JP7082670B2 - Implant with diagonal insertion axis - Google Patents

Description

The present invention generally relates to implants that support bone growth in patients.

A variety of different implants are used in the body. Implants used in the body to stabilize a region and promote internal growth of bone are both stable (ie, minimal deformation over time under pressure) and space for internal growth of bone. I will provide a.

Spinal fusion, also known as spinal fusion or spinal fusion, can be a variety of spinal fusion disorders, including degenerative disc disease, spondylolisthesis (slip of the spine), spinal canal stenosis, spinal kyphosis, fractures, infections or tumors. It is a surgical treatment used to treat the condition. The purpose of spinal fusion procedures is to reduce instability and thus pain.

Most of the disc is removed in preparation for spinal fusion. Implants, or spinal fixation cages, are placed between the vertebrae to maintain spinal alignment and disc height. Healing (ie, bone pons) occurs between the endplates of the vertebrae.

U.S. Patent Application Publication No. 2018/0110626 U.S. Patent Application Publication No. 2017/0042697 U.S. Patent Application Publication No. 2018/0256531 U.S. Patent Application Publication No. 2016/0324656 U.S. Patent Application Publication No. 2018/02565352 U.S. Patent Application Publication No. 2018/0256553 U.S. Patent Application Publication No. 2018/0256361 U.S. Patent Application Publication No. 2018/0296347 U.S. Patent Application Publication No. 2018/0296350

In one aspect of the invention, the implant comprises a body composed of a peripheral structure, the body further comprising an opening for receiving a portion of the insertion device. The implant also includes multiple bone contact elements attached to the body. The peripheral structure is further composed of a first outer portion, a second outer portion, a front portion, and a rear portion. The first outer part and the front part are connected by the first corner portion of the peripheral structure, and the second outer part and the rear part are connected by the second corner portion of the peripheral structure. There is. The opening is arranged in the first corner portion of the peripheral structure.

In another aspect, the implant comprises a body composed of a peripheral structure and a support beam. The implant also includes multiple bone contact elements attached to the body. The peripheral structure is further composed of a first outer portion, a second outer portion, a front portion, and a rear portion. The first lateral portion and the front portion are connected by the first corner portion of the peripheral structure, and the second outer portion and the rear portion are connected by the second corner portion of the peripheral structure. The support beam has a first end attached to the first corner of the peripheral structure and the support beam has a second end attached to the second corner of the peripheral structure.

In another aspect, the implant comprises a body composed of a peripheral structure and a plurality of bone contact elements attached to the body. The peripheral structure is further composed of a first outer portion, a second outer portion, a front portion, and a rear portion. The first outer portion and the front portion are connected by the first corner portion of the peripheral structure, and the second outer portion and the rear portion are connected by the second corner portion of the peripheral structure. The second outer portion and the front portion are connected by the third corner portion of the peripheral structure, and the first outer portion and the rear portion are connected by the fourth corner portion of the peripheral structure. The plurality of bone contact elements exhibit a curved surface on the upper side of the device, and the curved surface is curved from the third corner portion to the fourth corner portion.

Other systems, methods, features and advantages of this embodiment will be apparent or will be apparent to those of skill in the art in light of the following drawings and detailed description of the invention. All such additional systems, methods, features and advantages are contained herein and herein, within the scope of the embodiments, and are protected by the claims below. Intended.

This embodiment can be better understood with reference to the following drawings and description. The components in the drawings are not necessarily on scale, but rather emphasized in explaining the principles of the embodiments. Also, in the drawings, similar reference numerals represent corresponding parts through various drawings.

It is a schematic isometric view which shows the embodiment of an implant. It is a schematic isometric view which shows the embodiment of an implant. It is a schematic isometric view which shows the embodiment of an implant. It is a schematic top view which shows the main body part of an implant. FIG. 6 is a schematic isometric view of the main body of the implant of FIG. It is a schematic front view which shows the embodiment of an implant. It is a schematic rear view which shows the embodiment of an implant. It is a schematic diagram of an arch bone contact element including some exemplary cross sections. It is a schematic diagram of an implant including an enlarged schematic view of the attachment area between an exemplary arched bone contact element and a portion of the body of the implant. It is a schematic top view of the implant of FIG. FIG. 6 is a schematic top view showing another embodiment of the implant. FIG. 3 is a schematic isometric view showing another embodiment of the implant. It is a schematic top view of the implant of FIG. It is a schematic isometric view which shows the embodiment of the implant including the roughened surface. It is a schematic diagram of an exemplary roughened surface region. It is a schematic diagram depicting a patient undergoing an exemplary anterior lateral interbody fusion. It is a schematic diagram which shows a part of an exemplary spine. It is a schematic isometric view which shows the embodiment of an exemplary implant. It is a schematic diagram which shows the embodiment of the implant of FIG. FIG. 16 is a schematic view showing an embodiment of the implant of FIG. 16, in which a threaded cavity can be seen. It is a schematic diagram which shows the embodiment of the implant of FIG. FIG. 8 is a schematic view of the implant of FIG. 18 with a curved surface showing the convex geometry of the upper side of the implant. It is a schematic diagram of the implant of FIG. 18 showing the convex geometry of the upper side and the lower side. FIG. 8 is a schematic representation of the implant of FIG. 18, including some enlarged schematic views of some bone contact elements.

Embodiments of the invention described herein relate to implants for use in the spine. Embodiments include an implant comprising a body and one or more arched bone contact elements.

In addition to the various means described below, any of the embodiments disclosed herein are incorporated herein by reference in their entirety, "Implant with Protected" by McShane III et al. Of the body / support structures, frames, plates, coils or other structures disclosed in Patent Document 1 published April 26, 2018, entitled "Fusion Zones". Any one may be used (agent reference number 138-1007).

Also, any of the embodiments disclosed herein are incorporated herein by reference in their entirety, "Implant with Arched Bone Contacting Elements" by McShane, III et al. Using any of the body / support structures, elements, frames, plates or other structures disclosed in Patent Document 2 published February 16, 2017, entitled "Implants with Elements)". It may be (agent reference number 138-1009).

Also, any of the embodiments disclosed herein are incorporated herein by reference in their entirety as a "Ring application", referred to herein by "Implant" by McShane III et al. Main body / support structure, element, frame disclosed in Patent Document 3 published on September 13, 2018, entitled "with Structural Members Arranged Around a Ring (implant having a structural member arranged around a ring)". , Plates or any other structure may be utilized (agent reference number 138-1012).

Also, any embodiment is entitled "Coiled Implants and Systems of Methods of Use Thereof" by Morris et al., Which is incorporated herein by reference in its entirety. Alternatively, any of the main body / support structure, frame, plate or other structure disclosed in Patent Document 4 published on November 10, 2016 may be used. For convenience, Morris applications are referred to as "coiled implant applications" throughout the application (agent reference numbers 138-1024).

Also, any of the embodiments disclosed herein are incorporated herein by reference in their entirety, such as Nyahay et al., "Implant with Bone Contacting Elements Haveing Helical and Undulating Specter Geometry". Implants with bone contact elements with undulating planar geometry) ”, a body / support structure, element, frame, plate or other disclosed in Patent Document 5 published September 13, 2018. Any of the structures may be used (agent reference number 138-1037).

Also, any of the embodiments disclosed herein, which is incorporated herein by reference in its entirety, entitled "Patenty Implant" by Nyahay et al. Any of the body / support structures, elements, frames, plates or other structures disclosed in Patent Document 6 published on September 13, 2018 may be utilized (agent reference number). 138-1042).

Also, any of the embodiments disclosed herein are incorporated herein by reference in their entirety, "Implant with Supported Helical Members" by Bishop et al. Any of the body / support structures, elements, frames, plates or other structures disclosed in Patent Document 7 published on September 13, 2018, entitled ". Person reference number 138-1043).

Also, any of the embodiments disclosed herein comprises the "Implant with Curved Bone Contacting Elements" of Hamsey et al., Which is incorporated herein by reference in its entirety. Implants) ”, any of the body / support structures, elements, frames, plates or other structures disclosed in Patent Document 8 published October 18, 2018 may be utilized. (Agent reference number 138-1059).

Also, any of the embodiments disclosed herein are incorporated herein by reference in their entirety, "Implant with Multi-Layer Bone Interfacing Lattice" by Hamsey et al. Implants) ”, utilizing any of the body / support structures, elements, frames, plates or other structures disclosed in Patent Document 9 published October 18, 2018. It may be (agent reference number 138-1067).

<Outline of implant>
1 to 3 show isometric views of embodiments of the implant 100. Implant 100 may also be referred to as a cage or fixation device. In some embodiments, the implant 100 is configured to be implanted within a portion of the human body. In some embodiments, the implant 100 may be configured for implantation in the spine. In some embodiments, the implant 100 is a spinal fixation implant or spine that is inserted between adjacent vertebrae to provide support between the vertebrae and / or to facilitate fusion between the vertebrae. It may be a fixed device.

In some embodiments, the implant 100 comprises a body 102. The body 102 may generally provide a frame or skeleton for the implant 100. In some embodiments, the implant 100 may also include a plurality of arched bone contact elements 104. The plurality of arched bone contact elements 104 may be attached to the body portion 102 and / or may be continuously formed (or "integrally formed") with the body portion 102.

As used herein, each arched bone contact element comprises a characteristic member or element that spans the area or area of the implant. In some embodiments, these elements may overlap or intersect, similar to the elements in the grid or other 3D mesh structures. In other embodiments, the elements may or may not overlap. In some embodiments, elements whose length is greater than their width and thickness may be used. For example, in embodiments where the element has a substantially circular cross-sectional shape, the element has a length greater than its diameter.

