U.S. patent application number 14/534884 was filed with the patent office on 2016-04-21 for interconnected locking plates for adjacent spinal vertebral bodies.
The applicant listed for this patent is VG Innovations, LLC. Invention is credited to Tov Inge Vestgaarden.
Application Number | 20160106549 14/534884 |
Document ID | / |
Family ID | 55748112 |
Filed Date | 2016-04-21 |
United States Patent
Application |
20160106549 |
Kind Code |
A1 |
Vestgaarden; Tov Inge |
April 21, 2016 |
Interconnected Locking Plates for Adjacent Spinal Vertebral
Bodies
Abstract
A device for insertion into a gap between adjacent, spaced apart
bony elements includes an adjustable length interconnecting member
having a distal and a proximal retention plate secured to opposite
ends of the interconnecting member. The distal retention plate has
a non-rotated position and a plurality of rotated positions. The
non-rotated position aligns the distal retention plate with the gap
prior to and during insertion of the distal retention plate into
the gap. The distal retention plate is rotated after it has exited
the gap on a distal side of the gap to prevent its return into the
gap. The proximal retention plate is misaligned with the gap so
that it cannot enter into the gap. The rotated distal retention
plate cooperates with the proximal retention plate to hold bony
elements such as adjacent vertebral bodies in a stable relationship
to one another when the interconnecting member is shortened.
Inventors: |
Vestgaarden; Tov Inge; (St.
Petersburg, FL) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
VG Innovations, LLC |
St. Petersburg |
FL |
US |
|
|
Family ID: |
55748112 |
Appl. No.: |
14/534884 |
Filed: |
November 6, 2014 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
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13238524 |
Sep 21, 2011 |
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14534884 |
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Current U.S.
Class: |
623/17.16 |
Current CPC
Class: |
A61F 2002/30836
20130101; A61F 2002/30616 20130101; A61F 2002/30364 20130101; A61F
2002/30843 20130101; A61F 2002/30578 20130101; A61F 2002/30779
20130101; A61F 2310/00017 20130101; A61F 2002/30538 20130101; A61F
2002/30579 20130101; A61F 2310/00179 20130101; A61F 2002/30471
20130101; A61F 2/447 20130101; A61F 2002/30556 20130101; A61F
2002/30433 20130101; A61F 2002/30904 20130101; A61F 2002/30576
20130101; A61F 2002/30484 20130101; A61F 2250/0007 20130101; A61F
2002/30785 20130101; A61F 2310/00023 20130101; A61F 2002/30841
20130101; A61F 2002/30624 20130101; A61F 2250/0065 20130101; A61F
2002/30593 20130101; A61F 2002/30777 20130101 |
International
Class: |
A61F 2/44 20060101
A61F002/44 |
Claims
1. A device for insertion into a gap between two adjacent bony
elements, comprising: a distal retention plate having an elongate
shaft secured in normal relation thereto; a proximal retention
having an elongate shaft secured in normal relation thereto; said
elongate shaft of said distal retention plate being disposed in
telescoping relation to said elongate shaft of said proximal
retention plate.
2. The device of claim 1, further comprising: each of said
retention plates being sufficiently large to span a distance
between said adjacent bony elements when rotated after
insertion.
3. The device of claim 2, further comprising: said distal and
proximal plate shafts being secured to one another in telescoping
and non-rotating relation to one another.
4. The device of claim 3, further comprising: each of said elongate
shafts having a non-round transverse cross-section; said distal
retention plate shaft having a non-round lumen that telescopically
mates with a non-round transverse cross-section of said proximal
retention plate shaft; whereby rotation of said proximal retention
plate effects conjoint rotation of said distal retention plate.
5. The device of claim 3, further comprising: each of said elongate
shafts having a non-round transverse cross-section; said proximal
retention plate shaft sleeve having a non-round lumen that
telescopically mates with a non-round transverse cross-section of
said distal retention plate shaft; whereby rotation of said
proximal retention plate effects conjoint rotation of said distal
retention plate.
6. The device of claim 2, further comprising: each of said elongate
shafts having a length sufficient to enable the proximal and distal
retention plates to extend beyond said adjacent bony elements.
7. The device of claim 2, further comprising: said device having an
unrotated position of repose and an infinite plurality of rotated
positions relative to said unrotated position of repose.
