Devices and techniques for a posterior lateral disc space approach
First Claim
Patent Images
1. A method for inserting an implant in a spinal disc space, comprising:
- creating a posterior lateral opening into the disc space;
providing an implant for insertion into the disc space;
positioning a leading end of the implant at the opening; and
alternately applying pushing and pivoting forces to the implant to position the implant through the opening and in the disc space along a non-linear insertion path.
2 Assignments
0 Petitions
Accused Products
Abstract
This invention relates to methods and instruments for performing disc space preparation and implant insertion from a unilateral approach to the spine through a posterior lateral opening to the disc space. The instruments include spreaders, distractors, reamers, scrapers, cutters, chisels, pushers and implant inserters. A surgical procedure is provided that allows bilateral support of the adjacent vertebrae with at least one interbody fusion device inserted into the disc space via a unilateral approach. Implants for insertion into the disc space are also provided.
595 Citations
73 Claims
-
1. A method for inserting an implant in a spinal disc space, comprising:
-
creating a posterior lateral opening into the disc space;
providing an implant for insertion into the disc space;
positioning a leading end of the implant at the opening; and
alternately applying pushing and pivoting forces to the implant to position the implant through the opening and in the disc space along a non-linear insertion path. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
positioning the implant in a portion of the disc space spaced distally from the opening; and
positioning a second implant in a proximal portion of the disc space adjacent the opening.
-
-
5. The method of claim 1, wherein applying pushing and pivoting forces to the implant includes contacting at least one instrument with a trailing end of the implant and applying pushing and pivoting forces with the at least one instrument.
-
6. The method of claim 1, wherein the implant includes a convexly curved wall and an opposite concavely curved wall, and positioning the leading end of the implant includes orienting the convexly curved wall and the concavely curved wall so that the convexly curved wall is anteriorly oriented in the disc space.
-
7. The method of claim 1, wherein applying pushing and pivoting forces includes applying pushing and pivoting forces with an inserter instrument engaged to a trailing end of the implant and a pusher instrument engaged to the inserter instrument.
-
8. The method of claim 1, further comprising placing bone growth material around the implant.
-
9. The method of claim 8, wherein placing bone growth material includes placing bone growth material in an anterior portion of the disc space and the implant is positioned in the disc space posteriorly of the anteriorly placed bone growth material.
-
10. The method of claim 9, wherein the implant includes a convexly curved wall and an opposite concavely curved wall, and positioning the leading end of the implant includes orienting the implant so that the convexly curved wall is anteriorly oriented and extends along the bone growth material when the implant is positioned in the disc space.
-
11. A method for inserting an implant in a spinal disc space, comprising:
-
providing a posterior lateral opening into the disc space;
selecting an implant for insertion into the disc space;
securing a trailing end of an implant to the implant inserter;
positioning a leading end of the implant at the opening;
engaging a pusher to the implant inserter;
applying an impaction force to the implant with the pusher to push the implant through the opening and into the disc space; and
applying a pivoting force to the implant with the implant inserter to move the leading end of the implant towards a distal portion of the disc space. - View Dependent Claims (12, 13, 14, 15, 16, 17)
positioning the implant at a distal portion of the disc space; and
inserting a second implant into the disc space through the opening after positioning the implant at the distal portion of the disc space.
-
-
16. The method of claim 11, further comprising:
inserting an implant template into the disc space prior to selecting the implant.
-
17. The method of claim 11, further comprising inserting an implant insertion guide into the disc space prior to positioning the leading end of the implant at the opening.
