CA2518068C - Cervical disc replacement - Google Patents
Cervical disc replacement Download PDFInfo
- Publication number
- CA2518068C CA2518068C CA002518068A CA2518068A CA2518068C CA 2518068 C CA2518068 C CA 2518068C CA 002518068 A CA002518068 A CA 002518068A CA 2518068 A CA2518068 A CA 2518068A CA 2518068 C CA2518068 C CA 2518068C
- Authority
- CA
- Canada
- Prior art keywords
- curvature
- articulation
- radius
- spinal column
- articulation surface
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Fee Related
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Classifications
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S623/00—Prosthesis, i.e. artificial body members, parts thereof, or aids and accessories therefor
- Y10S623/902—Method of implanting
- Y10S623/908—Bone
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S623/00—Prosthesis, i.e. artificial body members, parts thereof, or aids and accessories therefor
- Y10S623/909—Method or apparatus for assembling prosthetic
- Y10S623/911—Bone
Abstract
An apparatus (100) for replacing at least a portion of an intervertebral disc in a spinal column includes: a first member (200) having a first vertebral contact surface (202) for engagement with an endplate of a first vertebral bone in the spinal column, and having a first saddle shaped articulation surface (212, 214); and a second member (300) having a second vertebral contact surface (302) for engagement with an endplate of a second vertebral bone in the spinal column, and having a second saddle shaped articulation surface (312, 314), wherein: an intervertebral disc space is defined substantially between the first and second endplates of the first and second vertebral bones, and the first and second articulation surfaces (212, 214, 312, 314) are sized and shaped to engage one another when the first and second members (200, 300) are disposed in the intervertebral disc space to enable the first and second vertebral bones to articulate in at least one of flexion, extension and lateral bending.
Description
CERVICAL DISC REPLACEMENT
Technical Field The present invention is directed to a cervical joint replacement implant and more particularly to a cervical intervertebral disc prosthesis having opposing constant radii saddle shaped articulating surfaces.
Background Art The structure of the intervertebral disc disposed between the cervical bones in the human spine comprises a peripheral fibrous shroud (the annulus) which circumscribes a spheroid of flexibly deformable material (the nucleus). The nucleus comprises a hydrophilic, elastomeric cartilaginous substance that cushions and supports the separation between the bones while also permitting articulation of the two vertebral bones relative to one another to the extent such articulation is allowed by the other soft tissue and bony structures surrounding the disc. The additional bony structures that define pathways of motion in various modes include the posterior joints (the facets) and the lateral intervertebral joints (the unco-vertebral joints). Soft tissue components, such as ligaments and tendons, constrain the overall segmental motion as well.
Traumatic, genetic, and long term wearing phenomena contribute to the degeneration of the nucleus in the human spine. This degeneration of this critical disc material, from the hydrated, elastomeric material that supports the separation and flexibility of the vertebral bones, to a flattened and inflexible state, has profound effects on the mobility (instability and limited ranges of appropriate motion) of the segment, and Ican cause significant pain to the individual suffering from the condition.
Although the specific causes of pain in patients suffering from degenerative disc disease of the cervical spine have not been definitively established, it has been recognized that pain may be the result of neurological implications (nerve fibers being compressed) and/or the subsequent degeneration of the surrounding tissues (the arthritic degeneration of the facet joints) as a result of their being overloaded.
Traditionally, the treatment of choice for physicians caring for patients who suffer from significant degeneration of the cervical intervertebral disc is to remove some, or all, of the damaged disc. In instances in which a sufficient portion of the intervertebral disc material is removed, or in which much of the necessary spacing between the vertebrae has been lost (significant subsidence), restoration of the intervertebral separation is required.
Unfortunately, until the advent of spine arthroplasty devices, the only methods known to surgeons to maintain the necessary disc height necessitated the immobilization of the segment. Immobilization is generally achieved by attaching metal plates to the anterior or posterior elements of the cervical spine, and the insertion of some osteoconductive material (autograft, allograft, or other porous material) between the adjacent vertebrae of the segment. This immobilization and insertion of osteoconductive material has been utilized in pursuit of a fusion of the bones, which is a procedure carried out on tens of thousands of pain suffering patients per year.
This sacrifice of mobility at the immobilized, or fused, segment, however, is not without consequences. It was traditionally held that the patient's surrounding joint segments would accorninodate any additional articulation demanded of them during normal motion by virtue of the fused segment's immobility. While this is true over the short-term (provided only one, or at most two, segments have been fused), the effects of this increased range of articulation demanded of these adjacent segments has recently bec~me a concern. Specifically, an increase in the frequency of returning patients who suffer from degeneration at adjacent levels has been reported.
Whether this increase in adjacent level deterioration is truly associated with rigid fusion, or if it is simply a matter of the individual patient's predisposition to degeneration is unlmown. Either way, however, it is clear that a progressive fusion of a long sequence of vertebrae is undesirable from the perspective of the patient's quality of life as well as from the perspective of pushing a patient to undergo multiple operative procedures.
While spine arthroplasty has been developing in theory over the past several decades, and has even seen a number of early attempts in the lumbar spine show promising results, it is only recently that arthoplasty of the spine has become a truly realizable promise. The field of spine arthroplasty has several classes of devices. The most popular among these are: (a) the nucleus replacements, which are characterized by a flexible container filled with an elastomeric material that can mimic the healthy nucleus; and (b) the total disc replacements, which are designed with rigid endplates which house a mechanical articulating structure that attempts to mimic and promote the healthy segmental motion.
Technical Field The present invention is directed to a cervical joint replacement implant and more particularly to a cervical intervertebral disc prosthesis having opposing constant radii saddle shaped articulating surfaces.
Background Art The structure of the intervertebral disc disposed between the cervical bones in the human spine comprises a peripheral fibrous shroud (the annulus) which circumscribes a spheroid of flexibly deformable material (the nucleus). The nucleus comprises a hydrophilic, elastomeric cartilaginous substance that cushions and supports the separation between the bones while also permitting articulation of the two vertebral bones relative to one another to the extent such articulation is allowed by the other soft tissue and bony structures surrounding the disc. The additional bony structures that define pathways of motion in various modes include the posterior joints (the facets) and the lateral intervertebral joints (the unco-vertebral joints). Soft tissue components, such as ligaments and tendons, constrain the overall segmental motion as well.
Traumatic, genetic, and long term wearing phenomena contribute to the degeneration of the nucleus in the human spine. This degeneration of this critical disc material, from the hydrated, elastomeric material that supports the separation and flexibility of the vertebral bones, to a flattened and inflexible state, has profound effects on the mobility (instability and limited ranges of appropriate motion) of the segment, and Ican cause significant pain to the individual suffering from the condition.
Although the specific causes of pain in patients suffering from degenerative disc disease of the cervical spine have not been definitively established, it has been recognized that pain may be the result of neurological implications (nerve fibers being compressed) and/or the subsequent degeneration of the surrounding tissues (the arthritic degeneration of the facet joints) as a result of their being overloaded.
Traditionally, the treatment of choice for physicians caring for patients who suffer from significant degeneration of the cervical intervertebral disc is to remove some, or all, of the damaged disc. In instances in which a sufficient portion of the intervertebral disc material is removed, or in which much of the necessary spacing between the vertebrae has been lost (significant subsidence), restoration of the intervertebral separation is required.
Unfortunately, until the advent of spine arthroplasty devices, the only methods known to surgeons to maintain the necessary disc height necessitated the immobilization of the segment. Immobilization is generally achieved by attaching metal plates to the anterior or posterior elements of the cervical spine, and the insertion of some osteoconductive material (autograft, allograft, or other porous material) between the adjacent vertebrae of the segment. This immobilization and insertion of osteoconductive material has been utilized in pursuit of a fusion of the bones, which is a procedure carried out on tens of thousands of pain suffering patients per year.
This sacrifice of mobility at the immobilized, or fused, segment, however, is not without consequences. It was traditionally held that the patient's surrounding joint segments would accorninodate any additional articulation demanded of them during normal motion by virtue of the fused segment's immobility. While this is true over the short-term (provided only one, or at most two, segments have been fused), the effects of this increased range of articulation demanded of these adjacent segments has recently bec~me a concern. Specifically, an increase in the frequency of returning patients who suffer from degeneration at adjacent levels has been reported.
Whether this increase in adjacent level deterioration is truly associated with rigid fusion, or if it is simply a matter of the individual patient's predisposition to degeneration is unlmown. Either way, however, it is clear that a progressive fusion of a long sequence of vertebrae is undesirable from the perspective of the patient's quality of life as well as from the perspective of pushing a patient to undergo multiple operative procedures.
While spine arthroplasty has been developing in theory over the past several decades, and has even seen a number of early attempts in the lumbar spine show promising results, it is only recently that arthoplasty of the spine has become a truly realizable promise. The field of spine arthroplasty has several classes of devices. The most popular among these are: (a) the nucleus replacements, which are characterized by a flexible container filled with an elastomeric material that can mimic the healthy nucleus; and (b) the total disc replacements, which are designed with rigid endplates which house a mechanical articulating structure that attempts to mimic and promote the healthy segmental motion.
Among these solutions, the total disc replacements have begun to be regarded as the most probable long-term treatments for patients having moderate to severe lumbar disc degeneration. In the cervical spine, it is likely that these mechanical solutions will also become the treatment of choice. At present, there are two devices being tested clinically in humans for the indication of cervical disc degeneration. The first of these is the Bryan disc, disclosed in part in US Patent Number 6,001,130. The Bryan disc is comprised of a resilient nucleus body disposed in between concaval-covex upper and lower elements that retain the nucleus between adjacent vertebral bodies in the spine. The concaval-convex elements are L-shaped supports that have anterior wings that accept bones screws for securing to the adjacent vertebral bodies.
The second of these devices being clinically tested is the Bristol disc, disclosed substantially in US Patent Number 6,113,637. The Bristol disc is comprised of two L-shaped elements, with corresponding ones of the legs of each element being interposed between the vertebrae and in opposition to one another. The other of the two legs are disposed outside of the intervertebral space and include screw holes through which the elements may be secured to the corresponding vertebra; the superior element being secured to the upper vertebral body and the inferior element being attached to the lower vertebral body. The opposing portions of each of the elements comprise the articulating surfaces that include an elliptical channel formed in the lower element and a convex hemispherical structure disposed in the channel.
As is evident from the above descriptions, the centers of rotation for both of these devices, which are being clinically tested in human subjects, is disposed at some point in the disc space. More particularly with respect to the Bryan disc, the center of rotation is maintained at a central portion of the nucleus, and hence in the center of the disc space. The Bristol disc, as a function of its elongated channel (its elongated axis being oriented along the anterior to posterior direction), has a moving center of rotation which is, at all times maintained within the disc space at the rotational center of the hemispherical ball (near the top of the upper element).
The uses, features and advantages of the invention not explicitly stated will be set forth and will be more clearly understood in conjunction with the descriptions of the embodiments disclosed hereafter.
The second of these devices being clinically tested is the Bristol disc, disclosed substantially in US Patent Number 6,113,637. The Bristol disc is comprised of two L-shaped elements, with corresponding ones of the legs of each element being interposed between the vertebrae and in opposition to one another. The other of the two legs are disposed outside of the intervertebral space and include screw holes through which the elements may be secured to the corresponding vertebra; the superior element being secured to the upper vertebral body and the inferior element being attached to the lower vertebral body. The opposing portions of each of the elements comprise the articulating surfaces that include an elliptical channel formed in the lower element and a convex hemispherical structure disposed in the channel.
As is evident from the above descriptions, the centers of rotation for both of these devices, which are being clinically tested in human subjects, is disposed at some point in the disc space. More particularly with respect to the Bryan disc, the center of rotation is maintained at a central portion of the nucleus, and hence in the center of the disc space. The Bristol disc, as a function of its elongated channel (its elongated axis being oriented along the anterior to posterior direction), has a moving center of rotation which is, at all times maintained within the disc space at the rotational center of the hemispherical ball (near the top of the upper element).
The uses, features and advantages of the invention not explicitly stated will be set forth and will be more clearly understood in conjunction with the descriptions of the embodiments disclosed hereafter.
Summary Of The Invention The above objects are achieved by the present invention, which provides an articulating joint implant that includes a pair of opposing upper and lower elements having nested articulation surfaces providing a center of rotation of the implant above the adjacent vertebral body endplate surfaces in one mode of motion (e.g., lateral bending) and a center of rotation of the implant below those surfaces in another mode of motion (e.g., flexion/extension), and that further permit axial rotation of the opposing elements relative to one another (for example, about an axis such as, for example, a longitudinal axis, for example, of the spinal column)) through a range of angles without causing them to move in directions that are directed away from one another (for example, in opposing directions along the axis of axial rotation) within that range. In preferred embodiments, the articulation surfaces further cause such opposite (or otherwise directed away from one another) movement of the opposing elements beyond that range.
More particularly, the present invention contemplates that with regard to the cervical anatomy, a device that maintains a center of rotation, moving or otherwise, within the disc space is inappropriate and fails to properly support healthy motion.
Specifically, the cervical joint comprises five separate articulating elements: the facet joints in the posterior of the segment; the lateral unco-vertebral joints; and the nucleus in the intervertebral space. It is contemplated by the present invention that a track defined by the cervical facets falls along the planes between the inferior surface of the upper facets said the superior surface of the lower facets, and that this plane extends upwardly and forward, forcing the overall joint to pivot around a center of rotation that resides in the lower vertebral bone in flexion/extension articulation.
Conversely, it is contemplated by the present invention that in lateral bending the unto-vertebral joints influence the track of motion. Specifically, the unco-vertebral joints are formed at the lateral edges of the intervertebral space and are defined by a pair of upwardly extending surfaces of the inferior vertebral endplate and the corresponding surfaces of the superior bony endplate. It is contemplated by the present invention that this U-shaped configuration guides the segment into a rotation about a center within the superior vertebral bone during lateral bending.
Finally, it is contemplated by the present invention that during axial rotation of the adjacent vertebral bones of the cervical segment relative to one another about the longitudinal axis of the spinal column, the opposing bones do not simply axially rotate relative to one another for more than a few degrees, but rather follow the coupled influences of the unco-vertebral joints and the nucleus, and that this coupled motion vertically separates the opposing bones of the facet joints as the rotation continues, thus freeing the bones to rotate farther that would otherwise be permitted if the facets locked together (as is often seen as a symptom of degenerative cervical disease).
Both the Bryan and Bristol discs described above do provide distraction and maintenance of intervertebral disc height, and thereby provide immediate and short-term relief from pain. However, it should be understood, in light of the above described anatomy as contemplated by the present invention, that neither provides for proper anatomical motion because their respective centers of rotation are located within the disc space. Thus, neither will afford significant motion preservation, and patients with these devices implanted in their necks will find no significant mobility at the implanted segment. This may lead to spontaneous fusions, long term facet deterioration, and/or accelerated adjacent level degeneration.
The constraints placed on the prosthesis by the above-described anatomy are considerable. To provide an implant having a pair of articulation surfaces that provide a center of rotation of the implant above the surfaces in one mode of motion (lateral bending) and a center of rotation of the implant below the surfaces in another mode of motion (flexion/extension), that further permit the surfaces to axially rotate relative to one another about a longitudinal axis of the spinal column through a range of angles without causing movement of the surfaces in opposing directions along the longitudinal axis of the spinal column, and that further cause such movement (and accordingly a vertical separation of the facet joints) beyond that range is a difficult engineering task. The present invention contemplates that a saddle joint provides a geometric approach to the taslc.
The solution to this problem, however, is not open to any saddle joint configuration. US Patent Numbers 5,405,400 and 5,645,605 describe saddle joints utilized for prosthetic thumb joints. More particularly, US Patent Number 5,405,400 ("Linscheid") discloses an artificial thumb joint comprising a pair of surfaces that are nesting hyperbolic paraboloids. A hyperbolic paraboloid is a surface defined by a first specific geometric form (the hyperbola) that is swept along a second geometric form (the parabola) that is perpendicular to the first form, and which first and second forms are opposite in the direction of their convexities. A common feature of both hyperbolae and parabolae is that neither has a constant radius of curvature along its extent. Constant radii of curvature are necessary for a pair of surfaces to smoothly flow over one another. Accordingly, the nesting hyperbolic paraboloids set forth in the reference are, therefore, not capable of any smooth articulation. Any attempted articulation causes the two surfaces to immediately move in opposing directions.
Stated more simply, nesting hyperbolic paraboloids have continuously changing centers of rotation (by the nature of the geometric forms selected). The present invention contemplates that the cervical joint anatomy enables smooth articulation in two modes of motion (lateral bending and flexion/extension), and also smooth relative axial rotation about the longitudinal axis of the spinal column through a small range of angles. It is understood by the present invention that the vertical separation motion of the natural cervical joint does not occur immediately, but rather occurs only outside that small angular range of relative axial rotation. Thus, the present invention contemplates that the nesting hyperbolic paraboloids disclosed by Linscheid are inappropriate for use in the cervical joint.
US Patent Number 5,645,605 ("Klawitter") discloses an alternate form of a saddle surface, again for use in an artificial thumb joint, that comprises a pair of nesting toroidal surfaces. Toroidal surfaces are defined by an arc of one circle being swept along an arc of another, again having opposing convexitees. As circles have constant radii of curvatures, it is possible with these surfaces to have smooth motion in two perpendicular planes. More particularly, if the corresponding radii of curvature are approximately equivalent, the two surfaces may nest and articulate in flexion/extension and lateral bending smoothly, without causing the surfaces to move in opposing directions upon an attempted articulate~n. However, Klawitter teaches that these toroidal surfaces should have the same radii of curvature, inasmuch as it is a necessity that axial rotational motion of the joint be inhibited, or if it is permitted to occur, it should cause an immediate axial distraction of the joint. As explained above with regard to the saddle joint in Linscheid, this elimination of the capacity of the surfaces to axially rotate relative to one another for even a small range of angles prevents such a design from being effectively used in a cervical disc application.
In order for two nesting toroidal saddles to rotate within the same plane, each of the concave radii of the surfaces must be greater than the radius of its nested convex surface. An artificial cervical joint that provides a center of rotation in the vertebral bone below during flexion/extension and in the vertebral bone above during lateral bending and has the capacity to axially rotate within a small range of angles prior to causing oppositely directed movement of the surfaces requires nesting surfaces with such a configuration.
The present invention, therefore, provides an articulating joint implant for use in the cervical spine, including a first (e.g., upper) element and a second (e.g., lower) element, each having an outwardly facing vertebral body contact surface, and each having an inwardly facing articulation surface. The elements are disposed with the articulation surfaces nested against one another, and the vertebral body contact surfaces facing away from one another. When the implant is disposed in an intervertebral disc space in a cervical spine, in this configuration and with the vertebral body contact surfaces engaged with respective adjacent vertebral body endplates, the implant enables the adjacent vertebral bones to move relative to one another in accordance with proper anatomical motion.
Preferably, each of the elements has at least one long-term fixation structure (e.g., a flange) having at least one feature (e.g., a through hole) for securing the element to an adjacent vertebral body. For example, the upper element has an anterior flange that extends upwardly and has two through holes, each of which accepts a bone screw. And, for example, the lower element has an anterior flange that extends downwardly and has one through hole that accepts a bone screw. Further preferably, each of the elements has at least one short-term fixation structure (e.g., spikes on the outwardly directed vertebral body contact surface) for securing the element to an adjacent vertebral body endplate.
Further preferably, each of the outvJardly directed vertebral body contact surfaces is shaped to conform to the endplate of an adjacent vertebral body against which it is to be positioned. For example, vertebral body contact surface of the upper element is curvate (to match the anatomy of the superior vertebral body endplate) and the vertebral body contact surface of the lower element is flat (to match the anatomy of the inferior vertebral body endplate). Further preferably, each vertebral body contact surface has an osteoinductive or osteoconductive feature, such as, for example, porous or rough areas.
The longitudinally inwardly directed articulation surface of the upper element forms a constant radii saddle-shaped articulation surface. More particularly, the saddle surface is defined by a concave arc that is swept perpendicular to and along a convex arc. The articulation surface has a cross-section in one plane that forms a concave arc, and a cross-section in another plane (perpendicular to that plane) that forms a convex arc. The concave arc has a respective constant radius of curvature about an axis perpendicular to the one plane. The convex arc has a respective constant radius of curvature about an axis perpendicular to the other plane.
In a preferred embodiment, the concave arc has a constant radius of curvature A about an axis perpendicular to the anterior-posterior plane, and the convex arc has a constant radius of curvature B about an axis perpendicular to the lateral plane.
Preferably, radius A is less than radius B.
The longitudinally inwardly directed articulation surface of the lower element also forms a constant radii saddle-shaped articulation surface. More particularly, the saddle surface is defined by a convex arc that is swept perpendicular to and along a concave arc. The articulation surface has a cross-section in one plane that forms a convex arc, and a cross-section in another plane (perpendicular to that plane) that forms a concave arc. The convex arc has a respective constant radius of curvature about an axis perpendicular to the one plane. The concave arc has a respective constant radius of curvature about an axis perpendicular to the other plane.
In a preferred embodiment, the convex arc has a constant radius of curvature C
about an axis perpendicular to the anterior-posterior plane, and the concave arc has a constant radius of curvature D about an axis perpendicular to the lateral plane.
Preferably, radius C is less than radius D.
The constant radii saddle shaped articulation surfaces are configured and sized to be nestable against one another and articulatable against one another, to enable adjacent vertebral bones (against which the upper and lower elemeaits az°e respectively disposed in the intervertebral space) to articulate in flexion, extension, and lateral bending. More particularly, the artificial disc implant of the present invention is assembled by disposing the upper and lower elements such that the vertebral body contact surfaces are directed away from one another, and the articulation sur faces are nested against one another such that the concave arcs accommodates the convex arcs.
Accordingly, movement of the adjacent vertebral bones relative to one another is permitted by the movement of the upper and lower elements relative to one another.
In flexion and extension, the concave arcs of the upper element ride on the convex arcs of the lower element about a center of rotation below the articulation surfaces. In lateral bending, the concave arcs of the lower element ride on the convex arcs of the upper element about a center of rotation above the articulation surfaces.
During these articulation's, the elements are maintained at constant relative distraction positions, i.e, the elements do not move in directions that are directed away from one another (for example, do not move in opposing axial directions from one another (e.g., along a longitudinal axis of the spine)). Accordingly, the present invention provides a pair of articulation surfaces that have a center of rotation above the surfaces in one mode of motion (lateral bending), and below the surfaces in another (flexion/extension), consistent in these regards with a natural cervical intervertebral joint.
