Instrumentation and associated methods for joint prosthesis implantation

Abstract

An assembly for preparing a vertebral disc space to receive a prosthesis comprises a support frame having a base and a pair of guide tracks extending from the base. The base is adapted to attach to a plurality of vertebral bodies. The assembly further includes a guide block operatively connected to at least one of the guide tracks and having an opening disposed there through. The assembly further includes a position control mechanism corresponding to the at least one of the guide tracks. The position control mechanism has a plate extending there from for coupling to the guide track and the guide block and an actuating knob for adjusting the position of the plate and therefore the guide block. The assembly further includes a bone-removal device positioned through the opening of the guide block and operatively connected to the guide block.

1 . An assembly for preparing a vertebral disc space to receive a prosthesis, the assembly comprising: 
 a support frame having a base and a pair of guide tracks extending from the base wherein the base is adapted to attach to a plurality of vertebral bodies;    a guide block operatively connected to at least one of the guide tracks, the guide block having an opening disposed there through;    a position control mechanism corresponding to the at least one of the guide tracks, the position control mechanism having a plate extending there from for coupling to the guide track and the guide block and an actuating knob for adjusting the position of the plate and therefore the guide block; and    a bone-removal device positioned through the opening of the guide block and operatively connected to the guide block.    
   
   
       2 . The assembly of  claim 1  further comprising an upper support member for linking the proximal ends of the guide tracks.  
   
   
       3 . The assembly of  claim 1  further comprising a plurality of adjustable bushings for receiving a locking mechanism for securing the support frame to the vertebral bodies.  
   
   
       4 . The assembly of  claim 1  wherein the guide tracks angle outwards relative to the base.  
   
   
       5 . The assembly of  claim 4  wherein each of the guide tracks includes a hinge for setting the angle of the guide tracks relative to the base.  
   
   
       6 . The assembly of  claim 1  wherein the position control mechanism comprises a threaded rod and wherein the plate comprises a threaded opening for receiving the threaded rod.  
   
   
       7 . The assembly of  claim 1  wherein the bone-removal device comprises a plurality of pivot pins for engaging a plurality of pivot slots disposed in the guide block.  
   
   
       8 . The assembly of  claim 1  wherein the guide block further comprises a means for coupling to the at least one of the guide tracks and a locking mechanism for locking the guide block to the plate.  
   
   
       9 . The assembly of  claim 8  wherein the locking mechanism comprises an opening disposed through the guide block and a threaded screw passing through the opening for threading to a threaded opening disposed through the plate.  
   
   
       10 . The assembly of  claim 1  wherein the bone removal device comprises 
 a handpiece having a drive connecting portion at the proximal end of the handpiece and a hollow channel extending there from;    a tool having a shaft disposed through the hollow channel and a bone-removal element extending from the distal end of the shaft.    
   
   
       11 . The assembly of  claim 10  further comprising a positioning portion operatively connected to the handpiece for positioning the bone-removal device in a bone-removal assembly.  
   
   
       12 . The assembly of  claim 10  wherein the drive connecting portion is operatively connected to a power source.  
   
   
       13 . The assembly of  claim 10  wherein the bone-removal element comprises distal and proximal bone-removal sections having a rectilinear profile and a central bone-removal section having a curvilinear profile.  
   
   
       14 . An assembly for preparing a vertebral disc space to receive a prosthesis, comprising: 
 a sagittal wedge adapted to be disposed between a pair of vertebral bodies;    a support frame positioned over the sagittal wedge and adjacent the vertebral bodies;    a disc spacer clip positioned over the sagittal wedge and inside the support frame;    a tilting guide member having a mounting member, the tilting guide member adapted to be positioned in the disc spacer clip;    a transverse unit for mounting to the mounting member, the transverse unit having at least one transverse block; and    a bone-removal tool positioned through the at least one transverse block.    
   
   
       15 . The assembly of  claim 14  wherein the support frame comprises a plurality of openings formed there through for receiving a plurality of retaining pins to secure the support frame to the vertebral bodies.  
   
   
       16 . The assembly of  claim 14  wherein the disc spacer clip comprises a pivot saddle for providing a pivot point between the vertebral bodies.  
   
   
       17 . The assembly of  claim 16  wherein the tilting guide member comprises a saddle point at its distal end and a locking mechanism at its proximal end wherein the saddle point and the locking mechanism are connected via the mounting member.  
   
