Expandable interbody implant and method
First Claim
1. A method of distracting and fusing two adjacent vertebrae bodies, each of said adjacent vertebrae bodies having a cortical rim and an endplate with an annulus and a disc space between said adjacent vertebrae bodies, said disc space having an interior within said annulus and further having disc material within the interior of the disc space, said method comprising the following steps:
- a. make an incision in said annulus at a desired level to access the disc space between the adjacent vertebrae bodies, said incision being in a posterior lateral quadrant of said annulus and extending generally from an approximate location of a pedicle in said posterior lateral quadrant to a position in or proximate to an ipsilateral anterior lateral quadrant of said annulus, said incision being of sufficient length so as to simultaneously accommodate the insertion of surgical instrumentation and endoscopic instrumentation into said disc space thereby enabling endoscopic viewing of the interior of the disc space while performing discectomy and while preparing said endplates;
b. through said incision, perform a discectomy of the disc material within the disc space;
c. through said incision, prepare the endplates of said adjacent vertebrae bodies;
d. through said incision, distract said disc space;
e. through said incision, insert an implant into said disc space via said incision such that one end of said implant is at least partially received in an anterior portion of said incision such that said implant extends across said vertebrae bodies and is at least in part supported by said cortical rim so as to maintain distraction of said disc space; and
f. through said incision, insert bone graft material in said disc space so as to promote fusing of said adjacent vertebrae bodies.
1 Assignment
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Accused Products
Abstract
An intervertebral implant that can be surgically introduced between adjacent vertebrae and expanded in situ to occupy an optimal space between the vertebrae. The implant is inserted into the evacuated disc space obliquely and then oriented so as to extend laterally across the anterior adjacent vertebrae with its outer ends of the implant supported by the cortical rims on the opposite sides of the vertebrae. The implant has two body members with a space therebetween so the implant may be then distracted and a spacer of predetermined thickness that may be inserted within the space between the body members so as to maintain a desired amount of distraction. The upper and lower surfaces of the implant may have a desired lordotic angle. A method of using an implant is disclosed which permits endoscopic visualization of the disc space.
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Citations
29 Claims
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1. A method of distracting and fusing two adjacent vertebrae bodies, each of said adjacent vertebrae bodies having a cortical rim and an endplate with an annulus and a disc space between said adjacent vertebrae bodies, said disc space having an interior within said annulus and further having disc material within the interior of the disc space, said method comprising the following steps:
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a. make an incision in said annulus at a desired level to access the disc space between the adjacent vertebrae bodies, said incision being in a posterior lateral quadrant of said annulus and extending generally from an approximate location of a pedicle in said posterior lateral quadrant to a position in or proximate to an ipsilateral anterior lateral quadrant of said annulus, said incision being of sufficient length so as to simultaneously accommodate the insertion of surgical instrumentation and endoscopic instrumentation into said disc space thereby enabling endoscopic viewing of the interior of the disc space while performing discectomy and while preparing said endplates; b. through said incision, perform a discectomy of the disc material within the disc space; c. through said incision, prepare the endplates of said adjacent vertebrae bodies; d. through said incision, distract said disc space; e. through said incision, insert an implant into said disc space via said incision such that one end of said implant is at least partially received in an anterior portion of said incision such that said implant extends across said vertebrae bodies and is at least in part supported by said cortical rim so as to maintain distraction of said disc space; and f. through said incision, insert bone graft material in said disc space so as to promote fusing of said adjacent vertebrae bodies.
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2. A method of distracting and fusing a disc space between two adjacent vertebrae bodies, said vertebrae bodies each having an annulus and a disc space therebetween, said disc space having an interior within said annulus and further having disc material within the interior of the disc space, said vertebrae bodies further having a cortical rim and an endplate within said annulus, an implant configured to be inserted into said disc space through a posterolateral incision in the annulus and having an elongate body having a height ranging between about 8 mm.-10 mm. and a width ranging between about 11 mm.-13 mm., said implant elongate body being of a length sufficient such that when the implant is positioned in the disc space said implant extends generally laterally of said vertebrae bodies so as to maintain distraction of said adjacent vertebrae bodies, said method comprising the following steps:
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a. make an incision in said annulus at the desired level to access the disc space between the adjacent vertebrae bodies to be fused, said incision being in a posterior lateral quadrant of said annulus and extending generally from an approximate location of a pedicle in said posterior lateral quadrant toward an ipsilateral anterior quadrant of said annulus, said incision being of sufficient length so as to simultaneously accommodate the insertion of surgical instrumentation into the disc space and so as to accommodate the use of endoscopic instrumentation to enable visualization of the disc space while surgical procedures are carried out within the disc space; b. perform a discectomy of the disc material within the disc space via said incision; c. prepare the endplates of said adjacent vertebrae bodies; d. insert said implant into said disc space via said incision so as to extend substantially across said vertebrae bodies in an anterior region of said disc space and so as to be at least in part supported on at least one of said cortical rims of said vertebrae bodies; e. distract said disc space; and f. insert bone graft material in said disc space so as to promote fusing of said adjacent vertebrae bodies. - View Dependent Claims (3, 4)
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5. A method of distracting and fusing two adjacent vertebrae bodies, each of said adjacent vertebrae bodies having a cortical rim and an endplate with an annulus and a disc space therebetween, said disc space having disc material therewithin, said method comprising the following steps:
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a. make an incision in said annulus at a desired level to access the disc space between the adjacent vertebrae bodies, said incision being in a posterior lateral quadrant of said annulus and extending generally from an approximate location of a pedicle in said posterior lateral quadrant to a position in or proximate to an ipsilateral anterior lateral quadrant of said annulus, said incision being of sufficient length so as to accommodate the insertion of surgical instrumentation into the disc space and to enable endoscopic instrumentation to view the interior of said disc space so that discectomy of the disc space and preparation of the endplates of said vertebrae bodies may be performed while the surgeon endoscopically views the disc space; b. utilize said endoscopic instrumentation so as to enable viewing of said disc space while performing steps “
c” and
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, below;c. through said incision, perform a discectomy of the disc material within the disc space; d. through said incision, prepare the endplates of said adjacent vertebrae bodies; e. insert an expandable implant into said disc space via said incision; f. through said incision, distract said implant and said adjacent vertebrae bodies; g. fix said expandable implant in a desired distracted position within said disc space so as to maintain distraction of said adjacent vertebrae bodies; and h. through said incision, insert bone graft material in said disc space so as to promote fusing of said adjacent vertebrae bodies.
