# US 2004/0176852 A1 · Instrumentation and methods for use in implanting a cervical disc replacement device

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- Number: US 2004/0176852 A1
- Document ID: US20040176852A1
- Status: Published application
- Kind: A1
- Application number: 10/781,484
- Filed: 2004-05-06
- Published: 2004-09-09
- Earliest claimed: 2003-03-06
- Assignees: SpineCore, Inc.
- Inventors: Rafail Zubok; Michael W. Dudasik; Joseph P. Errico
- Web page: https://patentgrep.com/patent/US20040176852A1

## CPC

- A61F 2/4425: {made of articulated components}
- A61B 17/7059: {Cortical plates (A61B17/7007, A61B17/7058 take precedence)}
- A61B 17/8033: {having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers}
- A61B 17/8042: {the additional component being a cover over the screw head}
- A61B 17/8625: {Shanks, i.e. parts contacting bone tissue}
- A61F 2/442: {Intervertebral or spinal discs, e.g. resilient (non-disc-shaped intervertebral inflatable pockets A61F2/441; non-disc-shaped intervertebral fusion implants A61F2/4455)}
- A61F 2/4611: {of spinal prostheses}
- A61F 2/4684: {Trial or dummy prostheses}
- A61B 17/1728: {for holes for bone plates or plate screws}
- A61B 17/866: {Material or manufacture}
- A61F 2002/30301: {saddle-shaped}
- A61F 2002/30578: {having apertures, e.g. for receiving fixation screws}
- A61F 2002/30616: {Sets comprising a plurality of prosthetic parts of different sizes or orientations}
- A61F 2002/3065: {Details of the ball-shaped head}
- A61F 2002/30841: {Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes}
- A61F 2002/30843: {Pyramidally-shaped}
- A61F 2002/449: {comprising multiple spinal implants located in different intervertebral spaces or in different vertebrae}
- A61F 2002/4625: {with relative movement between parts of the instrument during use}
- A61F 2002/4627: {with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument}
- A61F 2002/4628: {with linear motion along or rotating motion about an axis transverse to the instrument axis or to the implantation direction, e.g. clamping}
- A61F 2002/4629: {connected to the endoprosthesis or implant via a threaded connection}
- A61F 2230/0065: toroidal, e.g. ring-shaped, doughnut-shaped
- A61F 2230/0095: Saddle-shaped
- Y10S 623/908: Bone
- Y10S 623/911: Bone
- 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 (dental prosthetics A61C)
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- Y10S: TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS

## Abstract

Instrumentation for implanting an intervertebral disc replacement device includes an insertion plate, comprising a base, a first mounting element of the base operable to engage a first member of an intervertebral disc replacement device and a first intermediate mounting element of the base operable to engage a first intermediate member of the intervertebral disc replacement device, wherein the first and first intermediate mounting elements are offset with respect to one another relative to a longitudinally directed axis of the base running substantially parallel to a longitudinal axis of a spinal column, and the first and first intermediate mounting elements cooperate to engage and orient the first and first intermediate members of the intervertebral disc replacement device for simultaneous insertion into an intervertebral disc space of the spinal column. The invention also comprising a method for replacing at least a portion of at least two intervertebral discs in a spinal column, comprising removing respective portions of the intervertebral discs from the spinal column, simultaneously inserting first and first intermediate members of an intervertebral disc replacement device into a first intervertebral disc space of the spinal column, and simultaneously inserting second and second intermediate members of an intervertebral disc replacement device into a second intervertebral disc space of the spinal column.

## Claims

### Claim 1

An intervertebral disc replacement device for replacing at least portions of at least two intervertebral discs in a spinal column, comprising:
a first member having a first vertebral contact surface and a first flange including at least one through hole for receiving a bone screw for fastening the first member to a first vertebral bone of a spinal column, and at least one fastener hole; and
a first intermediate member having a first intermediate vertebral contact surface and a first intermediate flange including at least one fastener hole, the first intermediate vertebral contact surface being operable to couple to an endplate of an intermediate vertebral bone adjacent to the first vertebral bone of the spinal column,
wherein the fastener holes of the first flange and the first intermediate flange are sized and positioned to receive at least one fastener operable to couple a first insertion plate thereto such that the first member and the first intermediate member are oriented in registration with one another for simultaneous insertion into a first intervertebral disc space defined by respective endplates of the first and intermediate vertebral bones.

