US20060149384A1 - Artificial disc prosthesis - Google Patents

Artificial disc prosthesis Download PDF

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Publication number
US20060149384A1
US20060149384A1 US11/361,621 US36162106A US2006149384A1 US 20060149384 A1 US20060149384 A1 US 20060149384A1 US 36162106 A US36162106 A US 36162106A US 2006149384 A1 US2006149384 A1 US 2006149384A1
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United States
Prior art keywords
prosthesis
endplate
members
disc
motion
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US11/361,621
Inventor
Richard Navarro
Bharadwaj Ananthan
Randall Theken
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Theken Spine LLC
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Theken Disc LLC
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Priority to US11/361,621 priority Critical patent/US20060149384A1/en
Assigned to THEKEN DISC, LLC, AN OHIO LIMITED LIABILITY COMPANY reassignment THEKEN DISC, LLC, AN OHIO LIMITED LIABILITY COMPANY ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: ANANTHAN, BHARADWAJ, NAVARRO, RICHARD R., THEKEN, RANDALL R.
Publication of US20060149384A1 publication Critical patent/US20060149384A1/en
Abandoned legal-status Critical Current

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    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
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    • A61F2/442Intervertebral or spinal discs, e.g. resilient
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    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30362Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit with possibility of relative movement between the protrusion and the recess
    • A61F2002/3037Translation along the common longitudinal axis, e.g. piston
    • A61F2002/30372Translation along the common longitudinal axis, e.g. piston with additional means for limiting said translation
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    • A61F2002/30604Special structural features of bone or joint prostheses not otherwise provided for modular
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    • A61F2/30771Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30884Fins or wings, e.g. longitudinal wings for preventing rotation within the bone cavity
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    • A61F2/00Filters 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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    • A61F2002/30878Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30891Plurality of protrusions
    • A61F2002/30892Plurality of protrusions parallel
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    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
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    • A61F2002/30904Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves serrated profile, i.e. saw-toothed
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Definitions

