Apparatus and method of spinal implant and fusion

• US 8,366,748 B2
• Filed: 12/07/2009
• Issued: 02/05/2013
• Est. Priority Date: 12/05/2008
• Status: Active Grant

• Current Assignee: Jeffrey Kleiner
• Original Assignee: Jeffrey Kleiner
• Inventors: Kleiner, Jeffrey
• Primary Examiner(s): Stewart, Alvin
• Assistant Examiner(s): COMSTOCK, DAVID C
• Application Number:
  US12/632,720
• Publication Number:
  US 20100145391A1
• Time in Patent Office: 1,156 Days
• Field of Search: 606/60, 606/246, 606/279, 606/301, 606/304, 606/306, 606/75, 606/323, 606/331, 606/77, 606/78, 606/99, 606/104, 606/86.A, 623/17.11, 623/17.16
• US Class Current: 606/279
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/0642 for bones, e.g. for osteosynthesis or connecting tendon to bone
• 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 17/1757 for the spine
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/7064 Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor
• CPC Class Codes: A61B 17/7076 for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation
• CPC Class Codes: A61B 17/7082 for driving, i.e. rotating, screws or screw parts specially adapted for spinal fixation, e.g. for driving polyaxial or tulip-headed screws driving other bone screws A61B17/8875
• CPC Class Codes: A61B 17/846 Nails or pins, i.e. anchors without movable parts, holding by friction only, with or without structured surface A61B17/72, A61B17/86 take precedence
• CPC Class Codes: A61B 17/864 hollow, e.g. with socket or cannulated
• CPC Class Codes: A61B 2017/00004 (bio)absorbable, (bio)resorbable, resorptive for implantable prostheses A61F2210/0004
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2017/3433 with different outer diameters of the cannula
• CPC Class Codes: A61B 2017/922 Devices for impaction, impact element
• CPC Class Codes: A61F 2/30724 Spacers for centering an implant in a bone cavity, e.g. in a cement-receiving cavity
• 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 2/4455 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 2002/30622 Implant for fusing a joint or bone material
• CPC Class Codes: A61F 2002/30754 : Implants for interposition between two natural articular surfaces
• CPC Class Codes: A61F 2220/0016 : with sharp anchoring protrusions, e.g. barbs, pins, spikes
• CPC Class Codes: A61L 24/046 : obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds A61L24/043 takes precedence
• CPC Class Codes: A61L 24/12 : Ionomer cements, e.g. glass-ionomer cements A61L24/043 takes precedence
• CPC Class Codes: A61L 2400/06 : Flowable or injectable implant compositions
• CPC Class Codes: A61L 27/54 : Biologically active materials, e.g. therapeutic substances A61L27/227 takes precedence

Abstract

An apparatus and method of performing a minimally invasive posterior spine fusion. More specifically an apparatus with a handle and a forked head on the distal end of the handle is used to grasp implant material and introduce the material to an implant site. The shaft of the apparatus is shaped so as to allow the affixation of a drill guide and drill while simultaneously holding the implant material in the implant site. After removal of the boring tools and assembly of the fusing element, the apparatus can be selectively removed from the implant site. A method of achieving facet joint fusion with near simultaneous fixation is also disclosed.

Claims

1. A method of spine fusion comprising:

preparing a facet joint to receive an implantation device;

inserting a tool into the facet joint, said tool consisting essentially of a handle, a head associated with said handle, said head adapted to grasp a bioactive material, said tool having a forked end and a flexible distal shaft, said forked end having at least two tines at predetermined angles;

providing bioactive material in a predetermined amount, said bioactive material fitted onto said forked end, and placing the bioactive material into the facet joint using the tool;

creating at least one hole through the bone adjacent the joint;

inserting at least one fixation device through the at least one hole; and

wherein the steps of providing bioactive material and inserting at least one fixation device occur in near simultaneous fashion.

2. The method of claim 1 further comprising the step of:

Adjusting the angle between the head of the tool and the shaft of the tool for accommodating the anatomy of the patient and the orientation of the vertebrae located at the surgical site.

3. The method of claim 2 wherein the angle is capable of adjustment to approximately 45 degrees from the axis of the shaft of the tool for surgery in the cervical spine, to approximately 90 degrees for surgery in the thoracic spine, and approximately 180 degrees for surgery in the lumbar spine.

4. An apparatus for providing fixation of adjacent vertebral bodies comprising:

a handle;

an elongated shaft;

a head coupled to the elongated shaft;

wherein the head further comprises one or more tines for grasping, an implantable material which is adapted to be inserted into the joint space between two or more intervertebral bodies;

wherein the head is connected to the shaft of the apparatus by connecting means, the connecting means comprising means for selectively attaching and removing the head from the shaft; and

wherein the connecting means is comprised of a ball and socket connection.

5. The apparatus according to claim 4 wherein the head is comprised of bioactive material, and wherein the head is inserted and remains in the joint after the shaft of the apparatus is removed from the patient.

6. The apparatus according to claim 4 further comprising at least one conduit from the elongated shaft to the head comprised of bioactive material through which inoculation of the implantable material may be achieved with one or more activating biomaterials.

7. The apparatus according to claim 4 wherein the connecting means is comprised of a pinned connection.

8. The apparatus according to claim 4 wherein the apparatus further comprises means for selectively grasping and releasing the implantable material.

9. The apparatus according to claim 4 wherein the implantable material comprises one or more channels which are oriented to contact the one or more tines of the head of the apparatus.

10. An apparatus for providing fixation of adjacent vertebral bodies comprising:

a handle;

an elongated shaft;

a head coupled to the elongated shaft;

wherein the head further comprises one or more tines for grasping, an implantable material which is adapted to be inserted into the joint space between two or more intervertebral bodies;

wherein the head is connected to the shaft of the apparatus by connecting means, the connecting means comprising means for selectively attaching and removing the head from the shaft; and

wherein the connecting means is comprised of a plurality of opposing magnetic elements.

11. The apparatus according to claim 10 wherein the head is comprised of bioactive material, and wherein the head is inserted and remains in the joint after the shaft of the apparatus is removed from the patient.

12. The apparatus according to claim 10 further comprising at least one conduit from the elongated shaft to the head comprised of bioactive material through which inoculation of the implantable material may be achieved with one or more activating biomaterials.

13. The apparatus according to claim 10 wherein the connecting means is comprised of a pinned connection.

14. The apparatus according to claim 10 wherein the apparatus further comprises means for selectively grasping and releasing the implantable material.

15. The apparatus according to claim 10 wherein the implantable material comprises one or more channels which are oriented to contact the one or more tines of the head of the apparatus.

16. A method of fusing one or more vertebral bodies comprising the steps of:

Accessing the surgical site by inserting a first probing device followed by increasingly larger cannulae to expand the region in which to operate;

Using curettes and rasps to prepare the surgical site and create a bleeding surface about the faces of the joint;

Inserting a tool comprising a forked end and a flexible distal shaft, the forked end fitted with a bioactive membrane, through the cannulae and between the leaves of the joint;

Placing at least one drill guide over the shaft of the tool and adjacent the joint;

Employing a drill inserted through the at least one drill guide to create at least one hole(s) in the joint;

Fastening a screw or other like device to the at least one hole(s) and adjacent the facet, thereby trapping the bioactive membrane in the joint;

Removing the forked tool, the cannulae and the at least one drill guide from the patient;

Wherein the foregoing steps are accomplished in a minimally invasive manner and provide near-simultaneous fixation of the vertebral bodies surrounding the joint.