8. The device of claim 7, further comprising: said unrotated
position of repose aligning said device with said gap prior to
insertion and during insertion of said device into said gap; said
device being in a rotated position after said distal retention
plate has exited said gap on a distal side of said gap, but prior
to said proximal retention plate entering said gap; said device
when in said rotated position preventing distal-to-proximal or
proximal-to-distal displacement of said retention plates into said
gap; and said distal retention plate when in said rotated position
cooperating with said proximal retention plate to hold said
adjacent bony elements in a stable relationship to one another.
9. The device of claim 8, further comprising: said telescoping
means enabling retraction of the elongate shafts to thereby enable
the proximal and distal retention plates to positively engages the
adjacent bony elements
10. The device of claim 2, further comprising; a roughened inboard
surface formed on each of said distal and proximal retention
plates.
11. The device of claim 2, further comprising; said proximal
retention plate having screw-receiving holes formed therein to
enable screws to fasten the proximal retention plate to said
adjacent bony elements.
12. A device for insertion into a gap between two bony elements,
comprising: a distal retention plate with an affixed elongate
shaft; a proximal retention plate with an affixed elongate shaft;
said distal retention plate shaft being non-round in transverse
cross-section and said proximal retention plate shaft being
non-round in transverse cross-section and said shafts being
disposed in sliding, mating relation to one another; said elongate
shafts having a length sufficient to enable said plates to extend
beyond said adjacent bony elements; said device having an unrotated
position of repose and an infinite plurality of rotated positions
relative to said position of repose; said unrotated position of
repose aligning said device with said gap prior to insertion and
during insertion of said device into said gap; said device being in
a rotated position after said distal retention plate has exited
said gap on a distal side of said gap, but prior to said proximal
retention plate entering said gap; said device when in said rotated
position preventing distal-to-proximal or proximal-to-distal
displacement of said retention plates into said gap; said distal
retention plate when in said rotated position cooperating with said
proximal retention plate to hold said adjacent bony elements in a
stable relationship to one another; whereby rotation of said
proximal retention plate effects conjoint rotation of said distal
retention plate; and whereby a combined length of said elongate
shafts is reduced to enable said proximal and distal retention
plates to positively engage said adjacent bony elements.
13. The device of claim 12, further comprising: said distal
retention plate shaft having a non-round lumen; said proximal
retention plate shaft having a non-round transverse cross-section;
said non-round transverse cross-section of said proximal retention
plate shaft being slideably disposed within said non-round lumen of
said distal retention plate shaft.
14. The device of claim 12, further comprising: said proximal
retention plate shaft having a non-round lumen; said distal
retention plate shaft having a non-round transverse cross-section;
said non-round transverse cross-section of said distal retention
plate shaft being slideably disposed within said non-round lumen of
said proximal retention plate shaft.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This disclosure is a continuation-in-part of and claims
priority to pending U.S. patent application Ser. No. 13/238,524,
entitled "Method and Apparatus for Spinal Interbody Fusion
Including Fixation or Locking Plate," filed Sep. 21, 2011 by the
present inventor. That disclosure is hereby incorporated by
reference into this disclosure.
BACKGROUND OF THE INVENTION
[0002] 1. Field of the Invention
[0003] 1. This invention relates to surgical methods and apparatus
in general, and more particularly to surgical methods and apparatus
for fusing spinal vertebral bodies.
[0004] 2. Brief Description of the Related Art
[0005] In disc herniation, a spinal disc bulges from between two
vertebral bodies and impinges on adjacent nerves, causing pain. In
some cases, non-operative procedures such as bed rest, medication,
lifestyle modifications, exercise, physical therapy, chiropractic
care and steroid injections may suffice. However, in other cases,
surgical intervention may be necessary. In cases where surgical
intervention is prescribed, spinal vertebral body fusion may be
desirable, i.e., the spine may have deteriorated so much that
adjacent vertebral bodies must be fused together.
[0006] Spinal fixation is the current standard of care for
surgically treating disc herniation in patients who have chronic
pain and who have, or are likely to develop, associated spinal
instability. Spinal fixation procedures are intended to relieve
impingement on nerves by removing the portion of the disc or bone,
or both, responsible for compressing the neural structures and
destabilizing the spine.
[0007] The prior art teaches that excised disc or bone must be
replaced with one or more intervertebral implants, or spacers,
placed between adjacent vertebral bodies. These implants stabilize
the adjacent vertebral bodies relative to one another so that the
two vertebral bodies can fuse together.
[0008] The prior art considered as a whole at the time the present
invention was made does not include any discussion concerning
whether or not spinal fixation can be accomplished in the absence
of a spinal fusion implant. It necessarily follows that it was not
obvious to those of ordinary skill in the art at the time the
present invention was made that spinal fixation could be
accomplished in the absence of spinal fusion implants.
