WO2008063941A1 - Intervertebral prosthetic assembly for spinal stabilization and method of implanting same - Google Patents
Intervertebral prosthetic assembly for spinal stabilization and method of implanting same Download PDFInfo
- Publication number
- WO2008063941A1 WO2008063941A1 PCT/US2007/084384 US2007084384W WO2008063941A1 WO 2008063941 A1 WO2008063941 A1 WO 2008063941A1 US 2007084384 W US2007084384 W US 2007084384W WO 2008063941 A1 WO2008063941 A1 WO 2008063941A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- spacer
- vertebra
- cross
- assembly
- bar
- Prior art date
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
- A61B17/7067—Devices bearing against one or more spinous processes and also attached to another part of the spine; Tools therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
- A61B17/7043—Screws or hooks combined with longitudinal elements which do not contact vertebrae with a longitudinal element fixed to one or more transverse elements which connect multiple screws or hooks
Definitions
- the present invention relates to an intervertebral prosthetic assembly for stabilizing the human spine, and a method of implanting same.
- Intervertebral discs that extend between adjacent vertebrae in vertebral columns of the human body provide critical support between the adjacent vertebrae while permitting multiple degrees of motion. These discs can rupture, degenerate, and/or protrude by injury, degradation, disease, or the like, to such a degree that the intervertebral space between adjacent vertebrae collapses as the disc loses at least a part of its support function, which can cause impingement of the nerve roots and severe pain.
- Intervertebral prosthetic devices have been designed that can be implanted between the adjacent vertebrae, both anterior and posterior of the column. Many of these devices are supported between the spinous processes of the adjacent vertebrae to prevent the collapse of the intervertebral space between the adjacent vertebrae and provide motion stabilization of the spine.
- the present invention is thus directed to an intervertebral prosthetic assembly that is implantable between two adjacent vertebrae to provide motion stabilization, despite the fact that at least one vertebra is void of a spinous process.
- Various embodiments of the invention may possess one or more of the above features and advantages, or provide one or more solutions to the above problems existing in the prior art. BRIEF DESCRIPTION OF THE DRAWINGS
- Fig. 1 is a side elevational view of an adult human vertebral column.
- Fig. 2 is a posterior elevational view of the column of Fig. 1.
- Fig. 3 is an enlarged, front elevational view of one of the vertebrae of the column of Figs. 1 and 2.
- Fig. 4 is an isometric view of a portion of the column of Figs. 1 and 2, including the lower three vertebrae of the column, and depicting an intervertebral prosthetic assembly according to an embodiment of the invention implanted between two adjacent vertebrae.
- Fig. 5 is an enlarged view of a portion of the column and the assembly shown in Fig. 4.
- Figs. 6 and 7 are views similar to that of Fig. 5, but depicting alternate embodiments of the assembly of Fig. 5.
- Figs. 8 and 9 are partial elevational/partial sectional views of two additional alternate embodiments of the assembly of Fig. 5.
- the reference numeral 10 refers, in general, to the lower portion of a human vertebral column.
- the column 10 includes a lumbar region 12, a sacrum 14, and a coccyx 16.
- the flexible, soft portion of the column 10, which includes the thoracic region and the cervical region, is not shown.
- the lumbar region 12 of the vertebral column 10 includes five vertebrae Vl, V2, V3, V4 and V5 separated by intervertebral discs Dl, D2, D3, and D4, with the disc Dl extending between the vertebrae Vl and V2, the disc D2 extending between the vertebrae V2 and V3, the disc D3 extending between the vertebrae V3 and V4, and the disc D4 extending between the vertebrae V4 and V5.
- the sacrum 14 includes five fused vertebrae, one of which is a superior vertebra V6 separated from the vertebra V5 by a disc D5.
- the other four fused vertebrae of the sacrum 14 are referred to collectively as V7.
- a disc D6 separates the sacrum 14 from the coccyx 16, which includes four fused vertebrae (not referenced).
- the vertebra V5 includes two laminae 20a and 20b extending to either side (as viewed in Fig. 2) of a spinous process 22 that extends posteriorly from the juncture of the two laminae.
- Two transverse processes 24a and 24b extend laterally from the laminae 20a and 20b, respectively.
