Apparatus and method of inserting spinal implants

• US 20020198532A1
• Filed: 08/20/2002
• Published: 12/26/2002
• Est. Priority Date: 06/10/1993
• Status: Active Grant

• Current Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Original Assignee: Sofamor Danek Holdings, Inc (Medtronic Plc)
• Inventors: Michelson, Gary Karlin
• Granted Patent: US 7,399,303 B2
• Time in Patent Office: Days
• US Class Current: 606/90
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: Y10S 623/908 Bone
• CPC Class Codes: Y10T 407/1964 Arcuate cutting edge

Abstract

Apparatus and a method of inserting spinal implants is disclosed in which an intervertebral space is first distracted, a hollow sleeve having teeth at one end is then driven into the vertebrae adjacent that disc space. A drill is then passed through the hollow sleeve removing disc and bone in preparation for receiving the spinal implant which is then inserted through the sleeve.

Claims

1. An apparatus for use in human lumbar interbody spinal surgery comprising:

a guard having a passage for providing guided access to the disc space and the adjacent vertebral bodies, said passage having an inner diameter of at least 16.5 mm to permit the movement of a spinal implant therethrough, said guard having a proximal end and an opposite distal end, said guard having extensions at said distal end of said guard, at least two of said extensions being adapted to penetrate the disc space between the adjacent endplates of the adjacent vertebral bodies, said extensions being at least in part in line with side surfaces of said guard so that said extensions do not substantially increase the outer cross-sectional dimension of said guard near the distal end of said guard, said guard having a flat portion between at least some of said extensions for preventing over-penetration of said extensions into the spine.

2. The apparatus of claim 1, wherein the inner diameter of said passage is at least 18 mm.

3. The apparatus of claim 1, wherein said passage is configured to provide guided access to a bone removal device having a cutting portion with a diameter less than that of the spinal implant.

4. The apparatus of claim 1, in combination with a spinal implant sized for passage through said guard.

5. The apparatus of claim 1, wherein at least two of said extensions are diametrically opposed to one another.

6. The apparatus of claim 1, wherein said guard is a hollow tubular sleeve.

7. The apparatus of claim 1, wherein said guard has a circular cross section.

8. The apparatus of claim 1, wherein said passage has a circular cross section.

9. The apparatus of claim 1, wherein said guard has an increased outer dimension portion at its proximal end.

10. The apparatus of claim 1, wherein said distal end of said guard is contoured to the curvature of the adjacent vertebral bodies to permit an intimate fit between said guard and the adjacent vertebral bodies.

11. The apparatus of claim 1, wherein said guard has a footplate.

12. The apparatus of claim 1, further comprising means for cooperatively engaging to the proximal end of said guard an impaction end member for receiving an impaction force for driving said guard into the spine.

13. The apparatus of claim 1, further comprising a cap adapted to engage said proximal end of said guard.

14. The apparatus of claim 1, wherein said extensions are selected from at least one of teeth, pins, and projections.

15. The apparatus of claim 1, wherein said extensions are adapted to penetrate the adjacent vertebral bodies.

16. The apparatus of claim 1, wherein at least one of said extensions has a tapered leading end to facilitate placement of at least one of said extensions into the spine.

17. The apparatus of claim 1, wherein at least one of said extensions has upper and lower surfaces that are parallel to each other.

18. The apparatus of claim 1, further comprising a removable inner guard.

19. The apparatus of claim 18, wherein said removable inner guard is a hollow tubular sleeve.

20. The apparatus of claim 18, wherein said removable inner guard is adapted to be inserted into said guard.

21. The apparatus of claim 20, wherein said inner guard has limiting means for limiting the travel of said inner guard within said guard when said inner guard is inserted into said guard.

22. The apparatus of claim 18, wherein said inner guard has a proximal end having an increased cross sectional dimension to prevent passage of said inner guard through said passage of said guard.

23. The apparatus of claim 1, wherein said distal end further includes openings through said side surfaces of said guard.

24. The apparatus of claim 23, wherein said openings through said side surfaces of said guard are perpendicular to a longitudinal axis of said guard.

25. The apparatus of claim 23, wherein said openings are slots through said side surfaces of said guard.

26. The apparatus of claim 25, wherein said slots are opposite one another.

27. The apparatus of claim 25, wherein said slots are parallel to one another.

28. The apparatus of claim 23, wherein said openings are two slots arranged parallel to one another and to a mid-longitudinal axis passing through said apparatus.

29. The apparatus of claim 1, further comprising a bone removal device for forming through said guard an implantation space across the disc space.

30. The apparatus of claim 1, further comprising an implant driver sized in part for passage through said passage of said guard for passing the implant through said guard and into an implantation space.

31. The apparatus of claim 30, wherein said implant driver comprises an elongated shaft having means for engaging the implant at one end and means for manipulating said implant driver at the other end of said elongated shaft.

32. The apparatus of claim 31, further comprising means for limiting the depth of insertion of said implant driver into said guard.

33. The apparatus of claim 32, wherein said limiting means includes a portion of said implant driver cooperating with said guard to limit the depth of insertion of said implant driver into said guard.

34. The apparatus of claim 1, further comprising a spinal distractor sized for passage through said guard, said spinal distractor having a body and a disc penetrating member extending from said body and into the disc space between the two adjacent vertebral bodies for bearing against adjacent endplates of the two adjacent vertebral bodies.

