The spinal column is a highly complex structure which houses and protects critical elements of the nervous system. In spite of these complexities, the spinal column is a highly flexible structure, capable of a high degree of curvature and twist through a wide range motion. Genetic or developmental irregularities, trauma, chronic stress, tumors, and disease, however, can result in spinal pathologies which either limit this range of motion, or threaten the critical elements of the nervous system housed within the spinal column.
In various orthopedic surgical procedures, it is necessary to stabilize portions of a spinal column relative to one another. This need is typically a result of disease, damage or congenital deformation. In one method of treatment for intervertebral disk degeneration, the normal gap between adjacent vertebral bodies is surgically re-established and maintained with a rigid spacer inserted between the bodies. The rigid spacer is filled with bone graft material to facilitate bony fusion of the two vertebral bodies. A successful fusion stabilizes the spine, reduces pressure on the spinal cord and nerve roots, and reduces or eliminates back pain.
While known devices for spinal fusion have proven to be effective in various applications, there remains a need for spinal implants that do not require large incisions for implantation, that can relieve localized stress on adjacent vertebral end plates, and that can prevent migration and retropulsion within the spinal column.
The present teachings provide an expandable spinal implant including a first member and a second member. The first member has first and second arms. The first and second arms of the first member both including an upper face partially defining an upper contact area of the implant and a lower face partially defining a lower contact surface of the implant. The second member has first and second arms that both include an upper face partially defining an upper contact area of the implant and a lower face partially defining a lower contact surface of the implant. The first and second members are pivotally coupled to each other for relative movement about a rotation axis between a closed position for inserting the implant into a spine and an expanded position for providing structural support to the spine. The rotation axis extends generally perpendicular to the upper and lower contact surfaces.
The present teachings also provide an expandable spinal implant having first and second members both with a central portion and first and second arms extending from the central portion. The central portion of the second member is coupled to the central portion of the first member for rotation about a rotation axis between a closed orientation for insertion into a spine and an expanded orientation for providing structural support to the spine. The spinal implant further includes a locking mechanism for arresting relative movement between the first member and the second member.
The present teachings provide a method of stabilizing a portion of a spine. The method includes providing a spinal implant having a first elongated member and a second elongated member. The first elongated member has a central portion rotatably coupled to a central portion of the second elongated member for rotation between a closed position and an expanded position. The method additionally includes orienting the first and second elongated members in the closed position and inserting the spinal implant into the spine between first and second vertebral bodies. The rotation axis is vertically oriented. The method further includes rotating the first and second elongated members to the expanded position while the spinal implant is within the spine.
Further areas of applicability of the present invention will become apparent from the detailed description provided hereinafter. It should be understood that the detailed description and specific examples are intended for purposes of illustration only and are not intended to limit the scope of the invention.
The present invention will become more fully understood from the detailed description and the accompanying drawings, wherein:
The following description of various embodiments is merely exemplary in nature and is in no way intended to limit the invention, its application, or uses.
With initial reference to
With continued reference to the environmental views of
With particular reference to
Various different views of the first elongated member 16 are provided in
Extending through the central portion 20, between the upper surface 22 and the lower surface 24, is a through slot 26. The through slot 26 permits bone ingrowth through the implant 10 to more rigidly secure the implant 10 within the spine 12. The through slot 26 also reduces the weight of the implant 10 while maintaining the strength of the implant 10. Further, the through slot 26 allows the implant 10 to be easily held and positioned by a physician using suitable medical instrumentation.
Extending from opposite sides of the central portion 20 are a first arm 28 and a second arm 30. In the embodiment illustrated, the first arm 28 and the second arm 30 are identical and generally extend tangentially from the central portion 20. The first arm 28 and the second arm 30 preferably extend from the central portion 20 parallel to each other, but are slightly offset from each other. As seen best
As seen most clearly in
The upper wall 32 includes an upper face 42 that partially defines an upper contact surface 44. The lower wall 34 includes a lower face 46 that partially defines a lower contact surface 48. The upper contact surface 44 and the lower contact surface 48 are preferably convex in shape. Alternatively, the upper and lower contact surfaces 44 and 48 may be flat or conically shaped.
Both the upper contact surface 44 and the lower contact surface 48 are preferably formed to include a plurality of teeth 50. The teeth 50 extend towards the central portion 20. When the implant 10 is in its expanded orientation (as shown in
With particular reference to
The first member 16 and the second member 18 are pivotally coupled to each other for relative movement about a rotation axis R (identified in
The elongated members 16 and 18 are illustrated coupled together in the closed position in
With particular reference to
The first elongated member 16 and the second elongated member 18 each further comprise a pair of protrusions 52 and a pair cooperating of recesses 54. The protrusions 52 extend from the upper face 42 and the recesses 54 are located within the outer surface 24 of the central portion 20. The recesses 54 have a sidewall 56 and a retention surface 58 (see
As seen most clearly in
To secure the implant 10 in the open position, the implant 10 further includes a locking mechanism. The locking mechanism is preferably an active locking mechanism comprised of an arm or detail 60 that extends from the central portion 20 of both the first member 16 and the second member 18. The detail 60 is flexible, preferably a leaf spring, and can be moved between a neutral position (as shown in
As seen in
In the open position the details 60 automatically extend into their neutral positions as the details 60 are no longer restricted by the inner walls 38. In its neutral position, the detail 60 of the first elongated member 16 abuts an outer surface 62 of the inner wall 38 of the second elongated member 16. Similarly, the detail 60 of the second elongated member 18 abuts an outer surface 62 of the inner wall 38 of the first elongated member 14 to prevent the implant 10 from returning to its closed position. The implant 10 can only be returned to the closed position if pressure is applied to the details 60 to return them to their collapsed state where they no longer contact the corresponding outer surfaces 62 respectively and can each again recede beneath the inner wall 38 of the opposite elongated of member 14 or 16.