In the embodiments seen in FIGS. 1-3, each arched bone contact element has a substantially round or circular cross-sectional shape along at least a portion of the element (ie, the element is a solid tube geometry). Has). However, in other embodiments, the element can have a variety of polygonal cross-sectional shapes, as well as any other cross-sectional shape, including any other regular and / or irregular cross-sectional shape. Deaf, but not limited to these. In some cases, for example, the cross-sectional shape of the arched bone contact element may vary along its length (eg, the diameter or shape may vary along its length). You can do it).

For clarity, reference is made to the detailed description of the invention and various adjectives pointing in the claims. As used herein, the term "anterior" refers to a side or portion of an implant that is intended to be directed towards the anterior surface of the human body when the implant is placed inside the body. Similarly, the term "posterior" refers to a side or portion of an implant that is intended to be directed towards the dorsal surface of the human body after implantation. Also, the term "upper" refers to the side or part of the implant that is intended to be directed towards the upper part of the body (eg, the head), while "lower" is towards the bottom of the body. Refers to the side or part of the implant intended to be directed. Also referred to herein is the "lateral" side or portion of the implant, which is the laterally facing side or portion of the body after implantation.

In FIGS. 1 to 3, it is understood that the implant 100 is composed of an anterior side portion 110 and a posterior side portion 112. The implant 100 may also include a first outer side 114 and a second outer side 116 extending between the posterior side 112 and the anterior side 110 on either side of the implant 100. In addition, the implant 100 may also include an upper side 130 and a lower side 140.

References to orientation or axis refer to the implant itself, not the orientation it is intended for the body. For example, the term "distal" refers to the part located far from the center of the implant, while the term "proximal" refers to the part located closer to the center of the implant. As used herein, the "center of implant" could be the center of mass and / or the center plane and / or another reference plane located at the center.

Implants may also be associated with different axes. Referring to FIG. 1, the implant 100 may be associated with a lateral axis 120 extending along the implant 100 between the first outer side portion 114 and the second outer side portion 116. Further, the implant 100 may be associated with an anterior-posterior axis 122 extending between the posterior side portion 112 and the anterior side portion 110. The implant 100 may also be associated with a vertical axis 124 that extends along the thickness dimension of the implant 100 and is substantially perpendicular to both the lateral axis 120 and the anterior-posterior axis 122.

Implants may also be associated with various reference planes or reference surfaces. As used herein, the term "median plane" is a vertical plane that divides the implant into right and left halves, or two lateral halves, from the anterior side to the posterior side of the implant. Point to. As used herein, the term "cross-section" refers to a horizontal plane located in the center of the implant that divides the implant into upper and lower halves. As used herein, the term "coronal plane" refers to the centrally located vertical plane of the implant that divides the implant into anterior and posterior halves. In some embodiments, the implant is symmetrical about two planes, such as a cross section.

<Peripheral structure>
In some embodiments, the body may include a peripheral structure and one or more support beams extending from the peripheral structure. The peripheral structure may consist of any number of plates, walls or similar structures. In some embodiments, the peripheral structure could include a ring. In other words, in some embodiments, the peripheral structure could be a peripheral ring structure.

As seen in FIGS. 1 to 3, the main body 102 may further be composed of a peripheral structure 150. Peripheral structure 150 is shown to have a ring geometry.

FIG. 4 is a schematic isometric view of the main body 102 shown alone without any arched bone contact element, and FIG. 5 is a schematic view of the main body 102 separated from any arched bone contact element. It is a top view.

Referring to FIGS. 4-5, the peripheral structure 150 may further be composed of a front side portion 152, a rear side portion 154, a first outer side portion 156 and a second outer side portion 158.

As can be seen in FIGS. 1 and 2, in this embodiment, in the peripheral structure 150, the front side portion 152 is connected to the first outer side portion 156, and the first outer side portion 156 is connected to the rear side portion 154. The rear side portion 154 is connected to the second outer side portion 158, and the second outer side portion 158 is connected to the front side portion 152 in a continuous structure. That is, the front side portion 152, the first outer side portion 156, the rear side portion 154, and the second outer side portion 158 all form a continuous or uninterrupted ring.

FIG. 6 is a schematic front view of the implant 100, while FIG. 7 is a schematic rear view of the implant 100.

Referring to FIGS. 4-7, the front side portion 152 is further composed of a first front portion 160 and a second front portion 162. The first outer side portion 156 extends from the first front portion 160 of the front side portion 152 to the rear side portion 154. Similarly, the second outer side portion 158 extends from the second front portion 162 of the front side portion 152 to the rear side portion 154.

The first anterior portion 160 is composed of a distal surface 164 (most clearly seen in FIG. 6), an upper side surface 166 and a lower side surface 168. The first anterior portion 160 also includes a first outer surface 170 and a second outer surface (not shown) facing the first outer surface 170. Further, the first anterior portion 160 includes a proximal surface 174 joined to the second support beam 254, as described below.

The second anterior portion 162 includes a distal surface 184 (best seen in FIG. 6), an upper side surface 186 and a lower side surface (not shown). The second front portion 162 also includes a first outer surface 190 (see FIG. 5). Further, the second anterior portion 162 includes a proximal surface 194 joined to the third support beam 256, as described below. Further, the second front portion 162 is arranged adjacent to the first front portion 160. In some embodiments, the first anterior portion 160 and the second anterior portion 162 are joined together.

Each of the first lateral side portion 156 and the second lateral side portion 158 includes a distal surface joined to the proximal surface. In some cases, the proximal surface may be convex. For example, the first lateral side portion 156 includes the distal surface 210 and the proximal surface 212, the proximal surface 212 being convex and the distal surface 210 along the upper and lower sides of the implant 100. Is directly joined to.

The posterior side portion 154 of the implant 100 includes an upper side surface 200 and a lower side surface 202 (see FIG. 7). The posterior side portion 154 also includes the distal surface 204 and the proximal surface 206. As can be seen in FIG. 5, the geometry of the implant 100 at the posterior side 154 tapers towards the first outer side 156 and the second outer side 158.

In some embodiments, the vertical height or thickness of different parts of the perimeter structure could vary. In the embodiment shown in FIG. 6, which shows a schematic view of the anterior surface of the implant 100, the first anterior portion 160 is shown to have a first height 300, while the second anterior portion 162 is a second height. It is shown to have a 302. Here, the first height 300 is shown to be larger than the second height 302. In some embodiments, this tapering of height from the centrally located first anterior portion 160 to the adjacent second anterior portion 162 gives the anterior side portion 152 of the peripheral structure 150 a convex shape. Helps to fit better between adjacent vertebral bodies during implantation.

Further, as seen in FIG. 7, the height of the peripheral structure 150 along the rear side portion 154 is shown as the third height 304. In the embodiment, the third height 304 is smaller than the first height 300. Further, in some cases, the third height 304 may be slightly smaller than the second height 302.

In some embodiments, the height or vertical thickness variation between the posterior and anterior sides of the implant causes the implant to have a hyperlordosis angle between the inferior and superior sides. It may be possible. In other embodiments, vertical thickness variation may be used to control the relative stiffness of the device at different locations.

In some embodiments, the thickness of the peripheral structure 150 is both the first outer side portion 156 and the second outer side portion 158, rather than the thickness along either the front side portion 152 or the rear side portion 154. May be smaller along. In the embodiment, the first outer side portion 156 and the second outer side portion 158 have a similar fourth height 306. Here, the fourth height 306 is smaller than the first height 300, the second height 302, and the third height 304. Outer side while maintaining a smooth vertical profile across the upper and lower sides of the implant 100 by using reduced lateral side height or vertical thickness compared to anterior and posterior sides. An arched bone contact element can be attached to the side (see Figure 7).

<Support beam>
In some embodiments, the body may include one or more support beams (or support structures) that act to reinforce the peripheral structure. In some embodiments, one or more support beams could be placed along the interior of the perimeter structure. For example, in some embodiments, one or more support beams are from a first position on the surface of the inwardly facing support structure to a second on the surface of the inwardly facing (or proximal) support structure. Will be able to extend to the position. In other words, in some embodiments, the one or more supporting beams may span an internal region bounded by a peripheral structure.

As seen in FIGS. 4-5, the body 102 includes a plurality of support beams 250. These include a first support beam 252, a second support beam 254 and a third support beam 256.

In the embodiments shown in FIGS. 4-5, each of these supporting beams is from the first position on the surface 260 of the inwardly facing peripheral structure 150 to the first on the surface of the inwardly facing peripheral structure 150. It extends to two positions. Here, the surface 260 of the peripheral structure 150 facing inward is composed of proximal surfaces (eg, proximal surface 174, proximal surface 194, proximal surface 212, etc.) on various sides of the peripheral structure 150. Will be understood.

Referring to FIGS. 4-5, the first support beam 252 has a first end 270 attached to a first anterior position 271 of an inwardly facing surface 260 and a second anterior surface of the inwardly facing surface 260. Includes a second end 272 mounted at position 273. Similarly, each of the second support beam 254 and the third support beam 256 includes opposed ends mounted at different positions along the inwardly facing surface 260. With this configuration, it can be seen that the plurality of support beams 250 span the internal region 290 (or central region) bounded by the peripheral structure 150.

The plurality of support beams 250 may be considered to be centrally located within the implant 100 with respect to the peripheral structure 150. As used herein, "central position" does not refer to the exact position that is the geometric center or mass center of the implant, but rather inside the peripheral structure (eg, within the internal region 290). ) Refers to the general area or area where it is placed. Therefore, in the following description and claims, the support beam may be referred to as a central beam.

In different embodiments, the number of support beams could be varied. In some embodiments, a single support beam could be used. In other embodiments, more than one support beam could be used. In the embodiments shown in FIGS. 4-5, three support beams are used.

