Field
The present invention relates to medical devices and, more particularly, to an intervertebral implant.
Description of the Related Art
The human spine is a flexible weight bearing column formed from a plurality of bones called vertebrae. There are thirty three vertebrae, which can be grouped into one of five regions (cervical, thoracic, lumbar, sacral, and coccygeal). Moving down the spine, there are generally seven cervical vertebra, twelve thoracic vertebra, five lumbar vertebra, five sacral vertebra, and four coccygeal vertebra. The vertebra of the cervical, thoracic, and lumbar regions of the spine are typically separate throughout the life of an individual. In contrast, the vertebra of the sacral and coccygeal regions in an adult are fused to form two bones, the five sacral vertebra which form the sacrum and the four coccygeal vertebra which form the coccyx.
In general, each vertebra contains an anterior, solid segment or body and a posterior segment or arch. The arch is generally formed of two pedicles and two laminae, supporting seven processes—four articular, two transverse, and one spinous. There are exceptions to these general characteristics of a vertebra. For example, the first cervical vertebra (atlas vertebra) has neither a body nor spinous process. In addition, the second cervical vertebra (axis vertebra) has an odontoid process, which is a strong, prominent process, shaped like a tooth, rising perpendicularly from the upper surface of the body of the axis vertebra. Further details regarding the construction of the spine may be found in such common references as Gray's Anatomy, Crown Publishers, Inc., 1977, pp. 33-54, which is herein incorporated by reference.
The human vertebrae and associated connective elements are subjected to a variety of diseases and conditions which cause pain and disability. Among these diseases and conditions are spondylosis, spondylolisthesis, vertebral instability, spinal stenosis and degenerated, herniated, or degenerated and herniated intervertebral discs. Additionally, the vertebrae and associated connective elements are subject to injuries, including fractures and torn ligaments and surgical manipulations, including laminectomies.
The pain and disability related to the diseases and conditions often result from the displacement of all or part of a vertebra from the remainder of the vertebral column. Over the past two decades, a variety of methods have been developed to restore the displaced vertebra to their normal position and to fix them within the vertebral column. Spinal fusion is one such method. In spinal fusion, one or more of the vertebra of the spine are united together (“fused”) so that motion no longer occurs between them. Thus, spinal fusion is the process by which the damaged disc is replaced and the spacing between the vertebrae is restored, thereby eliminating the instability and removing the pressure on neurological elements that cause pain.
Spinal fusion can be accomplished by providing an intervertebral implant between adjacent vertebrae to recreate the natural intervertebral spacing between adjacent vertebrae. Once the implant is inserted into the intervertebral space, osteogenic substances, such as autogenous bone graft or bone allograft, can be strategically implanted adjacent the implant to prompt bone in-growth in the intervertebral space. The bone ingrowth promotes long-term fixation of the adjacent vertebrae. Various posterior fixation devices (e.g., fixation rods, screws etc.) can also be utilize to provide additional stabilization during the fusion process.
Recently, intervertebral implants have been developed that allow the surgeon to adjust the height of the intervertebral implant. This provides an ability to intra-operatively tailor the intervertebral implant height to match the natural spacing between the vertebrae. This reduces the number of sizes that the hospital must keep on hand to match the variable anatomy of the patients.
In many of these adjustable intervertebral implants, the height of the intervertebral implant is adjusted by expanding an actuation mechanism through rotation of a member of the actuation mechanism. In some intervertebral implants, the actuation mechanism is a screw or threaded portion that is rotated in order to cause opposing plates of the implant to move apart. In other implants, the actuation mechanism is a helical body that is counter-rotated to cause the body to increase in diameter and expand thereby.
Furthermore, notwithstanding the variety of efforts in the prior art described above, these intervertebral implants and techniques are associated with another disadvantage. In particular, these techniques typically involve an open surgical procedure, which results higher cost, lengthy in-patient hospital stays and the pain associated with open procedures.
Therefore, there remains a need in the art for an improved intervertebral implant. Preferably, the implant is implantable through a minimally invasive procedure. Further, such devices are preferably easy to implant and deploy in such a narrow space and opening while providing adjustability and responsiveness to the clinician.
Certain aspects of this disclosure are directed toward an adjustable spinal fusion intervertebral implant. The implant can include upper and lower body portions each having proximal and distal surfaces at proximal and distal ends thereof. The proximal and distal surfaces of the upper and lower body portions can generally face each other. The implant can include a proximal wedge member disposed at the proximal ends of the respective ones of the upper and lower body portions, and a distal wedge member disposed at the distal ends of the respective ones of the upper and lower body portions. The implant can include first and second linkages each connected to the upper and lower body portions. The implant can include an actuator shaft received between the upper and lower body portions. The actuator shaft can extend intermediate the distal and proximal wedge members. Rotation of the actuator shaft can cause the distal and proximal wedge members to be drawn together such that longitudinal movement of the distal wedge member against the distal surfaces and the longitudinal movement of the proximal wedge member against the proximal surfaces causes separation of the upper and lower body portions. The implant features described in the specification can be included in any of the implant embodiments.
In some embodiments, The proximal surfaces of the respective ones of the upper and lower body portions each define a proximal slot therein, and distal surfaces of the respective ones of the upper and lower body portions each define a distal slot therein. In certain aspects, the slots of the proximal and distal surfaces of the upper and lower body portions are generally dove-tailed. In certain aspects, the proximal wedge member and the distal wedge member can each include upper and lower guide members extending at least partially into the respective ones of the proximal and distal slots of the upper and lower body portions with at least a portion of the proximal wedge member and the distal wedge member contacting the proximal and distal surfaces of the upper and lower body portions. The guide members of the proximal and distal wedge members can be generally dovetailed.
In some embodiments, each of the upper and lower body portions can include a first side portion having an extending portion and a second side portion having a receiving portion. The first side portion of the upper body portion can be configured to mate with the second side portion of the lower body portion. The second side portion of the upper body portion can be configured to mate with the first side portion of the lower body portion. In certain aspects, the first and second side portions of the upper body portion can be configured to disengage from the first and second side portions of the lower body portion when the implant is in an expanded state.
In some embodiments, the proximal and distal surfaces of the upper and lower body portions can be sloped.
In some embodiments, the upper and lower body portions comprise generally arcuate respective upper and lower exterior engagement surfaces.
In some embodiments, the proximal wedge member can include an anti-rotational element. The anti-rotational engagement can be configured to engage an implant tool to prevent rotation of the implant when the actuator shaft is rotated relative to the implant. In certain aspects, the anti-rotational element can include a pair of apertures extending into the proximal wedge member.
In some embodiments, each of the first and second linkages can include at least one cam path. In certain aspects, a pin can extend from the at least one cam path to one of the upper and lower body portions.
In some embodiments, a length of the implant varies from about 45 mm to about 54 mm and/or a height of the implant varies from about 6.5 mm to about 12 mm during the separation of the upper and lower body portions. In certain aspects, the length of the implant varies from about 21 mm to about 31 mm during the separation of the upper and lower body portions.
In some embodiments, the upper and lower body portions can be coated with a bio-active coating, including, but not limited to, a hydroxyapatite coating, a titanium plasma spray, a resorbable blast media coating, or composite coatings.
Certain aspects of this disclosure are directed toward a method of manufacturing an adjustable spinal fusion intervertebral implant. The method can include extending an actuator shaft from a proximal wedge member to a distal wedge member. The method can include engaging the proximal and distal wedge members with each of the upper and lower body portions. The method can include connecting first and second linkages to each of the upper and lower body portions. The method of manufacturing steps described in the specification can be included in any of the embodiments discussed herein.
In some embodiments, extending the actuator shaft from the proximal wedge member to the distal wedge member can include inserting the actuator shaft through a central aperture of the proximal wedge member and through a central aperture of the distal wedge member.
In some embodiments, engaging the proximal and distal wedge members with each of the upper and lower body portions can include extending upper and lower guide members of the proximal and distal wedge members at least partially into respective ones of proximal and distal slots of the upper and lower body portions.
In some embodiments, the method can include engaging a first side portion of the upper body portion and a second side portion of the lower body portion. The first side portion can have an extending portion, and the second side portion can have a receiving portion. The receiving portion can be configured to receive the extending portion.
In some embodiments, engaging the first and second linkages with each of the upper and lower body portions can include extending a pin from a cam path of one of the first and second linkages to one of the upper and lower body portions.
In some embodiments, the method can include shot-peening the upper and lower body portions.
In some embodiments, the method can include coating the upper and lower body portions with a bio-active coating, including, but not limited to, a hydroxyapatite coating, a titanium plasma spray, a resorbable blast media coating, or composite coatings.
Certain aspects of this disclosure are directed toward a method of implanting an expandable intervertebral implant. The method can include positioning the implant between two vertebral bodies. The method can include rotating a screw mechanism of the implant to cause proximal and distal wedge members to converge toward each other and engage respective ones of proximal and distal surfaces of upper and lower body portions of the implant. The method can include separating the upper and lower body portions to cause the implant to expand. In certain aspects, separating the upper and lower body portions can cause first and second linkages to rotate from a first configuration to a second configuration. The method of use steps discussed in the specification can be included in any of the embodiments described herein.
In some embodiments, a height of the first and second linkages can be greater in the second configuration than in the first configuration.
In some embodiments, the method can include moving one or more pins along a respective cam path of one of the first and second linkages to cause the first and second linkages to rotate from the first configuration to the second configuration.
For purposes of summarizing the disclosure, certain aspects, advantages and features of the inventions have been described herein. It is to be understood that not necessarily any or all such advantages are achieved in accordance with any particular embodiment of the inventions disclosed herein. No aspects of this disclosure are essential or indispensable.
In accordance with certain embodiments disclosed herein, an improved intervertebral implant is provided that allows the clinician to insert the intervertebral implant through a minimally invasive procedure. For example, one or more intervertebral implants can be inserted percutaneously to reduce trauma to the patient and thereby enhance recovery and improve overall results of the surgery.
An intervertebral implant can include a plurality of body sections that are selectively separable and expandable upon contraction of a centrally disposed actuator. The actuator can be utilized to contract against faces of the body sections to cause the expansion thereof. The implant can also be configured such that the actuator provides for both the expansion and contraction of the body sections. The actuator can comprise an interaction between the body sections and another element, an action performed by another element, or a combination of interactions between various elements of the implant and its body sections. Further, the implant can be configured to allow either rough or fine incremental adjustments in the expansion of the implant.
The embodiments disclosed herein are discussed in the context of an intervertebral implant and spinal fusion because of the applicability and usefulness in such a field. As such, various embodiments can be used to properly space adjacent vertebrae in situations where a disc has ruptured or otherwise been damaged. As also disclosed herein, embodiments can also be used as vertebral body replacements. Thus, “adjacent” vertebrae can include those originally separated only by a disc or those that are separated by intermediate vertebra and discs. Such embodiments can therefore tend to recreate proper disc height and spinal curvature as required in order to restore normal anatomical locations and distances. However, it is contemplated that the teachings and embodiments disclosed herein can be beneficially implemented in a variety of other operational settings, for spinal surgery and otherwise.
For example, the implant disclosed herein can also be used as a vertebral body replacement. In such a use, the implant could be used as a replacement for a lumbar vertebra, such as one of the L1-L5 vertebrae. Thus, the implant could be appropriately sized and configured to be used intermediate adjacent vertebrae, or to entirely replace a damaged vertebra.
