巴西专利BR112013022322B1 system to provide spinal stabilization

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专利摘要:
SYSTEM TO PROVIDE STABILIZATION OF THE VERTEBRAL COLUMN Systems, methods and devices to provide stabilization between the first and second vertebrae are provided. More particularly, in one form, a system includes an implant configured to be positioned in a disc space between the first and second vertebrae and an independent plate for fitting with extradiscal surfaces of the first and second vertebrae. The system also includes an insertion instrument with a fitting part configured to fit freely with the implant and plate so that the implant and plate can be positioned together in relation to the first and second vertebrae. In one aspect, an angular orientation of the implant in relation to the plate is adjustable when the implant and the plate are fitted by the instrument. In this or another aspect, the implant and the plate are attached in a continuous relationship when fitted by the instrument. However, different orders and forms are also foreseen.
公开号:BR112013022322B1
申请号:R112013022322-7
申请日:2012-03-01
公开日:2020-12-29
发明作者:William D. Armstrong；Thomas A. Carls；John A. Cowan；James P. Duncan；Richard A. Hynes；Anthony J. Melkent；Jean-Pierre Mobasser；M.D. Hall Silcox Iii
申请人:Warsaw Orthopedic, Inc；
IPC主号:

专利说明:

FUNDAMENTALS
[001] The present application refers generally to the stabilization of the spine, involving an intercorporeal implant device and a related support plate, and to instruments and methods for inserting and positioning the device and plate together in relation to the spine vertebral.
[002] Various systems and techniques have been developed to correct and stabilize the spine and to facilitate fusion at various levels of the spine. Some of these include the placement of one or more intercorporeal implants in a spinal disc space between adjacent vertebrae. When an implant is placed in a disc space, the channel or path that the implant took to enter the disc space provides a path for the retrograde movement of the disc space implant. In some forms, a plaque can be used to prevent retrograde movement of the implant and / or to provide additional stability between adjacent vertebrae. If used, the plate is often placed in a socket with the adjacent vertebrae in a separate surgical step following the implantation of the implant. The implant can also be placed on the plate prior to implantation, although such an accessory may limit the adjustability of the implant and the plate relative to each other to accommodate for various aspects of the anatomy of the spine and / or increase the size and complexity of the procedure surgical.
[003] Thus, there is still a need for further improvements in spinal stabilization, involving an intercorporeal implant device and a related support plate, and in the instruments and methods for inserting and positioning it. SUMMARY
[004] Intercorporeal implants and support plates related to spinal stabilization are provided, as well as instruments and techniques to insert and position an implant and a plate together in relation to the spine. More particularly, in one form, a system includes an implant configured to be positioned in a disc space between the first and second vertebrae and an independent plate for fitting with the first and second vertebrae. The system also includes an insertion instrument with a fitting part configured to fit freely with the implant and plate so that the implant and plate can be positioned together in relation to the first and second vertebrae in a single surgical step. In one aspect, an angular orientation of the implant in relation to the plate is adjustable when the implant and the plate are fitted by the instrument. In this or another aspect, the implant and the plate are attached in a continuous relationship when fitted by the instrument. However, different applications and forms are also envisaged.
[005] In one embodiment, a system for providing spinal stabilization includes an implant with a body extending from a front end to an opposite rear end. The body also includes an upper bone engaging surface and an opposite lower bone engaging surface, with the upper and lower bone engaging surfaces engaging the respective upper and lower vertebrae end plates when the implant is positioned in a space of the disc between the upper and lower vertebrae. The system also includes a plate for fitting with the upper and lower vertebrae. The plate includes a body that extends between an upper end and an opposite lower end, and the body of the plate includes an upper surface and an opposite lower surface facing the upper and lower vertebrae, when the plate is engaged therein. An insertion instrument includes a fitting part configured to fit freely with the implant and the plate so that an angular orientation of the implant relative to the plate is adjustable when the implant and plate are fitted by the instrument.
[006] In another embodiment, a system for providing spinal stabilization includes an implant with a body extending from a front end to an opposite rear end. The body also includes an upper bone engaging surface and an opposite lower bone engaging surface, with the upper and lower bone engaging surfaces engaging the respective upper and lower vertebrae end plates when the implant is positioned in a space of the disc between the upper and lower vertebrae. The system also includes a plate for fitting with the upper and lower vertebrae and including a body extending between an upper end and an opposite lower end. The additional plate body includes a proximal surface, an opposite distal surface, and a distal facing the intermediate part configured to cooperate with the rear end of the implant. An insertion instrument includes a fitting part configured to fit freely with the implant and the plate so that the implant and plate are attached in a continuous relationship when fitted by the instrument and the implant is displaceable from the plate by disengaging the instrument.
[007] In another new embodiment, a method for providing spinal stabilization between the first and second vertebrae includes providing an implant, including a body extending from a front end to an opposite rear end, with the body also including one engaging surface of the upper bone and engaging surface of the lower bone. The method also includes providing a plate for fitting with the first and second vertebrae. The plate includes a body extending between an upper end and an opposite lower end. New steps in the method include fitting an insertion instrument with the implant and plate, which includes retaining the implant and plate in a contiguous uncoupled arrangement, and inserting the front end of the implant into a spinal disc space between the first and second vertebra with the insertion instrument and advancing the implant in the disc space to a lower surface of the extradiscal contact surfaces of the plate of the first and second vertebrae. Another aspect of this modality includes the rotation of the implant in relation to the plate when the insertion instrument is engaged with the implant and plate and the implant and plate are retained in the continuous, uncoupled arrangement. Yet another aspect of this modality includes guiding at least one fixing element through a corresponding guide hole through the insertion instrument and the plate in engagement with one of the vertebrae.
[008] Other modalities include exclusive methods, techniques, systems, devices, kits, assemblies, equipment and / or apparatus for use in connection with the stabilization and support of the first and second vertebrae. However, in other modalities, different applications and forms are also envisaged.
[009] Other modalities, forms, characteristics, aspects, benefits, objects and advantages of the current application will become apparent by the detailed description and figures provided here. BRIEF DESCRIPTION OF THE FIGURES
[010] FIG. 1 is a diagrammatic plan view, with some features being shown in the section, looking towards the axial plane of a vertebral body end plate of a spine with an intercorporeal implant and a plate positioned relative to them.
[011] FIG. 2 is a diagrammatic elevation view, looking at the sagittal plane at a vertebral level of the spine, including the vertebral body, Intercorporal implant and plate of FIG. 1.
[012] FIG. 3 is a top plan view of the intercorporeal implant illustrated in FIG. 1.
[013] FIG. 3 is a side plan view of the intercorporeal implant illustrated in FIG. 1.
[014] FIGS. 4A and 4B are the side plan views of Intercorporeal implants of an alternative modality.
[015] FIG. 5 is a perspective view of the intercorporeal implant illustrated in FIG. 1.
[016] FIG. 6 is a front plan view of the plate shown in FIG. 1.
[017] FIGS. 7 and 8 are opposite side views of the plate shown in FIG. 1.
[018] FIG. 9 is a plan view of an insertion instrument of the modality configured to insert and position the intercorporeal implant and the plate of FIG. 1 in relation to the spine.
[019] FIG. 10 is a plan view of the insertion instrument illustrated in FIG. 9 rotated ninety degrees on its longitudinal axis.