In different embodiments, one or more beams could be redirected. In some embodiments, two or more support beams could be directed in parallel. In other embodiments, two or more support beams could be placed at an oblique angle to each other. In the embodiment, the first support beam 252, the second support beam 254 and the third support beam 256 may be arranged in parallel with each other. Also, in the embodiment, the plurality of support beams 250 may be oriented in the rear-forward direction (ie, along the anteroposterior axis 122). Of course, in other embodiments, the plurality of support beams 250 could be oriented in any other direction.

In different embodiments, the spacing or separation between adjacent support beams could be varied. In some embodiments, the spacing between adjacent support beams could be reduced relative to the width of the implant. For example, the spacing could range from 0% to 10% of the width of the implant. In other embodiments, the spacing between adjacent support beams could be increased relative to the width of the implant. For example, the spacing could range from 10% to 95% of the width of the implant (eg, two beams located adjacent to both lateral sides of the implant, 95 of the width of the implant. Could be separated by%). The spacing between adjacent beams (or between the beam and a portion of the surrounding structure) may be constant or may vary across the implant.

Relative spacing between support beams depends on many factors, including the thickness of one or more support beams, the number of support beams used, the desired intensity-to-weight ratio for the implant, and other factors. It will be understood that you may choose. In addition, since the arch bone contact element extends between adjacent support beams (or between the support beam and the surrounding structure), the spacing between adjacent support beams depends on the dimensions of one or more arch bone contact elements. May be decided.

In the embodiment shown in FIG. 4, the first support beam 252 is separated from the first outer side portion 156 by an interval 292. The first support beam 252 and the second support beam 254 are separated from each other by an interval 294. The second support beam 254 and the third support beam 256 are separated from each other by an interval of 296. The third support beam 256 is separated from the second outer side portion 158 by an interval of 298. In the examples, each of Interval 292, Interval 294, Interval 296 and Interval 298 has a value in the range of approximately 15% to 30% of the width 199 of the implant 100. Of course, the spacing between adjacent components can be varied, for example, along the anteroposterior axis 122, so it will be appreciated that each spacing is an average or approximate spacing.

In different embodiments, it will be possible to change the geometry of one or more support beams. In some embodiments, one or more supporting beams could have curved geometry. In other embodiments, the one or more support beams could have a substantially linear geometry.

In the embodiments shown in FIGS. 4-5, each of the plurality of support beams 250 has a substantially linear geometric shape. Also, the cross-sectional geometry of each support beam is substantially rounded. However, in other embodiments, the one or more supporting beams can have any other cross-sectional shape including, but not limited to, rectangular, polygonal, regular and / or irregular shapes. Will. The cross-sectional shape could also vary from, for example, a round cross-sectional shape (eg, circular or elliptical) to a polygonal cross-sectional shape (eg, rectangular) over the length of the support beam.

In different embodiments, the thickness of one or more support beams could vary. Roughly speaking, the thickness (or diameter) of the support beam could vary from 1% to 95% of the width (or length) of the implant. In the embodiment, the first support beam 252, the second support beam 254 and the third support beam 256 have diameters ranging from about 2% to 15% of the width 199 of the implant 100, as seen in FIG. More specifically, the second support beam 254 has a diameter 255 that is larger than the diameter 253 of the first support beam 252 and larger than the diameter 257 of the third support beam 256.

In some cases, the second support beam 254 may have a maximum diameter. This larger diameter for the second support beam 254 is such that the impact force is applied to the center of the implant 100 (where the second support beam 254 is located) by the device coupled to the implant 100 at the first internal portion 160. , May help reinforce the center of the implant 100.

In at least some embodiments, the support beam within the body of the implant may be coplanar.

In FIGS. 4-5, it can be seen that the first support beam 252, the second support beam 254 and the third support beam 256 exist in a similar plane of the implant 100. The coplanar arrangement of the support beams may help provide a substantially symmetrical arrangement for the implant 100 between the upper and lower sides.

In general, the geometry of one or more parts of the body of the implant could be varied depending on the embodiment. For example, a portion of the body may include one or more windows, slots and / or openings that may penetrate the implant and promote bone growth and / or reduce weight.

<Fastening means>
Some embodiments may include one or more fastener receiving means. Some embodiments may include one or more mounting openings that engage the insertion device or implant device. In some embodiments, the implant can include one or more threaded cavities. In some embodiments, the threading cavity can be configured to fit into a corresponding thread tip on an embedding tool or device. In another embodiment, the threaded cavity can accept fasteners for fastening implants to another device or component within an implant system that uses multiple implants and / or multiple components.

As best seen from FIG. 6, the implant 100 includes a first threaded cavity 360 located in the first anterior portion 160. Implant 100 also includes a second threaded cavity 362 located in the second anterior portion 162. In some embodiments, the first threaded cavity 360 may accept the threaded tip of an embedding tool (not shown). Such a tool could be used to screw the implant 100 between adjacent vertebral bodies.

Optionally, in some cases, the implant 100 may also include a pair of indentations (indentation 365 and indentation 367) that facilitates alignment between the implant tool and the implant 100. In some embodiments, the second threaded cavity 362 could be used to fasten the implant 100 to a separate component (not shown) of the broader implant system. For example, some embodiments may incorporate a separate plate that is fastened to the implant 100 using fasteners secured within a second threaded cavity 362. Such plates could include additional fixing members (eg, screws) that could be used with the implant.

<Arrow bone contact element>
In some embodiments, the arched bone contact element may include a first end, an intermediate and a second end. In some embodiments, the middle portion may have an arched geometry. In such a case, the intermediate portion having a bow-shaped geometric shape is referred to as a "bow-shaped portion". In some embodiments, the first and / or second ends could have flared geometry. In such a case, the end having a flared geometric shape is referred to as a "flared leg" of the arched bone contact element.

FIG. 8 is a schematic representation of an exemplary arched bone contact element seen separately, including several enlarged schematic cross-sections at different locations of the element.

Referring to FIG. 8, the arched bone contact element 400 includes a first end referred to as a first flared leg 402. The arched bone contact element 400 also includes an arched portion 404. Further, the arched bone contact element 400 also includes a second end portion referred to as a second flared leg portion 406.

In some embodiments, the arched bone contact element can include means for engaging the vertebral body after implantation. In some embodiments, the one or more arched bone contact elements can include at least one distal surface region configured to be in direct contact with the vertebral endplate. In some cases, the distal surface area could be a flat surface area. In other cases, the distal surface region could be a convex region. In yet other cases, the distal surface region could be a concave surface region. More generally, the distal surface region could have a different curvature than the adjacent surface region of the arched portion. Also, the particular curvature for the distal surface region could be selected to fit the local geometry of the opposing vertebral endplates.

As an example, in FIG. 8, it can be seen that the arched bone contact element 400 includes a distal surface region 490 disposed within the arched portion 404. In some embodiments, the distal surface region 490 may have a convex curvature less than the curvature of the adjacent region of the arched portion 404. Similarly, as best seen from FIG. 7, the remaining arched bone contact element of the implant 100 is also composed of a distal bone contact region having a curvature smaller than the adjacent surface region of the arched portion 404. (Ie, these distal surface regions may be flatter than the rest of the arched portion 404, but may not be perfectly flat). Together, these distal bone contact areas provide a partially smooth surface that can engage the vertebral body.

Moreover, in some embodiments, the collection of flat (or convex) bone contact areas forms the smallest contact surface with the bone, thereby providing a larger amount of graft material or bone growth promoting material. It can be placed in direct contact with the bone. Specifically, the bone growth promoting material placed between the arched bone contact elements, including those placed in the open area along the superior and inferior surfaces, is brought into direct contact with the bone. May be good.

For reference purposes, the arched bone contact element 400 may be characterized as having a curved central axis 401. As used herein, the axis of curvature of the element is an axis that extends along the length of the element and is located approximately at the center of the element at each position along that length.

It will be appreciated that the cross section described below and shown in FIG. 8 is along a plane perpendicular to the curved central axis 401.

As can be seen in FIG. 8, the arched portion 404 has an arched geometry. It can also be seen that the bow-shaped portion 404 has a rounded cross-sectional shape. More specifically, in some cases, the arched portion 404 has a substantially circular (or substantially circular) cross-sectional shape. In some embodiments, the diameter and cross-sectional shape of the arched portion 404 remain relatively constant along most of the length of the arched portion 404 (ie, along the curved central axis 401). .. However, it will be appreciated that the cross-sectional shape of the arched portion 404 can vary, for example, along the flat bone contact area 490. For reference, a cross section of the arched portion 404 on the reference plane 471 is shown in FIG. Of course, in other embodiments, the arched portion 404 can have any other cross-sectional shape.

The cross-sectional shape of the arched bone contact element 400 may change at each flared leg. For example, as seen in FIG. 8, the cross-sectional shape of the first flared leg 402 has a first cross-sectional shape 410 at a position adjacent to the arched portion 404 (on the reference plane 472). The first flared leg 402 also has a second cross-sectional shape 412 and a third cross-sectional shape 414. Here, the third cross-sectional shape 414 is at the position farthest from the bow-shaped portion 404 (at the reference plane 474), and the second cross-sectional shape 412 is the first flare-shaped leg (at the reference plane 473). It is at an intermediate position along the portion 402.

As shown in FIG. 8, the cross-sectional shape of the first flared leg portion 402 changes from a substantially circular cross-sectional shape (that is, the first cross-sectional shape 410) to a substantially elliptical cross-sectional shape (that is, the third cross-sectional shape 414). It changes with. For example, the first cross-sectional shape 410 of the first flared leg 402 has a similar diameter 420 along both the first axis 430 and the second axis 432. However, the second cross-sectional shape 412 has a large diameter 422 along the first axis 430, which is larger than its small diameter 424 along the second axis 432. Further, the third cross-sectional shape 414 also has a large diameter 426 along the first axis 430 and a small diameter 428 along the second axis 432, the large diameter 426 being larger than the large diameter 422 and the small diameter 428 being larger than the small diameter 424. Is also big. Therefore, the cross-sectional size of the first flared leg 402 also increases as its shape changes from a substantially circular shape to a substantially elliptical shape.

