US20040068320A1 - Prosthetic disc and vertebral body replacement device having pyrolytic carbon bearing members - Google Patents

Abstract

A spinal motion device for implanting in the spine as a replacement for the natural disc, to permit motion between adjacent vertebral bodies or as a vertebral body replacement that permits motion at its ends. The spinal motion device comprises a composite structure formed by a body having at least one bearing member, made from a biocompatible material such as pyrolytic carbon, attached to a support surface thereof.

Description

FIELD OF THE INVENTION
• The present invention relates to prosthetic devices. More particularly, the present invention relates to a spinal motion device for implanting in the disc space of the spine or as an artificial bone or bone segment, wherein the device has one or more bearing members made of pyrolytic carbon.[0001]
BACKGROUND OF THE INVENTION
• A large segment of the population have chronic back and neck problems which cause pain and disability. The cause of the pain is often due to irritation of nerves, nerve roots or the spinal cord itself. This irritation can be caused by both chemical and mechanical processes. For example, nuclear material from the disc has been shown to irritate nerve cells. Also, pressure, resulting from contact with adjacent tissue can also be applied directly and induce pain in nerve tissues. A second cause of pain is believed to be degeneration of the disc material that lies between two adjacent vertebrae. Degeneration can result in pain directly, or it can lead to abnormal motions which result in pain.[0002]
• Surgical techniques have been developed to eliminate the cause of the persistent pain either by clearing space around the nerves, nerve roots or spinal cord (so called decompressions) or by removing the disc and filling the space. The space filler can be a device that prevents motion (fusion) or can be a device that permits motion, preferably in a physiologic way. In some decompressive cases, it is necessary to remove part of the vertebral body and the adjacent discs.[0003]
• Known prosthetic discs are typically designed to allow for some motion between the adjacent vertebrae. However, these known devices typically require resection of some limited amount of bone so as to obtain fixation. This is problematic for both the cases of true disc degeneration, and for many decompressive cases. In true disc degeneration, the disc is the source of pain and its removal is required, not the bone of the adjacent vertebral bodies. Removal of the bone, through a variety of instruments, can be surgically difficult and typically removes the densest cancellous bone in the vertebral body, thereby weakening the reconstruction. In decompressive cases where a portion of the vertebral body must be removed, the existing prosthetic devices are not designed to fit the void space created by the decompression. Devices that fit the space do not permit motion between the replaced vertebral body and adjacent vertebral bodies.[0004]
• Accordingly, a spinal motion device is needed which permits either replacement of the disc without bone removal or that permits partial resection of the bone and still restores motion.[0005]
SUMMARY OF THE INVENTION
• In summary, the present invention is a spinal motion device for implanting in the spine as a replacement for the natural disc, to permit motion between the two adjacent vertebral bodies or as a vertebral body replacement that permits motion at its ends. The device comprises a body having opposing first and second surfaces, and at least a first bearing member attached to the first support surface.[0006]
• In one aspect of the invention, the device further comprises a second bearing member attached to the second surface.[0007]
• In a further aspect of the invention, one or both of the bearing members are made of pyrolytic carbon.[0008]
• In another aspect of the present invention, the device can be made in different sizes by changing the distance between the support surfaces to allow the device to function as a disc replacement or as a vertebral body replacement.[0009]
BRIEF DESCRIPTION OF THE DRAWINGS
• FIG. 1 is a side elevational view of a motion device according to a first illustrative embodiment of the present invention.[0010]
• FIG. 2 is a plan view of the motion device of FIG. 1.[0011]
• FIG. 3 is an anterior end view of the motion device of FIG. 1.[0012]
• FIGS.[0013]4A-4C are side elevational views of three different types of mechanical attachment arrangements that may be utilized in the motion device of the present invention.
• FIG. 5 is a side elevational view of a motion device according to a second illustrative embodiment of the present invention.[0014]
• FIG. 6 is an anterior end view of the motion device of FIG. 5.[0015]
• FIG. 7 is an exploded perspective view of a motion device according to a third illustrative embodiment of the present invention.[0016]
• FIG. 8 is an exploded side elevational view of the motion device of FIG. 7.[0017]
• FIG. 9 is an exploded anterior elevational view of the motion device of FIG. 7.[0018]
• The drawings use like numerals to identify like elements. It should be understood that the drawings are for purposes of illustrating the concepts of the invention and are not necessarily to scale.[0019]
DETAILED DESCRIPTION OF THE INVENTION
• FIGS.[0020]1-3 collectively show a spinal motion device10 according to an illustrative embodiment of the present invention. The motion device10 has a composite structure comprised of aporous body12 and at least a one bearingmember18. The motion device10 typically has a wedge-shape, side profile that tapers down from ananterior end face30 toward aposterior end face32. The embodiment of the device10 shown in FIGS.1-3, has a symmetrical taper, however, the device10 may be also be asymmetrically tapered. The motion device10 is intended as a replacement for the natural disc, to permit motion between the two adjacent vertebral bodies or as a vertebral body replacement that permits motion at its ends.