35. The apparatus of claim 34, wherein said disc penetrating member of said spinal distractor has a first portion for bearing against one of the endplates and a second portion for bearing against a second of the endplates, said first and second portions being in a parallel relationship to each other.

36. The apparatus of claim 1, further comprising a tap for insertion through said guard for tapping the two adjacent vertebral bodies.

38. The apparatus of claim 37, wherein the inner diameter of said passage is at least 18 mm.

39. The apparatus of claim 37, wherein said passage is configured to provide guided access to a bone removal device having a cutting portion with a diameter less than that of the spinal implant.

40. The apparatus of claim 37, in combination with a spinal implant sized for passage through said guard.

41. The apparatus of claim 37, wherein at least two of said extensions are diametrically opposed to one another.

42. The apparatus of claim 37, wherein a mid-longitudinal axis passing through the center of at least one of said openings in said sides is perpendicular to a longitudinal axis of said guard.

43. The apparatus of claim 37, wherein said openings are at least two slots.

44. The apparatus of claim 43, wherein said slots are opposite one another.

45. The apparatus of claim 43, wherein said slots are parallel to one another.

46. The apparatus of claim 43, wherein said slots are parallel to one another and to a mid-longitudinal axis passing through said apparatus.

47. The apparatus of claim 43, wherein said openings in said sides divide at least a portion of said guard into an upper portion and a lower portion.

48. The apparatus of claim 47, wherein said upper portion and said lower portion are adapted to move apart from one another to facilitate the insertion of the implant.

49. The apparatus of claim 37, wherein said guard is a hollow tubular sleeve.

50. The apparatus of claim 37, wherein said guard has a circular cross section.

51. The apparatus of claim 37, wherein said passage has a circular cross section.

52. The apparatus of claim 37, wherein said guard has an increased outer dimension portion at its proximal end.

53. The apparatus of claim 37, wherein said distal end of said guard is contoured to the curvature of the adjacent vertebral bodies to permit an intimate fit between said guard and the adjacent vertebral bodies.

54. The apparatus of claim 37, wherein said guard has a footplate.

55. The apparatus of claim 37, further comprising means for cooperatively engaging to the proximal end of said guard an impaction end member for receiving an impaction force for driving said guard into the spine.

56. The apparatus of claim 37, further comprising a cap adapted to engage said proximal end of said guard.

57. The apparatus of claim 37, wherein said extensions are selected from at least one of teeth, pins, and projections.

58. The apparatus of claim 37, wherein said extensions are adapted to penetrate the adjacent vertebral bodies.

59. The apparatus of claim 37, wherein at least one of said extensions has a tapered leading end to facilitate placement of at least one of said extensions into the spine.

60. The apparatus of claim 37, wherein at least one of said extensions has upper and lower surfaces that are parallel to each other.

61. The apparatus of claim 37, further comprising a removable inner guard.

62. The apparatus of claim 61, wherein said removable inner guard is a hollow tubular sleeve.

63. he apparatus of claim 61, wherein said removable inner guard is adapted to be inserted into said guard.

64. The apparatus of claim 63, wherein said inner guard has limiting means for limiting the travel of said inner guard within said guard when said inner guard is inserted into said guard.

65. The apparatus of claim 61, wherein said inner guard has a proximal end having an increased cross sectional dimension to prevent passage of said inner guard through said passage of said guard.

66. The apparatus of claim 37, further comprising a bone removal device for forming through said guard an implantation space across the disc space.

67. The apparatus of claim 37, further comprising an implant driver sized in part for passage through said passage of said guard for passing the implant through said guard and into an implantation space.

68. The apparatus of claim 67, wherein said implant driver comprises an elongated shaft having means for engaging the implant at one end and means for manipulating said implant driver at the other end of said elongated shaft.

69. The apparatus of claim 68, further comprising means for limiting the depth of insertion of said implant driver into said guard.

70. The apparatus of claim 69, wherein said limiting means includes a portion of said implant driver cooperating with said guard to limit the depth of insertion of said implant driver into said guard.

71. The apparatus of claim 37, further comprising a spinal distractor sized for passage through said guard, said spinal distractor having a body and a disc penetrating member extending from said body and into the disc space between the two adjacent vertebral bodies for bearing against adjacent endplates of the two adjacent vertebral bodies.

72. The apparatus of claim 71, wherein said disc penetrating member of said spinal distractor has a first portion for bearing against one of the endplates and a second portion for bearing against a second of the endplates, said first and second portions being in a parallel relationship to each other.

73. The apparatus of claim 37, further comprising a tap for insertion through said guard for tapping the two adjacent vertebral bodies.

37. An apparatus for use in human lumbar interbody spinal surgery comprising:

a guard having a passage for providing guided access to the disc space and the adjacent vertebral bodies, said passage having an inner diameter of at least 16.5 mm to permit the movement of a spinal implant therethrough, said guard having a proximal end and an opposite distal end and sides therebetween, said guard having openings in said sides, said guard having extensions at said distal end of said guard, at least two of said extensions being adapted to penetrate the disc space between the adjacent endplates of the adjacent vertebral bodies, said extensions being at least in part in line with said sides of said guard so that said extensions do not substantially increase the outer cross-sectional dimension of said guard near the distal end of said guard.