Expandable implant

Abstract

An expandable implant for inserting within a skeletal space is provided, and a method for using the implant to expand the skeletal space. The implant is preferably designed to be inserted into an intervertebral space to replace at least part of an intervertebral disc between adjacent vertebral bodies. The expandable implant contains at least one first expansion compartment and at least one second expansion compartments, which compartments can be inflatable balloons that are inflated by a catheter. Inflating the first expansion compartment expands the implant in a first direction and inflating the second expansion compartment expands the implant in a second direction.

Claims

1. An intervertebral implant configured for insertion along a lateral insertion direction into an intervertebral space defined between a superior vertebra and an inferior vertebra, the intervertebral implant comprising: a first bone contacting member having a first bone contacting surface configured to face the inferior vertebra; a second bone contacting member spaced from the first bone contacting member along a cranial-caudal direction, the second bone contacting member having a second bone contacting surface configured to face the superior vertebra, wherein the first and second bone contacting members have respective sides that are spaced apart along an anterior-posterior direction that is substantially perpendicular to the cranial-caudal direction, wherein the anterior-posterior direction and the cranial-caudal direction are substantially perpendicular to the lateral insertion direction when the implant is disposed in the intervertebral space; at least two expansion compartments that are elongate along the lateral insertion direction and disposed between the first and second bone contacting surfaces, the at least two expansion compartments being spaced apart with respect to each other along the anterior-posterior direction, each expansion compartment defining a first side, a second side spaced from the first side along the anterior-posterior direction, and a distance that extends from the first side to the second side along the anterior-posterior direction, each expansion compartment configured to expand so as to increase the distance between the first and second sides, wherein each of the at least two expansion compartments are configured to cooperate with at least one of the first and second bone contacting members to cause the expansion of the implant in the anterior-posterior direction without substantially causing the implant to expand in the cranial-caudal direction.

2. The implant of claim 1, wherein the first bone contacting member comprises a first contacting component, a second contacting component spaced from the first contacting component along the anterior-posterior direction, and a first expandable connection that links the first and second contacting components, wherein the first and second contacting components define an anterior-posterior dimension that is parallel to the anterior-posterior direction, wherein the first and second contacting components of the first bone contacting member are arranged such that as the anterior-posterior dimension of the implant increases the first expandable connection expands and the first and second contacting components move apart relative to each other along the anterior-posterior direction.

3. The implant of claim 2, wherein the second bone contacting member comprises a third contacting component, a fourth contacting component, and a second expandable connection that links the third contacting component with the fourth contacting component.

4. The implant of claim 3, further comprising two or more additional expansion compartments.

5. The implant of claim 2, wherein the first expandable connection comprises a wire netting.

6. The implant of claim 5, wherein the wire netting comprises a plurality of individual link members.

7. The implant of claim 1, wherein the at least two expansion compartments are first and second expansion compartments, and the first and second expansion compartments are arranged parallel to each other.

8. The implant of claim 7, wherein the first and second expansion compartments are aligned with each other along the anterior-posterior direction.

9. The implant of claim 1, wherein each one of the at least two expansion compartments is an inflatable balloon.

10. The implant of claim 9, wherein the inflatable balloon is an elongated expansion balloon having a length substantially greater than an un-inflated diameter.

11. The implant of claim 10, wherein the length extends in a direction that is perpendicular to the cranial-caudal direction and the anterior-posterior direction.

12. The implant of claim 1, wherein the at least two expansion compartments are configured to expand in the cranial-caudal direction.

13. The implant of claim 1, wherein an axis that is aligned with the anterior-posterior direction extends through the at least two expansion compartments.

14. A method for implanting an intervertebral implant into an intervertebral space defined between a superior vertebra and an inferior vertebra spaced apart along a cranial-caudal direction, each vertebrae including an anterior side and a posterior side spaced from the anterior side along an anterior-posterior direction that is perpendicular to the cranial-caudal direction, the method comprising: inserting the intervertebral implant into the intervertebral space along a lateral insertion direction that is perpendicular to the cranial caudal direction and the anterior-posterior direction, the intervertebral implant including a first bone contacting member, a second bone contacting member spaced from the first bone contacting member along the cranial-caudal direction; and after the insertion step, expanding at least two expansion compartments of the intervertebral implant along the anterior-posterior direction, the at least two expansion compartments being spaced apart with respect to each other along the anterior-posterior direction, wherein during the expanding step, the at least two expansion compartments cooperate with at least one of the first and second bone contacting members to expand the intervertebral implant along the anterior-posterior direction without expanding the intervertebral implant in the cranial-caudal direction.