SUMMARY OF THE INVENTION
[0009] The long-standing but heretofore unfulfilled need for an
improved spinal fusion implant is now met by a new, useful, and
non-obvious invention.
[0010] The novel structure does not include a spinal fusion implant
having a main body having a predetermined length, width, and
thickness as disclosed in all prior art literature relating to
spinal fusion implants.
[0011] However, the novel structure stops motion between adjacent
vertebral bodies, thereby allowing fusion to occur. Conventional
fusion accelerants, such as bone, are added to the empty space
conventionally occupied by a spinal fusion implant main body in
order to promote fusion.
[0012] The novel main body-less spinal fusion implant is inserted
into a gap between adjacent, spaced apart vertebral bodies in a
spinal joint, said gap created by surgical removal of a disc.
[0013] The novel spinal fusion implant includes an elongate
interconnecting member that may have a fixed length or an
adjustable length, a distal retention plate rotatably secured to a
distal end of the interconnecting member, and a proximal retention
plate secured to a proximal end of the interconnecting member.
[0014] The distal retention plate has an unrotated position of
repose and an infinite plurality of rotated positions relative to
said position of repose. Similarly, the proximal retention plate
may have an unrotated position of repose and an infinite plurality
of rotated positions relative to the position of repose.
[0015] When the distal and proximal retention plates are in their
respective positions of repose, they are rotationally aligned with
one another.
[0016] The proximal retention plate may be fixedly secured into its
operable position so that it does not rotate relative to the
interconnecting member but can be rotated conjointly with the
interconnecting member.
[0017] The distal retention plate is in its position of repose when
it is inserted into the surgically-created gap between adjacent
vertebral bodies and is in a rotated position after the distal
retention plate has cleared the distal surface of the spinal
vertebral bodies, i.e., when the distal retention plate has passed
through and is not positioned in said gap.
[0018] The distal retention plate when in the second position after
said insertion abuts the superior and inferior vertebral bodies on
the distal side of the spine and therefore prevents
distal-to-proximal travel of the distal retention plate and thus
prevents retraction of the interconnecting member from the gap and
cooperates with the rotated proximal retention plate to hold
adjacent vertebral bodies in a stable relationship to one
another.
[0019] After the distal retention plate has cleared the distal
spinal vertebral bodies and is rotated to prevent its re-entry into
the gap, the interconnecting member is shortened to cause the
proximal and distal retention plates to converge toward one
another, thereby tightly sandwiching the adjacent vertebral bodies
between them and holding said adjacent vertebral bodies against
movement.
[0020] The rotation of the distal retention plate is preferably a
ninety degree (90.degree.) rotation relative to its position of
repose, but the distal retention plate can still perform its
function when rotated less than ninety degrees (90.degree.) and
such reduced angles of rotation are within the scope of this
invention.
[0021] Both retention plates may have a roughened inboard surface
to enhance their respective grips on their respective vertebral
bodies.
[0022] Both retention plates may also have at least one protrusion
formed on an inboard surface thereof to enhance their respective
grips on their respective vertebral bodies.
[0023] The maximum length of the adjustable length interconnecting
member is sufficient to span the proximal-to-distal extent of the
gap and to allow the proximal and distal retention plates to be
positioned outside the gap. The minimum length of the adjustable
length interconnecting member is sufficient to enable the distal
and proximal retention plates to tightly grip the adjacent
vertebral bodies in sandwiched relation between them.
[0024] The proximal retention plate may be in its unrotated
position of repose, rotationally aligned with the distal retention
plate during distal retention plate insertion, or it may be rotated
into its deployed configuration prior to insertion of the distal
retention plate because the proximal retention plate does not enter
into the gap.
[0025] The length of the interconnecting member is fixed or
adjustable by any suitable mechanical means. The retention plates
converge toward one another when the length of the interconnecting
member is shortened, thereby holding the adjacent vertebral bodies
in a stable relationship to one another as aforesaid.
[0026] The suitable mechanical means may include providing the
interconnecting member in telescoping form.
[0027] As in the incorporated patent, the novel device does not
require incisions on both sides of the spine, thereby obtaining an
important object of the invention, i.e., providing a spinal fusion
device that does not require incisions on both sides of a
spine.
[0028] Another important object is to provide a spinal fusion
device having no main body as in all prior art spinal fusion
devices.
