CA2443429A1 - Anterior cervical plate system having vertebral body engaging anchors, connecting plate, and method for installation thereof - Google Patents
Anterior cervical plate system having vertebral body engaging anchors, connecting plate, and method for installation thereof Download PDFInfo
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- CA2443429A1 CA2443429A1 CA002443429A CA2443429A CA2443429A1 CA 2443429 A1 CA2443429 A1 CA 2443429A1 CA 002443429 A CA002443429 A CA 002443429A CA 2443429 A CA2443429 A CA 2443429A CA 2443429 A1 CA2443429 A1 CA 2443429A1
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- vertebral body
- body engaging
- plate system
- connecting plate
- engaging anchors
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- 238000000034 method Methods 0.000 title claims abstract 38
- 238000009434 installation Methods 0.000 title abstract 2
- 230000006835 compression Effects 0.000 claims abstract 3
- 238000007906 compression Methods 0.000 claims abstract 3
- 210000000988 bone and bone Anatomy 0.000 claims 107
- 230000004927 fusion Effects 0.000 claims 24
- 239000000126 substance Substances 0.000 claims 21
- 239000007943 implant Substances 0.000 claims 19
- 230000001737 promoting effect Effects 0.000 claims 18
- 239000000463 material Substances 0.000 claims 14
- 230000000845 anti-microbial effect Effects 0.000 claims 8
- 239000004599 antimicrobial Substances 0.000 claims 8
- 230000012010 growth Effects 0.000 claims 4
- 102000007350 Bone Morphogenetic Proteins Human genes 0.000 claims 3
- 108010007726 Bone Morphogenetic Proteins Proteins 0.000 claims 3
- 230000008468 bone growth Effects 0.000 claims 3
- 229940112869 bone morphogenetic protein Drugs 0.000 claims 3
- 229910052588 hydroxylapatite Inorganic materials 0.000 claims 3
- 230000002401 inhibitory effect Effects 0.000 claims 3
- 238000004519 manufacturing process Methods 0.000 claims 3
- XYJRXVWERLGGKC-UHFFFAOYSA-D pentacalcium;hydroxide;triphosphate Chemical group [OH-].[Ca+2].[Ca+2].[Ca+2].[Ca+2].[Ca+2].[O-]P([O-])([O-])=O.[O-]P([O-])([O-])=O.[O-]P([O-])([O-])=O XYJRXVWERLGGKC-UHFFFAOYSA-D 0.000 claims 3
- 108090000623 proteins and genes Proteins 0.000 claims 3
- 230000036573 scar formation Effects 0.000 claims 3
- 230000004936 stimulating effect Effects 0.000 claims 3
- 238000003780 insertion Methods 0.000 claims 2
- 230000037431 insertion Effects 0.000 claims 2
- 238000000926 separation method Methods 0.000 claims 2
- 230000000087 stabilizing effect Effects 0.000 claims 1
- 238000007747 plating Methods 0.000 abstract 4
- 238000004873 anchoring Methods 0.000 abstract 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7059—Cortical plates
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7058—Plates mounted on top of bone anchor heads or shoulders
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/8004—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with means for distracting or compressing the bone or bones
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/8004—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with means for distracting or compressing the bone or bones
- A61B17/8009—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with means for distracting or compressing the bone or bones the plate having a ratchet
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/808—Instruments for holding or positioning bone plates, or for adjusting screw-to-plate locking mechanisms
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/8052—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded
Abstract
An anterior cervical plating system includes vertebral body engaging anchors coupled to a connecting plate in moveable relationship to vary the spacing between the anchoring points of the plating system to the vertebral bodies and to allow and/or cause intersegmental compression of vertebral bodies. The plating system includes instrumentation and method for installation thereof.
The plating system is capable of both passive and active dynamization and the ability to produce the former from the latter.
The plating system is capable of both passive and active dynamization and the ability to produce the former from the latter.
Claims (197)
1. A plate system adapted to be applied to the anterior aspect of a human cervical spine for contacting the anterior aspects of at least two cervical adjacent vertebral bodies to be fused together, said plate system comprising:
at least a first vertebral body engaging anchor adapted to be attached to one of the adjacent vertebral bodies to be fused and at least a second vertebral body engaging anchor adapted to be attached to another one of the adjacent vertebral bodies to be fused, each of said first and second vertebral body engaging anchors having a lower facing surface adapted to contact one of the vertebral bodies, at least one upper facing surface opposite said lower facing surface, and at least one bone screw receiving hole extending from said upper facing surface through said lower facing surface, each of said bone screw receiving holes adapted to overlie one of the vertebral bodies and being adapted to receive at least one bone screw for engaging the vertebral body to attach a respective one of said at least first and second vertebral body engaging anchors to the cervical spine, each of said first and second vertebral body engaging anchors having opposite ends adapted to be oriented along a longitudinal axis of the human spine, each of said first and second vertebral body engaging anchors having opposite sides;
a connecting plate configured to connect said first and second vertebral body engaging anchors, said connecting plate configured to overlap at least a portion of each of said first and second vertebral body engaging anchors, respectively, said connecting plate having a lower facing surface adapted to be oriented toward the vertebral bodies and an upper facing surface opposite said lower facing surface, said connecting plate having at least one fastener receiving opening extending from said upper facing surface through said lower facing surface of said connecting plate, said fastener receiving opening adapted to receive a fastener to attach said connecting plate to at least one of said first and second vertebral body engaging anchors; and at least two fasteners, each of said fasteners adapted to couple together said connecting plate and one of said first and second vertebral body engaging anchors.
