# US 8,771,355 B2 · Inter-vertebral disc motion devices and methods of use

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- Number: US 8,771,355 B2
- Document ID: US8771355B2
- Status: Granted
- Kind: B2
- Application number: 11/754,979
- Filed: 2007-05-29
- Published: 2007-12-06
- Granted: 2014-07-08
- Earliest claimed: 2006-05-26
- Applicants: M. S. Abdou
- Inventors: M. S. Abdou
- Web page: https://patentgrep.com/patent/US8771355B2

## CPC

- A61F 2/4425: {made of articulated components}
- A61F 2/441: {made of inflatable pockets or chambers filled with fluid, e.g. with hydrogel}
- A61F 2/4455: {for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages (intervertebral discs A61F2/442)}
- A61B 17/7001: {Screws or hooks combined with longitudinal elements which do not contact vertebrae (A61B17/7058 takes precedence)}
- A61B 17/7037: {wherein pivoting is blocked when the rod is clamped}
- A61B 17/7041: {with single longitudinal rod offset laterally from single row of screws or hooks (A61B17/7044 takes precedence)}
- A61B 17/7059: {Cortical plates (A61B17/7007, A61B17/7058 take precedence)}
- A61B 17/7071: {Implants for expanding or repairing the vertebral arch or wedged between laminae or pedicles; Tools therefor}
- A61B 17/8038: {the additional component being inserted in the screw head}
- A61B 17/8047: {wherein the additional element surrounds the screw head in the plate hole (A61B17/8052 takes precedence)}
- A61B 2017/0256: {for the spine}
- A61F 2/44: for the spine, e.g. vertebrae or spinal discs
- A61F 2002/2835: {Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material}
- A61F 2002/30232: {Half-cylinders}
- A61F 2002/30286: {barrel-shaped}
- A61F 2002/30301: {saddle-shaped}
- A61F 2002/30365: {with additional means for limiting said rotation}
- A61F 2002/30387: {Dovetail connection}
- A61F 2002/30405: {made by screwing complementary threads machined on the parts themselves}
- A61F 2002/30433: {using additional screws, bolts, dowels, rivets or washers e.g. connecting screws}
- A61F 2002/30471: {connected by a hinged linkage mechanism, e.g. of the single-bar or multi-bar linkage type}
- A61F 2002/30563: {having elastic means or damping means, different from springs, e.g. including an elastomeric core or shock absorbers}
- A61F 2002/30566: {Helical springs}
- A61F 2002/30578: {having apertures, e.g. for receiving fixation screws}
- A61F 2002/30579: {with mechanically expandable devices, e.g. fixation devices}
- A61F 2002/30588: {filled with solid particles}
- A61F 2002/30607: {Kits of prosthetic parts to be assembled in various combinations for forming different prostheses}
- A61F 2002/30772: {Apertures or holes, e.g. of circular cross section}
- A61F 2002/30884: {Fins or wings, e.g. longitudinal wings for preventing rotation within the bone cavity}
- A61F 2002/30934: {Special articulating surfaces}
- A61F 2002/443: {having two transversal endplates and at least one intermediate component}
- A61F 2002/449: {comprising multiple spinal implants located in different intervertebral spaces or in different vertebrae}
- A61F 2002/4629: {connected to the endoprosthesis or implant via a threaded connection}
- A61F 2002/4685: {by means of vacuum}
- A61F 2220/0025: Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F 2220/0033: made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
- A61F 2220/0041: using additional screws, bolts, dowels or rivets, e.g. connecting screws
- A61F 2220/0091: connected by a hinged linkage mechanism, e.g. of the single-bar or multi-bar linkage type
- A61F 2230/0063: Three-dimensional shapes
- A61F 2230/0069: cylindrical
- A61F 2230/0095: Saddle-shaped
- A61F 2250/0062: Kits of prosthetic parts to be assembled in various combinations for forming different prostheses
- A61F 2310/00796: Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite
- A61F 2310/00976: Coating or prosthesis-covering structure made of proteins or of polypeptides, e.g. of bone morphogenic proteins BMP or of transforming growth factors TGF
- 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)

## Abstract

A mobile device is adapted to at least partially replace the motion characteristics of a natural inter-vertebral disc positioned in a disc space. In an embodiment, a receptacle is coupled to the bearing surface. The receptacle is adapted to accept an implantable material without the removal of the bearing surface, wherein the implantable material contacts the abutment surface of each of the vertebral bodies adjacent to the disc space and leads to fusion and immobilization of two vertebral bodies adjacent the disc space.

