Method of maintaining distraction of a spinal disc space

• US 7,722,619 B2
• Filed: 04/25/2006
• Issued: 05/25/2010
• 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:
  US11/410,634
• Publication Number:
  US 20060200164A1
• Time in Patent Office: 1,491 Days
• Field of Search: 606/90, 606/105, 623/17.11, 623/17.16
• US Class Current: 606/90
• 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 of maintaining distraction of a spinal disc space, the method comprising:

exposing a portion of the spine at the disc space;

distracting the disc space to a desired height with a first distractor;

selecting second and third distractors each having an extension and a shaft connected to the extension, the extensions each having a height between a top surface and a bottom surface that corresponds to the distracted disc space height, the extensions each further having a length extending between a leading end and a trailing end thereof;

inserting the extension of one of the second and third distractors into the disc space through the first distractor;

removing the one of the second and third distractors from the disc space through the first distractor; and

performing subsequent procedures in the disc space.

2. The method according to claim 1, wherein the selecting the second and third distractors act further comprises selecting the second and third distractors with the extension lengths are sized to correspond to the depth of the disc space.

3. The method according to claim 1, wherein the height to width ratio of each of the extensions is greater than about three.

4. The method according to claim 1, wherein the performing subsequent procedures in the disc space act further comprises forming, through the first distractor, an opening across at least a portion of the disc space.

5. The method according to claim 4, wherein the forming act comprises milling the opening.

6. The method according to claim 4, wherein the forming act comprises drilling the opening.

7. The method according to claim 6, wherein the forming act further comprises placing a drill having a diameter greater than the height of the disc space through the first distractor prior to the act of drilling.

8. The method according to claim 6, wherein the forming act further comprises placing a drill through the first distractor prior to the act of drilling.

9. The method according to claim 8, wherein the performing subsequent procedures in the disc space act further comprises removing the drill from the disc space after the forming act is complete.

10. The method according to claim 4, further comprising inserting an implant into the opening.

11. The method according to claim 10, wherein the inserting an implant act comprises attaching a driving member to the implant, and using the driving member to insert the implant into the opening through the first distractor.

12. The method according to claim 11, further comprising removing the driving member from the implant after the inserting an implant act.

13. The method according to claim 12, wherein the driving member is removed through the first distractor after the inserting an implant act.

14. The method according to claim 13, further comprising removing the first distractor from the disc space after the inserting an implant act.

15. The method according to claim 10, further comprising loading the implant with fusion promoting material prior to the inserting an implant act.

16. The method according to claim 15, wherein the fusion promoting material includes bone.

17. The method according to claim 4, wherein the forming an opening act comprises removing bone from at least a portion of each vertebral body adjacent the disc space.

18. The method according to claim 17, wherein the bone is removed from each of the adjacent vertebral bodies simultaneously.

19. The method according to claim 18, further comprising removing a portion of each adjacent vertebral body through the first distractor.