Method of insertion of an expandable intervertebral implant

• US 20050283244A1
• Filed: 05/20/2005
• Published: 12/22/2005
• Est. Priority Date: 08/05/2003
• Status: Active Grant

• Current Assignee: Tyler Fusion Technologies LLC
• Original Assignee: Flexuspine Incorporated
• Inventors: Gordon, Charles R., Hanson, Heather S., Harbold, Corey T.
• Granted Patent: US 8,257,440 B2
• Time in Patent Office: Days
• US Class Current: 623/17.15
• CPC Class Codes: A61B 17/7005 Parts of the longitudinal elements, e.g. their ends, being specially adapted to fit in the screw or hook heads
• 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 17/7008 with parts of, or attached to, the longitudinal elements, bearing against an outside of the screw or hook heads, e.g. nuts on threaded rods A61B17/7007 takes precedence
• 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 17/7023 with a pivot joint
• CPC Class Codes: A61B 17/7032 Screws or hooks with U-shaped head or back through which longitudinal rods pass
• CPC Class Codes: A61B 17/7037 wherein pivoting is blocked when the rod is clamped
• CPC Class Codes: A61B 17/7064 Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor
• CPC Class Codes: A61B 17/80 Cortical plates , i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
• CPC Class Codes: A61B 17/86 Pins or screws or threaded wires; nuts therefor A61B17/72 take precedence
• CPC Class Codes: A61F 2/30767 Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
• CPC Class Codes: A61F 2/4405 for apophyseal or facet joints, i.e. between adjacent spinous or transverse processes devices implanted between spinous or transverse processes A61B17/7062
• CPC Class Codes: A61F 2/4425 made of articulated components
• CPC Class Codes: A61F 2/4455 for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages intervertebral discs A61F2/442
• CPC Class Codes: A61F 2/4611 of spinal prostheses
• 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 2002/30092 using shape memory or superelastic materials, e.g. nitinol
• CPC Class Codes: A61F 2002/30131 horseshoe- or crescent- or C-shaped or U-shaped
• CPC Class Codes: A61F 2002/30133 kidney-shaped or bean-shaped
• CPC Class Codes: A61F 2002/30225 Flat cylinders, i.e. discs
• CPC Class Codes: A61F 2002/3023 : wedge-shaped cylinders
• CPC Class Codes: A61F 2002/30235 : tubular, e.g. sleeves
• CPC Class Codes: A61F 2002/30331 : made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
• CPC Class Codes: A61F 2002/30365 : with additional means for limiting said rotation
• CPC Class Codes: A61F 2002/30369 : Limited lateral translation of the protrusion within a larger recess
• CPC Class Codes: A61F 2002/30383 : made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
• CPC Class Codes: A61F 2002/30462 : retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2002/30471 : connected by a hinged linkage mechanism, e.g. of the single-bar or multi-bar linkage type
• CPC Class Codes: A61F 2002/30476 : locked by an additional locking mechanism
• CPC Class Codes: A61F 2002/30492 : using a locking pin
• CPC Class Codes: A61F 2002/305 : Snap connection
• CPC Class Codes: A61F 2002/30505 : spring biased
• CPC Class Codes: A61F 2002/30507 : using a threaded locking member, e.g. a locking screw or a set screw
• CPC Class Codes: A61F 2002/30515 : using a locking wedge or block
• CPC Class Codes: A61F 2002/3052 : unrestrained in only one direction, e.g. moving unidirectionally
• CPC Class Codes: A61F 2002/30538 : for adjusting angular orientation
• CPC Class Codes: A61F 2002/3055 : for adjusting length
• CPC Class Codes: A61F 2002/30556 : for adjusting thickness
• CPC Class Codes: A61F 2002/30563 : having elastic means or damping means, different from springs, e.g. including an elastomeric core or shock absorbers
• CPC Class Codes: A61F 2002/30565 : having spring elements
• CPC Class Codes: A61F 2002/30578 : having apertures, e.g. for receiving fixation screws
• CPC Class Codes: A61F 2002/30579 : with mechanically expandable devices, e.g. fixation devices
• CPC Class Codes: A61F 2002/30601 : telescopic
• CPC Class Codes: A61F 2002/30624 : Hinged joint, e.g. with transverse axle restricting the movement
• CPC Class Codes: A61F 2002/30649 : Ball-and-socket joints
• CPC Class Codes: A61F 2002/30662 : with rotation-limiting means
• CPC Class Codes: A61F 2002/30772 : Apertures or holes, e.g. of circular cross section
• CPC Class Codes: A61F 2002/30785 : parallel
• CPC Class Codes: A61F 2002/3079 : Stepped or enlarged apertures, e.g. having discrete diameter changes
• CPC Class Codes: A61F 2002/30841 : Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
• CPC Class Codes: A61F 2002/30904 : serrated profile, i.e. saw-toothed
• CPC Class Codes: A61F 2002/443 : having two transversal endplates and at least one intermediate component
• 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 2002/4629 : connected to the endoprosthesis or implant via a threaded connection
• CPC Class Codes: A61F 2210/0014 : using shape memory or superelastic materials, e.g. nitinol
• CPC Class Codes: A61F 2220/0025 : Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2220/0033 : made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
• CPC Class Codes: A61F 2220/0075 : sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2220/0091 : connected by a hinged linkage mechanism, e.g. of the single-bar or multi-bar linkage type
• CPC Class Codes: A61F 2230/0013 : Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped
• CPC Class Codes: A61F 2230/0015 : Kidney-shaped, e.g. bean-shaped
• CPC Class Codes: A61F 2230/0069 : cylindrical
• CPC Class Codes: A61F 2250/0006 : for adjusting angular orientation
• CPC Class Codes: A61F 2250/0009 : for adjusting thickness
• CPC Class Codes: A61F 2310/00023 : Titanium or titanium-based alloys, e.g. Ti-Ni alloys

Abstract

An artificial functional spinal unit including an expandable intervertebral implant that can be inserted via a posterior surgical approach and used with one or more facet replacement devices to provide an anatomically correct range of motion is described. Lordotic and non-lordotic expandable, articulating implants and cages are described, along with embodiments of facet replacement devices and instruments for insertion. Methods of insertion are also described.