It is contemplated that the implant can be used as an interbody or intervertebral device or can be used to replace a vertebral body entirely. The implant can also be used in vertebral body compression fractures. Further, the implant can be used as a tool to expand an intervertebral space or bone in order to fill the space or bone with a cement; in such cases, the implant can be removed or left in once the cement is placed. Furthermore, the implant can also be used as a tool to pre-dilate the disc space. In some embodiments, the implant can be removed once the disc space is dilated, and a different implant (expandable or non-expandable) can then be implanted in the dilated disc space. The implant can also be introduced into the disc space anteriorly in an anterior lumbar interbody fusion (ALIF) procedure, posterior in an posterior lumbar interbody fusion (PILF) or posterior lateral interbody fusion, from extreme lateral position in an extreme lateral interbody fusion procedure (XLIF) or direct lateral interbody fusion (DLIF), from a far lateral position in a transforaminal lumbar interbody fusion (TLIF), to name a few. In other arrangements, the implant can be inserted through the Kambin triangle or be inserted through the Kambin triangle after the Kambin triangle has been enlarged via removing bone (e.g., techniques such as PerX360® System™ sold by Intervention Spine®). Although the implant is primarily described herein as being used to expand in a vertical direction, it can also be implanted to expand in a horizontal direction in order to increase stability and/or increase surface area between adjacent vertebral bodies.
Therefore, it is contemplated that a number of advantages can be realized utilizing various embodiments disclosed herein. For example, as will be apparent from the disclosure, no external distraction of the spine is necessary. Further, no distraction device is required in order to install various embodiments disclosed herein. In this regard, embodiments of the implant can enable sufficient distraction of adjacent vertebra in order to properly restore disc height or to use the implant as a vertebral body replacement. Thus, normal anatomical locations, positions, and distances can be restored and preserved utilizing many of the embodiments disclosed herein.
Referring to
In certain embodiment, the implant can be installed in an operation that generally entails the following procedures. The damaged disc or vertebra can be decompressed, such as by distracting. The subject portion (or entire) disc or vertebra can then be removed. The adjacent vertebrae can be prepared by scraping the exposed adjacent portion or plates thereof (typically to facilitate bleeding and circulation in the area). Typically, most of the nucleus of the disc is removed and the annulus of the disc is thinned out. Although individual circumstances may vary, it may be unusual to remove all of the annulus or to perform a complete diskectomy. The implant can then be installed. In some embodiments, distraction of the disc may not be a separate step from placement of the implant; thus, distraction can be accomplished and can occur during placement of the implant. Finally, after implantation of the implant, osteogenic substances, such as autogenous bone graft, bone allograft, autograft foam, or bone morphogenic protein (BMP) can be strategically implanted adjacent the implant to prompt bone in-growth in the intervertebral space. In this regard, as the implant is expanded, the spaces within the implant can be backfilled; otherwise, the implant can be pre-packed with biologics.
The intervertebral implant is often used in combination with posterior and/or anterior fixation devices (e.g., rods, plates, screws, etc. that span two or more vertebrae) to limit movement during the fusion process. U.S. Pat. No. 7,824,429 discloses a particularly advantageous posterior fixation device and method which secures two adjacent vertebra to each other in a trans-laminar, trans-facet or facet-pedicle (e.g., the Boucher technique) application using fixation screws.
It should also be appreciated that in
In certain embodiments, the implant 200 can be used in combination with a dynamic stabilization devices such as those disclosed in U.S. Pat. No. 7,648,523, filed Feb. 11, 2005; U.S. Pat. No. 6,951,561, filed on May 6, 2004; U.S. Pat. No. 7,998,176, filed on Jun. 6, 2008; and U.S. Pat. No. 7,824,429, filed Jul. 18, 2003; the entireties of the disclosures of which are hereby incorporated by reference. In this manner, the implant 200 can be used to maintain height between vertebral bodies while the dynamic stabilization device provides limits in one or more degrees of movement.
It is contemplated that the actuator shaft 210 can be rotated to cause the proximal and distal wedge members to move toward each other, thus causing the upper and lower body portions 202, 204 to be separated. In some embodiments, the implant 200 can include one or more linkages configured to connect the upper and lower body portions 202, 204 when the implant 200 is in an expanded state. For example, as shown in
Each of the intervertebral implant components will be described in further detail below in reference to
In some embodiments, the height of the implant 200 can be or vary within a range from at least about 6 mm to less than or equal to about 15 mm, and more preferably, from about 6.5 mm to about 12 mm. The width of the implant can be at least about 7 mm and/or less than or equal to about 18 mm, and preferably approximately 9 mm or 18 mm. Thus, the implant 200 can have a preferred aspect ratio of between approximately 6:18 and 15:7, and preferably approximately between 6.5:9 and 12:9, or between 6.5:18 and 12:18.
The length of the implant 200 can be or vary within a range from at least 18 mm to less than or equal to about 54 mm. In certain aspects, the length of the implant 200 can be or vary within a range from least about 18 mm to less than or equal to about 35 mm, and preferably from about 25 mm to about 31 mm. In certain aspects, the length of the implant 200 can be or vary within a range from least about 45 mm to less than or equal to about 54 mm. In some embodiments, the implant can have a greater length in the unexpanded state than in the expanded state. It is contemplated that various modifications to the dimension disclosed herein can be made by one of skill and the mentioned dimensions shall not be construed as limiting.
The intervertebral implant components can be manufactured in accordance with any of a variety of techniques which are well known in the art, using any of a variety of medical-grade construction materials. For example, the upper and lower body portions 202, 204, the actuator shaft 210, and other components can be injection-molded from a variety of medical-grade polymers including high or other density polyethylene, PEEK™ polymers, nylon and polypropylene.
The intervertebral implant 200 components can be molded, formed or machined from biocompatible metals such as Nitinol, stainless steel, titanium, and others known in the art. Non-metal materials such as plastics, PEEK™ polymers, and rubbers can also be used. Further, the implant components can be made of combinations of PEEK™ polymers and metals. In some embodiments, the intervertebral implant components can be injection-molded from a bioabsorbable material, to eliminate the need for a post-healing removal step.
The intervertebral implant components may be coated with or contain one or more bioactive substances, such as antibiotics, chemotherapeutic substances, angiogenic growth factors, substances for accelerating the healing of the wound, growth hormones, anti-thrombogenic agents, bone growth accelerators or agents, and the like. Such bioactive implants may be desirable because they contribute to the healing of the injury in addition to providing mechanical support. For example, in some embodiments, the upper and lower body portions 202, 204 can be coated with a bio-active coating, including, but not limited, to a hydroxyapatite coating, a titanium plasma spray, a resorbable blast media coating, or composite coatings. The upper and lower body portions 202, 204 can be coated after the implant is fully assembled, such that other components exposed along the upper and lower surfaces of the implant can also be coated with hydroxyapatite.
In some embodiments, the intervertebral implant components can be surface treated to increase the strength of the components. For example, the intervertebral implant components can be sand blasted, shot peened, laser peened, or otherwise treated to increase strength.
In addition, the intervertebral implant components may be provided with any of a variety of structural modifications to accomplish various objectives, such as osteoincorporation, or more rapid or uniform absorption into the body. For example, osteoincorporation may be enhanced by providing a micropitted or otherwise textured surface on the intervertebral implant components. Alternatively, capillary pathways may be provided throughout the intervertebral implant, such as by manufacturing the intervertebral implant components from an open cell foam material, which produces tortuous pathways through the device. This construction increases the surface area of the device which is exposed to body fluids, thereby generally increasing the absorption rate. Capillary pathways may alternatively be provided by laser drilling or other technique, which will be understood by those of skill in the art in view of the disclosure herein. Additionally, apertures can be provided in the implant to facilitate packing of biologics into the implant, backfilling, and/or osseointegration of the implant. In general, the extent to which the intervertebral implant can be permeated by capillary pathways or open cell foam passageways may be determined by balancing the desired structural integrity of the device with the desired reabsorption time, taking into account the particular strength and absorption characteristics of the desired polymer.
The implant 200 can be at least partially radiolucent, which radiolucency can allow a doctor to perceive the degree of bone growth around and through the implant. The individual components of the implant 200 can be fabricated of such materials based on needed structural, biological and optical properties.
The intervertebral implant may be sterilized by any of the well-known sterilization techniques, depending on the type of material. Suitable sterilization techniques include heat sterilization, ultrasonic sterilization, radiation sterilization, such as cobalt irradiation or electron beams, ethylene oxide sterilization, and the like.
In some embodiments, the two openings 274, 276 can be similarly shaped. For example, as shown in
In certain variants, the openings 274, 276 can be single elongate portions through which the first and second linkages 254, 265 extend. Although not shown in the FIGS., the upper and lower body portions 202, 204 can include additional openings for receiving graft material or other bioactive substances. Each of the openings can be shaped similarly or differently. The additional openings can be vertically and/or horizontally displaced from each other along the upper and body portions 202, 204. The additional opens can be aligned with a longitudinal axis of the implant 200 or positioned off-center. One or more of the openings can be generally rounded, including, but not limited to, a generally elliptical shape, or include a light-bulb shape. The width of one or more of the openings can vary across a length of the opening.
In some embodiments, the implant 200 can comprise one or more protrusions 260 on a bottom surface 262 of the lower body portion 204. As shown in
The protrusions 260 can be configured in various patterns. As shown, the protrusions 260 can be formed from grooves extending widthwise along the bottom surface 262 of the implant 200 (also shown extending from a top surface 264 of the upper body portion 202 of the implant 200). The protrusions 260 can become increasingly narrow and pointed toward their apex. However, it is contemplated that the protrusions 260 can be one or more raised points, cross-wise ridges, or the like.
In
In
Accordingly, in such an embodiment, the wedge members 206, 208 may not be separable from the implant when the implant 200 is in the unexpanded state (as shown in
Such an embodiment of the implant 200 can therefore be assembled by placing or engaging the wedge members 206, 208 with the actuator shaft 210, moving the wedge members 206, 208 axially together, and inserting the upper guide members 230, 232 into the slots 220 of the upper body portion 202 and the lower guide members 270, 272 into the slots 222 of the lower body portion 204. The wedge members 206, 208 can then be moved apart, which movement can cause the guide members and slots to engage and bring the upper and lower body portions toward each other. The implant 200 can then be prepared for insertion and deployment by reducing the implant 200 to the unexpanded state.
Referring again to
It is contemplated that some embodiments of the implant 200 can be configured such that the upper and lower body portions 202, 204 each include side portions (shown as first side portion 240 and second side portion 242 of the upper body portion 202) to facilitate the alignment, interconnection, and stability of the components of the implant 200. The first and second side portions 240, 242 can be configured to have complementary structures that enable the upper and lower body portions 202, 204 to move in a vertical direction an maintain alignment in a horizontal direction. For example, as shown in
In some embodiments, the implant 200 can be configured to include one or more apertures 252 to facilitate osseointegration of the implant 200 within the intervertebral space. As mentioned above, the implant 200 may contain one or more bioactive substances, such as antibiotics, chemotherapeutic substances, angiogenic growth factors, substances for accelerating the healing of the wound, growth hormones, anti-thrombogenic agents, bone growth accelerators or agents, and the like. Indeed, various biologics can be used with the implant 200 and can be inserted into the disc space or inserted along with the implant 200. The apertures 252 can facilitate circulation and bone growth throughout the intervertebral space and through the implant 200. In such implementations, the apertures 252 can thereby allow bone growth through the implant 200 and integration of the implant 200 with the surrounding materials.
As shown in
The threads can be configured to be left hand threads at a distal end of the actuator shaft 210 and right hand threads at a proximal other end of the actuator shaft 210 for engaging the respective ones of the distal and proximal wedge members 208, 206. Accordingly, upon rotation of the actuator shaft 210, the wedge members 206, 208 can be caused to move toward or away from each other to facilitate expansion or contraction of the implant 200.
