WO2001001895A1 - Reinforced expandable cage - Google Patents
Reinforced expandable cage Download PDFInfo
- Publication number
- WO2001001895A1 WO2001001895A1 PCT/IB2000/000971 IB0000971W WO0101895A1 WO 2001001895 A1 WO2001001895 A1 WO 2001001895A1 IB 0000971 W IB0000971 W IB 0000971W WO 0101895 A1 WO0101895 A1 WO 0101895A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- cage
- prosthesis
- accordance
- collapsed
- shape memory
- Prior art date
Links
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2/00—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
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
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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
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- 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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- A—HUMAN NECESSITIES
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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
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/442—Intervertebral or spinal discs, e.g. resilient
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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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
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
- A61F2002/3006—Properties of materials and coating materials
- A61F2002/30092—Properties of materials and coating materials using shape memory or superelastic materials, e.g. nitinol
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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
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- A61F2002/30153—Convex polygonal shapes rectangular
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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
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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
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- A61F2002/30291—Three-dimensional shapes spirally-coiled, i.e. having a 2D spiral cross-section
- A61F2002/30293—Cylindrical body made by spirally rolling up a sheet or a strip around itself
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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
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- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
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- A61F2210/0014—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol
- A61F2210/0023—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol operated at different temperatures whilst inside or touching the human body, heated or cooled by external energy source or cold supply
- A61F2210/0033—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol operated at different temperatures whilst inside or touching the human body, heated or cooled by external energy source or cold supply electrically, e.g. heated by resistor
- A61F2210/0038—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol operated at different temperatures whilst inside or touching the human body, heated or cooled by external energy source or cold supply electrically, e.g. heated by resistor electromagnetically
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2210/0014—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol
- A61F2210/0023—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol operated at different temperatures whilst inside or touching the human body, heated or cooled by external energy source or cold supply
- A61F2210/0042—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol operated at different temperatures whilst inside or touching the human body, heated or cooled by external energy source or cold supply using a fluid, e.g. circulating
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0017—Angular shapes
- A61F2230/0019—Angular shapes rectangular
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0028—Shapes in the form of latin or greek characters
- A61F2230/0058—X-shaped
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0063—Three-dimensional shapes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0063—Three-dimensional shapes
- A61F2230/0082—Three-dimensional shapes parallelepipedal
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0063—Three-dimensional shapes
- A61F2230/0091—Three-dimensional shapes helically-coiled or spirally-coiled, i.e. having a 2-D spiral cross-section
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00005—The prosthesis being constructed from a particular material
- A61F2310/00011—Metals or alloys
Definitions
- This application relates to the field of producing an improved spinal cage that is used in surgical procedures for inter-vertebra replacement.
- This invention relates to an improved method for a minimally invasive operation for spinal fusion. After a part or entire removal of the damaged inter-vertebra disc, the two adjacent vertebra bodies are brought to their normal distance by means of external tension force on the spine.
- the implant that is used exists from at least one expandable cage, eventually reinforced by a filler strip that can take up high loads.
- the cage has the tendency of expansion in a direction parallel to the length axis of the spine, hereafter called the Z-axis.
- a series of elastic or plastic hinges enable a large expansion ratio and they also provide the cage with a well-defined final geometry after expansion.
- the cage is made out of a single piece of shape memory material by means of cutting from a solid block.
- the cage has been heat-treated to give it the tendency to open up at body temperature by its superelastic properties, and therefore elastic energy will be stored in the cage as long as it is collapsed.
- a collapsed cage is brought into place, but the delivery of a cage with a lot of stored energy would cause a very uncontrolled and sudden shape change. Therefore an additional restraining means is attached to keep the cage in its collapsed state, even after leaving the leading end of the delivery tube. Once it is found to be in the desired location, the restraining means is gradually released, thus enabling the full expansion of the cage. After placement of the cage the restraining means is removed through the delivery tube. Eventually several small units can build up the cage. After placement of a first cage a second one can be placed in a different position or orientation to construct an assembled cage that provides more support to the vertebra bodies and gives stability along more directions.
