193 results about "Lamina terminalis" patented technology

The current invention is directed to a system and method for fusing two adjacent vertebrae. In one embodiment, the vertebrae are fused by inserting a self-broaching interbody apparatus into a disc space without the need for separately drilling and broaching. The self-broaching interbody apparatus may include cutting flutes or other broaching means capable of cutting through the cartilaginous endplates of the vertebrae. In another embodiment, an interbody apparatus with an expanding means capable of distracting the disc space between the adjacent vertebrae is inserted into the disc space. Another embodiment includes a sleeve that fits around an interbody apparatus that has at least one opening in its outer surface leading to a cavity filled with bone and / or ortho-biological materials.

The present invention includes pin guides and methods for placing pins in adjacent vertebrae. The present invention also includes methods for placing pins in adjacent vertebrae using the pin guides described herein. The present invention also includes an intervertebral implant insertion and alignment instrument, a distraction instrument, an intervertebral implant insertion guide, and methods for inserting an implant into an intervertebral space. Despite existing tools and techniques, present positioning of implants in intervertebral spaces and pins in adjacent vertebrae often depend on a surgeon's skill, experience and technique. Practice of the present invention can aide in the placement of an implant into an intervertebral space and placement of pins in adjacent vertebrae, e.g., midline to the coronal plane spine and / or parallel to vertebral endplates that abut the intervertebral space.

An expandable interbody fusion device for implantation into the intradiscal space between two opposing vertebral bodies of a spine comprises a superior endplate member having an upper surface for engaging a superior vertebral body in a spine, and an inferior endplate member having a lower surface for engaging an inferior vertebral body in the spine. The superior endplate member and the inferior endplate member are releasably coupled and define a cavity therebetween. At least one expansion member is configured to be introduced into the cavity to move the superior endplate and the inferior endplate members relatively apart upon introduction and to thereby decouple the superior endplate member and the inferior endplate member. An inserter may be releasably coupled to the device to facilitate insertion of the device as well as to provide a track for insertion of the expansion members.

A total artificial expansible disc having at least two pairs of substantially parallel shells, which move in multiple directions defined by at least two axes, is disclosed. Several methods for implanting the total artificial expansile disc are also disclosed. The total artificial expansile disc occupies a space defined by a pair of vertebral endplates. An expansion device, which preferably includes a jackscrew mechanism, moves the pairs of shells in multiple directions. A core is disposed between the pairs of shells, and the core permits the vertebral endplates to move relative to one another.

An implant apparatus and a method for spinal fusion from oblique, lateral, ALIF, PLIF, and TLIF approach are disclosed. The apparatus can be configured to include an expandable implant cage and an inserter. The cage can be inserted between endplates of upper and lower vertebra using lateral, ALIF, PLIF, and TLIF approach. The cage generally includes a male and female screw configuration and a cage expansion mechanism. The inserter inserts the cage in a spinal disc space and tightens the male and female screw arrangement. Once the cage is inserted to the desired position, viewed by X-ray you will begin to tighten the male portion of the screw in the device, and continue to tighten until final deployment of cage has been achieved. This provides a much greater footprint that allows the device to reach the cortical ring or apophyseal ring of the vertebral body. Tightening of male and female screw arrangement operates the cage expansion mechanism to expand the cage size. The cage can be inserted through a smaller surgical opening and then expanded to a full size assembly between the vertebrae.

An articulating joint implant for use in the cervical spine includes a pair of opposing upper and lower elements having nested articulation surfaces providing a center of rotation of the implant above the adjacent vertebral body endplate surfaces in one mode of motion lateral bending and a center of rotation of the implant below those surfaces in flexion / extension, and that further permit axial rotation of the opposing elements relative to one another about the longitudinal axis of the spinal column through a range of angles without causing them to move in opposing directions along the longitudinal axis within that range. In preferred embodiments, the articulation surfaces further cause such opposite movement of the opposing elements beyond that range.

The present invention includes intervertebral prosthetic devices and methods for installing intervertebral prosthetic devices into an intervertebral space. In one embodiment, an intervertebral prosthetic disc includes a superior endplate; an inferior endplate; and at least one protrusion element, wherein at least one of the superior endplate and the inferior endplate is adapted to receive the protrusion element. In another embodiment, the invention includes an intervertebral prosthetic disc having a superior endplate including a core retaining member; an inferior endplate including a core retaining member; and an asymmetric core positioned between the superior endplate and the inferior endplate, wherein the superior endplate and the inferior endplate are adapted to accommodate the core. The present invention also includes an intervertebral prosthetic disc system that includes an intervertebral prosthetic disc and at least one spring element.

