CA2624986A1 - Intervertebral prosthetic device for spinal stabilization and method of implanting same - Google Patents

Intervertebral prosthetic device for spinal stabilization and method of implanting same Download PDF

Info

Publication number
CA2624986A1
CA2624986A1 CA002624986A CA2624986A CA2624986A1 CA 2624986 A1 CA2624986 A1 CA 2624986A1 CA 002624986 A CA002624986 A CA 002624986A CA 2624986 A CA2624986 A CA 2624986A CA 2624986 A1 CA2624986 A1 CA 2624986A1
Authority
CA
Canada
Prior art keywords
spacers
vertebrae
spacer
plates
teeth
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.)
Abandoned
Application number
CA002624986A
Other languages
French (fr)
Inventor
Kent M. Anderson
Thomas A. Carls
Fred J. Molz, Iv
Eric C. Lange
Matthew M. Morrison
Jonathan M. Dewey
Aurelien Bruneau
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.)
Warsaw Orthopedic Inc
Original Assignee
Warsaw Orthopedic, Inc.
Kent M. Anderson
Thomas A. Carls
Fred J. Molz, Iv
Eric C. Lange
Matthew M. Morrison
Jonathan M. Dewey
Aurelien Bruneau
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Warsaw Orthopedic, Inc., Kent M. Anderson, Thomas A. Carls, Fred J. Molz, Iv, Eric C. Lange, Matthew M. Morrison, Jonathan M. Dewey, Aurelien Bruneau filed Critical Warsaw Orthopedic, Inc.
Publication of CA2624986A1 publication Critical patent/CA2624986A1/en
Abandoned legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • 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
    • A61F2/30Joints
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • 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
    • A61F2/30Joints
    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7062Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
    • A61B17/7065Devices with changeable shape, e.g. collapsible or having retractable arms to aid implantation; Tools therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/025Joint distractors
    • A61B2017/0256Joint distractors for the spine
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • 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
    • A61F2/30Joints
    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/4405Joints for the spine, e.g. vertebrae, spinal discs for apophyseal or facet joints, i.e. between adjacent spinous or transverse processes
    • AHUMAN NECESSITIES
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    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • 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
    • AHUMAN NECESSITIES
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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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    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • 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
    • A61F2002/30364Rotation about the common longitudinal axis
    • A61F2002/30367Rotation about the common longitudinal axis with additional means for preventing said rotation
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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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    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • 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
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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
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • 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
    • A61F2002/30373Translation along the common longitudinal axis, e.g. piston with additional means for preventing said translation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • 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
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30492Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a locking pin
    • AHUMAN NECESSITIES
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    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • 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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    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30507Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a threaded locking member, e.g. a locking screw or a set screw
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    • A61F2002/30518Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements with possibility of relative movement between the prosthetic parts
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    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
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    • A61F2002/30522Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements with possibility of relative movement between the prosthetic parts unrestrained in only one direction, e.g. moving unidirectionally releasable, e.g. using a releasable ratchet
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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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    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
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    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30537Special structural features of bone or joint prostheses not otherwise provided for adjustable
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    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033Connections 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

Abstract

A prosthetic device (40) and a method of implanting same between two vertebrae of a vertebral column to stabilize the column, according to which each vertebrae is engaged by a spacer (42, 44) , and the spacers are connected to permit relative movement between the spacers so that the distance between the spacers can vary to conform with the distance between the vertebrae and accommodate bending movements of the vertebral column.

Description

~
INT,ERVERTF.ORAL PROSTINTIC OEVIC.~'+.~ .FO,~ SP.INAL
STARILMATC:O:N AND -81116THOD OF PbIP11.:1.NTIl'+1~ SAME

ti ~~ck~3r~t~nt~
'1.~'iie presezit inUentinn relates toan inter.verlebrM prostbetic device for staiaiizzing) the liÃ.tmaix s~.~iiie~ and a method for implantiÃig sai-ne.
Spinal discs tiiat ex.t.ezict bemeen adiacent ve~eb.rae in v extebrai colUÃ11.t1s o#'tb e htimaÃi body provide critical stippart bemeen the ac~jacent vertebrae. These discs call 'lU rupttÃze, degenerate, a.z3cl/or protrrade by .iÃ~yuzy, rleggrada,iion, diseaset or the like tk) such a, degree that the iÃiter4ertebral space betweenadjacent vertebrae collapses as the disc loses a.t.least a part of it.v,,, support tiÃzicticsn, which caÃ3 ca.Ãi5t-imp3n~emexit of tlie nen~e roots a.litl severe pain.
in tb:esc ca.ses. illterve1Ctc;brilt prosthetic deNrices have beeii Ã.lesiu.~n.es.l ti7at can be I5 implant:ecl between t#Ãeatljacentvertebra.e, both aÃiteriOr a.rtid posterior of- the colLÃmii, to Pre~~ent.tlle cs.;ltapse of tlic intcrtrertebrÃ-Ãl space hetw ~.a~-i the acijaceni vertebrae an.d tla~.~s stabilize the spine.
However, many of these devices a.re .relatively dit~'Ãc:ull, to iÃisert, and Of-ieÃl do not provide aii optirtiÃ.Ãm. f.it with. -tlle ana:Ãom1-.

Sif mmary I'13e intervertebral prosthe3.r.ic. device accordizyg to aÃi embodirÃyezat of the invention overc:tanies the above deficiencies by providing in7proveel. biomechanics a~id increased streng,Ãi3, iii additiori tt-) being relatively easy tc, insert, yet pit'wÃ~Ie~+ an improved fit with th~.' Various :embOdi.mer.Ãts o-f the iavew.ioi7. zÃuq pcssyes~~, oÃte. or mnre oi'tlÃe ak~ove features and. adwantagcs~ or provide one or more solutions to the above problems existing in tl3e prlor art.

