skilled artisan would understand from Example 1 the factors that impact the generated magnetic force, including magnet thickness, the magnet diameter, and the separation distance between the magnets, and understand the size of the magnets and arrangement of the magnets within the superior and inferior plates necessary to apply the prescribed force. Thus, the skilled artisan can determine how to arrange the magnets by considering the size and dimensions of the space of the disc that requires replacement, the type of force that is required for the treatment (e.g., a levitating force or a reducing force to decrease wear), as well as other factors such as the subject's weight, height, activity level, etc., which could all have an effect on loading forces experienced in the spine.
- An aspect of the invention relates to an intervertebral disc replacement device that comprises a superior plate and an inferior plate, in which each plate contains one or more magnets embedded therein. Upon implantation, the superior plate is fixated to the adjacent vertebra superior to the disc that is being replaced, the inferior plate is fixated to the adjacent vertebra inferior to the disc that is being replaced, and the superior plate and the inferior plate are in contact with each other via articulating surfaces.
- Without being bound by theory, an advantage of a two-plate contacting device with non-zero loading across the articulating surfaces may be the additional stability provided by the articulating surfaces. Such stability helps produce and maintain normal or desired size and motion, as well as constrain any abnormal motions or translations created by the magnetic fields generated from the embedded magnets or by the body. In addition, the additional stability provided by the two-plate contacting device can help reduce wear and the generation of wear debris. As noted above, wear debris can elicit an adverse tissue reaction which can lead to treatment failure and need for device removal.
- An example of a two-plate contacting intervertebral disc replacement device according to embodiments of the invention is shown in
FIGS. 4A and 4B .Superior plate 200 andinferior plate 200′ may each comprise afixation surface surface edge surface FIGS. 10A-11B ,fixation surface fixation surface 205 may face the endplate ofvertebra 1 that is superior to the disc that is being replaced, andfixation surface 205′ may face the endplate ofvertebra 1′ that is inferior to the intervertebral disc that is being replaced. Further, articulatingsurface 210 of thesuperior plate 200 may articulate against articulatingsurface 210′ ofinferior plate 200′.Edge surface plate - Each plate may also comprise a fixation extension that extends beyond the fixation surface of the plate. This is illustrated in
FIGS. 4A and 4B , in whichplate fixation extension fixation extension 220′ ofinferior plate 200′ shown inFIG. 4B ) or may comprise more than one unit (see, e.g.,fixation extension 220 ofsuperior plate 200 shown inFIG. 4A ). Upon implantation, as shown for example inFIGS. 10A-11B ,fixation extension vertebral body vertebra - Each plate may generally have the same shape, although that shape may vary. The plates may comprise a shape that generally resembles a sphere, cylinder, ellipsoid, prism (e.g., cube, rectangular prism, triangular prism, pentagonal prism, hexagonal prism, etc.), pyramid, cone, or other three-dimensional shapes known in the art. In some embodiments, each plate may comprise a cross-sectional shape that generally resembles the cross-sectional shape of the vertebral body portion of a vertebra.
- In some embodiments, the plates may comprise a shape that resembles, is derived from, or is largely the same as, plates that are apart of intervertebral disc replacement devices known in the art. Such devices include those that are described in U.S. Pat. Nos. 6,001,130, 7,491,240, 7,494,508, 7,766,966, 8,353,964, 8,858,635, 8,911,498, 9,566,164, and 9,883,945, each of which are incorporated herein by reference.
- The fixation surface of each plate (i) may be flat as shown in
FIGS. 4A and 4B (seefixation surface - The articulating surface of the superior plate and the articulating surface of the inferior plate may have conforming or near-conforming geometries to allow motion through articulation of these surfaces. Examples of such conforming or near-conforming geometries include those resembling a ball-and-socket interface; a cup-and-dish interface; a flat-surface interface; toroidal-surface interface such as the surfaces described in U.S. Pat. No. 9,173,748, which is incorporated herein by reference; or the like.
