IP Library › Granted Patent US 7,186,256

Granted Patent B2

US 7,186,256 · App. 10/160,062 · Granted Mar 6, 2007

Dynamic, modular, single-lock anterior cervical plate system having assembleable and movable segments

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Quick Facts

Patent No.: US 7,186,256
App. No.: 10/160,062
Granted: Mar 6, 2007
Kind: B2

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Abstract

An anterior cervical plating system having modular plate segments that are assembleable to vary the overall length of the plate, moveable to allow and/or cause intersegmental compression of vertebral bodies, and coupled together by a detachable fastener. The plating system includes locking elements for locking only one bone screw to the plate, instrumentation, and method for installation thereof. The plating system is capable of both passive and active dynamization and the ability to produce the former from the latter.

Claims (177)

1. A plate adapted to be applied to the anterior human cervical spine for contacting the anterior aspects of at least two adjacent cervical vertebral bodies to be fused together, said plate comprising:

at least a first plate segment adapted to be attached to one of the adjacent vertebral bodies to be fused and at least a second plate segment adapted to be attached to another one of the adjacent vertebral bodies to be fused, said at least first and second plate segments adapted to be connected to one another and at least in part overlapped to form said plate, said at least first and second plate segments being in a moveable relationship to one another along a longitudinal axis of said plate, each of said at least first and second plate segments including:

at least one bone screw receiving hole extending from said upper surface through said lower surface, each of said bone screw receiving holes adapted to overlie one of the cervical vertebral bodies and being adapted to receive at least one bone screw for engaging the cervical vertebral body to attach said plate to the cervical spine;

at least one fastener adapted to couple together said first and second plate segments, said fastener being detachably attached to at least one of said first and second plate segments so as to permit assembly of said first and second plate segments by the surgeon and complete uncoupling of said first and second plate segments relative to one another, said fastener having a first position adapted to facilitate movement of said first and second plate segments in a direction toward one another along the longitudinal axis of said plate and to resist movement of said first and said second plate segments in a direction away from one another along the longitudinal axis of said plate; and

at least one bone screw lock adapted to lock to said plate only a single bone screw inserted in one of said bone screw receiving holes.

2. The plate of claim 1 , wherein said fastener has a second position adapted to limit movement of said first and second plate segments relative to one another along the longitudinal axis of said plate.

3. The plate of claim 1 , wherein said fastener is configured so as to be able to completely restrict movement of said first and second plate segments relative to one another along at least a longitudinal axis of said plate.

4. The plate of claim 1 , wherein said fastener passes through at least a portion of said first and second plate segments.

5. The plate of claim, 1 wherein said fastener is configured to limit separation of said first and second plate segments relative to one another.

6. The plate of claim 1 , wherein said fastener is configured to be tightened to only one of said at least first and second plate segments so as to permit movement of said first and second plate segments relative to one another.

7. The plate of claim 1 , wherein said fastener is a part of a mechanism for moving said first and second plate segments relative to one another along a longitudinal axis of said plate.

8. The plate of claim 1 , wherein said fastener is a screw.

9. The plate of claim 1 , where said fastener is at least in part threaded.

10. The plate of claim 1 , wherein said fastener has a head.

11. The plate of claim 9 , wherein said fastener has a shaft.

12. The plate of claim 1 , wherein said first and second plate segments are adapted to move toward one another in response to movement of the adjacent cervical vertebral bodies toward each other.

13. The plate of claim 1 , wherein said first and second plate segments are adapted to move the adjacent cervical vertebral bodies toward each other in response to movement of said first and second plate segments moving toward each other.

14. The plate of claim 2 , wherein said first and second plate segments are adapted to maintain a compressive load across a disc space between the adjacent cervical vertebral bodies when said fastener is in said second position.

15. The plate of claim 1 , wherein at least a portion of said upper surface of said second plate segment is convex at least in part along at least a portion of the longitudinal axis of said plate.

16. The plate of claim 1 , wherein said at least first and second plate segments are configured to cooperate so as to maintain said first and second plate segments generally aligned along the longitudinal axis of said plate.

