Devices and techniques for a posterior lateral disc space approach
First Claim
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1. A spinal implant insertion assembly, comprising:
- an inserter including a shaft having a proximal handle portion extending along a first longitudinal axis and a distal portion including a connecting portion for engagement with a spinal implant, said connecting portion extending along a second longitudinal axis obliquely oriented to said first longitudinal axis, said shaft further including a lateral offset portion extending between said connecting portion and said proximal handle portion of said shaft proximally of said connecting portion, said lateral offset portion being obliquely oriented to said proximal handle portion of said shaft;
a pusher including a distal end engaged with said shaft at a position proximal to where said lateral offset portion is obliquely oriented to said proximal handle portion and where said shaft lies on said first longitudinal axis and said pusher extends from said shaft toward said proximal handle portion of said inserter along a second shaft to a second proximal handle portion; and
a spinal implant having an insertion tool engaging portion, wherein said implant defines a shape in a plane generally parallel to opposing vertebral endplates, wherein said shape includes an elongated convexly curved outer wall and an opposite elongated concavely curved outer wall and opposite convexly curved outer end walls at opposite ends of said spinal implant extending between and connecting said convexly curved outer wall and said concavely curved outer wall and said insertion tool engaging portion of said spinal implant lies on one of said convexly curved outer end walls of said spinal implant, wherein said inserter engages said insertion tool engaging portion of said spinal implant so that said elongated concavely and convexly curved outer walls of said spinal implant extend distally from said inserter to the other of said convexly curved outer end walls.
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Abstract
This invention relates to methods and instruments for performing disc space preparation and implant insertion from a unilateral approach to the spine through a posterior lateral opening to the disc space. The instruments include spreaders, distractors, reamers, scrapers, cutters, chisels, rasps, pushers and implant inserters. A surgical procedure is provided that allows bilateral support of the adjacent vertebrae with at least one interbody fusion device inserted into the disc space via a unilateral approach. Implants for insertion into the disc space are also provided.
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Citations
22 Claims
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1. A spinal implant insertion assembly, comprising:
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an inserter including a shaft having a proximal handle portion extending along a first longitudinal axis and a distal portion including a connecting portion for engagement with a spinal implant, said connecting portion extending along a second longitudinal axis obliquely oriented to said first longitudinal axis, said shaft further including a lateral offset portion extending between said connecting portion and said proximal handle portion of said shaft proximally of said connecting portion, said lateral offset portion being obliquely oriented to said proximal handle portion of said shaft; a pusher including a distal end engaged with said shaft at a position proximal to where said lateral offset portion is obliquely oriented to said proximal handle portion and where said shaft lies on said first longitudinal axis and said pusher extends from said shaft toward said proximal handle portion of said inserter along a second shaft to a second proximal handle portion; and a spinal implant having an insertion tool engaging portion, wherein said implant defines a shape in a plane generally parallel to opposing vertebral endplates, wherein said shape includes an elongated convexly curved outer wall and an opposite elongated concavely curved outer wall and opposite convexly curved outer end walls at opposite ends of said spinal implant extending between and connecting said convexly curved outer wall and said concavely curved outer wall and said insertion tool engaging portion of said spinal implant lies on one of said convexly curved outer end walls of said spinal implant, wherein said inserter engages said insertion tool engaging portion of said spinal implant so that said elongated concavely and convexly curved outer walls of said spinal implant extend distally from said inserter to the other of said convexly curved outer end walls. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11)
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12. An assembly for non-linear insertion of an implant in an intradiscal space, comprising:
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a spinal implant having an insertion tool engaging portion, wherein said spinal implant defines a shape in a plane generally parallel to opposing vertebral endplates, wherein said shape includes an elongated convexly curved outer wall and an opposite elongated concavely curved outer wall and opposite convexly curved outer end walls at opposite ends of said spinal implant extending between and connecting said convexly curved outer wall to said concavely curved outer wall and said insertion tool engaging portion of said spinal implant lies on one of said convexly curved outer end walls of said spinal implant; an inserter connectable to said spinal implant, said inserter including; an elongated shaft having an impaction tool engaging portion adjacent a distal end of said shaft, said shaft extending along a longitudinal axis proximally from said impaction tool engaging portion; a handle at the proximal end of said shaft; an implant connector at the distal end of said shaft and including a proximal end engageable for rotating said connector within said shaft for engaging a distal end of said implant connector to said insertion tool engaging portion of said spinal implant so that said elongated concavely and convexly curved outer walls of said spinal implant extend distally from said inserter to the other of said convexly curved outer end walls; and a pusher including a second shaft with a distal end removably mating with said elongate shaft of said inserter at a portion of said elongate shaft lying on said longitudinal axis with said second shaft extending proximally from said portion of said shaft toward said handle of said inserter to a second proximal handle of said pusher. - View Dependent Claims (13, 14, 15, 16, 17)
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18. A spinal implant insertion assembly, comprising:
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an inserter including a shaft having a proximal handle portion and a distal portion including a connecting portion for engagement with a spinal implant, said inserter further including a lateral offset portion extending between said proximal handle portion and said connecting portion, said lateral offset portion forming an angle with said proximal handle portion, said distal portion further including a straight portion extending from said lateral offset portion, said straight portion being offset a distance from said proximal handle portion, wherein said connecting portion rotates in said straight portion and includes a proximal end extending from a proximal end of said straight portion and an opposite distal protrusion extending distally from a distal end of said straight portion; a pusher including a second distal end portion engaged to said inserter adjacent said distal portion of said inserter and extending on a first side of said inserter and away from said inserter along a second shaft having a second proximal handle portion; a driver extending along a third shaft on a second side of said shaft of said inserter opposite said first side, said driver including a first end removably engageable to said proximal end of said connecting portion; and a spinal implant having an insertion tool engaging portion to the spinal implant, wherein said implant defines a shape in a plane generally parallel to opposing vertebral endplates, wherein said shape includes an elongated convexly curved outer wall and an opposite elongated concavely curved outer wall and convexly curved outer end walls at opposite ends of said spinal implant extending between and connecting said convexly curved outer wall to said concavely curved outer wall and said insertion tool engaging portion of said spinal implant lies on one of said convexly curved outer end walls of said spinal implant, wherein said driver is operable to rotate said connecting portion in said straight portion to engage said distal protrusion to said insertion tool engaging portion of said spinal implant so that said elongated concavely and convexly curved outer walls of said spinal implant extend distally from said inserter to the other of said convexly curved outer end walls. - View Dependent Claims (19, 20, 21, 22)
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Specification