- The diameter or, in the case of a non-circular plate, long axis (widest distance across) of the plates (shown as 225 and 225′ of
plate FIGS. 4A and 4B ) may be about 3 mm to about 50 mm, or about 5 mm to about 30 mm, or about 10 mm to about 20 mm. The thickness of the plates (shown as 226 and 226′ ofplate FIGS. 4A and 4B ) may be about 1 mm to about 15 mm, or about 2 mm to about 10 mm, or about 4 mm to about 8 mm. The fixation extensions may extend beyond the fixation surface by a distance (shown as 227 and 227′ ofplate FIGS. 4A and 4B ) of about 0.5 to 5 mm, or about 1 to about 3 mm. - The plates may be of a material appropriate for implantation into the body. For instance, the material may be a metal such as titanium or cobalt chromium alloys; a biopolymer such as PEEK; a ceramic such as aluminum oxide or zirconia alloys; or a combination thereof.
- Each plate comprises one or more appropriate-sized rare earth magnets. The one or more magnets may be embedded within the plates, such as embedded in the articulating surface of the superior plate and/or in the articulating surface of the inferior plate; however, the magnet(s) are not exposed to outside of the plate.
- The shape of the magnets includes, but is not limited to, a shape that generally resembles a sphere, cylinder, hollow cylinder, ellipsoid, prism (e.g., cube, rectangular prism, triangular prism, pentagonal prism, hexagonal prism, etc.), hollow prism, pyramid, cone, torus, or other three-dimensional shapes known in the art. In some embodiments, more than one magnet may be present in a plate, such as in a configuration or array that provides the appropriate magnetic field for interacting with the magnet(s) of the other plate. If more than one magnet is present, the magnets may have any of the shapes described above, or portions thereof.
- The magnets may comprise materials known in the art. For example, the magnets may be iron-based, nickel-based, cobalt-based, or an alloy of rare-earth metals. In certain embodiments, the magnets may be a rare-earth magnet, which generally has strong attraction and repulsion forces and have high retentive capacity and resistance to demagnification. In a preferred embodiment, the rare-earth magnet is an alloy of NdFeB.
- The diameter or, in the case of a non-circular magnet, long axis (widest distance across) of the magnet(s) may be about 5 mm to about 30 mm, or about 10 mm to about 20 mm. The thickness of the magnet(s) plate may be about 0.5 mm to about 10 mm, or about 1 mm to about 6 mm.
- One of ordinary skill in the art would be able to determine the arrangement of magnet(s) in the superior plate and magnet(s) in the inferior plate in order to achieve a prescribed magnetic force between the magnet(s) of the superior plate and the magnet(s) of the inferior plate, based upon the teachings in the Examples provided below. For example, the skilled artisan would understand from Example 1 the factors that impact the generated magnetic force, including magnet thickness, the magnet diameter, and the separation distance between the magnets, and understand the size of the magnets and arrangement of the magnets within the superior and inferior plates necessary to apply the prescribed force. Thus, the skilled artisan can determine how to arrange the magnets by considering the size and dimensions of the space of the disc that requires replacement, the type of force that is required for the treatment (e.g., a levitating force or a reducing force to decrease wear), as well as other factors such as the subject's weight, height, activity level, etc., which could all have an effect on loading forces experienced in the spine.
- An aspect of the invention relates to an intervertebral disc replacement device that comprises a superior plate, an inferior plate, and a spacer. Upon implantation, the superior plate is fixated to the adjacent vertebra superior to the disc that is being replaced, the inferior plate is fixated to the adjacent vertebra inferior to the disc that is being replaced, and the spacer is between the superior and inferior plates. Each plate contains one or more magnets embedded therein and optionally, the spacer may have one or more magnets embedded therein.
- Without being bound by theory, an advantage of a two-plate-with-spacer contacting device may be the additional decrease in wear and generation of wear debris. In addition, the spacer may comprise one or more magnets that interact with the magnet(s) of the superior and/or inferior plates and decrease the separation distance between the magnet surfaces, therefore providing additional stability to the intervertebral disc replacement device.