Claims

1-157. -157. (canceled)

158. A method of inserting an intervertebral implant between vertebrae in a human spine, comprising:

creating an opening through an annulus between the vertebrae;

inserting the intervertebral implant through the opening;

positioning the intervertebral implant between the vertebrae;

elevating an insert in the intervertebral implant to increase a height of the intervertebral implant; and

maintaining at least a portion of the increased height of the intervertebral implant.

159. The method of claim 158, wherein elevating the insert comprises advancing a member of the intervertebral implant in a first direction to elevate the insert in a direction substantially perpendicular to the first direction.

160. The method of claim 158, wherein elevating the insert comprises inserting a member between the insert and a lower body of the intervertebral implant to elevate the insert from the lower body of the intervertebral implant.

161. The method of claim 158, wherein elevating the insert comprises inserting a from the lower body of the intervertebral implant, wherein the insert is elevated by a height of the member.

162. The method of claim 158, wherein elevating the insert comprises inserting a member between the insert and a lower body of the intervertebral implant to elevate the insert from the lower body of the intervertebral implant, wherein the insert is elevated by a height of the member, and wherein maintaining the increased height of the intervertebral implant comprises inhibiting backout of the member from the intervertebral implant.

163. The method of claim 158, wherein elevating the insert comprises increasing a separation distance between an upper body and a lower body of the intervertebral implant.

164. The method of claim 158, wherein increasing the height of the intervertebral implant allows articulation or increased articulation of the intervertebral implant.

165. The method of claim 158, wherein maintaining at least the portion of the increased height of the intervertebral implant comprises inserting a spacer between an upper body and a lower body of the intervertebral implant.

166. The method of claim 158, wherein maintaining at least the portion of the increased height of the intervertebral implant comprises allowing an inferior surface of a first portion of the intervertebral implant to rest upon a superior surface of a second portion of the intervertebral implant.

167. A method of inserting an intervertebral implant between vertebrae in a human spine, comprising:

creating an opening through an annulus between the vertebrae;

inserting the intervertebral implant through the opening;

positioning the intervertebral implant between the vertebrae;

at least partially rotating an insert in the intervertebral implant to increase a height of the intervertebral implant; and

maintaining at least a portion of the increased height of the intervertebral implant.

168. The method of claim 167, wherein at least partially rotating the insert comprises advancing a member of the intervertebral implant in a first direction to at least partially rotate the insert about an axis substantially perpendicular to the first direction such that the insert interacts with at least a portion of the intervertebral implant to increase the height of the intervertebral implant.

169. The method of claim 167, wherein at least partially rotating the insert comprises at least partially rotating the insert about an axis substantially perpendicular to an inferior surface of the insert.

170. The method of claim 167, wherein at least partially rotating the insert comprises allowing a cam portion of the insert to travel along an extension of the intervertebral implant.

171. The method of claim 167, wherein at least partially rotating the insert comprises allowing a projection of the insert to travel along a cam portion of the intervertebral implant.

172. The method of claim 167, wherein increasing the height of the intervertebral implant allows articulation or increased articulation of the intervertebral implant.

173. The method of claim 167, wherein rotating the insert comprises increasing a separation distance between an upper body and a lower body of the intervertebral implant.

174. The method of claim 167, wherein maintaining at least a portion of the increased height of the intervertebral implant comprises inserting a spacer between an upper body and a lower body of the intervertebral implant.

175. The method of claim 167, wherein maintaining at least a portion of the increased height of the intervertebral implant comprises allowing an inferior surface of a first portion of the intervertebral implant to rest on a superior surface of a second portion of the intervertebral implant.

176. A method of inserting an intervertebral implant between vertebrae in a human spine, comprising:

creating an opening through an annulus between the vertebrae;

inserting the intervertebral implant through the opening;

positioning the intervertebral implant between the vertebrae;

engaging an angled portion of a first member of the intervertebral implant with an angled portion of a second member of the intervertebral implant to increase a height of the intervertebral implant; and

maintaining at least a portion of the increased height of the intervertebral implant.

177. The method of claim 176, wherein engaging the angled portion of the first member comprises elevating the first member.

178. The method of claim 176, wherein engaging the angled portion of the first member comprises at least partially rotating the first member.

179. The method of claim 176, wherein engaging the angled portion of the first member comprises translating the first member.

180. The method of claim 176, wherein increasing the height of the intervertebral implant allows articulation or increased articulation of the intervertebral implant.

181. The method of claim 176, wherein maintaining at least a portion of the increased height of the intervertebral implant comprises inserting a spacer between an upper body and a lower body of the intervertebral implant.

182. The method of claim 176, wherein maintaining at least a portion of the increased height of the intervertebral implant comprises allowing an inferior surface of a first portion of the intervertebral implant to rest on a superior surface of a second portion of the intervertebral implant.