BI-DIRECTIONAL FIXATING TRANSVERTEBRAL BODY SCREWS AND POSTERIOR CERVICAL AND LUMBAR INTERARTICULATING JOINT CALIBRATED STAPLING DEVICES FOR SPINAL FUSION

• US 20130018468A1
• Filed: 08/15/2011
• Published: 01/17/2013
• Est. Priority Date: 04/12/2005
• Status: Active Grant

• Current Assignee: Moskowitz Family LLC
• Original Assignee: Moskowitz Family LLC
• Inventors: MOSKOWITZ, Ahmnon D., ALVARADO, Pablo A. Valdivia Y., MOSKOWITZ, Mosheh T., MOSKOWITZ, Nathan C.
• Granted Patent: US 9,889,022 B2
• Time in Patent Office: Days
• US Class Current: 623/17.16
• CPC Class Codes: A61B 17/0642 for bones, e.g. for osteosynthesis or connecting tendon to bone
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 17/7064 Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor
• CPC Class Codes: A61B 17/809 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 17/8635 Tips of screws
• CPC Class Codes: A61B 17/8875 Screwdrivers, spanners or wrenches
• CPC Class Codes: A61B 17/8894 holding the implant into or through which the screw is to be inserted A61B17/7082, A61B17/7091 take precedence
• CPC Class Codes: A61B 17/92 Impactors or extractors, e.g. for removing intramedullary devices insertion or extraction of artificial joints A61F2/4603
• CPC Class Codes: A61B 2017/00407 Ratchet means
• CPC Class Codes: A61B 2017/0641 having at least three legs as part of one single body
• CPC Class Codes: A61B 2017/0648 threaded, e.g. tacks with a screw thread
• CPC Class Codes: A61B 2017/922 Devices for impaction, impact element
• 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 2002/2835 Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
• CPC Class Codes: A61F 2002/30133 kidney-shaped or bean-shaped
• CPC Class Codes: A61F 2002/30387 Dovetail connection
• CPC Class Codes: A61F 2002/30448 : using adhesives
• CPC Class Codes: A61F 2002/30507 : using a threaded locking member, e.g. a locking screw or a set screw
• CPC Class Codes: A61F 2002/3055 : for adjusting length
• CPC Class Codes: A61F 2002/30579 : with mechanically expandable devices, e.g. fixation devices
• CPC Class Codes: A61F 2002/30593 : hollow
• CPC Class Codes: A61F 2002/30604 : modular
• CPC Class Codes: A61F 2002/30772 : Apertures or holes, e.g. of circular cross section
• CPC Class Codes: A61F 2002/30878 : with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
• CPC Class Codes: A61F 2002/30879 : Ribs
• CPC Class Codes: A61F 2002/30904 : serrated profile, i.e. saw-toothed
• 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 2002/4681 : by applying mechanical shocks, e.g. by hammering
• 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 2220/005 : using adhesives
• CPC Class Codes: A61F 2230/0015 : Kidney-shaped, e.g. bean-shaped
• CPC Class Codes: A61F 2250/0007 : for adjusting length

Abstract

A self-drilling bone fusion screw apparatus is disclosed which includes at least first and second sliding boxes. A first screw member having a tapered end and a threaded body is disposed within the first sliding box, and a second screw member having a tapered end and a threaded body disposed within the second sliding box. An adjuster adjusts the height of the sliding boxes. The screw members are screwed into vertebral bodies in order to fuse the vertebral bodies together. A plurality of the self-drilling bone fusion screw apparatuses may be attached together and/or integrated via a plate or cage. Also disclosed is a cervical facet staple that includes a curved staple base and at least two prongs attached to the bottom surface of the curved staple base.

Claims

1-25. -25. (canceled)

26. A universal, intervertebral combination bone fusion spacer and self-drilling screw apparatus for insertion into a disc space between a first vertebral body and a second vertebral body and fusion of the first vertebral body to the second vertebral body via biological bone fusion and screw fusion, the apparatus comprising:

an intervertebral cage including;

a first integral screw guide having a first predetermined angle;

a second integral screw guide having a second predetermined angle; and

a first screw member disposed in the first integral screw guide at the first predetermined angle and at least partially within the intervertebral cage;

a second screw member disposed in the second integral screw guide at the second predetermined angle and at least partially within the intervertebral cage,

wherein each of the first internal screw guide and the second internal screw guide is angled to orient the first screw member and the second screw bi-directionally in opposite directions.