- Two articular processes 26a and 26b extend superiorly from the laminae 20a and 20b respectively, and two articular processes 28a and 28b extend inferiorly from the laminae 20a and 20b, respectively.
- the inferior articular processes 28a and 28b rest in the superior articular process of the vertebra V2 to form a facet joint. Since the vertebrae V1-V4 are similar to the vertebra V5, and since the vertebrae V6 and V 7 are not involved in the present invention, they will not be described in detail.
- a spacer 40 is provided that is fabricated from a relatively flexible, soft material, and is substantially rectangular in shape with the exception that a curved notch, or saddle, 40a is formed at one end for receiving the spinous process 22 of the vertebra V3.
- a through opening 40b extends through the spacer in a spaced relation to the saddle 40a, and a flexible cross-bar 42 extends through the opening 40b in the spacer 40 and generally transverse to the axis of the spine.
- the cross-bar 42 spans a substantial portion of the width of the vertebra V4.
- Two transversely-spaced retainers 44a and 44b are fastened to the vertebra V4 by two screws 46a and 46b, respectively.
- Each screw 46a and 46b has a head (not shown) extending in a corresponding retainer, and an externally threaded shank extending from the head that is screwed in the vertebra V4.
- the respective end portions of the crossbar 42 extend through openings in the retainers 44a and 44b.
- a strap 48 extends through another opening 40c in the spacer 40 and around the process 22 of the vertebra V3 to secure the spacer to the process.
- the spacer 40 is thus firmly secured in its implanted position shown in Fig. 4, and stabilizes the vertebrae V3-V5. Also, the relatively flexible, soft spacer 40 readily conforms to the process 22 of the vertebra V3 and provides excellent shock absorption and deformability, resulting in an improved fit.
- a spacer 50 is provided that is fabricated from a relatively flexible, soft material, and is substantially rectangular in shape with the exception that a saddle 50a is formed at one end of the spacer for receiving the spinous process 22 of the vertebra V3. Also, a transversely extending notch, or groove 50b is formed in the other end of the spacer 50, and two through openings 50c and 5Od extend through the spacer, for reasons to be described.
- a central portion of the cross-bar 42 of the previous embodiment extends into the notch 50b and generally transverse to the axis of the spine, and spans a substantial portion of the width of the vertebra V4.
- the respective end portions of the cross-bar 42 extend through openings in the retainers 44a and 44b (Fig. 4) which are mounted to the vertebra V4 by the screws 46a and 46b, respectively.
- the strap 48 extends through the opening 50c in the spacer 50 and around the process 22 of the vertebra V3 to secure the spacer to the vertebra.
- a second strap 52 (Fig. 7) extends through the opening 5Od in the spacer 50 and around the notch 50b and the cross-bar 42, to secure the cross-bar to the spacer.
- the spacer 50 is thus firmly secured in the same implanted position as shown in connection with the spacer 40 of the embodiment of Figs. 4 and 5, and stabilizes the vertebrae V3-V5. Also, the relatively flexible, soft, spacer 50 readily conforms to the process 22 of the vertebra V3 and provides excellent shock absorption and deformability resulting in an improved fit.
- a spacer 60 is provided that is fabricated from a relatively flexible, soft material, and is substantially rectangular in shape with the exception that a saddle 60a is formed at one end for receiving the spinous process 22 of the vertebra V3.
- a flexible cross-bar 62 is provided that has two slightly-spaced, circular flanges 62a and 62b formed on its central portion.
- the central portion of the cross-bar 62, along with the flanges 62a and 62b are embedded in the spacer 60 in any conventional manner, such as by forming the spacer of a rubber material and molding it over the cross-bar.
- the respective end portions of the cross-bar 62 extend through openings in the retainers 44a and 44b (Fig. 4), which are mounted to the vertebra V4 by the screws 46a and 46b, respectively, as described above.
- the strap 48 of the embodiment of Figs. 4 and 5 can extend through the spacer 60 and around the process 22 of the vertebra V3 to secure the spacer to the vertebra.
- the spacer 60 is thus firmly secured in the same implanted position as shown in connection with the spacer 40 of the embodiment of Figs. 4 and 5, and stabilizes the vertebrae V3 - V5. Also, the relatively flexible, soft spacer 60 readily conforms to the process 22 of the vertebra V3 and provides excellent shock absorption and deformability resulting in an improved fit.