at least a first vertebral body engaging anchor adapted to be attached to one of the adjacent vertebral bodies to be fused and at least a second vertebral body engaging anchor adapted to be attached to another one of the adjacent vertebral bodies to be fused, each of said first and second vertebral body engaging anchors having a lower facing surface adapted to contact one of the vertebral bodies, at least one upper facing surface opposite said lower facing surface, and at least one bone screw receiving hole extending from said upper facing surface through said lower facing surface, each of said bone screw receiving holes adapted to overlie one of the vertebral bodies and being adapted to receive at least one bone screw for engaging the vertebral body to attach a respective one of said at least first and second vertebral body engaging anchors to the cervical spine, each of said first and second vertebral body engaging anchors having opposite ends adapted to be oriented along a longitudinal axis of the human spine, each of said first and second vertebral body engaging anchors having opposite sides;
a connecting plate configured to connect said first and second vertebral body engaging anchors, said connecting plate configured to overlap at least a portion of each of said first and second vertebral body engaging anchors, respectively, said connecting plate having a lower facing surface adapted to be oriented toward the vertebral bodies and an upper facing surface opposite said lower facing surface, said connecting plate having at least one fastener receiving opening extending from said upper facing surface through said lower facing surface of said connecting plate, said fastener receiving opening adapted to receive a fastener to attach said connecting plate to at least one of said first and second vertebral body engaging anchors; and at least two fasteners, each of said fasteners adapted to couple together said connecting plate and one of said first and second vertebral body engaging anchors.
2. The plate system of claim 1, wherein said first and second vertebral body engaging anchors are interchangeable with one another.
3. The plate system of claim 1, wherein at least one of said first and second vertebral body engaging anchors has a length between said opposite ends, said length being less than the height of a vertebral body to which said at least one of said first and second vertebral body engaging anchors is adapted to be attached.
4. The plate system of claim 1, wherein at least one of said first and second vertebral body engaging anchors has a thickness between said upper facing surface and said lower facing surface, said connecting plate having a thickness less than said thickness of said at least one of said first and second vertebral body engaging anchors.
5. The plate system of claim 1, wherein at least one of said first and second vertebral body engaging anchors has a thickness between said upper facing surface and said lower facing surface, said thickness being in the range of 1.5 mm to 3.5 mm.
6. The plate system of claim 1, wherein at least one of said first and second vertebral body engaging anchors has a thickness between said upper facing surface and said lower facing surface, said thickness being in the range of 2 mm to 3 mm.
7. The plate system of claim 1, wherein said first and second vertebral body engaging anchors when attached to the adjacent vertebral bodies and connected to said connecting plate, respectively, are adapted to allow for movement toward one another in response to movement of the adjacent cervical vertebral bodies toward each other.
8. The plate system of claim 1, wherein said first and second vertebral body engaging anchors when attached to the adjacent vertebral bodies and connected to said connecting plate, respectively, are adapted to allow for movement of the adjacent cervical vertebral bodies toward each other in response to movement of said first and second vertebral body engaging anchors moving toward each other.
9. The plate system of claim 1, wherein said first and second vertebral body engaging anchors when attached to the adjacent vertebral bodies and connected to said connecting plate, respectively, are adapted to restrict movement apart from one another.
10. The plate system of claim 1, wherein said first and second vertebral body engaging anchors when attached to the adjacent vertebral bodies and connected to said connecting plate, respectively, are adapted to maintain a compressive load across a disc space between the adjacent cervical vertebral bodies.
11. The plate system of claim 1, wherein said first and second vertebral body engaging anchors when attached to the adjacent vertebral bodies and connected to said connecting plate, respectively, are adapted to store compression across a disc space between the adjacent cervical vertebral bodies.
12. The plate system of claim 1, wherein at least a portion of said upper facing surface of at least one of said first and second vertebral body engaging anchors is configured to cooperatively engage at least a portion of said connecting plate.
13. The plate system of claim 1, wherein at least a portion of at least one of said first and second vertebral body engaging anchors is configured to form an interference fit with at least a portion of said connecting plate.
14. The plate system of claim 1, wherein at least a portion of said lower facing surface of said connecting plate is configured to contact at least a portion of said upper facing surface of at least one of said first and second vertebral body engaging anchors.
15. The plate system of claim 1, wherein at least a portion of said connecting plate is configured to interdigitate with at least a portion of at least one of said first and second vertebral body engaging anchors.
16. The plate system of claim 15, wherein at least a portion of said lower facing surface of said connecting plate and at least a portion of said upper facing surface of at least one of said first and second vertebral body engaging anchors includes ratchetings.
17. The plate system of claim 16, wherein said ratchetings are configured to permit movement of said first and second vertebral body engaging anchors toward one another in a first direction along the longitudinal axis of said connecting plate and to resist movement in a direction opposite to said first direction.
18. The plate system of claim 1, further comprising at least a third vertebral body engaging anchor adapted to be attached to one of the vertebral bodies to be fused and adapted to be connected to at least a portion of said connecting plate.
19. The plate system of claim 1, wherein said lower facing surface of at least one of said first and second vertebral body engaging anchors is at least in part concave.
20. The plate system of claim 19, wherein said concave part of said lower facing surface of said at least one of said first and second vertebral body engaging anchors is configured to conform to the anterior aspect of at least a portion of the cervical vertebral bodies.
21. The plate system of claim 1, wherein at least a portion of said lower facing surface of at least one of said first and second vertebral body engaging anchors is roughened to promote the growth of bone along said lower facing surface.
22. The plate system of claim 1, wherein at least a portion of said lower facing surface of at least one of said first and second vertebral body engaging anchors comprises a bone ingrowth surface.