## Claims

### Claim 1

A method for the correction of vertebral scoliosis without bone fusion using a minimally invasive surgical technique, comprising:
laterally approaching a side of a convexity of a deformity in the spine, wherein the side of the convexity is a side of the vertebral midline in which the vertical distance between the pedicle portion of each vertebral body of the spine is greatest; and
placing a mobile orthopedic prosthesis into a disc space via the lateral approach, wherein the orthopedic prosthesis contains at least one bearing surface that is adapted to at least partially replace a natural inter-vertebral disc, wherein the length of the prosthesis in the coronal plane is less than that of the inter-vertebral disc.

### Claim 2

A method of repairing and augmenting a fractured vertebral body that abuts an implanted mobile disc prosthesis without fusion to another vertebral body, comprising:
placing a rigid orthopedic brace across a fracture site via a convex side of a spine deformity and anchoring the brace to bone using bone fasteners on either side of the fracture site, wherein the brace contains at least one rigid member wherein the brace is positioned in the disc space so as to resist aberrant settlement of an upper vertebral bone relative to a lower vertebral bone and re-formation of the abnormal alignment in the coronal plane; and
preserving the mobility of a natural disc or mobile disc prosthesis that abuts the fractured vertebra.

### Claim 3

An orthopedic implant that is adapted to be positioned within a space between a first bone and an adjacent second bone, comprising:
a first member having a first abutment surface that is adapted to abut a first surface of the first bone, wherein the first member further contains a second abutment surface that is adapted to form a first articulation with a second member;
the second member having a first abutment surface that is adapted to abut a first surface of the second bone, wherein the second member further contains a second abutment surface that is adapted to form the first articulation with the second abutment surface of the first member, and wherein the second member is movable relative to the first member across the first articulation;
a cavity that is at least partially contained within the implant and adapted to accept a bone forming material, wherein the cavity contains a first aperture that opens onto a surface of the first bone and at least a second aperture that opens onto a surface of the second bone, wherein bone forming material, when implanted into the cavity, directly contacts a surface of each of said first and the second bones and produces a bony fusion that abolishes movement between them.

### Claim 4 (depends on 3)

An orthopedic implant as in claim 3, having a third member, wherein the third member is adapted to be at least partially positioned within the cavity of the implant, and wherein the third member contains a first abutment surface that is adapted to abut a bone surface of the first bone, a second abutment surface that is adapted to abut a bony surface of the second bone and at least one connecting member between the first and second abutment surfaces of the third member.

### Claim 5 (depends on 4)

An orthopedic implant as in claim 4, wherein the third member forms a receptacle that is adapted to at least partially contain a bone graft material.

### Claim 6 (depends on 4)

An orthopedic implant as in claim 4, wherein the third member is adapted to support at least a portion of a load transmitted between the first and the second bone.

### Claim 7 (depends on 4)

An orthopedic implant as in claim 4, wherein the third member is adapted to limit motion between the first and the second bones.

### Claim 8 (depends on 4)

An orthopedic implant as in claim 4, wherein the third member is adapted to return the position of the first bone to a predetermined relationship relative to the second bone.

### Claim 9 (depends on 4)

An orthopedic implant as in claim 4, wherein the third member is adapted to rigidly affix onto the first bone.

### Claim 10 (depends on 4)

An orthopedic implant as in claim 4, wherein the third member is adapted to rigidly affix onto the second bone.

### Claim 11 (depends on 4)

An orthopedic implant as in claim 4, wherein the third member is adapted to rigidly affix the first bone onto the second bone.

### Claim 12 (depends on 4)

An orthopedic implant as in claim 4, wherein the third member is adapted to limit motion between the first member and the second member of the prosthesis.

### Claim 13 (depends on 3)

An orthopedic implant as in claim 3, wherein a fixation member is adapted to rigidly immobilize the first member relative to the second member.

### Claim 14

A method for the treatment of cervical spine disease, comprising:
positioning a first orthopedic implant into at least one unco-vertebral joint at the level of a diseased cervical intervertebral disc, wherein the joint is located between an unicate process of a superior surface of an inferior cervical vertebral bone and an inferior surface of an adjacent superior cervical bone;
orienting the implant so that an inferior abutment surface of the implant rests atop the uncite process of the superior surface of the interior vertebral bone;
leaving at least a segment of the diseased cervical intervertebral disc undisturbed.

### Claim 15 (depends on 14)

A method as in claim 14, wherein the inferior abutment surface of the first implant forms an oblique angle with the body of the diseased cervical intervertebral disc.

### Claim 16 (depends on 14)

A method as in claim 14, wherein a second orthopedic implant is positioned into the contra-lateral unco-vertebral joints at the level of a diseased cervical intervertebral disc.

