METHODS AND INSTRUMENTATION FOR DISC REPLACEMENT

• US 20080051897A1
• Filed: 07/12/2007
• Published: 02/28/2008
• Est. Priority Date: 03/28/2006
• Status: Active Grant

• Current Assignee: Depuy Spine Incorporated (Johnson & Johnson)
• Original Assignee: Depuy Spine Incorporated (Johnson & Johnson)
• Inventors: LaSota, Douglas, Bellas, Jonathan, Lopez, Erasmo, Borgstrom, Amie
• Granted Patent: US 8,282,641 B2
• Time in Patent Office: Days
• US Class Current: 623/17.13
• CPC Class Codes: A61F 2/4611 of spinal prostheses
• CPC Class Codes: A61F 2/4637 for connecting or disconnecting two parts of a prosthesis
• CPC Class Codes: A61F 2002/3008 radio-opaque, e.g. radio-opaque markers
• CPC Class Codes: A61F 2002/30112 Rounded shapes, e.g. with rounded corners
• CPC Class Codes: A61F 2002/30133 kidney-shaped or bean-shaped
• CPC Class Codes: A61F 2002/30151 rhomboidal or parallelogram-shaped
• CPC Class Codes: A61F 2002/30153 rectangular
• CPC Class Codes: A61F 2002/30179 X-shaped
• CPC Class Codes: A61F 2002/30387 Dovetail connection
• 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 2002/30571 Leaf springs
• CPC Class Codes: A61F 2002/30604 modular
• CPC Class Codes: A61F 2002/30649 Ball-and-socket joints
• CPC Class Codes: A61F 2002/30884 Fins or wings, e.g. longitudinal wings for preventing rotation within the bone cavity
• CPC Class Codes: A61F 2002/30975 made of two halves
• 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 2002/4677 using a guide wire
• CPC Class Codes: A61F 2220/0025 Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2230/0004 : Rounded shapes, e.g. with rounded corners
• CPC Class Codes: A61F 2230/0015 : Kidney-shaped, e.g. bean-shaped
• CPC Class Codes: A61F 2230/0017 : Angular shapes
• CPC Class Codes: A61F 2230/0019 : rectangular
• CPC Class Codes: A61F 2230/0058 : X-shaped
• CPC Class Codes: A61F 2250/0098 : radio-opaque, e.g. radio-opaque markers

Abstract

Various exemplary instruments for introducing an implant using a posterolateral approach are also provided, as well as various exemplary methods for using such instruments. In general, the instruments are configured to interconnect to an implant and/or to a guide member such that the components are all docked relative to one another. This allows the various components of a multi-piece implant to be mated intraoperatively within the disc space, and in particular to be guided into alignment with one another.

Claims

1. A method for implanting a spinal implant, comprising:

manipulating a first inserter tool to position a first component of a spinal disc implant within a disc space between adjacent vertebrae; and

advancing a second inserter tool along a guide that is coupled to at least one of the first inserter tool and the first component such that a second component mated to the second inserter tool is guided into mating alignment with the first component to thereby mate the second component to the first component.

2. The method of claim 1, wherein the guide comprises a guidewire coupled to the first inserter tool, the first component, and the second inserter tool, and wherein the second inserter tool is slid along the guidewire.

3. The method of claim 1, wherein the guide comprises a frame coupled to the first inserter tool, and wherein the second inserter tool is advanced through an opening in the frame.

4. The method of claim 3, wherein the frame is positioned at least partially outside of the disc space.

5. The method of claim 1, wherein the first inserter tool is inserted into the disc space on a posterolateral side of the disc space, and the second inserter tool is inserted into the disc space on a contralateral side of the disc space.

6. The method of claim 1, further comprising advancing a third inserter tool along the guide such that a third component mated to the third inserter tool is guided into mating alignment with the first component to thereby mate the third component to the first component.

7. The method of claim 6, wherein the second component is mated to a lateral side of the first component, and the third component is mated to a contralateral side of the first component.

8. The method of claim 1, wherein the first component includes superior and inferior members that are positioned adjacent to superior and inferior endplates of the adjacent vertebrae and that are movable relative to one another.

9. The method of claim 1, wherein the second component includes superior and inferior members that are positioned adjacent to superior and inferior endplates of the adjacent vertebrae.

10. A method for implanting an artificial disc replacement, comprising:

inserting a central inserter tool into a disc space between adjacent vertebrae to position a central component mated to the central inserter tool within the disc space; and

inserting a first lateral inserter tool into the disc space to mate a first lateral component mated to the first lateral inserter tool to a first lateral side of the central component.

