Method of inserting an expandable intervertebral implant without overdistraction

• US 8,753,398 B2
• Filed: 05/20/2005
• Issued: 06/17/2014
• Est. Priority Date: 08/05/2003
• Status: Expired due to Fees

• Current Assignee: Flexuspine Incorporated
• Original Assignee: Flexuspine Incorporated
• Inventors: Gordon, Charles R., Harbold, Corey T., Hanson, Heather S.
• Primary Examiner(s): Sweet, Thomas J
• Assistant Examiner(s): Prone, Christopher D
• Application Number:
  US11/134,055
• Publication Number:
  US 20050273171A1
• Time in Patent Office: 3,315 Days
• Field of Search: 623/17.11, 623/17.15, 623/17.16
• US Class Current: 623/17.15
• CPC Class Codes: A61B 17/7005 Parts of the longitudinal elements, e.g. their ends, being specially adapted to fit in the screw or hook heads
• CPC Class Codes: A61B 17/7007 Parts of the longitudinal elements, e.g. their ends, being specially adapted to fit around the screw or hook heads
• CPC Class Codes: A61B 17/7008 with parts of, or attached to, the longitudinal elements, bearing against an outside of the screw or hook heads, e.g. nuts on threaded rods A61B17/7007 takes precedence
• CPC Class Codes: A61B 17/701 Longitudinal elements with a non-circular, e.g. rectangular, cross-section A61B17/7005, A61B17/7007 take precedence
• CPC Class Codes: A61B 17/7023 with a pivot joint
• CPC Class Codes: A61B 17/7032 Screws or hooks with U-shaped head or back through which longitudinal rods pass
• CPC Class Codes: A61B 17/7037 wherein pivoting is blocked when the rod is clamped
• CPC Class Codes: A61B 17/7064 Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor
• CPC Class Codes: A61B 17/80 Cortical plates , i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
• CPC Class Codes: A61B 17/86 Pins or screws or threaded wires; nuts therefor A61B17/72 take precedence
• CPC Class Codes: A61F 2/30767 Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
• CPC Class Codes: A61F 2/4405 for apophyseal or facet joints, i.e. between adjacent spinous or transverse processes devices implanted between spinous or transverse processes A61B17/7062
• CPC Class Codes: A61F 2/4425 made of articulated components
• 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 2/4611 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 2002/30092 using shape memory or superelastic materials, e.g. nitinol
• CPC Class Codes: A61F 2002/30131 horseshoe- or crescent- or C-shaped or U-shaped
• CPC Class Codes: A61F 2002/30133 kidney-shaped or bean-shaped
• CPC Class Codes: A61F 2002/30225 Flat cylinders, i.e. discs
• CPC Class Codes: A61F 2002/3023 : wedge-shaped cylinders
• CPC Class Codes: A61F 2002/30235 : tubular, e.g. sleeves
• CPC Class Codes: A61F 2002/30331 : made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
• CPC Class Codes: A61F 2002/30365 : with additional means for limiting said rotation
• CPC Class Codes: A61F 2002/30369 : Limited lateral translation of the protrusion within a larger recess
• CPC Class Codes: A61F 2002/30383 : made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
• CPC Class Codes: A61F 2002/30462 : retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2002/30471 : connected by a hinged linkage mechanism, e.g. of the single-bar or multi-bar linkage type
• CPC Class Codes: A61F 2002/30476 : locked by an additional locking mechanism
• CPC Class Codes: A61F 2002/30492 : using a locking pin
• CPC Class Codes: A61F 2002/305 : Snap connection
• CPC Class Codes: A61F 2002/30505 : spring biased
• CPC Class Codes: A61F 2002/30507 : using a threaded locking member, e.g. a locking screw or a set screw
• CPC Class Codes: A61F 2002/30515 : using a locking wedge or block
• CPC Class Codes: A61F 2002/3052 : unrestrained in only one direction, e.g. moving unidirectionally
• CPC Class Codes: A61F 2002/30538 : for adjusting angular orientation
• CPC Class Codes: A61F 2002/3055 : for adjusting length
• CPC Class Codes: A61F 2002/30556 : for adjusting thickness
• CPC Class Codes: A61F 2002/30563 : having elastic means or damping means, different from springs, e.g. including an elastomeric core or shock absorbers
• CPC Class Codes: A61F 2002/30565 : having spring elements
• CPC Class Codes: A61F 2002/30578 : having apertures, e.g. for receiving fixation screws
• CPC Class Codes: A61F 2002/30579 : with mechanically expandable devices, e.g. fixation devices
• CPC Class Codes: A61F 2002/30601 : telescopic
• CPC Class Codes: A61F 2002/30624 : Hinged joint, e.g. with transverse axle restricting the movement
• CPC Class Codes: A61F 2002/30649 : Ball-and-socket joints
• CPC Class Codes: A61F 2002/30662 : with rotation-limiting means
• CPC Class Codes: A61F 2002/30772 : Apertures or holes, e.g. of circular cross section
• CPC Class Codes: A61F 2002/30785 : parallel
• CPC Class Codes: A61F 2002/3079 : Stepped or enlarged apertures, e.g. having discrete diameter changes
• CPC Class Codes: A61F 2002/30841 : Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
• CPC Class Codes: A61F 2002/30904 : serrated profile, i.e. saw-toothed
• CPC Class Codes: A61F 2002/443 : having two transversal endplates and at least one intermediate component
• CPC Class Codes: A61F 2002/4622 : having the shape of a forceps or a clamp
• 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 2002/4628 : 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 2210/0014 : using shape memory or superelastic materials, e.g. nitinol
• CPC Class Codes: A61F 2220/0025 : Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2220/0033 : made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
• CPC Class Codes: A61F 2220/0075 : sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2220/0091 : connected by a hinged linkage mechanism, e.g. of the single-bar or multi-bar linkage type
• CPC Class Codes: A61F 2230/0013 : Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped
• CPC Class Codes: A61F 2230/0015 : Kidney-shaped, e.g. bean-shaped
• CPC Class Codes: A61F 2230/0069 : cylindrical
• CPC Class Codes: A61F 2250/0006 : for adjusting angular orientation
• CPC Class Codes: A61F 2250/0009 : for adjusting thickness
• CPC Class Codes: A61F 2310/00023 : Titanium or titanium-based alloys, e.g. Ti-Ni alloys