### Claim 17 (depends on 16)

A method as in claim 16, wherein an inferior abutment surface of the second implant forms an oblique angle with the body of the diseased cervical intervertebral disc.

### Claim 18 (depends on 16)

A method as in claim 16, wherein the second implant maintains movement between the superior and inferior cervical vertebral bones that border the diseased cervical intervertebral disc.

### Claim 19 (depends on 18)

A method as in claim 18, wherein the second implant contains a visco-elastic member.

### Claim 20 (depends on 14)

A method as in claim 14, wherein the first implant maintains movement between the superior and inferior cervical vertebral bones that border the diseased cervical intervertebral disc.

### Claim 21 (depends on 20)

A method as in claim 20, wherein the first implant contains a visco-elastic member.

### Claim 22

An orthopedic implant that is adapted to be positioned within an intervertebral disc space that is between a first vertebral bone and an adjacent second vertebral bone, comprising:
a first implant member having a bone abutment surface that is adapted to abut a first surface of the first vertebral bone, wherein the first member contains a first bearing surface and a second bearing surface that are rigidly connected to one another by a first interposed segment;
a second implant member having a bone abutment surface that is adapted to abut a first surface of the second vertebral bone, wherein the second member contains a first bearing surface that is adapted to articulate with the first bearing surface of the first member, wherein the second member contains a second bearing surface that is adapted to articulate with the second bearing surface of the first member;
wherein motion between the first and the second vertebral bones is maintained by the implant, and wherein the first member articulates with the second member at the first and second bearing surfaces alone.

### Claim 23 (depends on 22)

An orthopedic implant as in claim 22, wherein the first and second bearing surfaces of the second implant member are separated by a first distance.

### Claim 24 (depends on 23)

An orthopedic implant as in claim 23, wherein the first distance is variable.

### Claim 25 (depends on 23)

An orthopedic implant as in claim 23, wherein the distance between the bone abutment surface of the first implant member and the bone abutment surface of the second implant member is determined by the first distance of the second implant member.

### Claim 26 (depends on 22)

An orthopedic implant as in claim 22, wherein the first bearing surface of the second implant member is coupled to a first malleable member.

### Claim 27 (depends on 26)

An orthopedic implant as in claim 26, wherein the first malleable member is adapted to resist movement of the first bearing surface towards the second bearing surface.

### Claim 28 (depends on 26)

An orthopedic implant as in claim 26, wherein the first malleable member opposes a compressive force that urges the first vertebral bone towards the second vertebral bone.

### Claim 29 (depends on 22)

An orthopedic implant as in claim 22, wherein the second bearing surface of the second implant member is coupled to a second malleable member.

### Claim 30 (depends on 29)

An orthopedic implant as in claim 29, wherein the second malleable member is adapted to resist movement of the second bearing surface towards the first bearing surface.

### Claim 31 (depends on 29)

An orthopedic implant as in claim 29, wherein the second malleable member opposes a compressive force that urges the first vertebral bone towards the second vertebral bone.

### Claim 32 (depends on 22)

An orthopedic implant as in claim 22, wherein at least one of said implant members contains a projection that extends outward from a bone abutment surface and away for the bearing surfaces.

### Claim 33 (depends on 32)

An orthopedic implant as in claim 32, wherein the projection forms a ridge extending along a longitudinal axis and having a total width, wherein the ridge contains at least one movable segment that is adapted to rotate from a first to a second configuration relative to a second ridge segment, and wherein the total width of the ridge is greater when the movable segment is in the second configuration.

### Claim 34 (depends on 33)

An orthopedic implant as in claim 33, wherein the movable segment is in the first configuration prior to positioning the implant within the intervertebral disc space, and wherein the movable member is transitioned to the second configuration after positioning the implant.

### Claim 35 (depends on 22)

An orthopedic implant as in claim 22, wherein the first implant members contains an anterior surface and an elongated member that extends posteriorly along a first longitudinal axis form a aperture of said anterior surface, the elongated member being attached to a proximal aspect of a bone fixation member, wherein the fixation member is adapted to rotate in a circular trajectory about the first longitudinal axis;
wherein the bone fixation member contains a curved distal tip that is tapered along the direction of rotation of the first circular trajectory, wherein the tapered tip is adapted to forcibly advance and fixate into the adjacent first vertebral bone when the fixation member is rotated in the direction of the taper, and wherein the fixation member is separated from simultaneous anchor into each of the first and the second vertebral bones.