Preferably, the articulation surfaces are sized and configured so that the respective ranges of angles through which flexionlextension and lateral bending can be experienced are equal to or greater than the respective normal physiologic ranges for such movements in the cervical spine.
It is preferable that, in addition to the flexion, extension, and lateral bending motions described above, the adjacent vertebral bones be permitted by the artificial disc implant to axially rotate relative to one another (e.g., about the longitudinal axis of the spinal column), through a small range of angles, without moving in opposite (or otherwise directed away from one another) directions (e.g., along the longitudinal axis) within that range, and then to engage in such opposite (or otherwise directed away from one another) movement once that range is exceeded. Preferably, the articulation surfaces 204, 304 are accordingly configured and sized to permit such movements. In a preferred configuration, the constant radius of curvature A is larger than the constant radius of curvature C, and the constant radius of curvature D is larger than the constant radius of curvature B. Because of the space, afforded by the differing radii, at the edges of the articulation surfaces, the upper and lovJer elements are able to axially rotate relative to one another about the longitudinal axis of the spinal column through a range of angles without causing the vertebral body contact surfaces to move away from one another along the longitudinal axis. Once the axial rotation exceeds that range, the articulation surfaces interfere with one another as the concave arcs move toward positions in which they would be parallel to one another, and the distance between the vertebral body contact surfaces increases with continued axial rotation as the concave arcs ride up against their oppositely directed slopes.
Thus, the articulation surfaces are configurable according to the present invention to permit normal physiologic axial rotational motion of the adjacent vertebral bones about the longitudinal axis through a range of angles without abnormal immediate axially opposite (or otherwise directed away from one another) movement, and to permit such axially opposite (or otherwise directed away from one another) movement when under normal physiologic conditions it should occur, that is, outside that range of angles.
In preferred embodiments where the constant radius of curvature A is larger than the constant radius of curvature C, and the constant radius of curvature D is larger than the constant radius of curvature B, the articulation surfaces maintain point-to-point contact over a range of normal physiologic articulating movement between the adjacent vertebral bones. That is, through flexion, extension, lateral bending, and axial rotation, the articulation surfaces are in point-to-point contact with one another.
Preferably, the surface area dimensions of,the articulation surfaces are selected in view of the selected radii of curvature to prevent the edges of the saddle surfaces (particularly the edges of the concave arcs) from hitting any surrounding anatomic structures, or other portions of the opposing upper or lower element, before the limit of the normal physiologic range of an attempted articulation is reached.
The novel features of the present invention, as well as the invention itself, both as to its structure and its operation will be understood from the accompanying drawings, taken in conjunction with the accompanying description, in which similar reference characters refer to similar parts throughout.
Brief I)escripti~n ~f The Drawings Figures 1-5 show an artificial disc implant of the present invention in perspective, anterior, lateral, lateral cutaway, and posterior cutaway views, respeetively.
Figures 6-12 show an upper element of the artificial disc implant of Figures 1-in perspective, bottom (looking longitudinally up), lateral, anterior, lateral cutaway, top (looking longitudinally down), and posterior cutaway views, respectively.
Figures 13-19 show a lower element of the artificial disc implant of Figures 1-5 in perspective, top (looking longitudinally down), lateral, anterior, lateral cutaway, bottom (looking longitudinally up), and posterior cutaway views, respectively.
Figure 20 shows a lateral cross-section view of the artificial disc implant of Figures 1-5 in extension.
Figure 21 shows a posterior cross-section view of the artificial disc implant of Figures 1-5 in lateral bending.
Best Mode Of Carrying Out Invention For the purposes of promoting an understanding of the principles of the invention, reference will now be made to the embodiment illustrated in the drawings and specific language will be used to describe the same. It will nevertheless be understood that no limitation of the scope of the invention is thereby intended, such alterations and further modifications in the illustrated device, and such further applications of the principles of the invention as illustrated therein, being contemplated as would normally occur to one skilled in the art to which the invention relates.
Referring now to Figures 1-5, an artificial disc implant 100 of the present invention is shown in perspective, anterior, lateral, lateral cutaway, and posterior cutaway views, respectively. The implant 100 includes a first (e.g., upper) element 200 and a second (e.g., lower) element 300, each having an outwardly facing vertebral body contact surface 202, 302, and each having an inwardly facing articulation surface 204, 304. The elements 200, 300 are disposed as shown with the articulation surfaces 204, 304 nested against one another, and the vertebral body contact surfaces 202, 302 facing away from one another. When the implant 100 is disposed in an intervertebral disc space in a cervical spine, in this configuration and with the vertebral body contact surfaces 202, 302 engaged with respective adjacent vertebral body endplates (not shown), the implant 100 enables the adjacent vertebral bones to move relative to one another in accordance with proper anatomical motion, as further described below.
Preferably, at least one (and more preferably both) of the elements 200, 300 has at least one long-term fixation structure (e.g., flange 206, 306) having at least one feature (e.g., through hole 208a, 208b, 308) for securing the element to an adjacent vertebral body. For example, the upper element 200 has an anterior flange 206 that extends upwardly and has two tluough holes 208a, 208b, each of which accepts a bone screw (not shown). And, for example, the lower element 300 has an anterior flange 306 that extends downwardly and has one through hole 308 that accepts a bone screw (not shown). Once the elements 200, 300 are disposed in the intervertebral space with the vertebral body contact surfaces 202, 302 engaged with respective adjacent vertebral body endplates (not shown), securing of bone screws through the holes 208a, 208b, 308 and into the anterior surfaces of the adjacent vertebral bones helps prevent the elements from becoming dislodged from, or displaced in, the intervertebral space. Preferably, the bore axes of the through holes 208a, 208b, 308 are angled toward the adjacent vertebral body as shown.
Further preferably, at least one (and more preferably both) of the elements 200, 300 has at least one short-term fixation structure (e.g., spike 210a, 210b, 310a, 310b) for securing the element to an adjacent vertebral body (and more preferably to an adjacent vertebral body endplate). For example, each of the elements 200, 300 has a respective pair of outwardly directed spikes 210a, 210b, 310a, 310b. Once the elements 200, 300 are disposed in the intervertebral space with the vertebral body contact surfaces 202, 302 engaged with respective adjacent vertebral body endplates (not shown), the spikes 210a, 210b, 310a, 310b dig into the adjacent vertebral body endplates under the compression along the longitudinal axis of the spinal column, and thus help prevent the elements from becoming dislodged from, or displaced in, the intervertebral space. Preferably, each of the spikes 210a, 210b, 310a, 310b is sloped toward the vertebral body contact surface 202, 302 and toward the posterior direction on its posterior side as shown, to facilitate ease of insertion of the implant 100 into the intervertebral space, and is either perpendicular to the vertebral body contact surface 202, 302 on its anterior side (as shown) or sloped toward the vertebral body contact surface 202, 302 and toward the posterior direction on its anterior side (not shown), to help prevent the elements 200, 300 from anteriorly (or otherwise) slipping out of the intervertebral space.
More particularly, and referring now to Figures 6-12, the upper element 200 of the artificial disc implant 100 shown in Figures 1-5 is shown in perspective, bottom (loolcing longitudinally up), lateral, anterior, lateral cutaway, top (looking longitudinally down), and posterior cutaway views, respectively. Further particularly, and referring now to Figures 13-19, the lower element 300 of the artificial disc implant 100 shown in Figures 1-5 is shown in perspective, top (looking longitudinally down), lateral, anterior, lateral cutaway, bottom (looking longitudinally up), and posterior cutaway views, respectively.
As introduced above, each of the elements 200, 300 has a longitudinally outwardly directed vertebral body contact surface 202, 302. Preferably, each surface 202, 302 is shaped to conform to an endplate of an adjacent vertebral body (not shown) against which it is to be positioned. For example, inasmuch as a review of the relevant anatomy indicates that lower endplates of vertebral bones in the cervical spine each have a central concavity, it is preferable that the surface 202 is curvate (and more preferably, domed as shown, or semi-cylindrical), to conform to the central concavity. And, for example, inasmuch as a review of the relevant anatomy indicates that upper endplates of vertebral bones in the cervical spine are generally flat, it is preferable that the surface 302 is flat, as shown. It should be understood that the surfaces 202, 302 can be formed or can be dynamically formable to have these or other shapes that closely conform to the adjacent vertebral body endplate, without departing from the scope of the present invention.
Each vertebral body contact surface 202, 302 further preferably has an osteoinductive or osteoconductive feature. For example, each surface 202, 302 is preferably porous and/or roughened. This can be accomplished by any manner known in the art, including, for example, grit blasting, porous coating, etching, burning, electrical discharge machining, and sintered beading. While both surfaces 202, 302 are preferably provided with such a feature, it should be understood that only one could have such a feature without departing from the scope of the present invention. Further, it should be understood that it is not necessary for the entire surface to be so featured, but rather only a portion, some portions, or all of the surface can be so featured, or have a variety of such features, without departing from the scope of the present invention.
Each vertebral body contact surface 202, 302 further preferably has the long-term fixation and short-term fixation structures described above and denoted by corresponding reference numbers on these Figures 6-19.
As introduced above, the upper element 200 has a longitudinally inwardly directed articulation surface 204. Preferably, as shown, the articulation surface 204 includes a saddle surface that is defined by a concave arc (denoted by reference numeral 212 on Figure 10) that is swept perpendicular to and along a convex arc (denoted by reference numeral 214 on Figure 12). As best seen in Figures 4, 5, 10, and 12, the articulation surface 204 has a cross-section in one plane that forms a concave arc 212, and a cross-section in another plane (perpendicular to that plane) that forms a convex arc 214. The concave arc 212 has a respective constant radius of curvature about an axis perpendicular to the one plane. The convex arc 214 has a respective constant radius o,f curvature about an axis perpendicular to the other plane.
Therefore, the articulation surface 204 forms a constant radii saddle-shaped articulation surface.
In this preferred embodiment, as indicated in Figure 10, the concave arc 212 has a constant radius of curvature A about an axis perpendicular to the anterior-posterior plane. And, in this preferred embodiment, as indicated in Figure 12, the convex arc 214 has a constant radius of curvature B about an axis perpendicular to the lateral plane. Preferably, radius A is less than radius B, and most,preferably, radius A
is 0.329 and radius B is 0.340. It should be noted, however, that the present invention is not limited to any particular dimension set, and further than in some embodiments of the present invention, radius A is equal to or greater than radius B.
Also as introduced above, the lower element 300 has a longitudinally inwardly directed articulation surface 304. Preferably, as shown, the articulation surface 304 includes a saddle surface that is defined by a convex arc (denoted by reference numeral 312 on Figure 17) that is swept perpendicular to and along a concave arc (denoted by reference numeral 314 on Figure 19). As best seen in Figures 4, 5, 17, and 19, the articulation surface 304 has a cross-section in one plane that forms a convex arc 312, and a cross-section in another plane (perpendicular to that plane) that forms a concave arc 314. The convex arc 312 has a respective constant radius of curvature about an axis perpendicular to the one plane. The concave arc 314 has a respective constant radius of curvature about an axis perpendicular to the other plane.
Therefore, the articulation surface 304 also forms a constant radii saddle-shaped articulation surface.
In this preferred embodiment, as indicated in Figure 17, the convex arc 312 has a constant radius of curvature C about an axis perpendicular to the anterior-posterior plane. And, in this preferred embodiment, as indicated in Figure 19, the concave arc 314 has a constant radius of curvature I~ about an axis perpendicular to the lateral plane. Preferably, radius C is less than radius D, and most preferably, radius C is 0.280 inches and radius I~ is 0.401 inches. It should be noted, however, that the present invention is not limited to any particular dimension set, and further than in some embodiments of the present invention, radius C is equal to or greater than radius D. Further in some embodiments, radii A, B, C, and D are of equal dimension.
Importantly, the constant radii saddle shaped articulation surfaces 204, 304 are configured and sized to be nestable against one another and articulatable against one another, to enable adjacent vertebral bones (against which the upper and lower elements 200, 300 are respectively disposed in the intervertebral space) to articulate in flexion, extension, and lateral bending. More particularly, as best shown in Figures 1-5, the artificial disc implant 100 of the present invention is assembled by disposing the upper 200 and lower 300 elements such that the vertebral body contact surfaces 202, 302 are directed away from one another, and the articulation surfaces 204, 304 are nested against one another such that the concave arc 212 accommodates the convex arc 312 and such that the convex arc 214 is accommodated by the concave arc 314. Either during or after such assembly of the implant 100, the vertebral body contact surface 202 of the upper element 200 is fixed against a lower endplate of a superior vertebral body (not shown), and the vertebral body contact surface 302 of the lower element 300 is fixed against an upper endplate of an inferior vertebral body (not shown). As noted above, the preferable long-term and short-term fixation structures on the elements 200, 300 are useful for securing the elements 200, 300 to these adjacent vertebral bones.
Accordingly, movement of the adjacent vertebral bones relative to one another is permitted by the movement of the upper 200 and lower 300 elements relative to one another. With regard to the articulation surfaces 204, 304 being configured and sized to enable the adjacent vertebral bones to articulate in flexion, extension, and lateral bending, it is understood from the described geometry and positioning of the upper 200 and lower 300 elements once the implant 100 is assembled and implanted that in flexion and extension, the concave arcs (e.g., 212) of the upper element 200 ride on the convex arcs (e.g., 312) of the lower element 300 about a center of rotation (referenced as 123 on Figure 18) at the center of the cii°cle defined by the convex arc 312. This center of rotation I~3 is below the articulation surface 304. It is further understood from the described geometry and positioning of the upper 200 and lower 300 elements that in lateral bending, the concave arcs (e.g., 314) of the lower element 300 ride on the convex arcs (e.g., 214) of the upper element 200 about a center of rotation (referenced as R2 on Figure 12) at the center of the circle defined by the convex arc 214. This center of rotation R2 is above the articulation surface 204.
1?uring these articulations, the elements 200, 300 are maintained at constant relative distraction positions, i.e, the elements 200, 300 do not move in directions that are directed away from one another (for example, do not move in opposing axial directions from one another (e.g., along the longitudinal axis of the spine)).
Accordingly, the present invention provides a pair of articulation surfaces 204, 304 that have a center of rotation above the surfaces in one mode of motion (lateral bending), and below the surfaces in another (flexion/extension), consistent in these regards with a natural intervertebral joint in the cervical spine. Preferably, the articulation surfaces 204, 304 are sized and configured so that the respective ranges of angles through which flexion/extension and lateral bending can be experienced are equal to or greater than the respective normal physiologic ranges for such movements in the cervical spine. While the present invention is not limited to any particular dimensions, a preferred embodiment has the following radii of curvature for the convex arc 312 and the convex arc 214: C = 0.280 inches and B = 0.340 inches.
Such preferable radii of curvature provide the preferred embodiment with a flexion/extension range of plus or minus 7.5 degrees (total of 15 degrees), and a lateral bending range of plus or minus 7.5 degrees (total of 15 degrees).
While the preferred embodiment is shown with concave arc 212 having a larger constant radius of curvature A than the constant radius of curvature C
of convex arc 312 (for reasons that are described in detail below), and with concave arc 314 having a larger constant radius of curvature D than the constant radius of curvature B of convex arc 214 (for reasons that are described in detail below), it should be understood that the above described functionality can also be achieved using other relative radii sizes. For example, flexion, extension, and lateral bending are also possible if the constant radius of curvature A of concave arc 212 is otherwise non-congruent with (e.g., less than) or is congruent with (i.e., equal to) the constant radius of curvature C of convex arc 312, and/or if the constant radius of curvature D
of concave arc 314 is otherv~ise non-congruent with (e.g., less than) or is conguuent with (i.e., equal to) the constant radius of curvature B of convex arc 214.
As noted above, it is preferable that, in addition to the flexion, extension, and lateral bending motions described above, the adjacent vertebral bones be permitted by the artificial disc implant 100 to axially rotate relative to one another (e.g., about the longitudinal axis of the spinal column), through a range of angles without moving in opposite (or otherwise directed away from one another) directions (e.g., along the longitudinal axis) within that range. Preferably, the articulation surfaces 204, 304 are accordingly configured and sized to permit such movement. Referring again to Figures 1-5, a preferred configuration is shown as an example, where the constant radius of curvature A of concave arc 212 is larger than the constant radius of curvature C of convex arc 312, and the constant radius of curvature D of concave arc 314 is larger than the constant radius of curvature B of convex arc 214. It is understood from the described geometry and positioning of the upper 200 and lower 300 elements that, because of the space, afforded by the differing radii, at the edges of the articulation surfaces 204, 304, the upper 200 and lower 300 elements are able to axially rotate relative to one another (e.g., about the longitudinal axis) through a range of angles without causing the vertebral body contact surfaces 202, 302 to move in opposite (or otherwise directed away from one another) directions (e.g., along the longitudinal axis). Once the axial rotation exceeds that range, the articulation surfaces 204, 304 interfere with one another as the concave arcs 212, 314 move toward positions in which they would be parallel to one another, and the distance between the vertebral body contact surfaces 202, 302 increases with continued axial rotation as the concave arcs 212, 314 ride up against their oppositely directed slopes. Thus, the articulation surfaces 204, 304 are configurable according to the present invention to permit normal physiologic axial rotational motion of the adjacent vertebral bones about the longitudinal axis of the spinal column through a range of angles without abnormal immediate axially opposite (or otherwise directed away from one another) movement, and to permit such axially opposite (or otherwise directed away from one another) movement when under normal physiologic conditions it should occur, that is, outside that range of angles. While the present invention is not limited to any particular dimensions, a preferred embodiment has the following radii of curvature: A
= 0.329 inches, B = 0.340 inches, C = 0.280 inches, and D = 0.401 inches. Such preferable radii of curvate provide the preferred embodiment with a longitudinal axial rotation range of plus or minus 3 degrees (total of 6 degrees) before oppositely directed movement of the articulating surfaces occurs.
It should be noted that in the preferred embodiment, and in other preferable embodiments where the constant radius of curvature A of concave arc 212 is larger than the constant radius of curvature C of convex arc 312, and the constant radius of curvature D of concave arc 314 is larger than the constant radius of curvature B of convex arc 214, the articulation surfaces 204, 304 maintain point-to-point contact over a range of normal physiologic articulating movement between the adjacent vertebral bones. This is illustrated in Figures 4, 5, 20, and 21. More particularly, it is understood from the described geometry and positioning of the upper 200 and lower 300 elements that through flexion, extension, lateral bending, and axial rotation, the articulation surfaces 204, 304 are in point-to-point contact with one another as they are in Figures 4 and 5. Figures 20 and 21 are provided to show the implant 100 in extension and lateral bending, respectively, to further illustrate this preferable feature.
It should further be noted that in addition to the radii of curvature dimensions of the articulation surfaces 204, 304 being relevant to a configuration and sizing of the articulation surfaces 204, 304 permitting normal physiologic flexion, extension, lateral bending, and axial rotation movements of the adjacent vertebral bones, the surface area dimensions are also relevant, particularly in relation to the selected radii of curvature. More particularly, in order to provide a range of relative angulation that is within the normal physiologic range of the cervical spine, not only must the selected radii of curvature be suitable as described above, but also and accordingly the surface area of the saddle surfaces should be of a dimension that, given the selected radii of curvature, prevents the edges of the saddle surfaces (particularly the edges of the concave arcs (e.g., 212 and e.g., 314)) from hitting any surrounding anatomic structures, or other portions of the opposing element (200 or 300), before the limit of the normal physiologic range of the attempted articulation is reached. As shown, one or both of the inwardly facing surfaces of the upper 200 and lower 300 elements can be tapered inwardly before presenting its articulation surface (204 or 304), to ensure a suitable surface area dimension to prevent such interference. While the present invention is not limited to any particular surface area dimensions, the illustrated preferred embodiment has a surface area of articulation surface 204 equal to 0.146 square inches, and a surface area of articulation surface 304 equal to 0.153 square inches.
Further preferably, the articulation surfaces 204, 304 are formed of cobalt-chrome that is polished to provide a smooth bearing surface. It should be understood that the articulation surfaces 204, 304, while preferably formed of cobalt-chrome, can be additionally or alternatively formed of other metals, such as, for example, stainless steel and/or titanium, or of non-metals, such as, for example, polyethylene and/or ceramic materials (e.g., alumina and zirconia), or of any other suitable material without departing from the scope of the present invention.
It should be noted that while the present invention is illustrated and described as an artificial disc implant for use in the cervical spine, the artificial disc implant of the present invention can be adapted for use in any other portion of the spine without departing from the scope of the present invention.
While the particular prostheses for the cervical intervertebral joint of the spine as herein shown and disclosed in detail are each fully capable of obtaining the objects and providing the advantages previously stated, it shall be understood that these variations are merely illustrative of the presently preferred embodiments of the invention and that no limitations to the scope of the present invention are intended to be inferred from the details of the construction or design herein shown.
More particularly, the present invention contemplates that with regard to the cervical anatomy, a device that maintains a center of rotation, moving or otherwise, within the disc space is inappropriate and fails to properly support healthy motion.
Specifically, the cervical joint comprises five separate articulating elements: the facet joints in the posterior of the segment; the lateral unco-vertebral joints; and the nucleus in the intervertebral space. It is contemplated by the present invention that a track defined by the cervical facets falls along the planes between the inferior surface of the upper facets said the superior surface of the lower facets, and that this plane extends upwardly and forward, forcing the overall joint to pivot around a center of rotation that resides in the lower vertebral bone in flexion/extension articulation.
Conversely, it is contemplated by the present invention that in lateral bending the unto-vertebral joints influence the track of motion. Specifically, the unco-vertebral joints are formed at the lateral edges of the intervertebral space and are defined by a pair of upwardly extending surfaces of the inferior vertebral endplate and the corresponding surfaces of the superior bony endplate. It is contemplated by the present invention that this U-shaped configuration guides the segment into a rotation about a center within the superior vertebral bone during lateral bending.
Finally, it is contemplated by the present invention that during axial rotation of the adjacent vertebral bones of the cervical segment relative to one another about the longitudinal axis of the spinal column, the opposing bones do not simply axially rotate relative to one another for more than a few degrees, but rather follow the coupled influences of the unco-vertebral joints and the nucleus, and that this coupled motion vertically separates the opposing bones of the facet joints as the rotation continues, thus freeing the bones to rotate farther that would otherwise be permitted if the facets locked together (as is often seen as a symptom of degenerative cervical disease).
