Patient-specific anterior plate implants
The present technology provides patient-specific implants. The implants can include a plate having a geometry contoured to mate with an identified anatomical structure at a target position. The plate can include a first projection having a first contact surface with a first topography designed to mate with a corresponding first surface of a first vertebral body, and a second projection having a second contact surface with second topography designed to mate with a corresponding second surface of a second vertebral body. The first topography can be different than the second topography. In some embodiments, the first and/or second projection can be configured to contact, and have topographies designed to mate, with a plurality of surfaces, such as two adjacent surfaces, of the respective first and second vertebral bodies.
1 . A computer-implemented method for providing patient-specific medical care, the method comprising:
receiving a patient data set for a patient, the patient data set including one or more images of at least a portion of the patient's spine including a superior vertebra and an inferior vertebra, the one or more images showing the patient's native anatomical configuration;
determining, using a computing system, a corrected anatomical configuration for the patient, wherein the corrected anatomical configuration is different than the native anatomical configuration; and
designing, using the computing system, a patient-specific anterior plate based on the corrected anatomical configuration, wherein the patient-specific anterior plate includes—
a first contact region contoured to mate with an anterior surface of the superior vertebra,
a second contact region contoured to mate with an anterior surface of the inferior vertebra, and
an intermediate projection configured to mate with endplates of the superior and inferior vertebrae when the first and second contact regions are mated with the respective anterior surfaces of the superior and inferior vertebrae, wherein the intermediate projection has a length of between 1 mm and 20 mm and a posterior terminus of the intermediate projection is configured to extend past at least one of a first cortical rim of the superior vertebra and/or a second cortical rim of the inferior vertebra by between 1 mm and 10 mm in a posterior direction.
2 . The computer-implemented method of claim 1 , further comprising:
determining a target implant location along a virtual model of the patient's spine in the corrected anatomical configuration; and
constructing a virtual model of at least one of the patient-specific anterior plates to seat against the target implant location.
3 . The computer-implemented method of claim 1 , further comprising:
designing a virtual model of an intervertebral implant for implantation between a first vertebra and a second vertebra; and
designing the patient-specific anterior plate to couple to the first and second vertebrae to obstruct movement of the intervertebral implant when the intervertebral implant is located between the first and second vertebrae.
4 . The computer-implemented method of claim 1 , wherein the patient-specific anterior plate includes one or more seating features configured to hold the at least one of the patient-specific anterior plate at a specific location along the patient's spine.
5 . The computer-implemented method of claim 1 , further comprising:
identifying registration features along the patient's spine for engaging the patient-specific anterior plate; and
designing regions of the patient-specific anterior plate to contact the identified registration features for inhibiting movement of a spinal segment of the patient's spine.
6 . The computer-implemented method of claim 1 , further comprising:
generating a virtual model of the patient's spine in the corrected anatomical configuration; and
in response to modifying the virtual model, dynamically adjusting a first virtual model of the patient-specific anterior plate and a second virtual model of another spinal implant.
7 . The computer-implemented method of claim 1 , further comprising:
generating a virtual model of the patient's spine in the corrected anatomical configuration;
modifying the virtual model to generate a modified virtual model of the patient's spine; and
designing the patient-specific anterior plate based on the modified virtual model.
8 . The computer-implemented method of claim 1 , further comprising identifying one or more target positions along the patient's spine, wherein the patient-specific anterior plate is designed to correspond with one or more anatomical structures at a corresponding target position.
9 . The computer-implemented method of claim 8 , wherein the patient-specific anterior plate is a first patient-specific anterior plate, and wherein the computer-implemented method further includes:
designing a second patient-specific anterior plate configured to be implanted at a different target location than the first patient-specific anterior plate, wherein the first patient-specific anterior plate has a different geometry than the second patient-specific anterior plate.
10 . The computer-implemented method of claim 1 wherein designing the patient-specific anterior plate includes designing the intermediate projection to contact an intervertebral disc in an intervertebral space between the inferior vertebra and the superior vertebra.
11 . The computer-implemented method of claim 1 , further comprising designing, using the computing system, a patient-specific lateral plate based on the corrected anatomical configuration, wherein the patient-specific lateral plate is configured to mate with at least one of a first lateral surface of the superior vertebra and/or a second lateral surface of the inferior vertebra.
12 . The computer-implemented method of claim 11 wherein designing the patient-specific lateral plate includes designing one or more connectors configured to couple the patient-specific lateral plate to the patient-specific anterior plate.
