CA2493643A1 - Interbody spine fusion cage - Google Patents

Interbody spine fusion cage Download PDF

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Publication number
CA2493643A1
CA2493643A1 CA002493643A CA2493643A CA2493643A1 CA 2493643 A1 CA2493643 A1 CA 2493643A1 CA 002493643 A CA002493643 A CA 002493643A CA 2493643 A CA2493643 A CA 2493643A CA 2493643 A1 CA2493643 A1 CA 2493643A1
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CA
Canada
Prior art keywords
cage body
cage
internal cavity
perforated
vertebral bodies
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
CA002493643A
Other languages
French (fr)
Other versions
CA2493643C (en
Inventor
David G. Malone
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
DePuy Spine LLC
Original Assignee
Individual
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Filing date
Publication date
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Publication of CA2493643A1 publication Critical patent/CA2493643A1/en
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Publication of CA2493643C publication Critical patent/CA2493643C/en
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

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Classifications

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    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
    • A61B17/7064—Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor
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    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72—Intramedullary pins, nails or other devices
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    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
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    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/864—Pins or screws or threaded wires; nuts therefor hollow, e.g. with socket or cannulated
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    • A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4611—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
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    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30772—Apertures or holes, e.g. of circular cross section
    • A61F2002/30784—Plurality of holes
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    • A61F2002/3085—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface
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    • A61F2002/30904—Special 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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    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/448—Joints for the spine, e.g. vertebrae, spinal discs comprising multiple adjacent spinal implants within the same intervertebral space or within the same vertebra, e.g. comprising two adjacent spinal implants
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    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
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Abstract

An improved spine fusion cage is provided which is particularly useful with biological compounds which are utilized in place of or in combination with a patient's bone matter. In one embodiment there is provided a cage with preselected perforated and non-perforated zones to direct the growth of bone in desired directions. In another embodiment there is provided a cage having inner and outer perforated cage bodies separated by an annulus. An end closu re with occluding surfaces suitable for introduction into the annulus serves to establish one or more desired zones or patterns of occluded apertures in the cage body. In still another embodiment an end closure having occluding surfaces is provided for use in connection with conventional perforated fusi on cages so as to establish desired zones or patterns of occluded apertures.</S DOAB>

Claims (24)