Both the Bryan and Bristol discs described above do provide distraction and maintenance of intervertebral disc height, and thereby provide immediate and short-term relief from pain. However, it should be understood, in light of the above described anatomy as contemplated by the present invention, that neither provides for proper anatomical motion because their respective centers of rotation are located within the disc space. Thus, neither will afford significant motion preservation, and patients with these devices implanted in their necks will find no significant mobility at the implanted segment. This may lead to spontaneous fusions, long term facet deterioration, and/or accelerated adjacent level degeneration.
The constraints placed on the prosthesis by the above-described anatomy are considerable. To provide an implant having a pair of articulation surfaces that provide a center of rotation of the implant above the surfaces in one mode of motion (lateral bending) and a center of rotation of the implant below the surfaces in another mode of motion (flexion/extension), that further permit the surfaces to axially rotate relative to one another about a longitudinal axis of the spinal column through a range of angles without causing movement of the surfaces in opposing directions along the longitudinal axis of the spinal column, and that further cause such movement (and accordingly a vertical separation of the facet joints) beyond that range is a difficult engineering task. The present invention contemplates that a saddle joint provides a geometric approach to the taslc.
The solution to this problem, however, is not open to any saddle joint configuration. US Patent Numbers 5,405,400 and 5,645,605 describe saddle joints utilized for prosthetic thumb joints. More particularly, US Patent Number 5,405,400 ("Linscheid") discloses an artificial thumb joint comprising a pair of surfaces that are nesting hyperbolic paraboloids. A hyperbolic paraboloid is a surface defined by a first specific geometric form (the hyperbola) that is swept along a second geometric form (the parabola) that is perpendicular to the first form, and which first and second forms are opposite in the direction of their convexities. A common feature of both hyperbolae and parabolae is that neither has a constant radius of curvature along its extent. Constant radii of curvature are necessary for a pair of surfaces to smoothly flow over one another. Accordingly, the nesting hyperbolic paraboloids set forth in the reference are, therefore, not capable of any smooth articulation. Any attempted articulation causes the two surfaces to immediately move in opposing directions.
Stated more simply, nesting hyperbolic paraboloids have continuously changing centers of rotation (by the nature of the geometric forms selected). The present invention contemplates that the cervical joint anatomy enables smooth articulation in two modes of motion (lateral bending and flexion/extension), and also smooth relative axial rotation about the longitudinal axis of the spinal column through a small range of angles. It is understood by the present invention that the vertical separation motion of the natural cervical joint does not occur immediately, but rather occurs only outside that small angular range of relative axial rotation. Thus, the present invention contemplates that the nesting hyperbolic paraboloids disclosed by Linscheid are inappropriate for use in the cervical joint.
US Patent Number 5,645,605 ("Klawitter") discloses an alternate form of a saddle surface, again for use in an artificial thumb joint, that comprises a pair of nesting toroidal surfaces. Toroidal surfaces are defined by an arc of one circle being swept along an arc of another, again having opposing convexitees. As circles have constant radii of curvatures, it is possible with these surfaces to have smooth motion in two perpendicular planes. More particularly, if the corresponding radii of curvature are approximately equivalent, the two surfaces may nest and articulate in flexion/extension and lateral bending smoothly, without causing the surfaces to move in opposing directions upon an attempted articulate~n. However, Klawitter teaches that these toroidal surfaces should have the same radii of curvature, inasmuch as it is a necessity that axial rotational motion of the joint be inhibited, or if it is permitted to occur, it should cause an immediate axial distraction of the joint. As explained above with regard to the saddle joint in Linscheid, this elimination of the capacity of the surfaces to axially rotate relative to one another for even a small range of angles prevents such a design from being effectively used in a cervical disc application.
In order for two nesting toroidal saddles to rotate within the same plane, each of the concave radii of the surfaces must be greater than the radius of its nested convex surface. An artificial cervical joint that provides a center of rotation in the vertebral bone below during flexion/extension and in the vertebral bone above during lateral bending and has the capacity to axially rotate within a small range of angles prior to causing oppositely directed movement of the surfaces requires nesting surfaces with such a configuration.
The present invention, therefore, provides an articulating joint implant for use in the cervical spine, including a first (e.g., upper) element and a second (e.g., lower) element, each having an outwardly facing vertebral body contact surface, and each having an inwardly facing articulation surface. The elements are disposed with the articulation surfaces nested against one another, and the vertebral body contact surfaces facing away from one another. When the implant is disposed in an intervertebral disc space in a cervical spine, in this configuration and with the vertebral body contact surfaces engaged with respective adjacent vertebral body endplates, the implant enables the adjacent vertebral bones to move relative to one another in accordance with proper anatomical motion.
Preferably, each of the elements has at least one long-term fixation structure (e.g., a flange) having at least one feature (e.g., a through hole) for securing the element to an adjacent vertebral body. For example, the upper element has an anterior flange that extends upwardly and has two through holes, each of which accepts a bone screw. And, for example, the lower element has an anterior flange that extends downwardly and has one through hole that accepts a bone screw. Further preferably, each of the elements has at least one short-term fixation structure (e.g., spikes on the outwardly directed vertebral body contact surface) for securing the element to an adjacent vertebral body endplate.
Further preferably, each of the outvJardly directed vertebral body contact surfaces is shaped to conform to the endplate of an adjacent vertebral body against which it is to be positioned. For example, vertebral body contact surface of the upper element is curvate (to match the anatomy of the superior vertebral body endplate) and the vertebral body contact surface of the lower element is flat (to match the anatomy of the inferior vertebral body endplate). Further preferably, each vertebral body contact surface has an osteoinductive or osteoconductive feature, such as, for example, porous or rough areas.
The longitudinally inwardly directed articulation surface of the upper element forms a constant radii saddle-shaped articulation surface. More particularly, the saddle surface is defined by a concave arc that is swept perpendicular to and along a convex arc. The articulation surface has a cross-section in one plane that forms a concave arc, and a cross-section in another plane (perpendicular to that plane) that forms a convex arc. The concave arc has a respective constant radius of curvature about an axis perpendicular to the one plane. The convex arc has a respective constant radius of curvature about an axis perpendicular to the other plane.
In a preferred embodiment, the concave arc has a constant radius of curvature A about an axis perpendicular to the anterior-posterior plane, and the convex arc has a constant radius of curvature B about an axis perpendicular to the lateral plane.
Preferably, radius A is less than radius B.
The longitudinally inwardly directed articulation surface of the lower element also forms a constant radii saddle-shaped articulation surface. More particularly, the saddle surface is defined by a convex arc that is swept perpendicular to and along a concave arc. The articulation surface has a cross-section in one plane that forms a convex arc, and a cross-section in another plane (perpendicular to that plane) that forms a concave arc. The convex arc has a respective constant radius of curvature about an axis perpendicular to the one plane. The concave arc has a respective constant radius of curvature about an axis perpendicular to the other plane.
In a preferred embodiment, the convex arc has a constant radius of curvature C
about an axis perpendicular to the anterior-posterior plane, and the concave arc has a constant radius of curvature D about an axis perpendicular to the lateral plane.
Preferably, radius C is less than radius D.
The constant radii saddle shaped articulation surfaces are configured and sized to be nestable against one another and articulatable against one another, to enable adjacent vertebral bones (against which the upper and lower elemeaits az°e respectively disposed in the intervertebral space) to articulate in flexion, extension, and lateral bending. More particularly, the artificial disc implant of the present invention is assembled by disposing the upper and lower elements such that the vertebral body contact surfaces are directed away from one another, and the articulation sur faces are nested against one another such that the concave arcs accommodates the convex arcs.
Accordingly, movement of the adjacent vertebral bones relative to one another is permitted by the movement of the upper and lower elements relative to one another.
In flexion and extension, the concave arcs of the upper element ride on the convex arcs of the lower element about a center of rotation below the articulation surfaces. In lateral bending, the concave arcs of the lower element ride on the convex arcs of the upper element about a center of rotation above the articulation surfaces.
During these articulation's, the elements are maintained at constant relative distraction positions, i.e, the elements do not move in directions that are directed away from one another (for example, do not move in opposing axial directions from one another (e.g., along a longitudinal axis of the spine)). Accordingly, the present invention provides a pair of articulation surfaces that have a center of rotation above the surfaces in one mode of motion (lateral bending), and below the surfaces in another (flexion/extension), consistent in these regards with a natural cervical intervertebral joint.
Preferably, the articulation surfaces are sized and configured so that the respective ranges of angles through which flexionlextension and lateral bending can be experienced are equal to or greater than the respective normal physiologic ranges for such movements in the cervical spine.
It is preferable that, in addition to the flexion, extension, and lateral bending motions described above, the adjacent vertebral bones be permitted by the artificial disc implant to axially rotate relative to one another (e.g., about the longitudinal axis of the spinal column), through a small range of angles, without moving in opposite (or otherwise directed away from one another) directions (e.g., along the longitudinal axis) within that range, and then to engage in such opposite (or otherwise directed away from one another) movement once that range is exceeded. Preferably, the articulation surfaces 204, 304 are accordingly configured and sized to permit such movements. In a preferred configuration, the constant radius of curvature A is larger than the constant radius of curvature C, and the constant radius of curvature D is larger than the constant radius of curvature B. Because of the space, afforded by the differing radii, at the edges of the articulation surfaces, the upper and lovJer elements are able to axially rotate relative to one another about the longitudinal axis of the spinal column through a range of angles without causing the vertebral body contact surfaces to move away from one another along the longitudinal axis. Once the axial rotation exceeds that range, the articulation surfaces interfere with one another as the concave arcs move toward positions in which they would be parallel to one another, and the distance between the vertebral body contact surfaces increases with continued axial rotation as the concave arcs ride up against their oppositely directed slopes.
Thus, the articulation surfaces are configurable according to the present invention to permit normal physiologic axial rotational motion of the adjacent vertebral bones about the longitudinal axis through a range of angles without abnormal immediate axially opposite (or otherwise directed away from one another) movement, and to permit such axially opposite (or otherwise directed away from one another) movement when under normal physiologic conditions it should occur, that is, outside that range of angles.
In preferred embodiments where the constant radius of curvature A is larger than the constant radius of curvature C, and the constant radius of curvature D is larger than the constant radius of curvature B, the articulation surfaces maintain point-to-point contact over a range of normal physiologic articulating movement between the adjacent vertebral bones. That is, through flexion, extension, lateral bending, and axial rotation, the articulation surfaces are in point-to-point contact with one another.
Preferably, the surface area dimensions of,the articulation surfaces are selected in view of the selected radii of curvature to prevent the edges of the saddle surfaces (particularly the edges of the concave arcs) from hitting any surrounding anatomic structures, or other portions of the opposing upper or lower element, before the limit of the normal physiologic range of an attempted articulation is reached.
The novel features of the present invention, as well as the invention itself, both as to its structure and its operation will be understood from the accompanying drawings, taken in conjunction with the accompanying description, in which similar reference characters refer to similar parts throughout.
Brief I)escripti~n ~f The Drawings Figures 1-5 show an artificial disc implant of the present invention in perspective, anterior, lateral, lateral cutaway, and posterior cutaway views, respeetively.
Figures 6-12 show an upper element of the artificial disc implant of Figures 1-in perspective, bottom (looking longitudinally up), lateral, anterior, lateral cutaway, top (looking longitudinally down), and posterior cutaway views, respectively.
Figures 13-19 show a lower element of the artificial disc implant of Figures 1-5 in perspective, top (looking longitudinally down), lateral, anterior, lateral cutaway, bottom (looking longitudinally up), and posterior cutaway views, respectively.
Figure 20 shows a lateral cross-section view of the artificial disc implant of Figures 1-5 in extension.
Figure 21 shows a posterior cross-section view of the artificial disc implant of Figures 1-5 in lateral bending.
Best Mode Of Carrying Out Invention For the purposes of promoting an understanding of the principles of the invention, reference will now be made to the embodiment illustrated in the drawings and specific language will be used to describe the same. It will nevertheless be understood that no limitation of the scope of the invention is thereby intended, such alterations and further modifications in the illustrated device, and such further applications of the principles of the invention as illustrated therein, being contemplated as would normally occur to one skilled in the art to which the invention relates.
Referring now to Figures 1-5, an artificial disc implant 100 of the present invention is shown in perspective, anterior, lateral, lateral cutaway, and posterior cutaway views, respectively. The implant 100 includes a first (e.g., upper) element 200 and a second (e.g., lower) element 300, each having an outwardly facing vertebral body contact surface 202, 302, and each having an inwardly facing articulation surface 204, 304. The elements 200, 300 are disposed as shown with the articulation surfaces 204, 304 nested against one another, and the vertebral body contact surfaces 202, 302 facing away from one another. When the implant 100 is disposed in an intervertebral disc space in a cervical spine, in this configuration and with the vertebral body contact surfaces 202, 302 engaged with respective adjacent vertebral body endplates (not shown), the implant 100 enables the adjacent vertebral bones to move relative to one another in accordance with proper anatomical motion, as further described below.
Preferably, at least one (and more preferably both) of the elements 200, 300 has at least one long-term fixation structure (e.g., flange 206, 306) having at least one feature (e.g., through hole 208a, 208b, 308) for securing the element to an adjacent vertebral body. For example, the upper element 200 has an anterior flange 206 that extends upwardly and has two tluough holes 208a, 208b, each of which accepts a bone screw (not shown). And, for example, the lower element 300 has an anterior flange 306 that extends downwardly and has one through hole 308 that accepts a bone screw (not shown). Once the elements 200, 300 are disposed in the intervertebral space with the vertebral body contact surfaces 202, 302 engaged with respective adjacent vertebral body endplates (not shown), securing of bone screws through the holes 208a, 208b, 308 and into the anterior surfaces of the adjacent vertebral bones helps prevent the elements from becoming dislodged from, or displaced in, the intervertebral space. Preferably, the bore axes of the through holes 208a, 208b, 308 are angled toward the adjacent vertebral body as shown.
Further preferably, at least one (and more preferably both) of the elements 200, 300 has at least one short-term fixation structure (e.g., spike 210a, 210b, 310a, 310b) for securing the element to an adjacent vertebral body (and more preferably to an adjacent vertebral body endplate). For example, each of the elements 200, 300 has a respective pair of outwardly directed spikes 210a, 210b, 310a, 310b. Once the elements 200, 300 are disposed in the intervertebral space with the vertebral body contact surfaces 202, 302 engaged with respective adjacent vertebral body endplates (not shown), the spikes 210a, 210b, 310a, 310b dig into the adjacent vertebral body endplates under the compression along the longitudinal axis of the spinal column, and thus help prevent the elements from becoming dislodged from, or displaced in, the intervertebral space. Preferably, each of the spikes 210a, 210b, 310a, 310b is sloped toward the vertebral body contact surface 202, 302 and toward the posterior direction on its posterior side as shown, to facilitate ease of insertion of the implant 100 into the intervertebral space, and is either perpendicular to the vertebral body contact surface 202, 302 on its anterior side (as shown) or sloped toward the vertebral body contact surface 202, 302 and toward the posterior direction on its anterior side (not shown), to help prevent the elements 200, 300 from anteriorly (or otherwise) slipping out of the intervertebral space.
More particularly, and referring now to Figures 6-12, the upper element 200 of the artificial disc implant 100 shown in Figures 1-5 is shown in perspective, bottom (loolcing longitudinally up), lateral, anterior, lateral cutaway, top (looking longitudinally down), and posterior cutaway views, respectively. Further particularly, and referring now to Figures 13-19, the lower element 300 of the artificial disc implant 100 shown in Figures 1-5 is shown in perspective, top (looking longitudinally down), lateral, anterior, lateral cutaway, bottom (looking longitudinally up), and posterior cutaway views, respectively.
As introduced above, each of the elements 200, 300 has a longitudinally outwardly directed vertebral body contact surface 202, 302. Preferably, each surface 202, 302 is shaped to conform to an endplate of an adjacent vertebral body (not shown) against which it is to be positioned. For example, inasmuch as a review of the relevant anatomy indicates that lower endplates of vertebral bones in the cervical spine each have a central concavity, it is preferable that the surface 202 is curvate (and more preferably, domed as shown, or semi-cylindrical), to conform to the central concavity. And, for example, inasmuch as a review of the relevant anatomy indicates that upper endplates of vertebral bones in the cervical spine are generally flat, it is preferable that the surface 302 is flat, as shown. It should be understood that the surfaces 202, 302 can be formed or can be dynamically formable to have these or other shapes that closely conform to the adjacent vertebral body endplate, without departing from the scope of the present invention.
Each vertebral body contact surface 202, 302 further preferably has an osteoinductive or osteoconductive feature. For example, each surface 202, 302 is preferably porous and/or roughened. This can be accomplished by any manner known in the art, including, for example, grit blasting, porous coating, etching, burning, electrical discharge machining, and sintered beading. While both surfaces 202, 302 are preferably provided with such a feature, it should be understood that only one could have such a feature without departing from the scope of the present invention. Further, it should be understood that it is not necessary for the entire surface to be so featured, but rather only a portion, some portions, or all of the surface can be so featured, or have a variety of such features, without departing from the scope of the present invention.
Each vertebral body contact surface 202, 302 further preferably has the long-term fixation and short-term fixation structures described above and denoted by corresponding reference numbers on these Figures 6-19.
As introduced above, the upper element 200 has a longitudinally inwardly directed articulation surface 204. Preferably, as shown, the articulation surface 204 includes a saddle surface that is defined by a concave arc (denoted by reference numeral 212 on Figure 10) that is swept perpendicular to and along a convex arc (denoted by reference numeral 214 on Figure 12). As best seen in Figures 4, 5, 10, and 12, the articulation surface 204 has a cross-section in one plane that forms a concave arc 212, and a cross-section in another plane (perpendicular to that plane) that forms a convex arc 214. The concave arc 212 has a respective constant radius of curvature about an axis perpendicular to the one plane. The convex arc 214 has a respective constant radius o,f curvature about an axis perpendicular to the other plane.
Therefore, the articulation surface 204 forms a constant radii saddle-shaped articulation surface.
In this preferred embodiment, as indicated in Figure 10, the concave arc 212 has a constant radius of curvature A about an axis perpendicular to the anterior-posterior plane. And, in this preferred embodiment, as indicated in Figure 12, the convex arc 214 has a constant radius of curvature B about an axis perpendicular to the lateral plane. Preferably, radius A is less than radius B, and most,preferably, radius A
is 0.329 and radius B is 0.340. It should be noted, however, that the present invention is not limited to any particular dimension set, and further than in some embodiments of the present invention, radius A is equal to or greater than radius B.
Also as introduced above, the lower element 300 has a longitudinally inwardly directed articulation surface 304. Preferably, as shown, the articulation surface 304 includes a saddle surface that is defined by a convex arc (denoted by reference numeral 312 on Figure 17) that is swept perpendicular to and along a concave arc (denoted by reference numeral 314 on Figure 19). As best seen in Figures 4, 5, 17, and 19, the articulation surface 304 has a cross-section in one plane that forms a convex arc 312, and a cross-section in another plane (perpendicular to that plane) that forms a concave arc 314. The convex arc 312 has a respective constant radius of curvature about an axis perpendicular to the one plane. The concave arc 314 has a respective constant radius of curvature about an axis perpendicular to the other plane.
Therefore, the articulation surface 304 also forms a constant radii saddle-shaped articulation surface.
In this preferred embodiment, as indicated in Figure 17, the convex arc 312 has a constant radius of curvature C about an axis perpendicular to the anterior-posterior plane. And, in this preferred embodiment, as indicated in Figure 19, the concave arc 314 has a constant radius of curvature I~ about an axis perpendicular to the lateral plane. Preferably, radius C is less than radius D, and most preferably, radius C is 0.280 inches and radius I~ is 0.401 inches. It should be noted, however, that the present invention is not limited to any particular dimension set, and further than in some embodiments of the present invention, radius C is equal to or greater than radius D. Further in some embodiments, radii A, B, C, and D are of equal dimension.
Importantly, the constant radii saddle shaped articulation surfaces 204, 304 are configured and sized to be nestable against one another and articulatable against one another, to enable adjacent vertebral bones (against which the upper and lower elements 200, 300 are respectively disposed in the intervertebral space) to articulate in flexion, extension, and lateral bending. More particularly, as best shown in Figures 1-5, the artificial disc implant 100 of the present invention is assembled by disposing the upper 200 and lower 300 elements such that the vertebral body contact surfaces 202, 302 are directed away from one another, and the articulation surfaces 204, 304 are nested against one another such that the concave arc 212 accommodates the convex arc 312 and such that the convex arc 214 is accommodated by the concave arc 314. Either during or after such assembly of the implant 100, the vertebral body contact surface 202 of the upper element 200 is fixed against a lower endplate of a superior vertebral body (not shown), and the vertebral body contact surface 302 of the lower element 300 is fixed against an upper endplate of an inferior vertebral body (not shown). As noted above, the preferable long-term and short-term fixation structures on the elements 200, 300 are useful for securing the elements 200, 300 to these adjacent vertebral bones.
Accordingly, movement of the adjacent vertebral bones relative to one another is permitted by the movement of the upper 200 and lower 300 elements relative to one another. With regard to the articulation surfaces 204, 304 being configured and sized to enable the adjacent vertebral bones to articulate in flexion, extension, and lateral bending, it is understood from the described geometry and positioning of the upper 200 and lower 300 elements once the implant 100 is assembled and implanted that in flexion and extension, the concave arcs (e.g., 212) of the upper element 200 ride on the convex arcs (e.g., 312) of the lower element 300 about a center of rotation (referenced as 123 on Figure 18) at the center of the cii°cle defined by the convex arc 312. This center of rotation I~3 is below the articulation surface 304. It is further understood from the described geometry and positioning of the upper 200 and lower 300 elements that in lateral bending, the concave arcs (e.g., 314) of the lower element 300 ride on the convex arcs (e.g., 214) of the upper element 200 about a center of rotation (referenced as R2 on Figure 12) at the center of the circle defined by the convex arc 214. This center of rotation R2 is above the articulation surface 204.
1?uring these articulations, the elements 200, 300 are maintained at constant relative distraction positions, i.e, the elements 200, 300 do not move in directions that are directed away from one another (for example, do not move in opposing axial directions from one another (e.g., along the longitudinal axis of the spine)).
