U.S. patent application number 10/776754 was filed with the patent office on 2004-11-18 for device for fusing two bone segments.
This patent application is currently assigned to SDGI Holdings, Inc.. Invention is credited to Eisermann, Lukas.
Application Number | 20040230307 10/776754 |
Document ID | / |
Family ID | 32869579 |
Filed Date | 2004-11-18 |
United States Patent
Application |
20040230307 |
Kind Code |
A1 |
Eisermann, Lukas |
November 18, 2004 |
Device for fusing two bone segments
Abstract
A fusion-promoting, spinal plating assembly is described. The
plating assembly includes a first plate, and at least one
additional plate connected to the first plate, the at least one
additional plate extending transversely to the first plate. The
plating assembly is adapted to be completely inserted within an
intervertebral space defined between a first vertebral body and a
second vertebral body.
Inventors: |
Eisermann, Lukas; (Memphis,
TN) |
Correspondence
Address: |
HAYNES AND BOONE, LLP
901 MAIN STREET, SUITE 3100
DALLAS
TX
75202
US
|
Assignee: |
SDGI Holdings, Inc.
Wilmington
DE
|
Family ID: |
32869579 |
Appl. No.: |
10/776754 |
Filed: |
February 11, 2004 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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10776754 |
Feb 11, 2004 |
|
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10752725 |
Jan 7, 2004 |
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60446963 |
Feb 12, 2003 |
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Current U.S.
Class: |
623/17.11 |
Current CPC
Class: |
A61F 2002/3008 20130101;
A61F 2230/0028 20130101; A61F 2002/30785 20130101; A61F 2002/30884
20130101; A61F 2230/0015 20130101; A61F 2002/30925 20130101; A61B
2017/1602 20130101; A61F 2230/0052 20130101; A61B 17/1624 20130101;
A61F 2/447 20130101; A61F 2002/30649 20130101; A61F 2002/30845
20130101; A61F 2002/2835 20130101; A61F 2002/30593 20130101; A61B
17/1637 20130101; A61F 2/08 20130101; A61F 2002/30836 20130101;
A61B 17/1757 20130101; A61F 2002/30131 20130101; A61F 2002/30156
20130101; A61F 2002/30686 20130101; A61F 2310/00023 20130101; A61F
2002/30172 20130101; A61F 2230/0023 20130101; A61B 17/1671
20130101; A61F 2220/0025 20130101; A61F 2220/0033 20130101; A61F
2310/00796 20130101; A61F 2002/30401 20130101; A61F 2002/30507
20130101; A61F 2250/0098 20130101; A61F 2002/30769 20130101; A61F
2002/30166 20130101; A61F 2/4611 20130101; A61F 2002/30133
20130101; A61B 17/1615 20130101; A61B 17/1642 20130101; A61F
2/30767 20130101; A61F 2002/30387 20130101; A61F 2/4425 20130101;
A61F 2230/0013 20130101; A61F 2310/00017 20130101; A61F 2002/4627
20130101; A61F 2/4684 20130101; A61F 2002/30373 20130101 |
Class at
Publication: |
623/017.11 |
International
Class: |
A61F 002/44 |
Claims
What is claimed is:
1. A fusion-promoting prosthetic device for insertion into an
intervertebral space, comprising a sagitally-extending plate having
caudal and cephalad edges, the caudal edge being adapted for
complete insertion within a first vertebral body and the cephalad
edge being adapted for complete insertion within a second vertebral
body adjacent to the first vertebral body, a first transverse plate
connected to the sagitally-extending plate, and a second transverse
plate connected to the sagitally-extending plate, the first and
second transverse plates being adapted for complete insertion
within the intervertebral space.
2. The prosthetic device of claim 1 wherein the first transverse
plate comprises a bearing surface, the bearing surface being
adapted to engage the first vertebral body.
3. The prosthetic device of claim 1 wherein the second transverse
plate comprises a bearing surface, the bearing surface being
adapted to engage the second vertebral body.
4. The prosthetic device of claim 1 wherein the sagitally-extending
plate further comprises a plurality of openings extending
therethrough.