  • This invention relates to an artificial visco-elastic, constrained motion disc for replacing intervertebral discs in the lower back, particularly in the lumbar and lumbar-sacral regions.
  • the human spine is composed of many vertebral bones stacked one upon the other, with an intervertebral disc between each pair of adjacent vertebral bones.
  • the discs act as cartilaginous cushions and shock absorbers.
  • the spinal cord runs in a bony canal formed by successive openings in these bones.
  • the spinal nerves exit the spinal cord between pairs of vertebrae and supply nerves and nerve signals to and from other body structures.
  • the intervertebral disc is a complex joint both anatomically and functionally. It is composed of three component structures: the nucleus pulposus; the annulus fibrosus, and the vertebral endplates. The biomedical composition and anatomical arrangements within these component structures are related to the biomechanical function of the disc.
  • the nucleus pulposus occupying about 25% to 40% of the total disc cross-sectional area, usually contains approximately 70% to 90% water by weight. Because of this high water content, the nucleus may be mechanically described as an incompressible hydrostatic material.
  • the annulus fibrosus is a concentrically laminated structure which contains highly aligned collagen fibers and fibrocartilage embedded in an amorphous ground substance.
  • the annular layers are oriented at approximately ⁇ 60° to the longitudinal axis of the spine.
  • the annulus fibrosus usually contains approximately 8 to 12 layers, and is mechanically the main stabilizing structure which resists torsional and bending forces applied to the disc.
  • the two vertebral endplates separate the disc from the adjacent vertebral bodies, and are composed of hyaline cartilage.
  • Spinal discs may be damaged or displaced due to trauma or disease.
  • the nucleus pulposus may herniate and protrude into the vertebral canal or intervertebral foramen. This condition is known as a herniated or “slipped” disc.
  • the disc may in turn press upon the spinal nerve that exits the vertebral canal through the partially obstructed foramen, causing pain or paralysis in the area of its distribution.
  • the most frequent site of occurrence of a herniated disc is in the lower lumbar region. To alleviate this condition, two procedures are common.
  • a second method for alleviating disc problems is insertion of an intervertebral disc replacement.
  • the object of an intervertebral disc replacement is to provide a prosthetic disc that combines both stability to support the high loads of the patient's vertebrae and flexibility to provide the patient with sufficient mobility and proper spinal column load distribution.
  • basically four types of artificial intervertebral discs have been developed: elastomer discs, ball and socket discs, mechanical spring discs, and hybrid discs.
  • Elastomer discs typically include an elastomer cushion which is sandwiched between upper and lower rigid endplates. Elastomer discs can provide cushion or damping functions similar in mechanical behavior to the removed intervertebral disc tissue.
  • known elastomer discs experience long-term in-vivo problems stemming from micro-cracking, fixation problems with respect to the endplates, insufficient compression and torsional resistance, and excessive motion which can lead to bulging of the replacement disc and resultant pain for the patient.
  • One hypothesis for the failures of previous elastomer based disc designs is the unlimited potential for strain. High load in vivo events cause subsequent changes in structural characteristics of the elastomer, a characteristic called the Mullins effect.
  • Ball and socket discs typically incorporate two plate members having cooperating inner ball and socket portions allowing an articulating motion of the members during movement of the spine. These types of discs generally restore spinal motion, but inadequately replicate the natural stiffness of the intervertebral disc. Furthermore, dislocation and wear problems exist with these devices as well as unsatisfactory motion limiting components. Some types also comprise polymers in conjunction with metallic components.
  • a Link Charite disc includes polyethylene/cobalt chrome molybdenum (CCM) construction.
  • CCM polyethylene/cobalt chrome molybdenum
  • This design restores motion, but in a very unphysiologic manner.
  • the design is essentially a ball and socket joint which does not provide the nonlinear elastic response of the normal disc including hysteresis and therefore shock absorption. As in hip replacements this design is subject to wear and polyethylene debris complications.
  • This disc which has been extensively implanted in Europe and the United States, relies on a relatively incompressible ultra high molecular weight polyethylene center mating with concave surfaces in cobalt chrome upper and lower endplates. The mating surfaces provide a low friction pseudo ball-socket joint with motion constraints in compression and anterior-posterior as well as lateral translation.
  • the device is totally unconstrained in rotation about its axis, and in tension. Though this device has a semi successful in vivo history, it lacks fundamental stress strain characteristics of the normal disc. Instead, it provides low friction, high movement, non-energy absorbing kinematic function restoration to the spine motion segment.
  • the disc is designed to move freely until limits of travel are reached. The stopping action provided is very abrupt and thus loads the vertebral endplate in a shock-like manner at end-of-travel. This disc imitates a free moving ball and socket joint, not a natural disc that behaves very elastically until annulus fibers play the role of a “limiter”.
  • a natural disc is load sharing between the elastic elements and fibrous tissue limiters.
  • Mechanical spring discs which generally have only two or three degrees of freedom, typically incorporate one or more coiled springs disposed between metal endplates. These discs generally allow movement of the vertebrae during flexion and extension. However, these types have significant wear problems, as well as problems dealing with in-vivo torsional loads, and overall these discs cannot replicate the six-degree of freedom movement of a natural intervertebral disc.
  • Hybrid types of discs generally incorporate two or more principals of any of the aforementioned disc types.
  • one common hybrid disc arrangement includes a ball and socket set surrounded by a non-adhered elastomer ring. This hybrid disc is more complex than would be preferred for common usage, and more importantly, the intermittent contact between the ball socket and the elastomer ring that occasionally occurs in-vivo causes critical wear problems.
  • an artificial disc constructed with a polymer between two metal endplates undergoes compression as a result of both gravity and patient activities requiring exertion of energy. Therefore, ideally a disc would include a means of protecting the polymer and the possible bond joint between polymer and metal. Mechanical stops and motion-limiters can be added to maintain the integrity of the prosthesis. Such structures can take the form of rods, tension cables, or other connectors, as well as metal-to-metal contact in compression, to name but a few examples. Moreover, it would be beneficial for a disc also to include a means to convey to surgeons and to patients the actual state of the loads experienced by the device.
  • the artificial disc should maintain the vertebrae spaced from each other and prevent pinching of nerves or spinal cord.
  • the artificial disc should provide good load distribution.
  • the artificial disc should be sufficiently resilient to accommodate other motions of the spine, including flexion, extension, lateral bending, and rotation, as well as combinations of these motions. In humans, the bony facet joints actually limit the rotational movement.
  • a disc typically need only rotate approximately three degrees.
  • the disc should provide restorative force to bias toward the resting position.
  • the artificial disc should be both biocompatible and biostable such that the disc itself or any of its degradation byproducts, if any, do not cause adverse tissue reactions.
  • the disc can also provide stored or real-time data to the surgeon and the patient regarding the state of the loads and displacements experienced by the disc.
  • the present invention is directed to a prosthetic intervertebral disc replacement that restores and preserves the physiologic function of a normal spinal motion segment.
  • the intervertebral disc replacement addresses the detrimental phenomenon of cascading spine syndrome observed in long-term patients with fused-spinal segments.
  • the present intervertebral disc replacement is designed to avoid the need for spinal fusion or at least prolong the need for it.
  • the invention incorporates elements to bear high load in the design, while preserving the ability of the elastomer to provide substantial motion at low to moderate loads.
  • the invention demonstrates the potential to survive high cycle fatigue in bending, compression, and shear along all three mutually orthogonal axes. The motion-limiting features survive high load, low cycle fatigue and preserve the integrity of the elastic range performance of the device.
  • the elastomer and the bond interface experiences no additional significant loads as the limiter feature will prevent further significant strain.
  • In vivo loading varies by the individual, activity level, and unique high load events.
  • limiting strains prevents the elastomer from continually changing its structural characteristics with each high load event. A stable stress strain characteristic can be reached and predictable disc performance can be achieved.
  • the present invention is a visco-elastic constrained-motion disc prosthesis generally comprising specially designed rigid upper and lower endplates having therewithin channels or openings for receiving one or more motion-limiting members fitted on each end with an enlarged portion.
  • the lower surface of the upper endplate contains a first projection therefrom that extends toward the lower endplate.
  • the upper surface of the lower endplate can contain a second projection extending toward said upper endplate and substantially aligned with said first projection.
  • the first and second projections terminate to create a gap therebetween, forming a compression stop.
  • an elastomer cushion Interposed between the upper and lower endplates is an elastomer cushion.
  • the elastomer cushion is not in direct contact with either the motion-limiting members or the first or second projections to avoid wear and debris problems.
  • the gap allows a predetermined amount of axial movement, but no more, between the upper endplate and the lower endplate. As a result, the gap prevents excess compression from occurring, and is usually designed to allow approximately 1 to 2 millimeters of relative movement between the upper and lower endplates. This limits the compressive stresses seen by the elastomer. During most activities of the patient, the elastomer will exclusively carry the load. The compression stop will be engaged typically only during activities of high exertion.
  • the motion-limiting members with enlarged portions are inserted into internal cavities in the elastomer and link the upper endplate to the lower endplate.
  • the motion-limiting members are dimensioned so as to have a length that is slightly greater than the distance between the lower surface of the upper endplate and the upper surface of the lower endplate (and also preferably slightly less than the overall length of the internal cavities in which they reside). This allows space for the motion-limiting members to move during compression.
  • the motion-limiting members are strategically oriented to resist the tension in the posterior region of the disc. If motion-limiting members are present at the anterior portion of the disc, they float freely in the internal cavities during bending.
  • the external surfaces of the upper and lower endplates can also be fitted with wedges, spikes, keels, or other appurtenances to aid in attachment to a vertebral body. These appurtenances can also serve as covers to enclose the enlarged portions of the motion-limiting members.
  • some embodiments of the invention utilize strain gauges, pressure transducers, piezoelectric force transducers, or other means of force transduction to provide stored or real-time data to the surgeon or patient of the load state of the disc.
  • Hybrid discs according to the invention can overcome one of the failure modes of previous artificial disc designs, namely that of delamination and fatigue failure of the bonded interface between the elastomer and metal. This can be accomplished through improved bonding and motion-limiting features, in those embodiments where the visco-elastic cushion is bonded to the endplates. Other embodiments that utilize no bonding between the visco-elastic cushion and the endplates also achieve improved results with motion-limiting features.
  • a particularly useful embodiment comprises an artificial intervertebral disc prosthesis having an anterior portion and a posterior portion, further comprising: a first endplate having an upper surface and a lower surface, wherein the first endplate further comprises at least one opening for receiving at least one motion-limiting member; a first projection extending from the lower surface of the first endplate terminating in a first distal end; a second endplate having an upper surface and a lower surface, wherein the second endplate further comprises at least one opening for receiving at least one motion-limiting member; a second projection extending from the upper surface of the second endplate and substantially aligned with the first projection, wherein the second projection terminates at a second distal end to form a gap having a predetermined distance between the first and second distal ends; at least one motion-limiting member received respectively in the at least one opening of the first and second endplates, linking the two endplates and allowing only a predetermined amount of movement thereof; and a visco-elastic cushion
  • FIG. 1 is a graph showing the typical nonlinear response to load of human spine motion segments
  • FIG. 2 is a diagram showing a reference coordinate system for a functional spinal unit to be used herein;
  • FIG. 3 is a posterior perspective view of a first embodiment of an artificial disc of the present invention.
  • FIG. 3 ( a ) is the artificial disc of FIG. 3 showing a second type of appurtenance fitted to the upper and lower endplates;
  • FIG. 3 ( b ) is the artificial disc of FIG. 3 showing a third type of appurtenance fitted to the upper and lower endplates;
  • FIG. 3 ( c ) is the artificial disc of FIG. 3 showing a fourth type of appurtenance fitted to the upper and lower endplates;
  • FIG. 4 is a top plan view of the artificial disc of FIG. 3 ;
  • FIG. 5 is a bottom plan view of the artificial disc of FIG. 3 ;
  • FIG. 6 is a posterior elevation view of the artificial disc of FIG. 3 ;
  • FIG. 7 is a lateral elevation view of the artificial disc of FIG. 3 ;
  • FIG. 8 is an exploded perspective view of the artificial disc shown in FIG. 3 ;
  • FIG. 9 is a section view taken along plane A-A in FIG. 3 ;
  • FIG. 10 is a section view taken along plane B-B in FIG. 3 ;
  • FIG. 11 is a section view taken along plane C-C in FIG. 3 ;
  • FIG. 12 is a section view taken along plane D-D in FIG. 3 ;
  • FIG. 13 is an exploded perspective view of an exemplary motion-limiting member of a first embodiment of the invention.
  • FIG. 14 is a perspective view of a second embodiment of an artificial disc of the present invention having four motion-limiting members therein;
  • FIG. 15 is an exploded perspective view of the embodiment of the artificial disc of the present invention shown in FIG. 14 ;
  • FIG. 16 is a section view taken along plane E-E in FIG. 14 ;
  • FIG. 17 is a section view taken along plane F-F in FIG. 14 ;
  • FIG. 18 is a section view taken along plane G-G in FIG. 14 ;
  • FIG. 19 is a section view taken along plane H-H in FIG. 14 ;
  • FIG. 20 is a section view taken along plane I-I in FIG. 14 ;
  • FIG. 21 is a side elevation view of a disc according to a first embodiment of the invention showing the disc in normal bending mode;
  • FIG. 22 is a top view of an embodiment of a lower endplate flex circuit for an artificial disc using strain gauges to provide force transduction for providing data external to the disc;
  • FIG. 23 is a side section view of the disc shown in FIG. 21 in normal bending mode
  • FIG. 24 is a perspective view of a motion-limiting member according to an embodiment of the invention incorporating a split ring in place around the enlarged portion of the motion-limiting member;
  • FIG. 25 is a side elevation schematic of an embodiment of an artificial disc using strain gauges to provide force transduction for providing data to locations external to the disc;
  • FIG. 26 is a perspective view of the posterior side of an alternative embodiment of the disc showing removable appurtenances
  • FIG. 27 is a perspective view of the anterior side of the disc shown in FIG. 26 ;
  • FIG. 28 is a perspective view of the posterior side of an appurtenance and an upper endplate according to an embodiment of the invention.
  • FIG. 29 is a perspective view of the anterior side of the endplate shown in FIG. 28 .
  • FIG. 1 is a graph of the response of the normal human disc to load.
  • the nonlinear response of the motion segment is a function not only of the disc, but of the facet joints and ligaments. Facet joint function and ligamentous structures may be compromised and unable to provide load sharing as in a normal motion segment.
  • the nonlinear response of spine motion segment to load shown in FIG. 1 is a typical curve shape in compression, shear, torsion, and bending.
  • FIG. 2 is a perspective view of a reference intervertebral disc coordinate system that will be used throughout this discussion for ease of reference.
  • the figure shows typical loads (forces and moments) and typical displacements (translation and rotation) that can occur in each of the three mutually orthogonal directions.
  • the load-deflection curve shape of FIG. 1 is similar in all three directions for a normal disc.
  • a disc 10 of the present invention provides a nonlinear response to torsion, shear, and compressive loads.
  • the disc 10 comprises a first or upper endplate 20 , a second or lower endplate 30 , and a visco-elastic cushion 40 interposed between and adhered to the two endplates.
  • the upper and lower plates 20 , 30 are substantially symmetrical about an anterior-posterior horizontally extending plane (a transverse plane shown in FIG. 2 ), as well as about a sagittal plane ( FIG. 2 ).
  • the terms “upper” and “lower” are used herein only for illustration purposes with reference to the orientation of the disc 10 when it is implanted in the human body between two adjacent vertebrae V 1 and V 2 (defined as the cephalad-caudal direction in FIG. 2 ). Indeed, the upper plate is more generally described as a first plate and the lower plate is more generally described as a second plate.
  • the upper endplate 20 is rigid and is preferably made from a biocompatible material such as stainless steel, titanium, titanium alloys (such as Ti6Al4V), composite materials, and the like.
  • a biocompatible material such as stainless steel, titanium, titanium alloys (such as Ti6Al4V), composite materials, and the like.
  • the most preferred material is cobalt chrome molybdenum (CoCrMo or “CCM”) comprising approximately 66% Co, 28% Cr, and 6% Mo by weight.
  • the upper endplate 20 has an upper surface 21 and a lower surface 22 and an anterior portion 23 and a posterior portion 24 .
  • Upper surface 21 and lower surface 22 are generally parallel.
  • the anterior portion 23 is the portion of the upper endplate 20 that is disposed anteriorly in the spine when the disc 10 is implanted.
  • the posterior portion 24 is the portion of the upper endplate 20 that is disposed posteriorly in the spine when the disc 10 is implanted.
  • the upper endplate 20 has an external surface 29 therearound that preferably defines a generally “D” shape.
  • the posterior portion 24 of the external surface 29 has a concavity 28 therein that defines posterior lobes 25 , 26 projecting from the posterior portion 24 (see FIGS. 3, 4 , 5 , 12 , 14 , and 15 ).
  • One or more appurtenance 27 may be optionally affixed to the upper surface 21 to facilitate attachment.
  • the upper endplate 20 likewise may comprise an upper subplate 200 (see FIG. 15 ) that can be formed monolithic with the upper endplate 20 or as a separate component affixed thereto subsequent to manufacture.
  • the structures that comprise the upper subplate 200 may simply be included in the upper endplate 20 .
  • the subplate 200 further comprises an upper surface 210 and a lower surface 220 and an anterior portion 230 and a posterior portion 240 .
  • a first projection 270 optionally may depend from the lower surface 220 of the subplate 200 to act as part of a compression stop, as will be described below.
  • the upper subplate 200 also has a plurality of openings 271 therethrough for receiving one or more motion-limiting members 80 (described below).
  • the upper subplate 200 includes two openings 271 , one disposed posteriorly and slightly to the left (in the medial-lateral plane) of the first projection 270 and another disposed posteriorly and slightly to the right (in the medial-lateral plane) of the first projection 270 (assuming the center of rotation is at the geometric center of the disc).
  • the openings 271 further comprise a bearing surface 272 for interacting with the motion-limiting members 80 or a split ring assembly 400 (described below).
  • the bearing surface 272 is preferably a tapered opening having a larger diameter at the upper surface 210 than at the lower surface 220 .
  • the taper can be linear or nonlinear, including conic sections, parabolic sections, spherical sections, and so forth, to name only a few examples.
  • the first projection 270 preferably extends from said lower surface 220 a height of approximately 1 mm to approximately 3 mm. Many shapes are possible for the first projection 270 , and indeed multiple projections, or no projections, are contemplated as well.
  • the first projection 270 takes the form of a substantially cylindrical section having a slight radius on its terminal end of approximately 2 mm to approximately 15 mm, preferably approximately 8 mm to approximately 12 mm.
  • the disc 10 further comprises a lower endplate 30 .
  • the lower endplate 30 is rigid and is preferably made from a biocompatible material such as stainless steel, titanium, titanium alloys (such as Ti6Al4V), composite materials, and the like.
  • the preferred material is cobalt chrome molybdenum (CCM) comprising approximately 66% Co, 28% Cr, and 6% Mo by weight, respectively.
  • the lower endplate 30 has an upper surface 31 and a lower surface 32 and an anterior portion 33 and a posterior portion 34 .
  • Upper surface 31 and lower surface 32 are generally parallel.
  • the anterior portion 33 is the portion of the lower endplate 30 that is disposed anteriorly in the spine when the disc 10 is implanted.
  • the posterior portion 34 is the portion of the lower endplate 30 that is disposed posteriorly in the spine when the disc 10 is implanted.
  • the lower endplate 30 has an external surface 39 therearound that preferably defines a generally “D” shape.
  • the posterior portion 34 of the external surface 39 has a concavity 38 therein that defines posterior lobes 35 , 36 projecting from the posterior portion 34 (see FIGS. 3, 4 , 5 , 12 , 14 , and 15 ).
  • One or more appurtenance 37 may be optionally affixed to the lower surface 32 to facilitate attachment.
  • the lower endplate 30 may comprise a lower subplate 300 (see FIGS. 8 and 15 ) that can be formed monolithic with the lower endplate 30 or as a separate component affixed thereto subsequent to manufacture.
  • the subplate 300 further comprises an upper surface 310 and a lower surface 320 and an anterior portion 330 and a posterior portion 340 .
  • a second projection 370 depends from the upper surface 310 of the subplate 300 to act as part of a compression stop, as will be described below.
  • the lower subplate 300 also has a plurality of openings 371 therethrough, having bearing surfaces 372 , for receiving one or more motion-limiting members 80 (described below).
  • the lower subplate 300 includes two openings 371 , one disposed posteriorly and slightly to the left of the first projection 370 and another disposed posteriorly and slightly to the right of the first projection 370 .
  • the second projection 370 preferably extends from said upper surface 310 a height of approximately 3 mm to approximately 6 mm.
  • the second projection 370 is in substantial alignment with the first projection 270 .
  • the second projection 370 preferably will have its longitudinal axis aligned with or close to the longitudinal axis of the first projection 270 .
  • the two projections 270 , 370 may be offset from one another, it being more important that at least a portion of the projections 270 , 370 overlap during contact therebetween.
  • the amount of offset may vary. Many shapes are possible for the second projection 370 , including, but not limited to, all regular polygonal shapes.
  • the projections 270 , 370 may take the form of partial polygons (for example, a half cylinder or a partial elliptical cylinder, to name but a few).
  • the second projection 370 takes the form of a cylindrical platform having a diameter of approximately 6 mm to 10 mm, and more particularly, approximately 7 mm to approximately 9 mm.
  • a motion-limiting member 80 typically resides within each opening 271 , 371 .
  • Each motion-limiting member 80 has a length 81 and a diameter 82 , and a first end 83 and a second end 84 .
  • At each end 83 , 84 is an enlarged portion 90 .
  • the motion-limiting members 80 link the upper endplate 20 to the lower endplate 30 and assist in handling the loads associated with flexion, as will be described below.
  • the motion-limiting members 80 can be any of several longitudinal rod-like members, both rigid and semi-rigid, including solid metallic bars or rods of varying cross-sections, and wire. If wire is used as the motion-limiting member 80 , the motion-limiting members 80 typically have diameters of approximately 0.038 inches to approximately 0.080 inches. However, the number of motion-limiting members 80 used plays a role in determining the diameter of each motion-limiting member 80 . In the preferred embodiment, there are two motion-limiting members 80 that are braided metal wires, preferably a braided stainless steel wire having a diameter of approximately 0.062 inches and a rated tensile strength of approximately 320 pounds.
  • the motion-limiting members 80 can be of any material described above, but are preferably cables of 316L stainless, MP35N, Haynes 25 .
  • the diameters can be significantly smaller.
  • the enlarged portion 90 at each end 83 , 84 is typically a spherically-shaped structure, or ball 91 , that is affixed to the motion-limiting member 80 .
  • Balls 91 are preferably of the same material as the motion-limiting members 80 .
  • the ball 91 has an upper surface 92 and a lower surface 93 .
  • ball 91 is preformed onto the motion-limiting member 80 .
  • methods of fixation are also varied and include welding, both during formation of the ball 91 at the first end 83 and during assembly of the ball 91 at the second end 84 ; as well as crimping on a ball 91 .
  • the balls 91 are preferably hemispheres wherein the lower surface 93 engages the bearing surface 272 of the plates 20 , 30 and/or the subplate 200 , 300 .
  • the upper surface 92 of the ball 91 provides little to no advantage and merely takes up space.
  • the upper surface 92 is preferably flat or very low-profile so as to take up a minimal amount of space.
  • the appurtenances 27 , 37 on the upper and lower endplates 20 , 30 may be used to cover a portion of the enlarged portions 91 .
  • the inside surface 400 d of the split ring assembly (described below) can be used to effectively shorten the length of the motion-limiting member 80 such that no part of the enlarged portion 91 extends beyond the upper surface 21 of the upper endplate or the lower surface 32 of the lower endplate 30 .
  • a split ring assembly 400 fits into the openings 271 of the upper subplate 200 and into openings 371 of the lower subplate 300 .
  • the split ring assembly 400 comprises a first half 400 a and a second half 400 b .
  • the two halves 400 a , 400 b of the split ring assembly 400 are combined, they form a ring-shaped member having a port 400 c defined by a periphery 400 e .
  • the split ring assembly 400 includes an inside surface 400 d that serves as a bearing surface against which the balls 91 can articulate, resulting in a mini-ball and socket joint.
  • the diameter of port 400 c is smaller than that of the ball 91 .
  • the motion-limiting member 80 Since the diameter of the port 400 c in the split ring assembly is smaller than that of the ball 91 at the first end 83 of the motion-limiting member 80 , the motion-limiting member 80 is prevented from slipping through the opening 271 of the upper subplate 270 .
  • a split ring assembly 400 is inserted into the opening 371 of the lower subplate 300 above the ball 91 at the second end 84 of the motion-limiting member 80 in order to prevent the motion-limiting member 80 from slipping through the opening 370 of the lower subplate 300 .
  • the split ring assemblies 400 may be welded or permanently affixed by some other means known in the art to the upper and lower subplate assemblies 200 , 300 .
  • the split ring assembly 400 includes an inside surface 400 d that serves as a bearing surface against which the balls 91 can articulate, resulting in a mini-ball and socket joint, thus minimizing the bending of the motion-limiting member 80 and extending fatigue life.
  • the split ring assembly 400 is not present, and the balls 91 are not preformed onto the motion-limiting members 80 . Instead the balls 91 are fixed onto the motion-limiting members 80 through some other means such as welding or crimping, as discussed above. However, welding the ends of the motion-limiting members 80 into balls 91 can lower the strength of the motion-limiting members 80 by 10 to 15 percent.
  • the diameter of ball 91 can be controlled during welding, ranging in size from approximately slightly larger than the diameter of the motion-limiting member 80 up to a maximum diameter of approximately two times the motion-limiting member diameter. In embodiments using other attachment methods, other diameters are possible.
  • the balls 91 at the first end 83 and the second end 84 mate with the bearing surface 272 of the openings 271 in each endplate 20 , 30 and/or subplate 200 , 300 .
  • each union of ball 91 and bearing surface 272 results in a mini-ball and socket joint that allows articulation of the ball 91 and motion-limiting member 80 within the opening 271 , thus limiting bending of the motion-limiting member 80 , thereby extending fatigue life.
  • the disc 10 of the preferred embodiment provides motion-limiting features in compression and bending, thereby behaving in vivo in a fashion more similar to a natural spinal disc.
  • the first projection 270 and the second projection 370 by way of the predetermined gap 470 therebetween (see FIGS. 9, 10 , 11 , 16 , 17 , and 19 ), provide a compression stop preventing movement between the upper and lower plates 20 , 30 in a magnitude greater than a predetermined amount. Varying limits of movement may be set, depending on the type and location of the disc 10 in the body.
  • the gap 470 between the first and second projections 270 , 370 is approximately 1 to 2 millimeters.
  • Elastomers that can handle excessive compressive loadings may be able to accommodate a gap greater than 2 millimeters.
  • the visco-elastic cushion 40 absorbs the compression in a visco-elastic fashion according to design properties of the elastomer.
  • the first and second projections 270 , 370 then come into contact and prevent further compressive loads from being applied to the elastomer. It is expected that the stop mechanism will only be activated during the most strenuous of activities of the patient.
  • the motion-limiting members 80 can perform the primary or secondary motion limiting functions.
  • the most common bending scenario for the spine is bending in the sagittal plane (that is, bending about the x-axis). For example, this would be accomplished by bending over to tie one's shoes.
  • the disc 10 can undergo both shear and lateral displacement.
  • FIGS. 21 and 23 a disc 10 is depicted in such a scenario and is shown exaggerated for easier reference. It can be seen that the anterior side is slightly compressed, while the posterior side is slightly in tension and a slight translation of the upper endplate 20 with respect the lower endplate 30 .
  • the motion-limiting members 80 can become oriented diagonally. In this event, the motion-limiting members 80 in tension provide a force preventing the upper endplate 20 and lower endplate 30 from separating because the lower surface 93 of the ball 91 begins to bear upon the split ring assembly 400 and/or bearing surfaces 272 of the openings 271 .
  • the mechanics of the disc 10 depicted in FIGS. 21 and 23 are basically identical whether the bending is in the sagittal plane (front to back, or tying ones shoes) or in the frontal plane (side to side bending).
  • the motion-limiting members 80 are strategically oriented to resist the tension in the posterior region of the disc 10 .
  • compression of the cables can cause splaying, which shortens their fatigue life. Therefore, placing more motion-limiting members 80 posteriorly than anteriorly (for example, see FIG. 12 ) accounts for the greater expected flexion moments of 20-30 N ⁇ m versus the lesser extension moments of about 10 N ⁇ m.
  • a further factor in the allowed range of motion in flexion and extension is a consideration of the cable distance from an assumed center of rotation at the center of the disc 10 .
  • Combinations of cable placement and initial diagonal orientation may be necessary to solve these conflicting design goals.
  • preferable ranges of stiffnesses and motion for the disc 10 are as follows: Nonlinear stiffness in compression (1,000 to 3,000 N/mm) and in flexion (1.0 to 5.0 N ⁇ m/deg) and maximum motion in compression (1.0 to 2.0 mm) and in flexion (8 to 12 deg).
  • FIGS. 14, 15 , 16 , 17 , 18 , and 19 there are corresponding four openings 271 , 371 in both the upper and lower subplates, 200 , 300 .
  • One of the openings 271 , 371 is located anteriorly and slightly to the left of the first and second projections 270 , 370
  • another opening 271 , 371 is located anteriorly and slightly to the right of the first and second projections 270 , 370 .
  • a third opening 271 , 371 is located posteriorly and slightly to the left of the first and second projections 270 , 370
  • the fourth opening 271 , 371 is located posteriorly and slightly to the right of the first and second projection 270 , 370 .
  • the motion-limiting members 80 at the posterior portion of the disc 10 are strategically-oriented to resist the tension in the posterior region of the disc 10
  • the motion-limiting members 80 at the anterior portion of the disc 10 float freely in the spike cavity in the anterior region of the disc 10 .
  • a disadvantage of this embodiment is the presence of motion-limiting members 80 at the anterior portion of the disc 10 .
  • motion-limiting members 80 when braided cables are used for the motion-limiting members 80 , compression can cause splaying, leading to a shorter fatigue life. As motion-limiting members 80 located at the anterior of the disc 10 encounter significantly more compression than motion-limiting members 80 located at the posterior of the disc 10 during the normal activity patterns of most individuals, anteriorly-located motion-limiting members 80 are likely to have a shorter life than those located at the posterior of the disc 10 .
  • the compression stop formed by the first and second projections 270 , 370 also limits motion in flexion and lateral bending. This is accomplished by sizing the first and second projections 270 , 370 such that when the prosthesis engages in flexion or bending and the first projection 270 tilts toward the second projection 370 , the leading edge of the first projection 270 will come into contact with the second projection 370 after a predetermined amount of flexion or bending, preventing further motion.
  • This has the advantage of eliminating the need for the motion-limiting members 80 , thereby reducing the number of elements within the prosthesis that are susceptible to wear and fatigue.
  • the preferred disc has certain load versus deflection characteristics that are similar to those found in the natural human disc. As was stated above, it is useful, once implanted, that the surgeon and patient can know the state of load experienced by the device.
  • embodiments of the disc have, integral to its construction, strain gauges or other means of force or pressure transduction.
  • strain gauges can be connected to signal conditioning and amplification circuitry on a micro scale in order to fit within the constraints of space available in the upper or lower endplate.
  • the center stop is integral to the lower endplate and consists of a hollow raised cylindrical platform.
  • the space inside this cylinder can house, for example, a 3 ⁇ 3 ⁇ 3 mm electronics package.
  • the package can be wired to strain gauges on the inside of the raised cylinder and in peripheral locations around the bottom endplate.
  • the transduction means can be connected to electronics such as piezoelectronics that eliminate the need for signal conditioning and amplification.
  • FIGS. 22 and 25 depict how one embodiment of an artificial disc 10 uses strain gauges to measure the load experienced by the prosthesis and relay that data on demand.
  • the transducers within the polymer is not preferred since fatigue of wires or the introduction of stress risers within the polymer can lead to fatigue failure initiation sites. For these reasons, placing the signal conditioning microelectronics within the center compression stop is advantageous. Once conditioned, the signal is telemeterized on demand through excitation of an internal coil from an inductively coupled external coil. This couple energizes the electronics and transmits the data upon request. This mode of interrogating the device for its load condition can be done real time or fed back from memory storage according to a preset sampling routine. It is also possible to sample the device remotely and wirelessly via the internet.
  • the data can indicate changes in the device since its implantation. It can also store load history to indicate if the patient is following doctor's orders for allowed activities.
  • the power source for memory-based data is optionally a micro battery or a capacitor charged from the external inductive couple. The use of piezos is also possible.
  • a mylar flex circuit is pre-made and placed on the second endplate. Transducers are embedded on the mylar circuit and connected to the signal conditioning and amplifying electronics.
  • FIGS. 26-29 show an alternative embodiment of the invention wherein the disc 10 comprises multiple components that may be implanted separately. Indeed, the disc 10 may comprise many forms and embodiments that are implantable in pieces. The desirability of multi-part prostheses is known by surgeons and simplifies the implantation procedures.
  • FIGS. 26-29 simply depict one example.
  • the appurtenances 27 are removably insertable into the upper and lower endplates 20 , 30 .
  • the upper surface 92 of the balls 91 is not depicted but typically would be visible.
  • the groove into which appurtenances 27 are slid form a taper lock fit to lock the appurtenance into place.
  • One example of a surgical procedure using a multi-part disc 10 involves the surgeon first removing the diseased or damaged disc using the typical procedures in practice.
  • An instrument (not shown) is used to prepare the site by cutting grooves into the adjacent vertebrae to receive the appurtenances 27 of the disc 10 .
  • the instrument cuts both the upper and lower grooves simultaneously so as to maintain the tolerances needed for the implantation of the disc 10 .
  • An instrument then inserts the appurtenances 27 into the prepared site.
  • the disc 10 is then inserted between the appurtenances 27 , which receive the grooves of the upper and lower endplates 20 , 30 .
  • the taper lock secures the appurtenances 27 to the prosthesis.
  • the endplates 20 , 30 and/or endplate subplates 200 , 300 may be of the materials described above. Further, they may have thicknesses in the range of approximately 1 mm to approximately 3 mm. Their surfaces may be surface-treated or machined for texture and bonding improvement. Examples of such treatments include but are not limited to ion etching, simple grit blasting, plasma spraying, or CNC machined geometry.
  • the endplates 20 , 30 (and/or 200 , 300 ) are a CCM which is good in wear.
  • the upper surfaces 21 , 210 of the upper endplate 20 and upper subplate 200 , and the lower surfaces 31 , 310 of the lower endplate 30 and lower subplate 300 , as well as the surfaces that interact with the visco-elastic cushion, may be coated with Titanium 6Al4V to improve bone interface and bonding.
  • the second projection 370 can, as stated above, take many forms, including by way of mere examples, a cylinder, a post, a platform, and so forth.
  • the preferred cylindrical member is a solid projection from the lower endplate 20 or lower subplate 200 . However, the cylindrical member could be hollow so as to accommodate integral microelectronics diagnostics, as was discussed above.
  • the endplates 20 , 30 are first machined of either titanium or cobalt chrome molybdenum (CCM), with openings 270 representing areas where there will be no elastomer cushion 40 .
  • CCM cobalt chrome molybdenum
  • the endplates 20 , 30 are inserted into a mold with cores to create voids that will later contain the center stop and the motion-limiting members 80 . It is preferable to keep the elastomer free of the cables and center stop so as not to introduce elastomer abrasion leading to fatigue failures.
  • the motion-limiting members 80 are then assembled to the molded subassembly with a welding process.
  • the cable assemblies terminate in a ball end. In the preferred embodiment the ball is preformed onto the cable, though this is not required.
  • the enlarged portion 90 extends beyond the plane of the upper surface 21 of the upper endplate 20 or the lower surface 32 of the lower endplate 30 .
  • these appurtenances serve as temporary anchors in the vertebra and covers that enclose the mini ball-socket joint created between the endplate and the ball. Additionally, the ball-socket articulation prevents bending in the cables, thereby extending fatigue life.
  • the motion-limiting members 80 it is possible for the motion-limiting members 80 to be laser welded into the endplates in the openings where cores created voids in the elastomer.
  • the center stop is a designed gap preferably to prevent more than 1-2 mm of compression from occurring, thereby limiting the elastomer compressive stress. This mandates a good wear interface for the stop.
  • a choice of CCM on CCM is preferred due to its recent introduction as the wear couple in some FDA-approved metal-on-metal hips.
  • many structural configurations for the first and second protrusions 270 , 370 are possible, including pin-on-pin, pin-on-plate (shown), plate-on-plate, ball-on-plate, and so forth.
  • the elastomer will exclusively carry the load during most activities of daily living.
  • the center stop will be engaged only during activities of high exertion, except in the embodiment in which no motion-limiting members 80 are present.