- An example of a two-plate-with-spacer intervertebral disc replacement device according to embodiments of the invention is shown in
FIGS. 5A and 5B .Superior plate 300 andinferior plate 300′ may each comprise afixation surface surface edge surface Spacer 350 may comprise a superior articulatingsurface 355, an inferior articulatingsurface 360, and anedge surface 365. In embodiments of the invention, upon implantation as shown inFIGS. 12A-15B ,fixation surface fixation surface 305 may face the endplate ofvertebra 1 that is superior to the disc that is being replaced, andfixation surface 305′ may face the endplate ofvertebra 1′ that is inferior to the intervertebral disc that is being replaced; superior articulatingsurface 355 ofspacer 350 may form an articulating interface with articulatingsurface 310 ofsuperior plate 300; and inferior articulatingsurface 360 ofspacer 350 may form an articulating interface with articulatingsurface 310′ ofinferior plate 300′.Edge surface plates spacer 350, respectively. - Each plate may also comprise a fixation extension that extends beyond the fixation surface of the plate. This is illustrated in
FIGS. 5A and 5B , in whichplate fixation extension fixation extension 320′ ofinferior plate 300′ shown inFIG. 5B ) or may comprise more than one unit (see, e.g.,fixation extension 320 ofsuperior plate 300 shown inFIG. 5A ). Upon implantation, as shown for example inFIGS. 12A-15B ,fixation extension vertebral body vertebra - Each plate generally has the same shape, although that shape may vary. The plates may comprise a shape that generally resembles a sphere, cylinder, ellipsoid, prism (e.g., cube, rectangular prism, triangular prism, pentagonal prism, hexagonal prism, etc.), pyramid, cone, or other three-dimensional shapes known in the art. In some embodiments, each plate may comprise a cross-sectional shape that generally resembles the cross-sectional shape of the vertebral body portion of a vertebra.
- In some embodiments, the plates may comprise a shape that resembles, is derived from, or is largely the same as, plates that are apart of intervertebral disc replacement devices known in the art. Such devices include those that are described in U.S. Pat. Nos. 6,001,130, 7,491,240, 7,494,508, 7,766,966, 8,353,964, 8,858,635, 8,911,498, 9,566,164, and 9,883,945, each of which are incorporated herein by reference.
- The fixation surface of each plate (i) may be flat as shown in
FIGS. 5A and 5B (seefixation surfaces - The articulating surface of the superior plate and the superior articulating surface of the spacer may have conforming or near-conforming geometries to allow motion through articulation of these surfaces. The articulating surface of the inferior plate and the inferior articulating surface of the spacer may also have conforming or near-conforming geometries to allow motion through articulation of these surfaces. Examples of such conforming or near-conforming geometries include those resembling a ball-and-socket interface; a cup-and-dish interface; a flat-surface interface; toroidal-surface interface such as the surfaces described in U.S. Pat. No. 9,173,748, which is incorporated herein by reference; or the like.
- The diameter or, in the case of a non-circular plate, long axis (widest distance across) of the plates (shown as 325 and 325′ of
plate FIGS. 5A and 5B ) may be about 3 mm to about 50 mm, or about 5 mm to about 30 mm, or about 10 mm to about 20 mm. The thickness of the plates (shown as 326 and 326′ ofplate FIGS. 5A and 5B ) may be about 1 mm to about 15 mm, or about 2 mm to about 10 mm, or about 4 mm to about 8 mm. The fixation extensions may extend beyond the fixation surface by a distance (shown as 327 and 327′ ofplate FIGS. 5A and 5B ) of about 0.5 to 5 mm, or about 1 to about 3 mm. - The spacer may comprise a shape that generally resembles a sphere, cylinder, ellipsoid, prism (e.g., cube, rectangular prism, triangular prism, pentagonal prism, hexagonal prism, etc.), pyramid, cone, or other three-dimensional shapes known in the art. In some embodiments, the spacer may comprise a cross-sectional shape that generally resembles the cross-sectional shape of the superior and/or inferior plate. The diameter or, in the case of a non-circular spacer, long axis (widest distance across) of the spacer (shown as 375 of
spacer 350 inFIGS. 5A and 5B ) may be about 1 mm to about 48 mm, or about 2 mm to about 45 mm. The thickness of the spacer (shown as 376 ofspacer 350 inFIGS. 5A and 5B ) may be about 3 mm to about 25 mm, or about 5 mm to about 20 mm. - The plates and the spacer may be of a material appropriate for implantation into the body. For instance, the plates may comprise a metal such as titanium or cobalt chromium alloys; a biopolymer such as PEEK; a ceramic such as aluminum oxide or zirconia alloys; or a combination thereof. The spacer may comprise a polymer.