With the above configuration, the cross-sectional area of the arched bone contact element 400 may be minimized at the arched portion 404. Further, when the bow-shaped portion 404 is moved to the first flared leg portion 402 along the curved central axis 401, the maximum is reached at the farthest end portion of the first flared leg portion 402 (similarly, the second flared shape). The cross-sectional area increases until it reaches the maximum at the farthest end of the leg 406).

This increase in cross-section can provide a wider base for each arched bone contact element in its attachment to the body and thus can improve the attachment strength between the arched bone contact element and the body. Also, the change in cross-sectional shape allows the increase in size to be directed primarily in the direction parallel to the underlying structure (eg, the cross-section of the supporting beam or peripheral structure).

For example, as seen in FIG. 9, the first flared leg 402 has the longest dimension parallel to the central axis 480 of the peripheral segment 482 to which the first flared leg 402 is attached. Here, the peripheral segment 482 is the segment of the implant 499. Further, the first flared leg portion 402 has a minimum dimension parallel to the width direction axis 484 of the peripheral segment 482. Therefore, the mounting surface area between the arched bone contact element 400 and the peripheral segment 482 is increased while preventing the first flared leg 402 from extending beyond the peripheral segment 482 in the direction of the widthwise axis 484.

Although the geometric shape of the first flared leg 402 is described in detail, it is understood that the second flared leg 406 may have the same geometric shape as the first flared leg 402. Will be done. Similarly, the flared leg of the remaining arched bone contact element of the implant 100 may have the same geometry as the first flared leg 402.

The particular cross-sectional geometry (circular and oval) shown for the portion of the arched bone contact element in FIG. 8 may be a schematic representation of possible variations in the geometry for the arched bone contact element. It is only intended. In some embodiments, the flared legs may be able to have a more irregular geometry while increasing in size and elongated along one axis, substantially. It does not have an elliptical cross-sectional shape. Also, the cross-sectional shape could be varied between any two shapes at both ends of the flared legs. The cross-sectional shape is exemplified by rounded (including circular and elliptical), rectangular, polygonal, regular, irregular, and any other shape. Including, but not limited to.

Embodiments could include any number of arched bone contact elements. Some embodiments may include a single arched bone contact element. Still other embodiments can include any number of arched bone contact elements in the range of 2-50. In yet another embodiment, the implant can contain more than 50 elements.

In the embodiments shown in FIGS. 1-3, the implant 100 has 18 arched bone contact elements including 9 elements on the upper side 130 and 9 elements on the lower side 140. including. The number of arched bone contact elements used will vary depending on factors including implant size, desired implant strength, desired volume for bone graft or other bone growth promoting material, and other possible factors. be able to.

In different embodiments, the placement of the arcuate contact element of the implant can be varied. In some embodiments, the arched bone contact element can be attached to any part of the surrounding structure, to any beam of the implant, and to other arched bone contact elements. In some embodiments, the arched bone contact element can extend across the width of the implant. In other embodiments, the arched bone contact element may only extend across a portion of the width of the implant.

To increase the strength of the implant, in some embodiments, an arched bone contact element that only extends between adjacent beams or between the beam and adjacent portions of the surrounding structure may be used.

FIG. 10 is a schematic top view of the implant 100. Referring to FIG. 10, the plurality of arched bone contact elements 104 includes an upper set 502 of the arched bone contact element and a lower set 504 of the arched bone contact element (visible in FIG. 7). The upper set 502 further comprises a first group 510 (or simply the first group 510) of the arched bone contact element, a second group 512 (or simply the second group 512) of the arched bone contact element, and an arched bone contact element. It is composed of a third group 514 (or simply a third group 514) and a fourth group 516 (or simply a fourth group 516) of arched bone contact elements.

In the embodiment of FIG. 10, each group of arched bone contact elements comprises two or more elements extending between the same two beams or between the same beam and the same side of the peripheral structure 150.

As seen in FIG. 10, the first group 510 includes a first arch bone contact element 521, a second arch bone contact element 522, and a third arch bone contact element 523. Each of these elements extends between the first outer side portion 156 of the peripheral structure 150 and the first support beam 252. For example, the first arched bone contact element 521 has a flared leg portion 531 attached to the first lateral side portion 156 and a flared leg portion 532 attached to the first support beam 252. Similarly, each of the second arched bone contact element 522 and the third arched bone contact element 523 was attached to one flared leg attached to the first lateral side portion 156 and to the first support beam 252. It has another flared leg.

The second group 512 includes a fourth arch bone contact element 524 and a fifth arch bone contact element 525. Each of these elements extends between the first support beam 252 and the second support beam 254. For example, the fourth arched bone contact element 524 has a flared leg 541 attached to the first support beam 252 and another flared leg 542 attached to the second support beam 254. Similarly, the fifth arched bone contact element 525 has a flared leg attached to the first support beam 252 and another flared leg attached to the second support beam 254.

The third group 514 includes a sixth arch bone contact element 526 and a seventh arch bone contact element 527. Each of these elements extends between the second support beam 254 and the third support beam 256. For example, the sixth arched bone contact element 526 has a flared leg 551 attached to the second support beam 254 and another flared leg 552 attached to the third support beam 256. Similarly, the seventh arched bone contact element 527 has a flared leg attached to the second support beam 254 and another flared leg attached to the third support beam 256.

The fourth group 516 includes an eighth arch bone contact element 528 and a ninth arch bone contact element 529. Each of these elements extends between the third support beam 256 and the second outer side portion 158 of the peripheral structure 150. For example, the eighth arched bone contact element 528 has a flared leg 561 attached to the third support beam 256 and another flared leg 562 attached to the second lateral side 158. .. Similarly, the ninth arched bone contact element 529 has a flared leg attached to the third support beam 256 and another flared leg attached to the second lateral side portion 158.

In some cases, some parts of adjacent arched bone contact elements may be in contact or may partially overlap. For example, some embodiments could have flared legs that are in contact or partially overlap.

For example, in FIG. 10, the flared leg portion 532 is arranged adjacent to the flared leg portion 541 and is partially in contact with the flared leg portion 541. However, it will be appreciated that each arched bone contact element is attached at its end to a portion of the body of the implant 100.

The ends of two or more arched bone contact elements may contact each other, but the arched portion of each element remains separated from the adjacent element. In other words, there are no intersections between the arched portions of the different arched bone contact elements. Specifically, in some embodiments, the arched portions of each arched bone contact element may not intersect or may be separated from each other. Also, there is no intersection of the arched bone contact elements in or near the area where the arched bone contact elements contact the vertebrae. Therefore, it will be seen that the implant 100 provides a plurality of arched bone contact elements 104 that are not intersecting and are arranged to contact the opposing vertebral surfaces.

Some embodiments may include, for example, means to allow the structure to be self-supporting at the time of manufacture, if the structure is manufactured using a 3D printing process. In some embodiments, the placement of the arched bone contact element may be chosen to facilitate self-support during manufacturing (eg, during a 3D printing process). In some embodiments, the arched bone contact element can be placed in an inclined orientation with respect to the body or the axis of the body. In some embodiments, the arched bone contact elements may be arranged in a herringbone pattern that is further composed of the individual V-shaped configurations of the elements. Such a configuration will allow the implant to be printed using a self-supporting structure.

The one or more arched bone contact elements may be angled with respect to one or more axes of the implant.

Referring to FIG. 10, for example, the second arched bone contact element 522 is oriented at an oblique angle with respect to the lateral axis 120 (and also with respect to the anterior-posterior axis 122). Further, the fourth arched bone contact element 524 is oriented at an oblique angle with respect to the horizontal axis 120 (and also with respect to the anterior-posterior axis 122). Further, the second bone contact element 522 and the fourth bone contact element 524 are oriented at different angles from the horizontal axis 122.

As shown in FIG. 10, the remaining arched bone contact elements may also be oriented at an oblique angle with respect to the lateral axis 120 of the implant 100. Therefore, it will be seen that the arched bone contact elements are not placed parallel on the implant 100.

In some embodiments, at least two arched bone contact elements may be placed on the body of the implant in a V-shaped configuration or pattern. For example, the second arched bone contact element 522 and the fourth arched bone contact element 524 are arranged in the first V-shaped configuration 600. Further, the sixth arched bone contact element 526 and the eighth arched bone contact element 528 are arranged in the second V-shaped configuration 602. Further, the third arch bone contact element 523 and the fifth arch bone contact element 525 are arranged in the third V-shaped configuration 604. Finally, the 7th arched bone contact element 527 and the 9th arched bone contact element 529 are arranged in the 4th V-shaped configuration 606. This embodiment includes four V-shaped configurations on the upper side (ie, the upper set 502 of the arched bone contact element) and another four V-shaped configurations on the lower side, but other embodiments. Would be able to include any other number of V-shaped configurations in the upper or lower side.

In different embodiments, the V-shaped configuration could be positioned and oriented. In some embodiments, all of the V-shaped configurations may be oriented in the same direction. In other embodiments, two or more V-shaped configurations could be oriented in different directions. Also, in some cases, two or more V-shaped configurations could be placed in rows and / or columns.