[020] FIG. 11 is a plan view of the distal end of the instrument shown in FIG. 9 rotated one hundred and eighty degrees on its longitudinal axis.
[021] FIG. 12 is a view of the proximal end section of the instrument illustrated in FIG. 9 taken along line 12-12 of the view.
[022] FIG. 13 is a plan view of an internal member of the instrument illustrated in FIG. 9.
[023] FIG. 14 is a view of the section of the inner member illustrated in FIG. 13 taken along line 14-14 of the view.
[024] FIG. 15 is a perspective view of the distal end of the inner member shown in FIG. 13.
[025] FIG. 16 is a plan view of an external member of the instrument illustrated in FIG. 9.
[026] FIG. 17 is a view of the section of the external member illustrated in FIG. 16 taken along line 17-17 of the view.
[027] FIG. 18 is a plan view of the instrument illustrated in FIG. 9 attached to the intercorporeal implant and the plate of FIG. 1.
[028] FIG. 19 is a plan view of an insertion instrument of an alternative embodiment configured to insert and position the intercorporeal implant and the plate of FIG. 1 in relation to the spine.
[029] FIG. 20 is a plan view of the insertion instrument illustrated in FIG. 19 rotated ninety degrees on its longitudinal axis and with some features being shown in the section along line 20-20 of the view. DESCRIPTION OF THE ILLUSTRATED MODALITIES
[030] In order to promote an understanding of the principles of the invention, reference will now be made to the modalities illustrated in the drawings and a specific language will be used to describe them. However, it is understood that there is no intention to limit the scope of the invention. Any further changes and modifications to the illustrated devices and methods described and any additional applications of the principles of the invention as illustrated herein are contemplated as occurrences common to those skilled in the art to which the invention relates.
[031] Methods, techniques, instrumentation, devices and implants are provided to restore and / or maintain a collapse, partially broken, damaged, diseased or otherwise weakened spinal disc space at a height of disc space and a desired orientation of the adjacent end plate. Instruments and implants can be used in techniques employing minimally invasive technology and instruments to access disk space, although access in non-minimally invasive procedures is also contemplated. Access to the broken disk space can be uniportal, biportal, or multiportal. Instruments and implants can also be used in a direct anterior approach to spinal disc space, although other approaches are also contemplated, including lateral, anterolateral, posterolateral, oblique and posterior approaches. Also, surgical methods, techniques, instruments and implants can find application in all vertebral segments of the spine, including the regions of the lumbar, thoracic and cervical spine.
[032] In one aspect, intercorporeal implants and support plates related to spinal stabilization are provided, as well as instruments and techniques for inserting and positioning an implant and plate together in relation to the spine. More particularly, in one form, a system includes an implant configured to be positioned in a disc space between the first and second vertebrae and an independent plate for fitting with the first and second vertebrae. The system also includes an insertion instrument with a fitting part configured to fit freely with the implant and plate so that the implant and plate can be positioned together in relation to the first and second vertebrae in a single surgical step. In one aspect, an angular orientation of the implant in relation to the plate is adjustable when the implant and the plate are fitted by the instrument. In this or another aspect, the implant and the plate are held in a continuous relationship when fitted by the instrument. However, different orders and forms are also foreseen.
[033] With general reference to FIG. 1, this illustrates a plan view with some features being shown in the section, looking through the tail to the axial plane of a vertebral body V1. As illustrated in FIGS. 1 and 2, the intercorporeal implant of the column 10 is positioned on the vertebral end plate E1 intradiscal between the vertebral bodies V1, V2 and a plate 12 is substantially extradiscal, or outside the disc space, for vertebral bodies V1, V2 , with a plurality of bones fitting fixing elements, two of which are presented in the form of bone screws 14, 16. In the illustrated form, a part of the plate 12 also extends between the vertebral bodies V1, V2, although forms in which plate 12 is positioned entirely extradiscally with no part of it extending between the vertebral bodies V1, V2 are also contemplated. The vertebral body V1, together with the vertebral body V2 and disc space in the D column make up a level of the SC spine segment in the cervical region, although implantation of implant 10 and plaque 12 in the thoracic and lumbar regions is also possible and contemplated, as indicated above. The implant 10 is positioned in the disk space D between the vertebral bodies V1 and V2, so that, when in its implanted orientation, it makes contact with the end plates E1 and E2. In the illustrated form, the plate 12 is positioned to abut against opposite opposite surfaces of the vertebral bodies V1, V2, although the positioning of the plate 12 along alternatively facing the surfaces of the vertebral bodies, V1, V2, depending on the orientation of the implant 10 of the vertebral bodies, V1, V2 is also contemplated. Likewise, in the vertebral bodies of the illustrated form V1, V2 are accessed from an anterior approach, although lateral, anterolateral, posterolateral, oblique and posterior approaches are also possible. In addition, as illustrated, the implant 10 and the plate 12 are generally positioned at the side and in an adjacent fit with the other, although it should be noted that the movement of the implant 10 away from the plate 12 is possible as long as the implant 10 and the plate 12 are not physically attached or otherwise coupled to each other, as will be discussed in more detail below.
[034] With general reference to FIGS. 3-5, implant 10 includes a body 18 sized to fit within the disk space D between adjacent vertebral bodies V1, V2. The body 18 extends from a front end 20 to an opposite rear end 22. In the illustrated form, the front end 20 generally includes a planar surface 24 positioned between the angular surfaces 26, 28 that can facilitate the insertion of the implant 10 into the space disc D and / or the distraction of the vertebral bodies V1, V2. In other forms not shown, the front end 20 may include a convex rounded tip to facilitate insertion into disk space D and distraction of the vertebral bodies V1, V2. As illustrated in FIG. 3, for example, the body 18 also includes a container 23 in which a radiographic marker can be positioned to facilitate the image-guided placement of the implant 10 between the vertebral bodies V1, V2.
[035] The body 18 also includes the surfaces 30, 32 of the upper and lower bone fitting with the ridges 34, 36 (only some of which are referenced to preserve clarity) to enhance the fitting with the vertebral end plates E1, E2. In other forms, the surfaces 30, 32 of the upper and lower bones can be provided with threads, grooves, serrated teeth or other rough surfaces, just to provide some possibilities, to increase the fit with end plates vertebral E1, E2. In the illustrated form, the bone engaging surface 30 includes a generally convex configuration between the front end 20 and the rear end 22, while the bone engaging surface 32 includes a generally planar or straight configuration between the front end 20 and the rear 22 In other forms, it should be noted that the bone engaging surface 30 can also be planar and that the bone engaging surface 32 could also be curved convexly. In addition, other variations in the bone engaging surface configurations 30, 32 between the front end 20 and rear end 22 are possible. In addition, the bone engaging surfaces 30, 32 are generally configured so that the implant 10 is received between and in contact with at least part of the end plates E1, E2 along at least part of the body 18. The body 18 also includes opposite walls on the side 38, 40, extending from the front end 20 to the rear end 22, and also extending from the bone engaging surface 30 to the bone engaging surface 32. The side walls 38, 40 can be parallel to each other or tapered in relation to each other to converge or diverge towards the front end 20. The side walls 38, 40 can be flat, concave or convex from the front end 20 to the rear end 22, concave or convex from the bone engaging surface 30 to the bone engaging surface 32, or combinations thereof.