- the hinges in the expanding cage have such a shape, that upon full expansion these hinges arrive in a locked end position, thus giving the cage a predictable and stable end shape.
- an additional reinforcement can be put into the hollow core of the cage.
- This reinforcement can have different shapes and can be made from several materials. Of course it is favorable if this reinforcement can be inserted through the same delivery tube.
- the reinforcement has an oblong geometry that transforms into a compact body that fills the cage in such a way that the axial stability is increased considerably and that the overall geometry of the filled cage enables a permanent spinal fusion.
- the strip can be made of any material and form that give it the capability to be delivered in an oblong shape and to roll up in the cage. It can be made of a strip with a curved cross section, like in the well-known measuring band that easily rolls up in a cylindrical housing. Such a strip, e.g. made of surgical steel, can be moved into the cage with a very low axial force.
- the strip can also be made from a shape memory material with superelastic or shape memory behavior.
- shape memory strip will curl as soon as it leaves the restraining delivery tube and in the latter case it can be heated above its transformation temperature by means of a small heating source in the distal tip of the delivery tube.
- friction in the delivery tube is lower than in the option with the superelastic strip, where the tendency to curl has to be opposed by the inner wall of the delivery tube over the entire length of the strip.
- Figure 1 a shows a side view of a collapsed cage and the restraining tool
- Figure lb shows the collapsed cage and restraining tool of fig. la in a delivery tube
- Figure lc shows a side view of two vertebra bodies and a cross section of the assembly of fig. lb;
- Figure 2a shows a side view of an expanded cage and a released restraining tool
- Figure 2b shows the expanded cage and released restraining tool of fig.2a outside of the delivery tube
- Figure 2c shows a side view of two unloaded vertebra bodies and a cross section of the assembly of fig.2b;
- Figure 3a shows a side view of an expanded cage and a removed restraining tool
- Figure 3b shows a loaded expanded cage with the hinges in locked position
- Figure 3c shows a side view of two loaded vertebra bodies and a cross section of the cage of fig.2b;
- Figure 4a shows two expanded cages that can build an assembled cage
- Figure 4b shows a top view of a vertebra, a first cage and a delivery tube just after placement of the cage;
- Figure 5 a shows two expanded cages after they have been assembled
- Figure 5b shows a top view of the vertebra, the assembled cage and the delivery tube just after placement of the second cage
- Figure 6a shows a top view of a vertebra and the insertion from the delivery tube of the reinforcing strip into the unloaded assembled cage
- Figure 6b shows the final situation of an assembled cage in the loaded state where the cage has been filled with a large amount of helical loops of the strip and the hinges of the cage are in their final, stable position;
- Figure 7a shows a loaded cage of a different type, which already has expanded into the Z-direction and has additional expansion capability by means of hinges in the X-Y-plane, but in this plane it is still unexpanded;
- Figure 7b shows the cage of fig.7a after expansion in the X-Y-plane
- Figure 7c shows the cage of fig.7b after it has been filled with the reinforcing strip
- Figure 8a shows a loaded cage of still another different type, which already has expanded into the Z-direction and has additional expansion capability by means of bending in the X-Y-plane, but in this plane it is still unexpanded;
- Figure 8b shows the cage of fig.8a after expansion in the X-Y-plane; and Figure 8c shows the cage of fig. ⁇ b after it has been filled with the reinforcing strip.
- Figure la shows a side view of a collapsed cage 1 with hinges 10,20,30 and 40 at the corners and hinges 50 and 60 in the middle of the left and right planes.
- the restraining tool 80 contains two components: a tension wire 70 with an end button or hook 71 that can be attached through a small hole near hinge 60 and an outer tube 81, that can be pushed against hinge 50 with its distal end 82. Hinges 50 and 60 can be pulled close towards each other, thus bringing and keeping the cage in its collapsed state.
- This constraint can be controlled at the proximal end of the constraining tool, by keeping tension on wire 70.