23. The plate system of claim 1, wherein said connecting plate has opposite ends and a length therebetween, said length being sufficient to overlap at least a portion of two adjacent vertebral bodies and to span a disc space therebetween.
24. The plate system of claim 1, wherein said connecting plate has opposite ends and a length therebetween, said length being sufficient to overlap at least a portion of three adjacent vertebral bodies and to span the disc spaces therebetween.
25. The plate system of claim 1, wherein said connecting plate has opposite ends and a longitudinal axis therebetween, said lower facing surface of said connecting plate being concave along at least a portion of the longitudinal axis thereof.
26. The plate system of claim 1, wherein said connecting plate has opposite ends and a longitudinal axis therebetween, said lower facing surface of said connecting plate being at least in part concave transverse to the longitudinal axis thereof.
27. The plate system of claim 1, wherein said lower facing surface of said connecting plate is configured to conform to the anterior aspect of at least a portion of the adjacent vertebral bodies.
28. The plate system of claim 1, wherein at least a portion of said lower facing surface of said connecting plate is roughened to promote the growth of bone along said lower facing surface.
29. The plate system of claim 1, wherein at least a portion of said lower facing surface of said connecting plate comprises a bone ingrowth surface.
30. The plate system of claim 1, wherein said connecting plate has opposite ends and a longitudinal axis therebetween, said upper facing surface of said connecting plate being convex along at least a portion of the longitudinal axis thereof.
31. The plate system of claim 1, wherein said connecting plate has opposite ends and a longitudinal axis therebetween, said upper facing surface of said connecting plate being at least in part convex transverse to the longitudinal axis thereof.
32. The plate system of claim 1, wherein at least a portion of said connecting plate when attached to at least one of said first and second vertebral body engaging anchors is configured to cover at least a portion of said at least one bone screw receiving hole.
33. The plate system of claim 1, wherein at least a portion of said connecting plate when attached to at least one of said first and second vertebral body engaging anchors is configured to cover at least a portion of at least two of said bone screw receiving holes in at least one of said first and second vertebral body engaging anchors.
34. The plate system of claim 1, wherein at least a portion of said connecting plate when attached to at least one of said first and second vertebral body engaging anchors is configured to cover at least a portion of at least one bone screw in said bone receiving holes.
35. The plate system of claim 1, wherein at least a portion of said connecting plate when attached to at least one of said first and second vertebral body engaging anchors is configured to cover at least a portion of at least two bone screws in said bone receiving holes in at least one of said first and second vertebral body engaging anchors.
36. The plate system of claim 1, wherein at least a pair of said bone screw receiving holes are oriented side-by-side and said connecting plate cooperates with said vertebral engaging anchors to cover at least a portion of said pair of bone screw receiving holes.
37. The plate system of claim 32, wherein at least a portion of said connecting plate slides over at least a portion of at least two of said bone screw receiving holes.
38. The plate system of claim 35, wherein said at least a portion of said connecting plate slides over at least a portion of at least two bone screws in said bone screw receiving holes.
39. The plate system of claim 1, further comprising a fastener lock adapted to lock to said connecting plate said at least one fastener.
40. The plate system of claim 39, wherein said lock includes a ring configured to be placed at least in part within said fastener receiving opening.
41. The plate system of claim 39, wherein said fastener lock covers at least a portion of said at least one fastener.
42. The plate system of claim 1, further comprising a bone screw lock configured to lock only one bone screw to one of said vertebral body engaging anchors.
43. The plate system of claim 1, further comprising a bone screw lock configured to lock at least two bone screws to one of said vertebral body engaging anchors.
44. The plate system of claim 1, wherein at least one of said fasteners has a first position adapted to facilitate movement of at least one of said first and second vertebral body engaging anchors relative to said connecting plate in a direction toward one another along the longitudinal axis of said connecting plate and to resist movement of at least one of said first and said second vertebral body engaging anchors in a direction away from one another along the longitudinal axis of said connecting plate.
45. The plate system of claim 44, wherein said first and second vertebral body engaging anchors move in only a single direction toward one another along the longitudinal axis of said connecting plate when said fastener is in said first position.
46. The plate system of claim 44, wherein said fastener has a second position adapted to limit movement of said first and second vertebral body engaging anchors along the longitudinal axis of said connecting plate.
47. The plate system of claim 1, wherein said fastener is configured so as to be able to completely restrict movement of said first and second vertebral body engaging anchors along at least the longitudinal axis of said connecting plate.
48. The plate system of claim 1, wherein said fastener passes through at least a portion of said connecting plate and at least one of said first and second vertebral body engaging anchors.
49. The plate system of claim 44, wherein said fastener in said first position is configured to limit separation of said connecting plate and at least one of said first and second vertebral body engaging anchors.
50. The plate system of claim 1, wherein said fastener is configured to be tightened to only one of said connecting plate and at least one of said first and second vertebral body engaging anchors so as to permit movement of said first and second vertebral body engaging anchors relative to said connecting plate.
51. The plate system of claim 1, wherein said fastener is a screw.
52. The plate system of claim 1, where said fastener is at least in part threaded.
53. The plate system of claim 1, wherein said fastener has a head.
54. The plate system of claim 53, wherein said fastener has a shaft.
55. The plate system of claim 1, wherein at least one of said bone screw receiving holes is configured to form an interference fit with at least a portion of the trailing end of a properly dimensioned bone screw to be received therein.
56. The plate system of claim 1, wherein at least one of said bone screw receiving holes is configured to hold a bone screw in fixed relationship to said plate.
57. The plate system of claim 1, wherein at least one of said bone screw receiving holes is configured to allow a bone screw to be in a moveable relationship to said plate.