- In embodiments of the present invention, each plate may comprise one or more appropriate-sized rare earth magnets and the spacer does not comprise a magnet. The one or more magnets may be embedded within the plates, such as embedded in the articulating surface of the superior plate and in the articulating surface of inferior plate; however, the magnet(s) are not exposed to outside of the plate. The magnet(s) of the superior plate and the magnet(s) of the inferior plate may be oriented such that a repulsive magnetic force exists between the magnet(s) of the superior plate and the magnet(s) of the inferior plate. Alternatively, the magnet(s) of the superior plate and the magnet(s) of the inferior plate may be oriented such that an attractive magnetic force exists between the magnet(s) of the superior plate and the magnet(s) of the inferior plate.
- In other embodiments of the invention, each plate and the spacer may comprise one or more appropriate-sized rare earth magnets. The one or more magnets may be embedded within the plates, such as embedded in the articulating surface of the superior plate and in the articulating surface of the inferior plate, and may be embedded within the spacer. In certain embodiments the one or more magnets may be embedded in the superior articulating surface and/or in the inferior articular surface of the spacer; however, the magnet(s) are not exposed to outside of the plate or the spacer. In some embodiments, the magnet(s) embedded in the spacer may be oriented such that a repulsive magnetic force exists with the magnet(s) embedded in the superior plate and/or a repulsive magnetic force exists with the magnet(s) embedded in the inferior plate. As a result, each interface of two articulating surfaces experience a repulsive magnetic force in an effort to reduce contact stress and subsequent wear of the materials. In other embodiments, the magnet(s) embedded in the spacer may be oriented such that an attractive magnetic force exists with the magnet(s) embedded in the superior plate, and/or an attractive magnetic force exists with the magnet(s) embedded in the inferior plate. Thus, interfaces of two articulating surfaces can experience an attractive magnetic force in an effort to reduce the possibility of dislocation or dissociation of the spacer. Although not providing a wear reduction benefit, the reduction in dissociation risk is significant as this too is a major source of clinical failure. In further embodiments, the magnet(s) embedded in the spacer may be oriented such that a repulsive magnetic force exists with the magnet(s) embedded in the superior plate, and/or an attractive magnetic force exists with the magnet(s) embedded in the inferior plate. In yet other embodiments, the magnet(s) embedded in the spacer may be oriented such that an attractive magnetic force exists with the magnet(s) embedded in the superior plate, and/or a repulsive magnetic force exists with the magnet(s) embedded in the inferior plate.
- The shape of the magnets includes, but is not limited to, a shape that generally resembles a sphere, cylinder, hollow cylinder, ellipsoid, prism (e.g., cube, rectangular prism, triangular prism, pentagonal prism, hexagonal prism, etc.), hollow prism, pyramid, cone, torus, or other three-dimensional shapes known in the art. In some embodiments, more than one magnet may be present in a plate or the spacer, such as in a configuration or array that provides the appropriate magnetic field for interacting with the magnet(s) of the other plate(s) and/or of the spacer. If more than one magnet is present, the magnets may have any of the shapes described above, or portions thereof.
- The magnets may comprise materials known in the art. For example, the magnets may be iron-based, nickel-based, cobalt-based, or an alloy of rare-earth metals. In certain embodiments, the magnets may be a rare-earth magnet, which generally has strong attraction and repulsion forces and have high retentive capacity and resistance to demagnification. In a preferred embodiment, the rare-earth magnet is NdFeB.
