Apparatus and method for implant insertion

• US 5,885,299 A
• Filed: 03/14/1996
• Issued: 03/23/1999
• Est. Priority Date: 09/15/1994
• Status: Expired due to Term

• Current Assignee: Howmedica Osteonics Corp. (Stryker Corporation)
• Original Assignee: Surgical Dynamics Incorporated (Medtronic Plc)
• Inventors: Mitchell, Steven T., Winslow, Charles J.
• Primary Examiner(s): Tucker, Guy V.
• Application Number:
  US08/616,120
• Time in Patent Office: 1,104 Days
• Field of Search: 606/61, 606/73, 606/91, 606/99, 606/104, 606/72, 606/60, 606/86, 623/17
• US Class Current: 606/99
• CPC Class Codes: A61B 17/861 specially shaped for gripping driver
• CPC Class Codes: A61B 17/8877 characterised by the cross-section of the driver bit
• CPC Class Codes: A61B 17/8888 at its central region
• CPC Class Codes: A61F 2/30744 End caps, e.g. for closing an endoprosthetic cavity
• 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 2/446 having a circular or elliptical cross-section substantially parallel to the axis of the spine, e.g. cylinders or frustocones
• 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 2/4603 for insertion or extraction of endoprosthetic joints or of accessories thereof
• 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 2002/2835 Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
• CPC Class Codes: A61F 2002/30121 with lobes
• CPC Class Codes: A61F 2002/30143 hexagonal
• CPC Class Codes: A61F 2002/30154 square
• CPC Class Codes: A61F 2002/3021 frustoconical
• CPC Class Codes: A61F 2002/30217 hollow cones, e.g. tubular-like cones
• CPC Class Codes: A61F 2002/30235 tubular, e.g. sleeves
• CPC Class Codes: A61F 2002/30327 differing in diameter
• 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 2002/30405 made by screwing complementary threads machined on the parts themselves
• CPC Class Codes: A61F 2002/30593 : hollow
• CPC Class Codes: A61F 2002/30617 : Visible markings for adjusting, locating or measuring
• CPC Class Codes: A61F 2002/30774 : internally-threaded
• CPC Class Codes: A61F 2002/30777 : Oblong apertures
• CPC Class Codes: A61F 2002/30785 : parallel
• CPC Class Codes: A61F 2002/30787 : inclined obliquely with respect to each other
• CPC Class Codes: A61F 2002/30797 : internally-threaded
• CPC Class Codes: A61F 2002/30813 : Stepped or enlarged blind bores, e.g. having discrete diameter changes
• CPC Class Codes: A61F 2002/3082 : Grooves
• CPC Class Codes: A61F 2002/3085 : with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface
• CPC Class Codes: A61F 2002/30863 : the entry end surface having flutes, relief grooves, starter notches or bevelled indentations
• CPC Class Codes: A61F 2002/30873 : Threadings machined on non-cylindrical external surfaces
• CPC Class Codes: A61F 2002/30968 : Sintering
• CPC Class Codes: A61F 2002/448 : comprising multiple adjacent spinal implants within the same intervertebral space or within the same vertebra, e.g. comprising two adjacent spinal implants
• 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 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 2230/0006 : circular
• CPC Class Codes: A61F 2230/0017 : Angular shapes
• CPC Class Codes: A61F 2230/0021 : square
• CPC Class Codes: A61F 2230/0067 : conical
• CPC Class Codes: A61F 2230/0069 : cylindrical
• CPC Class Codes: A61F 2250/0039 : differing in diameter
• CPC Class Codes: A61F 2250/0097 : Visible markings, e.g. indicia
• CPC Class Codes: A61F 2310/00023 : Titanium or titanium-based alloys, e.g. Ti-Ni alloys