,{3 Bri~.~f :1[3escriÃpfiua offhe 113raWings :~'i4.;. I is a side ele'vatio7ÃaI vieW oi'a.naduit liumaià veÃ-te~.iral colaÃniÃ.
.4.'}.g. 2 is C7, posterior elew-atIonal. view o#'tkÃ.e cOl-LinaTi c}f-Fig. 1.

Fzg. 3 is ati eniar~ed, fi'aiit clevati~iial view of aiie of tiie vertebrae Of'the coiui-nza of Figm 'i. and 2.
:iiiog. 4 is axi enlarged, paztiai, isonietric view of apaz-tioii o~the cOlumzi of Figs. I
anti 2, iiepictin~ mi intervertebral pros>ihet.ic dcti-ice;, acctmling to an cmbcdiment of the invcntion. inserted betweeiy. two adjacent vertebrae.
Fig. 5 is an enlarged, iaci-netrict exploded view (3f the prostbetio cie-,,Yicc of'Fig. 4.
Figs. 6-8, ati 9A-9C are z~iews s.imilarto fl .toi'M& 5, btitdep.icting alternate embodiniciits.
Figs. 10AM1OC are vietivs shnikar t.~a tttai of Mg. 7 bit depicting an aiter~iate enibodimeiit.

Deta.iled Description Witii rei'ercnce to Figs. 1 aaid 2, the reference iiunicral 1.0 refers, in geÃicrai, to a human vertebral coi-urn~i .10. 11e lower portion ot the vertebral column 10 is shown and .15 inclticics the lumbar region 1.2, tiie vertebrae V~, anci the coccyx 16.
The fle~:iblrz soft portion of the veilebrat column 10,, -which .iiiciudes the -t.horacic region az.td the ccrtricai rebxioii, is not shQwa.
The I.umbar re gion 1~ot: the z-ertcbral coiumn 10 iziClLides five v~itebrac V 1.. V2T
V3, V4 and V5 sepan, ted by intei-~~ertebrai discs DI, D?, :Ds, atict D4, -~vith the disc DI
extending bct.vveen the vertebrae V.t a.33d V2, the disc.D? extend.ing.
between t.t3e vertebrae V2 and N1:.~, the d.ise D3 emending betweei3 tlie z3crtelar~.e V.'y and V4, and the disc U4 extending, bcbvcen t1ic vertebrae V4 aixd VS.
'i'iie vertebrae V6 incl~des five fused vertetirae, c~~~~ ofwhich is asuperior vertebrae V6 separated from the vertc~~~e V> by a disc D-5. Thr c~the.r .four ftiseti ve.rtcbra.c of the sacrum 14 are referred to coIlcctivel.y a-s V7. A disc D6 separates tlic vertebrae V6 from the coccyx 15 which iiiciudes four fi7sed vcrtei.~rae (not referenced).
Wrt'li ret.ereiycc to Fig. 3, the vcrf.ebra.e V4 includes two ianii.na.c 20a anci "ab extending to either side (as vic-%ved. in Fz g. 2) of a spinous process ~'?2.
that exte-iitis post-criciriy frojii the juncture oi:'fihc two laminae. Two transverse processes 24a and 24~
extend tat:erallyl iroin tiie laminae 20a. art~d 20b, respectilreIy. TWO
a.rticÃ.ilar processes 26a anti 26b cx-:tcnd sirpctioriy from the iatiii.iiae 20a and 20b respectively, and trN,,c articrilar prcicesscs 28a anrl28b extend inferiorly -fioin the laminae 20a and 20b, respectively. 'rhe inferic~r articular processes 28a and 28b rest in ttie superior articular process O:i'the Vextet3~a ~'S tta fc~.r.~~ ~ fa.cet.~c~i.a~t. Since t17e other vertebrae Vt-V3 and VS are sirrtil:t.t= tcz the vertebrae V4 they vAli not be described in det.ail.
RcferrÃng to Fig, 4., it will hc assumed tttafi, for one or iiit,jrc of the reasons swfi fortl~
above} the vertebrae Nr-4 and VS are taOt being ~adequa:teiy supported by the disc D4 and that it is thereft,3re. necessary to prc~-,,icle supplemental wulipcart.ancl.
stabilization of these vet~ÃÃebrae. l'o this ezid, ati intetwerÃebra.i prosthetic device 40 according =Ãt) a-n etnbodi~~ent of the invention is .impiantcd beuveest tl;e spinous processes 22 of ttie vertebrae -4F4 and Zr,~