The present invention provides an expandable intervertebral implant that is selectively disposed in the intervertebral space and deployed, thereby in-situ distracting, realigning, and / or stabilizing or fusing a portion of the spine of a patient in the treatment of injury, disease, and / or degenerative condition. The expandable intervertebral implant includes a superior member and an inferior member, each of which has a partially or substantially wedge or prismatic shape and a partially or substantially convex or other-shaped surface that is suitable for engaging the substantially concave surfaces of the associated bony superior and inferior intervertebral endplates. Once disposed in the intervertebral space, the expandable intervertebral implant is actuated and deployed, with the superior member and the inferior member moving apart from one another, seating against the associated intervertebral endplates, and distracting, realigning, and / or stabilizing them to a desired degree. The external surface of each of the superior member and the inferior member is provided with a plurality of ridges or other friction structures, providing purchase with the associated intervertebral endplates.

Instrument systems and methods for the fusion of two or more adjacent vertebrae include devices to facilitate placement of screws and plates to stabilize the vertebrae and instruments to facilitate parallel decortication of the vertebral endplates prior to insertion of the bone graft. A targeter allows proper placement of a plurality of vertebral screws into the vertebral bodies. A distractor is temporarily attached to the vertebral screws and a bushing is inserted between the two arms of the distractor. The bushing acts as a guide for a cutting tool, to allow the perfect parallel decortication of the vertebral endplates. After insertion of the bone graft, a plate is affixed to the vertebral screws using locking screws, to stabilize the joint so that fusion may occur. The invention features a novel bushing that allows parallel decortication of the vertebral endplates to facilitate fusion.

An intervertebral implant for fusing vertebrae is disclosed. The implant has a body with curved, substantially parallel posterior and anterior faces separated by two narrow implant ends, superior and inferior faces having a plurality of undulating surfaces for contacting upper and lower vertebral endplates, and at least one depression at a first end for engagement by an insertion tool. The arcuate implant configuration facilitates insertion of the implant from a transforaminal approach into a symmetric position about the midline of the spine so that a single implant provides balanced support to the spinal column. The implant may be formed of a plurality of interconnecting bodies assembled to form a single unit. An implantation kit and method are also disclosed.

An angled fixation device, such as an angled screw. This angled fixation device may be used by the surgeon to secure a spacer to a spinal disc space. The proximal end portion of the angled fixation device is driven perpendicular to the anterior wall of the spacer, and so is parallel to the vertebral endplates and in-line with the inserter. The distal end portion of the angled fixation device is oriented at about a 45 degree angle (plus or minus 30 degrees) to the vertebral endplate it enters.

A vertebral shock absorber in the form of an elongated compressible member having two ends, one fastened to an upper vertebra, and the other fastened to a lower vertebra. The elongated member may be fastened using pedicle screws or by way of ball-and-socket joints for enhanced range of motion. In the preferred embodiment, the elongated compressible member is constructed using telescoping sleeves to create a cavity wherein there is disposed a compressible, resilient component such as a spring, elastomeric material, liquid, gel, hydrogel, or other suitable substance. The shock absorber may be combined with an intradiscal component and / or one or more plates that extends at least partially onto a vertebral endplate to facilitate lateral application.

An implant has a first contact surface to contact a first vertebral body endplate and a second contact surface to contact a second vertebral body endplate adjacent the first vertebral body. The implant is deployable, when positioned within an intradiscal space between the first and second vertebral bodies, from a first non-expanded condition where the first contact surface has a first effective footprint area A1 to a second expanded condition where the first contact surface has a second effective footprint area A2. The ratio A2 / A1 is at least 1.05.

Instrument systems and methods for the fusion of two or more adjacent vertebrae include devices to facilitate placement of screws and plates to stabilize the vertebrae and instruments to facilitate parallel decortication of the vertebral endplates prior to insertion of the bone graft. A targeter allows proper placement of a plurality of vertebral screws into the vertebral bodies. A distractor is temporarily attached to the vertebral screws and a bushing is inserted between the two arms of the distractor. The bushing acts as a guide for a cutting tool, to allow the perfect parallel decortication of the vertebral endplates. After insertion of the bone graft, a plate is affixed to the vertebral screws using locking screws, to stabilize the joint so that fusion may occur. The invention features a novel bushing that allows parallel decortication of the vertebral endplates to facilitate fusion.