In some embodiments, the actuator shaft 210 can facilitate expansion of the implant 200 through rotation, longitudinal contract of the pin, or other mechanisms. The actuator shaft 210 can include threads that threadably engage at least one of the proximal and distal wedge members 206, 208. The actuator shaft 210 can also facilitate expansion through longitudinal contraction of the actuator shaft as proximal and distal collars disposed on inner and outer sleeves move closer to each other to in turn move the proximal and distal wedge members closer together. It is contemplated that in certain variants, at least a portion of the actuator shaft can be axially fixed relative to one of the proximal and distal wedge members 206, 208 with the actuator shaft being operative to move the other one of the proximal and distal wedge members 206, 208 via rotational movement or longitudinal contraction of the pin.
In some embodiments, wherein the actuator shaft 210 is threaded, it is contemplated that the actuator shaft 210 can be configured to bring the proximal and distal wedge members closer together at different rates. In such embodiments, the implant 200 could be expanded to a V-configuration or wedged shape. For example, the actuator shaft 210 can comprise a variable pitch thread that causes longitudinal advancement of the distal and proximal wedge members at different rates. The advancement of one of the wedge members at a faster rate than the other could cause one end of the implant to expand more rapidly and therefore have a different height that the other end. Such a configuration can be advantageous depending on the intervertebral geometry and circumstantial needs.
The actuator shaft 210 can be utilized to provide a stabilizing axial force to the proximal and distal wedge members 206, 208 in order to maintain the expansion of the implant 200. However, it is also contemplated that other features can be incorporated into such an embodiment to facilitate the maintenance of the expansion. In this regard, although the axial force provided by the actuator shaft 210 can tend to maintain the position and stability of the proximal and distal wedge members 206, 208, additional features can be employed to ensure the strength and stability of the implant 200 when in its expanded state. For example, the proximal and distal wedge members 206, 208 can include ribbed engagement surfaces (not shown). The use of the ribbed engagement surfaces can permit one-way, ratchet type longitudinal movement of proximal and distal wedge members 206, 208 relative to the upper and lower body portions 202, 204 in order to maintain the upper and lower body portions at a given separation distance. Various other features that can be used to facilitate the expansion of two body portions of an intervertebral implant are disclosed in U.S. Pat. No. 8,105,382, filed Dec. 7, 2007, the entirety of which is hereby incorporated by reference.
The actuator shaft 210 can be cannulated and/or include one or more apertures. The one or more apertures and/or cannula can provide access to an internal portion of the implant, so bone graft or other bioactive materials described herein can be directly injected into the implant to promote fusion.
In accordance with an embodiment, the actuator shaft 210 can also comprise a tool engagement section 296. The tool engagement section 296 can be configured as a to be engaged by a tool 400. The tool engagement section 296 can be shaped as a polygon, such as a hex shape to facilitate the transfer of torque to the actuator shaft 210 from the tool 400. For example, the tool 400 can include a distal engagement member 430 being configured to engage a proximal end of the actuator shaft 210 of the implant 200 for rotating the actuator shaft 210 to thereby expand the implant from an unexpanded state to and expanded state.
The proximal end of the actuator shaft can also include a number of tool engagement features configured to engage with a number of corresponding engagement features at a distal end of the tool 400 (shown in
In some embodiments, the implant 200 can be configured such that the proximal and distal wedge members 206, 208 are interlinked with the upper and lower body portions 202, 204 to improve the stability and alignment of the implant 200. For example, the upper and lower body portions 202, 204 can be configured to include slots (slot 220 is shown in
In some embodiments, the implant 200 can be configured to include anti-torque structures 250. The anti-torque structures 250 can interact with at least a portion of a deployment tool during deployment of the implant to ensure that the implant maintains its desired orientation. For example, when the implant 200 is being deployed and a rotational force is exerted on the actuator shaft 210, the anti-torque structures 250 can be engaged by a non-rotating structure of the deployment tool to maintain the rotational orientation of the implant 200 while the actuator shaft 210 is rotated. The anti-torque structures 250 can comprise one or more inwardly extending holes or indentations on the proximal wedge member 206, which are shown as a pair of holes in
The tool 400 can also include an anti-torque component to engage one or more anti-torque structures 250 of the implant 200. The anti-torque component can include one or more protrusions that engage the anti-torque structures 250 to prevent movement of the implant 200 when a rotational force is applied to the actuator shaft 210 via the tool 400. Other deployment methods can also be used, such as those disclosed in U.S. Pat. No. 8,105,382.
As shown in
The linkages can be positioned such that the longer shaft portion 278 can engage the side portions 240, 242 of the upper and lower body portions 202, 204. For example, each of the side portions 240, 242 can include a receiving portion 293, 295 for receiving the longer shaft portion 278 when the implant 202 is in the unexpanded state. Each of the upper and lower body portions 202, 204 can also include internal receiving portions 297, 299 for receiving the shorter shaft portions 286 when the implant 200 is in the unexpanded state. The receiving portions can be slots, grooves, indentations, or other features capable of receiving the shaft portions 278, 286.
The linkages 254, 265 can facilitate the alignment, interconnection, and stability of the upper and lower body portions 202, 204. As shown in
In addition, the linkages 254, 265 can act as motion limiting structures that limit the separation between the upper and lower body portions 202, 204. As the upper and lower side portions 202, 204 move apart, the pins 258, 263 move along their respective cam paths 282, 284 and force the linkages 254, 265 to rotate from the first configuration to the second configuration. In the first configuration, an axis extending across the width W of each linkage 254, 265 is substantially transverse to a longitudinal axis of the implant 200. In the second configuration, the axis extending across the width W of each linkage 254, 265 is nearly or substantially parallel to the longitudinal axis of the implant 200. The upper and lower body portions 202, 204 can only move apart so far as the linkages 254, 265 will permit. As such, the distance between the upper and lower body portions 202, 204 is limited by the distance between far ends of cam paths 282, 284.
Although not shown in the FIGS., the implant 200 can include additional linkages to provide further stability. Each of the additional linkages can connect to the upper and lower body portions 202, 204 as described above. For example, the additional linkages can be horizontally displaced from the first and second linkages 254, 265 described herein. In certain variants, the additional linkages can connect to the first and second linkages 254, 265 to permit further expansion of the upper and lower body portions 202, 204. For example, the upper and lower body portions 202, 204 can be separated by a distance equivalent to two linkages.
The specific dimensions of any of the embodiment disclosed herein can be readily varied depending upon the intended application, as will be apparent to those of skill in the art in view of the disclosure herein. Moreover, although the present inventions have been described in terms of certain preferred embodiments, other embodiments of the inventions including variations in the number of parts, dimensions, configuration and materials will be apparent to those of skill in the art in view of the disclosure herein. In addition, all features discussed in connection with any one embodiment herein can be readily adapted for use in other embodiments herein to form various combinations and sub-combinations. The use of different terms or reference numerals for similar features in different embodiments does not imply differences other than those which may be expressly set forth. Accordingly, the present inventions are intended to be described solely by reference to the appended claims, and not limited to the preferred embodiments disclosed herein.