~I0 ! Ti3e device 40 is shoWn in detail in Fig. 5 and iiicludes a solid spacer 42 liaLTilig a substantially rectangular cz=osisM~:ectionwith the exceptioa that a longitudinal curved slot 42a is farmed in ot3e etid pot-tioi.i. 'rtte slot 42a is sized 5o as, to receive a process 22 of a~iy of the -vertebrac:VIMV7, hicluding, the vertebrae NF4 shown in.Fig. 4.
Anotlter so1iti spacer 44 is provided that bas a substantially rectangular cross-section -with ttie exception that a.
.15 l.on_<~duclinai cxirvccl slot 44a. is forÃiied in one oxir3 portion.
'.i'lic slot 44a receives ttie process 22 (Fig. 4) ft=atn the verteb.rae V5. Prcfcxa.tal3 . the spacers 42.
aiid 44 are fabricated of a relative soft inateria.l.
A:ti adjustable mec.ba.nism 50 connects the spacers 42 and 44 while permitting relative a\iai ziioveznent of the znen-ibers relative to each Other. The inechariism 50 20 consists of a bi=acke.t. 52 extending -from the ertd 44b of t}ie spacer 44, and connected to the spacer in atiy caxtvetitl.onai manner. 'I'lie bra&-et 52 has a.
sut.'stantidfly I:-shaped cross-section that inc~ludes abase 52a and two spaced, para.llel, legs ';~~b ancl 52o extending froni, and at right. angles to, ttie base. A-i3 internally ti3readed olse.t=ting, 52d extends through the base 52a.
?5 'lae mechanism 50als0 includes a. ~late 56 evtendin- ~~c~n~ the etid ~zl'ihe spacer 42 ~~id connected to the spacer in any conventional matiner. Tlie plate 56 lias a rect.az~gular cr~s'~ sectiort and is sized soas to extend in the bracket 52, tlyat is, in the area of the bracket 52 dc:fiticd by the base 52a e.iid the two legs y?b atici 52e.
An elongated slot 56a is torrncd tlirough the pla:te. 56.
Aset screw 58 is pro-idded that lras aii extertially threaded shank portioÃi.
that extcnds throu~lt the slot 5f~a. in the plate 56 artci tl~.rea.r3e~lIjY
et~.,~ages the t~.readcd opening 52d in ttie bracket,52. The scxew 58 has a head portion the dianictax of which is ~,Yreater r.i7azi the -widtlà of fliesiot: 56a.
As an iziitial set-u.p prior to the surgical procedures the plate 56 is positioned in, the bracket. '~2, i~nd. the screw 58 Ãs e:ct,c~nd~:d. tlirt,3'41gh the slot 5t~~.
and in tlirc~~.ci~:~. t;ngagenient w-itii the opening52d o1;'d3e bracket 52. 'I'bezi, die screw 58 is fightc.ncd niilj} su{~~:tcic.ntly to retain the plate 56 in the brackwt 52 while permitting relative axial nxovem.ent of the spacers 42 aÃ3d 44, while the slot 56a defines the 11mits of t~~e axial tl3otirement.
Referring to Fig. =1, the device 40 is insertcd between tlic processes 22 of the -':reriebr~~~.cV4 and the vertebrae Vf;. 'I'ho sur~~:or.~ c~a3 then anantially adjust the m.eohanism 50 (Fig. 5.) arÃd therefore the spacing between the spacers 42 and 44 .intraoperativcly in the manner di.scus;;od abovc, wit.il the spinous processes 22 o#'tl~e ve.rtebrao V4 szid. VS ox-teÃtd in the notches 42a. nnd 44a, of the spacers 4? and 44, respectively, witli an optinium tÃt. If Ãieeded, a conventional distractor 59, shown by ttie phantom lines in BY. 5, can be uscd. 3c3 assist in nial4izig the above a4justment, with the scrow, 88 tightened to the exte-Ãit ttiat it .1.5 rotaiiis the spacers 42' and 44 in sn extended position ~whiie peniiitting relative axial mcavenleÃrt a.S necessary. WlieÃi tlic optimum fit is achieved, the set screw 58 is tightened against the plate 56 to lock the plate to the bracket 5 M and thus lock the spacers 42 and 44 in the desired position.
It can be appreciated diat after the device 40 has been zmplaiited in the .inanner di scusscd above, the device c=arà .respond to various movements of the ps.ÃioÃit. -ttlat. place stross oÃ3 tiic vertebral ctzluÃ~~~i 10 (Fig. I) axtd accommodate those n3oG=cments by relative moveniciit between the spacers 42 ~and 44. For example, if the patient bends backwardly, the spacers 42 and 44Would tziove closer together, and the set screw 58 permitting the relative axial movuiiient. l:t the patient bends f.onvardty, tbeu the axial spacing betwoezi the spacers 42 aiiti 44 Would increase, -,vith ttie sot screw a8 perÃ3iitt.iÃtty t:lic re1atyvo axiat niovemeÃit. In ~.~ottx c.if the above ca.scs, when the paticiit rett.trÃis to s, i7ornial position the set sorowr >8 woÃiIct permit the spacers 42 aiid. 44 to iiiovc bac: to their original position.
If the above backward movement is extrcine, the spacers 42 and 44 cattld reach a positiozi in Nvhich t~ieir correspovdiÃi~ ~iids abut. In tl=iis pc}sitic}q, ttie entl of the spacer 42 :.)O tbat abu.t:.~ the corresponding end o:t the spaccr 44 would compress s1ip ght1y since the spacer 42 is fabricated of a reiati-~,,e soft-rnatcrial.