17. The plate of claim 1 , wherein said at least first and second plate segments are configured to cooperate so as to limit movement of said first and second plate segments in a direction generally transverse to the longitudinal axis of said plate.

18. The plate of claim 1 , wherein at least a portion of said lower surface of said first plate segment is configured to cooperatively engage at least a portion of said upper surface of said second plate segment.

19. The plate of claim 1 , at least a portion of said lower surface of said first plate segment is configured to interdigitate with at least a portion of said upper surface of said second plate segment.

20. The plate of claim 19 , wherein said at least a portion of said lower surface of said first plate segment and said at least a portion of the upper surface of said second plate segment include ratchetings.

21. The plate of claim 1 , wherein at least one of said first and second plate segments is selected from a group of plate segments of various lengths.

22. The plate of claim 1 , wherein at least one of said first and second plate segments is selected from a group of plate segments of various configurations.

23. The plate of claim 1 , further comprising at least a third plate segment adapted to be connected to at least one of said first and second plate segments to form said plate.

24. The plate of claim 23 , wherein said third plate segment is an intermediate plate segment configured to be coupled between at least two plate segments.

25. The plate of claim 23 , wherein at least one of said first, second, and third plate segments is selected from a group of plate segments of various lengths.

26. The plate of claim 23 , wherein at least one of said first, second, and third plate segments is selected from a group of plate segments of various configurations.

27. The plate of claim 26 , wherein said first, second, and third plate segments are selected from a group including end segments and intermediary segments.

28. The plate of claim 27 , wherein each of said end segments is configured to connect to one of said end segments and said intermediary segments, and each of said intermediary segments is configured to connect to at least one of said end segments and said intermediary segments.

29. The plate of claim 1 , wherein said at least one bone screw lock is coupled to said plate.

30. The plate of claim 29 , wherein said at least one bone screw lock is removably coupled to said plate.

31. The plate of claim 29 , wherein said at least one bone screw lock is adapted to be coupled to said plate prior to the insertion of bone screws into said bone screw receiving holes.

32. The plate of claim 1 , wherein said at least one bone screw lock is configured to move from an initial position that permits the insertion of bone screws into said bone screw receiving holes to a final position that is adapted to extend over at least a portion of the bone screw to retain the bone screws to said plate.

33. The plate of claim 32 , wherein said at least one bone screw lock in the final position covers at least a portion of said bone screw receiving holes.

34. The plate of claim 32 , wherein said at least one bone screw lock is adapted to be rotated from the initial position to the final position.

35. The plate of claim 34 , wherein less than a full rotation of said at least one bone screw look rotates said bone screw lock from the initial position to the final position.

36. The plate of claim 32 , wherein at least a portion of said at least one bone screw lock slides from the initial position to the final position.

37. The plate of claim 36 , wherein said at least one bone screw lock slides over at least a portion of one of said bone screw receiving holes.

38. The plate of claim 37 , wherein said at least one bone screw lock slides over at least a portion of the bone screws in said bone screw receiving holes.

39. The plate of claim 1 , wherein said at least one bone screw lock comprises at least one of a screw, a rivet, a cap, and a cover.

40. The plate of claim 1 , wherein said at least one bone screw lock comprises a head that is at least in part circular.

41. The plate of claim 40 , wherein said head has at least one cutout segment.

42. The plate of claim 1 , wherein said at least one bone screw lock has a central longitudinal axis and is adapted to engage a respective one of said bone screw receiving holes with the central longitudinal axis of said at least one bone screw lock being substantially coaxial with the central longitudinal axis of a respective one of said bone screw receiving holes.

43. The plate of claim 42 , wherein said at least one bone screw lock is configured to threadably engage one of said bone screw receiving holes.

44. The plate of claim 1 , wherein said at least one bone screw lock is part of a bone screw configured to threadably engage one of said bone screw receiving holes.

45. The plate of claim 43 , wherein said at least one bone screw lock has threads with different thread pitches.

46. The plate of claim 1 , wherein at least one end of said plate is configured to cooperatively engage a compression tool for movement of at least one vertebral body toward another vertebral body during installation of said plate.