Abstract

A visco-elastic motion-limiting artificial intervertebral disc prosthesis is provided that mimics the physiologic function of a normal spinal disc. The disc comprises upper and lower endplates having therewithin channels or openings for optionally receiving one or more motion-limiting members fitted on each end with an enlarged portion. One or more compression stops is provided between the upper and lower endplates. Additionally, an elastomeric cushion is disposed between the endplates and surrounds the motion-limiting members. Also, force transducers and microelectronics can be utilized to provide data to the surgeon or the patient regarding the load state of the disc.

Description

    CROSS-REFERENCE TO RELATED APPLICATIONS
  • This patent application is a continuation of and claims priority to and benefit from, currently pending, U.S. patent application Ser. No. 10/552,094, filed on Oct. 4, 2005, which is a '371 filing from PCT/US2004/010000, filed on Apr. 2, 2004, which is a continuation of U.S. Provisional Patent Application Ser. No. 60/460,613, filed on Apr. 4, 2003.
  • BACKGROUND OF THE INVENTION
  • 1. Field of the Invention
  • This invention relates to an artificial visco-elastic, constrained motion disc for replacing intervertebral discs in the lower back, particularly in the lumbar and lumbar-sacral regions.
  • 2. Background
  • The human spine is composed of many vertebral bones stacked one upon the other, with an intervertebral disc between each pair of adjacent vertebral bones. The discs act as cartilaginous cushions and shock absorbers. The spinal cord runs in a bony canal formed by successive openings in these bones. The spinal nerves exit the spinal cord between pairs of vertebrae and supply nerves and nerve signals to and from other body structures.
  • The intervertebral disc is a complex joint both anatomically and functionally. It is composed of three component structures: the nucleus pulposus; the annulus fibrosus, and the vertebral endplates. The biomedical composition and anatomical arrangements within these component structures are related to the biomechanical function of the disc.
  • The nucleus pulposus, occupying about 25% to 40% of the total disc cross-sectional area, usually contains approximately 70% to 90% water by weight. Because of this high water content, the nucleus may be mechanically described as an incompressible hydrostatic material.
  • The annulus fibrosus is a concentrically laminated structure which contains highly aligned collagen fibers and fibrocartilage embedded in an amorphous ground substance. The annular layers are oriented at approximately ±60° to the longitudinal axis of the spine. The annulus fibrosus usually contains approximately 8 to 12 layers, and is mechanically the main stabilizing structure which resists torsional and bending forces applied to the disc.
  • The two vertebral endplates separate the disc from the adjacent vertebral bodies, and are composed of hyaline cartilage.
  • Spinal discs may be damaged or displaced due to trauma or disease. In either case, the nucleus pulposus may herniate and protrude into the vertebral canal or intervertebral foramen. This condition is known as a herniated or “slipped” disc. The disc may in turn press upon the spinal nerve that exits the vertebral canal through the partially obstructed foramen, causing pain or paralysis in the area of its distribution. The most frequent site of occurrence of a herniated disc is in the lower lumbar region. To alleviate this condition, two procedures are common.
  • First, it may be necessary to remove the involved disc surgically and fuse the two adjacent vertebrae together. Spinal fusion is a good method of eliminating symptoms, but at the expense of total loss of motion of the fused vertebral joint, as well as increased stress in the adjacent segments. In many long-term patients of fused-spinal segments, a detrimental phenomenon has been observed whereby discs adjacent to the fused-spinal segment will have increased motion and stress due to the increased stiffness of the fused segment. This is sometimes referred to as “cascading spine syndrome,” where previously normal motion segments above or below a fused segment exhibit spondylolisthesis, or degenerative disc disease due to increased loading.
  • A second method for alleviating disc problems is insertion of an intervertebral disc replacement. The object of an intervertebral disc replacement is to provide a prosthetic disc that combines both stability to support the high loads of the patient's vertebrae and flexibility to provide the patient with sufficient mobility and proper spinal column load distribution. In attempting to satisfy these competing design requirements, basically four types of artificial intervertebral discs have been developed: elastomer discs, ball and socket discs, mechanical spring discs, and hybrid discs.
  • Elastomer discs typically include an elastomer cushion which is sandwiched between upper and lower rigid endplates. Elastomer discs can provide cushion or damping functions similar in mechanical behavior to the removed intervertebral disc tissue. However, known elastomer discs experience long-term in-vivo problems stemming from micro-cracking, fixation problems with respect to the endplates, insufficient compression and torsional resistance, and excessive motion which can lead to bulging of the replacement disc and resultant pain for the patient. One hypothesis for the failures of previous elastomer based disc designs is the unlimited potential for strain. High load in vivo events cause subsequent changes in structural characteristics of the elastomer, a characteristic called the Mullins effect. After initial stress softening effects are accounted for, a stable stress strain curve is reached. However, if a new load cycle is encountered exceeding the previous peak strain, the structural properties will again change. This is the rationale for the failure of previous elastomer disc designs and the inspiration for new motion-limited designs.
  • Ball and socket discs typically incorporate two plate members having cooperating inner ball and socket portions allowing an articulating motion of the members during movement of the spine. These types of discs generally restore spinal motion, but inadequately replicate the natural stiffness of the intervertebral disc. Furthermore, dislocation and wear problems exist with these devices as well as unsatisfactory motion limiting components. Some types also comprise polymers in conjunction with metallic components.
  • For example, a Link Charite disc includes polyethylene/cobalt chrome molybdenum (CCM) construction. This design restores motion, but in a very unphysiologic manner. The design is essentially a ball and socket joint which does not provide the nonlinear elastic response of the normal disc including hysteresis and therefore shock absorption. As in hip replacements this design is subject to wear and polyethylene debris complications. This disc, which has been extensively implanted in Europe and the United States, relies on a relatively incompressible ultra high molecular weight polyethylene center mating with concave surfaces in cobalt chrome upper and lower endplates. The mating surfaces provide a low friction pseudo ball-socket joint with motion constraints in compression and anterior-posterior as well as lateral translation. The device is totally unconstrained in rotation about its axis, and in tension. Though this device has a semi successful in vivo history, it lacks fundamental stress strain characteristics of the normal disc. Instead, it provides low friction, high movement, non-energy absorbing kinematic function restoration to the spine motion segment. The disc is designed to move freely until limits of travel are reached. The stopping action provided is very abrupt and thus loads the vertebral endplate in a shock-like manner at end-of-travel. This disc imitates a free moving ball and socket joint, not a natural disc that behaves very elastically until annulus fibers play the role of a “limiter”. A natural disc is load sharing between the elastic elements and fibrous tissue limiters.
  • Mechanical spring discs, which generally have only two or three degrees of freedom, typically incorporate one or more coiled springs disposed between metal endplates. These discs generally allow movement of the vertebrae during flexion and extension. However, these types have significant wear problems, as well as problems dealing with in-vivo torsional loads, and overall these discs cannot replicate the six-degree of freedom movement of a natural intervertebral disc.
  • Hybrid types of discs generally incorporate two or more principals of any of the aforementioned disc types. For example, one common hybrid disc arrangement includes a ball and socket set surrounded by a non-adhered elastomer ring. This hybrid disc is more complex than would be preferred for common usage, and more importantly, the intermittent contact between the ball socket and the elastomer ring that occasionally occurs in-vivo causes critical wear problems.
  • It is to be recognized that an artificial disc constructed with a polymer between two metal endplates undergoes compression as a result of both gravity and patient activities requiring exertion of energy. Therefore, ideally a disc would include a means of protecting the polymer and the possible bond joint between polymer and metal. Mechanical stops and motion-limiters can be added to maintain the integrity of the prosthesis. Such structures can take the form of rods, tension cables, or other connectors, as well as metal-to-metal contact in compression, to name but a few examples. Moreover, it would be beneficial for a disc also to include a means to convey to surgeons and to patients the actual state of the loads experienced by the device.
  • As a result, the need exists for an artificial intervertebral disc that more closely imitates a natural disc. This means that the artificial disc should maintain the vertebrae spaced from each other and prevent pinching of nerves or spinal cord. The artificial disc should provide good load distribution. Furthermore, the artificial disc should be sufficiently resilient to accommodate other motions of the spine, including flexion, extension, lateral bending, and rotation, as well as combinations of these motions. In humans, the bony facet joints actually limit the rotational movement. A disc typically need only rotate approximately three degrees. Moreover, the disc should provide restorative force to bias toward the resting position. The artificial disc should be both biocompatible and biostable such that the disc itself or any of its degradation byproducts, if any, do not cause adverse tissue reactions. Ideally, through the use of strain gauges or other means of force transduction, the disc can also provide stored or real-time data to the surgeon and the patient regarding the state of the loads and displacements experienced by the disc.
  • BRIEF SUMMARY OF THE INVENTION
  • The present invention is directed to a prosthetic intervertebral disc replacement that restores and preserves the physiologic function of a normal spinal motion segment. The intervertebral disc replacement addresses the detrimental phenomenon of cascading spine syndrome observed in long-term patients with fused-spinal segments. The present intervertebral disc replacement is designed to avoid the need for spinal fusion or at least prolong the need for it. The invention incorporates elements to bear high load in the design, while preserving the ability of the elastomer to provide substantial motion at low to moderate loads. The invention demonstrates the potential to survive high cycle fatigue in bending, compression, and shear along all three mutually orthogonal axes. The motion-limiting features survive high load, low cycle fatigue and preserve the integrity of the elastic range performance of the device.
  • According to the present invention, once the disc reaches its mechanically constrained limits in compression, bending, and shear, then the elastomer and the bond interface experiences no additional significant loads as the limiter feature will prevent further significant strain. In vivo loading varies by the individual, activity level, and unique high load events. In the present invention, limiting strains prevents the elastomer from continually changing its structural characteristics with each high load event. A stable stress strain characteristic can be reached and predictable disc performance can be achieved.
  • The present invention is a visco-elastic constrained-motion disc prosthesis generally comprising specially designed rigid upper and lower endplates having therewithin channels or openings for receiving one or more motion-limiting members fitted on each end with an enlarged portion. In some embodiments, the lower surface of the upper endplate contains a first projection therefrom that extends toward the lower endplate. Likewise, the upper surface of the lower endplate can contain a second projection extending toward said upper endplate and substantially aligned with said first projection. The first and second projections terminate to create a gap therebetween, forming a compression stop. Interposed between the upper and lower endplates is an elastomer cushion. Preferably, the elastomer cushion is not in direct contact with either the motion-limiting members or the first or second projections to avoid wear and debris problems.
  • The gap allows a predetermined amount of axial movement, but no more, between the upper endplate and the lower endplate. As a result, the gap prevents excess compression from occurring, and is usually designed to allow approximately 1 to 2 millimeters of relative movement between the upper and lower endplates. This limits the compressive stresses seen by the elastomer. During most activities of the patient, the elastomer will exclusively carry the load. The compression stop will be engaged typically only during activities of high exertion.
  • The motion-limiting members with enlarged portions are inserted into internal cavities in the elastomer and link the upper endplate to the lower endplate. The motion-limiting members are dimensioned so as to have a length that is slightly greater than the distance between the lower surface of the upper endplate and the upper surface of the lower endplate (and also preferably slightly less than the overall length of the internal cavities in which they reside). This allows space for the motion-limiting members to move during compression.
  • In bending, which is the most important movement of an L4-L5 or L5-S1 disc, the motion-limiting members are strategically oriented to resist the tension in the posterior region of the disc. If motion-limiting members are present at the anterior portion of the disc, they float freely in the internal cavities during bending.
  • The external surfaces of the upper and lower endplates can also be fitted with wedges, spikes, keels, or other appurtenances to aid in attachment to a vertebral body. These appurtenances can also serve as covers to enclose the enlarged portions of the motion-limiting members.
  • Additionally, some embodiments of the invention utilize strain gauges, pressure transducers, piezoelectric force transducers, or other means of force transduction to provide stored or real-time data to the surgeon or patient of the load state of the disc.
  • Several commercially available low durometer (i.e., approximately 70-85 A) polyurethanes with a history of animal and human implantation are candidates to be used in a titanium or CoCrMo/elastomer construction. Hybrid discs according to the invention can overcome one of the failure modes of previous artificial disc designs, namely that of delamination and fatigue failure of the bonded interface between the elastomer and metal. This can be accomplished through improved bonding and motion-limiting features, in those embodiments where the visco-elastic cushion is bonded to the endplates. Other embodiments that utilize no bonding between the visco-elastic cushion and the endplates also achieve improved results with motion-limiting features.
  • These and other benefits are obtained in the many embodiments of the invention. A particularly useful embodiment comprises an artificial intervertebral disc prosthesis having an anterior portion and a posterior portion, further comprising: a first endplate having an upper surface and a lower surface, wherein the first endplate further comprises at least one opening for receiving at least one motion-limiting member; a first projection extending from the lower surface of the first endplate terminating in a first distal end; a second endplate having an upper surface and a lower surface, wherein the second endplate further comprises at least one opening for receiving at least one motion-limiting member; a second projection extending from the upper surface of the second endplate and substantially aligned with the first projection, wherein the second projection terminates at a second distal end to form a gap having a predetermined distance between the first and second distal ends; at least one motion-limiting member received respectively in the at least one opening of the first and second endplates, linking the two endplates and allowing only a predetermined amount of movement thereof; and a visco-elastic cushion between the first endplate and the second endplate, further comprising therein at least one cavity in substantial alignment with the at least one opening in the first endplate and the second endplate through which the motion-limiting member may pass and at least one cavity surrounding the first and second projections.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • The teachings of the present invention can be readily understood by considering the following detailed description in conjunction with the accompanying drawings, in which:
  • FIG. 1 is a graph showing the typical nonlinear response to load of human spine motion segments;
  • FIG. 2 is a diagram showing a reference coordinate system for a functional spinal unit to be used herein;
  • FIG. 3 is a posterior perspective view of a first embodiment of an artificial disc of the present invention.
  • FIG. 3(a) is the artificial disc of FIG. 3 showing a second type of appurtenance fitted to the upper and lower endplates;
  • FIG. 3(b) is the artificial disc of FIG. 3 showing a third type of appurtenance fitted to the upper and lower endplates;
  • FIG. 3(c) is the artificial disc of FIG. 3 showing a fourth type of appurtenance fitted to the upper and lower endplates;
  • FIG. 4 is a top plan view of the artificial disc of FIG. 3;
  • FIG. 5 is a bottom plan view of the artificial disc of FIG. 3;
  • FIG. 6 is a posterior elevation view of the artificial disc of FIG. 3;
  • FIG. 7 is a lateral elevation view of the artificial disc of FIG. 3;
  • FIG. 8 is an exploded perspective view of the artificial disc shown in FIG. 3;
  • FIG. 9 is a section view taken along plane A-A in FIG. 3;
  • FIG. 10 is a section view taken along plane B-B in FIG. 3;
  • FIG. 11 is a section view taken along plane C-C in FIG. 3;
  • FIG. 12 is a section view taken along plane D-D in FIG. 3;
  • FIG. 13 is an exploded perspective view of an exemplary motion-limiting member of a first embodiment of the invention;
  • FIG. 14 is a perspective view of a second embodiment of an artificial disc of the present invention having four motion-limiting members therein;
  • FIG. 15 is an exploded perspective view of the embodiment of the artificial disc of the present invention shown in FIG. 14;
  • FIG. 16 is a section view taken along plane E-E in FIG. 14;
  • FIG. 17 is a section view taken along plane F-F in FIG. 14;
  • FIG. 18 is a section view taken along plane G-G in FIG. 14;
  • FIG. 19 is a section view taken along plane H-H in FIG. 14;
  • FIG. 20 is a section view taken along plane I-I in FIG. 14;
  • FIG. 21 is a side elevation view of a disc according to a first embodiment of the invention showing the disc in normal bending mode;
  • FIG. 22 is a top view of an embodiment of a lower endplate flex circuit for an artificial disc using strain gauges to provide force transduction for providing data external to the disc;
  • FIG. 23 is a side section view of the disc shown in FIG. 21 in normal bending mode;
  • FIG. 24 is a perspective view of a motion-limiting member according to an embodiment of the invention incorporating a split ring in place around the enlarged portion of the motion-limiting member;
  • FIG. 25 is a side elevation schematic of an embodiment of an artificial disc using strain gauges to provide force transduction for providing data to locations external to the disc;
  • FIG. 26 is a perspective view of the posterior side of an alternative embodiment of the disc showing removable appurtenances;
  • FIG. 27 is a perspective view of the anterior side of the disc shown in FIG. 26;
  • FIG. 28 is a perspective view of the posterior side of an appurtenance and an upper endplate according to an embodiment of the invention; and
  • FIG. 29 is a perspective view of the anterior side of the endplate shown in FIG. 28.
  • DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
  • While the present invention will be described more fully hereinafter with reference to the accompanying drawings, in which particular embodiments and methods are shown, it is to be understood from the outset that persons of ordinary skill in the art may modify the invention herein described while achieving the functions and results of this invention. Accordingly, the description which follows is to be understood as illustrative and exemplary of specific embodiments within the broad scope of the present invention and not as limiting the scope of the invention. In the following descriptions, like numbers refer to similar features or like elements throughout.
  • A successful intervertebral disc prosthesis should restore and preserve physiologic function of a normal spinal motion segment. FIG. 1 is a graph of the response of the normal human disc to load. The nonlinear response of the motion segment is a function not only of the disc, but of the facet joints and ligaments. Facet joint function and ligamentous structures may be compromised and unable to provide load sharing as in a normal motion segment. The nonlinear response of spine motion segment to load shown in FIG. 1 is a typical curve shape in compression, shear, torsion, and bending.
  • FIG. 2 is a perspective view of a reference intervertebral disc coordinate system that will be used throughout this discussion for ease of reference. The figure shows typical loads (forces and moments) and typical displacements (translation and rotation) that can occur in each of the three mutually orthogonal directions. The load-deflection curve shape of FIG. 1 is similar in all three directions for a normal disc. Like that of a normal disc, a disc 10 of the present invention provides a nonlinear response to torsion, shear, and compressive loads.
  • Referring now to FIG. 3, the disc 10 comprises a first or upper endplate 20, a second or lower endplate 30, and a visco-elastic cushion 40 interposed between and adhered to the two endplates. The upper and lower plates 20, 30 are substantially symmetrical about an anterior-posterior horizontally extending plane (a transverse plane shown in FIG. 2), as well as about a sagittal plane (FIG. 2). The terms “upper” and “lower” are used herein only for illustration purposes with reference to the orientation of the disc 10 when it is implanted in the human body between two adjacent vertebrae V1 and V2 (defined as the cephalad-caudal direction in FIG. 2). Indeed, the upper plate is more generally described as a first plate and the lower plate is more generally described as a second plate.
  • The upper endplate 20 is rigid and is preferably made from a biocompatible material such as stainless steel, titanium, titanium alloys (such as Ti6Al4V), composite materials, and the like. The most preferred material is cobalt chrome molybdenum (CoCrMo or “CCM”) comprising approximately 66% Co, 28% Cr, and 6% Mo by weight.
  • The upper endplate 20 has an upper surface 21 and a lower surface 22 and an anterior portion 23 and a posterior portion 24. Upper surface 21 and lower surface 22 are generally parallel. The anterior portion 23 is the portion of the upper endplate 20 that is disposed anteriorly in the spine when the disc 10 is implanted. Likewise, the posterior portion 24 is the portion of the upper endplate 20 that is disposed posteriorly in the spine when the disc 10 is implanted. The upper endplate 20 has an external surface 29 therearound that preferably defines a generally “D” shape. In one embodiment of the invention, the posterior portion 24 of the external surface 29 has a concavity 28 therein that defines posterior lobes 25, 26 projecting from the posterior portion 24 (see FIGS. 3, 4, 5, 12, 14, and 15). One or more appurtenance 27 may be optionally affixed to the upper surface 21 to facilitate attachment.
  • The upper endplate 20 likewise may comprise an upper subplate 200 (see FIG. 15) that can be formed monolithic with the upper endplate 20 or as a separate component affixed thereto subsequent to manufacture. Alternatively, the structures that comprise the upper subplate 200 may simply be included in the upper endplate 20. The remainder of this description will discuss structure related to subplate 200, but it should be recognized that the description applies equally to discs having no separate subplate. The subplate 200 further comprises an upper surface 210 and a lower surface 220 and an anterior portion 230 and a posterior portion 240. A first projection 270 optionally may depend from the lower surface 220 of the subplate 200 to act as part of a compression stop, as will be described below. The upper subplate 200 also has a plurality of openings 271 therethrough for receiving one or more motion-limiting members 80 (described below). Preferably, the upper subplate 200 includes two openings 271, one disposed posteriorly and slightly to the left (in the medial-lateral plane) of the first projection 270 and another disposed posteriorly and slightly to the right (in the medial-lateral plane) of the first projection 270 (assuming the center of rotation is at the geometric center of the disc). The openings 271 further comprise a bearing surface 272 for interacting with the motion-limiting members 80 or a split ring assembly 400 (described below). The bearing surface 272 is preferably a tapered opening having a larger diameter at the upper surface 210 than at the lower surface 220. The taper can be linear or nonlinear, including conic sections, parabolic sections, spherical sections, and so forth, to name only a few examples.
