Method of securing vertebrae

• US 20030073998A1
• Filed: 10/25/2002
• Published: 04/17/2003
• Est. Priority Date: 08/01/2000
• Status: Active Grant

• Current Assignee: Zimmer Spine, Inc. (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Endius Incorporated (Zimmer Biomet Holdings, Inc.)
• Inventors: Davison, Thomas W., Unger, John D., Pagliuca, James J.
• Granted Patent: US 7,056,321 B2
• Time in Patent Office: Days
• US Class Current: 606/61
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/0293 with ring member to support retractor elements
• CPC Class Codes: A61B 17/1604 Chisels; Rongeurs; Punches; Stamps
• CPC Class Codes: A61B 17/1606 of forceps type, i.e. having two jaw elements moving relative to each other
• CPC Class Codes: A61B 17/1608 the two jaw elements being linked to two elongated shaft elements moving longitudinally relative to each other
• CPC Class Codes: A61B 17/1735 for rasps or chisels
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3423 Access ports, e.g. toroid shape introducers for instruments or hands access sites for liquids A61M39/0247
• CPC Class Codes: A61B 17/3439 with means for changing the inner diameter of the cannula, e.g. expandable A61B17/3423, A61B17/3431 take precedence; catheters A61M25/0662
• CPC Class Codes: A61B 17/7007 Parts of the longitudinal elements, e.g. their ends, being specially adapted to fit around the screw or hook heads
• CPC Class Codes: A61B 17/701 Longitudinal elements with a non-circular, e.g. rectangular, cross-section A61B17/7005, A61B17/7007 take precedence
• CPC Class Codes: A61B 17/7032 Screws or hooks with U-shaped head or back through which longitudinal rods pass
• CPC Class Codes: A61B 17/7035 Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
• CPC Class Codes: A61B 17/7037 wherein pivoting is blocked when the rod is clamped
• CPC Class Codes: A61B 17/7038 to a different extent in different directions, e.g. within one plane only
• CPC Class Codes: A61B 17/7041 with single longitudinal rod offset laterally from single row of screws or hooks A61B17/7044 takes precedence
• CPC Class Codes: A61B 17/7059 Cortical plates A61B17/7007, A61B17/7058 take precedence
• CPC Class Codes: A61B 17/7074 : Tools specially adapted for spinal fixation operations other than for bone removal or filler handling A61B17/7062, A61B17/808, A61B17/8858 take precedence; for spinal image producing devices A61B90/36, A61B34/20; markers A61B90/39
• CPC Class Codes: A61B 2017/00238 : Type of minimally invasive operation A61B2017/00805 takes precedence
• CPC Class Codes: A61B 2017/0046 : with a releasable handle; with handle and operating part separable for prosthetic joint-implanting tools A61F2/4603
• CPC Class Codes: A61B 2017/0256 : for the spine

Abstract

A method of fixing first and second vertebrae of a patient together at a surgical site includes inserting a first cannula into the body of the patient. A fusion device is moved through the cannula and inserted between the first and second vertebrae. A first fastener is moved through the cannula and secured to the first vertebra. A second fastener is moved through the cannula and secured to the second vertebra. A first fixation element is moved through the cannula. The first fixation element is fixed to the first and second fasteners. The fusion device has first and second ends, upper and lower surfaces for engaging the first and second vertebrae, and first and second side surfaces extending between the upper and lower surfaces. Each of the first and second side surfaces extend along an arc from the first end of the fusion device to the second end. The upper and lower surfaces have teeth that extend between the first and second side surfaces along secant lines of circles partially defined by the first and second side surfaces.

Claims

1. A method of fixing first and second vertebrae of a patient together at a surgical site comprising the steps of:

inserting a first cannula into the body of the patient;

moving a fusion device through the cannula and inserting the fusion device between the first and second vertebrae;

moving a first fastener through the cannula and securing the first fastener to the first vertebra;

moving a second fastener through the cannula and securing the second fastener to a second vertebra;

moving a first fixation element through the cannula; and

fixing the first fixation element to the first and second fasteners.

2. The method as defined in claim 1 further including the steps of:

moving a third fastener through the cannula and securing the third fastener to a third vertebra; and

fixing the first fixation element to the third fastener.

3. A method as defined in claim 2 further including the step of moving a second fusion device through the cannula and inserting the second fusion device between the second vertebra and the third vertebra.

4. A method as defined in claim 1 further including the step of inserting a shield apparatus into the cannula and shielding tissue at the surgical site.

5. A method as defined in claim 4 further including the step of inserting a distal portion of the shield apparatus between the first and second vertebrae to facilitate insertion of the fusion device between the first and second vertebrae.

6. A method as defined in claim 5 wherein said step of inserting the distal portion of the shield apparatus between the first and second vertebrae includes inserting the distal portion into an annulotomy in an annulus between the first and second vertebrae.