ThÃ.Ãs, the device 40 is relatively easy to iÃ~sert , p.ro~ ides aii optinitar~i fit bet-ween the processes of, t.Yvo a.daacent. vertebra.e, and is adapted t.a va.rcY in axial lenggtb. i.rI xesp01.1se to movements Of the Patient.
Rderring to Fig. 6, another embtsdiÃÃieÃÃt of an iiitervertabral prosthetic device is 5 Ã=eferred to, IÃ3 general, by the reference numera.l 60 and, is also ada.lited to i3e h3~piaated between the spinous processes 22 of'thc vertebrae V4 a-nci V5, 't'i3e d.evice .iciciucies t#-ie saziie spacers 42 and 44 of d3e previous e.n3bodin3e'#3t but titilizes a. tlif'fcrcÃit coiinecting nicclianism, which is referred to, in gcilerai, by the Ã=el~ercnce numeral 62.
The i-neelian.ism 62 incltÃcies a plate 64 extending from the eÃÃd saf'the spacer 42 and connected to t:i3e q7acer i-n any conventional manner, and a. phate 66 extending from the oÃyd 44fi of the spacer 44 wid corii3e:cteci to tl3e latter spacer in aÃiy coÃiveiy.t.ioÃ3al. Ã7iaYi#3er.
Thc iÃiner facing surfaces of'the plates 64 atid 66 are provided vdth tec;th.
A rc:3aiii eÃ= 69 extends arotind the plates 64 and 66 and is par-tia.lly shor=vn in Fi~;. 6iÃ3 the interest of uiarity.
.
A spÃ.iÃ= gear 68, hav.iÃig teetii forined on its outer surface, is moÃ.iÃ7ted betweeÃl tlle plates 64 and 66 and between the ends of the bracket. The teeth Oi'the gear (18 a.r.e in eÃzga~~rnent: itlz the teeth of the liZa:tes 64 and 68 so that: rotation of the gear causes translatiuÃxa.l Ã~~ovc.ment. of tkie plates relative to each otlier. AithauuFh xiat sIiOWn .izl the dra~~iÃatys it is understood tliat a conventioÃ3al. torsion spring c:aÃi be a.tta.clÃecl to the gea7- 68 go that rotafioxi of ti3e gear in otle directioÃ3 cause the spring to coil t~p aticl tis;hten so d3a.t., -when, the rotation ceases the sprin~.f will uncoil wxd cause flie gear t0 rc}tate in the other directioÃt.
An opening 68a is proiri.cled in the gear 68 tbat receives a tool, sucix as an .A.lle-n xvrench, or the like, to pern?.it the gear t:c} be znantially rotat.etl.. I'o this end, and altl3ough not shown in the drarvings, it is underst.oad that ari apeniÃÃg would be provided in uno of the- eÃid pl.at.es of the bracket 69 tha.t would re-4?ister wid3 a eorres~onding), czid of'the gear 68 to pennit access to tiic opening 68a gear for this prirpase.
Ref 'oÃ-Ãing tc} Fig. 4, tlie device 60 xvouid be inserted bet.wecz3. the procc:s'se-s 22 E?f the vertebrae V4 and the vertebrae '1} S in. the swne manner as the device 40, as discussed above. The surgeon can tbon Ã-otate the gear 68 to adjiÃst the spacing, bibtvc;c;n the spacers 42 and 44 untii the spinous processes 22 of the vertebrae V4 aiid V'h extend in the notches 42a. and 44a; Ofi'the spacers 42 ar.id 44, respectively, wit.li aai aptiniuxn fit. Ii; needed, the cli.;;tra.ctor 59, cllown, in t:lle enlbtzdiment of Fig. 5, oe1n, be used to irzake ttae above adjustment.
It caii be appreciated that after t'he d.evicc, 60 lias beeii iiiiplwite-[~
in'the siiaÃisie.'r ~ diseussed above, the device caii respkiiid to variou:, nxoveiiiezat.s of the patient that place stress on flie vertebral cc.}la$Emn 10 (Fi& 1) and accommoclate these movements by relative moveniet3t between ti-ie sliacers 42 ,atid 44. For example, if the pati ezit bends iaackWarcilv 3 the sl.~a.cers =12 and 44 wvt-lcl iiiave closer together, with Oie gear 68 atid tlle above sp.ring peniiitiing the rela.ti.l=e ~miai nioveiii.eii.t. 1-f #I}e patient beiid.s #:brWardly4 t.lien the axial lo spacing between the spacers 42 a.ud. 44 vvaulct increase, Witli the gear 68 and the sprÃngy permitting the relative wdal movement. TA bvtl3 o1 the above cases, whezi the patiei3t returns to a normal position the spri~g wotiId rotate the gear 68 in t13e msilner discussed above to mc~ve- the spacers 4? aai(i 44 back to their vrigiiiai position.
1f the aliove l.~a.ckwarÃI movement is ext.reine, the spacers 42 and 44 could reacii a 15 positic~ii in, which their rorrespOuciiug ends abut, I'D tiai.s larasffic}n~, ti-ie enil ofthe spacer 42 that a.buts the cor.respozidi-ng end of the spacer 44 wcittld compress s1ightiy since the slia.cer 42 is fabricated ol:'a rela.tsve soft material.
'I"hms, the device 40 :is relatively easy to insert:, prol%ide;~ a.ii ol-Ai.Ãzium t7.t. between ttle processes c~~ two adjacent. vertebrae, and is adapted to varyt in axial length in xespcizise 20 to movements oftlie taa:liem As a resu:lt, t.l;e lc~nggitudina.l, or axial, distance between tlie spacers 42- wid 44 cm n be adjtisted, depending on ttie distance betrveen the processes 22 of 4ic vertebrae V4 and V5. Thus, the device 60 is relativelv easy to insext ai3d provides an optim uin tit b eÃtix=een the two vertebrae V4 and VS. Thiis, tiic above niasiua.l. rotation c3f tliegaeas= 68 causes reative axial ~~~ovement_ bemeen ttie l.ylatz4 64 and 66, and therefore the spa.cers 42 and 44.
As a.result, the loragit~idiiia.lY or axial, distance between tlie spacers 42,and 44 caii be adjusted, depending on the distance bem}een -fhe processes 22 of the vertebrae V4 and VS.
r'1zxOtlier c:n-ibodinxeiit of aii inte.rveita.br.al prosthetic device is referred to, in general, by the refe-reiiie r.iume.rs.1. 70 in Fig. 7 aÃid is also atlapted It) be iniplantecl between.
~~ the spinous processes 22 of the vertel.irs.e V4 artid VS.

