Devices and techniques for a posterior lateral disc space approach

• US 7,060,073 B2
• Filed: 04/10/2002
• Issued: 06/13/2006
• Est. Priority Date: 10/21/1999
• Status: Expired due to Term

• Current Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Original Assignee: SDGI Holdings Incorporated (Medtronic Plc)
• Inventors: DeRidder, Steven D., White, John L., Frey, George, Ebner, Harald
• Primary Examiner(s): Philogene, Pedro
• Application Number:
  US10/120,104
• Publication Number:
  US 20020165550A1
• Time in Patent Office: 1,525 Days
• Field of Search: 606/61, 606/85, 606/99, 606/90, 623 1711- 1716
• US Class Current: 606/85
• CPC Class Codes: A61B 17/0206 with antagonistic arms as supports for retractor elements
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/1604 Chisels; Rongeurs; Punches; Stamps
• CPC Class Codes: A61B 17/1631 Special drive shafts, e.g. flexible shafts A61B17/1642, A61B17/164 take precedence
• CPC Class Codes: A61B 17/1642 for producing a curved bore
• 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 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 2/4455 for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages intervertebral discs A61F2/442
• 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 2/4603 for insertion or extraction of endoprosthetic joints or of accessories thereof
• CPC Class Codes: A61F 2/4611 of spinal prostheses
• CPC Class Codes: A61F 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 2002/3008 radio-opaque, e.g. radio-opaque markers
• CPC Class Codes: A61F 2002/30115 circular-O-shaped
• CPC Class Codes: A61F 2002/30133 kidney-shaped or bean-shaped
• CPC Class Codes: A61F 2002/30235 tubular, e.g. sleeves
• CPC Class Codes: A61F 2002/30329 Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2002/30593 hollow
• 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 2002/30789 : perpendicular with respect to each other
• CPC Class Codes: A61F 2002/30828 : parallel
• CPC Class Codes: A61F 2002/30912 : made of expanded metal, e.g. diamond mesh or metal nets having lozenge-shaped apertures
• 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 2002/4635 : using minimally invasive surgery
• CPC Class Codes: A61F 2002/4687 : Mechanical guides for implantation instruments
• CPC Class Codes: A61F 2220/0025 : Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2230/0006 : circular
• CPC Class Codes: A61F 2230/0015 : Kidney-shaped, e.g. bean-shaped
• CPC Class Codes: A61F 2230/0069 : cylindrical
• CPC Class Codes: A61F 2250/0098 : radio-opaque, e.g. radio-opaque markers
• CPC Class Codes: A61F 2310/00017 : Iron- or Fe-based alloys, e.g. stainless steel
• CPC Class Codes: A61F 2310/00023 : Titanium or titanium-based alloys, e.g. Ti-Ni alloys
• CPC Class Codes: Y10S 606/907 : Composed of particular material or coated
• CPC Class Codes: Y10S 606/91 : Polymer
• CPC Class Codes: Y10S 606/911 : Memory material
• CPC Class Codes: Y10S 606/912 : Radiolucent material

Abstract

This invention relates to devices and instruments for implant insertion through a posterior lateral opening to the disc space. The instruments include an implant inserter, and the devices include a spinal fusion implant engageable by the implant inserter. The implant provides bilateral support of the adjacent vertebrae when inserted into the disc space from a postero-lateral approach.

Claims

1. A spinal implant insertable in a spinal disc space, the implant comprising a body including:

a middle portion having opposite first and second ends and a convexly curved anterior wall and a concavely curved posterior wall extending therebetween;

a leading end portion extending from said first end of said middle portion;

a trailing end portion extending from said second end of said middle portion;

an upper surface and an opposite lower surface along said middle portion and said leading end portion and said trailing end portion; and

an inserter instrument engaging receptacle formed as a groove extending in a concavely curved profile extending along a junction of said middle portion and said trailing end portion.

2. The implant of claim 1, wherein said groove extends between said upper surface and said lower surface.

3. The implant of claim 1, further comprising an inserter instrument engaging receptacle at a junction of said middle portion and said leading end portion.

4. The implant of claim 1, wherein said anterior wall and said posterior wall each extend along a respective side of said middle portion, said leading end portion and said trailing end portion.

5. The implant of claim 4, wherein said anterior wall has a generally convex profile and said posterior wall has a generally concave profile.

