Impaction grafting for vertebral fusion

• US 8,323,341 B2
• Filed: 11/12/2009
• Issued: 12/04/2012
• Est. Priority Date: 09/07/2007
• Status: Active Grant

• Current Assignee: Intrinsic Therapeutics, Inc.
• Original Assignee: Intrinsic Therapeutics, Inc.
• Inventors: Lambrecht, Gregory, Einhorn, Jacob, Tarapata, Christopher, Moore, Robert Kevin, Kavanaugh, Sean
• Primary Examiner(s): Truong, Kevin T
• Assistant Examiner(s): Beccia, Christopher
• Application Number:
  US12/617,613
• Publication Number:
  US 20100114317A1
• Time in Patent Office: 1,118 Days
• Field of Search: 606/60, 606/70, 606/71, 606/74, 606/75, 606/86.A, 606246-279, 606280-299, 606300-331, 623 1711- 1716
• US Class Current: 623/17.11
• CPC Class Codes: A61B 17/0642 for bones, e.g. for osteosynthesis or connecting tendon to bone
• CPC Class Codes: A61B 17/70 Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
• CPC Class Codes: A61B 17/7056 Hooks with specially-designed bone-contacting part
• CPC Class Codes: A61B 17/809 with bone-penetrating elements, e.g. blades or prongs bone staples A61B17/0642; intramedullary nails with a plate at an end A61B17/7233
• CPC Class Codes: A61B 17/86 Pins or screws or threaded wires; nuts therefor A61B17/72 take precedence
• CPC Class Codes: A61B 2017/922 Devices for impaction, impact element
• CPC Class Codes: A61F 2/441 made of inflatable pockets or chambers filled with fluid, e.g. with hydrogel
• 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 2/447 substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section
• CPC Class Codes: A61F 2/4611 of spinal prostheses
• CPC Class Codes: A61F 2002/30062 (bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
• CPC Class Codes: A61F 2002/3008 radio-opaque, e.g. radio-opaque markers
• CPC Class Codes: A61F 2002/30133 kidney-shaped or bean-shaped
• CPC Class Codes: A61F 2002/30176 V-shaped
• CPC Class Codes: A61F 2002/30451 soldered or brazed or welded
• CPC Class Codes: A61F 2002/30461 sutured, ligatured or stitched
• 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 2002/305 Snap connection
• 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 2002/30738 : Sleeves
• CPC Class Codes: A61F 2002/30785 : parallel
• CPC Class Codes: A61F 2002/30787 : inclined obliquely with respect to each other
• CPC Class Codes: A61F 2002/30841 : Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
• CPC Class Codes: A61F 2002/3085 : with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface
• CPC Class Codes: A61F 2002/30884 : Fins or wings, e.g. longitudinal wings for preventing rotation within the bone cavity
• CPC Class Codes: A61F 2002/30892 : parallel
• CPC Class Codes: A61F 2002/30925 : etched
• CPC Class Codes: A61F 2002/3093 : for promoting ingrowth of bone tissue
• CPC Class Codes: A61F 2002/30932 : for retarding or preventing ingrowth of bone tissue
• CPC Class Codes: A61F 2002/4435 : Support means or repair of the natural disc wall, i.e. annulus, e.g. using plates, membranes or meshes
• 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 2002/4495 : having a fabric structure, e.g. made from wires or fibres
• CPC Class Codes: A61F 2210/0004 : bioabsorbable
• CPC Class Codes: A61F 2220/0025 : Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2220/0058 : soldered or brazed or welded
• 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 2230/0015 : Kidney-shaped, e.g. bean-shaped
• CPC Class Codes: A61F 2230/0054 : V-shaped
• 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: A61F 2310/00029 : Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
• CPC Class Codes: A61F 2310/00407 : Coating made of titanium or of Ti-based alloys
• CPC Class Codes: A61F 2310/00796 : Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite
• CPC Class Codes: A61F 2310/00976 : Coating or prosthesis-covering structure made of proteins or of polypeptides, e.g. of bone morphogenic proteins BMP or of transforming growth factors TGF

Abstract

Methods of providing graft impaction using anchored implants are disclosed. In some embodiments, the graft impaction provided by the anchored implants can facilitate surgical spinal fusion procedures. The anchored implants provide increased strength and increased pull-out resistance. The anchored implants can be used in conjunction with various surgical vertebral fusion approaches or techniques, such as anterior, posterior, transforaminal, and/or extreme lateral interbody fusion.