  • The first projection 270 preferably extends from said lower surface 220 a height of approximately 1 mm to approximately 3 mm. Many shapes are possible for the first projection 270, and indeed multiple projections, or no projections, are contemplated as well. In the preferred embodiment, the first projection 270 takes the form of a substantially cylindrical section having a slight radius on its terminal end of approximately 2 mm to approximately 15 mm, preferably approximately 8 mm to approximately 12 mm.
  • In like manner, the disc 10 further comprises a lower endplate 30. The lower endplate 30 is rigid and is preferably made from a biocompatible material such as stainless steel, titanium, titanium alloys (such as Ti6Al4V), composite materials, and the like. The preferred material is cobalt chrome molybdenum (CCM) comprising approximately 66% Co, 28% Cr, and 6% Mo by weight, respectively.
  • The lower endplate 30 has an upper surface 31 and a lower surface 32 and an anterior portion 33 and a posterior portion 34. Upper surface 31 and lower surface 32 are generally parallel. The anterior portion 33 is the portion of the lower endplate 30 that is disposed anteriorly in the spine when the disc 10 is implanted. Likewise, the posterior portion 34 is the portion of the lower endplate 30 that is disposed posteriorly in the spine when the disc 10 is implanted. The lower endplate 30 has an external surface 39 therearound that preferably defines a generally “D” shape. In one embodiment of the invention, the posterior portion 34 of the external surface 39 has a concavity 38 therein that defines posterior lobes 35, 36 projecting from the posterior portion 34 (see FIGS. 3, 4, 5, 12, 14, and 15). One or more appurtenance 37 may be optionally affixed to the lower surface 32 to facilitate attachment.
  • Although not preferred, it is possible that the lower endplate 30 may comprise a lower subplate 300 (see FIGS. 8 and 15) that can be formed monolithic with the lower endplate 30 or as a separate component affixed thereto subsequent to manufacture. The subplate 300 further comprises an upper surface 310 and a lower surface 320 and an anterior portion 330 and a posterior portion 340. A second projection 370 depends from the upper surface 310 of the subplate 300 to act as part of a compression stop, as will be described below. The lower subplate 300 also has a plurality of openings 371 therethrough, having bearing surfaces 372, for receiving one or more motion-limiting members 80 (described below). Preferably, the lower subplate 300 includes two openings 371, one disposed posteriorly and slightly to the left of the first projection 370 and another disposed posteriorly and slightly to the right of the first projection 370.
  • The second projection 370 preferably extends from said upper surface 310 a height of approximately 3 mm to approximately 6 mm. Preferably the second projection 370 is in substantial alignment with the first projection 270. Stated otherwise, the second projection 370 preferably will have its longitudinal axis aligned with or close to the longitudinal axis of the first projection 270. This is not mandatory, however. Indeed, the two projections 270, 370 may be offset from one another, it being more important that at least a portion of the projections 270, 370 overlap during contact therebetween. And, depending on the respective shapes of the projections 270, 370, the amount of offset may vary. Many shapes are possible for the second projection 370, including, but not limited to, all regular polygonal shapes. Additionally, the projections 270, 370 may take the form of partial polygons (for example, a half cylinder or a partial elliptical cylinder, to name but a few). In the preferred embodiment, the second projection 370 takes the form of a cylindrical platform having a diameter of approximately 6 mm to 10 mm, and more particularly, approximately 7 mm to approximately 9 mm.
  • Referring now to FIGS. 8, 9, 12 and 13, a motion-limiting member 80 typically resides within each opening 271, 371. Each motion-limiting member 80 has a length 81 and a diameter 82, and a first end 83 and a second end 84. At each end 83, 84 is an enlarged portion 90. The motion-limiting members 80 link the upper endplate 20 to the lower endplate 30 and assist in handling the loads associated with flexion, as will be described below.
  • The motion-limiting members 80 can be any of several longitudinal rod-like members, both rigid and semi-rigid, including solid metallic bars or rods of varying cross-sections, and wire. If wire is used as the motion-limiting member 80, the motion-limiting members 80 typically have diameters of approximately 0.038 inches to approximately 0.080 inches. However, the number of motion-limiting members 80 used plays a role in determining the diameter of each motion-limiting member 80. In the preferred embodiment, there are two motion-limiting members 80 that are braided metal wires, preferably a braided stainless steel wire having a diameter of approximately 0.062 inches and a rated tensile strength of approximately 320 pounds. More specifically, the motion-limiting members 80 can be of any material described above, but are preferably cables of 316L stainless, MP35N, Haynes 25. In alternative, though less preferred, embodiments where substantially more numerous motion-limiting members 80 are used (for example ten to twenty), the diameters can be significantly smaller.
  • The enlarged portion 90 at each end 83, 84 is typically a spherically-shaped structure, or ball 91, that is affixed to the motion-limiting member 80. Balls 91 are preferably of the same material as the motion-limiting members 80. The ball 91 has an upper surface 92 and a lower surface 93. Preferably, ball 91 is preformed onto the motion-limiting member 80. However, methods of fixation are also varied and include welding, both during formation of the ball 91 at the first end 83 and during assembly of the ball 91 at the second end 84; as well as crimping on a ball 91. The balls 91 are preferably hemispheres wherein the lower surface 93 engages the bearing surface 272 of the plates 20, 30 and/or the subplate 200, 300. The upper surface 92 of the ball 91 provides little to no advantage and merely takes up space. As a result, the upper surface 92 is preferably flat or very low-profile so as to take up a minimal amount of space. The appurtenances 27, 37 on the upper and lower endplates 20, 30, respectively, may be used to cover a portion of the enlarged portions 91. In some embodiments, however, the inside surface 400d of the split ring assembly (described below) can be used to effectively shorten the length of the motion-limiting member 80 such that no part of the enlarged portion 91 extends beyond the upper surface 21 of the upper endplate or the lower surface 32 of the lower endplate 30.
  • In the preferred embodiment, a split ring assembly 400, as shown in FIGS. 8, 13, 15, and 24, fits into the openings 271 of the upper subplate 200 and into openings 371 of the lower subplate 300. The split ring assembly 400 comprises a first half 400 a and a second half 400 b. When the two halves 400 a, 400 b of the split ring assembly 400 are combined, they form a ring-shaped member having a port 400 c defined by a periphery 400 e. The split ring assembly 400 includes an inside surface 400 d that serves as a bearing surface against which the balls 91 can articulate, resulting in a mini-ball and socket joint. The diameter of port 400 c is smaller than that of the ball 91. Thus, when assembling the artificial disc prosthesis, the motion-limiting member 80 is inserted into the opening 271 of the upper subplate 200 at the first end 83 and into the opening 371 of the lower subplate 300 at the second 84. The first half 400 a of the split ring assembly 400 is then inserted into the opening 271 underneath the ball 91 at the first end 83 of the motion-limiting member 80. Then, the second half 400 b of the split ring assembly 400 is inserted into the opening 271 of the upper subplate 200 underneath the ball 91 at the first end 83 of the motion-limiting member 80, completing the split ring assembly 400 in the upper subplate 200. Since the diameter of the port 400 c in the split ring assembly is smaller than that of the ball 91 at the first end 83 of the motion-limiting member 80, the motion-limiting member 80 is prevented from slipping through the opening 271 of the upper subplate 270.
  • In the same manner, a split ring assembly 400 is inserted into the opening 371 of the lower subplate 300 above the ball 91 at the second end 84 of the motion-limiting member 80 in order to prevent the motion-limiting member 80 from slipping through the opening 370 of the lower subplate 300. Once the split ring assemblies 400 are in place, they may be welded or permanently affixed by some other means known in the art to the upper and lower subplate assemblies 200, 300. The split ring assembly 400 includes an inside surface 400 d that serves as a bearing surface against which the balls 91 can articulate, resulting in a mini-ball and socket joint, thus minimizing the bending of the motion-limiting member 80 and extending fatigue life.
  • In another embodiment, the split ring assembly 400 is not present, and the balls 91 are not preformed onto the motion-limiting members 80. Instead the balls 91 are fixed onto the motion-limiting members 80 through some other means such as welding or crimping, as discussed above. However, welding the ends of the motion-limiting members 80 into balls 91 can lower the strength of the motion-limiting members 80 by 10 to 15 percent. In this embodiment, the diameter of ball 91 can be controlled during welding, ranging in size from approximately slightly larger than the diameter of the motion-limiting member 80 up to a maximum diameter of approximately two times the motion-limiting member diameter. In embodiments using other attachment methods, other diameters are possible. Since no split ring assembly 400 is present in this embodiment to prevent the motion-limiting members 80 from slipping out of the openings 271, 371 of the upper and lower subplates 200, 300, respectively, it is necessary that the diameter of the balls 91 be larger than the diameter of the opening 271 at the lower surface 220 of the upper subplate 200 and the opening 371 at the upper surface 310 of the lower subplate 300.
  • In the embodiments containing no split ring assembly, the balls 91 at the first end 83 and the second end 84 mate with the bearing surface 272 of the openings 271 in each endplate 20, 30 and/or subplate 200, 300. As a result, each union of ball 91 and bearing surface 272 results in a mini-ball and socket joint that allows articulation of the ball 91 and motion-limiting member 80 within the opening 271, thus limiting bending of the motion-limiting member 80, thereby extending fatigue life.
  • The disc 10 of the preferred embodiment provides motion-limiting features in compression and bending, thereby behaving in vivo in a fashion more similar to a natural spinal disc. The first projection 270 and the second projection 370, by way of the predetermined gap 470 therebetween (see FIGS. 9, 10, 11, 16, 17, and 19), provide a compression stop preventing movement between the upper and lower plates 20, 30 in a magnitude greater than a predetermined amount. Varying limits of movement may be set, depending on the type and location of the disc 10 in the body. In the preferred embodiment, the gap 470 between the first and second projections 270, 370 is approximately 1 to 2 millimeters. Elastomers that can handle excessive compressive loadings may be able to accommodate a gap greater than 2 millimeters. Once a compressive load is applied to the disc 10, the visco-elastic cushion 40 absorbs the compression in a visco-elastic fashion according to design properties of the elastomer. Upon absorbing the compressive loads in amounts sufficient to cause relative movement between the upper endplate 20 and the lower endplate 30 in an amount equal to the gap 470, the first and second projections 270, 370 then come into contact and prevent further compressive loads from being applied to the elastomer. It is expected that the stop mechanism will only be activated during the most strenuous of activities of the patient.
  • In bending, the motion-limiting members 80 can perform the primary or secondary motion limiting functions. Referring to FIG. 2, the most common bending scenario for the spine is bending in the sagittal plane (that is, bending about the x-axis). For example, this would be accomplished by bending over to tie one's shoes. As a bending moment is applied to the disc 10, the disc 10 can undergo both shear and lateral displacement. Referring now to FIGS. 21 and 23, a disc 10 is depicted in such a scenario and is shown exaggerated for easier reference. It can be seen that the anterior side is slightly compressed, while the posterior side is slightly in tension and a slight translation of the upper endplate 20 with respect the lower endplate 30. It can be seen that the motion-limiting members 80 can become oriented diagonally. In this event, the motion-limiting members 80 in tension provide a force preventing the upper endplate 20 and lower endplate 30 from separating because the lower surface 93 of the ball 91 begins to bear upon the split ring assembly 400 and/or bearing surfaces 272 of the openings 271. It should be noted that the mechanics of the disc 10 depicted in FIGS. 21 and 23, with reference to FIG. 2, are basically identical whether the bending is in the sagittal plane (front to back, or tying ones shoes) or in the frontal plane (side to side bending).
  • In flexion, which is the most important movement of an L4-L5 or L5-S1 disc, the motion-limiting members 80 are strategically oriented to resist the tension in the posterior region of the disc 10. When braided cables are used as the motion-limiting members 80, compression of the cables can cause splaying, which shortens their fatigue life. Therefore, placing more motion-limiting members 80 posteriorly than anteriorly (for example, see FIG. 12) accounts for the greater expected flexion moments of 20-30 N·m versus the lesser extension moments of about 10 N·m.
  • A further factor in the allowed range of motion in flexion and extension is a consideration of the cable distance from an assumed center of rotation at the center of the disc 10. The farther from the center, the greater the resisting moment, but the more initial slack necessary to allow the required 8-12 degrees of flexion. The more initial slack allowed, the more bending movement is allowed. Combinations of cable placement and initial diagonal orientation may be necessary to solve these conflicting design goals. Although greater ranges are certainly possible for the invention, preferable ranges of stiffnesses and motion for the disc 10 are as follows: Nonlinear stiffness in compression (1,000 to 3,000 N/mm) and in flexion (1.0 to 5.0 N·m/deg) and maximum motion in compression (1.0 to 2.0 mm) and in flexion (8 to 12 deg).
  • In one embodiment of the artificial intervertebral disc prosthesis (see FIGS. 14, 15, 16, 17, 18, and 19), four motion-limiting members are present. In this embodiment, there are corresponding four openings 271, 371 in both the upper and lower subplates, 200, 300. One of the openings 271, 371 is located anteriorly and slightly to the left of the first and second projections 270, 370, while another opening 271, 371 is located anteriorly and slightly to the right of the first and second projections 270, 370. Similarly , a third opening 271, 371 is located posteriorly and slightly to the left of the first and second projections 270, 370, while the fourth opening 271, 371 is located posteriorly and slightly to the right of the first and second projection 270, 370. In this embodiment, when the disc 10 is in flexion, the most important movement of an L4-L5 disc, the motion-limiting members 80 at the posterior portion of the disc 10 are strategically-oriented to resist the tension in the posterior region of the disc 10, while the motion-limiting members 80 at the anterior portion of the disc 10 float freely in the spike cavity in the anterior region of the disc 10. However, a disadvantage of this embodiment is the presence of motion-limiting members 80 at the anterior portion of the disc 10. As discussed above, when braided cables are used for the motion-limiting members 80, compression can cause splaying, leading to a shorter fatigue life. As motion-limiting members 80 located at the anterior of the disc 10 encounter significantly more compression than motion-limiting members 80 located at the posterior of the disc 10 during the normal activity patterns of most individuals, anteriorly-located motion-limiting members 80 are likely to have a shorter life than those located at the posterior of the disc 10.
  • Another embodiment of the artificial disc intervertebral prosthesis is envisioned in which no motion-limiting member 80 is present. Instead, the compression stop formed by the first and second projections 270, 370 also limits motion in flexion and lateral bending. This is accomplished by sizing the first and second projections 270, 370 such that when the prosthesis engages in flexion or bending and the first projection 270 tilts toward the second projection 370, the leading edge of the first projection 270 will come into contact with the second projection 370 after a predetermined amount of flexion or bending, preventing further motion. This has the advantage of eliminating the need for the motion-limiting members 80, thereby reducing the number of elements within the prosthesis that are susceptible to wear and fatigue.
  • The preferred disc has certain load versus deflection characteristics that are similar to those found in the natural human disc. As was stated above, it is useful, once implanted, that the surgeon and patient can know the state of load experienced by the device. In this regard, embodiments of the disc have, integral to its construction, strain gauges or other means of force or pressure transduction. For illustration purposes only, not to be construed as limiting the invention thereto, the discussion will be directed to the use of strain gauges. A transducer can be connected to signal conditioning and amplification circuitry on a micro scale in order to fit within the constraints of space available in the upper or lower endplate. In this embodiment, the center stop is integral to the lower endplate and consists of a hollow raised cylindrical platform. The space inside this cylinder can house, for example, a 3×3×3 mm electronics package. The package can be wired to strain gauges on the inside of the raised cylinder and in peripheral locations around the bottom endplate. Alternatively, the transduction means can be connected to electronics such as piezoelectronics that eliminate the need for signal conditioning and amplification.
  • Since the center stop cylinder is not in contact with the polymer, the strain gauge placed there will only measure contacts between the upper endplate and the center stop on the lower endplate. This data is useful in itself as an indicator of when loads are sufficiently high to engage the stop mechanism. However, in addition, more continuous data is available from peripherally placed strain gauges that will measure stress in the endplate caused by compression, bending, torsion, and shear loads in all directions. This information can give a precise measure of the magnitude and direction of loads on the disc. FIGS. 22 and 25 depict how one embodiment of an artificial disc 10 uses strain gauges to measure the load experienced by the prosthesis and relay that data on demand.
  • Placing the transducers within the polymer is not preferred since fatigue of wires or the introduction of stress risers within the polymer can lead to fatigue failure initiation sites. For these reasons, placing the signal conditioning microelectronics within the center compression stop is advantageous. Once conditioned, the signal is telemeterized on demand through excitation of an internal coil from an inductively coupled external coil. This couple energizes the electronics and transmits the data upon request. This mode of interrogating the device for its load condition can be done real time or fed back from memory storage according to a preset sampling routine. It is also possible to sample the device remotely and wirelessly via the internet.
  • The data can indicate changes in the device since its implantation. It can also store load history to indicate if the patient is following doctor's orders for allowed activities. The power source for memory-based data is optionally a micro battery or a capacitor charged from the external inductive couple. The use of piezos is also possible. In one embodiment, a mylar flex circuit is pre-made and placed on the second endplate. Transducers are embedded on the mylar circuit and connected to the signal conditioning and amplifying electronics.
  • FIGS. 26-29 show an alternative embodiment of the invention wherein the disc 10 comprises multiple components that may be implanted separately. Indeed, the disc 10 may comprise many forms and embodiments that are implantable in pieces. The desirability of multi-part prostheses is known by surgeons and simplifies the implantation procedures. FIGS. 26-29 simply depict one example. In these figures, the appurtenances 27 are removably insertable into the upper and lower endplates 20, 30. In FIG. 26 the upper surface 92 of the balls 91 is not depicted but typically would be visible. Preferably, the groove into which appurtenances 27 are slid form a taper lock fit to lock the appurtenance into place. One example of a surgical procedure using a multi-part disc 10 involves the surgeon first removing the diseased or damaged disc using the typical procedures in practice. An instrument (not shown) is used to prepare the site by cutting grooves into the adjacent vertebrae to receive the appurtenances 27 of the disc 10. Preferably the instrument cuts both the upper and lower grooves simultaneously so as to maintain the tolerances needed for the implantation of the disc 10. An instrument then inserts the appurtenances 27 into the prepared site. The disc 10 is then inserted between the appurtenances 27, which receive the grooves of the upper and lower endplates 20, 30. The taper lock secures the appurtenances 27 to the prosthesis.
  • Many possibilities exist for the manufacturing and the materials involved in an artificial intervertebral disc prosthesis according to the present invention. The endplates 20, 30 and/or endplate subplates 200, 300 may be of the materials described above. Further, they may have thicknesses in the range of approximately 1 mm to approximately 3 mm. Their surfaces may be surface-treated or machined for texture and bonding improvement. Examples of such treatments include but are not limited to ion etching, simple grit blasting, plasma spraying, or CNC machined geometry. Preferably the endplates 20, 30 (and/or 200, 300) are a CCM which is good in wear. The upper surfaces 21, 210 of the upper endplate 20 and upper subplate 200, and the lower surfaces 31, 310 of the lower endplate 30 and lower subplate 300, as well as the surfaces that interact with the visco-elastic cushion, may be coated with Titanium 6Al4V to improve bone interface and bonding. The second projection 370 can, as stated above, take many forms, including by way of mere examples, a cylinder, a post, a platform, and so forth. The preferred cylindrical member is a solid projection from the lower endplate 20 or lower subplate 200. However, the cylindrical member could be hollow so as to accommodate integral microelectronics diagnostics, as was discussed above.
  • Manufacturing the disc 10 can be accomplished in a variety of manners. Preferably, the endplates 20, 30 are first machined of either titanium or cobalt chrome molybdenum (CCM), with openings 270 representing areas where there will be no elastomer cushion 40. The endplates 20, 30 are inserted into a mold with cores to create voids that will later contain the center stop and the motion-limiting members 80. It is preferable to keep the elastomer free of the cables and center stop so as not to introduce elastomer abrasion leading to fatigue failures. The motion-limiting members 80 are then assembled to the molded subassembly with a welding process. The cable assemblies terminate in a ball end. In the preferred embodiment the ball is preformed onto the cable, though this is not required.
  • These ball-cable assemblies are then inserted into the endplates 20, 30 with the split ring assemblies 400 as described above. In those embodiments not utilizing split ring assemblies 400, the ball-cable assemblies are inserted into the endplates 20, 30 as described above. Preferably, over each ball location on the upper endplate 20 and on the lower endplate 30 are appurtenances 27, 37, respectively. These appurtenances are shown in FIG. 3 as keels, but they could be individual conical spikes as shown in FIG. 3(a) or other appurtenances, for example FIGS. 3(b) and 3(c). For those embodiments where the enlarged portion 90 extends beyond the plane of the upper surface 21 of the upper endplate 20 or the lower surface 32 of the lower endplate 30, these appurtenances serve as temporary anchors in the vertebra and covers that enclose the mini ball-socket joint created between the endplate and the ball. Additionally, the ball-socket articulation prevents bending in the cables, thereby extending fatigue life. In certain embodiments utilizing many motion-limiting members 80, it is possible for the motion-limiting members 80 to be laser welded into the endplates in the openings where cores created voids in the elastomer.
  • As stated above, the center stop is a designed gap preferably to prevent more than 1-2 mm of compression from occurring, thereby limiting the elastomer compressive stress. This mandates a good wear interface for the stop. A choice of CCM on CCM is preferred due to its recent introduction as the wear couple in some FDA-approved metal-on-metal hips. Also as stated, many structural configurations for the first and second protrusions 270, 370 are possible, including pin-on-pin, pin-on-plate (shown), plate-on-plate, ball-on-plate, and so forth. The elastomer will exclusively carry the load during most activities of daily living. The center stop will be engaged only during activities of high exertion, except in the embodiment in which no motion-limiting members 80 are present.
  • While there has been described and illustrated particular embodiments of a novel artificial disc prosthesis, and in particular, a visco-elastic constrained motion disc, it will be apparent to those skilled in the art that variations and modifications may be possible without deviating from the broad spirit and principle of the present invention, which shall be limited solely by the scope of the claims appended hereto.