6. The implant of claim 4, wherein said anterior wall includes a recessed area extending along said trailing end portion.

7. The implant of claim 6, wherein said anterior wall includes a second recessed area extending along said leading end portion.

8. The implant of claim 4, wherein said posterior wall has a height that is less than a height of said anterior wall.

9. The implant of claim 1, wherein said leading end portion and said trailing end portion each define a chamber extending between said upper surface and said lower surface.

10. The implant of claim 9, wherein said middle portion defines a chamber extending between said upper surface and said lower surface.

11. The implant of claim 10, further comprising:

a first strut between said chamber of said leading end portion and said chamber of said middle portion; and

a second strut between said chamber of said trailing end portion and said chamber of said middle portion.

12. The implant of claim 11, wherein said inserter instrument engaging receptacle is formed at the junction of said second strut and a posterior wall of said body.

13. The implant of claim 1, wherein said body is comprised of non-resorbable material selected from the group consisting of:

non-reinforced polymers, carbon-reinforced polymer composites, PEEK, PEEK composites, shape-memory alloys, titanium, titanium alloys, cobalt chrome alloys, stainless steel, ceramics and combinations thereof.

14. The implant of claim 1, wherein said body is comprised of PEEK material.

15. The implant of claim 14, further comprising at least one radiographic marker in said body.

16. The implant of claim 1, wherein said body includes at least one chamber.

17. The implant of claim 16, further comprising bone growth material in said at least one chamber.

18. The implant of claim 17, wherein said bone growth material includes one or more selected from group consisting of:

bone morphogenetic protein, transforming growth factor, insulin-like growth factor, platelet-derived growth factor, fibroblast growth factor, and LIM mineralization protein (LMP).

19. A spinal implant insertable in a spinal disc space, the implant comprising a body having:

a leading end wall;

a trailing end wall;

a concavely curved posterior wall extending between said leading end wall and said trailing end wall; and

a convexly curved anterior wall extending between said leading end wall and said trailing end wall, wherein said anterior wall includes a middle portion, a trailing end portion, and a leading end portion, said middle portion including an offset portion projecting anteriorly from said middle portion of said anterior wall, wherein said middle portion includes an upper bearing surface and an opposite lower bearing surface extending along said anterior wall and said offset portion.

20. The implant of claim 19, further comprising:

said upper bearing surface extending between said leading end wall, said anterior wall, said posterior wall and said trailing end wall; and

said opposite lower bearing surface extending between said leading end wall, said anterior wall, said posterior wall and said trailing end wall.

21. The implant of claim 19, wherein:

said posterior wall includes a middle portion, a leading end portion, and a Wailing end portion; and

said posterior wall includes an inserter instrument engaging receptacle at a junction of said middle portion and said trailing end portion thereof.

22. The implant of claim 21, wherein said receptacle is a groove extending between said upper surface and said lower surface.

23. The implant of claim 21, wherein said posterior wall includes an inserter instrument engaging receptacle at a junction of said middle portion and said leading end portion thereof.

24. The implant of claim 19, wherein said anterior wall has a generally convex profile and said posterior wall has a generally concave profile.

25. The implant of claim 19, wherein said anterior wall includes a first recessed area extending along said leading end portion thereof and a second recessed area extending along said trailing end portion thereof.

26. The implant of claim 19, wherein said posterior wall has a height that is less than a height of said anterior end wall.

27. The implant of claim 19, further comprising a first chamber between a leading end portion of said posterior wall and said leading end portion of said anterior wall and a second chamber between a trailing end portion of said posterior wall and said trailing end portion of said anterior wall.

28. The implant of claim 27, further comprising a third chamber between a middle portion of said posterior wall and said middle portion of said anterior wall.

29. The implant of claim 28, further comprising:

a first strut extending from said anterior wall to said posterior wall between said first chamber and said third chamber; and

a second strut extending from said anterior wall to said posterior wall between said second chamber and said third chamber.

30. The implant of claim 29, further comprising an inserter instrument engaging receptacle in said posterior wall at the junction of said second strut and said posterior wall.

31. The implant of claim 30, further comprising a second inserter instrument engaging receptacle in said posterior wall formed at the junction of said first strut and said posterior wall.

