Patient-specific vertebral implants with positioning features

Abstract

The present technology provides patient-specific vertebral implants. The implants can include a cage having a geometry contoured to mate with an inferior surface of a superior vertebra and a superior surface of an inferior vertebra at a first target position. The implants can also include a plate having a geometry contoured to mate with an identified anatomical structure at a second target position. The cage and plate can be coupled in a predetermined three-dimensional orientation that simultaneously permits the cage to occupy the first target position and the plate to occupy the second target position when the implant is implanted.

I/We claim: 
     
         1 . A patient-specific intervertebral implant, comprising:
 a cage having a first patient-specific geometry contoured to mate with an inferior surface of a superior vertebra and a superior surface of an inferior vertebra at a first target position;   a plate having a second patient-specific geometry contoured to mate with an identified anatomical structure at a second target position different than the first target position; and   a connection mechanism coupling or configured to couple the plate to the cage in a predetermined configuration that directs the cage to occupy the first target position when the plate is positioned at the second target position.   
     
     
         2 . The patient-specific implant of  claim 1  wherein, when the cage is implanted at the first target position, the cage forms a generally gapless interface with the inferior surface of the superior vertebra and the superior surface of the inferior vertebra. 
     
     
         3 . The patient-specific implant of  claim 2  wherein the cage has an upper surface contoured to mate with the inferior surface of the superior vertebra and a lower surface contoured to mate with the superior surface of the inferior vertebra, and wherein, when the cage is implanted at the first target position, at least 90% of the surface area of the upper surface contacts the inferior surface of the superior vertebra and at least 90% of the surface area of the lower surface contacts the superior surface of the inferior vertebra. 
     
     
         4 . The patient-specific implant of  claim 1  wherein, when the plate is implanted at the second target position, the plate forms a generally gapless interface with the identified anatomical structure. 
     
     
         5 . The patient-specific implant of  claim 4  wherein when the plate has a surface contoured to mate with the identified anatomical structure, and wherein, when the plate is implanted at the second target position, at least 90% of the surface area of the surface contacts the identified anatomical structure. 
     
     
         6 . The patient-specific implant of  claim 1  wherein the identified anatomical structure includes (i) an anterior surface of the first and/or second vertebrae, (ii) a lateral surface of the first and/or second vertebrae, and/or (iii) a portion of the inferior surface of the first vertebra and the superior surface of the second vertebra adjacent an anterior margin of the first and second vertebrae. 
     
     
         7 . The patient-specific implant of  claim 1  wherein the cage includes:
 an upper surface having an upper surface topography contoured to mate with the inferior surface of the superior vertebra; and 
 a lower surface having a lower surface topography contoured to mate with the superior surface of the inferior vertebra, 
 wherein the upper surface topography is different than the lower surface topography. 
 
     
     
         8 . The patient-specific implant of  claim 1  wherein, when the cage is implanted at the first target position and the plate is implanted at the second target position, the plate is configured to reduce migration of the cage. 
     
     
         9 . The patient-specific implant of  claim 8  wherein the plate includes one or more apertures for receiving one or more fastening elements configured to secure the plate to the identified anatomical structure. 
     
     
         10 . The patient-specific implant of  claim 1  wherein the connection mechanism is rigid. 
     
     
         11 . The patient-specific implant of  claim 10  wherein the connection mechanism includes a screw, a bolt, a rivet, and/or a key-and-slot mechanism. 
     
     
         12 . The patient-specific implant of  claim 1  wherein the connection mechanism is semi-rigid. 
     
     
         13 . The patient-specific implant of  claim 12  wherein the connection mechanism includes a semi-rigid arm or tether. 
     
     
         14 . The patient-specific implant of  claim 1  wherein the connection mechanism includes an extension projecting from the plate and having a lumen extending therethrough for receiving a bolt or a screw, and wherein the extension is configured to interface with the cage. 
     
     
         15 . A method for implanting a patient-specific vertebral implant including a cage and a plate into a patient, the method comprising:
 delivering the cage to a first location proximate a first target position at the patient's spinal column, wherein the cage is designed to mate with a first anatomical structure at the first target position;   delivering the plate to a second location proximate a second target position at the patient's spinal column, wherein the plate is designed to mate with a second anatomical structure at the second target position;   positioning the plate at the second target position such that the plate mates with the second anatomical structure; and   coupling the plate to the cage, wherein coupling the plate to the cage automatically positions the cage at the first target position such that the cage mates with the first anatomical structure.   
     