1. An interbody spine fusion cage for promoting fusion between adjacent bone structures, comprising:
a cage body having a posterior end and an anterior end and defining an internal cavity, the cage body further having an outer surface and a plurality of apertures extending through the outer surface in communication with the internal cavity, the outer surface comprising a preselected pattern of perforated and non-perforated areas, wherein, upon implantation, a perforated area is in contact with an adjacent bone structure while all areas of the cage body not in contact with adjacent bone structure are imperforate; and a non-perforated end closure at each end of said cage body, at least one of the end closures being movable so as to provide access to the internal cavity.
2. The cage according to claim 1, further comprising an upper perforated area for locating adjacent an upper bone structure to be fused and a lower perforated area for locating adjacent a lower bone structure to be fused, wherein said upper perforated area and said lower perforated area are separated exclusively by non-perforated areas.
3. The cage according to claim 1, wherein:
said non-perforated zones are on lateral sides of the cage and extend in opposing relation from the posterior end toward the anterior end; and said perforated areas comprise two opposed perforated areas oriented so that upon insertion the perforated areas are adjacent the bone structures to be fused.
4. An apparatus for insertion into a vertebral interspace between adjacent vertebral bodies to facilitate arthrodesis between bone structures of the adjacent vertebral bodies while preventing bony overgrowth toward neural elements, comprising:
a cage body having a posterior end and an anterior end and defining an internal cavity, the cage body further having an outer surface and a plurality of apertures extending through the outer surface in communication with the internal cavity in areas of the outer surface which, upon implantation of the apparatus, allow for arthrodesis between the bone structures;
wherein areas of the cage body directed toward neural elements upon implantation of the apparatus are not in communication with the internal cavity so as prevent bony overgrowth toward the neural elements.
5. The apparatus of claim 4, further comprising:
means on the cage body for aiding insertion of the cage body between adjacent vertebral bodies.
6. The apparatus of claim 4, further comprising:
a non-perforated removable end cap securable to the posterior end of the cage body.
7. In a body having vertebral bodies defining a central canal, a spinal cord located in the central canal, neural elements branching out from said spinal cord through openings between the vertebral bodies, an arthrodesis facilitating therapeutic combination comprising:
a cage body inserted between the adjacent vertebral bodies, said cage body having a posterior end and an anterior end and defining an internal cavity, the cage body further having an outer surface that forms a periphery of said cage body, said outer surface having at least one aperture formed therein;
a longitudinal occluded area on said cage body, said occluded area for preventing communication between said internal cavity and said outer surface; and wherein said longitudinal occluded area shields the neural elements from said internal cavity.
8. An apparatus for insertion between adjacent vertebral bodies to facilitate arthrodesis between bone structures of the adjacent vertebral bodies while preventing bony overgrowth toward neural elements, comprising:
a cage body having a posterior end and an anterior end and defining an internal cavity, the cage body further having an outer surface that forms a periphery of said cage body, said outer surface having a plurality of apertures formed therein;
wherein one of said posterior end and said anterior end is a non-perforate surface and one of said posterior end and said anterior end is an open end;
an end closure for locating at said open end of said cage body, said end closure having a longitudinal occluding surface for selectively occluding a longitudinal portion of said apertures of said cage body, said longitudinal occluding surface sized to provide an occluded portion of sufficient size to prevent bone growth from impinging on neural tissue when said cage body is inserted between adjacent vertebral bodies.
9. An interbody spine fusion cage for promoting fusion between adjacent bone structures, comprising:
a cage body having a posterior end and an anterior end and defining an internal cavity, the cage body further having an outer surface and a plurality of apertures extending through the outer surface in communication with the internal cavity, the outer surface comprising a preselected pattern of perforated and non-perforated zones; and a non-perforated end closure at each end of said cage body, at least one of the end closures being movable so as to provide access to the internal cavity; and wherein the preselected pattern comprises at least a first non-perforated zone extending from the posterior end of the cage body for a length of 5-10 mm toward the anterior end of the cage body, wherein said cage body is imperforate except for where said cage body defines at least one opening, said at least one opening is in contact with an adjacent bone structure upon implantation.
10. The cage according to claim 9, wherein the preselected pattern further includes at least a second non-perforated zone extending from the first zone further toward the anterior end of the cage body on a lateral side of the cage body wherein said second non-perforated zone comprises at least 25% of a circumference of said cage body.
11. The cage according to claim 9, wherein the preselected pattern further includes:
second and third non-perforated zones on the lateral sides of the cage extending in opposing relation from the first zone further toward the anterior end;
two opposed perforated zones oriented so that upon insertion the perforated zones adjacent the bone structures to be fused; and wherein said second and third non-perforated zones each comprise at least 25%
of a circumference of said cage body.
12. An interbody spine fusion cage for promoting fusion between adjacent bone structures, comprising:
a cage body having a posterior end and an anterior end and defining an internal cavity, the cage body further having an outer surface and a plurality of apertures extending through the outer surface in communication with the internal cavity;
a non-perforated end closure at each end of said cage body, at least one of the end closures being movable so as to provide access to the internal cavity; and wherein the movable end closure has at least one aperture occluding surface extending therefrom, the surface being suitable for introduction into the internal cavity to establish a desired pattern of occluded apertures.
13. The cage according to claim 12, further comprising:
a second cage body having a posterior end and an anterior end and being disposed within the internal cavity of the other cage body and so positioned as to form an annulus therebetween, the outer surface of the second cage body having a plurality of radial apertures extending therethrough so as to establish communication with the annulus; and wherein the occluding surface of the movable end closure being suitable for introduction into the annulus to establish a desired pattern of occluded apertures.
14. End closure means for effecting the closure of the posterior end of a fusion cage while establishing a desired occlusion pattern of apertures in the wall of the fusion cage which comprises:
a first sealing member to effect the closure of the posterior end of the internal cavity of said fusion cage; and at least one occluding surface extending from the sealing member and essentially parallel to the longitudinal axis of the fusion cage so as to establish a predetermined pattern of occlusion of the apertures in the wall of the fusion cage.
15. The end closure means according to claim 14, further comprising a pair of opposed occluding surfaces so spaced as to occlude laterally positioned apertures along the wall of the fusion cage.
16. An apparatus for insertion into a vertebral interspace between adjacent vertebral bodies to facilitate arthrodesis between bone structures of the adjacent vertebral bodies while preventing bony overgrowth toward neural elements, comprising:
a cage body having a posterior end and an anterior end and defining an internal cavity, the cage body further having an outer surface and a plurality of apertures extending through the outer surface in communication with the internal cavity in areas of the outer surface which, upon implantation of the apparatus, allow for arthrodesis between the bone structures;