~
The device 70 includas, the sarzie spacers 42 and 44 of the previotÃs enibodina.ent but 7ut7.l.i7es a diffi-erettt connecting mec,han.ÃSm, which is t=e:('er.Teci to4 in general, by the referetice numeral 72.
The ri-icclianistn 72 includes a i.~lat~ *74,~xtending, dc}Wrtwat=cii}r from the end o#'the s spacer 42, as viewed iti the dumving, atyd coÃuiecttvd to tiie spacer in atau coà ~~nhonal manner. A plate 76 extends Ãtpvvarcily from the end 44b of the spacer 44 anc9 is connected tc) the iatter spacer in atiy conlr~~itiona! xnatinar.
".~'1;e iniier surface of the iala.te 74 is provided i-vith a plt.trality of ratcliet teeth 74a each o#'Wiy.ieh has aiy. angled surface extending ciolvnWa.rd:ly -fr.oin a hoxiznnt-al suri'a.ce. A
flexible ta~.~ 76a is fornied integsxa.lly wiit7 the plate 76 and prujects outwardly froni the iti.aer stir#'ac~ of ttte pl a.ie. 76. The length of the ta.t) 76a is siÃcli that it can extend aioz3g, t~~e angled saÃfflace of apai-ticular tooth 74a and abut the i3ot-izoi3tal surface of a toot1l immediatelv abo-ve the particular tooth. A. retainer 78 extr-.nds around tiic plates 74 anci '7 i a.nti is shown in cross section in the interest oi' charity.
.15 Tht.Ãs, tiie plate 74, and tiicreiorc tiie spacer 4" can be moved t~antÃaiiy in atl upwardly direction relative to the pfate 76, aiici therefare the spacer 44;
and/or the plate 76, and therefore ttie spacer 44 can be moved in an downwardly direction relative to til~ ~lat:e 74, attel therefore t}te si3acor 42. During this mc:svement; the tab 76a ri4es along the outer surfaces of the teetl-t 74a azid, vOien tiie m.o-vement is stopped, the tab ~~exes outwardly to a positiuti atotag the angled stÃrtace of a particular tootit.
l'be de-v-ice 70 is inserted hetweet3 the processes 22 of the vertebrae V4a:t3d tlie vertcbrae V5 in thc.~ same manner as the device 40, as si?c3mx irt.Fi& 4 aiici dise;aÃsseci above.
The strrgeait cati then adjust the l.ongitudit-tal spa.cing, bet.~~en the spacers 4:2 atid 44 in the tna~ner described above until the spzn.ous processes 22 of the vertebrae V4 and V5 extend in, the notches 42a and 44a, of tÃ-ie spacers 42 and 44, respeetiMy-, witi3 ati optim-lÃ~nflit. Ii:
needed, the distractor -59, sha-vvn in the cr~ibodir~ient of Fig. 5, can be used to assist in making t.iÃe above inseriy.on.
An aiterns.te version ofttie niechanistn 72 is shm3 n by the reference iiumerai 72' in Fig. 8. The n-iec:tia.nisni -72i is similar to tl-ie nYeriianisrn 72 of Fig. 7 a.~ld incit.ides ~ie "0 piates 74 and 76 atid the retaÃner78. However the .ratchet teeth 74a. of the mechaÃtiszn 72.
are eIimh3atedancl the ouler surface of the plate 74of the r~~~~baz3isrt3 72' is provided wittt fi.

plurality of axially-spaced indentations tila.t fo.rÃz, a p1uralitv ~~ axially-spaced teet1i 74b having a. rectangular crosswsectron.
A flexible tab 76b is bent out from a ctit-atrt pOrtioÃi of ttie inner surface of the pl.atc:7~, with the lct;s;th. of the tab boing such that it can ride along the teeth 74b wiien the plate 74 moG=es upwardly relative to ttie plate 76, and/Or ttie pla.te 76 moves downwardly relative tc} thc plate 74. When this movement is stopped, the tab 76b flexes into an indentation behveen a4j,.cent teet~i 74b to block aq aNiai nicveriieixt between. the pfa.te 74 downwardly relative to the plate 76, and,+'or rncvemcnt of the plate 76 upwardly relative to t~e. plate 74.
The deviceof Fig. 8 is inserted beteveen the processes 22 of the vertel.~.rae V4 and the vertebrae V5 and the axial ci.istance. between the spacers 42 and 44 is a(tiusted as dcseribed above, st) that the spinou~ processcs, 22 of the vertebrae V4 ai3d VS exteÃid in the Ãiote-hes 42a aÃid 44a, of the staa.~:ers 42 aiid 44, respectively, -witii an optimum iit.
As a result, relative movement betwecÃr the plates 74arad 76, and therefore the sl~accrs 42 aÃict 44, in a direction away frcim eaÃ;l-I otiiÃ;r is pLrriAtted, Wbiie relative movement of the piates aiid the staac,ers. in a direction towards each. otlier is p.reven#:ed.
Thtrs, ttic mec.lr.anism 72' of Fig. 8 en~oys the sarn e advantages as the mcciiarYism 72 of ttie Fig. 7.
Referring to Figy. 9A -9C, a.tiott-ier eml~odiment. of atr. interl~c.rtcbra.l prosthctic, device is shm~,n, in general, by the reference nLÃrneraI 80 atid iricir,rdes a solid spacer 42' tha.t.is siriiilar to the st.~a.cer 42 of the previous embodiments. Thc spa.cer 42 is fhbricated from a relatively soft materiaJ. aaid has a curved portion 42a' that receives a, proecss 22 of any of tlie vertebrae V1N7, inclitciÃnt., the vertebrae V4 shown in Fzg. 4.
Ac:c.orciingtothe embodiment of'Figs. 9A ariti 9B, a substantially rectan4ula.r ciat-otit 421)' iss provided in ttie ?.5 lower eÃid of the spacer 42'. Tlie ~pacer 44 trorti the prcviouscmbotl.inflertts i;; also provided arud, since it is well disclosed above, it will z3ot be des;.~ibed i.n detail.
rtiY adjttstabte mechanism 8' connects the spacers 42' ariti 44 while periiyittÃilg zelatil e a.-.,.ial movement of the xnenibeÃ-s .reiative to each ctlier. The zncchan.ism 82 consists of a brac~~t 84 cxtzz3el.izi- -ftoin the upper e-nd ot't_he spacer 44, as viexvcd in ttie drmvings, arid connected to the spacer in anvy conventional rnanner. The bracket 84 has a substantiait} U-shapeti cross-section tliar. incI{7des a base 84a. and two spaceci, paxallc1, ieE~s 84b and. 84c e.,aeÃtding ~rartx, and a-t right angales to, ttie base.
~.kn.internaily threaded opening 84d ex-Ãetids tlirouglt ttic base 84a.
Tiie mechanism 82 also includes apiate 86 tiiat extends from the base of ttie eut-oufi 42b' of ttie spacer 42' Hi3cl y.s connected to the spacer inar.tiY
conventional rtiH.a3t~er. 'l;'iae plat-e 86 ltas a t~ctart4ft~l~a erns~; section and is sized so as to extend in the area of the 13rac1<et 84 defiÃ3ed by the base 84a and the two legs 84b and 84c. An elongmted slot 86a is forni~.acl through the plate 86.
A. set screitr 88 is provided that has ati externally threaded shs:nlti portion that extends through the s1c.}t 86a in the plate 86 and threadedly engages the t1ircaciecl ~penytYg"
84d in the bracket K The screw 88 bs.s a head portion ttie diatnete.r of Wbich is "gres:ter than the Mdth of the slot 86a.
As aÃi initial set~up prioÃ- to the surgical procer3tire, the plate 86 is posii:i.atiecl in -ltie bracket 84, a.Ãid the se-reW 88 is extended through theslot 86a. siÃd in tlÃresdes~ eng<l'g'ement with. the opeiiing 84d of flie bracket 84. Theii, tli.e scre"? 88 is tightened c.in1y sufflicientl}:
I5 to xe-taiÃi the -p1aÃe 86 in the brs.eke-t 84 wliile permittang! relati~~ axial 7ao-,,ement of the spacers 42' and 44, while ttie sl.ot 86a detiaics ttie IiÃtiits ot'ttae axial rt3.o-vemrnt.
Fig. 9B shows the spacers 42' aild 44 in sii asseirtblecl, s1igl"-tlve\tended posifion -widh tlÃc amount of the extension 6pcnding, cÃf coursq, on tlic ciistanc~ b dwc:en the a4jacent processes. In this cotitext, and referring to:t ig. 4, during the surgical procedure., the device 40 is insertQcl between t1le processes *212 of the vertebrae N14 and. the vertebrae 1o'5. 'l:lze surgeon can tben. martitaily adjust the mechanism 82, aÃicl tberefot=e the spacing betw-een the sps:cers 42' and 44, intrapperati.vely in ttie n1araner clisotÃssed above, iintil the spinous processes 22 of the vertebrae V4 ancl V-i extend. in the notelies 4'?a and. 44a, of the spacers 42' atid 44, resp~.ac~tively, with at3. OptiÃiaurn.#it.
If Ãieeded, the distractor 59 a1.i0 m by the 1~hantu.ia 1Ãnes in fig. 9A, and discussed above, can he- used to assist in making ttie riboire. adjustment. T'13e 5crerv 88 is tl3eri tighteÃied to the extent tlis.t. it pen-rtits relative axial niovemetit of the sps.cers 42' and 44 bcmeen az~ extended position, sLich as that shmvzi in Fig. 9B, axid the.
compietel.v ret~c-ted iaositioti of Fig. 9C, as tiecessary, Witlt the lez~;~th oftlze slot 86a liÃnitir2g tbis moveÃrte-rtt.
It caii be appreciated that after the device 80 has i3eei; implanted in the inanner discussed above, the device can respond to various i-n~~~~i-nertts of t1ie pafient that place stress oti ttie v-e.t-tebÃ=ai coittmn 10 (Fxg. i.) atid accommodate tiaese moi=ements by reiati-ve '1{}