13 . The computer-implemented method of claim 1 , further comprising:
designing a patient-specific cage sized and shaped to be inserted between the endplates of the superior and inferior vertebrae at a target position, wherein the patient-specific cage has patient-specific surfaces configured to mate with the endplates of the superior and inferior vertebrae,
wherein the intermediate projection is designed to contact the patient-specific cage when the first and second contact regions are mated with the respective anterior surfaces of the superior and inferior vertebrae and the patient-specific cage is positioned at the target position.
14 . The computer-implemented method of claim 13 wherein the intermediate projection is releasably coupleable to the patient-specific cage.
15 . A patient-specific implant, comprising:
a plate configured to be implanted at a target position along a patient's spine so as to mate with a superior vertebra and an inferior vertebra, wherein the plate includes:
a first contact region contoured to mate with an anterior surface of the superior vertebra,
a second contact region contoured to mate with an anterior surface of the inferior vertebra, and
an intermediate projection configured to mate with endplates of the superior and inferior vertebrae when the first and second contact regions are mated with the respective anterior surfaces of the superior and inferior vertebra,
wherein the intermediate projection has a length of between 1 mm and 20 mm and a posterior terminus of the intermediate projection is configured to extend past at least one of a first cortical rim of the superior vertebra and/or a second cortical rim of the inferior vertebra by between 1 mm and 10 mm in a posterior direction.
16 . The patient-specific implant of claim 15 , further comprising an intervertebral device positioned in an intervertebral space between the superior and inferior vertebrae, wherein the intermediate projection is further configured to extend into the intervertebral space to contact the intervertebral device.
17 . The patient-specific implant of claim 16 wherein, when implanted at the target position, the plate is further configured to inhibit anterior movement of the intervertebral device.
18 . The patient-specific implant of claim 16 wherein the intervertebral device is configured to be coupled to the intermediate projection when the intervertebral device is positioned in the intervertebral space and the plate is implanted at the target position.
19 . The patient-specific implant of claim 16 wherein the intervertebral device is configured to receive at least a portion of a load applied by the superior vertebra or the inferior vertebra to the patient-specific implant when the intervertebral device is positioned in the intervertebral space.
20 . The patient-specific implant of claim 19 wherein the portion of the load is a first portion of the load, and wherein the intermediate projection is configured to receive at least a second portion of the load when the plate is implanted at the target position, the second portion of the load being at least 10% of the total load.
21 . The patient-specific implant of claim 15 wherein the plate is an anterior plate, further comprising a lateral plate configured to mate with at least one of a first lateral surface of the superior vertebra and/or a second lateral surface of the inferior vertebra.
22 . The patient-specific implant of claim 21 , further comprising a connector configured to couple the lateral plate to the anterior plate at least when the anterior plate is implanted at the target position.
23 . The patient-specific implant of claim 15 wherein the intermediate projection includes a posterior terminus configured to contact an intervertebral disc positioned within an intervertebral space between the superior vertebra and the inferior vertebra when the plate is implanted at the target position.
24 . The patient-specific implant of claim 15 wherein the intermediate projection has a length of between 5 mm and 15 mm.
25 . The patient-specific implant of claim 15 wherein the intermediate projection is configured to occupy at least 50% of the void space in an intervertebral space between the superior vertebra and the inferior vertebra.
26 . A patient-specific implant, comprising:
a plate configured to mate with a superior vertebra and an inferior vertebra at a target position along a patient's spine, wherein the plate includes—
a first projection including a first vertebral contact surface having a first patient-specific geometry contoured to mate with an anterior surface of the superior vertebra,
a second projection including a second vertebral contact surface having a second patient-specific geometry contoured to mate with an anterior surface of the inferior vertebra; and
an intermediate projection including—
a first intermediate contact surface having a third patient-specific geometry contoured to mate with at least a portion of an inferior surface of the superior vertebra, and
a second intermediate contact surface having a fourth patient-specific geometry contoured to mate with at least a portion of a superior surface of the inferior vertebra,
wherein the intermediate projection has a length of between 1 mm and 20 mm;
wherein the first patient-specific geometry is different from the second, third, and/or fourth patient-specific geometry.
27 . The patient-specific implant of claim 26 wherein, when the plate is implanted at the target position, the plate forms a generally gapless interface with the anterior surface of the superior vertebra and the anterior surface of the inferior vertebra.
28 . The patient-specific implant of claim 26 wherein the first projection includes an uppermost portion having a third contact surface, wherein the third contact surface has a fifth patient-specific geometry contoured to mate with a surface adjacent the anterior surface of the superior vertebra.