5. The prosthetic device of claim 1 wherein each of the first and
second transverse plates comprises a plurality of openings
extending therethrough.
6. The prosthetic device of claim 1 wherein the sagitally-extending
plate is coated with a bone-growth promoting substance.
7. The prosthetic device of claim 1 wherein the first and second
transverse plates are each coated with a bone-growth promoting
substance.
8. The prosthetic device of claim 1 wherein the first transverse
plate is angled relative to the sagitally-extending plate.
9. The prosthetic device of claim 8 wherein the second transverse
plate is angled relative to the sagitally-extending plate, the
angulation of the first and second transverse plates corresponding
to an angular relationship defined between the first and second
vertebral bodies.
10. The prosthetic device of claim 1 wherein the first and second
transverse plates each extend at a substantially right angle to the
sagitally-extending plate.
11. The prosthetic device of claim 1 wherein the caudal edge is
beveled at a posterior portion thereof.
12. The prosthetic device of claim 1 wherein the cephalad edge is
beveled at a posterior portion thereof.
13. A fusion-promoting, spinal plating assembly, comprising a first
plate adapted to engage a first vertebral body and a second
vertebral body, and at least one additional plate connected to the
first plate, the at least one additional plate extending
transversely to the first plate, wherein the at least one
additional plate is adapted to be inserted within an intervertebral
space.
14. The plating assembly of claim 13 wherein the at least one
additional plate is integrally formed with the first plate.
15. The plating assembly of claim 13 wherein the at least one
additional plate is removably connected to the first plate.
16. The plating assembly of claim 13 wherein the at least one
additional plate extends at an angle relative to the first
plate.
17. The plating assembly of claim 13 wherein the first plate is
adapted to be impacted into each of the first and second vertebral
bodies.
18. The plating assembly of claim 13 wherein the first plate is
adapted to be inserted into a preformed opening in each of the
first and second vertebral bodies.
19. A method for promoting fusion in an intervertebral space
defined between first and second vertebral bodies, comprising:
providing a prosthetic device having a first plate adapted to
engage each of the first and second vertebral bodies, and a pair of
additional plates connected to the first plate, the additional pair
of plates extending in a direction transverse to the first plate;
and inserting the prosthetic device into the intervertebral space
such that a first edge of the first plate is completely inserted
within the first vertebral body, a second edge of the first plate
is completely inserted within the second vertebral body, and each
of the additional pair of plates are completely disposed within the
intervertebral space.
20. The method of claim 19 further comprising inserting bone grafts
into the intervertebral space.
21. The method of claim 19 wherein inserting the prosthetic device
comprises impacting the first and second edges of the first plate
into the first and second vertebral bodies, respectively.
22. The method of claim 19 wherein inserting the prosthetic device
comprises forming openings in each of the first and second
vertebral bodies and inserting the first and second edges of the
first plate into the preformed openings of the first and second
vertebral bodies, respectively.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application claims the benefit of U.S. Provisional
Application No. 60/446,963 filed on Feb. 12, 2003. U.S. Provisional
Application No. 60/446,963 is herein incorporated by reference for
all legitimate purposes. This application is a continuation of U.S.
patent application Ser. No. ______ (Attorney Docket No. 31132.44),
entitled "Device For Fusing Two Bone Segments" (Inventor: Lukas
Eisermann) filed on Jan. 7, 2004. U.S. patent application Ser. No.
______ (Attorney Docket No. 31132.44) is herein incorporated by
reference for all legitimate purposes. This application is also
related to U.S. patent application Ser. No. 10/430,473, which is
herein incorporated by reference for all legitimate purposes.
BACKGROUND
[0002] The present disclosure relates generally to the field of
orthopedics and spinal surgery, and in some embodiments, the
present disclosure relates to fusion-promoting prosthetic devices
for insertion into an intervertebral disc space.