movement between the spaGCrs 42' aÃad 4.4. For e:~ample, if the pa.tielit bends backWRrclly, the spacers 42' antl 44 would move closer togc; ~ier, and t1ie set screw 88 waLÃitl permit the relative axial inoveInent. lf the patieiit bends forwardly, tlleii the axial spacing between the. spacers 41' aii.d 44 Woiild increase, Wit.h ttie set sci=evy 58 1,7er~iii#.tina the reia.ti.ve ax-dal moverixeÃit. Iz3 biutll czt t-?ae above cases, tisYtzerà the patient returns -to a. riorirlal position the set screw would perinit ttie spacers 42' and 44 to move 1~~ck, to fi1ieir original positioii.
if the above backward movement is extreme, the spacers, 42' and 44 could.reach a pasitioii in whic:i-i their c=respOni:lirig endsabm as shovm in Fig. 9C l:n this laositiori, the end of ttie spacer 42' that abuts t:}te corresponding eÃrd ofi the spacer 44 would compress 14 slightly sinee. t}ie spacer 42" is -f'abricatecl of a relative soft, material.
Tiitis, the device 80 is relatively easy to iiisert., provides an opÃ.irr.mrrÃ
tit between the processes of uv-o a4jacent vertebrae, azid is adapted to vary in a:,.dal length irà .response tomovements at' the pat.ient.
Anotlier en-ibodin-ieÃit of an interveÃ-tabraI pr~.~sthetic device is referred to, in 11-S general, by gic reference niÃnYeral 90 in Figs. 1.t3A-1OC aixd is also ad.apteci to be implanted between the spinous processes 22 ot'the veitebrae V4 and V 5.
The cie'vice 90 includes the saine spacers 42 and 44 of tlie previous embcÃdiÃnent but lltil1zes a d1ft'eIeI3t connecting meCbc'1n#sm, whicb is referred to, in 4ener-al, by ttie reference numeral 92.
2.0 Referring to Fig. :tOA, th+C;MCC138I11S213 92 Ãf7CltÃdeS a plate 94 extenclirig dow:Ãx'tN,arcll.y :f..rona the loNve.r end at't.i1e spacer 42, as va.eAvec3 in the axi(i CCj21S.1~Gt~~~ ~C~ ~~.1L 51)t~i~C"]' f.#1 c3E~~ CC~13Vtr11~7.Ci~1<'1~
L~c~Ã~TÃ~Ã. The inÃ-Ãe.r 4uri:ace of the p) ate 94 is pi'mided with aplural.ity of ratchet teeth 94a each o:i'whieh has aÃi angled surface extericliiog ci0A~;~aivarclly frcim a horizontal surface. A plate 96 extends upwardly trc3m tlie 25 upper eiirl oi't:}ie spacer 44 and is connected to the latter spaeer. in any conventional ~iiai-ine.r. The iiiiier surface ol'l.he plate 96 is pro-vided witli a pltÃrality of ratcl.i~.~t teeth 96;Ã
eacb. of wbioh tza5 an. angled curface extending up from a horizontal surfa.e:e. The teeth 96a are a.dapt.ed to nxesh ith the teetb. 94a.
Fig. .l OB depicts an operat:i-ve posi.tioz7. o~'the tle-0.ce 90 in -w-hici3 t-,;vo crf- the lower 30 teeth 94a riies}i Avith mv0 ot'the tipper teeth 96a to Iocl;. the spacers 42 and 44 ill an extended position. Fig. 1OC depicts another operative position cit the device 90 in \vhich aii of the teeth 94a mesh with all of the teedl. 96a.1.0 tC1Ck ttie SpaCers 42 ,a13d 44 in another .~ .~