Number | Name | Date | Kind |
---|---|---|---|
1802560 | Kerwin | Apr 1923 | A |
2077804 | Morrison | Apr 1937 | A |
2121193 | Hanicke | Jun 1938 | A |
2243717 | Moreira | May 1941 | A |
2388056 | Hendricks | Jul 1943 | A |
2381050 | Hardinge | Aug 1945 | A |
2485531 | Dzus et al. | Oct 1949 | A |
2489870 | Dzus | Nov 1949 | A |
2570465 | Lundholm | Oct 1951 | A |
2677369 | Knowles | May 1954 | A |
3115804 | Johnson | Dec 1963 | A |
3312139 | Di Cristina | Apr 1967 | A |
3486505 | Morrison | Dec 1969 | A |
3489143 | Holloran | Jan 1970 | A |
3698391 | Mahony | Oct 1972 | A |
3760802 | Fischer et al. | Sep 1973 | A |
3805775 | Fischer et al. | Apr 1974 | A |
3811449 | Gravlee et al. | May 1974 | A |
3842825 | Wagner | Oct 1974 | A |
3848601 | Ma et al. | Nov 1974 | A |
3986504 | Avila | Oct 1976 | A |
4013071 | Rosenberg | Mar 1977 | A |
4052988 | Doddi et al. | Oct 1977 | A |
4091806 | Aginsky | May 1978 | A |
4175555 | Herbert | Nov 1979 | A |
4236512 | Aginsky | Dec 1980 | A |
4262665 | Roalstad et al. | Apr 1981 | A |
4275717 | Bolesky | Jun 1981 | A |
4312353 | Shahbabian | Jan 1982 | A |
4341206 | Perrett et al. | Jul 1982 | A |
4350151 | Scott | Sep 1982 | A |
4369790 | McCarthy | Jan 1983 | A |
4401112 | Rezaian | Aug 1983 | A |
4401433 | Luther | Aug 1983 | A |
4409974 | Freedland | Oct 1983 | A |
4449532 | Storz | May 1984 | A |
4451256 | Weikl et al. | May 1984 | A |
4456005 | Lichty | Jun 1984 | A |
4463753 | Gustilo | Aug 1984 | A |
4488543 | Tornier | Dec 1984 | A |
4494535 | Haig | Jan 1985 | A |
4532660 | Field | Aug 1985 | A |
4537185 | Stednitz | Aug 1985 | A |
4545374 | Jacobson | Oct 1985 | A |
4573448 | Kambin | Mar 1986 | A |
4601710 | Moll | Jul 1986 | A |
2173655 | Himoud | Oct 1986 | A |
4625725 | Davison et al. | Dec 1986 | A |
4629450 | Suzuki et al. | Dec 1986 | A |
4632101 | Freedland | Dec 1986 | A |
4640271 | Lower | Feb 1987 | A |
4641640 | Griggs | Feb 1987 | A |
4653489 | Tronzo | Mar 1987 | A |
4667663 | Miyata | May 1987 | A |
4686984 | Bonnet | Aug 1987 | A |
4688561 | Reese | Aug 1987 | A |
4721103 | Freedland | Jan 1988 | A |
4723544 | Moore et al. | Feb 1988 | A |
4743257 | Tormala et al. | May 1988 | A |
4760843 | Fischer et al. | Aug 1988 | A |
4790304 | Rosenberg | Dec 1988 | A |
4790817 | Luther | Dec 1988 | A |
4796612 | Reese | Jan 1989 | A |
4802479 | Haber et al. | Feb 1989 | A |
4815909 | Simons | Mar 1989 | A |
4827917 | Brumfield | May 1989 | A |
4858601 | Glisson | Aug 1989 | A |
4862891 | Smith | Sep 1989 | A |
4863476 | Shepperd | Sep 1989 | A |
4873976 | Schreiber | Oct 1989 | A |
4898186 | Ikada et al. | Feb 1990 | A |
4903692 | Reese | Feb 1990 | A |
4917554 | Bronn | Apr 1990 | A |
4940467 | Tronzo | Jul 1990 | A |
4959064 | Engelhardt | Sep 1990 | A |
4963144 | Huene | Oct 1990 | A |
4966587 | Baumgart | Oct 1990 | A |
4968317 | Tormala et al. | Nov 1990 | A |
4978334 | Toye et al. | Dec 1990 | A |
4978349 | Frigg | Dec 1990 | A |
4981482 | Ichikawa | Jan 1991 | A |
4988351 | Paulos et al. | Jan 1991 | A |
4994027 | Farrel | Feb 1991 | A |
5002557 | Hasson | Mar 1991 | A |
5011484 | Breard | Apr 1991 | A |
5013315 | Barrows | May 1991 | A |
5013316 | Goble et al. | May 1991 | A |
5059193 | Kuslich | Oct 1991 | A |
5062849 | Schelhas | Nov 1991 | A |
5080662 | Paul | Jan 1992 | A |
5084043 | Hertzmann et al. | Jan 1992 | A |
5092891 | Kummer et al. | Mar 1992 | A |
5098241 | Aldridge et al. | Mar 1992 | A |
5098433 | Freedland | Mar 1992 | A |
5098435 | Stednitz et al. | Mar 1992 | A |
5114407 | Burbank | May 1992 | A |
5116336 | Frigg | May 1992 | A |
5120171 | Lasner | Jun 1992 | A |
5122133 | Evans | Jun 1992 | A |
5122141 | Simpson et al. | Jun 1992 | A |
5139486 | Moss | Aug 1992 | A |
5158543 | Lazarus | Oct 1992 | A |
5167663 | Brumfield | Dec 1992 | A |
5167664 | Hodorek | Dec 1992 | A |
5169400 | Muhling et al. | Dec 1992 | A |
5171278 | Pisharodi | Dec 1992 | A |
5171279 | Mathews | Dec 1992 | A |
5171280 | Baumgartner | Dec 1992 | A |
5176651 | Allgood et al. | Jan 1993 | A |
5176697 | Hasson et al. | Jan 1993 | A |
5178501 | Carstairs | Jan 1993 | A |
5183464 | Dubrul et al. | Feb 1993 | A |
5188118 | Terwilliger | Feb 1993 | A |
5195506 | Hulfish | Mar 1993 | A |
5201742 | Hasson | Apr 1993 | A |
5217462 | Asnis et al. | Jun 1993 | A |
5217486 | Rice et al. | Jun 1993 | A |
5224952 | Deniega et al. | Jul 1993 | A |
5234431 | Keller | Aug 1993 | A |
5241972 | Bonati | Sep 1993 | A |
5242410 | Melker | Sep 1993 | A |
5242447 | Borzone | Sep 1993 | A |
5246441 | Ross et al. | Sep 1993 | A |
5250049 | Michael | Oct 1993 | A |
5269797 | Bonati et al. | Dec 1993 | A |
5280782 | Wilk | Jan 1994 | A |
5286001 | Rafeld | Feb 1994 | A |
5290243 | Chodorow et al. | Mar 1994 | A |
5300074 | Frigg | Apr 1994 | A |
5304142 | Liebl et al. | Apr 1994 | A |
5308327 | Heaven et al. | May 1994 | A |
5308352 | Koutrouvelis | May 1994 | A |
5312410 | Miller et al. | May 1994 | A |
5312417 | Wilk | May 1994 | A |
5324261 | Amundson et al. | Jun 1994 | A |
5334184 | Bimman | Aug 1994 | A |
5334204 | Clewett et al. | Aug 1994 | A |
5342365 | Waldman | Aug 1994 | A |
5342382 | Brinkerhoff et al. | Aug 1994 | A |
5344252 | Kakimoto | Sep 1994 | A |
5364398 | Chapman et al. | Nov 1994 | A |
5370646 | Reese et al. | Dec 1994 | A |
5370647 | Graber et al. | Dec 1994 | A |
5370661 | Branch | Dec 1994 | A |
5382248 | Jacobson et al. | Jan 1995 | A |
5387213 | Breard et al. | Feb 1995 | A |
5387215 | Fisher | Feb 1995 | A |
5390683 | Pisharodi | Feb 1995 | A |
5395317 | Kambin | Mar 1995 | A |
5395371 | Miller et al. | Mar 1995 | A |
5407430 | Peters | Apr 1995 | A |
5415661 | Holmes | May 1995 | A |
5424773 | Saito | Jun 1995 | A |
5449359 | Groiso | Sep 1995 | A |
5449361 | Preissmann | Sep 1995 | A |
5452748 | Simmons et al. | Sep 1995 | A |
5454790 | Dubrul et al. | Oct 1995 | A |
5464427 | Curtis et al. | Nov 1995 | A |
5470333 | Ray | Nov 1995 | A |
5472426 | Bonati et al. | Dec 1995 | A |
5474539 | Costa et al. | Dec 1995 | A |
5486190 | Green | Jan 1996 | A |
5496318 | Howland et al. | Mar 1996 | A |
5498265 | Asnis et al. | Mar 1996 | A |
5501695 | Anspach, Jr. et al. | Mar 1996 | A |
5505710 | Dorsey, III | Apr 1996 | A |
5512037 | Russell et al. | Apr 1996 | A |
5514180 | Heggeness et al. | May 1996 | A |
5520690 | Errico et al. | May 1996 | A |
5520896 | de Graaf et al. | May 1996 | A |
5527312 | Ray | Jun 1996 | A |
5536127 | Pennig | Jul 1996 | A |
5540688 | Navas | Jul 1996 | A |
5540693 | Fisher | Jul 1996 | A |
5545164 | Howland | Aug 1996 | A |
5549610 | Russell et al. | Aug 1996 | A |
5554191 | Lahille et al. | Sep 1996 | A |
5558674 | Heggeness et al. | Sep 1996 | A |
D374287 | Goble et al. | Oct 1996 | S |
5564926 | Branemark | Oct 1996 | A |
5569248 | Mathews | Oct 1996 | A |
5569251 | Baker et al. | Oct 1996 | A |
5569290 | McAfee | Oct 1996 | A |
5569548 | Koike et al. | Oct 1996 | A |
5591168 | Judet et al. | Jan 1997 | A |
5609634 | Voydeville | Mar 1997 | A |
5613950 | Yoon | Mar 1997 | A |
5618142 | Sonden et al. | Apr 1997 | A |
5618314 | Harwin et al. | Apr 1997 | A |
5624447 | Myers | Apr 1997 | A |
5626613 | Schmieding | May 1997 | A |
5628751 | Sander et al. | May 1997 | A |
5628752 | Asnis et al. | May 1997 | A |
5639276 | Weinstock et al. | Jun 1997 | A |
5643320 | Lower et al. | Jul 1997 | A |
5645589 | Li | Jul 1997 | A |
5645599 | Samani | Jul 1997 | A |
5647857 | Anderson et al. | Jul 1997 | A |
5649931 | Bryant et al. | Jul 1997 | A |
5653763 | Errico et al. | Aug 1997 | A |
5658335 | Allen | Aug 1997 | A |
5662683 | Kay | Sep 1997 | A |
5665095 | Jacobson | Sep 1997 | A |
5665122 | Kambin | Sep 1997 | A |
5667508 | Errico et al. | Sep 1997 | A |
5669915 | Caspar et al. | Sep 1997 | A |
5693100 | Pisharodi | Dec 1997 | A |
5702391 | Lin | Dec 1997 | A |
5707359 | Bufalinia | Jan 1998 | A |
5713870 | Yoon | Feb 1998 | A |
5713903 | Sander et al. | Feb 1998 | A |
5716415 | Steffee | Feb 1998 | A |
5716416 | Lin | Feb 1998 | A |
5720753 | Sander et al. | Feb 1998 | A |
5725541 | Anspach, III et al. | Mar 1998 | A |
5725588 | Errico et al. | Mar 1998 | A |
5728097 | Mathews | Mar 1998 | A |
5728116 | Rosenman | Mar 1998 | A |
5735853 | Olerud | Apr 1998 | A |
5741282 | Anspach, III et al. | Apr 1998 | A |
5743881 | Demco | Apr 1998 | A |
5743912 | Lahille et al. | Apr 1998 | A |
5743914 | Skiba | Apr 1998 | A |
5749889 | Bacich et al. | May 1998 | A |
5752969 | Cunci et al. | May 1998 | A |
5762500 | Lazarof | Jun 1998 | A |
5762629 | Kambin | Jun 1998 | A |
5772662 | Chapman et al. | Jun 1998 | A |
5772678 | Thomason et al. | Jun 1998 | A |
5776156 | Shikhman | Jul 1998 | A |