Abstract

A method of inserting an expandable intervertebral implant between vertebrae of a human spine without overdistraction of the vertebrae is described. The method includes removing a portion of a disc between the vertebrae to create a disc space between the vertebrae. The unexpanded intervertebral implant may be positioned in the disc space. The intervertebral implant may be expanded to increase a height of the intervertebral implant, thereby increasing a separation distance between the vertebrae or a separation distance between an upper body and a lower body of the intervertebral implant. The increased height of the intervertebral implant may be maintained at substantially the expanded height, wherein the maximum separation distance between the two vertebrae during the procedure is the separation distance created during expansion of the intervertebral implant.

Claims

1. A method of performing a surgical procedure on a human spine, comprising:

removing at least a portion of a disc between two vertebrae of the human spine to create a disc space between the two vertebrae;

positioning an upper body and a lower body of an unexpanded intervertebral implant in the disc space between the two vertebrae, wherein the intervertebral implant comprises;

the upper body;

the lower body, wherein the upper body and the lower body are substantially rigid; and

an expansion member configured to be inserted between the upper body and the lower body;

advancing the expansion member between the upper body and the lower body;

rotating a member with the advancing expansion member around a first axis perpendicular to a second axis extending longitudinally through the expansion member, wherein the first axis is spatially fixed relative to the second axis, wherein rotating the member expands the intervertebral implant along the first axis to increase a height of the intervertebral implant, and wherein increasing the height of the intervertebral implant increases a separation distance between the upper body and the lower body of the intervertebral implant; and

maintaining the height of the intervertebral implant at an expanded height, wherein the maximum separation distance between the two vertebrae during the procedure is the separation distance created during expansion of the intervertebral implant.

2. The method of claim 1, wherein expanding the intervertebral implant comprises rotating the member of the implant with a tool to increase a separation distance between the upper body and the lower body of the implant.

3. The method of claim 1, wherein positioning the intervertebral implant in the disc space comprises inserting the intervertebral implant from a posterior approach.

4. The method of claim 1, wherein positioning the intervertebral implant in the disc space comprises inserting the intervertebral implant from an anterior approach.

5. The method of claim 1, wherein the expansion member comprises a non-threaded planar-shaped body.

6. The method of claim 1, wherein the implant comprises a hollow opening configured to enable bone graft material to be packed inside the implant.

7. The method of claim 1, further comprising engaging a tool engagement notch of the upper body and a tool engagement notch of the lower body with complementary lobes of an implant tool.

8. The method of claim 1, wherein increasing the height of the intervertebral implant increases a separation distance between substantially the entireties of the upper body and the lower body of the intervertebral implant.

