Rasp for use in spine surgery

• US 6,436,101 B1
• Filed: 04/07/2000
• Issued: 08/20/2002
• Est. Priority Date: 10/13/1999
• Status: Expired due to Fees

• Current Assignee: PorOsteon Inc.
• Original Assignee: James S. Hamada
• Inventors: Hamada, James S.
• Primary Examiner(s): Robert, Eduardo C.
• Application Number:
  US09/545,401
• Time in Patent Office: 865 Days
• Field of Search: 606/85, 606/84, 606/53, 606/1, 132/76.4, 132/76.5, 29/761
• US Class Current: 606/85
• CPC Class Codes: A61B 17/1604 Chisels; Rongeurs; Punches; Stamps
• CPC Class Codes: A61B 17/1659 Surgical rasps, files, planes, or scrapers
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/8825 characterised by syringe details A61B17/8822, A61B17/8827 take precedence
• CPC Class Codes: A61B 17/8833 Osteosynthesis tools specially adapted for handling bone cement or fluid fillers; Means for supplying bone cement or fluid fillers to introducing tools, e.g. cartridge handling means
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2090/062 penetration depth
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/065 for measuring contact or contact pressure
• CPC Class Codes: A61F 2/28 Bones joints A61F2/30
• 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 2/4465 having a circular or kidney shaped cross-section substantially perpendicular to the axis of the spine
• 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 2/4611 of spinal prostheses
• CPC Class Codes: A61F 2/4657 Measuring instruments used for implanting artificial joints for surgical instruments A61B90/06
• CPC Class Codes: A61F 2002/2817 Bone stimulation by chemical reactions or by osteogenic or biological products for enhancing ossification, e.g. by bone morphogenetic or morphogenic proteins [BMP] or by transforming growth factors [TGF]
• 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 2002/2839 Bone plugs or bone graft dowels
• CPC Class Codes: A61F 2002/30133 kidney-shaped or bean-shaped
• CPC Class Codes: A61F 2002/302 toroidal, e.g. rings
• CPC Class Codes: A61F 2002/3023 : wedge-shaped cylinders
• CPC Class Codes: A61F 2002/30593 : hollow
• CPC Class Codes: A61F 2002/30828 : parallel
• 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 2002/4649 : Bone graft or bone dowel harvest sites
• CPC Class Codes: A61F 2002/4666 : for measuring force, pressure or mechanical tension
• CPC Class Codes: A61F 2002/4681 : by applying mechanical shocks, e.g. by hammering
• CPC Class Codes: A61F 2230/0015 : Kidney-shaped, e.g. bean-shaped
• CPC Class Codes: A61F 2230/0065 : toroidal, e.g. ring-shaped, doughnut-shaped
• CPC Class Codes: A61F 2230/0069 : cylindrical
• CPC Class Codes: A61F 2310/00365 : Proteins; Polypeptides; Degradation products thereof
• CPC Class Codes: A61L 2430/38 : for reconstruction of the spine, vertebrae or intervertebral discs
• CPC Class Codes: A61L 27/3608 : Bone, e.g. demineralised bone matrix [DBM], bone powder
• CPC Class Codes: A61L 27/3616 : Blood, e.g. platelet-rich plasma
• CPC Class Codes: A61L 27/365 : Bones
• CPC Class Codes: A61L 27/3804 : characterised by specific cells or progenitors thereof, e.g. fibroblasts, connective tissue cells, kidney cells
• CPC Class Codes: A61L 27/3847 : Bones

Abstract

The system and method of the invention includes surgical instrumentation to enable a spine fusion procedure to proceed more accurately, efficiently and safely by allowing precision placement of an intervertebral implant, precision preparation of the area into which the bone graft is placed, and pre-selection of a pre-specified known shape of bone graft. In the order in which they are used, improvements in a distractor, box chisel, curette, an anterior or anterolateral type intervertebral cylindrically directed or peripheral rasp, intervertebrally operated vertebral bone plate shaping rasp, or roughing combination rasp, and an intervertebral sizing tool; any combination of which may be anatomically shaped. Several embodiments of bone graft implants are disclosed including annular flat surface implants having angled surfaces, implants having line slots to help in the insertion and orientation on insertion and in registering the implant with an impactor; any combination of which may be anatomically shaped or not. Two improved impactor embodiments and an improved curette are disclosed.

Claims

1. A rasp for use in spine surgery comprising:

a head portion for fitting within an intervertebral space between two adjacent vertebral bone plates and having an upper face and a lower face and an outwardly disposed surface extending between said upper and said lower face, and wherein at least a portion of one of said upper face, said lower face and said outwardly disposed surface includes a rasp surface;

a shaft extending from said outwardly disposed surface to permit said head portion to be angularly displaced at least slightly within said intervertebral space; and

a measuring scale on said shaft for indicating a depth of said head portion within said intervertebral space.