[0029] A more specific object is to provide a spinal fusion device
that is inserted from a proximal side of a spine and which has a
distal retention plate mounted on the distal end of an adjustable
length interlocking member where the distal retention plate is
aligned with a gap formed between adjacent vertebral bodies and
inserted through said gap until the distal retention plate clears
the distal edge of the adjacent vertebral bodies.
[0030] A closely related object is to provide a device that is
inserted from a proximal side of a spine and which has a proximal
retention plate mounted on the proximal end of an adjustable length
interlocking member where the proximal retention plate may be
aligned with the gap formed between adjacent vertebral bodies but
which is not inserted into said gap.
[0031] Another closely related object is to provide a tool where
distal and proximal retention plates are respectively mounted to
distal and proximal ends of an adjustable length interconnecting
member and where the distal retention plate is in a non-rotated
position during insertion and in a rotated, deployed configuration
after insertion.
[0032] These and other important objects, advantages, and features
of the invention will become clear as this disclosure proceeds.
[0033] The invention accordingly comprises the features of
construction, combination of elements, and arrangement of parts
that will be exemplified in the disclosure set forth hereinafter
and the scope of the invention will be indicated in the claims.
BRIEF DESCRIPTION OF THE DRAWINGS
[0034] For a fuller understanding of the nature and objects of the
invention, reference should be made to the following detailed
disclosure, taken in connection with the accompanying drawings, in
which:
[0035] FIG. 1 is a perspective view of a first embodiment of the
invention;
[0036] FIG. 2 is a top plan view thereof;
[0037] FIG. 3 is a perspective view of a second embodiment;
[0038] FIG. 4 is a perspective view of a third embodiment;
[0039] FIG. 5 is a perspective view of a fourth embodiment; and
[0040] FIG. 6 is a perspective view of a fifth embodiment.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
[0041] A spine includes a plurality of vertebral bodies separated
by discs. A spine may deteriorate so much that adjacent vertebral
bodies must be fused together. The novel spinal fusion implant is
disposed between contiguous vertebral bodies to immobilize the
affected segment of the spine and facilitate fusion between said
adjacent vertebral bodies.
[0042] Prior art spinal fusion devices include a main body that
substantially fills the gap between adjacent vertebral bodies.
However, it has been discovered by the present inventor that fusion
can occur in the absence of a main body. With a lower mass in the
disc space, there is an increased chance, but no guarantee, of
subsidence. Any structure with bleeding bone and micro motion will
grow together. In this case the bleeding bone will grow to the
distal and proximal plates where they attach to the vertebral
bodies or directly between adjacent vertical bodies. If a surgeon
adds autograft, allograft, or biologics to the disc space, this
will be the traditional method of fusion.
[0043] The spine is prepared by removing some or all of the disc
that resides in the space where the novel spinal fusion implant is
to be inserted. The disc space is prepared with a rongeur or other
surgical instrument, not depicted.
[0044] The novel structure effectively stabilizes the joint but
permits the occurrence of "micro-motion" between the opposing
vertebral bodies, which is important for successful bone
fusion.
[0045] Referring now to FIGS. 1-3, novel tool 10 includes distal
retention plate 12 which is attached to the distal end of elongate
interconnecting member 14. Proximal retention plate 16 is attached
to the proximal end of said elongate interconnecting member 14.
Proximal retention plate 16 may be mounted for relative rotation
with respect to interconnecting member 14 or it may be fixedly
secured thereto or integrally formed therewith for conjoint
rotation therewith.
[0046] Boss 12a may be formed integrally with distal retention
plate 12 and boss 16a may be formed integrally with proximal
retention plate 16, said bosses receiving the opposite ends of
interconnecting member 14 to enhance the structural integrity of
the novel structure. There is no relative rotation and no
longitudinal displacement between the bosses and said opposite
ends.
[0047] In the embodiments of FIGS. 1-3, rotation of proximal
retention plate 16 by a surgeon effects conjoint rotation of distal
retention plate 12. Said plates may be in rotational alignment with
one another in a first embodiment as depicted in FIGS. 1 and 2, or
they may be rotated ninety degrees (90.degree.) with respect to one
another in a second embodiment as depicted in FIG. 3. Other angular
orientations between the retention plates are within the scope of
this invention.
[0048] The first embodiment of this invention as illustrated is a
non-telescoping embodiment. All other embodiments have
telescopically interconnected parts. The first embodiment could
also be modified so that the distal and proximal plates could be
telescopically interconnected to one another.
[0049] As shown in FIG. 3, proximal retention plate 16 has at least
two (2) openings that receive screws so that plate 16 may be
secured to the vertebral bodies.