58. The plate system of claim 1, wherein at least one of said bone screw receiving holes is configured to allow a bone screw to be in a variable angular relationship to said plate.
59. The plate system of claim 1, further comprising at least one bone screw having a leading end for insertion into the cervical spine and a head opposite said leading end, and at least one bone screw lock adapted to contact said head.
60. The plate system of claim 59, wherein said at least one bone screw is configured to be in fixed relationship to at least one of said vertebral body engaging anchors.
61. The plate system of claim 59, wherein said at least one bone screw is configured to be in a moveable relationship to at least one of said vertebral body engaging anchors.
62. The plate system of claim 59, wherein said at least one bone screw is configured to be in a variable angular relationship to at least one of said vertebral body engaging anchors.
63. The plate system of claim 1, wherein at least one of said bone screw receiving holes has a reduced dimension proximate said lower facing surface of said vertebral body engaging anchors to form a seat, said seat having a substantially planar surface adapted to contact at least a portion of a bone screw inserted therein.
64. The plate system of claim 1, in combination with an interbody spinal fusion implant.
65. The plate system of claim 64, wherein said implant comprises at least in part bone.
66. The plate system of claim 64, wherein said implant is an allograft interbody bone graft implant.
67. The plate system of claim 64, wherein said implant is an artificial implant.
68. The plate system of claim 1, in combination with a fusion promoting substance.
69. The plate system of claim 68, wherein said fusion promoting substance is at least in part other than bone.
70. The plate system of claim 68, wherein said fusion promoting substance is at least in part bone.
71. The plate system of claim 68, wherein said fusion promoting substance is hydroxyapatite.
72. The plate system of claim 68, wherein said fusion promoting substance comprises bone morphogenetic protein.
73. The plate system of claim 68, wherein said fusion promoting substance comprises genes coding for the production of bone.
74. The plate system of claim 1, further comprising bone screws for engaging said vertebral body engaging anchors to the cervical spine, wherein at least a portion of one of said vertebral body engaging anchors, said connecting plate, said at least one fastener, and said bone screws is a bioresorbable material.
75. The plate system of claim 74, wherein said bioresorbable material is at least in part bone.
76. The plate system of claim 1, in combination with a substance for inhibiting scar formation.
77. The plate system of claim 1, in combination with an antimicrobial material.
78. The plate system of claim 1, wherein at least one of said vertebral body engaging anchors, said connecting plate, and said fastener is treated with an antimicrobial material.
79. The plate system of claim 1, wherein at least one of said vertebral body engaging anchors, said connecting plate, and said fastener comprises an antimicrobial material.
80. The plate system of claim 1, wherein at least one of said vertebral body engaging anchors, said connecting plate, and said fastener is electrified for purposes of stimulating bone growth and contributing to bone fusion.
81. The plate system of claim 1, further in combination with at least one spinal fixation implant.
82. A method for stabilizing at least two adjacent vertebral bodies in the cervical human spine, comprising the steps of:
providing a plate system adapted to be applied to the anterior aspects of an anterior human cervical spine for contacting the anterior aspects of at least two cervical vertebral bodies to be fused together, the plate system having at least a first vertebral body engaging anchor adapted to be attached to one of the adjacent vertebral bodies to be fused and at least a second vertebral body engaging anchor adapted to be attached to another one of the adjacent vertebral bodies to be fused, a connecting plate configured to connect the first and second vertebral body engaging anchors, and at least two fasteners, each of the fasteners adapted to couple together the connecting plate and one of the first and second vertebral body engaging anchors;
inserting at least two bone screws through the first vertebral body engaging anchor of the plate system and into one of the vertebral bodies adjacent the disc space to be fused;
inserting at least two bone screws through the second vertebral body engaging anchor and into the other of the vertebral bodies adjacent the disc space to be fused;
connecting the first and second vertebral body engaging anchors with the connecting plate, the connecting plate overlapping at least a portion of each of said first and second vertebral body engaging anchors;
fastening together said connecting plate and the first and second vertebral body engaging anchors with at least two fasteners; and permitting movement of the first and second vertebral body engaging anchors attached to the adjacent vertebral bodies relative to the connecting plate and relative to one another.
providing a plate system adapted to be applied to the anterior aspects of an anterior human cervical spine for contacting the anterior aspects of at least two cervical vertebral bodies to be fused together, the plate system having at least a first vertebral body engaging anchor adapted to be attached to one of the adjacent vertebral bodies to be fused and at least a second vertebral body engaging anchor adapted to be attached to another one of the adjacent vertebral bodies to be fused, a connecting plate configured to connect the first and second vertebral body engaging anchors, and at least two fasteners, each of the fasteners adapted to couple together the connecting plate and one of the first and second vertebral body engaging anchors;
inserting at least two bone screws through the first vertebral body engaging anchor of the plate system and into one of the vertebral bodies adjacent the disc space to be fused;
inserting at least two bone screws through the second vertebral body engaging anchor and into the other of the vertebral bodies adjacent the disc space to be fused;
connecting the first and second vertebral body engaging anchors with the connecting plate, the connecting plate overlapping at least a portion of each of said first and second vertebral body engaging anchors;
fastening together said connecting plate and the first and second vertebral body engaging anchors with at least two fasteners; and permitting movement of the first and second vertebral body engaging anchors attached to the adjacent vertebral bodies relative to the connecting plate and relative to one another.
83. The method of claim 82, wherein the permitting step includes the step of permitting movement of the first and second vertebral body engaging anchors in only a single direction toward one another.
84. The method of claim 82, wherein the permitting step includes the step of allowing but not causing the movement of the adjacent vertebral bodies by movement of the first and second vertebral body engaging anchors relative to the connecting plate.