7. A method as defined in claim 1 further including the steps of:

inserting a second cannula into the body of the patient;

moving a second fusion device through the second cannula and inserting the second fusion device between the first and second vertebrae;

moving a third fastener through the second cannula and securing the third fastener to the first vertebra;

moving a fourth fastener through the second cannula and securing the fourth fastener to the second vertebra;

moving a second fixation element through the second cannula; and

fixing the second fixation element to the third and fourth fasteners.

8. A method as defined in claim 7 further including the steps of:

moving a fifth fastener through the first cannula and securing the fifth fastener to a third vertebra;

fixing the fifth fastener to the first fixation element;

moving a sixth fastener through the second cannula and securing the sixth fastener to the third vertebra; and

fixing the sixth fastener to the second fixation element.

9. A method as defined in claim 8 further including the steps of:

moving a third fusion device through the first cannula and inserting the third fusion device between the second vertebra and the third vertebra; and

moving a fourth fusion device through the second cannula and inserting the fourth fusion device between the second and third vertebrae;

10. A method as defined in claim 1 further including the steps of providing the fusion device with a first end tapered for insertion between the first and second vertebrae, a second end engageable with a tool for inserting the spinal implant between the first and second vertebrae, upper and lower surfaces for engaging the first and second vertebrae extending from the first end to the second end, and first and second side surfaces extending between the upper and lower surfaces along first and second arcs from the first end to the second end.

11. A method as defined in claim 10 further including the step of providing the second end of the fusion device with first and second recesses extending from the second end toward the first end for receiving projections on the tool.

12. A method as defined in claim 10 further including the step of providing the upper and lower surfaces of the fusion device with teeth for engaging the first and second vertebrae extending between the first and second side surfaces and along secant lines of circles partially defined by the first and second side surfaces.

13. A method as defined in claim 10 further including the step of providing the fusion device with first and second side surfaces that extend along concentric portions of circles.

14. A method as defined in claim 1 further including the step of making the fusion device of an allograft material.

15. A fusion device for use in fusing together adjacent vertebrae of a spinal column comprising:

first and second ends, said first end being tapered for insertion between the adjacent vertebrae and said second end being engageable with a tool for inserting said fusion device between the adjacent vertebrae;

upper and lower surfaces for engaging the adjacent vertebrae extending from said first end to said second end of said fusion device; and

first and second side surfaces extending between said upper and lower surfaces, each of said first and second side surfaces extending in an arc from said first end of said fusion device to said second end of said fusion device.

16. A fusion device as set forth in claim 15 wherein said second end of said fusion device includes a recess for receiving the tool.

17. A fusion device as set forth in claim 16 wherein said second end of said fusion device includes first and second recesses extending from said second end toward said first end for receiving projections on the tool.

18. A fusion device as set forth in claim 17 wherein said fusion device includes a gripping portion defined by said first and second recesses for extending between the projections on the tool.

19. A fusion device as set forth in claim 18 wherein each of said recesses is defined by an upper surface extending generally parallel to said upper surface of said fusion device and a lower surface extending generally parallel to said lower surface of said fusion device, said upper and lower surfaces of said recesses being engageable with the projections on the tool.

20. A fusion device as set forth in claim 15 wherein said upper and lower surfaces include teeth for engaging the adjacent vertebrae.

21. A fusion device as set forth in claim 20 wherein said teeth on said upper and lower surfaces extend between said first and second side surfaces and along secant lines of circles partially defined by said first and second side surfaces.

22. A fusion device as set forth in claim 21 wherein said teeth extend parallel to each other.

23. A fusion device as set forth in claim 15 wherein said fusion device is made of an allograft material.

24. A fusion device as set forth in claim 15 wherein said first and second side surfaces extend along portions of concentric circles.

25. A fusion device for use in fusing together adjacent vertebrae of a spinal column comprising:

first and second ends;

upper and lower surfaces for engaging the adjacent vertebrae extending from said first end to said second end of said fusion device; and

first and second side surfaces extending between said upper and lower surfaces, each of said first and second side surfaces extending along an arc from said first end of said fusion device to said second end of said fusion device;

said upper and lower surfaces having teeth for engaging the adjacent vertebrae, said teeth extending between said first and second side surfaces and along secant lines of circles partially defined by said first and second side surfaces.

26. A fusion device as set forth in claim 25 wherein said second end of said fusion device includes first and second recesses extending from said second end toward said first end for receiving projections on a tool for inserting said fusion device between the adjacent vertebrae.

27. A fusion device as set forth in claim 26 wherein said fusion device includes a gripping portion defined by said first and second recesses for extending between the projections on the tool.

28. A fusion device as set forth in claim 27 wherein each of said recesses has an upper surface and a lower surface, said upper and lower surfaces of said recesses being engageable with the projections on the tool.

29. A fusion device as set forth in claim 25 wherein said teeth extend parallel to each other.

30. A fusion device as set forth in claim 25 wherein said fusion device is made of an allograft material.

31. A fusion device as set forth in claim 25 wherein said first and second side surfaces extend along portions of concentric circles.