Accordingly, the present invention provides a pair of articulation surfaces 204, 304 that have a center of rotation above the surfaces in one mode of motion (lateral bending), and below the surfaces in another (flexion/extension), consistent in these regards with a natural intervertebral joint in the cervical spine. Preferably, the articulation surfaces 204, 304 are sized and configured so that the respective ranges of angles through which flexion/extension and lateral bending can be experienced are equal to or greater than the respective normal physiologic ranges for such movements in the cervical spine. While the present invention is not limited to any particular dimensions, a preferred embodiment has the following radii of curvature for the convex arc 312 and the convex arc 214: C = 0.280 inches and B = 0.340 inches.
Such preferable radii of curvature provide the preferred embodiment with a flexion/extension range of plus or minus 7.5 degrees (total of 15 degrees), and a lateral bending range of plus or minus 7.5 degrees (total of 15 degrees).
While the preferred embodiment is shown with concave arc 212 having a larger constant radius of curvature A than the constant radius of curvature C
of convex arc 312 (for reasons that are described in detail below), and with concave arc 314 having a larger constant radius of curvature D than the constant radius of curvature B of convex arc 214 (for reasons that are described in detail below), it should be understood that the above described functionality can also be achieved using other relative radii sizes. For example, flexion, extension, and lateral bending are also possible if the constant radius of curvature A of concave arc 212 is otherwise non-congruent with (e.g., less than) or is congruent with (i.e., equal to) the constant radius of curvature C of convex arc 312, and/or if the constant radius of curvature D
of concave arc 314 is otherv~ise non-congruent with (e.g., less than) or is conguuent with (i.e., equal to) the constant radius of curvature B of convex arc 214.
As noted above, it is preferable that, in addition to the flexion, extension, and lateral bending motions described above, the adjacent vertebral bones be permitted by the artificial disc implant 100 to axially rotate relative to one another (e.g., about the longitudinal axis of the spinal column), through a range of angles without moving in opposite (or otherwise directed away from one another) directions (e.g., along the longitudinal axis) within that range. Preferably, the articulation surfaces 204, 304 are accordingly configured and sized to permit such movement. Referring again to Figures 1-5, a preferred configuration is shown as an example, where the constant radius of curvature A of concave arc 212 is larger than the constant radius of curvature C of convex arc 312, and the constant radius of curvature D of concave arc 314 is larger than the constant radius of curvature B of convex arc 214. It is understood from the described geometry and positioning of the upper 200 and lower 300 elements that, because of the space, afforded by the differing radii, at the edges of the articulation surfaces 204, 304, the upper 200 and lower 300 elements are able to axially rotate relative to one another (e.g., about the longitudinal axis) through a range of angles without causing the vertebral body contact surfaces 202, 302 to move in opposite (or otherwise directed away from one another) directions (e.g., along the longitudinal axis). Once the axial rotation exceeds that range, the articulation surfaces 204, 304 interfere with one another as the concave arcs 212, 314 move toward positions in which they would be parallel to one another, and the distance between the vertebral body contact surfaces 202, 302 increases with continued axial rotation as the concave arcs 212, 314 ride up against their oppositely directed slopes. Thus, the articulation surfaces 204, 304 are configurable according to the present invention to permit normal physiologic axial rotational motion of the adjacent vertebral bones about the longitudinal axis of the spinal column through a range of angles without abnormal immediate axially opposite (or otherwise directed away from one another) movement, and to permit such axially opposite (or otherwise directed away from one another) movement when under normal physiologic conditions it should occur, that is, outside that range of angles. While the present invention is not limited to any particular dimensions, a preferred embodiment has the following radii of curvature: A
= 0.329 inches, B = 0.340 inches, C = 0.280 inches, and D = 0.401 inches. Such preferable radii of curvate provide the preferred embodiment with a longitudinal axial rotation range of plus or minus 3 degrees (total of 6 degrees) before oppositely directed movement of the articulating surfaces occurs.
It should be noted that in the preferred embodiment, and in other preferable embodiments where the constant radius of curvature A of concave arc 212 is larger than the constant radius of curvature C of convex arc 312, and the constant radius of curvature D of concave arc 314 is larger than the constant radius of curvature B of convex arc 214, the articulation surfaces 204, 304 maintain point-to-point contact over a range of normal physiologic articulating movement between the adjacent vertebral bones. This is illustrated in Figures 4, 5, 20, and 21. More particularly, it is understood from the described geometry and positioning of the upper 200 and lower 300 elements that through flexion, extension, lateral bending, and axial rotation, the articulation surfaces 204, 304 are in point-to-point contact with one another as they are in Figures 4 and 5. Figures 20 and 21 are provided to show the implant 100 in extension and lateral bending, respectively, to further illustrate this preferable feature.
It should further be noted that in addition to the radii of curvature dimensions of the articulation surfaces 204, 304 being relevant to a configuration and sizing of the articulation surfaces 204, 304 permitting normal physiologic flexion, extension, lateral bending, and axial rotation movements of the adjacent vertebral bones, the surface area dimensions are also relevant, particularly in relation to the selected radii of curvature. More particularly, in order to provide a range of relative angulation that is within the normal physiologic range of the cervical spine, not only must the selected radii of curvature be suitable as described above, but also and accordingly the surface area of the saddle surfaces should be of a dimension that, given the selected radii of curvature, prevents the edges of the saddle surfaces (particularly the edges of the concave arcs (e.g., 212 and e.g., 314)) from hitting any surrounding anatomic structures, or other portions of the opposing element (200 or 300), before the limit of the normal physiologic range of the attempted articulation is reached. As shown, one or both of the inwardly facing surfaces of the upper 200 and lower 300 elements can be tapered inwardly before presenting its articulation surface (204 or 304), to ensure a suitable surface area dimension to prevent such interference. While the present invention is not limited to any particular surface area dimensions, the illustrated preferred embodiment has a surface area of articulation surface 204 equal to 0.146 square inches, and a surface area of articulation surface 304 equal to 0.153 square inches.
Further preferably, the articulation surfaces 204, 304 are formed of cobalt-chrome that is polished to provide a smooth bearing surface. It should be understood that the articulation surfaces 204, 304, while preferably formed of cobalt-chrome, can be additionally or alternatively formed of other metals, such as, for example, stainless steel and/or titanium, or of non-metals, such as, for example, polyethylene and/or ceramic materials (e.g., alumina and zirconia), or of any other suitable material without departing from the scope of the present invention.
It should be noted that while the present invention is illustrated and described as an artificial disc implant for use in the cervical spine, the artificial disc implant of the present invention can be adapted for use in any other portion of the spine without departing from the scope of the present invention.
While the particular prostheses for the cervical intervertebral joint of the spine as herein shown and disclosed in detail are each fully capable of obtaining the objects and providing the advantages previously stated, it shall be understood that these variations are merely illustrative of the presently preferred embodiments of the invention and that no limitations to the scope of the present invention are intended to be inferred from the details of the construction or design herein shown.
Claims (165)
1. An articulating joint implant for use in a spinal column comprising:
a first element having an upper surface for seating against an endplate of a superior vertebral body and a lower articulating surface, the entirety of said lower articulating surface being a single saddle surface that is defined by a concave arc having a substantially constant radius of curvature A about a first axis perpendicular to an anterior-posterior plane of the spinal column, and a convex arc having a substantially constant radius of curvature B
about a first axis perpendicular to a lateral plane of the spinal column; and a second element having a lower surface for seating against an endplate of an inferior vertebral body and an upper articulating surface, the entirety of said upper articulating surface being a single saddle surface that is defined by a convex arc having a substantially constat-t radius of curvature C about a second axis perpendicular to the anterior-posterior plane of the spinal column, and a concave arc having a substantially constant radius of curvature D about a second axis perpendicular to the lateral plane of the spinal column, said constant radius of curvature A being greater than said constant radius of curvature C and said constant radius of curvature B being less than said constant radius of curvature D;
wherein the saddle surface of the first element and the saddle surface of the second element are nestable with one another and articulatable against one another in flexion/extension in an anterior-posterior plane of the spinal column and in lateral bending in a lateral plane of the spinal column.
a first element having an upper surface for seating against an endplate of a superior vertebral body and a lower articulating surface, the entirety of said lower articulating surface being a single saddle surface that is defined by a concave arc having a substantially constant radius of curvature A about a first axis perpendicular to an anterior-posterior plane of the spinal column, and a convex arc having a substantially constant radius of curvature B
about a first axis perpendicular to a lateral plane of the spinal column; and a second element having a lower surface for seating against an endplate of an inferior vertebral body and an upper articulating surface, the entirety of said upper articulating surface being a single saddle surface that is defined by a convex arc having a substantially constat-t radius of curvature C about a second axis perpendicular to the anterior-posterior plane of the spinal column, and a concave arc having a substantially constant radius of curvature D about a second axis perpendicular to the lateral plane of the spinal column, said constant radius of curvature A being greater than said constant radius of curvature C and said constant radius of curvature B being less than said constant radius of curvature D;
wherein the saddle surface of the first element and the saddle surface of the second element are nestable with one another and articulatable against one another in flexion/extension in an anterior-posterior plane of the spinal column and in lateral bending in a lateral plane of the spinal column.
2. The articulating joint implant set forth in claim 1, wherein the first element further includes an anterior flange including at least one through hole for receiving a bone screw.
3. The articulating joint implant set forth in claim 2, wherein the anterior flange of the first element extends above the upper surface of the first element.
4. The articulating joint implant set forth in claim 1, wherein the second element further includes an anterior flange including at least one through hole for receiving a bone screw.
5. The articulating joint implant set forth in claim 4, herein the anterior flange of the second element extends below the lower surface of the second implant.
6. The articulating joint implant set forth in claim 1, wherein the first and second elements each further include an anterior flange including at least one through hole for receiving a bone screw.
7. The articulating joint implant set forth in claim 6, wherein the anterior flange of one of the first and second elements includes at least two through holes for receiving bone screws.
8. The articulating joint implant set forth in claim 1, wherein at least one of: (i) the first and second axes perpendicular to the anterior-posterior plane of the spinal column are coaxial; and (ii) the first and second axes perpendicular to the lateral plane of the spinal column are coaxial.
9. The articulating joint implant set forth in claim 1, wherein at least one of: (i) the first and second axes perpendicular to the anterior-posterior plane of the spinal column are coplanar, and (ii) the first and second axes perpendicular to the lateral plane of the spinal column are coplanar.
10. The articulating joint implant as set forth in claim 1, wherein the first element has a center of rotation that remains below said articulating surfaces during flexion/extension in the anterior-posterior plane of the spinal column and that remains above said articulating surfaces during lateral bending in the lateral plane of the spinal column.
11. An apparatus for replacing at least a portion of an intervertebral disc in a spinal column, comprising:
a first member having a first vertebral contact surface for engagement with an endplate of a first vertebral bone in the spinal column and a first articulating surface, the entirety of the first articulating surface being a single saddle surface that is defined by a concave arc having a substantially constant radius of curvature A about a first axis perpendicular to an axis passing through leading and trailing ends of the first member and a convex arc having a substantially constant radius of curvature B about a first axis perpendicular to an axis passing through lateral ends of the first member;
a second member having a second vertebral contact surface for engagement with an endplate of a second vertebral bone in the spinal column, and a second articulating surface in contact with the first articulating surface, the entirety of the second articulating surface being a single saddle surface that is defined by a convex arc having a substantially constant radius of curvature C about a first axis perpendicular to an axis passing through leading and trailing ends of the second member and a concave arc having a substantially constant radius of curvature D
about a second axis perpendicular to an axis passing through lateral ends of the second member, wherein the constant radius of curvature A is non-congruent with the constant radius of curvature C and the constant radius of curvature B is non-congruent with the constant radius of curvature D;
an intervertebral disc space is defined substantially between the first and second endplates of the first and second vertebral bones; and the first and second members are operable to articulate relative to one another, when disposed in the intervertebral disc space, about at least one of: (i) a first center of rotation for at least one of flexion and extension that is located above the first and second articulating surfaces, and (ii) a second center of rotation for lateral bending that is located below the first and second articulating surfaces.
a first member having a first vertebral contact surface for engagement with an endplate of a first vertebral bone in the spinal column and a first articulating surface, the entirety of the first articulating surface being a single saddle surface that is defined by a concave arc having a substantially constant radius of curvature A about a first axis perpendicular to an axis passing through leading and trailing ends of the first member and a convex arc having a substantially constant radius of curvature B about a first axis perpendicular to an axis passing through lateral ends of the first member;
a second member having a second vertebral contact surface for engagement with an endplate of a second vertebral bone in the spinal column, and a second articulating surface in contact with the first articulating surface, the entirety of the second articulating surface being a single saddle surface that is defined by a convex arc having a substantially constant radius of curvature C about a first axis perpendicular to an axis passing through leading and trailing ends of the second member and a concave arc having a substantially constant radius of curvature D
about a second axis perpendicular to an axis passing through lateral ends of the second member, wherein the constant radius of curvature A is non-congruent with the constant radius of curvature C and the constant radius of curvature B is non-congruent with the constant radius of curvature D;
an intervertebral disc space is defined substantially between the first and second endplates of the first and second vertebral bones; and the first and second members are operable to articulate relative to one another, when disposed in the intervertebral disc space, about at least one of: (i) a first center of rotation for at least one of flexion and extension that is located above the first and second articulating surfaces, and (ii) a second center of rotation for lateral bending that is located below the first and second articulating surfaces.
12. The apparatus of claim 11, wherein:
the first articulation surface has a toroidal saddle shape; and the second articulation surface has a toroidal saddle shape, wherein the first and second articulation surfaces are sized and shaped to engage one another when the first and second members are disposed in the intervertebral disc space to enable at least one of flexion, extension, and lateral bending.
the first articulation surface has a toroidal saddle shape; and the second articulation surface has a toroidal saddle shape, wherein the first and second articulation surfaces are sized and shaped to engage one another when the first and second members are disposed in the intervertebral disc space to enable at least one of flexion, extension, and lateral bending.
13. The apparatus of claim 11, wherein the first and second articulation surfaces are sized and shaped to engage one another when the first and second members are disposed in the intervertebral disc space to enable the first and second vertebral bones to at least axially rotate relative to one another through a range of angles.
14. The apparatus of claim 13, wherein the radius A of the concave arc is greater than the radius C of the convex arc in order to permit axial rotation of the first and second vertebral bones relative to one another.
15. The apparatus of claim 13, wherein the radius D of the concave arc is greater than the radius B of the convex arc in order to permit axial rotation of the first and second vertebral bones relative to one another.
16. The apparatus of claim 13, wherein the first and second articulation surfaces are sized and shaped to achieve substantial point-to-point contact relative to one another when the spinal column is in at least some positions of flexion, extension, lateral bending, and/or axial rotation.
17. The apparatus of claim 13, wherein the first and second articulation surfaces are sized and shaped to engage one another when the first and second members are disposed in the intervertebral disc space to enable the first and second vertebral bones to axially rotate relative to one another through the range of angles without substantially displacing the first and second vertebral bones away from one another.
18. The apparatus of claim 17, wherein the range of angles is about plus/minus three degrees from a resting position.
19. The apparatus of claim 17, wherein the first and second articulation surfaces are sized and shaped such that the first and second vertebral bones are displaced away from one another at axial rotations outside the range of angles.
20. The apparatus of claim 11, wherein at least one of; (i) the first and second axes perpendicular to the axis passing through the leading and trailing ends are substantially coaxial;
and (ii) the first and second axes perpendicular to the axis passing through the lateral ends are substantially coaxial.
and (ii) the first and second axes perpendicular to the axis passing through the lateral ends are substantially coaxial.
21. The apparatus of claim 11, wherein at least one of: (i) the first and second axes perpendicular to the axes passing through the leading and trailing ends lie in a plane that is substantially perpendicular to the anterior-posterior plane; and (ii) the first and second axes perpendicular to the axes passing through the lateral ends lie in a plane that is substantially perpendicular to the lateral plane.
22. An apparatus for replacing at least a portion of an intervertebral disc in a spinal column, comprising:
a first means having a first surface for engagement with an endplate of a first vertebral bone in the spinal column;
a second means having a second surface for engagement with an endplate of a second vertebral bone in the spinal column, wherein the first and second means have opposing first and second articulating surfaces that are in contact with one another, the entirety of the first articulating surface being a single saddle surface that is defined by a concave arc having a substantially constant radius of curvature A about a first axis perpendicular to an axis passing through leading and trailing ends of the first means and a convex arc having a substantially constant radius of curvature B about a first axis perpendicular to an axis passing through lateral ends of the first means, the entirety of the second articulating surface being a single saddle surface that is defined by a convex arc having a substantially constant radius of curvature C
about a first axis perpendicular to an axis passing through leading and trailing ends of the second means and concave arc having a substantially constant radius of curvature D
about a second axis perpendicular to an axis passing through lateral ends of the second means, the constant radius of curvature A being non-congruent with the constant radius of curvature C and the constant radius of curvature B being non-congruent with the constant radius of curvature D;
an intervertebral disc space is defined substantially between the first and second endplates of the first and second vertebral bones, and the first and second means are operable to articulate relative to one another, when the first and second means are disposed in the intervertebral disc space, about at least one of: (i) a first center of rotation for at least one of flexion and extension that is located above the first and second articulating surfaces, and (ii) a second center of rotation for lateral bending that is located below the first and second articulating surfaces.
a first means having a first surface for engagement with an endplate of a first vertebral bone in the spinal column;
a second means having a second surface for engagement with an endplate of a second vertebral bone in the spinal column, wherein the first and second means have opposing first and second articulating surfaces that are in contact with one another, the entirety of the first articulating surface being a single saddle surface that is defined by a concave arc having a substantially constant radius of curvature A about a first axis perpendicular to an axis passing through leading and trailing ends of the first means and a convex arc having a substantially constant radius of curvature B about a first axis perpendicular to an axis passing through lateral ends of the first means, the entirety of the second articulating surface being a single saddle surface that is defined by a convex arc having a substantially constant radius of curvature C
about a first axis perpendicular to an axis passing through leading and trailing ends of the second means and concave arc having a substantially constant radius of curvature D
about a second axis perpendicular to an axis passing through lateral ends of the second means, the constant radius of curvature A being non-congruent with the constant radius of curvature C and the constant radius of curvature B being non-congruent with the constant radius of curvature D;
an intervertebral disc space is defined substantially between the first and second endplates of the first and second vertebral bones, and the first and second means are operable to articulate relative to one another, when the first and second means are disposed in the intervertebral disc space, about at least one of: (i) a first center of rotation for at least one of flexion and extension that is located above the first and second articulating surfaces, and (ii) a second center of rotation for lateral bending that is located below the first and second articulating surfaces.
23. An apparatus for replacing at least a portion of an intervertebral disc in a spinal column, comprising:
a first member having a first vertebral contact surface for engagement with an endplate of a first vertebral bone in the spinal column, and having a first articulation means, the entirety of the first articulating means being a single saddle surface that is defined by a concave arc having a substantially constant radius of curvature A about a first axis perpendicular to an axis passing through leading and trailing ends of the first member and a convex arc having a substantially constant radius of curvature B about a first axis perpendicular to an axis passing through lateral ends of the first member; and a second member having a second vertebral contact surface for engagement with an endplate of a second vertebral bone in the spinal column, and having a second articulation means the entirety of the second articulating means being a single saddle surface that is defined by a convex arc having a substantially constant radius of curvature C about a first axis perpendicular to an axis passing through leading and trailing ends of the second member and a concave arc having a substantially constant radius of curvature D about a second axis perpendicular to an axis passing through lateral ends of the second member, wherein the constant radius of curvature A is non-congruent with the constant radius of curvature C and the constant radius of curvature B is non-congruent with the constant radius of curvature D;
an intervertebral disc space is defined substantially between the first and second endplates of the first and second vertebral bones, and the first and second articulation means are operable to articulate relative to one another, when the first and second members are disposed in the intervertebral disc space, about at least one of (i) a first center of rotation for at least one of flexion and extension that is located above the first and second articulation means, and (ii) a second center of rotation for lateral bending that is located space below the first and second articulation means.
a first member having a first vertebral contact surface for engagement with an endplate of a first vertebral bone in the spinal column, and having a first articulation means, the entirety of the first articulating means being a single saddle surface that is defined by a concave arc having a substantially constant radius of curvature A about a first axis perpendicular to an axis passing through leading and trailing ends of the first member and a convex arc having a substantially constant radius of curvature B about a first axis perpendicular to an axis passing through lateral ends of the first member; and a second member having a second vertebral contact surface for engagement with an endplate of a second vertebral bone in the spinal column, and having a second articulation means the entirety of the second articulating means being a single saddle surface that is defined by a convex arc having a substantially constant radius of curvature C about a first axis perpendicular to an axis passing through leading and trailing ends of the second member and a concave arc having a substantially constant radius of curvature D about a second axis perpendicular to an axis passing through lateral ends of the second member, wherein the constant radius of curvature A is non-congruent with the constant radius of curvature C and the constant radius of curvature B is non-congruent with the constant radius of curvature D;
an intervertebral disc space is defined substantially between the first and second endplates of the first and second vertebral bones, and the first and second articulation means are operable to articulate relative to one another, when the first and second members are disposed in the intervertebral disc space, about at least one of (i) a first center of rotation for at least one of flexion and extension that is located above the first and second articulation means, and (ii) a second center of rotation for lateral bending that is located space below the first and second articulation means.
24. An apparatus for replacing at least a portion of an intervertebral disc in a spinal column, comprising:
a first member having a first vertebral contact surface for engagement with an endplate of a first vertebral bone in the spinal column, and having a first articulation surface; and a second member having a second vertebral contact surface for engagement with an endplate of a second vertebral bone in the spinal column, and having a second articulation surface, wherein:
an intervertebral disc space is defined substantially between the first and second endplates of the first and second vertebral bones, and each of the first and second articulation surfaces having a toroidal saddle shaped surface, and the articulation surfaces are sized and shaped to engage one another when the first and second members are disposed in the intervertebral disc space to enable the first and second vertebral bones to articulate in at least one of flexion, extension, and lateral bending, wherein the engaging articulation surfaces include opposing constant radius of curvature surfaces that are non-congruent.
a first member having a first vertebral contact surface for engagement with an endplate of a first vertebral bone in the spinal column, and having a first articulation surface; and a second member having a second vertebral contact surface for engagement with an endplate of a second vertebral bone in the spinal column, and having a second articulation surface, wherein:
an intervertebral disc space is defined substantially between the first and second endplates of the first and second vertebral bones, and each of the first and second articulation surfaces having a toroidal saddle shaped surface, and the articulation surfaces are sized and shaped to engage one another when the first and second members are disposed in the intervertebral disc space to enable the first and second vertebral bones to articulate in at least one of flexion, extension, and lateral bending, wherein the engaging articulation surfaces include opposing constant radius of curvature surfaces that are non-congruent.