Claims

1. A method of impaction grafting to facilitate interbody fusion between adjacent vertebral bodies, the method comprising:

providing an anchored implant comprising a bone anchoring member and a graft engagement member, wherein the graft engagement member is directly coupled to the bone anchoring member;

providing bone graft material;

accessing a disc space between adjacent vertebral bodies;

inserting the bone graft material within the disc space;

driving said bone anchoring member into an outer surface of at least one of the adjacent vertebral bodies along a direction of access;

impacting said inserted bone graft material;

displacing said inserted bone graft material further into the disc space with the graft engagement member; and

recessing the bone anchoring member within said outer surface of said at least one adjacent vertebral body such that no portion of the bone anchoring member lies beyond said outer surface.

2. The method of claim 1, further comprising removing at least a portion of an intervertebral disc within the disc space.

3. The method of claim 2, wherein removing at least a portion of an intervertebral disc within the disc space comprises removing a portion of the anulus fibrosus.

4. The method of claim 2, wherein removing at least a portion of an intervertebral disc within the disc space comprises removing a portion of the nucleus pulposus.

5. The method of claim 1, further comprising inserting a fusion cage within the disc space.

6. The method of claim 5, wherein compacting said inserted bone graft material comprises compacting said inserted bone graft material against said fusion cage.

7. The method of claim 1, further comprising applying continuous force to the inserted graft material.

8. The method of claim 1, wherein the bone graft material comprises autograft or allograft material.

9. The method of claim 1, wherein the bone graft material comprises xenograft material.

10. The method of claim 1, wherein the bone graft material comprises synthetic material.

11. The method of claim 1, wherein accessing the disc space comprises penetrating an anulus fibrosus of the intervertebral disc and forming a hole through the anulus fibrosus.

12. The method of claim 1, wherein driving said bone anchoring member into an outer surface of at least one of the adjacent vertebral bodies comprises driving said bone anchoring member into the outer surface at an angle substantially parallel to the endplate surfaces of the adjacent vertebral bodies.

13. The method of claim 1, wherein recessing the bone anchoring member within said outer surface of said at least one adjacent vertebral body comprises recessing the bone anchoring member such that a trailing end of the bone anchoring member is recessed greater than 1 mm within the outer surface of said at least one adjacent vertebral body.

14. The method of claim 1, wherein accessing a disc space between adjacent vertebral bodies comprises accessing the disc space using a posterior lumbar interfusion approach.

15. The method of claim 1, wherein accessing a disc space between adjacent vertebral bodies comprises accessing the disc space using a transforaminal lumbar interfusion approach.

16. The method of claim 1, wherein accessing a disc space between adjacent vertebral bodies comprises accessing the disc space using an anterior lumbar interfusion approach.

17. The method of claim 1, wherein accessing a disc space between adjacent vertebral bodies comprises accessing the disc space using an extreme lateral interfusion approach.

18. The method of claim 1, wherein the adjacent vertebral bodies comprise vertebral bodies of two adjacent lumbar, thoracic, or cervical vertebrae.

19. The method of claim 1, further comprising identifying a weakened or affected intervertebral disc.

20. The method of claim 1, further comprising augmenting a diseased vertebral endplate surface caused by said accessing the disc space.

21. The method of claim 1, wherein the graft engagement member is integrally coupled to the bone anchoring member.

22. The method of claim 1, wherein the graft engagement member is removably coupled to the bone anchoring member.