32. A spinal implant insertable in a spinal disc space, the implant comprising a body including:

a leading end wall;

a trailing end wall;

a posterior wall extending between said leading end wall and said trailing end wall;

an anterior wall extending between said leading end wall and said trailing end wall;

a first strut adjacent said leading end wall extending from said anterior wall to said posterior wall;

a second strut adjacent said trailing end wall extending from said anterior wall to said posterior wall;

a chamber formed by said first strut, said second strut, said anterior wall and said posterior wall; and

an inserter instrument engaging receptacle at the junction of said second strut and said posterior wall.

33. The implant of claim 32, further comprising:

a second chamber formed by said first strut, said leading end wall, said anterior wall and said posterior wall; and

a third chamber formed by said second strut, said trailing end wall, said anterior wall and said posterior wall forming a second chamber.

34. The implant of claim 32, wherein said anterior wall includes a middle portion, a trailing end portion, and a leading end portion, said middle portion being offset anteriorly from said leading end portion and said trailing end portion.

35. The implant of claim 32, further comprising an inserter instrument engaging receptacle at the junction of said first strut and said posterior wall.

36. A spinal implant insertable in a spinal disc space, the implant comprising a body including:

a middle portion having opposite first and second ends;

a leading end portion extending from said first end of said middle portion;

a trailing end portion extending from said second end of said middle portion;

an upper surface and an opposite lower surface along said middle portion and said leading end portion and said trailing end portion; and

an inserter instrument engaging receptacle at a junction of said middle portion and said trailing end portion, wherein said receptacle is a groove formed in a posterior wall of said body, said groove extending between said upper sin-face and said lower surface.

37. The implant of claim 36, further comprising an inserter instrument engaging receptacle at a junction of said middle portion and said leading end portion.

38. The implant of claim 36, wherein said body includes an anterior wall and a posterior wall each extending along a respective side of said middle portion, said leading end portion and said trailing end portion.

39. The implant of claim 38, wherein said anterior wall has a generally convex profile and said posterior wall has a generally concave profile.

40. The implant of claim 38, wherein said anterior wall includes a recessed area extending along said trailing end portion.

41. The implant of claim 40, wherein said anterior wall includes a second recessed area extending along said leading end portion.

42. The implant of claim 38, wherein said posterior wall has a height that is less than a height of said anterior end wall.

43. The implant of claim 36, wherein said leading end portion and said trailing end portion each define a chamber extending between said upper surface and said lower surface.

44. The implant of claim 43, wherein said middle portion defines a chamber extending between said upper surface and said lower surface.

45. The implant of claim 44, further comprising:

a first strut between said chamber of said leading end portion and said chamber of said middle portion; and

a second strut between said chamber of said trailing end portion and said chamber of said middle portion.

46. The implant of claim 45, wherein said inserter instrument engaging receptacle is formed at the junction of said second strut and a posterior wall of said body.

47. The implant of 36, further comprising bone growth material in a chamber of said body, wherein said bone growth material includes one or more selected from group consisting of:

bone morphogenetic protein, transforming growth factor, insulin-like growth factor, platelet-derived growth factor, fibroblast growth factor, and LIM mineralization protein (LMP).

48. A spinal implant insertable in a spinal disc space, the implant comprising a body including:

a middle portion having opposite first and second ends;

a leading end portion extending from said first end of said middle portion;

a trailing end portion extending from said second end of said middle portion;

an upper surface and an opposite lower surface along said middle portion and said leading end portion and said trailing end portion; and

an inserter instrument engaging receptacle at a junction of said middle portion and said trailing end portion, wherein said body includes an anterior wall and a posterior wall each extending along a respective side of said middle portion, said leading end portion and said trailing end portion, said anterior wall has a generally convex profile, and said posterior wall has a generally concave profile and includes said inserter instrument engaging receptacle in said concave profile.

49. The implant of claim 48, wherein said receptacle is a groove extending between said upper surface and said lower surface.

50. The implant of claim 48, further comprising an inserter instrument engaging receptacle at a junction of said middle portion and said leading end portion.

51. The implant of claim 48, wherein said anterior wall includes a recessed area extending along said trailing end portion.

52. The implant of claim 51, wherein said anterior wall includes a second recessed area extending along said leading end portion.

53. The implant of claim 48, wherein said posterior wall has a height that is less than a height of said anterior end wall.

54. The implant of claim 48, wherein said leading end portion and said trailing end portion each define a chamber extending between said upper surface and said lower surface.

