142 results about "Vertebral endplate" patented technology

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 in the anterior or posterior face for engagement by an insertion tool, at least two vertical through-channels extending through the implant from the superior face to the inferior face, a chamfer on the superior and inferior surfaces at one of the narrow implant ends, and a beveled edge along a perimeter of the superior and inferior faces. The arcuate implant configuration and the chamfers on the superior and inferior faces at the narrow end facilitate 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 include radiopaque markers extending through the thickness of the implant to indicate the location and size of the implant. 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.

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.

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 osteotomy of a portion of a vertebral endplate and / or vertebral body allows for easier insertion of a device that fits tightly into a disc space. A different aspect of the invention resides in a mechanical device to hold the osteotomized portion of the vertebra against the vertebral body after the intradiscal device is placed. The device may be removed after the pieces of vertebra heal and fuse together.

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 orthopedic device for implanting between adjacent vertebrae comprising: an arcuate balloon and a hardenable material within said balloon.In some embodiments, the balloon has a footprint that substantially corresponds to a perimeter of a vertebral endplate. An inflatable device is inserted through a cannula into an intervertebral space and oriented so that, upon expansion, a natural angle between vertebrae will be at least partially restored. At least one component selected from the group consisting of a load-bearing component and an osteobiologic component is directed into the inflatable device through a fluid communication means.

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.

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.

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.

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.

Barriers are used to hold prosthetic components, including intradiscal devices, in position while allowing natural movement within a “safe zone.” In the preferred embodiments, the barrier is in the form of a “buttress” plate coupled to a controlled linkage that prevents the device from moving into a dangerous position. The movable member(s) allow an intradiscal device to move through a safe zone while permitting mobile artificial disc replacements (ADRs) or other intradiscal devices to self-center with movement of the vertebrae. The link member(s) broadly serve as a “tether” to prevent extrusion of the intradiscal device into the spinal canal, or outside of the disc space. The intradiscal device may be mobile, or attached to one or both of the vertebral endplates. Other mechanisms to accommodate the movable link members are also disclosed. The plates are preferably constructed of metal, but the invention is not limited in terms of the biocompatible material(s) used for the plate or link members.

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.

Artificial disc replacement (ADR) systems with intradiscal components feature non anterior-posterior (A-P) or oblique-oriented keels such that the great vessels do not require as much retraction during insertion. The system may further include guides for aligning the ADR prior to insertion, and for cutting an oblique slot into a vertebral endplate to receive the keel. A screw adapted to penetrate a vertebral body may be used in conjunction with the keel. The screw and keel may converge, diverge or intersect. The screw may further include a mechanism providing a locking relationship with the keel. The system may further including a guide to direct drill bits and screws through holes in the keel. ADRs according to the invention may additionally, independently include a non-symmetrical endplate shaped so as to decrease the risk of injuring the great vessels. By virtue of the invention, a second ADR may be installed at a second level having a keel oriented differently from that of the ADR having an orientation other than anterior-to-posterior.

A series of instruments (30, 80, 120, 210, 510, 550) are provided for direct-anterior and oblique-anterior disc space and end plate preparation. The instruments (30, 80, 120, 210, 510, 550) provide precise guidance for channel formation in the vertebral endplates by guiding rotating and bladed cutting instruments (122, 250, 580). Instrumentation (550) for oblique-anterior disc space preparation includes compound angulation to account for the angle of approach to the spine and the angulation between adjacent vertebrae. Methods and techniques for use of the instruments (30, 80, 120, 210, 510, 550) are also described.

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.

Disclosed are devices, systems and methods for treating vertebral diseases and injuries, and more particularly to devices, systems and methods of delivering therapy to the spine within or in close proximity to the intervertebral disc space or vertebral endplate. The method involves positioning an implant having an internal passageway with a proximal and distal opening into a vertebra such that the distal opening is adjacent a delivery site such as an intervertebral disc space or a vertebral endplate. The method also involves delivery a therapeutic substance through the proximal opening and through the internal passageway to the delivery site while the implant is positioned in the vertebra. The devices, systems and methods can be performed with and without spinal fixation.

A spinal fusion implant of non-bone construction for introduction into any variety of spinal target sites. The implant may include generally arcuate anterior and posterior sides. The implant may also include a wedged shaped distal end which can provide self-distraction of vertebral endplates during insertion and positioning of the spinal fusion implant.

An osteotomy of a portion of a vertebral endplate and / or vertebral body allows for easier insertion of a device that fits tightly into a disc space. A different aspect of the invention resides in a mechanical device to hold the osteotomized portion of the vertebra against the vertebral body after the intradiscal device is placed. The device may be removed after the pieces of vertebra heal and fuse together.

A method for the pre-treatment of an intervertebral disc prior to the introduction of a disc prosthesis or implant includes removing at least a portion of the nucleus pulposus of the intervertebral disc to expose at least a portion of the endplate of an adjacent vertebra to the disc. A fluent treatment material is then injected into the disc space to come into contact with the portion of the endplate. The fluent treatment material is operable to prepare the portion of the endplate to accommodate a disc prosthesis, implant or graft subsequently introduced into the disc space. Different fluent treatment materials are provided that depend upon the condition of the vertebral endplates.

A multipart intervertebral implant is provided which includes an implant portion and an implant extender portion. The implant portion and the implant extender portion can be fastened together using any known fastening means including pins, interlocking structure (e.g., dovetail, tongue and groove, etc.), adhesives, etc. The size of the implant extender portion can be selected during a surgical procedure to provide an implant suitable for a particular intervertebral receiving bed. An intervertebral implant is also provided which may be formed from a multiplicity of implant sections which are fastened together to provide an implant having a desired length. Implants having surface configurations which more closely correspond to the configuration of vertebral endplates are also provided.

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 in the anterior or posterior face for engagement by an insertion tool, at least two vertical through-channels extending through the implant from the superior face to the inferior face, a chamfer on the superior and inferior surfaces at one of the narrow implant ends, and a beveled edge along a perimeter of the superior and inferior faces. The arcuate implant configuration and the chamfers on the superior and inferior faces at the narrow end facilitate 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 include radiopaque markers extending through the thickness of the implant to indicate the location and size of the implant. 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 interbody spinal implant including a body and an integration plate having a top surface, a bottom surface, opposing lateral sides, opposing anterior and posterior portions, and a substantially hollow center in communication with a vertical aperture. The body is recessed in a way that portions of the integration plate protrude above the top and / or bottom surface of the body to enhance the resistance of the implant to expulsion from the intervertebral space.

A laparoscopic surgical technique is provided for preparing a site for implantation of a novel 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 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. A distraction plug is provided for centering the outer sleeve and for providing midline distraction of the disc space. In one embodiment, a fusion device includes diverging bone screws passing through an end wall and upper and lower walls of the device to engage the adjacent vertebrae. In another embodiment, a connector plate is engaged to bilaterally position fusion devices to prevent rotation and resist expulsion of the devices from the disc space.

A series of instruments (30, 80, 120, 210, 510, 550) are provided for direct-anterior and oblique-anterior disc space and end plate preparation. The instruments (30, 80, 120, 210, 510, 550) provide precise guidance for channel formation in the vertebral endplates by guiding rotating and bladed cutting instruments (122, 250, 580). Instrumentation (550) for oblique-anterior disc space preparation includes compound angulation to account for the angle of approach to the spine and the angulation between adjacent vertebrae. Methods and techniques for use of the instruments (30, 80, 120, 210, 510, 550) are also described.