Spinal implant apparatus and methods

• US 9,717,604 B2
• Filed: 01/23/2015
• Issued: 08/01/2017
• Est. Priority Date: 03/31/2008
• Status: Active Grant

• Current Assignee: Stryker European Operations Holdings, LLC (Stryker Corporation)
• Original Assignee: Stryker European Holdings I, LLC (Stryker Corporation)
• Inventors: Thibodeau, Lee L.
• Primary Examiner(s): Hammond, Ellen C
• Assistant Examiner(s): Negrellirodrigue, Christina
• Application Number:
  US14/603,840
• Publication Number:
  US 20150142117A1
• Time in Patent Office: 921 Days
• Field of Search: 606246, 606248, 606249, 606 99, 606 86 A, 606279
• 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 2/447 substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section
• CPC Class Codes: A61F 2/4611 of spinal prostheses
• CPC Class Codes: A61F 2002/30133 kidney-shaped or bean-shaped
• CPC Class Codes: A61F 2002/30281 wedge-shaped
• CPC Class Codes: A61F 2002/30507 using a threaded locking member, e.g. a locking screw or a set screw
• CPC Class Codes: A61F 2002/30518 with possibility of relative movement between the prosthetic parts
• CPC Class Codes: A61F 2002/30537 adjustable
• CPC Class Codes: A61F 2002/30538 for adjusting angular orientation
• CPC Class Codes: A61F 2002/3054 about a connection axis or implantation axis for selecting any one of a plurality of radial orientations between two modular parts, e.g. Morse taper connections, at discrete positions, angular positions or continuous positions
• CPC Class Codes: A61F 2002/30579 with mechanically expandable devices, e.g. fixation devices
• CPC Class Codes: A61F 2002/30604 modular
• CPC Class Codes: A61F 2002/30617 Visible markings for adjusting, locating or measuring
• CPC Class Codes: A61F 2002/4615 of spacers
• 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 2220/0025 Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2230/0015 Kidney-shaped, e.g. bean-shaped
• CPC Class Codes: A61F 2230/0086 Pyramidal, tetrahedral, or wedge-shaped
• CPC Class Codes: A61F 2250/0006 for adjusting angular orientation
• CPC Class Codes: A61F 2250/0097 : Visible markings, e.g. indicia
• CPC Class Codes: A61F 2310/00023 : Titanium or titanium-based alloys, e.g. Ti-Ni alloys

Abstract

A method of inserting and positioning an intervertebral spacer is provided. The spacer includes a longitudinal axis, an on-axis interface coincident with or parallel to the longitudinal axis, and an off-axis interface angled to the longitudinal axis. The spacer'"'"'s front end may be curved. The method may include inserting the spacer into the disc space utilizing a tool to engage an on-axis interface and then to engage one or more of the off-axis interfaces, which may be used for further modification of the spacer. The tool is moved substantially along a single insertion direction, which may be substantially parallel to a posterior-anterior axis of the disc space. The method may result in the longitudinal axis of the spacer being perpendicular to the insertion direction, or substantially parallel to a medial-lateral axis of the disc space. The spacer may also be positioned in an anterior aspect of the disc space.

Claims

1. A method of inserting and positioning a prosthetic intervertebral spacer in the intervertebral disc space between two adjacent vertebrae, the method comprising the steps of:

providing a spacer including a longitudinal axis, an on-axis contact site for interfacing with a tool, and an off-axis contact site for interfacing with a tool, the on-axis contact site being coincident with or parallel to the longitudinal axis, and the off-axis contact site being angled with respect to the longitudinal axis;

applying a first force to the on-axis contact site to move the spacer in the intervertebral disc space, including threading a portion of the tool into a threaded hole aligned with the longitudinal axis;

applying a second force to the off-axis contact site to further move the spacer in the intervertebral disc space; and

expanding a height of the spacer by separating a top surface of the spacer from a bottom surface of the spacer.