     
         16 . The method of  claim 15  wherein:
 the first anatomical structure includes an inferior surface of a superior vertebra or a superior surface of an inferior vertebra; and 
 the second anatomical structure includes (i) an anterior surface of the first and/or second vertebrae, (ii) a lateral surface of the first and/or second vertebrae, or (iii) a portion of the inferior surface of the first vertebra and the superior surface of the second vertebra adjacent an anterior margin of the first and second vertebrae. 
 
     
     
         17 . The method of  claim 15  wherein positioning the plate at the second target position such that the plate mates with the second anatomical structure comprises forming a generally gapless interface between the plate and the second anatomical structure. 
     
     
         18 . The method of  claim 17  wherein forming the generally gapless interface between the plate and the second anatomical structure includes positioning a surface of the plate in contact with the second anatomical structure such that at least 90% of a surface area of the surface contacts the second anatomical structure. 
     
     
         19 . The method of  claim 15  wherein automatically positioning the cage at the first target position such that the cage mates with the first anatomical structure comprises forming a generally gapless interface between the cage and the first anatomical structure. 
     
     
         20 . The method of  claim 19  wherein forming the generally gapless interface between the cage and the first anatomical structure includes positioning a surface of the cage in contact with the first anatomical structure such that at least 90% of a surface area of the surface contacts the first anatomical structure. 
     
     
         21 . The method of  claim 15 , further comprising securing the plate to the second anatomical structure. 
     
     
         22 . The method of  claim 15  further comprising confirming that the cage is positioned at the first target position after coupling the plate to the cage. 
     
     
         23 . A method for implanting a patient-specific vertebral implant into a patient, the method comprising:
 delivering the patient-specific vertebral implant to a target region proximate the patient's spine, wherein the patient-specific implant includes:
 a cage designed to occupy a first target position between a first superior vertebra and a second inferior vertebra, the cage having a first patient-specific geometry contoured to mate with an inferior surface of the first superior vertebra and a superior surface of the second inferior vertebra at the first target position; and 
 a plate designed to occupy a second target position, the plate having a second patient-specific geometry contoured to mate with an identified anatomical structure at the second target position; and 
   positioning the plate at the second target position such that the cage is automatically positioned at the first target position.   
     
     
         24 . The method of  claim 23  wherein positioning the plate at the second target position includes forming a generally gapless interface between the plate and the identified anatomical structure. 
     
     
         25 . The method of  claim 24  wherein forming the generally gapless interface between the plate and the identified anatomical structure includes positioning a surface of the plate in contact with the identified anatomical structure such that at least 90% of a surface area of the surface contacts the identified anatomical structure. 
     
     
         25 . The method of  claim 23  wherein automatically positioning the cage at the first target position includes forming a generally gapless interface between the cage and the inferior surface of the superior vertebra and the superior surface of the inferior vertebra. 
     
     
         26 . The method of  claim 25  wherein the cage has an upper surface contoured to mate with the inferior surface of the superior vertebra and a lower surface contoured to mate with the superior surface of the inferior vertebra, and wherein forming the generally gapless interface between the cage and the inferior surface of the superior vertebra and the superior surface of the inferior vertebra includes:
 positioning the upper surface of the cage in contact with the inferior surface of the superior vertebra such that at least 90% of a surface area of the upper surface contacts the inferior surface of the superior vertebrae, and 
 positioning the lower surface of the cage in contact with the superior surface of the inferior vertebra such that at least 90% of a surface area of the lower surface contacts the superior surface of the inferior vertebra. 
 
     
     
         27 . The method of  claim 23  further comprising coupling the plate to the cage before delivering the patient-specific vertebral implant to the target region. 
     
     
         28 . The method of  claim 23 , further comprising securing the plate to the identified anatomical structure. 
     
     
         29 . The method of  claim 23  further comprising confirming that the cage is positioned at the first target position after positioning the plate at the second target position.