wherein areas of the cage body directed toward neural elements upon implantation of the apparatus are not in communication with the internal cavity so as prevent bony overgrowth toward the neural elements.
17. The apparatus of claim 16, further comprising:
means on the cage body for aiding insertion of the cage body between adjacent vertebral bodies.
18. The apparatus of claim 16, further comprising:
a non-perforated removable end cap securable to the posterior end of the cage body.
19. An arthrodesis facilitating therapeutic combination comprising:
adjacent vertebral bodies defining a central canal;
a spinal cord located in said central canal;
neural elements branching out from said spinal cord through openings between said vertebral bodies;
a cage body inserted between said adjacent vertebral bodies, said cage body having a posterior end and an anterior end and defining an internal cavity, the cage body further having an outer surface that forms a periphery of said cage body, said outer surface having at least one aperture formed therein;
a longitudinal occluded area on said cage body, said occluded area for preventing communication between said internal cavity and said outer surface; and wherein said longitudinal occluded area shields said neural elements from said internal cavity.
20. An apparatus for insertion between adjacent vertebral bodies to facilitate arthrodesis between bone structures of the adjacent vertebral bodies while preventing bony overgrowth toward neural elements, comprising:
a cage body having a posterior end and an anterior end and defining an internal cavity, the cage body further having an outer surface that forms a periphery of said cage body, said outer surface having a plurality of apertures formed therein;
wherein one of said posterior end and said anterior end is a non-perforate surface and one of said posterior end and said anterior end is an open end;
an end closure for locating at said open end of said cage body, said end closure having a longitudinal occluding surface for selectively occluding a longitudinal portion of said apertures of said cage body, said longitudinal occluding surface sized such that said occluded longitudinal portion of said apertures have a width of at least 1/4 of the periphery of said cage body, thereby providing an occluded portion of sufficient size to prevent bone growth from impinging on neural tissue when inserted between adjacent vertebral bodies.
21. An interbody spine fusion cage for promoting fusion between adjacent bone structures, comprising:
a cage body having a posterior end and an anterior end and defining an internal cavity, the cage body further having an outer surface and a plurality of apertures extending through the outer surface in communication with the internal cavity, the outer surface comprising a preselected pattern of perforated and non-perforated zones; and a first end closure at a first end of said cage body;
a second end closure having an orifice therein, said second end closure at a second end of said cage body, at least one of said first end closure and said second end closure being removable so as to provide access to the internal cavity; and a plug located in said orifice, said plug capable of being penetrated by a syringe needle for administering a bone growth accelerant to said internal cavity.
22. The interbody spine fusion cage according to claim 21 wherein:
the preselected pattern comprises at least a first non-perforated zone extending from the posterior end of the cage body for a length of 5-10 mm toward the anterior end of the cage body and at least one perforated zone positioned upon the outer surface of the cage body so as to be juxtaposed one of the bone structures upon implantation.
23. An apparatus for insertion into a vertebral interspace between adjacent vertebral bodies to facilitate arthrodesis between bone structures of the adjacent vertebral bodies, comprising:
a cage body having a posterior end and an anterior end and defining an internal cavity;
an end cap located at one end of said cage body, said end cap having an orifice therein; and a plug located in said orifice, said plug capable of being penetrated by a syringe needle.
24. The apparatus according to claim 23 further comprising:
a carrier material located in said internal cavity for receiving bone growth accelerant through said plug.
CA2493643A 2000-12-14 2002-07-23 Interbody spine fusion cage Expired - Lifetime CA2493643C (en)

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US09/737,074 US20020169507A1 (en) 2000-12-14 2000-12-14 Interbody spine fusion cage
PCT/US2002/023262 WO2004008999A1 (en) 2000-12-14 2002-07-23 Interbody spine fusion cage
US10/812,837 US7837735B2 (en) 2000-12-14 2004-03-30 Devices and methods for facilitating controlled bone growth or repair

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