Total disc replacement system and related methods
View Patent ↗Total disc replacement systems and related methods involving a lateral, trans-psoas surgical approach to the spine while performing at least one of continuous and intermittent intra-operative neural monitoring of the psoas muscle to avoid injury during introduction.
1. A total disc replacement implant positionable via a lateral trans-psoas surgical approach to the spine into a position within an intervertebral disc space between a first vertebra and a second vertebra comprising:
a first anchor plate, said first anchor plate having a first rectangular outer boundary, a first surface for engaging said first vertebra and a second interior surface opposite said first surface, said second interior surface having an integral semi-spherical articulation recess situated within the first outer boundary;
a second anchor plate, said second anchor plate having second rectangular outer boundary, a third surface for engaging said second vertebra, and a fourth interior surface opposite said third surface, the first anchor plate and second anchor plate together having an implant length defined by a distance along an X-axis, the X-axis being generally parallel to the coronal plane when the implant is positioned within the intervertebral space, an implant width defined by a distance along a Z-axis, the Z-axis being generally parallel to the sagittal plane when the implant is positioned in the intervertebral space, the implant length is at least 40 mm and the implant width being between 18 mma and 22 mm; and
an articulation element joined in a fixed relationship with said fourth interior surface, said articulation element having a semi-spherical articular surface dimensioned to articulate within said recess of said first anchor plate, said articulation element being situated within the second outer boundary.
2. The disc replacement implant of claim 1 , wherein said first anchor plate may rotate freely relative to said second anchor plate about any axis in a XZ plane that intersects with a Y-axis.
3. The disc replacement implant of claim 1 , wherein each of the first outer boundary and second outer boundary include a posterior side extending the entire implant length and parallel to said Z-axis and an anterior side extending the entire implant length and parallel to said Z-axis is positioned in the intervertebral disc space.
4. The disc replacement implant of claim 3 , wherein the articulation recess and the articulation element are offset posteriorly such that they are closer to the posterior side of the first and second anchor plates than they are to the anterior side of the first and second anchor plates.
5. The disc replacement implant of claim 4 , wherein at least one of the first anchor plate and second anchor plate includes at least one anti-migration feature situated to facilitate confirmation the proper intervertebral position of the posteriorly offset articulation recess and articulation element via radiographic imaging when said implant is positioned in the intervertebral disc space.
6. The disc replacement implant of claim 5 , wherein each of said first anchor plate and said second anchor plate include at least one anti-migration feature aligned along a lateral midline of said anchor plate and at least two anti-migration features aligned along a longitudinal midline of said anchor plate.
7. The disc replacement of claim 4 , further including an insertion instrument, the insertion instrument being configured to ensure said disc replacement implant is inserted in the proper anterior-posterior orientation.
8. The disc replacement of claim 7 , wherein said insertion instrument includes indicia on a handle portion that ensures the disc replacement implant is inserted in the proper orientation.
9. The method according to claim 8 , wherein said indicia is at least one orientation marker visible to a clinician during insertion.
10. The method according to claim 9 , wherein said orientation marker is at least one of a button and an alpha-numeric symbol.
11. The disc replacement implant of claim 1 , wherein at least one of said anchor plates has an angled cross-section to force the adjacent vertebral bodies into lordosis when the total disc replacement is introduced into a lumbar spine.
12. The disc replacement implant of claim 1 , wherein the first anchor plate, second anchor plate, and articulation element are all formed of titanium.
13. The disc replacement implant of claim 12 , wherein at least a portion of said first anchor plate first surface and at least a portion of said second anchor plate third surface is coated with zirconium oxide.
14. The disc replacement implant of claim 1 , wherein the first anchor plate first surface is convex.
15. The disc replacement implant of claim 1 , wherein the first anchor plate includes an aperture adjacent a first lateral end and an aperture adjacent a second lateral end, the apertures opening in said first surface and said second interior surface, and a wherein the second anchor plate includes an aperture adjacent a first lateral end and an aperture adjacent a second lateral end, the apertures opening in said third surface and said fourth interior surface.
16. The disc replacement implant of claim 15 , wherein said first anchor plate includes at least one recess adjacent each of said first lateral end and said second lateral end for engaging an insertion instrument.