An exemplary implantation of the implant 10 of the present invention within the spine 12 will now be described. Before the implant 10 is inserted, the spine 12 must be prepared to receive the implant 10 by the operating surgeon. Preparation of the spine 12 involves making a small incision posteriorly within the dura. The adjacent vertebrae 14 are distracted to return normal spacing and the intevetrabal disk is removed. Once the spine 12 has been prepared, the implant 10,.orientated in the closed position, is inserted between the first vertebra 14a and the second vertebra 14b. To insert the implant 10 in the closed position requires only a small incision in the dura matter and only minimal distraction of the spine 12, thus maintaining the integrity of the vertebrae 14 and permitting the surgeon to make the most efficient use of operating room time. When positioned in the open orientation (
After the implant 10 is properly installed within the spine 12, the first member 16 and the second member 18 are rotated from the closed position to the open position so that the implant 10 may provide the required support between the adjacent vertebrae 14. Rotation of the implant 10 from the closed position is effectuated by the attending surgeon using suitable operating room instrumentation. The implant 10 is maintained in the open position through interaction between the details 60 and the cooperating outer surfaces respectively.
Rotation of the implant 10 into the open position is facilitated by the ramped teeth 50, which are ramped in the direction of the expansion of the implant 10 from the closed position to the open position. The ramped teeth 50 also help maintain the implant 10 in the open position. Further, the ramped teeth 50 help maintain the implant 10 in its proper position between the vertebrae 14.
Adjacent vertebrae 14 may optionally be supported by multiple implants 10. The process for inserting multiple implants 10 is substantially identical to the process described above for inserting a single implant 10, with the exception being that at least one additional implant 10 is inserted between the vertebrae 14 during the insertion process. The use of multiple implants 10 is advantageous as multiple implants 10 provide additional support to the vertebrae 14 to further disperse stress loads.
The implant 10 may be of various different sizes to properly fit patients having spines 12 and vertebrae 14 of different sizes. The size of the implant 10 may vary in numerous different ways. For example, the first elongated member 16 and the second elongated member 18 may be of various different lengths to support vertebrae 14 of different surface areas. Further, the first elongated member 16, the second elongated member 18, and the central portions 20 may be of different heights to support vertebrae 14 that are spaced at varying distances from each other.
The implant 10, may be manufactured from any biocompatible material that is suitably rigid to withstand the pressures exerted upon the implant 10 by the vertebrae 14. Examples of materials that may be used to manufacture the implant 10 include, but are not limited to, titanium and allograft bone. As shown throughout the drawings, the first member 16, and the second member 18, each preferably comprise a single unitary structure.
Referring to
Referring to
Referring to FIGS. 11A-C and 14A-B, the first arm 128 of the first elongated member 116, or, more generally, at least one of the arms, 128, 130,128′, 130′, can be adapted to define an internally threaded bore 164 for accommodating a locking member 160 therein. The locking member 160 can be a fastener, such as an externally threaded screw, as illustrated in
The locking member 160 can include an end portion or boss 170 and a head 172 with an engagement formation or surface 174. The locking member 160 can be deployed to secure the implant 100 in the open orientation by engaging the first arm 128 of the first member 116 with the central portion 120′ of the second member 118, when the implant 100 is in the open orientation. In the open orientation, the recesses 172, 172′ in the central portions 120, 120′ of the first and second members 116, 118 become aligned and define a hole 168 that receives an end portion 170 of the locking member 160. The locking member 160 can be deployed using a driver or similar tool that is inserted into the internal bore 164 of the first arm 128 and operated to engage the engagement formation 174 and to rotate the locking member 160, thereby causing the locking member 160 to advance into the hole 128 and positively secure the implant 100 in the open orientation.
Referring to
Referring to
Similarly to implant 10, implant 100 can be inserted in the spine 12 in the closed orientation through a small incision. After implantation, the first and second members 116, 117 are pivoted about the central axis R relative to each other to bring the implant 100 to the open orientation. The implant 100 is then positively locked in the open orientation by deploying the locking member 160 using a suitable driver or tool.
It will be appreciated that implants 10 and 100 are merely exemplary illustrations, such that various features of exemplary implant 10 can be incorporated in exemplary implant 100, and vice versa.
The description of the invention is merely exemplary in nature and, thus, variations that do not depart from the gist of the invention are intended to be within the scope of the invention. Such variations are not to be regarded as a departure from the spirit and scope of the invention.
This application claims the benefit of U.S. Provisional Application No. 60/489,731, filed on Jul. 23, 2003. The disclosure of the above application is incorporated herein by reference.
Number | Date | Country | |
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60489731 | Jul 2003 | US |