[0003] In the treatment of diseases, injuries or malformations
affecting spinal motion segments, and especially those affecting
disc tissue, it has long been known to remove some or all of a
degenerated, ruptured or otherwise failing disc. In cases involving
intervertebral disc tissue that has been removed or is otherwise
absent from a spinal motion segment, corrective measures are taken
to ensure the proper spacing of the vertebrae formerly separated by
the removed disc tissue. In some instances, fusion-promoting
prosthetic devices, such as fusion cages and the like, are inserted
into the disc space to maintain the structural integrity of the
spinal column.
[0004] Anterior plating is often used in conjunction with fusion
devices to supplement the stability provided by such fusion
devices. However, in some instances, anterior plating is
inappropriate for use due to the presence of vascular structure,
which impedes the implantation and positioning of the anterior
plating.
[0005] Therefore, what is needed is an implantable fusion device
which eliminates, or at least reduces, the need for supplemental
plating external of the intervertebral space.
SUMMARY
[0006] A fusion-promoting prosthetic device for insertion into an
intervertebral space is described. The prosthetic device includes a
sagitally-extending plate having caudal and cephalad edges, the
caudal edge being adapted for complete insertion within a first
vertebral body and the cephalad edge being adapted for complete
insertion within a second vertebral body adjacent to the first
vertebral body. The prosthetic device further includes a first
transverse plate connected to the sagitally-extending plate, and a
second transverse plate connected to the sagitally-extending plate,
the first and second transverse plates being adapted for complete
insertion within the intervertebral space.
[0007] A fusion-promoting, spinal plating assembly is described.
The plating assembly includes a first plate adapted to engage a
first vertebral body and a second vertebral body, and at least one
additional plate connected to the first plate, the at least one
additional plate extending transversely to the first plate, wherein
the at least one additional plate is adapted to be inserted within
an intervertebral space.
[0008] A method for promoting fusion in an intervertebral space
defined between first and second vertebral bodies is described. The
method includes providing a prosthetic device having a first plate
adapted to engage each of the first and second vertebral bodies,
and a pair of additional plates connected to the first plate, the
additional pair of plates extending in a direction transverse to
the first plate. The method further includes inserting the
prosthetic device into the intervertebral space such that a first
edge of the first plate is completely inserted within the first
vertebral body, a second edge of the first plate is completely
inserted within the second vertebral body, and each of the
additional pair of plates are completely disposed within the
intervertebral space.
BRIEF DESCRIPTION OF THE DRAWINGS
[0009] FIG. 1 is a lateral view of a pair of adjacent vertebral
bodies.
[0010] FIG. 2 is a lateral view of a prosthetic device for
insertion between the adjacent vertebral bodies of FIG. 1.
[0011] FIG. 3a is a longitudinal view of the prosthetic device of
FIG. 2.
[0012] FIG. 3b is a longitudinal view of an alternative prosthetic
device.
[0013] FIG. 4a is a longitudinal view of a pair of the verterbral
bodies of FIG. 1 having longitudinally-formed slots for receiving
the prosthetic device of FIG. 2.
[0014] FIG. 4b is a lateral view of the prosthetic device of FIG. 2
shown longitudinally disposed between the vertebral endplates of
FIG. 1.
[0015] FIG. 5a is a lateral view of a pair of verterbral bodies
having laterally-formed slots for receiving a prosthetic
device.
[0016] FIG. 5b is a lateral view of an alternative prosthetic
device shown laterally disposed between the vertebral bodies of
FIG. 5a.
DESCRIPTION
[0017] For the purposes of promoting an understanding of the
principles of the disclosure, reference will now be made to the
embodiments, or examples, illustrated in the drawings and specific
language will be used to describe the same. It will nevertheless be
understood that no limitation of the scope of the disclosure is
thereby intended. Any alterations and further modifications in the
described embodiments, and any further applications of the
principles of the disclosure as described herein are contemplated
as would normally occur to one skilled in the art to which this
disclosure relates.
