Methods for distraction of a disc space

• US 7,686,805 B2
• Filed: 07/01/2004
• Issued: 03/30/2010
• Est. Priority Date: 06/13/1988
• Status: Expired due to Fees

• Current Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Original Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Inventors: Michelson, Gary Karlin
• Primary Examiner(s): Brown; Michael A.
• Application Number:
  US10/883,382
• Publication Number:
  US 20040236331A1
• Time in Patent Office: 2,098 Days
• Field of Search: 606 60- 61, 606/53, 606246-248, 623/16.1, 623/17.1, 623/17.3
• US Class Current: 606/53
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/1655 for tapping
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 17/32 Surgical cutting instruments A61B18/042 takes precedence; suture cutters A61B17/0467; instruments for ligaturing or cutting A61B17/128; instruments for rupturing the amniotic membrane A61B17/4208; specially adapted knives for eye surgery A61F9/0133
• CPC Class Codes: A61B 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• 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: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2017/922 Devices for impaction, impact element
• CPC Class Codes: A61B 2090/036 abutting on tissue or skin
• 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 2/4603 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 2002/30143 hexagonal
• CPC Class Codes: A61F 2002/30224 cylindrical
• CPC Class Codes: A61F 2002/30235 tubular, e.g. sleeves
• CPC Class Codes: A61F 2002/30405 : made by screwing complementary threads machined on the parts themselves
• CPC Class Codes: A61F 2002/30426 : Bayonet coupling
• CPC Class Codes: A61F 2002/30593 : hollow
• CPC Class Codes: A61F 2002/30774 : internally-threaded
• 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 2002/30836 : knurled
• CPC Class Codes: A61F 2002/3085 : with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface
• CPC Class Codes: A61F 2002/30904 : serrated profile, i.e. saw-toothed
• 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 2002/4619 : for extraction
• 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 2002/4629 : connected to the endoprosthesis or implant via a threaded connection
• CPC Class Codes: A61F 2002/4649 : Bone graft or bone dowel harvest sites
• CPC Class Codes: A61F 2002/4681 : by applying mechanical shocks, e.g. by hammering
• 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 2230/0017 : Angular shapes
• CPC Class Codes: A61F 2230/0069 : cylindrical

Abstract

Apparatus and a method of inserting spinal implants is disclosed in which an intervertebral space is first distracted, a hollow sleeve having teeth at one end is then driven into the vertebrae adjacent that disc space. A drill is then passed through the hollow sleeve removing disc and bone in preparation for receiving the spinal implant which is then inserted through the sleeve. Apparatus and a method of inserting spinal implants is disclosed in which an intervertebral space is first distracted to restore the normal angular relationship of the vertebrae adjacent to that disc space. An extended outer sleeve having extended portions capable of maintaining the vertebrae distracted in their normal angular relationship is then driven into the vertebrae adjacent that disc space. A drill is then passed through the hollow sleeve removing disc and bone in preparation for receiving the spinal implant which is then inserted through the sleeve.

Claims

1. A method for distracting a spinal disc space between endplates of adjacent vertebral bodies, the method comprising:

inserting a first distractor in the spinal disc space to contact both of the end plates of the adjacent vertebral bodies;

inserting a second distractor in the spinal disc space to contact both of the endplates of the adjacent vertebral bodies;

maintaining a spacing between the first distractor and the second distractor during relative movement of the first distractor and the second distractor with a guide surface positioned between the first and second distractors; and

engaging a guard into the adjacent vertebral bodies, the guard having a passage adapted to provide protected access to the adjacent vertebral bodies.

2. The method of claim 1 wherein the first and second distractors each have a central axis extending therethrough when in side-by side relation and the guide surface is offset from the central axes of the first and second distractors.

3. The method of claim 1, wherein inserting the first distractor and inserting the second distractor distracts the disc space to a desired disc space height.

4. The method of claim 1, further comprising anchoring at least one of the first and second distractors to an adjacent vertebrae.

5. The method of claim 1, further comprising:

removing one of the first and second distractors; and

guiding insertion of at least one implant into a distraction channel formed in the spinal disc space after withdrawal of the one of the first and second distractors.

6. The method of claim 5, further comprising the step of combining the implant with a fusion promoting substance.

7. The method of claim 6, wherein the fusion promoting substance includes bone.

8. The method of claim 1, wherein the guide surface includes a concave shape.

9. The method of claim 1, wherein the steps of inserting the first and second distractors include inducing angulation to the adjacent vertebral bodies relative to one another.

10. The method of claim 9, wherein the inducing angulation step includes the step of restoring lordosis to the spine.

11. The method of claim 9, wherein the inducing angulation step includes the step of restoring kyphosis to the spine.

12. The method of claim 1, further comprising the step of removing bone from at least a portion of each of the adjacent vertebral bodies.

13. The method of claim 12, wherein the bone is removed from each of the adjacent vertebral bodies simultaneously.

14. The method of claim 1, further comprising the step of utilizing an endoscope during said method.

15. The method of claim 1, further comprising the step of utilizing a radiographic imaging device during said method.

16. A method for distracting a spinal disc space between endplates of adjacent vertebral bodies, the method comprising:

inserting a first distractor in the spinal disc space to contact both of the endplates of the adjacent vertebral bodies;

inserting a second distractor in the spinal disc space to contact both of the endplates of the adjacent vertebral bodies;

maintaining a spacing between the first distractor and the second distractor during relative movement of the first distractor and the second distractor with a guide surface positioned between the first and second distractors; and

sliding each distractor through a guard having a passage adapted to provide protected access to the adjacent vertebral bodies.

17. The method of claim 16, further comprising the step of withdrawing the first and second distractors from the guard while the guard is engaged to the spine.

18. The method of claim 17, further comprising the step of removing a portion of each adjacent vertebral body through the guard after at least one of the first and second distractors has been withdrawn.