In the embodiment shown in FIG. 10, each V-shaped configuration has a common direction corresponding to the front-rear axis 122. Specifically, each configuration is arranged so that the tip of the V-shape points in the direction toward the rear side portion 154 along the front-rear axis 122. Further, the first V-shaped configuration 600 and the second V-shaped configuration 602 are arranged adjacent to each other in the first row so that they have different positions along the horizontal axis 120. Similarly, the third V-shaped configuration 604 and the fourth V-shaped configuration 606 are arranged adjacent to each other in the second line. Further, the first V-shaped configuration 600 and the third V-shaped configuration 604 are arranged adjacent to each other in the first row so that they have different positions along the front-rear axis 122. Similarly, the second V-shaped configuration 602 and the fourth V-shaped configuration 606 are arranged adjacent to each other in the second row.

As can be seen in FIG. 10, when considered together, the four V-shaped configurations form a large herringbone pattern 620 on the body 102.

Each V-shaped configuration may be centered on a single support beam. For example, the first V-shaped configuration 600 and the second V-shaped configuration may be centered on the first support beam 252. Further, the third V-shaped configuration and the fourth V-shaped configuration may be centered on the third support beam 256.

Each V-shaped configuration may extend from the outer side of the main body 102 to a central support beam (eg, a second support beam 254). For example, the first V-shaped configuration 600 extends from the first outer side portion 156 to the second support beam 254. Further, the second V-shaped configuration 602 extends from the second support beam 254 to the second outer side portion 158.

In some cases, the arched bone contact element may be oriented to the herringbone pattern, facilitating easier insertion of the implant. Specifically, by tilting the arched bone contact element away from the lateral direction, the element may present a small surface area along the implantation direction (ie, posterior), which is potentially insertable. It will make the work easier.

The arrangement of the arched bone contact elements may also be designed to achieve the desired total open capacity. As used herein, total volume is any opening between the arched bone contact elements, any opening within the body, or the combined volume of the openings between the arched contact element and the body. .. This open configuration may promote bone growth in or with implants. Part or all of the open space is optionally filled with bone grafts or bone growth-promoting material before or after implant insertion to promote bone growth.

The total capacity of the open space (also simply referred to as the open space capacity) within any particular implant depends on the overall dimensions of the implant as well as the size and dimensions of the individual components within the implant, including the arched bone contact element. is doing. The open space capacity may range from about 20% to 80% of the implant capacity. In some embodiments, the implant 100 may have an open space capacity that is 25% to 80% of the total capacity of the implant. In a further embodiment, the implant 100 may have an open space capacity of 50% to 70% of the total implant capacity.

In some embodiments, the implant can be configured with one or more symmetries. In some cases, the implant may have mirror plane symmetry with respect to one or more reference planes. In other cases, the implant may have translational symmetry with respect to one or more reference planes. In yet other cases, the implant could have both mirror plane symmetry and translational symmetry.

With reference to FIGS. 1 and 2, the implant 100 contains at least one mirror plane symmetry. For reference purposes, the implant 100 may be divided into an upper half body and a lower half body. Here, the "upper half body" of the implant 100 includes a portion of the body 102 and a plurality of arched bone contact elements 104 disposed on the cross section. Similarly, the "lower half body" of the implant 100 includes a portion of the body 102 and a plurality of arched bone contact elements 104 disposed below the cross section.

It will be seen that the upper half of the implant 100 is in a mirror image relationship with the lower half of the implant 100 with respect to the cross section (which roughly coincides with the body 102 in this embodiment). This includes not only the geometry of the body, but also the shape, size and orientation of each arched bone contact element. It will be appreciated that this mirror symmetry may only be an approximation in some embodiments. The symmetric configuration of the implant 100, eg, the mirror symmetry between the upper and lower halves of the implant 100, helps to balance the load in the vertical direction or along the length of the spine. May be good.

<Additional embodiment>
In different embodiments, the dimensions of the implant can be varied. Examples of dimensions that could be varied include length, width and thickness. Also, in some cases, the diameter of one or more arched bone contact elements could be varied depending on the embodiment.

FIG. 11 is a schematic diagram of another embodiment of the implant 700. The implant 700 may be similar to the implant 100 shown in FIGS. 1 to 10 described above in many respects. In some embodiments, the implant 700 may have a larger width and length (and thus a larger overall footprint) than the implant 100. To accommodate larger sizes, the implant 700 may include an additional arched bone contact element 702 on the upper side 710 and a corresponding element (not shown) on the lower side.

As seen in FIG. 11, the arched bone contact element 702 extends from the support beam 720 to the lateral side portion 722 of the implant 700. With this additional arched bone contact element, the group 730 of the arched bone contact element of the lateral side 724 has the same number (ie, 3) of elements as the group 732 of the arched bone contact element of the lateral side 722. It turns out that it has. It can be seen that this configuration of the arched bone contact element therefore has mirror plane symmetry with respect to the central axis 740 of the implant 700.

12 to 13 show schematic views of another embodiment of the implant 800. The implant 800 may be similar in many respects to the implants 100 and 700 shown in FIGS. 1-11 above. In some embodiments, the implant 800 may have a larger width and length (and thus a larger overall footprint) than the implant 700.

Some embodiments may include one or more arched bone contact elements attached at both ends to a single support beam. Some embodiments may include one or more arched bone contact elements attached to a single segment of the peripheral structure.

Referring to FIGS. 12-13, the implant 800 is composed of a plurality of arched bone contact elements 804 attached to the body portion 802. The main body portion 802 is further composed of a peripheral structure 806, a first support beam 810, a second support beam 812, and a third support beam 814.

Here, referring to FIG. 13, the plurality of arched bone contact elements 804 include a first group 820 (or first group 820) of the arched bone contact element and a second group 822 (or second group) of the arched bone contact element. Group 822), 3rd group 824 (or 3rd group 824) of the arched bone contact element, 4th group 826 (or 4th group 826) of the arched bone contact element, 5th group 828 of the arched bone contact element. (Or 5th group 828), 6th group 830 (or 6th group 830) of the arched bone contact element, 7th group 832 (or 7th group 832) of the arched bone contact element, and the arched bone contact element. It is further composed of the 8th group 834 (or the 8th group 834) of the above.

The second group 822 includes an arch bone contact element extending from the first lateral side portion 811 of the peripheral structure 806 to the first support beam 810. The fourth group 826 includes an arch bone contact element extending from the first support beam 810 to the second support beam 812. The fifth group 828 includes an arch bone contact element extending from the second support beam 812 to the third support beam 814. The seventh group 832 includes an arch bone contact element extending from the third support beam 814 to the second lateral side portion 813 of the peripheral structure 806. Also, the arched bone contact elements of the second group 822, the fourth group 826, the fifth group 828 and the seventh group 832 are generally in a herringbone pattern similar to the arrangement of the arched bone contact elements of the implant 100. It is arranged in a organized V-shaped structure.

Since the implant 800 has an increased footprint compared to the implant 100 and the implant 700, an additional arched bone contact element provides a larger (partial) contact surface on the upper and lower sides of the implant 800. May be included to do so.

In the embodiments shown in FIGS. 12-13, some of these additional arched bone contact elements are the lateral side of the body 802 and the first support beam 810, second support beam 812 and third support beam. Added along with 814.

The first group 820 includes the arched bone contact element 901 and the arched bone contact element 902, both of which are connected at each end to the first lateral side portion 811 of the peripheral structure 806. Specifically, for example, the arched bone contact element 901 has a first flared leg portion 911 attached to the first outer side portion 811 and a second flared leg portion 912 attached to the first outer side portion 811. including.

In addition, the third group 824 contains three arched bone contact elements, each attached to the first support beam 810 at both ends. For example, the arched bone contact element 903 includes a first flared leg 921 attached to the first support beam 810 and a second flared leg 922 attached to the first support beam 810. Similarly, the sixth group 830 includes three arched bone contact elements. Each of these elements includes two flared legs, each attached to a third support beam 814. In addition, Group 8 834 includes two arched bone contact elements. Each of these elements includes two flared legs attached to the second outer side portion 813 of the peripheral structure 806.

<Surface texture processing>
Embodiments can include means for textured one or more surfaces of the implant. Such texture processing can increase or otherwise promote bone growth and / or fusion to the surface of the implant. In some embodiments, the arched bone contact element and / or the section of the body may be textured.

In some embodiments, the surface structure of one or more areas of the implant may be roughened or the surface structure may be textured. In general, this roughened structure may be achieved through acid etching, bead or grit blasting, spatter coating with titanium, bead sintering of titanium or cobalt chromium, and the use of other methods onto the surface of the implant. In some embodiments, roughness can be created by 3D printing a raised pattern on the surface of one or more areas of the implant. In some embodiments, the resulting rough surface may have pores of various sizes. In some embodiments, the pore size could range from about 0.2 mm to 0.8 mm. In one embodiment, the pore size could be about 0.5 mm. Of course, in other embodiments, surface roughness including pore sizes less than 0.2 mm and / or greater than 0.8 mm is possible.

An embodiment using a textured surface is shown in the alternative embodiment seen in FIG. 14 and the isometric view of the implant 900.

As can be seen in FIG. 14, the implant 900 includes a smooth peripheral surface 902. However, the remaining surface of the implant 900 is roughened. These include the visible portion of the superior side surface 904, which is further composed of the superior side surface of the peripheral structure 950 and the surface of the plurality of arched bone contact elements 952.

For purposes of illustration, the roughened surface is schematically shown using pointillism. These roughened or porous surfaces may help improve bone growth along the surface of the implant. As a particular embodiment, the arched bone contact element 960 extends through the entire element, including the distal surface area 964, which is intended to be in direct contact with the adjacent vertebrae (also also in the enlarged schematic of FIG. 15). It can be seen that it has a roughened surface area 962 (as seen).

It will be appreciated that any of the embodiments shown in the figure can include one or more roughened surfaces. For example, in some embodiments, implant 100, implant 700 or implant 900 could include one or more roughened surfaces. It would also be possible to selectively apply the roughened surface to some parts of the implant and not to others.

