WO2000004851A1 - Threaded cylindrical multidiscoid single or multiple array disc prosthesis - Google Patents

Threaded cylindrical multidiscoid single or multiple array disc prosthesis Download PDF

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Publication number
WO2000004851A1
WO2000004851A1 PCT/US1999/016648 US9916648W WO0004851A1 WO 2000004851 A1 WO2000004851 A1 WO 2000004851A1 US 9916648 W US9916648 W US 9916648W WO 0004851 A1 WO0004851 A1 WO 0004851A1
Authority
WO
WIPO (PCT)
Prior art keywords
housing
disc
disc prosthesis
prosthesis
halves
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/US1999/016648
Other languages
English (en)
French (fr)
Inventor
Vincent Bryan
Alex Kunzler
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Medtronic Sofamor Danek Inc
Original Assignee
Spinal Dynamics Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Spinal Dynamics Corp filed Critical Spinal Dynamics Corp
Priority to AU53193/99A priority Critical patent/AU748746B2/en
Priority to CA002338379A priority patent/CA2338379A1/en
Priority to EP99938781A priority patent/EP1100416B1/en
Priority to US09/744,493 priority patent/US7147665B1/en
Priority to JP2000560845A priority patent/JP2002521090A/ja
Priority to DE69936263T priority patent/DE69936263T2/de
Publication of WO2000004851A1 publication Critical patent/WO2000004851A1/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

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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
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2002/4635—Special tools for implanting artificial joints using minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0058—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements soldered or brazed or welded
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0065—Three-dimensional shapes toroidal, e.g. ring-shaped, doughnut-shaped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0069—Three-dimensional shapes cylindrical
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0073—Quadric-shaped
    • A61F2230/0076—Quadric-shaped ellipsoidal or ovoid
    • 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
    • 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
    • A61F2310/00179—Ceramics or ceramic-like structures

Definitions

  • This invention relates to the design and use of a unique disc prosthesis for the lumbar, thoracic and cervical spine.
  • Degenerative disc disease including disc herniation may produce disabling symptoms of local pain, radiculopathy or myelopathy in an otherwise clinically stable spine, which proves to be unresponsive to non-surgical treatment.
  • Several surgical treatments are available to address the symptoms of degenerative disc disease when non- invasive therapies are not effective. These surgical treatments include decompression, discectomy and fusion. These treatments, and in particular the discectomy and fusion procedures, provide relief of clinical symptoms but they do not restore normal or near normal range of motion or cushioning to the affected functional spinal unit (FSU). This can result in acceleration of the degenerative process in spinal discs adjacent to the original surgical operation site. This degenerative process can, in turn, require additional surgical intervention.
  • FSU functional spinal unit
  • a functional disc prosthesis which provides for a full range of motion of the FSU and for cushioning between two adjacent vertebrae while maintaining stability, intervertebral body spacing and lordosis, is desirable, more specifically it is an object of the invention to provide a disc prosthesis having a small or narrow profile.
  • the novel exemplary prosthesis is cylindrical in exterior shape, comprised of two longitudinally split halves. Each housing half is separated from the other at all times by disk shaped resilient bodies contained therein, and is strong enough to support the loads to which it shall be subjected during the activities of daily living.
  • the housing contains multiple concave articulation recesses capable of mating with the discoid resilient bodies placed therebetween.
  • the discoid bodies are of smaller diameter than the natural disc they replace, and are positioned in series in the shells or articulation recesses contained in the interior of the cylindrical housing.
  • the cylindrical housing is threaded on its exterior for ease of introduction into, and mechanical stability in, a prepared space in the opposing vertebrae of the FSU.
  • the housing is configured to fit the restrictions imposed by the limited anatomical space available for the surgical placement of the implant, and is small so as to utilize implantation procedures and instrumentation such as those used in an endoscopic procedure.
  • a further object of the intention is to provide a disc prosthesis which will provide for cushioning between the housing halves.
  • Figure 1 is an isometric view of the novel disc prosthesis.
  • Figure 2 is a sectional view taken substantially in the plane of line 2-2 in figure 1.
  • Figure 3 is a sectional view taken substantially in the plane of line 3-3 in figure 2.
  • Figure 4 is an isometric view similar to figure 1 but showing an alternate embodiment of the invention.
  • Figure 5 is a sectional ⁇ iew taken substantially in the plane of line 5-5 in figure 4.
  • Figure 6 is a sectional view taken substantially in the plane of line 6-6 in figure
  • Figure 7 is an isometric view of a lower half housing of the invention.
  • Figure 8 is a top plan view of the lower half housing shown in figure 7.
  • Figure 9 is a sectional view taken substantially in the plane of line 9-9 in figure 8.
  • Figure 10 is a sectional view taken substantially in the plane of line 10-10 in figure 9.
  • Figure 11 is a top plan view of a lower half housing similar to figure 8 but showing and alternate embodiment of the invention.
  • Figure 12 is a sectional view similar to figure 9 but taken substantially in the plane of line 12 - 12 in figure 11.
  • Figure 13 is an isometric view of the lower half housing shown in figures 11 and 12.
  • Figure 14 is a sectional view taken substantially in the plane of line 14 - 14 in figure 12.
  • the 10 includes, as shown in figures 1 and 4, a cylindrical housing 20.
  • the housing 20 includes an upper half housing 22 and a lower half housing 24.
  • an upper fixator wing 26 is welded or otherwise associated with the upper half housing 22, and a lower fixator wing 28 is similarly welded or otherwise associated with the lower half housing 24.
  • These wings 26, 28 can be used to stabilize the prosthesis to bone, as suggested in U.S. Patent 5,674,296.
  • the wings 26, 28 can be omitted, as suggested in figures 4 - 14.
  • a plurality of resilient, viscoelastic discs 41, 42 are interposed between the upper half housing 22 and the lower half housing 24 to maintain the housing halves separate from one another and to provide for a defined range of motion.
  • the discs 41, 42 may be made of a suitable hydrogel.
  • generally conical bosses or posts 29 can fit into recesses 33 formed in the discs 41, 42 to provide stability and limitation against excessive motion.
  • the housing 20 has an exterior surface 30 which bears a screw thread shape 31.
  • This screw thread shape 31 is continuous, and is contiguous from housing half 22 to housing half 24 so that the disc prosthesis can be screwed into a pre-tapped intervertebral space hole formed within between two adjacent vertebrae as, for example, in the human spine. If desired, recesses 35 can be formed to permit bone ingrowth and further stabilization of the device.
  • the housing 20 shape can be that of a right cylinder or it can be conical.
  • this small or thin profile prosthesis 10 can be created by placing more than one ovoid resilient prosthetic discs 41, 42 within a cylindrical housing 20 of metal, ceramic or polymeric material (the housing 20 having been separated into two halves 22, 24 longitudinally).
  • This small device 10 can be implanted in the spine through a small surgical opening.
  • One device 20 containing two or more discs 41, 42 may be used, or by placing two such devices 20 in parallel, each containing two or more ovoid discs in series, a full range of motion of the functional spinal unit (FSU) can be achieved.
  • FSU functional spinal unit
  • the discoid material possesses resilient, viscoelastic properties, with the housing being split or otherwise open on its sides with the internally placed ovoid discs maintaining the separation of the upper and lower housing members, a cushioning effect may also be realized.
  • a flexible sheath or seal can be attached to the housing halves, as by a retaining wire or band, as suggested in U.S. Patent 5,674,296.
  • each ovoid disc 41, 42 may be surrounded by a concave surface 51, 52 formed or contained within the housing, and contoured to accept the upper and lower surface shape of each of the ovoid discs 41, 42 so that the housing 20 comprising the two or more halves or paired shells 23, 24 may slide and/or rotate over the surface of the discs 41,42 to provide for joint space separation and motion.
  • a single recess 61 can be provided to accommodate both discs 41, 42. If desired, posts 29 can be provided to limit disc - housing half relative motion.
  • the exterior surface of the split housing 20 has a threaded formation so that it may be screwed into a pre-tapped hole of appropriate size at an intervertebral, disc space.
  • the upper half of the threaded housing engages the cephalad vertebral bone inferior end plate and the other half 24 of the threaded housing engages the opposing superior end plate of the caudal vertebral bone when fully inserted.
  • the ovoid discs 41, 42 and their respective concave surfaces in any one housing unit may be of differing size so as to allow for appropriate spinal column curvature, especially when inserted in the anterior/ posterior direction, or they may be the same size in any one housing but differ from the size of the discs in the second housing placed in parallel when inserted from a lateral direction.
  • the device may be inserted via open or minimally invasive techniques including endoscopy, or by a variety of known surgical approaches where adequate anatomical space is available.
  • the prosthesis is inserted as a single threaded cylindrical unit, its final position is such that one half of the housing is left exclusively in contact with the end plate of one vertebral body and the other in the exclusive contact of the opposing vertebral body end plate.
  • the discoid vertebral bodies between the cylindrical housing halves contain two or more concave surfaces, allow movement by providing for sliding and rotating in multiple directions and cushioning in response to physiological loads placed upon them.
  • intervertebral spacing can be varied to achieve desired vertebrae positional relationships.