47. The plate of claim 1 , wherein said concave part of said lower surface of said first and second plate segment is configured to conform to the anterior aspect of at least a portion of two cervical vertebral bodies.

48. The plate of claim 1 , wherein at least a portion of said lower surface of said first and second plate segment is at least in part concave transverse to the longitudinal axis of the plate.

49. The plate of claim 1 , wherein at least a portion of said lower surface of said first and second plate segments is roughened to promote the growth of bone along said lower surface.

50. The plate of claim 1 , wherein at least a portion of said lower surface of said first and second plate segments comprises a bone ingrowth surface.

51. The plate of claim 1 , wherein at least one of said bone screw receiving holes is configured to form an interference fit with at least a portion of the trailing end of a properly dimensioned bone screw to be received therein.

52. The plate of claim 1 , wherein at least one of said bone screw receiving holes is configured to hold a bone screw in fixed relationship to said plate.

53. The plate of claim 1 , wherein at least one of said bone screw receiving holes is configured to allow a bone screw to be in a moveable relationship to said plate.

54. The plate of claim 1 , wherein at least one of said bone screw receiving holes is configured to allow a bone screw to be in a variable angular relationship to said plate.

55. The plate of claim 1 , wherein at least two of said bone screw receiving holes are oriented in said plate to overlie the anterior aspect of a single cervical vertebral body adjacent a disc space to be fused.

56. The plate of claim 1 , wherein at least a first pair of said bone screw receiving holes are oriented in said plate to overlie the anterior aspect of a first cervical vertebral body adjacent a disc space to be fused and at least a second pair of said bone screw receiving holes are oriented in said plate to overlie the anterior aspect of a second cervical vertebral body adjacent the disc space to be fused.

57. The plate of claim 1 , in combination with a fusion promoting substance.

58. The plate of claim 57 , wherein said fusion promoting substance Is at least in part other than bone.

59. The plate of claim 57 , wherein said fusion promoting substance is at least in part bone.

60. The plate of claim 57 , wherein said fusion promoting substance is hydroxyapatite.

61. The plate of claim 57 , wherein said fusion promoting substance comprises bone morphogenetic protein.

62. The plate of claim 57 , wherein said fusion promoting substance comprises genes coding for the production of bone.

63. The plate of claim 1 , further comprising bone screws for engaging said plate to the cervical spine, wherein at least a portion of one of said plate, said at least one bane screw lock, and said bone screws is a bioresorbable material.

64. The plate of claim 63 , wherein said bioresorbable material is at least in part bone.

65. The plate of claim 1 , in combination with a substance for inhibiting scar formation.

66. The plate of claim 1 , in combination with an antimicrobial material.

67. The plate of claim 1 , wherein said plate is treated with an antimicrobial material.

68. The plate of claim 1 , further comprising at least one bone screw having a leading end for insertion into the cervical spine and a head opposite said leading end, said at least one bone screw lock adapted to contact said head.

69. The plate of claim 68 , wherein said at least one bone screw is configured to be in fixed relationship to said plate.

70. The plate of claim 68 , wherein said at least one bone screw is configured to be in a moveable relationship to said plate.

71. The plate of claim 68 , wherein said at least one bone screw is configured to be in a variable angular relationship to said plate.

72. The plate of claim 68 , wherein at least one of said bone screw receiving holes has a reduced dimension proximate said lower surface of said plate to form a seat said seat having a substantially planar surface adapted to contact a lower surface of one of said bone screws.

73. A plate adapted to be applied to the anterior human cervical spine for contacting the anterior aspects of at least two adjacent cervical vertebral bodies to be fused together, said plate comprising:

at least one bone screw lock adapted to lock to said plate only a single bone screw inserted in one of said bone screw receiving holes.

74. The plate of claim 73 , wherein said first and second plate segments are configured to limit movement of said first and second plate segments relative to one another along the longitudinal axis of said plate.

75. The plate of claim 73 , wherein said first and second plate segments when attached to the adjacent vertebral bodies, respectively, are adapted to move toward one another in response to movement of the adjacent cervical vertebral bodies toward each other.