Claims (35)

1. A spinal disc prosthesis, comprising:
a first endplate and a second endplate each suitable to attach to respective vertebrae;
a first member interposed between and adhered to said first and second endplates, wherein said first member is capable of carrying compressive load from said first endplate to said second endplate; and
a second member or set of members which,
at a sufficiently large compression of said prosthesis, establishes contact suitably to transfer compressive load from said first endplate to said second endplate, and,
at a sufficiently small compression of said prosthesis, does not establish contact suitably to transfer compressive load from said first endplate to said second endplate.
2. The prosthesis of claim 1, wherein, at said sufficiently small compression of said prosthesis, said second member or set of members exhibits a gap.
3. The prosthesis of claim 1, wherein said second members or set of members comprises a protrusion on said first endplate.
4. The prosthesis of claim 3, wherein said second endplate comprises a stop.
5. The prosthesis of claim 3, wherein said second endplate does not comprise a stop.
6. The prosthesis of claim 1, wherein said first member comprises polymeric material, and said second member or set of members comprises metal.
7. A spinal disc prosthesis, comprising:
a first endplate and a second endplate each suitable to attach to respective vertebrae;
a first member interposed between and adhered to said first and second endplates, wherein said first member reacts against any flexion; and
a second member or set of members which,
at a sufficiently large flexion of said prosthesis, establishes contact suitably to react against flexion, and
at a sufficiently small flexion of said prosthesis, does not establish contact suitably to react against flexion.
8. The prosthesis of claim 7, wherein, at said sufficiently small flexion of said prosthesis, said second member or set of members exhibits a gap.
9. The prosthesis of claim 7, wherein said second member or set of members comprises a first element that is capable of carrying a compressive load between said first and second endplates and a second element that is capable of carrying a tensile load between said first and second endplates.
10. The prosthesis of claim 7, wherein said first member comprises polymeric material, and said second member or set of members comprises metal.
11. A spinal disc prosthesis, comprising:
a first endplate and a second endplate each suitable to attach to respective vertebrae;
a polymeric member interposed between and adhered to said first and second endplates; and
a metal member or set of members which, at a sufficiently large externally applied load, forms a load path suitable to carry a portion of at least some component of load between said first endplate and said second endplate, and, at a sufficiently small externally applied load, does not form a load path between said first endplate and said second endplate.
12. The prosthesis of claim 11, wherein, at said sufficiently small externally applied load, said metal members or set of members exhibit a gap.
13. The prosthesis of claim 11, wherein said metal member or set of members is capable of carrying a compressive load.
14. The prosthesis of claim 13, wherein said metal member or set of members comprises a protrusion connected to said first endplate suitable to contact said second endplate.
15. The prosthesis of claim 13, wherein said metal member or set of members comprises a protrusion connected to said first endplate and a stop connected to said second endplate, said protrusion being suitable to contact said stop.
16. The prosthesis of claim 11, wherein said metal member or set of members comprises a member that is capable of carrying a tensile load.
17. The prosthesis of claim 11, wherein said metal member or set of members comprises a first member that is capable of carrying a compressive load and a second member that is capable of carrying a tensile load.
18. The prosthesis of claim 11, wherein said sufficiently large externally applied load comprises compression.
19. The prosthesis of claim 11, wherein said sufficiently large externally applied load comprises flexion.
20. A spinal disc prosthesis comprising:
a first endplate and a second endplate each suitable to attach to respective vertebrae;
a first member interposed between and adhered to said first and second endplates; and
a second member which, under at least some conditions, is capable of transferring a tensile load between a first connection point on said first endplate and a second connection point on said second endplate.
21. The prosthesis of claim 20, wherein said second member comprises a metal.
22. The prosthesis of claim 20, wherein said second member is elongated.
23. The prosthesis of claim 20, wherein said second member is pivotable with respect to at least one of said endplates.
24. The prosthesis of claim 20, wherein said second member is pivotable with respect to both of said endplates.
25. The prosthesis of claim 20, wherein said second member comprises a ball or portion thereof suitable to be part of a ball-and-socket joint.
26. The prosthesis of claim 20, wherein said second member comprises two balls or portions thereof each suitable to be part of respective ball-and-socket joints, one of said balls or portions thereof being at each end of said first member.
27. The prosthesis of claim 26, wherein each of said balls or portions thereof has a respective convex curved surface, and said convex curved surfaces face each other.
28. The prosthesis of claim 20, wherein said second member comprises an elongated central portion having at each end a ball or portion thereof, and wherein each of said endplates further comprises a corresponding socket for each of said balls or portions thereof.
29. The prosthesis of claim 20, wherein said first member transfers said tensile load only for separation distances between said first connection point and said second connection point that are greater than a certain separation distance.
30. The prosthesis of claim 20, wherein said first member is disposed to be incapable of carrying any load component other than said tensile load.
31. The prosthesis of claim 20, further comprising a second member that is capable, under at least some conditions, of transferring a compressive load between said first endplate and said second endplate.
32. A spinal disc prosthesis comprising:
a first endplate and a second endplate each suitable to attach to respective vertebrae;
at least two first members which, under at least some conditions, are capable of transferring a tensile load between a first connection point on said first endplate and a second connection point on said second endplate.
33. The prosthesis of claim 32, wherein said two first members are substantially identical to each other.
34. The prosthesis of claim 32, wherein said two first members are symmetrically located around an anterior-posterior centerline of said prosthesis.
35. The prosthesis of claim 32, further comprising a polymeric member interposed between and adhered to said first and second endplates.
US11/361,621 2003-04-04 2006-02-24 Artificial disc prosthesis Abandoned US20060149384A1 (en)

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US10/552,094 US7771478B2 (en) 2003-04-04 2004-04-02 Artificial disc prosthesis
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US11/361,733 Expired - Fee Related US7806935B2 (en) 2003-04-04 2006-02-24 Artificial disc prosthesis
US11/361,880 Expired - Fee Related US7771480B2 (en) 2003-04-04 2006-02-24 Artificial disc prosthesis
US11/361,621 Abandoned US20060149384A1 (en) 2003-04-04 2006-02-24 Artificial disc prosthesis
US11/361,131 Expired - Fee Related US7763075B2 (en) 2003-04-04 2006-02-24 Artificial disc prosthesis
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US11/361,733 Expired - Fee Related US7806935B2 (en) 2003-04-04 2006-02-24 Artificial disc prosthesis
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Cited By (15)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20060069436A1 (en) * 2004-09-30 2006-03-30 Depuy Spine, Inc. Trial disk implant
US20080161928A1 (en) * 2006-12-27 2008-07-03 Warsaw Orthopedic, Inc. Compliant intervertebral prosthetic devices with motion constraining tethers
US20080183292A1 (en) * 2007-01-29 2008-07-31 Warsaw Orthopedic, Inc. Compliant intervertebral prosthetic devices employing composite elastic and textile structures
US20090204213A1 (en) * 2008-02-13 2009-08-13 Depuy Products, Inc. Metallic implants
US20090234456A1 (en) * 2008-03-14 2009-09-17 Warsaw Orthopedic, Inc. Intervertebral Implant and Methods of Implantation and Treatment
US20100100185A1 (en) * 2008-10-22 2010-04-22 Warsaw Orthopedic, Inc. Intervertebral Disc Prosthesis Having Viscoelastic Properties
US20100114685A1 (en) * 2006-03-30 2010-05-06 Reality Charity, Llc Systems and methods for management of fundraising campaigns
US20100234954A1 (en) * 2009-03-13 2010-09-16 Warsaw Orthopedic, Inc. Spinal implant and methods of implantation and treatment
US9254130B2 (en) 2011-11-01 2016-02-09 Hyun Bae Blade anchor systems for bone fusion
US9480511B2 (en) 2009-12-17 2016-11-01 Engage Medical Holdings, Llc Blade fixation for ankle fusion and arthroplasty
US9925051B2 (en) 2010-12-16 2018-03-27 Engage Medical Holdings, Llc Arthroplasty systems and methods
US10238382B2 (en) 2012-03-26 2019-03-26 Engage Medical Holdings, Llc Blade anchor for foot and ankle
US10390955B2 (en) 2016-09-22 2019-08-27 Engage Medical Holdings, Llc Bone implants
US10456272B2 (en) 2017-03-03 2019-10-29 Engage Uni Llc Unicompartmental knee arthroplasty
US11540928B2 (en) 2017-03-03 2023-01-03 Engage Uni Llc Unicompartmental knee arthroplasty