27. The apparatus of claim 26, wherein each of the first internal screw guide and the second internal screw guide has a 25 degree angulation.

28. The apparatus of claim 26, wherein the first screw member is oriented rostrally (superiorly) and the second screw member is oriented caudally (inferiorly).

29. The apparatus of claim 26, wherein the first internal screw guide and the second internal screw guide are aligned along a longitudinal axis of the intervertebral cage.

30. The apparatus of claim 26, wherein the first internal screw guide and the second internal screw guide are symmetrically disposed on each side of a center point of the intervertebral cage along a longitudinal axis of the intervertebral cage.

31. The apparatus of claim 26, wherein each of the first internal screw guide and the second internal screw guide includes a tunnel that permits only a predetermined angled trajectory of the first screw member and the second screw member.

32. The apparatus of claim 26, wherein a predetermined angled trajectory of the first internal screw guide is different than a predetermined angled trajectory of the second internal screw guide.

33. The apparatus of claim 26, wherein each of the first internal screw guide and the second internal screw guide includes a tunnel that permits only a 25 degree angulation of the first screw member and the second screw member.

34. The apparatus of claim 26, wherein the first screw member is a self-tapping and self-drilling screw member having a tapered end and a threaded body, and

wherein the second screw member is a self-tapping and self-drilling screw member having a tapered end and a threaded body.

35. The apparatus of claim 26, further comprising:

a bone graft cavity for receiving bone packing material for bone fusion between the first vertebral body and the second vertebral body.

36. The apparatus of claim 35, wherein the bone graft cavity extends through the intervertebral cage for receiving bone packing material for bone fusion between the first vertebral body and the second vertebral body and across the intervertebral space.

37. The apparatus of claim 26, further comprising:

a plurality of bone graft cavities extending through the intervertebral cage for receiving bone packing material for bone fusion between the first vertebral body and the second vertebral body and across the intervertebral space.

38. The apparatus of claim 26, wherein a surface of each longitudinal end of the intervertebral cage includes a slot or indentation formed adjacent to an edge of an upper surface of the intervertebral cage for receiving a distal end of a prong of an implantation tool.

39. The apparatus of claim 26, wherein the intervertebral cage includes an exit for one of the first integral screw guide and the second integral screw guide, the exit being adjacent to or formed in an edge of the bone graft cavity.

40. The apparatus of claim 39, wherein the exit is a hemi-circular indentation on the edge of the bone graft cavity.

41. The apparatus of claim 26, wherein the intervertebral cage is a cervical intervertebral cage adapted to fit into a bi-concave cervical disc space.

42. The apparatus of claim 26, wherein the intervertebral cage is a lumbar intervertebral cage adapted to fit into a bi-concave lumbar disc space.

43. The apparatus of claim 26, wherein the intervertebral cage is a posterior lumbar intervertebral cage adapted to fit into a bi-concave lumbar disc space.

44. The apparatus of claim 26, wherein the intervertebral cage is configured for one of posterior lumbar intervertebral placement, anterior lumbar intervertebral placement, anterio-lateral lumbar and thoracic intervertebral placement, and anterior cervical intervertebral placement.

45. The apparatus of claim 26, wherein the intervertebral cage includes a side having a plurality of ridges.

46. The apparatus of claim 45, wherein the plurality of ridges are disposed on a superior surface and/or an inferior surface of the intervertebral cage.

47. The apparatus of claim 26, where the intervertebral cage includes a screw insert for securing a second universal, intervertebral combination bone fusion spacer and self-drilling screw apparatus to the universal, intervertebral combination bone fusion spacer and self-drilling screw apparatus via a plate.

48. The apparatus of claim 26, wherein a wall of the intervertebral cage having the first integral screw guide and the second integral screw guide has a thickness that is greater than a thickness of sidewalls and longitudinal ends of the intervertebral cage.

49. The apparatus of claim 26, wherein a wall of the intervertebral cage having the first integral screw guide and the second integral screw guide has a height that is greater than a height of sidewalls and longitudinal ends of the intervertebral cage.

50. The apparatus of claim 26, wherein a height and width of sidewalls and longitudinal ends of the intervertebral cage are tapered in a direction extending away from a wall of the intervertebral cage having the first integral screw guide and the second integral screw guide.