55. The implant of claim 54, wherein said middle portion defines a chamber extending between said upper surface and said lower surface.

56. The implant of claim 55, further comprising:

a first strut between said chamber of said leading end portion and said chamber of said middle portion; and

a second strut between said chamber of said trailing end portion and said chamber of said middle portion.

57. The implant of claim 56, wherein said inserter instrument engaging receptacle is formed at the junction of said second strut and a posterior wall of said body.

58. The implant of 48, further comprising bone growth material in a chamber of said body, wherein said bone growth material includes one or more selected from group consisting of:

bone morphogenetic protein, transforming growth factor, insulin-like growth factor, platelet-derived growth factor, fibroblast growth factor, and LIM mineralization protein (LMP).

59. A spinal implant insertable in a spinal disc space, the implant comprising a body including:

a middle portion having opposite first and second ends;

a leading end portion extending from said first end of said middle portion;

a trailing end portion extending from said second end of said middle portion;

an upper surface and an opposite Iowa surface along said middle portion and said leading end portion and said trailing end portion; and

an inserter instrument engaging receptacle at a junction of said middle portion and said trailing end portion, wherein said body includes an anterior wall and a posterior wall each extending along a respective side of said middle portion, said leading end portion and said trailing end portion and said anterior wall includes a recessed area extending along said trailing end portion from said receptacle, and further comprising;

a first strut between said chamber of said leading end portion and said chamber of said middle portion; and

a second strut between said chamber of said trailing end portion and said chamber of said middle portion.

60. The implant of claim 59, wherein said receptacle is a groove formed in a posterior wall of said body, said groove extending between said upper surface and said lower surface.

61. The implant of claim 59, wherein said anterior wall has a generally convex profile and said posterior wall has a generally concave profile.

62. The implant of claim 59, wherein said anterior wall includes a second recessed area extending along said leading end portion.

63. The implant of claim 59, wherein said posterior wall has a height that is less than a height of said anterior end wall.

64. The implant of claim 59, wherein said leading end portion and said trailing end portion each define a chamber extending between said upper surface and said lower surface.

65. The implant of claim 64, wherein said middle portion defines a chamber extending between said upper surface and said lower surface.

66. The implant of claim 59, wherein said inserter instrument engaging receptacle is formed at the junction of said second strut and a posterior wall of said body.

67. The implant of 59, further comprising bone growth material in a chamber of said body, wherein said bone growth material includes one or more selected from group consisting of:

bone morphogenetic protein, transforming growth factor, insulin-like growth factor, platelet-derived growth factor, fibroblast growth factor, and LIM mineralization protein (LMP).

68. A spinal implant insertable in a spinal disc space, the implant comprising a body including:

a middle portion having opposite first and second ends and having a convexly curved anterior wall and concavely curved posterior wall;

a leading end portion extending from said first end of said middle portion;

a trailing end portion extending from said second end of said middle portion;

an upper surface and an opposite lower surface along said middle portion and said leading end portion and said trailing end portion; and

an inserter instrument engaging receptacle at a junction of said middle portion and said trailing end portion in a concavely curved profile along said middle portion and said trailing end portion, wherein said posterior wall has a height that is less than a height of said anterior wall.

69. The implant of claim 68, wherein said receptacle extends between said upper surface and said lower surface.

70. The implant of claim 68, wherein said anterior wall includes an offset portion forming a change in profile of said anterior wall along said middle portion.

71. The implant of claim 68, wherein said leading end portion and said trailing end portion each define a chamber extending between said upper surface and said lower surface.

72. The implant of claim 71, wherein said middle portion defines a chamber extending between said upper surface and said Lower surface.

73. The implant of claim 72, further comprising:

a first strut between said chamber of said leading end portion and said chamber of said middle portion; and

a second strut between said chamber of said trailing end portion and said chamber of said middle portion.

74. The implant of claim 73, wherein said inserter instrument engaging receptacle is formed at the junction of said second strut and a posterior wall of said body.