11. The method of claim 10, further comprising, prior to inserting the first lateral inserter tool into the disc space, positioning a retaining tool against the central component to maintain the central component in a substantially fixed position and detaching and removing the central inserter tool from the central component.

12. The method of claim 10, wherein the central inserter tool is inserted into the disc space on a posterolateral side of the disc space, and the first lateral inserter is inserted into the disc space on a contralateral side of the disc space.

13. The method of claim 10, wherein the central inserter tool is used to maintain the central component in a substantially fixed position while the first lateral component is mated to the central component.

14. The method of claim 10, wherein the first lateral inserter tool is advanced along a guide coupled to at least one of the central component and the central inserter tool.

15. The method of claim 14, wherein the guide comprises a guidewire mated to the central inserter tool and the central component, and wherein inserting the first lateral inserter tool into the disc space comprises coupling the guidewire mated to the first lateral inserter tool, and advancing the first lateral inserter tool along the guidewire to mate the first lateral component to the central component.

16. The method of claim 15, further comprising, prior to inserting the central inserter tool into a disc space, introducing the guidewire into the disc space using a guidewire inserter, grasping a terminal end of the guidewire located in the disc space with a grasper, and pulling the terminal end of the guidewire out of the disc space such that the guide wire has first and second terminal ends that are positioned outside of the disc space and a unshaped portion that is positioned in the disc space.

17. The method of claim 14, wherein the guide comprises a frame mated to the central inserter tool, and wherein inserting the first lateral inserter tool into the disc space comprises inserting the first lateral inserter tool through an opening formed in the frame such that the frame guides the first lateral component into mating alignment with the central component.

18. The method of claim 10, further comprising inserting a second lateral inserter tool into the disc space to mate a second lateral component mated to the second lateral inserter tool to a contralateral side of the central component.

19. The method of claim 18, wherein the central inserter tool is mated to the contralateral side of the central component, and wherein, prior to inserting the second lateral inserter tool into the disc space, the central inserter tool is disengaged from the contralateral side of the central component to allow the second lateral component to be mated to the contralateral side of the central component.

20. A spinal implant and instrumentation system, comprising:

an implant configured to be positioned within a disc space between adjacent vertebrae and having a central component and a first lateral component that is removably matable to a first lateral side of the central component;

a central inserter tool configured to removably mate to the central component;

a first lateral inserter tool configured to removably mate to the first lateral component; and

a guide configured to removably interconnect the implant, the central inserter tool, and the first lateral inserter tool to allow the first lateral component to be intraoperatively guided into alignment with and mated to the first lateral side of the central component.

21. The system of claim 20, wherein the guide comprises a guidewire configured to removably mate to the central inserter tool and the central component, and configured to slidably receive the first lateral inserter tool to guide the first lateral component into mating alignment with the central component.

22. The system of claim 21, wherein the central inserter tool and the first lateral inserter tool include a guidewire channel formed therein and configured to receive the guidewire.

23. The system of claim 20, wherein the guide comprises a frame configured to removably mate to the central inserter tool and to slidably receive the first lateral inserter tool.

24. The system of claim 23, wherein the frame includes a first channel adapted to removably receive the central inserter tool, and a second channel adapted to removably receive the first lateral inserter tool, the first and second channels being positioned so as to align the central inserter tool with a first lateral side of a disc space and the lateral inserter tool with a contralateral side of the disc space.

25. The system of claim 24, wherein the frame includes a third channel and the system includes a second lateral inserter tool configured to removably mate a second lateral component to the central component, and wherein the second and third channels in the frame are positioned so as to align the first lateral inserter tool and a second lateral inserter tool with first and second opposed lateral sides of the central component.

26. The system of claim 20, wherein the implant further comprises a second lateral component that is removably matable to a second lateral side of the central component, and the system further comprises a second lateral inserter tool configured to removably mate to the second lateral component.

27. The system of claim 26, wherein the central inserter tool is removably matable to the second lateral side of the central component.

28. The system of claim 20, wherein the central component includes superior and inferior members that are configured to be positioned adjacent to superior and inferior endplates of the adjacent vertebrae and that are movable relative to one another.

29. The method of claim 28, wherein the first lateral component includes superior and inferior members that are positioned adjacent to superior and inferior endplates of the adjacent vertebrae.