[0018] Referring now to FIG. 1, shown therein is a lateral view of
a portion of a spinal column 10, illustrating a pair of adjacent
upper and lower vertebrae V1 and V2, respectively, separated by an
intervertebral space S created by the removal of a natural
intervertebral disc. The illustration of two vertebrae is only
intended as an example. Another example would be a sacrum and one
vertebrae. Vascular structure 12, such as, for example, the aortic
artery and associated segmental arteries, is shown disposed
anteriorly adjacent to the upper and lower vertebrae V1, V2. As can
be appreciated, it is not desirable to impart pressure to, or
otherwise contact, the vascular structure 12 during insertion and
upon implantation of a prosthetic device.
[0019] Referring now to FIGS. 2 and 3a, a prosthetic device for
insertion into the space S (FIG. 1) is generally referred to by
reference numeral 20. In one embodiment, the device 20 includes a
sagittally-extending support plate 22 and a pair of additional
support plates 24, 26 integrally formed with and extending
generally transverse to the sagittal plate. It is understood that
the transverse plates 24, 26 may alternatively be removably
connected to the sagittal plate 22 such that the prosthetic device
20 is generally modular in nature. Although the sagittal plate 22
and the transverse plates 24, 26 of the prosthetic device 20 may be
formed from a wide variety of materials, in one embodiment of the
disclosure, the sagittal plate 22 and the transverse plates 24, 26
are formed of a cobalt-chrome-molybdenum metallic alloy (ASTM F-799
or F-75). However, in alternative embodiments of the disclosure,
the sagittal plate 22 and the transverse plates 24, 26 may be
formed of other materials such as titanium or stainless steel, a
polymeric material such as polyethylene, or any other biocompatible
material that would be apparent to one of ordinary skill in the
art.
[0020] The sagittal plate 22 is adapted to engage the upper and
lower vertebrae V1, V2, respectively, and in the present example,
the sagittal plate 22 extends in a plane substantially parallel to
the sagittal plane (represented by axis Y lying in the sagittal
plane in FIG. 1) when engaged with the upper and lower vertebrae.
The sagittal plate 22 includes an anterior edge 30, a posterior
edge 32, a caudal edge 34 and a cephalad edge 36. It is understood
that reference to anatomical directions in this specification such
as sagittal, anterior, posterior, caudal and cephalad is for
purposes of descriptive clarity only, and is not intended to limit
the prosthetic device 20 to having a specific orientation relative
to such anatomical directions.
[0021] The caudal and cephalad edges 34, 36 of the sagittal plate
22 are formed as keel-like structures, which aid in the insertion
of the prosthetic device 20 into the intervertebral space S. For
example, in one embodiment, the caudal edge 34 of the sagittal
plate 22 is beveled at the posterior portion thereof to provide a
sharp, forward edge 38 with which to pierce the vertebral body V2
upon insertion of the prosthetic device 20. In a like manner, the
cephalad edge 36 of the sagittal plate 22 is beveled at the
posterior portion thereof to provide a sharp, forward edge 39 with
which to pierce the vertebral body V1 upon insertion of the
prosthetic device 20.
[0022] It should be understood that other shapes and orientations
of the caudal and cephalad edges 34, 36 are also contemplated. For
example, the caudal and cephalad edges 34, 36 may be angled along
the entire surface thereof to aid in the circumvention of vascular
structure 12, or other obstacles, that may be in place during
insertion of the prosthetic device 20. Also, the caudal and
cephalad edges 34, 36 may be angled, tapered, or configured in some
other shape to facilitate the functional demands of insertion. In
still another embodiment, such as the one depicted in FIG. 3b, the
caudal and cephalad edges 34, 36 may be configured as having winged
portions, including a transverse portion 34a, 36a extending across
each edge 34, 36, respectively.
[0023] Referring again to FIGS. 2 and 3a, the sagittal plate 22 is
adapted to promote fusion between the vertebral bodies V1, V2 (FIG.
1), and as such, in one embodiment, a plurality of openings 40 are
defined through the sagittal plate to promote fusion therethrough.
It should be understood that any number of openings 40 may be
defined through the sagittal plate 22, including a single opening
or two or more openings. It should also be understood that the
openings 40 need not necessarily extend entirely through the
sagittal plate 22, but may alternatively extend partially
therethrough. It should further be understood that the sagittal
plate 22 need not necessarily define any openings 40 extending
either partially or entirely therethrough. Additionally, although
the openings 40 are illustrated as having a circular configuration,
it should be understood that other sizes and configurations of the
openings 40 are also contemplated.