9. A method of performing a surgical procedure on a human spine, comprising:

removing at least a portion of a disc between two vertebrae of the human spine to create a disc space between the two vertebrae;

positioning an upper body and a lower body of an unexpanded intervertebral implant in the disc space between the two vertebrae, wherein the intervertebral implant comprises;

the upper body;

the lower body; and

an expansion member configured to be inserted between the upper body and the lower body;

advancing the expansion member between the upper body and the lower body;

rotating a member with the advancing expansion member around a first axis perpendicular to a second axis extending longitudinally through the expansion member, wherein the first axis is spatially fixed relative to the second axis, wherein rotating the member expands, along the first axis, the intervertebral implant uniformly along the entire upper body and lower body to increase a height of the intervertebral implant, and wherein increasing the height of the intervertebral implant increases a separation distance between the two vertebrae; and

maintaining the height of the intervertebral implant at an expanded height, wherein the maximum separation distance between the two vertebrae during the procedure is achieved during expansion of the intervertebral implant.

10. The method of claim 9, wherein expanding the intervertebral implant comprises increasing a separation distance between an upper body and a lower body of the implant.

11. The method of claim 9, wherein expanding the intervertebral implant comprises rotating the member of the implant to increase a separation distance between an upper body and a lower body of the implant.

12. The method of claim 9, wherein expanding the intervertebral implant comprises rotating the member of the implant with a tool to increase a separation distance between an upper body and a lower body of the implant.

13. The method of claim 9, wherein positioning the intervertebral implant in the disc space comprises inserting the intervertebral implant from a posterior approach.

14. The method of claim 9, wherein positioning the intervertebral implant in the disc space comprises inserting the intervertebral implant from an anterior approach.

15. The method of claim 9, wherein the expansion member comprises a non-threaded planar-shaped body.

16. The method of claim 9, wherein the implant comprises a hollow opening configured to enable bone graft material to be packed inside the implant.

17. The method of claim 9, further comprising engaging a tool engagement notch of the upper body and a tool engagement notch of the lower body with complementary lobes of an implant tool.

18. The method of claim 9, wherein the upper body and the lower body are substantially rigid.

19. A method of performing a surgical procedure on a human spine, comprising:

removing at least a portion of a disc between two vertebrae of the human spine to create a disc space between the two vertebrae;

positioning an upper body and a lower body of an unexpanded intervertebral implant in the disc space between the two vertebrae, wherein the intervertebral implant comprises;

the upper body;

the lower body; and

an expansion member configured to be inserted between the upper body and the lower body;

advancing the expansion member between the upper body and the lower body, wherein advancing the expansion member expands the intervertebral implant to increase a height of the intervertebral implant, and wherein increasing the height of the intervertebral implant increases a separation distance between the two vertebrae;

securing the height of the intervertebral implant at an expanded height; and

wherein the maximum distance between the two vertebrae during the procedure is achieved as the increased height of the intervertebral implant is being secured or after the increased height of the intervertebral implant is secured, wherein a lateral cross section of a perimeter of the intervertebral implant comprises a curved shape such that at least a first portion of the perimeter is substantially convex and at least a second portion of the perimeter is substantially concave, wherein the second portion is substantially opposite the first portion.

20. The method of claim 19, wherein expanding the intervertebral implant comprises increasing a separation distance between an upper body and a lower body of the implant.

21. The method of claim 19, wherein expanding the intervertebral implant comprises rotating a member of the implant to increase a separation distance between an upper body and a lower body of the implant.

22. The method of claim 19, wherein expanding the intervertebral implant comprises rotating a member of the implant with a tool to increase a separation distance between an upper body and a lower body of the implant.

23. The method of claim 19, wherein positioning the intervertebral implant in the disc space comprises inserting the intervertebral implant from a posterior approach.

24. The method of claim 19, wherein positioning the intervertebral implant in the disc space comprises inserting the intervertebral implant from an anterior approach.

25. The method of claim 19, wherein the expansion member comprises a non-threaded planar-shaped body.

26. The method of claim 19, wherein the implant comprises a hollow opening configured to enable bone graft material to be packed inside the implant.

27. The method of claim 19, further comprising engaging a tool engagement notch of the upper body and a tool engagement notch of the lower body with complementary lobes of an implant tool.

28. The method of claim 19, wherein the upper body and the lower body are substantially rigid.

29. The method of claim 19, wherein increasing the height of the intervertebral implant increases a separation distance between substantially the entireties of the upper body and the lower body of the intervertebral implant.