- the relative movement between proximal ends 72 of wire and 83 of the tube enables the operator to maintain the pull force FI or release the cage.
- Figure lb shows the collapsed cage 1 and restraining tool 80 of fig. la in a delivery tube 90, that has been drawn in a cut-open version for clarity.
- Figure lc shows a side view of two vertebra bodies 31 and 32 with the inter- vertebra disc-removed, thus creating a gap 32 that has to be filled.
- a tension force F2 on the spine maintains gap 33.
- the cage 1 of fig. la, drawn in cross section, is inserted through insertion tube 90.
- Figure 2a shows a side view of an expanded cage and a released restraining tool.
- the hinges have returned to their released position, because the operator has allowed the relative movement between hinges 50 and 60. This was made possible by a relative displacement of distal end 71 of wire 70 and distal end 82 of tube 81.
- the geometry of the distal end 71 and hole 61 in hinge 60 is chosen in such a way, that wire end 71 can easily be detached from the hinge. It can for example automatically release by the shape change of hole 61, caused by the elastic deformation of hinge 60.
- the geometry of the opposing hinge, surrounding hole 51 has to allow the removal of distal end 71 of the wire, but it also has take up the pressure force FI of tube 81.
- Figure 2b shows the expanded cage and released restraining tool of fig.2a outside of the delivery tube.
- the function of tube 81 is double: it is used as a restraining tool but also to push the cage out of delivery tube 90.
- Figure 2c shows a side view of two unloaded vertebra bodies and a cross section of the assembly of fig.2b. The cage has just been pushed out of the delivery tube and the restraining tool has been released. As long as force FI in the restraining tool is maintained, it is very easy to push the cage out of tube 90, while the friction is negligible than. Repositioning of the cage is very easy and precise in this way.
- Figure 3a shows a side view of an expanded cage and a removed restraining tool. By compression force F2 the cage slightly deforms, until the hinges reach their locked position. For hinges 10,20,30 and 40 the respective gaps 12,22,32 and 42 close at the outside, while for hinges 50 and 60 the gaps 52 and 62 close at the inside.
- Figure 3b shows a perspective view of a loaded expanded cage with the hinges in locked position. The holes 51 and 61 can also be seen.
- Figure 3c shows a side view of two loaded vertebra bodies and a cross section of the cage of fig.2b.
- the removal of tension force F2 at the spine has lead to the loading of the cage.
- Figure 4a shows two expanded cages 4 and 5, which can build an assembled cage. If cage 4 is already expanded, cage 5 must first be collapsed and then it can be inserted perpendicular to the direction of delivery of cage 4.
- Cage 4 has special surfaces 45 and 46 and cage 5 has surfaces 55 and 56. The geometry of these surfaces is made so, that the two cages fit tightly together by the interaction between grooves 45 with 55 and 46 with 56 respectively.
- Figure 4b shows a top view of vertebra 32, a first cage 4 and a delivery tube just after placement of the first cage.
- Figure 5 a shows two expanded cages 4 and 5 after they have been assembled.
- Figure 5b shows a top view of the vertebra, the assembled cage and the delivery tube just after placement of the second cage. The position of the delivery tube is different than for placement of the first cage.
- Figure 6a shows a top view of a vertebra and the insertion from the delivery tube of the reinforcing strip 91 into the unloaded assembled cage. The distal end of strip 91 starts to roll up in the cavity of the cage and the rest of the strip can be pushed forward until the whole strip is brought into the cage. As long as the internal height of the cage is slightly larger than the width of the strip, it can easily be moved.
- the strip can be made of any material and form that give it the capability to be delivered in an oblong shape and to roll up in the cage. It can be made of a strip with a curved cross section, like in the well-known measuring band that easily rolls up in a cylindrical housing. Such a strip, e.g. made of surgical steel, can be moved into the cage with a very low axial force.
- the strip can also be made from a shape memory material with superelastic or shape memory behavior.