### Claim 2 (depends on 1)

The intervertebral disc replacement device of claim 1, further comprising:
a second intermediate member having a second intermediate vertebral contact surface and a second intermediate flange including at least one fastener hole, the second intermediate vertebral contact surface being operable to couple to an opposite endplate of the intermediate vertebral bone of the spinal column; and
a second member having a second vertebral contact surface and a second flange including at least one through hole for receiving a bone screw for fastening the second member to a second vertebral bone adjacent to the intermediate vertebral bone of the spinal column,
wherein the fastener holes of the second flange and the second intermediate flange are sized and positioned to receive at least one fastener operable to couple a second insertion plate thereto such that the second member and the second intermediate member are oriented in registration with one another for simultaneous insertion into a second intervertebral disc space adjacent to the first intervertebral disc space and defined by respective endplates of the intermediate and second vertebral bones.

### Claim 3 (depends on 2)

The intervertebral disc replacement device of claim 2, wherein the first and second insertion plates cooperate to orient the through holes of the first and second flanges of the intervertebral disc replacement device to have a configuration substantially similar to that of a spinal fusion plate when viewed from at least an anterior vantage point.

### Claim 4 (depends on 2)

The intervertebral disc replacement device of claim 2, wherein at least one of:
the first insertion plate cooperates to engage and orient the first member and the first intermediate member for simultaneous insertion into the first intervertebral disc space; and
the second insertion plate cooperates to engage and orient the second member and the second intermediate member for simultaneous insertion into the second intervertebral disc space.

### Claim 5 (depends on 4)

The intervertebral disc replacement device of claim 4, wherein:
the first insertion plate includes a base, a first mounting element of the base operable to engage the first member of the intervertebral disc replacement device, and a first intermediate mounting element of the base operable to engage the first intermediate member of the intervertebral disc replacement device;
the second insertion plate includes a base, a second mounting element of the base operable to engage a second member of the intervertebral disc replacement device, and a second intermediate mounting element of the base operable to engage the second intermediate member of the intervertebral disc replacement device; and
the first and first intermediate mounting elements are offset with respect to one another and the second and second intermediate mounting elements are offset with respect to one another relative to a longitudinally directed axis of the bases running substantially parallel to a longitudinal axis of a spinal column such that the first and second intermediate mounting elements do not interfere with one another when the first and first intermediate members of the intervertebral disc replacement device are positioned in the first intervertebral disc space of the spinal column and the second and second intermediate members of the intervertebral disc replacement device are positioned in the second intervertebral disc space of the spinal column.

### Claim 6 (depends on 5)

The intervertebral disc replacement device of claim 5, wherein the first intermediate mounting element and the second intermediate mounting element are offset in opposite directions with respect to the longitudinally directed axis of the bases.

### Claim 7

An insertion plate, comprising:
a base;
a first mounting element of the base operable to engage a first member of an intervertebral disc replacement device; and
a first intermediate mounting element of the base operable to engage a first intermediate member of the intervertebral disc replacement device,
wherein the first and first intermediate mounting elements are offset with respect to one another relative to a longitudinally directed axis of the base running substantially parallel to a longitudinal axis of a spinal column, and the first and first intermediate mounting elements cooperate to engage and orient the first and first intermediate members of the intervertebral disc replacement device for simultaneous insertion into an intervertebral disc space of the spinal column.

### Claim 8 (depends on 7)

The insertion plate of claim 7, wherein:
each of the first and first intermediate members include articulation surfaces that cooperate to facilitate articulation of adjacent vertebral bones of the intervertebral disc space when the intervertebral disc replacement device is disposed in the intervertebral disc space; and
the insertion plate cooperates to orient the articulation surfaces in substantial registration with one another for simultaneous insertion into the intervertebral disc space.

### Claim 9 (depends on 7)

The insertion plate of claim 7, wherein at least one of the first and first intermediate mounting elements includes a flange having a mounting hole therethrough, the mounting hole for receiving a fastener to couple the flange to at least one of the first and first intermediate members of the intervertebral disc replacement device.