-
18. A method for inserting an implant in a spinal disc space, comprising:
-
creating a posterior lateral opening into the disc space;
providing an implant for insertion into the disc space;
providing an inserter instrument including a shaft and a bend adjacent a distal end of the shaft; and
positioning the implant in the disc space along a non-linear insertion path with the bend of the inserter instrument positioned through the posterior lateral opening and the distal end of the inserter instrument in contact with the implant. - View Dependent Claims (19, 20, 21, 22)
-
-
23. A method for inserting an implant in a spinal disc space, comprising:
-
providing a posterior lateral opening into the disc space;
selecting an implant for insertion into the disc space;
positioning a leading end of the implant at the opening;
manipulating a first instrument to position the implant through the opening and into the disc space; and
manipulating a second instrument to advance the implant distally into the disc space to position the leading end of the implant on a side of the spinal column axis opposite the opening and a trailing end of the implant is positioned on a side of the spinal column axis adjacent to the opening. - View Dependent Claims (24, 25, 26, 27, 28, 29, 30)
-
-
31. A method for inserting an implant in a spinal disc space, comprising:
-
creating a posterior lateral opening into the disc space;
providing an implant for insertion into the disc space;
positioning a leading end of the implant at the opening; and
applying pushing and pivoting forces to the implant to position the implant through the opening and in the disc space along a non-linear insertion path, wherein applying pushing and pivoting forces includes applying pushing and pivoting forces with an inserter instrument engaged to a trailing end of the implant and a pusher instrument engaged to the inserter instrument. - View Dependent Claims (32, 33, 34, 35, 36, 37, 38)
positioning the implant in a portion of the disc space spaced distally from the opening; and
positioning a second implant in a proximal portion of the disc space adjacent the opening.
-
-
37. The method of claim 31, wherein the implant includes a convexly curved wall and an opposite concavely curved wall, and positioning the leading end of the implant includes orienting the convexly curved wall and the concavely curved wall so that the convexly curved wall is anteriorly oriented in the disc space.
-
38. The method of claim 31, further comprising placing bone growth material around the implant.
-
39. A method for inserting an implant in a spinal disc space, comprising:
-
creating a posterior lateral opening into the disc space;
providing an implant for insertion into the disc space;
positioning a leading end of the implant at the opening;
applying pushing and pivoting forces to the implant to position the implant through the opening and in the disc space along a non-linear insertion path; and
placing bone growth material around the implant. - View Dependent Claims (40, 41, 42, 43)
-
-
44. A method for inserting an implant in a spinal disc space, comprising:
-
creating a posterior lateral opening into the disc space;
providing an implant for insertion into the disc space;
positioning a leading end of the implant at the opening;
pushing the implant through the opening and into the disc space; and
pivoting the implant in the disc space to move the implant in the disc space so that a leading end of the implant is positioned in a distal portion of the disc space and a trailing end of the implant is positioned at a proximal portion of the disc space to bi-laterally support vertebrae on each side of the disc space, wherein pushing and pivoting the implant are conducted alternately. - View Dependent Claims (45, 46, 47, 48, 49, 50, 51, 52, 53)
-
-
54. A method for inserting an implant in a spinal disc space, comprising:
-
creating a posterior lateral opening into the disc space;
providing an implant for insertion into the disc space;
positioning a leading end of the implant at the opening;
pushing the implant through the opening and into the disc space; and
pivoting the implant in the disc space to move the implant in the disc space so that a leading end of the implant is positioned in a distal portion of the disc space and a trailing end of the implant is positioned at a proximal portion of the disc space to bi-laterally support vertebrae on each side of the disc space, wherein pushing and pivoting the implant includes pivoting and pushing the implant with an implant inserter engaged to the trailing end of the implant and a pusher instrument engaged to the inserter instrument. - View Dependent Claims (55, 56, 57, 58, 59, 60, 61, 62, 63)
-
-
64. A method for inserting an implant in a spinal disc space, comprising:
-
creating a posterior lateral opening into the disc space;
providing an implant for insertion into the disc space;
positioning a leading end of the implant at the opening;
pushing the implant through the opening and into the disc space;
pivoting the implant in the disc space to move the implant in the disc space so that a leading end of the implant is positioned in a distal portion of the disc space and a trailing end of the implant is positioned at a proximal portion of the disc space to bi-laterally support vertebrae on each side of the disc space; and
placing bone growth material around the implant. - View Dependent Claims (65, 66, 67, 68, 69, 70, 71, 72, 73)
-
Specification