[036] The body 18 also includes a cavity 42 that opens through the bone engaging surface 30, 32, to facilitate bone growth through the body 18, although shapes where the cavity 42 is not present are also possible. In other forms not shown, it is envisaged that body 18 may also include one or more openings, extending through side walls, 38, 40 and / or front and rear ends 20, 22 and in communication with cavity 42. In addition , while not illustrated, it should be noted that one or more biocompatible materials, which, for example, provide a therapeutic effect or improve bone growth through implant 10 can be positioned in cavity 42. Examples of such biocompatible materials may include the calcium phosphate, hirdroxiapatite tricalcium phosphate (HA-TCP) compounds, bioactive glasses, bone calcium sulphate void fillers, collagen, fibrin, albumin, keratin, silk, elastin, demineralized bone matrix, bone particles, mesenchymal stem cells , hormones, growth factors such as beta growth transformers (TGFb) proteins, bone morphogenic proteins (including BMP and BMP2) or factor-derived platelets growth, just to provide some possibilities. In one aspect, the biocompatible material (s) may, when included, extend slightly above and below the bone surrounding the surfaces 30, 32, respectively, to facilitate compressive loading by adjacent vertebral bodies in and through the biocompatible material (s).
[037] As illustrated in FIG. 4, for example, the front end 22 of the implant 10 is generally curved convexly between the engaging surfaces of the bone 30, 32. In addition, the leading end 22 also includes an elongated groove 44 that is positioned between the engaging surfaces of bone 30, 32 and extends between side walls 38, 40, although in other forms it should be noted that the front end 22 can be provided without the elongated groove 44. The body 18 also includes a first container 46 formed in the wall lateral 38 and generally including a circular arrangement configured to receive a correspondingly configured part of an insertion instrument, further details of this will be provided below. The body 18 also includes a slot or a groove 47 formed in the side wall 38. The groove 47 includes the upper and lower surfaces 48, 50 and side surfaces of linings 52, 54 and extends them by the rear end 22 in communication with the first container 46. In the illustrated form, the upper and lower surfaces 48, 50 are generally arranged in an oblique orientation with respect to each other, although other shapes are contemplated. The body 18 also includes a second container 56 formed in the side wall 40 and generally including a circular arrangement configured to receive a correspondingly configured part of an insertion instrument, further details of which will be provided below. The body 18 also includes a slot or groove 57 formed in the side wall 40. The groove 57 includes upper and lower surfaces 58, 60 and side surfaces of linings 62, 64 and extends them by the rear end 22 in communication with the second container 46. In the illustrated form, the upper and lower surfaces 58, 60 are generally arranged in an oblique orientation with respect to each other, although other shapes are contemplated.
[038] While not previously discussed, it should be noted that the general circular arrangement of containers 46, 56, which allows the receipt of a correspondingly configured part of the insertion instrument, allows an angular orientation of the implant 10 in relation to the plate 12 a be adjusted when implant 10 and plate 12 are attached to the insertion instrument, further details of this will be provided below. However, it should be noted that other implant 10 configurations are possible to allow the angular orientation of the implant 10 with respect to the plate 12 to be adjusted when implant 10 and plate 12 are engaged by the insertion instrument. For example, with reference to FIG. 4A, the elongated groove 44 and the grooves 47, 57 have been omitted from the alternative modality implant 10a. In addition, container 46a is generally configured as an elongated groove configured to receive a circular feature of the insertion instrument to hold the implant 10a with the instrument, while also allowing adjustment of the angular orientation of the implant 10a relative to the plate 12 and the instrument of insertion when the implant 10a and plate 12 are engaged by the insertion instrument. As another example, FIG. 4B illustrates another alternative modality implant 10b from which the elongated groove 44 and grooves 47, 57 have been omitted. Implant 10b includes a container 46b in the form of a curved groove configured to receive a circular feature of the insertion instrument to hold implant 10b with the instrument, while also allowing adjustment of the angular orientation of implant 10b relative to plate 12 and the insertion instrument when implant 10b and plate 12 are engaged by the insertion instrument. Although not shown in FIGS. 4A and 4B, it should be noted that the containers positioned opposite to the containers 46a, 46b are configured in the same way as the containers 46a, 46b. In addition, it should also be noted that, with the exception of the differences described above, implants 10a, 10b will generally be configured in the same way as the implant 10.
[039] Additional details with respect to plate 12 are shown in FIGS. 6-8. The plate 12 includes a body 66 which extends along a central axis 68 which is oriented to extend generally along the central axis of the SC of the spine and vertebral body V1 to the vertebral body V2 when the plate 12 is implanted. In the illustrated form, body 66 generally includes a substantially square configuration, although forms in which body 66 is elongated along central axis 68 and includes a rectangular, oval or elliptical shape, just to give some examples are also contemplated. Body 66 includes an upper end or towards head 70 and a lower end or opposite flow 72, and opposite side surfaces 74, 76 extending between ends 70, 72. Body 66 also includes upper screw holes bone, 78, 80 the upper adjacent end 70 and the lower screw holes 82, 84 the lower adjacent end 72. The bone screw holes 78, 80 and 82, 84 extend through and open on the upper surface 86 and the lower surface 88 of body 66, and are generally arranged to allow bone screws to extend obliquely across and away from body 66. More particularly, bone screw holes 78, 80 are generally arranged to allow bone screws that extend through it extend obliquely to the plate 12 on one side, towards the head, while bone screw holes 82, 84 are usually arranged to allow bone screws to extend through this plate. end obliquely to plate 12 in a lateral caudal direction. Among other things, the orientation of the bone screw holes 78, 80 and 82, 84 in this arrangement allows the use of relatively longer bone screws, resulting in a better fit and acquisition with the adjacent vertebral bodies. In addition, in this arrangement, the hole paths of bone screws 78, 80 and 82, 84 extend towards a common location above plate 12 so that the operating space required to insert screws through plate 12 is reduced , minimizing the impact that involves the patient's anatomy. In other forms not shown, it should be noted that the plate 12 may be provided with a bone screw hole or more than two bone screw holes adjacent to each upper end 70 and lower end 72.
[040] Body 66 also includes a retaining element 86 that can be attached to body 66 with a clamp, threaded shaft or other configuration that allows retaining element 86 to rotate when attached to body 66. Retaining element 86 includes a cross configuration including ends 86a-of a central driving tool container 88. For the sake of clarity, it should be noted that the retaining element 86 has been omitted from the body 66 in FIGS. 7-8. The retaining element 86 also includes the concave curved side wall parts 90a-b that can be simultaneously aligned with the respective adjacent bone screw hole 78, 80, 82, 84, to allow the insertion of a bone screw and its proximal head in the adjacent bone screw hole 78, 80, 82, 84. When the bone screw heads are seated in the bone screw holes 78, 80, 82, 84, the retaining element 86 can be rotated so that the ends 86a-d overlap the respective bone screw holes 80, 82, 84 and block it or come into contact with the bone screw head to prevent the bone screw from moving backwards from the bone screw holes 78, 80, 82, 84. It should also be noted that other shapes and designs of the retaining element 86 are possible to prevent the displacement of the bone screw behind the screw holes 78, 80, 82, 84. For example, in a way not illustrated, the retention 86 can be in the form of a threaded fastener that is engaged with the plate 12 after it is attached to vertebral bodies V1, V2 so that at least part of an enlarged head of the threaded fastener extends through the screw holes 78, 80 , 82, 84.
[041] Body 66 of plate 12 also includes grooves 92, 94 that extend on the side surfaces 74, 76 and from the upper surface 86 to the lower surface 88. As illustrated in FIG. 7, groove 92 includes a container 96 which generally has a circuit-shaped configuration. More particularly, the container 96 includes parallel sides between which parts of curved or circular ends extend. As illustrated in FIG. 8, groove 94 includes a container 98 which also generally has a circuit-shaped configuration. In other forms not illustrated, it should be noted that other configurations, including oval or polygonal to provide some possibilities, are also contemplated. Containers 96, 98 are configured to receive correspondingly configured parts of an insertion instrument, more details will be provided below.
