Spinal fusion instrumentation, implant and method

• US 20030036764A1
• Filed: 06/06/2002
• Published: 02/20/2003
• Est. Priority Date: 10/13/1999
• Status: Active Grant

• Current Assignee: James S. Hamada
• Original Assignee: James S. Hamada
• Inventors: Hamada, James S.
• Granted Patent: US 7,351,244 B2
• Time in Patent Office: Days
• US Class Current: 606/102
• CPC Class Codes: A61B 17/1604 Chisels; Rongeurs; Punches; Stamps
• CPC Class Codes: A61B 17/1659 Surgical rasps, files, planes, or scrapers
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/8825 characterised by syringe details A61B17/8822, A61B17/8827 take precedence
• CPC Class Codes: A61B 17/8833 Osteosynthesis tools specially adapted for handling bone cement or fluid fillers; Means for supplying bone cement or fluid fillers to introducing tools, e.g. cartridge handling means
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2090/062 penetration depth
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/065 for measuring contact or contact pressure
• CPC Class Codes: A61F 2/28 Bones joints A61F2/30
• CPC Class Codes: A61F 2/442 Intervertebral or spinal discs, e.g. resilient non-disc-shaped intervertebral inflatable pockets A61F2/441; non-disc-shaped intervertebral fusion implants A61F2/4455
• CPC Class Codes: A61F 2/4465 having a circular or kidney shaped cross-section substantially perpendicular to the axis of the spine
• CPC Class Codes: A61F 2/4601 for introducing bone substitute, for implanting bone graft implants or for compacting them in the bone cavity
• CPC Class Codes: A61F 2/4611 of spinal prostheses
• CPC Class Codes: A61F 2/4657 Measuring instruments used for implanting artificial joints for surgical instruments A61B90/06
• CPC Class Codes: A61F 2002/2817 Bone stimulation by chemical reactions or by osteogenic or biological products for enhancing ossification, e.g. by bone morphogenetic or morphogenic proteins [BMP] or by transforming growth factors [TGF]
• CPC Class Codes: A61F 2002/2835 Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
• CPC Class Codes: A61F 2002/2839 Bone plugs or bone graft dowels
• CPC Class Codes: A61F 2002/30133 kidney-shaped or bean-shaped
• CPC Class Codes: A61F 2002/302 toroidal, e.g. rings
• CPC Class Codes: A61F 2002/3023 : wedge-shaped cylinders
• CPC Class Codes: A61F 2002/30593 : hollow
• CPC Class Codes: A61F 2002/30828 : parallel
• CPC Class Codes: A61F 2002/4622 : having the shape of a forceps or a clamp
• CPC Class Codes: A61F 2002/4627 : with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument
• CPC Class Codes: A61F 2002/4628 : with linear motion along or rotating motion about an axis transverse to the instrument axis or to the implantation direction, e.g. clamping
• CPC Class Codes: A61F 2002/4649 : Bone graft or bone dowel harvest sites
• CPC Class Codes: A61F 2002/4666 : for measuring force, pressure or mechanical tension
• CPC Class Codes: A61F 2002/4681 : by applying mechanical shocks, e.g. by hammering
• CPC Class Codes: A61F 2230/0015 : Kidney-shaped, e.g. bean-shaped
• CPC Class Codes: A61F 2230/0065 : toroidal, e.g. ring-shaped, doughnut-shaped
• CPC Class Codes: A61F 2230/0069 : cylindrical
• CPC Class Codes: A61F 2310/00365 : Proteins; Polypeptides; Degradation products thereof
• CPC Class Codes: A61L 2430/38 : for reconstruction of the spine, vertebrae or intervertebral discs
• CPC Class Codes: A61L 27/3608 : Bone, e.g. demineralised bone matrix [DBM], bone powder
• CPC Class Codes: A61L 27/3616 : Blood, e.g. platelet-rich plasma
• CPC Class Codes: A61L 27/365 : Bones
• CPC Class Codes: A61L 27/3804 : characterised by specific cells or progenitors thereof, e.g. fibroblasts, connective tissue cells, kidney cells
• CPC Class Codes: A61L 27/3847 : Bones

Abstract

A system and method includes surgical instrumentation, implants, bone graft material, and measurement equipment to enable a spine fusion procedure to proceed more accurately, efficiently and safely by allowing precision measurement of the characteristics of the intervertebral space, selection of and provision of new implants, placement of an intervertebral implant, all where improved healing thereafter takes place.