5782800 | Yoon | Jul 1998 | A |
5782865 | Grptz | Jul 1998 | A |
5792044 | Foley et al. | Aug 1998 | A |
5810721 | Mueller et al. | Sep 1998 | A |
5810821 | Vandewalle | Sep 1998 | A |
5810866 | Yoon | Sep 1998 | A |
5814084 | Grivas et al. | Sep 1998 | A |
5836948 | Zucherman et al. | Nov 1998 | A |
5846259 | Berthiaume | Dec 1998 | A |
5849004 | Bramlet | Dec 1998 | A |
5851216 | Allen | Dec 1998 | A |
5860977 | Zucherman et al. | Jan 1999 | A |
5865848 | Baker | Feb 1999 | A |
5871485 | Rao et al. | Feb 1999 | A |
5873854 | Wolvek | Feb 1999 | A |
5876404 | Zucherman et al. | Mar 1999 | A |
5888228 | Knothe et al. | Mar 1999 | A |
5893850 | Cachia | Apr 1999 | A |
5893889 | Harrington | Apr 1999 | A |
5895428 | Berry | Apr 1999 | A |
5902231 | Foley et al. | May 1999 | A |
5904696 | Rosenman | May 1999 | A |
5908422 | Bresina | Jun 1999 | A |
5928235 | Friedl | Jul 1999 | A |
5928244 | Tovey et al. | Jul 1999 | A |
5931870 | Cuckler et al. | Aug 1999 | A |
5935129 | McDevitt et al. | Aug 1999 | A |
5947999 | Groiso | Sep 1999 | A |
5948000 | Larsen et al. | Sep 1999 | A |
5954722 | Bono | Sep 1999 | A |
5954747 | Clark | Sep 1999 | A |
5957902 | Teves | Sep 1999 | A |
5957924 | Tormala et al. | Sep 1999 | A |
5964730 | Williams et al. | Oct 1999 | A |
5964761 | Kambin | Oct 1999 | A |
5967783 | Ura | Oct 1999 | A |
5967970 | Cowan et al. | Oct 1999 | A |
5968044 | Nicholson et al. | Oct 1999 | A |
5968098 | Winslow | Oct 1999 | A |
5976139 | Bramlet | Nov 1999 | A |
5976146 | Ogawa et al. | Nov 1999 | A |
5976186 | Boa et al. | Nov 1999 | A |
5980522 | Koros et al. | Nov 1999 | A |
5984927 | Wenstrom, Jr. et al. | Nov 1999 | A |
5984966 | Kiena et al. | Nov 1999 | A |
5989255 | Pepper et al. | Nov 1999 | A |
5993459 | Larsen et al. | Nov 1999 | A |
5997510 | Schwemberger | Dec 1999 | A |
5997538 | Asnis et al. | Dec 1999 | A |
5997541 | Schenk | Dec 1999 | A |
6001100 | Sherman et al. | Dec 1999 | A |
6001101 | Augagneur et al. | Dec 1999 | A |
6004327 | Asnis et al. | Dec 1999 | A |
6005161 | Brekke et al. | Dec 1999 | A |
6007519 | Rosselli | Dec 1999 | A |
6007566 | Wenstorm, Jr. | Dec 1999 | A |
6007580 | Lehto et al. | Dec 1999 | A |
6010513 | Tormala et al. | Jan 2000 | A |
6015410 | Tormala et al. | Jan 2000 | A |
6019762 | Cole | Feb 2000 | A |
6022352 | Vandewalle | Feb 2000 | A |
6030162 | Huebner | Feb 2000 | A |
6030364 | Durgin et al. | Feb 2000 | A |
6033406 | Mathews | Mar 2000 | A |
6036701 | Rosenman | Mar 2000 | A |
6048309 | Flom et al. | Apr 2000 | A |
6048342 | Zucherman et al. | Apr 2000 | A |
6053935 | Brenneman et al. | Apr 2000 | A |
6066142 | Serbousek et al. | May 2000 | A |
6068630 | Zucherman et al. | May 2000 | A |
6068648 | Cole et al. | May 2000 | A |
6074390 | Zucherman et al. | Jun 2000 | A |
6080193 | Hochshuler et al. | Jun 2000 | A |
6083244 | Lubbers et al. | Jul 2000 | A |
6090112 | Zucherman et al. | Jul 2000 | A |
6102914 | Bulstra et al. | Aug 2000 | A |
6102950 | Vaccaro | Aug 2000 | A |
6117174 | Nolan | Sep 2000 | A |
6123711 | Winters | Sep 2000 | A |
6126661 | Faccioli et al. | Oct 2000 | A |
6126663 | Hair | Oct 2000 | A |
6129762 | Li | Oct 2000 | A |
6129763 | Chauvin et al. | Oct 2000 | A |
6146384 | Lee et al. | Nov 2000 | A |
6149652 | Zucherman et al. | Nov 2000 | A |
6152926 | Zucherman et al. | Nov 2000 | A |
6156038 | Zucherman et al. | Dec 2000 | A |
6159179 | Simonson | Dec 2000 | A |
6161350 | Espinosa | Dec 2000 | A |
6162234 | Friedland et al. | Dec 2000 | A |
6162236 | Osada | Dec 2000 | A |
6168595 | Durham et al. | Jan 2001 | B1 |
6168597 | Biedermann et al. | Jan 2001 | B1 |
6175758 | Kambin | Jan 2001 | B1 |
6176882 | Biedermann et al. | Jan 2001 | B1 |
6183471 | Zucherman et al. | Feb 2001 | B1 |
6183472 | Lutz | Feb 2001 | B1 |
6183474 | Bramlet et al. | Feb 2001 | B1 |
6190387 | Zucherman et al. | Feb 2001 | B1 |
6197041 | Shichman et al. | Mar 2001 | B1 |
6200322 | Branch et al. | Mar 2001 | B1 |
6206826 | Mathews et al. | Mar 2001 | B1 |
6206922 | Zdeblick et al. | Mar 2001 | B1 |
6213957 | Milliman et al. | Apr 2001 | B1 |
6217509 | Foley et al. | Apr 2001 | B1 |
6221082 | Marino et al. | Apr 2001 | B1 |
6228058 | Dennis et al. | May 2001 | B1 |
6231606 | Graf et al. | May 2001 | B1 |
6235030 | Zucherman et al. | May 2001 | B1 |
6238397 | Zucherman et al. | May 2001 | B1 |
6245107 | Ferree | Jun 2001 | B1 |
6248108 | Tormala et al. | Jun 2001 | B1 |
6251111 | Barker et al. | Jun 2001 | B1 |
6264676 | Gellman et al. | Jul 2001 | B1 |
6267765 | Taylor et al. | Jul 2001 | B1 |
6267767 | Strobel et al. | Jul 2001 | B1 |
6280444 | Zucherman et al. | Aug 2001 | B1 |
6287313 | Sasso | Sep 2001 | B1 |
6293909 | Chu et al. | Sep 2001 | B1 |
6293952 | Brosens et al. | Sep 2001 | B1 |
6306136 | Baccelli | Oct 2001 | B1 |
6319254 | Giet et al. | Nov 2001 | B1 |
6319272 | Brenneman et al. | Nov 2001 | B1 |
6332882 | Zucherman et al. | Dec 2001 | B1 |
6332883 | Zucherman et al. | Dec 2001 | B1 |
6346092 | Leschinsky | Feb 2002 | B1 |
6348053 | Cachia | Feb 2002 | B1 |
6355043 | Adam | Mar 2002 | B1 |
6361537 | Anderson | Mar 2002 | B1 |
6361538 | Fenaroli et al. | Mar 2002 | B1 |
6361557 | Gittings et al. | Mar 2002 | B1 |
6364897 | Bonutti | Apr 2002 | B1 |
6368351 | Glenn et al. | Apr 2002 | B1 |
6371971 | Tsugita et al. | Apr 2002 | B1 |
6371989 | Chauvin et al. | Apr 2002 | B1 |
6375682 | Fleishmann et al. | Apr 2002 | B1 |
6379355 | Zucherman et al. | Apr 2002 | B1 |
6379363 | Herrington et al. | Apr 2002 | B1 |
6387130 | Stone et al. | May 2002 | B1 |
6419676 | Zucherman et al. | Jul 2002 | B1 |
6419677 | Zucherman et al. | Jul 2002 | B2 |
6419704 | Ferree | Jul 2002 | B1 |
6423061 | Bryant | Jul 2002 | B1 |
6423067 | Eisermann | Jul 2002 | B1 |
6425919 | Lambrecht | Jul 2002 | B1 |
6428541 | Boyd et al. | Aug 2002 | B1 |
6428556 | Chin | Aug 2002 | B1 |
6436143 | Ross et al. | Aug 2002 | B1 |
6440154 | Gellman | Aug 2002 | B2 |
6440169 | Elberg et al. | Aug 2002 | B1 |
6443989 | Jackson | Sep 2002 | B1 |
6447527 | Thompson et al. | Sep 2002 | B1 |
6447540 | Fontaine et al. | Sep 2002 | B1 |
6450989 | Dubrul et al. | Sep 2002 | B2 |
6451019 | Zucherman et al. | Sep 2002 | B1 |
6451020 | Zucherman et al. | Sep 2002 | B1 |
6454807 | Jackson | Sep 2002 | B1 |
6458134 | Songer et al. | Oct 2002 | B1 |
6468277 | Justin et al. | Oct 2002 | B1 |
6468309 | Lieberman | Oct 2002 | B1 |
6468310 | Ralph et al. | Oct 2002 | B1 |
6471724 | Zdeblick et al. | Oct 2002 | B2 |
6475226 | Belef et al. | Nov 2002 | B1 |
6478029 | Boyd et al. | Nov 2002 | B1 |
6478796 | Zucherman et al. | Nov 2002 | B2 |
6485491 | Farris et al. | Nov 2002 | B1 |
6485518 | Cornwall et al. | Nov 2002 | B1 |
6488693 | Gannoe et al. | Dec 2002 | B2 |
6491714 | Bennett | Dec 2002 | B1 |
6494860 | Rocamora et al. | Dec 2002 | B2 |
6494893 | Dubrul et al. | Dec 2002 | B2 |
6500178 | Zucherman et al. | Dec 2002 | B2 |
6506192 | Gertzman et al. | Jan 2003 | B1 |
6511481 | von Hoffmann et al. | Jan 2003 | B2 |
6514256 | Zucherman et al. | Feb 2003 | B2 |
6517543 | Berrevoets et al. | Feb 2003 | B1 |
6520907 | Foley et al. | Feb 2003 | B1 |
6527774 | Lieberman | Mar 2003 | B2 |
6540747 | Marino | Apr 2003 | B1 |
6544265 | Lieberman | Apr 2003 | B2 |
6547793 | McGuire | Apr 2003 | B1 |
6547795 | Schneiderman | Apr 2003 | B2 |
6551319 | Lieberman | Apr 2003 | B2 |
6551322 | Lieberman | Apr 2003 | B1 |
6554831 | Rivard et al. | Apr 2003 | B1 |
6554852 | Oberlander | Apr 2003 | B1 |
6558389 | Clark et al. | May 2003 | B2 |
6562046 | Sasso | May 2003 | B2 |
6562049 | Norlander et al. | May 2003 | B1 |
6562074 | Gerbec et al. | May 2003 | B2 |
6575979 | Cragg | Jun 2003 | B1 |
6576016 | Hochshuler et al. | Jun 2003 | B1 |
6579293 | Chandran | Jun 2003 | B1 |
6582390 | Sanderson | Jun 2003 | B1 |
6582431 | Ray | Jun 2003 | B1 |
6582433 | Yun | Jun 2003 | B2 |
6582437 | Dorchak et al. | Jun 2003 | B2 |
6582441 | He et al. | Jun 2003 | B1 |
6582453 | Tran et al. | Jun 2003 | B1 |
6585730 | Foerster | Jul 2003 | B1 |
6585740 | Schlapfer et al. | Jul 2003 | B2 |
6589240 | Hinchliffe | Jul 2003 | B2 |
6589249 | Sater et al. | Jul 2003 | B2 |
6592553 | Zhang et al. | Jul 2003 | B2 |
6595998 | Johnson et al. | Jul 2003 | B2 |
6596008 | Kambin | Jul 2003 | B1 |
6599297 | Carlsson et al. | Jul 2003 | B1 |
6607530 | Carl et al. | Aug 2003 | B1 |
6610091 | Reiley | Aug 2003 | B1 |
6613050 | Wagner et al. | Sep 2003 | B1 |
6616678 | Nishtala et al. | Sep 2003 | B2 |
6620196 | Trieu | Sep 2003 | B1 |
6626944 | Taylor | Sep 2003 | B1 |
6632224 | Cachia et al. | Oct 2003 | B2 |
6635059 | Randall et al. | Oct 2003 | B2 |
6635362 | Zheng | Oct 2003 | B2 |
6648890 | Culbert et al. | Nov 2003 | B2 |
6648893 | Dudasik | Nov 2003 | B2 |
6652527 | Zucherman et al. | Nov 2003 | B2 |
6655962 | Kennard | Dec 2003 | B1 |
6666891 | Boehm, Jr. et al. | Dec 2003 | B2 |