76. The plate of claim 73 , wherein said first and second plate segments when attached to the adjacent vertebral bodies, respectively, are adapted to move the adjacent cervical vertebral bodies toward each other in response to movement of said first and second plate segments moving toward each other.

77. The plate of claim 73 , wherein said first and second plate segments when attached to the adjacent vertebral bodies, respectively, are adapted to maintain a compressive load across a disc space between the adjacent cervical vertebral bodies.

78. The plate of claim 73 , wherein said at least one bone screw lock comprises at least one of a screw, a rivet, a cap, and a cover.

79. The plate of claim 73 , in combination with a fusion promoting substance.

80. The plate of claim 79 , wherein said fusion promoting substance includes at least one of bone, hydroxyapatite, bone morphogenetic protein, and genes coding for the production of bone.

81. The plate of claim 73 , further comprising bone screws for engaging said plate to the cervical spine, wherein at least a portion of one of said plate and said bone screws is a bioresorbable material.

82. The plate of claim 73 , in combination with a substance for inhibiting scar formation.

83. The plate of claim 73 , in combination with an antimicrobial material.

84. A plate adapted to be applied to the anterior human cervical spine for contacting the anterior aspects of at least two adjacent cervical vertebral bodies to be fused together, said plate comprising:

a lower surface adapted to contact at least one of the cervical vertebral bodies and an upper surface opposite said lower surface, said lower surface being concave at least in part along at least a portion of the longitudinal axis of said plate, at least a portion of said upper surface of said second plate segment being convex at least in part along at least a portion of the longitudinal axis of said plate, said concave lower surface of said first plate segment having a radius of curvature that is different than the radius of curvature of said convex upper surface of said second plate segment;

at least one bone screw lock adapted to lock to said plate only a single bone screw inserted in one of said bone screw receiving holes.

85. The plate of claim 84 , wherein said first and second plate segments are configured to limit movement of said first and second plate segments relative to one another along the longitudinal axis of said plate.

86. The plate of claim 84 , wherein said first and second plate segments when attached to the adjacent vertebral bodies, respectively, are adapted to move toward one another in response to movement of the adjacent cervical vertebral bodies toward each other.

87. The plate of claim 84 , wherein said first and second plate segments when attached to the adjacent vertebral bodies, respectively, are adapted to move the adjacent cervical vertebral bodies toward each other in response to movement of said first and second plate segments moving toward each other.

88. The plate of claim 84 , wherein said first and second plate segments when attached to the adjacent vertebral bodies, respectively, are adapted to maintain a compressive load across a disc space between the adjacent cervical vertebral bodies.

89. The plate of claim 84 , wherein said at least one bone screw lock comprises at least one of a screw, a rivet, a cap, and a cover.

90. The plate of claim 84 , in combination with a fusion promoting substance.

91. The plate of claim 90 , wherein said fusion promoting substance includes at least one of bone, hydroxyapatite, bone morphogenetic protein, and genes coding for the production of bone.

92. The plate of claim 84 , further comprising bone screws for engaging said plate to the cervical spine, wherein at least a portion of one of said plate and said bone screws is a bioresorbable material.

93. The plate of claim 84 , in combination with a substance for inhibiting scar formation.

94. The plate of claim 84 , in combination with an antimicrobial material.

95. A plate adapted to be applied to the anterior human cervical spine for contacting the anterior aspects of at least two adjacent cervical vertebral bodies to be fused together, said plate comprising:

a lower surface adapted to contact at least one of the cervical vertebral bodies and an upper surface opposite said lower surface, said lower surface being concave at least in part along at least a portion of the longitudinal axis of said plate, at least a portion of said lower surface of said first plate segment being configured to interdigitate with at least a portion of said upper surface of said second plate segment at least a portion of said lower surface of said first plate segment and said at least a portion of the upper surface of said second plate segment including ratchetings configured to permit movement of said first and second plate segments toward one another in a first direction along a longitudinal axis of said plate and to restrict movement in a direction opposite to said first direction;

at least one bone screw lock adapted to lock to said plate only a single bone screw inserted in one of said bone screw receiving holes.

