Intervertebral Implant Component With Three Points of Contact
A method of implanting an intervertebral implant or component thereof, in which each component is selected to have an inner surface and an outer surface which engages an adjacent vertebra and presents only three distinct points of contact with a cortical rim of the vertebra. The outer surface is selected to have a footprint which is sized to be within that of the cortical rim. In disclosed embodiments, the footprint can be convexo-concave shaped or kidney shaped. The intervertebral implant can be provided with upper and lower (or first and second) components which engage adjacent first and second vertebrae and which move relative to one another. The implant has both the first and second outer surfaces sized to present a respective footprint sufficient for two lateral-anterior and one posterior points of contact with an adjacent cortical rim of the respective first and second vertebra.
This application is a continuation application of U.S. patent application Ser. No. 12/190,237 filed Aug. 12, 2008 which is a divisional application of U.S. patent application Ser. No. 11/686,021 filed Mar. 14, 2007 herein incorporated in its entirety by reference.
BACKGROUND OF THE INVENTIONHistorically, when it was necessary to completely remove a disc from between adjacent vertebrae, the conventional procedure is to fuse the adjacent vertebrae together. This “spinal fusion” procedure, which is still in use today, is a widely accepted surgical treatment for symptomatic lumbar degenerative disc disease. However, reported clinical results vary considerably, and complication rates are considered by some to be unacceptably high.
More recently, there have been important developments in the field of disc replacement, namely disc arthoplasty, which involves the insertion of an artificial intervertebral disc implant into the intervertebral space between adjacent vertebrae, and which allows limited universal movement of the adjacent vertebrae with respect to each other. The aim of total disc replacement is to remove pain generation (caused by a bad disc), restore anatomy (disc height), and maintain mobility in the functional spinal unit so that the spine remains in an adapted sagittal balance. Sagittal balance is defined as the equilibrium of the trunk with the legs and pelvis to maintain harmonious sagittal curves. In contrast with fusion techniques, total disc replacement preserves mobility in the motion segment and mimics physiologic conditions.
One such intervertebral implant includes an upper part that can communicate with an adjacent vertebrae, a lower part that can communicate with an adjacent vertebrae, and an insert located between these two parts. An example of this type of implant is disclosed in U.S. Pat. No. 5,314,477 (Marnay).
While this and other known implants represent improvements in the art of artificial intervertebral implants, there exists a continuing need for improvements in this field.
BRIEF SUMMARY OF THE INVENTIONIn accordance with the present invention, a component of an intervertebral implant is provided with an inner surface and an outer surface. The outer surface engages an adjacent vertebra and presents only three distinct points of contact with a cortical rim of the adjacent vertebra. Preferably, the outer surface has a footprint which is sized to be within that of the cortical rim. In disclosed embodiments, the footprint of the outer surface has a major convex side and can be convexo-concave shaped, D shaped, or kidney shaped.
Preferably, the three points of contact of the footprint of the outer surface with the cortical rim are two lateral-anterior points and one posterior point. In addition, the footprint of the outer surface includes opposed ends which provide the two lateral-anterior points of contact.
In a preferred embodiment, the outer surface of the component includes at least one vertebra engaging protrusion. The protrusion can include a protruding keel located adjacent an opposed or longitudinal end, which keel may be curved.
Also in a preferred embodiment, the inner surface includes a pair of cutouts extending to an adjacent outer edge thereof The cutouts are preferably angled centrally inwardly and dovetail shaped in cross section.
Also in accordance with the present invention, an intervertebral implant can be provided with upper and lower (or first and second) components, each as described above and each of which engages an adjacent first and second vertebrae. The implant also includes a means for allowing the first and second components to move relative to one another. The implant would have the outer surfaces of both the first and second components sized to present a respective footprint sufficient for only three points of contact with an adjacent cortical rim of the respective first and second vertebra.
It is an advantage of the present invention that a minimally sized intervertebral implant is provided.
It is also an advantage of the present invention that the intervertebral implant has only three points of contact made at the cortical rim of the adjacent vertebrae.
It is a further advantage of the present invention that a major convex-sided shape of the intervertebral implant presents a small insertion size which can be inserted along an arc shaped path.
Other features and advantages of the present invention are stated in or apparent from detailed descriptions of presently preferred embodiments of the invention found hereinbelow.
With reference now to the drawings in which like numerals represent like elements throughout the views, an intervertebral implant 10 according to the present invention is depicted in
Both upper and lower parts 12 and 14 each have an outer surface 24. As known in the art, outer surfaces 24 are each designed to contact an adjacent vertebrae, such as upper and lower vertebrae 26 and 28 depicted in
It is thus a feature of the present invention that outer surfaces 24 are designed or sized to provide three distinct points (or small areas) of contact 34a, 34b and 34c (or collectively, points 34) with the adjacent cortical rim 30 as shown in
As noted above, outer surface 24 is shaped with a major convex side according to the present invention to present a footprint so that only three points of contact 34 are provided thereby. As the size of vertebrae vary depending on location and on the individual user, implant 10 will be tailored to the individual so that only three points of contact 34 are made. This sizing of the footprint of outer surface 24 is conveniently determined by choosing the footprint of outer surface 24 to be located within the footprint of cortical rim 30 as shown. The points of contact 34 are left and right lateral-anterior points 34a and 34c which are preferably symmetrically located as shown, and a posterior point 34b. Conveniently, the footprint of the outer surface 24 includes opposed ends which provide the left and right lateral-anterior points 34a and 34c. Suitable footprints to provide the three points 34 of contact include: a) a convexo-concave footprint as shown by implant 10 in
The use of such a small footprint and only three points of contact 34 with one being posterior or anterior also makes it possible for implants 10, 110, 210 and 310 to have a relatively narrow or small maximum width between left and right points 34a and 34c as evident from the three footprints discussed above. This narrow maximum width, particularly where augmented by a longitudinal concavity or inward bowing as with implants 10, 210 and 310, permits implants 10, 110, 210 and 310 to be inserted between adjacent vertebrae 26 and 28 through a smaller incision than if the implant spanned cortical rim 30 in all directions. In
Implant 110 depicted in
Depicted in
In
Depicted in
In use, instrument 400 is used to grasp implant 310 by placing projections 406 and 410 on either sides of implant 310 and adjacent respective cutouts 372. Then, by manipulation of rod 414, movable arm 408 is moved towards fixed arm 404 so that projections 406 and 410 are received in and then locked in cutouts 372. Once projections 406 and 410 are locked in place in cutouts 372, implant 310 is securely attached to base 402 so that implant 310 can be inserted between vertebrae by manipulation of inserter shaft 403 as known in the art.