51. The apparatus of claim 26, wherein a wall of the intervertebral cage having the first integral screw guide and the second integral screw guide is parallel to an opposing wall, and

wherein a length of the wall is greater than a length of the opposing wall.

52. The apparatus of claim 26, wherein inner walls of the bone graft cavity are convergent.

53. The apparatus of claim 26, wherein an intersection of sidewalls and longitudinal ends of the intervertebral cage form a straight edge.

54. The apparatus of claim 26, wherein an intersection of sidewalls and longitudinal ends of the intervertebral cage form an arcuate edge.

55. The apparatus of claim 26, wherein the first integral screw guide and the second integral screw guide are adjacent to each other and at an angulation with respect to a wall having the first integral screw guide and the second integral screw guide.

56. The apparatus of claim 55, wherein a first angulation of the first integral screw guide is opposed to a second angulation of the second integral screw guide.

57. The apparatus of claim 26, wherein the first integral screw guide and the second integral screw guide are adjacent to each other along a longitudinal extent of a wall having the first integral screw guide and the second integral screw guide, and

wherein the first integral screw guide and the second integral screw guide are offset in opposite directions with respect to a center line of the longitudinal extent.

58. The apparatus of claim 57, wherein a part of the first integral screw guide overlaps a part of the second integral screw guide along the longitudinal extent of the wall having the first integral screw guide and the second integral screw guide.

59. The apparatus of claim 57, wherein the first integral screw guide and the second integral screw guide are at an angulation with respect to the wall having the first integral screw guide and the second integral screw guide.

60. The apparatus of claim 59, wherein a first angulation of the first integral screw guide extends in a first direction from the wall having the first integral screw guide and the second integral screw guide toward a first side of the intervertebral cage,

wherein a second angulation of the second integral screw guide extends in a second direction from the wall having the first integral screw guide and the second integral screw guide toward a second side of the intervertebral cage, and

wherein the first side is opposed to the second side.

61. The apparatus of claim 26, wherein the intervertebral cage includes a wall having an entry opening of the first integral screw guide and an entry opening of the second integral screw guide,

wherein the wall has four quadrants delineated by a first axis and a second axis each lying in a plane of the wall, and the first axis is at a right angle with respect to the second axis,

wherein the four quadrants include a first quadrant, a second quadrant, a third quadrant, and a fourth quadrant,

wherein the first quadrant and the fourth quadrant are opposed to the second quadrant and the third quadrant with respect to the first axis, and the first quadrant and the second quadrant are opposed to the third quadrant and the fourth quadrant with respect to the second axis,

wherein the first quadrant is diagonally opposed to the third quadrant, and the second quadrant is diagonally opposed to the fourth quadrant, and

wherein one of:

a majority of an area of the entry opening of the first integral screw guide is in the first quadrant and a majority of an area of the entry opening of the second integral screw guide is in the third quadrant; and

the majority of the area of the entry opening of the first integral screw guide is in the second quadrant and the majority of the area of the entry opening of the second integral screw guide is in the fourth quadrant.

62. The apparatus of claim 26, wherein the intervertebral cage includes a wall having an entry opening of the first integral screw guide and an entry opening of the second integral screw guide,

wherein the wall has four quadrants delineated by a first axis and a second axis each lying in a plane of the wall, and the first axis is at a right angle with respect to the second axis,

wherein the four quadrants include a first quadrant, a second quadrant, a third quadrant, and a fourth quadrant,

wherein the first quadrant and the fourth quadrant are opposed to the second quadrant and the third quadrant with respect to the first axis, and the first quadrant and the second quadrant are opposed to the third quadrant and the fourth quadrant with respect to the second axis,

wherein the first quadrant is diagonally opposed to the third quadrant, and the second quadrant is diagonally opposed to the fourth quadrant, and

wherein one of:

a center of the entry opening of the first integral screw guide is in the first quadrant and a center of the entry opening of the second integral screw guide is in the third quadrant; and

the center of the entry opening of the first integral screw guide is in the second quadrant and the center of the entry opening of the second integral screw guide is in the fourth quadrant.

63. The apparatus of claim 26, wherein the intervertebral cage includes a wall having an entry opening of the first integral screw guide and an entry opening of the second integral screw guide, the wall including a first corner and a second corner, the first corner being arranged at an opposite side of the wall and an opposite end of the wall with respect to the second corner,

wherein the first integral screw guide and the second integral screw guide are diagonally arranged along a direction extending from the first corner of the wall to the second corner of the wall.