An instrument system for preparing a disc space between adjacent vertebral bodies to receive a repair device includes a series of distractors for distracting the vertebral bodies in a manner that restores natural lordosis of the lumbar and cervical spine, a vertebrae immobilizing template to fix the positions of the bodies, a handle for employing the distractor and the template, and a reamer for cutting tissue from endplates of the vertebral bodies.

This invention provides a vertebral implant for impaction in a disc space to restore and / or maintain desired disc space height and spinal orientation. The implant has an elongated basis body having a generally lens-shape provided by convex upper and lower surfaces. Bearing surfaces are provided on the cross-edge surfaces of the endwalls. Grooves are provided in the upper and lower surfaces positioned between the bearing surfaces. The implant can be prepared from a wide variety of materials including metallic materials, synthetic materials, polymeric materials, ceramic materials, and composite materials including reinforced materials i.e. glass, fiber, and / or carbon fiber reinforced materials (CFRP). These preferred materials for fabricating implants in the present invention reduce costs, increase service life and provide excellent physiological compatibility. The non-metallic material can be selected to be either a substantially permanent material, a biodegradable material or a bioerodable material. Further, the implant material can be provided to be radio opaque to facilitate monitoring of bone ingrowth both into the implant and between the opposing endplates of the adjacent vertebrae.

A total artificial expansile disc and a method for posterior insertion between a pair of vertebral endplates are disclosed. The total artificial expansile disc includes at least one pair of substantially parallel plates that move apart along a first axis, in order to occupy a space defined by the vertebral endplates. In another embodiment, each of substantially parallel plates includes a first plate and a second sliding plate. An expansion device or tool is used to move the substantially parallel pair of plates apart along the first axis. A core is disposed between the pair of plates, and the core permits the vertebral endplates to move relative to one another. A ball limiter or ball extender prevents the core from being extruded from between the substantially parallel plates.

The present invention relates to a device and method which may be used to reinforce the native annulus during spinal surgery. The device is a catheter based device which is placed into the inter-vertebral space following discectomy performed by either traditional surgical or endoscopic approaches. The distal end of the catheter is comprised of an expansile loop which may be increased in diameter by advancement of a portion of the catheter via its proximal end, such proximal end remaining external to the body. The expansile loop may be formed such that when the loop is diametrically contracted the loop feeds into its other end, similar to a snake eating its own tail. Stabilization of the outer portion of the loop and pulling out the inner portion will thereby increase the overall diameter of the loop while maintaining it as a closed loop or torus. The expansile loop can use an attachment means to secure it to substantially healthy tissues of the annulus, nucleus, or endplates. The present invention comprises four embodiments and can be used to 1) facilitate disk fusing, 2) perform an artificial replacement of the nucleus, 3) perform an artificial replacement of the annulus, or 4, perform an artificial replacement of both the nucleus and annulus.

A porous intervertebral spacer having a flexible wire mesh as a vertebral body contact surface, the flexible wire mesh preferably being a convex titanium mesh laser-welded at its perimeter to the spacer. The mesh is domed in its initial undeflected conformation, but deflects as necessary during insertion of the spacer between vertebral bodies, and, once the spacer is seated between the vertebral bodies, deforms as necessary under anatomical loads to reshape itself to the concave surface of the vertebral endplate, providing gripping and holding strength upon initial implantation, and an osteoinductive surface through which the bone may ultimately grow, making the fixation of the spacer between the vertebral bodies secure.

Implants and methods for bone treatment, preferably minimally invasive treatment, including repositioning of vertebrae may comprise insertion of a bobbin having a wire, string, thread or band, coiled around the bobbin. During coiling, the diameter of the bobbing / band complex may increase. Such increase in diameter can push against the inner side of the endplates of the vertebral body, and augment the vertebral body to its original height. The implant may also take the form of a coiled sleeve which when inserted into the vertebral body is uncoiled. The force of the uncoiling sleeve pushes against the inner side o the endplates of the vertebral body, restoring the vertebral body to its original height. The implant may also take the form of fibrous masses comprised of a thread or other relatively thin structure, for example a fiber or strand, of any biocompatible material having desired characteristics, for example a shape memory alloy, titanium, stainless steel, another metal or metal alloy, a ceramic, a composite or any combination thereof. The, strand, thread or other fiber may be coiled, woven, matted, tangled or otherwise formed into a wool-like mass or body having a desired configuration. Expansion of the expandable member within the vertebral body or other bone may reposition the fractured bone to a desired height and augment the bone to maintain the desired height. A bone cement or other filler can be added to further treat and stabilize the vertebral body or other bone.