[0024] To further promote fusion, the sagittal plate 22 is
preferably coated with a bone-growth promoting substance, such as,
for example, a hydroxyapatite coating formed of calcium phosphate.
Additionally, the sagittal plate 22 may be roughened prior to being
coated with the bone-growth promoting substance to further enhance
bone on-growth. Such surface roughening may be accomplished by way
of, for example, acid etching, knurling, application of a bead
coating, or other methods of roughening that would occur to one of
ordinary skill in the art.
[0025] The sagittal plate 22 may include one or more notches (not
shown) or other types of indicia for receiving or engaging with a
corresponding portion of a surgical instrument (not shown) to aid
in the manipulation and insertion of the prosthetic device 20
within the intervertebral space S (FIG. 1) between the adjacent
vertebral bodies V1, V2 (FIG. 1). The surgical instrument (not
shown) is preferably configured to release the sagittal plate 22
once properly positioned between the adjacent vertebrae. One
example of a surgical instrument that can be used to insert the
prosthetic device 20 is described in co-pending application U.S.
Ser. No. 10/430,473.
[0026] The transverse plates 24, 26 are adapted to engage the
vertebral bodies V1, V2 via a pair of bearing surfaces 42, 44,
respectively. In the present example, the transverse plates 24, 26
angle towards one another in the posterior direction to accommodate
an angular relationship .PHI. defined between the upper and lower
vertebrae V1, V2. As can be appreciated, the angular relationship
between the vertebral bodies V1, V2 will vary depending on the
particular region of the spine such as the thoracic and lumbar
regions. Moreover, a variety of conditions can contribute to a
variety of more pronounced angular relationships between the
vertebral bodies V1, V2, such as lordosis, kyphosis, etc., and
therefore, the transverse plates 24, 26 may extend across the
sagittal plate 22 at a variety of angles relative to the sagittal
plate, including at right angles.
[0027] As with the sagittal plate 22, the transverse plates 24, 26
are adapted to promote fusion between the vertebral bodies V1, V2,
and as such, a plurality of openings 50 are defined through each of
the transverse plates to promote fusion therethrough. It should be
understood that any number of openings 50 may be defined through
the transverse plates 24, 26, including a single opening or two or
more openings. It should also be understood that the openings 50
need not necessarily extend entirely through the transverse plates
24, 26, but may alternatively extend partially therethrough. It
should further be understood that the transverse plates 24, 26 need
not necessarily define any openings 50 extending either partially
or entirely therethrough. Additionally, although the openings 50
are illustrated as having a circular configuration, it should be
understood that other sizes and configurations of the openings 50
are also contemplated.
[0028] To further promote fusion, the transverse plates 24, 26 are
preferably coated with a bone-growth promoting substance, such as,
for example, a hydroxyapatite coating formed of calcium phosphate.
Additionally, the transverse plates 24, 26 may be roughened prior
to being coated with the bone-growth promoting substance to further
enhance bone on-growth. Such surface roughening may be accomplished
by way of, for example, acid etching, knurling, application of a
bead coating, or other methods of roughening that would occur to
one of ordinary skill in the art.
[0029] Referring to FIGS. 4a and 4b, the prosthetic device 20
(FIGS. 2 and 3) may be inserted into the space S between the
vertebrae V1, V2 from a variety of approaches. For example, in
operation, to accommodate insertion of the prosthetic device 20,
the vertebral bodies V1, V2 can be prepared to accept the
prosthetic device therebetween from an offset longitudinal, or
anterior-oblique, approach. Specifically, elongate openings or
slots 60, 62 may be formed in the vertebral endplates of the upper
and lower vertebrae V1, V2, respectively, at a predetermined width
and to a predetermined depth. The slots 60, 62 can be substantially
aligned with each other to accommodate the sagittal plate 22, and
more specifically, to accommodate the caudal and cephalad edges 34,
36 defined on the sagittal plate. In one embodiment, the elongate
slots 60, 62 are rectangular-shaped and are formed by chiseling or
curetting. However, other methods of forming the slots 60, 62 are
also contemplated as would occur to one of ordinary skill in the
art, such as, for example, by drilling or reaming. Furthermore, for
some embodiments of the prosthetic device 20, the caudal and
cephalad edges 34, 36 can form their own corresponding slots by
engagement and impaction of the beveled edges 38, 39 with the
vertebrae V1, V2, and thus no preformed slots are necessary.