25. The apparatus of claim 24, wherein the second articulation surface is defined by at least one bearing surface for engaging respective portions of the first articulation surface when the first and second members are disposed in the intervertebral disc space to enable the first and second vertebral bones to articulate in at least one of flexion, extension, and lateral bending.
26. The apparatus of claim 24, wherein each of the saddle shaped articulation surfaces is defined by at least one bearing surface that cooperates to engage respective portions of the other articulation surface when the first and second members are disposed in the intervertebral disc space to enable the first and second vertebral bones to articulate in at least one of flexion, extension, and lateral bending.
27. The apparatus of claim 26, wherein the at least one bearing surface defines a contiguous saddle shaped articulation surface.
28. The apparatus of claim 24, wherein the toroidal saddle shaped articulation surfaces comprise:
the first articulation surface including a concave arc having a radius of curvature A about a first axis substantially perpendicular to an anterior-posterior plane of the spinal column, and a convex arc having a radius of curvature B about a first axis substantially perpendicular to a lateral plane of the spinal column; and the second articulation surface including a convex arc having a radius of curvature C
about a second axis substantially perpendicular to the anterior-posterior plane of the spinal column, and a concave arc having a radius of curvature D about a second axis substantially perpendicular to the lateral plane of the spinal column.
the first articulation surface including a concave arc having a radius of curvature A about a first axis substantially perpendicular to an anterior-posterior plane of the spinal column, and a convex arc having a radius of curvature B about a first axis substantially perpendicular to a lateral plane of the spinal column; and the second articulation surface including a convex arc having a radius of curvature C
about a second axis substantially perpendicular to the anterior-posterior plane of the spinal column, and a concave arc having a radius of curvature D about a second axis substantially perpendicular to the lateral plane of the spinal column.
29. The apparatus of claim 24, wherein the first and second articulation surfaces are sized and shaped to engage one another when the first and second members are disposed in the intervertebral disc space to enable the first and second vertebral bones to at least axially rotate relative to one another through a range of angles.
30. The apparatus of claim 24, wherein the first and second articulation surfaces are sized and shaped to engage one another when the first and second members are disposed in the intervertebral disc space to enable the first and second vertebral bones to axially rotate relative to one another through a range of angles without substantially displacing the first and second vertebral bones away from one another.
31. The apparatus of claim 30, wherein the first and second articulation surfaces are sized and shaped such that the first and second vertebral bones are substantially displaced away from one another at axial rotations outside the range of angles.
32. A use of an apparatus for replacing at least a portion of an intervertebral disc in an intervertebral disc space defined substantially between adjacent vertebral bones of a spinal column, the apparatus comprising a first member having a first vertebral contact surface for engagement with an endplate of a first of the vertebral bones in the spinal column and a first articulating surface, the entirety of the first articulating surface being a single saddle surface that is defined by a concave arc having a substantially constant radius of curvature A about a first axis perpendicular to an anterior-posterior plane of the spinal column, and a convex arc having a substantially constant radius of curvature B about a first axis perpendicular to a lateral plane of the spinal column;
the apparatus comprising a second member having a second vertebral contact surface for engagement with an endplate of a second of the vertebral bones in the spinal column and a second articulating surface, the entirety of the second articulating surface being a single saddle surface that is defined by a convex arc having a substantially constant radius of curvature C
about a second axis perpendicular to the anterior-posterior plane of the spinal column, and a concave arc having a substantially constant radius of curvature D about a second axis perpendicular to the lateral plane of the spinal column, said constant radius of curvature A being greater than said constant radius of curvature C and said constant radius of curvature B being less than said constant radius of curvature D; and the first and second members are operable to articulate with respect to one another to permit flexion and extension in an anterior-posterior plane of the spinal column, and to permit lateral bending in a lateral plane of the spinal column, respectively, wherein the apparatus is operable to permit the adjacent vertebral bones to articulate relative to one another about at least one of: (i) a first center of rotation for at least one of flexion and extension that is located below the articulating surfaces, and (ii) a second center of rotation for lateral bending that is located above the articulating surfaces.
the apparatus comprising a second member having a second vertebral contact surface for engagement with an endplate of a second of the vertebral bones in the spinal column and a second articulating surface, the entirety of the second articulating surface being a single saddle surface that is defined by a convex arc having a substantially constant radius of curvature C
about a second axis perpendicular to the anterior-posterior plane of the spinal column, and a concave arc having a substantially constant radius of curvature D about a second axis perpendicular to the lateral plane of the spinal column, said constant radius of curvature A being greater than said constant radius of curvature C and said constant radius of curvature B being less than said constant radius of curvature D; and the first and second members are operable to articulate with respect to one another to permit flexion and extension in an anterior-posterior plane of the spinal column, and to permit lateral bending in a lateral plane of the spinal column, respectively, wherein the apparatus is operable to permit the adjacent vertebral bones to articulate relative to one another about at least one of: (i) a first center of rotation for at least one of flexion and extension that is located below the articulating surfaces, and (ii) a second center of rotation for lateral bending that is located above the articulating surfaces.
33. The use of claim 32, wherein the first center of rotation is associated with the articulation of the first and second members in flexion and extension in the anterior-posterior plane of the spinal column.
34. The use of claim 32, wherein the second center of rotation is associated with the articulation of the first and second members in lateral bending in the lateral plane of the spinal column.
35. The use of claim 33, wherein at least one of: (i) the first and second axes perpendicular to the anterior-posterior plane of the spinal column are substantially coaxial;
and (ii) the first and second axes perpendicular to the lateral plane of the spinal column are substantially coaxial.
and (ii) the first and second axes perpendicular to the lateral plane of the spinal column are substantially coaxial.
36. The use of claim 34, wherein at least one of: (i) the first and second axes perpendicular to the anterior-posterior plane of the spinal column lie in a plane that is substantially perpendicular to the anterior-posterior plane; and (ii) the first and second axes perpendicular to the lateral plane of the spinal column lie in a plane that is substantially perpendicular to the lateral plane.
37. The use of claim 34, wherein the first member includes an anterior flange including at least one through hole, and the method further comprises inserting at least one bone screw through the at least one through hole to fasten the first member to the first vertebral bone.
38. The use of claim 37, wherein the anterior flange of the first member includes at least two through holes, and the method further comprises inserting a bone screw through each of the through holes to fasten the first member to the first vertebral bone.
39. The use of claim 34, wherein- the second member includes an anterior flange including at least one through hole, and the method further comprises inserting at least one bone screw through the at least one through hole to fasten the second member to the second vertebral bone.
40. The use of claim 34, wherein at least one of the first and second members further includes a curvate surface formed on its vertebral contact surface, and the method further comprises positioning the curvate surface to interface with a curvate portion of the endplate of the vertebral bone against which the vertebral contact surface is disposed.
41. The use of claim 34, wherein at least one of the first and second members further includes at least one spike formed on its vertebral contact surface, and the method further comprises urging the spike into the endplate of the vertebral bone against which the vertebral contact surface is disposed.
42. The use of claim 34, wherein the apparatus is operable to permit the first and second vertebral bones to at least axially rotate relative to one another through a range of angles.
43. The use of claim 42, wherein the apparatus is operable to permit the first and second vertebral bones to axially rotate relative to one another through the range of angles without substantially displacing the first and second vertebral bones away from one another.
44. The use of claim 43, wherein the range of angles is about plus/minus three degrees from a resting position.
45. The use of claim 43, wherein the apparatus is operable to permit the first and second vertebral bones to displace away from one another at axial rotations outside the range of angles.
46. A use of an apparatus for replacing at least a portion of an intervertebral disc in a spinal column, the apparatus comprising:
a first member having a first vertebral contact surface for engagement with an endplate of a first of the vertebral bones in the spinal column, and a first articulation surface, the entirety of the first articulation surface being a single saddle surface that is defined by a concave arc having a substantially constant radius of curvature A about an axis perpendicular to leading and trailing ends of the first member and a convex arc having a substantially constant radius of curvature B
about an axis perpendicular to lateral sides of the first member; the apparatus further comprising a second member having a second vertebral contact surface for engagement with an endplate of a second of the vertebral bones in the spinal column, and a second articulation surface, the entirety of the second articulation surface being a single saddle surface that is defined by a convex arc having a substantially constant radius of curvature C about an axis perpendicular to leading and trailing ends of the second member and a concave arc having a substantially constant radius of curvature D about an axis perpendicular to lateral sides of the second member, wherein the constant radius of curvature A is non-congruent with the constant radius of curvature C and the constant radius of curvature B is non-congruent with the constant radius of curvature D, and wherein the first and second articulation surfaces are operable to engage one another to permit flexion and extension in the anterior-posterior plane of the spinal column, lateral bending in the lateral plane of the spinal column, and axial rotation through a range of angles without permitting the vertebral bones to substantially move in directions directed away from one another along a longitudinal axis of the spinal column,
a first member having a first vertebral contact surface for engagement with an endplate of a first of the vertebral bones in the spinal column, and a first articulation surface, the entirety of the first articulation surface being a single saddle surface that is defined by a concave arc having a substantially constant radius of curvature A about an axis perpendicular to leading and trailing ends of the first member and a convex arc having a substantially constant radius of curvature B
about an axis perpendicular to lateral sides of the first member; the apparatus further comprising a second member having a second vertebral contact surface for engagement with an endplate of a second of the vertebral bones in the spinal column, and a second articulation surface, the entirety of the second articulation surface being a single saddle surface that is defined by a convex arc having a substantially constant radius of curvature C about an axis perpendicular to leading and trailing ends of the second member and a concave arc having a substantially constant radius of curvature D about an axis perpendicular to lateral sides of the second member, wherein the constant radius of curvature A is non-congruent with the constant radius of curvature C and the constant radius of curvature B is non-congruent with the constant radius of curvature D, and wherein the first and second articulation surfaces are operable to engage one another to permit flexion and extension in the anterior-posterior plane of the spinal column, lateral bending in the lateral plane of the spinal column, and axial rotation through a range of angles without permitting the vertebral bones to substantially move in directions directed away from one another along a longitudinal axis of the spinal column,
47. The use of claim 46, wherein the apparatus for replacing the portion of the intervertebral disc is further operable to cause the vertebral bones to displace from one another at axial rotations outside the range of angles.
48. The use of claim 46, wherein the first member includes an anterior flange including at least one through hole, and the method further comprises inserting at least one bone screw through the at least one through hole to fasten the first member to the first vertebral bone.
49. The use of claim 48, wherein the anterior flange of the first member includes at least two through holes, and the method further comprises inserting a bone screw through each of the through holes to fasten the first member to the first vertebral bone.
50. The use of claim 46, wherein the second member includes an anterior flange including at least one through hole, and the method farther comprises inserting at least one bone screw through the at least one through hole to fasten the second member to the second vertebral bone.
51. The use of claim 46, wherein at least one of the first and second members further includes a curvate surface formed on its vertebral contact surface, and the method further comprises positioning the curvate surface to interface with a curvate portion of the endplate of the vertebral bone against which the vertebral contact surface is disposed.
52. The use of claim 46, wherein at least one of the first and second members further includes at least one spike formed on its vertebral contact surface, and the method further comprises urging the spike into the endplate of the vertebral bone against which the vertebral contact surface is disposed.
53. The use of claim 46, wherein the articulation surfaces are non-congruent in shape and maintain substantial point-to-point contact over a range of articulating movement between the vertebral bones.
54. The use of claim 46, wherein at least one of (i) the axis perpendicular to leading and trailing ends of the first member and the axis perpendicular to leading and trailing ends of the second member are substantially coaxial, and (ii) the axis perpendicular to lateral sides of the first member and the axis perpendicular to lateral sides of the second member are substantially coaxial.
55. The use of claim 46, wherein the first and second articulation surfaces are saddle shaped such that they are operable to engage when the first and second members are disposed in the intervertebral disc space to articulate in at least one of flexion, extension, lateral bending, and axial rotation.
56. The use of claim 46, wherein the range of angles is about plus/minus three degrees from a resting position.
57. The use of claim 46, wherein the apparatus is operable to permit the vertebral bones to displace away from one another at axial rotations outside the range of angles.
58. A use of an apparatus for replacing at least a portion of an intervertebral disc in a spinal column, the apparatus for replacing the portion of the intervertebral disc comprising:
(i) a first member having a first vertebral contact surface for engagement with an endplate of a first vertebral bone in the spinal column, and having a first saddle shaped articulation surface, the entirety of the first saddle shaped articulation surface being defined by a concave arc having a substantially constant radius of curvature A about an axis perpendicular to leading and trailing ends of the first member and a convex arc having a substantially constant radius of curvature B about an axis perpendicular to lateral sides of the first member, and (ii) a second member having a second vertebral contact surface for engagement with an endplate of a second vertebral bone in the spinal column, and having a second saddle shaped articulation surface, the entirety of the second saddle shaped articulation surface being defined by a convex arc having a substantially constant radius of curvature C about an axis perpendicular to leading and trailing ends of the second member and a concave arc having a substantially constant radius of curvature D about an axis perpendicular to lateral sides of the second member, wherein the constant radius of curvature A is larger than the constant radius of curvature C and the constant radius of curvature B is larger than the constant radius of curvature D;
an intervertebral disc space is defined substantially between the first and second endplates of the first and second vertebral bones, wherein the first and second articulation surfaces are sized and shaped to engage one another when the first and second members are disposed in the intervertebral disc space to enable the first and second vertebral bones to articulate in at least one of flexion, extension and lateral bending.
(i) a first member having a first vertebral contact surface for engagement with an endplate of a first vertebral bone in the spinal column, and having a first saddle shaped articulation surface, the entirety of the first saddle shaped articulation surface being defined by a concave arc having a substantially constant radius of curvature A about an axis perpendicular to leading and trailing ends of the first member and a convex arc having a substantially constant radius of curvature B about an axis perpendicular to lateral sides of the first member, and (ii) a second member having a second vertebral contact surface for engagement with an endplate of a second vertebral bone in the spinal column, and having a second saddle shaped articulation surface, the entirety of the second saddle shaped articulation surface being defined by a convex arc having a substantially constant radius of curvature C about an axis perpendicular to leading and trailing ends of the second member and a concave arc having a substantially constant radius of curvature D about an axis perpendicular to lateral sides of the second member, wherein the constant radius of curvature A is larger than the constant radius of curvature C and the constant radius of curvature B is larger than the constant radius of curvature D;
an intervertebral disc space is defined substantially between the first and second endplates of the first and second vertebral bones, wherein the first and second articulation surfaces are sized and shaped to engage one another when the first and second members are disposed in the intervertebral disc space to enable the first and second vertebral bones to articulate in at least one of flexion, extension and lateral bending.
59. An apparatus for replacing at least a portion of an intervertebral disc in a spinal column, comprising:
a first member having a first vertebral contact surface for engagement with an endplate of a first vertebral bone in the spinal column, and having a first articulation surface that is a single toroidal saddle shaped surface including a first concave arc extending from the leading end to the trailing end of the first articulation surface and a first convex arc extending from the first lateral end to the second lateral end of the first articulation surface; and a second member having a second vertebral contact surface for engagement with an endplate of a second vertebral bone in the spinal column, and having a second articulation surface that is a single toroidal saddle shaped surface including a second convex arc extending from the leading end to the trailing end of the second articulation surface and a second concave arc extending first lateral end to the second lateral end of the second articulation surface, wherein the first concave arc has a radius that is greater than the radius of the second convex arc and the second concave arc has a radius that is greater than the radius of the first convex arc, wherein:, an intervertebral disc space is defined substantially between the first and second endplates of the first and second vertebral bones, and the first and second articulation surfaces are sized and shaped to engage one another when the first and second members are disposed in the intervertebral disc space to enable the first and second vertebral bones to articulate in at least one of flexion, extension and lateral bending.
a first member having a first vertebral contact surface for engagement with an endplate of a first vertebral bone in the spinal column, and having a first articulation surface that is a single toroidal saddle shaped surface including a first concave arc extending from the leading end to the trailing end of the first articulation surface and a first convex arc extending from the first lateral end to the second lateral end of the first articulation surface; and a second member having a second vertebral contact surface for engagement with an endplate of a second vertebral bone in the spinal column, and having a second articulation surface that is a single toroidal saddle shaped surface including a second convex arc extending from the leading end to the trailing end of the second articulation surface and a second concave arc extending first lateral end to the second lateral end of the second articulation surface, wherein the first concave arc has a radius that is greater than the radius of the second convex arc and the second concave arc has a radius that is greater than the radius of the first convex arc, wherein:, an intervertebral disc space is defined substantially between the first and second endplates of the first and second vertebral bones, and the first and second articulation surfaces are sized and shaped to engage one another when the first and second members are disposed in the intervertebral disc space to enable the first and second vertebral bones to articulate in at least one of flexion, extension and lateral bending.
60. The apparatus of claim 59, wherein the first and second articulation surfaces are sized and shaped to define at least one of: (i) a first center of rotation for at least one of flexion and extension that is located outside the intervertebral disc space, and (ii) a second center of rotation for lateral bending that is located outside the intervertebral disc space.
61. The apparatus of claim 60, wherein the first center of rotation is located outside the intervertebral disc space in one direction and the second center of rotation is located outside the intervertebral disc space in an opposite direction.
62. The apparatus of claim 59, wherein the first and second articulation surfaces are formed from one or more metals or metal alloys to achieve metal-to-metal engagement.
63. The apparatus of claim 62, wherein the one or more metals or metal alloys are selected from the group consisting of cobalt, chromium, stainless steel, and titanium.
64. The apparatus of claim 59, wherein at least one of the first and second articulation surfaces are formed from one or more non-metals.
65. The apparatus of claim 64, wherein the one or more non-metals are taken from the group consisting of polymers and ceramic materials.
66. An apparatus for replacing at least a portion of an intervertebral disc of a spinal column, comprising:
a first member having a first vertebral contact surface for engagement with an endplate of a first vertebral bone, and having a first articulation surface that is a single saddle shaped surface including a single concave arc extending from the leading end to the trailing end of the first articulation surface and a single convex arc extending from the first lateral end to the second lateral end of the first articulation surface; and a second member having a second vertebral contact surface for engagement with an endplate of a second vertebral bone, and having a second articulation surface that is a single saddle shaped surface including a single convex arc extending from the leading end to the trailing end of the second articulation surface and a single concave arc extending from the first lateral end to the second lateral end of the second articulation surface, wherein:
an intervertebral disc space is defined substantially between the first and second endplates of the first and second vertebral bones, and the first and second saddle shaped articulation surfaces are sized and shaped to engage one another when the first and second members are disposed in the intervertebral disc space to enable the first and second vertebral bones to at least axially rotate relative to one another through a range of angles, wherein the single concave arc of the first articulation surface has a radius that is greater than the single convex arc of the second articulation surface and the single concave arc of the second articulation surface has a radius that is greater than the radius of the single convex arc of the first articulation surface.
a first member having a first vertebral contact surface for engagement with an endplate of a first vertebral bone, and having a first articulation surface that is a single saddle shaped surface including a single concave arc extending from the leading end to the trailing end of the first articulation surface and a single convex arc extending from the first lateral end to the second lateral end of the first articulation surface; and a second member having a second vertebral contact surface for engagement with an endplate of a second vertebral bone, and having a second articulation surface that is a single saddle shaped surface including a single convex arc extending from the leading end to the trailing end of the second articulation surface and a single concave arc extending from the first lateral end to the second lateral end of the second articulation surface, wherein:
an intervertebral disc space is defined substantially between the first and second endplates of the first and second vertebral bones, and the first and second saddle shaped articulation surfaces are sized and shaped to engage one another when the first and second members are disposed in the intervertebral disc space to enable the first and second vertebral bones to at least axially rotate relative to one another through a range of angles, wherein the single concave arc of the first articulation surface has a radius that is greater than the single convex arc of the second articulation surface and the single concave arc of the second articulation surface has a radius that is greater than the radius of the single convex arc of the first articulation surface.
67. The apparatus of claim 66, wherein the first and second articulation surfaces are sized and shaped to achieve substantial point-to-point contact relative to one another when in at least some positions of flexion, extension, lateral bending, and/or axial rotation.
68. The apparatus of claim 66, wherein:
the single concave arc of the first saddle shaped articulation surface has a radius A about a first axis substantially perpendicular to an anterior-posterior plane of the spinal column, and the single convex arc of the first saddle shaped articulating surface has a radius B about a first axis substantially perpendicular to a lateral plane of the spinal column;
the single convex arc of the second saddle, shaped articulation surface has a radius C
about a second axis substantially perpendicular to the anterior-posterior plane of the spinal column, and the single concave arc of the second saddle shaped articulation surface has a radius D about a second axis substantially perpendicular to the lateral plane of the spinal column; and the radius A of the single concave arc of the first articulation surface is greater than the radius C of the single convex arc of the second saddle shaped articulation surface in order to permit axial rotation of the first and second articulation surfaces relative to one another.
the single concave arc of the first saddle shaped articulation surface has a radius A about a first axis substantially perpendicular to an anterior-posterior plane of the spinal column, and the single convex arc of the first saddle shaped articulating surface has a radius B about a first axis substantially perpendicular to a lateral plane of the spinal column;
the single convex arc of the second saddle, shaped articulation surface has a radius C
about a second axis substantially perpendicular to the anterior-posterior plane of the spinal column, and the single concave arc of the second saddle shaped articulation surface has a radius D about a second axis substantially perpendicular to the lateral plane of the spinal column; and the radius A of the single concave arc of the first articulation surface is greater than the radius C of the single convex arc of the second saddle shaped articulation surface in order to permit axial rotation of the first and second articulation surfaces relative to one another.
69. The apparatus of claim 68, wherein the radius D of the single concave arc of the second articulation surface is greater than the radius B of the single convex arc of the first articulation surface in order to permit axial rotation of the first and second articulation surfaces relative to one another.
