Method and device for fixing and correcting spondylolisthesis anteriorly

• US 6,056,749 A
• Filed: 03/15/1999
• Issued: 05/02/2000
• Est. Priority Date: 03/15/1999
• Status: Expired due to Fees

• Current Assignee: Spineology Incorporated
• Original Assignee: Spineology Incorporated
• Inventors: Kuslich, Stephen D.
• Primary Examiner(s): Buiz, Michael
• Assistant Examiner(s): Woo, Julian W.
• Application Number:
  US09/268,226
• Time in Patent Office: 414 Days
• Field of Search: 606/61, 606/72, 606/98, 606/99, 623/17
• US Class Current: 606/86.00A
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 17/864 hollow, e.g. with socket or cannulated
• CPC Class Codes: A61B 2017/0256 for the spine
• 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 2/447 substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section
• 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 2002/30593 hollow
• CPC Class Codes: A61F 2002/30777 Oblong apertures
• CPC Class Codes: A61F 2002/30785 parallel
• CPC Class Codes: A61F 2002/30789 perpendicular with respect to each other
• CPC Class Codes: A61F 2002/30858 Threads interrupted by grooves or sidewalls, e.g. flat sidewalls
• 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

Abstract

A method and apparatus for fixation and correction of spondylolisthesis anteriorly includes a disk cage which is inserted into the space between adjacent vertebrae, a drill guide for guiding and aligning a drill bit to angle an opening anteriorly between adjacent vertebrae, a distractor for temporarily aligning the vertebrae to position a disk cage and an elongated hollow screw positioned in said drilled opening through one vertebra, said disk cage and into said adjacent vertebra.

Claims

1. An apparatus for securing one vertebra to another in a living vertebrate animal across an interposed disk, the device including:

(a) a rigid disk cage sized to fit within an interdiscal space to support adjacent vertebrae;

(b) an elongated screw; and

(c) said disk cage including an angled bore therethrough constructed and arranged such that said screw may pass therethrough such that it would enter one vertebra anteriorly, pass into said disk cage and into the adjacent vertebra to cross-pin said vertebra to said disk cage.

2. The apparatus of claim 1 wherein said disk cage is substantially hollow defining a hollow region and includes a plurality of openings from an exterior surface to the hollow region to allow bone ingrowth through said disk cage.

3. The apparatus of claim 1 wherein said disk cage includes a tool receiving mechanism for receiving an insertion and guiding tool.

4. The apparatus of claim 1 wherein said disk cage includes exterior surface treatments for gripping against a bone surface.

5. The apparatus of claim 4 wherein said disk cage is prismoidal in shape, defining six surfaces;

a top and bottom surface, a right and left surface and a front and back end surface.

6. The apparatus of claim 5 wherein the distance between said top and bottom surface is greater than the distance between said right and left surfaces.

7. The apparatus of claim 6 wherein said top and bottom surfaces are generally convex and include a plurality of threads thereon.

8. The apparatus of claim 7 wherein said top and bottom surfaces are not parallel to each other.

15. The apparatus of claim 1 wherein said upper and lower surfaces are generally convex and include a plurality of threads thereon.

16. The apparatus of claim 1 wherein said upper and lower surfaces are not parallel to each other.

9. Apparatus for aligning and fixing adjacent vertebrae comprising:

(a) a disk cage having six external surface areas including a first pair of opposing generally flat exterior surfaces, a second pair of opposing generally flat exterior surfaces and a third pair of opposing surfaces defining two generally convex surfaces;

(b) said first pair of opposing surfaces including an opening into which a tool may be inserted and held to insert and rotate the disk cage relative to a tool;

(c) said second pair of opposing surfaces being spaced closer together than said third pair of opposing surface;

(d) said third pair of opposing surfaces including at least one opening therethrough angling from one convex surface to the other convex surface, each of said convex surfaces including bone engagement members; and

(e) an elongated screw sized to pass into said angled opening such that a portion of said screw extends past each convex surface in order to engage with vertebral bone when positioned within a disk and adjacent vertebrae.

10. An apparatus for securing one vertebra to another in a living vertebrate animal across an interposed disk, the device including:

(a) a rigid disk cage sized to fit within an interdiscal space to support adjacent vertebrae, said cage including an upper and a lower surface, a pair of opposing sides and a ventral and dorsal end;

(b) an elongated screw; and

(c) said disk cage including an angled bore through said upper and lower surfaces constructed and arranged such that said screw may pass therethrough such that it would enter one vertebra anteriorly, pass into and through said disk cage and into the adjacent vertebra to cross-pin said vertebra to said disk cage.

11. The apparatus of claim 10 wherein said disk cage is substantially hollow defining a hollow region and includes a plurality of openings from an exterior surface to the hollow region to allow bone ingrowth through said disk cage.

12. The apparatus of claim 10 wherein said disk cage includes a tool receiving mechanism at the ventral end for receiving an insertion and guiding tool.

13. The apparatus of claim 10 wherein said disk cage includes exterior surface treatments for gripping against a bone surface.

14. The apparatus of claim 10 wherein the distance between said upper and lower surface is greater than the distance between said opposing side surfaces.

