Intervertebral disc replacement

Abstract

An intervertebral disc replacement has two members attached to vertebral body endplates of two adjacent vertebrae. The two members are formed with respective articulation surfaces which form at least part of an articulation arrangement. When loaded with compressive axial force, the articulation arrangement supports the vertebral contact surfaces against the compressive force to ensure a predefined minimum intervertebral spacing, and allows a range of turning motion in all directions. The articulation arrangement is formed to provide an increase in the intervertebral spacing as a smooth function of angular displacement from a neutral position over at least part of the range of motion in each direction for each direction of motion, thereby providing motion attenuation and restoring forces.

1 . A method comprising the steps of:
 (a) providing a device comprising:
 (i) a first member having a first vertebral contact surface and a first articulation surface, and 
 (ii) a second member having a second vertebral contact surface and a second articulation surface; and 
   (b) deploying said device between first and second vertebral bodies with said first vertebral contact surface engaging a vertebral endplate of the first vertebral body and said second vertebral contact surface engaging a vertebral endplate of the second vertebral body, said first articulation surface and said second articulation surface forming at least part of an articulation arrangement between said first and second vertebral bodies,   
       wherein said articulation arrangement is configured such that:
 (i) the first vertebral body is displaceable relative to the second vertebral body in motion corresponding to axial rotation, anterior-flexion and posterior extension, and lateral bending, each of said motions having a corresponding range of motion; and 
 (ii) the intervertebral spacing between the centroids of the first and second vertebral endplates increases as a smooth function of angular displacement from a neutral position over at least part of said range of motion in each direction for each of said axial rotation, anterior-flexion and posterior extension, and lateral flexion. 
 
     
     
         2 . The method of  claim 1 , wherein said articulation arrangement is configured such that a first derivative of intervertebral spacing as a function of angular displacement from a neutral position increases substantially monotonically with respect to said angular displacement from said neutral position over a majority of said range of motion for motion in each direction for each of said axial rotation, anterior-flexion and posterior extension, and lateral flexion. 
     
     
         3 . The method of  claim 1 , wherein said articulation arrangement is configured such that said second member is displaceable relative to said first member in motion corresponding to combinations of axial rotation, anterior flexion or posterior extension, and lateral bending. 
     
     
         4 . The method of  claim 1 , wherein said articulation arrangement is configured such that the apparatus is self-centering under axial loading so as to tend to return substantially to a predefined neutral position. 
     
     
         5 . The method of  claim 1 , wherein said first member and said second member are rigid bodies. 
     
     
         6 . The method of  claim 1 , wherein said first member and said second member are formed primarily from metallic material. 
     
     
         7 . The method of  claim 1 , wherein said first member and said second member are formed primarily from ceramic material. 
     
     
         8 . The method of  claim 1 , wherein said first member and said second member are formed primarily from polymer material. 
     
     
         9 . The method of  claim 1 , wherein said first articulation surface and said second articulation surface are deployed in direct contact to provide at least part of said articulation arrangement. 
     
     
         10 . The method of  claim 1 , wherein said first articulation surface features a protuberance and said second articulation surface features a cooperating recess, wherein said protuberance is shaped such that, in sagittal cross-section, an external shape of said protuberance features:
 (a) a convexly curved crown region having varying curvature with a local minimum of curvature at a crest of said crown region; and   (b) a concavely curved transition region at the base of said protuberance.   
     
     
         11 . The method of  claim 10 , wherein said protuberance is further shaped such that, in coronal cross-section, an external shape of said protuberance features:
 (a) a convexly curved crown region having varying curvature with a local minimum of curvature at a crest of said crown region; and   (b) a concavely curved transition region at the base of said protuberance.   
     
     
         12 . The method of  claim 11 , wherein said protuberance is further shaped such that a width of said protuberance in said coronal cross-section is greater than a width of said protuberance in said sagittal cross-section. 
     
     
         13 . The method of  claim 11 , wherein said protuberance is further shaped such that, in axial cross-section, an external shape of said protuberance is substantially elliptical. 
     
     
         14 . The method of  claim 13 , wherein said cooperating recess is formed substantially as an elliptical concavity with a convexly curved transition region connecting to a surrounding area of said second articulation surface. 
     
     
         15 . The method of  claim 11 , wherein said protuberance exhibits a plurality of recessed flank regions, and wherein said cooperating recess includes a corresponding plurality of ridge regions. 
     
     
         16 . The method of  claim 1 , wherein said first articulation surface features a protuberance including a plurality of ridges, and wherein said second articulation surface features a cooperating recess including a plurality of channels for receiving said ridges, wherein said ridges interact with adjacent surfaces of said channels to generate said increase in intervertebral spacing. 
     
     
         17 . The method of  claim 1 , wherein said first articulation surface features a plurality of protuberances and said second articulation surface features cooperating recessed features. 
     
     
         18 . The method of  claim 1 , wherein said first articulation surface features a plurality of recesses and said second articulation surface features a corresponding plurality of recesses, said articulating arrangement further including a corresponding plurality of bearing elements, each of said bearing elements being entrapped between a facing pair of said recesses of said first and second articulation surfaces. 
     
     
         19 . The method of  claim 18 , wherein said bearing elements are implemented as ball bearings. 
     
     
         20 . The method of  claim 19 , wherein said plurality of recesses of said first and second articulation surfaces are implemented as partial spherical recesses of radius of curvature greater than said ball bearings, locations of said recesses of said first articulation surface being offset relative to locations of said recesses of said second articulation surface. 
     
     
         21 . The method of  claim 20 , wherein said articulation arrangement is implemented with four of said ball bearings and four of said recesses in each of said first and second articulation surfaces. 
     
     
         22 . An apparatus for use between endplates of a first vertebral body and a second vertebral body of a spinal column, the apparatus comprising:
 (a) a first member having a first vertebral contact surface for engagement with the first vertebral body endplate, and having a first articulation surface; and   (b) a second member having a second vertebral contact surface for engagement with the second vertebral body endplate, and having a second articulation surface,   
       wherein an intervertebral spacing is defined as the separation between central regions of said first and second vertebral contact surfaces, 
       and wherein said first articulation surface and said second articulation surface form at least part of an articulation arrangement configured such that:
 (i) said second member is displaceable relative to said first member in motion corresponding to axial rotation, anterior-flexion and posterior extension, and lateral bending, each of said motions having a corresponding range of motion; and 
 (ii) said intervertebral spacing increases as a smooth function of angular displacement from a neutral position over at least part of said range of motion in each direction for each of said axial rotation, anterior-flexion and posterior extension, and lateral flexion.