[0030] As is readily apparent from FIG. 4b, upon insertion into the
intervertebral space S defined between the vertebrae V1, V2, the
prosthetic device 20 is completely disposed within the
intervertebral space S such that no portion of the prosthetic
device extends beyond the anterior or posterior portion of the
vertebrae V1, V2. Moreover, no plating external of the
intervertebral space S is required upon insertion of the prosthetic
device 20, which is advantageous in avoiding the problems
associated with contacting the vascular structure 12. In addition,
the disposition of the prosthetic device 20 in the intervertebral
space S results in a relatively large graft area between the
vertebrae V1, V2, the graft area being defined, in one embodiment,
by that portion of the intervertebral space S not occupied by the
prosthetic device 20. As such, bone grafts (not shown) may be
inserted into the graft area between the vertebrae V1, V2 to
encourage fusion between the vertebrae. Moreover, although not
required, supplemental screws (not shown) may be impacted into the
vertebrae V1, V2 to provide additional support. Such screws,
however, can be press-fit completely into the vertebrae V1, V2 such
that no portion of the screws extends beyond the anterior or
posterior portion of the vertebrae V1, V2.
[0031] Referring now to FIGS. 5a and 5b, in another embodiment, a
prosthetic device 70 may be laterally inserted into an
intervertebral space S' defined between an upper vertebra V1' and a
lower vertebra V2'. In this embodiment, the upper and lower
vertebrae V1', V2' are substantially parallel to one another, and
as such, the prosthetic device 70 includes a pair of transverse
plates 72, 74, which are substantially parallel to one another and
are substantially perpendicular to an associated sagittal plate
76.
[0032] To accommodate insertion of the prosthetic device 70, the
vertebral bodies V1.zeta., V2' can be prepared to accept the
prosthetic device therebetween from the lateral approach by
laterally forming elongate openings or slots 78, 80 in the
vertebral endplates of the upper and lower vertebrae V1', V2',
respectively, at a predetermined width and to a predetermined
depth. The slots 78, 80 can be substantially aligned with each
other to accommodate the sagittal plate 76. In one embodiment, the
elongate slots 78, 80 are rectangular-shaped and are formed by
chiseling or curetting. However, other methods of forming the slots
78, 80 are also contemplated as would occur to one of ordinary
skill in the art, such as, for example, by drilling or reaming.
Furthermore, as described above with respect to the prosthetic
device 20, the prosthetic device 70 may be configured to form their
own corresponding slots by engagement and impaction with the
vertebrae V1, V2, and thus no preformed slots are necessary.
[0033] The present disclosure has been described relative to
several preferred embodiments. Improvements or modifications that
become apparent to persons of ordinary skill in the art after
reading this disclosure are deemed within the spirit and scope of
the application. For example, although described with respect to
circumventing vascular structure 12, it is understood that the
above-described prosthetic device 20 may be desirable for use in
scenarios where vascular structure 12 is not present. Moreover,
although described with respect to longitudinal and lateral
insertion, it is understood that the prosthetic device 20 may be
inserted into the intervertebral space S from a variety of other
approaches such as the transforaminal approach. Accordingly, it is
understood that several modifications, changes and substitutions
are intended in the foregoing disclosure and, in some instances,
some features of the disclosure will be employed without a
corresponding use of other features. It is also understood that all
spatial references, such as "longitudinal," "lateral," and
"transverse," are for illustrative purposes only and can be varied
within the scope of the disclosure. Accordingly, it is appropriate
that the appended claims be construed broadly and in a manner
consistent with the scope of the disclosure.
* * * * *