Landscapes

  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Neurology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)
  • Peptides Or Proteins (AREA)
  • Nitrogen And Oxygen Or Sulfur-Condensed Heterocyclic Ring Systems (AREA)
PCT/US1999/016648 1998-07-22 1999-07-22 Threaded cylindrical multidiscoid single or multiple array disc prosthesis Ceased WO2000004851A1 (en)

Priority Applications (6)

Application Number Priority Date Filing Date Title
AU53193/99A AU748746B2 (en) 1998-07-22 1999-07-22 Threaded cylindrical multidiscoid single or multiple array disc prosthesis
CA002338379A CA2338379A1 (en) 1998-07-22 1999-07-22 Threaded cylindrical multidiscoid single or multiple array disc prosthesis
EP99938781A EP1100416B1 (en) 1998-07-22 1999-07-22 Threaded cylindrical multidiscoid single or multiple array disc prosthesis
US09/744,493 US7147665B1 (en) 1998-07-22 1999-07-22 Threaded cylindrical multidiscoid single or multiple array disc prosthesis
JP2000560845A JP2002521090A (ja) 1998-07-22 1999-07-22 複数の円板状部材を用いる単一または複数列のネジ切り式円筒形椎間板プロテーゼ
DE69936263T DE69936263T2 (de) 1998-07-22 1999-07-22 Geschraubte zylindrische, multidiskoide einfach- oder mehrfach-netzwerkplattenprothese

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US9365498P 1998-07-22 1998-07-22
US60/093,654 1998-07-22

Publications (1)

Publication Number Publication Date
WO2000004851A1 true WO2000004851A1 (en) 2000-02-03

Family

ID=22240068

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1999/016648 Ceased WO2000004851A1 (en) 1998-07-22 1999-07-22 Threaded cylindrical multidiscoid single or multiple array disc prosthesis

Country Status (9)

Country Link
US (1) US7147665B1 (enExample)
EP (1) EP1100416B1 (enExample)
JP (1) JP2002521090A (enExample)
AT (1) ATE363877T1 (enExample)
AU (1) AU748746B2 (enExample)
CA (1) CA2338379A1 (enExample)
DE (1) DE69936263T2 (enExample)
ES (1) ES2286891T3 (enExample)
WO (1) WO2000004851A1 (enExample)

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