- The diameter or, in the case of a non-circular magnet, long axis (widest distance across) of the magnet(s) may be about 5 mm to about 30 mm, or about 10 mm to about 20 mm. The thickness of the magnet(s) plate may be about 0.5 mm to about 10 mm, or about 1 mm to about 6 mm.
- One of ordinary skill in the art would be able to determine the arrangement of magnet(s) in the superior plate, magnet(s) in the inferior plate, and/or magnets in the spacer in order to achieve a prescribed magnetic force between or among the magnet(s) of the superior plate, the magnet(s) of the inferior plate, and/or the magnet(s) of the spacer, based upon the teachings in the Examples provided below. For example, the skilled artisan would understand from Example 1 the factors that impact the generated magnetic force, including magnet thickness, the magnet diameter, and the separation distance between the magnets, and understand the size of the magnets and arrangement of the magnets within the superior plate, inferior plate, and/or spacer necessary to apply the prescribed force. Thus, the skilled artisan can determine how to arrange the magnets by considering the size and dimensions of the space of the disc that requires replacement, the type of force that is required for the treatment (e.g., a levitating force or a reducing force to decrease wear), as well as other factors such as the subject's weight, height, activity level, etc., which could all have an effect on loading forces experienced in the spine.
- The devices of the present invention may be used to address or help treat health issues that require replacement of one or more intervertebral discs.
- Therefore, aspects of the invention are directed to (i) a method of treating degenerative disc disease in an intervertebral disc, (ii) a method of relieving pain caused by degenerative disc disease in an intervertebral disc, and (iii) a method of reducing pain caused by degenerative disc disease in an intervertebral disc. Aspects of the invention are also directed to use of the intervertebral disc replacement devices according to embodiments of the present invention to (i) treat degenerative disc disease in an intervertebral disc, (ii) relieve pain caused by degenerative disc disease in an intervertebral disc, and (iii) reduce pain caused by degenerative disc disease in an intervertebral disc. Further aspects of the invention are directed to an intervertebral disc replacement devices according to embodiments of the present invention for use in (i) treating degenerative disc disease in an intervertebral disc, (ii) relieving pain caused by degenerative disc disease in an intervertebral disc, and (iii) reducing pain caused by degenerative disc disease in an intervertebral disc.
- In embodiments of the invention, these methods and uses may comprise replacing the intervertebral disc subject to the degenerative disc disease, which involves removing the intervertebral disc, and implanting the device. In some embodiments, removal of the intervertebral disc comprises removing the disc material and annulus. In some embodiments, the method may further comprise denuding the cartilage endplates and preparing the surfaces of the endplates of the adjacent vertebrae. The result of implanting the device is a levitating force or a force to reduce wear, either of which can lead to treatment of degenerative disc disease in an intervertebral disc, relief of pain caused by degenerative disc disease in an intervertebral disc, and/or reduction of pain caused by degenerative disc disease in an intervertebral disc, as well as increased function.
- In certain embodiments, the device is implanted by first exposing the disc space and inserting distracting pins in the vertebral bodies superior and inferior to the disc space. The joint may then be distracted using the pins for leverage and then a discectomy is performed whereby the annulus and nucleus, as well as the cartilage on the endplates of the vertebral bodies, are removed. The implant may then be trialed to determine the appropriate size implant and the actual implant placed in the disc space. The distraction may then be released and the implant may be put through a range of motion. The pins may then be removed and the wound is closed.