15. The method of claim 14, wherein the intervertebral implant is inserted along the lateral insertion direction through a lateral incision disposed laterally with respect to the superior and inferior vertebra.

16. The method of claim 14, wherein at least one of the first and second bone contacting members includes a first contacting component and a second contacting component spaced from the first contacting component along the anterior-posterior direction and defining a first dimension along the anterior-posterior direction, wherein the expanding step includes increasing the first dimension along the anterior-posterior direction.

17. The method of claim 16, further comprising an expandable connection that links the first and second contacting components, wherein the expanding step includes expanding the expandable connection.

18. The method of claim 16, wherein the expanding step includes inserting a filler material into the at least two expansion compartments.

19. The method of claim 18, wherein the at least two expansion compartments are a first expansion compartment and a second expansion compartment, wherein the expanding step includes simultaneously inserting the filler material into the first and second expansion compartments.

20. The method of claim 14, wherein each of the first and second bone contacting members includes a first end and a second end opposed to the first end, and the at least two expansion compartments are attached to the first end of the first and second bone contacting members, wherein the method further comprises detaching the at least two expansion compartments from the first ends of the first and second bone contacting members.

21. The method of claim 20, wherein each first end includes a respective fixing member, and each expansion compartment includes a hook attached to the respective fixing member, wherein the detaching step includes sliding the respective hooks off of the respective fixing members.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

(1) FIG. 1 is a top perspective view of an implant according to the present invention in an insertion configuration.

(2) FIG. 2 is a cross-sectional view of the implant shown in FIG. 1 taken through the plane A-A.

(3) FIG. 3 is a cross-sectional view of an implant shown in FIG. 1 positioned in an intervertebral space.

(4) FIG. 4 is a cross-sectional view of the implant shown in FIG. 1 which has been expanded in a first direction.

(5) FIG. 5 is a cross-sectional view of the implant shown in FIG. 1 which has been expanded in a first direction and in a second direction.

(6) FIG. 6 is a rear perspective view of the implant shown in FIG. 1 in an insertion configuration.

(7) FIG. 7 is a cross-sectional view of the implant shown in FIG. 1 taken through the plane B-B.

(8) FIG. 8 is a rear perspective view of the implant shown in FIG. 1 which has been expanded in a first direction.

(9) FIG. 9 is a rear perspective view of the implant shown in FIG. 1 which has been expanded in a first direction and in a second direction.

(10) FIG. 10 is a cross-section view of an alternative implant according to the present invention in an insertion configuration.

DETAILED DESCRIPTION

(11) Specific embodiments of the present invention are now described by way of example only with reference to the drawings. It will be recognised that features specified in one embodiment of the invention may be combined with other specified features to provide further embodiments.

(12) With reference to FIGS. 1, 2 and 3, an implant (10) according to one embodiment of the present invention is shown in an insertion configuration. The implant has a front end (80) and a rear end (90). The implant (10) has a first contacting member (12) consisting of two contacting components (16, 18) linked by a first expandable connection (24) and a second contacting member (14) consisting of two contacting components (20, 22) linked by a second expandable connection (26). The first contacting member (12) and the second contacting member (14) are linked by a third expandable connection (28, 30).

(13) The implant (10) has a first cavity (40) between one contacting component (18) of the first contacting member (10) and one contacting component (22) of the second contacting member (14) in which is housed a second expansion compartment (36). The implant (10) also has a second cavity (42) between the other contacting component (16) of the first contacting member (12) and the other contacting component (20) of the second contacting member (14) in which is housed a further second expansion compartment (38). The two second expansion compartments are in the form of longitudinally shaped balloons.

(14) The implant (10) has a third cavity (44) between the contacting components (20, 22) of the second contacting member (14) in which are housed two first expansion compartments (32, 34). The first expansion compartments are in the form of longitudinally shaped balloons.

(15) The contacting components (16, 18) of the first contacting member (12) each have a plurality of teeth (50) on their outermost surface. The contacting components (20, 22) of the second contacting member (14) each have a plurality of teeth (52) on their outermost surface.

(16) The two first expansion compartments (32, 34) may be filled with filling material via a catheter (not shown) attached to an entry portion (54, 56) of each of the first expansion compartments.

(17) The two second expansion compartments (36, 38) may be filled with filling material via a catheter (not shown) attached to an entry portion (58, 60) of each of the second expansion compartments.

(18) The first contacting member (12) comprises a groove (61, 62) on the outer edge of each of the contacting components (16, 18) to which an implant holding and insertion instrument (not shown) can be attached to the implant (10).

