US 20050038516 A1
Described herein is an intervertebral disk prosthesis with an angled leading edge for insertion into the intervertebral space. The disk prosthesis may provide for both rotation and compression.
1. A method of inserting an intervertebral disk replacement prosthesis into the intervertebral space, the method comprising retracting the intervertebral space with at least one retracting edge of an intervertebral disk prosthesis.
2. The method of
3. A method of intervertebral disk replacement comprising inserting into the intervertebral space a two half ball and socket intervertebral disk prosthesis with a compression function.
4. The method of
5. A method of providing an intervertebral disk replacement the method comprising:
inserting a disk ball and socket replacement prosthesis into the intervertebral space; and
at least one of the ball and the socket are movable whereby the disk prosthesis can compress.
6. A two half intervertebral disk prosthesis comprising:
a socket half base with a vertebra interface surface on one side;
a socket guide formed in the side of the socket half base opposite the vertebra interface surface;
a ball receiving socket movably placed in the socket guide;
an elastomeric insert between the bottom of the socket guide and the ball receiving socket;
a ball half base with a vertebra interface surface on one side; and
a ball head, which mates fits into the ball receiving socket opposite the vertebra interface surface.
7. The disk prosthesis of
8. The disk prosthesis of
9. The disk prosthesis of
10. The disk prosthesis of
11. The disk prosthesis of
12. A two half intervertebral disk prosthesis comprising:
a ball half base with a vertebra interface surface on one side;
a ball guide formed on the side of the ball half base opposite the vertebra interface surface;
a ball head movably placed in the ball guide; an elastomeric insert between the bottom of the ball guide and the ball head;
a socket half base with a vertebra interface surface on one side;
and, a ball receiving socket, which mates with the ball head on the side opposite the vertebra interface surface.
13. The disk prosthesis of
14. The disk prosthesis of
15. The disk prosthesis of
16. The disk prosthesis of
17. The disk prosthesis of
1. Field of the Invention
A method and device to stabilize an intervertebral space. More particularly an artificial spinal disk and method of installation and stabilization.
2. Description of Related Art
Diseased or degenerated disk material between vertebrae can cause persistent pain, stiffness and health problems. Surgical techniques such as fusion of two adjacent vertebrae can stabilize the spinal column but trade mobility for the support.
Artificial or prosthetic disk devices are known in the art. Primarily there are two types of solutions: an elastic type insert see generally U.S. Pat. No. 5,171,280; and a ball and socket type insert.
Elastic type inserts tend to degenerate and wear out over time. Moreover, elastic type inserts may become dislodged from the disk space. Ball and socket inserts allow for some mobility, and often perform well in vitro. However, in vivo, a ball and socket which performed well in the lab may not provide the same mobility as shown in vitro. U.S. Pat. No. 6,368,350 describes a ball and socket type disk replacement which is offset and has a variable access of rotation to mimic the movement of the spinal column.
Absent from the prior art is a ball and socket intervertebral disk replacement (prosthesis) which allows for rotation and compression.
Insertion into the intervertebral space of an intervertebral disk replacement is also a challenge. Methods of prosthetic disk insertion normally require intervertebral spacers to retract the upper and lower vertebrae and open up the space between those vertebrae and then to insert the disk replacement into the intervertebral space. During surgery, using intervertebral spacers requires additional time and bears with it the risk of the spinal column being damaged by the insertion of spacers. Other risks include opening the intervertebral space beyond what is necessary. It would therefore be a desideratum to have a method for fitting a disk replacement into a spinal column which could open the intervertebral space during insertion of the disk replacement. It would also be a desideratum to have a ball and socket disk prosthesis which provides for rotation and compression.
According to one aspect of the invention the ball and socket intervertebral disk replacement provides both rotation and compression.
In another aspect the intervertebral disk replacement can be used to help open up the intervertebral space. The leading edge of the IVDR helps retract the upper and lower vertebrae, relative to the intervertebral space being opened up.
It should be appreciated that for simplicity and clarity of illustration, elements shown in the Figures have not necessarily been drawn to scale. For example, the dimensions of some of the elements are exaggerated relative to each other for clarity. Further, where considered appropriate, reference numerals have been repeated among the Figures to indicate corresponding elements.
Other features and advantages of the present invention will be set forth, in part, in the descriptions which follow and the accompanying drawings, wherein the preferred embodiments of the present invention are described and shown, and in part, will become apparent to those skilled in the art upon examination of the following detailed description taken in conjunction with the accompanying drawings or may be learned by practice of the present invention. The advantages of the present invention may be realized and attained by means of the instrumentalities and combinations particularly pointed out in the appended claims.