Families Citing this family (93)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2824261B1 (en) 2001-05-04 2004-05-28 Ldr Medical INTERVERTEBRAL DISC PROSTHESIS AND IMPLEMENTATION METHOD AND TOOLS
FR2846550B1 (en) 2002-11-05 2006-01-13 Ldr Medical INTERVERTEBRAL DISC PROSTHESIS
JP4275699B2 (en) 2003-01-31 2009-06-10 スパイナルモーション, インコーポレイテッド Intervertebral prosthesis placement instrument
EP1587437B1 (en) 2003-01-31 2013-02-27 Spinalmotion, Inc. Spinal midline indicator
US7771478B2 (en) 2003-04-04 2010-08-10 Theken Spine, Llc Artificial disc prosthesis
US10052211B2 (en) 2003-05-27 2018-08-21 Simplify Medical Pty Ltd. Prosthetic disc for intervertebral insertion
ATE480203T1 (en) 2003-05-27 2010-09-15 Spinalmotion Inc INTERVERTEBRAL DISC PROSTHESIS FOR INTERVERTEBRAL INSERTION
US7575599B2 (en) 2004-07-30 2009-08-18 Spinalmotion, Inc. Intervertebral prosthetic disc with metallic core
US7794465B2 (en) * 2003-09-10 2010-09-14 Warsaw Orthopedic, Inc. Artificial spinal discs and associated implantation instruments and methods
ATE507803T1 (en) 2004-02-04 2011-05-15 Ldr Medical DISC PROSTHESIS
FR2865629B1 (en) 2004-02-04 2007-01-26 Ldr Medical INTERVERTEBRAL DISC PROSTHESIS
US7393361B2 (en) * 2004-02-20 2008-07-01 Spinecore, Inc. Artificial intervertebral disc having a bored semispherical bearing with a compression locking post and retaining caps
FR2869528B1 (en) 2004-04-28 2007-02-02 Ldr Medical INTERVERTEBRAL DISC PROSTHESIS
BRPI0511838A (en) * 2004-06-07 2008-01-15 Synthes Gmbh implant, bone plate, method for mending a broken bone, and monitoring system
CN101022770B (en) * 2004-06-30 2012-02-08 辛纳吉椎间盘置换公司 Artificial spinal disc
US9237958B2 (en) 2004-06-30 2016-01-19 Synergy Disc Replacement Inc. Joint prostheses
US8172904B2 (en) 2004-06-30 2012-05-08 Synergy Disc Replacement, Inc. Artificial spinal disc
US8114158B2 (en) * 2004-08-03 2012-02-14 Kspine, Inc. Facet device and method
US7585326B2 (en) 2004-08-06 2009-09-08 Spinalmotion, Inc. Methods and apparatus for intervertebral disc prosthesis insertion
US7850697B2 (en) 2004-12-06 2010-12-14 Axiomed Spine Corporation Method and apparatus for replacing a spinal disc
FR2879436B1 (en) 2004-12-22 2007-03-09 Ldr Medical INTERVERTEBRAL DISC PROSTHESIS
US8083797B2 (en) 2005-02-04 2011-12-27 Spinalmotion, Inc. Intervertebral prosthetic disc with shock absorption
US7799083B2 (en) * 2005-05-02 2010-09-21 Seaspine, Inc. Prosthesis for restoring motion in an appendage or spinal joint and an intervertebral spacer
AU2006242416A1 (en) * 2005-05-02 2006-11-09 Seaspine, Inc. Motion restoring intervertebral device
FR2887762B1 (en) 2005-06-29 2007-10-12 Ldr Medical Soc Par Actions Si INTERVERTEBRAL DISC PROSTHESIS INSERTION INSTRUMENTATION BETWEEN VERTEBRATES
EP1928362B1 (en) * 2005-09-01 2012-07-04 Spinal Kinetics, Inc. Prosthetic intervertebral discs
US7731753B2 (en) 2005-09-01 2010-06-08 Spinal Kinetics, Inc. Prosthetic intervertebral discs
FR2891135B1 (en) 2005-09-23 2008-09-12 Ldr Medical Sarl INTERVERTEBRAL DISC PROSTHESIS
US7985256B2 (en) 2005-09-26 2011-07-26 Coalign Innovations, Inc. Selectively expanding spine cage, hydraulically controllable in three dimensions for enhanced spinal fusion
US9028550B2 (en) 2005-09-26 2015-05-12 Coalign Innovations, Inc. Selectively expanding spine cage with enhanced bone graft infusion
US8070813B2 (en) * 2005-09-26 2011-12-06 Coalign Innovations, Inc. Selectively expanding spine cage, hydraulically controllable in three dimensions for vertebral body replacement
FR2893838B1 (en) 2005-11-30 2008-08-08 Ldr Medical Soc Par Actions Si PROSTHESIS OF INTERVERTEBRAL DISC AND INSTRUMENTATION OF INSERTION OF THE PROSTHESIS BETWEEN VERTEBRATES
US7691130B2 (en) * 2006-01-27 2010-04-06 Warsaw Orthopedic, Inc. Spinal implants including a sensor and methods of use
US8016859B2 (en) * 2006-02-17 2011-09-13 Medtronic, Inc. Dynamic treatment system and method of use
AU2007238092A1 (en) 2006-04-12 2007-10-25 Spinalmotion, Inc. Posterior spinal device and method
WO2008033457A2 (en) * 2006-09-14 2008-03-20 The University Of Toledo Variable height vertebral body replacement implant
US8715352B2 (en) * 2006-12-14 2014-05-06 Depuy Spine, Inc. Buckling disc replacement
US8465546B2 (en) 2007-02-16 2013-06-18 Ldr Medical Intervertebral disc prosthesis insertion assemblies
US8673005B1 (en) * 2007-03-07 2014-03-18 Nuvasive, Inc. System and methods for spinal fusion
FR2916956B1 (en) 2007-06-08 2012-12-14 Ldr Medical INTERSOMATIC CAGE, INTERVERTEBRAL PROSTHESIS, ANCHORING DEVICE AND IMPLANTATION INSTRUMENTATION
US10821003B2 (en) 2007-06-20 2020-11-03 3Spline Sezc Spinal osteotomy
US20090043391A1 (en) 2007-08-09 2009-02-12 Spinalmotion, Inc. Customized Intervertebral Prosthetic Disc with Shock Absorption
WO2009055481A1 (en) 2007-10-22 2009-04-30 Spinalmotion, Inc. Dynamic spacer device and method for spanning a space formed upon removal of an intervertebral disc
AU2008316600B2 (en) 2007-10-25 2014-09-18 Jeffery D. Arnett Systems and methods for vertebral disc replacement
US8118873B2 (en) * 2008-01-16 2012-02-21 Warsaw Orthopedic, Inc. Total joint replacement
WO2009094475A1 (en) * 2008-01-25 2009-07-30 Spinalmotion, Inc. Intervertebral prosthetic disc with shock absorbing core formed with disc springs
US20100145455A1 (en) * 2008-12-10 2010-06-10 Innvotec Surgical, Inc. Lockable spinal implant
US8992620B2 (en) 2008-12-10 2015-03-31 Coalign Innovations, Inc. Adjustable distraction cage with linked locking mechanisms
US8932355B2 (en) 2008-02-22 2015-01-13 Coalign Innovations, Inc. Spinal implant with expandable fixation
US8696751B2 (en) * 2008-12-10 2014-04-15 Coalign Innovations, Inc. Adjustable distraction cage with linked locking mechanisms
US8764833B2 (en) 2008-03-11 2014-07-01 Spinalmotion, Inc. Artificial intervertebral disc with lower height
US9034038B2 (en) 2008-04-11 2015-05-19 Spinalmotion, Inc. Motion limiting insert for an artificial intervertebral disc
CA2722048A1 (en) 2008-05-05 2009-11-12 Yves Arramon Polyaryletherketone artificial intervertebral disc
US9220603B2 (en) 2008-07-02 2015-12-29 Simplify Medical, Inc. Limited motion prosthetic intervertebral disc
EP2299944A4 (en) 2008-07-17 2013-07-31 Spinalmotion Inc Artificial intervertebral disc placement system
US8172902B2 (en) * 2008-07-17 2012-05-08 Spinemedica, Llc Spinal interbody spacers
EP2299941A1 (en) 2008-07-18 2011-03-30 Spinalmotion Inc. Posterior prosthetic intervertebral disc
US9364338B2 (en) 2008-07-23 2016-06-14 Resspond Spinal Systems Modular nucleus pulposus prosthesis
KR101614561B1 (en) * 2008-07-23 2016-04-21 마르크 아이. 말베르크 Modular nucleus pulposus prosthesis
US8814937B2 (en) 2008-09-18 2014-08-26 Peter L. Mayer Intervertebral disc prosthesis, method for assembling, method for implanting prosthesis, and method for explanting
US8187333B2 (en) * 2008-09-18 2012-05-29 Mayer Peter L Intervertebral disc prosthesis and method for implanting and explanting
DE102008048739A1 (en) * 2008-09-24 2010-04-01 Franz Dr. Copf jun. Disc prosthesis
US8821555B2 (en) 2009-02-11 2014-09-02 Howmedica Osteonics Corp. Intervertebral implant with integrated fixation
CA2753439C (en) * 2009-02-25 2017-06-20 Spinewelding Ag Spine stabilization device, and method and kit for its implantation
US20100286777A1 (en) * 2009-05-08 2010-11-11 Stryker Spine Stand alone anterior cage
US20100331733A1 (en) * 2009-06-30 2010-12-30 Orthosensor Sensing device and method for an orthopedic joint
US9462964B2 (en) * 2011-09-23 2016-10-11 Orthosensor Inc Small form factor muscular-skeletal parameter measurement system
WO2011019699A2 (en) 2009-08-10 2011-02-17 Howmedica Osteonics Corp Intervertebral implant with integrated fixation
WO2011056845A1 (en) 2009-11-03 2011-05-12 Howmedica Osteonics Corp. Intervertebral implant with integrated fixation
EP3323390A1 (en) 2009-12-31 2018-05-23 LDR Medical Système intervertébral avec un dispositif d'ancrage
US8206452B2 (en) * 2010-02-18 2012-06-26 Biomet Manufacturing Corp. Prosthetic device with damper
EP2377495A1 (en) * 2010-04-19 2011-10-19 Warsaw Orthopedic, Inc. Spinal implant
US8747479B2 (en) 2011-04-26 2014-06-10 Michael A. McShane Tibial component
US9615856B2 (en) 2011-11-01 2017-04-11 Imds Llc Sacroiliac fusion cage
US9844335B2 (en) * 2012-02-27 2017-12-19 Orthosensor Inc Measurement device for the muscular-skeletal system having load distribution plates
US9393126B2 (en) 2012-04-20 2016-07-19 Peter L. Mayer Bilaterally placed disc prosthesis for spinal implant and method of bilateral placement
US9364339B2 (en) 2012-04-30 2016-06-14 Peter L. Mayer Unilaterally placed expansile spinal prosthesis
CN103006356B (en) * 2013-01-07 2018-03-16 刘小勇 A kind of bionic type hydraulic movable artificial vertebral body
AU2014354694B2 (en) 2013-11-27 2019-07-04 Howmedica Osteonics Corp., Structurally supporting insert for spinal fusion cage
CA2917503A1 (en) 2015-01-14 2016-07-14 Stryker European Holdings I, Llc Spinal implant with fluid delivery capabilities
AU2016200179B2 (en) 2015-01-14 2020-09-17 Stryker European Operations Holdings Llc Spinal implant with porous and solid surfaces
CA2930123A1 (en) 2015-05-18 2016-11-18 Stryker European Holdings I, Llc Partially resorbable implants and methods
EP3103417B1 (en) 2015-06-10 2018-01-31 Biedermann Technologies GmbH & Co. KG Intervertebral implant and system of an intervertebral implant and an instrument for inserting the intervertebral implant
AU2017202311B2 (en) 2016-04-07 2022-03-03 Howmedica Osteonics Corp. Expandable interbody implant
EP3245982B1 (en) 2016-05-20 2023-11-01 Howmedica Osteonics Corp. Expandable interbody implant with lordosis correction
EP3292841B8 (en) 2016-09-12 2023-05-31 Howmedica Osteonics Corp. Interbody implant with independent control of expansion at multiple locations
AU2017251734B2 (en) 2016-10-26 2022-10-20 Howmedica Osteonics Corp. Expandable interbody implant with lateral articulation
EP3456294A1 (en) 2017-09-15 2019-03-20 Stryker European Holdings I, LLC Intervertebral body fusion device expanded with hardening material
EP3459502A1 (en) 2017-09-20 2019-03-27 Stryker European Holdings I, LLC Spinal implants
CN111405883B (en) 2017-09-29 2022-09-16 艾克西奥医疗有限公司 Artificial intervertebral disc with sensors
CA3108768C (en) * 2018-08-07 2022-05-10 Minimally Invasive Spinal Technology, LLC Device and method for correcting spinal deformities in patients
AU2022225229A1 (en) 2021-02-23 2023-09-21 Nuvasive Specialized Orthopedics, Inc. Adjustable implant, system and methods
CN116763510B (en) * 2023-08-24 2023-12-19 北京爱康宜诚医疗器材有限公司 Intervertebral fusion prosthesis structure

Citations (57)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4057857A (en) * 1975-09-08 1977-11-15 Shiley Laboratories, Inc. Heart valve with arcuate occluder
US4241463A (en) * 1978-10-16 1980-12-30 Precision Cast Specialties, Inc. Prosthetic implant device
US4688000A (en) * 1984-05-29 1987-08-18 Donovan John S Non biased push-pull amplifiers
US4714468A (en) * 1985-08-13 1987-12-22 Pfizer Hospital Products Group Inc. Prosthesis formed from dispersion strengthened cobalt-chromium-molybdenum alloy produced by gas atomization
US4714469A (en) * 1987-02-26 1987-12-22 Pfizer Hospital Products Group, Inc. Spinal implant
US4759769A (en) * 1987-02-12 1988-07-26 Health & Research Services Inc. Artificial spinal disc
US4863477A (en) * 1987-05-12 1989-09-05 Monson Gary L Synthetic intervertebral disc prosthesis
US4874389A (en) * 1987-12-07 1989-10-17 Downey Ernest L Replacement disc
US4911718A (en) * 1988-06-10 1990-03-27 University Of Medicine & Dentistry Of N.J. Functional and biocompatible intervertebral disc spacer
US4932969A (en) * 1987-01-08 1990-06-12 Sulzer Brothers Limited Joint endoprosthesis
US4946378A (en) * 1987-11-24 1990-08-07 Asahi Kogaku Kogyo Kabushiki Kaisha Artificial intervertebral disc
US4997432A (en) * 1988-03-23 1991-03-05 Waldemar Link Gmbh & Co. Surgical instrument set
US5002576A (en) * 1988-06-06 1991-03-26 Mecron Medizinische Produkte Gmbh Intervertebral disk endoprosthesis
US5062850A (en) * 1990-01-16 1991-11-05 University Of Florida Axially-fixed vertebral body prosthesis and method of fixation
US5071437A (en) * 1989-02-15 1991-12-10 Acromed Corporation Artificial disc
US5123926A (en) * 1991-02-22 1992-06-23 Madhavan Pisharodi Artificial spinal prosthesis
US5197488A (en) * 1991-04-05 1993-03-30 N. K. Biotechnical Engineering Co. Knee joint load measuring instrument and joint prosthesis
US5246458A (en) * 1992-10-07 1993-09-21 Graham Donald V Artificial disk
US5258031A (en) * 1992-01-06 1993-11-02 Danek Medical Intervertebral disk arthroplasty
US5300120A (en) * 1992-08-24 1994-04-05 Lipomatrix Incorporated Implant with electrical transponder marker
US5314477A (en) * 1990-03-07 1994-05-24 J.B.S. Limited Company Prosthesis for intervertebral discs and instruments for implanting it
US5370694A (en) * 1989-07-25 1994-12-06 Smith & Nephew Richards, Inc. Zirconium oxide and nitride coated endoprostheses for tissue protection
US5476465A (en) * 1993-04-21 1995-12-19 Amei Technologies Inc. Surgical cable crimp
US5511561A (en) * 1992-11-16 1996-04-30 Wanderman; Steven M. Gait cycle force monitor
US5536270A (en) * 1994-02-24 1996-07-16 Pioneer Laboratories, Inc. Cable system for bone securance
US5674294A (en) * 1993-09-14 1997-10-07 Commissariat A L'energie Atomique Intervertebral disk prosthesis
US5893889A (en) * 1997-06-20 1999-04-13 Harrington; Michael Artificial disc
US5906643A (en) * 1994-07-28 1999-05-25 Walker; Peter Stanley Stabilised mobile bearing knee
US6086613A (en) * 1997-12-23 2000-07-11 Depuy Acromed, Inc. Spacer assembly for use in spinal surgeries
US6179874B1 (en) * 1998-04-23 2001-01-30 Cauthen Research Group, Inc. Articulating spinal implant
US6366206B1 (en) * 1999-06-02 2002-04-02 Ball Semiconductor, Inc. Method and apparatus for attaching tags to medical and non-medical devices
US20020049394A1 (en) * 2000-08-25 2002-04-25 The Cleveland Clinic Foundation Apparatus and method for assessing loads on adjacent bones
US6425920B1 (en) * 1999-10-13 2002-07-30 James S. Hamada Spinal fusion implant
US6447448B1 (en) * 1998-12-31 2002-09-10 Ball Semiconductor, Inc. Miniature implanted orthopedic sensors
US6520996B1 (en) * 1999-06-04 2003-02-18 Depuy Acromed, Incorporated Orthopedic implant
US20030100951A1 (en) * 1997-10-17 2003-05-29 Hassan Serhan Spinal disc
US20030135277A1 (en) * 2001-11-26 2003-07-17 Sdgi Holdings, Inc. Implantable joint prosthesis and associated instrumentation
US20030153976A1 (en) * 1999-10-20 2003-08-14 Cauthen Joseph C. Spinal disc annulus reconstruction method and spinal disc annulus stent
US20030176923A1 (en) * 2002-03-12 2003-09-18 Waldemar Link Gmbh & Co. Intervertebral prosthesis
US20030187506A1 (en) * 2002-03-27 2003-10-02 Raymond Ross Modular disc prosthesis
US20030191533A1 (en) * 2000-01-30 2003-10-09 Diamicron, Inc. Articulating diamond-surfaced spinal implants
US20030191536A1 (en) * 1999-10-08 2003-10-09 Ferree Bret A. Artificial intervertebral disc replacements incorporating reinforced wall sections
US20030191534A1 (en) * 2000-03-10 2003-10-09 Guy Viart Intervertebral disc prosthesis
US20030195630A1 (en) * 2002-04-10 2003-10-16 Ferree Bret A. Disc augmentation using materials that expand in situ
US20030195631A1 (en) * 2002-04-12 2003-10-16 Ferree Bret A. Shape-memory spacers for artificial disc replacements
US20030199982A1 (en) * 1998-09-04 2003-10-23 Sdgi Holdings, Inc. Peanut spectacle multi discoid thoraco-lumbar disc prosthesis
US20030199981A1 (en) * 2002-04-23 2003-10-23 Ferree Bret A. Artificial disc replacements with natural kinematics
US20030204231A1 (en) * 2002-04-30 2003-10-30 Hine Douglas S. Method and apparatus for placing a coronary sinus/cardiac vein pacing and defibrillation lead with adjustable electrode spacing
US20040122517A1 (en) * 2002-12-10 2004-06-24 Axiomed Spine Corporation Artificial disc
US20050273170A1 (en) * 2004-06-08 2005-12-08 Navarro Richard R Prosthetic intervertebral spinal disc with integral microprocessor
US20060015183A1 (en) * 2004-07-09 2006-01-19 Pioneer Laboratories, Inc. Skeletal reconstruction device
US7060100B2 (en) * 1999-10-08 2006-06-13 Ferree Bret A Artificial disc and joint replacements with modular cushioning components
US7066958B2 (en) * 2002-05-10 2006-06-27 Ferree Bret A Prosthetic components with partially contained compressible resilient members
US20060142860A1 (en) * 2003-04-04 2006-06-29 Theken Disc, Llc Artificial disc prosthesis
US7201776B2 (en) * 1999-10-08 2007-04-10 Ferree Bret A Artificial intervertebral disc replacements with endplates
US7267688B2 (en) * 2002-10-22 2007-09-11 Ferree Bret A Biaxial artificial disc replacement
US7291171B2 (en) * 2002-05-10 2007-11-06 Ferree Bret A Artificial disc replacement (ADR) using elastic tether member