- Implantation of devices of the invention are illustrated in
FIGS. 6A-15B .FIGS. 6A-9B show a two-plate non-contacting intervertebral disc replacement device according to embodiments of the invention, implanted betweenvertebra 1 that is superior to the replaced disc andvertebra 1′ that is inferior to the replaced disc.FIGS. 6A-7B show implantation of the device having no linking material betweenplates FIGS. 7A and 7B showmagnets plates FIGS. 8A-9B show implantation of the device having a linkingmaterial 140 present betweenplates FIGS. 9A and 9B showmagnets plates Separation distance 135 betweenmagnet 130 ofsuperior plate 100 andmagnet 130′ ofinferior plate 100′, as well as the size ofmagnets distance 135 betweenmagnet 130 andmagnet 130′ may be about 0.25 mm to about 20 mm, or about 0.5 mm to about 15 mm, or about 1 mm to about 10 mm. -
FIGS. 10A-11B show a two-plate contacting intervertebral disc replacement device according to embodiments of the invention, implanted betweenvertebra 1 that is superior to the replaced disc andvertebra 1′ that is inferior to the replaced disc.FIGS. 11A and 11B showmagnets plates Separation distance 235 betweenmagnet 230 ofsuperior plate 200 andmagnet 230′ ofinferior plate 200′, as well as the size ofmagnets surfaces plates distance 235 betweenmagnet 230 andmagnet 230′ may be about 0.25 mm to about 20 mm, or about 0.5 mm to about 15 mm, or about 1 mm to about 10 mm. -
FIGS. 12A-15B show a two-plate-with-spacer contacting intervertebral disc replacement device according to embodiments of the invention, implanted betweenvertebra 1 that is superior to the replaced disc andvertebra 1′ that is inferior to the replaced disc.FIGS. 13A and 13B showmagnets plates Separation distance 335 is betweenmagnet 330 ofsuperior plate 300 andmagnet 330′ of inferior plate.FIGS. 14A and 14B showmagnets plates magnet 370 ofspacer 350 upon implantation of a device according to embodiments in which spacer 350 contains a magnet that is not in association with either of its superior articulatingsurface 355 or its inferior articulatingsurface 360.Separation distance 336 is betweenmagnet 330 ofsuperior plate 300 andmagnet 370 ofspacer 350, andseparation distance 336′ is betweenmagnet 330′ ofinferior plate 300′ andmagnet 370 of thespacer 350.FIGS. 15A and 15B showmagnets plates magnets surfaces magnet 371 in association with its superior articulatingsurface 355 and contains amagnet 371′ in association with its inferior articulatingsurface 360.Separation distance 337 betweenmagnet 330 ofsuperior plate 300 andmagnet 371 associated with superior articulatingsurface 355 ofspacer 350, andseparation distance 337′ betweenmagnet 330′ ofinferior plate 300′ andmagnet 371′ associated with inferior articulatingsurface 360 ofspacer 350, as well as the size ofmagnets distance - A series of analyses were conducted using JMAG simulation technology to study how the magnetic repulsion forces are impacted by the magnet thickness, the magnet diameter, and the separation distance between the magnets. JMAG utilizes finite element analysis to calculate the magnetic forces and fields. Briefly, the geometry of the magnets is loaded into the simulation software, and the magnetic strength and pole orientation is assigned when the simulation is performed.
- The analyses are designed to mimic the repulsion force generated between the magnet of a superior plate and the magnet of an inferior plate in a two-plate non-contacting intervertebral disc replacement device according to embodiments of the present invention; or between the magnet of a superior plate and the magnet of an inferior plate in a two-plate contacting intervertebral disc replacement device according to embodiments of the present invention; or between the magnet of a superior/inferior plate and the magnet of a spacer in a two-plate-with-spacer contacting intervertebral disc replacement device, according to embodiments of the present invention. The analyses considered magnet thicknesses of 3 mm and 5 mm; magnet diameters of 10 mm, 15 mm, 20 mm, and 25 mm; and separation distances of 0.25 mm, 0.5 mm, 1 mm, 3 mm, 5 mm, 7 mm, and 10 mm.
- The analyses show that, in general, a greater magnet diameter results in a greater repulsion force between the magnets (see Tables 1 and 2, and
FIGS. 16 and 17 ). In addition, a greater magnet thickness generates a greater repulsion force between the magnets (see Table 3 andFIG. 18 ). Further, for each magnet thickness and magnet diameter, an increase in separation distance between the magnets led to a decrease in repulsion force. - These results demonstrate how the magnet thickness, the magnet diameter, and the separation distance between magnets in the plates/spacer can all impact the magnetic repulsion forces that are generated.
