Selectively expanding spine cage with enhanced bone graft infusion

• US 9,814,600 B2
• Filed: 04/17/2015
• Issued: 11/14/2017
• Est. Priority Date: 09/26/2005
• Status: Active Grant

• Current Assignee: Howmedica Osteonics Corp. (Stryker Corporation)
• Original Assignee: Howmedica Osteonics Corp. (Stryker Corporation)
• Inventors: Shulock, Damien J., Ashley, John E., Grotz, Thomas, Pretti, Rudy
• Primary Examiner(s): Robert, Eduardo C
• Assistant Examiner(s): CARTER, TARA ROSE E
• Application Number:
  US14/689,634
• Publication Number:
  US 20150216676A1
• Time in Patent Office: 942 Days
• Field of Search: 606246-249, 606 90, 606 92- 94, 623 1711- 1716
• CPC Class Codes: A61F 2/30771 applied in original prostheses, e.g. holes or grooves
• CPC Class Codes: A61F 2/441 made of inflatable pockets or chambers filled with fluid, e.g. with hydrogel
• 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 2/4465 having a circular or kidney shaped cross-section substantially perpendicular to the axis of the spine
• CPC Class Codes: A61F 2/4601 for introducing bone substitute, for implanting bone graft implants or for compacting them in the bone cavity
• CPC Class Codes: A61F 2/4611 of spinal prostheses
• CPC Class Codes: A61F 2/484 Fluid means, i.e. hydraulic or pneumatic
• 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 2002/30062 (bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
• 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 2002/30433 using additional screws, bolts, dowels, rivets or washers e.g. connecting screws
• CPC Class Codes: A61F 2002/30538 for adjusting angular orientation
• CPC Class Codes: A61F 2002/3055 for adjusting length
• 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 2002/30579 with mechanically expandable devices, e.g. fixation devices
• CPC Class Codes: A61F 2002/30581 having a pocket filled with fluid, e.g. liquid
• CPC Class Codes: A61F 2002/30583 filled with hardenable fluid, e.g. curable in-situ
• CPC Class Codes: A61F 2002/30589 Sealing means
• CPC Class Codes: A61F 2002/30593 hollow
• CPC Class Codes: A61F 2002/30594 : slotted, e.g. radial or meridian slot ending in a polar aperture, non-polar slots, horizontal or arcuate slots
• CPC Class Codes: A61F 2002/30604 : modular
• CPC Class Codes: A61F 2002/30617 : Visible markings for adjusting, locating or measuring
• CPC Class Codes: A61F 2002/30622 : Implant for fusing a joint or bone material
• CPC Class Codes: A61F 2002/30772 : Apertures or holes, e.g. of circular cross section
• CPC Class Codes: A61F 2002/30777 : Oblong apertures
• 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 2002/4629 : connected to the endoprosthesis or implant via a threaded connection
• CPC Class Codes: A61F 2002/4631 : the prosthesis being specially adapted for being cemented
• CPC Class Codes: A61F 2002/4666 : for measuring force, pressure or mechanical tension
• CPC Class Codes: A61F 2210/0085 : hardenable in situ, e.g. epoxy resins
• CPC Class Codes: A61F 2220/0041 : using additional screws, bolts, dowels or rivets, e.g. connecting screws
• 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 2250/0097 : Visible markings, e.g. indicia
• 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: A61F 2310/00796 : Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite

Abstract

A selectively expanding spine cage has a minimized cross section in its unexpanded state that is smaller than the diameter of the neuroforamen through which it passes in the distracted spine. The cage conformably engages between the endplates of the adjacent vertebrae to effectively distract the anterior disc space, stabilize the motion segments and eliminate pathologic spine motion. Expanding selectively (anteriorly, along the vertical axis of the spine) rather than uniformly, the cage height increases and holds the vertebrae with fixation forces greater than adjacent bone and soft tissue failure forces in natural lordosis. Stability is thus achieved immediately, enabling patient function by eliminating painful motion. The cage shape intends to rest proximate to the anterior column cortices securing the desired spread and fixation, allowing for bone graft in, around, and through the implant for arthrodesis whereas for arthroplasty it fixes to endpoints but cushions the spine naturally.