6669698 | Tromanhauser et al. | Dec 2003 | B1 |
6669729 | Chin | Dec 2003 | B2 |
6673074 | Shluzas | Jan 2004 | B2 |
6676664 | Al-Assir | Jan 2004 | B1 |
6679833 | Smith et al. | Jan 2004 | B2 |
6682535 | Hoogland | Jan 2004 | B2 |
6685706 | Padget et al. | Feb 2004 | B2 |
6685742 | Jackson | Feb 2004 | B1 |
6689152 | Balceta et al. | Feb 2004 | B2 |
6692499 | Tormalaet et al. | Feb 2004 | B2 |
6695842 | Zucherman et al. | Feb 2004 | B2 |
6695851 | Zdeblick et al. | Feb 2004 | B2 |
6699246 | Zucherman et al. | Mar 2004 | B2 |
6699247 | Zucherman et al. | Mar 2004 | B2 |
6712819 | Zucherman et al. | Mar 2004 | B2 |
6716247 | Michelson | Apr 2004 | B2 |
6719760 | Dorchak et al. | Apr 2004 | B2 |
6723096 | Dorchak et al. | Apr 2004 | B1 |
6723126 | Berry | Apr 2004 | B1 |
6730126 | Boehm, Jr. et al. | May 2004 | B2 |
6733534 | Sherman | May 2004 | B2 |
6733535 | Michelson | May 2004 | B2 |
6733635 | Ozawa et al. | May 2004 | B1 |
6740090 | Cragg et al. | May 2004 | B1 |
6740093 | Hoschschuler et al. | May 2004 | B2 |
6743166 | Berci et al. | Jun 2004 | B2 |
6746451 | Middleton et al. | Jun 2004 | B2 |
6752831 | Sybert et al. | Jun 2004 | B2 |
6761720 | Senegas | Jul 2004 | B1 |
6770075 | Howland | Aug 2004 | B2 |
6773460 | Jackson | Aug 2004 | B2 |
6790210 | Cragg et al. | Sep 2004 | B1 |
6793656 | Mathews | Sep 2004 | B1 |
6796983 | Zucherman et al. | Sep 2004 | B1 |
6805695 | Keith | Oct 2004 | B2 |
6808526 | Magerl et al. | Oct 2004 | B1 |
6808537 | Michelson | Oct 2004 | B2 |
6821298 | Jackson | Nov 2004 | B1 |
6830589 | Erikson | Dec 2004 | B2 |
6835205 | Atkinson et al. | Dec 2004 | B2 |
6835206 | Jackson | Dec 2004 | B2 |
6875215 | Taras et al. | Apr 2005 | B2 |
6887243 | Culbert et al. | May 2005 | B2 |
6890333 | von Hoffmann et al. | May 2005 | B2 |
6893466 | Trieu | May 2005 | B2 |
6902566 | Zucherman et al. | Jun 2005 | B2 |
6908465 | von Hoffman et al. | Jun 2005 | B2 |
6916323 | Kitchens et al. | Jul 2005 | B2 |
6921403 | Cragg et al. | Jul 2005 | B2 |
6923811 | Carl et al. | Aug 2005 | B1 |
6929606 | Ritland | Aug 2005 | B2 |
6936072 | Lambrecht et al. | Aug 2005 | B2 |
6942668 | Padget et al. | Sep 2005 | B2 |
6945975 | Dalton | Sep 2005 | B2 |
6946000 | Senegas et al. | Sep 2005 | B2 |
6949100 | Venturini | Sep 2005 | B1 |
6951561 | Warren et al. | Oct 2005 | B2 |
6972035 | Michelson | Dec 2005 | B2 |
6997929 | Manzi et al. | Feb 2006 | B2 |
7004945 | Boyd et al. | Feb 2006 | B2 |
7018415 | McKay | Mar 2006 | B1 |
7025746 | Tal | Apr 2006 | B2 |
7029473 | Zucherman et al. | Apr 2006 | B2 |
7041107 | Pohjonen et al. | May 2006 | B2 |
7048736 | Robinson et al. | May 2006 | B2 |
7060068 | Tromanhauser et al. | Jun 2006 | B2 |
7063701 | Michelson | Jun 2006 | B2 |
7063702 | Michelson | Jun 2006 | B2 |
7066960 | Dickman | Jun 2006 | B1 |
7066961 | Michelson | Jun 2006 | B2 |
7070601 | Culbert et al. | Jul 2006 | B2 |
7074203 | Johanson et al. | Jul 2006 | B1 |
7087083 | Pasquet et al. | Aug 2006 | B2 |
7094239 | Michelson | Aug 2006 | B1 |
7094257 | Mujwid et al. | Aug 2006 | B2 |
7094258 | Lambrecht et al. | Aug 2006 | B2 |
7101375 | Zucherman et al. | Sep 2006 | B2 |
7114501 | Johnson et al. | Oct 2006 | B2 |
7118572 | Bramlet et al. | Oct 2006 | B2 |
7118579 | Michelson | Oct 2006 | B2 |
7118598 | Michelson | Oct 2006 | B2 |
7128760 | Michelson | Oct 2006 | B2 |
7153305 | Johnson et al. | Dec 2006 | B2 |
D536096 | Hoogland et al. | Jan 2007 | S |
7163558 | Senegas et al. | Jan 2007 | B2 |
7172612 | Ishikawa | Feb 2007 | B2 |
7179294 | Eisermann et al. | Feb 2007 | B2 |
7201751 | Zucherman et al. | Apr 2007 | B2 |
7226481 | Kuslich | Jun 2007 | B2 |
7238204 | Couedic et al. | Jul 2007 | B2 |
7267683 | Sharkey et al. | Sep 2007 | B2 |
7282061 | Sharkey et al. | Oct 2007 | B2 |
7306628 | Zucherman et al. | Dec 2007 | B2 |
7309357 | Kim | Dec 2007 | B2 |
7326211 | Padget et al. | Feb 2008 | B2 |
7335203 | Winslow et al. | Feb 2008 | B2 |
7361140 | Ries et al. | Apr 2008 | B2 |
7371238 | Soboleski et al. | May 2008 | B2 |
7377942 | Berry | May 2008 | B2 |
7400930 | Sharkey et al. | Jul 2008 | B2 |
7410501 | Michelson | Aug 2008 | B2 |
7413576 | Sybert et al. | Aug 2008 | B2 |
7422594 | Zander | Sep 2008 | B2 |
7434325 | Foley et al. | Oct 2008 | B2 |
7445636 | Michelson | Nov 2008 | B2 |
7445637 | Taylor | Nov 2008 | B2 |
D584812 | Ries | Jan 2009 | S |
7473256 | Assell et al. | Jan 2009 | B2 |
7473268 | Zucherman et al. | Jan 2009 | B2 |
7476251 | Zucherman et al. | Jan 2009 | B2 |
7488326 | Elliott | Feb 2009 | B2 |
7520888 | Trieu | Apr 2009 | B2 |
7547317 | Cragg | Jun 2009 | B2 |
7556629 | von Hoffmann et al. | Jul 2009 | B2 |
7556651 | Humphreys et al. | Jul 2009 | B2 |
7588574 | Assell et al. | Sep 2009 | B2 |
7625378 | Foley | Dec 2009 | B2 |
7641657 | Cragg | Jan 2010 | B2 |
7641670 | Davison et al. | Jan 2010 | B2 |
7647123 | Sharkey et al. | Jan 2010 | B2 |
7648523 | Mirkovic et al. | Jan 2010 | B2 |
7670354 | Davison et al. | Mar 2010 | B2 |
7674273 | Davison et al. | Mar 2010 | B2 |
7682370 | Pagliuca et al. | Mar 2010 | B2 |
7691120 | Shluzas et al. | Apr 2010 | B2 |
7699878 | Pavlov et al. | Apr 2010 | B2 |
7717944 | Foley et al. | May 2010 | B2 |
7722530 | Davison | May 2010 | B2 |
7727263 | Cragg | Jun 2010 | B2 |
7740633 | Assell et al. | Jun 2010 | B2 |
7744599 | Cragg | Jun 2010 | B2 |
7762995 | Eversull et al. | Jul 2010 | B2 |
7763025 | Assell et al. | Jul 2010 | B2 |
7763055 | Foley | Jul 2010 | B2 |
7766930 | DiPoto et al. | Aug 2010 | B2 |
7771479 | Humphreys et al. | Aug 2010 | B2 |
7794463 | Cragg | Sep 2010 | B2 |
7799032 | Assell et al. | Sep 2010 | B2 |
7799033 | Assell et al. | Sep 2010 | B2 |
7799036 | Davison et al. | Sep 2010 | B2 |
D626233 | Cipoletti et al. | Oct 2010 | S |
7814429 | Buffet et al. | Oct 2010 | B2 |
7819921 | Grotz | Oct 2010 | B2 |
7824410 | Simonson et al. | Nov 2010 | B2 |
7824429 | Culbert et al. | Nov 2010 | B2 |
7837734 | Flynn | Nov 2010 | B2 |
7846183 | Blain | Dec 2010 | B2 |
7850695 | Pagliuca et al. | Dec 2010 | B2 |
7850733 | Baynham | Dec 2010 | B2 |
7857832 | Culbert et al. | Dec 2010 | B2 |
7862590 | Lim et al. | Jan 2011 | B2 |
7862595 | Foley et al. | Jan 2011 | B2 |
7867259 | Foley et al. | Jan 2011 | B2 |
7875077 | Humphreys et al. | Jan 2011 | B2 |
7892171 | Davison et al. | Feb 2011 | B2 |
7892249 | Davison et al. | Feb 2011 | B2 |
7901438 | Culbert et al. | Mar 2011 | B2 |
7901459 | Hodges et al. | Mar 2011 | B2 |
7931689 | Hochschuler et al. | Apr 2011 | B2 |
7938832 | Culbert et al. | May 2011 | B2 |
7998176 | Culbert | Aug 2011 | B2 |
8062375 | Glerum | Nov 2011 | B2 |
8105382 | Olmos | Jan 2012 | B2 |
8109977 | Culbert et al. | Feb 2012 | B2 |
8133232 | Levy | Mar 2012 | B2 |
8262736 | Michelson | Sep 2012 | B2 |
8273129 | Baynham | Sep 2012 | B2 |
8317866 | Palmatier | Nov 2012 | B2 |
8366777 | Matthis | Feb 2013 | B2 |
8394129 | Lopez et al. | Mar 2013 | B2 |
8398713 | Weiman | Mar 2013 | B2 |
8926704 | Glerum et al. | Jan 2015 | B2 |
20010012950 | Nishtala et al. | Aug 2001 | A1 |
20010027320 | Sasso | Oct 2001 | A1 |
20010037126 | Stack et al. | Nov 2001 | A1 |
20010039452 | Zucherman et al. | Nov 2001 | A1 |
20010049529 | Cachia et al. | Dec 2001 | A1 |
20010049530 | Culbert et al. | Dec 2001 | A1 |
20020001476 | Nagamine et al. | Jan 2002 | A1 |
20020032462 | Houser et al. | Mar 2002 | A1 |
20020055740 | Lieberman | May 2002 | A1 |
20020087152 | Mikus et al. | Jul 2002 | A1 |
20020091387 | Hoogland | Jul 2002 | A1 |
20020120335 | Angelucci et al. | Aug 2002 | A1 |
20020143331 | Zucherman et al. | Oct 2002 | A1 |
20020143334 | von Hoffmann et al. | Oct 2002 | A1 |
20020143335 | von Hoffmann et al. | Oct 2002 | A1 |
20020151895 | Soboleski et al. | Oct 2002 | A1 |
20020161444 | Choi | Oct 2002 | A1 |
20020183848 | Ray et al. | Dec 2002 | A1 |
20030028250 | Reiley et al. | Feb 2003 | A1 |
20030063582 | Mizell et al. | Apr 2003 | A1 |
20030065330 | Zucherman et al. | Apr 2003 | A1 |
20030065396 | Michelson | Apr 2003 | A1 |
20030069582 | Culbert et al. | Apr 2003 | A1 |
20030083688 | Simonson | May 2003 | A1 |
20030139648 | Foley et al. | Jul 2003 | A1 |
20030139813 | Messerli et al. | Jul 2003 | A1 |
20030187431 | Simonson | Oct 2003 | A1 |
20030208122 | Melkent et al. | Nov 2003 | A1 |
20030208220 | Worley et al. | Nov 2003 | A1 |
20030220643 | Ferree | Nov 2003 | A1 |
20030229350 | Kay | Dec 2003 | A1 |
20030233102 | Nakamura et al. | Dec 2003 | A1 |
20040006391 | Reiley | Jan 2004 | A1 |
20040008949 | Liu et al. | Jan 2004 | A1 |
20040019359 | Worley et al. | Jan 2004 | A1 |
20040024463 | Thomas et al. | Feb 2004 | A1 |
20040049190 | Biedermann et al. | Mar 2004 | A1 |
20040049223 | Nishtala et al. | Mar 2004 | A1 |
20040054412 | Gerbec et al. | Mar 2004 | A1 |
20040059339 | Roehm, III et al. | Mar 2004 | A1 |
20040059350 | Gordon et al. | Mar 2004 | A1 |
20040097924 | Lambrecht et al. | May 2004 | A1 |