70. An apparatus for replacing at least a portion of an intervertebral disc of a spinal column, comprising:
a first member having a first vertebral contact surface for engagement with an endplate of a first vertebral bone, and having a first articulation surface that is a single saddle shaped surface including a concave arc extending from the leading end to the trailing end of the first articulation surface and a convex arc extending from the first lateral end to the second lateral end of the first articulation surface; and a second member having a second vertebral contact surface for engagement with an endplate of a second vertebral bone, and having a second articulation surface that is a single saddle shaped surface including a convex arc extending from the leading end to the trailing end of the second articulation surface and a concave arc extending from the first lateral end to the second lateral end of the second articulation surface, wherein:
an intervertebral disc space is defined substantially between the first and second endplates of the first and second vertebral bones, and the first and second articulation surfaces are sized and shaped to engage one another when the first and second members are disposed in the intervertebral disc space to enable the first and second vertebral bones to axially rotate relative to one another through a range of angles without substantially displacing the first and second vertebral bones away from one another, wherein the concave arc of the first articulation surface has a radius that is greater than the convex arc of the second articulation surface and the concave arc of the second articulation surface has a radius that is greater than the convex arc of the first articulation surface.
a first member having a first vertebral contact surface for engagement with an endplate of a first vertebral bone, and having a first articulation surface that is a single saddle shaped surface including a concave arc extending from the leading end to the trailing end of the first articulation surface and a convex arc extending from the first lateral end to the second lateral end of the first articulation surface; and a second member having a second vertebral contact surface for engagement with an endplate of a second vertebral bone, and having a second articulation surface that is a single saddle shaped surface including a convex arc extending from the leading end to the trailing end of the second articulation surface and a concave arc extending from the first lateral end to the second lateral end of the second articulation surface, wherein:
an intervertebral disc space is defined substantially between the first and second endplates of the first and second vertebral bones, and the first and second articulation surfaces are sized and shaped to engage one another when the first and second members are disposed in the intervertebral disc space to enable the first and second vertebral bones to axially rotate relative to one another through a range of angles without substantially displacing the first and second vertebral bones away from one another, wherein the concave arc of the first articulation surface has a radius that is greater than the convex arc of the second articulation surface and the concave arc of the second articulation surface has a radius that is greater than the convex arc of the first articulation surface.
71. The apparatus of claim 70, wherein the range of angles is about plus/minus three degrees from a resting position.
72. The apparatus of claim 70, wherein the first and second articulation surfaces are sized and shaped such that the first and second vertebral bones are displaced away from one another at axial rotations outside the range of angles.
73. The apparatus of claim 70, wherein:
the concave arc of the first saddle shaped articulation surface has a radius A
about a first axis substantially perpendicular to an anterior-posterior plane of the spinal column, and the convex arc of the first saddle shaped articulation surface has a radius B
about a first axis substantially perpendicular to a lateral plane of the spinal column; and the convex arc of the second saddle shaped articulation surface has a radius C
about a second axis substantially perpendicular to the anterior-posterior plane of the spinal column, and the concave arc of the second saddle shaped articulation surface has a radius D about a second axis substantially perpendicular to the lateral plane of the spinal column.
the concave arc of the first saddle shaped articulation surface has a radius A
about a first axis substantially perpendicular to an anterior-posterior plane of the spinal column, and the convex arc of the first saddle shaped articulation surface has a radius B
about a first axis substantially perpendicular to a lateral plane of the spinal column; and the convex arc of the second saddle shaped articulation surface has a radius C
about a second axis substantially perpendicular to the anterior-posterior plane of the spinal column, and the concave arc of the second saddle shaped articulation surface has a radius D about a second axis substantially perpendicular to the lateral plane of the spinal column.
74. The apparatus of claim 73, wherein the radius A of the concave arc of the first articulation surface is greater than the radius C of the convex arc of the second articulation surface.
75. The apparatus of claim 73, wherein the radius D of the concave are of the second articulation surface is greater than the radius B of the convex arc of the first articulation surface.
76. The apparatus of claim 73, wherein the radius A of the concave arc of the first articulation surface is about 0.329 inches, the radius B of the convex arc of the first articulation surface is about 0.340 inches, the radius C of the convex arc of the second articulation surface is about 0.280 inches, and the radius D of the concave arc of the second articulation surface is about 0.401 inches.
77. An apparatus for replacing at least a portion of an intervertebral disc in a spinal column, comprising:
a first member having a first vertebral contact surface for engagement with an endplate of a first vertebral bone in the spinal column, and having a first articulation surface that is defined at least by a concave are having a radius of curvature, A about a first axis substantially perpendicular to an anterior-posterior plane of the spinal column, and by a convex arc having a radius of curvature B about a first axis substantially perpendicular to a lateral plane of the spinal column; and a second member having a second vertebral contact surface for engagement with an endplate of a second vertebral bone in the spinal column, and having a second articulation surface that is defined at least by a convex arc having a radius of curvature C about a second axis substantially-perpendicular to the anterior-posterior plane of the spinal column, and by a concave arc having a radius of curvature D about a second axis substantially perpendicular to the lateral plane of the spinal column, said radius of curvature A being greater than said radius of curvature C and said radius of curvature B being less than said radius of curvature D, wherein:
an intervertebral disc space is defined substantially between the first and second endplates of the first and second vertebral bones, and the radii of curvature of the first and second articulation surfaces are sized such that the first and second articulation surfaces engage one another when the first and second members are disposed in the intervertebral disc space to enable the first and second vertebral bones to articulate in at least one of flexion, extension and lateral bending, wherein the first member has a first center of rotation that remains below said articulating surfaces during flexion/extension in the anterior-posterior plane of the spinal column and a second center of rotation that remains above the articulation surfaces during lateral bending in the lateral plane of the spinal column.
a first member having a first vertebral contact surface for engagement with an endplate of a first vertebral bone in the spinal column, and having a first articulation surface that is defined at least by a concave are having a radius of curvature, A about a first axis substantially perpendicular to an anterior-posterior plane of the spinal column, and by a convex arc having a radius of curvature B about a first axis substantially perpendicular to a lateral plane of the spinal column; and a second member having a second vertebral contact surface for engagement with an endplate of a second vertebral bone in the spinal column, and having a second articulation surface that is defined at least by a convex arc having a radius of curvature C about a second axis substantially-perpendicular to the anterior-posterior plane of the spinal column, and by a concave arc having a radius of curvature D about a second axis substantially perpendicular to the lateral plane of the spinal column, said radius of curvature A being greater than said radius of curvature C and said radius of curvature B being less than said radius of curvature D, wherein:
an intervertebral disc space is defined substantially between the first and second endplates of the first and second vertebral bones, and the radii of curvature of the first and second articulation surfaces are sized such that the first and second articulation surfaces engage one another when the first and second members are disposed in the intervertebral disc space to enable the first and second vertebral bones to articulate in at least one of flexion, extension and lateral bending, wherein the first member has a first center of rotation that remains below said articulating surfaces during flexion/extension in the anterior-posterior plane of the spinal column and a second center of rotation that remains above the articulation surfaces during lateral bending in the lateral plane of the spinal column.
78. The apparatus of claim 77, wherein at least one of (i) the first and second axes perpendicular to the anterior-posterior plane of the spinal column are substantially coaxial; and (ii) the first and second axes perpendicular to the lateral plane of the spinal column are substantially coaxial.
79. The apparatus of claim 77, wherein at least one of: (i) the first and second axes perpendicular to the anterior-posterior plane of the spinal column lie in a plane that is substantially perpendicular to the anterior-posterior plane; and (ii) the first and second axes perpendicular to the lateral plane of the spinal column lie in a plane that is substantially perpendicular to the lateral plane.
80. The apparatus of claim 77, wherein the first center of rotation for flexion and extension is located outside the intervertebral disc space, and the second center of rotation for lateral bending is located outside the intervertebral disc space.
81. The apparatus of claim 80, wherein the first center of rotation is located outside the intervertebral disc space in one direction and the second center of rotation is located outside the vertebral disc space in a substantially opposite direction.
82. The apparatus of claim 77, wherein the first and second articulation surfaces are sized and shaped to engage one another when the first and second members are disposed in the intervertebral disc space to enable the first and second vertebral bones to at least axially rotate relative to one another through a range of angles.
83. The apparatus of claim 77, wherein the first and second articulation surfaces are sized and shaped to engage one another when the first and second members are disposed in the intervertebral disc space to enable the first and second vertebral bones to axially rotate relative to one another through an initial range of angles without substantially displacing the first and second vertebral bones away from one another.
84. The apparatus of claim 83, wherein the first and second articulation surfaces are sized and shaped to achieve substantial point-to-point contact relative to one another when in at least some positions of flexion, extension, lateral bending, and/or axial rotation.
85. The apparatus of claim 83, wherein the initial range of angles is about plus/minus three degrees from a resting position.
86. The apparatus of claim 83, wherein the first and second articulation surfaces are sized and shaped such that the first and second vertebral bones are displaced away from one another at axial rotations outside the initial range of angles.
87. The apparatus of claim 77, wherein the radius A of the concave arc is greater than the radius C of the convex arc in order to permit axial rotation of the first and second articulation surfaces relative to one another.
88. The apparatus of claim 77, wherein the radius D of the concave arc is greater than the radius B of the convex arc in order to permit axial rotation of the first and second articulation surfaces relative to one another.
89. The apparatus of claim 77, wherein the radius A of the concave arc is about 0.329 inches, the radius B of the convex arc is about 0.340 inches, the radius C of the convex arc is about 0.280 inches, and the radius D of the concave arc is about 0.401 inches.
90. The apparatus of claim 77, wherein the first member further includes an anterior flange including at least one through hole for receiving a bone screw.
91. The apparatus of claim 77, wherein the second member further includes an anterior flange including at least one through hole for receiving a bone screw.
92. The apparatus of claim 77, wherein the first and second members each further include an anterior flange including at least one through hole for receiving a bone screw.
93. The apparatus of claim 92, wherein the anterior flange of one of the first and second members includes at least two through holes for receiving bone screws.
94. An apparatus for replacing at least a portion of an intervertebral disc in a spinal column, comprising:
a first member having a first vertebral contact surface for engagement with an endplate of a first vertebral bone in the spinal column, and having a first articulation surface that is defined by a plurality of concave arcs each having a respective radius of curvature about a corresponding axis substantially perpendicular to an anterior-posterior plane of the spinal column, and a plurality of convex arcs each having a respective radius of curvature about a corresponding axis substantially perpendicular to a lateral plane of the spinal column; and a second member having a second vertebral contact surface for engagement with an endplate of a second vertebral bone in the spinal column, and having a second articulation surface that is defined by a plurality of convex arcs each having a radius of curvature about a corresponding axis substantially perpendicular to the anterior-posterior plane of the spinal column, and a plurality of concave arcs each having a radius of curvature about a corresponding axis substantially perpendicular to the lateral plane of the spinal column, each of the plurality of concave arcs of the first articulation surface opposing one of the plurality of convex arcs of the second articulation surface and each of the concave arcs of the second articulation surface opposing one of the convex ares of the first articulation surface, the radius of curvature of each of the concave arcs of the first articulation surface being greater than the radius of curvature of the opposing convex arc of the second articulation surface and the radius of curvature of each of the concave ares of the second articulation surface being greater than the radius of curvature of the opposing convex arc of the first articulation surface, wherein:
an intervertebral disc space is defined substantially between the first and second endplates of the first and second vertebral bones, and the radii of curvature of the first and second articulation surfaces are sized such that the first and second articulation surfaces engage one another when the first and second members are disposed in the intervertebral disc space to enable the first and second vertebral bones to articulate in at least one of flexion, extension and lateral bending, wherein the first member has a first center of rotation that remains below the articulation surfaces during flexion/extension in the anterior-posterior plane of the spinal column and a second center of rotation that remains above the articulation surfaces during lateral bending in the lateral plane of the spinal column.
a first member having a first vertebral contact surface for engagement with an endplate of a first vertebral bone in the spinal column, and having a first articulation surface that is defined by a plurality of concave arcs each having a respective radius of curvature about a corresponding axis substantially perpendicular to an anterior-posterior plane of the spinal column, and a plurality of convex arcs each having a respective radius of curvature about a corresponding axis substantially perpendicular to a lateral plane of the spinal column; and a second member having a second vertebral contact surface for engagement with an endplate of a second vertebral bone in the spinal column, and having a second articulation surface that is defined by a plurality of convex arcs each having a radius of curvature about a corresponding axis substantially perpendicular to the anterior-posterior plane of the spinal column, and a plurality of concave arcs each having a radius of curvature about a corresponding axis substantially perpendicular to the lateral plane of the spinal column, each of the plurality of concave arcs of the first articulation surface opposing one of the plurality of convex arcs of the second articulation surface and each of the concave arcs of the second articulation surface opposing one of the convex ares of the first articulation surface, the radius of curvature of each of the concave arcs of the first articulation surface being greater than the radius of curvature of the opposing convex arc of the second articulation surface and the radius of curvature of each of the concave ares of the second articulation surface being greater than the radius of curvature of the opposing convex arc of the first articulation surface, wherein:
an intervertebral disc space is defined substantially between the first and second endplates of the first and second vertebral bones, and the radii of curvature of the first and second articulation surfaces are sized such that the first and second articulation surfaces engage one another when the first and second members are disposed in the intervertebral disc space to enable the first and second vertebral bones to articulate in at least one of flexion, extension and lateral bending, wherein the first member has a first center of rotation that remains below the articulation surfaces during flexion/extension in the anterior-posterior plane of the spinal column and a second center of rotation that remains above the articulation surfaces during lateral bending in the lateral plane of the spinal column.
95. The apparatus of claim 94, wherein at least one of: (i) the axes perpendicular to the anterior-posterior plane of the spinal column are substantially coaxial; and (ii) the axes perpendicular to the lateral plane of the spinal column are substantially coaxial.
96. The apparatus of claim 94, wherein at least one of (i) the axes perpendicular to the anterior-posterior plane of the spinal column lie in a plane that is substantially perpendicular to the anterior-posterior plane; and (ii) the axes perpendicular to the lateral plane of the spinal column lie in a plane that is substantially perpendicular to the lateral plane.
97. The apparatus of claim 94, wherein:
at least one of the concave arcs of the first articulation surface has a radius of curvature A
about a first axis substantially perpendicular to the anterior-posterior plane of the spinal column, and at least one of the convex arcs of the first articulation surface has a radius of curvature B
about a first axis substantially perpendicular to the lateral plane of the spinal column; and at least one of the convex arcs of the second articulation surface has a radius of curvature C about a second axis substantially perpendicular to the anterior-posterior plane of the spinal column, and at least one of the concave arcs of the second articulation surface has a radius of curvature D about a second axis substantially perpendicular to the lateral plane of the spinal column.
at least one of the concave arcs of the first articulation surface has a radius of curvature A
about a first axis substantially perpendicular to the anterior-posterior plane of the spinal column, and at least one of the convex arcs of the first articulation surface has a radius of curvature B
about a first axis substantially perpendicular to the lateral plane of the spinal column; and at least one of the convex arcs of the second articulation surface has a radius of curvature C about a second axis substantially perpendicular to the anterior-posterior plane of the spinal column, and at least one of the concave arcs of the second articulation surface has a radius of curvature D about a second axis substantially perpendicular to the lateral plane of the spinal column.
98. The apparatus of claim 94, wherein:
the concave ares of the first articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the anterior-posterior plane of the spinal column;
the convex arcs of the first articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the lateral plane of the spinal column;
the convex arcs of the second articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the anterior-posterior plane of the spinal column; and the concave arcs of the second articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the lateral plane of the spinal column.
the concave ares of the first articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the anterior-posterior plane of the spinal column;
the convex arcs of the first articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the lateral plane of the spinal column;
the convex arcs of the second articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the anterior-posterior plane of the spinal column; and the concave arcs of the second articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the lateral plane of the spinal column.
99. The apparatus of claim 94, wherein:
the concave arcs of the first articulation surface are of differing radii of curvature, each generally about a corresponding axis substantially perpendicular to the anterior-posterior plane of the spinal column; and the convex arcs of the second articulation surface are of differing radii of curvature, each generally about a corresponding axis substantially perpendicular to the anterior-posterior plane of the spinal column.
the concave arcs of the first articulation surface are of differing radii of curvature, each generally about a corresponding axis substantially perpendicular to the anterior-posterior plane of the spinal column; and the convex arcs of the second articulation surface are of differing radii of curvature, each generally about a corresponding axis substantially perpendicular to the anterior-posterior plane of the spinal column.
100. The apparatus of claim 99, wherein the convex arcs of the second articulation surface are of differing radii of curvature that correspond with the differing radii of curvature of the concave arcs of the first articulation surface.
101. The apparatus of claim 99, wherein:
the anterior-posterior plane and the lateral plane intersect along a longitudinal axis of the intervertebral disc space when the apparatus is disposed in the intervertebral disc space;
one or more of the radii of the concave arcs of the first articulation surface reduce as distances of origins of the radii from the anterior-posterior plane along the corresponding axes increase; and one or more of the radii of the convex arcs of the second articulation surface reduce as distances of origins of the radii of the convex arcs of the second articulation surface from the anterior-posterior plane along the corresponding axes increase.
the anterior-posterior plane and the lateral plane intersect along a longitudinal axis of the intervertebral disc space when the apparatus is disposed in the intervertebral disc space;
one or more of the radii of the concave arcs of the first articulation surface reduce as distances of origins of the radii from the anterior-posterior plane along the corresponding axes increase; and one or more of the radii of the convex arcs of the second articulation surface reduce as distances of origins of the radii of the convex arcs of the second articulation surface from the anterior-posterior plane along the corresponding axes increase.
102. The apparatus of claim 101, wherein the one or more of the radii of the convex arcs of the second articulation surface reduce in correspondence with the radii of the concave arcs of the first articulation surface.
103. The apparatus of claim 99, wherein:
the convex arcs of the first articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the lateral plane of the spinal column; and the concave arcs of the second articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the lateral plane of the spinal column.
the convex arcs of the first articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the lateral plane of the spinal column; and the concave arcs of the second articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the lateral plane of the spinal column.
104. The apparatus of claim 94, wherein:
the convex arcs of the first articulation surface are of differing radii of curvature, each generally about a corresponding axis substantially perpendicular to the lateral plane of the spinal column;
the concave ares of the second articulation surface are of differing radii of curvature, each of the concave arcs of the second articulation surface being generally about a corresponding axis substantially perpendicular to the lateral plane of the spinal column.
the convex arcs of the first articulation surface are of differing radii of curvature, each generally about a corresponding axis substantially perpendicular to the lateral plane of the spinal column;
the concave ares of the second articulation surface are of differing radii of curvature, each of the concave arcs of the second articulation surface being generally about a corresponding axis substantially perpendicular to the lateral plane of the spinal column.
105. The apparatus of claim 104, wherein the concave arcs of the second articulation surface cooperate with the convex arcs of the first articulation surface.
106. The apparatus of claim 104, wherein:
the anterior-posterior plane and the lateral plane intersect along a longitudinal axis of the intervertebral disc space when the apparatus is disposed in the intervertebral disc space;
one or more of the radii of the convex arcs of the first articulation surface reduce as distances of origins of the radii from the lateral plane along the corresponding axes increase; and one or more of the radii of the concave arcs of the second articulation surface reduce as distances of origins of the radii of the convex arcs of the second articulation surface from the lateral plane along the corresponding axes increase.
the anterior-posterior plane and the lateral plane intersect along a longitudinal axis of the intervertebral disc space when the apparatus is disposed in the intervertebral disc space;
one or more of the radii of the convex arcs of the first articulation surface reduce as distances of origins of the radii from the lateral plane along the corresponding axes increase; and one or more of the radii of the concave arcs of the second articulation surface reduce as distances of origins of the radii of the convex arcs of the second articulation surface from the lateral plane along the corresponding axes increase.
107. The apparatus of claim 106, wherein the one or more of the radii of the concave arcs of the second articulation surface reduce in correspondence with the radii of the convex arcs of the first articulation surface.
108. The apparatus of claim 104, wherein:
the concave arcs of the first articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the anterior-posterior plane of the spinal column; and the convex arcs of the second articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the anterior-posterior plane of the spinal column.
the concave arcs of the first articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the anterior-posterior plane of the spinal column; and the convex arcs of the second articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the anterior-posterior plane of the spinal column.
109. The apparatus of claim 94, wherein the first and second articulation surfaces are sized and shaped to engage one another when the first and second members are disposed in the intervertebral disc space to enable the first and second vertebral bones to at least axially rotate relative to one another through a range of angles.
110. The apparatus of claim 94, wherein the first and second articulation surfaces are sized and shaped to engage one another when the first and second members are disposed in the intervertebral disc space to enable the first and second vertebral bones to axially rotate relative to one another through a range of angles without substantially displacing the first and second vertebral bones away from one another.
111. The apparatus of claim 110, wherein the first and second articulation surfaces are sized and shaped to achieve substantial point-to-point contact relative to one another when in at least some positions of flexion, extension, lateral bending, and/or axial rotation.
112. The apparatus of claim 110, wherein the range of angles is about plus/minus three degrees from a resting position.
113. The apparatus of claim 110, wherein the first and second articulation surfaces are sized and shaped such that the first and second vertebral bones are displaced away from one another at axial rotations outside the range of angles.
114. An articulating spinal disc replacement comprising:
a first implant portion having a first vertebral contacting surface for contacting a top vertebral body and a first articulation surface including a continuous concave surface and a continuous convex surface; and a second implant portion having a second vertebral contacting surface for contacting a bottom vertebral body and a second articulation surface including a continuous concave surface and a continuous convex surface, wherein said first and second articulation surfaces cooperate to allow flexion/extension, lateral bending and rotation of said top and bottom vertebral bodies, said rotation occurring through at least a range of angles without said top and bottom vertebral bodies moving away from one another.
a first implant portion having a first vertebral contacting surface for contacting a top vertebral body and a first articulation surface including a continuous concave surface and a continuous convex surface; and a second implant portion having a second vertebral contacting surface for contacting a bottom vertebral body and a second articulation surface including a continuous concave surface and a continuous convex surface, wherein said first and second articulation surfaces cooperate to allow flexion/extension, lateral bending and rotation of said top and bottom vertebral bodies, said rotation occurring through at least a range of angles without said top and bottom vertebral bodies moving away from one another.
115. The replacement according to claim 114, wherein the entirety of said first articulation surface is saddle-shaped, and the entirety of said second articulation surface is saddle-shaped.
116. The replacement according to claim 115, wherein said first articulation surface includes a single concave surface and a single convex surface, and said second articulation surface includes a single concave surface and a single convex surface.
117. The replacement according to claim 116, wherein said single concave surface of said first articulation surface engages said single convex surface of said second articulation surface, and said single convex surface of said first articulation surface engages said single concave surface of said second articulation surface.
