Method of insertion of an expandable intervertebral implant

• US 8,257,440 B2
• Filed: 05/20/2005
• Issued: 09/04/2012
• Est. Priority Date: 08/05/2003
• Status: Active Grant

• Current Assignee: Flexuspine Incorporated
• Original Assignee: Flexuspine Incorporated
• Inventors: Gordon, Charles R., Harbold, Corey T., Hanson, Heather S.
• Primary Examiner(s): Robert, Eduardo C
• Assistant Examiner(s): HARVEY, JULIANNA NANCY
• Application Number:
  US11/134,091
• Publication Number:
  US 20050283244A1
• Time in Patent Office: 2,664 Days
• Field of Search: 623 1711- 1716, 606/279
• US Class Current: 623/17.15
• CPC Class Codes: A61B 17/7005 Parts of the longitudinal elements, e.g. their ends, being specially adapted to fit in the screw or hook heads
• CPC Class Codes: A61B 17/7007 Parts of the longitudinal elements, e.g. their ends, being specially adapted to fit around the screw or hook heads
• CPC Class Codes: A61B 17/7008 with parts of, or attached to, the longitudinal elements, bearing against an outside of the screw or hook heads, e.g. nuts on threaded rods A61B17/7007 takes precedence
• CPC Class Codes: A61B 17/701 Longitudinal elements with a non-circular, e.g. rectangular, cross-section A61B17/7005, A61B17/7007 take precedence
• CPC Class Codes: A61B 17/7023 with a pivot joint
• CPC Class Codes: A61B 17/7032 Screws or hooks with U-shaped head or back through which longitudinal rods pass
• CPC Class Codes: A61B 17/7037 wherein pivoting is blocked when the rod is clamped
• CPC Class Codes: A61B 17/7064 Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor
• CPC Class Codes: A61B 17/80 Cortical plates , i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
• CPC Class Codes: A61B 17/86 Pins or screws or threaded wires; nuts therefor A61B17/72 take precedence
• CPC Class Codes: A61F 2/30767 Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
• CPC Class Codes: A61F 2/4405 for apophyseal or facet joints, i.e. between adjacent spinous or transverse processes devices implanted between spinous or transverse processes A61B17/7062
• CPC Class Codes: A61F 2/4425 made of articulated components
• 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 2/4611 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 2002/30092 using shape memory or superelastic materials, e.g. nitinol
• CPC Class Codes: A61F 2002/30131 horseshoe- or crescent- or C-shaped or U-shaped
• CPC Class Codes: A61F 2002/30133 kidney-shaped or bean-shaped
• CPC Class Codes: A61F 2002/30225 Flat cylinders, i.e. discs
• CPC Class Codes: A61F 2002/3023 : wedge-shaped cylinders
• CPC Class Codes: A61F 2002/30235 : tubular, e.g. sleeves
• CPC Class Codes: A61F 2002/30331 : made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
• CPC Class Codes: A61F 2002/30365 : with additional means for limiting said rotation
• CPC Class Codes: A61F 2002/30369 : Limited lateral translation of the protrusion within a larger recess
• CPC Class Codes: A61F 2002/30383 : made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
• CPC Class Codes: A61F 2002/30462 : retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2002/30471 : connected by a hinged linkage mechanism, e.g. of the single-bar or multi-bar linkage type
• CPC Class Codes: A61F 2002/30476 : locked by an additional locking mechanism
• CPC Class Codes: A61F 2002/30492 : using a locking pin
• CPC Class Codes: A61F 2002/305 : Snap connection
• CPC Class Codes: A61F 2002/30505 : spring biased
• CPC Class Codes: A61F 2002/30507 : using a threaded locking member, e.g. a locking screw or a set screw
• CPC Class Codes: A61F 2002/30515 : using a locking wedge or block
• CPC Class Codes: A61F 2002/3052 : unrestrained in only one direction, e.g. moving unidirectionally
• CPC Class Codes: A61F 2002/30538 : for adjusting angular orientation
• CPC Class Codes: A61F 2002/3055 : for adjusting length
• CPC Class Codes: A61F 2002/30556 : for adjusting thickness
• CPC Class Codes: A61F 2002/30563 : having elastic means or damping means, different from springs, e.g. including an elastomeric core or shock absorbers
• CPC Class Codes: A61F 2002/30565 : having spring elements
• CPC Class Codes: A61F 2002/30578 : having apertures, e.g. for receiving fixation screws
• CPC Class Codes: A61F 2002/30579 : with mechanically expandable devices, e.g. fixation devices
• CPC Class Codes: A61F 2002/30601 : telescopic
• CPC Class Codes: A61F 2002/30624 : Hinged joint, e.g. with transverse axle restricting the movement
• CPC Class Codes: A61F 2002/30649 : Ball-and-socket joints
• CPC Class Codes: A61F 2002/30662 : with rotation-limiting means
• CPC Class Codes: A61F 2002/30772 : Apertures or holes, e.g. of circular cross section
• CPC Class Codes: A61F 2002/30785 : parallel
• CPC Class Codes: A61F 2002/3079 : Stepped or enlarged apertures, e.g. having discrete diameter changes
• CPC Class Codes: A61F 2002/30841 : Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
• CPC Class Codes: A61F 2002/30904 : serrated profile, i.e. saw-toothed
• CPC Class Codes: A61F 2002/443 : having two transversal endplates and at least one intermediate component
• CPC Class Codes: A61F 2002/4622 : having the shape of a forceps or a clamp
• 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 2002/4628 : with linear motion along or rotating motion about an axis transverse to the instrument axis or to the implantation direction, e.g. clamping
• CPC Class Codes: A61F 2002/4629 : connected to the endoprosthesis or implant via a threaded connection
• CPC Class Codes: A61F 2210/0014 : using shape memory or superelastic materials, e.g. nitinol
• CPC Class Codes: A61F 2220/0025 : Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2220/0033 : made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
• CPC Class Codes: A61F 2220/0075 : sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2220/0091 : connected by a hinged linkage mechanism, e.g. of the single-bar or multi-bar linkage type
• CPC Class Codes: A61F 2230/0013 : Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped
• CPC Class Codes: A61F 2230/0015 : Kidney-shaped, e.g. bean-shaped
• CPC Class Codes: A61F 2230/0069 : cylindrical
• CPC Class Codes: A61F 2250/0006 : for adjusting angular orientation
• CPC Class Codes: A61F 2250/0009 : for adjusting thickness
• CPC Class Codes: A61F 2310/00023 : Titanium or titanium-based alloys, e.g. Ti-Ni alloys