29 . The patient-specific implant of claim 28 wherein the surface adjacent the anterior surface of the superior vertebra is a superior surface of the superior vertebra.
30 . The patient-specific implant of claim 26 wherein the second projection includes a lowermost portion having a third contact surface, wherein the third contact surface has a fifth patient-specific geometry contoured to mate with a surface adjacent the anterior surface of the inferior vertebra.
31 . The patient-specific implant of claim 30 wherein the surface adjacent the anterior surface of the inferior vertebra is an inferior surface of the inferior vertebra.
32 . The patient-specific implant of claim 26 wherein the plate is a first plate and the target position is a first target position, further comprising a second plate configured to mate with the superior vertebra and the inferior vertebra at a target position, wherein the second plate includes:
a third projection including a fifth contact surface, the fifth contact surface having a fifth patient-specific geometry contoured to mate with a lateral surface of the superior vertebra, and
a fourth projection having a sixth contact surface, the sixth contact surface having a sixth patient-specific geometry contoured to mate with a lateral surface of the inferior vertebra,
wherein the first plate is coupled to the second plate by one or more connectors.
33 . The patient-specific implant of claim 32 wherein the second plate further includes a second intermediate projection positioned between the third projection and the fourth projection, the second intermediate projection including—
a third intermediate contact surface having a seventh patient-specific geometry contoured to mate with at least a portion of the inferior surface of the superior vertebra, and
a fourth intermediate contact surface having an eighth patient-specific geometry contoured to mate with at least a portion of the superior surface of the inferior vertebra.
34 . A patient-specific implant system, comprising:
a patient-specific cage sized and shaped to be inserted between endplates of a superior and inferior vertebrae and positioned at a target intervertebral position, wherein the patient-specific cage has patient-specific surfaces configured to mate with the endplates of the superior and inferior vertebrae when positioned at the target intervertebral position; and
an anterior positioning structure configured to engage the patient-specific cage and an anterior surface of the superior and/or inferior vertebra, wherein the anterior positioning structure includes—
one or more contact regions configured to abut with the anterior surface of the superior and/or inferior vertebra, and
an intermediate projection configured to extend between the endplates of the superior and inferior vertebrae when the one or more contact regions abut with the anterior surface of the superior and/or inferior vertebra to contact the patient-specific cage,
wherein the intermediate projection has a length of between 1 mm and 20 mm and a posterior terminus of the intermediate projection is configured to extend past at least one of a first cortical rim of the superior vertebra and/or a second cortical rim of the inferior vertebra by between about 1 mm and about 10 mm in a posterior direction,
wherein an entire contact region between the implant system and the endplates of the superior and inferior vertebrae comprise patient-specific contouring.
35 . The patient-specific implant system of claim 34 wherein the intermediate projection is releasably coupleable to the patient-specific cage.
36 . The patient-specific implant system of claim 34 wherein the intermediate projection is configured to mate with the endplates of the superior and inferior vertebrae when the one or more contact regions abut with the anterior surface of the superior and/or inferior vertebra.
37 . The patient-specific implant system of claim 34 wherein, when the anterior positioning structure is coupled to the patient-specific cage and the one or more contact regions abut with the anterior surface of the superior and/or inferior vertebra, the patient-specific cage is positioned within 20 mm of an anterior margin of the superior and/or the inferior vertebrae.
38 . A patient-specific implant system, comprising:
a patient-specific cage sized and shaped to be inserted between endplates of a superior and inferior vertebrae and positioned at a target intervertebral position, wherein the patient-specific cage has patient-specific surfaces configured to mate with the endplates of the superior and inferior vertebrae when positioned at the target intervertebral position; and
an anterior positioning structure having—
one or more contact regions configured to abut with an anterior surface of the superior and/or inferior vertebra, and
an intermediate projection releasably coupleable to the patient-specific cage and configured to extend between the endplates of the superior and inferior vertebrae when the one or more contact regions abut with the anterior surface of the superior and/or inferior vertebra,
wherein, when the intermediate projection is releasably coupled to the patient-specific cage and the one or more contact regions abut with the anterior surface of the superior and/or inferior vertebra, an anterior aspect of the patient-specific cage is positioned within 1 mm to 20 mm of an anterior margin of the superior and/or inferior vertebra, and
wherein an entire contact region between the implant system and the endplates of the superior and inferior vertebrae comprise patient-specific contouring.
39 . The patient-specific implant system of claim 38 wherein the intermediate projection is configured to mate with the endplates of the superior and inferior vertebrae when the one or more contact regions abut with the anterior surface of the superior and/or inferior vertebra.