<Bone growth promoting material>
In some embodiments, bone growth can be promoted by applying a bone growth promoting material within or around a portion of the implant. As used herein, a "bone growth promoting material" (or BGPM) is any material that aids in bone growth. Bone growth promoting materials may include means of freeze-drying or adhering to metal on the surface by the use of linker molecules or binders.

Examples of bone growth promoting materials are any material, including bone morphogenetic proteins (BMPs) such as BMP-1, BMP-2, BMP-4, BMP-6 and BMP-7. These are hormones that convert stem cells to bone-forming cells. Another example includes recombinant human BMPs (rhBMPs) such as rhBMP-2, rhBMP-4 and rhBMP-7. Yet another example includes platelet-derived growth factor (PDGF), fibroblast growth factor (FGF), collagen, BMP mimicking peptide, and RGD peptide. In general, combinations of these chemicals may also be used. These chemicals can be applied using sponges, substrates or gels.

Also, some bone growth promoting materials may be applied to the implantable prosthesis using plasma spray or electrochemical techniques. Examples of these materials include, but are not limited to, hydroxyapatite, β-tricalcium phosphate, calcium sulfate, calcium carbonate, and other chemicals.

Bone growth promoting materials can include or may be used in combination with bone grafts or bone graft substitutes. Various materials act as bone implants or bone implant substitutes containing autologous implants (extracted from the iliac crest of the patient's body), allogeneic implants, demineralized bone substrates, and various synthetic materials. May be good.

Some embodiments may use autologous implants. Autologous implants provide a calcium-collagen scaffold for spinal fixation for new bone growth (bone conduction). In addition, autologous implants include bone growth cells, mesenchymal stem cells and osteoblasts that regenerate bone. Finally, the autologous implant contains a bone growth protein, including a bone morphogenetic protein (BMP), to promote new bone growth in the patient.

Bone graft substitutes include calcium phosphate or hydroxyapatite, stem cell-containing products that combine stem cells with one of other types of bone graft substitutes, and Medtronic, Inc. May contain synthetic materials containing growth factor-containing substrates such as INFUSE® (rhBMP-2-containing bone graft).

It should be understood that the means listed here are not intended to be an exhaustive list of possible bone growth-promoting materials, bone grafts or bone graft substitutes.

In some embodiments, BGPM may be applied to one or more outer surfaces of the implant. In other embodiments, BGPM may be applied to the internal volume within the implant. In yet another embodiment, BGPM may be applied both on the outer surface and inside the implant.

<Manufacturing and materials>
The various components of the implant include, but are not limited to, metals (eg, titanium or other metals), ceramics, and / or combinations thereof, depending on the particular application and / or choice by the physician. It may be made from a biocompatible material suitable for implantation.

In general, implants can be formed from any suitable biocompatible non-degradable material that is strong enough. Typical materials are, but are not limited to, titanium, biocompatible titanium alloys (eg, γ titanium aluminide, Ti6-Al4-V ELI (ASTM F 136) or Ti6-Al4-V (ASTM F 1108 and ASTM F). 1472)) and include inert biocompatible polymers such as polyether Etherketone (PEEK) (eg PEEK-OPTIMA®, Invibio Inc). Optionally, the implant contains an x-ray opaque marker to facilitate visualization during imaging.

In different embodiments, the process of making an implant can be varied. In some embodiments, the entire implant is injection molded, cast or injection molded, insert molded, coextruded, drawn molded, transferred molded, overmolded, compression molded, three-dimensional (3D) printing, immersion coating, spray coating. , Powder coating, porous coating, grinding from solid raw materials, and combinations thereof may be manufactured and assembled. Also, embodiments can utilize any of the features, parts, assemblies, processes and / or methods disclosed in the "Coiled Implant Application".

The design of embodiments (eg, implant 100, implant 700 and implant 900) may help provide improved and / or accelerated bone fusion. Specifically, after one implant of the implant, bone fusion may first occur at one or more distal surfaces or apex of the arched bone contact element. Below these distal planes, bone growth may continue along the arched portion of each arched bone contact element and may therefore be directed towards the interior of the implant. Thus, new bone growth initiated in the distal planes of the superior and inferior sides of the implant may be directed towards the center of the implant and eventually merge from one vertebral body. , May form a continuous section of new bone growth that extends through the implant to the adjacent vertebral body. Further, as a result, the bone contact element may be placed primarily on the surface of the implant, accelerating the interbody fusion process on a structure that does not extend medially.

<Implant for anterior lateral interbody fusion>
16-24 show various schematics of implants and other embodiments of the method of use. In some embodiments, the implant may be inserted using an anterior lateral interbody fusion (OLIF) surgical procedure, in which the disc gap is lateral to the spine. It is healed by approaching.

FIG. 16 shows a schematic view of a patient 1000 lying sideways, with the implant in a position for insertion into the body. In the OLIF approach, an incision 1002 (which may optionally be 3-5 inches long) may be made on the side of the abdomen.

FIG. 17 shows a schematic diagram of a region of the spine 1010 that includes a plurality of vertebrae 1012. To understand the OLIF surgical procedure, some variations of the spinal procedure are shown. These procedures are schematically shown in FIG. 17 in the direction of approaching the spine.

This includes the anterior lumbar interbody fusion (ALIF) approach 1020, the direct lateral interbody fusion (DLIF) approach 1022 and the OLIF approach 1024. In the ALIF approach 1020, a surgical incision is made in front of the abdomen and an implant is inserted anteriorly to the spine. In the DLIF approach 1022, a surgical incision is made on the side of the abdomen and the implant is inserted laterally to the spine. The OLIF approach 1024 may be similar to the DLIF approach 1022 in some respects. However, in contrast to the DLIF approach 1022, the OLIF approach 1024 inserts the implant from an oblique angle, so direct access to the lowest lumbar spine, which can be obscured by the pelvic bone in the direct lateral approach. Enables.

18 to 19 show isometric views and side views of embodiments, which are also referred to as OLIF implants 1100, or simply implants 1100, respectively. Implant 1100 may also be referred to as a cage or fixation device. In some embodiments, the implant 1100 is configured to be implanted within a portion of the human body. In some embodiments, the implant 1100 may be configured for implantation in the spine. In some embodiments, the implant 1100 is a spinal fixation implant or a spinal fixation implant that is inserted between adjacent vertebrae to provide support between the vertebrae and / or to facilitate fusion between the vertebrae. It may be a spinal fixation device.

In some embodiments, the implant 1100 may include a body portion 1102. The body 1102 may generally provide a frame or skeleton for the implant 1100. In some embodiments, the implant 1100 may also include a plurality of arched bone contact elements 1104. The plurality of bone contact elements 1104 may be attached to the body portion 1102 and / or may be continuously formed (or "integrally formed") with the body portion 1102.

In FIGS. 18-19, it is understood that the implant 1100 is composed of anterior and posterior sides. The implant 1100 may also include a first lateral side and a second lateral side extending between the posterior and anterior sides of the implant 1100 on both sides. In addition, the implant 1100 may also include an upper side portion 1130 and a lower side portion 1140 (see FIG. 19).

For clarity, the discussion will primarily focus on the upper side 1130 of the implant 1100. However, in some cases it will be appreciated that the implant 1100 is symmetrical with respect to the cross section that divides the implant 1100 into an upper side portion 1130 and a lower side portion 1140. In such cases, the lower side portion 1140 may include the same means as described for the upper side portion 1130.

In some embodiments, the body may include a peripheral structure and one or more support beams extending from the peripheral structure. The peripheral structure may consist of any number of plates, walls or similar structures. In some embodiments, the peripheral structure could include a ring. In other words, in some embodiments, the peripheral structure could be a peripheral ring structure.

As seen in FIGS. 18-19, the main body 1102 may further be composed of a peripheral structure 1150. Peripheral structure 1150 is shown to have a ring geometry.

Referring to FIG. 18, the peripheral structure 1150 may further be composed of a front side portion 1152, a rear side portion 1154, a first outer side portion 1156 and a second outer side portion 1158.

As can be seen in FIG. 18, in this embodiment, in the peripheral structure 1150, the front side portion 1152 is connected to the first outer side portion 1156. Further, the first outer side portion 1156 is connected to the rear side portion 1154. Further, the rear side portion 1154 is connected to the second outer side portion 1158. The structure is continuous so that the second outer side portion 1158 is connected to the front side portion 1152. That is, the front side portion 1152, the first outer side portion 1156, the rear side portion 1154 and the second outer side portion 1158 all form a continuous or uninterrupted ring.

Peripheral structure 1150 may be characterized by four corners. These include a first corner portion 1160, a third corner portion 1162, a second corner portion 1164 and a fourth corner portion 1166. The first corner portion 1160 may be arranged at the intersection of the front side portion 1152 and the first outer side portion 1156. The third corner portion 1162 may be arranged at the intersection of the front side portion 1152 and the second outer side portion 1158. The second corner portion 1164 may be arranged at the intersection of the rear side portion 1154 and the second outer side portion 1158. The fourth corner portion 1166 may be arranged at the intersection of the rear side portion 1154 and the first outer side portion 1156.

In the embodiment of FIG. 18, the first corner portion 1160 and the second corner portion 1164 are thicker than the third corner portion 1162 and the fourth corner portion 1166. In addition, fasteners and / or insertion tool receiving means may be placed in the first corner portion 1160, as described in more detail below. These measures may aid in the easy insertion of the implant 1100 along the bevel.

In some embodiments, the body may include one or more support beams (or support structures) that act to reinforce the peripheral structure. In some embodiments, one or more support beams could be placed along the interior of the perimeter structure. For example, in some embodiments, one or more support beams are from a first position on the surface of the inwardly facing support structure to a second on the surface of the inwardly facing (or proximal) support structure. Will be able to extend to the position. In other words, in some embodiments, the one or more supporting beams may span an internal region bounded by a peripheral structure.