### Claim 36

A mobile orthopedic implant that is adapted to be positioned within an intervertebral disc space between a first vertebral bone and an adjacent second vertebral bone, comprising:
a first implant member having a bone abutment surface that is adapted to abut a surface of the first vertebral bone and having a first bearing that is adapted to articulate with a bearing surface of a second implant member;
an elongated member that extends posteriorly along a first longitudinal axis form a aperture of an anterior surface of the first implant member, the elongated member being attached to a proximal aspect of at least one bone fixation member, wherein the fixation member is adapted to rotate in a circular trajectory about the first longitudinal axis, wherein the bone fixation member contains a curved distal tip that is tapered along the direction of rotation of the first circular trajectory, wherein the tapered tip is adapted to forcibly advance and fixate into the adjacent first vertebral bone when the fixation member is rotated in the direction of the taper, and wherein the fixation member is separated from simultaneous anchor into each of the first and the second vertebral bones;
a second implant member having a bone abutment surface that is adapted to abut a surface of the second vertebral bone and having a first bearing that is adapted to articulate with the first bearing surface of the first implant member, wherein the articulation maintains motion between said first and second vertebral bones.

### Claim 37 (depends on 36)

An orthopedic implant as in claim 36, wherein at least a segment of the implant is manufactured from a metallic alloy.

### Claim 38 (depends on 37)

An orthopedic implant as in claim 37, wherein the metallic alloy is at least partially comprised of Titanium.

### Claim 39 (depends on 36)

An orthopedic implant as in claim 36, wherein at least a segment of the implant is manufactured from a plastic material.

### Claim 40 (depends on 36)

An orthopedic implant as in claim 36, wherein the bone fixation member is in a first rotational position before the device is implanted into the inter-vertebral space, and wherein the bone fixation member is transitioned into a second rotational position after device implantation wherein the implant is positioned into the inter-vertebral space while the bone fixation member is in a first rotational position, and wherein the fixation member is subsequently rotated into a second rotational position.

### Claim 41 (depends on 40)

An orthopedic implant as in claim 40, wherein the fixation member provides greater implant fixation to bone when in the second rotational position.

### Claim 42

A orthopedic implant adapted to be positioned within an intervertebral disc space that is between a first vertebral bone and an adjacent second vertebral bone, comprising:
a first bone abutment surface that is adapted to abut a surface of the first vertebral bone and a second bone abutment surface that is adapted to abut a surface of the second vertebral bone;
a projection that extends outward along a longitudinal axis from the first bone abutment surface, wherein the projection forms a ridge having a total width, wherein the ridge contains at least one movable segment that is adapted to rotate from a first to a second position relative to a second ridge segment, and wherein the total width of the ridge is greater when the movable segment is in the second position.

### Claim 43 (depends on 42)

An orthopedic implant as in claim 42, wherein at least a segment of the implant is manufactured from a metallic alloy.

### Claim 44 (depends on 42)

An orthopedic implant as in claim 42, wherein at least a segment of the implant is manufactured from a plastic material.

### Claim 45 (depends on 42)

An orthopedic implant as in claim 42, wherein the movable segment is in the first position before the device is implanted into the inter-vertebral space, and wherein the movable segment is transitioned into the second position after device implantation.

### Claim 46

An orthopedic implant for placement within an intervertebral disc space that is positioned between a first and a second immediately-adjacent vertebral bones, comprising:
a body having a first bone abutment surface that can abut the first vertebral bone, a second bone abutment surface that can abut the second vertebral bone and a connecting segment that joins the said abutment surfaces, wherein the body extends from an anterior surface to a posterior end, wherein the anterior surface contains at least one aperture that extends along a first trajectory and onto at least one of said abutment surfaces;
an anchor that is adapted to be positioned within the aperture of the anterior surface and to extend from a proximal segment to a distal end along a trajectory that is at least partially curvilinear, wherein the anchor has a total length greater than that of the aperture, wherein, when seated in the aperture, at least the distal end of the anchor is positioned within one of the said vertebral bones and separated from threaded engagement with it.

### Claim 47 (depends on 46)

An orthopedic prosthesis as in claim 46, wherein the anchor is separated from simultaneous engagement of each of the first and the second vertebral bones when it is seated in the aperture.

### Claim 48 (depends on 46)

An orthopedic prosthesis as in claim 46, wherein at least a segment of the first trajectory is curvilinear.

### Claim 49 (depends on 46)

An orthopedic prosthesis as in claim 46, wherein a proximal end of the anchor is larger than the internal dimensions of aperture.

### Claim 50 (depends on 46)

An orthopedic prosthesis as in claim 46, wherein the distal end of the anchor is formed of a tapered tip.

### Claim 51 (depends on 50)

An orthopedic prosthesis as in claim 50, wherein the tapered tip is sufficiently stiff to be advanced into the vertebral bone.