20040097941 | Weiner et al. | May 2004 | A1 |
20040097973 | Loshakove et al. | May 2004 | A1 |
20040106925 | Culbert | Jun 2004 | A1 |
20040127906 | Culbert et al. | Jul 2004 | A1 |
20040133280 | Trieu | Jul 2004 | A1 |
20040143284 | Chin | Jul 2004 | A1 |
20040143734 | Buer et al. | Jul 2004 | A1 |
20040147877 | Heuser | Jul 2004 | A1 |
20040147950 | Mueller et al. | Jul 2004 | A1 |
20040153156 | Cohen | Aug 2004 | A1 |
20040158258 | Bonati et al. | Aug 2004 | A1 |
20040162617 | Zucherman et al. | Aug 2004 | A1 |
20040172134 | Berry | Sep 2004 | A1 |
20040186471 | Trieu | Sep 2004 | A1 |
20040186482 | Kolb et al. | Sep 2004 | A1 |
20040199162 | von Hoffmann et al. | Oct 2004 | A1 |
20040215343 | Hochschuler et al. | Oct 2004 | A1 |
20040215344 | Hochschuler et al. | Oct 2004 | A1 |
20040220580 | Johnson et al. | Nov 2004 | A1 |
20040225292 | Sasso et al. | Nov 2004 | A1 |
20040225361 | Glenn et al. | Nov 2004 | A1 |
20040243239 | Taylor | Dec 2004 | A1 |
20040249466 | Liu et al. | Dec 2004 | A1 |
20040254575 | Obenchain et al. | Dec 2004 | A1 |
20040260297 | Padget et al. | Dec 2004 | A1 |
20040266257 | Ries et al. | Dec 2004 | A1 |
20050033434 | Berry | Feb 2005 | A1 |
20050043796 | Grant et al. | Feb 2005 | A1 |
20050065610 | Pisharodi | Mar 2005 | A1 |
20050090443 | Michael John | Apr 2005 | A1 |
20050090833 | DiPoto | Apr 2005 | A1 |
20050102202 | Linden et al. | May 2005 | A1 |
20050113927 | Malek | May 2005 | A1 |
20050118550 | Turri | Jun 2005 | A1 |
20050119657 | Goldsmith | Jun 2005 | A1 |
20050130929 | Boyd | Jun 2005 | A1 |
20050131406 | Reiley et al. | Jun 2005 | A1 |
20050131409 | Chervitz et al. | Jun 2005 | A1 |
20050131411 | Culbert et al. | Jun 2005 | A1 |
20050131538 | Chervitz et al. | Jun 2005 | A1 |
20050137595 | von Hoffmann et al. | Jun 2005 | A1 |
20050143734 | Cachia et al. | Jun 2005 | A1 |
20050149030 | Serhan | Jul 2005 | A1 |
20050154467 | Peterman et al. | Jul 2005 | A1 |
20050165398 | Reiley | Jul 2005 | A1 |
20050171552 | Johnson et al. | Aug 2005 | A1 |
20050171608 | Peterman et al. | Aug 2005 | A1 |
20050171610 | Humphreys et al. | Aug 2005 | A1 |
20050177240 | Blain | Aug 2005 | A1 |
20050182414 | Manzi et al. | Aug 2005 | A1 |
20050182418 | Boyd et al. | Aug 2005 | A1 |
20050187558 | Johnson et al. | Aug 2005 | A1 |
20050187559 | Raymond et al. | Aug 2005 | A1 |
20050203512 | Hawkins et al. | Sep 2005 | A1 |
20050216026 | Culbert | Sep 2005 | A1 |
20050251142 | von Hoffmann et al. | Nov 2005 | A1 |
20050256525 | Warren et al. | Nov 2005 | A1 |
20050278026 | Gordon et al. | Dec 2005 | A1 |
20050283238 | Reiley | Dec 2005 | A1 |
20060004326 | Collins et al. | Jan 2006 | A1 |
20060004457 | Collins et al. | Jan 2006 | A1 |
20060004458 | Collins et al. | Jan 2006 | A1 |
20060009778 | Collins et al. | Jan 2006 | A1 |
20060009779 | Collins et al. | Jan 2006 | A1 |
20060009851 | Collins et al. | Jan 2006 | A1 |
20060015105 | Warren et al. | Jan 2006 | A1 |
20060020284 | Foley et al. | Jan 2006 | A1 |
20060030872 | Culbert et al. | Feb 2006 | A1 |
20060036246 | Carl et al. | Feb 2006 | A1 |
20060036256 | Carl et al. | Feb 2006 | A1 |
20060036259 | Carl et al. | Feb 2006 | A1 |
20060036323 | Carl et al. | Feb 2006 | A1 |
20060036324 | Sachs et al. | Feb 2006 | A1 |
20060041314 | Millard | Feb 2006 | A1 |
20060058790 | Carl et al. | Mar 2006 | A1 |
20060058807 | Landry et al. | Mar 2006 | A1 |
20060058880 | Wysocki et al. | Mar 2006 | A1 |
20060079908 | Lieberman | Apr 2006 | A1 |
20060084977 | Lieberman | Apr 2006 | A1 |
20060084988 | Kim | Apr 2006 | A1 |
20060085010 | Lieberman | Apr 2006 | A1 |
20060100707 | Stinson et al. | May 2006 | A1 |
20060106381 | Ferree et al. | May 2006 | A1 |
20060122609 | Mirkovic et al. | Jun 2006 | A1 |
20060122610 | Culbert et al. | Jun 2006 | A1 |
20060129244 | Ensign | Jun 2006 | A1 |
20060142765 | Dixon et al. | Jun 2006 | A9 |
20060142776 | Iwanari | Jun 2006 | A1 |
20060161166 | Johnson et al. | Jul 2006 | A1 |
20060178743 | Carter | Aug 2006 | A1 |
20060195103 | Padget et al. | Aug 2006 | A1 |
20060217711 | Stevens et al. | Sep 2006 | A1 |
20060229629 | Manzi et al. | Oct 2006 | A1 |
20060235403 | Blain | Oct 2006 | A1 |
20060235412 | Blain | Oct 2006 | A1 |
20060247634 | Warner et al. | Nov 2006 | A1 |
20060276899 | Zipnick et al. | Dec 2006 | A1 |
20060276901 | Zipnick et al. | Dec 2006 | A1 |
20060276902 | Zipnick et al. | Dec 2006 | A1 |
20060293662 | Boyer, II et al. | Dec 2006 | A1 |
20060293663 | Walkenhorst et al. | Dec 2006 | A1 |
20070010826 | Rhoda | Jan 2007 | A1 |
20070016191 | Culbert et al. | Jan 2007 | A1 |
20070032790 | Aschmann et al. | Feb 2007 | A1 |
20070055236 | Hudgins et al. | Mar 2007 | A1 |
20070067035 | Falahee | Mar 2007 | A1 |
20070073399 | Zipnick et al. | Mar 2007 | A1 |
20070118132 | Culbert et al. | May 2007 | A1 |
20070118223 | Allard et al. | May 2007 | A1 |
20070123868 | Culbert et al. | May 2007 | A1 |
20070123891 | Ries et al. | May 2007 | A1 |
20070123892 | Ries et al. | May 2007 | A1 |
20070129730 | Woods et al. | Jun 2007 | A1 |
20070162005 | Peterson et al. | Jul 2007 | A1 |
20070168036 | Ainsworth et al. | Jul 2007 | A1 |
20070203491 | Pasquet et al. | Aug 2007 | A1 |
20070233083 | Abdou | Oct 2007 | A1 |
20070233089 | DiPoto et al. | Oct 2007 | A1 |
20070270954 | Wu | Nov 2007 | A1 |
20070270968 | Baynham et al. | Nov 2007 | A1 |
20070282449 | de Villiers | Dec 2007 | A1 |
20080058598 | Ries et al. | Mar 2008 | A1 |
20080077148 | Ries et al. | Mar 2008 | A1 |
20080082172 | Jackson | Apr 2008 | A1 |
20080097436 | Culbert et al. | Apr 2008 | A1 |
20080108996 | Padget et al. | May 2008 | A1 |
20080140207 | Olmos et al. | Jun 2008 | A1 |
20080147193 | Matthis et al. | Jun 2008 | A1 |
20080255618 | Fisher et al. | Oct 2008 | A1 |
20080262619 | Ray | Oct 2008 | A1 |
20080287981 | Culbert et al. | Nov 2008 | A1 |
20080287997 | Altarac et al. | Nov 2008 | A1 |
20080300685 | Carls et al. | Dec 2008 | A1 |
20080306537 | Culbert et al. | Dec 2008 | A1 |
20090069813 | von Hoffmann et al. | Mar 2009 | A1 |
20090105745 | Culbert et al. | Apr 2009 | A1 |
20090131986 | Lee et al. | May 2009 | A1 |
20090149857 | Culbert et al. | Jun 2009 | A1 |
20090182429 | Humphreys et al. | Jul 2009 | A1 |
20090222100 | Cipoletti et al. | Sep 2009 | A1 |
20090275890 | Leibowitz et al. | Nov 2009 | A1 |
20090292361 | Lopez | Nov 2009 | A1 |
20100040332 | Van Den Meersschaut et al. | Feb 2010 | A1 |
20100076492 | Warner et al. | Mar 2010 | A1 |
20100082109 | Greenhalgh | Apr 2010 | A1 |
20100114147 | Biyani | May 2010 | A1 |
20100174314 | Mirkovic | Jul 2010 | A1 |
20100191336 | Greenhalgh | Jul 2010 | A1 |
20100211176 | Greenhalgh | Aug 2010 | A1 |
20100268231 | Kuslich | Oct 2010 | A1 |
20100292700 | Ries | Nov 2010 | A1 |
20100292796 | Greenhalgh et al. | Nov 2010 | A1 |
20100298938 | Humphreys et al. | Nov 2010 | A1 |
20100331891 | Culbert et al. | Dec 2010 | A1 |
20110054538 | Zehavi et al. | Mar 2011 | A1 |
20110071527 | Nelson et al. | Mar 2011 | A1 |
20110098531 | To | Apr 2011 | A1 |
20110098628 | Yeung et al. | Apr 2011 | A1 |
20110130838 | Morgenstern Lopez | Jun 2011 | A1 |
20110153020 | Abdelgany | Jun 2011 | A1 |
20110172774 | Varela | Jul 2011 | A1 |
20110238072 | Tyndall | Sep 2011 | A1 |
20110251690 | Berger | Oct 2011 | A1 |
20110282453 | Greenhalgh | Nov 2011 | A1 |
20110307010 | Pradhan | Dec 2011 | A1 |
20110313465 | Warren et al. | Dec 2011 | A1 |
20110319997 | Glerum et al. | Dec 2011 | A1 |
20120059474 | Weiman | Mar 2012 | A1 |
20120059475 | Weiman | Mar 2012 | A1 |
20120150304 | Glerum | Jun 2012 | A1 |
20120150305 | Glerum | Jun 2012 | A1 |
20120158146 | Glerum | Jun 2012 | A1 |
20120158147 | Glerum | Jun 2012 | A1 |
20120158148 | Glerum | Jun 2012 | A1 |
20120185049 | Varela | Jul 2012 | A1 |
20120197405 | Cuevas | Aug 2012 | A1 |
20120203290 | Warren et al. | Aug 2012 | A1 |
20120203347 | Glerum | Aug 2012 | A1 |
20120215262 | Culbert et al. | Aug 2012 | A1 |
20120226357 | Varela | Sep 2012 | A1 |
20120232552 | Lopez et al. | Sep 2012 | A1 |
20120232658 | Lopez et al. | Sep 2012 | A1 |
20120265309 | Glerum et al. | Oct 2012 | A1 |
20120277795 | Hoffmann | Nov 2012 | A1 |
20120290090 | Glerum | Nov 2012 | A1 |
20120290097 | Cipoletti | Nov 2012 | A1 |
20120323328 | Weiman | Dec 2012 | A1 |
20120330421 | Weiman | Dec 2012 | A1 |
20120330422 | Weiman | Dec 2012 | A1 |
20130006361 | Glerum | Jan 2013 | A1 |
20130023993 | Weiman | Jan 2013 | A1 |
20130023994 | Glerum | Jan 2013 | A1 |
20130197642 | Ernst | Aug 2013 | A1 |
20130197647 | Wolters et al. | Aug 2013 | A1 |
20140236296 | Wagner et al. | Aug 2014 | A1 |
20140277473 | Perrow | Sep 2014 | A1 |
Number | Date | Country |
---|---|---|
2005-314079 | Oct 2012 | AU |
1177918 | Apr 1998 | CN |
3 023 353 | Apr 1981 | DE |
198 32 798 | Nov 1999 | DE |
201 01 793 | May 2001 | DE |
0 077 159 | Apr 1983 | EP |
0 260 044 | Mar 1988 | EP |