extended pOsitiozi. Izr the positions oi'.1~igs. 'lOB and IOC, a retaizier 98, shOram iir cross-section, extends around the plates 94 and 96 and retains the plates, and tire.re.{'are the spacer 42 aird 44 in the pasitioii shown. i:t caiz be appreciated that ttie spa.cers 42 axid 44. can be locked in relative ~Yial positions other than those disctissod above, depexr(iiirs; ~ii the r3uitiber of the teetir 94a. airti 96a that en?age.
The device 90 is yiiserted behveen the processes ~~,21. of'the vertebrae V'4 and tre vertebrae V5 in the same Ãrr,anner as the device 40, as shmka3 in Fig. 4 af3d discrissed aboG-e.
The stirge0ti can tlreir aeljust the langitudi~ia1 spacing bebveen the spacers 42 a7rd 44 in the i3iaiiner described above uzr.fii the spinous processes 22 of t:13e vertebrae V4 a.iitl VS extend in tlre. notches 42a ancl. 44a, of are spacers 42 a.ird 44, respectively, with air optimum fit. 1:1' needed, the distractor 59, sliown izr. the embodim~iit. of Fia. 5, can be used to assist in nta14ing t1ie above iirsertiory..
Variations It is understood that variat.ion.:;may be made i-n the kor~'goir.~g without departing .15 frcinr ihe invc;ntiL3n arad. e~:amples of some variations are as foil.ows:
= Any conventional substance that pramntes 13orle grc,ivth, such as HA
coating, BMP, or the lgi;c~, ewx be incorporated in the prosthetic device of ~iic or both offl~e kov ~ embc?cli merit:s.
= '>;'he surfaces of the spacers 42, 42', arrd 4.4 spacer defiiring i1ie notches 42a, 42a' and 44b can be treated, such as by providing teeth, radges, knurl.in~.~, etc., to better grip flze spinous pr-cx:esses ~a.nd the adapters.
= The spacer caia be fabricated of a permanently det'onnabl~ niaterial thtis providing a. c1an;ping aGtiun. -against: the spinous process.
= One or both of the spacers 42, 42, and 44 may have throuigh openiirgs #'o.nrred therein to improve integration a:t'bozie growth;

= The spacers 42, 42', and 44 arzri their -i.ssociai~d mechanisms 50, 02, 814, ariel 92 c-iri vary in shape, size, cori-rposit:i.on, and phycical properties;
= 1n the einbadixneÃrts of Fig. S a~~~ 9A-9C,the brackets can be connected to the sp aeez~s 42 and 42' arztl Ã.17.e plates 56 and 86 cari lre connected #c) -tlie spacer ~#~.
* 0.ne or botti ofithe spacers 42, 42' and 44 may.have through openings formed tlre.rem t.v receive tethers fibr attaclri.trg, t13espacer to a. vertebrae or Ã:t) a ;pin.0irs process;

~- :1n the einbodixnent of 1"~gs,. 5 axid (,)M9C, ttie h.raolket 52 can belo&-ed tothe plate 56 in. inanners other than by the set screvv- 58;
= :In the eanbadiTnent of Fig,. 6, only one of the plates 64 or 66 can have tectli formed thereon;
= TIie shape, nuinburx and spacing of the teeth in the embodiments afFigs. 7, 8, and I gA-:1 OC, as rvell a.s the s1iape of the tabs in Figs. 7 aiid 8, can be varied.
= The prostlics.i5 of the a.bs--we e.mbadi.inc.=ws can bc placed between M,,v vertebrae in the ve7.tcbrt1l ctzlumn. other i:ba.n ttie ones described ai.~ove;
+Bilateral extrusions, or the like, caii be provided an, one or more oftile devices f ttie above e:anborlimertts to enable a, tethering device -to be at.t:a.ched;
= 'C'I;e prosd3cses of the above embodiments cati be inserted i3~~~74~-.en tNVO vertebrae follvz-ving a discectemy in ~~~liiei3 a ciisc bet.w~ea ttie ac1acent veii.e.b.rae is reznczvedt or a corpectomy in --which at least oiic vertebrae is removed.
= 'nie prmkitesets of ttie ~~boi%e emb~.~dimcav,; cati be inserted bet."Vec;n ti-ie -facet-, of acljacent Y=ertei7rae, ratiier than the spinoLis pxocesses; mid = l"ir~ spatial ret:ere.aces made above, suehas ' under,,.. "c-sver", "between", .:#'iex-lbl:e, soft7-z "lawez"z "top". <'bOtto&", etc., are for ttie purpose of illustration only axad do not.limit thiv. specific orzc;titation or location r.if ttio sfrus;tc7re described above.
The precediTig specific embodintents iare illustradve of tl3e pracfice of the invention. It is to be understood, therefore, that. Of.lrer e%iaetiients kntm-,n t(3 those skiiled in the art or diselosed berein, may be employed Withotit. departing froni ttie .iiivexttioxi or tlle scope of the appended ciaiiiis, as detailed above. 'in tJie c-lainis, zneans-pluswft-neflon clauses are iiite-ndeci to cover i-fie gtruct.ures described hereiij as perfibmii.ag the recited ftinciic~ii and not on14r siTuctr.irat ecILYi4aIeiYts but also equivalent str#~cttires. Thtis, a1thot7gI~

a nail a.zad a sc:rew-.itiax? irot be structural equivalents in that a. nail employs a cylindrical surface tr) secure tvoodeÃj. parts, to;efiher, whereas ascrew smploys t~.
helical surface, in tiye eiiviTC)i3.i-nLilt of fc1st.en1ng'4N'C30dCtT parts a 2nnl aIlti a SCrL='vv are equivalent 5tru.Gt112'f:S.