- the shape memory strip will curl as soon as it leaves the restraining delivery tube and in the latter case it can be heated above its transformation temperature by means of a small heating source in the distal tip of the delivery tube.
- the heating source can be of any type, comprising radiation,warm liquid, a Peltier element and resistance heating.
- Figure 6b shows the final situation of an assembled cage in the loaded state. The cage has been filled with a large amount of spiral loops of the strip.
- FIG. 7a shows a cage 7 of a different type, which already has expanded into the Z- direction. It has additional expansion capability by means of hinges in the X-Y-plane, but in this plane it is still unexpanded.
- the top surface of this cage has two hinges 73 and 74,that are deformed to a closed position, while hinges 75 and 76 are deformed to an open position.
- the separate parts 77 and 78 of the top surface will move apart to relieve elastic energy.
- the shape of the hinges 73 to 76 enables a rotation of non-deforming surface sections 77 and 78.
- Figure 7b shows the cage of fig.7a after expansion in the X-Y-plane.
- Figure 7c shows the cage of fig.7b after it has been filled with the reinforcing strip. It may be clear that such a single-piece cage can be inserted through only one incision, while for the assembled cage of figs. 4,5 and 6 more incisions are used.
- the placement of cage 7 may also have some drawbacks.
- the construction of a restraining tool that keeps the cage under constraint in three main directions is more complicated than for the cage that only expands in Z-direction.
- Figure 8a shows a cage 8 of still another different type, which already has expanded into the Z-direction. It has additional expansion capability by means of bending in the X-Y- plane, but in this plane it is still unexpanded. Sections 87 and 88 of the top surface are still parallel, but without restraint they have the tendency to bend in the X-Y-surface. In contrary to cage 7 the parts 87 and 88 deform, where in cage 7 the hinges take up the strain.
- Figure 8b shows the cage of fig.8a after expansion in the X-Y-plane, in the fully released state.
- Figure 8c shows the cage of fig.8b after it has been filled with the reinforcing strip.
- a cage, like cage 8 of fig. 8c can also have some hinges like the cage of fig. 7 has, so the strains can be divided between bending sections like 87 and 88 and hinges like 74 to 76.
- the cage can be made of any material and form that give it the capability to be delivered in an collapsed shape and to expand when it is in place. It can be made from any metal, but preferably of shape memory material with superelastic or shape memory behavior. This is because of the high strains that these materials can take up without failure. In the first case the superelastic shape memory cage will expand as soon as it is released.
- the reinforcement has an oblong geometry that transforms into a compact body that fills the cage in such a way that the axial stability is increased considerably and that the overall geometry of the filled cage enables a permanent spinal fusion.
- the material of the cage can deform pure elastically or also partly plastically.
- Another object of the invention is that the reinforcing strip is not necessary for special cases, by a proper dimensioning of the hinges and the cage-wall or by stronger materials for the cage.
- the cage not only works with locking hinges, but also without the end stops.