96. The plate of claim 95 , wherein said first and second plate segments when attached to the adjacent vertebral bodies, respectively, are adapted to move toward one another in response to movement of the adjacent cervical vertebral bodies toward each other.

97. The plate of claim 95 , wherein said first and second plate segments when attached to the adjacent vertebral bodies, respectively, are adapted to move the adjacent cervical vertebral bodies toward each other in response to movement of said first and second plate segments moving toward each other.

98. The plate of claim 95 , wherein said first and second plate segments when attached to the adjacent vertebral bodies, respectively, are adapted to maintain a compressive load across a disc space between the adjacent cervical vertebral bodies.

99. The plate of claim 95 , wherein said at least one bone screw lock comprises at least one of a screw, a rivet, a cap, and a cover.

100. The plate of claim 95 , in combination with a fusion promoting substance.

101. The plate of claim 100 , wherein said fusion promoting substance includes at least one of bone, hydroxyapatite, bone morphogenetic protein, and genes coding for the production of bone.

102. The plate of claim 95 , further comprising bone screws for engaging said plate to the cervical spine, wherein at least a portion of one of said plate and said bone screws is a bioresorbable material.

103. The plate of claim 95 , in combination with a substance for inhibiting scar formation.

104. The plate of claim 95 , in combination with an antimicrobial material.

105. A system adapted to be applied to the anterior human cervical spine for contacting the anterior aspects of at least two adjacent cervical vertebral bodies to be fused together, said system comprising:

at least a first plate segment adapted to be attached to one of the adjacent vertebral bodies to be fused and at least a second plate segment adapted to be attached to another one of the adjacent vertebral bodies to be fused, said at least first and second plate segments adapted to be connected to one another and at least in part overlapped to form a plate, said at least first and second plate segments being in a moveable relationship to one another along a longitudinal axis of said plate, each of said at least first and second plate segments including:

at least one bone screw lock adapted to lock to said plate only a single bone screw inserted in one of said bone screw receiving holes; and

an interbody spinal fusion implant.

106. The system of claim 105 , wherein said first and second plate segments are configured to limit movement of said first and second plate segments relative to one another along the longitudinal axis of said plate.

107. The system of claim 105 , wherein said first and second plate segments when attached to the adjacent vertebral bodies, respectively, are adapted to move toward one another in response to movement of the adjacent cervical vertebral bodies toward each other.

108. The system of claim 105 , wherein said first and second plate segments when attached to the adjacent vertebral bodies, respectively, are adapted to move the adjacent cervical vertebral bodies toward each other in response to movement of said first and second plate segments moving toward each other.

109. The system of claim 105 , wherein said first and second plate segments when attached to the adjacent vertebral bodies, respectively, are adapted to maintain a compressive load across a disc space between the adjacent cervical vertebral bodies.

110. The system of claim 105 , wherein said at least one bone screw lock comprises at least one of a screw, a rivet, a cap, and a cover.

111. The system of claim 105 , in combination with a fusion promoting substance.

112. The system of claim 111 , wherein said fusion promoting substance includes at least one of bone, hydroxyapatite, bone morphogenetic protein, and genes coding for the production of bone.

113. The system of claim 105 , further comprising bone screws for engaging said plate to the cervical spine, wherein at least a portion of one of said plate and said bone screws is a bioresorbable material.

114. The system of claim 105 , in combination with a substance for inhibiting scar formation.

115. The system of claim 105 , In combination with an antimicrobial material.

116. The plate of claim 105 , wherein said implant comprises at least in part bone.

117. The plate of claim 105 , wherein said implant is an allograft interbody bone graft implant.

118. The plate of claim 105 , wherein said implant is an artificial implant.

119. A system adapted to be applied to the anterior human cervical spine for contacting the anterior aspects of at least two adjacent cervical vertebral bodies to be fused together, said system comprising:

at least a first plate segment adapted to be attached to one of the adjacent vertebral bodies to be fused and at least a second plate segment adapted to be attached to another one of the adjacent vertebral bodies to be fused, said at least first and second plate segments adapted to be connected to one another and at least in part overlapped to form a plate, said at least first and second plate segments being in a moveable relationship to one another along a longitudinal axis of said plate, each of said at least first and second plate segments including:

at least one bone screw lock adapted to lock to said plate only a single bone screw inserted in one of said bone screw receiving holes; and

at least one spinal fixation implant.