[042] In addition, body 66 also includes an intermediate part 100 which includes a concave surface 102 moving away from the upper surface 86. Surface 102 is generally configured to cooperate with the front end 22 of the implant 10 when the implant 10 and plate 12 are positioned adjacent to each other. The intermediate part 100 extends away from the upper surface 86 so that the surface 102 is displaced from the upper surface 86 with respect to the upper and lower parts 104, 106 of the lower surface 88. Likewise, as shown in FIG. 2, for example, this arrangement results in the surface 102 and at least a part of the intermediate part 100 being positioned in the disc space D between the vertebral bodies V1, V2 when the upper and lower parts 104, 106 of the lower surface come into contact. contact with vertebral bodies V1, V2 and the plate 12 is fitted with vertebral bodies V1, V2. In other forms not illustrated, however, it should be noted that the surface 102 can be aligned with the upper and lower parts 104, 106 of the lower surface 88 or displaced to the upper surface 86 with respect to the upper and lower parts 104, 106 of the lower surface 88 so that no part of the plate 12 extends into the disc space D when it is fitted with vertebral bodies V1, V2. In other forms not shown, the surface 102 may be flat or include a convex shape that is configured to cooperate with the implant 10 having a concave front end 22.
[043] With general reference to FIGS. 9-17, more details will be provided regarding an insertion instrument 120 configured to fit with implant 10 and a plate 12 and position the implant 10 and plate 12 with respect to the vertebral bodies V1, V2. The instrument 120 extends along the longitudinal axis L from the proximal end 122 to the distal end 124 and includes an inner member 126, an outer member 128 and a guiding member 130. The inner member 126 extends between a threaded proximal part 132 and a distal engaging part 134. The distal engaging part 134 is forked into parts 148, 150 that surround a hollow interior 160 and from which the teeth 136, 138 extend. The parts 148, 150 also include the tapered surfaces 162, 164 adjacent to the proximal ends of the teeth 136, 138, and are rotatable over the passage 158 so that the teeth 136, 138 can be moved relative to each other to facilitate fitting and the detachment of the instrument 120 with the implant 10 and the plate 12. When not shown, it should be noted that a spring or other elastic material with elasticity, such as a rubber plug, can be positioned in the passage 158, in a way that teeth 136, 138 are normally angled away from each other. Tooth 136 includes a generally circular distal projection 140 configured to be positioned in container 46 of implant 10. Tooth 136 also includes a projection generally in circuit form 142 proximally spaced from projection 140 and configured to be positioned in container 96 of the implant. plate 12. Tooth 136 is then configured to be positioned in groove 47 of implant 10 and in groove 92 of plate 12 when instrument 120 is engaged with implant 10 and plate 12. Tooth 138 includes a distal projection generally circular in shape 144 configured to be positioned in the container 56 of the implant 10. The tooth 138 also includes a projection generally in the form of a circuit 142 proximally spaced from the projection 144 and configured to be positioned in the container 98 of the plate 12. The tooth 138 is then configured to be positioned in groove 57 of implant 10 and groove 94 of plate 12 when instrument 120 is engaged with implant 10 and plate 12. The inter-member No. 126 also includes an opening 152 that extends obliquely to the longitudinal axis L and in communication with the hollow interior 160. Another set of openings 154, 156 is positioned in front of opening 152 and extends obliquely to the longitudinal axis L and in communication with hollow interior 160.
[044] The outer member 128 extends between the proximal end 170 and the distal end 172 and includes a hollow interior 174 that receives the inner member 126. The outer member 128 also includes an opening 176 that extends obliquely to the longitudinal axis L and in communication with the hollow interior 174. A ridge 177 extends along an opening part 176 and defines opposing parts 176a, 176b of opening 176. Another set of openings 178, 180 (FIG. 11) is positioned at in front of opening 176 and extending obliquely to the longitudinal axis L and in communication with the hollow interior 174. When the inner member 126 is positioned on the outer member 128 and the instrument 120 engages with the implant 10 and the plate 12, the opening 176 of the outer member 128 generally aligns with the opening 152 of the inner member 126 and the openings 178, 180 of the outer member 128 generally align with the openings 154, 156 of the inner member 126. Likewise, in the present arrangement, the cooperation of the openings 152, 176 allows the placement of bone screws through the instrument 120 in and through bone screw holes 82, 84 of the plate 12. More particularly, part 176a of opening 176 and opening 152 are arranged so that the crest 177 guide a bone screw to the bone screw opening 82 of the plate 12, while the part 176b of the opening 176 and the opening 152 are arranged so that the crest 177 guides a bone screw to the bone screw opening 84 of the plate 12. In addition, the cooperation of openings 154, 156 and openings 178, 180 allows the placement of bone screws through the instrument 120 in and through bone screw holes 82, 84 of the plate 12. More particularly, the openings 154 and 178 are generally arranged with with respect to the instrument 120 to guide a bone screw to the opening of the bone screw 80 of the plate 12, while the openings 156 and 180 are generally arranged with respect to the instrument 120 to guide a bone screw to the opening of the plate bone screw 78 of the plate 12. In addition, while not previously discussed, it should be noted that the cooperation of the openings 152, 176 can also facilitate the fitting of the container 88 of the retaining element 86 to facilitate the rotation of the retaining element 86 after the placement of the bone screws, although the attachment of the retaining element 86 by inserting an instrument along the length of the instrument 120 through the hollow interior 160 is also contemplated. In addition, while not discussed previously, it should also be noted that the cooperation of openings 152, 176, openings 154, 178 and openings 156, 180 can also facilitate access to vertebral bodies V1, V2 with one or more instruments such as drills, drills or taps, just to provide some possibilities, to prepare the vertebral bodies V1, V2 for bone screws.
[045] The proximal end 170 of outer member 128 also includes an annular groove 182 within which a retaining ring 184 is positioned to engage outer member 128 with guiding member 30 so that guiding member 130 is independently rotatable with respect to the outer member 128. Guiding member 130 includes an internal threading configured to engage with proximal threaded portion 132 of inner member 126. Likewise, rotation of guiding member 130 results in axial displacement of inner member 126 along longitudinal axis L in with respect to the outer member 128. A pin 186 extends from the outer member 128 in a groove 190 on the inner member 126 to prevent rotation of the inner member 126 relative to the outer member 128. In addition, a locking member 188 extends by the steering member 130 and is selectively nestable with the inner member 126 to prevent rotation of the steering member 130 with respect to the inner member 1 26 since a desired relationship between inner member 126 and outer member 128 has been obtained. While not previously discussed, it should be noted that the axial movement of the inner member 126 along the longitudinal axis L in the proximal direction in relation to the outer member 128 results in fitting of the distal end 172 of the outer member 128 with tapered surfaces 162, 164 of the distal engaging part 134 of inner member 126. As the distal end 172 engages with tapered surfaces 162, 164, parts 148, 150 and teeth 136, 138 are forced towards each other. In addition, the axial movement of the inner member 126 along the longitudinal axis L in a distal direction with respect to the outer member 128 disengages the distal end 172 of the outer member 128 from the tapered surfaces 162, 164 to allow the parts 148, 150 and teeth 136, 138 are moved away from each other.