   
       18 . The assembly of  claim 17  wherein the saddle point is positioned in the pivot saddle.  
   
   
       19 . The assembly of  claim 14  wherein the support frame comprises: 
 a base having a curvilinear profile;    at least one lateral support member extending from the base; and    an upper support member connected to the at least one lateral support member.    
   
   
       20 . The assembly of  claim 16  wherein the disc spacer clip comprises: 
 a lower member forming the pivot saddle; and    an upper member adapted to contact the vertebral bodies.    
   
   
       21 . The assembly of  claim 20  wherein the upper member of the disc spacer clip further comprises at least one keyway for receiving a shoulder of the sagittal wedge.  
   
   
       22 . The assembly of  claim 20  wherein the upper member of the disc spacer clip comprises a support frame interface for connecting the disc spacer clip to the support frame.  
   
   
       23 . The assembly of  claim 17  wherein the locking mechanism of the tilting guide member comprises an arcuate track having a means for receiving the support frame in a slideable engagement.  
   
   
       24 . The assembly of  claim 14  wherein the mounting member of the tilting guide member comprises a T-track for receiving the transverse unit in a slideable engagement.  
   
   
       25 . The assembly of  claim 14  wherein the transverse unit comprises a proximal transverse block and a distal transverse block and a lateral support interconnecting the blocks, each block comprising an opening formed there through for receiving the bone-removal tool.  
   
   
       26 . The assembly of  claim 25  wherein the opening of the proximal transverse block is larger in size than the opening of the distal transverse block.  
   
   
       27 . The assembly of  claim 26  wherein the proximal and distal transverse blocks each comprise: 
 an outer member having a pair of opposed slots and a mounting slot;    an inner member having a pair of angled slots and a pair of opposed pivot slots; and    a central member having a pair of pins extending into the angled slots of the inner member and a pair of pins extending into the opposed slots of the outer member.    
   
   
       28 . The assembly of  claim 27  wherein the transverse unit further comprises an actuating member connecting the central members of each transverse block.  
   
   
       29 . The assembly of  claim 28  wherein the actuating member comprises a rod for threadably engaging the central members of each transverse block and an actuating knob for providing a means for translating the bone-removal tool positioned through the transverse unit.  
   
   
       30 . The assembly of  claim 27  wherein the bone-removal tool comprises a pair of pins for fitting to the opposed pivot slots of the proximal transverse block.  
   
   
       31 . The assembly of  claim 25  wherein the opening of the distal transverse block has an oblong configuration for guiding the path of the bone-removal tool.  
   
   
       32 . The assembly of  claim 24  further comprising a pivot tool having a slot for engaging the bone-removal tool for aiding in the control of the bone-removal tool.  
   
   
       33 . A method for preparing a vertebral disc space to receive a prosthesis, the method comprising: 
 attaching a support frame to a plurality of vertebral bodies, wherein the support frame includes a base and a pair of guide tracks extending from the base and wherein the base is secured to the plurality of vertebral bodies;    operatively connecting a guide block to at least one of the guide tracks, the guide block having an opening disposed there through;    coupling a position control mechanism to at least one of the guide tracks, wherein the position control mechanism includes a plate extending there from for coupling to the guide track and the guide block and an actuating knob;    adjusting the position of the plate and therefore the guide block by adjusting the actuating knob;    positioning a bone-removal device through the opening of the guide block; and    operatively connecting the bone-removal device to the guide block.    
   
   
       34 . The method of  claim 33  wherein the base is secured to an anterior surface of the plurality of the vertebral bodies.  
   
   
       35 . The method of  claim 33  further comprising: 
 setting an angle of one of the guide tracks relative to the base.    
   
   
       36 . The method of  claim 35  wherein the angle is adjustable between 0 and 90 degrees.  
   
   
       37 . The method of  claim 33  wherein coupling a position control mechanism to at least one of the guide tracks further comprises slideably attaching the position control mechanism to the at least one of the guide tracks.  
   
   
       38 . The method of  claim 33  further comprising: 
 locking the guide block to the plate.    
   
   
       39 . The method of  claim 33  wherein adjusting the position of the plate and therefore the guide block includes threadedly adjusting the position of the plate.  
   
   
       40 . The method of  claim 33  further comprising: 
 connecting the bone-removal device to a power source.