Claims

1. An intervertebral measuring instrument for use in spine surgery comprising:

a first portion fittable to bear against a second portion, said first and said second portions for insertion into an intervertebral space;

a load cell mounted to receive the force of said first portion toward said second portion; and

information transmission structures associated with said load cell for transmitting information about said measured force of said first portion toward said second portion away from said load cell.

2. The intervertebral measuring instrument for use in spine surgery as recited in claim 1 wherein at least one of said first portion and said second portion include a load cell accommodation space within which said load cell is at least partially stabilized.

3. The intervertebral measuring instrument for use in spine surgery as recited in claim 1 and further comprising at least a second load cell having information transmission structures extending away from at least one of said first and second load cells.

4. The intervertebral measuring instrument for use in spine surgery as recited in claim 1 and further comprising a computation device, connected to said information transmission structures for computing at least one of said measured force and a displacement of said first and said second portions.

5. The intervertebral measuring instrument for use in spine surgery as recited in claim 4 wherein said computation device also computes at least one of a displacement force characteristic of said intervertebral space and an optimal intervertebral separation magnitude and an intervertebral size magnitude for loading.

6. The intervertebral measuring instrument for use in spine surgery as recited in claim 5 wherein at least one of a displacement force characteristic of said intervertebral space and an optimal intervertebral separation magnitude and an intervertebral size magnitude for loading is based upon at least one of an individual'"'"'s height, weight and a patient'"'"'s bone size.

7. A bone implant useful in spine fusion procedures comprising:

a cylindrical structure having a circumferentially outwardly disposed outer wall including an anterior end and a posterior end, said cylindrical structure having an first side and a second side oppositely disposed with respect to said first side, said cylindrical structure having a central aperture, and wherein at least a portions of said posterior side is concave outwardly disposed.

8. The bone implant as recited in claim 7 wherein said first side is angled with respect to said second side at an angle of from about three degrees to about five degrees.

9. The bone implant as recited in claim 7 wherein at least one of said first and second sides include at least a first series of slots each slot of said series lying generally adjacent and spaced apart from each other.

10. The bone implant as recited in claim 9 wherein an angle of said series of slots with respect to said first side is from about fifty degrees to about seventy degrees.

11. The bone implant as recited in claim 10 wherein said least a first series of slots are inclined in a direction along a line from said anterior side of said implant to said posterior side of said implant and away from said posterior side of said implant to facilitate an insertion of said implant from the anterior direction.

12. The bone implant as recited in claim 10 wherein said least a first series of slots are inclined in a direction at an angle with respect to a line from said anterior side of said implant to said posterior side of said implant said angle having a magnitude indicative of the deviation from a straight anterior approach to facilitate an insertion of said implant from at least an anterolateral direction.

13. The bone implant as recited in claim 7 wherein a first distance of separation between said first side and said second side at said anterior end is greater than a second distance of separation between said first side and said second side at said posterior end to give additional support at an anterior portion of a spine to improve lordosis.

14. The bone implant as recited in claim 7 and wherein said first and second sides have surfaces portions which are convex for complementing the naturally biconcave intervertebral disc space.

15. The bone implant as recited in claim 14 and wherein said surface portion of said first side is more acute curvature than said surface portion of said second side in order to more closely complement the natural intervertebral disc space in which an upper, downwardly directed bone plate has a greater concavity than the concavity of a lower, upwardly directed bone plate.

16. A bone graft composition useful in facilitating the bone graft growth and healing process comprising:

from about thirteen to about seventeen cubic centimeters of demineralized cortical bone powder having an average particle size range of from about 100 to 500 micrometers;

from about two cubic centimeters to about five cubic centimeters of autologous bone chips having a particle size of from about 0.5 millimeters to about 2.0 millimeters;

from about twenty to about fifty cubic centimeters of a natural mixture of autologous platelets and fibrin in mutual proportion as extracted from human blood; and

from about one to about five cubic centimeters of bovine thrombin.

17. The bone graft composition as recited in claims 16 and further comprising from about 0.25 cubic centimeters to about five cubic centimeters of demineralized bone matrix.

18. A syringe for use in applying a bone graft composition in conjunction with spine surgery comprising:

a cylindrical tube having a first end and a second end;

a restriction cap attachable to said first end of said cylindrical tube;

a plunger having a piston engageable with an inside surface of said cylindrical tube;

a finger ring fitting, for slidably supporting said plunger and for engaging said second end of said cyclindrical tube, said syringe and restriction cap to enable pressured removal of excess liquid from a bone graft composition and injection of bone graft composition into a bone graft.