• The[0021]body12 of the device10 may symmetrically or asymmetrically taper down from ananterior end13 toward aposterior end15. The angle θ₁of this taper may be 6.8 degrees as measured between a firstbearing support surface14 and a second bearingsupport surface14′ of thebody12. The first bearingmember18 is attached to the firstbearing support surface14 of thebody12 and, in the embodiment of FIGS.1-3, a second bearingmember18′ is attached to the secondbearing support surface14′ of thebody12.
• Alternatively, the[0022]porous body12 of the motion device10 may have support surfaces that are generally parallel and bearing members constructed to provide the device with a posteriorly directed taper. In applications relating, for example, to the thoracic spine, the motion device may not to have a posteriorly directed taper or may be constructed such that the device has an anteriorly directed taper.
• The[0023]porous body12 is preferably made from a porous material. One example is the porous metal material available under the tradename HEDROCEL® from the Implex Corporation, the assignee herein. This material mimics the microstructure of natural cancellous bone and is described in detail in U.S. Pat. No. 5,282,861 entitled “OPEN CELL TANTALUM STRUCTURES FOR CANCELLOUS BONE IMPLANTS AND CELL AND TISSUE RECEPTORS” issued to R. B. Kaplan, the entire disclosure of which is incorporated herein by reference. This material consists of a three dimensional network of pores which form continuous, uniform channels with no dead ends. The material has a much lower modulus than a pure metallic implant, and has a significantly better pore size and shape distribution than prior art materials. This intricate network of interconnected pores provides optimal permeability and a high surface area to encourage tissue ingrowth, vascularization, and deposition of new bone, while also allowing for the interdigitation of bone cement for those situations that require it.
• The bearing[0024]members18,18′ can be made from a biocompatible material or combination of biocompatible materials. Such materials may include biocompatible metals, metal alloys, ceramics, and polymers. Preferably, the bearingmembers18,18′ are made from a graphite and pyrolytic carbon composite (pyrolytic carbon). Pyrolytic carbon is preferred due to its excellent capabilities to articulate against cartilage (see, for example, “Wear Characteristics Of The Canine Acetabulum Against Different Femoral Prostheses” Cook et al.,The Journal Of Bone And Joint Surgery, vol. 71-B, No. 2, pp.189-197, March 1989). Pyrolytic carbon is typically made by machining a graphite substrate to have a geometry similar to, but smaller than, the desired final size of the part. The graphite is then placed in a fluidized or rotating bed reactor. The bed and graphite parts are heated to between 1,200 and 1,500 degrees C. and then a hydrocarbon is introduced in the bed. The hydrocarbon undergoes pyrolysis and pyrolytic carbon is deposited on the substrate. Processes for making pyrolytic carbon are well known in the art. For example, a process for making pyrolytic carbon is described in detail in U.S. Pat. No. 6,410,087.
• As shown in FIGS. 1 and 2, the[0025]body12 generally forms the anterior and posterior end faces30 and32 of the motion device10. Theposterior end face32 is planar, and theanterior end face30 is convexly curved, to substantially match the shape of the anterior portion of the outer edge of the vertebra. Thebody12 also forms a planar,first side face34 and an opposed, planar,second side face36 that convergingly extend from the anterior end face30 to theposterior end face32, such that each of the side faces34,36 is disposed at angle θ₂that may be about 15 degrees as measured from imaginary line A, which is parallel to the center line C_Lof the device10. The angulation prevents the motion device from moving posteriorly into the spinal cord. Further, when the device10 is used as a vertebral body replacement, the planar side faces34,36 allow the surgeon to easily cut the bone flat using an oscillating saw or osteotome or similar instrument.
• For cervical replacement applications, the width W of the device[0026]10 as measured between the junctions of the side faces34,36 and theanterior end face30 may range between about 0.433 inches and about 0.551 inches. The length L of the device10 as measured between anterior face and the posterior face at the center line C_Lof the device10, may range between 0.39 inches and about 0.55 inches. The thickness T_Dof the device10 (FIG. 3) as measured at theanterior end face30, may range between 0.118 inches and 1.50 inches. The convexly curvedanterior end face30 may have a radius R of about 4.33 inches. One of ordinary skill in the art will of course recognize that the device10 can be constructed in a different shapes and dimensions for other applications.
• Referring still to FIGS.[0027]1-3, the bearingmembers18,18′ of the motion device10 define a pair of spaced apart, bearing surfaces38,38′ which extend between theanterior face30 and theposterior face32, and between thefirst side face34 and thesecond side face36. The bearingmembers18,18′ may each have a profile, which when viewed in plan, is substantially identical to the plan profile of thebody12. The bearing surfaces38,38′ may convexly curve in an elliptical and/or spherical manner in any one or all of a plurality of directions. In the embodiment shown in FIGS.1-3, the bearing surfaces38,38′ each convexly curves in an elliptical manner from theanterior face30 to theposterior face32, and convexly curves in an elliptical manner from thefirst side face34 to thesecond side face36. One of ordinary skill in the art will of course appreciate that one or both bearingmembers18 may be formed with other bearing surface configurations including but not limited to concavely curved bearing surfaces and planar bearing surfaces.
• Attachment of the bearing[0028]members18,18′ to thebody12 can be accomplished using a variety of means. For example, mechanical means in the form of a post and hole press-fit arrangement may be utilized to attach the bearingmembers18,18′ to thebody12. As shown in FIG. 4A, the post and hole arrangement may include at least onehole16,16′ provided in each of the support surfaces14,14′ of thebody12 and at least onepost21,21′ extending from each of the body mating surfaces20,20′ of the bearingmembers18,18′. Theholes16,16′ and theposts21,21′ may be dimensioned in a manner which creates a press-fit therebetween, thus mechanically retaining the bearingmembers18,18′ to thebody12.