2. The rasp as recited in claim 1 and wherein said outwardly disposed surface has a maximum dimension extending between said upper and said lower face at an anterior side of said head portion and a minimum dimension extending between said upper and said lower face at a posterior side of said head portion, to account for a natural lordosis in said intervertebral space between two adjacent vertebral bone plates.

3. The rasp as recited in claim 2 wherein said shaft extends from said head portion substantially collinear with a longitudinal axis extending from said posterior side of said head portion to thereby form an anterior procedure rasp.

4. The rasp as recited in claim 2 wherein said shaft extends from said head portion at an angle with respect to a longitudinal axis extending from said posterior side of said head portion to thereby form an anterolateral procedure rasp.

5. The rasp as recited in claim 4 wherein said angle from which said shaft extends from said head portion with respect to said longitudinal axis extending from said from said posterior side of said head portion is from about 20°

to about 70°

.

7. The rasp as recited in claim 3 and wherein both said upper and said lower faces are convex said upper face has a more acute curvature than said lower face in order to more closely complement the natural biconcave intervertebral disc space in which an upper, downwardly directed bone plate has a greater concavity than a concavity of a lower, upwardly directed bone plate.

6. A rasp for use in spine surgery comprising:

a head portion for fitting within an intervertebral space between two adjacent vertebral bone plates and having an upper face and a lower face and an outwardly disposed surface extending between said upper and said lower face, and wherein at least a portion of one of said upper face, said lower face and said outwardly disposed surface includes a rasp surface;

a shaft extending from said outwardly disposed surface to permit said head portion to be angularly displaced at least slightly within said intervertebral space; and

wherein said upper and said lower faces are convex for complementing a naturally biconcave intervertebral disc space.

8. The rasp as recited in claim 6 wherein said rasp is an intervertebral cylindrically directed rasp having a rasp surface on at least a portion of said outwardly disposed surface and wherein said upper and said lower faces are substantially smooth.

9. The rasp as recited in claim 8 and further comprising a measuring scale on said shaft for indicating the depth of said head portion within said intervertebral space.

10. The rasp as recited in claim 8 and wherein said upper face has a more acute curvature than said lower face in order to more closely complement the natural intervertebral disc space in which the upper, downwardly directed bone plate has a greater concavity than the concavity of the lower, upwardly directed bone plate.

11. The rasp as recited in claim 8 and wherein said outwardly disposed surface has a maximum dimension extending between said upper and said lower face at an anterior side of said head portion and a minimum dimension extending between said upper and said lower face at a posterior side of said head portion, to account for the natural lordosis in said intervertebral space between two adjacent vertebral bone plates.

12. The rasp as recited in claim 11 wherein said shaft extends from said head portion substantially collinear with a line extending from said from said posterior side of said head portion to thereby form an anterior procedure rasp.

13. The rasp as recited in claim 11 wherein said shaft extends from said head portion at an angle with respect to a line extending from said from said posterior side of said head portion to thereby form an anterolateral procedure rasp.

14. The rasp as recited in claim 13 and wherein said outwardly disposed surface has a maximum dimension extending between said upper and said lower face at an anterior side of said head portion and a minimum dimension extending between said upper and said lower face at a posterior side of said head portion, to account for the natural lordosis in said intervertebral space between two adjacent vertebral bone plates.

15. The rasp as recited in claim 14 wherein said shaft extends from said head portion substantially collinear with a line extending from said from said posterior side of said head portion to thereby form an anterior procedure rasp.

16. The rasp as recited in claim 14 wherein said shaft extends from said head portion at an angle with respect to a line extending from said from said posterior side of said head portion to thereby form an anterolateral procedure rasp.

17. The rasp as recited in claim 8 and wherein said rasp has a small smooth area on said outwardly disposed surface at said posterior side of said head portion for providing interruption to said rasp surface so that the progression toward the posterior of the human spine will be mitigated.

18. The rasp as recited in claim 6 wherein said rasp is an intervertebrally operated vertebral bone plate shaping rasp having a rasp surface on at least a portion of at least one of said upper and said lower faces and wherein said outwardly disposed surface is substantially smooth.

19. The rasp as recited in claim 18 and further comprising a measuring scale on said shaft for indicating the depth of said head portion within said intervertebral space.

20. The rasp as recited in claim 18 and wherein said upper face has a more acute curvature than said lower face in order to more closely complement the natural intervertebral disc space in which the upper, downwardly directed bone plate has a greater concavity than the concavity of the lower, upwardly directed bone plate.

21. The rasp as recited in claim 6 wherein said rasp is an intervertebrally operated vertebral bone plate shaping rasp having a rasp surface on at least a portion of both said upper and said lower faces and wherein said outwardly disposed surface is substantially smooth.