Claims

1. A surgical method comprising:

providing an interbody implant having first and second bone contacting surfaces, the interbody implant including a port having a first interlocking structure;

inserting the interbody implant between first and second vertebral bodies using an insertion tool having a second interlocking structure detachably interlocked with the first interlocking structure of the port, such that the first bone contacting surface contacts the first vertebral body and the second bone contacting surface contacts the second vertebral body;

moving the first and second bone contacting surfaces away from one another after the inserting step; and

subsequent to the moving step, supplying bone graft material into the interbody implant through the port such that the bone graft material moves from a first location outside of the interbody implant to a second location inside the interbody implant through the port, in order to facilitate infusion of the bone graft material into an intervertebral space.

2. The surgical method of claim 1, wherein the interbody implant has an extendable member and the moving step comprises extending the extendable member by supplying fluid to the extendable member.

3. The surgical method of claim 2, wherein the extendable member comprises a piston within a cylinder and the moving step comprises supplying fluid to the cylinder.

4. The surgical method of claim 1, wherein the interbody implant has a plurality of extendable members coupled to the first and second bone contacting surfaces and the moving step comprises extending the plurality of extendable members to move the first and second vertebral contacting surfaces away from one another.

5. The surgical method of claim 4, wherein the moving step comprises extending each of the plurality of extendable members independently of one another.

6. The surgical method of claim 1, wherein the first bone contacting surface is disposed on a base member and the second bone contacting surface is disposed on a pressure applying member and the moving step comprises moving the pressure applying member away from the base member.

7. The surgical method of claim 1, wherein the interbody implant includes a bone graft window when the first and second bone contacting surfaces are moved away from one another, and wherein the method further includes transferring the bone graft material through the bone graft window into an intervertebral space.

8. The surgical method of claim 1, wherein the interbody implant includes a locking system and the method further comprises locking the interbody implant in an expanded state as the first and second bone contacting surfaces are moved away from one another.

9. The method of claim 8, wherein the locking step further comprises automatically locking the interbody implant in the expanded state as the first and second bone contacting surfaces are moved away from one another.

10. The surgical method of claim 1, further comprising providing bone graft material to the interbody implant prior to the inserting step.

11. The surgical method of claim 1, wherein the supplying step comprises supplying the bone graft material into the interbody implant via the insertion tool.

12. A method for fusing first and second vertebral bodies comprising:

implanting an interbody implant between the first and second vertebral bodies using an insertion tool having a second interlocking structure detachably interlocked with a first interlocking structure of a connector on the interbody implant, so that a first member contacts the first vertebral body and a second member contacts the second vertebral body, the interbody implant having a distal portion and a proximal portion;

expanding the first and second members away from each other to increase the size of a cavity formed in the implant after the implanting step; and

supplying a bone graft material into the increased size cavity of the interbody implant through an aperture in the implant such that the bone graft material moves from a first location outside of the interbody implant to a second location inside the interbody implant through the aperture, wherein the aperture and the connector are both disposed on the proximal portion of the interbody implant.

13. The surgical method of claim 12, wherein the interbody implant has an extendable member adapted to be extended by fluid and the moving step comprises extending the extendable member via fluid.

14. The surgical method of claim 13, wherein the fluid is a curable polymer.

15. The surgical method of claim 13, wherein the interbody implant comprises a body to house at least a portion of the extendable member and wherein expanding the first and second members away from each other includes expanding at least one of the first and second members away from the body.

16. The surgical method of claim 13, wherein the extendable member comprises a piston within a cylinder and the moving step comprises supplying hydraulic fluid to the cylinder to expand the piston away from the cylinder.

17. The surgical method of claim 12, wherein the interbody implant has a plurality of extendable members coupled to the first and second members and the moving step comprises extending at least one of the plurality of extendable members to move the first and second members away from one another.

18. The surgical method of claim 17, wherein the moving step comprises extending each of the plurality of extendable members independently of one another.

19. The surgical method of claim 12, further comprising providing bone graft material to the interbody implant prior to the inserting step.

20. The surgical method of claim 12, wherein the cavity extends completely through the interbody implant along an axis transverse to the first and second members.

21. The surgical method of claim 12, wherein the interbody implant includes a locking system and the method further comprises locking the interbody implant in an expanded state as the first and second members are moved away from one another.

22. The surgical method of claim 12, wherein the supplying step comprises supplying the bone graft material into the increased size cavity of the interbody implant via the insertion tool.