Abstract

Apparatus for and methods of inserting implants are disclosed wherein the apparatus includes a handle portion and a body portion attached to the handle portion and defining a longitudinal axis. The body portion includes an outer tubular member fixed relative to the handle portion for rotation therewith about the longitudinal axis. The outer tube member has first implant engaging structure adjacent a distal end. An inner tubular member is disposed at least partially within the outer tubular member and is mounted for longitudinal motion relative to the outer tubular member. Second implant engaging structure is positioned adjacent a distal end of the inner tubular member. The body portion further includes an inner shaft, coaxially mounted at least partially within the inner tubular member for independent rotation relative to the inner and outer tubular members, the inner shaft having third implant engaging structure adjacent a distal end. In a method for inserting an implant having a hollow portion with a closed distal end and a removable cap, the first, second and third implant engaging structures are attached to the implant with at least one of the engaging structure attached to the removable cap and another of the engaging structure attached to the hollow portion. The implant is preferably preloaded with bone chips and/or bone growth inducing substances prior to attachment. Thereafter, the preloaded implant is inserted into the desired surgical location.

Claims

1. Apparatus for implant insertion comprising:

a housing portion;

a body portion attached to the housing portion and defining a longitudinal axis, the body portion including;

an outer member mounted to the housing portion, the outer member having first implant engaging structure adjacent a distal end thereof;

an inner member mounted within the outer member and being rotatable independent of the outer member, the inner member having second implant engaging structure adjacent a distal end thereof;

an inner shaft coaxially mounted at least partially within the inner member for independent rotation relative to the inner and outer members, the inner shaft having third implant engaging structure adjacent a distal end thereof; and

a first actuator mounted adjacent the housing and operatively connected to the inner member, the first actuator movable to cause corresponding longitudinal movement of the inner member; and

a second actuator mounted adjacent the housing and operatively connected to the inner shaft, the second actuator movable to cause corresponding rotational movement of the inner shaft.

2. Apparatus as in claim 1 including a handle portion releasably attached to one of the housing portion and the body portion.

3. Apparatus as in claim 2 wherein the handle portion is T-shaped.

4. Apparatus as in claim 1 wherein the first actuator includes a wheel positioned on the inner member for independent rotation thereof relative to the outer member.

5. Apparatus as in claim 1 wherein the second actuator includes a wheel positioned on the inner shaft for independent rotation thereof relative to the outer and inner members.

6. Apparatus as in claim 1 wherein the first implant engaging structure comprises a pair of tabs projecting from the distal end of the outer member.

7. Apparatus as in claim 1 wherein the second implant engaging structure comprises a polygonal structure extending from the distal end of the inner member.

8. Apparatus as in claim 1 wherein the third implant engaging structure comprises a threaded portion formed on the distal end of the inner shaft.

9. Apparatus as in claim 1 wherein the first implant engaging structure is removably mounted to the outer member.

10. Apparatus for implant insertion comprising:

a handle portion; and

a body portion defining a longitudinal axis and having a proximal end configured to engage the handle portion, a distal end configured to engage an implant, and a housing fixed relative to the proximal end and positioned intermediate the proximal and distal ends, the body portion including an outer tubular member fixed to the housing and extending distally therefrom, the outer tubular member having first implant engaging structure at a distal end, an inner tubular member disposed at least partially within the outer tubular member and mounted for longitudinal motion relative to the outer tubular member, the inner tubular member including a first wheel confined at least partially within a first cavity in the housing for rotating the inner tubular member relative to the outer tubular member, the inner tubular member having second implant engaging structure adjacent a distal end and an inner shaft, coaxially mounted at least partially within the inner tubular member, the inner shaft including a second wheel confined at least partially within a second cavity in the housing for independently rotating the inner shaft relative to the inner and outer tubular members, the inner shaft having third implant engaging structure adjacent a distal end.

11. Apparatus as in claim 10 wherein the first implant engaging structure comprises a pair of tabs projecting from the distal end of the outer tubular member.

12. Apparatus as in claim 11 wherein the tabs are on radially opposed sides of the longitudinal axis and are configured to engage an outer peripheral wall of an implant.

13. Apparatus as in claim 10 wherein the second implant engaging structure comprises a polygonal structure extending from the distal end of the inner tubular member.

14. Apparatus as in claim 10 wherein the third implant engaging structure comprises a threaded portion formed on the distal end of the inner shaft.