64. The apparatus of claim 26, wherein the intervertebral cage includes a wall having an entry opening of the first integral screw guide and an entry opening of the second integral screw guide, the wall including a first corner and a second corner, the first corner being arranged at an opposite side of the wall and an opposite end of the wall with respect to the second corner,

wherein the first integral screw guide and the second integral screw guide are adjacent to each other along a longitudinal extent of the wall and are diagonally arranged along a direction extending from the first corner of the wall to the second corner of the wall.

65. The apparatus of claim 26, wherein the intervertebral cage includes an arcuate wall.

66. The apparatus of claim 26, wherein the first integral screw guide and the second integral screw guide are at an angulation with respect to a wall having the first integral screw guide and the second integral screw guide.

67. The apparatus of claim 26, wherein the first integral screw guide and the second integral screw guide diverge from each other.

68. The apparatus of claim 26, wherein the first integral screw guide and the second integral screw guide diverge from each other and at an angulation with respect to a wall having the first integral screw guide and the second integral screw guide.

69. The apparatus of claim 26, wherein the intervertebral cage further comprises:

a third integral screw guide having a third predetermined angle;

a fourth integral screw guide having a fourth predetermined angle; and

wherein the apparatus further comprises;

a third screw member disposed in the third integral screw guide at the third predetermined angle and at least partially within the intervertebral cage; and

a fourth screw member disposed in the fourth integral screw guide at the fourth predetermined angle and at least partially within the intervertebral cage.

70. The apparatus of claim 69, wherein the first screw member and the fourth screw member are oriented rostrally (superiorly) and the second screw member and the third screw member are oriented caudally (inferiorly).

71. The apparatus of claim 70, wherein the second screw member and the third screw member are disposed between the first screw member and the fourth screw member along a longitudinal length of the intervertebral cage.

72. The apparatus of claim 69, wherein each of the first internal screw guide, the second internal screw guide, the third internal screw guide, and the fourth internal screw guide has a 25 degree angulation.

73. The apparatus of claim 69, wherein the first internal screw guide and the fourth internal screw guide are disposed adjacent to longitudinal ends of the intervertebral cage and the second internal screw guide and the third internal screw guide are disposed between the first internal screw guide and the fourth internal screw guide, and

wherein the first internal screw guide, the second internal screw guide, the third internal screw guide, and the fourth internal screw guide angled to orient the first screw member and the fourth screw member in opposite directions from the second screw member and the third screw member.

74. The apparatus of claim 69, wherein the first internal screw guide, the second internal screw guide, the third internal screw guide, and/or the fourth internal screw guide are aligned along a longitudinal axis of the intervertebral cage.

75. The apparatus of claim 69, wherein the first internal screw guide, the second internal screw guide, the third internal screw guide, and the fourth internal screw guide are symmetrically disposed on each side of a center point of the intervertebral cage along a longitudinal axis of the intervertebral cage.

76. The apparatus of claim 69, wherein the second screw member and the third screw member are disposed between the first screw member and the fourth screw member along a longitudinal axis of the intervertebral cage.

77. The apparatus of claim 69, where the intervertebral cage includes a screw insert for securing a second universal, intervertebral combination bone fusion spacer and self-drilling screw apparatus to the universal, intervertebral combination bone fusion spacer and self-drilling screw apparatus via a plate.

78. The apparatus of claim 69, wherein a wall of the intervertebral cage having the first integral screw guide, the second integral screw guide, the third integral screw guide, and the fourth integral screw guide has a thickness that is greater than a thickness of sidewalls and longitudinal ends of the intervertebral cage.

79. The apparatus of claim 69, wherein a wall of the intervertebral cage having the first integral screw guide, the second integral screw guide, the third integral screw guide, and the fourth integral screw guide has a height that is greater than a height of sidewalls and longitudinal ends of the intervertebral cage.

80. The apparatus of claim 69, wherein a height and width of sidewalls and longitudinal ends of the intervertebral cage are tapered in a direction extending away from a wall of the intervertebral cage having the first integral screw guide, the second integral screw guide, the third integral screw guide, and the fourth integral screw guide.

81. The apparatus of claim 69, wherein a wall of the intervertebral cage having the first integral screw guide, the second integral screw guide, the third integral screw guide, and the fourth integral screw guide is parallel to an opposing wall, and

wherein a length of the wall is greater than a length of the opposing wall.