75. A spinal implant insertable in a spinal disc space, the implant comprising a body having:

a leading end wall;

a trailing end wall;

a posterior wall extending between said leading end wall and said trailing end wall; and

an anterior wall extending between said leading end wall and said trailing end wall, wherein said anterior wall includes a middle portion, a trailing end portion, and a leading end portion, said middle portion being offset anteriorly from said leading end portion and said trailing end portion, wherein;

said posterior wall includes a middle portion, a leading end portion, and a trailing end portion;

said posterior wall includes an inserter instrument engaging receptacle at a junction of said middle portion and said trailing end portion thereof; and

said middle portion offset forms an abrupt change in profile of said anterior wall.

76. The implant of claim 75, further comprising:

an upper bearing surface extending between said leading end wall, said anterior wall, said posterior wall and said trailing end wall; and

an apposite lower bearing surface extending between said leading end wall, said anterior wall, said posterior wall and said trailing end wall.

77. The implant of claim 75, wherein said receptacle is a groove extending said upper surface and said lower surface.

78. The implant of claim 77, wherein said posterior wall includes an inserter instrument engaging receptacle at a junction of said middle portion and said leading end portion thereof.

79. The implant of claim 75, wherein said anterior wall has a generally convex profile and said posterior wall has a generally concave profile.

80. The implant of claim 75, wherein said anterior wall includes a first recessed area extending along said leading end portion thereof and a second recessed area extending along said trailing end portion thereof.

81. The implant of claim 75, further comprising a first chamber between a leading end portion of said posterior wall and said leading end portion of said anterior wall and a second chamber between a trailing end portion of said posterior wall and said trailing end portion of said anterior wall.

82. The implant of claim 81, further comprising a third chamber between a middle portion of said posterior wall and said middle portion of said anterior wall.

83. The implant of claim 82, further comprising:

a first strut extending from said anterior wall to said posterior wall between said first chamber and said third chamber; and

a second strut extending from said anterior wall to said posterior wall between said second chamber and said third chamber.

84. The implant of claim 83, further comprising an inserter instrument engaging receptacle in said posterior wall at the junction of said second strut and said posterior wall.

85. The implant of claim 84, further comprising a second inserter instrument engaging receptacle in said posterior wall formed at the junction of said first strut and said posterior wall.

86. A spinal implant insertable in a spinal disc space, the implant comprising a body having:

a leading end wall;

a trailing end wall;

a posterior wall extending between said leading end wall and said trailing end wall; and

an anterior wall extending between said leading end wall and said trailing end wall, wherein said anterior wall includes a middle portion, a trailing end portion, and a leading end portion, said middle portion being offset anteriorly from said leading end portion and said trailing end portion, wherein said anterior wall includes a first elongated continuous recess extending along said leading end portion thereof and a second elongated continuous recess extending along said trailing end portion thereof.

87. The implant of claim 86, further comprising:

an upper bearing surface extending between said leading end wall, said anterior wall, said posterior wall and said trailing end wall; and

an opposite lower bearing surface extending between said leading end wall, said anterior wall, said posterior wall and said trailing end wall.

88. The implant of claim 86, wherein:

said posterior wall includes a middle portion, a leading end portion, and a trailing end portion; and

said posterior wall includes an inserter instrument engaging receptacle at a junction of said middle portion and said trailing end portion thereof.

89. The implant of claim 88, wherein said receptacle is a groove extending said upper surface and said lower surface.

90. The implant of claim 88, wherein said posterior wall includes an inserter instrument engaging receptacle at a junction of said middle portion and said leading end portion thereof.

91. The implant of claim 86, wherein said anterior wall has a generally convex profile and said posterior wall has a generally concave profile.

92. The implant of claim 86, wherein said posterior wall has a height that is less than a height of said anterior wall.

93. The implant of claim 86, further comprising a first chamber between a leading end portion of said posterior wall and said leading end portion of said anterior wall and a second chamber between a trailing end portion of said posterior wall and said trailing end portion of said anterior wall.

94. The implant of claim 93, further comprising a third chamber between a middle portion of said posterior wall and said middle portion of said anterior wall.

95. The implant of claim 94, further comprising:

a first strut extending from said anterior wall to said posterior wall between said first chamber and said third chamber; and

a second strut extending from said anterior wall to said posterior wall between said second chamber and said third chamber.

96. The implant of claim 95, further comprising an inserter instrument engaging receptacle in said posterior wall at the junction of said second strut and said posterior wall.

97. The implant of claim 96, further comprising a second inserter instrument engaging receptacle in said posterior wall formed at the junction of said first strut and said posterior wall.