Family Cites Families (244)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US623525A (en) * 1899-04-25 Electric meter
SE391122B (en) 1971-01-25 1977-02-07 Cutter Lab PROTESTS IN THE FORM OF A SPINE BONIC DISC AND PROCEDURES FOR MANUFACTURE THEREOF
CA1146301A (en) 1980-06-13 1983-05-17 J. David Kuntz Intervertebral disc prosthesis
US4309777A (en) 1980-11-13 1982-01-12 Patil Arun A Artificial intervertebral disc
US4860751A (en) 1985-02-04 1989-08-29 Cordis Corporation Activity sensor for pacemaker control
US4772287A (en) 1987-08-20 1988-09-20 Cedar Surgical, Inc. Prosthetic disc and method of implanting
US5609635A (en) 1988-06-28 1997-03-11 Michelson; Gary K. Lordotic interbody spinal fusion implants
CA1333209C (en) 1988-06-28 1994-11-29 Gary Karlin Michelson Artificial spinal fusion implants
AU624627B2 (en) 1988-08-18 1992-06-18 Johnson & Johnson Orthopaedics, Inc. Functional and biocompatible intervertebral disc spacer containing elastomeric material of varying hardness
US5545229A (en) 1988-08-18 1996-08-13 University Of Medicine And Dentistry Of Nj Functional and biocompatible intervertebral disc spacer containing elastomeric material of varying hardness
JP3007903B2 (en) 1991-03-29 2000-02-14 京セラ株式会社 Artificial disc
US5306307A (en) 1991-07-22 1994-04-26 Calcitek, Inc. Spinal disk implant
US5320644A (en) 1991-08-30 1994-06-14 Sulzer Brothers Limited Intervertebral disk prosthesis
US5425773A (en) 1992-01-06 1995-06-20 Danek Medical, Inc. Intervertebral disk arthroplasty device
DE4208116C2 (en) 1992-03-13 1995-08-03 Link Waldemar Gmbh Co Intervertebral disc prosthesis
DE4208115A1 (en) 1992-03-13 1993-09-16 Link Waldemar Gmbh Co DISC ENDOPROTHESIS
ATE141149T1 (en) * 1992-04-21 1996-08-15 Sulzer Medizinaltechnik Ag ARTIFICIAL DISC BODY
DE4213771C1 (en) * 1992-04-27 1993-09-30 Eska Medical Gmbh & Co Spinal disc endoprosthesis - has elastic core with rim beading between shaped cover plates with a screw bonding for implantation without adhesive
US5306309A (en) 1992-05-04 1994-04-26 Calcitek, Inc. Spinal disk implant and implantation kit
US5431694A (en) 1992-08-18 1995-07-11 Snaper; Alvin A. Bio-operable power source
US5716407A (en) 1992-08-24 1998-02-10 Lipomatrix, Incorporated Method of rendering identifiable a living tissue implant using an electrical transponder marker
US5326363A (en) 1992-09-14 1994-07-05 Zimmer, Inc. Provisional implant
US5676701A (en) 1993-01-14 1997-10-14 Smith & Nephew, Inc. Low wear artificial spinal disc
ES2161725T3 (en) 1993-02-09 2001-12-16 Depuy Acromed Inc INTERVERTEBRAL DISC.
FR2707480B1 (en) 1993-06-28 1995-10-20 Bisserie Michel Intervertebral disc prosthesis.
US5425772A (en) 1993-09-20 1995-06-20 Brantigan; John W. Prosthetic implant for intervertebral spinal fusion
US5456724A (en) 1993-12-15 1995-10-10 Industrial Technology Research Institute Load sensor for bone graft
US5514180A (en) 1994-01-14 1996-05-07 Heggeness; Michael H. Prosthetic intervertebral devices
US5458642A (en) 1994-01-18 1995-10-17 Beer; John C. Synthetic intervertebral disc
AU2621295A (en) 1994-05-24 1995-12-18 Smith & Nephew Plc Intervertebral disc implant
US5674296A (en) 1994-11-14 1997-10-07 Spinal Dynamics Corporation Human spinal disc prosthesis
FR2728159B1 (en) 1994-12-16 1997-06-27 Tornier Sa ELASTIC DISC PROSTHESIS
US6149688A (en) 1995-06-07 2000-11-21 Surgical Dynamics, Inc. Artificial bone graft implant
US6423095B1 (en) 1995-10-16 2002-07-23 Sdgi Holdings, Inc. Intervertebral spacers
ES2278091T3 (en) 1995-11-08 2007-08-01 Zimmer Gmbh DEVICE FOR INTRODUCING AN IMPLANT, IN PARTICULAR AN INTERVERTEBRAL PROTESIS.
US5683465A (en) 1996-03-18 1997-11-04 Shinn; Gary Lee Artificial intervertebral disk prosthesis
US5861018A (en) 1996-05-28 1999-01-19 Telecom Medical Inc. Ultrasound transdermal communication system and method
US7104986B2 (en) 1996-07-16 2006-09-12 Arthrocare Corporation Intervertebral disc replacement method
US5782832A (en) 1996-10-01 1998-07-21 Surgical Dynamics, Inc. Spinal fusion implant and method of insertion thereof
US5895428A (en) 1996-11-01 1999-04-20 Berry; Don Load bearing spinal joint implant
US5749909A (en) 1996-11-07 1998-05-12 Sulzer Intermedics Inc. Transcutaneous energy coupling using piezoelectric device
AU7178698A (en) 1996-11-15 1998-06-03 Advanced Bio Surfaces, Inc. Biomaterial system for in situ tissue repair
US5827328A (en) 1996-11-22 1998-10-27 Buttermann; Glenn R. Intervertebral prosthetic device
US7169123B2 (en) * 1997-01-22 2007-01-30 Advanced Medical Optics, Inc. Control of pulse duty cycle based upon footswitch displacement
US6034296A (en) 1997-03-11 2000-03-07 Elvin; Niell Implantable bone strain telemetry sensing system and method
US6033438A (en) 1997-06-03 2000-03-07 Sdgi Holdings, Inc. Open intervertebral spacer
GB9713330D0 (en) 1997-06-25 1997-08-27 Bridport Gundry Plc Surgical implant
US6529127B2 (en) 1997-07-11 2003-03-04 Microstrain, Inc. System for remote powering and communication with a network of addressable, multichannel sensing modules
US6259937B1 (en) * 1997-09-12 2001-07-10 Alfred E. Mann Foundation Implantable substrate sensor
US5824094A (en) 1997-10-17 1998-10-20 Acromed Corporation Spinal disc
US6139579A (en) 1997-10-31 2000-10-31 Depuy Motech Acromed, Inc. Spinal disc
US5888226A (en) 1997-11-12 1999-03-30 Rogozinski; Chaim Intervertebral prosthetic disc
US5935171A (en) 1997-11-17 1999-08-10 John E. Schneider Apparatus for, and method of, detecting dislocations and material wear in hip replacements
US5899941A (en) 1997-12-09 1999-05-04 Chubu Bearing Kabushiki Kaisha Artificial intervertebral disk
US6162252A (en) 1997-12-12 2000-12-19 Depuy Acromed, Inc. Artificial spinal disc
US5989291A (en) 1998-02-26 1999-11-23 Third Millennium Engineering, Llc Intervertebral spacer device
US6019792A (en) 1998-04-23 2000-02-01 Cauthen Research Group, Inc. Articulating spinal implant
US6679915B1 (en) 1998-04-23 2004-01-20 Sdgi Holdings, Inc. Articulating spinal implant
US6800093B2 (en) 1998-05-06 2004-10-05 Cortek, Inc. Device for spinal fusion
US6368325B1 (en) 1998-05-27 2002-04-09 Nuvasive, Inc. Bone blocks and methods for inserting bone blocks into intervertebral spaces
US6132465A (en) 1998-06-04 2000-10-17 Raymedica, Inc. Tapered prosthetic spinal disc nucleus
US6296664B1 (en) 1998-06-17 2001-10-02 Surgical Dynamics, Inc. Artificial intervertebral disc
US6136031A (en) 1998-06-17 2000-10-24 Surgical Dynamics, Inc. Artificial intervertebral disc
DE19829637C2 (en) 1998-07-02 2000-10-19 Implex Hear Tech Ag Medical implant
US6231609B1 (en) 1998-07-09 2001-05-15 Hamid M. Mehdizadeh Disc replacement prosthesis
US5928284A (en) 1998-07-09 1999-07-27 Mehdizadeh; Hamid M. Disc replacement prosthesis
US6063121A (en) 1998-07-29 2000-05-16 Xavier; Ravi Vertebral body prosthesis
US6059784A (en) 1998-10-08 2000-05-09 The United States Of America As Represented By The Administrator Of The National Aeronautics And Space Administration Capacitive extensometer particularly suited for measuring in vivo bone strain
FR2784891B1 (en) 1998-10-22 2001-01-26 Hassan Razian INTERSOMATIC CAGE WITH HOLDING DEVICE
US6039763A (en) 1998-10-27 2000-03-21 Disc Replacement Technologies, Inc. Articulating spinal disc prosthesis
US6193757B1 (en) 1998-10-29 2001-02-27 Sdgi Holdings, Inc. Expandable intervertebral spacers
FR2787016B1 (en) 1998-12-11 2001-03-02 Dimso Sa INTERVERTEBRAL DISK PROSTHESIS
FR2787019B1 (en) 1998-12-11 2001-03-02 Dimso Sa INTERVERTEBRAL DISC PROSTHESIS WITH IMPROVED MECHANICAL BEHAVIOR
FR2787017B1 (en) 1998-12-11 2001-04-27 Dimso Sa INTERVERTEBRAL DISC PROSTHESIS WITH IMPROVED MECHANICAL BEHAVIOR
US6115636A (en) 1998-12-22 2000-09-05 Medtronic, Inc. Telemetry for implantable devices using the body as an antenna
US6206923B1 (en) 1999-01-08 2001-03-27 Sdgi Holdings, Inc. Flexible implant using partially demineralized bone
US6368350B1 (en) 1999-03-11 2002-04-09 Sulzer Spine-Tech Inc. Intervertebral disc prosthesis and method
US6170488B1 (en) 1999-03-24 2001-01-09 The B. F. Goodrich Company Acoustic-based remotely interrogated diagnostic implant device and system
US6216537B1 (en) 1999-03-31 2001-04-17 Medtronic, Inc. Accelerometer for implantable medical device
US6110210A (en) 1999-04-08 2000-08-29 Raymedica, Inc. Prosthetic spinal disc nucleus having selectively coupled bodies
AU4810800A (en) 1999-04-26 2000-11-10 Li Medical Technologies, Inc. Prosthetic apparatus and method
US6579321B1 (en) 1999-05-17 2003-06-17 Vanderbilt University Intervertebral disc replacement prosthesis
US6419704B1 (en) 1999-10-08 2002-07-16 Bret Ferree Artificial intervertebral disc replacement methods and apparatus
US6491724B1 (en) 1999-08-13 2002-12-10 Bret Ferree Spinal fusion cage with lordosis correction
CA2376097A1 (en) 1999-06-04 2000-12-14 Sdgi Holdings, Inc. Artificial disc implant
ES2303381T3 (en) 1999-07-02 2008-08-01 Spine Solutions Inc. INTERVERTEBRAL IMPLANT.
WO2002009626A1 (en) 1999-07-26 2002-02-07 Advanced Prosthetic Technologies, Inc. Improved spinal surgical prosthesis
NL1012719C1 (en) 1999-07-28 2001-01-30 Veldhuizen Dr Ag Spine prosthesis.
US20040249461A1 (en) 1999-08-13 2004-12-09 Ferree Bret A. Coupled artificial disc replacements methods and apparatus
EP1328221B1 (en) 1999-08-18 2009-03-25 Intrinsic Therapeutics, Inc. Devices for nucleus pulposus augmentation and retention
US7507243B2 (en) 1999-08-18 2009-03-24 Gregory Lambrecht Devices and method for augmenting a vertebral disc
US6264695B1 (en) 1999-09-30 2001-07-24 Replication Medical, Inc. Spinal nucleus implant
US20040260286A1 (en) 1999-10-08 2004-12-23 Ferree Bret A. Intradiscal devices with anti-extrusion keels
US6878167B2 (en) 2002-04-24 2005-04-12 Bret A. Ferree Methods and apparatus for placing intradiscal devices
US20050273111A1 (en) 1999-10-08 2005-12-08 Ferree Bret A Methods and apparatus for intervertebral disc removal and endplate preparation
US20050256582A1 (en) 1999-10-08 2005-11-17 Ferree Bret A Spinal implants, including devices that reduce pressure on the annulus fibrosis
JP4326134B2 (en) 1999-10-20 2009-09-02 ウォーソー・オーソペディック・インコーポレーテッド Method and apparatus for performing a surgical procedure
US7004970B2 (en) 1999-10-20 2006-02-28 Anulex Technologies, Inc. Methods and devices for spinal disc annulus reconstruction and repair
US6592625B2 (en) 1999-10-20 2003-07-15 Anulex Technologies, Inc. Spinal disc annulus reconstruction method and spinal disc annulus stent
US6830570B1 (en) 1999-10-21 2004-12-14 Sdgi Holdings, Inc. Devices and techniques for a posterior lateral disc space approach
US6764491B2 (en) 1999-10-21 2004-07-20 Sdgi Holdings, Inc. Devices and techniques for a posterior lateral disc space approach
WO2001028469A2 (en) 1999-10-21 2001-04-26 Sdgi Holdings, Inc. Devices and techniques for a posterior lateral disc space approach
US6245109B1 (en) 1999-11-18 2001-06-12 Intellijoint Systems, Ltd. Artificial joint system and method utilizing same for monitoring wear and displacement of artificial joint members
ATE374571T1 (en) * 1999-11-24 2007-10-15 Innovative Dev & Marketing As DEVICE FOR TRAINING THE PELVIC MUSCLES
US6395034B1 (en) 1999-11-24 2002-05-28 Loubert Suddaby Intervertebral disc prosthesis
US6592624B1 (en) 1999-11-24 2003-07-15 Depuy Acromed, Inc. Prosthetic implant element
DE10011564C1 (en) 2000-03-09 2001-09-27 Goldschmidt Ag Th Process for the preparation of polyorganosiloxane emulsions
ATE390099T1 (en) 2000-04-04 2008-04-15 Link Spine Group Inc INTERVERBEL PLASTIC IMPLANT
US6805695B2 (en) 2000-04-04 2004-10-19 Spinalabs, Llc Devices and methods for annular repair of intervertebral discs
US6350283B1 (en) 2000-04-19 2002-02-26 Gary K. Michelson Bone hemi-lumbar interbody spinal implant having an asymmetrical leading end and method of installation thereof
US6482234B1 (en) 2000-04-26 2002-11-19 Pearl Technology Holdings, Llc Prosthetic spinal disc
US6851430B2 (en) 2000-05-01 2005-02-08 Paul M. Tsou Method and apparatus for endoscopic spinal surgery
US7008427B2 (en) 2000-05-25 2006-03-07 Orthoplex, Llc Inter-vertebral disc prosthesis for rachis through anterior surgery thereof
DE60141964D1 (en) 2000-06-29 2010-06-10 Mount Sinai Hospital Corp LUMBAR
FR2811540B1 (en) 2000-07-12 2003-04-25 Spine Next Sa IMPORTING INTERVERTEBRAL IMPLANT
US6610093B1 (en) 2000-07-28 2003-08-26 Perumala Corporation Method and apparatus for stabilizing adjacent vertebrae
US7601174B2 (en) 2000-08-08 2009-10-13 Warsaw Orthopedic, Inc. Wear-resistant endoprosthetic devices
US6620196B1 (en) 2000-08-30 2003-09-16 Sdgi Holdings, Inc. Intervertebral disc nucleus implants and methods
WO2002026170A2 (en) 2000-09-26 2002-04-04 Neurortho Implants Design, Llc Inter-vertebral disc prosthesis for lumbar rachis through posterior surgery thereof
CA2323252C (en) 2000-10-12 2007-12-11 Biorthex Inc. Artificial disc
US6764446B2 (en) 2000-10-16 2004-07-20 Remon Medical Technologies Ltd Implantable pressure sensors and methods for making and using them
US6733531B1 (en) 2000-10-20 2004-05-11 Sdgi Holdings, Inc. Anchoring devices and implants for intervertebral disc augmentation
DE60137073D1 (en) 2000-10-24 2009-01-29 Warsaw Orthopedic Inc DEVICES FOR THE SPINAL FUSION
US6692528B2 (en) 2000-11-09 2004-02-17 The Polymer Technology Group Incorporated Devices that change size/shape via osmotic pressure
US6579319B2 (en) 2000-11-29 2003-06-17 Medicinelodge, Inc. Facet joint replacement
US6773460B2 (en) 2000-12-05 2004-08-10 Roger P. Jackson Anterior variable expandable fusion cage
US6565605B2 (en) 2000-12-13 2003-05-20 Medicinelodge, Inc. Multiple facet joint replacement
US6692501B2 (en) 2000-12-14 2004-02-17 Gary K. Michelson Spinal interspace shaper
FR2818530B1 (en) 2000-12-22 2003-10-31 Spine Next Sa INTERVERTEBRAL IMPLANT WITH DEFORMABLE SHIM
US6468311B2 (en) 2001-01-22 2002-10-22 Sdgi Holdings, Inc. Modular interbody fusion implant
FR2819715B1 (en) 2001-01-25 2004-01-02 Cousin Biotech BONE REPAIR DEVICE
US6669730B2 (en) 2001-02-15 2003-12-30 Spinecore, Inc. Intervertebral spacer device utilizing a spirally slotted belleville washer having radially extending grooves
US6863689B2 (en) 2001-07-16 2005-03-08 Spinecore, Inc. Intervertebral spacer having a flexible wire mesh vertebral body contact element
US6673113B2 (en) 2001-10-18 2004-01-06 Spinecore, Inc. Intervertebral spacer device having arch shaped spring elements
US7235081B2 (en) 2001-07-16 2007-06-26 Spinecore, Inc. Wedge plate inserter/impactor and related methods for use in implanting an artificial intervertebral disc
US7563285B2 (en) 2001-07-16 2009-07-21 Spinecore, Inc. Artificial intervertebral disc utilizing a ball joint coupling
US6989032B2 (en) 2001-07-16 2006-01-24 Spinecore, Inc. Artificial intervertebral disc
US6764515B2 (en) 2001-02-15 2004-07-20 Spinecore, Inc. Intervertebral spacer device utilizing a spirally slotted belleville washer and a rotational mounting
US6607559B2 (en) 2001-07-16 2003-08-19 Spine Care, Inc. Trial intervertebral distraction spacers
WO2002098332A1 (en) 2001-02-16 2002-12-12 Sulzer Spine-Tech Inc. Bone implants and methods
JP4790917B2 (en) 2001-02-23 2011-10-12 独立行政法人科学技術振興機構 Artificial vertebral body
US6652585B2 (en) 2001-02-28 2003-11-25 Sdgi Holdings, Inc. Flexible spine stabilization system
US6478822B1 (en) 2001-03-20 2002-11-12 Spineco, Inc. Spherical spinal implant
US6368351B1 (en) 2001-03-27 2002-04-09 Bradley J. Glenn Intervertebral space implant for use in spinal fusion procedures
WO2002085261A1 (en) * 2001-04-20 2002-10-31 Douglas Stafford Maclennan Intervertebral disc implant device
US6607558B2 (en) 2001-07-03 2003-08-19 Axiomed Spine Corporation Artificial disc
US6447548B1 (en) 2001-07-16 2002-09-10 Third Millennium Engineering, Llc Method of surgically treating scoliosis
US6527806B2 (en) 2001-07-16 2003-03-04 Third Millennium Engineering, Llc Intervertebral spacer device having a spiral wave washer force restoring element
US7160327B2 (en) 2001-07-16 2007-01-09 Spinecore, Inc. Axially compressible artificial intervertebral disc having limited rotation using a captured ball and socket joint with a solid ball and compression locking post
US7153310B2 (en) 2001-07-16 2006-12-26 Spinecore, Inc. Vertebral bone distraction instruments
US6471725B1 (en) 2001-07-16 2002-10-29 Third Millenium Engineering, Llc Porous intervertebral distraction spacers
WO2003007780A2 (en) 2001-07-16 2003-01-30 Third Millenium Engineering Llc Artificial intervertebral disc having a wave washer force restoring element
US6890356B2 (en) 2001-07-16 2005-05-10 Spinecore, Inc. Surgical method of treating scoliosis
US6468310B1 (en) 2001-07-16 2002-10-22 Third Millennium Engineering, Llc Intervertebral spacer device having a wave washer force restoring element
US6436102B1 (en) 2001-07-16 2002-08-20 Third Millennium Engineering, Llc Method of distracting vertebral bones
US7182784B2 (en) 2001-07-18 2007-02-27 Smith & Nephew, Inc. Prosthetic devices employing oxidized zirconium and other abrasion resistant surfaces contacting surfaces of cross-linked polyethylene
US6610096B2 (en) 2001-08-22 2003-08-26 Macdonald Stuart G. Prosthetic implants having enhanced utility
DE50114038D1 (en) 2001-08-24 2008-07-31 Zimmer Gmbh Artificial disc
EP1287794B1 (en) 2001-08-24 2008-06-18 Zimmer GmbH Artificial spinal disc
US20040024463A1 (en) 2001-08-27 2004-02-05 Thomas James C. Expandable implant for partial disc replacement and reinforcement of a disc partially removed in a discectomy and for reduction and maintenance of alignment of cancellous bone fractures and methods and apparatuses for same
DE50109043D1 (en) 2001-08-28 2006-04-27 Johannes Schroeder Spine implant with adjustable height
DE20115281U1 (en) 2001-09-10 2001-11-22 Aesculap Ag & Co Kg Implant
DE60232893D1 (en) 2001-10-02 2009-08-20 Rex Medical Lp EDDY IMPLANT
US20030069644A1 (en) 2001-10-05 2003-04-10 Nebojsa Kovacevic Dual-tray teletibial implant
US7179295B2 (en) 2001-10-05 2007-02-20 Nebojsa Kovacevic Prosthetic shock absorber
WO2003032801A2 (en) 2001-10-18 2003-04-24 Third Millennium Engineering Llc Artificial intervertebral disc having a spider spring force restoring element
FR2832917B1 (en) 2001-11-30 2004-09-24 Spine Next Sa ELASTICALLY DEFORMABLE INTERVERTEBRAL IMPLANT
US6572653B1 (en) 2001-12-07 2003-06-03 Rush E. Simonson Vertebral implant adapted for posterior insertion
US7052515B2 (en) 2001-12-07 2006-05-30 Simonson Rush E Vertebral implant with dampening matrix adapted for posterior insertion
JP3553919B2 (en) 2001-12-12 2004-08-11 コーリンメディカルテクノロジー株式会社 Lower limb artery stenosis diagnostic device
US6740118B2 (en) 2002-01-09 2004-05-25 Sdgi Holdings, Inc. Intervertebral prosthetic joint
FR2835739B1 (en) 2002-02-11 2004-05-14 Spinevision SYSTEM FOR FIXING A WORKPIECE ON A BONE BODY
US20030181982A1 (en) 2002-03-04 2003-09-25 Spineology, Inc. No-profile, lumbo-sacral fixation device and method
EP1482877B1 (en) 2002-03-11 2007-05-30 Spinal Concepts Inc. Instrumentation for implanting spinal implant devices
ATE363878T1 (en) 2002-03-12 2007-06-15 Cervitech Inc INTERVERBAL PROSTHESIS, ESPECIALLY FOR THE CERVICAL SPINE
EP1344507A1 (en) 2002-03-12 2003-09-17 Waldemar Link (GmbH & Co.) Intervertebral prosthesis for the cervical spine
US20030176921A1 (en) 2002-03-13 2003-09-18 Lawson Kevin Jon Two-part prosthetic nucleus replacement for surgical reconstruction of intervertebral discs
FR2837094B1 (en) 2002-03-15 2004-11-26 Fixano INTERVERTEBRAL IMPLANT
US6991653B2 (en) 2002-03-21 2006-01-31 Sdgi Holdings, Inc. Vertebral body and disc space replacement devices
AU2003228391A1 (en) 2002-03-30 2003-10-20 Cool Brace Intervertebral device and method of use
US8038713B2 (en) 2002-04-23 2011-10-18 Spinecore, Inc. Two-component artificial disc replacements
US20080027548A9 (en) 2002-04-12 2008-01-31 Ferree Bret A Spacerless artificial disc replacements
US20060106462A1 (en) 2002-04-16 2006-05-18 Tsou Paul M Implant material for minimally invasive spinal interbody fusion surgery
DE10218093B4 (en) 2002-04-23 2005-04-07 Signus Medizintechnik Gmbh spinal implant
US20030233148A1 (en) 2002-04-23 2003-12-18 Ferree Bret A. Modular components to improve the fit of artificial disc replacements
US20030233097A1 (en) 2002-04-23 2003-12-18 Ferree Bret A. Artificial disc replacement (ADR) distraction sleeves and cutting guides
US20040030390A1 (en) 2002-04-23 2004-02-12 Ferree Bret A. Intradiscal component installation apparatus and methods
US7156848B2 (en) 2002-04-24 2007-01-02 Ferree Bret A Check reins for artificial disc replacements
US20040030391A1 (en) 2002-04-24 2004-02-12 Bret Ferree Artificial intervertebral disc spacers
US7179294B2 (en) 2002-04-25 2007-02-20 Warsaw Orthopedic, Inc. Articular disc prosthesis and method for implanting the same
EP1496819A4 (en) 2002-04-25 2007-02-14 Blackstone Medical Inc Artificial intervertebral disc
US7338525B2 (en) 2002-04-30 2008-03-04 Ferree Bret A Methods and apparatus for preventing the migration of intradiscal devices
DE10220139A1 (en) 2002-05-06 2003-11-20 Tutogen Medical Gmbh Bone material implant
US20040024461A1 (en) 2002-05-10 2004-02-05 Ferree Bret A. Spring and spherical joint artificial disc replacements
US7235102B2 (en) 2002-05-10 2007-06-26 Ferree Bret A Prosthetic components with contained compressible resilient members
WO2003095026A1 (en) 2002-05-13 2003-11-20 Pflueger D Russell Spinal disc therapy system
US20040010318A1 (en) 2002-05-15 2004-01-15 Ferree Bret A. Conformable endplates for artificial disc replacement (ADR) devices and other applications
US6689132B2 (en) 2002-05-15 2004-02-10 Spineco, Inc. Spinal implant insertion tool
US6840944B2 (en) 2002-05-21 2005-01-11 Loubert Suddaby Vertebral body end plate cutter
US7001433B2 (en) 2002-05-23 2006-02-21 Pioneer Laboratories, Inc. Artificial intervertebral disc device
US20040049283A1 (en) 2002-06-04 2004-03-11 Tushar Patel Medical implant and method of reducing back pain
US6770095B2 (en) 2002-06-18 2004-08-03 Depuy Acroned, Inc. Intervertebral disc
FR2841123B1 (en) 2002-06-25 2004-08-27 Hassan Razian IMPROVED INTERVERTEBRAL CAGE
US6981991B2 (en) 2002-06-27 2006-01-03 Ferree Bret A Arthroplasty devices configured to reduce shear stress
US7033393B2 (en) 2002-06-27 2006-04-25 Raymedica, Inc. Self-transitioning spinal disc anulus occulsion device and method of use
US6793678B2 (en) 2002-06-27 2004-09-21 Depuy Acromed, Inc. Prosthetic intervertebral motion disc having dampening
US20040002759A1 (en) 2002-06-28 2004-01-01 Ferree Bret A. Fusion and arthroplasty devices configured to receive bone growth promoting substances
US6682564B1 (en) 2002-07-02 2004-01-27 Luis Duarte Intervertebral support device and related methods
US20040010312A1 (en) 2002-07-09 2004-01-15 Albert Enayati Intervertebral prosthesis
US7101400B2 (en) 2002-08-19 2006-09-05 Jeffery Thramann Shaped memory artificial disc and methods of engrafting the same
US6958078B2 (en) 2002-08-19 2005-10-25 The University Of Toledo Bioartificial intervertebral disc
US20040049270A1 (en) 2002-09-10 2004-03-11 Gewirtz Robert J. Bone graft device
DE10242329B4 (en) 2002-09-12 2005-03-17 Biedermann Motech Gmbh Disc prosthesis
US20040054413A1 (en) 2002-09-16 2004-03-18 Howmedica Osteonics Corp. Radiovisible hydrogel intervertebral disc nucleus
US20040054414A1 (en) 2002-09-18 2004-03-18 Trieu Hai H. Collagen-based materials and methods for augmenting intervertebral discs
CA2499116A1 (en) 2002-09-18 2004-04-01 Sdgi Holdings, Inc. Natural tissue devices and methods of implantation
WO2004026186A1 (en) 2002-09-18 2004-04-01 Mathys Medizinaltechnik Ag Implant comprising a two-piece joint
US6932843B2 (en) 2002-09-25 2005-08-23 Medicinelodge, Inc. Apparatus and method for the in-situ formation of a structural prosthesis
US6899735B2 (en) 2002-10-02 2005-05-31 Sdgi Holdings, Inc. Modular intervertebral prosthesis system
US20040106998A1 (en) 2002-10-04 2004-06-03 Ferree Bret A. Multiaxial artificial disc replacements
US20040068321A1 (en) 2002-10-04 2004-04-08 Ferree Bret A. Reduced-friction artificial disc replacements
US20040068320A1 (en) 2002-10-04 2004-04-08 Robie Bruce H. Prosthetic disc and vertebral body replacement device having pyrolytic carbon bearing members
US7156876B2 (en) 2002-10-09 2007-01-02 Depuy Acromed, Inc. Intervertebral motion disc having articulation and shock absorption
DE10247762A1 (en) 2002-10-14 2004-04-22 Waldemar Link (Gmbh & Co.) Intervertebral prosthesis
AU2003267215B2 (en) 2002-10-29 2008-12-04 Spinecore, Inc. Instrumentation, methods, and features for use in implanting an artificial intervertebral disc
US6966929B2 (en) 2002-10-29 2005-11-22 St. Francis Medical Technologies, Inc. Artificial vertebral disk replacement implant with a spacer
WO2004041131A2 (en) 2002-10-31 2004-05-21 Spinal Concepts, Inc. Movable disc implant
FR2846550B1 (en) 2002-11-05 2006-01-13 Ldr Medical INTERVERTEBRAL DISC PROSTHESIS
US20040093087A1 (en) 2002-11-05 2004-05-13 Ferree Bret A. Fluid-filled artificial disc replacement (ADR)
US6733533B1 (en) 2002-11-19 2004-05-11 Zimmer Technology, Inc. Artificial spinal disc
US20040186471A1 (en) 2002-12-07 2004-09-23 Sdgi Holdings, Inc. Method and apparatus for intervertebral disc expansion
US7204852B2 (en) 2002-12-13 2007-04-17 Spine Solutions, Inc. Intervertebral implant, insertion tool and method of inserting same
US7004971B2 (en) 2002-12-31 2006-02-28 Depuy Acromed, Inc. Annular nucleus pulposus replacement
WO2004098466A2 (en) 2003-05-02 2004-11-18 Smart Disc, Inc. Artificial spinal disk
JP2007511746A (en) 2003-05-29 2007-05-10 アップチャーチ・サイエンティフィック・インコーポレイテッド Improved apparatus and method for electrospray applications
US7048766B2 (en) 2003-06-06 2006-05-23 Ferree Bret A Methods and apparatus for total disc replacements with oblique keels
US7008452B2 (en) 2003-06-26 2006-03-07 Depuy Acromed, Inc. Dual durometer elastomer artificial disc
US20040267367A1 (en) 2003-06-30 2004-12-30 Depuy Acromed, Inc Intervertebral implant with conformable endplate
US20050015150A1 (en) 2003-07-17 2005-01-20 Lee Casey K. Intervertebral disk and nucleus prosthesis
US7153325B2 (en) 2003-08-01 2006-12-26 Ultra-Kinetics, Inc. Prosthetic intervertebral disc and methods for using the same
US7128761B2 (en) 2003-12-10 2006-10-31 Axiomed Spine Corporation Method and apparatus for replacing a damaged spinal disc
US7556651B2 (en) 2004-01-09 2009-07-07 Warsaw Orthopedic, Inc. Posterior spinal device and method
US7172628B2 (en) 2004-07-27 2007-02-06 Lonnie Jay Lamprich Spinal disc prosthesis and methods
US7419506B2 (en) 2005-11-18 2008-09-02 Zimmer Spine, Inc. Artificial spinal discs and methods