[0050] Each retention plate preferably has a roughened inboard
surface as at 18. The inboard surface is the surface that abuts the
patient's body. At least one protuberance may also be formed in the
respective inboard surfaces of distal and proximal retention plates
12 and 16, respectively. Such protuberances would perform the same
gripping function as the aforesaid roughened surfaces. The use of
only one (1) protrusion is within the scope of this invention and
is considered the equivalent of a roughened surface.
[0051] FIG. 4 depicts a third embodiment. Retention plates 12 and
16 in this embodiment have a square bracket ([) shape with rounded
corners and the retention plates 12, 16 contact the patient's body
only at the inboard-projecting opposite ends of such retention
plates. The body-contacting opposite ends have roughened surfaces
18 similar to the roughened surfaces of the first embodiment.
[0052] Elongate interconnecting member 14 in this embodiment has
three parts, i.e., elongate base 14a having an octagonal transverse
cross-section, distal part or sleeve 14b which is formed integrally
with or fixedly secured to distal retention plate 12 for conjoint
rotation therewith, and proximal part or sleeve 14c which is formed
integrally with or fixedly secured to proximal retention plate 16
for conjoint rotation therewith.
[0053] Parts 14b and 14c are provided with octagonal lumens that
telescopically mate with elongate base 14a. A surgeon may insert
distal retention plate 12 through the disc space until said distal
retention plate clears the vertebrae while holding proximal
retention plate 16 in the position depicted in FIG. 4. Rotation of
proximal retention plate 16 then effects conjoint rotation of
distal retention plate 12 just as in the first three embodiments.
The difference is that said retention plates of this second
embodiment are telescopically interconnected so that tool 10 can be
used with patients of varying sizes. Thus it is understood that the
transverse cross-section of base 14a and the mating lumens of parts
14b and 14c could be of any non-round cross-section.
[0054] A fourth embodiment is depicted in FIG. 5. This embodiment
eliminates base member 14a. Distal and proximal parts 14b, 14c
telescopically engage one another. More particularly 14c has an
internal lumen designed to accept the cross-sectional shape of
14b.
[0055] A fifth embodiment is depicted in FIG. 6. This embodiment
also eliminates base member 14a. Distal and proximal parts 14b, 14c
telescopically engage one another. More particularly, each part
14b, 14c has two diametrically opposed arms and two diametrically
opposed slots so that the arms of distal part 14b slidingly engage
the slots of proximal part 14c and the arms of proximal part 14c
slidingly engage the slots of distal part 14b.
[0056] Distal retention plate 12 in FIG. 6 has a different
structure than proximal retention plate 16 to allow plate 12 to cut
through surrounding soft tissue.
[0057] Misalignment (at least some rotation) of distal retention
plate 12 from its non-rotated position limits motion in a
multi-directional joint. More particularly, the shape of the main
body in the incorporated disclosure limits motion in
flexion/extension, while distal retention plate 12 in cooperation
with proximal retention plate 16 limits lateral bending.
Accordingly, this main body-less embodiment does not limit motion
in flexion/extension.
[0058] Thus it is understood that the spine is locked in sandwiched
relation between proximal retention plate 16 on the proximal side
and distal retention plate 12 on the distal side even though only
one incision has been made, said incision being on said proximal
side, thereby distinguishing the invention from prior art tools and
methods that require two (2) incisions, i.e., incisions on both the
proximal and the distal side of the spine.
[0059] Spinal fusion implant 10 is inserted into a disc space using
a lateral approach. The lateral approach is preferred because it is
familiar to spine surgeons, and also minimizes the possibility of
damage to the spinal cord during insertion of the tool.
[0060] Although tool 10 has been disclosed in the context of fusing
an intervertebral joint, it may also be used to stabilize and fuse
any joint having an anatomy similar to an intervertebral joint,
i.e., a pair of opposing bony surfaces defining a gap therebetween.
By way of example and not limitation, the novel tool may be used in
small joints as in the finger, toe, etc.
[0061] It will thus be seen that the objects set forth above, and
those made apparent from the foregoing disclosure, are efficiently
attained. Since certain changes may be made in the above
construction without departing from the scope of the invention, it
is intended that all matters contained in the foregoing disclosure
or shown in the accompanying drawings shall be interpreted as
illustrative and not in a limiting sense.
[0062] It is also to be understood that the following claims are
intended to cover all of the generic and specific features of the
invention herein disclosed, and all statements of the scope of the
invention that, as a matter of language, might be said to fall
therebetween.
* * * * *