### Claim 10 (depends on 9)

The insertion plate of claim 9, wherein the fastener is a mounting screw operable to engage a threaded bore in the at least one of the first and first intermediate members of the intervertebral disc replacement device.

### Claim 11 (depends on 7)

The insertion plate of claim 7, further comprising a ledge member extending from a posteriorly directed surface of the base, the ledge member being sized and shaped to extend at least partially between the first and first intermediate members of the intervertebral disc replacement device such that they may be at least one of inserted into and moved within the intervertebral disc space without substantially changing their orientation with respect to one another.

### Claim 12 (depends on 11)

The insertion plate of claim 11, wherein at least one of:
at least one of the first and second spaced apart surfaces of the ledge member are contoured for engagement with respective surfaces of the first and first intermediate members of the intervertebral disc replacement device; and
the first surface of the ledge member is curved and the second surface of the ledge member is flat.

### Claim 13 (depends on 11)

The insertion plate of claim 11, wherein at least one of:
each of the first and first intermediate mounting elements includes a flange having a mounting hole therethrough, the mounting holes for receiving respective fasteners to couple the flanges to respective ones of the first and first intermediate members of the intervertebral disc replacement device;
the mounting holes are oriented in a direction substantially parallel to a longitudinal axis of the spinal column; and
the ledge member extends in a direction along the posteriorly directed surface of the base that is substantially transverse with respect to the longitudinal axis of the spinal column.

### Claim 14 (depends on 7)

The insertion plate of claim 7, further comprising an insertion member extending away from an anteriorly directed surface of the base and operable to facilitate movement of the intervertebral disc replacement device and insertion thereof into the intervertebral disc space.

### Claim 15 (depends on 14)

The insertion plate of claim 14, wherein the insertion member includes an anteriorly extending stem to facilitate movement of the intervertebral disc replacement device such that the first and first intermediate members may be at least one of inserted into and moved within the intervertebral disc space without substantially changing their orientation with respect to one another.

### Claim 16 (depends on 15)

The insertion plate of claim 15, wherein the stem is sized and shaped for engagement with an insertion handle to further facilitate movement of the intervertebral disc replacement device.

### Claim 17 (depends on 16)

The insertion plate of claim 16, wherein the stem is detachable from the insertion handle to facilitate removal of the handle when the intervertebral disc replacement device is positioned within the intervertebral disc space.

### Claim 18 (depends on 17)

The insertion plate of claim 17, wherein one of the stem and the insertion handle includes a bore and the other of the stem and the insertion handle includes a tapered shaft that frictionally engages the bore to facilitate detachable engagement with one another.

### Claim 19

A method for replacing at least a portion of at least two intervertebral discs in a spinal column, comprising:
removing respective portions of the intervertebral discs from the spinal column;
simultaneously inserting first and first intermediate members of an intervertebral disc replacement device into a first intervertebral disc space of the spinal column, the first and first intermediate members being engageable with and operable to permit adjacent vertebral bones defining the first intervertebral disc space to articulate with respect to one another, and the first and first intermediate members being detachably coupled to a first insertion plate that is operable to orient the first and first intermediate members with respect to one another for such insertion; and
simultaneously inserting second and second intermediate members of an intervertebral disc replacement device into a second intervertebral disc space of the spinal column, the second and second intermediate members being engageable with and operable to permit adjacent vertebral bones defining the second intervertebral disc space to articulate with respect to one another, and the second and second intermediate members being detachably coupled to a second insertion plate that is operable to orient the second and second intermediate members with respect to one another for such insertion.

### Claim 20 (depends on 19)

The method of claim 19, wherein the first and second intervertebral disc spaces are adjacent to one another.

### Claim 21 (depends on 19)

The method of claim 19, further comprising at least one of:
manipulating the first and first intermediate members as a single unit by way of the first insertion plate such that they may be at least one of inserted into and moved within the first intervertebral disc space without substantially changing their orientation with respect to one another;
manipulating at least one of the second and second intermediate members as a single unit by way of the second insertion plate such that they may be at least one of inserted into and moved within the second intervertebral disc space without substantially changing their orientation with respect to one another

### Claim 22 (depends on 19)

The method of claim 19, further comprising: detaching the first and second insertion plates from the first and first intermediate members, and the second and second intermediate members, respectively, after they have been coupled to the respective vertebral bones.