0 433 717 | Jun 1991 | EP |
0 525 352 | Feb 1993 | EP |
0 611 557 | Aug 1994 | EP |
0 625 336 | Nov 1994 | EP |
1 046 376 | Apr 2000 | EP |
0 853 929 | Sep 2002 | EP |
1 378 205 | Jul 2003 | EP |
1 374 784 | Jan 2004 | EP |
2 331 023 | Jun 2011 | EP |
1 845 874 | Oct 2012 | EP |
200801551 | May 2008 | ES |
2 699 065 | Dec 1992 | FR |
2 728 778 | Dec 1994 | FR |
2 745 709 | Mar 1996 | FR |
2 800 601 | Nov 1999 | FR |
2 801 189 | Nov 1999 | FR |
2 808 182 | Apr 2000 | FR |
2157788 | Oct 1985 | GB |
2173565 | Oct 1986 | GB |
64-52439 | Feb 1989 | JP |
6-500039 | Jun 1994 | JP |
6-319742 | Nov 1994 | JP |
07-502419 | Mar 1995 | JP |
07-184922 | Jul 1995 | JP |
10-085232 | Apr 1998 | JP |
11-089854 | Apr 1999 | JP |
2011-520580 | Jul 2011 | JP |
4988203 | Aug 2012 | JP |
5164571 | Dec 2012 | JP |
WO 9109572 | Dec 1989 | WO |
WO 9304652 | Mar 1993 | WO |
WO 9628100 | Sep 1996 | WO |
WO 9952478 | Oct 1999 | WO |
WO 9962417 | Dec 1999 | WO |
WO 0067652 | May 2000 | WO |
WO 0076409 | Dec 2000 | WO |
WO 0112054 | Feb 2001 | WO |
WO 0180751 | Nov 2001 | WO |
WO 0243601 | Jun 2002 | WO |
WO 03021308 | Mar 2003 | WO |
WO 03043488 | May 2003 | WO |
WO 2004008949 | Jan 2004 | WO |
WO 2004064603 | Aug 2004 | WO |
WO 2004078220 | Sep 2004 | WO |
WO 2004078221 | Sep 2004 | WO |
WO 2004098453 | Nov 2004 | WO |
WO 2005112835 | Dec 2005 | WO |
WO 2006017507 | Feb 2006 | WO |
WO 2006063083 | Jun 2006 | WO |
WO 2006108067 | Oct 2006 | WO |
WO 2007119212 | Oct 2007 | WO |
WO 2007124130 | Apr 2008 | WO |
WO 2008044057 | Apr 2008 | WO |
WO 2008064842 | Jun 2008 | WO |
WO 2008070863 | Jun 2008 | WO |
WO 2009152919 | Dec 2009 | WO |
WO 2010136170 | Dec 2010 | WO |
WO 2010148112 | Dec 2010 | WO |
WO 2011079910 | Jul 2011 | WO |
WO 2011142761 | Nov 2011 | WO |
WO 2011150350 | Dec 2011 | WO |
Entry |
---|
Jan. 26, 2005 International Search Report and Written Opinion received in corresponding PCT App. No. PCT/US04/06129, 13 pages. |
Aug. 4, 2005 EPO Examination Report for App. No. 01 932 643.8. |
Sep. 19, 2005 Office Action received in Australian Application No. 2002250488 filed Mar. 29, 2002. |
Apr. 13, 2006 International Search Report for App. No. PCT/US2005/044321. |
Jun. 22, 2006 European Search Report for Application No. 02719402.6 filed Mar. 29, 2002. |
Apr. 6, 2007 Office Action received in Chinese Application No. 02810329.7 filed Mar. 29, 2002. |
Apr. 22, 2004 International Search Report for App. No. PCT/US03/23645 filed Jul. 18, 2003. |
Apr. 18, 2007 EPO Examination Report for App. No. 01 932 643.8. |
Apr. 19, 2007 Office Action for European Application No. 02 719 402.6 filed Mar. 29, 2002. |
Apr. 19, 2007 Office Action Communication for Application No. 02719402.6 filed on Mar. 29, 2002. |
Jun. 18, 2007 Notice of Acceptance received in Australian Application No. 2002250488 filed Mar. 29, 2002. |
Jan. 9, 2008 Supplemental Partial European Search Report received in corresponding European Application No. 0 471 618. |
Apr. 17, 2008 International Search Report and Written Opinion from corresponding PCT Application No. PCT/US07/09794 filed Apr. 20, 2007 in 8 pages. |
Apr. 22, 2008 Supplemental ISR rec'd in corresponding EP Application No. 04716129.4. |
Apr. 29, 2008 Notice for Preliminary Rejection in Korean Application No. 2003-7012847 filed Mar. 29, 2002. |
May 30, 2008 International Search Report & Written Opinion received in corresponding PCT Application No. PCT/US06/12728 in 9 pgs. |
Jul. 3, 2008 Office Action received for Canadian Application No. 2,442,334 filed Mar. 29, 2002. |
Jul. 7, 2008 International Search Report and Written Opinion received in co-pending PCT Application No. PCT/US2005/027431 filed Aug. 2, 2005. |
Jul. 7, 2008 International Search Report and Written Opinion received in co-pending PCT Application No. PCT/US2007/086866 filed Dec. 7, 2007. |
Mar. 12, 2009 International Preliminary Report on Patentability, received in corresponding PCT Application No. PCT/US2007/009794 filed Apr. 20, 2007, in 5 pages. |
Apr. 3, 2009 Extended European Search Report received in European Application No. 09152476.9 in 5 pages. |
May 25, 2009 Notice of Allowance received in Canadian Application No. 2,442,334 filed Mar. 29, 2002. |
May 27, 2009 Office Action for Japanese Patent Application No. 2005-50552 filed on Jul. 18, 2003. |
Jun. 18, 2009 Preliminary Report on Patentability received in co-pending PCT Application No. PCT/US2007/086866 filed Dec. 7, 2007. |
Jul. 2, 2009 Office Action for U.S. Appl. No. 11/308,767 filed on May 1, 2006. |
Aug. 4, 2009 Extended European Search Report received in European Application No. 09164698.4, 5 pages. |
Sep. 7, 2009 Office Action for European Application No. 05 853 282.1filed Dec. 8, 2005. |
Mar. 31, 2010 Office Action for Japanese Patent Application No. 2005-505552 filed on Jul. 18, 2003. |
Apr. 20, 2010 International Search Report and Written Opinion in co-pending PCT Application No. PCT/IB2009/005972 in 19 pages. |
Sep. 10, 2010 Supplementary European Search Report of European Application No. EP 0 674 0 578 filed on Apr. 4, 2006. |
Jan. 27, 2011 Office Action for Australian Application No. 2005314079 filed Dec. 8, 2005. |
Feb. 7, 2011 Office Action for Japanese Application No. 2007-524917 filed Aug. 2, 2005. |
Feb. 24, 2012 Office Action for Japanese Application No. 2007-524917 filed Aug. 2, 2005. |
Mar. 23, 2011 Office Action for Japanese Application No. 2005-505552 filed Jul. 18, 2003. |
Jul. 5, 2011 Office Action (Rejection Notice dispatched Jul. 13, 2011) for Japanese Application No. 2007-545602. |
Apr. 28, 2011 Supplementary European Search Report for Application No. EP 07 75 5880 filed on Apr. 20, 2007. |
Mar. 14, 2012 Supplemental European Search Report for Application No. EP 05 77 7628. |
Apr. 2, 2012 Office Action (to proceed and to respond to Search Report) for Application No. 05777628.8. |
May 25, 2012 Office Action for EP Application No. 04716128.6. |
Jun. 25, 2012 International Search Report and Written Opinion for PCT Application No. PCT/US2012/02811 0, the PCT counterpart of the present application. |
Alfen, et al., “Developments in the Area of Edoscopic Spine Surgery”. European Musculoskeletal Review 2006, pp. 23-24. ThessysTM, Transforminal Endoscopic Spine System. Medical Solutions, ioimax®. |
Brooks, M.D., et al. Efficacy of Supplemental Posterior Transfacet Pedicle Device Fixation in the Setting of One—or Two-Level Anterior Lumbar Interbody Fusion Brochure for PERPOS PLS System Surgical Technique by Interventional Spine. |
Paul D. Fuchs, “The Use of an Interspinous Implant in Conjunction With a Graded Facetectomy Procedure”, SPINE vol. 30, No. 11, pp. 1266-1272. |
Iprenburg, et al., “Transforaminal Endoscopic Surgery in Lumbar Disc Herniation in an Economic Crisis—The TESSYS Method”. US Musculoskeletal, 2008 pp. 47-49. |
King, M.D., Don, “Internal Fixation for Lumbosacral Fusion”, The Journal of Bone and Joint Surgery. J Bone Joint Surg Am. 1948; 30:560-578. |
Medco Forum, “Percutaneous Lumbar Fixation Via PERPOS PLS System Interventional Spine”. Sep. 2008, vol. 15, No. 37. |
Medco Forum, “Percutaneous Lumbar Fixation via PERPOS System From Interventional Spine”. Oct. 2007, vol. 14, No. 49. |
Mahar, et al. Biomechanical Comparison of a Novel Percutaneous Transfacet Device and a Traditional Posterior System for Single Level Fusion. Journal of Spinal Disorders & Techniques, Dec. 2006, vol. 19 No. 8, pp. 591-594. |
Morgenstern R; Transforaminal Endoscopic Stenosis Surgery—A Comparative Study of Laser and Reamed Foraminoplasty.In: European Musculoskeletal Review, Issue 1,2009. |
ProMapTM EMG Navigation Probe. Technical Brochure Spineology Inc., Dated May 2009. |
Chin, Kingsley R., M.D. “Early Results of the Triage Medical Percutaneous Transfacet Pedicular BONE-LOK Compression Device for Lumbar Fusion”. |
Niosi, Christina A., “Biomechanical characterization of the three-dimentional kinematic behaviour of the Dynesys dynamic stabilization system: an in vitro study”, Eur Spine J (2006) 15: pp. 913-922. |
Manal Siddiqui, “The Positional Magnetic Resonance Imaging Changes in the Lumbar Spine Following Insertion of a Novel Interspinous Process Distraction Device”, SPINE vol. 30, No. 23, pp. 2677-2682. |
Vikram Talwar, “Insertion loads of the X STOP interspinous process distraction system designed to treat neurogenic intermittent claudication”, Eur Spine J (2006) 15: pp. 908-912. |
James F. Zucherman, “A Multicenter, Prospective, Randomized Trial Evaluating the X STOP Interspinous Process Decompression System for the Treatment of Neurogenic Intermittent Claudication”, SPINE vol. 30, No. 12, pp. 1351-1358. |
Kambin, et al; Percutanseous Lateral Discectomy of the Lumbar Spine: A Preliminary Report; Clin. Orthop.; 1983; 174: 127-132. |
Number | Date | Country | |
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20140257484 A1 | Sep 2014 | US |