[046] As indicated above, implant 10 and plate 12 are not coupled or otherwise attached to each other. However, implant 10 and plate 12 can be positioned adjacent to each other with the rear end 22 of implant 10 cooperating with surface 102 of plate 12. When implant 10 and plate 12 are positioned in this arrangement, they can be fitted by instrument 120 as illustrated in FIG. 18, for example. More particularly, the tooth 136 can be positioned in the groove 94 of the plate 12 and in the groove 57 of the implant 10 with the projection 140 positioned in the container 56 of the implant 10 and the projection 142 positioned in the container 98 of the plate 10. Likewise, the tooth 138 can be positioned in groove 92 of plate 12 and groove 47 of implant 10 with projection 144 positioned in container 46 of implant 10 and projection 146 positioned in container 96 of plate 10. Once teeth 136, 183 are engaged with implant 10 and plate 12, inner member 126 can be moved proximally to external member 128 to secure implant 10 and plate 12 between teeth 136, 138. The fit of implant 10 and plate 12 with the instrument 120 usually holds implant 10 and plate 12 in a continuous relationship. More particularly, the fit of the projections 140, 144 with the containers 46, 56 of the implant 10 and the fit of the projections, 142, 146 with the containers 96, 98 of the plate 10 prevents the displacement of the implant 10 from the plate 12. However, a Once detached by the instrument 120, the implant 10 can be displaced from the plate 12.
[047] While not discussed previously, it should be noted that the circular configuration of the containers 46, 56 and projections 140, 144, as well as the convex shape of the front end 22 of the implant 10 and the corresponding concave shape of the surface 102 of the plate 12 , allow the implant 10 to rotate in relation to the instrument 120 and the plate 12 when it is engaged by the instrument 120. In addition, the circuit-shaped configuration of the slots 96, 98 and projections 142, 146 prevents the plate 12 from rotating in in relation to the instrument 120 when it fits the plate 12. In the illustrated way, the rotation of the implant 10 in relation to the plate 12 and the instrument 120 will be limited in a first direction by the contact of the tooth 136 with the upper surface 58 of the groove 57 and the tooth 138 with the upper surface 48 of the groove 47, and in a second direction by the contact of the tooth 136 with the lower surface 60 of the groove 57 and of the tooth 138 with the lower surface 50 of the groove 47. Similarly, it should be noted that the orientation of the upper and lower surfaces 48, 50 relative to each other and of the upper and lower surfaces 58, 60 relative to each other can be modified to facilitate divergent degrees of rotation of the implant 10 in relation to the plate 12 when they are fitted by the instrument 120 In other ways, however, it is contemplated that the implant 10 can be configured so that its rotation in relation to the plate 12 is not limited.
[048] When fitted by instrument 120, implant 10 and plate 12 can be positioned with respect to vertebral bodies V1, V2 together in a single surgical step. More particularly, the front end 20 of the implant 12 can be positioned in the disc space D between the vertebral bodies V1, V2 and advanced in the disc space D until the lower surface 88 of the plate 12 contacts the vertebral bodies V1, V2. While implant 10 is introduced and advanced into disc space D, it can rotate with respect to plate 12 as needed to accommodate for the orientation of vertebral bodies V1, V2 with respect to disc space D. For example, when implant 10 and plate 12 are used in a curved or lordotic part of the spine, the implant 10 can extend obliquely as illustrated in FIG. 18, rather than orthogonally, even plate 12 is once inserted in disk space D. Once implant 10 is properly positioned in disk space D and plate 12 is positioned against vertebral bodies V1, V2, bone screws can be inserted through instrument 120 to attach the plate 12 to the vertebral bodies V1, V2, and the retaining element 86 can be rotated to position the ends 86a-d on the bone screws to prevent the screw from moving backwards. While only two bone screws have the bone illustrated in FIG. 18, it should be noted that the plate 12 can be joined to the vertebral bodies V1, V2 with an upper pair of screws and a lower pair of screws. After the screws have been inserted and covered retaining element 86, instrument 120 can be detached from implant 10 and plate 12 and removed from the surgical site.
[049] An insertion instrument of an alternative modality 200 configured to fit with the implant 10 and the plate 12 and position the implant 10 and plate 12 in relation to the vertebral bodies V1, V2 is illustrated in FIGS. 19-20. The instrument 200 extends along the longitudinal axis LL from the proximal end 202 to the distal end 204 and includes an inner member 208, an outer member 208 and a guiding member 210. The inner member 206 extends between a threaded proximal part 212 and a fitted distal part 214. The distal fitting part 214 is forked into parts 216, 218 that form teeth 220, 222. Parts 148, 150 also include the tapered surfaces positioned close to teeth 220, 222 and are laterally displaced one relative to another so that teeth 220, 222 can be moved to facilitate the fitting and disengaging of the instrument 200 with the implant 10 and the plate 12. The tooth 220 includes a distal projection generally circular in shape 224 configured to be positioned in the container 46 of the implant 10. The tooth 220 also includes a projection generally in the form of a circuit 226 proximally spaced from the projection 224 and configured to be positioned in the container 96 of the plate 12. The tooth 220 is then configured to be positioned in the groove 47 of the implant 10 and in the groove 92 of the plate 12 when instrument 200 is engaged with the implant 10 and the plate 12. The tooth 222 includes a distal projection generally in circular shape 228 configured to be positioned in the container 56 of the implant 10. The tooth 222 also includes a projection generally in the form of a circuit 230 proximally spaced from the projection 228 and configured to be positioned in the container 98 of the plate 12. The tooth 222 is then configured to be positioned in groove 57 of implant 10 and groove 94 of plate 12 when instrument 200 is engaged with implant 10 and plate 12.
[050] The outer member 208 extends between the proximal end 232 and the distal end 234 and includes a hollow interior that receives the inner member 206. The distal end 234 also includes the opposing teeth 236, 238 which are configured to extend longitudinally and fit with the lateral surfaces of teeth 220, 222. The outer member 208 also includes the tapered surfaces positioned close to the teeth 236, 238 and configured to fit with the tapered surfaces of the inner member 206. The proximal end 232 of the outer member 208 also includes an annular groove within which a retaining ring 240 is positioned to engage outer member 208 with steering member 210 so that steering member 210 is independently rotatable with respect to outer member 208. Driving member 210 includes internal threading configured to fit with proximal threaded part 212 of inner member 206. Likewise, the rotation of the Directing member 210 results in axial displacement of the inner member 206 along the longitudinal axis L with respect to the outer member 208. A pin 242 extends from the outer member 208 in a groove in the inner member 206 to prevent rotation of the inner member 206 in with respect to the outer member 208. In addition, a locking member 244 extends through the steering member 210 and is selectively interlocking with the inner member 206 to prevent rotation of the steering member 210 with respect to the inner member 206 once a desired relationship between inner member 206 and outer member 208 was obtained. While not discussed previously, it should be noted that the axial movement of the inner member 206 along the longitudinal axis L in the proximal direction in relation to the outer member 208 results in a fit of the tapered surfaces of the outer member 208 with the tapered surfaces of the inner member 206 which forces teeth 220, 222 towards each other. In addition, the axial movement of the inner member 206 along the longitudinal axis L in a distal direction with respect to the outer member 208 disengages the tapered surfaces of the inner and outer members 206, 208 to allow parts 216, 218 and teeth 220 , 222 are moved away from each other.
[051] When implant 10 and plate 12 are positioned adjacent to each other as discussed above, they can be fitted by instrument 200. More particularly, tooth 220 can be positioned in groove 94 of plate 12 and groove 57 of the implant 10 with the projection 224 positioned in the container 56 of the implant 10 and the projection 226 positioned in the container 98 of the plate 10. Likewise, the tooth 222 can be positioned in the groove 92 of the plate 12 and in the groove 47 of the implant 10 with projection 288 positioned on container 46 of implant 10 and projection 230 positioned on container 96 of plate 10. Once teeth 200, 222 are engaged with implant 10 and plate 12, inner member 206 can be moved proximally to the outer member 208 to secure the implant 10 and the plate 12 between teeth 220, 222. The fitting of the implant 10 and plate 12 with the 2000 instrument generally holds the implant 10 and plate 12 in a continuous relationship. More particularly, the fitting of the projections 224, 228 with the containers 46, 56 of the implant 10 and the fitting of the projections, 226, 230 with the containers 96, 98 of the plate 10 prevents the displacement of the implant 10 from the plate 12. However, once detached by the instrument 200, the implant 10 is freely movable from the plate 12.