85. The method of claim 84, wherein the permitting step includes the first and second vertebral body engaging anchors being free to move toward one another.
86. The method of claim 82, wherein the permitting step includes the step of allowing movement of the first and second vertebral body engaging anchors of the plate in response to movement of the adjacent vertebral bodies.
87. The method of claim 82, wherein the permitting step includes the sub-step of limiting the movement of the first and second vertebral body engaging anchors relative to one another to sequential increments along the longitudinal axis of the connecting plate.
88. The method of claim 82, wherein the permitting step includes the step of causing movement of the adjacent vertebral bodies by moving the first and second vertebral body engaging anchors relative to one another and relative to the connecting plate.
89. The method of claim 88, wherein the step of causing movement of the adjacent vertebral bodies includes the step of generating a compressive load across the disc space between the adjacent vertebral bodies.
90. The method of claim 89, wherein the permitting step includes the first and second vertebral body engaging anchors being free to move toward one another.
91. The method of claim 88, wherein the step of causing movement of the adjacent vertebral bodies includes the step of storing a compressive load across the disc space between the adjacent vertebral bodies.
92. The method of claim 82, further comprising the step of applying a compressive load to the adjacent vertebral bodies.
93. The method of claim 82, further comprising the step of aligning the first vertebral body engaging anchor with the second vertebral body engaging anchor prior to the connecting step.
94. The method of claim 82, wherein the permitting step includes moving the first and second vertebral body engaging anchors from a first position to a second position.
95. The method of claim 82, further comprising the step of tightening the fastener from a first position to a second position to resist movement of the first and second vertebral body engaging anchors relative to the connecting plate in at least one direction.
96. The method of claim 95, wherein the tightening step includes resisting movement of the first and second vertebral body engaging anchors relative to one another when the fastener is in the second position.
97. The method of claim 95, wherein the tightening step includes permitting movement of the first and second vertebral body engaging anchors relative to one another when the fastener is in the second position.
98. The method of claim 97, wherein the tightening step includes limiting the movement of the first and second vertebral body engaging anchors relative to one another to one direction along a longitudinal axis of the connecting plate.
99. The method of claim 97, wherein the tightening step includes limiting the movement of the first and second vertebral body engaging anchors relative to one another to sequential increments along a longitudinal axis of the connecting plate.
100. The method of claim 82, wherein the providing step includes providing a plate system having at least a third vertebral body engaging anchor.
101. The method of claim 82, further comprising the step of locking the at least two of the bone screws with at least a portion of the connecting plate.
102. The method of claim 82, further comprising the step of combining the plate system with an interbody spinal fusion implant.
103. The method of claim 102, wherein the implant comprises at least in part bone.
104. The method of claim 102, wherein the implant is an allograft interbody bone graft implant.
105. The method of claim 102, wherein the implant is an artificial implant.
106. The method of claim 82, further comprising the step of combining the plate system with a fusion promoting substance.
107. The method of claim 106, wherein the fusion promoting substance is at least in part other than bone.
108. The method of claim 106, wherein the fusion promoting substance is at least in part bone.
109. The method of claim 106, wherein the fusion promoting substance is hydroxyapatite.
110. The method of claim 106, wherein the fusion promoting substance comprises bone morphogenetic protein.
111. The method of claim 106, wherein the fusion promoting substance comprises genes coding for the production of bone.
112. The method of claim 82, wherein at least a portion of one of the vertebral body engaging anchors, the connecting plate, the fastener, and the bone screws is a bioresorbable material.
113. The method of claim 112, wherein the bioresorbable material is at least in part bone.
114. The method of claim 82, further comprising the step of combining at least one of the vertebral body engaging anchors, the connecting plate, the fasteners, and the bone screws with a substance for inhibiting scar formation.
115. The method of claim 82, further comprising the step of combining at least one of the vertebral body engaging anchors, the connecting plate, the fasteners, and the bone screws with an antimicrobial material.
116. The method of claim 82, further comprising the step of treating at least one of the vertebral body engaging anchors, the connecting plate, the fasteners, and the bone screws with an antimicrobial material.
117. The method of claim 82, further comprising the step of electrifying at least one of the vertebral body engaging anchors, the connecting plate, the fastener, and the bone screws with an antimicrobial material for purposes of stimulating bone growth and contributing to bone fusion.
118. A plate system adapted to be applied to the anterior aspect of a human cervical spine for contacting the anterior aspects of at least two cervical adjacent vertebral bodies to be fused together, said plate system comprising:
at least a first vertebral body engaging anchor adapted to be attached to one of the adjacent vertebral bodies to be fused and at least a second vertebral body engaging anchor adapted to be attached to another one of the adjacent vertebral bodies to be fused, each of said first and second vertebral body engaging anchors having a lower facing surface adapted to contact one of the vertebral bodies, at least one upper facing surface opposite said lower facing surface, and at least one bone screw receiving hole extending from said upper facing surface through said lower facing surface, each of said bone screw receiving holes adapted to overlie one of the vertebral bodies and being adapted to receive at least one bone screw for engaging the vertebral body to attach a respective one of said at least first and second vertebral body engaging anchors to the cervical spine, each of said first and second vertebral body engaging anchors having opposite ends adapted to be oriented along a longitudinal axis of the human spine, each of said first and second vertebral body engaging anchors having opposite sides;
a connecting plate configured to connect said first and second vertebral body engaging anchors, said connecting plate configured to overlap at least a portion of each of said first and second vertebral body engaging anchors, respectively, said connecting plate having a lower facing surface adapted to be oriented toward the vertebral bodies and an upper facing surface opposite said lower facing surface, said connecting plate having at least one fastener receiving opening extending from said upper facing surface through said lower facing surface of said connecting plate, said fastener receiving opening adapted to receive a fastener to attach said connecting plate to said first and second vertebral body engaging anchors; and said connecting plate and at least one of said vertebral body engaging anchors being configured to couple together.