Patent Citations (58)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4057857A (en) * 1975-09-08 1977-11-15 Shiley Laboratories, Inc. Heart valve with arcuate occluder
US4241463A (en) * 1978-10-16 1980-12-30 Precision Cast Specialties, Inc. Prosthetic implant device
US4688000A (en) * 1984-05-29 1987-08-18 Donovan John S Non biased push-pull amplifiers
US4714468A (en) * 1985-08-13 1987-12-22 Pfizer Hospital Products Group Inc. Prosthesis formed from dispersion strengthened cobalt-chromium-molybdenum alloy produced by gas atomization
US4932969A (en) * 1987-01-08 1990-06-12 Sulzer Brothers Limited Joint endoprosthesis
US4759769A (en) * 1987-02-12 1988-07-26 Health & Research Services Inc. Artificial spinal disc
US4714469A (en) * 1987-02-26 1987-12-22 Pfizer Hospital Products Group, Inc. Spinal implant
US4863477A (en) * 1987-05-12 1989-09-05 Monson Gary L Synthetic intervertebral disc prosthesis
US4946378A (en) * 1987-11-24 1990-08-07 Asahi Kogaku Kogyo Kabushiki Kaisha Artificial intervertebral disc
US5035716A (en) * 1987-12-07 1991-07-30 Downey Ernest L Replacement disc
US4874389A (en) * 1987-12-07 1989-10-17 Downey Ernest L Replacement disc
US4997432A (en) * 1988-03-23 1991-03-05 Waldemar Link Gmbh & Co. Surgical instrument set
US5002576A (en) * 1988-06-06 1991-03-26 Mecron Medizinische Produkte Gmbh Intervertebral disk endoprosthesis
US4911718A (en) * 1988-06-10 1990-03-27 University Of Medicine & Dentistry Of N.J. Functional and biocompatible intervertebral disc spacer
US5071437A (en) * 1989-02-15 1991-12-10 Acromed Corporation Artificial disc
US5370694A (en) * 1989-07-25 1994-12-06 Smith & Nephew Richards, Inc. Zirconium oxide and nitride coated endoprostheses for tissue protection
US5062850A (en) * 1990-01-16 1991-11-05 University Of Florida Axially-fixed vertebral body prosthesis and method of fixation
US5314477A (en) * 1990-03-07 1994-05-24 J.B.S. Limited Company Prosthesis for intervertebral discs and instruments for implanting it
US5123926A (en) * 1991-02-22 1992-06-23 Madhavan Pisharodi Artificial spinal prosthesis
US5197488A (en) * 1991-04-05 1993-03-30 N. K. Biotechnical Engineering Co. Knee joint load measuring instrument and joint prosthesis
US5258031A (en) * 1992-01-06 1993-11-02 Danek Medical Intervertebral disk arthroplasty
US5300120A (en) * 1992-08-24 1994-04-05 Lipomatrix Incorporated Implant with electrical transponder marker
US5246458A (en) * 1992-10-07 1993-09-21 Graham Donald V Artificial disk
US5511561A (en) * 1992-11-16 1996-04-30 Wanderman; Steven M. Gait cycle force monitor
US5476465A (en) * 1993-04-21 1995-12-19 Amei Technologies Inc. Surgical cable crimp
US5674294A (en) * 1993-09-14 1997-10-07 Commissariat A L'energie Atomique Intervertebral disk prosthesis
US5536270A (en) * 1994-02-24 1996-07-16 Pioneer Laboratories, Inc. Cable system for bone securance
US5906643A (en) * 1994-07-28 1999-05-25 Walker; Peter Stanley Stabilised mobile bearing knee
US5893889A (en) * 1997-06-20 1999-04-13 Harrington; Michael Artificial disc
US20030100951A1 (en) * 1997-10-17 2003-05-29 Hassan Serhan Spinal disc
US6086613A (en) * 1997-12-23 2000-07-11 Depuy Acromed, Inc. Spacer assembly for use in spinal surgeries
US6179874B1 (en) * 1998-04-23 2001-01-30 Cauthen Research Group, Inc. Articulating spinal implant
US20030199982A1 (en) * 1998-09-04 2003-10-23 Sdgi Holdings, Inc. Peanut spectacle multi discoid thoraco-lumbar disc prosthesis
US6447448B1 (en) * 1998-12-31 2002-09-10 Ball Semiconductor, Inc. Miniature implanted orthopedic sensors
US6366206B1 (en) * 1999-06-02 2002-04-02 Ball Semiconductor, Inc. Method and apparatus for attaching tags to medical and non-medical devices
US6520996B1 (en) * 1999-06-04 2003-02-18 Depuy Acromed, Incorporated Orthopedic implant
US7201776B2 (en) * 1999-10-08 2007-04-10 Ferree Bret A Artificial intervertebral disc replacements with endplates
US7060100B2 (en) * 1999-10-08 2006-06-13 Ferree Bret A Artificial disc and joint replacements with modular cushioning components
US20030191536A1 (en) * 1999-10-08 2003-10-09 Ferree Bret A. Artificial intervertebral disc replacements incorporating reinforced wall sections
US6425920B1 (en) * 1999-10-13 2002-07-30 James S. Hamada Spinal fusion implant
US20030153976A1 (en) * 1999-10-20 2003-08-14 Cauthen Joseph C. Spinal disc annulus reconstruction method and spinal disc annulus stent
US20030191533A1 (en) * 2000-01-30 2003-10-09 Diamicron, Inc. Articulating diamond-surfaced spinal implants
US20030191534A1 (en) * 2000-03-10 2003-10-09 Guy Viart Intervertebral disc prosthesis
US20020049394A1 (en) * 2000-08-25 2002-04-25 The Cleveland Clinic Foundation Apparatus and method for assessing loads on adjacent bones
US20030135277A1 (en) * 2001-11-26 2003-07-17 Sdgi Holdings, Inc. Implantable joint prosthesis and associated instrumentation
US20030176923A1 (en) * 2002-03-12 2003-09-18 Waldemar Link Gmbh & Co. Intervertebral prosthesis
US20030187506A1 (en) * 2002-03-27 2003-10-02 Raymond Ross Modular disc prosthesis
US20030195630A1 (en) * 2002-04-10 2003-10-16 Ferree Bret A. Disc augmentation using materials that expand in situ
US20030195631A1 (en) * 2002-04-12 2003-10-16 Ferree Bret A. Shape-memory spacers for artificial disc replacements
US20030199981A1 (en) * 2002-04-23 2003-10-23 Ferree Bret A. Artificial disc replacements with natural kinematics
US20030204231A1 (en) * 2002-04-30 2003-10-30 Hine Douglas S. Method and apparatus for placing a coronary sinus/cardiac vein pacing and defibrillation lead with adjustable electrode spacing
US7066958B2 (en) * 2002-05-10 2006-06-27 Ferree Bret A Prosthetic components with partially contained compressible resilient members
US7291171B2 (en) * 2002-05-10 2007-11-06 Ferree Bret A Artificial disc replacement (ADR) using elastic tether member
US7267688B2 (en) * 2002-10-22 2007-09-11 Ferree Bret A Biaxial artificial disc replacement
US20040122517A1 (en) * 2002-12-10 2004-06-24 Axiomed Spine Corporation Artificial disc
US20060142860A1 (en) * 2003-04-04 2006-06-29 Theken Disc, Llc Artificial disc prosthesis
US20050273170A1 (en) * 2004-06-08 2005-12-08 Navarro Richard R Prosthetic intervertebral spinal disc with integral microprocessor
US20060015183A1 (en) * 2004-07-09 2006-01-19 Pioneer Laboratories, Inc. Skeletal reconstruction device

Cited By (21)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20060069436A1 (en) * 2004-09-30 2006-03-30 Depuy Spine, Inc. Trial disk implant
US20100114685A1 (en) * 2006-03-30 2010-05-06 Reality Charity, Llc Systems and methods for management of fundraising campaigns
US20080161928A1 (en) * 2006-12-27 2008-07-03 Warsaw Orthopedic, Inc. Compliant intervertebral prosthetic devices with motion constraining tethers
US20080183292A1 (en) * 2007-01-29 2008-07-31 Warsaw Orthopedic, Inc. Compliant intervertebral prosthetic devices employing composite elastic and textile structures
US20090204213A1 (en) * 2008-02-13 2009-08-13 Depuy Products, Inc. Metallic implants
US20090234456A1 (en) * 2008-03-14 2009-09-17 Warsaw Orthopedic, Inc. Intervertebral Implant and Methods of Implantation and Treatment
US20100100185A1 (en) * 2008-10-22 2010-04-22 Warsaw Orthopedic, Inc. Intervertebral Disc Prosthesis Having Viscoelastic Properties
US20100234954A1 (en) * 2009-03-13 2010-09-16 Warsaw Orthopedic, Inc. Spinal implant and methods of implantation and treatment
US8128699B2 (en) 2009-03-13 2012-03-06 Warsaw Orthopedic, Inc. Spinal implant and methods of implantation and treatment
US9480511B2 (en) 2009-12-17 2016-11-01 Engage Medical Holdings, Llc Blade fixation for ankle fusion and arthroplasty
US10238426B2 (en) 2009-12-17 2019-03-26 Engage Medical Holdings, Llc Blade fixation for ankle fusion and arthroplasty
US9925051B2 (en) 2010-12-16 2018-03-27 Engage Medical Holdings, Llc Arthroplasty systems and methods
US10342667B2 (en) 2010-12-16 2019-07-09 Engage Medical Holdings, Llc Arthroplasty systems and methods
US11197763B2 (en) 2010-12-16 2021-12-14 Engage Medical Holdings, Llc Arthroplasty systems and methods
US9254130B2 (en) 2011-11-01 2016-02-09 Hyun Bae Blade anchor systems for bone fusion
US10245090B2 (en) 2011-11-01 2019-04-02 Engage Medical Holdings, Llc Blade anchor systems for bone fusion
US10238382B2 (en) 2012-03-26 2019-03-26 Engage Medical Holdings, Llc Blade anchor for foot and ankle
US10390955B2 (en) 2016-09-22 2019-08-27 Engage Medical Holdings, Llc Bone implants
US10456272B2 (en) 2017-03-03 2019-10-29 Engage Uni Llc Unicompartmental knee arthroplasty
US11369488B2 (en) 2017-03-03 2022-06-28 Engage Uni Llc Unicompartmental knee arthroplasty
US11540928B2 (en) 2017-03-03 2023-01-03 Engage Uni Llc Unicompartmental knee arthroplasty

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Owner name: THEKEN DISC, LLC, AN OHIO LIMITED LIABILITY COMPAN

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