An intervertebral disk replacement “IVDR” is shown in
Also shown is the socket half base 20 which supports a ball receiving socket 22 extended from its interior surface 24. The ball receiving socket 22 is of a size and shape to receive and hold the ball head 18.
Opposite the ball receiving socket 22 is the vertebra interface surface 26 of the socket half 20 of the IVDR 10. This vertebra interface surface 26 also has a principal surface 27 which may be rough, porous and/or porous and rough. Moreover, protrusion 28 may extend from the principal surface 27. The number of protrusions is variable and about two to about twenty protrusions are preferred, with about three to about twelve protrusions being more preferred and about three to about six protrusions being most preferred. Although protrusion 28 are shown only extending from the principal surface 26 of the socket half base 20 protrusions can also be formed on, or extended from, the principal surface 15 of the ball half base 12. A section of each vertebra interface surfaces 14 and 26 (shown in
Preferred materials for the construction of the IVDR include chrome cobalt, and titanium. It is possible to control the porosity at the principal surfaces 15 and 27 by either selection of material with the appropriate porosity or by modifying the principal surface to increase or decrease porosity. Well known in the art are methods such as shoot peening or ion beam exposure which can be used to modify the porosity of a principal surface. Porosity of the principle surface can facilitate bone growth from the adjacent vertebra to the principal surface of the IVDR.
Moreover, it is possible to coat the principal surfaces 15 and 27 (not shown) by commonly used methods such as sintering, pressure sintering (to add metal), cold spray, or coating with porous beads whereby a plastic or other material is affixed to the principal surfaces. The methods for affixing or applying coating materials to the base substrate materials for the IVDR 10 are commonly known in the art by those skilled in the art and therefore a detailed description of those processes are not provided. However, it is possible that after application of a coating (not shown) it may be advantageous to further sinter, or otherwise effect the coating to further select the roughness, variance, and/or porosity of the coating material.
The angular leading edge of each IVDR forms a retracting edge 30 and 30′ useful for insertion of the IVDR into the spinal column. Generally accepted practices of disk replacement require the opening of the intervertebral space “IVS” before insertion of an IVDR.
Once the IVDR is positioned in the IVS bone from the upper and lower vertebra VDA1 and VDA2 may grow into the principle surfaces 15 and 27 of the IVDR 10. Bone growth into a porous or rough region is not wholly predictable, therefore the roughness of the principal surfaces 15 and 27 and/or the protrusion 28 can be useful to provide additional anchor points between the IVDR 10 and the upper and/or lower vertebra VDA1 and VDA2.
One limitation of prior art ball and socket vertebral disk replacement prosthetic devices is an inability to mimic the compression of a natural disk. The embodiment shown in
In this embodiment the ball half base 62 of the IVDR 60, is substantially similar to the ball half base 12 of the IVDR shown in
Suitable elastomeric inserts include, but are not limited to C-Flex™ (Concept Inc.) or Pellethane™ (DOW Chemical), styrene-butadiene-butylene-styrene copolymer (SBBS), styrene-butadiene-styrene copolymer (SBS).
The top edge of the ball receiving socket 84 is shown in line with the top edge 85 of the socket support rim 76. The socket half base 70 of the IVDR 60 also has a top vertebra interfaced surface 86 which has a principle surface region 88. When a compression force “F” is applied the elastomeric insert 100 can compress. During compression (
The following example is given to enable those skilled in the art to most clearly understand and to practice the present invention which is not to be considered as limiting the scope of the invention but merely as being illustrative and representative thereof.
The distance between the bottom of the socket guide channel 80 and the bottom 82 of the ball receiving socket 82 is defined by the elastomeric material 100 as the initial elastomeric height EHi. After the facet joints have interface and “locked out” at the subjoint interface 92, as shown in
The compression of the elastomeric material 100, although shown substantially even, may also be localized whereby one area of the elastomeric material 100 compresses greater than another area thereby providing additional flex or extension. In those embodiments which provide uneven compression, to facilitate the uneven compression of the elastomeric material 100 the movable ball receiving socket 72 should have a diameter which is less than the diameter of the socket guide channel 75 to allow for uneven movement within the socket guide channel 75.
Since certain changes may be made in the above apparatus without departing from the scope of the invention herein involved, it is intended that all matter contained in the above description, as shown in the accompanying drawing, shall be interpreted in an illustrative, and not a limiting sense. It is not intended that the invention be limited to the illustrative embodiments.