Claims (21)

1. A prosthetic device for insertion between two vertebrae of a vertebral column to stabilize same, the device comprising:
a first spacer for engaging one of the vertebrae;
a second spacer for engaging the other vertebrae; and a mechanism for connecting the spacers and permitting relative movement between the spacers so that the distance between the spacers can vary to conform with the distance between the vertebrae and accommodate bending movements of the vertebral column.
2. The device of claim wherein the connecting mechanism comprises a first member extending from one of the spacers and a second member extending from the other spacer and slidably mounted relative to the first member.
3. The device of claim 2 wherein the first member is a bracket and wherein the second member is a plate and wherein the plate and the bracket are adapted for relative slidable movement to permit corresponding relative movement between the spacers.
4. The device of claim 3 wherein the connecting mechanism further comprises means for retaining the plate relative to the bracket while permitting the relative movement.
5. The device of claim 4 wherein the retaining means comprises a set screw extending through the bracket and engaging the plate.
6. The device of claim 2 wherein the first spacer has a cutout formed therein to define two legs, and wherein one of the members extends from the base of the cutout so that the legs engage the other spacer when the device is in a fully retracted position, to compress the legs.
7. The device of claim 1, wherein the connecting mechanism comprises two plates respectively mounted to the spacers with each plate having teeth formed on one surface thereof, and a gear in engagement with the teeth so that rotation of the gear cause relative movement between the plates and therefore between the spacers.
8. The device of claim 7 wherein the gear extends between the two plates and has teeth mounted on its outer surface in engagement with the teeth on the plates.
9. The device of claim 8 further comprising a retainer extending around the plates to retain the plates, and therefore the spacers, in different relative axial positions, the retainer having an opening formed therein to permit access to the gear so that it can be manually rotated.
10. The device of claim 1 wherein the connecting mechanism comprises two plates respectively mounted on the spacers with one plate having, teeth formed on one surface thereof, and the other plate having a flexible tab extending therefrom and adapted to engage the teeth to permit relative movement between the plates and therefore the spacers.
11. The device of claim 10 wherein the tab rides on the outer surface of the teeth to permit relative movement between the plates and therefore the spacers in a direction away from each other and the tab flexes to prevent relative movement of the plates and therefore the spacer in a direction towards each other.
12. A prosthetic device for insertion between two vertebrae of a vertebral column to stabilize same, the device comprising:
a first spacer for engaging one of the vertebrae;
a second spacer for engaging the other vertebrae; and a mechanism for connecting the spacers and permitting relative movement between the spacers so that the distance between the spacers can vary to conform with the distance between the vertebrae.
13. The device of claim 12 wherein the connecting mechanism comprises two plates respectively mounted to the spacers with each plate having teeth formed on one surface thereof, so that one or more teeth of one plate can engage one or more teeth of the other plate in different relative axial positions of the spacers to lock the spacers in the positions.
14. The device of claim 12 further comprising a retainer extending around the plates to retain the shafts, and therefore the spacers.
15. A method of implanting a prosthetic device between two vertebrae of a vertebral column to stabilize same, the device comprising:
engaging one of the vertebrae with a spacer;
engaging the other vertebrae with another spacer; and connecting the spacers in a manner to permit relative movement between the spacers so that the distance between the spacers can vary to conform with the distance between the vertebrae and accommodate bending movements of the vertebral column.
16. The method of claim 15 wherein the step of connecting comprises extending a member from one of the spacers, extending a member from the other spacer, and mounting the members for relative slidable movement.
17. The method of claim 16 further comprising forming a cutout in one of the spacers to define two legs, and wherein one of the members extends from the base of the cutout so that the legs engage the other spacer when the device is in fully retracted position, to compress the legs.
18. The method of claim 16 wherein each of the members has teeth formed on one surface thereof, and further comprising engaging a gear with the teeth so that rotation of the gear causes relative movement between the plates and therefore between the spacers.
19. The method of claim 16 wherein one member has teeth formed on one surface thereof, and the other member has a flexible tab extending therefrom and adapted to engage the teeth to permit relative movement between the plates and therefore the spacers.
20. The method of claim 19 wherein the tab rides on the outer surface of the teeth to permit relative movement between the plates and therefore the spacers in a direction away from each other, and the tab flexes to prevent relative movement of the plates and therefore the spacer in a direction towards each other.
21. The method of claim 16 further comprising retaining one member to the other while permitting the relative movement.
CA002624986A 2005-10-27 2006-10-27 Intervertebral prosthetic device for spinal stabilization and method of implanting same Abandoned CA2624986A1 (en)

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US11/261,386 2005-10-27
US11/261,386 US8357181B2 (en) 2005-10-27 2005-10-27 Intervertebral prosthetic device for spinal stabilization and method of implanting same
PCT/US2006/060316 WO2007051172A1 (en) 2005-10-27 2006-10-27 Intervertebral prosthetic device for spinal stabilization and method of implanting same

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EP (1) EP1951160B1 (en)
JP (1) JP2009513287A (en)
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JP2009513287A (en) 2009-04-02
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KR20080056022A (en) 2008-06-19
EP1951160B1 (en) 2012-07-11
EP1951160A1 (en) 2008-08-06
US8357181B2 (en) 2013-01-22

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