[052] While not discussed previously, it should be noted that the circular configuration of the containers 46, 56 and projections 224, 228, as well as the convex shape of the front end 22 of the implant 10 and the corresponding concave shape of the surface 102 of the plate 12 , allow the implant 10 to rotate in relation to the instrument 200 and the plate 12 when it is fitted by the instrument 200. In addition, the circuit-shaped configuration of the slots 96, 98 and projections 226, 230 prevents the plate 12 from rotating in in relation to the instrument 200 when it fits the plate 12. In the illustrated way, the rotation of the implant 10 in relation to the plate 12 and the instrument 200 will be limited in a first direction by the contact of the tooth 220 with the upper surface 58 of the groove 57 and the tooth 222 with the upper surface 48 of the groove 47, and in a second direction by the contact of the tooth 220 with the lower surface 60 of the groove 57 and of the tooth 222 with the lower surface 50 of the groove 47. Similarly, it should be noted that the orientation of the upper and lower surfaces 48, 50 relative to each other and of the upper and lower surfaces 58, 60 relative to each other can be modified to facilitate divergent degrees of rotation of the implant 10 relative to the plate 12 when they are fitted by the instrument 200. In other ways, however, it is contemplated that the implant 10 can be configured so that its rotation in relation to the plate 12 is not limited. When fitted by instrument 200, implant 10 and plate 12 can be positioned with respect to vertebral bodies V1, V2 together in a single surgical step, as discussed above with respect to instrument 120. Once implant 10 and plate 12 are positioned in relation to the vertebral bodies V1, V2, one or more instruments to prepare the vertebral bodies V1, V2 to receive the bone screws can be positioned between teeth 220, 222 and through the bone screw holes 78, 80, 82, 84 of plate 12, followed by insertion of bone screws through plate 12 between teeth 220, 222.
[053] As discussed above, instruments 120, 200 can be used to fit and insert implant 10 and plate 12 which is free from implant 10; that is, the plate 12 is not mechanically joined or otherwise coupled to the implant 10. In this way, the implant 10 and plate 12 are kept adjacent to each other in a continuous relationship by the instruments 120, 200, but otherwise they are freely movable each other when not fitted with instruments 120, 200. In addition, fitting the implant 10 and plate 12 with instruments 120, 200 allows the implant 10 to be rotated relative to plate 12, which is held stationary by instruments 120, 200 and instruments 120, 200 so that the orientation of the implant 10 in relation to the plate 12 can be adjusted during the implantation of the implant 10 and plate 12. In other forms not shown, it should be noted that the implant configurations 10 and of plate 12 can be reversed so that plate 12 can be rotated with respect to implant 10, which is held stationary by instruments 120, 200, and instruments 120, 200 so that the orientation of plate 12 in relation to the implant te 10 can be adjusted during implantation of implant 10 and plate 12. In other ways, it is also contemplated that instruments 120, 200 can be used to fit and insert an implant that is coupled to a plate. In addition, when the specific designs of implant 10 and plate 12 are illustrated and described, it should be appreciated that other designs of implant 10 and plate 12 are also within the scope of this disclosure.
[054] In addition, while not discussed previously, it should be noted that implant 10 is generally centered on plate 12 when implant 10 and plate 12 are engaged by instruments 120, 200. Likewise, in the present arrangement, the plate 12 will generally be centralized in relation to implant 10 and the corresponding disk space in which implant 10 is inserted followed by the positioning of implant 10 and plate 12 with instruments 120, 200 without any other manipulation or adjustment of plate 12. Among others things, the centralization of the plate 12 in relation to the implant 10 by these results of the arrangement in the holes of the bone screws 78, 80 and 82, 84 being properly positioned in relation to the end plates of the vertebrae positioned on opposite sides to the disk space to facilitate the insertion of bone screws through and into the socket with the vertebrae. Likewise, in certain aspects, given the proper placement of bone screw holes 78, 80 and 82, 84 in relation to the adjacent vertebrae due to the centralization effect of plate 12 in relation to implant 10 provided by instruments 120, 200, the plate 12 can be supplied with a relatively shorter length. However, in other respects, it is provided that the length of the plate 12 is not adjusted due to this arrangement.
[055] In one embodiment, a system to provide stabilization of the first and second vertebrae includes an implant configured to be positioned between the vertebrae and a plate configured to be positioned against and embedded with an outer surface of each vertebra. The implant and the plate can each be wrapped by a single surgical instrument in an arrangement that facilitates the adjustment of the orientation of the implant and plate in relation to each other during implantation of the implant and plate. In addition, the fitting of the implant and the plate by the instrument facilitates the implantation of the implant and plate together in a single surgical step without eliminating the adjustability of the implant in relation to the plate. In one aspect, the implant and the plate are free from each other (that is, the implant and the plate are not coupled to each other) and the instrument holds the implant and the plate in a continuous relationship when it is attached to it .
[056] While not discussed earlier, it should be noted that, unless otherwise described, the implants, devices and instruments described in this document can be made from any appropriate biocompatible material, including, but not limited to, titanium, alloy titanium, stainless steel, metal alloys, polyaryethylketone (PAEK), polyetheretherketone (PEEK), carbon fiber reinforced PEEK, polyetheretherketoneketone (PEKK), polysulfone, polyetherimide, polyamide, polyethylene ultra high molecular weight (UHMWPE) and plastics, just to name a few possibilities. Implants and plates can be made of the same or different material. Naturally, it is understood that the relative size of the components can be modified for the specific vertebra (s) to be instrumented (s) and for the specific position or structure of the vertebra (s) in relation to to which (s) the implant and the plate will be positioned.
[057] Still, it should also be noted that the implants, instruments, devices, systems, techniques and methods described here can also be used in surgical procedures involving animals or in demonstrations for training, education, marketing, sales and / or advertising purposes . In addition, the implants, instruments, devices, systems, techniques and methods described herein can also be used in or in relation to a non-living object, such as a corpse, model or training aid, or in connection with tests of surgical systems, procedures surgical devices, orthopedic devices and / or instruments.
[058] Any theory, mechanism of operation, proof or discovery here is intended to further increase the understanding of this application and is not intended to make this application in any way dependent on such theory, mechanism of operation, proof or discovery. It should be understood that while the use of the word preferable, preferably or preferred in the description above indicates that the characteristic thus described may be more desirable, it may, however, not be necessary and modalities that do not have the characteristic can be contemplated as in. the scope of the order, which is being defined by the following claims. In reading the claims, it is intended that when words / phrases such as "one", "at least one", or "at least a part" are used, there is no intention to limit the claim to just one item unless specifically stated otherwise in the order. In addition, when the terms "at least a part" and / or "a part" are used, the item may include a part and / or the entire item unless specifically indicated otherwise.
[059] While the application was illustrated and described in detail in the previous drawings and description, it is considered to be illustrative and not restrictive, it being understood that only the selected modalities were shown and described and that all changes, modifications and equivalents that come in the spirit of the application as defined herein or by any of the following claims are intended to be protected.