82. A method of inserting a universal, intervertebral combination bone fusion spacer and self-drilling screw apparatus into a disc space between a first vertebral body and a second vertebral body and fusing the first vertebral body to the second vertebral body via biological bone fusion and screw fusion, the method comprising:

measuring a dimension of the disc space between the first vertebral body and the second vertebral body;

determining that the disc space is a posterior lumbar disc space, an anterior lumbar disc space, or an anterior cervical disc space;

selecting the universal, intervertebral combination bone fusion spacer and self-drilling screw apparatus based on the measured dimension of the disc space and based on the determination of the disc space being the posterior lumbar disc space, the anterior lumbar disc space, or the anterior cervical disc space;

inserting the selected universal, intervertebral combination bone fusion spacer and self-drilling screw apparatus into a midline of the disc space until the selected universal, intervertebral combination bone fusion spacer and self-drilling screw apparatus is flush or countersunk relative to the first vertebral body and the second vertebral body;

inserting a first screw member into a first internal screw guide of the selected universal, intervertebral combination bone fusion spacer and self-drilling screw apparatus;

inserting a second screw member into a second internal screw guide of the selected universal, intervertebral combination bone fusion spacer and self-drilling screw apparatus;

screwing the first screw member and the second screw member into the first vertebral body and the second vertebral body respectively;

confirming a position and placement of the universal, intervertebral combination bone fusion spacer and self-drilling screw apparatus relative to the first vertebral body and the second vertebral body.

83. A universal, intervertebral combination bone fusion spacer and self-drilling screw apparatus for insertion into a disc space between a first vertebral body and a second vertebral body and fusion of the first vertebral body to the second vertebral body via biological bone fusion and screw fusion, the apparatus comprising:

an intervertebral cage including;

a first integral screw guide having a first predetermined angle;

a second integral screw guide having a second predetermined angle; and

a bone graft cavity for receiving bone packing material for bone fusion between the first vertebral body and the second vertebral body;

a first screw member disposed in the first integral screw guide at the first predetermined angle and at least partially within the intervertebral cage; and

a second screw member disposed in the second integral screw guide at the second predetermined angle and at least partially within the intervertebral cage,

wherein the bone graft cavity extends through the intervertebral cage for receiving bone packing material for bone fusion between the first vertebral body and the second vertebral body and across the intervertebral space,

wherein each of the first internal screw guide and the second internal screw guide is angled to orient the first screw member and the second screw bi-directionally in opposite directions,

wherein each of the first internal screw guide and the second internal screw guide includes a tunnel that permits only a predetermined angled trajectory of the first screw member and the second screw member, and the predetermined angled trajectory of the first internal screw guide is different than the predetermined angled trajectory of the second internal screw guide,

wherein the intervertebral cage includes an exit for one of the first integral screw guide and the second integral screw guide, the exit being adjacent to or formed in an edge of the bone graft cavity,

wherein the first screw member is a self-tapping and self-drilling screw member having a tapered end and a threaded body, and wherein the second screw member is a self-tapping and self-drilling screw member having a tapered end and a threaded body,

wherein the intervertebral cage includes a side having a plurality of ridges,

wherein a surface of each longitudinal end of the intervertebral cage includes a slot or indentation formed adjacent to an edge of an upper surface of the intervertebral cage for receiving a distal end of a prong of an implantation tool,

wherein the intervertebral cage includes a wall having an entry opening of the first integral screw guide and an entry opening of the second integral screw guide,

wherein the wall has four quadrants delineated by a first axis and a second axis each lying in a plane of the wall, and the first axis is at a right angle with respect to the second axis,

wherein the four quadrants include a first quadrant, a second quadrant, a third quadrant, and a fourth quadrant,

wherein the first quadrant and the fourth quadrant are opposed to the second quadrant and the third quadrant with respect to the first axis, and the first quadrant and the second quadrant are opposed to the third quadrant and the fourth quadrant with respect to the second axis,

wherein the first quadrant is diagonally opposed to the third quadrant, and the second quadrant is diagonally opposed to the fourth quadrant, and

wherein one of;

a majority of an area of the entry opening of the first integral screw guide is in the first quadrant and a majority of an area of the entry opening of the second integral screw guide is in the third quadrant; and

the majority of the area of the entry opening of the first integral screw guide is in the second quadrant and the majority of the area of the entry opening of the second integral screw guide is in the fourth quadrant.