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6. A method of distracting and fusing a disc space between two adjacent vertebrae bodies, said vertebrae bodies each having an annulus and a disc space therebetween, each said vertebrae bodies further having a cortical rim and an endplate within said annulus, an expandable implant having an elongate body configured to have a height ranging between about 8 mm.-10 mm. and a width ranging between about 11 mm.-13 mm. so that said implant may be inserted into the disc space through a posterolateral incision in the annulus, said implant being further configured to have a length so that when the implant is positioned in the disc space the implant extends generally laterally with respect to said vertebrae bodies, said expandable implant being capable of being distracted within said disc space so as to distract said adjacent vertebrae bodies and being capable of being fixed in a desired distracted condition so as to maintain a desired amount of distraction between said adjacent vertebrae bodies, said method comprising the following steps:
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a. make an incision in said annulus at the desired level to access the disc space between the adjacent vertebrae bodies to be fused, said incision being substantially in a posterior lateral quadrant of said annulus and extending generally from an approximate location of a pedicle in said posterior lateral quadrant to a position in or proximate to an ipsilateral anterior lateral quadrant of said annulus, said incision being of sufficient length so as to accommodate surgical instrumentation for performing surgical procedures within said disc space and so as to permit the use of endoscopic instrumentation so as to enable the surgeon to visualize the interior of the disc space while performing said surgical procedures; b. utilize endoscopic instrumentation for viewing of said disc space; c. perform a discectomy of the disc space via said incision in said annulus under endoscopic viewing of the disc space; d. prepare the endplates of said adjacent vertebrae bodies under endoscopic viewing of the disc space; e. insert said expandable implant into said disc space via said incision so as to extend generally laterally of said vertebrae bodies in an anterior region thereof; f. distract said expandable implant and said adjacent vertebrae bodies; g. fix said expandable implant and said adjacent vertebrae bodies in a desired distracted condition; and h. insert bone graft material in said disc space so as to promote fusing of said adjacent vertebrae bodies. - View Dependent Claims (7, 8)
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9. A method of distracting and fusing two adjacent vertebrae bodies, each of said adjacent vertebrae bodies having a cortical rim and an endplate with an annulus and a disc space therebetween, said method comprising the following steps:
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a. make an incision in said annulus at a desired level to access the disc space between the adjacent vertebrae bodies, said incision being in a posterior lateral quadrant of said annulus and extending generally from an approximate location of a pedicle in said posterior lateral quadrant to a position in or proximate to an ipsilateral anterior lateral quadrant of said annulus, said incision being of sufficient length so as to accommodate surgical instrumentation for performing surgical procedures within said disc space and so as to permit the use of endoscopic instrumentation so as to enable the surgeon to visualize the interior of the disc space while performing at least some of said surgical procedures; b. through said incision, perform a discectomy of the disc material within the disc space while under endoscopic viewing by said surgeon; c. through said incision, prepare the endplates of said adjacent vertebrae bodies while under endoscopic viewing by said surgeon; d. insert an implant into said disc space via said incision; e. through said incision, distract said adjacent vertebrae bodies with said implant maintaining a desired distraction of said adjacent vertebrae bodies; and f. through said incision, insert bone graft material in said disc space so as to promote fusing of said adjacent vertebrae bodies.
