Devices and techniques for a posterior lateral disc space approach

• US 7,967,863 B2
• Filed: 12/12/2008
• Issued: 06/28/2011
• Est. Priority Date: 10/21/1999
• Status: Expired due to Fees

• Current Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Original Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Inventors: Josse, Loic, Liu, Mingyan, Boyd, Lawrence M., Frey, George
• Primary Examiner(s): Philogene; Pedro
• Application Number:
  US12/316,400
• Publication Number:
  US 20090105836A1
• Time in Patent Office: 928 Days
• Field of Search: 623 1711- 1716, 606/246, 606/279
• US Class Current: 623/17.11
• 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 adapted for non-linear insertion in an intradiscal space, comprising:

a leading end wall;

a trailing end wall opposite said leading end wall having an insertion tool engaging portion;

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

an anterior wall extending between and convexly curved from said leading end wall to said trailing end wall;

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

an opposite lower bearing member extending between and connected to said leading end wall, said anterior wall, said posterior wall and said trailing end wall, said lower bearing member defining a lower bearing surface;

at least one strut on said upper bearing surface and at least one strut on said lower bearing surface, each of said at least one struts connecting said posterior wall to said anterior wall,

wherein said posterior wall has a height from said upper bearing surface to said lower bearing surface that is less than the height of said anterior wall from said upper bearing surface to said lower bearing surface.

2. The implant of claim 1, wherein said trailing end wall and said leading end wall each have a height from said upper bearing surface to said lower bearing surface that is less than the height of both said anterior wall and said posterior wall from said upper bearing surface to said lower bearing surface.

3. The implant of claim 1, wherein said leading end wall and said trailing end wall have the same height from said upper bearing surface to said lower bearing surface.

4. The implant of claim 1, wherein said upper bearing member and said lower bearing member each include a cantilevered portion extending beyond said anterior wall.

5. The implant of claim 4, wherein said anterior wall includes a first anterior lateral opening adjacent said leading end wall and a second anterior lateral opening adjacent said trailing end wall.

6. The implant of claim 5, wherein:

said first anterior lateral opening is defined between a first vertical strut, said leading end wall and said upper and lower bearing members;

said second anterior lateral opening is defined between a second vertical strut, said trailing end wall and said upper and lower bearing members; and

said anterior wall further including a middle opening defined between said first strut, said second strut, and said upper and lower bearing members.

7. The implant of claim 1, wherein said leading end wall includes an insertion tool engaging portion.

8. The implant of claim 1, wherein said insertion tool engaging portion is an internally threaded hole formed through said trailing end wall.

9. The implant of claim 1, wherein:

said upper bearing member defines a pair of openings on either side of said at least one strut on said upper bearing surface; and

said lower bearing member defines a pair of openings on either side of said at least one strut on said lower bearing surface.

10. The implant of claim 1 wherein:

said upper bearing member includes a number of grooves formed in said upper bearing surface thereof; and

said lower bearing member includes a number of grooves formed in said lower bearing surface thereof.

11. The implant of claim 1, wherein the implant has a center axis extending generally in the direction between said leading end wall and said trailing end wall, said posterior wall and said anterior wall being positioned on opposite sides of said center axis, wherein said trailing end wall and said leading end wall each have a height from said upper bearing surface to said lower bearing surface that is less than the height of both said anterior wall and said posterior wall from said upper bearing surface to said lower bearing surface, and said anterior wall has a height greater than a height of said posterior wall from said upper bearing surface to said lower bearing surface.

12. A spinal implant adapted for non-linear insertion in an intradiscal space, comprising:

a leading end wall;

a trailing end wall including an engaging tool engaging portion;

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;

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

an opposite lower bearing member extending between said leading end wall, said anterior wall, said posterior wall and said trailing end wall, wherein the implant has a center axis extending generally in the direction between said leading end wall and said trailing end wall, said posterior wall and said anterior wall being positioned on opposite sides of said center axis, wherein said leading end wall and said trailing end wall are each offset from said center axis in the direction of said posterior wall, and further wherein said upper bearing member and said lower bearing member are each convexly curved in a direction extending from said anterior wall to said posterior wall.

13. The implant of claim 12, wherein said upper bearing member and said lower bearing member each include a cantilevered portion along said anterior wall.

14. The implant of claim 12, wherein said trailing end wall and said leading end wall each have a height that is less than the height of both said anterior wall and said posterior wall.

15. The implant of claim 12, wherein:

at least one strut of said upper bearing member defines at least a portion of an upper bearing surface and at least one strut of said lower bearing member defines at least a portion of a lower bearing surface each of said at least one struts connectin said osterior wall to said anterior wall; and

said posterior wall has a height from said upper bearing surface to said lower bearing surface that is less than the height of said anterior wall from said upper bearing surface to said lower bearing surface.

16. The implant of claim 12, wherein said leading end wall and said trailing end wall have the same height.

17. The implant of claim 12, wherein:

said posterior wall is concavely curved from said leading end wall to said trailing end wall; and

said anterior wall is concavely curved from said leading end wall to said trailing end wall.

18. The implant of claim 17, wherein said upper bearing member and said lower bearing member are each convexly curved in a direction extending from said leading end wall to said trailing end wall, said convex curvature of said upper and lower bearing members fitting with concavity of vertebral endplates adjacent the intradiscal space.