(19) The first contacting member (12) comprises recesses (64, 66) and the second contacting member comprises recesses (68, 70) to which an implant holding and insertion instrument (not shown) can be attached to the implant (10).

(20) While in the insertion configuration, the implant (10) may be inserted into a skeletal space. FIGS. 2 and 3 show the implant (10) inserted into an intervertebral space (200) between a first vertebra (100) and a second vertebra (102). The implant (10) may be inserted into the intervertebral space (200) through a lateral incision in a patient. An implant holding and insertion instrument (not shown) engages with an arrangement of grooves (61, 62) and recesses (64, 66, 68, 70) on the implant (10) and the implant holding and insertion instrument is used to insert the implant into the intervertebral space (200). The implant holding and insertion instrument (not shown) is then detached from the implant (10). In the insertion configuration, the implant has a dimension d.sub.1 in a first direction and a dimension t.sub.1 in a second direction.

(21) When inserted into the intervertebral space, the plurality of teeth (50) on the outermost surface of the first contacting member (12) engage with a surface (104) of the first vertebra (100) and the plurality of teeth (52) on the outermost surface of the second contacting member (14) engage with a surface (106) of the second vertebra (102).

(22) With reference to FIGS. 4 and 5, which show features corresponding to those in FIGS. 2 and 3, the sequential expansion of the embodiment described in FIGS. 1 to 3, is effected by first simultaneously expanding the first expansion compartments (32, 34) with a filler material via catheters (not shown). Expansion of the first expansion compartments (32, 34) causes the first expandable connection (24) and the second expandable connection (26) to expand and the contacting components (16, 18) in the first contacting member (12) to move apart such that the implant has a dimension d.sub.2 in the first direction. The third expandable connection (28, 30) does not expand and the dimension t.sub.1 in the second direction remains unchanged. In this embodiment, the implant (10) is inserted such that the first direction corresponds to the a-p direction.

(23) Subsequent to expansion of the first expansion compartments (32, 34), expansion in second direction, which corresponds to the c-c direction, is effected by simultaneously expanding the second expansion compartments (36, 38). Expansion of the second expansion compartments (36, 38) causes the third expandable connection (28, 30) to expand and the first and second contacting members (12, 14) to move apart such that the implant has a dimension t.sub.2 in the second direction. The dimension d.sub.2 in the second direction remains unchanged.

(24) With reference to FIGS. 6 and 7 the first expansion compartments (32, 34) each comprise a hook portion (132, 134) that cooperates with first fixings (122, 124) positioned at the rear end (90) of the implant (10) to attach the first expansion compartments (32, 34) to the implant (10). The second expansion compartments (36, 38) each comprise a hook portion (130,136) that cooperates with second fixings (120, 126) positioned at the rear end (90) of the implant (10) to attach the second expansion compartments (36, 38) to the implant (10).

(25) With reference to FIGS. 8 and 9, as the first expansion compartments (32, 34) expand, the contacting components (16, 18) of the first contacting member move apart, the contacting components (20, 22) of the second contacting member move apart and the first and second expandable connections (24, 26) expand. This expansion allows the hook portions (132, 134) of first expansion compartments (32, 34) to slide off the first fixings (122, 124) and hence the first expansion compartments (32, 34) detach from the implant (10).

(26) As the second expansion compartments (36, 38) expand, the contacting components (16, 18) of the first contacting member move apart from the contacting components (20, 22) of the second contacting member and the third expandable connection (30) expands. This expansion allows the hook portions (130, 136) of the second expansion compartments (36, 38) to slide off the second fixings (120, 126) and hence the second expansion compartments (36, 38) detach from the implant (10).

(27) With reference to FIG. 9, following detachment of the first and second expansion compartments (32, 34, 36, 38), the contacting components (16, 18) of the first contacting member (12) are able to tilt relative to each other and relative to the respective contacting components (20, 22) of the second contacting member (14).

(28) With reference to FIG. 10, an implant (310) according to an alternative embodiment of the present invention is shown in an insertion configuration. The implant (310) has a first contacting member (312) consisting of two contacting components (316, 318) linked by a first expandable connection (324) and a second contacting member (314) consisting of two contacting components (320, 322) linked by a second expandable connection (326). The first contacting member (312) and the second contacting member (314) are linked by a third expandable connection (328, 330).

(29) The implant (310) has a first cavity (340) between one contacting component (318) of the first contacting member (310) and one contacting component (322) of the second contacting member (314) in which is housed a second expansion compartment (336). The implant (310) also has a second cavity (342) between the other contacting component (316) of the first contacting member (310) and the other contacting component (320) of the second contacting member (314) in which is housed a further second expansion compartment (338).