Abstract
Description
Claims
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
AU57012/00A AU5701200A (en) | 1999-07-02 | 2000-06-30 | Reinforced expandable cage |
US09/797,927 US6488710B2 (en) | 1999-07-02 | 2001-03-02 | Reinforced expandable cage and method of deploying |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US14225299P | 1999-07-02 | 1999-07-02 | |
US60/142,252 | 1999-07-02 |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US09/797,927 Continuation-In-Part US6488710B2 (en) | 1999-07-02 | 2001-03-02 | Reinforced expandable cage and method of deploying |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2001001895A1 true WO2001001895A1 (en) | 2001-01-11 |
Family
ID=22499178
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/IB2000/000971 WO2001001895A1 (en) | 1999-07-02 | 2000-06-30 | Reinforced expandable cage |
Country Status (3)
Country | Link |
---|---|
US (1) | US6488710B2 (en) |
AU (1) | AU5701200A (en) |
WO (1) | WO2001001895A1 (en) |
Cited By (85)
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WO2002076351A1 (en) | 2001-03-27 | 2002-10-03 | Glenn Bradley J | Intervertebral space implant for use in spinal fusion procedures |
WO2004084768A2 (en) | 2003-03-20 | 2004-10-07 | Medtronic Inc. | Expandable spherical spinal implant |
WO2004103226A2 (en) * | 2003-05-21 | 2004-12-02 | Aesculap Ag & Co. Kg | Vertebral column implant |
EP1506753A1 (en) * | 2003-07-23 | 2005-02-16 | Epi. L.P. | Expandable spinal implant |
FR2871367A1 (en) * | 2004-06-09 | 2005-12-16 | Ceravic Soc Par Actions Simpli | Osseous prosthetic implant for treating e.g. osteoporosis, has predetermined expansion value adjusting unit with material veil disposed between supports and corresponding plates and having thickness to control expansion of implant |
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US7678148B2 (en) | 2004-07-23 | 2010-03-16 | Warsaw Orthopedic, Inc. | Expandable spinal implant having interlocking geometry for structural support |
US7824431B2 (en) | 2006-12-29 | 2010-11-02 | Providence Medical Technology, Inc. | Cervical distraction method |
US8192759B2 (en) | 2004-07-12 | 2012-06-05 | Isto Technologies, Inc. | Matrix made of polyester polymers entangled with hyaluronic polymers useful for supporting tissue repair |
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US8444968B2 (en) | 2005-12-07 | 2013-05-21 | Isto Technologies, Inc. | Cartilage repair methods |
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US8512347B2 (en) | 2008-06-06 | 2013-08-20 | Providence Medical Technology, Inc. | Cervical distraction/implant delivery device |
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US8579977B2 (en) | 2008-04-24 | 2013-11-12 | Henry F. Fabian | Spine surgery method and inserter |
US8986386B2 (en) | 2009-03-12 | 2015-03-24 | Vexim Sas | Apparatus for bone restoration of the spine and methods of use |
US9005288B2 (en) | 2008-01-09 | 2015-04-14 | Providence Medical Techonlogy, Inc. | Methods and apparatus for accessing and treating the facet joint |
USD732667S1 (en) | 2012-10-23 | 2015-06-23 | Providence Medical Technology, Inc. | Cage spinal implant |
USD745156S1 (en) | 2012-10-23 | 2015-12-08 | Providence Medical Technology, Inc. | Spinal implant |
US9271843B2 (en) | 2005-09-27 | 2016-03-01 | Henry F. Fabian | Spine surgery method and implant |
US9295562B2 (en) | 2008-01-17 | 2016-03-29 | DePuy Synthes Products, Inc. | Expandable intervertebral implant and associated method of manufacturing the same |
US9320615B2 (en) | 2010-06-29 | 2016-04-26 | DePuy Synthes Products, Inc. | Distractible intervertebral implant |
US9333086B2 (en) | 2008-06-06 | 2016-05-10 | Providence Medical Technology, Inc. | Spinal facet cage implant |
US9381049B2 (en) | 2008-06-06 | 2016-07-05 | Providence Medical Technology, Inc. | Composite spinal facet implant with textured surfaces |
US9402737B2 (en) | 2007-06-26 | 2016-08-02 | DePuy Synthes Products, Inc. | Highly lordosed fusion cage |
US9414934B2 (en) | 2008-04-05 | 2016-08-16 | DePuy Synthes Products, Inc. | Expandable intervertebral implant |
US9414933B2 (en) | 2011-04-07 | 2016-08-16 | Vexim Sa | Expandable orthopedic device |
EP3103417A1 (en) * | 2015-06-10 | 2016-12-14 | Biedermann Technologies GmbH & Co. KG | Intervertebral implant and system of an intervertebral implant and an instrument for inserting the intervertebral implant |
US9526620B2 (en) | 2009-03-30 | 2016-12-27 | DePuy Synthes Products, Inc. | Zero profile spinal fusion cage |
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US6488710B2 (en) | 2002-12-03 |
US20010032020A1 (en) | 2001-10-18 |
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