• Alternatively, as shown in FIG. 4B, the post and hole arrangement may include at least one[0029]hole22,22′ in each of the mating surfaces20,20′ of the bearingmembers18,18′ and at least onepost17,17′ extending from each of the support surfaces14,14′ of thebody12.
• In addition, as shown in FIG. 4C, the post and hole arrangement may include at least one[0030]hole16,16′ in each of the support surfaces14,14′ of thebody12 and at least onepost17,17′ extending from each of the support surfaces14,14′ of thebody12, and at least onehole22,22′ in each of the mating surfaces20,20′ of the bearingmembers18,18′ and at least onepost21,21′ extending from each of the mating surfaces20,20′ of the bearingmembers18,18′.
• To further ensure attachment of the bearing[0031]members18,18′ to thebody12, a grout in the form of a cement or a resilient polymer may be applied to the support surfaces14,14′ of thebody12 and the mating surfaces20,20′ of the bearingmembers18,18′. The grout may also be applied to the surfaces of theholes16,16′,22,22′, and the surfaces of theposts17,17′,21,21′. Suitable grout materials include polyethylene, polymethylmethacrylate (PMMA), polyurethanes, polycarbonate urethanes, sand resilient polymers such as hydrogels, silicones, urethanes and siloxane-urethanes. When grout is utilized, theholes16,16′,22,22′, and theposts17,17′,21,21′ are dimensioned in a manner which create a gap therebetween, the gap being filled by the grout material, thus mechanically retaining the bearingmembers18,18′ to thebody12. One advantage of using a resilient polymer grout between the bearingmembers18,18′ and thebody12 is that it provides a slight cushioning effect between the bearingmembers18,18′ and thebody12, which enables the device10 to simulate the compliance of the normal disc.
• FIGS. 5 and 6 collectively show a motion device[0032]100 according to a second illustrative embodiment of the present invention. In this embodiment, the bearing member denoted bynumeral118 defines a concave bearing surface138 (the other bearingmember18 is substantially identical to the previous embodiment of FIGS.1-3 with a convex bearing surface38). Theconvex bearing surface38 and theconcave bearing surface138 both extend between theanterior face30 and theposterior face32, and between thefirst side face34 and thesecond side face36. Theconvex bearing surface38 may convexly curve in an elliptical and/or spherical manner as described earlier, and theconcave bearing surface138′ may concavely curve in an elliptical and/or spherical manner. The bearingmembers18 and118 are also preferably made from the earlier described graphite and pyrolytic carbon composite material and may be attached to theporous body12 using the methods described above.
• As shown in FIGS. 5 and 6, the[0033]convex bearing surface38 convexly curves in an elliptical manner from theanterior face30 to theposterior face32, and convexly curves in an elliptical manner from thefirst side face34 to thesecond side face36. Theconcave bearing surface138 concavely curves in an elliptical manner from theanterior face30 to theposterior face32, and concavely curves in an elliptical manner from thefirst side face34 to thesecond side face36. As in the first embodiment, because theporous body12 tapers down from theanterior end13 toward theposterior end15, the motion device100 has a wedge-shape, side profile that tapers down from theanterior face30 toward theposterior face32.
• The motion device[0034]100 shown in FIGS. 5 and 6 can be used as a prosthetic device to replace the disc in cases where the endplate of one of the vertebral bodies is concave and the other is convex. Additionally, as a vertebral body replacement, the motion device shown in FIGS. 5 and 6 can be used in combination with the motion device shown in FIGS.1-3 to replace two vertebral bodies, and to permit pyrolytic carbon on pyrolytic carbon articulation between the two vertebral body replacement devices.
• FIGS.[0035]7-9 collectively show amotion device200 according to a third illustrative embodiment of the present invention. Thismotion device200 is intended for use in the lumbar spine as a disc replacement. Theporous body210 ofmotion device200 may be configured with a short axis As that extends in an anterior-posterior direction, and a long axis AL that extends perpendicular to the short axis A_S. Thebody210 may symmetrically or asymmetrically taper down from theanterior end212 toward the posterior end213. Asingle bearing member220, preferably made from the earlier described graphite and pyrolytic carbon composite material, attaches to bearingsupport surface214 of thebody212 as described previously. The bearingmember220 may have a profile, which when viewed in plan, is substantially identical to the plan profile of thebody210. The bearingmember220 further includes abearing surface224 that may convexly curve in an elliptical and/or spherical manner in any one or all of a plurality of directions. One of ordinary skill in the art will of course appreciate that the bearingmember220 may be formed with other bearing surface configurations including but not limited to concavely curved bearing surfaces and planar bearing surfaces.
• Still referring to FIGS.[0036]7-9, the bearingsupport surface214 and opposingsurface215 of thebody212 are separated by convexly curved side surfaces216,217, which extend between truncated posterior end face218 and convexanterior end face219. The convexly curved shape of the side faces216,217 andanterior end face219 mimic the overall of the vertebral bodies. One ormore apertures222 are provided in the anteriorconvex end face219 for enabling thedevice200 to be inserted in the lumbar spine with a conventional insertion instrument (not shown).
• While the foregoing invention has been described with reference to the above embodiments, various modifications and changes can be made without departing from the spirit of the invention. Accordingly, all such modifications and changes are considered to be within the scope of the appended claims.[0037]