(30) The implant (310) has a third cavity (344) between the contacting components (320, 322) of the second contacting member (314) in which are housed two first expansion compartments (332, 334).

(31) Expansion of the first expansion compartments (332, 334) causes the contacting components (320, 322) of the second contacting member (314) to move apart and the first and second expandable connections (324, 326) to expand. In this way, the implant (310) increases in dimension in a first direction (x). Due to the angled shape of the cavities (340, 342) between the first and second expansion members (312,314), expansion of the second expansion compartments (336, 338) causes the first contacting member (312) to move apart from the second contacting member (314), causing the third expandable connection (328, 330) to expand and, in addition, causes contacting components (316, 318) of the first contacting member (312) to move further apart and the first expandable connection (324) to further expand.

EXAMPLES

(32) Embodiments of the present invention are now described, by way of illustration only, in the following examples. It will be understood that these examples are not limiting and that variations and modifications may be made within the spirit and scope of the invention as set out above and as defined in the following claims.

Example 1

(33) Four separate catheter balloons (OPN NC High Pressure PTCA Balloons from Sis Medical, having a highest rated burst pressure of 35 bar) were inserted into a bottom end of a cannulated implant holding and insertion instrument and pushed through the instrument such that part of the tubes connected to the catheter balloons were retained within the instrument but catheter balloons protruded from the top end of the instrument. The four balloons were subsequently inserted into an implant as shown in FIG. 1. The implant was mounted on the implant holding and insertion instrument using a pair of protruding blade springs which engaged with grooves on either side of the implant and retained the implant in a compressed, insertion configuration.

(34) A lateral incision was made in a cadaveric specimen and residual intervertebral disc material was removed between the L3 and L4 vertebrae. The implant was inserted in a compressed, insertion configuration into the L3 to L4 intervertebral disc space.

(35) A first inflation device (High Pressure Inflation Device from Sis Medical) was attached to the two balloons arranged to cause anterior-posterior expansion and a second inflation device of the same type was attached to the two balloons arranged to cause cranio-caudal expansion. The implant holding and insertion instrument was detached from the implant.

(36) Water at a pressure of between 24 and 30 bar was introduced into the two balloons arranged to cause antero-posterior expansion using the first inflation device. The anterior-posterior dimension of the implant increased without causing any increase in the cranio-caudal dimension of the implant.

(37) Subsequently, water at a pressure of between 24 and 30 bar was introduced into the two balloons arranged to cause cranio-caudal expansion using the second inflation device. The cranio-caudal dimension of the implant increased without causing any increase in the anterior-posterior dimension of the implant. A biomechanical study of the resulting expanded implant showed that it stabilized the L3 and L4 vertebrae.

Example 2

(38) Four separate catheter balloons (OPN NC High Pressure PTCA Balloons from Sis Medical, having a highest rated burst pressure of 35 bar) were inserted into a bottom end of a cannulated implant holding and insertion instrument and pushed through the instrument such that part of the tubes connected to the catheter balloons were retained within the instrument but catheter balloons protruded from the top end of the instrument. The four balloons were subsequently inserted into an implant as shown in FIG. 1. The implant was mounted on the implant holding and insertion instrument using a pair of protruding blade springs which engaged with grooves on either side of the implant and retained the implant in a compressed, insertion configuration.

(39) A lateral incision was made in a cadaveric specimen and residual intervertebral disc material was removed between the L3 and L4 vertebrae. The implant was inserted in a compressed, insertion configuration into the L3 to L4 intervertebral disc space.

(40) A first inflation device (High Pressure Inflation Device from Sis Medical) was attached to the two balloons arranged to cause anterior-posterior expansion and a second inflation device of the same type was attached to the two balloons arranged to cause cranio-caudal expansion. The implant holding and insertion instrument was detached from the implant.

(41) Polymethyl methacrylate (PMMA) cement in a fluid state and at a pressure of between 24 and 30 bar was introduced into the two balloons arranged to cause anterior-posterior expansion using the first inflation device. The anterior-posterior dimension of the implant increased without causing any increase in the cranio-caudal dimension of the implant.

(42) Subsequently, PMMA cement at a pressure of between 24 and 30 bar was introduced into the two balloons arranged to cause cranio-caudal expansion using the second inflation device. The cranio-caudal dimension of the implant increased without causing any increase in the anterior-posterior dimension of the implant.

(43) The PMMA cement was cured. After curing of the PMMA cement, the tubes attached to the balloon catheters were removed. A biomechanical study of the resulting expanded implant showed that it stabilized the L3 and L4 vertebrae.