- a spacer 70 is provided that is fabricated from a relatively flexible, soft material, and has a generally U-shaped cross section.
- a saddle 70a is defined at one end of the spacer 70 for receiving the spinous process 22 of the vertebra V3.
- a flexible cross-bar 72 is provided that has two slightly-spaced protrusions 72a and 72b that extend transverse to the axis of the cross-bar and form, with the corresponding portion of the cross-bar, a U-shaped portion that receives the spacer 70.
- the spacer 70 could be formed of a rubber material that is molded over the cross-bar 72.
- the respective end portions of the cross-bar 72 extend through openings in the retainers 44a and 44b (Fig. 4), which are mounted on the vertebra V4 by the screws 46a and 46b in the manner described above.
- the strap 48 of the embodiment of Figs. 4 and 5 can extend through the spacer 70 and around the process 22 of the vertebra V3 to secure the spacer to the vertebra.
- the spacer 70 is thus firmly secured in the same implanted position as shown in connection with the spacer 40 of the embodiment of Figs. 4 and 5, and therefore stabilizes the vertebrae V3 - V5. Also, the relatively flexible, soft spacer 70 readily conforms to the process 22 of the vertebra V3 and provides excellent shock absorption deformability resulting in an improved fit.
- the assemblies of the above embodiments can be inserted between two vertebrae following a discectemy in which a disc between the adjacent vertebrae is removed, or corpectomy in which at least one vertebrae is removed.
- cross-bars in each of the previous embodiments can be rigidly connected to the pedicles of the vertebra by means other than the screws and retainers described in the above examples.
- the components disclosed above can be fabricated from materials other than those described above and may include a combination of soft and rigid materials.
- Any conventional substance that promotes bone growth such as HA coating, BMP, or the like, can be incorporated in the spacers in the above embodiments.
- the surfaces of the spacers disclosed above that define the saddles that receive the spinous process can be treated, such as by providing teeth, ridges, knurling, etc., to better grip the spinous process.
- the spacers disclosed above can be fabricated of a permanently deformable material thus providing a clamping action against the spinous processes.
- One or more of the components disclosed above may have through-holes formed therein to improve integration of the bone growth.
- the components of one or more of the above embodiments may vary in shape, size, composition, and physical properties.
- Through-openings can be provided through one or more components of each of the above embodiments to receive tethers for attaching the devices to a vertebra or to a spinous process.
- each of the above embodiments can be placed between two vertebrae in the vertebral column other than the ones described above.
- (11) The number and lengths of the cross-bars in one or more of the embodiments can be varied.
- the cross-bars can be flexible or rigid.
- the assemblies of the above embodiments can be implanted between body portions, or anatomical structures other than vertebrae.
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Neurology (AREA)
- Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
- Surgical Instruments (AREA)
Abstract
Description
Claims
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP07864255A EP2091450A1 (en) | 2006-11-13 | 2007-11-12 | Intervertebral prosthetic assembly for spinal stabilization and method of implanting same |
AU2007323934A AU2007323934A1 (en) | 2006-11-13 | 2007-11-12 | Intervertebral prosthetic assembly for spinal stabilization and method of implanting same |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US11/559,013 | 2006-11-13 | ||
US11/559,013 US20080114358A1 (en) | 2006-11-13 | 2006-11-13 | Intervertebral Prosthetic Assembly for Spinal Stabilization and Method of Implanting Same |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2008063941A1 true WO2008063941A1 (en) | 2008-05-29 |
Family
ID=39154125
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US2007/084384 WO2008063941A1 (en) | 2006-11-13 | 2007-11-12 | Intervertebral prosthetic assembly for spinal stabilization and method of implanting same |
Country Status (4)
Country | Link |
---|---|
US (1) | US20080114358A1 (en) |
EP (1) | EP2091450A1 (en) |
AU (1) | AU2007323934A1 (en) |
WO (1) | WO2008063941A1 (en) |
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Also Published As
Publication number | Publication date |
---|---|
US20080114358A1 (en) | 2008-05-15 |
EP2091450A1 (en) | 2009-08-26 |
AU2007323934A1 (en) | 2008-05-29 |
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