A vertebral prosthesis is adapted to be implanted adjacent a spinal disc prosthesis. According to one embodiment, the vertebral prosthesis includes a shaft and an endplate coupled to one end of the shaft. The endplate is adapted to be implanted adjacent a disc prosthesis, thereby obviating the need to fuse the endplate to an adjacent vertebral body.

A vertebral endplate chisel having upper and lower shaving portions, and a non-cutting guide integrally connected to and extending between the shaving portions and adapted to center the chisel within the disc space so that equal amounts of bone are removed from each endplate by the shaving portions as the chisel moves through the disc space.

An intervertebral implant having an endplate that can be slidably expanded following its placement in the intervertebral space.

An artificial disc replacement (ADR) includes a pair of opposing endplate components, each attached to one of the upper and lower vertebrae, a cushioning component disposed between the endplate components; and a filler material contained within the cushioning component. The filler material may be a gas, liquid, foam, or gel, including a hydrogel. In a preferred embodiment, the ADR may further include one or more opposing, spaced-apart projections configured to impinge if the endplate components are subjected to an excessive force. Such projections may allow for unrestricted motion between the endplates until impingement, or may restrict translation between the endplates until a greater excessive force is reached. One or both of the endplate components may include a modified surface to increase adherence to the respective vertebral endplates.

An implant apparatus and a method for spinal fusion from oblique, lateral, ALIF, PLIF, and TLIF approach. The apparatus can include an expandable implant cage and an inserter. The cage can be inserted between endplates of upper and lower vertebra using lateral, ALIF, PLIF, and / or TLIF approaches. The cage generally includes a male and female screw configuration and a cage expansion mechanism. The inserter inserts the cage in a spinal disc space and tightens the male and female screw arrangement. Once the cage is inserted to the desired position, the male portion of the screw can be tightened until final deployment of cage has been achieved. Tightening of male and female screw arrangement operates the cage expansion mechanism to expand the cage size. The cage can be inserted through a smaller surgical opening and then expanded to a full size assembly between the vertebrae.

An osteoimplant comprising an expandable, biocompatible material. The expandable material may be demineralized bone particles such as demineralized cancelous chips or demineralized cortical fibers or may be another material such as a polymer. The osteoimplant has a first state and a second expanded state. The osteoimplant may be used with another device or on its own. The osteoimplant may be inserted into a device such as an intervertebral body fusion device in the compressed state. The osteoimplant may be rehydrated to expand to an increased size, for example as far as permitted by the confines of the intervertebral body fusion device and spinal endplates, thereby aiding in greater vertebral endplate contact and conformity in spinal surgery.

A laparoscopic surgical technique is provided for preparing a site for implantation of a fusion device or implant. In accordance with one embodiment of the technique, a laparoscope is provided having an outer sleeve with distraction fingers at one end to distract the disc space. The laparoscope includes a laparoscopic port at its opposite end through which instruments and implants are inserted. The laparoscope provides a sealed working channel to the disc space, through which the disc space is distracted, the vertebral endplates and surrounding disc is reamed, and the fusion device inserted. The laparoscope is alternately engaged within bilateral locations in the disc space for insertion of a pair of fusion implants. A switching sleeve extends through the laparoscope to protect the tissue at the surgical site as the laparoscope is moved between the bilateral fusion locations.

A pair of flat support plates in a spinal fusion implant device contact and rest against the softer, central cancellous bone portion of respective endplates of adjacent vertebrae. Each support plate has a front template that is orthogonal to the plate and is bent to communicate with the anterior surface of the hard cortical endplate the vertebrae. A wedge-shaped support strut in a central channel between the two plates is configured to vary the distance between the support plates such that the height of the device proximate the anterior end is greater than the height of the device at the posterior end to maintain the natural lordosis of the spine. Channels formed on either side of the support strut are filled with bone graft material and contact the endplates of the vertebrae through large openings in the flat support plates to facilitate fusion.