118. The replacement according to claim 114, wherein said first articulation surface includes continuous concave and convex surfaces extending between outer edges of said first articulation surface, and said second articulation surface includes continuous concave and convex surfaces extending between outer edges of said second articulation surface.
119. The replacement according to claim 114, wherein said range of angles is approximately plus/minus three degrees from a resting position.
120. The replacement according to claim 114, wherein said replacement is operable to permit said top and bottom vertebral bodies to move away from one another upon axial rotation outside of said range of angles.
121. The replacement according to claim 115, wherein said first articulation surface is defined by a concave arc having a substantially constant radius of curvature A about a first axis, and a convex arc having a substantially constant radius of curvature B about a second axis perpendicular to the first axis, and said second articulation surface is defined by a convex arc having a substantially constant radius of curvature C about a third axis, and a concave arc having a substantially constant radius of curvature D about a fourth axis perpendicular to the third axis.
122. The replacement according to claim 121, wherein said radius of curvature A is greater than said radius of curvature C and said radius of curvature B is less than said radius of curvature D.
123. The replacement according to claim 121, wherein at least one of: (i) said first and third axes are coaxial; and (ii) said second and fourth axes are coaxial.
124. The replacement according to claim 121, wherein at least one of; (i) said first and third axes are coplanar; and (ii) said second and fourth axes are coplanar.
125. The replacement according to claim 114, wherein the first implant portion has a center of rotation that remains below said articulation surfaces during flexion/extension and that remains above said articulation surfaces during lateral bending.
126. The replacement according to claim 114, wherein said first and second implant portions further include means for engaging said vertebral bodies.
127. The replacement according to claim 123, wherein said means for engaging said vertebral bodies is selected from the group consisting of flanges, keels and spikes.
128. A use of an articulating spinal disc replacement for axially rotating a first and second vertebral bodies with respect to one another, the replacement comprising two portions where each portion has a vertebral body contacting surface and an articulating surface having a continuous concave surface and a continuous convex surface to allow axially rotating said first vertebral body with respect to said second vertebral body, wherein said axially rotating step occurs through at least a range of angles without said first and second vertebral bodies moving away from one another.
129. The use of claim 128, wherein said articulating surfaces are entirely saddle-shaped.
130. The use of claim 129, further comprising a first portion having a first articulation surface and a second portion having a second articulation surface, wherein said first articulation surface includes a single concave surface and a single convex surface, and said second articulation surface includes a single concave surface and a single convex surface.
131. The use of claim 130, wherein said single concave surface of said first articulation surface engages said single convex surface of said second articulation surface, and said single convex surface of said first articulation surface engages said single concave surface of said second articulation surface.
132. The use of claim 129, wherein said first articulation surface includes continuous concave and convex surfaces extending between outer edges of said first implant portion, and said second articulation surface includes continuous concave and convex surfaces extending between outer edges of said second implant portion.
133. The use of claim 128, wherein said articulating surfaces of said two portions of said replacement cooperate to allow flexion/extension, lateral bending and rotation of said first and second vertebral bodies.
134. The use of claim 128, wherein said range of angles is approximately plus/minus three degrees from a resting position.
135. The use of claim 128, wherein said replacement is operable to permit said first and second vertebral bodies to move away from one another upon axial rotation outside of said range of angles.
136. The use of claim 128, wherein said replacement includes a first implant portion having a first vertebral body contacting surface and a first articulating surface, and a second implant portion having a second vertebral body contacting surface and a second articulating surface.
137. The use of claim 136, wherein said first articulation surface is defined by a concave arc having a substantially constant radius of curvature A about a first axis, and a convex arc having a substantially constant radius of curvature B about a second axis perpendicular to the first axis, and said second articulation surface is defined by a convex arc having a substantially constant radius of curvature C about a third axis, and a concave arc having a substantially constant radius of curvature D about a fourth axis perpendicular to the third axis.
138. The use of claim 137, wherein said radius of curvature A is greater than said radius of curvature C and said radius of curvature B is less than said radius of curvature D.
139. The use of claim 137, wherein at least one of: (i) said first and third axes are coaxial; and (ii) said second and fourth axes are coaxial.
140. The use of claim 137, wherein at least one of: (i) said first and third axes are coplanar;
and (ii) said second and fourth axes are coplanar.
and (ii) said second and fourth axes are coplanar.
141. The use of claim 136, wherein the first implant portion has a center of rotation that remains below said articulating surfaces during flexion/extension and that remains above said articulation surfaces during lateral bending.
142. The use of claim 136, wherein said first and second implant portions further include means for engaging said vertebrae.
143. The use of claim 142, wherein said means for engaging said vertebrae is selected from the group consisting of flanges, keels and spikes.
144. An intervertebral implant comprising:
a first member having a first articulation surface that is defined by a plurality of concave arcs each having a respective radius of curvature about a first axis, and a plurality of convex arcs each having a respective radius of curvature about a second axis substantially perpendicular to the first axis; and a second member having a second articulation surface that is defined by a plurality of convex arcs each having a radius of curvature about a third axis, and a plurality of concave arcs each having a radius of curvature about a fourth axis substantially perpendicular to the third axis, each of the plurality of concave arcs of the first articulation surface opposing one of the plurality of convex arcs of the second articulation surface and each of the concave arcs of the second articulation surface opposing on of the convex arcs of the first articulation surface, the radius of curvature of each of the concave arcs of the first articulation surface being greater than the radius of curvature of the opposing convex arc of the second articulation surface, wherein the first member has a first center of rotation that remains below the articulation surfaces during flexion/extension and a second center of rotation that remains above the articulation surfaces during lateral bending.
a first member having a first articulation surface that is defined by a plurality of concave arcs each having a respective radius of curvature about a first axis, and a plurality of convex arcs each having a respective radius of curvature about a second axis substantially perpendicular to the first axis; and a second member having a second articulation surface that is defined by a plurality of convex arcs each having a radius of curvature about a third axis, and a plurality of concave arcs each having a radius of curvature about a fourth axis substantially perpendicular to the third axis, each of the plurality of concave arcs of the first articulation surface opposing one of the plurality of convex arcs of the second articulation surface and each of the concave arcs of the second articulation surface opposing on of the convex arcs of the first articulation surface, the radius of curvature of each of the concave arcs of the first articulation surface being greater than the radius of curvature of the opposing convex arc of the second articulation surface, wherein the first member has a first center of rotation that remains below the articulation surfaces during flexion/extension and a second center of rotation that remains above the articulation surfaces during lateral bending.
145. The intervertebral implant of claim 144, wherein the entirety of said first articulation surface is saddle-shaped, and the entirety of said second articulation surface is saddle-shaped.
146. The intervertebral implant of claim 145, wherein said first articulation surface includes a single concave surface and a single convex surface, and said second articulation surface includes a single concave surface and a single convex surface.
147. The intervertebral implant of claim 146, wherein said single concave surface of said first articulation surface engages said single convex surface of said second articulation surface, and said single convex surface of said first articulation surface engages said single concave surface of said second articulation surface.
148. The intervertebral implant of claim 144, wherein said first articulation surface includes continuous concave and convex surfaces extending between outer edges of said first articulation surface, and said second articulation surface includes continuous concave and convex surfaces extending between outer edges of said second articulation surface.
149. The intervertebral implant of claim 144, wherein the concave ares of the second articulation surface are greater than the radius of curvature of the opposing convex arc of the first articulation surface.
150. The intervertebral implant of claim 144, wherein said first and second members further include means for engaging a vertebral body.
151. The intervertebral implant of claim 150, wherein said means for engaging a vertebral body is selected from the group consisting of flanges, keels and spikes.
152. The intervertebral implant of claim 144, wherein rotation of said first member with respect to said second member occurs through at least a range of angles without said first and second members moving away from one another.
153. The intervertebral implant of claim 152, wherein said range of angles is approximately plus/minus three degrees from a resting position.
154. An intervertebral implant comprising:
a first member having a first articulation surface; and a second member having a second articulation surface, wherein each of the first and second articulation surfaces has a toroidal saddle shaped surface, and the articulation surfaces are adapted to engage one another during at least one of flexion/extension and lateral bending, wherein the engaging articulation surfaces include opposing constant radius of curvature surfaces that are non-congruent.
a first member having a first articulation surface; and a second member having a second articulation surface, wherein each of the first and second articulation surfaces has a toroidal saddle shaped surface, and the articulation surfaces are adapted to engage one another during at least one of flexion/extension and lateral bending, wherein the engaging articulation surfaces include opposing constant radius of curvature surfaces that are non-congruent.
155. The intervertebral implant of claim 154, wherein rotation of said first member with respect to said second member occurs through at least a range of angles without said first and second members moving away from one another.
156. The intervertebral implant of claim 155, wherein said range of angles is approximately plus/minus three degrees from a resting position.
157. The intervertebral implant of claim 154, wherein said first articulation surface includes continuous concave and convex surfaces extending between outer edges of said first articulation surface, and said second articulation surface includes continuous concave and convex surfaces extending between outer edges of said second articulation surface.
158. The intervertebral implant of claim 154, wherein said first articulation surface is defined by a concave arc having a substantially constant radius of curvature A
about a first axis, and a convex ara having a substantially constant radius of curvature B about a second axis perpendicular to the first axis, and said second articulation surface is defined by a convex arc having a substantially constant radius of curvature C about a third axis, and a concave arc having a substantially constant radius of curvature D about a fourth axis perpendicular to the third axis.
about a first axis, and a convex ara having a substantially constant radius of curvature B about a second axis perpendicular to the first axis, and said second articulation surface is defined by a convex arc having a substantially constant radius of curvature C about a third axis, and a concave arc having a substantially constant radius of curvature D about a fourth axis perpendicular to the third axis.
159. The intervertebral implant of claim 158, wherein said radius of curvature A is greater than said radius of curvature C and said radius of curvature B is less than said radius of curvature D.
160. The intervertebral implant of claim 158, wherein at least one of: (i) said first and third axes are coaxial; and (ii) said second and fourth axes are coaxial.
161. The intervertebral implant of claim 158, wherein at least one of: (i) said first and third axes are coplanar; and (ii) said second and fourth axes are coplanar.
162. The intervertebral implant of claim 154, wherein the first implant portion has a center of rotation that remains below said articulation surfaces during flexion/extension and that remains above said articulation surfaces during lateral bending.
163. The intervertebral implant of claim 154, wherein said first and second member further include means for engaging a vertebral body.
164. The intervertebral implant of claim 163, wherein said means for engaging a vertebral body is selected from the group consisting of flanges, keels and spikes.
165. An intervertebral implant comprising:
a first member having a first articulating surface, the entirety of the first articulating surface being a single saddle surface that is defined by a concave arc having a substantially constant radius of curvature A about a first axis perpendicular to leading and trailing ends of the first member and convex arc having a substantially constant radius of curvature B about a first axis perpendicular to lateral sides of the first member; and a second member having a second articulating surface in contact with the first articulating surface, the entirety of the second articulating surface being a single saddle surface that is defined by a convex arc having a substantially constant radius of curvature C
about a first axis perpendicular to leading and trailing ends of the second member and concave arc having a substantially constant radius of curvature D about a second axis perpendicular to lateral sides of the second member, wherein the constant radius of curvature A is non-congruent with the constant radius of curvature C and the constant radius of curvature B is non-congruent with the radius of curvature D;
the first and second members are operable to articulate relative to one another about at least one of: (i) a first center of rotation for at least one of flexion and extension that is located above the first and second articulating surfaces, and (ii) a second center of rotation for lateral bending that is located below the first and second articulating surfaces.
167. The intervertebral implant of claim 165, wherein rotation of said first member with respect to said second member occurs through at least a range of angles without said first and second members moving away from one another.
168. The intervertebral implant of claim 167, wherein said range of angles is approximately plus/minus three degrees from a resting position.
169. An intervertebral implant comprising:
first and second members have opposing first and second articulating surfaces that are in contact with one another, the entirety of the first articulating surface being a single saddle surface that is defined by a concave arc having a substantially constant radius of curvature A about a first axis perpendicular to an axis passing through leading and trailing ends of the first member and a convex arc having a substantially constant radius of curvature B about a first axis perpendicular to an axis passing through lateral ends of the first member, the entirety of the second articulating surface being a single saddle surface that is defined by a convex arc having a substantially constant radius of curvature C about a first axis perpendicular to an axis passing through leading and trailing ends of the second member and a concave arc having a substantially constant radius of curvature D about a second axis perpendicular to an axis passing through lateral ends of the second member, the constant radius of curvature A being non-congruent with the constant radius of curvature C and the constant radius of curvature B being non-congruent with the constant radius of curvature D, wherein the first and second members are adapted to articulate relative to one another about at least one of: (i) a first center of rotation for at least one of flexion and extension that is located above the first and second articulating surfaces, and (ii) a second center of rotation for lateral bending that is located below the first and second articulating surfaces.
170. The intervertebral implant of claim 169, wherein rotation of said first member with respect to said second member occurs through at least a range of angles without said first and second members moving away from one another.
171. The intervertebral implant of claim 170, wherein said range of angles is approximately plus/minus three degrees from a resting position.
172. An intervertebral implant comprising:
a first element having a lower articulating surface, the entirety of said lower articulating surface being a single saddle surface that is defined by a concave arc having a substantially constant radius of curvature A about a first axis, and a convex arc having a substantially constant radius of curvature B about a second axis perpendicular to the first axis; and a second element having an upper articulating surface, the entirety of said upper articulating surface being a single saddle surface that is defined by a convex arc having a substantially constant radius of curvature C about a third axis, and a concave arc having a substantially constant radius of curvature D about a fourth axis perpendicular to the third axis, said constant radius of curvature A being greater than said constant radius of curvature C, wherein the saddle surface of said first element and the saddle surface of said second element are nestable with one another and articulatable against one another in flexion/extension in an anterior-posterior plane of the spinal column and in lateral bending in a lateral plane of the spinal column.
173. The intervertebral implant of claim 172, wherein rotation of said first element with respect to said second element occurs through at least a range of angles without said first and second elements moving away from one another.
174. The intervertebral implant of claim 173, wherein said range of angles is approximately plus/minus three degrees from a resting position.
175. The intervertebral implant of claim 172, wherein said first articulating surface includes a single concave surface and a single convex surface, and said second articulating surface includes a single concave surface and a single convex surface.
176. The intervertebral implant of claim 175, wherein said single concave surface of said first articulating surface engages said single convex surface of said second articulating surface, and said single convex surface of said first articulating surface engages said single concave surface of said second articulating surface.
177. The intervertebral implant of claim 172, wherein said first articulating surface includes continuous concave and convex surfaces extending between outer edges of said first articulating surface, and said second articulating surface includes continuous concave and convex surfaces extending between outer edges of said second articulating surface.
178. The intervertebral implant of claim 172, wherein said radius of curvature B is less than said radius of curvature D.
179. The intervertebral implant of claim 172, wherein at least one of: (i) said first and third axes are coaxial; and (ii) said second and fourth axes are coaxial.
180. The intervertebral implant of claim 172, wherein at least one of; (i) said first and third axes are coplanar; and (ii) said second and fourth axes are coplanar.
181. The intervertebral implant of claim 172, wherein said first element has a center of rotation that remains below said articulating surfaces during one of said flexion/extension and lateral bending, and that remains above said articulating surfaces during the other of said flexion/extension and lateral bending.
182. The intervertebral implant of claim 172, wherein said first and second elements further include means for engaging a vertebral body.
183. The intervertebral implant of claim 182, wherein said means for engaging a vertebral body is selected from the group consisting of flanges, keels and spikes.
184. An intervertebral implant comprising:
a first member having a first toroidal saddle shaped articulation surface including a first concave arc extending between leading and trailing ends of the first articulation surface and a first convex arc extending between first and second lateral sides of the first articulation surface;
and a second member having a second toroidal saddle shaped articulation surface including a second convex arc extending between leading and trailing ends of the second articulation surface and a second concave arc extending between first and second lateral sides of the second articulation surface, wherein the first concave arc has a radius that is greater than the radius of the second convex arc, and the first and second articulation surfaces are adapted to engage one another during flexion, extension and lateral bending.
185. The intervertebral implant of claim 184, wherein rotation of said first member with respect to said second member occurs through at least a range of angles without said first and second members moving away from one another.
186. The intervertebral implant of claim 185, wherein said range of angles is approximately plus/minus three degrees from a resting position.
187. The intervertebral implant of claim 184 wherein said first articulation surface includes a single concave surface and a single convex surface, and said second articulation surface includes a single concave surface and a single convex surface.
188. The intervertebral implant of claim 187, wherein said single concave surface of said first articulation surface engages said single convex surface of said second articulation surface, and said single convex surface of said first articulation surface engages said single concave surface of said second articulation surface.
189. The intervertebral implant of claim 184, wherein said first articulation surface includes continuous concave and convex surfaces extending between outer edges of said first articulation surface, and said second articulation surface includes continuous concave and convex surfaces extending between outer edges of said second articulation surface.
190. The intervertebral implant of claim 184, wherein said first articulation surface is defined by a concave arc having a substantially constant radius of curvature A
about a first axis, and a convex arc having a substantially constant radius of curvature B about a second axis perpendicular to the first axis, and said second articulation surface is defined by a convex arc having a substantially constant radius of curvature C about a third axis, and a concave arc having a substantially constant radius of curvature D about a fourth axis perpendicular to the third axis.
191. The intervertebral implant of claim 190, wherein said radius of curvature A is greater than said radius of curvature C and said radius of curvature B is less than said radius of curvature D.
192. The intervertebral implant of claim 190, wherein at least one of: (i) said first and third axes are coaxial; and (ii) said second and fourth axes are coaxial.
193. The intervertebral implant of claim 190, wherein at least one of: (i) said first and third axes are coplanar; and (ii) said second and fourth axes are coplanar.
194. The intervertebral implant of claim 184, wherein the first member has a center of rotation that remains below said articulation surfaces during flexion/extension and that remains above said articulation surfaces during lateral bending.
195. The intervertebral implant of claim 184, wherein said first and second members further include means for engaging a vertebral body.
196. The intervertebral implant of claim 195, wherein said means for engaging a vertebral body is selected from the group consisting of flanges, keels and spikes.
197. An intervertebral implant comprising:
a first member having a first articulation surface that is defined at least by a concave arc having a radius of curvature A about a first axis, and by a convex arc having a radius of curvature B about a second axis substantially perpendicular to the first axis;
and a second member having a second articulation surface that is defined at least by a convex arc having a radius of curvature C about a third axis, and by a concave arc having a radius of curvature D about a fourth axis substantially perpendicular to the third axis, said radius of curvature A being greater than said radius of curvature C, wherein the first member has a first center of rotation that remains below said articulating surfaces during flexion/extension and a second center of rotation that remains above the articulation surfaces during lateral bending.
198. The intervertebral implant of claim 197, wherein rotation of said first member with respect to said second member occurs through at least a range of angles without said first and second members moving away from one another.
199. The intervertebral implant of claim 198, wherein said range of angles is approximately plus/minus three degrees from a resting position.
200. The intervertebral implant of claim 197, wherein said radius of curvature B is less than said radius of curvature D.
201. The intervertebral implant of claim 197, wherein said first articulation surface includes a single concave surface and a single convex surface, and said second articulation surface includes a single concave surface and a single convex surface.
202. The intervertebral implant of claim 201, wherein said single concave surface of said first articulation surface engages said single convex surface of said second articulation surface, and said single convex surface of said first articulation surface engages said single concave surface of said second articulation surface.
203. The intervertebral implant of claim 197, wherein said first articulation surface includes continuous concave and convex surfaces extending between outer edges of said first articulation surface, and said second articulation surface includes continuous concave and convex surfaces extending between outer edges of said second articulation surface.
204. The intervertebral implant of claim 197, further comprising means for engaging a vertebral body.
205. The intervertebral implant of claim 204, wherein said means for engaging a vertebral body are selected from the group consisting of flanges, keels and spikes.
206. An apparatus for replacing at least a portion of an intervertebral disc in a spinal column, comprising:
a first member having a first vertebral contact surface for engagement with an endplate of a first vertebral bone in the spinal column, and having a first articulation surface that is defined by a plurality of concave arcs each having a respective radius of curvature about a corresponding axis substantially perpendicular to an anterior-posterior plane of the spinal column, and a plurality of convex arcs each having a respective radius of curvature about a corresponding axis substantially perpendicular to a lateral plane of the spinal column; and a second member having a second vertebral contact surface for engagement with an endplate of a second vertebral bone in the spinal column, and having a second articulation surface that is defined by a plurality of convex arcs each having a radius of curvature about a corresponding axis substantially perpendicular to the anterior-posterior plane of the spinal column, and a plurality of concave arcs each having a radius of curvature about a corresponding axis substantially perpendicular to the lateral plane of the spinal column, each of the plurality of concave arcs of the first articulation surface opposing one of the plurality of convex arcs of the second articulation surface and each of the concave arcs of the second articulation surface opposing one of the convex arcs of the first articulation surface, the radius of curvature of each of the concave arcs of the first articulation surface being greater than the radius of curvature of the opposing convex arc of the second articulation surface and the radius of curvature of each of the concave arcs of the second articulation surface being greater than the radius of curvature of the opposing convex arc of the first articulation surface, wherein:
an intervertebral disc space is defined substantially between the first and second endplates of the first and second vertebral bones, and the radii of curvature of the first and second articulation surfaces are sized such that the first and second articulation surfaces engage one another when the first and second members are disposed in the intervertebral disc space to enable the first and second vertebral bones to articulate in at least one of flexion, extension and lateral bending, wherein the first member has a first center of rotation that remains below the articulation surfaces during flexion/extension in the anterior-posterior plane of the spinal column and a second center of rotation that remains above the articulation surfaces during lateral bending in the lateral plane of the spinal column.
207. The apparatus of claim 206, wherein at least one of (i) the axes perpendicular to the anterior-posterior plane of the spinal column are substantially coaxial; and (ii) the axes perpendicular to the lateral plane of the spinal column are substantially coaxial.
268. The apparatus of claim 206, wherein at least one of: (i) the axes perpendicular to the anterior-posterior plane of the spinal column lie in a plane that is substantially perpendicular to the anterior-posterior plane; and (ii) the axes perpendicular to the lateral plane of the spinal column lie in a plane that is substantially perpendicular to the lateral plane.