Abstract

A method of inserting an intervertebral implant between vertebrae in a human spine includes positioning the intervertebral implant in a closed configuration between the vertebrae. After positioning the intervertebral implant, the intervertebral implant is activated to increase a height of the intervertebral implant. After activation, at least a portion of the increased height of the intervertebral implant is maintained.

Claims

1. A method of inserting an intervertebral implant between vertebrae in a human spine, comprising:

positioning an intervertebral implant between the vertebrae, wherein the intervertebral implant comprises a first member having a substantially planar first surface configured to couple to a first vertebra, a second member having a substantially planar second surface configured to couple to a second vertebra, and an insert positioned between the first member and the second member;

linearly advancing a third member in a direction substantially parallel with the substantially planar first or second surface of the first or second members such that the third member engages and moves the insert between the first member and the second member to increase a distance between the first member and the second member, thereby increasing a height of the intervertebral implant, wherein the height of the intervertebral implant comprises a distance between the substantially planar first surface and the substantially planar second surface, wherein linearly advancing the third member raises a portion of the intervertebral implant through an opening in the second member such that a second vertebra is supported on a contact surface of the portion of the intervertebral implant raised through the opening in the second member; and

maintaining at least a portion of the increased height of the intervertebral implant.

2. The method of claim 1, wherein linearly advancing the third member raises the second member relative to the first member and wherein a second vertebra is supported on a contact surface of the second member.

3. The method of claim 1, further comprising inhibiting backout of the third member from the intervertebral implant.

4. The method of claim 1, further comprising inhibiting backout of the third member from the intervertebral implant by positioning the at least a portion of the third member beyond a protrusion of the first member.

5. The method of claim 1, further comprising coupling the third member to a tool, using the tool to place the third member between the first member and the insert.

6. A method of inserting an intervertebral implant between vertebrae in a human spine, comprising:

positioning an intervertebral implant between the vertebrae, wherein the intervertebral implant comprises a first member configured to couple to a first vertebra, a second member configured to couple to a second vertebra and having at least one cam surface, and an insert positioned between the first member and the second member, the insert comprising a cylindrical cam having at least one radial projection configured to engage a cam surface of the second member, wherein the first member comprises a post, and wherein the post is positioned in a central opening of the insert to allow rotation of the insert and inhibit translational movement of the insert away from the post;

linearly advancing a third member into engagement with the radial projection to rotate the insert such that the projection travels along a cam surface of the second member to raise the second member relative to the first member and increase a height of the intervertebral implant; and

maintaining at least a portion of the increased height of the intervertebral implant.

7. The method of claim 6, wherein the third member comprises a screw.

8. The method of claim 6, further comprising coupling a tool to the third member, and rotating at least a portion of the tool to advance the third member.

9. The method of claim 6, further comprising using stabilizers extending between the first member and the second member to limit the separation distance allowed by advancing the third member.

10. The method of claim 6, further comprising inserting a spacer between an upper body and a lower body of the intervertebral implant.

11. The method of claim 6, wherein maintaining at least a portion of the increased height of the intervertebral implant comprises substantially preventing a reduction in height of the intervertebral implant by inhibiting rotation of the insert via a force provided by the third member.

12. The method of claim 6, further comprising inhibiting backout of the third member from the intervertebral implant.

13. A method of inserting an intervertebral implant between vertebrae in a human spine, comprising:

positioning an intervertebral implant between the vertebrae, wherein the intervertebral implant comprises a first member having a substantially planar first surface configured to couple to a first vertebra, a second member having a substantially planar second surface configured to couple to a second vertebra, and an insert positioned between the first member and the second member;

linearly advancing a third member in a direction substantially parallel with the substantially planar first or second surface of the first or second members such that the third member engages and moves the insert between the first member and the second member to increase a distance between the first member and the second member, thereby increasing a height of the intervertebral implant, wherein the height of the intervertebral implant comprises a distance between the substantially planar first surface and the substantially planar second surface, wherein linearly advancing the third member raises a portion of the intervertebral implant through an opening in the second member such that a second vertebra is supported on a contact surface of the portion of the intervertebral implant raised through the opening in the second member, and wherein linearly advancing the third member raises the second member relative to the first member and wherein a second vertebra is supported on a contact surface of the second member;

inhibiting backout of the third member from the intervertebral implant; and

maintaining at least a portion of the increased height of the intervertebral implant.

14. The method of claim 13, further comprising inhibiting backout of the third member from the intervertebral implant by positioning the at least a portion of the third member beyond a protrusion of the first member.

15. The method of claim 13, further comprising coupling the third member to a tool, using the tool to place the third member between the first member and the insert.