at least a first vertebral body engaging anchor adapted to be attached to one of the adjacent vertebral bodies to be fused and at least a second vertebral body engaging anchor adapted to be attached to another one of the adjacent vertebral bodies to be fused, each of said first and second vertebral body engaging anchors having a lower facing surface adapted to contact one of the vertebral bodies, at least one upper facing surface opposite said lower facing surface, and at least one bone screw receiving hole extending from said upper facing surface through said lower facing surface, each of said bone screw receiving holes adapted to overlie one of the vertebral bodies and being adapted to receive at least one bone screw for engaging the vertebral body to attach a respective one of said at least first and second vertebral body engaging anchors to the cervical spine, each of said first and second vertebral body engaging anchors having opposite ends adapted to be oriented along a longitudinal axis of the human spine, each of said first and second vertebral body engaging anchors having opposite sides;
a connecting plate configured to connect said first and second vertebral body engaging anchors, said connecting plate configured to overlap at least a portion of each of said first and second vertebral body engaging anchors, respectively, said connecting plate having a lower facing surface adapted to be oriented toward the vertebral bodies and an upper facing surface opposite said lower facing surface, said connecting plate having at least one fastener receiving opening extending from said upper facing surface through said lower facing surface of said connecting plate, said fastener receiving opening adapted to receive a fastener to attach said connecting plate to said first and second vertebral body engaging anchors; and said connecting plate and at least one of said vertebral body engaging anchors being configured to couple together.
119. The plate system of claim 118, wherein said first and second vertebral body engaging anchors are interchangeable with one another.
120. The plate system of claim 118, wherein at least one of said first and second vertebral body engaging anchors has a length between said opposite ends, said length being less than the height of a vertebral body to which said at least one of said first and second vertebral body engaging anchors is adapted to be attached.
121. The plate system of claim 118, wherein at least one of said first and second vertebral body engaging anchors has a thickness between said upper facing surface and said lower facing surface, said connecting plate having a thickness less than said thickness of said at least one of said first and second vertebral body engaging anchors.
122. The plate system of claim 118, wherein at least one of said first and second vertebral body engaging anchors has a thickness between said upper facing surface and said lower facing surface, said thickness being in the range of 1.5 mm to 3.5 mm.
123. The plate system of claim 118, wherein at least one of said first and second vertebral body engaging anchors has a thickness between said upper facing surface and said lower facing surface, said thickness being in the range of 2 mm to 3 mm.
124. The plate system of claim 118, wherein said first and second vertebral body engaging anchors when attached to the adjacent vertebral bodies and connected to said connecting plate, respectively, are adapted to allow for movement toward one another in response to movement of the adjacent cervical vertebral bodies toward each other.
125. The plate system of claim 118, wherein said first and second vertebral body engaging anchors when attached to the adjacent vertebral bodies and connected to said connecting plate, respectively, are adapted to allow for movement of the adjacent cervical vertebral bodies toward each other in response to movement of said first and second vertebral body engaging anchors moving toward each other.
126. The plate system of claim 118, wherein said first and second vertebral body engaging anchors when attached to the adjacent vertebral bodies and connected to said connecting plate, respectively, are adapted to restrict movement apart from one another.
127. The plate system of claim 118, wherein said first and second vertebral body engaging anchors when attached to the adjacent vertebral bodies and connected to said connecting plate, respectively, are adapted to maintain a compressive load across a disc space between the adjacent cervical vertebral bodies.
128. The plate system of claim 118, wherein said first and second vertebral body engaging anchors when attached to the adjacent vertebral bodies and connected to said connecting plate, respectively, are adapted to store compression across a disc space between the adjacent cervical vertebral bodies.
129. The plate system of claim 118, wherein at least a portion of said upper facing surface of at least one of said first and second vertebral body engaging anchors is configured to cooperatively engage at least a portion of said connecting plate.
130. The plate system of claim 118, wherein at least a portion of at least one of said first and second vertebral body engaging anchors is configured to form an interference fit with at least a portion of said connecting plate.
131. The plate system of claim 118, wherein at least a portion of said lower facing surface of said connecting plate is configured to contact at least a portion of said upper facing surface of at least one of said first and second vertebral body engaging anchors.
132. The plate system of claim 118, wherein at least a portion of said connecting plate is configured to interdigitate with at least a portion of at least one of said first and second vertebral body engaging anchors.
133. The plate system of claim 132, wherein at least a portion of said lower facing surface of said connecting plate and at least a portion of said upper facing surface of at least one of said first and second vertebral body engaging anchors includes ratchetings.
134. The plate system of claim 133, wherein said ratchetings are configured to permit movement of said first and second vertebral body engaging anchors toward one another in a first direction along the longitudinal axis of said connecting plate and to resist movement in a direction opposite to said first direction.
135. The plate system of claim 118, further comprising at least a third vertebral body engaging anchor adapted to be attached to one of the vertebral bodies to be fused and adapted to be connected to at least a portion of said connecting plate.
136. The plate system of claim 118, wherein said lower facing surface of at least one of said first and second vertebral body engaging anchors is at least in part concave.
137. The plate system of claim 136, wherein said concave part of said lower facing surface of said at least one of said first and second vertebral body engaging anchors is configured to conform to the anterior aspect of at least a portion of the cervical vertebral bodies.