As can be seen in FIG. 18, the main body 1102 includes a plurality of support beams 1250. These include a first support beam 1252, a second support beam 1254 and a third support beam 1256.

In the embodiment shown in FIG. 18, each of these supporting beams is from a first position on the surface of the inwardly facing peripheral structure 1150 to a second position on the surface of the inwardly facing peripheral structure 1150. It is extending.

Referring to FIG. 18, the first support beam 1252 includes a first end 1270 attached to the first position of the peripheral structure 1150 and a second end 1272 attached to the second position of the peripheral structure 1150. .. Similarly, each of the second support beam 1254 and the third support beam 1256 includes opposite ends mounted at different positions along the peripheral structure 1150. With this configuration, it can be seen that the plurality of support beams 1250 span the internal region (or central region) of the implant 1100, which is bounded by the peripheral structure 1150.

The plurality of support beams 1250 may be considered to be centrally located within the implant 1100 with respect to the peripheral structure 1150. As used herein, "center position" does not refer to the exact location of the implant's geometric or mass center, but rather inside the surrounding structure (eg, within an internal region). Refers to the general area or area in which it is placed. Therefore, in the following description and claims, the support beam may be referred to as a central beam.

In different embodiments, the number of support beams could be varied. In some embodiments, a single support beam could be used. In other embodiments, more than one support beam could be used.

In the embodiment shown in FIG. 18, three support beams are used.

In different embodiments, it will be possible to change the geometry of one or more support beams. In some embodiments, one or more supporting beams could have curved geometry. In other embodiments, the one or more support beams could have a substantially linear geometry. In the embodiment shown in FIG. 18, each of the plurality of support beams 1250 has a substantially linear geometric shape. Also, the cross-sectional geometry of each support beam is substantially rounded. However, in other embodiments, the one or more supporting beams can have any other cross-sectional shape including, but not limited to, rectangular, polygonal, regular and / or irregular shapes. Will.

In different embodiments, the thickness of one or more support beams could vary. Roughly speaking, the thickness (or diameter) of the support beam could vary from 1% to 95% of the width (or length) of the implant.

In at least some embodiments, the support beam within the body of the implant may be coplanar. In FIG. 18, it can be seen that the first support beam 1252, the second support 1254 and the third support beam 1256 are in a similar plane of the implant 1100. The coplanar arrangement of the support beams may help provide a substantially symmetrical arrangement for the implant 1100 between the upper and lower sides.

In general, the geometry of one or more parts of the body of the implant could be varied depending on the embodiment. For example, a portion of the body may include one or more windows, slots and / or openings that may penetrate the implant and promote bone growth and / or reduce weight.

Some embodiments may include one or more fastener receiving means. In some embodiments, the implant can include one or more threaded cavities. In some embodiments, the threading cavity can be configured to fit into a corresponding thread tip on an embedding tool or device. In another embodiment, the threaded cavity can accept fasteners for fastening implants to another device or component within an implant system that uses multiple implants and / or multiple components.

As best seen in FIG. 20, implant 1100 includes a receiving portion 1352 located at first corner portion 1160. The receiving portion 1352 further comprises a threaded cavity 1350. In some embodiments, the threading cavity 1350 may accept the threading tip of an embedding tool (not shown). Such a tool could be used to screw the implant 1100 between adjacent vertebral bodies. Optionally, in some cases, the implant 1100 may also include a pair of indentations (indentation 1365 and indentation 1367) that may facilitate alignment between the implant tool and the implant 1100. In some embodiments, the threaded cavity 1350 could be used to fasten the implant 1100 to a separate component (not shown) of the broader implant system.

In some embodiments, the bone contact element may include a first end, an intermediate and a second end. In some embodiments, the middle portion may have a curved geometry. In some embodiments, the first and / or second ends could have flared geometry. In such a case, the end having a flared geometric shape may be referred to as a "flared leg" of the bone contact element.

In different embodiments, the geometry of the bone contact element could be varied. In some embodiments, the bone contact element could have a spiral or spiral geometry. In other embodiments, the bone contact element could have other curved geometry. An example of the geometric shape of the bone contact element is illustrated in FIG.

As seen in FIG. 21, the implant 1100 further includes a bone contact element composed of a first end 1491, a second end 1492, and an intermediate 1490. The curvature of the bone contact element 1489 is represented by a curve 1494 extending along the length of the bone contact element 1489.

From FIG. 21, it can be seen that the curve 1494 is not straight or flat, but rather curved from the first end 1491 to the second end 1492. In some cases, the curve 1494 may be slightly spiral. Similarly, in some embodiments, the remaining bone contact elements may have curved geometry as well.

As seen in FIGS. 18-19, the implant 1100 contains a plurality of bone contact elements 1104. Each bone contact element may include any of the above-mentioned features for bone contact elements shown in FIGS. 8-10. In some embodiments, the bone contact elements 1104 may be grouped into different rows or sets.

As seen in FIG. 18, they may include a first set 1302, a second set 1304, a third set 1306 and a fourth set 1308. In this case, the first set 1302 includes two elements extending from the peripheral structure 1150 to the first support beam 1252. Similarly, the second set 1304 includes three elements extending from the first support beam 1252 to the second support beam 1254. In addition, the third set 1306 includes three elements extending from the second support beam 1254 to the third support beam 1256. Finally, the fourth set 1308 contains two elements extending from the third support beam 1256 to the peripheral structure 1150.

In some embodiments, the bone contact elements within each group may share some properties. For example, in the embodiment of FIG. 18, the bone contact elements of each group may have similar orientations. In some cases, the bone contact elements in each group may have about the same size (eg, height and / or length), especially relative to the size of the elements in the other groups. In other embodiments, the arched bone contact elements within the group could have different orientations and / or sizes.

In some embodiments, the bone contact element can include means for engaging the vertebral body after implantation. In some embodiments, the one or more bone contact elements can include at least one bone contact area. As described above, the bone contact region may be a region of the surface of the bone contact member having a different curvature than the surrounding area. Specifically, the surface within the bone contact area could be convex, concave and / or nearly flat to provide a better fit with the vertebral endplates upon implantation.

In FIGS. 18-19, the plurality of bone contact elements 1104 are shown to include a bone contact area 1340. Together, these bone contact areas provide a partially smooth surface that can engage the vertebral body.

The embodiment could include any number of bone contact elements. Some embodiments may include a single bone contact element. Yet another embodiment may include any number of bone contact elements in the range of 2-50. In yet another embodiment, the implant could contain more than 50 elements.

In the embodiment shown in FIG. 18, the implant 1100 comprises 20 bone contact elements, including 10 elements on the upper side 1130 and 10 elements on the lower side 1140. Specifically, the first set 1302 contains two elements, the second set 1304 contains three elements, the third set 1306 contains three elements, and the fourth set 1308 contains two elements. including. The number of bone contact elements used may vary depending on factors including implant size, desired implant strength, desired volume of bone graft or other bone growth promoting material, and other possible factors. can.

In different embodiments, the placement of the bone contact elements of the implant could be altered. In some embodiments, the bone contact element could be attached to any part of the surrounding structure, to any beam of the implant, and to other bone contact elements. In some embodiments, the bone contact element will be able to extend across the width of the implant. In other embodiments, the bone contact element may only extend across a portion of the width of the implant.

In some embodiments, the pair of bone contact elements can be arranged in a V-shaped configuration that collectively forms a herringbone pattern, such as one of the patterns illustrated above in FIGS. 10-13. Let's go. Alternatively, in other embodiments, the bone contact elements could be arranged in any other pattern or configuration.

Embodiments can include means to facilitate oblique lateral insertion of the implant. In some embodiments, one or more features of the implant may be aligned with the insertion axis.

FIG. 21 is a schematic diagram of an embodiment of the implant 1100. With reference to FIG. 21, implant 1100 may be characterized by a multi-axis. The implant 1100 may be associated with an anterior-posterior axis 1400 extending from the anterior side portion 1152 to the posterior side portion 1154. Further, the implant 1100 may be associated with a lateral axis 1402 extending from the first outer side portion 1156 to the second outer side portion 1158.

The implant 1100 may further be associated with an additional axis oriented at an oblique angle with respect to the anterior-posterior axis 1400 and the lateral axis 1402.

As seen in FIG. 21, the implant 1100 may include a first diagonal axis, also referred to as an insertion axis 1404. The insertion shaft 1404 may extend between the first corner portion 1160 and the second corner portion 1164. In some cases, the insertion shaft 1404 may run parallel to one or more of the support beams 1250. The implant 1100 may also include a second diagonal axis 1406, which extends from the third corner portion 1162 to the fourth corner portion 1166.

As seen in FIG. 21, the receiving portion 1352 may be associated with the insertion axis 1404. More specifically, the threaded cavity 1350 may have a central axis 1351 (see FIG. 20) parallel to the insertion axis 1404. This configuration ensures that the implant 1100 can be inserted at an oblique angle to the spine, while ensuring that the implant 1100 is accurately oriented anteriorly and laterally after insertion.

In different embodiments, one or more beams could be redirected. In some embodiments, two or more support beams could be directed in parallel. In other embodiments, two or more support beams could be placed at an oblique angle to each other. In the embodiment, the first support beam 1252, the second support beam 1254, and the third support beam 1256 may be arranged in parallel with each other. Further, in the embodiment, a plurality of support beams 1250 may be oriented along the insertion axis 1404. Of course, in other embodiments, the plurality of support beams 1250 could be oriented in any other direction.