While the present invention has been described with respect to exemplary embodiments thereof, it will be understood by those of ordinary skill in the art that variations and modifications can be effected within the scope and spirit of the invention.
Claims
1. An intervertebral implant component comprising:
- an outer surface configured to engage a cortical rim of an adjacent vertebra, the outer surface defining an outer surface footprint;
- an inner surface configured to engage an intervertebral insert, the inner surface opposite the outer surface;
- wherein the outer surface engages the cortical rim at only three distinct points of contact, and the outer surface footprint is sized to fit entirely within the cortical rim.
2. The intervertebral implant component of claim 1, wherein the outer surface footprint is convexo-concave shaped.
3. The intervertebral implant component of claim 1, wherein the outer surface footprint is D-shaped.
4. The intervertebral implant component of claim 1, wherein the outer surface footprint is kidney shaped.
5. The intervertebral implant component of claim 1, wherein the three distinct points of contact of the outer surface with the cortical rim are two lateral-anterior points and one posterior point.
6. The intervertebral implant component of claim 5, wherein the outer surface includes opposed ends which provide the two lateral-anterior points of contact.
7. The intervertebral implant component of claim 1, wherein the outer surface further comprises at least one vertebra engaging protrusion.
8. The intervertebral implant component of claim 7, wherein the at least one vertebra engaging protrusion comprises a keel.
9. The intervertebral implant component of claim 8, wherein the keel is curved.
10. The intervertebral implant component of claim 1, wherein the inner surface comprises a pair of instrument receiving cutouts which extend to an outer edge of the inner surface.
11. The intervertebral implant component of claim 10, wherein the cutouts are angled centrally inwardly.
12. The intervertebral implant component of claim 12, wherein the cutouts are dovetail shaped in cross section.
13. An intervertebral implant comprising:
- a first part comprising a first outer surface configured to engage a first vertebra and a first inner surface;
- a second part comprising a second outer surface configured to engage a second vertebra and a second inner surface; and
- an insert comprising an upper surface and an opposing lower surface, the upper surface engaging with the first inner surface and the lower surface engaging with the second inner surface, such that the first part and the second part are moveable relative to one another;
- wherein the first outer surface and the second outer surface each engage an adjacent cortical rim of the respective first and second vertebra at only three, distinct points of contact, the first outer surface and the second outer surface each comprising a footprint configured to fit completely within the adjacent cortical rim to be engaged.
14. The intervertebral implant of claim 13, wherein said footprints of said outer surfaces are convexo-concave shaped.
15. The intervertebral implant of claim 13, wherein said footprints of said outer surface are D-shaped.
16. The intervertebral implant of claim 13, wherein said footprints of said outer surfaces are kidney shaped.
17. The intervertebral implant of claim 13, wherein said three points of contact of each of said footprints of said outer surfaces with the adjacent cortical rims are two lateral-anterior points and one posterior point.
18. The intervertebral implant of claim 17, wherein each of said footprints of said outer surfaces include opposed ends which provide the two lateral-anterior points of contact.
19. The intervertebral implant of claim 13, wherein each of said outer surfaces includes at least one vertebra engaging protrusion.
20. The intervertebral implant of claim 19, wherein each of said at least one vertebra engaging protrusions includes a protruding keel located adjacent a longitudinal end of the respective said outer surface.
21. The intervertebral implant of claim 20, wherein each said keel is curved.
22. The intervertebral implant of claim 13, wherein each of said inner surfaces includes a pair of instrument receiving cutouts extending to an adjacent outer edge thereof
23. The intervertebral implant of claim 22, wherein each of said cutouts is angled centrally inwardly.
24. The intervertebral implant of claim 23, wherein each of said cutouts is dovetail shaped in cross section.
25. The intervertebral implant of claim 13, wherein the upper surface and the first inner surface comprise corresponding curved surfaces which enable the first part and the second part to move relative to one another.
26. The intervertebral implant of claim 25, wherein the curved surfaces of the upper surface and the lower surface are concave and the curved surfaces of the first inner surface and the second inner surface are convex.
Type: Application
Filed: Sep 1, 2010
Publication Date: Dec 23, 2010
Inventors: Heather Cannon (West Chester, PA), Edwin Cham (Schwenksville, PA), Thierry Marnay (Casteinau Le Lez)
Application Number: 12/873,724
International Classification: A61F 2/44 (20060101);