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10. A method of fusing two adjacent vertebrae bodies, each of said adjacent vertebrae bodies having a cortical rim and an endplate with an annulus and a disc space between said adjacent vertebrae bodies, said disc space having an interior within said annulus and further having disc material within the interior of the disc space, said method comprising the following steps:
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a. make an incision in said annulus at a desired level to access the disc space between the adjacent vertebrae bodies, where at least a portion of said incision is in a posterior lateral quadrant of said annulus and where said incision is of a sufficient length so as to accommodate the insertion of endoscopic instrumentation into said disc space so as to enable viewing of the interior of the disc space and so as to permit the insertion of surgical instrumentation into said disc space for performing discectomy of the disc space and for preparing the endplates of said vertebrae bodies; b. perform a discectomy of the disc material within the disc space; c. prepare the endplates of said adjacent vertebrae bodies; d. form an opening in an anterior contralateral side of said annulus; e. distract said disc space; f. insert an implant into said disc space via said incision such that said implant extends across said vertebrae bodies with said implant being at least in part supported by said cortical rim and maintaining distraction of said disc space; and g. insert bone graft material in said disc space so as to promote fusing of said adjacent vertebrae bodies. - View Dependent Claims (11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21)
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22. A method of distracting and fusing a disc space between two adjacent vertebrae bodies, said vertebrae bodies each having an annulus and a disc space therebetween, said disc space having disc material therein, each said vertebrae bodies further having a cortical rim and an endplate within said annulus, an expandable implant having an elongate body of a length sufficient such that when the implant is positioned in the disc space said implant extends across said vertebrae bodies and is at least in part supported by at least one of said cortical rims of said adjacent vertebrae bodies, said expandable implant having a lower body member and an upper body member movable toward and away from one another and having a spacer configured to be inserted between said upper and lower body members so as to maintain distraction of said adjacent vertebrae bodies, said method comprising the following steps:
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a. make an incision in said annulus at the desired level to access the disc space between the adjacent vertebrae bodies to be fused, said incision being substantially in a posterior lateral quadrant of said annulus and being of sufficient length so as to accommodate surgical instrumentation for performing surgical procedures within said disc space and so as to accommodate endoscopic instrumentation in said disc space so as to enable visualization of the disc space for the surgeon performing said surgical procedures; b. perform a discectomy of the disc space via said incision in said annulus under endoscopic viewing of the disc space; c. prepare the endplates of said adjacent vertebrae bodies under endoscopic viewing of the disc space; d. form an opening in an anterior contralateral side of said annulus; e. insert said expandable implant into said disc space via said incision so as to extend substantially across said vertebrae bodies in an anterior region of said disc space and so as to be at least in part supported by at least one of said cortical rims; f. distract said expandable implant and said disc space; g. insert said spacer between said upper and lower body members of said expandable implant so as to substantially maintain distraction of said adjacent vertebrae bodies; and h. insert bone graft material in said disc space so as to promote fusing of said adjacent vertebrae bodies. - View Dependent Claims (23, 24, 25, 26, 27)
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28. A method of distracting a disc space between two adjacent vertebrae bodies to be fused together, said adjacent vertebrae bodies having an annulus and a disc space therebetween with disc material within the disc space, each of said adjacent vertebrae bodies further having a cortical rim and an endplate within said annulus, said method comprising the following steps:
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a. make an incision in said annulus at the desired level to access a disc space between the adjacent vertebrae to be fused, a portion of said incision being in a posterior lateral quadrant of said annulus and extending anteriorly at least partially into a proximate anterior quadrant of said annulus, said incision being of sufficient length so as to accommodate surgical instrumentation for performing surgical procedures within said disc space and so as to accommodate endoscopic instrumentation in said disc space; b. perform a discectomy of the disc space via said incision in said annulus under endoscopic viewing of the disc space; c. prepare the endplates of said adjacent vertebrae bodies under endoscopic viewing of the disc space; d. form an opening in an anterior contralateral side of said annulus; e. provide an implant having an elongate body of a length sufficient such that when the implant is positioned in an anterior portion of said disc space said implant extends across said vertebrae bodies; and f. insert said implant into said disc space via said incision and positioning the implant so as to extend substantially across said adjacent vertebrae bodies in the anterior region of said vertebrae bodies with one end of said implant being at least partially received in said opening and with another end of said implant being at least partially received in an anterior portion of said incision so that said implant is at least in part supported by at least one of said cortical rims upon retraction of said disc space.
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29. A method of distracting a disc space between two adjacent vertebrae bodies to be fused together, said vertebrae bodies having an annulus and a disc space therebetween with disc material within the disc space, each of said vertebrae bodies further having a cortical rim and an endplate within said annulus, said method comprising the following steps:
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a. make an incision in said annulus at the desired level to access a disc space between the adjacent vertebrae to be fused, said incision being substantially in a posterior lateral quadrant of said annulus; b. perform a discectomy of the disc material within the annulus via said incision; c. prepare the endplates of said adjacent vertebrae bodies; d. form a first opening in an anterior contralateral side of said annulus; e. form a second opening in said annulus substantially opposite said first opening; f. insert an expandable implant into said disc space via said incision, said implant having ends that are received in said first and second openings such that the implant extends substantially across said vertebrae bodies in an anterior region of said vertebrae bodies and is at least in part supported by at least one of said cortical rims; g. distract said expandable implant; and h. install a spacer between said upper and lower bodies of said implant so as to maintain distraction.
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Specification