Instruments and techniques for disc space preparation

• US 20060241626A1
• Filed: 03/17/2006
• Published: 10/26/2006
• Est. Priority Date: 02/22/2000
• Status: Active Grant

• Current Assignee: Eric C Lange, Steven D. DeRidder, Thomas V. Mcgahan
• Original Assignee: Eric C Lange, Steven D. DeRidder, Thomas V. Mcgahan
• Inventors: Lange, Eric C., DeRidder, Steven D., McGahan, Thomas V.
• Granted Patent: US 8,062,299 B2
• Time in Patent Office: Days
• US Class Current: 606/79
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/1604 Chisels; Rongeurs; Punches; Stamps
• 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: A61B 2017/1602 Mills
• CPC Class Codes: A61B 2090/033 Abutting means, stops, e.g. abutting on tissue or skin
• CPC Class Codes: A61B 2090/062 penetration depth
• 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 2/4455 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 2002/30113 circular
• CPC Class Codes: A61F 2002/30593 hollow
• CPC Class Codes: A61F 2002/30772 Apertures or holes, e.g. of circular cross section
• CPC Class Codes: A61F 2002/30828 parallel
• CPC Class Codes: A61F 2002/30879 Ribs
• 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 2230/0006 circular

Abstract

A series of instruments (30, 80, 120, 210, 510, 550) are provided for direct-anterior and oblique-anterior disc space and end plate preparation. The instruments (30, 80, 120, 210, 510, 550) provide precise guidance for channel formation in the vertebral endplates by guiding rotating and bladed cutting instruments (122, 250, 580). Instrumentation (550) for oblique-anterior disc space preparation includes compound angulation to account for the angle of approach to the spine and the angulation between adjacent vertebrae. Methods and techniques for use of the instruments (30, 80, 120, 210, 510, 550) are also described.

Claims

1-10. -10. (canceled)

11. A medical instrument for preparation of a disc space between adjacent vertebrae of a patient, comprising:

a cutting blade guide adapted to matingly engage a window assembly that is coupled to between the adjacent vertebrae, said guide having a blade channel defined therein adapted to receive a cutting blade, said blade channel having a guide channel adapted to receive a guiding rib on said cutting blade to maintain alignment of said cutting blade.

12. The instrument of claim 11, wherein said guide has a working channel defined therein adapted to allow removal of cutting debris.

13. The instrument of claim 11, further comprising said cutting blade received in said blade channel.

14. The instrument of claim 13, wherein said cutting blade has a stop to limit advancement of said cutting blade.

15. The instrument of claim 13, wherein said cutting blade has an angled cutting surface adapted to remove from an oblique approach with respect to a sagital plane of the patient a portion with a substantially uniform depth from an endplate of one of the vertebrae.

16. The instrument of claim 15, wherein said guide includes a lower blade guide and said cutting blade includes a lower cutting blade, said guide channel of said lower blade guide being offset, and said guide rib of said cutting blade being offset to only mate with said guide channel of said lower blade guide.

17. The instrument of claim 11, wherein said guide is constructed and arranged to guide said cutting blade from an oblique approach with respect to a sagital plane of the patient.

18. The instrument of claim 11, wherein said guide has a front portion and a back portion opposite said front portion, said guide further having a pair of opposing sides adjoining said front portion and said back portion, said blade channel being obliquely angled with respect to said front and back portions, and said blade channel being obliquely angled with respect to said opposing sides.

19. The instrument of claim 11, further comprising a depth gauge provided in said blade channel, said depth gauge being adapted to visually indicate an intended cutting depth of said cutting blade.

20. The instrument of claim 11, further comprising said window assembly matingly engaged to said guide.

44. The instrument of claim 11, wherein said cutting blade guide extends proximally and distally along a longitudinal axis and said blade channel opens through said cutting blade guide proximally and distally at an angle relative to said longitudinal axis to orient said cutting blade to cut said endplate at said angle.

21-43. -43. (canceled)

45. A medical instrument for preparation of a disc space between adjacent vertebrae of a patient, comprising:

a cutting blade guide adapted to matingly engage a window assembly that is positionable between the adjacent vertebrae, said cutting blade guide having a blade channel defined therein, said blade channel extending proximally and distally through said guide; and

a cutting blade sized and shaped to received in said blade charnel, wherein one of said cutting blade and said cutting blade guide includes a guide channel adapted to receive a guiding rib on the other of said cutting blade and said cutting blade guide to maintain alignment of said cutting blade in said blade channel as said cutting blade is moved proximally and distally in said blade channel.

46. The instrument of claim 45, wherein said cutting blade guide has a working channel defined therein extending proximally and distally through said cutting blade guide, said working channel being sized to view through said working channel said cutting blade extending distally from said blade channel.

47. The instrument of claim 45, wherein said cutting blade has a stop extending therefrom adjacent a proximal portion of said cutting blade, said stop contacting said cutting blade guide to limit advancement of said cutting blade through said blade channel.

48. The instrument of claim 45, wherein said cutting blade guide extends proximally and distally along a longitudinal axis and said blade channel opens through said cutting blade guide proximally and distally at an angle relative to said longitudinal axis, wherein said angle orients said cutting blade so that said cutting blade extends distally from said blade channel toward said longitudinal axis at said angle to cut said endplate at said angle.

49. The instrument of claim 45, wherein said cutting blade includes a leading cutting blade at a distal end thereof extending transversely to a longitudinal axis of said cutting blade, said cutting blade further including first and second lateral cutting blades extending from opposite sides of said leading cutting blade to opposite sides of said cutting blade, said lateral cutting blades being obliquely oriented to said leading cutting blade.

50. The instrument of claim 49, wherein one of said lateral cutting blades is longer then the other of said lateral cutting blades.

51. The instrument of claim 45, wherein said cutting blade guide has a front portion and a back portion opposite said front portion, said cutting blade guide further having a pair of opposing sides adjoining said front portion and said back portion, said blade channel being obliquely angled with respect to said front and back portions, and said blade channel being obliquely angled with respect to said opposing sides.

52. A medical instrument for preparation of a disc space between adjacent vertebrae of a patient, comprising:

a cutting blade guide adapted to matingly engage a window assembly that is engageable between the adjacent vertebrae, said guide having a blade channel defined therein extending between and opening at proximal and distal faces of said cutting blade guide, said cutting blade guide further including a window extending along said blade channel and between said distal and proximal faces of said cutting guide, wherein a guide surface of said blade channel is located between said blade channel and said window; and

a cutting blade sized and shaped to be slidingly received in said blade channel.

53. The instrument of claim 52, wherein one of said cutting blade and said cutting blade guide includes a guide channel adapted to receive a guiding rib on the other of said cutting blade and said cutting blade guide to maintain alignment of said cutting blade as said cutting blade is moved along said blade channel.