22. The rasp as recited in claim 21 and further comprising a measuring scale on said shaft for indicating the depth of said head portion within said intervertebral space.

23. The rasp as recited in claim 21 and wherein said upper face has a more acute curvature than said lower face in order to more closely complement the natural intervertebral disc space in which the upper, downwardly directed bone plate has a greater concavity than the concavity of the lower, upwardly directed bone plate.

24. The rasp as recited in claim 21 and wherein said outwardly disposed surface has a maximum dimension extending between said upper and said lower face at an anterior side of said head portion and a minimum dimension extending between said upper and said lower face at a posterior side of said head portion, to account for the natural lordosis in said intervertebral space between two adjacent vertebral bone plates.

25. The rasp as recited in claim 24 wherein said shaft extends from said head portion substantially collinear with a line extending from said from said posterior side of said head portion to thereby form an anterior procedure rasp.

26. The rasp as recited in claim 24 wherein said shaft extends from said head portion at an angle with respect to a line extending from said from said posterior side of said head portion to thereby form an anterolateral procedure rasp.

27. The rasp as recited in claim 6 and wherein said outwardly disposed surface has a maximum dimension extending between said upper and said lower face at an anterior side of said head portion and a minimum dimension extending between said upper and said lower face at a posterior side of said head portion, to account for a natural lordosis in said intervertebral space between two adjacent vertebral bone plates.

28. The rasp as recited in claim 27 wherein said shaft extends from said head portion substantially collinear with a longitudinal axis extending from said posterior side of said head portion to thereby form an anterior procedure rasp.

29. The rasp as recited in claim 27 wherein said shaft extends from said head portion at an angle with respect to a longitudinal axis extending from said posterior side of said head portion to thereby form an anterolateral procedure rasp.

30. The rasp as recited in claim 29 wherein said angle from which said shaft extends from said head portion with respect to said longitudinal axis extending from said from said posterior side of said head portion is from about 20°

to about 70°

.

31. A rasp for use in spine surgery comprising:

a head portion for fitting within an intervertebral space between two adjacent vertebral bone plates and having an upper face and a lower face and an outwardly disposed surface extending between said upper and said lower face, and wherein at least a portion of one of said upper face, said lower face and said outwardly disposed surface includes a rasp surface;

a shaft extending from said outwardly disposed surface to permit said head portion to be angularly displaced at least slightly within said intervertebral space; and

a locking slot on said shaft and further comprising a handle portion and wherein said handle portion has a slot and a locking ring at least partially extending into said slot to engage said locking slot when said second end of tip portion is inserted into a blind bore at a front end of said handle portion.

32. The rasp as recited in claim 31 and wherein said handle portion is at least partially hollow is oval at least to the extent of a transverse rectangular oval shape.

33. A rasp for use in spine surgery comprising:

a circular head portion for fitting within an intervertebral space between two adjacent vertebral bone plates and having an upper face and a lower face and an outwardly disposed surface extending between said upper and said lower face, and wherein at least a portion of one of said upper face, said lower face and said outwardly disposed surface includes a rasp surface; and

a shaft extending from said outwardly disposed surface to permit said head portion to be angularly displaced at least slightly within said intervertebral space, and

wherein said rasp is a roughing combination rasp having a rasp surface on at least a portion of said outwardly disposed surface and upon on at least a portion of at least one of said upper and said lower faces, so that said circular head portion may be rotated about a center to remove intervertebral material.

34. The rasp as recited in claim 33 and further comprising a measuring scale on said shaft for indicating a depth of said head portion within said intervertebral space.

35. The rasp as recited in claim 33 and wherein said upper and said lower faces are convex for complementing a naturally biconcave intervertebral disc space.

36. The rasp as recited in claim 35 and wherein said upper face has a more acute curvature than said lower face in order to more closely complement a natural intervertebral disc space in which an upper, downwardly directed bone plate has a greater concavity than a concavity of a lower, upwardly directed bone plate.

37. The rasp as recited in claim 33 and wherein said outwardly disposed surface has a maximum dimension extending between said upper and said lower face at an anterior side of said head portion and a minimum dimension extending between said upper and said lower face at a posterior side of said head portion, to account for a natural lordosis in said intervertebral space between two adjacent vertebral bone plates.

38. The rasp as recited in claim 37 wherein said shaft extends from said head portion substantially collinear with a longitudinal axis extending from said posterior side of said head portion to thereby form an anterior procedure rasp.

39. The rasp as recited in claim 37 wherein said shaft extends from said head portion at an angle with respect to a longitudinal axis line extending from said posterior side of said head portion to thereby form an anterolateral procedure rasp.