Methods and instruments for interbody fusion
First Claim
1. Laparoscopic instrumentation for performing surgical procedures between adjacent vertebrae, said instrumentation comprising:
- a tubular sleeve having a longitudinal axis and a hollow interior along said axis sized for advancement of surgical tools from outside the patient'"'"'s body to the adjacent vertebrae, said sleeve including a spike connected with and projecting from said sleeve substantially parallel to said longitudinal axis; and
a centering device including an elongated stem sized for introduction into the disc space between the adjacent vertebrae, said stem defining a bore sized to receive said spike of said tubular sleeve therethrough.
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Accused Products
Abstract
A laparoscopic surgical technique is provided for preparing a site for implantation of a novel fusion device or implant. In accordance with one embodiment of the technique, a laparoscope is provided having an outer sleeve with distraction fingers at one end to distract the disc space. The laparoscope provides a sealed working channel to the disc space, through which the disc space is distracted, the vertebral endplates and surrounding disc is reamed, and the fusion device inserted. A distraction plug is provided for centering the outer sleeve and for providing midline distraction of the disc space. In one embodiment, a fusion device includes diverging bone screws passing through an end wall and upper and lower walls of the device to engage the adjacent vertebrae. In another embodiment, a connector plate is engaged to bilaterally position fusion devices to prevent rotation and resist expulsion of the devices from the disc space.
506 Citations
44 Claims
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1. Laparoscopic instrumentation for performing surgical procedures between adjacent vertebrae, said instrumentation comprising:
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a tubular sleeve having a longitudinal axis and a hollow interior along said axis sized for advancement of surgical tools from outside the patient'"'"'s body to the adjacent vertebrae, said sleeve including a spike connected with and projecting from said sleeve substantially parallel to said longitudinal axis; and
a centering device including an elongated stem sized for introduction into the disc space between the adjacent vertebrae, said stem defining a bore sized to receive said spike of said tubular sleeve therethrough. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)
said elongated stem of said centering device has a height sufficient to distract the disc space between the adjacent vertebrae; and
said sleeve includes an extension projecting therefrom substantially parallel to said spike, said extension having a height substantially equal to the height of said elongated stem.
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4. The laparoscopic instrumentation according to claim 1, wherein said sleeve includes a tubular wall and said spike extends contiguously from said wall.
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5. The laparoscopic instrumentation according to claim 1, wherein said sleeve includes a tubular wall and said spike is attached to the outside of said wall.
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6. The laparoscopic instrumentation according to claim 1 wherein:
- said sleeve includes a bore extending along the length of said sleeve; and
said spike is sized for slidable passage through said bore in said sleeve.
- said sleeve includes a bore extending along the length of said sleeve; and
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7. The laparoscopic instrumentation according to claim 1, wherein said spike is integrally connected with said sleeve.
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8. The laparoscopic instrumentation according to claim 1, wherein said spike is rigidly connected with said sleeve.
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9. The laparoscopic instrumentation according to claim 1, wherein said spike is slidably connected with said sleeve.
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10. The laparoscopic instrumentation according to claim 1, wherein said spike is non-rigidly connected with said sleeve.
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11. The laparoscopic instrumentation according to claim 1, wherein said spike projects from an end wall of said sleeve.
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12. The laparoscopic instrumentation according to claim 1, wherein said spike projects from a side wall of said sleeve.
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13. Laparoscopic instrumentation for performing a surgical procedure between adjacent vertebrae, comprising:
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a plug adapted for introduction between the adjacent vertebrae; and
a sleeve defining a hollow interior; and
wherein one of said plug and said sleeve defines a passage, another of said plug and said sleeve defining a projection at least partially received within said passage to locate said sleeve relative to the adjacent vertebrae, said projection contiguously connected with and projecting from said another of said plug and said sleeve. - View Dependent Claims (14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29)
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30. Laparoscopic instrumentation for performing a surgical procedure between adjacent vertebrae, comprising:
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a plug adapted for introduction between the adjacent vertebrae; and
a sleeve defining a hollow interior; and
wherein one of said plug and said sleeve defines a passage, another of said plug and said sleeve defining a projection at least partially received within said passage to locate said sleeve relative to the adjacent vertebrae, at least a portion of said passage having a non-circular shape, said projection having a shaped portion substantially complementary to said non-circular shape of said passage to prevent relative rotation between said plug and said sleeve. - View Dependent Claims (31)
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32. Laparoscopic instrumentation for performing a surgical procedure between adjacent vertebrae, comprising:
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a plug adapted for introduction between the adjacent vertebrae, said plug having a height sufficient to distract a space between the adjacent vertebrae; and
a sleeve defining a hollow interior and including an extension member projecting therefrom having a height substantially equal to said height of said plug; and
wherein one of said plug and said sleeve defines a passage, another of said plug and said sleeve defining a projection at least partially received within said passage to locate said sleeve relative to the adjacent vertebrae. - View Dependent Claims (33)
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34. Laparoscopic instrumentation for performing a surgical procedure between adjacent vertebrae, comprising:
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a plug adapted for introduction between the adjacent vertebrae; and
a sleeve defining a hollow interior; and
wherein said plug defines a passage, said sleeve defining a projection at least partially received within said passage to locate said sleeve relative to the adjacent vertebrae, said projection extending axially from a distal end of said sleeve and integrally formed with said sleeve.
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35. Laparoscopic instrumentation for performing a surgical procedure between adjacent vertebrae, comprising:
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a plug adapted for introduction between the adjacent vertebrae; and
a sleeve defining a hollow interior; and
wherein one of said plug and said sleeve defines a passage, another of said plug and said sleeve defining a projection at least partially received within said passage to locate said sleeve relative to the adjacent vertebrae, said projection laterally coupled to an outer surface said sleeve.
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36. A method for performing a surgical procedure between adjacent vertebrae, comprising:
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providing a plug;
providing a sleeve defining a hollow interior, one of the plug and the sleeve defining a passage and another of the plug and the sleeve defining a projection;
introducing the plug between the adjacent vertebrae; and
inserting the projection within the passage to locate the sleeve relative to the adjacent vertebrae. - View Dependent Claims (37, 38, 39, 40, 41, 42, 43, 44)
removing the projection from the passage;
repositioning the sleeve relative to the plug; and
reinserting the projection within the passage to locate the sleeve in a second position relative to the adjacent vertebrae.
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41. The method according to claim 40, wherein the repositioning comprises rotating the sleeve to a laterally opposite position relative to the plug.
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42. The method according to claim 36, further comprising advancing a surgical tool through the sleeve and performing a drilling operation on the adjacent vertebrae.
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43. The method according to claim 36, further comprising advancing a surgical tool through the sleeve and performing a reaming operation on the adjacent vertebrae.
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44. The method according to claim 36, further comprising advancing an implant through the sleeve and inserting the implant between the adjacent vertebrae.
Specification