权利要求:
Claims (11)
[0001]
1. A system for providing spinal stabilization, comprising: an implant (10) including a body (18) extending from a front end (20) to an opposite rear end (22), such a body (18) including a fitting surface of the upper bone (30) and an opposite fitting surface of the lower bone (32), with said fitting surfaces of the upper and lower bones (30, 32) fitting the respective end plates of the upper and lower vertebrae (V1 , V2) when said implant (10) is positioned in a disc space between the upper and lower vertebrae (V1, V2); a plate (12) for fitting with the upper and lower vertebrae (V1, V2), said plate (12) including a plate body (66) extending between an upper end (70) and an opposite lower end ( 72), said plate body (66) including an upper surface (86) and an opposite bottom surface (88) facing the upper and lower vertebrae (V1, V2), when said plate (12) is engaged in this; and an insertion instrument (120; 200) including a fitting part (134; 214) configured to fit freely with said implant (10) and said plate (12), in which an angular orientation of said implant (10) in relation to said plate (12) is adjustable when said implant (10) and said plate (12) are fitted by said instrument (120; 200), characterized by the fact that the rotation of said plate (12) with respect to said instrument (120; 200) is limited when said implant (10) and said plate (12) are fitted by said insertion instrument and in which the fitting of said implant (10) and said plate (12) with said instrument (120; 200) prevents the displacement of said implant (10) with respect to said plate (12) and in the disengagement of said implant and said plate from said instrument (120; 200), said implant (10) is freely movable with respect to said plate (12).
[0002]
2. System according to claim 1, characterized by the fact that said implant (10) includes a first pair of containers (46, 56) positioned on opposite sides of said implant between said upper and lower bone fitting surfaces lower (30, 32) and said plate (12) includes a second pair of containers (96, 98) positioned on opposite sides of said plate between said upper and lower surfaces (86, 88).
[0003]
3. System according to claim 2, characterized by the fact that said fitting part (134, 214) of said instrument (120, 200) includes a pair of positioned opposing teeth (136, 138; 220, 222) said teeth each including a first projection (140, 144; 224, 228) configured to be positioned in a respective said first pair of containers (46, 56) and a second projection (142, 146; 226, 230 ) configured to be positioned in the respective referred second pair of containers (96, 98).
[0004]
4. System according to claim 3, characterized in that said plate (12) includes the first and second grooves (92, 94) formed on said opposite sides and extending between said upper and lower surfaces (86, 88), and a respective said second pair of containers (96, 98) is positioned in each of the said first and second grooves.
[0005]
5. System according to claim 4, characterized in that said implant (10) includes a first notch (47) which extends from a first of said first pair of containers (46, 56) and which opens through said rear end (22) of said implant (10) and a second notch (57) extending from a second of said first pair of containers and which opens through said rear end of said implant.
[0006]
6. System, according to claim 5, characterized by the fact that said teeth (136, 138; 220, 222) are positioned in the respective of the first said notch (47) and in the first said groove (92) and the second said groove (94) when said implant (10) and said plate (12) are engaged by said instrument (120; 200).
[0007]
7. System, according to claim 3, characterized by the fact that the first said projections (140, 144; 224, 228) of said teeth (136, 138; 220, 222) include a generally cylindrical configuration and the second said projections (142, 146; 226, 230) of said teeth generally include a circuit-shaped configuration.
[0008]
8. System, according to claim 3, characterized by the fact that the first projections (140, 144; 224, 228) of said teeth (136, 138; 220, 222) are positioned at a distal end of said instrument and the second projections (142, 146; 226, 230) of said teeth are spaced close to the first projections.
[0009]
System according to claim 1, characterized in that said plate body (66) includes a pair of holes (78, 80) adjacent to said upper end (70) that extends through said upper surfaces and lower (86, 88) and a second pair of holes (82, 84) adjacent to said lower end (72) extending across said upper and lower surfaces, and further comprising a first pair of locking fasteners bone (14) extending through the first pair of holes for fitting with the upper vertebra (V1) and a second pair of bone fitting fixing elements (16) extending through the second pair of holes for fitting with the vertebra bottom (V2).
[0010]
10. System according to claim 9, characterized by the fact that said plate includes (12) a retention element rotatable with respect to said plate between a first position where said bone fitting fasteners (14, 16 ) are positionable through said holes (78, 80 82, 84) and a second position where a part of said retaining element covers the part of each of said bone fitting fasteners to prevent backward displacement of said elements for fixing the bone socket of said holes.
[0011]
11. System according to claim 1, characterized by the fact that said insertion instrument (120; 200) includes a plurality of guide holes configured to facilitate the insertion of one or more bone fitting fixation elements (14, 16) through said insertion instrument and said plate (12) in the socket with said vertebrae (V1, V2).

