摘要:
A system for the in situ formation of prostheses between adjacent vertebrae of a patient. The system includes a first mold adapted to be located in an intervertebral disc space between the adjacent vertebrae and at least a second mold adapted to be positioned between adjacent posterior elements. Lumens are fluidly coupled to each of the molds. One or more in situ curable biomaterials are delivered through the lumens to the molds. The at least partially cured biomaterial and the molds cooperate to maintain a desired alignment and spacing of the intervertebral disc space and the posterior elements.
摘要:
A nuclectomy method for creating a nuclear cavity in an annulus located in an intervertebral disc space and for preparing the nuclear cavity to receive an intervertebral prosthesis. The method involves identifying a plurality of regions in at least a portion of the nucleus. A sequence for removing the regions is also determined. At least one annulotomy is formed in the annulus along an annular axis to provide access to the nucleus. A guide system is positioned relative to the annulotomy. The guide system is configured to limit motion of at least one surgical tool relative to the guide system. A portion of the nucleus is removed from a first region using the surgical tool. At least one of the guide system and the surgical tool are configured to remove a portion of the nucleus from a second region. A portion of the nucleus is removed from a second region using the surgical tool.
摘要:
A nuclectomy method for creating a nuclear cavity in an annulus located in an intervertebral disc space and for preparing the nuclear cavity to receive an intervertebral prosthesis. The method involves identifying a plurality of regions in at least a portion of the nucleus. A sequence for removing the regions is also determined. At least one annulotomy is formed in the annulus along an annular axis to provide access to the nucleus. A guide system is positioned relative to the annulotomy. The guide system is configured to limit motion of at least one surgical tool relative to the guide system. A portion of the nucleus is removed from a first region using the surgical tool. At least one of the guide system and the surgical tool are configured to remove a portion of the nucleus from a second region. A portion of the nucleus is removed from a second region using the surgical tool.
摘要:
An assembly for the in situ formation of a prosthesis in an intervertebral disc space between adjacent vertebrae of a patient. At least one retention structure is located in the intervertebral disc space. A distal end of at least one lumen is located proximate the at least one retention structure. One or more in situ curable biomaterials are delivered to the intervertebral disc space through the first lumen and into engagement with the retention structure. The retention structure serves to retain at least a portion of the biomaterial in the intervertebral disc space by surface tension, adhesion, mechanical capture, friction, viscosity, and/or a variety of other mechanisms. The at least partially cured biomaterial and the at least one retention structure cooperate to comprise the prosthesis.
摘要:
An assembly for the in situ formation of a prosthesis in an intervertebral disc space between adjacent vertebrae of a patient. At least one retention structure is located in the intervertebral disc space. A distal end of at least one lumen is located proximate the at least one retention structure. One or more in situ curable biomaterials are delivered to the intervertebral disc space through the first lumen and into engagement with the retention structure. The retention structure serves to retain at least a portion of the biomaterial in the intervertebral disc space by surface tension, adhesion, mechanical capture, friction, viscosity, and/or a variety of other mechanisms. The at least partially cured biomaterial and the at least one retention structure cooperate to comprise the prosthesis.
摘要:
A chisel with U.V-shaped, saw tooth or other shaped opposing blades is used to form channels in adjacent vertebrae. The chisel has a projection extending from at least one of the top and bottom surfaces to limit depth of penetration into the vertebrae. A guide member may be attached to the forward tip of the chisel to guide the chisel into the disc space to uniformly chisel both adjacent vertebrae simultaneously to form a channel in the vertebrae. The so formed channels serve as sa guide for a second chisel having no guide member. The second chisel, which may be a box chisel, is used to complete the channels to the desired depth to receive an associated implant, typically of cortical bone. Other embodiments are disclosed in which a two step box chisel has a retractable guide member for initially guiding the chisel as it forms partial channels in the vertebrae disc space. The guide member is then retracted and the channels formed to the desired depth. The chisels include guide member pins which serve to both limit the extension and retraction of the guide member and also to serve to limit the depth of penetration of the chisel, physically and visually. The guide member may be retracted with a rotatable knob and a threaded engaged rod or with an axially displaceable pin and rod assembly attached to the guide member. A procedure for using the chisels is also disclosed.
摘要:
A plurality of differently configured bone spinal implants for insertion in a spine have a cylindrical bore for receiving an insertion head stud. A plurality of instruments are disclosed each of which have a first connection element which is either a male or female member such as e.g., a ball and socket, a cylinder and socket and so on for forming either a stationary or articulating interchangeable joint for a plurality of disc processing heads or implant insertion heads. The plurality of disc space processing heads or implant insertion heads have a complementary second joint member for interchangeable attachment to the first connection element. The implant insertion heads or disc processing heads have different configurations for different shaped implants. Different instrument insertion or disc processing heads such as implant inserters, impactors, rasps, distractors, curettes, rongeur, and so on are disclosed as being interchangeable with a common instrument in which articulating or fixed joints are provided the interchangeable heads.
摘要:
A multi-lumen mold is for the in situ formation of a prosthesis in an intervertebral disc space located between adjacent vertebrae of a patient. The multi-lumen mold a flexible mold, a first lumen, a second lumen and a curable biomaterial. The flexible mold is shaped to be positioned in the intervertebral disc space. The first lumen and the second lumen each have a distal end is fluidly coupled to the flexible mold at a first location and a second location, respectively. The first lumen is shaped to extend out through a first opening extending through one of the adjacent vertebrae when the mold is positioned in the intervertebral disc space. The curable biomaterial is delivered into the flexible mold through at least one of the first and second lumens. The first and second locations can optionally be located on generally opposite sides of the mold, on the same side of the mold, or a variety of other configurations. One or more securing members can be used to secure the mold in the intervertebral disc space. The securing members can engage with the annulus, the end plates, and/or another surface of a vertebrae.
摘要:
Various instrumentation, implants and methodology are disclosed for implanting bone implants in the TLIF approach. The implants are preferably cortical bone of various shapes. The instruments include chisels, rasps, trials, inserters, spreaders, adjustors, curettes, rongeurs, and impactors. The instruments have straight and bent shafts. The implants may have recesses or notches in their sides for receipt of a mating insertion instrument. Some of the implants have a threaded hole for receiving a mating threaded stud of an implant insertion instrument. The implants may have saw tooth vertebral gripping surfaces which are lordotic or parallel, may be C-shaped, multi-faceted or annular.
摘要:
A cortical bone implant is formed of two or more planks of bone which are connected with one or more offset pins. The pins may be right circular cylinders inserted into a corresponding offset bore which offset bends the inserted pin. The bending creates compression and tensile loads in the pin which loads creates friction compression forces on the planks connecting them to the pins by friction. The pins may have different shapes to form offset configurations in place of the offset bores for friction attachment to the planks. The implants may be formed of flat or L-shaped planks or bones formed into other shapes including interlocking arrangements. Processes and fixtures are disclosed for forming the pins, planks and implants. Various embodiments of the pins, planks, implants and processes are disclosed.