138. The plate system of claim 118, wherein at least a portion of said lower facing surface of at least one of said first and second vertebral body engaging anchors is roughened to promote the growth of bone along said lower facing surface.
139. The plate system of claim 118, wherein at least a portion of said lower facing surface of at least one of said first and second vertebral body engaging anchors comprises a bone ingrowth surface.
140. The plate system of claim 118, wherein said connecting plate has opposite ends and a length therebetween, said length being sufficient to overlap at least a portion of two adjacent vertebral bodies and to span a disc space therebetween.
141. The plate system of claim 118, wherein said connecting plate has opposite ends and a length therebetween, said length being sufficient to overlap at least a portion of three adjacent vertebral bodies and to span the disc spaces therebetween.
142. The plate system of claim 118, wherein said connecting plate has opposite ends and a longitudinal axis therebetween, said lower facing surface of said connecting plate being concave along at least a portion of the longitudinal axis thereof.
143. The plate system of claim 118, wherein said connecting plate has opposite ends and a longitudinal axis therebetween, said lower facing surface of said connecting plate being at least in part concave transverse to the longitudinal axis thereof.
144. The plate system of claim 118, wherein said lower facing surface of said connecting plate is configured to conform to the anterior aspect of at least a portion of the adjacent vertebral bodies.
145. The plate system of claim 118, wherein at least a portion of said lower facing surface of said connecting plate is roughened to promote the growth of bone along said lower facing surface.
146. The plate system of claim 118, wherein at least a portion of said lower facing surface of said connecting plate comprises a bone ingrowth surface.
147. The plate system of claim 118, wherein said connecting plate has opposite ends and a longitudinal axis therebetween, said upper facing surface of said connecting plate being convex along at least a portion of the longitudinal axis thereof.
148. The plate system of claim 118, wherein said connecting plate has opposite ends and a longitudinal axis therebetween, said upper facing surface of said connecting plate being at least in part convex transverse to the longitudinal axis thereof.
149. The plate system of claim 118, wherein at least a portion of said connecting plate when attached to at least one of said first and second vertebral body engaging anchors is configured to cover at least a portion of said at least one bone screw receiving hole.
150. The plate system of claim 118, wherein at least a portion of said connecting plate when attached to at least one of said first and second vertebral body engaging anchors is configured to cover at least a portion of at least two of said bone screw receiving holes in at least one of said first and second vertebral body engaging anchors.
151. The plate system of claim 118, wherein at least a portion of said connecting plate when attached to at least one of said first and second vertebral body engaging anchors is configured to cover at least a portion of at least one bone screw in said bone receiving holes.
152. The plate system of claim 118, wherein at least a portion of said connecting plate when attached to at least one of said first and second vertebral body engaging anchors is configured to cover at least a portion of at least two bone screws in said bone receiving holes in at least one of said first and second vertebral body engaging anchors.
153. The plate system of claim 118, wherein at least a pair of said bone screw receiving holes are oriented side-by-side and said connecting plate cooperates with said vertebral engaging anchors to cover at least a portion of said pair of bone screw receiving holes.
154. The plate system of claim 149, wherein at least a portion of said connecting plate slides over at least a portion of at least two of said bone screw receiving holes.
155. The plate system of claim 152, wherein said at least a portion of said connecting plate slides over at least a portion of at least two bone screws in said bone screw receiving holes.
156. The plate system of claim 118, further comprising a fastener lock adapted to lock to said connecting plate said at least one fastener.
157. The plate system of claim 156, wherein said lock includes a ring configured to be placed at least in part within said fastener receiving opening.
158. The plate system of claim 156, wherein said fastener lock covers at least a portion of said at least one fastener.
159. The plate system of claim 118, further comprising a bone screw lock configured to lock only one bone screw to one of said vertebral body engaging anchors.
160. The plate system of claim 118, further comprising a bone screw lock configured to lock at least two bone screws to one of said vertebral body engaging anchors.
161. The plate system of claim 118, further comprising at least one fastener having a first position adapted to facilitate movement of at least one of said first and second vertebral body engaging anchors relative to said connecting plate in a direction toward one another along the longitudinal axis of said connecting plate and to resist movement of at least one of said first and said second vertebral body engaging anchors in a direction away from one another along the longitudinal axis of said connecting plate.
162. The plate system of claim 161, wherein said first and second vertebral body engaging anchors move in only a single direction toward one another along the longitudinal axis of said connecting plate when said fastener is in said first position.
163. The plate system of claim 161, wherein said fastener has a second position adapted to limit movement of said first and second vertebral body engaging anchors along the longitudinal axis of said connecting plate.
164. The plate system of claim 161, wherein said fastener is configured so as to be able to completely restrict movement of said first and second vertebral body engaging anchors along at least the longitudinal axis of said connecting plate.
165. The plate system of claim 161, wherein said fastener passes through at least a portion of said connecting plate and at least one of said first and second vertebral body engaging anchors.
166. The plate system of claim 161, wherein said fastener in said first position is configured to limit separation of said connecting plate and at least one of said first and second vertebral body engaging anchors.
167. The plate system of claim 161, wherein said fastener is configured to be tightened to only one of said connecting plate and at least one of said first and second vertebral body engaging anchors so as to permit movement of said first and second vertebral body engaging anchors relative to said connecting plate.
168. The plate system of claim 161, wherein said fastener is a screw.
169. The plate system of claim 161, where said fastener is at least in part threaded.
170. The plate system of claim 161, wherein said fastener has a head.
171. The plate system of claim 170, wherein said fastener has a shaft.
172. The plate system of claim 118, wherein at least one of said bone screw receiving holes is configured to form an interference fit with at least a portion of the trailing end of a properly dimensioned bone screw to be received therein.