15. Apparatus as in claim 10 wherein the first implant engaging structure is removably mounted to the body portion.

16. Apparatus as in claim 10 wherein the handle portion is T-shaped.

17. An apparatus for facilitating placement of an intervertebral implant, which comprises:

a housing;

an elongated body portion connected to the housing and extending at least distally therefrom, the elongated body including;

an outer member fixedly mounted to the housing and having first implant engaging structure at a distal end thereof;

an inner member disposed at least partially within the outer member and having second implant engaging structure at a distal end thereof, the inner member mounted for rotational and longitudinal movement relative to the outer member;

a shaft member at least partially disposed within the inner member and having third implant engaging structure at a distal end thereof, the shaft member mounted for rotational movement relative to the inner member;

a first manually rotatable member mounted adjacent the housing and operatively connected to the inner member, the first rotatable member being rotatable and longitudinally movable relative to the housing to cause corresponding respective rotational and longitudinal movement of the inner member relative to the outer member; and

a second manually rotatable member mounted adjacent the housing and operatively connected to the shaft member, the second rotatable member being rotatable relative to the housing to cause corresponding rotational movement of the shaft member.

18. Apparatus as in claim 17 wherein the first implant engaging structure includes a projecting member extending from the distal end of the outer member.

19. Apparatus as in claim 18 wherein the first implant engaging structure includes a pair of opposed projecting members extending from the distal end of the outer member.

20. Apparatus as in claim 17 wherein the second implant engaging structure includes a polygonal member extending from the distal end of the inner member.

21. Apparatus as in claim 17 wherein the third implant engaging structure includes a threaded potion disposed on the distal end of the shaft member.

22. Apparatus as in claim 17 wherein the second rotatable member is mounted for longitudinal movement relative to the housing portion to cause corresponding longitudinal movement of the shaft member.

23. A system for facilitating fusion of adjacent vertebrae, which comprises:

an implant including an implant body defining leading and trailing ends, and an end cap mountable to the trailing end of the implant body, the implant body having at least one recess adjacent the trailing end, the end cap defining an indenture in an outer surface thereof and an internally threaded bore; and

an insertion tool for facilitating positioning of the implant within the adjacent vertebrae, the insertion tool, including;

an elongated body defining a longitudinal axis and having proximal and distal ends, the elongated body including;

an outer member having at least one tab extending from a distal end of the outer member, the tab being dimensioned to be accommodated within the recess of the implant body;

an inner member at least partially disposed within the outer member, the inner member having projecting structure extending from a distal end of the inner member, the projecting structure being dimensioned to be received within the indenture of the end cap of the implant;

an inner shaft at least partially disposed within the inner member and having a threaded portion adjacent a distal end thereof, the threaded portion dimensioned to threadably engage the threaded bore of the end cap of the implant;

wherein the tab, projecting structure and the threaded portion of the insertion tool cooperatively engage the respective recess, indenture and threaded bore of the implant to releasably engage the implant to the insertion tool to thereby facilitate placement of the implant within the adjacent vertebrae.

24. The system as in claim 23 wherein the insertion tool includes a housing mounted to the elongated body.

25. The system as in claim 24 further including a first actuator operatively connected to the inner member and mounted with respect to the housing, the first actuator mounted for longitudinal movement relative to the housing to at least retract the inner member to cause release of the projecting structure from the indenture of the end cap.

26. The system as in claim 25 wherein the first actuator is rotatably mounted relative to the housing to facilitate alignment of the projecting structure of the inner member with the indenture of the end cap.

27. The system as in claim 26 including a second actuator connected to the inner shaft and rotatably mounted with respect to the housing, the second actuator rotatable to cause corresponding rotation of the inner shaft to thereby cause selective engagement of the threaded portion of the inner shaft with the threaded bore of the end cap.

28. The system as in claim 27 including a handle operatively connected to the outer member to facilitate rotation of the outer member and the implant to thereby enhance positioning of the implant with respect to the adjacent vertebrae.