120. The system of claim 119 , wherein said first and second plate segments are configured to limit movement of said first and second plate segments relative to one another along the longitudinal axis of said plate.

121. The system of claim 119 , wherein said first and second plate segments when attached to the adjacent vertebral bodies, respectively, are adapted to move toward one another in response to movement of the adjacent cervical vertebral bodies toward each other.

122. The system of claim 119 , wherein said first and second plate segments when attached to the adjacent vertebral bodies, respectively, are adapted to move the adjacent cervical vertebral bodies toward each other in response to movement of said first and second plate segments moving toward each other.

123. The system of claim 119 , wherein said first and second plate segments when attached to the adjacent vertebral bodies, respectively, are adapted to maintain a compressive load across a disc space between the adjacent cervical vertebral bodies.

124. The system of claim 119 , wherein said at least one bone screw lock comprises at least one of a screw, a rivet, a cap, and a cover.

125. The system of claim 119 , in combination with a fusion promoting substance.

126. The system of claim 125 , wherein said fusion promoting substance includes at least one of bone, hydroxyapatite, bone morphogenetic protein, and genes coding for the production of bone.

127. The system of claim 119 , further comprising bone screws for engaging said plate to the cervical spine, wherein at least a portion of one of said plate and said bone screws is a bioresorbable material.

128. The system of claim 119 , In combination with a substance for inhibiting scar formation.

129. The system of claim 119 , in combination with an antimicrobial material.

130. A plate adapted to be applied to the anterior human cervical spine for contacting the anterior aspects of at least two adjacent cervical vertebral bodies to be fused together, said plate comprising:

at least one bone screw lock adapted to lock to said plate only a single bone screw inserted in one of said bone screw receiving holes, at least one of said plate, said fastener, and said bone screw lock being electrified for purposes of stimulating bone growth and contributing to bone fusion.

131. The plate of claim 130 , wherein said first and second plate segments are configured to limit movement of said first and second plate segments relative to one another along the longitudinal axis of said plate.

132. The plate of claim 130 , wherein said first and second plate segments when attached to the adjacent vertebral bodies, respectively, are adapted to move toward one another in response to movement of the adjacent cervical vertebral bodies toward each other.

133. The plate of claim 130 , wherein said first and second plate segments when attached to the adjacent vertebral bodies, respectively, are adapted to move the adjacent cervical vertebral bodies toward each other in response to movement of said first and second plate segments moving toward each other.

134. The plate of claim 130 , wherein said first and second plate segments when attached to the adjacent vertebral bodies, respectively, are adapted to maintain a compressive load across a disc space between the adjacent cervical vertebral bodies.

135. The plate of claim 130 , wherein said at least one bone screw lock comprises at least one of a screw, a rivet, a cap, and a cover.

136. The plate of claim 130 , in combination with a fusion promoting substance.

137. The plate of claim 136 , wherein said fusion promoting substance includes at least one of bone, hydroxyapatite, bone morphogenetic protein, and genes coding for the production of bone.

138. The plate of claim 130 , further comprising bone screws for engaging said plate to the cervical spine, wherein at least a portion of one of said plate and said bone screws is a bioresorbable material.

139. The plate of claim 130 , in combination with a substance for inhibiting scar formation.

140. The plate of claim 130 , in combination with an antimicrobial material.

Assignments (1)

CORRECTIVE ASSIGNMENT TO CORRECT T0 REMOVE APPLICATION NUMBER PREVIOUSLY RECORDED AT REEL: 018573 FRAME: 0086. ASSIGNOR(S) HEREBY CONFIRMS THE MERGER. Recorded Oct 7, 2014

From: SDGI HOLDINGS, INC.

To: WARSAW ORTHOPEDIC, INC

Reel/Frame 033904/0891 →