173. The plate system of claim 118, wherein at least one of said bone screw receiving holes is configured to hold a bone screw in fixed relationship to said plate.
174. The plate system of claim 118, wherein at least one of said bone screw receiving holes is configured to allow a bone screw to be in a moveable relationship to said plate.
175. The plate system of claim 118, wherein at least one of said bone screw receiving holes is configured to allow a bone screw to be in a variable angular relationship to said plate.
176. The plate system of claim 118, further comprising at least one bone screw having a leading end for insertion into the cervical spine and a head opposite said leading end, and at least one bone screw lock adapted to contact said head.
177. The plate system of claim 176, wherein said at least one bone screw is configured to be in fixed relationship to at least one of said vertebral body engaging anchors.
178. The plate system of claim 176, wherein said at least one bone screw is configured to be in a moveable relationship to at least one of said vertebral body engaging anchors.
179. The plate system of claim 176, wherein said at least one bone screw is configured to be in a variable angular relationship to at least one of said vertebral body engaging anchors.
180. The plate system of claim 118, wherein at least one of said bone screw receiving holes has a reduced dimension proximate said lower facing surface of said vertebral body engaging anchors to form a seat, said seat having a substantially planar surface adapted to contact at least a portion of a bone screw inserted therein.
181. The plate system of claim 118, in combination with an interbody spinal fusion implant.
182. The plate system of claim 181, wherein said implant comprises at least in part bone.
183. The plate system of claim 181, wherein said implant is an allograft interbody bone graft implant.
184. The plate system of claim 181, wherein said implant is an artificial implant.
185. The plate system of claim 118, in combination with a fusion promoting substance.
186. The plate system of claim 185, wherein said fusion promoting substance is at least in part other than bone.
187. The plate system of claim 185, wherein said fusion promoting substance is at least in part bone.
188. The plate system of claim 185, wherein said fusion promoting substance is hydroxyapatite.
189. The plate system of claim 185, wherein said fusion promoting substance comprises bone morphogenetic protein.
190. The plate system of claim 185, wherein said fusion promoting substance comprises genes coding for the production of bone.
191. The plate system of claim 118, further comprising bone screws for engaging said vertebral body engaging anchors to the cervical spine, wherein at least a portion of one of said vertebral body engaging anchors, said connecting plate, said at least one fastener, and said bone screws is a bioresorbable material.
192. The plate system of claim 191, wherein said bioresorbable material is at least in part bone.
193. The plate system of claim 118, in combination with a substance for inhibiting scar formation.
194. The plate system of claim 118, in combination with an antimicrobial material.
195. The plate system of claim 118, wherein at least one of said vertebral body engaging anchors, said connecting plate, and said fastener is treated with an antimicrobial material.
196. The plate system of claim 118, wherein at least one of said vertebral body engaging anchors, said connecting plate, and said fastener is electrified for purposes of stimulating bone growth and contributing to bone fusion.
197. The plate system of claim 118, wherein said connecting plate and at least one of said vertebral engaging anchors are configured to cooperatively engage one another.
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PCT/US2002/017481 WO2002098277A2 (en) | 2001-06-04 | 2002-06-04 | Anterior cervical plate system having vertebral body engaging anchors, connecting plate, and method for installation thereof |
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CA2443429C CA2443429C (en) | 2010-08-10 |
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JP3981252B2 (en) * | 2001-06-07 | 2007-09-26 | 株式会社日立製作所 | Image display panel and image viewer having image display panel |
US20030036759A1 (en) * | 2001-08-14 | 2003-02-20 | Emilio Musso | Modular spinal plate system |
-
2002
- 2002-06-04 JP JP2003501326A patent/JP4286130B2/en not_active Expired - Fee Related
- 2002-06-04 EP EP02756114A patent/EP1404225A4/en not_active Withdrawn
- 2002-06-04 CA CA2443429A patent/CA2443429C/en not_active Expired - Fee Related
- 2002-06-04 AU AU2002322028A patent/AU2002322028C1/en not_active Ceased
- 2002-06-04 WO PCT/US2002/017481 patent/WO2002098277A2/en active Application Filing
- 2002-06-04 US US10/160,408 patent/US7740630B2/en not_active Expired - Fee Related
-
2005
- 2005-04-26 US US11/114,540 patent/US8048076B2/en not_active Expired - Fee Related
- 2005-11-07 US US11/268,169 patent/US8323283B2/en active Active
-
2008
- 2008-03-20 AU AU2008201340A patent/AU2008201340B2/en not_active Ceased
Also Published As
Publication number | Publication date |
---|---|
JP4286130B2 (en) | 2009-06-24 |
JP2004533878A (en) | 2004-11-11 |
EP1404225A2 (en) | 2004-04-07 |
US8323283B2 (en) | 2012-12-04 |
AU2002322028B2 (en) | 2007-12-20 |
EP1404225A4 (en) | 2009-09-16 |
AU2008201340A1 (en) | 2008-04-24 |
US7740630B2 (en) | 2010-06-22 |
US8048076B2 (en) | 2011-11-01 |
AU2008201340B2 (en) | 2009-03-19 |
WO2002098277A3 (en) | 2003-12-04 |
US20060085001A1 (en) | 2006-04-20 |
US20050187554A1 (en) | 2005-08-25 |
US20020183754A1 (en) | 2002-12-05 |
WO2002098277A2 (en) | 2002-12-12 |
AU2002322028C1 (en) | 2008-06-26 |
CA2443429C (en) | 2010-08-10 |
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