-
TABLE 1 Repulsion forces generated between the magnets of the disc replacement devices for variations in magnet diameter and separation distance and with a 3 mm magnet thickness. Separation Distance Magnet Diameter (mm) (mm) 10 15 20 25 1 14.1N 24.1N 34.1N 44.1 N 3 6.1N 12.4N 18.2N 24.2 N 5 3.0N 6.9N 11.0N 15.8 N 7 1.4N 4.4N 7.4N 10.8 N 10 0.5N 2.0N 4.0N 6.5N -
TABLE 2 Repulsion forces generated between the magnets of the disc replacement devices for variations in magnet diameter and separation distance and with a 5 mm magnet thickness. Separation Distance Magnet Diameter (mm) (mm) 10 15 20 25 1 22.1N 40.7N 61.0N 83.0 N 3 10.3N 22.8N 35.8N 49.7 N 5 5.5N 13.7N 23.5N 33.6 N 7 3.0N 8.7N 16.2N 23.8 N 10 1.1N 4.4N 9.4N 15.4N -
TABLE 3 Repulsion forces generated between the magnets of the disc replacement devices for variations in magnet thickness and separation distance and with a 25 mm magnet diameter. Separation Distance Magnet Thickness (mm) (mm) 3 5 0.25 65.8N 112.8N 0.5 56.4N 100.9 N 1 44.1N 83.0 N 3 24.2N 49.7 N 5 15.8N 33.6 N 7 10.8N 23.8 N 10 6.5N 15.4N - A finite element analysis was conducted using JMAG as described in Example 1 to study how the magnetic repulsion forces are impacted by motion between the superior plate and inferior plate of an intervertebral disc replacement device. In particular, the analysis assesses the magnetic force field that is generated when the angle between the plates, and therefore the angle between the magnets that are embedded therein, is at 7°.
- The analysis shows that a greater repulsive magnetic force is generated at the ends of the magnet that are closer together, as compared to the ends of the magnet that are more separated (see
FIGS. 19 and 20 ). Such results demonstrate that, upon implantation, as motion occurs the plates will move closer together, which brings the opposing poles of the magnets closer together and a greater repulsive resistance force may be generated. This resistance force may limit the motion and prevents extreme motion and contact between the surfaces. - The foregoing description is given for clearness of understanding only, and no unnecessary limitations should be understood therefrom, as modifications within the scope of the invention may be apparent to those having ordinary skill in the art.
- Detailed embodiments of the present intervertebral disc replacement devices and methods thereof are disclosed herein; however, it is to be understood that the disclosed embodiments are merely illustrative of the intervertebral disc replacement device and methods that may be embodied in various forms. In addition, each of the examples given in connection with the various embodiments of the systems and methods are intended to be illustrative, and not restrictive.
- Throughout this specification and the claims which follow, unless the context requires otherwise, the word “comprise” and variations such as “comprises” and “comprising” will be understood to imply the inclusion of a stated integer or step or group of integers or steps but not the exclusion of any other integer or step or group of integers or steps.
- Throughout the specification, where devices are described as including plates, spacers, and/or materials, it is contemplated that the compositions can also consist essentially of, or consist of, any combination of the recited plates, spacers, and/or materials, unless described otherwise. Likewise, where methods are described as including particular steps, it is contemplated that the methods can also consist essentially of, or consist of, any combination of the recited steps, unless described otherwise. The invention illustratively disclosed herein suitably may be practiced in the absence of any element or step which is not specifically disclosed herein.
- The practice of a method disclosed herein, and individual steps thereof, can be performed manually and/or with the aid of or automation provided by electronic equipment. Although processes have been described with reference to particular embodiments, a person of ordinary skill in the art will readily appreciate that other ways of performing the acts associated with the methods may be used. For example, the order of various steps may be changed without departing from the scope or spirit of the method, unless described otherwise. In addition, some of the individual steps can be combined, omitted, or further subdivided into additional steps.
- All patents, publications and references cited herein are hereby fully incorporated by reference. In case of conflict between the present disclosure and incorporated patents, publications and references, the present disclosure should control.
Claims (21)
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