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同族专利:

公开号 | 公开日

US8690948B2|2014-04-08|

JP6010560B2|2016-10-19|

CA2828568A1|2012-09-07|

EP3173051A1|2017-05-31|

US20160000475A1|2016-01-07|

US9925063B2|2018-03-27|

EP2680794A4|2014-08-13|

WO2012118941A2|2012-09-07|

US20120226319A1|2012-09-06|

US9526532B2|2016-12-27|

AU2012223306A1|2013-09-26|

US9615940B2|2017-04-11|

CN103402463A|2013-11-20|

US20130231749A1|2013-09-05|

US20170151064A1|2017-06-01|

EP3173051B1|2020-10-07|

US20160256294A1|2016-09-08|

EP2680794B1|2017-05-03|

CA2828568C|2018-12-11|

JP2014514014A|2014-06-19|

CN103402463B|2016-04-27|

WO2012118941A3|2012-11-15|

US9180019B2|2015-11-10|

AU2012223306B2|2017-02-02|

EP2680794A2|2014-01-08|

US8454694B2|2013-06-04|

US20140156009A1|2014-06-05|

BR112013022322A2|2016-12-06|

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法律状态:
2018-12-18| B06F| Objections, documents and/or translations needed after an examination request according art. 34 industrial property law|

2020-08-11| B06A| Notification to applicant to reply to the report for non-patentability or inadequacy of the application according art. 36 industrial patent law|

2020-11-24| B09A| Decision: intention to grant|

2020-12-29| B16A| Patent or certificate of addition of invention granted|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 01/03/2012, OBSERVADAS AS CONDICOES LEGAIS. |

优先权:

申请号 | 申请日 | 专利标题

US13/040035|2011-03-03|

US13/040,035|US8454694B2|2011-03-03|2011-03-03|Interbody device and plate for spinal stabilization and instruments for positioning same|

PCT/US2012/027230|WO2012118941A2|2011-03-03|2012-03-01|Interbody device and plate for spinal stabilization and instruments for positioning same|

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