2. The method of claim 1, wherein between the steps of applying the first force and applying the second force, the tool remains attached to and is realigned with respect to the spacer.

3. The method of claim 1, wherein between the steps of applying the first force and applying the second force, the tool is disengaged from the spacer.

4. The method of claim 1, wherein the spacer is formed of a plurality of parts, and the step of expanding includes maintaining the top and bottom surfaces parallel to one another.

5. The method of claim 1, further comprising the steps of:

applying a third force to a second off-axis contact site of the spacer to further move the spacer in the intervertebral disc space.

6. The method of claim 1, wherein the spacer further includes a front end having frictional properties that are greater than frictional properties of a rear end of the spacer, and wherein the applying steps include allowing the front end to turn within the intervertebral disc space as it frictionally engages one or both of the adjacent vertebrae.

7. The method of claim 1, wherein the on-axis contact site and the off-axis contact site are ports, the tool includes a retractable member, and the applying steps include placing the retractable member in the respective ports.

8. The method of claim 1, further comprising the step of packing bone graft material into an opening in the spacer.

9. A method of inserting and positioning a prosthetic intervertebral spacer in the intervertebral disc space between two adjacent vertebrae, the method comprising the steps of:

providing a spacer including a longitudinal axis, an on-axis interface, and an off-axis interface, the on-axis interface being coincident with or parallel to the longitudinal axis, and the off-axis interface being angled with respect to the longitudinal axis;

threading a portion of a tool into a threaded hole at the on-axis interface;

inserting the spacer at least partially into the intervertebral disc space;

realigning the tool to the off-axis interface while maintaining engagement between the tool and the spacer;

inserting the spacer further into the intervertebral disc space; and

expanding a height of the spacer by separating a top surface of the spacer from a bottom surface of the spacer.

10. The method of claim 9, wherein the spacer is formed of a plurality of parts, and the step of expanding includes maintaining the top and bottom surfaces parallel to one another.

11. The method of claim 9, further comprising the steps of:

realigning the tool to a second off-axis interface while maintaining engagement between the tool and the spacer; and

inserting the spacer further into the intervertebral disc space.

12. The method of claim 9, wherein the inserting steps result in the spacer being positioned in an anterior aspect of the intervertebral disc space.

13. The method of claim 9, wherein the spacer further includes a front end having frictional properties that are greater than frictional properties of a rear end of the spacer, and wherein the inserting steps include allowing the front end to turn within the intervertebral disc space as it frictionally engages one or both of the adjacent vertebrae.

14. The method of claim 9, further comprising the step of packing bone graft material into an opening in the spacer.

15. A method of inserting and positioning a prosthetic intervertebral spacer in the intervertebral disc space between two adjacent vertebrae, the method comprising the steps of:

providing a spacer formed of a plurality of parts and including a longitudinal axis, an on-axis contact site for interfacing with a tool, and an off-axis contact site for interfacing with a tool, the on-axis contact site being coincident with or parallel to the longitudinal axis, and the off-axis contact site being angled with respect to the longitudinal axis;

engaging a tool to the on-axis contact site, including threading a portion of the tool into a threaded hole aligned with the longitudinal axis;

inserting the spacer at least partially into the intervertebral disc space;

engaging the tool to the off-axis contact site;

inserting the spacer further into the intervertebral disc space; and

expanding a height of the spacer, including separating a top surface of the spacer from a bottom surface of the spacer.

16. The method of claim 15, wherein between the steps of engaging the tool to the on-axis contact site and engaging the tool to the off-axis contact site, the tool remains attached to and is realigned with respect to the spacer.

17. The method of claim 15, wherein between the steps of engaging the tool to the on-axis contact site and engaging the tool to the off-axis contact site, the tool is disengaged from the spacer.

18. The method of claim 15, wherein the step of expanding the height of the spacer includes separating the top surface of the spacer from the bottom surface of the spacer while maintaining the top and bottom surfaces parallel to one another.