Devices and techniques for a posterior lateral disc space approach

• US 20060264968A1
• Filed: 05/26/2006
• Published: 11/23/2006
• Est. Priority Date: 10/21/1999
• Status: Active Grant

• Current Assignee: George Frey, Harald Ebner, John L. White, Steven D. DeRidder
• Original Assignee: George Frey, Harald Ebner, John L. White, Steven D. DeRidder
• Inventors: DeRidder, Steven D., White, John L., Frey, George, Ebner, Harald
• Granted Patent: US 7,481,812 B2
• Time in Patent Office: Days
• US Class Current: 606/99
• CPC Class Codes: A61B 17/0206 with antagonistic arms as supports for retractor elements
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/1604 Chisels; Rongeurs; Punches; Stamps
• CPC Class Codes: A61B 17/1631 Special drive shafts, e.g. flexible shafts A61B17/1642, A61B17/164 take precedence
• CPC Class Codes: A61B 17/1642 for producing a curved bore
• 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 2017/0256 for the spine
• 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 2/4603 for insertion or extraction of endoprosthetic joints or of accessories thereof
• 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 2002/3008 radio-opaque, e.g. radio-opaque markers
• CPC Class Codes: A61F 2002/30115 circular-O-shaped
• CPC Class Codes: A61F 2002/30133 kidney-shaped or bean-shaped
• CPC Class Codes: A61F 2002/30235 tubular, e.g. sleeves
• CPC Class Codes: A61F 2002/30329 Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2002/30593 hollow
• CPC Class Codes: A61F 2002/30774 : internally-threaded
• CPC Class Codes: A61F 2002/30777 : Oblong apertures
• CPC Class Codes: A61F 2002/30785 : parallel
• CPC Class Codes: A61F 2002/30787 : inclined obliquely with respect to each other
• CPC Class Codes: A61F 2002/30789 : perpendicular with respect to each other
• CPC Class Codes: A61F 2002/30828 : parallel
• CPC Class Codes: A61F 2002/30912 : made of expanded metal, e.g. diamond mesh or metal nets having lozenge-shaped apertures
• 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 2002/4627 : 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 2002/4635 : using minimally invasive surgery
• CPC Class Codes: A61F 2002/4687 : Mechanical guides for implantation instruments
• CPC Class Codes: A61F 2220/0025 : Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2230/0006 : circular
• CPC Class Codes: A61F 2230/0015 : Kidney-shaped, e.g. bean-shaped
• CPC Class Codes: A61F 2230/0069 : cylindrical
• 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: Y10S 606/907 : Composed of particular material or coated
• CPC Class Codes: Y10S 606/91 : Polymer
• CPC Class Codes: Y10S 606/911 : Memory material
• CPC Class Codes: Y10S 606/912 : Radiolucent material

Abstract

This invention relates to devices and instruments for implant insertion through a posterior lateral opening to the disc space. The instruments include an implant inserter, and the devices include a spinal fusion implant engageable by the implant inserter. The implant provides bilateral support of the adjacent vertebrae when inserted into the disc space from a postero-lateral approach.

Claims

1. An instrument for inserting a spinal implant, comprising:

a proximal portion including a handle and a shaft extending distally from said handle; and

an implant engaging portion at a distal end of said shaft, said implant engaging portion having a first member and a second member, said second member movable along said first member from a first position wherein said spinal implant is insertable between said first and second members to a second position wherein said first member and said second member engage the implant therebetween.

2. The instrument of claim 1, wherein in said second position said first and second members define an implant receptacle therebetween.

3. The instrument of claim 2, wherein said implant receptacle is defined by a first concave surface extending along an inner side of said first member and a second concave surface extending along an inner side of said second member, said first and second concave surfaces being oriented toward one another.

4. The instrument of claim 3, wherein said first member includes a projection extending from said first concave surface toward said second concave surface.

5. The instrument of claim 3, wherein said first concave surface has a first curvature and said second concave surface has a second concave curvature.

6. The instrument of claim 5, wherein said first concave curvature is different than said second concave curvature.

7. The instrument of claim 1, wherein said proximal portion is pivotal relative to said implant engaging portion.

8. The instrument of claim 1, wherein said first member and said second member are movably engaged along a distal shaft of said implant engaging portion.

9. The instrument of claim 7, wherein said first member includes a first finger extending distally from said distal shaft of said implant engaging portion and said second member includes a second finger extending distally from said distal shaft of said implant engaging portion, said first and second fingers defining an implant receptacle therebetween when said second member is in said second position.

10. The instrument of claim 1, wherein said shaft of said proximal portion includes an inner shaft movably positioned therein.

11. The instrument of claim 10, further comprising an actuator slidably positioned about said shaft and engaged to said inner shaft, said actuator being movable from a first position wherein said inner shaft engages said implant engaging portion to a second position wherein said inner shaft is disengaged from said implant engaging portion.

12. The instrument of claim 11, wherein with said actuator in said second position said proximal portion is pivotal relative to said implant engaging portion.

13. The instrument of claim 12, wherein:

with said actuator in said second position said proximal portion is pivotal between a first position and a second position; and

with said actuator in said first position said inner shaft engages said implant engaging portion to fix said proximal portion in one of said first position and said second position.

14. The instrument of claim 1, wherein said implant engaging portion includes a lateral offset portion extending in a first direction from a central axis of said proximal portion.