209. The apparatus of claim 206, wherein: at least one of the concave arcs of the first articulation surface has a radius of curvature A about a first axis substantially perpendicular to the anterior-posterior plane of the spinal column, and at least one of the convex arcs of the first articulation surface has a radius of curvature B about a first axis substantially perpendicular to the lateral plane of the spinal column; and at least one of the convex arcs of the second articulation surface has a radius of curvature C about a second axis substantially perpendicular to the anterior-posterior plane of the spinal column, and at least one of the concave arcs of the second articulation surface has a radius of curvature D about a second axis substantially perpendicular to the lateral plane of the spinal column.
210. The apparatus of claim 206, wherein: the concave arcs of the first articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the anterior-posterior plane of the spinal column; the convex arcs of the first articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the lateral plane of the spinal column;
the convex arcs of the second articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the anterior-posterior plane of the spinal column; and the concave arcs of the second articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the lateral plane of the spinal column.
211. The apparatus of claim 206, wherein: the concave arcs of the first articulation surface are of differing radii of curvature, each generally about a corresponding axis substantially perpendicular to the anterior-posterior plane of the spinal column; and the convex arcs of the second articulation surface are of differing radii of curvature, each generally about a corresponding axis substantially perpendicular to the anterior-posterior plane of the spinal column.
212. The apparatus of claim 211, wherein the convex arcs of the second articulation surface are of differing radii of curvature that correspond with the differing radii of curvature of the concave arcs of the first articulation surface.
213. The apparatus of claim 211, wherein: the anterior-posterior plane and the lateral plane intersect along a longitudinal axis of the intervertebral disc space when the apparatus is disposed in the intervertebral disc space; one or more of the radii of the concave arcs of the first articulation surface reduce as distances of origins of the radii from the anterior-posterior plane along the corresponding axes increase; and one or more of the radii of the convex arcs of the second articulation surface reduce as distances of origins of the radii of the convex arcs of the second articulation surface from the anterior-posterior plane along the corresponding axes increase.
214. The apparatus of claim 213, wherein the one or more of the radii of the convex arcs of the second articulation surface reduce in correspondence with the radii of the concave arcs of the first articulation surface.
215. The apparatus of claim 211, wherein: the convex arcs of the first articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the lateral plane of the spinal column; and the concave arcs of the second articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the lateral plane of the spinal column.
216. The apparatus of claim 206, wherein: the convex arcs of the first articulation surface are of differing radii of curvature, each generally about a corresponding axis substantially perpendicular to the lateral plane of the spinal column; the concave arcs of the second articulation surface are of differing radii of curvature, each of the concave arcs of the second articulation surface being generally about a corresponding axis substantially perpendicular to the lateral plane of the spinal column.
217. The apparatus of claim 216, wherein the concave arcs of the second articulation surface cooperate with the convex arcs of the first articulation surface.
218. The apparatus of claim 216, wherein: the anterior-posterior plane and the lateral plane intersect along a longitudinal axis of the intervertebral disc space when the apparatus is disposed in the intervertebral disc space; one or more of the radii of the convex arcs of the first articulation surface reduce as distances of origins of the radii from the lateral plane along the corresponding axes increase; and one or more of the radii of the concave arcs of the second articulation surface reduce as distances of origins of the radii of the convex arcs of the second articulation surface from the lateral plane along the corresponding axes increase.
219. The apparatus of claim 218, wherein the one or more of the radii of the concave arcs of the second articulation surface reduce in correspondence with the radii of the convex arcs of the first articulation surface.
220. The apparatus of claim 216, wherein: the concave arcs of the first articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the anterior-posterior plane of the spinal column; and the convex arcs of the second articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the anterior-posterior plane of the spinal column.
221. The apparatus of claim 206, wherein the first and second articulation surfaces are sized and shaped to engage one another when the first and second members are disposed in the intervertebral disc space to enable the first and second vertebral bones to at least axially rotate relative to one another through a range of angles.
222. The apparatus of claim 206, wherein the first and second articulation surfaces are sized and shaped to engage one another when the first and second members are disposed in the intervertebral disc space to enable the first and second vertebral bones to axially rotate relative to one another through a range of angles without substantially displacing the first and second vertebral bones away from one another.
223. The apparatus of claim 222, wherein the first and second articulation surfaces are sized and shaped to achieve substantial point-to-point contact relative to one another when in at least some positions of flexion, extension, lateral bending, and/or axial rotation.
224. The apparatus of claim 222, wherein the range of angles is about plus/minus three degrees from a resting position.
225. The apparatus of claim 222, wherein the first and second articulation surfaces are sized and shaped such that the first and second vertebral bones are displaced away from one another at axial rotations outside the range of angles.
a first member having a first articulating surface, the entirety of the first articulating surface being a single saddle surface that is defined by a concave arc having a substantially constant radius of curvature A about a first axis perpendicular to leading and trailing ends of the first member and convex arc having a substantially constant radius of curvature B about a first axis perpendicular to lateral sides of the first member; and a second member having a second articulating surface in contact with the first articulating surface, the entirety of the second articulating surface being a single saddle surface that is defined by a convex arc having a substantially constant radius of curvature C
about a first axis perpendicular to leading and trailing ends of the second member and concave arc having a substantially constant radius of curvature D about a second axis perpendicular to lateral sides of the second member, wherein the constant radius of curvature A is non-congruent with the constant radius of curvature C and the constant radius of curvature B is non-congruent with the radius of curvature D;
the first and second members are operable to articulate relative to one another about at least one of: (i) a first center of rotation for at least one of flexion and extension that is located above the first and second articulating surfaces, and (ii) a second center of rotation for lateral bending that is located below the first and second articulating surfaces.
167. The intervertebral implant of claim 165, wherein rotation of said first member with respect to said second member occurs through at least a range of angles without said first and second members moving away from one another.
168. The intervertebral implant of claim 167, wherein said range of angles is approximately plus/minus three degrees from a resting position.
169. An intervertebral implant comprising:
first and second members have opposing first and second articulating surfaces that are in contact with one another, the entirety of the first articulating surface being a single saddle surface that is defined by a concave arc having a substantially constant radius of curvature A about a first axis perpendicular to an axis passing through leading and trailing ends of the first member and a convex arc having a substantially constant radius of curvature B about a first axis perpendicular to an axis passing through lateral ends of the first member, the entirety of the second articulating surface being a single saddle surface that is defined by a convex arc having a substantially constant radius of curvature C about a first axis perpendicular to an axis passing through leading and trailing ends of the second member and a concave arc having a substantially constant radius of curvature D about a second axis perpendicular to an axis passing through lateral ends of the second member, the constant radius of curvature A being non-congruent with the constant radius of curvature C and the constant radius of curvature B being non-congruent with the constant radius of curvature D, wherein the first and second members are adapted to articulate relative to one another about at least one of: (i) a first center of rotation for at least one of flexion and extension that is located above the first and second articulating surfaces, and (ii) a second center of rotation for lateral bending that is located below the first and second articulating surfaces.
170. The intervertebral implant of claim 169, wherein rotation of said first member with respect to said second member occurs through at least a range of angles without said first and second members moving away from one another.
171. The intervertebral implant of claim 170, wherein said range of angles is approximately plus/minus three degrees from a resting position.
172. An intervertebral implant comprising:
a first element having a lower articulating surface, the entirety of said lower articulating surface being a single saddle surface that is defined by a concave arc having a substantially constant radius of curvature A about a first axis, and a convex arc having a substantially constant radius of curvature B about a second axis perpendicular to the first axis; and a second element having an upper articulating surface, the entirety of said upper articulating surface being a single saddle surface that is defined by a convex arc having a substantially constant radius of curvature C about a third axis, and a concave arc having a substantially constant radius of curvature D about a fourth axis perpendicular to the third axis, said constant radius of curvature A being greater than said constant radius of curvature C, wherein the saddle surface of said first element and the saddle surface of said second element are nestable with one another and articulatable against one another in flexion/extension in an anterior-posterior plane of the spinal column and in lateral bending in a lateral plane of the spinal column.
173. The intervertebral implant of claim 172, wherein rotation of said first element with respect to said second element occurs through at least a range of angles without said first and second elements moving away from one another.
174. The intervertebral implant of claim 173, wherein said range of angles is approximately plus/minus three degrees from a resting position.
175. The intervertebral implant of claim 172, wherein said first articulating surface includes a single concave surface and a single convex surface, and said second articulating surface includes a single concave surface and a single convex surface.
176. The intervertebral implant of claim 175, wherein said single concave surface of said first articulating surface engages said single convex surface of said second articulating surface, and said single convex surface of said first articulating surface engages said single concave surface of said second articulating surface.
177. The intervertebral implant of claim 172, wherein said first articulating surface includes continuous concave and convex surfaces extending between outer edges of said first articulating surface, and said second articulating surface includes continuous concave and convex surfaces extending between outer edges of said second articulating surface.
178. The intervertebral implant of claim 172, wherein said radius of curvature B is less than said radius of curvature D.
179. The intervertebral implant of claim 172, wherein at least one of: (i) said first and third axes are coaxial; and (ii) said second and fourth axes are coaxial.
180. The intervertebral implant of claim 172, wherein at least one of; (i) said first and third axes are coplanar; and (ii) said second and fourth axes are coplanar.
181. The intervertebral implant of claim 172, wherein said first element has a center of rotation that remains below said articulating surfaces during one of said flexion/extension and lateral bending, and that remains above said articulating surfaces during the other of said flexion/extension and lateral bending.
182. The intervertebral implant of claim 172, wherein said first and second elements further include means for engaging a vertebral body.
183. The intervertebral implant of claim 182, wherein said means for engaging a vertebral body is selected from the group consisting of flanges, keels and spikes.
184. An intervertebral implant comprising:
a first member having a first toroidal saddle shaped articulation surface including a first concave arc extending between leading and trailing ends of the first articulation surface and a first convex arc extending between first and second lateral sides of the first articulation surface;
and a second member having a second toroidal saddle shaped articulation surface including a second convex arc extending between leading and trailing ends of the second articulation surface and a second concave arc extending between first and second lateral sides of the second articulation surface, wherein the first concave arc has a radius that is greater than the radius of the second convex arc, and the first and second articulation surfaces are adapted to engage one another during flexion, extension and lateral bending.
185. The intervertebral implant of claim 184, wherein rotation of said first member with respect to said second member occurs through at least a range of angles without said first and second members moving away from one another.
186. The intervertebral implant of claim 185, wherein said range of angles is approximately plus/minus three degrees from a resting position.
187. The intervertebral implant of claim 184 wherein said first articulation surface includes a single concave surface and a single convex surface, and said second articulation surface includes a single concave surface and a single convex surface.
188. The intervertebral implant of claim 187, wherein said single concave surface of said first articulation surface engages said single convex surface of said second articulation surface, and said single convex surface of said first articulation surface engages said single concave surface of said second articulation surface.
189. The intervertebral implant of claim 184, wherein said first articulation surface includes continuous concave and convex surfaces extending between outer edges of said first articulation surface, and said second articulation surface includes continuous concave and convex surfaces extending between outer edges of said second articulation surface.
190. The intervertebral implant of claim 184, wherein said first articulation surface is defined by a concave arc having a substantially constant radius of curvature A
about a first axis, and a convex arc having a substantially constant radius of curvature B about a second axis perpendicular to the first axis, and said second articulation surface is defined by a convex arc having a substantially constant radius of curvature C about a third axis, and a concave arc having a substantially constant radius of curvature D about a fourth axis perpendicular to the third axis.
191. The intervertebral implant of claim 190, wherein said radius of curvature A is greater than said radius of curvature C and said radius of curvature B is less than said radius of curvature D.
192. The intervertebral implant of claim 190, wherein at least one of: (i) said first and third axes are coaxial; and (ii) said second and fourth axes are coaxial.
193. The intervertebral implant of claim 190, wherein at least one of: (i) said first and third axes are coplanar; and (ii) said second and fourth axes are coplanar.
194. The intervertebral implant of claim 184, wherein the first member has a center of rotation that remains below said articulation surfaces during flexion/extension and that remains above said articulation surfaces during lateral bending.
195. The intervertebral implant of claim 184, wherein said first and second members further include means for engaging a vertebral body.
196. The intervertebral implant of claim 195, wherein said means for engaging a vertebral body is selected from the group consisting of flanges, keels and spikes.
197. An intervertebral implant comprising:
a first member having a first articulation surface that is defined at least by a concave arc having a radius of curvature A about a first axis, and by a convex arc having a radius of curvature B about a second axis substantially perpendicular to the first axis;
and a second member having a second articulation surface that is defined at least by a convex arc having a radius of curvature C about a third axis, and by a concave arc having a radius of curvature D about a fourth axis substantially perpendicular to the third axis, said radius of curvature A being greater than said radius of curvature C, wherein the first member has a first center of rotation that remains below said articulating surfaces during flexion/extension and a second center of rotation that remains above the articulation surfaces during lateral bending.
198. The intervertebral implant of claim 197, wherein rotation of said first member with respect to said second member occurs through at least a range of angles without said first and second members moving away from one another.
199. The intervertebral implant of claim 198, wherein said range of angles is approximately plus/minus three degrees from a resting position.
200. The intervertebral implant of claim 197, wherein said radius of curvature B is less than said radius of curvature D.
201. The intervertebral implant of claim 197, wherein said first articulation surface includes a single concave surface and a single convex surface, and said second articulation surface includes a single concave surface and a single convex surface.
202. The intervertebral implant of claim 201, wherein said single concave surface of said first articulation surface engages said single convex surface of said second articulation surface, and said single convex surface of said first articulation surface engages said single concave surface of said second articulation surface.
203. The intervertebral implant of claim 197, wherein said first articulation surface includes continuous concave and convex surfaces extending between outer edges of said first articulation surface, and said second articulation surface includes continuous concave and convex surfaces extending between outer edges of said second articulation surface.
204. The intervertebral implant of claim 197, further comprising means for engaging a vertebral body.
205. The intervertebral implant of claim 204, wherein said means for engaging a vertebral body are selected from the group consisting of flanges, keels and spikes.
206. An apparatus for replacing at least a portion of an intervertebral disc in a spinal column, comprising:
a first member having a first vertebral contact surface for engagement with an endplate of a first vertebral bone in the spinal column, and having a first articulation surface that is defined by a plurality of concave arcs each having a respective radius of curvature about a corresponding axis substantially perpendicular to an anterior-posterior plane of the spinal column, and a plurality of convex arcs each having a respective radius of curvature about a corresponding axis substantially perpendicular to a lateral plane of the spinal column; and a second member having a second vertebral contact surface for engagement with an endplate of a second vertebral bone in the spinal column, and having a second articulation surface that is defined by a plurality of convex arcs each having a radius of curvature about a corresponding axis substantially perpendicular to the anterior-posterior plane of the spinal column, and a plurality of concave arcs each having a radius of curvature about a corresponding axis substantially perpendicular to the lateral plane of the spinal column, each of the plurality of concave arcs of the first articulation surface opposing one of the plurality of convex arcs of the second articulation surface and each of the concave arcs of the second articulation surface opposing one of the convex arcs of the first articulation surface, the radius of curvature of each of the concave arcs of the first articulation surface being greater than the radius of curvature of the opposing convex arc of the second articulation surface and the radius of curvature of each of the concave arcs of the second articulation surface being greater than the radius of curvature of the opposing convex arc of the first articulation surface, wherein:
an intervertebral disc space is defined substantially between the first and second endplates of the first and second vertebral bones, and the radii of curvature of the first and second articulation surfaces are sized such that the first and second articulation surfaces engage one another when the first and second members are disposed in the intervertebral disc space to enable the first and second vertebral bones to articulate in at least one of flexion, extension and lateral bending, wherein the first member has a first center of rotation that remains below the articulation surfaces during flexion/extension in the anterior-posterior plane of the spinal column and a second center of rotation that remains above the articulation surfaces during lateral bending in the lateral plane of the spinal column.
207. The apparatus of claim 206, wherein at least one of (i) the axes perpendicular to the anterior-posterior plane of the spinal column are substantially coaxial; and (ii) the axes perpendicular to the lateral plane of the spinal column are substantially coaxial.
268. The apparatus of claim 206, wherein at least one of: (i) the axes perpendicular to the anterior-posterior plane of the spinal column lie in a plane that is substantially perpendicular to the anterior-posterior plane; and (ii) the axes perpendicular to the lateral plane of the spinal column lie in a plane that is substantially perpendicular to the lateral plane.
209. The apparatus of claim 206, wherein: at least one of the concave arcs of the first articulation surface has a radius of curvature A about a first axis substantially perpendicular to the anterior-posterior plane of the spinal column, and at least one of the convex arcs of the first articulation surface has a radius of curvature B about a first axis substantially perpendicular to the lateral plane of the spinal column; and at least one of the convex arcs of the second articulation surface has a radius of curvature C about a second axis substantially perpendicular to the anterior-posterior plane of the spinal column, and at least one of the concave arcs of the second articulation surface has a radius of curvature D about a second axis substantially perpendicular to the lateral plane of the spinal column.
210. The apparatus of claim 206, wherein: the concave arcs of the first articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the anterior-posterior plane of the spinal column; the convex arcs of the first articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the lateral plane of the spinal column;
the convex arcs of the second articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the anterior-posterior plane of the spinal column; and the concave arcs of the second articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the lateral plane of the spinal column.
211. The apparatus of claim 206, wherein: the concave arcs of the first articulation surface are of differing radii of curvature, each generally about a corresponding axis substantially perpendicular to the anterior-posterior plane of the spinal column; and the convex arcs of the second articulation surface are of differing radii of curvature, each generally about a corresponding axis substantially perpendicular to the anterior-posterior plane of the spinal column.
212. The apparatus of claim 211, wherein the convex arcs of the second articulation surface are of differing radii of curvature that correspond with the differing radii of curvature of the concave arcs of the first articulation surface.
213. The apparatus of claim 211, wherein: the anterior-posterior plane and the lateral plane intersect along a longitudinal axis of the intervertebral disc space when the apparatus is disposed in the intervertebral disc space; one or more of the radii of the concave arcs of the first articulation surface reduce as distances of origins of the radii from the anterior-posterior plane along the corresponding axes increase; and one or more of the radii of the convex arcs of the second articulation surface reduce as distances of origins of the radii of the convex arcs of the second articulation surface from the anterior-posterior plane along the corresponding axes increase.
214. The apparatus of claim 213, wherein the one or more of the radii of the convex arcs of the second articulation surface reduce in correspondence with the radii of the concave arcs of the first articulation surface.
215. The apparatus of claim 211, wherein: the convex arcs of the first articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the lateral plane of the spinal column; and the concave arcs of the second articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the lateral plane of the spinal column.
216. The apparatus of claim 206, wherein: the convex arcs of the first articulation surface are of differing radii of curvature, each generally about a corresponding axis substantially perpendicular to the lateral plane of the spinal column; the concave arcs of the second articulation surface are of differing radii of curvature, each of the concave arcs of the second articulation surface being generally about a corresponding axis substantially perpendicular to the lateral plane of the spinal column.
217. The apparatus of claim 216, wherein the concave arcs of the second articulation surface cooperate with the convex arcs of the first articulation surface.
218. The apparatus of claim 216, wherein: the anterior-posterior plane and the lateral plane intersect along a longitudinal axis of the intervertebral disc space when the apparatus is disposed in the intervertebral disc space; one or more of the radii of the convex arcs of the first articulation surface reduce as distances of origins of the radii from the lateral plane along the corresponding axes increase; and one or more of the radii of the concave arcs of the second articulation surface reduce as distances of origins of the radii of the convex arcs of the second articulation surface from the lateral plane along the corresponding axes increase.
219. The apparatus of claim 218, wherein the one or more of the radii of the concave arcs of the second articulation surface reduce in correspondence with the radii of the convex arcs of the first articulation surface.
220. The apparatus of claim 216, wherein: the concave arcs of the first articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the anterior-posterior plane of the spinal column; and the convex arcs of the second articulation surface are of substantially the same radius of curvature, each generally about a corresponding axis substantially perpendicular to the anterior-posterior plane of the spinal column.
221. The apparatus of claim 206, wherein the first and second articulation surfaces are sized and shaped to engage one another when the first and second members are disposed in the intervertebral disc space to enable the first and second vertebral bones to at least axially rotate relative to one another through a range of angles.
222. The apparatus of claim 206, wherein the first and second articulation surfaces are sized and shaped to engage one another when the first and second members are disposed in the intervertebral disc space to enable the first and second vertebral bones to axially rotate relative to one another through a range of angles without substantially displacing the first and second vertebral bones away from one another.
223. The apparatus of claim 222, wherein the first and second articulation surfaces are sized and shaped to achieve substantial point-to-point contact relative to one another when in at least some positions of flexion, extension, lateral bending, and/or axial rotation.
224. The apparatus of claim 222, wherein the range of angles is about plus/minus three degrees from a resting position.
225. The apparatus of claim 222, wherein the first and second articulation surfaces are sized and shaped such that the first and second vertebral bones are displaced away from one another at axial rotations outside the range of angles.
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US10/382,702 | 2003-03-06 | ||
US10/382,702 US6908484B2 (en) | 2003-03-06 | 2003-03-06 | Cervical disc replacement |
PCT/US2004/003966 WO2004080349A1 (en) | 2003-03-06 | 2004-02-11 | Cervical disc replacement |
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Publication Number | Publication Date |
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CA2518068A1 CA2518068A1 (en) | 2004-09-23 |
CA2518068C true CA2518068C (en) | 2008-12-23 |
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CA002518068A Expired - Fee Related CA2518068C (en) | 2003-03-06 | 2004-02-11 | Cervical disc replacement |
CA2802827A Abandoned CA2802827A1 (en) | 2003-03-06 | 2004-02-19 | Instrumentation and methods for use in implanting a cervical disc replacement device |
CA2653994A Expired - Fee Related CA2653994C (en) | 2003-03-06 | 2004-02-19 | Instrumentation and methods for use in implanting a cervical disc replacement device |
Family Applications After (2)
Application Number | Title | Priority Date | Filing Date |
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CA2802827A Abandoned CA2802827A1 (en) | 2003-03-06 | 2004-02-19 | Instrumentation and methods for use in implanting a cervical disc replacement device |
CA2653994A Expired - Fee Related CA2653994C (en) | 2003-03-06 | 2004-02-19 | Instrumentation and methods for use in implanting a cervical disc replacement device |
Country Status (6)
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US (30) | US6908484B2 (en) |
EP (1) | EP1599150A4 (en) |
JP (5) | JP4701162B2 (en) |
AU (1) | AU2010201667B2 (en) |
CA (3) | CA2518068C (en) |
WO (1) | WO2004080349A1 (en) |
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