17. A method for anteriorly correcting spondylolisthesis comprising the steps of:

(a) exposing adjacent vertebrae and the disk therebetween anteriorly;

(b) reaming out said disk to create and interdiscal space;

(c) lifting and realigning the adjacent vertebra as required;

(d) inserting a disk cage into the interdiscal space to provide a rigid support across the adjacent vertebrae;

(e) drilling an opening through one vertebra, through an angled opening in said disk a cage and into said adjacent vertebra; and

(f) inserting an elongated screw through said opening to cross-pin said disk cage to said adjacent vertebrae.

18. A system for fixing and correcting spondylolisthesis anteriorly comprising:

a) an instrument having a pair of linked arms each having a free end and each further having a sharp projection located upon the free end;

a slide member supported upon said linked arms and being freely moveable along the length of said linked arms;

said slide member having a plurality of push members oriented in the direction opposite to that of the sharp projections;

a central rod attached to the linked arms through a central opening and being further attached to the slide member; and

a depth adjustment mechanism having the means to fix the position of the slide member along the linked arms;

b) a substantially hollow disk cage having an opening therethrough and a plurality of side holes;

said disk cage further having an upper and a lower surface which each contain one or more guide holes;

c) an insertion tool having an elongated body, said elongated body having a head constructed and manufactured to be of determinable size and shape so that said head can fasten to said opening of the disk cage;

d) a drill guide having a means for fastening to the opening of the disk cage;

said drill guide further having a hollow shaft mounted to the fastening means so that when the drill guide is properly fastened to the disk cage the hollow shaft will be in linear alignment with the guide holes of the disk cage; and

e) an elongated screw constructed and arranged to pass through said guide holes of said disk cage.

19. The system for fixing and correcting spondylolisthesis anteriorly of claim 18 wherein the screw is a threaded screw having a hollow bore and side openings.

20. The system for fixing and correcting spondylolisthesis anteriorly of claim 18 wherein the upper and lower surfaces of the disk cage have a threaded surface treatment.

21. A method of correcting and fixing spondylolisthesis anteriorly comprising:

(a) placing a distracting tool against and between two adjacent vertebrae at the point where said vertebrae are in misalignment;

(b) realigning said vertebrae by utilizing the distraction tool to lift and distract one vertebra from the adjacent vertebra thereby increasing the gap between said vertebrae;

(c) reaming out the disk between said vertebrae to create an interdiscal space;

(d) inserting an insertion device into a disk cage, said disk cage including an angled through guide hole therethrough;

(e) placing the disk cage into the interdiscal space;

(f) aligning said disk cage by placing the guide holes of said disk cage in alignment with the vertebrae surrounding said disk cage;

(g) removing of said insertion device from the disk cage;

(h) removing said distracting tool from said adjacent vertebrae;

(I) mounting a drill guide into said disk cage to position said drill guide to be in linear alignment with said disk cage guide holes;

(j) drilling a hole through said drill guide anteriorly into a vertebra at an angle sufficient to lead a drill bit through the guide hole of the drill cage and into the adjacent vertebra;

(k) removing said drill bit and drill guide from said disk cage; and

(l) inserting a screw into the hole running between both vertebra thereby cross-pinning the adjacent vertebrae together through the disk cage and screw.

22. A method of correcting and fixing spondylolisthesis anteriorly comprising:

(a) placing a distracting tool against and between two adjacent vertebrae at the point where said vertebrae are in misalignment;

(b) realigning said vertebrae by utilizing the distraction tool to lift and distract one vertebra from the adjacent vertebra thereby increasing the gap between said vertebrae;

(c) reaming out a disk between said vertebrae to create an interdiscal space;

(d) inserting an insertion device into a disk cage, said disk cage being prismoidal in shape and having a first pair of opposing surfaces that are spaced closer together than a second pair of generally opposing surfaces;

(e) placing the disk cage into said interdiscal space with the first pair of opposing surfaces against said vertebrae;

(f) rotating said disk cage through application of torque to said insertion device until said second pair of opposing surfaces are against said vertebrae to thereby firmly seat said disk cage between said vertebrae;

(g) aligning said disk cage by placing the guide holes of said disk cage in alignment with the vertebrae surrounding said disk cage;

(h) removing of said insertion device from the disk cage;

(I) removing said distracting tool from said adjacent vertebrae;

(j) mounting a drill guide into said disk cage to position said drill guide to be in linear alignment with said disk cage guide holes;

(k) drilling a hole through said drill guide anteriorly into a vertebra at an angle sufficient to lead a drill bit through the guide hole of the drill cage and into the adjacent vertebra;

(l) removing said drill bit and drill guide from said disk cage;

(m) inserting a screw into the hole running between both vertebra thereby cross-pinning the adjacent vertebrae together through the disk cage and screw.

(n) aligning said disk cage thereby placing the guide holes of said disk cage in alignment with the vertebrae surrounding said disk cage;

(o) applying bone ingrowth medium into said disk cage and said hollow screw to thereby encourage formation of bone and fibrous fusions between both vertebra across said disk.