15. The instrument of claim 1, wherein:

said shaft includes an inner shaft movably positioned therein, said inner shaft including a first extension, a second extension and a slot between said first extension and said second extension; and

said implant engaging portion includes a shaft engaging portion at a proximal end thereof, said shaft engaging portion including a first receptacle engaging said first extension with said proximal portion in a first position relative to said implant engaging portion, said shaft engaging portion including a second receptacle engaging said second extension with said proximal portion pivoted to a second position relative to said implant engaging portion.

16. The instrument of claim 15, wherein said inner shaft is spring biased to engage said first extension and said second extension in one of said first receptacle and said second receptacle when said proximal portion is in a corresponding one of said first position and said second position.

17. The instrument of claim 16, further comprising an actuator slidably position about said shaft and coupled to said inner shaft to move said inner shaft proximally to disengage said first extension and said second extension with respect ones of said first receptacle and said second receptacle.

18. The instrument of claim 1, further comprising an alignment instrument engageable to a proximal end of said proximal portion, said alignment instrument having an alignment member alignable with a portion of a patient'"'"'s anatomy when the spinal implant is inserted to a desired position in the patient.

19. The instrument of claim 1, further comprising a driving member rotatably captured in said first member and engaged to said second member, said driving member rotatable to move said second member between said first position and said second position.

20. An instrument for inserting a spinal implant in a disc space, comprising:

a proximal portion including a handle and a shaft extending distally from said handle; and

an implant engaging portion at a distal end of said shaft, said implant engaging portion engageable to the spinal implant, said proximal portion engageable to said implant engaging portion in a first position for inserting the spinal implant in the disc space, said proximal portion movable relative to said implant engaging portion and engageable to said implant engaging portion in a second position for inserting the spinal implant in the disc space.

21. The instrument of claim 20, wherein said implant engaging portion includes a first member and a second member, said second member movable along said first member from a first position wherein said spinal implant is insertable between said first and second members to a second position wherein said first member and said second member engage the implant therebetween.

22. The instrument of claim 21, wherein in said second position said first and second members define an implant receptacle therebetween.

23. The instrument of claim 22, wherein said implant receptacle is defined by a first concave surface extending along an inner side of said first member and a second concave surface extending along an inner side of said second member, said first and second concave surfaces being oriented toward one another.

24. The instrument of claim 23, wherein said first member includes a projection extending from said first concave surface toward said second concave surface.

25. The instrument of claim 21, wherein said first member and said second member are movably engaged along a distal shaft of said implant engaging portion.

26. The instrument of claim 25, wherein said first member includes a first finger extending distally from said distal shaft and said second member includes a second finger extending distally from said distal shaft, said first and second fingers defining an implant receptacle therebetween when said second member is in said second position.

27. The instrument of claim 20, wherein said shaft of said proximal portion includes an inner shaft movably positioned therein.

28. The instrument of claim 27, further comprising an actuator slidably positioned about said shaft and engaged to said inner shaft, said actuator being movable from an engaged position wherein said inner shaft engages said implant engaging portion to a disengaged position wherein said inner shaft is disengaged from said implant engaging portion.

29. The instrument of claim 28, wherein:

said shaft of said proximal portion is pivotally coupled to said implant engaging portion;

said inner shaft engages said implant engaging portion with said proximal portion in said first position;

said inner shaft is disengaged from said implant engaging portion with said actuator in said disengaged position and said proximal portion is pivotal to said second position; and

said actuator is movable to said engaged position to engage said inner shaft to said implant engaging portion with said proximal portion in said second position to fix said proximal portion in said second position.

30. The instrument of claim 20, wherein:

said shaft includes an inner shaft movably positioned therein, said inner shaft including a first extension, a second extension and a slot between said first extension and said second extension; and

said implant engaging portion including a shaft engaging portion, said shaft engaging portion including a first receptacle engaging said first extension with said proximal portion in said first position, said shaft engaging portion including a second receptacle engaging said second extension with said proximal portion in said second position.

31. The instrument of claim 30, wherein said inner shaft is spring biased to engage said first extension and said second extension with respective ones of said first receptacle and said second receptacle.

32. The instrument of claim 31, further comprising an actuator slidably position about said shaft and coupled to said inner shaft to move said inner shaft proximally to disengage said first extension and said second extension with respective ones of said first receptacle and said second receptacle.

33. The instrument of claim 20, further comprising an alignment instrument engageable to a proximal end of said proximal portion, said alignment instrument having an alignment member alignable with a portion of a patient'"'"'s anatomy when the spinal implant is inserted to a desired position in the disc space.

34. An instrument for inserting a spinal implant in a disc space, comprising:

a proximal portion including a handle and shaft extending distally from said handle; and

an implant engaging portion at a distal end of said shaft, said implant engaging portion engageable to the spinal implant; and

an alignment instrument engageable to a proximal end of said proximal portion, said alignment instrument having an alignment member alignable with a portion of a patient'"'"'s anatomy when the spinal implant is inserted to a desired position in the disc space.

35. The instrument of claim 34, wherein said alignment instrument includes an engagement end including a cup portion positionable over a proximal end of said handle.

36. The instrument of claim 34, wherein said alignment instrument includes an engagement end including a shaft engageable with a ball detent mechanism in said handle.

37. The instrument of claim 36, wherein said alignment member includes an extension member extending from said engagement end to said alignment member.

38. The instrument of claim 34, wherein said proximal portion has a first position and a second position relative to said implant engaging portion.

39. The instrument of claim 38, wherein said alignment instrument includes a second alignment instrument, each of said alignment instruments adapted for use with a corresponding one of said first position and said second position of said proximal portion.

40. The instrument of claim 34, wherein the portion of the patient anatomy is alignable between a predetermined location on the spinal implant and said alignment member.