In different embodiments, the spacing or separation between adjacent support beams could be varied. In some embodiments, the spacing between adjacent support beams could be reduced relative to the width of the implant. For example, the spacing could range from 0% to 10% of the width of the implant. In other embodiments, the spacing between adjacent support beams could be increased relative to the width of the implant. For example, the spacing could range from 10% to 95% of the width of the implant (eg, two beams located adjacent to both lateral sides of the implant, 95 of the width of the implant. Could be separated by%). The spacing between adjacent beams (or between the beam and a portion of the surrounding structure) may be constant or may vary across the implant.

Relative spacing between support beams depends on many factors, including the thickness of one or more support beams, the number of support beams used, the desired intensity-to-weight ratio for the implant, and other factors. It will be understood that you may choose. In addition, since the bone contact element extends between adjacent support beams (or between the support beam and the surrounding structure), the spacing between adjacent support beams is determined according to the dimensions of one or more bone contact elements. May be good.

In the embodiment illustrated in FIG. 21, each of the support beam 1252, the support beam 1254 and the support beam 1256 is oriented parallel to the insertion axis 1404. This will help improve the strength of the implant 1100 along the insertion direction. This is because the load is in the direction of being loaded during the OLIF surgical procedure.

In some embodiments, the geometry of the bone contact element may be configured to align with one or more axes.

For example, in the embodiment illustrated in FIG. 21, the end of the bone contact element 1489 may be oriented substantially along the support beam (or other structure) to which such end is attached. Specifically, the first end 1491 is oriented substantially along the support beam 1252 and the second end 1492 is oriented approximately along the support beam 1254 (ie, first and second). The end of the is aligned with the insertion shaft 1404). In contrast, the intermediate portion 1490 may be oriented substantially along a direction parallel to the anteroposterior axis 1400. Also, some bone contact elements have an intermediate portion arranged along the anterior-posterior axis 1400, while other bone contact elements are arranged in a direction parallel to the second diagonal axis 1406. It has an intermediate part. In this configuration, the bone contact element may provide strength along multiple directions of the implant, including the directions associated with the insertion axis 1404, the anterior-posterior axis 1400 and the second diagonal axis 1406.

Embodiments can include means for ensuring good fit with the endplates of adjacent vertebral bodies. The bone contact element 1104 is curved along both the insertion axis 1404 and the second diagonal axis 1406, as best seen in FIG. 22, which depicts a curved surface 1500 that substantially coincides with the superior surface of the implant 1100. It may be configured to exhibit a substantially convex upper side surface and a lower side surface.

As can be seen in FIG. 22, the curved surface 1500 is substantially curved from the third corner portion 1162 to the lower fourth corner portion 1166. In some cases, the curved surface 1500 may also be slightly curved from the first corner portion 1160 to the second corner portion 1164.

This substantially convex surface may be configured to fit the corresponding concave geometry of the adjacent vertebral endplates. Similarly, in some cases, the superior flank of the implant 1100 may be provided with a snug-fitting convex surface that fits into the corresponding concave geometric element of the adjacent vertebral endplate.

This curvature is a convex curve along the upper side portion 1130, as seen in FIG. 23 showing a front view of the second corner portion 1164 (ie, a front view along the insertion axis 1404). It may be characterized by a 1510 and another convex curve 1512 along the lower side portion 1140.

In some embodiments, this convex geometry changes the length of, and thereby the height, of the bone contact element between the third corner portion 1162 and the fourth corner portion 1166. May be achieved).

As can be seen in FIG. 24, which illustrates a schematic diagram of the four adjacent bone contact elements, the height of the elements may be proportional to their length. For example, the first bone contact element 1520 has a first height 1530 and a first overall length 1531. The second bone contact element 1522 includes a second height 1532 and a second total length 1533. The third bone contact element 1524 has a third height 1534 and a third overall length 1535. The fourth bone contact element 1526 has a fourth height 1536 and a fourth overall length 1537. It may also be found that the height generally increases from the first height 1530 to the third height 1534 and decreases slightly again to the fourth height 1536. Similarly, the total length of each element changes correspondingly, increasing from the first total length 1531 to the third total length 1533 and slightly decreasing again to the fourth total length 1537.

It will be appreciated that the implant 1100 may be configured with any of the means shown above in the embodiments of FIGS. 1 to 13. Such means may include the use of textured surfaces, material structures and bone growth promoting materials. Thus, in some embodiments, the implant 1100 may be configured with a textured surface. In another embodiment, the implant 1100 may be filled with a bone growth promoting material prior to insertion into the spine.

Although various embodiments have been described, the description is exemplary rather than restrictive, allowing one of ordinary skill in the art to have more embodiments and embodiments within the scope of the embodiments. It will be clear that. Many possible combinations of features are shown in the accompanying drawings and described in detail in the invention, but many other combinations of disclosed features are possible. Any feature of any embodiment may be used in combination with or in place of any other feature or element of any other embodiment, unless otherwise limited. As such, it will be appreciated that any of the features illustrated and / or described in this disclosure may be performed together in any suitable combination. Accordingly, embodiments shall not be restricted except in view of the appended claims and their equivalents. In addition, various amendments and changes may be made within the scope of the attached claims.

<Related application>
This application applies to US provisional applications No. 62 / 301,546 filed on February 29, 2016, US provisional applications No. 62 / 217,542 and April 29, 2015, filed on September 11, 2015. 2018, entitled "Coiled Implants and Systems and Methods" by Morris et al., Claiming priority over US provisional application No. 62 / 154,599 filed in Japan. 2017, entitled "Implant with Arched Bone Contacting Elements," by McShane III, claiming priority over US Patent Publication No. 2016/0324656, published March 20, 2017. This is a partial continuation application of US Patent Publication No. 2017/0042697 published on February 16. Each of the above applications is incorporated herein by reference in its entirety.

Claims (18)

An implant comprising a main body composed of a peripheral structure and a plurality of bone contact elements attached to the main body.
The body contains an opening for receiving a portion of the insertion device.
The peripheral structure is composed of a first outer portion, a second outer portion, a front portion, and a rear portion.
The first outer portion and the front portion are connected by a first corner portion of the peripheral structure, and the second outer portion and the rear portion are connected by a second corner portion of the peripheral structure.
The opening has a central axis and is located at the first corner of the peripheral structure.
The implant further comprises at least three support beams, the first support beam extending from the anterior portion to the posterior portion of the peripheral structure along an anterior-posterior axis passing through the center of the implant, to each said support beam. An implant in which one end of at least one bone contact element of the plurality of bone contact elements is connected and the anterior-posterior axis of the first support beam is oriented obliquely with respect to the central axis of the opening . The implant according to claim 1, wherein the central axis of the opening extends in a direction oriented between the first corner portion and the second corner portion. The lateral axis of the implant extends from the first lateral side portion of the peripheral structure to the second outer lateral portion, and the central axis of the opening is oriented obliquely with respect to the lateral axis, claim 1 . Or the implant according to claim 2 . The implant according to claim 1 , wherein the second support beam out of the at least three support beams extends from the anterior portion to the posterior portion of the peripheral structure . The implant according to claim 4 , wherein the second support beam is parallel to the first support beam . Peripheral structure , a main body composed of a first support beam , a second support beam and a third support beam ,
With a plurality of bone contact elements attached to the main body,
Is an implant that contains
The peripheral structure is further composed of a first outer portion, a second outer portion, a front portion, and a rear portion.
The first outer portion and the front portion are connected by a first corner portion of the peripheral structure, and the second outer portion and the rear portion are connected by a second corner portion of the peripheral structure.
The first support beam has a first end attached to the first corner portion of the peripheral structure, and the first support beam is attached to the second corner portion of the peripheral structure. Has a second end that is
At least one of the plurality of bone contact elements bridges the gap between the second support beam and the peripheral structure.
An implant to which the end of at least one of the plurality of bone contact elements is connected to each of the support beams . The implant according to claim 6 , wherein the first support beam and the second support beam are arranged in parallel. The implant according to claim 6 , wherein the third support beam is arranged in parallel with the first support beam and the second support beam. The implant according to any one of claims 6 to 8 , wherein the main body portion includes an opening for receiving a part of the insertion device . The implant according to claim 9 , wherein the opening is located in the first corner portion. The implant according to claim 10 , wherein the opening has a central axis, the central axis of the opening being aligned with the first support beam. The implant according to claim 6 , wherein the anterior-posterior axis of the implant extends from the posterior portion of the peripheral structure to the anterior portion, and the first support beam is directed obliquely with respect to the anterior-posterior axis. .. The main body composed of peripheral structures and
With a plurality of bone contact elements attached to the main body,
Is an implant that contains
The peripheral structure is further composed of a first outer portion, a second outer portion, a front portion, and a rear portion.
The first outer portion and the front portion are connected by a first corner portion of the peripheral structure, and the second outer portion and the rear portion are connected by a second corner portion of the peripheral structure.
The second outer portion and the front portion are connected by a third corner portion of the peripheral structure, and the first outer portion and the rear portion are connected by a fourth corner portion of the peripheral structure.
The plurality of bone contact elements exhibit a first curved surface on the upper side of the implant .
The first curved surface is curved from the third corner portion to the fourth corner portion .
The implant comprises three support beams, each of which is connected to the end of at least one of the plurality of bone contact elements . 13. The implant of claim 13 , wherein the implant comprises an opening for receiving a portion of the insertion device. The implant according to claim 14 , wherein the opening is located in the first corner portion. 13. The implant according to claim 13 , wherein the first curved surface constitutes a convex surface, and the convex surface is curved in the first direction and the second direction . 16. The first direction is a direction connecting the third corner portion and the fourth corner portion, and the second direction is a direction connecting the first corner portion and the second corner portion, according to claim 16 . The implant described. 13. The implant of claim 13, wherein the plurality of bone contact elements exhibit a second curved surface on the underside of the implant.

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