Claims (24)

What is claimed is:

1. A spinal motion device comprising:

a body having opposing first and second surfaces; and

at least a first bearing member attached to the first surface.

2. The device ofclaim 1, wherein the body is porous.

3. The device according toclaim 1, wherein the at least first bearing member is made from pyrolytic carbon.

4. The device ofclaim 1, wherein the support surfaces are separated by side surfaces which extend between a posterior end of the body and an anterior end of the body.

5. The device according toclaim 1, wherein the support surfaces taper posteriorly such that the body has a thickness that decreases from the anterior end to the posterior end.

6. The device according toclaim 1, wherein the at least first bearing member defines a convex bearing surface.

7. The device according toclaim 1, wherein the at least first bearing member defines a bearing surface that convexly curves in an elliptical manner.

8. The device according toclaim 1, further comprising a second bearing member attached to the second surface.

9. The device according toclaim 8, wherein the bearing members are made from pyrolytic carbon.

10. The device according toclaim 8, wherein the first bearing member defines a convex bearing surface.

11. The device according toclaim 10, wherein the second bearing member defines a concave bearing surface.

12. The device according toclaim 1, further comprising a post and hole arrangement associated with the at least first bearing member and the body for attaching the bearing member to the first surface of the body.

13. The device according toclaim 12, further comprising a grout for aiding the post and hole arrangement in attaching the at least first bearing member to the first surface of the body.

14. The device according toclaim 13, wherein the grout comprises one of a cement and a polymer.

15. The device according toclaim 14, wherein the polymer is selected from the group consisting of polyethylene, urethane, silicone, siloxane-urethane, polyurethane, polycarbonate urethane, and hydrogel.

16. The device according toclaim 14, wherein the polymer is resilient.

17. The device according toclaim 1, further comprising a grout for attaching the at least first bearing member to the first surface of the body.

18. The device according toclaim 17, wherein the grout comprises one of a cement and a polymer.

19. The device according toclaim 18, wherein the polymer is selected from the group consisting of polyethylene, urethane, silicone, siloxane-urethane, polyurethane, polycarbonate urethane, and hydrogel.

20. The device according toclaim 18, wherein the polymer is resilient.

21. The device according toclaim 1, wherein the device is useable as a disc replacement or as a vertebral body replacement.

22. The device according toclaim 1, wherein the at least first bearing member defines a concave bearing surface.

23. A spinal motion device for implanting in a spine, the device comprising:

a porous body having opposing first and second surfaces;

a first bearing member made from a biocompatible material selected from the group consisting of biocompatible metals, metal alloys, ceramics, polymers, pyrolytic carbon and combinations thereof; and

attaching means for attaching the first bearing member to the first surface.

24. The device according toclaim 23, further comprising:

a second bearing member made from a biocompatible material selected from the group consisting of biocompatible metals, metal alloys, ceramics, polymers, pyrolytic carbon, and combinations thereof; and

attaching means for attaching the second bearing member to the second surface.

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